Pharmacology Test Seven (Final Exam) Flashcards
(207 cards)
1
Q
During pregnancy, women require 27 mg/day (normally it’s 18 mg/day). Not necessary usually until 2nd trimester. Goal is to prevent maternal iron deficiency anemia.
A
Iron
2
Q
Prevents neural tube defects
A
Folic acid
3
Q
Can be used to control pain during pregnancy and can be used all throughout pregnancy on short term basis
A
acetaminophen (Tylenol) and ASA
4
Q
What are Uterine Stimulants-Oxytocics used for in labor and delivery?
A
induce labor
5
Q
What are Tocolytics used for in labor and delivery?
A
stop labor
6
Q
What is magnesium used for in labor and delivery?
A
Slow labor down
7
Q
What are opioids used for in labor and delivery?
A
Pain relief
8
Q
What is Ethinyl estradiol and drospirenone (Yasmin) classified as?
A
Oral Contraception – ethinyl estradiol and drospirenone
9
Q
Action for Yasmin
A
Prevent pregnancy
10
Q
Side effects for Yasmin
A
No protection against STDs, no barrier to microbes. Has cardiovascular risk, DVT, thrombolism if combined with smoking
11
Q
Nursing for Yasmin
A
Needs prescription, may be expensive, must be taken as prescribed in order to be effective
12
Q
What is Estrogen HRT:
Conjugated equine estrogen (Premarin)
classified as?
A
Conjugated estrogen
13
Q
Action for Premarin
A
Used to treat moderate to severe menopause symptoms i.e. hot flashes, osteoporosis
14
Q
Side effects for Premarin
A
Fluid retention, nausea, vomiting, breast tenderness, depression, thromboembolus, increase in cancers, endometrial cancers
15
Q
Nursing for Premarin
A
Try to use lowest possible dose for shortest amount of time.
16
Q
What is Oxytocin (Pitocin) classified as?
A
Uterine smooth muscle stimulant
17
Q
Action for Pitocin
A
Ovulation stimulant and uterine smooth muscle contractor
18
Q
Side effects for Pitocin
A
Tachycardia, premature ventricular contractions, hypotension, nausea, vomiting.
19
Q
Nursing for Pitocin
A
Monitor vitals, notify physician of abnormal contractions, check for blood loss
20
Q
What is the classification for Terbutaline (Brethine)?
A
Premature labor inhibitor
21
Q
Action for Brethine
A
Inhibits uterine contractions
22
Q
Side effects for Brethine
A
Tremors, anxiety, drowsiness, headache, nausea, dizziness
23
Q
Nursing for Brethine
A
Offer emotional support, assess vitals, observe for cyanosis
24
Q
Classification for Clomiphene citrate (Clomid)
A
Estrogen antagonist
25
Action for Clomid
Binds with estrogen and makes body produce more estrogen. Stimulates ovulation.
26
Side effects for Clomid
Breast discomfort, depression, fluid retention, vision disturbances, weight gain, ectopic pregnancy
27
Nursing for Clomid
Used for women who wish to become pregnant
28
Classification for Raloxifene (Evista)
Osteoporosis preventive
29
Action for Evista
Binds to estrogen receptors, increasing bone mineral density
30
Side effects for Evista
Hot flashes, flu-like symptoms, weight gain, nausea, vaginal bleeding, breast pain
31
Nursing for Evista
Avoid prolonged restriction of movement during travel, take supplemental calcium & vitamin D. perform regular weight bearing exercise, no alcohol or smoking
32
Classification for alendronate (Fosamax)
Calcium regulator
33
Action for Fosamax
Inhibits normal and abnormal bone resorption, without retarding mineralization
34
Side effects for Fosamax
Back pain, abdominal pain, nausea, constipation, diarrhea, flatulence. Does cause damage to esophagus you take and then lay down.
35
Nursing for Fosamax
Must take with a full glass of plain water, first thing in the morning, and at least 30 min before eating, drinking, taking any other medications. Stay upright for at least 30 min after taking
36
Classification for Calcitonin-salmon (Calcimar)
Calcium regulator
37
Action for Calcimar
Regulates serum calcium concentrations
38
Side effects for Calcimar
Nausea, hypersensitivity
39
Nursing for Calcimar
Pts must have skin testing before treatment if suspected sensitivity.
