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GRCC AD 175 III meds
Test 3 meds
| Question | Answer |
|---|---|
| Procrit, EPO (erythopoietin) and Arnesp | Colony stimulating factor meds that stimulate erythrocyte production. |
| Celexa, Lexapro, Prozac, Paxil, Zoloft | SSRI selective seratonin reuptake inhibitors. |
| Decrease appetite = decreased nutrition with this type of antidepressant | SSRI's: celexa, lexapro, prozac, paxil, zoloft |
| Why is prozac (fluoretine) not suitable option for the elderly? | d/t the effects of weight loss |
| Which SSRI benefits elderly to increase appetite, wt gain | Remeron (mirtazapine) |
| Side effects of remeron | sleepiness, increased appetite, wt gain. |
| What nursing consideration ahould you consider when giving remeron | Give at HS r/t sleepiness |
| The action of this drug reuptakes serotonin and norepinephrine | Effexor |
| Effexor | increased b/p, GI upset & constipation, along with somnolence (sleepiness) are side effects of which anti-depressant? |
| This drug affects sleep due to Increase frequency and urgency | diuretics |
| This drug causes vivid dreams and insomnia | parkinson meds (levadopa/carbadopa & sinemet) |
| This drug acts like a stimulant, tremors, anxiety and effects sleep | Bronchodilators |
| This causes vivid dreams and extreme drowsiness or insomnia | Beta Blockers |
| A beverage that acts as a stimulate and diuretic causes sleeplisness | caffeine |
| This beverage causes pt to awaken earlier, unable to fall back asleep and causes nightmares | alcohol. |
| What type of drug causes sleepliness or insomnia. | antidepressants. |
| Ambien, Sonata, Lunesta, Rozerem | Sedative/hypnotics, benzo-benzo-like meds |
| This sedative hypnotic is the first choice of drug to help with insomnia | Ambien |
| How much ambien do you give at night? 5mg or 1-2mg | 5mg |
| why is ambien the 1st drug of choice? | Less hang-over effect |
| What is the onset of ambien? 5min, 30min, 1 hour | 30 minutes |
| What are the side effects of ambien | anxiety and agitation |
| Which sleeping medication has a rapid onset, and short duration. | Sonata |
| What time can you give sonata? | As late as 3am |
| 5mg | What dose do you give of Sonata? 1to2, 5mg? |
| What is the dosage amount can an elderly person recieve of the sleeping med Lunesta? 1 to 2mg, 5mg, 10mg? | 1 to 2 mg and 1 to 2 doses per elderly |
| What is the duration of lunesta? | Effects last about 8 hours |
| When should you take Lunesta? | Early in evening, d/t the drug interaction. |
| This affects melatonin | Rozerem (ramelteon) a little different class drug from the sleeping meds |
| Rozerem (Ramelteon) | This sleep aid is not a controlled substance and there is no risk for dependence. |
| Why is benadryl a bad drug for the elderly? | Can cause delirium, constipation, urinary retention. |
| This is an anticholingeric OTC drug that shoudl not be used by elderly. | benadryl |
| What does anticholinergic effects have on the body? | Dry mouth, urinary retention, blurred vision, constipation. |
| Pamelor (nortriptyline) Trazadone and remeron | Sedative antidepressants given to someone who is having trouble sleeping at night. |
| What are the benefits of nortriptyline, trazadone and remeron | decreases sleep latency, helps with depression and insomnia. |
| These sedative antidepressants cause orthostatic hypotension and daytime grogginess | nortriptyline, trazadone, remeron |
| Melatonin | natural hormone that affects the sleep/wake cycle. |
| levels of this natural hormone decreases in the elderly, therefore can be given as a sedative to help with sleep | melatonin. |
| Valerian Root | herbal med that decreases sleep latency and takes 1 to 3 weeks to take effect |
| MRS.K help with periodic limb movement disorder (nocturnal myoclonus) | mirapex, requip, sinemet, klonopin treat |
| Mrs. N helps with restless leg syndrome | mirapex, requip, sinemet,neurontin |
| Alpha Blockers that end in "-osin" that help in managing BPH | Cadura (doxazosin) Hyrin (terazosin) Flomax (Tamsulosin) Urotraxal (alfuzosin) |
| The action of Alpha Blockers is to? | relax spinchter, relax smooth muscle to help effectiveness of prostate. |
| Which of the alpha blockers, block alpha receptors in prostate only? | Flomax (tamsulosin) Uroxatral (alfuzosin) |
| What are the side effects of alfa blockers ("-osin")? | Decreases B/P, HA, fatigue, orthostasis/fainting, nasal congestion. |
