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Pharmacology-RN > Test 3 > Flashcards

Test 3 Flashcards

1
Q

How are obstructive and restrictive diseases different?

How are they managed?

A

Obstructive diseases respond to medications that open the airway.

Restrictive diseases require removal of outer forces that prevent lung expansion

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2
Q

8 causes of dyspnea and note the differences in medication management

A

Heart failure

Asthma

Pneumonia

Clot

Farmers lung

Abd distention

Anemia

Fever

Pain

Metabolic acidosis

Copd

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3
Q

Side effects of spiriva and related precautions

A

Anticholinergic effects

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4
Q

Side effects of advair and related precautions

A

Adrenergic effects and thrush due to steroid immune suppression

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5
Q

Side effects of albuterol and related precautions

A

Adrenergic effects ( tachycardia? HTN, tremors, nervousness )

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6
Q

What is a duoneb and how is it different from combivent

A

They are the same. Combo of albuterol and ipratropium

One is an inhaler and one is a neb tx

Neb is more powerful

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7
Q

Can inhalers be given to people who are having allergic reactions ?

A

Yes but they won’t suppress acute immune flares

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8
Q

How are albuterol and salmetrerol different

A

Salmeterol- is a maintenance Rx

Albuterol is a rescue Rx

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9
Q

How are tiatrooium and ipatropium different

A

Tiatrooium (spariva) is maintenance RX

Ipratropium is more rapid acting

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10
Q

How are fluticasone and Atrovent different ?

A

Flovent - Immune suppressor

Atrovent - ipratropium is a bronchodilator

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11
Q

Risks of aminophylline toxicity ?

A

Seizures and arrhythmias

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12
Q

Normal aminophylline toxicity

A

10-20mcg

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13
Q

Difference between robitussin and guaifensin

A

Guaifensin is the generic name for robitussin

Mucinex and gerituss preparations

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14
Q

3 ways that neurological disturbances can affect respiration

A

Pressure on the brain stem, dropping rate and depth of respiration’s, impairing respiratory muscles and ability to cough

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15
Q

What is carafate ?

What type of compound

A

A coating medication that protects the stomach from acid erosion

Aluminum compound

Adheres to gastric lining

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16
Q

How and when is carafate given?

A

It is going to before eating and apart from other medications, especially reflux meds and antibiotics

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17
Q

How Are carafate and antacids different from H2 blockers and Proton pump inhibitors?

A

H2 blockers and PPis reduce acid production

Carafate protects the stomach from acid erosion

Antacids neutralize acid and can be taken after the meal of heartburn occurs

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18
Q

How is hyperacidity treated in renal patients ??

A

With calcium carbonate, PPIs and H2 blockers

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19
Q

What antiacids should renal patients avoid ??

A

Magnesium and aluminum

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20
Q

Should reflux medications be given with food or on a empty stomach?

A

1/2 hour before meals

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21
Q

What meds should not be given with antacids?

A

Tetracyclines, quinolones, PPIs , Carafate, H2 blockers

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22
Q

What’s meds should NOT be taken on an empty stomach?

A

Prednisone, NSAIDS, Lytes and griseofulvin

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23
Q

What is the difference between Reglan and Zofran ?

A

Reglan has direct acting cholinergic effects and blocks dopamine in the CNS

Zofran acts on the CNS by blocking 5HT3 (serotonin) receptors

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24
Q

Why might a systemic reaction occur after giving prn Compazine?

A

It is a phenothiazine (neuroleptic)

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25
Q

If lomotil is part noneuphiric opiates and part atropine, what might be the side effects?

A

Anticholinergic effects: constipation, urine retention, tachycardia and pupil dilation

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26
Q

How is irritable bowel syndrome treated?

A

With anticholinergic

and perhaps benzodiazepines

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27
Q

How are colonic infections treated?

A

Hydration and probiotics

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28
Q

Should people with Cdiff be treated with steroids to suppress inflammation?

A

No!

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29
Q

What causes Cdiff and how is it treated ?

A

Loss of normal flora due to immune suppression or antibiotics

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30
Q

What nursing precautions should be taken when caring for patients with C-Diff

A

Contact precautions

Do not rely on hand sanitizers

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31
Q

Which medications cause constipation

A

Opiates, anti-cholinergics, trazodone, tramadol, psychotropics

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32
Q

What situations cause constipation?