40
Classification for Testosterone (Androgel)
Androgen
41
Action for Androgel
Given to promote growth and development of male sex organs in males that are androgen deficient (or for treatment of breast cancer in women)
42
Side effects for Androgel
Black box: can cause male characteristics in women/children that take it such as deep voice & hair growth. Can affect people that touch it or are exposed. Abdominal pain.
43
Nursing for Androgel
Make sure no one comes into contact with site. Should apply morning to upper arms/shoulders.
44
Classification for Finasteride (Propecia, Proscar)
Benign prostatic hyperplasia agent
45
Action for Proscar
Prescribed for an enlarged prostate, can also treat hair loss
46
Side effects for Proscar
Gynecomastia, sexual dysfunction
47
Nursing for Proscar
Pt should be aware of potential for impotence , women of childbearing age should not handle tablets or be exposed to semen
48
Classification for Tamsulosin (Flomax)
Benign prostatic hyperplasia agent
49
Action for Flomax
For enlarged prostate, improves urinary flow
50
Side effects for Flomax
Dizziness, drowsiness, headache, anxiety, first-dose syncope
51
Nursing for Flomax
Give at same time each day, 30 min after meal. Avoid tasks that require alertness until you know how you react to the pill
52
Classification for Sildenafil (Viagra)
Erectile dysfunction adjunct
53
Action for Viagra
Used to treat erectile dysfunction, inhibits enzyme responsible for breakdown of neurotransmitter in tissues of penis to have more vasodilation.
54
Side effects for Viagra
Headache, flushing, prolonged erections (more than 4 hrs)
55
Nursing for Viagra
High fat meals will delay absorption. Peak in 1 hr, duration for 4 hrs.
Also treats pulmonary arterial hypertension (high blood pressure within pulmonary arteries that can cause an enlarged heart) in women and children.
56
Classification for Oxybutynin chloride (Ditropan)
Antispasmodic/anticholinergic
57
Action for Ditropan
Used to increase bladder capacity and delay desire to void
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Side effects for Ditropan
Constipation, dry mouth, drowsiness, decreased perspiration
59
Nursing for Ditropan
For men or women who complain of urinary frequency, avoid alcohol, nurse palpate bladder for retention
60
Classification for Bethanechol (Urecholine)
Cholinergic
61
Action for Urecholine
Used to treat urinary retention, helps increase urge to void
62
Side effects for Urecholine
Frequent urinary urgency, changes in vision
63
Nursing for Urecholine
Report GI discomfort, monitor urine output
64
an area of the medulla that receives inputs from blood-borne drugs or hormones, and communicates with the vomiting center to initiate vomiting.
Chemoreceptor trigger zone (CTZ)
65
drug that is effective against vomiting and nausea.
Antiemetic
66
Drug to induce vomiting, not used much anymore due to risk of aspiration
Emetic: Ipecac
67
Antidiarrheal medications contain opiates because they slow bowel motility. Should not be used longterm – usually no longer than 2 days.
Antidiarrheals: opiates
68
Ex. is GoLytely, usually given before procedures. Salt pulls water in, do not use if the pt has heart failure. Must monitor electrolytes.
osmotic (saline) laxative
69
Irritate the sensory nerve endings, thus increasing peristalsis
stimulant laxatives
70
Contains fibrous substance that pulls water in, thus increasing peristalsis
bulk-forming laxatives
71
Soften the stool, not a laxative. Make the stool easier to pass.
emollients (stool softeners)
72
Classification for ondansetron (Zofran)
Serotonin antagonist, anti-nausea, antiemetic
73
Action for Zofran
Blocks serotonin in CTZ. Used with cancer chemo and also post-op.
