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ResU Pharm
Pharm Final/ ATI
| Question | Answer |
|---|---|
| inhibits serotonin re-uptake by allowing serotonin to stay at the neuron junctions | SSRI |
| CNS depression, amnesia, Respiratory depression, cardiac arrest, paradoxical response, manifestations or withdrawal | Adverse Effects of Benzodiazepine |
| (Contraindication) Erythromycin, St John's Wort, and grapefruit juice increases medication effects | Non- Barbiturate Anxiolytic |
| Butabarbital, Amobarbital, Pentobarnital, Secobarbital,Mephobarbital | Barbiturates- inhibits neuronal impulse conductions |
| Antidote for Benzodiazepine Toxicity | Flumazenil |
| Pregnancy, uncontrolled pain, CNS depression, acute angle-closure glaucoma | C/C: Benzodiazepines |
| Orthostatic hypotension, Anticholinergic effects, sedation, toxicity, decrease in seizure threshold, excessive sweating | TCA- Tricyclics |
| PRIL | ACE Inhibitors |
| PRESSIN | Anti-Diuretic |
| PINE (exception) Diltiazem | Calcium Channel Blockers |
| ZOLE | Protein Pump Inhibitor |
| PAM, LAM (exception) Chlordiazepoxide, Clorazepate | Benzodiazepines |
| Antidote is Phentolamine or Nifedipine | MAO Inhibitors |
| GI distress, polyuria,weight gain, goiter, hypothyroidism, bradycardia,hypotension, electrolyte imbalance | Lithium |
| blocks serotonin, dopamine, norepinephrine,histamine,acetylcholine | Atypical Anti-Psychotics |
| neuroleptic malignant syndrome, muscle rigidity, change in consciousness levels, Anticholinergic effects, neuroendocrine effects | Conventional Anti-Psychotic Adverse effects |
| Atomoxetine | SNRI Drug |
| Paroxetine, Sertraline, Escitalopram, Fluvoxamine | Selective Serotonin Reuptake Inhibitors |
| Increases levels of norepinephrine, serrotonin and dopamine in the CNS | CNS Stimulant Methylphenidate |
| Slows sodium entering the neuron suppressing neuron firing and inhibiting GABA effects | Hydantoins |
| GI effects, CNS effects, indicated for absent seizures ONLY | Succinimides ex. Ethosuximide |
| treatment of myoclonic seizures | Valproic Acid |
| Teratogenesis- birth defects, bone marrow suppression, bleeding disorder,liver disorder | Carbamazepine |
| Tyramine enriched foods interact with what drug | MAO INHIBITORS |
| aged cheese...peperoni...salami...avocado...figs...bananas...smoked fish...protein supplements...soups...soy sauce...some beers...red wine are examples of what? | Tyramine Enriched Foods |
| (Early Effects)Nausea, diaphoresis, tremor, fatigue, drowsiness, (Later Effects) Sexual Dysfunction | SSRI's |
| use mouth guard...do not discontinue abruptly...avoid caffeinated beveraged | Nursing Administration for SSRI's |
| Bruxism | excessive teeth grinding |
| Androgens Suffix | terone |
| Adverse effect of Ace Inhibitors | Cough |
| Beta Blocker Suffix | lol |
| Anti Viral Suffix | vir |
| Thyroid Hormones contains | "thy" |
| Antilipidemic Suffix | statin |
| Haloperidol | Blocks dopamine, acetylcholine, histamine,and norepinephrine receptors |
| Extrapyramdial side effects | Acute dystonia, parkinsonism, akathisia, tardive dyskinesia |
| Atypical Antipsychotic | -pine, done |
| Clozapine | works by blocking serotonin and some dopamine receptors |
| CNS stimulation | insomnia, restlessness, headaches, dizziness, blurred vision, aphasia, vomiting, depression |
| Ritalin | Methylphenidate, ADHD |
| Proper use of a patch for Ritalin | use on hip, 1 per day, no longer than 9 hrs. |
| Phenytoin and Lamotrigine adverse effects | Teratogenic effect (cleft palate, heart defects) |