A

Immobility , trauma, hypokalemia

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33
Q

Name 5 meds that promote bowel motility

A

Miralax or Metamucil , colace, senna, milk of magnesia

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34
Q

What is the protocol for constipation ?

A

Miralax or Metamucil , colace, senna, milk of magnesia in that order , then Suppositories, then enemas

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35
Q

What are the risks of too many laxatives?

A

Dependency, dehydration, electrolyte depletion

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36
Q

Three problems associated with nitroglycerin

A

Headache, hypertension, fall risk

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37
Q

Three problems associated with calcium channel blocker’s

A

Edema, constipation, orthostatic hypotension

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38
Q

problems associated with beta blockers

A

Hypotension, Bradycardia , wheezing , and hypoglycemia

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39
Q

Ace inhibitor problems

A

Cough and hyperkalemia

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40
Q

Lanoxin problems

A

Bradycardia, arrhythmias of toxic (level 2.2, green halo vision, gi upset)

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41
Q

Problems that can occur with critical drip rates for shock?

A

Peripheral and renal ischemia and injury

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42
Q

Problems that may occur with atropine ?

A

Tachycardia, dry mouth , constipation, urine retention, blurred vision, dilated pupils

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43
Q

Problems that may occur with statins

A

Muscle break down (rhabdomyolisis) with grapefruit juice , risk of liver injury

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44
Q

Problems that may occur with ventricular arrhythmias?

A

Backward contractions don’t perfusion , systemic hypoxia

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45
Q

Supraventricular arrythmias- problems that may occur

A

drop in cardiac output due to lack of ventricular fill time

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46
Q

Problems let me be associated with atrial Fibrillation

A

Clot formation, drop in cardiac output due to loss of atrial kick

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47
Q

Problem is it may be associated with Bradycardia

A

syncope (falls), drop in cardiac output (poor perfusion) due to c.o=HRxSV

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48
Q

What to know when giving or teaching patients about Coumadin

A

Watch INR

Report black tarry stools, bruising , pink urine

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49
Q

What to know when giving or teaching patients about lanoxin

A

Hold of apical pulse below 60

Report visual disturbances

Report GI upset

Report Less than -Level 2.0

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50
Q

What to know when giving or teaching patients about atropine

A

Don’t feed after giving patient

Watch for urine retention (catch PRN)

Keep lights low

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51
Q

What to know when giving or teaching patients about beta blockers

A

Check pulse and BP before giving, watch glucose and lung sounds

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52
Q

What to know when giving or teaching patients about nitroglycerin

A

Check BP before giving

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53
Q

What to know when giving or teaching patients about lasix

A

Watch potassium, take potassium unless also taking ace inhibitor, Sparta or potassium sparing diuretic

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54
Q

What to know when giving or teaching patients about Potassium

A

Don’t crush

Give with food

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55
Q

3 types of meds that reduce risk of plaque development in veins

A

Anti-hypertensives

Statins

Anti-platelets

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56
Q

Name three measures for chest pain

A

Lay down or sit

Check BP

Offer nitro and ASA

Call 911 is nitro doesn’t resolve it

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57
Q

Name Rx meds to reduce MI risk

A

Anti-anginals

Anti-hypertensives

Statins

Antiplatelets

Anticoagulants

58
Q

What is the cause of pulmonary edema and what can be done to prevent it

A

Back pressure of fluids into the lungs when the left ventricle can’t keep up with everything coming into it

59
Q

What does the following lab tell us? Troponin ?

A

Myocardial injury

60
Q

What does the following lab tell us? BNP

A

Heart failure (atrial stretch)

61
Q

What does the following lab tell us? EKG

A

Where damage or ischemia is occurring (what part of the heart)

62
Q

What does the following lab tell us? Echocardiogram

A

Structural damage (heart walk stasis, septal defect or valve damage)

63
Q

What OTC meds should renal patients be counseled not to take?

A

ASA

MOM

Fleets

Gaviscon

64
Q

When do Renal patients need to go on dialysis?