74
Side effects for Zofran
Anxiety, drowsiness, respiratory depression, hypertension
75
Nursing for Zofran
Assess for frequency of vomiting and dehydration
76
Classification for prochlorperazine (Compazine)
Dopamine antagonist
77
Action for Compazine
Inhibits dopamine in CTZ. Also used for psychosis
78
Side effects for Compazine
Black box warning for increased risk of death in elderly. Nausea, vomiting, drowsiness, hypotension, first dose syncope
79
Nursing for Compazine
Avoid tasks that require alertness, don’t drive after first dose
80
Classification for dimenhydrinate (Dramamine)
Antihistamine
81
Action for Dramamine
Diminishes vestibular stimulation in CTZ, depresses labyrinthine function
82
Side effects for Dramamine
Drowsiness, dry mouth
83
Nursing for Dramamine
Assess for dehydration if vomiting, take 30 min before nausea-inducing activity
84
Classification for metoclopramide (Reglan)
Prokinetic
85
Action for Reglan
Stimulates peristalsis, used for GERD
86
Side effects for Reglan
Grimacing, involuntary limb movements rarely
87
Nursing for Reglan
Assess for amount of nausea/vomiting, watch for dehydration
88
Classification for psyllium (Metamucil)
Fiber supplement
89
Action for Metamucil
Prevent constipation by increasing bulk of stool
90
Nursing for Metamucil
Not absorbable into system, works 8-24 hrs, may take up to 3 days. Mixed in water followed by more water. Doesn’t cause dependence.
91
Classification for bisacodyl (Dulcolax)
Stimulant laxative
92
Action for Dulcolax
Increases peristalsis by irritating nerve endings
93
Side effects for Dulcolax
Nausea, vomiting, cramps
94
Nursing for Dulcolax
Results in 6-12 hrs
95
Classification for diphenoxylate with atropine (Lomotil)
Antidiarrheal
96
Action for Lomotil
Reduces intestinal motility
97
Side effects for Lomotil
Drowsiness, lightheadedness, dizziness, nausea
98
Nursing for Lomotil
Don’t combine with alcohol, should not be used long term (more than 2 days)
99
Classification for aluminum hydroxide (Amphojel)
Antacid
100
Action for Amphojel
Promote ulcer healing by neutralizing hydrochloric acid and reducing pepsin activity. Do not coat the ulcer.
101
Side effects for Amphojel
Aluminum can cause constipation, magnesium can cause diarrhea
102
Nursing for Amphojel
Onset is rapid, duration is ~3 hours. Not used very often for people with GERD because they’d have to take it so often (about 1 hr before meal and 3 hrs after meal)
103
Classification for omeprazole (Prilosec)
Proton pump inhibitor
104
Action for Prilosec
Inhibits the enzyme that produces gastric acid
105
Side effects for Prilosec
Insignificant side effects: some diarrhea, headache. Increased risk for pneumonia.
106
Nursing for Prilosec
Observe for signs of pneumonia, most pts that have an ulcer have to take for ~4 weeks. Monitor for occult bleeding.
107
Classification for ranitidine (Zantac)
Histamine 2 blocker
108
Action for Zantac
Suppresses gastric acid, used for gastric ulcers and GERD
109
Side effects for Zantac
Pregnancy category B, very few adverse effects
110
Nursing for Zantac
Encourage good nutrition, small meals, avoid alcohol/smoking. OTC meds can delay real medical help
111
Classification for sucralfate (Carafate)
Pepsin inhibitor or mucosal protective drug
112
Action for Carafate
Sticks to ulcer to protect it, used for duodenal ulcers
113
Nursing for Carafate
Drink plenty of fluids, watch for constipation
114
Classification for misoprostol (Cytotec)
Prostaglandin E analog
115
Action for Cytotec
Used for people that have longterm NSAIDs prescription
116
Side effects for Cytotec
Pregnancy category X, abdominal pain, nausea
117
Nursing for Cytotec
Pt must use birth control, also used to terminate pregnancy
118
Classification for amoxicillin (Amoxil)
Antibiotic
119
Action for Amoxil and Flagyl
Treatment of infection associated with H. pylori
120
Side effects for Amoxil
Mild GI disturbances, oral/vaginal candidiasis, headache
121
Nursing for Amoxil
Continue for full length of treatment, take with meals if GI upset occurs
122
Classification for metronidazole (Flagyl)
Antibiotic
123
Side effects for Flagyl
Anorexia, nausea, diarrhea
124
Nursing for Flagyl
Urine may be red-brown of dark, avoid alcohol for at least 48 hrs after last dose
125
Dye put into eye to detect defects in corneal epithelium, such as scratches or foreign bodies. Turns bright green and makes green ring around foreign bodies. The dye does appear in nasal secretions and lacrimal ducts so pts should be warned
Diagnostic aids: Fluorescein
126
Can be used for removal of foreign bodies. Administered as eye drops, takes about 1 min to work and lasts about 15 min.
Ophthalmic Topical Anesthetics
127
Used for eye infections such as conjuntivitis, anti-inflammatories may include steroids.
