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Pharmacology (kelsey) > Test 3 (22-35) > Flashcards

Test 3 (22-35) Flashcards

0
Q

Primary Hypertension

A

Elevated systemic arterial pressure for which no cause can be found

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1
Q

Secondary Hypertension

A

High blood pressure associated with renal, pulmonary, endocrine, and vascular disease

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2
Q

Primary effect of diuretic

A

Decrease plasma and extracellular fluid volumes

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3
Q

Another name for primary hypertension

A

Idiopathic, essential

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4
Q

Drugs used in the management of hypertensive emergencies

A

Vasodilators

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5
Q

Orthostatic hypotension

A

A common adverse effect of adrenergic drugs involving a sudden drop in blood pressure when a patient changes position

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6
Q

Drugs used as first line drugs in treatment of both heart failure and hypertension

A

ACE inhibitors

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7
Q

Possible adverse effects of ACE inhibitors?

A

Fatigue, headaches, dry cough

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8
Q

Drug used to treat hypertensive emergencies

A

Sodium Nitroprusside (Nitropress)

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9
Q

Woman in eighth month of pregnancy, has pre eclampsia. BP 210/100. What type of hypertension is this?

A

Secondary

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10
Q

Adverse effect while on beta 1 blocker that may indicate serious problem

A

Edema, shortness of breath

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11
Q

Purpose of antianginal drug therapy

A

Increase blood flow to ischemic cardiac muscle

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12
Q

Common adverse effect of troglycerin (nitrostat)

A

Headache

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13
Q

Nitroglycerin can be given through which routes

A

Sublingual, buccal, continuous IV drip, oral dosage forms, topical ointment

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14
Q

How do we prevent tolerance of nitroglycerin (typically patches)

A

Remove the patch at night for 8 hours and then apply a new patch in the morning

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15
Q

What is important patient teaching with beta blockers (for angina)

A

These drugs are for long-term prevention of angina episodes

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16
Q

Potential Effect of ACE inhibitors

A

Hyperkalemia

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17
Q

Who are most commonly taking Calcium Channel Blockers

A

Patients with Coronary Artery Spasms (For treatment)

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18
Q

Before giving Digoxin, the patient has a radial pulse of 52 bpm. What do you do next?

A

Check apical pule for 60 seconds

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19
Q

What increases chance of digoxin toxicity

A

Low potassium levels

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20
Q

What should you monitor for when infusing Milrinone (Primacor)

A

Cardiac Status

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21
Q

Signs and Symptoms of Toxicity of Digoxin

A 
Anorexia
Visual Changes
Nausea and Vomiting
Headache
Bradycardia
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22
Q

Laboratory tests that are priority with ACE inhibitors

A

Serum potassium leve
Creatinine level
Blood urea nitrogen (BUN)

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23
Q

What medication are you typically taking with Ventricular Dysrythmias?

A

Lidocane (Infusion)

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24
Q

Possible adverse effects of Quinidine (Quinidex)

A

GI upset
Tinnitus
Ventricular Ectopic Beats

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25
Q

Adverse Effect of amiodarone (Cordarone)

A

Pulmonary Toxicity

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26
Q

What medication is used to treat Recurrent Paroxysmal Supraclavicular Tachycardia (PSVT)

A

Verapamil (Calan)

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27
Q

Correct administration of adenosine (Adenocard)

A

Fast intravenous push

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28
Q

If a drug has a prodysrhythmic effect, what must be monitored

A

New Dysrhythmias

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29
Q

Potential drug interaction with quinidine (Quinidex)

A

amiodarone (Cordarone)
digoxin (Lanoxin)
erythromycin (Erythrocin)

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30
Q

A drug that prevents the lysis of fibrin, thereby promoting clot formation.

A

Antifibrinolytic

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31
Q

The termination of bleeding by mechanical or chemical means

A

Hemostasis

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32
Q

A substance that prevents platelet plugs from forming

A

Anti platelet Drug

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33
Q

The general term for a drug that dissolves thrombi

A

Thrombolytic Drug

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34
Q

The general term for a substance that prevents or delays coagulation of the blood

A

Anticoagulant

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35
Q

A laboratory test used to measure the effectiveness of heparin therapy

A

Activated partial thromboplastin time

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36
Q

Two tests used to monitor the effects of drug therapy with warfarin sodium

A 
Prothrombin time (PT)
International Normalized Ratio (INR)
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37
Q

A standardized measure of the degree of coagulation achieved by drug therapy with warfarin sodium

