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NUR 325 exam 2 Flashcards

(103 cards)

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1
Q

cholinesterase inhibitor

A

donepezil

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2
Q

donepezil moa

A

-inhibits acetylcholinesterase in brain
-increases acetylcholine

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3
Q

donepezil indication

A

mild-moderate alzhiemers

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4
Q

NMDA receptor agonist

A

memantine

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5
Q

memantine agonist moa

A

blocks stimulation of NMDA receptors

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6
Q

memantine indication

A

moderate-severe alzhiemers

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7
Q

memantine se

A

constipation (give with stool softener)

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8
Q

centrally acting analgesic

A

tramadol

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9
Q

tramadol moa

A

-binds to mu opioid receptors
-inhibits reuptake of serotonin and norepinephrine

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10
Q

tramadol indication

A

moderate-severe pain

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11
Q

gabapentin, pregabin class

A

anticonvulsants

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12
Q

gabapentin moa

A

-unknown
-suppresses neural firing

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13
Q

gabapentin indication

A

neuropathic pain

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14
Q

gabapentin side effects

A

drowsy, dizzy, visual problems

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15
Q

gabapentin ceiling effect

A

1800mg

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16
Q

acetaminophen moa

A

-unknown
-decrease prostaglandin synthesis in cns

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17
Q

acetaminophen indication

A

mild-moderate pain, fever

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18
Q

acetaminophen overdose

A

hepatic necrosis, liver failure, nephropathy

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19
Q

acetaminophen ceiling effect

A

1000mg

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20
Q

acetaminophen dosing

A

4g/24hr max in adults
2mg/24hr max in alcoholics

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21
Q

non-selective cox inhibitors

A

ibuprofen, naproxen, ketorolac, aspirin

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22
Q

nonselective cox inhibitor moa

A

block cox1 and cox2

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23
Q

cox1

A

protect gastric mucosa and thromboxane synthesis

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24
Q

cox2

A

inflammation and fever

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25
nonselective cox inhibitor indication
mild-moderate pain, fever
26
nonselective cox inhibitor bbw
cardiovascular and gi risk
27
naproxen nursing consideration
-hard on kidneys -lasts longer
28
ketorolac nursing considerations
-most potent nsaid -used for <5days -hard on kidneys
29
aspirin toxicities
salicylate poisoning, Reye's syndrome
30
salicylate poisoning
-nausea, vomiting, seizures, cerebral edema -tinnitus, hearing loss
31
reye's syndrome
-severe brain and kidney damage -high mortality rate -do NOT give children <15yo aspirin
32
aspirin moa
-blocks cox1 -stops thromboxane synthesis -stops platelet aggregation
33
cox2 selective nsaid
celecoxib
34
celecoxib indication
mild-moderate pain, inflammation
35
celecoxib side effects
cardiovascular thrombotic events (clotting)
36
all opioids are...
high alert drugs
37
assess before administering opioids
LOC, BP, pulse, RR before and periodically after admin (initial drowsiness expected, but watch for hypoventilation)
38
opioid nursing consideration
-impaired ability to drive -proactively treat constipation (paralytic ileus) -make sure patient is ok with opioids
39
morphine moa
-mimics endogenous opioids -binds to mu receptors
40
morphine indication
moderate-severe pain
41
morphine side effects
-interacts with alcohol and cns depressants -resp depression -cns depression -constipation
42
hydromorphone moa
-mimics endogenous opioids -binds to mu receptors
