Pharm Flashcards
(204 cards)
1
Q
zolpidem (ambien) is a
A
Sedative hypnotic
2
Q
Zolpidem may cause
A
daytime drowsiness and dizziness
3
Q
Zolpidem enhances:
A
inhibitory effects of GABA, inducing sleep
4
Q
ZOlpidem can cause:
A
parasomnias (unusual behaviors that occur during sleep)
5
Q
ZOlpidem can cause amnesia and patient may do things they dont remember doing like:
A
walking driving or eating
6
Q
Zolpidem should be administered
A
before bed with 8 hours of possible sleep
7
Q
Zolpidem should not be taken with
A
alcohol or other CNS depressants
8
Q
Amphetamine is a
A
CNS stimuant
9
Q
Amphetamine is used to treat:
A
ADD, ADHD, and Narcolepsy
10
Q
Amphetamine often gets
A
abused and misused
11
Q
Side effects of amphetamine use include:
A
psychosis, cardiovascular issues, and abrupt withdrawal results in abstinence syndrome
12
Q
Nursing implications:(Amphetamine)
A
watch blood pressure, baseline EKG, CBC and Platelets
13
Q
Buspirone (Buspar) is an:
A
Anxiolytic
14
Q
Buspar is used to treat
A
Generalized anxiety disorder
15
Q
Adverse effects of Buspar include:
A
CNS effects, however it does not potentiate CNS depressants (so could be taken with another drug like benzodiazapine)
16
Q
Buspar interacts with:
A
Erythromycin, ketoconazole, and grapefruit juice
17
Q
Buspar should be taken with
A
meals to prevent gastric irritation
18
Q
Alprazolam(Xanax) is a
A
Benzodiazepine…….so you must watch for CNS depression
19
Q
Lithium(Lithobid) is a:
A
Mood stabilizer
20
Q
Lithium works by:
A
causing a serotonin receptor blockade
21
Q
Lithium is used to treat:
A
Manic episodes in bipolar disorder, can be used in schizophrenia
22
Q
Narrow therapeutic index:
A
(>1.5 mEq/L is toxic)
23
Q
When using Lithium you must closely monitor:
A
RENAL! Kidney function is extremely important!!!
24
Q
Patients with renal impairment must:
A
have dose reduced and serum blood levels carefully monitored
25
Patients taking Lithium should not take:
Diuretics because diuretics cause loss of sodium and water , which increases lithium toxicity
26
Side effects of Lithium include:
Lithium tremors, polyuria(excessive urination), goiter/hypothyroidism
27
Lithium should be given:
with milk to reduce GI effects
28
Risperidone(Risperdal):
| RISPER rhymes with WHISPER(calms whispering voices of schizophrenia)
2nd Gen Antipsycotic
29
Risperidone is used to treat:
positive and negative symptoms of schizophrenia and MANIA
30
Risperidone works by:
by acting as a stronger blockade for serotonin
| but produces only moderate blockade of dopamine receptor (has fewer side effects than first generation antipsychotics)
31
SIde effects of Risperidone often include:
Weight gain, and GI problems
32
Haloperidol (Haldol): is a
1st generation antipsychotic
33
Haldol works by
blocking receptor for dopamine in the central nervous system* Treat positive symptoms
34
Haldol is used to treat
schizophrenia, acute psychosis, tourettes Syndrome
35
Haldol can cause
serious movement disorders known as extrapyramidal symptoms(EPS)
36
Haldol can cause
neuroendocrine effects
37
Haldol can
prolong the QT interval and cause dysrhythmias
38
Haldol can cause
sleep problems
39
Psychotic disorders include:
schizophrenia, Mania, Acute Psychosis
40
Positive symptoms are not good, means the activating symptoms, and includes:
hallucinations, delusions, and racing thoughts
41
Negative symptoms include:
apathy, lack of emotion, poor or non-existant social functioning.
