Pharm Flashcards
(141 cards)
1
Q
what is the half life
A
time it takes for plasma concentration or the amount of drug in the body to be reduced by 50%
2
Q
what drug levels are increased by grapefruit
A
nifedipine
verapamin
statins
midazolam
SSRIs
3
Q
what drugs prolong qt interval
A
ondansetron
haloperidol
4
Q
antidote for lead
A
succimer
5
Q
local anesthetics end in what?
A
-caine
6
Q
opioids side effects (MORPHINE)
A
miosis
out of it
resp depression
pruritus, pneumonia
hypotension, headache
infrequent elimination
nausea and nervousness
emesis
7
Q
what kinds of drug is buprenorphine & nalbuphine
A
opioid agonist-antagonist
8
Q
when would you use buprenorphine
A
mild to moderate pain, opioid addiction
less euphoric effect
less chance of abuse
9
Q
what kind of drug is naltrexone
A
opioid antagonist
10
Q
s/s of ASA toxicity (salicylism)
A
tinnitus
sweating
headache
dizziness
metabolic acidosis
11
Q
when do we give aspirin to kids
A
kawasaki’s disease
12
Q
what drugs can help lower bp (ABCD)
A
ACE inhibitors and ARBS
beta blockers
CCBs
diuretics
13
Q
can you take ACEs or ARBS during pregnancy
A
no
14
Q
what are the nonselective CCBs
A
verapamil and diltiazem
15
Q
what are the effects of the non selective CCBs
A
cause vasodilation of the blood vessels, increasing coronary perfusion
in the heart - slow HR, slow AV node conduction, decrease force of contraction
16
Q
what drugs are nifedipine, amlodipine, etc.
A
selective CCBs - only act on blood vessels not the heart!
17
Q
side effects of selective CCBS?
A
dizziness, edema
gingival hyperplasia
reflex tachy
18
Q
does hydralazine dilate the veins or arteries
A
arteries
19
Q
what are the arterial AND venous dilators
A
nitrates (nitroglycerin, nitroprusside)
20
Q
can you take calcium supplements with CCBs
A
yes! do not need to discontinue
21
Q
which CCBs can cause constipation
A
nondihyrdos (vera and dil)
22
Q
what kind of drugs are procainamide and lidocaine
A
sodium channel blockers
23
Q
what kind of drug is amiodarone
A
K+ channel blocker
24
Q
when would you use amiodarone
A
V tach if patient is awake and alert
PVCs
25
AEs of amiodarone
Liver, thyroid, pulmonary toxicity
26
when do you use adenosine
SVT
27
how do you administer adenosine
rapid push
28
what should you expect after adenosine
period of asystole
patient will feel like someone kicked them in the chest
29
MOA of digoxin
increases contractility while decreases HR
30
therapeutic range for digoxin?
.5-2
31
early s/s of digoxin toxicity
n/v
anorexia
yellow/green halos in vision
32
late s/s of digoxin toxicity
bradycardia leading to fatal arrythmias
33
who are at risk for digoxin toxicity
hypokalemia
hypomagnesemia
hypercalcemia
34
digoxin antidote
digoxin immune fab
35
what are inhaled glucocorticoids used for (i.e. budesonide)
for asthmatics to take regularly
not for acute attacks!
36
what are systemic glucocorticoids used for (i.e. methylprednisolone)?