A

International Normalized Ratio

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38
Q

A substance that reverses the effect of heparin

A

Protamine sulfate

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39
Q

A substance that reverses the effect of warfarin sodium

A

Vitamin K

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41
Q

A pharmaceutically available tissue plasminogen activator that is created through recombinant DNA techniques

A

alteplase (Activase)

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41
Q

Anticoagulants are used for which conditions

A

Atrial Fibrillation
Myocardial Infarction
Presence of mechanical heart valve

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42
Q

A blood clot that dislodges and travels through the bloodstream

A

Embolus

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43
Q

Over the counter drug use with warfarin sodium (Coumadin), what to teach the patient

A

Aspirin products mat result in increased bleeding

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44
Q

Which drug is recommended to prevent platelet aggregation for stroke prevention by the American Stroke Society?

A

Aspirin

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45
Q

Which symptoms may indicate a serious problem during thrombolytic therapy

A

Hypotension
Decreased LOC
Increased pulse rate
Restlessness

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46
Q

Which medication must a nurse remember to inject the medication without aspirating for blood return

A

Heparin

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47
Q

What drug is most often used for DVT prevention after orthopedic surgery after the patient has been discharged?

A

Low molecular weight heparins, such as enoxaparin (Lovenox)

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48
Q

Patients taking cholestyramine (Questran) may experience which adverse effects?

A

Belching and bloating

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49
Q

Dietary measures with antilipemic drugs

A

Taking supplements of fat-soluble vitamins
Increasing fluid intake
Choosing foods that are lower in cholesterol and saturated fats
Increasing the intake of raw vegetables, fruit, and bran

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50
Q

Patient will have a cantraindication to antilipemic therapy if they had what condition

A

Liver Disease

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51
Q

Negative (favorable) risk factor for coronary artery disease

A

HDL cholesterol of 75 mg/dL

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52
Q

Good cholesterol

A

HDL

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53
Q

Bad cholesterol

A

LDL

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54
Q

What medication can minimize adverse effects of niacin if taken 30 minutes before dose (of niacin)

A

Ibuprofen (Advil)

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55
Q

Which medications may cause an interaction with the statin drug

A

Warfarin (Coumadin)
erythromycin (Erythrocin)
cyclosporine (Gengraf)
gemfibrozil (Lopid)

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56
Q

Potent drugs that act along the ascending limb of the loop of Henle; furosemide is an example

A

Loop diuretics

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57
Q

Abbreviation for the term that describes a gauge of how well the kidneys are functioning as filters

A

GFR

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58
Q

A general term for drugs that accelerate the rate of urine formation

A

Diuretics

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59
Q

The main structural unit of the kidney

A

Nephron

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60
Q

Part of the kidney structure located between the proximal and distal convoluted tubules

A

Loop of Henle

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61
Q

Diuretics that result in the diuresis of sodium and water and the retention of potassium; sironolactone is an example

A

Potassium-sparing diuretics

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62
Q

Diuretics that act on the distal convoluted tubule, where they inhibit sodium and water resorption; hydrochlorothiazide (HCTZ) is an example

A

Thiazides

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63
Q

Abbreviation for a class of diuretics that inhibit the enzyme carbonic anhydrase; acetazolamide is an example

A

CAIs

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64
Q

Drugs that induce diuresis by increasing the osmotic pressure of the glomerular filtrate, which results in rapid diuresis; mannitol is an example

A

Osmotic diuretics

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65
Q

An abnormal intraperitoneal accumulation of fluid

A

Ascites

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66
Q

Indications for the use of diuretics

A

Increase urine output
Treat hypertension
Treat open angle glaucoma
Treat edema associated with heart failure

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67
Q

Dietary guidelines for potassium-sparing drug such as spironolactone (Aldactone)?

A

Avoid excessive intake of foods high in potassium

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68
Q

Best time to take medication during diuretics therapy

A

Morning

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69
Q

Symptoms of hypokalemia related to diuretic use

A

Muscle weakness and lethargy

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70
Q

Reason for short treatment of CAI in heart failure

A

Metabolic acidosis develops in 2 to 4 days after therapy is started

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71
Q

Condition that may be a contraindication of spironolactone (Aldactone)

A

Renal Failure

Hyperkalemia

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72
Q

Common uses of crystalloids

A

Fluid replacement
Promotion of urinary flow
Replacement of electrolytes
As maintenance fluids