A

BUN: 70

Creatine: 7

Potassium greater than 5.5

Metabolic acidosis

65
Q

At what point should fluids be restricted in renal patient

A

If creatine above 5

66
Q

Who should be on a no added salt diet

A

Renal patient ?

Consider salt substitute but not is retaining potassium

67
Q

What is the difference between LDL and HDL

A

LDLs turn to plaque

HDLs do not

68
Q

How are spironoactone, lasix and dyazide different ?

A

Potassium sparing vs potassium wasting vs combo RX

69
Q

Report bilat muscle aches in legs

A

Statins

70
Q

Avoid grapefruit when taking this

A

Statin

71
Q

Hold if pulse is below 60

A

Digoxin

72
Q

What meds have no antidote if bleeding

A

Ibans

73
Q

This med gives you a headache

A

Nitro

74
Q

Hold if level is above 2 or if see yellow halo vision

A

Digoxin

75
Q

Do not give with lithium Or NSAIDS

A

Diuretics

76
Q

Expect constipation and edema with this med

A

Calcium channel blockers

77
Q

Warn against taking with viagra

A

Nitro

78
Q

When to give statins

A

At HS

79
Q

How to give nitro

A

Every 5 minutes

Only when sitting

80
Q

Antidote to herparin

A

Protamine sulfate

81
Q

What not to give at HS

A

Diuretics

Prils

82
Q

When to give protamine sulfate

A

If PTT is too high

83
Q

Pril side effect

A

Cough

84
Q

Cdiff prevention

A

Take probiotics

Flagyl

Vancomycin

Metronidazole

Rifaximin

85
Q

IBS tx

A

Increase chloride and bicarbonate output to stimulate peristalsis

Linzess

86
Q

What is used to prevent diarrhea

A

Non euphoric opiates

Such as Imodium

Paragoric

Lomotil

87
Q

Dopamine blockers used for nausea control

A

Reglan

Conpazine (risk of depression and movements )

88
Q

Serotonin blockers to reduce nausea

A

Zofran

Lotronex

89
Q

Opiate adjuvants for nausea control

A

Phenergan
(Promethazine)

Vistaril
(Hydroxyzine)

90
Q

Bronchodilator/rescue meds with adrenergic effects

Side effects

A

Albuterol

Anxiousness and tremors

Drops potassium

91
Q

Calcium/tums (antacid) cause what side effect

A

Constipation

92
Q

Acid suppressors

Meds and what do they lead to

A

PPIs (prazoles)

Tidines (H2 blockers)

Diarrhea

93
Q

Lining protective (meds)

Compound type

A

sucralfate -carafate

Adheres to gastric lining

Aluminum compound

94
Q

Bronchodilator/rescue meds with adrenergic and anticholinergic effects

A

Combination of and albuterol

Combivent vs duoneb

Use one or the other (never both)

95
Q

Bronchodilator/rescue meds with anticholinergic effects

A

Ipratropium

Increases heart rate

Bad for glaucoma

Increased UTI risk

96
Q

Maintenance anticholinergic (dry) agents for resp

A

Spiriva

Once a day

Causes constipation

Worsens glaucoma —

Increased UTI

Do not use with BPH—

97
Q

Maintenance adrenergic agents for resp

How often to take

A

Salmeterol (sevent)

Twice a day

Never for rescue

98
Q

Maintenance anticholinergic and adrenic combo agents for resp

What to watch for ??

A

Advir (erol,asone, nide)

Breo

Symbicort

Watch for thrush!

99
Q

How to treat thrush

A

Mycostatin

100
Q

Steroid maintenance drugs

What to do after inhaling

A

Fluticasone

Beclonethasone

Rinse after inhaling

101
Q

What to watch for with anti-inflammatory resp steroids

A

Increased glucose

Decrease potassium

Take with food

Hydrocort

Medrol

102
Q

Non steroid agents to prevent inflammation

A

Antihistamines

Claritin

Benedryl (dine)

103
Q

Cough agent suppressors

Best for COPD

A

Codiene

Dextromethophan

104
Q

Expectorant cough agent

A

Robitussin / tussin/ mucinex

105
Q

Mucolytic cough agent also used to treat Tylenol overdose and cystic fibrosis

A

Acetylcystiene (mucomyst)

