Pharm HESI study Flashcards
(183 cards)
1
Q
Aim at drug therapy for Parkinsons disease
A
To increase amount of dopamine or to lower amount of acetylcholine.
2
Q
-cyclines
A
Anbx
3
Q
Tetracyclines not for who?
A
children <8 (teeth d/c) and pregnant (passes to breastmilk)
4
Q
What don’t you give tetracyclines with
A
dairy, iron, sodium bicarb, antacids, kaolin and pectin
5
Q
-tidines
A
Histamine (H2) receptor blockers
6
Q
Do not take what with CCBs
A
grapefruit juice
7
Q
Do not give what with MAOIs?
A
Anything with thiamin
8
Q
What contains thiamin
A
aged cheese, chocolate, red wine, organ meats, beer, yogurt
9
Q
What will thiamin and MAOI cause?
A
hypertensive crisis that can lead to stroke
10
Q
When do you draw peaks?
A
30 to 60 min after giving
11
Q
When do you draw troughs?
A
Right before next dose
12
Q
Edema can affect what?
A
Absorption
13
Q
What can potentiate digoxin toxicity
A
hypokalemia
14
Q
Herbs can lead to what
A
bleeding toxitcities
15
Q
Salt palmedo can cause what?
A
False positive in PSA tests
16
Q
St johns wart can affect what
A
Oral contraceptives and decreases anticoagulation of coumadin
17
Q
Black cohosh can cause what
A
Hypotension if on antihypertensives and hypoglycemia if on insulin
18
Q
How to apply ear drops in children
A
Pull down and back
19
Q
How to apply ear drops in adults
A
Pull up and back
20
Q
How to apply eye drops
A
lower eye, midline. Not in inner canthus b/c can cause systemic absorption. Do not drop directly on cornea.
21
Q
When do you remove nitro patches & why
A
At nighttime to prevent hypotension
22
Q
-lol
A
Beta blockers
23
Q
-cycline
A
antibiotics
24
Q
-prazole
A
Proton pump inhibitors
25
-mycin
Antibiotics
26
-semide
loop diuretics
27
What metabolizes drugs
liver
28
What excretes drugs
Kidneys, breast milk, lungs and bile
29
Antidote for lovenox
protamine sulfate
30
slowest route for absorption
Transdermal
31
Fastest route for absorption
IV
32
Antidote for iodine toxicity
sodium theosulfate
33
What do anticholinergics do?
reduce cholinergic activity
34
Adverse reactions for anticholinergics
increased HR, postural hypotension, dry mouth, urinary retention, constipation
35
Teaching for anticholinergics
Not to change positions abruptly, gum or hard candy for dry mouth, avoid extreme heat
36
Dopamine replacement drugs do what?
stimulate dopamine production or increase sensitivity of dopamine receptors
37
Adverse effects for dopamine replacements?
involuntary movements
38
Teaching for dopamine replacements
may take months to work, avoid foods high in vitamin B, take last dose early in day, avoid driving
39
What foods to avoid with dopamine replacements (levodopa)
foods high in vitamin B
40
MAOI (selegine) are used with?
Dopamine agonists when their symptoms do not respond
41
Adverse effects of selegine
confusion, dizziness, nausea, dry mouth and insomnia
42
Tetracycline teaching
Do not give to children, pregnant or lactating women, causes teeth staining, decreases effect of oral contraceptives, do not give with dairy or antacids or iron, potentiates effect of anticoagulatns, give 1-2 hrs before eating, can cause photosensitivity
43
If OD on opiates give what
NARCAN, IV. Onset <2 min. Duration is 0.5-2 hrs
44
Adverse effect of narcan
opiate withdrawal
45
Spironolactone (aldactone) desired effects
Excretion of Na + H2o and retention of K+. (Competitive antagonist of aldosterone). It binds to aldosterone receptors and blocks reabsorption of NA and H20 in the collecting ducts. It elevates chloride levels.
46
contraindications for aldactone
Severe renal failure, hyperkalemia and anuria
47
What not to take with aldactone because can cause hyperkalemia
Ace inhibitors
48
Food teaching with aldactone
Avoid foods high in potassium (bananas, oranges, apricots, dates, tomatoes, potatoes)...
49
When do you give H2 receptor blockers
Morning and bedtime
50
When do you admin PPIS
before meals (30 min). can be mixed
51
When do you give antacids
after meals, not within 1-2 hours of other meds
52
When do you give carafate (sucraflate)
1 hr before meals and at bedtime.