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73
Q

High TSH

A

Hypothyroidism

Decreased of T3 and T4

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74
Q

Low TSH

A

Hyperthyroidism

Increase in T3 and T4

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75
Q

IV of normal saline (NS) at 100mL/hr, what concentration will be used

A

0.9%

76
Q

IV administered for severe dehydration

A

0.9% sodium chloride

77
Q

What is important to remember when giving IV potassium

A

Potassium must always be given in diluted form

78
Q

What product will be given when a patient with a blood disorder needs tranfusion

A

Fresh frozen plasma

79
Q

What signs should you monitor for when patient is receiving blood products

A

Apprehension, restlessness, fever, and chills

80
Q

Functions of Adrenocorticotropic hormone (ACTH, corticotropin)

A

Targets adrenal glands
Mediates adaptation to stressors
Promotes synthesis of the following three hormones (glucocorticoids, mineralocorticoids, androgens)

81
Q

Appropriate actions by nurse when patient is taking conivaptan (Vaprisol)?

A

Report serum levels of 149mEq/L

82
Q

Mimicking drug of Adrenocorticotropic hormone (ACTH, corticotropin)

A

Cosyntropin

83
Q

Functions of Growth hormone

A 
Regulates anabolic processes related to growth and adaptation to stressors
Promotes skeletal and muscle growth
Increases protein synthesis
Increased liver glycogenolysis
Increased fat mobilization
84
Q

Mimicking drug of growth hormone

A

Somatropin and somatrem

85
Q

Functions of Antidiuretic hormone (ADH)

A

Increases water resorption in distal tubules and collection duct of nephron
Concentrates urine
Potent vasoconstrictor

86
Q

Mimicking drugs of Antidiuretic hormone

A

Vasopressin and Desmopression

87
Q

Function of Oxytocin

A

Promotes uterine contraction

88
Q

Mimicking drug of oxytocin

A

Pitocin

89
Q

Test for Diabetes

A

A1C

90
Q

Prior assessment for Vasopressin

A

Blood pressure

91
Q

Purpose of octreotide (Sandostatin) in patient with metastatic carcinoid tumor

A

Helps to control the flushing and diarrhea that you are experiencing

92
Q

Nursing diagnosis most appropriate for patient taking pituitary drug

A

Disturbed body image

93
Q

How to obtain maximum benefit from desmopressin acetate as a nasal spray

A

Clear the nasal passages before spraying the medication

94
Q

During vasopressin therapy, what is the priority nursing action

A

Monitor the IV site for sign of infiltration

95
Q

Closely monitor what when taking octreotide (Sandostatin) therapy

A

Blood glucose levels

96
Q

The type of hypothyroidism that results from insufficient secretion of thyroid stimulating hormone (TSH) from the pituitary gland

A

Secondary

97
Q

The principal thyroid hormone that influences the metabolic rate

A

Thyroxine

98
Q

The type of hypothyroidism that is due to inability of the thyroid gland to perform a function

A

Primary

99
Q

The most commonly prescribed synthetic thyroid hormone

A

Levothyroxine

100
Q

Excessive secretion of thyroid hormones

A

Hyperthyroidism

101
Q

A drug used to treat hyperthyroidism

A

Propylthiouracil

102
Q

The type of hypothyroidism that stems from reduces secretion of thyrotropin-releasing hormone from the hypothalamus

A

Tertiary

103
Q

Another name for TSH

A

Thyrotropin

104
Q

Nurse responds to patient wanting to switch to a different brand of levothyroxine (Synthroid)

A

Check with provider before switching

105
Q

How long after beginning levothyroxine (Synthroid) will it start working

A

Within a few weeks

106
Q

What foods need to be avoided when taking antithyroid medications

A

Soy products and seafood

107
Q

What information needs to be included in the nurse’s teaching of patients taking thyroid medication

A

Keeping a log or journal of individual responses and a graph of pulse rate, weight, and mood would be helpful
The medication needs to be taken at the same time every day
Nervousness, irritability, and insomnia may be a result of a dosage that is too high

108
Q

What medication order needs to be made before a radioactive isotope study is scheduled when taking levothyroxine (Levothroid)

A

Stop the levothyroxine 4 weeks before the test

109
Q

What is the most immediate and serious adverse effect of insulin therapy

A

Hypoglycemia

110
Q

Which type of insulin is long acting (taken at bedtime)

A

Glargine

111
Q

Which type of insulin is used for an IV drip to control high blood glucose levels

A

Regular

112
Q

Signs of hypoglycemia

A

Irritability
Sweating
Confusion

113
Q

When would a nurse administer the drug acarbose (Precose)

A

With the first bite of a meal

114
Q

What information would be important to provide regarding the mechanism of action of glipizide (Glucotrol)

A

Increases insulin production

115
Q

What condition is a contraindication of the amylin mimetic drug pramalintide (Symlin)

A

Gastroparesis

116
Q

Monitor for significant interaction if sitagliptin (Januvia) is given with…

A

Sulfonylureas

117
Q

What are rapid acting antidiabetic drugs?