Ophthalmic antiinfectives and antiinflammatories
128
Used for dry eyes, can also be used as artificial tears for comatose pts
Ophthalmic lubricants
129
Used to treat glaucoma and increase fluid production
Antiglaucoma agents
130
Classification for Pilocarpine 0.25 – 10% (Isopto-Carpine)
Miotic
131
Action for Isopto-Carpine
Decreases intraocular pressure, stimulates muscles in eye.
132
Side effects for Isopto-Carpine
Blurred vision, eye irritation, nausea, vomiting, shortness of breath, tachycardia
133
Nursing for Isopto-Carpine
Used daily. Must be used carefully in pts with heart disease. Make sure you hold pressure over inner canthus to decrease systemic absorption. Also available as disc placed in eye every 7 days.
134
Classification for Betaxolol (Betoptic) &
| Timolol (Timoptic)
Miotics
135
Action of Betoptic and Timoptic
Reduce production of aqueous humor, decrease intraocular pressure
136
Side effects of Betoptic and Timoptic
Irritation, burning, tearing, blurred vision, drowsiness, difficulty sleeping
137
Nursing for Betoptic and Timoptic
Remove any exudates in eye before applying solution or ointment, Allow 5 minutes between instillation of another medication, Gently apply pressure to the inner canthus for 2-3 minutes to prevent systemic absorption
138
Classification for Echothiophate (phospholine Iodide)
Miotic
139
Action for Phospholine iodide
constricts pupils
140
Side effects for Phospholine iodide
headaches, sweating
141
Nursing for Phospholine iodide
Teach correct administration
142
Do not give high doses of what to pts with COPD because they will stop breathing
Oxygen
143
Used for pts that are acidotic, often used in cardiac arrest as a code drug
Sodium bicarbonate
144
Classification for dopamine (Intropin)
Adrenergic
145
Action for Intropin
Stimulates sympathetic nervous system and causes vasoconstriction, which increases heart rate.
146
Side effects for Intropin
increased urine output
147
Nursing for Intropin
Given by IV infusion, monitor BP constantly. Given to pts with low BP to increase it.
148
Classification for nitroprusside sodium (Nipride)
Vasodilator
149
Action for Nipride
Used when pt has a very high BP to bring it down.
150
Side effects for Nipride
If exposed to light, the bag turns to cyanide.
151
Nursing for Nipride
Monitor BP constantly. Given by IV infusion. Must be protected from light.
152
Classification for levothyroxine (Synthroid)
Anti-hypothyroidism replacement therapy
153
Action for Synthroid
increases basal metabolic rate
154
Side effects for Synthroid
Weight loss at beginning of therapy. Usually due to overmedication, may have signs of hyperthyroidism: fast heart rate, heart palpitations, weight loss. Black box warning to not be used for weight loss
155
Nursing for Synthroid
Pt must be monitored at beginning of therapy for weight, vitals, height (children), chest pain and palpitations. Pregnancy category A. Monitor blood levels. Pt should always take at same time of day, usually morning before eating. Don’t switch brands.
156
Classification for Nitroglycerine
Anti-anginal
157
Action for Nitroglycerine
Dilates coronary arteries, improves collateral blood flow, dilates some systemic veins and arteries. Decreases preload.
158
Side effects for Nitroglycerine
Headache, dizziness, syncope, contact dermatitis, sublingual tablet does burn, orthostatic hypotension, reflex tachycardia, tolerance may lead to dose increase, severe headaches
159
Nursing for NItroglycerine
Do not use if pt has hypotension, monitor vitals, pt should lie down when taking for first time, if using patches on chest do no defibrillate since patches can explode
160
Classification for Aspirin
Antiplatelet
161
Action for Aspirin
Affects platelets immediately if chewed
162
Nursing for Aspirin
81 mg or 325 mg/day is antiplatelet dose
163
Classification for diazepam (Valium)
Benzodiazepine
164
Action for Valium
Binds with receptors in brain and enhances effects of brain
165
Side effects for Valium
Contraindicated in people that have some form of respiratory depression, severe liver, or kidney disease. Pain with IM administration, fatigue, in overdose pt gets confused and has diminished reflexes
166
Nursing for Valium
Assess vitals (baseline is important in respirations especially), do not stop abruptly with long term use
167
Classification for warfarin (Coumidin)
Anticoagulant
168
Action for Coumidin
Antagonizes Vitamin K, used for treatment of venous thrombosis, atrial fibrillation, prevention of MI and stroke
169
Side effects for Coumidin
GI distress, adverse effect of bleeding. Black box for major or fatal bleeding.
