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Chapter 15, 16, & 17

Pharmacology

QuestionAnswer
Anti-Anginals & Peripheral Vasodilators Action Cause vascular smooth muscle to relax and decreases myocardial oxygen use.
Anti-Anginals & Peripheral Vasodilators Uses Relief of pain in acute angina. Prevention of angina attacks when used long-term.
Anti-Anginals & Peripheral Vasodilators Adverse Reactions Flushing, postural hypotension, tachycardia, dizziness, headache. High doses may cause violent headaches. Use extreme caution in patients with recent history of stroke.
Anti-Anginals & Peripheral Vasodilators Drug Interactions Nitrates increase the effect of atropine-like drugs & tricyclic antidepressants;decrease the effects of all choline-like drugs. Alcohol, beta-blockers, antihypertensives, narcotics, & vasodilators may produce severe hypotension & cardiac collapse.
Anti-Anginals & Peripheral Vasodilators Common Drug Names nitroglycerin
Anti-dysrhythmics Action Act on the individual cells of the heart to make the heart less excitable & maintain regular rhythm.
Anti-dysrhythmics Uses Treatment of acute & chronic cardiac dysrhythmias.
Anti-dysrhythmics Adverse Reactions Cardiac dysrhythmias, congestive heart failure, GI distress, bradycardia, dizziness.
Anti-dysrhythmics Drug Interactions Verapamil has increased effects when used at the same time as digoxin & beta blockers.
Anti-dysrhythmics Common Drug Names propranolol, digoxin, lidocaine, verapamil
Anti-hyperlipidemics Uses Treat hyperlipidemia.
Anti-hyperlipidemics Adverse Reactions Decreased liver function, constipation.
Anti-hyperlipidemics Drug Interactions Increases the effects of anticoagulants, making the patient at risk for bleeding. Decreases absorption of fat-soluble vitamins.
Anti-hyperlipidemics Common Drug Names atorvastatin Ca (Lipitor)
Anti-hyperlipidemics Suffix -statin
Cardiotonics Action Increase the force of the heart's contraction & slow the heart rate.
Cardiotonics Uses Treat heart failure & rapid or irregular heartbeats.
Cardiotonics Adverse Reactions Signs of digitalis toxicity include dysrhythmias, excessive fatigue, confusion, blurred vision yellow-green vision, seeing spots or halos, anorexia, nausea & vomiting.
Cardiotonics Drug Interactions Beta-adrenergic blocking agents, calcium gluconate, calcium chloride, & verapamil increase the therapeutic & toxic effects of cardiotonics. Any medication that changes the electrolyte balance may also lead to digitalis toxicity.
Cardiotonics Common Drug Names digoxin (Lanoxin)
Anti-hypertensives, Diuretics, & Renal Uses Treatment of elevated blood pressure. Used in conjunction with lifestyle changes. Diuretic may be used to lower blood pressure or to reduce edema.
Anti-hypertensives, Diuretics, & Renal Adverse Reactions Hypo- or hyper-kalemia, drowsiness, bradycardia, sexual dysfunction, headache.
Anti-hypertensives, Diuretics, & Renal Drug Interactions Check with a drug handbook for drug interactions prior to administering. Be particularly careful with drugs that lower blood pressure to avoid severe hypotension.
Anti-hypertensives, Diuretics, & Renal Common Drug Names propranolol (Inderal), captopril (Capoten), nifedipine (Procardia), verapamil (Calan), furosemide (Lasix)
Anti-hypertensives, Diuretics, & Renal Suffixes Beta blockers:-olol Ace-inhibitors:-pril Calcium channel blockers:-ipine
Other Non-Diuretic Drugs for urinary problems Action Stops contraction of the bladder & decreases the response of some bladder muscles.
Other Non-Diuretic Drugs for urinary problems Uses Urinary incontinence, benign prostatic hyperplasia, short term analgesia in patients with UTI.
Fluid & Electrolyte Uses Replace fluid & electrolytes lost through poor dietary intake, vomiting or severe diarrhea.
Anti-Migraine Medication Action Reduces cerebral blood flow & arterial pulsing, which reduces headache pain.
Anti-Migraine Medication Uses Prevention & treatment of vascular (migraine) headaches.
Anti-Migraine Medication Adverse Reactions Heart murmurs, dizziness, drowsiness, fixed miosis (constriction) of the pupil of the eyes, paresthesias
Anti-Migraine Medication Drug Interactions Cannot be used at the same time as MSOI's, SSRI's, or lithium
Anti-Migraine Medication Common Drug Names sumatriptan succinate (Imitrex), dihydroergotamine (DHE45, Migranal)
Anticonvulsants or Antiepileptic Uses 1 of 2 Decrease frequency of seizure activity in pt with seizure disorder. Barbiturates for status epilepticus. Benzodiazepines for partial seizures. Hydantoins for tonic-clonic & psychomotor seizures. Succinimides for absence seizures.