| Hydantoins | control seizures by slowing entrance of sodium into neuron. Suppress neuron firing. inhibits effects, |
| Alkylating Agent (Chlorambucil) is typically used for... | slow growing cancers |
| Used for absence seizures only | Exthosumides |
| Treats partial seizures can also manage bipolar disorder | Carbamazepines |
| Valproic acidic side effects | GI effects, hepatoxicity, fatigue, abdominal pain, jaundice. pancreatitis, thrombocytopenia |
| Alkylating Agent | non cell specific, most useful in the treatment of slow-growing cancers. |
| Chlorambucil Adverse effects | tremors, muscle twitching, confusion, nausea, hepatotaxcity, bone marrow, suppression, sterility, more cancer |
| Priority nursing action for Benzodiazepine toxicity | level of orientation |
| Antimetabolite agents are used for? | rapidly growing neoplastic and normal cells |
| Methotrexate | treats leukemia, psoriasis, rheumatoid, choriocarinomas |
| Doxorubicin adverse effect | cardiac toxicity , alopecia, RED urine, fever, chills, rash, acute cardiac dysrythmias, cardiomyopathy |
| treats leukemia, cancers, and liposomal for AIDS associated Kaposi sarcoma | Doxorubicin |
| Mitotic inhibitors | Vincristine |
| Vincristine side effects | Ataxia, cranial nerve, neuritic pain, muscle wasting, loss of hair, death, constipation, neuropathy |
| Tamoxifen is a drug used for | breast cancer |
| causes hotflashes, rash, nausea, vomiting, vaginal bleeding, menstrual irregularities, edema, pain, CVA, pulmonary emboli | Tamoxifen |
| Aspirin actions | inhibit synthesis of prostaglandin of inflammatory rxn |
| NSAIDS | Ibuprofen |
| Ibuprofen adverse effects | headache, dizziness, somnolence, fatigue, rash, nausea, dyspepia, bleeding, constipation |
| Acetaminophen causes | vasodilation |
| acetaminophen adverse effects | do not take over 4 grams daily |
| Lidocaine actions | CNS excitiation, hypotension, bradycardia, allergic, RXN, labor and delivery, spinal headache, urinary retention |
| direct-acting cholinergic agonist | Bethanechol |
| Name a Chlonergic agonists | pyridastgime |
| pyridastigime uses | prevents CHK from inactivating ACh, increase ACh at receptor site |
| Pyridastigime administration | take at the same time everyday, very low doses |
| Dopamine adverse effects | Beta receptor acitvation in the heart can cause dysrhythmia, increase workload of heart, oxygen, necrosis |
| treatment of pain, arthritis, dysmenorrhea, juvenile arthritis | Ibuprofen |
| Dopamine actions | activation of receptors in the kidneys caused renal blood vessels to dilate, increases heart rate, MI contractility, AV nodes, vasoconstriction for shock |
| what do immune stimulants do | Stimulate bone marrow to produce more white blood cells |
| Interferon Alfa-2b treatments | Leukemia, warts, hep b malignant melanoma |
| Communicate between lymphocytes-stimulate cellular immunity & inhibit tumor growth | Intereukins |
| T and B cell suppressor | Cyclosporine |
| Cyclosporine uses | block antibody of B cells and T cells |
| Cyclosporine A/E | tremor, HTN, gum hyperplasia, diarrhea. hirsutism, acne, renal dysfunction |
| Measles, mumps, rubella | activates an active immune rxn with the production of antibodies to the viruses |
| At what age are MMRs given | 12-15 months |
| What is Immune Globulin used for | provides passive, short term immunity, Prophylaxis after exposure to hep A., measles, varicella, or rubella |
| Immune Globulin adverse effects | tenderness, muscle stiffness, rash, angiodema, vomiting, chills, fever, chest lightness |