42
Promoting adherence involves:
ensuring that medication is getting taken, encourage family members to oversee medication for outpatients
and using an intramuscular depot preparation for long term therapy(NVEGA)
43
Fosamax
decreases activity of osteoclasts
44
Fosamax is contraindicated on patients who
should remain flat on bed rest
45
Side effects of fosamax include:
jaw pain, blurred vision, muscle pain(can cause joint and muscle pain
46
When administering elavil:
tell patients to position slowing from sitting or lying to standing
47
Do not stop taking this drug immediately:
elavidil
48
Take elavil:
at bedtime to prevent daytime drowsiness
49
When taking elavil:
you should increase your fluid and fiber intake
50
Nardil and Venlafaxine can't be taken together cause:
it could cause serotonin syndrome
51
Patients recieving Lithium need:
to get thyroid function tests done occasionally since one of the adverse effects is hypothyroidism
52
Patients should know not to take viagra with:
high fat foods because it delays absorption and PEAK
53
When taking Levodopa/Carbidopa (sinemet) you should be careful while:
changing postitions-change positions slowly to avoid orthostatic hypotension
54
When taking Mirapex:
labs need to be monitored,especially CPK, creatinine phospokinase
55
DO not take (Phenytoin)Dilantin with Depakote:
my cause Phenotoyin toxicity
56
When taking Depakote:
watch for drowsiness and rash
57
Baclofen:
avoid driving until the drug effects are evident
58
Dantrium may cause:
Diarrhea(DD)
59
When patient is taking Dantrium you should monitor:
liver function
60
Tegretol should be:
stared at a low dose(titrated)
61
Side effect of Risperidone is:
polyuria
62
Prozaac can cause:
serotonin syndrome and suicidal thoughts
63
NArdil can cause
a hypertensive crisis
64
Lithium should not be taken with:
Lasix because it may cause Lithium toxicity
65
When taking Xanax you might have/get:
withdrawal symptoms
66
Ambien can cause
memory impairment
67
When taking Buspar you shouldn't expect to feel better until after:
2-4 weeks
68
Flomax and Viagra shouldn't be taken together:
because it may cause hypotenstion
69
Pitocin(Oxytocin):
induces labor
70
Conjugated estrogen(Premarin) can cause:
vaginal bleeding
71
When taking PREMPO, you should:
have your BP monitored regularly
72
When patient is taking Proscar you must monitor there:
PSA (Prostate Specific Antigen)
73
Cervidol:
have patient urinate prior to insertion(think it might cause urinary retention), remove pouch before active labor begins, monitor for uterine hypertension, and monitor patients temperature
74
Do not take NSAIDs while taking:
Lithium
75
Depakote can cause:
jaundice
76
LITHIUM CAN CAUSE:
tremors, confusion, nausea, and muscle weakness
77
patients should not drink alcohol while taking Xanax:
side effects of Xanax may include, anxiety, sedation, respiratory depression, and tolerance
78
Pitocin mimics:
oxytocin that naturally occurs in the body
79
Pitocin induces or
augments labor by increasing strength, frequency and length of uterine contractions
80
Pitocin can also help with
control of postpartum bleeding
81
SIde effects of pitocin include:
hyperstimulation, uterine rupture, post delivery atony when used intrapartum (risk for bleeding)
82
Pitocin can potentiate:
hypertensive effects of other drugs
83
Cervidil is a
synthetic Prostaglandin( it is inserted into the vagina and placed near the cervix)
84
Cervidil works on the
CERVIX, it ripens or softens it., It induces contractions
85
Contraindications for CERVIDIL are:
previous C-sections
86
Side effects of Cervidil:
Nausea/Vomiting, fever, uterine rupture, hyperstimulation
87
Strattera:
SNRI used to treat ADD and ADHD
88
Strattera:
Non stimulating, no potential for abuse, administered once a day
89
Adverse effects of strattera:
Strattera- Gastrointestinal reactions, reduced appetite, dizziness, somnolence, mood swings, trouble sleeping
90
Chantix(Vareniciline):
Partial agonist at nicotinic receptors
91
Chantix:
Most effective aid for smoking sessation
92
Chantix may cause:
Nausea, sleep disturbances, abnormal dreams, constipation, vomiting, dry mouth, flatulance, Potential for serious neuropsychiatric effects, cardiovascular events
93
Magnesium Sulfate:
used in premature onset of labor, preeclampsia, eclampsia
94
Magnesium Sulfate:
decreases uterine contraction
95
Magnesium Sulfate:
Decreases neuromuscular conduction
96
MAgnesium sulfate:
causes vasodilation
97
Side effects of Magnesium sulfate:
CNS depression, Heart and Reflexes depression, flushing, sweating, hypotension, FLaccid Paralysis
98
Contraindication of Mag Sulfate:
Additive effect with CNS depressants
99
Premarin is
conjugated estrogen: mimics hormone estrogen
100
Premarin is used to
relieve vasomotor symptoms of menopause
101
Premarin should be used
for the shortest amount of time as possible.
