Group 1

Question 1

Medication Safety

Answer 1

5 rights, complete orders, assessment of effectiveness, drug action

Question 2

Adrenergic Agonist Names

Answer 2

Sympathetic = Fight or Flight
Epinephrine, Norepinephrine, Vasopressin, Albuterol, Dopamine, Dobutamine

Question 3

Adrenergic Blockers (Antagonist)

Answer 3

Beta Blockers (-olol)
Inhibits sympathetic -> slows everything

Question 4

Beta Blocker (-olol) Names

Answer 4

Selective: Metoprolol, Atenolol
Non-selective: Propranolol
Alpha-beta: Carvedilol, Labetalol

Question 5

Beta Blocker (-olol) Indications

Answer 5

HTN, dysrhythmia, angina, stage fright

Question 6

Beta Blocker (-olol) Sx/Adverse

Answer 6

Bradycardia, hypotension, bronchoconstriction, fatigue, orthostatic hypotension

Question 7

Cholinergic Agonist Types

Answer 7

Direct Acting: stimulate release of acetylcholine
Indirect Acting: inhibit acetylcholinesterase

Question 8

Cholinergic Agonist Example

Answer 8

Bethanechol (Urecholine)

Question 9

Cholinergic Agonist General Effects

Answer 9

Cholinergic Stimulation (Chill Drug)
GI and Urinary: increase gastric secretions, motility, urinary frequency
Miosis: constriction of pupil, decreased intraocular pressure
Cardiovascular: decreased HR, vasodilation
Lungs: increased secretion and restriction
Skeletal: increased contraction (nicotinic)

Question 10

Bethanechol (Urecholine) Indications

Answer 10

Tx of post-op and postpartum non-obstructive urinary retention

Question 11

Bethanechol (Urecholine) Contraindication

Answer 11

GI tract/bladder integrity is questionable or if there is a mechanical obstruction

Question 12

Bethanechol (Urecholine) Sx/Adverse

Answer 12

Hypotension, tachycardia, HA, seizure, GI upset, asthma attacks

Question 13

Bethanechol (Urecholine) Drug Interactions

Answer 13

Acetylcholinesterase inhibitors (indirect-acting cholinergic) can enhance the effects

Question 14

Bethanechol (Urecholine) Nursing Considerations

Answer 14

Atropine is the antidote, change position slowly, monitor vitals, early ambulation and increased fluid intake if not contraindicated

Question 15

Anti-cholinergic Examples

Answer 15

Atropine, Tolterodine

Question 16

Anti-cholinergic General Effects

Answer 16

Cardiovascular: increased HR, dysrhythmias
CNS: restlessness, irritability, disorientation, hallucinations, delirium
Eye: dilates pupils, decreased visual accommodation, increased intraocular pressure
GI: decreased salivation, gastric secretions, motility
GU: urinary retention
Glandular: decreased sweating
Respiratory: decreased bronchial secretions
Dry mucous membranes/dryness

Question 17

Atropine Indications

Answer 17

Bradycardia, decrease secretions peri-op

Question 18

Atropine Sxs

Answer 18

Dry mouth, tachycardia, urinary retention, constipation

Question 19

Tolterodine Indications

Answer 19

Urinary frequency, urgency, incontinence

Question 20

Tolterodine Sxs

Answer 20

Urinary retention, constipation, dry mouth, dizziness, 3A4

Question 21

Tolterodine Contraindication

Answer 21

Urinary retention mechanical blockage

Question 22

Benzodiazepines

Answer 22

Diazepam, lorazepam, alprazolam

For anxiety, seizure, insomnia

Question 23

Benzodiazepine (Diazepam, Lorazepam, Alprazolam) Sxs

Answer 23

CNS depression sxs (drowsiness, dizziness, confusion, sedation, respiratory depression)

Question 24

Benzodiazepine (Diazepam, Lorazepam, Alprazolam) Nursing Considerations

Answer 24

Could be abused
Tolerance can be built
Antidote is flumazenil

Question 25

Anticonvulsants

Answer 25

Phenytoin (Dilantin) Levetiracetam (Keppra) Prevent and treat seizures

Question 26

Phenytoin (Dilantin) Sxs

Answer 26

CNS depression sxs (confusion, dizziness, slurred speech)

Question 27

Phenytoin (Dilantin) Nursing Considerations

Answer 27

Contraindicated with pregnancy (teratogenic to fetus) Can cause low vitamin K

Question 28

Levetiracetam (Keppra) Sxs

Answer 28

Mood changes, suicidal ideation, anger (lower the dose)

Question 29

Levetiracetam (Keppra) Nursing Considerations

Answer 29

No true contraindications, only allergy Pregnancy C

Question 30

Parkinson's Medication

Answer 30

Carbidopa-Levodopa Decreases Acetylcholine

Question 31

Carbidopa-Levodopa Sxs

Answer 31

Dry mouth, constipation, orthostatic hypotension, DARK URINE, ACTIVATES MELANOMA

Question 32

Carbidopa-Levodopa Nursing Considerations

Answer 32

Fall risk Anticoagulation risk

Question 33

Alzheimer's Medication

Answer 33

Rivastigmine Elevates acetylcholine

Question 34

Rivastigmine Sxs

Answer 34

Dizziness, constipation, nausea

Question 35

Muscle Relaxant

Answer 35

Cyclobenzaprine Short term treatment of muscle spasm

Question 36

Cyclobenzaprine Sxs

Answer 36

Dizziness, drowsiness, constipation, dry mouth

Question 37

Cyclobenzaprine Nursing Consideration

Answer 37

Take with food Do not use for more than 1-3 weeks

Question 38

Anti-inflammatory Medications

Answer 38

NSAID's (Ibuprofen) Cox-2 inhibitor (Celecoxib) Tumor Necrosis Factor Blocker - Infliximab (Remicade) Allopurinol Colchicine

Question 39

NSAID (Ibuprofen) Sxs

Answer 39

Nausea, rash, fluid retention, GI bleed

Question 40

NSAID (Ibuprofen) Nursing Considerations

Answer 40

Reduce pain, inflammation, fever DO NOT USE IN RENAL DX BLACK BOX WARNING (MI, CVA) Increases risk of bleeding with AC, and antiplatelets

Question 41

Cox-2 Inhibitor (Celecoxib) Sxs

Answer 41

Nausea, dizziness

Question 42

Cox-2 Inhibitor (Celecoxib) Nursing Considerations

Answer 42

Decrease pain and inflammation for osteoarthritis Less GI bleeding BLACK BOX WARNING INCREASED FATAL CARDIOVASCULAR EVENTS (MI and CVA)

Question 43

Infliximab (Remicade) Sxs

Answer 43

SEVERE INFECTIONS, headache, dizziness

Question 44

Infliximab (Remicade) Nursing Considerations

Answer 44

Treat rheumatoid arthritis and Crohn's Don't use in HF

Question 45

Allopurinol Sxs

Answer 45

CATARACTS, N/V, stomatitis Treats gout (reduces uric acid synthesis)

Question 46

Colchicine

Answer 46

Treatment and prophylaxis gout, pericarditis (prevents migration of leukocytes) Does not effect uric acid levels AVOID PURINES (beer, organ meats, sardines)