| Treatment of specific renal carcinomas in adults | Aldesleukin |
| Volatile liquids used in outpatient surgery | Halothane |
| Very potent amnesiac used therapeutically, for diagnostic and endoscopic procedures | Non Barbiturate Midazolam |
| emergence delirium, headaches,restlessness,anxiety,cardiac/resp depression,apnea,hiccups,salivation, rash | Adverse Effects of Barbiturate Anesthetics |
| Preferred over ergot derivatives | Triptans |
| Numbness, tingling in fingers/toes, pulselessness, weakness in legs, tachycardia, ergotism | Ergot Derivatives |
| binds strongly to opioid receptors but doesn't activate them | Narcotic Antagonist |
| Stimulates only specific opioid receptors | Narcotic Agonist |
| drowsiness, dizziness, weakness, fatigue, diarrhea, hepatitis, myalgia, tachycardia, BP changes, rash and urinary frequency | Adverse effects for Muscle Relaxants |
| Interferes with reflexes that causes muscle spasms in the CNS ----SPASMOLYTICS | Baclofen |
| diminishes neuron excitability, decrease dopamine, centrally acting antagonist | Anticholinergic Agent Diphenhydramine |
| CNS effects, atropine like effects, skin discoloration (livedo reticularis) | Adverse effects of Dopaminergic Agent Amantadine |
| pain relief with opioid receptors | Narcotics |
| Morphine Antidote | Naloxone |
| Atropine is an anticholinergic should not be used in patients that have what? | narrow angle glaucoma |
| atropine is the antidote for what ? | Cholinergic drugs |
| how long is a medication holiday | 10 days |
| RN Rationale for Orthostatic Hypotension | Monitor BP and HR before administering meds and 1 HR after |
| Voiding before taking meds, increasing fluids( 2-3L daily), chewing sugar-free gum, exercise, sip water, wear sunglasses, high fiber diet | Minimizing Anticholinergic effects |
| Common manifestation of a toxicity or reaction | fever |
| Lithium A/E of fine hand tremors that interfere with motor skills can be resolved with | Beta blockers-Propranolol |
| < 1.5 mEq/L Lithium Level | withhold medication |
| 1.5- 2.0 mEq/L Lithium Level | Promote excretion |
| 2.0- 2.5 mEq/L Lithium Level | Gastric Lavage |
| 2.5 and > | Hemodialysis |
| Tetrogenic especially in 1st trimester | Lithium |
| Obtain Lithium blood levels at what time | Morning |
| _________ are best given slow and low | Medications |
| Halperidol A/E--EPS, acute dystonia, Parkinsonism and Akathisia can be treated with | Anticholinergic Agents |
| Diazepam Contraindications | Sleep apnea, respiratory depression, glaucoma, liver disease, Hx of mental illness, Hx of substance abuse |
| After taking Benzodiazepines regularly Pt's need to be _______________ for several weeks | tapered slowly |
| Tx: seizures, severe convulsions, anxiety, alcohol withdrawal, tetanus,pre-op sedation | Benzodiazepine- Diazepam |
| C/C: glaucoma, psychosis,shock,coma,acute alcohol intoxication | Diazepam |
| Tx: seizures, anxiety, sedative (hypnotic), pre-anesthesia | Phenobarbital |
| A/E: CNS depression, hallucinations, headaches, vomiting, nausea, diarrhea, nightmares,insomnia, hypotension, bradycardia, ataxia, hyperkinesias, withdrawal, respiratory depression, Steven Johnson Syndrome, altered balance/proprioception | Barbiturates- Phenobarbital |
| Phenytoin | Tx: tonic-clonic seizures, control status epilepticus, seizures post neurosurgery |
| A/E: CNS depression, confusion, liver toxicity, cardiac arrthymias, decreased libido, urinary retention, decreased bone depression, gingival hyperplasia, Steven Johnson | Hydantoin- phenytoin |
