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PHARMACOLOGY EXAM 3
| Question | Answer |
|---|---|
| What is the biggest concern with Afrin? | rebound congestion and ADDICTION, if used more than 3-5 days |
| What type of Immunoglobin-mediated response is active in an allergic reaction? | IgE mediated response |
| How is Histamines involved in an allergic reaction? | When an allergen comes into the body and the body has an overreacted response; the immune system immediately goes into action releasing histamine |
| What is histamines effects on the body during a reaction? | Histamines increase mucous production which lead to tearing, sneezing, coughing, inflammation, and even sometimes vomiting and diarrhea |
| What is Allergic Rhinitis? | Inflammation of the nasal mucosa. |
| How is Allergic Rhinitis characterized? | Characterized by sneezing, watery eyes, and nasal congestion. Caused by exposure to antigen (allergen) |
| What is the medication class of Docusate sodium? | Stool softeners |
| What are the therapeutic uses of Docusate sodium? | relieves constipation and prevents straining during bowel movements |
| What is the trade name for docusate sodium? | Colace |
| What is the main purpose of stool softeners? | softens the stool by increasing water content |
| What is the best way to take stool softeners? | Tablets and solution must be taken with full glass of water for this medication to have maximum results |
| What are the contraindications of docusate sodium? | Contraindicated in those with bowel obstructions |
| What is the patient education for docusate sodium? | do not administer within one hour of other drugs, antacids or milk. Do NOT use over a long period of time (1-week max). Fiber, fluids, and fruit fill up the toilet! |
| What is the medication class for PPIs? | proton pump inhibitors |
| What are the therapeutic uses for PPIs? | Treats stress ulcer prevention in hospitalized/surgical clients, treats gastric and duodenal ulcers (H.pylori infections). Treats GERD. Suppresses production of gastric acid |
| What medication is an example of a PPI? | omeprazole |
| What is the trade name for omeprazole | Prilosec |
| What is the suffix for PPIs? | -prazole |
| What are the four P's of PPIs? | Prazole suffix Prevents holes "stress ulcer prophylaxis" Porous bones (osteoporosis) Possible GI infection-->acid helps fight infection, but this medication blocks acid secretion |
| What are the side effects of PPIs? | GI upset-->headaches, diarrhea, nausea, and abdominal pain |
| What is the patient education for PPIs? | Take 30 minutes before the first meal of the day, take calcium and vitamin D to help prevent osteoporosis |
| A patient asks while in the hospital, "Why am I on this medication? I do not take this at home?" How would the nurse respond? | "PPIs prevent the development of ulcers due to surgery or hospitalization" |
| What medication class are cimetidine and famotidine in? | Histamine (H2) receptor antagonist |
| What are the therapeutic uses for H2 receptor antagonists? | Treats ulcers (duodenal and gastric) prevention, treats GERD, long lasting relief |
| what is the trade name for cimetidine? | Tagamet |
| what is the trade name for famotidine? | Pepcid |
| What are the side effects of H2 receptor antagonists ? | Stomach infection-->acid helps fight infection, but this medication blocks acid secretion-->decreases gastric secretions by blocking H2 receptors in the stomach |
| What is the patient education for H2 receptor antagonists? | Take 30 minutes BEFORE meals--> "-tiDINE you take before you DINE" Prevention of GERD symptoms--> don't overeat, decrease stress, don't smoke, don't take NSAIDs (risk for GI bleeding) |
| What is the medication class for sucralfate? | Pepsin inhibitors or mucosal protective agents |
| What are the therapeutic uses of sucralfate? | prevention and short term treatment of duodenal ulcers *Does NOT reduce stomach acid production, but forms a protective layer against acid in the GI mucosa |
| What is the trade name for sucralfate? | Carafate |
| what is the main side effect of sucralfate? | constipation "SUCralfate...SUCks to have constipation" |
| What is the patient education for sucralfate? | Acid-reducing medications (PPIs and H2 blockers) should be avoided within 30 mins of taking sucralfate. Take ALL other meds 1-3 hours before or after taking sucralfate-->binds with many meds. Three F's fill up the toilet! |