A 
Insulin lispro (humalog)
Insulin aspart (novolog)
Glulisine (apidra)
118
Q

What is the onset for rapid acting antidiabetic drugs?

A

5-15 minutes

119
Q

What is the onset for short acting antidiabetic drugs?

A

30-60 minutes

120
Q

What is the short acting antidiabetic drug?

A

Humulin R (regular) IV

121
Q

What is the onset for intermediate acting antidiabetic drugs?

A

1-3 hours

122
Q

What is the intermediate acting antidiabetic drug?

A

NPH (cloudy)

123
Q

What are the long acting antidiabetic drugs?

A

Glarine (lantus)

Detemir (levemir)

124
Q

Long acting insulin drugs are also called what kind of insulin?

A

Basal insulin

125
Q

Why can you not suddenly stop taking prednisone (Deltasone), even when the dose gradually decreases

A

Sudden discontinuation of this medication may result in adrenal insufficiency

126
Q

Preferred oral glucocorticoid for anti-inflammatory or immunosupressant purposes

A

prednisone (Deltasone)

127
Q

Adverse effects of coritcosteroids

A

Fragile skin, Hyperglycemia, Nervousness

128
Q

Drug that is used to inhibit the function of adrenal cortex in the treatment of Cushing’s syndrome

A

aminoglutethimide (Cytadren)

129
Q

Nursing diagnosis for “moon face”, facial redness, and many bruises on arms

A

Disturbed body image

130
Q

What patients will be monitored when taking corticosteroids? Why?

A

Heart Failure patients

b/c they may cause sodium retention

131
Q

Adverse effects of aminoglutethimide

A

Dizziness
Anorexia
Lethargy

132
Q

Important health history factors when administering oral contraceptives

A

Pregnancy
Thrombophlebitic disorders
Estrogen-dependent cancers

133
Q

When combination oral contraceptives are given for emergency contraceptive (Plan B), what must be remembered

A

The are not effective if the woman is already pregnant

134
Q

Purpose for dinoprostone cervical gel (Prepidil)

A

To improve cervical ripening near term for labor induction

135
Q

Pharmacologic measures are used to stop contractions in pregnancy is okay during what time frame

A

Between the 20th and 37th weeks

136
Q

Patient teaching that is important when taking alendronate (Fosamax)

A

Take with 8-oz glass of water
Take first think in the morning upon arising
Do not lie down for at least 30 minutes after taking

137
Q

Potential adverse effects of raloxifene (Evista)

A

Leg cramps

Hot flashes

138
Q

What is important to know about taking steroids to “beef up”

A

Long-term use may cause a life-threatening liver condition

139
Q

When would androgens be prescribed for women

A

Fibrocystic breast disease
Treatment of endometriosis
Inoperable breast cancer

140
Q

Teaching about transdermal testosterone (Testoderm); testosterone therapy

A

Apply patch only to the scrotum

141
Q

What lab test needs to be performed before therapy with finasteride (Proscar)

A

Prostate specific antigen (PSA) level

142
Q

What is important teaching for finasteride (Proscar) if a pregnant woman is involved

A

This medication should not be handled by pregnant women because it may harm the fetus

143
Q

Drug that can be used for male baldness (androgenetic alopecia)

A

finasteride (Propecia)

Low dosages

144
Q

Drug that would cause significant interaction with sildenafil (Viagra)

A

isosorbide dinitrate (Isordil), nitrate

146
Q

Adverse effects for finasteride (Proscar)

A

Loss of Erection
Gynecomastia
Ejaculatory dysfunction

147
Q

Which hypertensives are considered more effective in white patients than in African American patients

A

Beta blockers and ACE inhibitors

148
Q

Which hypertensives are considered more effective in African American patients than in white patients

A

Calcium channel blockers and diuretics

149
Q

Best ACE inhibitor for patient with liver dysfunction, seriously ill, and high blood pressure

A

Captopril; short half life (if problem arrives then they are short lived); not a prodrug

150
Q

Best ACE inhibitor for patient with history of poor adherence to medication regimine

A

Drug with a long half life and long duration of action

Benazepril, fosinopril, lisinopril, quinapril, ramipril

151
Q

What should be taught before the first dose of prazosin (Minipress)

A

Must be lying down and arise slowly because it will cause a sudden decrease in blood pressure because it has a first dose effect.