106
Q

Digoxin does not decrease what

A

Blood pressure

107
Q

Atropine side effects with eyes

A

Dialated eyes

Dim lights

108
Q

Normal PTT

A

60-80

109
Q

INR normal lab

A

2-3

110
Q

Platelet normal lab

A

150,000-450,000

111
Q

What meds increase Coumadin levels

A

Antibiotics and steroids

112
Q

Anitidote for Coumadin

Stay away from what

A

Vitamin k or green leafy veggies

Herbals

113
Q

Stay away from what with statins

A

Grapefruit

114
Q

Treatment with pulmonary embolism

A

Oxygen

115
Q

Lung sound with farmers lung

A

Crackles

116
Q

Statins (cholesterol)

Zocor , Crestor , Lipitor , mevacor

What labs to watch

A

Liver enzymes

117
Q

When to hold antiplatelet meds (plavix , ticlid, baby ASA, persantin)

Don’t give with what

A

Hold if PLatelets are low below 150k.

Anticoagulants besides baby ASA

118
Q

How long does it take for anticoagulants to come into full effect

A

A week

119
Q

What enhances effects of Coumadin

A

Antibiotics , alcohol, herbs , garlic, cranberry

120
Q

Alternative meds to no Coumadin

No labs

Report bruising

A

Pradaxa

Xarelto

Eliquis

121
Q

Heparin works how fast

How to give?
how not to give why?
Diet?

A

Quickly

No diet restrictions

Given subQ when stable

Never give IM!!! Hematoma will occur

122
Q

This dissolves clots so it can cause bleeding

Effect lasts how long

A

TPA

2-3 hours

123
Q

Beta blockers (vasodialator)

Used for

Side effects

When to hold

A

Arrhythmias

Hold if pulse below 60 or if systolic below 100
Unless doctor says otherwise

Olols

Mask hypoglycemia

Cause wheezing

124
Q

What to do before giving calcium channel blockers (vasodilator)

A

Check pulse and BP

Hold if either is low

125
Q

Vasolating Anti arrhythmics do what

Side effects

What not to take with

A

Block sodium and potassium and calcium

Constipation and edema

No grapefruit

126
Q

Anti arrhythmic rhythm rx that does not drop BP

What does it do?

When to hold

Target level?

Side effect of toxicity

What indicates toxicity

A

Digoxin
(Slows and strengthens pulse)

Hold if HR is below 60

0.8-1.8

Toxicity green halos

Electrolyte increase or decrease may indicate toxicity along with rhythm

127
Q

Atropine is what type
Of med

What to know

A

Anticholinergic

Increased HR

Don’t feed after giving

watch for Bladder distension

Dialate pupils

Dim lights

128
Q

Anti hypertensive diuretics

A

Loop and thiazides

Potassium sparing

Dyazide

129
Q

Loop and thiazides
(lasix, HCTZ)
Do what?

How to give

What to eat with

A

Reduces edema/fluids, decreases HTN

Give in AM

Give with food

Dissolve in water, never crush

Never push IV

Encourage bananas , oranges (replace potassium) that is lost with fluid

130
Q

Potassium sparing diuretic (antihypertensive)

Aldactone , angiotension, prils, Sartans

May cause what ?

Dietary restrictions ?

A

Arrythmias if potassium is greater than 5

No salt substitutes

131
Q

When will a patient be NPO

A

Epigastric pain, acute pancreatitis, bloody vomit , gag reflux diminished

132
Q

What med will heal the stomach over time

A

PPIs

133
Q

When to take protonix and how many times a day

A

30 min before meals up to 4 x a day

134
Q

Phenergan EPS causes

A

Distonia

135
Q

When to take montelulaskt why?

A

Evening

Can prevent asthma while asleep

136
Q

What antacid is safest for renal failure

A

Tums because aluminum and magnesium are bad for renal failure

137
Q

Calcium lab

A

8-10

138
Q

Normal potassium

A

3.5-5

139
Q

Sodium levels

A

135-145

140
Q

Magnesium levels

A

1.5-2.5

141
Q

PTT LEVELS

A

25-35 seconds?

142
Q

Digoxin

A

0.5-2

Pharmacology-RN (3 decks)

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