| Should you check VS before giving alpha blockers? | Yes, it is recommended you check VS because it decreases B/P, and csn cause orthostatic hypotension and fainting. |
| Androgen HORMONE inhibitors that end in "-asteride" shrinks prostate so pressure is not on sphincter | Proscar (finasteride) Avodart (dutasteride) |
| Proscar (finasteride) Avodart (dutasteride) | Shrinks prostate so pressure isn't on sphincter. |
| These BPH medications effect libido, can cause ED, and impotence? | Proscar (finasteride) Avodart (dutasteride) |
| How long does it take Proscar and avodart to work? | One month |
| Which BPH med circultates in blood for at lease six months, there fore should not donate blood. | Proscar (finasteride) Avodart (dutasteride) |
| What handling precautions should everyone consider, especially pregnant women,before handling proscar and avodart? | Should wear gloves since it absorbs through the skin. |
| This is a complimentary natural supplement to BPH medications | Saw Palmetto |
| Saw Palmetto actions | Decreases prostate size and relieves urinary symptoms, however mechanism of action is not known at this time. |
| B&O Suppositories | Controlled substance that help with Bladder spasms |
| This is given following a TURP surgery to eleviate discomfort and pain from bladder spasms | B&O suppositories. |
| A person is told that he has stage I prostate cancer. | This is found unexpectedly via PSA or DRE, person has few symptoms and cancer is confined within the prostate. |
| These hormone medications are given following a prostectomy | Lupron (leuprolide acetate) Zoladex (goserelin) |
| This hormone therapy works on the pituatary to decrease luteinizing hormone, thus DECREASES testosterone production | Lupron and Zoladex actions |
| Men who are on a hormone therapy (Lupron or Zoladex) that decreases/removes testosterone may experience these type of side effects | Decreased libido, impotence, hot flashes (r/t removal of testosterone = estrogen effects), osteoporosis, |
| How is lupron administered? | Subq daily or IM qmonth or q3months. If taking subq daily, then patient is taught how to do them selves at home |
| Other medications that a man may recieve after prostectomy | Eulexin (flutamide) Casodex (Bicalutimide) (think "-timide") |
| What is the action of Eulexin (flutamide) and casodex (bicalutamide)? | Testorne is still there, it can bind because this med inhibits androgen uptake at the target tissues by blocking at the receptors to testosterone. |
| Which drugs blocks testosterone from binding to the receptor sites- (testoterone is still there, it just can't bind) | Eulexin (flutamide) Casodex (bicalutamide) Teste |
| As a nurse, what side effects would you warn the patient if taking either Eulexin or casodex? | Diarrhea, N&V, |
| This type of chemo therapy for breast cancer blocks the estrogen from binding to the tumor | Hormone receptors Tamoxifen (Nolvadex) or Raloxifene (Evista |
| Tamoxifen (Nolvadex) Raloxifene (Evista) | Doesn't cure breast cancer, it decreases tumor growth. |
| Tamoxifen (nolvadex) and Raloxifene (Evista) are hormone receptor blockers that deprive breast tumors of which hormone? | Estrogen. |
| Who is given tamoxifen or raloxifene (Evista) | used by pre and post-menopausal women |
| Nursing teaching for women taking tamoxifen and raloxifene | Side effects; Hotflashes, N&V, weight gain, vaginal dryness, irregular periods |
| It is okay to smoke if taking tamoxifen (nolvadex) or Raloxifene (Evista) | No, it is recommended not to smoke r/t increase risk of DVT |
| What action should a female take when on either tamoxifen (nolvadex) or raloxifene (Evista) and they have been having abnormal bleeding. | They need to report abnormal bleeding to their doctor. |
| letrozole (Femara) and anastrozole (arimidex) | These medications Inhibits aromatase enzyme inhibitors- deprive breast cancer of estrogen |
| This is a chemo drug that deprives breast cancer of estrogen by inhibiting armatase enzyme inhibitors | Letrozole (Femara) Anastrozole (Arimidex) |
| Side effects of letrozole (femara) an anastrozole (arimidex) | Hot flashes, n&v, weight gain, bloating, difficulty eating, urinary frequency and urgency |
| How long do side effect last when taking letrozole (femara) & anastrozole (arimidex) | Side effects occur almost daily for greater than a few weeks. |
| Herceptin (Transtuzumab) | Bio therapy medication given to treat breast cancer. |
| The action of Herceptin (transtuzumab) | binds to HER2 nuegene and stops growth |
