UNIT 1 PHARMACOLOGY

Question 1

Medications for Chlamydia

Answer 1

Doxycycline and Azithromycin (both inhibit protein synthesis)

Question 2

Alternate Meds for Chlamydia

Answer 2

Erythromycin, ofloxacin, or levofloxacin

Question 3

Pt education for Doxycycline

Answer 3

Avoid sun exposure
Do not take with antacids, iron, or dairy

Question 4

Medication for HPV

Answer 4

No medication cures HPV, only treats symptoms.

Acyclovir, famciclovir, and valacyclovir

Question 5

Medications for Herpes

Answer 5

Acyclovir, famciclovir, and valacyclovir (Zovirax)

+++ analgesics for pain

Question 6

Comfort measures for Herpes

Answer 6

warm sitz bath, cotton underwear, and loose-fitting clothes

Question 7

Meds for Gonorrhea

Answer 7

Ceftriaxone (Rocephin)

Question 8

Meds for Syphilis

Answer 8

Penicillin G (used for all stages & safe for pregnancy)

Question 9

Alt meds for syphilis

Answer 9

doxycycline (unsafe in pregnancy), tetracycline (unsafe in pregnancy), erythromycin (unlikely to cure fetal infection)

Question 10

Meds for PID

Answer 10

Ceftriaxone, Metronidazole (flagyl), ofloxacin, doxyxycline (vibramycin)

Question 11

Pt education for Metronidazole

Answer 11

avoid alcohol & can cause numbness, pain, hives, weakeness

Question 12

Meds for Candidiasis

Answer 12

Antifungal: Miconazole (Monistat)

Antibiotic: Ketoconazole (monitor for liver functions)

Question 13

Pt education for ketoconazole

Answer 13

avoid sun and alcohol

Question 14

Comfort care for candidiasis

Answer 14

sitz bath w/ oatmeal powder to decrease inflammation

Question 15

Meds for Trichomoniasis

Answer 15

Metronidazole (Flagyl)

Question 16

What pharmacologic agent is indicated for pain during pregnancy?

Answer 16

Acetaminophen (analgesics)

Question 17

What pharmacologic agent is indicated for the prevention of spina bifida during pregnancy?

Answer 17

folic acid

Question 18

What pharmacologic agent is CONTRAINDICATED for depression during pregnancy?

Answer 18

tricyclic antidepressants

Question 19

What pharmacologic agent is indicated for the promotion of uterine relaxation during pregnancy? (minimizes risk of preterm labor)

Answer 19

progesterone

Question 20

What pharmacologic agent is indicated for blood type difference during pregnancy?

Answer 20

Rhogram (RH immune globulin)

Question 21

What pharmacologic agent is indicated for preterm labor during pregnancy?

Answer 21

Tocolytics (rifedipine)

Question 22

What pharmacologic agent is indicated for preeclamptic pt’s and preterm labor during pregnancy?

Answer 22

magnesium sulfate

Question 23

What pharmacologic agent is indicated for vomiting during pregnancy?

Answer 23

Antiemetics (promethazine, ondansetron)

Question 24

Assessment required prior to antidepressant administration

Answer 24

suicide assessment

Question 25

SSRI's 1. Drug type 2. S/E 3. PT Education 4. Assessment

Answer 25

1. First choice antidepressant (fluoxetine, paroxetine, sertraline, citalopram, and escitalopram) 2. Least # of side effects; S/E are drowsiness, low libido, insomnia, dizziness 3. Takes 3-6 weeks to take effect (depression); 8-12 weeks for therapeutic effect (anxiety) 4. SUICIDE ASSESSMENT B4 GIVING MED - some young ppl will experience thoughts of suicide when beginning SSRI

Question 26

SNRI's 1. Drug type 2. S/E 3. Assessment

Answer 26

1. Antidepressant (duloxetine/Cymbalta) 2. S/E are HTN, nausea, dizziness, swelling, loss of appetite, abnormal dreams 3. SUICIDE ASSESSMENT B4 GIVING MED

Question 27

TRICYCLICS (3rd or 4th tier choice) 1. Drug type 2. S/E 3. PT considerations 4. Assessment

Answer 27

1. LAST CHOICE Antidepressant b/c side effects (amitryptyline, amoxapine, clomipramine (used for OCD), imipramine) 2. jitteriness (when first taken), constipation, increased eye pressure, urinary retention, rash, sexual dysfunction, liver failure, abd. cramps, HTN, seizures, AFIB, etc.... 3. May increase anxiety in older adults, start w/ low dose 4. SUICIDE ASSESSMENT B4 GIVING MED

Question 28

MAOI's (2nd or 3rd tier choice) 1. Drug type 2. PT Education 3. Assessment 4. PT !!! Consideration

