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Pharmacology-NRSE-3010-001 > LastPharmFinalStudy > Flashcards

LastPharmFinalStudy Flashcards

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1
Q

What is methadone used for?

A

heroin withdrawal

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2
Q

What is medication is used in the maintenance of alcohol sobriety by eliciting an unpleasant response if alcohol is consumed?

A

disulfiram

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3
Q

If a patient has a magnesium level of 2.8 mEq/L, absent DTRs, and respiratory depression, what can the nurse suspect to administer?

A

calcium gluconate (antidote for magnesium sulfate overdose)

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4
Q

A patient recently prescribed ferrous sulfate states, “ever since I started taking my iron, my poop has been black and green.” The nurse should:

A

note that this is a common unharmful effect of taking ferrous sulfate

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5
Q

What foods should be recommended to those taking ferrous sulfate to aid in increasing iron levels?

A

tofu, egg yolks, leafy greens (high iron foods)

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6
Q

Vitals: HR-48 bpm, BP 132/92, Temp 98.9, SpO2 99%
Next dose of metoprolol is due now, what action should the nurse take?

A

hold the dose because HR is less than 50 bpm

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7
Q

What is the first line treatment for alcohol withdrawal?

A

chlordiazepoxide (a benzodiazepine)

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8
Q

What are some common indications for benzodiazepines?

A

GAD, panic disorder, seizure disorder, status epilepticus (diazepam)

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9
Q

When is the CIWA assessment used?

A

to determine the dose of benzodiazepine for those taking them for alcohol withdrawal

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10
Q

What should the nurse have available for those taking a benzodiazepine in case of overdose?

A

flumazenil

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11
Q

What would anxiety, rage, insomnia, and excitation indicate in a patient taking benzodiazepines?

A

paradoxical response

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12
Q

what kind of medications are zolpidem, zaleplon, and eszopiclone?

A

Non-benzodiazepines

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13
Q

What medication may be used in the short term management of insomnia?

A

zolpidem

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14
Q

what may phenytoin be used in the treatment of?

A

seizures

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15
Q

if a patient reports inflamed and swollen gums while taking their phenytoin, what may this indicate?

A

gingival hyperplasia

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16
Q

why should patients taking hydantoins be encouraged to take calcium and vitamin D supplements?

A

adverse effect of osteomalacia

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17
Q

What is a fatal adverse effect of hydantoins when given through IV?

A

cardiac collapse

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18
Q

what medication may be used in the treatment of those with seizures r/t to epilepsy?

A

carbamazepine

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19
Q

What are the 3 black box warnings for carbamazepine?

A

blood dyscrasias (monitor for infection, bleeding, anemia), heart failure, and fluid overload

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20
Q

What questions should the nurse ask for those taking carbamazepine (anticonvulsant) to assess for the adverse effect that impacts their mental health?

A

questions about suicidal ideation

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21
Q

what medication is use in the treatment of dementia associated with alzheimers?

A

donepezil

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22
Q

Because donepezil can cause cholinergic crisis, what should the nurse have available?

A

atropine and crash cart

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23
Q

What combination medication is often used in the treatment of Parkinsons disease?

A

carbidopa-levodopa

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24
Q

What should patients receiving carbidopa-levodopa therapy avoid?

A

high protein diet and multivitamins (B6 and iron)

