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Drugs 44

Units 7-9

What is an anticoagulant? They prevent new clots from forming and prevent existing clots from becoming larger.
What must the nurse teach a patient on anticoagulants long term to avoid? Avoid activities that can traumatize tissue and lead to bleeding.
What do antiplatelet drugs do? Prevent platelets from clumping together (aggregating).
What do thrombin inhibitors and clotting factor synthesis inhibitors do? Prevent new clots from forming and existing clots from getting larger.
What type of drug is given to persons exhibiting stroke symptoms? A thrombolytic drug (clot buster)
A thrombolytic drug must be administered within how many hours of the onset of symptoms? These drugs must be administered within 3 hours of the onset of symptoms of a stroke.
After receiving a thrombolytlic drug the patient is at risk for what effect? High risk for bleeding with any invasive procedures.
On what factor is the initial heparin bolus based? The patient's weight.
What is the goal of continuous heparin therapy? To keep the aPTT within a therapeutic range of 1.5 to 2.5 times greater than the laboratory established control value.
What is a major advantage of prescribing enoxaparin? Patients are not required to have laboratory work done to guide their therapy.
What is the normal platelet range? 200,000 to 400,000/mm3
What does a low platelet count mean for someone on heparin? It is an indication of an adverse reaction to heparin known as heparin-induces thrombocytopenia.
What vitamin counteracts the therapeutic effects of warfarin? Vitamin K
In what foods is vitamin K found? Green leafy vegatables
What is the therapeutic warfarin level for INR? Therapeutic warfarin levels should maintain the INR between 2.0 and 3.0.
What is the normal range for INR? 0.7 to 1.8 is the normal INR range
What are common side effects of anticoagulant therapy? Bleeding from the gums, oozing from cuts or wounds, nosebleeds, and heavier than usual menstrual bleeding.
What effect does darbepoetin alfa have on a patient? Darbepoetin alfa increases blood cell production, the blood becomes more viscous (thicker).
What effect does viscous blood have on a patient's vascular system? This raises blood pressure, increases clot formation and slows blood movement through small vessels.
What is the action of oprelvekin? Oprelvekin is a thrombpoietic colony-stimulating factor that increases production of platelets to at least 50,000/mm3
What is the purpose of short acting but rapid acting beta2 agonists (albuterol)? Reduce the severity or stop an asthma attack.
What is the purpose of a long acting beta2 agonist (salmeterol)? Can prevent attacks when taken daily.
For what purpose might a short acting beta2 adrenergic agonist be prescribed for a COPD patient? Extra doses might be needed to open airways whenever the patient feels especially breathless.
What is the advantage of inhaled drugs? Inhaled drugs go more to the site where the intended responses are needed and less drug is absorbed systemically; there are fewer side effects.
What must you teach a patient using a dry powder inhaler? Washing the DPI may cause the medication in the inhaler to clump together.
What is the therapeutic range for theophylline? A very narrow 10 to 20 mcg/mL.
What is the recommended loading dose of IV aminophylline? 5 to 7 mg/kg
What is the intended action of bronchodilators? To widen the airways to improve breathing.
What does aminophylline do? Stimulates the sympathetic nervous system.
What are signs and symptoms of aminophylline toxicity? CNS irritability, restlessness, temperature elevation, tremors, tachycardia, nausea and vomiting, palpitations and dizziness.
Which side effect reported by the patient taking Brethine should the nurse report to the prescriber? Chest pain. This may mean constriction of the coronary arteries.
What is a patient at risk for when using a steroid inhaler excessively? Excessive use reduces the local immune function and increases the patient's risk for infection.
What is a side effect of leukotriene inhibitors? They can cause liver impairment.
What lab value indicates liver impairment? Lactate dehydrogenase.
What is the purpose of cromolyn sodium? It is a prophylactic drug that stabilizes mast cell membranes.
What is the pregnancy warning for benzodiazepines? Have caused birth defects when used during the first trimester and can cause the fetus to become dependent and experience withdrawal symptoms after birth.
What is ondansetron? An antinausea drug.
What is a contraindication to prescribing metoclopramide? A history of depression
What is the action of metoclopramide? Increases stomach and small intestine peristalsis which helps move food through the GI system.
What are the effects of promethazine? It is an antiemetic drug which induces sedation and confusion; some patients have reduced memory about events occurring within a few hours after receiving the drug.
What effect do antiemetic drugs have on the central nervous system? All of the antiemetic drugs cause some degree of central nervous system depression.
Scopolamine is what type of drug? Anticholinergic
What is a side effect of an anticholinergic drug? Urinary retention
What is a rare and life threatening side effect of prochlorperazine? Neuroleptic malignant syndrome in which dangerously high body temperatures can occur.
What is a dangerous side effect of bisacodyl? Hypokalemia
What are the symptoms of toxic megacolon, a serious complication of diarrhea therapy? Increasing abdominal size, fever, abdominal pain, rapid heart rate and dehydration.
What are cholinergic antagonists? Anticholinergic
What do anticholinergic drugs do? Block the parasympathetic nervous system
What are systemic effects of bronchodilators? Rapid heart rate, increased blood pressure, a feeling of nervousness and difficulty sleeping
What are the actions of a mucolytic? Reduce the thickness of mucus, allowing the mucus to more easily move out of the airways.
Name a mucolytic. Guaifenesin
What is the major mucolytic drug for COPD? Acetylcysteine
What are common side effects of antiemetic drugs? Dizziness, fatigue, headache, blurred vision, constipation and drowsiness
What is a side effect of Reglan? May cause mild to severe depression. Should not be prescribed to patients with a history of depression.
What instruction do you give patients taking antiemetic drugs for chemotherapy? Take 30 minutes before meals
What are the 3 types of antidiarrheal drugs? Antimobility, Adsorbent/absorbent, and antisecretory
What are signs and symptoms of hypokalemia? Cardiac dysrhythmias, muscle pain, general discomfort or irritability, weakness and paralysis
What are common side effects of antidiarrheal drugs? Constipation, abdominal discomfort. dizziness and dry mouth
What is an alert for Pepto Bismol? It contains aspirin and can increase the effects of the anticoagulant warfarin.
What foods should patients with GERD avoid? Chocolate, peppermint, alcohol and caffeinated drinks
For best effects when should PPIs be given? Before meals, preferably in the morning
What are characteristics of a complex partial seizure? Loss of consciousness for 1 to 3 minutes and automatisms such as lip smacking, patting or picking at clothes.
What is a pediatric consideration with phenytoin? Excessive growth of gum tissue (gingival hyperplasia)
What are common side effects of first line drugs for generalized and partial seizures? Dizziness, drowsiness, nausea/vomiting and ataxia (loss of coordination)
What is the effect of drugs for partial and generalized seizures on anticoagulant drugs? Can increase the effects. Watch for abnormal bleeding.
What is the effect of drugs for partial and generalized seizures on oral contraceptive drugs? They interfere with the effects. An additional form of contraception should be used.
TRUE or FALSE: Absorption of phenytoin is decreased by antacids TRUE
TRUE or FALSE: Grapefruit and grapefruit juice increase the action of carbamazepine TRUE
Created by: judypilcher