| what is the medication administration for sucralfate? | Take on an empty stomach, with a glass of water, 1 hour before meals to protect the stomach |
| What is the medication class for loperamide? | antidiarrheals |
| what are the therapeutic uses for loperamide? | treats diarrhea and DECREASES INTESTINAL PERISTALSIS |
| what is the trade name for loperamide? | Imodium |
| What is loperamide chemically related to? | Opioids, opioids cause constipation |
| what are the side effects of loperamide? | dizziness + drowsiness, sedation + euphoric effect, loperamide doesn't exhibit an analgesic effect like opioids |
| what is the patient education for loperamide? | Use caution when driving or performing hazardous tasks since this medication may cause drowsiness. Do NOT take other CNS depressant or consume alcohol while on this medication |
| What should you not do with loperamide? | Don't use for more than 2 days!!! If diarrhea persists for longer than 2 days, STOP the drug and contact HCP |
| What is the medication class of misoprostol? | synthetic prostagladin and prostaglandin E1 |
| What are the therapeutic uses for misoprostol? | Prevents gastric ulcers in clients taking long term NSAIDs therapy and is a cervical ripening agent |
| what is the trade name of misoprostol? | Cytotec |
| What are the side effects of misoprostol? | GI upset-->diarrhea, abdominal pain and cramping |
| Is misoprostol safe during pregnancy? | NO, category X. *MISoprostol can cause MIScarriages* |
| What is the only exception for misoprostol use during pregnancy? | During labor to ripen the cervix |
| What is the patient education for misoprostol? | Taking with food helps decrease GI upset, take a pregnancy test before administering this medication, educate about being on birth control, DO NOT take this med with antacids, report severe menstrual pain, bleeding or spotting |
| What medication class is calcium carbonate in? | antacids |
| what are the therapeutic uses for antacids? | treats peptic ulcers, treats GERD, neutralizes the stomach QUICKLY, NOT LONG LASTING |
| What are the trade names for calcium carbonate? | Tums/Rolaids |
| What is the main side effect of calcium carbonate? | Constipation |
| What is the medication administration/patient education for calcium carbonate? | DO NOT take with meals, not with OTHER MEDS (1 hour before or after), 1-3 hours after meals, at bedtime |
| What is the medication class of Antihistamines? | Histamine antagonists, H1 blockers |
| What are the therapeutic uses of antihistamines? | treats common cold, rhinitis, nausea and vomiting, motion sickness, and urticaria |
| What generation is diphenhydramine in? | 1st |
| what is the suffix of 1st generation Antihistamines? | -ramine |
| what is the trade name for diphenhydramine? | Benadryl |
| What are side effects for 1st generation antihistamines? | sedation, anticholinergic side effects, can't see (blurry vision + dry eyes), can't spit (dry mouth + no sweat), can't pee, can't poop |
| what is the patient education for antihistamines ? | these are OTC medications- be sure to read the label and follow the instructions |
| What is the medication class of leukotriene inhibitors ? | Leukotriene inhibitors! Prevents the release of leukotrienes (inflammatory substance) |
| what are the therapeutic uses for Leukotriene inhibitors? | treats CHRONIC asthma and seasonal allergic rhinitis |
| what is a medication that is a Leukotriene inhibitor example? | montelukast |
| what is the suffix used for Leukotriene inhibitors ? | -lukast |
| what is the trade name for montelukast? | Singulair |
| what are the side effects for Leukotriene inhibitors | headache and flu-like symptoms |
| What is the patient education for Leukotriene inhibitors? | Long-term management-->NOT a rescue drug, not used during ACUTE attacks. May take 1-2 weeks to reach therapeutic levels |
| What is the medication class for Guafenesin? | Expectorants |
| What are the therapeutic uses for Guafenesin? | treats asthma, pneumonia, bronchitis, cystic fibrosis, tracheostomy care, relief of cough ESPECIALLY WHEN ITS DRY AND NONPRODUCTIVE |
| what is the trade name for Guafenesin? | Mucinex, Robitussin |
| What is the main function of Expectorants? | Used to facilitate mobilization of mucous. Reduces viscosity of secretions (thins secretions) to make it easier to cough them up |
| What are the side effects of Guafenesin? | Nausea and vomiting, headache, drowsiness, and rash |