| This is a cytoxic drug that kills cancer | Herceptin (trastuzumab) |
| Will Herceptin (Transtuzumab) help with any type of breast cancer? | No, it only works if tumor has HER2 positive tumors |
| When is Herceptin (Transtuzumab) given | It is used for women who failed other tx, and is also used in combo with other drugs. |
| Weekly treatment for Herceptin (Trastuzumab) | IV infusion or large doses every 3 weeks. |
| side effects of Herceptin (Trastuzumab) | Causes cardiac damage, flu-like symptoms: FEver, chills, pain, N&V |
| How long do the side effects of Herceptin last (Flu like symptoms and cardiac damage) | They will diminish with subsequent transfusions. |
| Gardisil Vaccine | Girls 9 to 26 years and most effective if given before exposure to HPC |
| Procrit, EPO and aranesp | stimulates erythocyte production |
| Which labs should be monitored when taking pocrit, EPO and aranesp | Hgb and Hct |
| Uses for procrit, EPO and aranesp | anemia of chronic renal failure, HIV, chemotherapy and cancer. |
| When does therapeutic level take effect for procrit, EPO, and aranesp | Therapeutic in one month. |
| Neumega (Opreluekin) | Stimulates platelet production |
| How is Nuemega administered? | IV |
| What to monitor if on Nuemega? | Platelets. |
| Side effects of nuemega | fluid retention, tachycardia, and headache |
| Neupogen/filgastrim | Neutrophils given inpatient |
| Neulasta/Pegfilgastim | Neutrophils given 24 hours after chemo is done as one-time long lasting injection. |
| what meds stimulate neutrophil production? | Neupogen/filgastim Neulasta/Pegfilgrastim |
| Deficiency in neutrophils | Neutropenia |
| ANC | Determines risk of infection by looking at number of neutrophils. |
| Normal ANC | > 1500 |
| Moderate risk ANC | <1000 |
| Severe risk of ANC | < 500 |
| What does anc <500 mean | extremley low count of neutrophil....severe risk...and only symptom is fever of 100.5 |
| What is sign of infection for neutropenic patient? | Fever of 100.5 or more. |
| what do you treat/prevent thrush for cancer patient | Rinse with HCO3 or NS or H20 |
| what mouthwash do you give someone who has stomitis | Peridex, collins soln, tetra-myco-ben and artificial saliva |
| Anti-emiotic meds (n&V) | Drugs ending in "-setron", Zofran, kytril, anzemet and aloxi |
| Side effects of anit-emetic meds: zofran, kytril, anzemet, aloxi ("-setron") | HA, Sedation, dizziness |
| Med known as substance P (neurokinin)1 receptor antagonist : aprepitant (Emend) | give in combo with 5HT3 blocker and dexamethasone. |
| Name the medication given for sever N&V | Aprepitant (Emend) |
| Side effects of Aprepitant (Emend) | Dehydration, dizziness, fatigue |
| Antiemetics that end in "-zine" | works in the chemoreceptor zone in brain. |
| Prochloperazine (Compazine) & Promethazine (phenegran) | Antiemetics |
| Side Effects of Prochloperazine (Compazine) & promethazine (phenegran) | Sedation, tremors, dyskinesias, pseudoparkinsonism, decreased BP |
| Cyclophosphomide (Cytoxan) is an | Alkylating agents |
| Side effects of Cyclophosphomide (Cytoxan) | hemorrhagic cystitis & neutropenia. |
| Side effect of Cytoxan is hemorrhagic cystitis which is? | Infection/irritation causing bleeding |
| How to treat hemorrhagic cystitis (which is side effect of taking cytoxan) | Increase fluid intake before during and after chemo and give mesna |
| What is Mesna? | It protects bladder wall and given for hemorrhagic cystitis (s.e. of taking cytoxan) |
| What do you assess when giving pt cytoxan? | Monitor ANC because they are at risk for neutropenia (decreased neutrophils) |
| Platinol (cisplatin) is classifed as an | Alkalyting agent |
| What are the side effects of taking platinol (cisplatin)? | Neutropenia and nephrotoxicity. |
| What do you monitor when giving platinol (Cisplatin)? | Monitor ANC (Neutraphil count) and GFR (Renal function) |
| Oxalplatin (eloxatin) side effects | Neurotoxicity & exposure to cold is painful. |
| What do you monitor for Eloxatin (oxalplatin)? | Numbness, tingling, paresthesias (r/t side effects of taking this med neurotoxicity) |
| Nursing care or teaching for someone taking Eloxatin (Oxalplatin) | Advise to dress warmly, keep dry, avoid ice and ice water because exposure to cold is painful |
| Paraplatin (carboplatin) side effects | Neutropenia |
| What do you assess when taking paraplatin? | ANC...d/t risks of neutropenia |
| Methotrexate side effects | Stomatitis (Oral ulcers), Neutropenia, Leucovorin rescue |