Anticonvulsants or Antiepileptic Uses 2 of 2 GABA medications are effective in treating all types of seizures. Dylantin (a hydantoin) is the most commonly used anticonvulsant.
Anticonvulsants or Antiepileptic Adverse Actions Ataxia (poor coordination), dizziness, drowsiness, hallucinations, inattentiveness, ocular disturbances.
Anticonvulsants or Antiepileptic Drug Interactions Additive effect when used with other CNS depressants or alcohol. Refer to a drug handbook before administering.
Anticonvulsants or Antiepileptic Common Drug Names phenobarbital, diazepam (Valium), phenytoin (Dilantin)
Antiemetic-Antivertigo Meds Uses Control nausea & vomiting. Control acute vertigo & nausea, Extreme hiccups.
Antiemetic-Antivertigo Meds Adverse Reactions Drowsiness, sedation, dry mouth, blurred vision, constipation.
Antiemetic-Antivertigo Meds Drug Interactions Other CNS depressants increase the sedative effect of antiemetic agents.
Antiemetic-Antivertigo Meds Common Drug Names prochlorperazine (Compazine), diphenhydramine (Benadryl)
Anti-parkinsonian Meds Uses Control the symptoms of Parkinson disease.
Anti-parkinsonian Meds Adverse Reactions Dysrhythmias, muscle twitching, rigidity, GI distress, blurred vision.
Anti-parkinsonian Meds Drug Interactions Refer to a drug handbook.
Anti-parkinsonian Meds Common Drug Names diphenhydramine (Benadryl)
Anti-Anxiety Meds Uses Relieve anxiety, tension & fears. Management of delirium tremens after alcohol withdrawal.
Anti-Anxiety Meds Adverse Reactions Hypotension, tachycardia, confusion, drowsiness, insomnia.
Anti-Anxiety Meds Drug Interactions Alcohol, anesthetics, MAO inhibitors or CNS depressants may increase the effect of anti-anxiety meds. Caffeinated products & excessive cigarette smoking can decrease the anti-anxiety effect.
Anti-Anxiety Meds Nursing Implications Patient should be prescribed the lowest dosage possible to reduce the risk for overdose, especially in those with history of drug addiction or dependence.
Anti-Anxiety Meds Common Drug Names diazepam (Valium)
Tricyclic Antidepressants Uses Relieve the symptoms of severe depression that has internal biologic causes.
Tricyclic Antidepressants Adverse Reactions Dysrhythmias, postural hypotension, confusion, drowsiness that lasts a long time, photosensitivity.
Tricyclic Antidepressants Overdosage Initially causes CNS stimulation, followed by CNS depression until coma or cardiorespiratory arrest occur.
Tricyclic Antidepressants Drug Interactions Increases the CNS depressant effect of alcohol & other CNS depressants. The effect of anticonvulsants may be decreased when used with TCA's.
Tricyclic Antidepressants Common Drug Names amitriptyline
Monoamine Oxidase Inhibitors (MAOIs) Uses Relieve the symptoms of severe reactive or endogenous depression that have not responded to TCA therapy or other treatments. Second-line treatment for depression because of their serious adverse effects.
Monoamine Oxidase Inhibitors (MAOIs) Adverse Reactions Dysrhythmias, ataxia, drowsiness, hallucinations, photosensitivity.
Monoamine Oxidase Inhibitors (MAOIs) Drug Interactions May potentiate the CNS depressant effect of alcohol anesthetics, sedatives, hypnotics & narcotics. Drug handbook should be consulted.
Monoamine Oxidase Inhibitors (MAOIs) Food & Beverage Interactions High in tyramine and other vasopressor amines; as well as alcohol. These foods interact with MAOIs and cause sudden and severe hypertension. See box on pg 279.
Selective Serotonin Reuptake Inhibitors Action Prolong the effect of natural serotonin in the brain.
Selective Serotonin Reuptake Inhibitors Uses Drug choice for most depressive disorders due to their low incidence of adverse effects.
Selective Serotonin Reuptake Inhibitors Adverse Reactions Dizziness, drowsiness, weight gain, insomnia, sexual dysfunction in males.
Selective Serotonin Reuptake Inhibitors Drug Interactions Wellbutrin has interactions with levodopa and other anticonvulsants. Prozac interacts with warfarin & digitoxin.
Selective Serotonin Reuptake Inhibitors Common Drug Names fluoxetine (Prozac), bupropion (Wellbutrin)
Antipsychotic Meds Uses Reducing & relieving acute & chronic psychosis of schizophrenia, schizoaffective disorders, & involutional psychosis.