| What is the patient education for Guafenesin? | Take with a full glass of water-->fluids are needed to decrease the viscosity of secretions. Report if the cough lasts more than 1 week and if you have a sore throat, fever or rash |
| what is the medication class for corticosteroids? | steroids |
| What are the therapeutic uses for INHALED corticosteroids? | treats chronic asthma, nasal polyps and rhinitis |
| What are the therapeutic uses for TOPICAL corticosteroids? | Treats dermatitis, eczema, rashes, insect bites |
| What are the therapeutic uses for NON-RESPIRATORY corticosteroids? | treats addison's disease |
| What are medications that are classified as corticosteroids? | Prednisone and fluticasone |
| What is the trade name of prednisone? | Deltasone |
| What is the trade name of fluticasone? | Flovent/Flonase |
| What are the suffixes of corticosteroids ? | -sone, -ide |
| Do steroids have a slow or fast onset? | Steroids think Slow onset |
| What can steroids cause? Think the S's of Steroids | Sugar-->hyperglycemia, Salt-->salt and water retention (HTN), Soft bones-->cause osteoporosis, Sex-->decreased libido, Sick-->decreased immunity/sepsis, Swollen-->water gain/weight gain, Sad-->depression, Sight-->risk for cataracts |
| What is the patient education for corticosteroids? | Report signs of infection-->corticosteroids are immunosuppressants and anti-inflammatories. Increase calcium in the diet. Yearly optometrist appointment-->risk for cataracts. Stress causes decrease in cortisol-->may need to increase dose |
| Do steroids have a fast or slow onset? | slow |
| What medication class are LABAs in? | Bronchodilators |
| What are the therapeutic uses for LABAs? | COPD, Chronic Bronchitis, prevention of bronchospasms. |
| What medication is classified as a LABA? | salmeterol |
| what is the suffix for LABAs and SABAs? | -terol |
| what are side effects of LABAs and SABAs? Think Fight or Flight (SNS) | Tachycardia, palpitations, cardiac arrhythmias, HTN, nervousness and anxiety, insomnia/restlessness, tremors |
| What is the medication administration if a patient is taking a LABA and a corticosteroid? | 1) Bronchodilator first to help open up the airways 2) Wait 5 minutes 3) Administer the Corticosteroid |
| What is the patient education for LABAs? | After inhalation, rinse the mouth with water (don't swallow) to reduce the risk of oral/esophageal candidasis. A spacer can help reduce the risk of thrush |
| What medication class are SABAs in? | Bronchodilators |
| What is the difference between LABAs and SABAs? | LABAs are LONG acting Beta-2 agonists, SABAs are SHORT actingh Beta-2 agonists |
| What are the therapeutic uses of SABAs? | Relieves ACUTE symptoms of bronchospasms, asthma-->rescue inhaler |
| What medication is classified as a SABA? | albuterol *Think Albuterol is for Acute Asthma Attacks* |
| what is the trade name for albuterol? | Proventil |
| What is the medication administration for SABAs? | Shake it well before administering. Do NOT exceed 3 doses of 2-4 puffs every 20 minutes-->If it's not working after 3 does report it. If albuterol is NOT effective, an inhaled corticosteroid can be taken |
| What is the patient education for SABAs? | after inhalation, rinse the mouth with water (don't swallow) to reduce the risk of thrush. Use a spacer to reduce the risk of thrush |
| What is the medication class of acetaminophen ? | Analgesics |
| What are the therapeutic uses of acetaminophen? | Treats mild-moderate pain, aspirin substitute for those-->allergic to aspirin and those with bleeding tendencies. Treats children with fever/flu-like symptoms |
| What is the trade name for acetaminophen? | Tylenol |
| What is the antidote for acetaminophen? | acetylcysteine (Mucomyst) |
| What are the side effects of acetaminophen? | Hepatotoxicity, liver damage, hepatic failure, jaundice |
| what is the medication administration for acetaminophen ? | Assess overall health and alcohol. Malnourished patient and those with chronic alcohol use (>3 drinks/day) are at increased risk for liver damage. Limit dosage to 1000-2000 mg/day |
| What medication class are NSAIDs in? | analgesics |
| What are the therapeutic uses of NSAIDs? | treats mild-moderate pain, treats menstrual cramps, decreases fever, treats musculoskeletal disorders-->OA and RA |
| What are medications that are classified as NSAIDs? | ibuprofen and celecoxib |
| what is the trade name of ibuprofen? | Advil |
| What is the trade name of celecoxib? | Celebrex |
