Pharm Final Test

Question 1

Describe use of Baclofen…

Answer 1

Skeletal muscle relaxant. Used with Spine injuries, CP, MS.

Functions in GABA receptors

Question 2

Discontinue Baclofen (Muscle relaxant for CP, Spine injuries) over how long period….

Why….

Answer 2

2 weeks

Avoid withdrawal symptoms Hallucinations, seizures, increased spacity

Question 3

Do narcotic dosages need to be double checked by another RN…

Answer 3

Yes

Question 4

When on a morphine pump PCA infusion

What special type of monitoring is needed…

Answer 4

CR monitor with Pulse Ox

Question 5

Major SE of baclofen….

Answer 5

Drowsiness
Dizziness

Depresses CNS

Question 6

CP child is prescribed Baclofen describe possible routes of delivery…

Answer 6

PO

Intrathecal

Question 7

Max dose of Tylenol daily…

Answer 7

4 grams

Question 8

Major considerations before give acetaminophen…

Answer 8

Liver function

Check labs
Ensure no Alcohol consumption

Question 9

Acetylcysteine is used for…

Answer 9

Acetaminophen (Tylenol) OD

Question 10

Acetylsalicylic acid
Ibuprofen
Naproxen
Ketorolac

Are which type of medication…

Answer 10

NSAIDS

Question 12

Acetylsalicylic acid (Aspirin)
Ibuprofen
Naproxen
Ketorolac

Are all NSAIDS

Which major side effect must be monitored fir..

Answer 12

GI bleeding / Ulcer dec

Question 13

Ketorolac (NSAID) shouldn’t be taken longer than…

Answer 13

5 days

Question 14

Used in peds with Polyarticular Juvenile Idiopathic Arthritis

Monitor for bone marrow suppression & Bllod Cells

EDUCATE ON REPRODUCTIVE RISK IN BOTH MEN AND WOMEN

This medication is classed as a Antineoplastic, Antirheumatic, immunosuppressant…

Answer 14

Methotrexate

Question 15

This medication can cause birth defects and double gloves are required when handling

Monitor for SS of hyperthyroidism & dev of hypothyroidism/ Enlargement of cervical lymph nodes.

Answer 15

Methotrexate

Question 16

What are human chorionic Gonadotropin test used for…

Answer 16

hCG test are used to determine pregnancy

Question 17

Methotrexate has potential for fetal harm if partner becomes oreggers while taking the med.

Describe instructions for both men & women using this medication…

Answer 17

Men: Use birth control while taking med & 3 months after

Women: Birth control during & for 6 months after.

Breastfeeding Contradicted during med and for 1 week after taking last dose

Question 18

Classification: Antianemic

Epoetin alfa is a synthetic form of Erythropoietin (a hormone that stimulates the production of RBC)

It is commonly prescribed for these diseases…

Answer 18

CKD
CHEMOTHERAPY
HIV

Question 19

Epoetin alfa medication

What is the highest level of Hemoglobin when this medication can still be given…

Answer 19

11g/dl

Increased hg level is Increased risk of cardiovascular events

Question 20

Filgrastim

Classification….

Action….

Therapeutic effects…

Answer 20

Colony-Stimulating factor

Stimulation of growth of immature neutrophils & differenation active mature neutrophils

Reduction in infection due to chemotherapy

Question 21

_____ is a granulocytes colony-stimulating factor that stimulates bone marrow to produc3 neutrophils

Answer 21

Filgrastim

Question 22

Filgrastim: A granulocyte colony-stimulating factor that stimulates bone marrow to produce more neutrophils.

Monitor CBC 2X wkly

This type of pain is common…

Monitor Spleen size due to risk of splenomegaly/rupture, where to monitor…

When not to adminster…

Don’t shake vile

Answer 22

Bine pain common

Assess left upper quadrant for spleen enlargement

Don’t adminster 24 hrs before or after chemo

Question 23

This vitamin essential for prevention of Neural Tube Defects also is required for production of RBC, DNA, RNA. Also stimulates production of RBC,WBC, Platelets….

Answer 23

B9 folic acid

Question 25

Assure women of childbearing age are supplementing with this vitamin to prevent neural tube defects...