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25
Should the nurse be alarmed if a pt taking carbidopa-levodopa has dark urine?
no, this is a harmless side effect
26
Why should patients taking carbidopa-levodopa report new skin lesions/rashes?
this medication can cause Stevens Johnsons
27
Describe On/Off syndrome with carbidopa-levodopa?
period btwn doses when med wears off and dopamine levels are low, causing pt to experience increased Parkinsons s/s
28
If a patient has neostigmine on their med list, we can likely suspect they have which condition?
myasthenia gravis
29
what effects may occur with neostigmine?
SLUDGES; bradycardia
30
What antidote medication should be available for those taking neostigmine for myasthenia gravis?
atropine
31
Mnemonic to remember central acting muscle relaxants?
ABCD Acting (central A muscle relaxants) Baclofen Dantrolene Cyclobenzaprine
32
what medications are used in the treatment of muscle spasms?
baclofen, dantrolene, cyclobenzaprine
33
What would decreased pain and increased ROM indicate in those taking baclofen?
effective treatment
34
what is a severe adverse effect that can occur with neuromuscular blocking drugs (succinylcholine)?
MH (malignant hyperthermia)
35
what med should be given for malignant hyperthermia?
dantrolene (+stop med immediately, admin O2, decrease body temp)
36
what is the antidote for neuromuscular blocking drugs?
neostigmine
37
what would indicate need for haloperidol or chlorpromazine (typical antipsychotic)?
schizophrenia, drug-induced psychosis
38
what would indicate development of neuroleptic malignant syndrome in those taking haloperidol (typical antipsychotic)?
sudden, high grade fever, BP fluctuations, dysrhythmias, muscle rigidity, diaphoresis, tachycardia, LOC/coma
39
What class is clozapine?
atypical antipsychotics
40
Patient taking urinary frequency, increased thirst and hunger, which effect of atypical antipsychotics may this indicate?
diabetes mellitus
41
what is a potential fatal effect of clozapine?
fatal agranulocytosis
42
what should pts taking clozapine (atypical antipsychotics) report?
abnormal movements, seizures, gynecomastia, galactorrhea, s/s DM
43
Why may a patient be prescribed fluoxetine (SSRI)?
depression, PTSD, OCD
44
which adverse effect may cause a patient to avoid taking their sertraline (SSRI)?
sexual dysfunction
45
What may indicate serotonin syndrome?
confusion, agitation, poor concentration, seizures
46
What should the nurse assess for in a patient taking citalopram (SSRI) to ensure safety?
SI
47
what kind of medication is phenelzine?
MAOI
48
what pt would benefit from isocarboxazid (MAOI)?
depression that doesn't respond to other modes of therapy
49
what foods should be avoided while taking selegiline/phenelzine/tranylcypromine (MAOIs)?
tyramine (aged cheese, yogurts, coffee, chocolate, pickled foods, yeast, beer, red wine, bananas, liver, smoked meats
50
what medication is a mood stabilizer used for bipolar and schizophrenia?
lithium
51
what stage of lithium toxicity is indicated by: extreme polyuria, tinnitus, ataxia, severe hypotension, and seizures?
advanced (2-2.5)
52
what drug class is amitriptyline?
TCA
53
Because amitriptyline (TCA) can decrease the seizure threshold, what should pt be monitored for?
seizures/history of
54
when should methotrexate be avoided?
current infection, live virus vaccine, pregnancy (X)
55
what is the minimum infusion time for vancomycin?
60 mins
56
what medication could cause achilles tendon rupture and arthropathy?
fluoroquinolones (-oxacin)
57
How can crystalluria be prevented with those taking ciprofloxacin?
increase fluids
58
what drug class is gentamicin? when should its peak be taken?
aminoglycosides 30 mins after completion of infusion
59
what intervention can the nurse implement to prevent peripheral neuropathy in their pt who is taking INH (isoniazid) for Tb?
administer pyridoxine (B6)
60
what should be avoided by those taking INH?
alcohol (disulfiram reaction), tyramine foods
61
This medication may be indicated for pts with shingles or herpes?
acyclovir
62
How may vaginal candidiasis/yeast infection be treated?
fluconazole therapy
63
why may a patient being treated for breast cancer experience bone pain?
an adverse effect of of tamoxifen is hypercalcemia
64
what adverse effect of tamoxifen should be reported immediately?
blood clots
65
This medication may be used in the prevention of need for transfusion w/elective surgeries, CKD-related anemia and may cause hypertension?
epoetin alfa
66
Which growth factor is used to increase platelet count, to decrease need for transfusion following chemo?
oprelvekin
67
what would a platelet level of 50,000 indicate in oprelvekin therapy??
effective therapy
68
what adverse effects may occur with phenylephrine?
cardio (palpitations, arrhythmias, and HTN) and CNS (hallucinations, convulsions, delusions)
69
who should avoid decongestants?
HTN, glaucoma, cardiac disease, hyperthyroidism
70
which cardiac glycoside used for atrial fibrillation, HF, and atrial flutter?
digoxin
71
what must the nurse assess prior to digoxin administration?
apical pulse >60 bpm
72
How may hypokalemia impact digoxin therapy?
increases risk for digoxin toxicity
73
How can tolerance be prevented in a pt using a transdermal nitroglycerin patch?
remove at night/ at least 10-12hrs
74
what should be avoided with amiloride/triamterene, eplerenone?
potassium rich foods
75
If a nurse auscultates crackles in a patient receiving HCTZ, what should they suspect is occurring?
ineffective treatment
76
How can severe rebound HTN be prevented with clonidine?
taper off
77
How long can clonidine patches be worn?
1 week
78
what medication is not used as monotherapy for african american pts?
ACE inhibitors
79
what medication is used for non-obstructive urinary retention?
bethanechol
80
This medication decreases urinary incontinence in pts with overactive bladder?
oxybutynin
81
when should oxybutynin be avoided?
glaucoma, paralytic ileus, GI/urinary obstruction, myasthenia gravis
82
Case study- Pt history: type 2 DM, takes metformin reports: muscle cramps/body ache, fast/deep breathing, exhaustion, N/V what is this patient likely experiencing?
lactic acidosis from metformin
83
what condition would an order for magnesium hydroxide be contraindicated in?
renal failure
84
What should be monitored in a pt taking cimetidine and warfarin?
PT/INR because cimetidine increases warfarin effect
85
What are the 6 rights of medication administration?
med, dose, route, client, time, documentation
86
How can medication interactions be prevented?
medication reconciliation
87
What statement by the new grad nurse represents understanding for administration of enteric coated (ER, XR, SR) medications?
"do not cut, crush of chew enteric coated medicines"
88
Patient reports: muscle pain, brown/tea-colored urine, stiff muscles. Med Rec: HMG-CoA Reductase Inhibitor (-statins) what are the likely experiencing?
rhabdomyolysis
89
What medication may a patient with a total cholesterol of 290 mg/dL benefit from? a. metoprolol b. lactulose c. atorvastatin d. cimetidine
c. atorvastatin HMG CoA-Reductase Inhibitor (effective treatment is shown by a total cholesterol of <200)
90
what should the PTT level be for those taking heparin?
120-140 seconds
91
Why should a patient taking risedronate avoid dental work?
bisphosphonates can cause jaw necrosis
92
When should we teach patients to hold their dose of levothyroxine?
HR >100 bpm
93
What are the O,P, and D for rapid acting insulins (lispro, aspart, glulisine)?
O- 15-30 mins P- 30-2.5 hrs D- 3-6 hrs
94
What are O, P, and D for short acting insulin (regular)?
O - 30 -60 mins P- 1-5 hrs D- 6-10hrs
95
What are O, P, and D for intermediate insulin (NPH)?
O- 1-2hrs P- 6-14 hrs D- 16 -24 hrs
96
What are the O, P, and D for long acting insulins (glargine and detemir)?
O- 70 mins P- NA D- 18-24 hrs
97
What would indicate methimazole treatment is effective?
antithyroid med, so absence of hyperthyroid manifestations (weight gain, decrease T4, less anxiety)

Pharmacology-NRSE-3010-001 (12 decks)

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