170
Nursing for Coumidin
Watching for bruising, hemorrhage. Risk factors include hypertension, coronary artery disease , past history of GI disease. Vitamin K is reversal agent so avoid foods high in it. Take at same time every day. Many drug/drug interactions. Don’t take aspirin. Pregnancy Category X
171
Classification for Heparin
Anticoagulant
172
Action for Heparin
Inactivates thrombin formation and affects clotting factor 10A so fibrin doesn’t form
173
Side effects for Heparin
Itching, adverse effect of bleeding
Reversal agent is protamine sulfate
174
Nursing for Heparin
Given to pts that already have clots to keep them from getting bigger, also given for high risk of getting clots (bedrest, artificial heart valves, decreased activity). Monitor for bleeding, teach what to do if they cut themselves, use soft toothbrushes & electric razors
175
All insulins are clear except for?
Intermediate-acting
| Humulin N
176
Onset for Rapid -acting:
| Humalog (Lispro)
5-15 min
177
Peak for Rapid -acting:
| Humalog (Lispro)
30-90 min
178
Duration for Rapid-acting Humalog (Lispro)
2-5 hrs
179
Onset for Short-acting:
| Humulin R
30 min
180
Peak for Short-acting:
| Humulin R
2-4 hrs
181
Duration for Short-acting: Humulin R
6-8 hrs
182
Onset for Intermediate-acting
| Humulin N
1-2 hrs
183
Peak for Intermediate-acting Humulin N
6-12 hrs
184
Duration for Intermediate-acting Humulin N
18-24 hrs
185
Onset for Long-acting
| glargine (Lantus)
1 hr
186
Peak for Long-acting glargine (Lantus)
none
187
Duration for Long-acting: glargine (Lantus)
24 hrs
188
any method of allowing a person in pain to administer their own pain relief. The infusion is programmable by the prescriber. If it is programmed and functioning as intended, the machine is unlikely to deliver an overdose of medication.
Patient controlled analgesia
189
What is preprocedure for starting an IV?
```
o Check order
o Assess the patient
o 6 rights
o Wash hands
o Examine the solution
o Prime tubing
o Gloves
o Assess area
o Patient teaching
```
190
What is the procedure for starting an IV?
```
o Use a clean tourniquet or BP cuff
o Select vein
o Untie the tourniquet
o Clean the area
o Remove cover from catheter
o Anchor the vein
o Warn the patient
o Insert the catheter
o Look for flashback
o Lower the hub
o Advance just the catheter
o Stabilize the IV and release the tourniquet
o Apply pressure above the site
o Remove the needle
o Maintain pressure
o Apply dressing
o Avoid covering the site with tape
o Regulate the IV rate
o Throw everything away
```
191
What should you document after starting an IV?
```
o Date and time of insertion
o Insertion site and appearance
o Catheter size
o Type of dressing
o IV fluid and rate
o Number of attempts
o Patient response
```
192
What are long term tunneled catheters called that are used for home therapy?
Hickman
193
What are Hickman catheters flushed with?
Heparin
194
What are long term catheters called that are tunneled and have a single or double lumen?
Groshong
195
What are Groshong catheters flushed with?
Saline
196
What are huber needles (non coring) used for?
To access ports
197
Placed into the epidural space for administration of analgesics
Epidural catheters
198
The use of what an any infusion site is prohibited?
Scissors
199
How does TPN have to be administered?
Central venous access
200
TPN and PPN bags must be changed every _____ hours.
24
201
Used for pts receiving home therapy. Delivered at night while the pt is sleeping.
Cyclic infusions
202
Where can enteral tube feedings be infused into?
Stomach, duodenum, or jejunum
203
What is very important to check with tube feedings?
Gastric residual volumes (GRV)
204
Where should the IV piggyback hang?
Lower than the primary bag
205
When should you flush with saline?
To check the position of the IV catheter
When medications are not compatible
To keep a lock from clotting
206
What are blood and blood products used for?
```
Increase intravascular volume
Replace clotting factors
Replace components of blood
Replace blood loss
Improve oxygen carrying capacity
```
207
What can blood be infused with?
Normal saline