acute attacks
best to use <10 days
37
what kind of drugs is montelukast
leukotriene receptor antagonist
38
when do you take montelukast
long term control, cannot abort ongoing attack
39
SE of montelukast
liver injury
neuropsychiatric effects (including SI)
churg-strauss syndrome
40
what do monoclonal antibodies (like omalizumab) act on
IgE --> reduce to decrease inflammatory reaction
41
how long do you have to monitor someone after monoclonal antiboties
2 hours after first 3 doses and 30 mins after all other doses
monitoring for anaphylaxis
42
examples of long acting beta 2 agonists
salmeterol
formoterol
43
side effects of beta 2 agonists
relaxation of smooth muscle in airways
but also tachycardia angina, tremor
44
what are theophylline and aminophylline used for
asthma maintenance
45
what kind of drug is ipatropium and what is it used for
anticholinergic
used for asthma and COPD, can be used for acute attack
46
what do alpha antagonists end with
-osin
47
when do you use apha antagonists
HTN
BPH
raynaud's
pheochromocytoma
48
why are beta blockers used in caution with diabetics
will mask symptoms of hypoglycemia
49
which beta blockers are safer for asthmatics and diabetics and why
metoprolol, carvedilol, esmolol, labetalol,
because they are beta 1 selective
50
what do cholinesterase inhibitors end in and what is there effect
-stigmine
increase cholinergic effects - rest and digest
51
who do you avoid cholinergics with
intestinal obstruction
uti
asthma
hyperthyroidism
hypotension
52
do you take cholinergics with food
no! take on empty stomach
53
cholinergic drug side effects (DUMBELS)
diaphoresis and diarrhea
urination
miosis
bradycardia, bronchospasm
emesis
lacrimation
salivation
54
how do you treat muscarinic posioning
atropine (anti-cholinergic)
55
how do anticholinergics like oxybutynin impact urinary system
helps with urination retention
you would take oxybutynin for overactive bladder
56
what it is the antidote for anticholinergic toxicity
physostigmine
57
what kind of drugs are donepezil and rivastigmine
cholinesterase inhibitors
help improve symptoms in mild and moderate AD like improving memory and reasoning
58
what is a side effect of phenytoin
gingival hyperplasia
59
can you take phenytoin during pregnancy
no
60
what are 5 long term anticonvulsants
phenytoin
fosphenytoin
carbamazepine
phenobarbital
valproic acid
61
what should you use to abort a seizure
lorazepam
diazepam
62
what should you not take with anticonvulsants
antacids
63
H2 receptor antagonists MOA
block release of stomach acids
64
can you take H2 receptor antagonists with meals
yes
65
when should you take PPIs
30-60 mins before meals
66
what should you report for PPIs
black tarry stools
67
when should you take sucraflate
1 hour before meals or 2 hours after and at bedtime
68
what drugs does sucralfate decrease bioavailability of
warfarin
digoxin
phenytoin
levothyroxine
separate drugs by at least 2 hours!
69
what kind of drug is bisacodyl
stimulant laxative
70
what would you use for chornic constpiation
polyethylene glycol
mag hydroxide, mag citrate
mag sulfate
lactulose
71
what would you take to reduce diarrhea
loperamide - activates opioids receptors
72
what kind of drug is ondansetron
anti-emetic
serotonin antagonists
73
how do you delivery ondansetron
slow!
fast push can cause QT prolongation and VT
74
what are dopamine antagonists used for nausea
promethazine
chlorpromazine
75
how often do you change TPN tubing and bag
q 24 hours
76
if you run out of TPN, what do you give
dextrose 10% at same rate as TPN was running
77
ae of furosemide
hyponatremia
hypochloremia
hypokalemia
ototoxicity
dehydration
78
which drugs trigger beta cells to release insulin
sulfonylureas (glimepiride, glyburide)
79
what kind of drug is metformin
biguanide
80
what is rosiglitazone used for
reduces glucose production and increases insulin receptor sensitivity
81
how does metformin work
inhibit liver glucose production and reduce intestinal absorption of glucose
82
therapeutic aptt on heparin
1.5-2x normal
normal = 30-40 seconds
83
heparin antidote
protamin sulfate
84
door to TPA time
60 mins
85
what is compatible with blood
normal saline
86
when do you take vitals during blood admin
before
during
after
87
what are augmentin and zosyn
beta lactamase inhibitors + antibiotics
88
if you take valproate, what antibiotic should you avoid
carbapenems (i.e. meropenem)
89
when do you use doxycycline
roxy mt spotted fever
chlamydia
cholera
lyme
anthrax
h. pylori
90
what are nursing considerations for tetracyclines
teeth staining
photosensitivity
poorly absorbed when taken with minerals
91
what do macrolide antibiotics end in
-mycin
92
what do aminoglycoside anitbiotics end in
-icin
93
side effects of aminoglycosides
ototoxic!
monitor for tinnitus
94
when do we usually give sulfonamides
UTIs
95
nursing considerations: sulfonamies
hypersensitivity reactions
blood dyscrasia
kernicterus (avoid in infants and later in pregnancy)
nephrotoxic (drink lots of water!)