53
PPIs end in what
-prazole
54
H2 receptor blockers end in what
-tidine
55
tiotropium (spiriva) is for what
COPD (maintanence medication)
56
what does spiriva do
relaxing airways and keeping them open. (blocks ach receptors to prevent bronchoconstriction)
57
common side effect for spiriva
dry mouth, constipation and trouble passing urine
58
Report s/sx of what with spiriva
acute narrow angle glaucoma
59
Orlistat (Xenical) is for what
Weight management (anorexiant)
60
Patient teaching for xenical
Give with or 1 hrs after meals with fats, give multivitamin 2 hrs before, supplementation of vitamin ADE and beta carotene, skip dose if missed meal or meal doesnt have fats, glycemic control may change with weight loss, report sx of hepatic failure,may cause flatulence and fecal incontinence.
61
Vancomycin trough optimal level
10-20 mcg/mL
62
Vancomycin peak optimal level
18-50 mcg/mL
63
Vancomycin too low if level....
<5 mcg/mL
64
Vancomycin too high if level...
>50 mcg/mL
65
Vancomycin too high can cause
nephrotoxicity and ototoxicity
66
Non harmful effect of vanc if given too rapid
red man syndrome
67
What are effects if giving vancomycin too rapidly
Red man syndrome and hypotension.
68
donepezil (aricept) is used for what
Dementia
69
What does aricept do?
Increases level or acetylcholine
70
Aricept increase risk for what?
Increases gastric secretions which can cause ulcers
71
When do you take aricept
In evening
72
How to check efficiency of aricept
improvement in s/sx of alzheimers
73
Triglycerides may be high if....
eating a lot of candy
74
Signs of digoxin toxicity
visual and GI disturbances (yello, green halios, hypotension, blurred vision, NVD, dyrthmias, fatigue, muscle weakness, drowsiness)
75
What is an early sign of dig toxicity
vomiting (spit up in babies)
76
Teaching for digoxin
Take apical pulse, <60bpm hold. For children, take 1 full minute. No skipping or making up missed doses. Do not mix with food or formula. Give 1 hrs before or 2 hrs after meals
77
Therapeutic level for digoxin
0.5-2
78
What can occur if overdiuresing with LAsix
Leg cramping (hypokalemia)
79
Signs of hypokalemia
K+ level <3.5, muscle weakness, cramping, decreased GI, anorexia, fatigue, dysrthmias, paresthesia, flat T waves on ECG
80
brand name for diclofenac potassium
Zipsor
81
Zipsor is what
NSAID used to treat mild to moderate pain (>18 yrs age) for rheumatoid arthritis, osteoarthritis
82
NSAIDS reduce effect of what
ACE inhibitors
83
Whn is pain releived by with Zipsor
1 hrs
84
Byetta is used for what
Type 2 diabetes
85
What does byetta do
enhances body's ability to release own insulin. When body senses blood sugar low, the release slows.
86
Do not take byetta with what
rapid acting or short acting insulins
87
Report signs of what with byetta
Pancreatitis
88
What is a COMMON side effect of byetta
Nausea occurs when first starting byetta and will becomes less over time
89
How to administer Byetta
Prefilled syringe given SC (thigh, abdomen and upper arm) taken twice a day, at any time within 1 hr before morning and evening meals, NOT after your meals, give birth control and anbx 1 hrs before, do not skip dose or double up.
90
Rapid acting insulins names
lispro (humalog) and insulin aspart (novalog)
91
short acting insulin name
Regular insulin
92
Intermediate acting insulin name
NPH and humulin L
93
Long acting insulin
Lantus
94
Rapid acting Onset, peak and duration
Onset 5-30 min, peak 1-1.5 hrs, duration 3-4 hrs
95
short acting onset, peak and duration
onset 30-60 min, peak 2-3 hrs, duration 3-6 hrs
96
Intermediate acting onset peak and duration
Onset 2-4 hrs, peak 4-10 hrs, duration 10-16 hrs
97
Long acting insulin
Onset 1-3 hrs, peak none, duration 24 hrs
98
What insulin can you give IV
Regular
99
When is lantus usually administered
Same time each day, usually at night time.
100
s/sx of hyperthyroidism
T3 > 220, T4 >12. Exopthalmus, weight loss, tachycardia, sensitivity to heat, diarrhea, palpitations, HTN, diaphoresis. Thyroid storm and graves disease.