| What medications would we "BAN" for asthma patients? | Beta blockers Aspirin NSAIDs |
| Why don't we give the "BAN" medications to asthma patients | cause bronchospasms |
| What are the side effects of NSAIDs? | GI upset-->diarrhea, nausea, vomiting, anorexia, abdominal pain/discomfort. Heart--> HTN + failure. Kidney-->nephrotoxicity. Blood clots. Stroke. |
| What is the patient education for NSAIDs? | Report signs of GI bleeding-->black tarry stool, coffee ground emesis, abdominal cramping |
| What is the medication class for Opioids? | analgesics |
| What are the therapeutic uses for opioids? | reduces anxiety and sedate postop, reduces anxiety in those with dyspnea, relieves pain (MI), treats diarrhea and intestinal cramping. |
| What medications are classified as opioids? | Fentanyl, oxycodone, and morphine sulfate |
| what is the gold standard/most common opioid for chronic pain? | morphine sulfate |
| what forms can morphine sulfate be given? | PO, nasally, subQ, IM, IV, and suppository |
| what is the antidote for opioids? | naloxone |
| what is the trade name for naloxone? | narcan |
| What will occur after giving a patient narcan? | this reverses the opioids effects and the patients pain will come back |
| Can you give more than one dose of naloxone? Why? | Yes. Opioids last longer than the effect of naloxone. Repeat the dose if needed. |
| What is the most serious adverse reaction with opioids? | respiratory depression. |
| When do you stop giving opioids? | RR<12, if the client is unarousable, if client falls asleep mid sentence |
| what are long term side effects of opioids? | slow GI function-->constipation. Client WILL NOT build tolerance |
| What are short term side effects of opioids? | decreased HR, BP, RR. Nausea/vomiting and itching. Clients WILL build tolerance |
| What is the patient education for opioids? | preventive measures for constipation-->increase the 3 F's! Possibly laxatives or stool softeners |
| What are the therapeutic uses for corticosteroids? ENDOCRINE SYSTEM | treats ADDISON'S DISEASE |
| what medications are classified as corticosteroids? ENDOCRINE | hydrocortisone and dexamethasone |
| what is the trade name for hydrocortisone ? | Hydrocort |
| what is the trade name for dexamethasone? | Ozurdex |
| What medication class is levothyroxine in? | synthetic hormone |
| What are the therapeutic uses for levothyroxine? | treats hypothyroidism, hypothyroidism in pregnancy, hormone replacement after a thyroidectomy |
| what is the trade name for levothyroxine? | Synthroid |
| what are therapeutic responses of levothyroxine? | *no longer showing signs of hypothyroidism*--->normal HR, improved energy levels (not fatigued), normal skin (not cool or pale) |
| Is levothyroxine safe during pregnancy? | Yes |
| Should you stop levothyroxine if the symptoms resolve WHILST being pregnant? | NO, do not stop the medication if symptoms resolve. Thyroid hormone is needed for fetal brain development |
| What is the patient education for levothyroxine? | It may take 8 weeks to see the full effect. Report signs of HYPERthyroidism-->tachycardia, heart palpations, weight loss, insomnia, anxiety. take once a day, take at the same time everyday, take on EMPTY STOMACH |
| what is the medication class of metformin? | anti-diabetic medication (oral hypoglycemic) |
| what are the therapeutic uses of metformin? | manages hyperglycemia in clients with T2 DM |
| what is the trade name for metformin? | Glucophage, Riomet, Fortamet |
| what are the side effects of metformin? | GI upset, B12 deficiency, metallic taste, lactic acidosis |
| what is the difference between an ORAL ANTI-DIABETIC and INSULIN? | ORAL ANTI-DIABETIC-->minimal risk for hypoglycemia, given PO INSULIN-->high risk for hypoglycemia, given IV or subQ |
| what is the patient education for metformin? | STOP metformin 24-48 hours before administration of any IV contrast dye. STOP the medication if NPO-->risk for hypoglycemia |
| what are the therapeutic uses of sulfonylureas | manages hyperglycemia in clients with T2DM |
| what medications are classified as sulfonylureas? | glyburide |
| what is the trade name for glyburide? | Diabeta, Glynase |
| what are the side effects of sulfonylureas? | HYPOglycemia, weight gain, GI upset-->nausea, epigastric pain, heartburn |
| what is the patient education for sulfonylureas? | avoid direct sun and wear sunscreen, avoid alcohol while on this medication, take 30 mins before a meal |