152
Q

How would you administer a 0.2 mg/hr of a transdermal nitroglycerin patch, when there are only 0.4 mg/hr available

A

Call the provider and DO NOT CUT IT IN HALF

153
Q

Adverse effect you might see with a beta blocker

A

Lethargy, depression, unusual dreams

154
Q

Adverse effects of glycosides

A

Vomiting, headache, fatigue, dysrhythmias

155
Q

Positive intropic effect

A

Increases myocardial contractility

156
Q

Negative chronotropic effect

A

Decreases heart rate

157
Q

Negative dromotropic effect

A

Slows the conduction of electrical impulses in the heart

158
Q

Digioxin effects on stroke volume

A

Increases

159
Q

Digoxin effect on venous blood pressure and vein engorgment

A

Decreased

160
Q

Digoxin effects on coronary circulation

A

Increased

161
Q

Digoxin effects on diuresis

A

Increased due to improved circulation

162
Q

Drug for management of life-threatening ventricular tachycardia

A

Amiodarone

163
Q

Amiodarone caused conditions

A 
Hypothyroidism
Hyperthyroidism
Corneal microdeposits
Pulmonary toxicity
Dysrythmias
164
Q

Lidocaine administration

A

Injected IM or IV

165
Q

Expected therapeutic effects of verapamil (Calan)

A

Prevention or reduction of supraventricular rhythms

166
Q

adenosine (Adenocard) use

A

Useful for the treatment of PSVT (paroxysmal supraventricular tachycardia) that has failed to respond to verapamil

167
Q

What is the antidote for warfarin toxicity

A

Vitamin K (use lowest amount possible)

168
Q

Use of antifibrinolytic drugs

A

Stop excessive oozing from surgical sites

169
Q

What condition is Desmopressin used for and why

A

Patients with type IWillebrand’s disease; it increases the levels of clotting factor VIII

170
Q

What herbal products should be avoided when taking clopidogrel (Plavix)

A

Products that contain St. John’s wort, garlic, ginger, ginseng, and ginkgo because they have anticoagulant properties

171
Q

Important patient teaching about atorvastatin (Lipitor)

A

Dietary guidlines should still be followed for the antilipemic medication to be effective

172
Q

What is an uncommon but clinically important side effect of statins

A

Myopathy (muscle pain)

173
Q

Generic drugs that decrease cholesterol synthesis end with this suffix

A

“statins”

174
Q

Patient (taking Lasix/furosemide for 3 months) is feeling tired, has muscle weakness, no appetite, BP is 100/50, what does this suggest and how did it happen?

A

Suggest hypokalemia; Furosemide causes potassium to be excreted along with sodium and water

175
Q

What type of food should you maybe avoid while taking furosemide (Lasix)

A

Foods high in potassium, including, bananas, broccoli, oranges, apricots, dates, raisins, green beans, potatoes, tomatoes, meats, fish, wheat bread, and legumes

176
Q

How does spironolactone (Aldactone) differ from furosemide

A

Spironolactone is a potassium sparing diuretic; it causes sodium and water to be excreted, but potassium is retained

177
Q

What is the normal protein level

A

Around 7.4 g/dL

178
Q

How will albumin work to help with chronic malnutrition causing hypopreoteinemia

A

The albumin will increase the colloid oncotic pressure (COP) and move fluid from outside the blood vessels to inside, thus reducing the edema

179
Q

What is cosyntropin (Cortrosyn)

A

The diagnosis of adrenalcortical insufficiency, NOT treatment

180
Q

How do you administer vasopressin

A

Injections, either IM or SC, two to four times a day

181
Q

What are the most damaging or serious adverse effects of propylthiouracil (PTU)

A

Liver and bone marrow toxicity; important to asses liver function and do complete blood count during therapy

182
Q

Symptoms associated with hyperglycemia

A

Fatigue, polydipsia

183
Q

Symptoms associated with hypoglycemia

A

Irriratability, tremors, sweating

184
Q

How do oral contraceptives effect adrenal drugs

A

They increase the half life

185
Q

Important teaching about corticosteroids

A

They must not be stopped suddenly; because these drugs cause endogenous (body’s own) production of the hormones to stop.

186
Q

-pril

A

ACE inhibitor

187
Q

-olol

A

Beta Blocker

188
Q

-dipine

A

Calcium Channel Blocker

189
Q

-mycin

A

Aminoglycocide

Pharmacology (kelsey) (1 decks)

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