Antipsychotic Meds Adverse Reactions Weight gain, glucose metabolism, increased risk of development of Type 2 diabetes, changes in cardiac rhythm.
Antipsychotic Meds Drug Interactions Many other drugs interact with antipsychotic meds & the patient should be closely monitored.
Anti-Manic Meds Uses Used to treat patients with bipolar disorder who are in acute manic phase; prevents recurrent manic episodes. Mood-stabilizing drug.
Anti-Manic Meds Adverse Reactions Dysrhythmias, dizziness, slurred speech, rash, abdominal pain.
Anti-Manic Meds Overdose May produce toxicity which will present as diarrhea, vomiting, muscle weakness, drowsiness & ataxia
Anti-Manic Meds Drug Interactions Use of lithium with diuretics can lead to lithium toxicity. Consult drug handbook.
Anti-Manic Meds Common Drug Names Lithium
Sedative-Hypnotic Meds Action Relaxes the patient & may lead to sleep. Induces drowsiness & promotes sleep in the patient.
Sedative-Hypnotic Meds Uses Short-term treatment of insomnia.
Sedative-Hypnotic Meds Adverse Reactions Drowsiness, decreased emotional reaction distortion of mood, impaired coordination.
Sedative-Hypnotic Meds Drug Interactions Increase the effects of other CNS depressants & alcohol.
Pain Medication Action Prevent pain perception in the central nervous system.
Pain Medication Uses Treatment of moderate to severe pain.
Pain Medication Adverse Reactions Bradycardia, decreased respiratory rate, hypotension, confusion, constipation.
Pain Medication Drug Interactions Other CNS depressants & alcohol increase the effects of narcotics. Anesthetics, muscle relaxants, & antidepressants also increase the effects of narcotics.
Pain Medication Common Drug Names morphine, MS Contin, codeine, Narcan
Pain Medication Tolerance same amount of drug produces less effect over time
Pain Medication Dependence state in which the body shows withdrawal symptoms when the drug is stopped or a reversing drug or antagonist is giver
Pain Medication Addiction the desperate need to have & use a drug for a nonmedical reason & patients have a limited ability to control their drug use
Anti-Anginals & Peripheral Vasodilators Nursing Implications Wear gloves. Get full description of angina. Stop smoking,limit alcohol,salt. Lose weight, exercise,diet rich in fruit/veg, potass.& mag., avoid sat. fats, reduce stress. Tablet in cheek/under lip to dissolve. Stop if blurred vision, headache. Take B/P.
Anti-Anginals & Peripheral Vasodilators Patient & Family Teaching After meds if pain persists call for help. Nitroglycerine is fragile, keep out of sun, expires in 3 mo's. Use gloves. Analgesics for headache. Nitro ointmnt close tight/in fridge. Thin layer on skin w/ruler. Hairless spot. If dev. tolerance stop few days.
Antihypertensive Medication Patient & Family Education Change positions slowly to avoid or minimize postural hypotension.
Antimigraine Medication Patient Education Take the medication at the onset of a headache for the greatest relief.
Nitroglycerin Patient Education Do not stop taking nitroglycerin suddenly. Gradually cut down the frequency of the medication over a period of time.
Anti-hyperlipidemic Medication and Patient Education Do not take other medication for 4-6 hours after taking anti-hyperlipidemic.
Anti-Anginals and Patient Education Avoid heavy exercise to prevent future attacks.
Diuretic medication and Patient Education Diuretics should be reduced gradually when they are discontinued by the physician.
Early signs of toxicity in patient taking anti-Parkinson medication Muscle twitching and blepharospasm
Antivertigo Medications and Patient Education Take 30-60 minutes before airplane or boat departure.
Signs of narcotic overdose Decrease in mental alertness, cyanosis, respiratory depression.
Diuretic Medications and Patient Education When taking a thiazide diuretic, the patient should supplement their potassium intake.
Anti-parkinson Medications and Nursing Implications Long-term use of these medications often leads to tardive dyskinesia
Narcan and Nursing Implications After administration of Narcan, monitor closely for rebound narcotic symptoms since Narcan is short-acting.
Signs and symptoms of digitalis toxicity Excessive fatigue, yellow-green vision, seeing halos or bright lights, anorexia, nausea.
Lithium and Patient Education Drink adequate amounts of fluid. Contact health care provider if you develop vomiting or diarrhea. Avoid activities that lead to excessive sweating. Keep all appointments and get labs drawn as ordered.
Nitroglycerin and Patient Education Medication should be replaced every 3 months and should cause a throbbing in the head when taken. Take medication every 3 minutes for a total of three doses, if necessary. If pain is not resolved, call 9-1-1.
Created by: ms_molly
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