| What are the therapeutic uses for insulins? | Replaces insulin in TYPE 1 DM and supplements insulin production in TYPE 2 DM. Treats DKA, hyperkalemia in combination with glucose. |
| what insulins are classified as long acting insulins? | insulin glargine and insulin detemir |
| what is the trade name for glargine? | Lantus |
| What is the trade name for detemir? | Levemir |
| What is the onset for long acting insulins? | 1-2 hours |
| what is the peak for long acting insulins? | NONE |
| what is the duration for long acting insulins? | 24 hours+ |
| What insulin puts the patient at the LOWEST risk for hypoglycemia? | Long acting insulin |
| How is long acting insulin typically prescribed? | 1 or 2 times a day |
| If a patient is given insulin what must you monitor for? | HYPOkalemia-->Insulin shifts glucose and potassium OUT of the veins and INTO the cells |
| Do you mix Long acting insulins with other insulins? | NEVER--> Long acting is Lonely |
| what is the patient education for insulins? | Rotate sites of administration. 2 inches from umbilicus and best site is the abdomen |
| What is the trade name for NPH? | Humulin N, Novolin N |
| What is the onset of NPH insulin? | 1-2 hours |
| What is the peak of NPH insulin? | 4-12 hours |
| What is the duration of NPH insulin? | 12-18 hours |
| What do you NEVER do with NPH? | give in IV |
| how much is NPH insulin typically prescribed? | typically prescribed 2 times a day (morning and evening) |
| What insulin is mixed with NPH insulin? | regular |
| how do you mix regular insulin with NPH insulin? | Inject air into NPH, inject air into Regular insulin, withdraw insulin from Regular, withdraw insulin from NPH |
| what is the trade names for Regular insulin? | Humulin R, Novolin R |
| what is the onset for Regular insulin? | 30-60 minutes |
| what is the peak for Regular insulin? | 2-4 hours |
| what is the duration for Regular insulin? | 5-7 hours |
| what is one way you can tell the difference between NPH and regular insulin? | NPH is CLOUDY, Regular is CLEAR |
| What insulin is on a sliding scale? | Rapid or regular insulin |
| how is a sliding scale determined? | Amount of insulin given is based on the clients blood glucose measurements |
| What is the ONLY insulin given IV? | Regular "Regular goes Right into the vein" |
| What insulins are classified as Rapid-acting insulin? | lispro, aspart, and glulisine |
| What is the trade name for lispro? | Humalog |
| What is the trade name for aspart? | Novolog |
| What is the trade name for glulisine? | Apidra |
| What is the onset of rapid acting insulin? | 10-15 minutes-->the brain needs glucose-->no glucose causes brain death |
| what is the peak of rapid acting insulin? | 30-90 mins |
| what is the duration of rapid acting insulin? | 3-5 hours |
| what is the patient education for rapid acting insulin? | MUST EAT within 15 minutes of administration of rapid acting insulin to prevent hypoglycemic reaction |
| What is the medication class of colchicine? | antigout agent |
| what are the therapeutic uses for colchicine? | Relieves acute gout attacks, prevents gout attacks, does NOT help with pain relief-->take NSAIDS for acute attacks not aspirin |
| what is the trade name for colchicine? | Mitigare, Colcrys |
| What is colchicine's main function? | Helps reduce inflammation! NO effect on uric acid metabolism |
| What is the adverse reaction for colchicine? | Bone marrow suppression |
| what is the side effect for colchicine? | GI upset-->nausea, vomiting, abdominal pain, diarrhea |
| what is the patient education for colchicine and allopurinol? think GOUT | Gulp a lot of fluid during the day (2000-3000 mL/day) and take medication with a glass of water. no Organ meats Urine output up to 2 L/day Takes several months to take effect |
| what is the medication class for allopurinol? | uric acid inhibitors |
| what are the therapeutic uses for allopurinol? | prevents gout attacks, does NOT help with acute attacks |
| what is the trade name for allopurinol? | Aloprim, Zyloprim, and Lopurin |
| what is the patient education for allopurinol? | Stop the medication if a RASH occurs-->this may indicate a hypersensitivity reaction (stevens-johnson syndrome) |
| Can you take aspirin with allopurinol? Why or why not? | NO, a combination of those medications increase uric acid levels-->take acetaminophen instead |
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mkozej001
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