Answer 25

B9 folic acid

Question 27

Vitamin B9 Folic acid is found in these types of foods...

Answer 27

Red meats, fish, dark green vegetable, fortified cerals

Question 28

Iron ferrous Sulfate: Therapeutic effect:

Answer 28

Prevents iron deficiency often found with Anemia

Question 29

Adverse reactions of Iron Ferrous Sulfate...

Answer 29

PO: Staining of teeth Hypotension Nausea Constipation/ dark diarrhea (May cause False positive in Guaic Test)

Question 31

SS of Iron overdose Early... Late...

Answer 31

Stomach Pain NVD LATE CYANOSIS DROWSINESS TACHYCARDIA SEIZURES

Question 32

When giving PO Iron what considerations to eating/full stomach does it have...

Answer 32

Take on empty 1hr before 2 hrs after for best absorption

Question 33

Give what to increase the absorption of iron...

Answer 33

Vitamin C

Question 34

Chelating agents to remove iron are associated with these diseases...

Answer 34

B- Thalassemia Sickle Cell Disease

Question 36

Aspirin What pts are at risk to dev hypersensitivity reaction...

Answer 36

Pts with asthma, allergies, nasal polyps

Question 37

Max doses per day / Max dose daily...

Answer 37

Don't exceed 5 doses in 24 hrs 4 grams Or 75/mg/kg/day Which ever is lower

Question 38

Why should pts with renal failure not be given NSAIDS...

Answer 38

Blocks Prostaglandin synthesis; decrease renal perfusion leading to renal failure

Question 39

Hydroxyzine (Vistaril, Atarax) Classification: Therapeutic: Antianxiety agent, antihistamine, sedative/hypnotic Pharmacologic: Piperazine derivative Indications... Mechanism of Action...

Answer 39

Indications: Anxiety Preoperative sedation Nausea and vomiting Pruritus (itching) due to allergic conditions Can be used off-label for insomnia and alcohol withdrawal symptom MOA: Mechanism of Action: Blocks histamine (H1) receptors Has anticholinergic, analgesic, and sedative properties Produces CNS depression (though it is not a benzodiazepine)

Question 40

Metoclopramide (Reglan) Classification: Therapeutic: Antiemetic Indications... Pt. Teaching...

Answer 40

Indications: Prevention of nausea and vomiting (especially with chemotherapy or post-op) Gastroparesis (especially in diabetic patients) GERD (short-term use if other treatments fail) Aid in small bowel intubation and radiologic exams Pt. Teaching Patient Teaching: Report symptoms of involuntary movements or muscle stiffness immediately Avoid alcohol and other CNS depressants while taking Drowsiness may occur—use caution when driving or operating machinery Notify provider of signs of depression, agitation, or suicidal thoughts Take exactly as prescribed, especially with regard to timing before meals

Question 41

Antidotes for Iron OD List route of adminstion: Deferoxamine.... Deferasirox.....

Answer 41

Deferoxamine IM / IV Deferasirox PO

Question 42

Edetate disodium calcium Chelation therapy Adminster IV or IM With IM this consideration.... How many days is the therapy given... This consideration for adminstion with other meds...

Answer 42

IM give with procaine or lidocaine 5 days stopped for 2 - 4 days then 5 more days Can cause encephalopathy when given alone . It's use alone is not recommended in pts with BLL >70 mcg/dl

Question 43

Succimer A derivative of Dimercaprol that can be administered orally Which advantage does Succimer have over Dimercaprol...

Answer 43

Can be gicen with Iron without toxic reaction

Question 44

This medication is used in the treatment of Sickle cell & thalassemia to stimulate the production of hemoglobin f (fetal hemoglobin that prevents sickeling) Antineoplastic agent Monitor for: Mild GI Modest neutropenia Hyperpigmentation of skin & nails

Answer 44

Hydroxyurea

Question 45

____ can be given several days before chemotherapy to prevent Tumor Lysis Syndrome.

Answer 45

Allopurinol

Question 46

____ is the time after administration of a drug when bone marrow suppression is at the greatest.

Answer 46

Nadir

Question 47

Nadir is the point of time after taking chemotherapy drugs when the bone marrow suppression is the highest. Typical how long...

Answer 47

7 - 28 days