pharmacology exam 1

Question 1

diphenhydramine (benadryl)

Answer 1

anti hystamine

used to treat allergies and mild parkinsons

side effects: drowsiness, fatigue,

Question 2

foods that interact with medications

Answer 2

grapefruit juice: effects will cause toxicity due to slowed metabolism

dietary tyramine (wine, processed meats): will cause a hypertensive crisis

milk: interacts with tetracycline and creates reduced therapeutic effect

avocados: interacts with warfarin and will create a reduced therapeutic effect

high protein meals: interact with levodopa and creates a sudden loss of therapeutic effect

Question 3

educating patients on opiods

Answer 3

patients should never abruptly stop taking them

opiods can decrease bladder awareness

opiods will slow peristalsis - patients should increase fluid and fiber intake

move and sit up slowly for risk of orthostatic hypotension

Question 4

opiod patient assessments

Answer 4

monitor respiratory rate - must be over 12

assess clients pain levels

assess sedation PRIOR to giving

use cautiously in patients with head injuries - opiods can mask them

Question 5

PCA pump analsgesic

Answer 5

patient has control

there is a limit - maxium dose can be given out

lockout interval

**there must be 2 nurse check offs, both prior to administering, and after

Question 6

opiod antagonists (reversing agents)

Answer 6

*naloxone - immediate use for reversal of opiods - administered IV, IM, intra nasaly

Naltrexone - maintenece treatment, to prevent relapse by preventing euphoria

Question 7

opiod antagonists continued

Answer 7

suboxone: Buprenorphine + nalaxone

buprenorphine works by tricking brain into thinking it is taking an opioid, naloxone blocks activation of opioid receptors

methadone: an agonist that reduces opioid craving - can overdose on

Question 8

complications of anti gout medication

Answer 8

kidney injury - nurse should educate clients to drink 3L of water a day to dilute urine

headaches

bone marrow suppression

hypersensitivity syndrome - teach patients to report fever, rash, abdominal pain, swilling

patients on anti gout should wear sunglasses and protective clothing, and frequently get eye exams and report blurry vision

Question 9

adverse effects of glucocorticoids

Answer 9

myopathy and muscle weakness

hyperglycemia

redistribution of fat to face, back, torso, “moon face, buffalo hump”

inhibits prostaglandin synthesis which leads to risk of peptic ulcer disease and GI distress

suppress immune system

Question 10

contraindications of glucocorticoids

Answer 10

interact with live vaccines

lasix - increases risk of hypokalemia

digoxin induced arrythmias

concurrent NSAID use can lead to GI bleeding and ulcers

Question 11

pharmacokinetics of NSAIDS (aspirin, ibuprofen, naproxen, ketorolac)

Answer 11

COX 1 - decreased platelet aggregation and kidney damage

cox 2 - decreased inflammation, fever and pain management

rapidly absorbed in the GI tract

Question 12

NSAIDs contraindications

Answer 12

avoid in pregnancy

peptic ulcer disease

bleeding disorders

stop aspirin 1 week before surgery

Question 13

NSAID considerations / education

Answer 13

anticoagulants will increase risk of bleeding (heparin, warfarin) - should monitor PT /INR

glucocorticoids increase risk of bleeding

alcohol increases risk of bleeding and gastric ulceration

DO NOT take aspirin and ibuprofen concurrently

Question 14

contraindications of acetaminophen (Tylenol)

Answer 14

caution in pregnancy and lactation

hepatic dysfunction / chronic alcoholism

Question 15

acetaminophen adverse reactions

Answer 15

headache

hemolytic anemia

renal dysfunciton

skin rash and fever

Question 16

penicillin pharmacokinetics

Answer 16

rapidly absorbed from GI tract reaching peak level in 1 hr

Question 17

penicillin education

Answer 17

amoxicillin, augmentin and penicillin can and should be administered with food

take all other penicillin with 8oz water 1-2 hrs after meal

USE 2ND FORM OF CONTRACEPTION

Question 18

cephalasporins

Answer 18

treats infections caused by suscpetible bacteria

Question 19

phamacokinetics of cephalasporins

Answer 19

well absobed from GI tract

metabolized in liver, excreted in urine

can cross placenta and enter breast milk

Question 20

actions and education of cephalasporins

Answer 20

administer in diluted intermittent dosing

take oral doses with food

monitor for diarrhea

Question 21

what do sulfonamides treat

Answer 21

UTIs

Question 22

education for sulfonamides

Answer 22

Sun - photosensitivity

Urine - crystals can cause kidney stones

Love - love water, drink 2-3 L a day

Folic acid - take every day

Question 23

considerations for sulfonamides

Answer 23

contraindicated in pregnancy and breastfeeding

use back up contraception

Question 24

fluoroquines

Answer 24

treats infections caused by susceptible strains of gram negative bacteria

Question 25

fluoroquines education

Answer 25

encourage patients to take with food (NO DAIRY) increased suprainfection risk phototoxicity

Question 26

vancomycin side effects and nursing considerations

Answer 26

side effects: red man syndrome and renal toxicity monitor for peaks and troughs and assess IV site

Question 27

aminoglycosides

Answer 27

end with mycin poorly absorbed from GI tract but rapidly after IM injection adverse effects = ototoxicity and nephrotoxicity avoid in pregnancy and lactation

Question 28

macroslides nursing considerations

Answer 28

take on empty stomach or 2 hrs after meal with water avoid in patients with prolonged QT interval if taking STD medication avoid intercourse until FULL completion

Question 29

peak levels

Answer 29

time when a drug is at its highest level drawn 1 to several hours after drug is administered

Question 30

trough levels

Answer 30

when drug is at lowest level drawn immediatly before next dose of drug is administered

Question 31

teaching patients about side effects

Answer 31

be specific and realistic consider how effects will impact daily activities like driving, working out, exercising provide patients with ways to cope AVOID MEDICAL JARGON ask questions and provide visual aids