102
If you are using a Premarin and
you still have a uterus, you must also take progestin to prevent endometrial buildup that leads to endometrial cancer
103
Premarin can cause:
GI issues, fluid retention/weight gain, depression (these are considered then minor ones)
104
Premarin has a black box label:
increased risks of thromboembolic events, stroke
105
There is a risk of breast cancer when
Premarin and progestin is taken together
106
Premarin may increase
risk for Dementia in postmenopausal women
107
Premarin is contraindicated in:
Liver disease, those at risk for any of the above disorders, those with family history of repro cancer, smoking, fibroids, or UNDIAGNOSED vaginal bleeding
108
Premarin interacts with:
Anticonvulsants, barbituates, Rifampin
109
Depo-Provera:
Synthetic Progestin that mimics naturally occurring hormone PROGESTERONE
110
Depo-Provera Uses:
decreases hyperplasia of uterine lining
changes proliferative endometriium into secretory
Suppress pituitary hormones to inhibit ovulation
111
Depo Provera Black Box:
Increased risk of cardiac complications, thromboembolic events
Bone Loss
112
Depo Provera side effects:
Headcahe/migraines/Depression/Vision/changes/loss/weight gain
irregular vaginal bleeding
GI upset with nausea and vomiting
113
Depo Provera is contraindicated in:
```
Cardiovascular disease, history of thromboembolic event or cerebral hemorrhage, renal disease(progestin metabolites excreted in urine),
hepatic disease(metabolism of progestin occurs in liver)
```
114
Prempo:
Conjugated Estrogen(Premarin) and Medoxyprogesterone acetate(Provera) combined in one pill
115
Prempo was created for:
women with an intact uterus who need to take Progestin with Estrogen HRT to reduce endometrial hyperplasia and subsequent risks
116
Ortho-Novum AKA the pill:
Synthetic Estrogen and Progestin used to suppress menstrual cycle
117
Ortho Novum used for:
for contraception, Acne, PMDD, Menstrual dosorders
118
Side Effect of Ortho Novum:
Nausea/vomiting(take with food or at bedtime to reduce)
thromboembolism/MI/stroke/Cardiovascular(SMoking significantly increases risks)
Gallbladder disease
Edema/weight gain/headache
119
Ortho Novum is contraindicated in:
```
35+ smoking
liver issues
reproductive cancers in your family -esp. breast
history of clots
Migraine with Aura
```
120
Drug Interactions for Ortho Novum:
Antibiotics, Anticonvulsants, Barbituates, Griseofulvin-
| Increase chance of pregnancy
121
Fosamax is used to treat:
osteoporosis, works by suppressing osteoclasts
| *osteoclasts are bone cells that absorb bone in the process of bone turnover
122
Side effects of Fosamax include:
Esophagitis, dysphagia, esophageal ulcers, headache, muscle pain, decrease in serum calcium, atypical femur fracture/Osteonecrosis of the jaw
123
Nursing Implications for Fosamax includes:
take with a FULL glass of WATER, not juice or coffee
should be taken 30 minutes before breakast and before other drugs
Patient should stay upright for 30 minutes after to promote absorption and decrease gastric irrigation
124
Fosamax is contraindicated in
patients who cannot stay sitting up for 30 minutes, no renal impairment, NO ASA, NSAIDS, Antacids and Ca+2 hours apart from admin
125
Testosterone:
man made version of naturally occurring testosterone in the body
126
Testosterone is used to treat:
Androgen deficiency
127
Side effects of testosterone include:
acne, hair loss, headache, hypercalcemia, bitter taste, mouth irrigation, gum tenderness, jaundice, edema
128
Contraindications for testosterone are:
Liver disease, prostate issues
129
Viagra is
PDE 5 inhibitor and is used to treat erectile dysfunction
130
Viagra enhances
erection by increasing blood flow to penis
131
Viagra onset:
20-60 minutes, lasts up to 4 hours, should only take once in a 24 hour period
132
Viagra side effects:
Increased risk of hypotension, headache, facial flushing, dyspepsia, nasal congestion, dizziness, permanent loss of vision(rare), loss of hearing(rare)
133
Interactions for Viagra include:
Nitrates, Alpha blockers, Antifungals, Erythromycin, antiviral, antiretrovirals, fatty foods decrease absorption, alcohol
134
Proscar:
5 Alpha Reductase Inhibitor (Anti-testosterone drug
135
Proscar is used in:
benign prostatic Hyperplasia...it shrinks prostate so urine can pass
136
Proscar side effects;
sexual dysfunction, feminine characteristics enhanced in men(breast growth)
137
Proscar is contraindicated in:
pregnant women should not handle this med
children should not take this med
cannot give blood while taking it
138
Proscar interacted in:
testosterone, anticholinergics, saw palmetto(herbal)
139
Drugs used to treat Parkinsons include:
Levodopa/Carbidopa, mirapex
140
Parkinsons is treated by
increasing Dopamine and decreasing acytecholine
141
Levodopa/Carbidopa:
Levodopa becomes dopamine in the brain(crosses the BBB), Carbidopa is the CAR that gets the dopamine there(does not cross the BBB)
142
Side effects of Levadopa/Carbidopa include:
Nause/vomiting, cardiovascular, hallucinations, CNS effects, activates melanoma, dyskinesias
143
Levadopa/Carbidopa interacts with:
MAO-I(risk of hypertensive crisis)
Antipsycotics block dopamine making this drug inaffective
High-protein foods reduce therapeutic effects-instruct patient to spread protein throughout the day
144
Mirapex is used to
treat Parkinsons
145
Mirapex is a:
nonergot Dopamine Agonist-direct activation of Dopamine in Stiatum
146
Mirapex can be used
alone or as adjunct to Ldopa/Cdopa
147
Mirapex can cause unusual side effects like:
compulsive gambling (do not give to someone with an underlying impulse control disorder)
148
Mirapex when used alone can cause:
Nausea, constipation, dizziness, sleep disturbances and hallucinations
149
Mirapex when combined with Ldopa/Cdopa can cause
orthostatic hypotension, dyskinesias, hallucinations
150
Alzheimers disease is a
depletion of acetylcholine, to treat you have to increase Acetycholine
Donepezil inhibits acetycholinesterase, and stops the breakdown of acetycholine
151
Donepezil:
UNCLE DON has alzheimers so give him the med before bed
152
Donepezil is a
acetycholinesterase inhibitor-inhibits metabolism of acetycholinein brain, making it more available
153
Donepezil does not cure,
it delays progression by a little more than a year
154
Side effects of Donepezil are
Nausea, diarrhea, bradycardia, fainting, falls, fall related fractures
155
Donepezil should be taken
at bedtime due to side effects of bradycardia/fainting thus reducing risk of falls
156
Donepezil should not be combined with
anticholinergic drugs including first generation antihistamines(Benadryl)
157
siezures are a
neurological storm
158
Antiepileptic meds calm the storm by
Depressing the CNS
159
Antiepileptic meds need to be
taken as prescribed and should not be stopped abruptly (can cause siezure or status epilepticus)
160
If you are of the childbearing years and sexually active
and taking an antiepileptic you need to take two forms of birth control because most are rated Preg D or X , anti epileptic meds reduce effectiveness of birthcontrol pills
161
Phenytoin(Dilantin):
Selective inhibition of sodium channels
162
Dilantin can cause:
vision issues, gingival hyperplasia (swollen gums)-good oral hygiene is critical
Drowsiness and CNS depression
163
Dilantin drug interactions:
oral contraceptives, warfarin, glucocorticoids, and CNS depressants (alcohol)
164
Tegretol works by:
inhibiting the influx of sodium through sodium channels
165
Side effects of Tegretol include:
visual disturbances, decreased excretion of water (fluid retention)skin rash(may be serious- epidermal necrolysis, stevens johnsons syndrome)
Bone marrow suppression(fatigue, bleeding, fever, chills, etc.)