101
Drugs for hyperthyroidism
PTU and methimadole (tapazole)
102
What does PTU and tapazole do
block synthesis of t3 and T4. Dosage based on BW and give over several months
103
s/sx of hypothyroidism
weight gain, fatigue, drug skin and hair, bradycardia, goiter, periorbital edema, facial puffiness, intolerance to cold, low T3 (<5), presence of T4 antibodies.
104
mEdication for hypothyroidism
Levothyroxine (synthroid)
105
Action of synthroid
Increases metabolic rates of T4
106
Teaching for foods for synthroid
Avoid voids high in iodine
107
when to take synthroid
early in day
108
What is an intranasal antidiuretic hormone
DDAVP for DI
109
what does desmopressen acetate DDAVP do
causes retention of water, increase in urine osmalality and decrease in serum osmalaltiy
110
Labs to check with tylenol overdose
ALT and AST; liver enzymes
111
What to give for tylenol overdose
Mucomyst, give one empty stomach and mix it with a drink (tastes horrible)
112
When do you hold clopidogrel
Before surgery and invasive procedures like liver biospy.
113
Why is clopidogrel given
Antiplatelet agent used for short term use after cardiac interventions, reduces the risk of thrombolytic stroke and preventing thrombo disorders.
114
Antifungal medication see if working
Wont have a rash anymore
115
Antifungal application
Keep area clean and dry, avoid contact with eyes, wear gloves, common place applied in toes, groin, under breast and folds
116
Why do we give NSAIDs
decrease inflammation and pain. (analgesic, antiinflammatory and antipyretic). Used to treat headaches, myalgia, neuralgia, arthralgia, postop pain, inhibit platelet aggregation
117
All NSAIDS can cause what
GI bleeding because they are ulcerogenic
118
Pregabalin trade name
Lyrica
119
Lyrica is what
Antidepressant and anticonvulsant
120
What is lyrica used for
fibromyalgia, refractory pain, neuropathic pain, partial seizures
121
When discontining Lyrica
Do it slowly over 7 days, can cause seizures if not
122
Efficiency for lyrica
Decreae pain intensity in neuropathy, fibromyalgia and neuropathic, reduction in frequency of seizures.
123
Teahing for lyrica
Driving, do not get pregnant, teach contraceptive measures
124
Another name for acyclovir
Zovirax
125
Zovirax is used for what
antiviral for Herpes, CMV
126
What is important when taking zovirax
Increase fluids to 2000-4000 mL/day because acute glomeruloneprhitis is a complication that is possible
127
Viagra is contraindicated wit...
nitrates because it vasodilates.
128
When do you administer bronchodilators
With wheezing, acute exacerbation of asthma
129
Long steroid use can cause
hyperglycemia, decreased immunity, growth retardation in children, immunosuppression, impaired wound healing
130
Long term steroids should be administerd when
IN the morning to coincide with normal secretion of cotisol.
131
Patient taking long term steroid should increase intake of what
Calcium and dairy products.
132
Rifampin is used fr what
TB
133
RIfampin can cause what
Orange color urine and secretions and decreaes effectiveness of oral contraceptives
134
Accutane teaching
No pregnancy, hard on liver, vitamin A toxicity can occur so no additional multivitamins, stop taking for 6 months before cosmetic procedures, admin 2x daily for 15-20 weeks, if need 2nd course have to wait 2 months, take with food, do not crush, monitor triglyceride (can elevate), no tetracyclines. Discontinue -cyclines before use, sun toxicity
135
Monitor what with antisezure meds
Liver enzymes
136
Drug of choice for C diff
metronidazole or Flagyl
137
Teaching for flagyl
may have metallic taste, admin with or after meals, NO alcohol
138
trade name for esomeprazole
nexium
139
Why take nexium
To reduce the risk of ulcers in patients who are regular users of NSAIDS. Take before meals.
140
Antidepressants and addiction
Taper off antidepressants rather than stopping abruptly
141
Side effects of nitroglycerin
Headaches. They vasodilate. Decrease in blood presssure.
142
What does nitro do
It reduces myocardial consumption, which decreases ischemia and reduces chest pain. It vasodilates
143
Diet for coumadin
Diet with no vitamin K (green leafy vegetables, peas, asparagus, meat, milk, soybean oil)
144
Bulk forming laxative teachin
lots of fluids, high fiber diet, take with at least 8 ox of water, do not take if N/V or abdominal pain, swallow tablets whole, contact HCP with abdominal pain dizziness weakness and cramps b/c can be f&e problems.