Answer 28

1.LAST CHOICE Antidepressant 2. Foods including tyramine for example, chocolate, red wine, cheese, nuts, tofu, many meats, beans, fruit (raspb., pineal., plums, figs) 3. SUICIDE ASSESSMENT B4 GIVING MED 4. NEVER USED AS FIRST LINE MED, FATAL INTERACTION W/ Phenelzine, Selegiline, and Isocarboxazid

Question 29

LITHIUM 1. Drug type 2. Dosage considerations 3. PT Education 4. Assessment

Answer 29

1. Anti-psychotic; first choice for MANIA in BIPOLAR DISORDER 2. Begin w/ lower dose to prevent toxicity, should be taken w/ Birth Control to prevent pregnancy 3. Pt needs to know signs of LITHIUM TOXICITY, DO NOT USE DURING BREAST FEEDING 4. PREGNANCY TEST BEFORE, Kidney & liver function, blood range (very narrow therapeutic blood range b4 toxicity)

Question 30

LITHIUM LIVER TOXICITY SIGNS

Answer 30

Diarrhea, vomiting, drowsiness, muscular weakness, lack of coordination SEVERE: ataxia, giddiness, tinnitus, blurred vision, large output of dilute urine

Question 31

LITHIUM LONG-TERM S/E

Answer 31

thirst, frequent urination, tremors, diarrhea, weight gain, edema

Question 32

Anti-epileptic Drugs 1. Drug usage in mood disorders 2. S/E 3. PT Consideration/Assessment

Answer 32

1. Mood stabilizer for episodes of bipolar disorder (Carbamazepine, Valpropic acid/valproate, and Lamotrigine) 2. In elderly patients, causes POTS, anticholinergic adverse effects, extrapyramidal symptoms 3. Carbamazepine can cause toxicity, be mindful of the therapeutic blood range

Question 33

Consideration for ALL mood spectrum disorder MEDICATIONS

Answer 33

CANNOT BE ABRUPTLY STOPPED

Question 34

Beta blocker 1. Use 2. MOA 3. S/E 4. Contra-indications

Answer 34

Propranolol, Metoprolol, Clonidide, Atenolol 1. PRN for anxiety (traumatic nightmares, extrapyramidal S/E of antipsychotics, performance anxiety) - decreases tremors and tachycardia 2. blocks effect of norepinephrine & epinephrine 3. postural hypotension, dizziness, brady 4. heart block, glaucoma, diabetes, bradycardia

Question 35

Benzodiazepines 1. Use 2. MOA 3. RISK 4. S/E 5. Contra-indications

Answer 35

Lorazepam, Alprazolam, Clonazepam, Diazepam 1. Scheduled dose or PRN (as needed) for SHORT-TERM management of anxiety 2. inhibits nerve activity by enhancing effect of neurotransmitter GABA 3. highly addictive & can cause life threatening withdrawal (not for long term use) 4. CNS sedation (dizziness & sedation) & rebound anxiety 5. alcohol use

Question 36

Non-Benzo Anti-anxiolytic 1. Use 2. Pt consideration 3. S/E 4. MOA

Answer 36

Buspirone & Hydroxyzine 1. Anxiety relief 2. Less effective for pt's sensitized to benzo's 3. 4. Buspirone MOA: diminishes serotonin activity (less CNS sedation); Hydroxyzine MOA: blocks histamine 1 receptor to promote sedation

Question 37

Cholinesterase inhibitors 1. Use 2. MOA

Answer 37

Donepezil, Rivastigmine, Galantamine, Memantine 1. used to maintain memory in those w/ Alzheimer's (for a few months to 1 year) 2. blocks cholinesterase (breaks down acetylcholine)

Question 38

Glutamate receptor antagonist 1. Use

Answer 38

delays functional decline in moderate to severe Alzheimer's

Question 39

Anti-hypertensives, such as beta-blockers, can cause adverse changes in ___? A. Cognition B. Sexuality C. Reproduction

Answer 39

COGNITION

Question 40

Cholinesterase inhibitors 1. Use 2. MOA 3. Length of effectiveness

Answer 40

Donepezil, rivastigmine, galantamine 1. Used to treat decreased memory and cognition in AD 2. blocks cholinesterase to prevent breakdown of acetylcholine ; *Memantine protects nerve cells from excessive glutamate 3. Effective for a few months to a year

Question 41

Glutamate receptor antagonist (NMDA receptor antagonist) 1. Use 2. MOA

Answer 41

Memantine 1. Delays functional decline in moderate to severe AD 2. protects nerve cells from excess amounts of glutamate

Question 42

Which antipsychotics are used in AD for behavioral problems?

Answer 42

Haloperidol (haldol) and Risperidone (risperdal)

Question 43

Which benzodiazepine is used for behavioral problems in AD?

Answer 43

Lorazepam (Ativan)