166
Drug interactions for tegretol:
Phenytoin, phenobarbital, OC, Warfarin
167
Depakote:
suppresses neuronal Na+ and Ca+ channels, increase GABA effects
168
Depakote is used to treat:
seizure, bipolar disorder
169
Life threatening adverse effects of Depakote include:
Hepatic failure and Pancreatitis/GI disturbances
170
Gabapentin:
single agent used for partial seizures
| clinically prescribed for Neuropathic pain
171
Side effects of Gabapentin:
well tolerated , CNS, Somnolence, dizziness, ataxia, fatigue, nystagmus, peripheral edema
172
Status Epilepticus:
continuous series of tonic-clonic seizures
173
When treating Status Epilepticus goals of treatment:
maintain ventilation
terminate seizures:Diazepam(Valium)
correct hypoglycemia
initiate or continue long term suppression drugs such as phenytoin (Dilantin)
Will have to administer a rescue dose of Diazepam
not orally because person is seizing: IV, intranasal, Rectal, IM
174
Elavil:
a try-cyclic antidepressant that ELAvates mood
175
Elavil side effects:
sedation, orthostatic hypotension, and anticholinergic effects
Cardiac toxicity
Danger of overdose, therefore limited use and never in suicidal patients
176
Nardil:
Monoamine Oxidase Inhibitor, used for deression and OCD
177
Nardil has a high
incidence of drug-drug and drug-food interactions so rarely given unless treatment resistant depression
178
Nardil:
blocks MAO in brain making norepinephrine and serotonin available
179
Side effects of Nardil:
Orthostatic hypotension
CNS stimulation
Hypertensive crisis from dietary tyramine
180
Contraindications for Nardil:
tyramine rich foods and many drug interactions
181
Diazepam(Valium) is a benzodiazepam
enhances inhibitory effects of GABA
182
Valium is used in
status epilepticus, muscle relaxant, and anxiety
183
Valium side effects can cause
```
CNS depression(check respirations
Serious adverse effect=cardiovascular collapse, bradycardia and hypotension
```
184
Multiple sclerosis:
neurological autoimmune disorder
immune system eats away at protective myelin sheaths to nerves
disease progression can be slowed with treatment
early treatment increases the chances of significantly improving the prognosis
NO cure for MS
185
Refib:
Immunomodulator
186
Refib is a:
disease modifying drug, a naturally occurring cytokine
187
refib:
reduces the frequency/severity of MS attacks and the number and size of lesions
188
refib:
delays progression of disability(MS)-does not cure
| *only available in injectable forms
189
Refib side effects:
flu like symptoms
depression(suicidal thoughts)
extensive liver involvement
*check liver function before administration
*do not administer with other drugs that affect liver(tylenol)
*do not take alcohol with this drug
190
Refib Nursing Implications:
Obtain baseline CBC and LFTs
191
```
Spasticity:
treat with
Baclofen(CNS)
Dantrolene(directly on muscle)
Diazepam(CNS)
```
movement disorders of CNS origin
most common causes: multiple sclerosis and cerebral palsy
*heightened muscle tone, spasm, loss of dexterity
192
Baclofen:
works in the CNS
| Mimics GABA in spinal(BACK) neurons to suppress hyper reflexes
193
Baclofen is used to treat:
relief of spasticity related to cerebral palsy, spinal cord injury, and multiple sclerosis
*can be administered orally or intrathecally(in the back)
194
Side effects of Baclofen includes:
nausea, urinary retention, constipation, orthostatic hypotension
195
Baclofen:
do not operate heavy machinery(drive) until you kow response to drug
196
When quiting Baclofen you need to
taper the drug because abrupt intrathecal withdrawal can cause rhabdomyolysis
197
Dantrolene is a
peripherally acting muscle relaxant, inhibits muscle contraction by preventing release of calcium in skeletal muscles
198
Dantrolene used to
relieve spasticity due to cerebral palsy or multiple sclerosis
treatment of malignant hyperthermia
199
Adverse effects of Dantrolene include:
CNS depression and hepatic toxicity
200
Contraindications of Dantrolene:
*impaired liver function
| CNS depressants have an additive effect
201
Prozac:
| used to treat depression, anxiety, and OCD
SSRI
| BLocks serotonin reuptake which increases serotonin availability for the body
202
Prozac can cause:
nausea, vomiting, anxiety, insomnia, and diarrhea
203
Prozac can be life threatening if
interacted with MAO-I, must wait 2 weeks between use
| Black Box Warning: Suicidal Ideation
204
Effexor:
| can treat depression, anxiety, and pain
SNRI
Inhibits serotonin and Norepinephrin Reuptake making more available for use
More side effects than SSRI, but much less than TCA and MAO-I