| Leucovorin rescue | Given day later after high dose of methotrexate to protect cells from futher damage |
| At risk for fatality | Leucovorin rescue is given a day after high dose of methotrexate, must be given specific time and specific length of time...can be fatal if time and dose not correct. |
| What do you monitor when giving methotrexate? | Assess for infection: fever and ANC d/t risk of becoming neutropenic |
| Teaching for someone who takes methotrexate? | Thorough oral assessment, treatment for stomitis, swish and spit, soft toothbrush |
| Cytarabine (Ara-C)side effects | tumor lysis syndrome, neurotoxicity and neutropenia |
| Tumor lysis syndrome | Side effect of taking Cytarabine (Ara-C) in which toxic substances and waste products end up in blood stream....this medication causes cells to die too fast and lead to kidney failure. |
| what drug would you give if Tumor lysis syndrome develops (Side effect of taking cytarabine (Ara-C)) | Allopurinol (zloprim) is given prophylactically (gout med...uric acid) |
| What do you monitor when giving cytarabine (Ara-C)? | (neutropenia) ANC, Fever, and (neurotoxicity) numbness, tingling and confusion. |
| 5-Fluroacil (5-FU) side effects | Stomatitis, Diarrhea, and thrombocytopenia |
| What do you monitor when giving 5-fluroacil (5-fu) | Oral ulcers, oral care, eval hydration d/t diarrhea and platelet count & bleeding (r/t thrombocytopenia) |
| Doxorubicin (Adriamycin) side effects | Cardiac toxicity and neutropenia |
| What test needs to be given before administering doxorubicin (Adriamycin)? | MUGA scan - tests cadiac function ejaculation fraction d/t risks of cardiac toxicity. |
| Belomycin (Blenoxane) side effects | Pulmonary toxicity and Anaphylaxis |
| What would you monitor or test prior to administration of Belomycin (Blenoxane)? | PFT (pulomary function test) for base line and intraderma test (skin test) before each dose. |
| Pulmonary toxicity | side effect of Bleomycin (Belnoxane) - will see pulmonary fibrosis and pneumonitis later down the road |
| Vincristine (Oncovin) side effect | Neurotoxicity and constipation. |
| Paclitaxal (Taxol) side effects | Neutropenia and neurotoxicity |
| Estrogen targeted meds | Tamoxifen (nolvadex)/Raloxifene (Evista) Letrozole (Femara)/ Anastrozole (Arimidex) |
| Side effects of Tamoxifen and raloxifene, letrozole and arimedex? | Hot flashes, n&v, wt gain, vag dryness, irregular periods, risk of DVT if smoker. |
| Testosterone targeted meds | Eulexin, casodex, lupron and zoladex |
| Rituxin (rituximab) | MoAbs med that is given for non-hodgkins lymphoma, targets the CD20 protein |
| Herceptin (trastuzumab) | MoAbs med given for breast cancer, tarkets the HER2 protein. |
| Mylotarg (Gemtuzumab ozogamicin) | MoABS med given for AML, targets Cd33 protein, not used commonly. |
| MoAbs | antibody medication that targets one specific cell |
| Side effects of Herceptin, Rituxin and Mylotarg | Fever, chills, rigors (tremors) diaphoresis, malaise, urticaria (hives) and N&V |
| Serious side effect of Herceptin, Rituxin and Mylotarg | Hypoxia, hypotension, Hypertension, dyspnea |
| What medication shoudl be given before administering MoABS? | Steroids and benadryl to help decrease reactions |
| Interferon | Protects cells that have not been infected yet, slows tumor growth, stimulates natural killer cell suppresses oncogenes |
| Interferon uses | Hep C, melanoma, Karposi's sarcoma, and Hairy cell leukemia |
| Interferon Side Effects | HA, Mylagia (muscle pain), Athralgia (joint pain), Malaise, Fatigue, anorexia, wt loss, rigors (shaking) |
| When giving interferon, what med should be given to decrease side effects? | Tylenol |
| Interleukin | Stimulates T cell to destroy cancer, helps recognize immune cells and destroys abnormal cells. |
| Interleukin side effects | Fatigue, GI, Skin, CNS side effects, chills, fever, rigors, capillary leadk syndrome |
| Capillary lead syndrome | potential fatal side effect from taking interleukin. |
| Release of protein out of vascular system: fluid follows protein, body becomes edamatous leading to respiratory failure. | Capillary leak syndrome |
| A lot of toxicity and given in patien where ICU is available. | Interleukin |
| Angiogensis inhibitors | Stop nutrients taht supply tumor growth, stops cells from growing |
| Angiogenisis inhibitor side effects | Can affect good tissue growth and could lead to complications such as delayed wound healing. |
Created by:
Wends1984
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