145
What is bulk forming laxatives used for
acute and chronic constipation, IBS and diverticulitis
146
Side effects of dilaudid
lifht headedness, dizziness, sedation, nause, vomiting, sweating, flushing, euphoria, dry mouth, pruritis.
147
Concepts of weaning off steroids
Do not stop abruptly. The production of steroids is controlled by feedback mechanism "HPAA and continuous use of steroids inhibits this mechanism causing it to hibernate. Tapering drug gives adrenal gland time to return to their normal pattern of secretion. 4 to 6 weeks is a reasonable period.
148
Concepts of aspirin and anticlotting effect
Decreases size of clot if already have clot. Makes platelet less sticky by decreasing platelet aggregation
149
What do you evaluate when assessing effects of atorvastatin (lipitor)
Look at cholesterol. Used to treat hypercholesteremia and hypertriglyceridemia. Decreases LDL and plasma triglycerides and increases HDLs. Lowers rate of cholesterol production.
150
what to monitor with statins
Liver panel....hard on liver
151
S/sx of hypoglycemia
sweaty, shaky, confused, belligerent, pale, dizzy, tremors, faintness, cold and clammy, emotional changes, slurred speech, BS <70
152
S/sx of hyperglycemia
gradual onset. high BS, increased urination, increase in appetite followed by decrease, weakness, fatigue, blurred vision, headache, glycosuria, nausea, vomiting, abdominal crmps
153
Treatment for hypoglycemia,
if conscious give sugar, orange juice, soft drink honey or candy. If unconscious give IV or SC glucagon or give 50% dextrose IV
154
Effects of NPO and blood sugar
give them their diabetic meds even if they are NPO. Hypoglycemia may occur if med isnt taken and they havent eateb.
155
Neupogen (filgastim) is used for what
To reduce risk of infection in patients with turmors who are recieving strong chemo that may cause severe neutropenia with fever.
156
How to see if neupogen is effective
WBC 10,000 (causes raise),
157
How to give neupogen
IV or SC, dilute in D5W for IV infusion
158
Epogen affects what
RBCs (HCT) ....epogen stimulates production of RBCS.
159
What do you use epogen for
anemia
160
Monitor what lab for eopgen
HCT
161
If erythropoetin is too high, what are they at risk for
uncontrolled hypertension
162
Cyclosporin (gengraf) is used for what
to lower your bodys immune system in transplant patients (protect from treating new organ as invader).
163
Administration of cycloporin (gengraf)
AVOID grapefruit juice, admin on consistent schedule, give 4-12 hrs prior to transplantation or given postop. Monitor serum creatinine and blood pressure every 2 weeks during first 2 months. NO live vaccines.
164
Phenytoin (dilantin) teaching
can cause gingival hyperplasia. Teach good oral hygeine. Can cause hirsutism. Do not abruptly withdraw.
165
Signs of drug toxicity with dilantin
nystagmus and diplopia
166
Therapeutic level of dilantin
10-20 mcg/ml
167
Administration of dilantin
Admin IV in 0.9% NS with in line filter. Abrupt withdraw after long term can cause seizures, must be seizure free for 2-5yrs before weaning
168
What is toradol
paraenteral NSAID. (nonopioid analgesic)
169
How to evaluate effectiveness of toradol
Pain rating scale
170
NItrofuratoin (macrodantin) used for what
UTI
171
Teaching for macrodantn
take with food, milk. Do not freeze, SHake well. Can change urin color. Avoid using antacids.
172
Theophylline can cause what
nervousness and tachycardia
173
Teaching with theophylline
Avoid caffeine and stimulatns, give with food, assess pulse (causes tachycardia)
174
Theophyilline therapeutic level
10-20
175
what is mannitol for
ICP
176
How to give mannitol
within live filter, give slowly over 30 to 90 minutes. short term use only
177
what helps assess effectiveness of mannitol
urine output
178
What is lithium for
manic phase of bipolar disorder
179
Therapeutic level for lithium
0.6-1.2
180
Moderate toxicity of lithium
1.8
181
Think what with lithium toxicity for s/sx
think being intoxicated. Staggering gait, blurred vision, cotton mouth, slurred speech. If toxic, stop taking and go to er.
182
When to monitor levels for lithium
Moniro every 2 months once stable. Assess concentration 2 to 4 days after initial therapy
183
What labs to check with lithium
Liver and lithium levels