96
what organ does vancomycin affect
kidneys! it is nephrotoxic
97
what are 2 drugs that work against TB
isoniazid
rifampin
98
isoniazid nursing considerations
hepatoxicity
peripheral neuritis
can raise some levels of anti-seizure drugs
99
what drug turns bodily fluids red-orange
rifampin
100
what drugs does rifampin mess with
accelerates metabolism of HIV drugs
reduce effectiveness of OCs and warfarin
101
why would you take amphotericin
systemic fungal infections
102
nursing considerations for amphotericin
highly renal toxic
give with one liter of saline
IV only
103
what is the longest acting benzo
diazepam
104
what is the shortest acting benzo
midazolam
105
side effects of TCAs
tachycardia
cardiac effects (prolonged QT)
anticholinergic effects
sedation/sexual dysfunction
106
what should you avoid when administering lithium
no NSAIDS!
107
5 nursing considerations of haloperidol
EPS
tardive dyskinesia
neuroleptic malignant syndrome
prolong QT
CT in pregnancy
108
s/s of neuroleptic malignant syndrome
high fever
rigid muscles
109
what 2 drugs are used as tocolytics
terbutaline
mag sulfate
110
when can you give ibuprofen to a peds patient
not before 6 months d/t immature liver
111
what is oseltmaivir
tamaflu
112
in low doses where does epi work
beta 1
113
in high doses where does epi work
beta 1 and alpha 1
114
what receptors does norepi work on
alpha 1 leading to peripheral vasoconstriction
use for shock and hypotension
115
when do we use dopamine in critical care
shock, hypotension, trauma
high doses cause vasoconstriction to increase BP
116
what is third line in septic shock
vasopressin
116
what will low doses of dopamine do
increase renal blood flow
117
when is milrinone used
cardiogenic shock
decreased CO
congenital/acquired heart defects
when heart is not strong enough to maintain adequate cardiac output
118
MOA of milrinone
phosphodiesterase inhibitor --> usually breaks down camp so inhibiting allows more cells of heart muscle to contract
119
how often do you change IV tubing for a CVC
q 96 hours or per facility protocol
120
how often do you do CVC dressing changes
weekly or more often
sterile!
121
what pt position do you place and remove a CVC
trendelenburg
122
how often do you change bag and tubing for TPN
q24 hours
123
when is s3 heard
systolic HF
124
when is s4 heard
diastolic HF
125
where do you assess macewans sign
junction of the frontal, temporal, and parietal bones
126
what 6 vaccines are given at 2 and 6 months
Dtap
rotavirus
ipv
pcv13
hep b
hib
Dripping in hep b and hib
127
4 month vaccines
Dtap
rotavirus
ipv
pcv
hib
dripping in hib
128
12 month vaccines
VAMP hib
varicella
hep A
MMR
pcv13
hib
129
4-6 vaccines
MID v
MMR
IPV
Dtap
varicella
130
when do you start getting annual flu shot
6 months
131
what are the live vaccines
MMR
varicella
rotavirus
palivizumab (for RSV)
many vaccines ready to pounce!
132
when does colorectal screening start
50+
133
when is breast cancer screening started
>40
134
what family planning method increases risk for TSS
diaphragm
135
what is ribavirin used for
to treat hep c
136
can an LPN give rhogam
no - blood product
137
do you need to take your blood sugar before taking metformin
no because it does not cause hypoglycemia!
138
does calcitonin increase or decrease calcium levels
decrease
139
what is Phenazopyridine
urinary tract analgesic
140