43
hydromorphone indication
SEVERE pain
44
fentanyl considerations
-completely synthetic -often transdermal patch
45
fentanyl indications
moderate-severe pain (surgical inductions, chronic pain)
46
merperidine indication
-moderate-severe pain -weaker than morphine -less resp depression
47
meperidine side effects
-lots of drug interactions -do NOT give multiple doses
48
codeine indication
-mild-moderate pain -antitussive
49
codeine nursing considerations
-NOT for children <18yo -life threatening breathing problems
50
oxycodone considerations
HIGH potential for abuse
51
percocet
oxycodone and acetaminophen
52
oxycontin
time release oxycodone
53
oxycodone indication
moderate-severe pain (10x more potent than codeine)
54
hydrocodeine indications
-mild-moderate pain (6x more potent than codeine) -cough suppressant
55
methadone indication
detox treatment for opioid addiction
56
naloxone class
opioid antagonist
57
naloxone moa
clogs, but does not activate, opioid receptors
58
naloxone indications
reverse effects of opioids
59
aed moa
1. increases threshold of activity in motor cortex 2. limit spread from origin 3. decrease speed of impulse in neuron
60
aed bbw
increases suicidal ideation and mood changes
61
aed side effects
teratogen, dizzy, drowsy, gi upset
62
aed nursing considerations
-do NOT stop abruptly (will cause seizures) -continued therapeutic monitoring -started after MULTIPLE seizures
63
hydantoins
phenytoin
64
phenytoin indications
tonic-clonic and focal seizures
65
phenytoin side effects
-gingival hyperplasia -hirsutism, osteoporosis -dilantin facies
66
phenytoin nursing considerations
-highly protein bound, interacts with other drugs -watch albumin and pre albumin levels
67
valpronic acid indications
generalized and partial seizures
68
valpronic acid contraindications
liver disease, urea cycle disorders
69
valpronic acid side effects
hepatoxicity, pancreatitis
70
valpronic acid nursing considerations
-highly protein bound, interacts with other drugs -watch albumin and pre albumin levels
71
topiramate indications
partial and secondary generalized seizures
72
topiramate side effects
-cns depression -gi upset -glaucoma
73
topiramate nursing considerations
interacts with oral contraceptives
74
levetiracetam indications
-inpatient setting -partial seizures with or without generalization
75
sulfonylureas
glipizide, glyburide
76
sulfonylureas moa
-close KATP channels in pancreatic beta cells -increase insulin production -decrease glucose release
77
sulfonylureas side effects
hypoglycemia
78
sulfonylurea nursing considerations
NOT during pregnancy
79
biguanides
metformin
80
metformin moa
-decrease production of glucose in liver -increase glucose uptake by muscle
81
metformin side effects
acidosis, not for elevated ALT
82
metformin nursing considerations
hold for 48 hr after IV contrast
83
DPP4 inhibitors
linagliptin, sazagliptin, sitagliptin
84
DDP 4 inhibitor moa
-inhibits DPP4 -increases insulin release -decreases glucose absorption -slows digestion
85
DPP4 side effects
increased risk of pancreatitis
86
GLP1 receptor agonist
dulaglutide, exenatide, semaglutide
87
GLP1 moa
-increase glucose dependent insulin response -slows gastric emptying
88
GLP1 bbw
thyroid and renal issues
89
SLGT2 inhibitors
dapaglifloxin
90
dapaglifloxin moa
prevents kidneys from reabsorbing glucose into blood
91
dapaglifloxin side effects
uti
92
glucagon moa
-activates glucagon receptors -releases glucose from liver
93
glucagon indications
hypoglycemia
94
orlistat moa
-blocks pancreatic and gastric enzymes -stops fat absorption
95
orlistat bbw
liver injury
96
orlistat side effects
gi problems and vitamin insufficiency
97
insulin lispro
rapid onset: 15 min peak: 1 hr duration: 2-4 hr
98
insulin regular
short acting onset: 30 min peak: 2-4 hr duration: 3-8 hr
99
NHP insulin
intermediate onset: 2-4 hrs peak: 4-10 hr duration: 10-20 hr
100
glargine
long acting onset: 70 min peak: none duration: all day
101
lipodystrophy and lipoatrophy
depression of skin at insulin injection site
102
somogyi effect
-overdose of insulin -counterregulates hypoglycemia with hyperglycemia and ketosis -usually from poor diabetes management
103
dawn phenomenon
-hyperglycemia in the morning -due to natural hormonal release

ABSN (7 decks)

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