| Tx: Absent seizure | Succinamides- ethosuximide |
| D 2 D: Anti-histamines, TCAs, barbituates, MAOIs, alcohol (Herbs)Chamomile, Kava, Valerian | Benzodiazepines |
| R/I: admin. in slow doses, give w/food, monitor renal/liver funct, access anxiety B/A Tx, notify Provider if dose becomes ineffective, taper slow, | Benzodiazepines |
| Depresses CNS by mimicking/enhancing GABA effects | Benzodiazepines |
| D 2 D: Warfarin, Beta-blockers, corticosteroids,valproic acid, TCAs, theophyllines, contraceptives, MAOIs, Acetaminophen (Herbs) Kava, Valerian | Barbituates |
| Unknown mechanism- mimics/enhances GABA | Barbituates |
| C/C: pregnancy, uncontrolled pain, CNS depression, Hx of acute porphyria | Barbituates |
| R/I: Assess sleep patterns, Avoid alcohol, monitor drug serum levels/Resp/CV dep, taper slow | Barbituates |
| Butyrophenones, Atypical Anti-psychotics, Phenothiazines | blocks dopamine, inhibits chemoreceptors in the medulla's trigger zone |
| Tx: Nausea, vomiting during surgery, or diagnostic procedures, anesthesia, psychosis, Tourette synd, explosive hyperactivity in children | Haloperidol Droperidol |
| C/C: angle-closure glaucoma, CNS depression, may reduce seizure threshold, MI, Heart disease, benign prostatic hyperplasia, orthostatic hypotension prolonged QT (Droperidol) | Butyrophenones, Atypical Anti-psychotics |
| A/E: EPS, Tardive kinesis, Neuroleptic Malignant synd, sedation, blurr'd vision, dry mouth, constipation, blood dyscrasias, photosensitivity, sunburn, heat intolerance | Butyrophenones, Atypical Anti-psychotics |
| D 2 D: alcohol, CNS depression, antihypertensives, nitrates, antacids, neuroleptics | Haloperidol, Droperidol |
| R/I: Avoid alcohol, driving, CNS depressants | Butyrophenones |
| Haloleridol, Droperidol | Anti-psychotics |
| Tx: psychosis, OCD, Bipolar, recurrent suicidal behavior | Risperidone, clozapine. clomipramine, danzipine, loxapine |
| R/I: Assess mental status, monitor for EPS, orthostatic hypotension, RBC,WBC, avoid antacids w/i 1 hr of med intake, taper slow, avoid alcohol, use sunscreen and protective clothing | Atypical- Anti-psychotic |
| Phenothiazines | chlorapromazine, mesoridazine, fluphenazine, thioridazine, trifluoperazine, thietylperazine |
| Tx: psychosis, schizoaffective disorders, psychotic features w/ organic brain synd, nausea, vomiting | Phenothiazines |
| R/I: Pink/ Reddish Brown urine, Monitor Pts QT Interval w/ thioridazine, consult provider before taking OTC drugs | Phenothiazines |
| amitriptyline, Iimipramine, amoxapine, clomipramine,desipramine,doxepin,mirtazapine, nortriptyline protriptyline, bupropion, duloxetine, fluoxetine, maprotiline, nefazodone, trazodone,venlafaxine | TCA's |
| Tx: Depression, Bipolar disorder, neuropathic pain, fibromyalgia, anxiety, insomnia | Amitriptyline |
| A/E: Orthostatic Hypotension, Anticholinergic effects, Sedation, decreased seizure threshold, excessive sweating, cardiac dysrhythmias | TCAs |
| Imipramine | C/C: Pregnancy, seizure disorder, CV disease, diabetes, liver/kidney disorder, respiratory disorder, urinary retention/ obstruction, open angle glaucoma, benign prostatic hyperplasia, hyperthyroidism |
| D/D: MAOIs, St John's Wort, antihistamines, anticholinergic agents, alcohol, benzo's and opioids | TCAs |
| MAOIs | Phenelzine, Selegiline, Tranylcypromine, Isocarboxazid |
| blocks reuptake of serotonin and norepinephrine | TCAs |
| blocks MAO increasing norepinephrine, dopamine, serotonin | MAOIs |
| Tx: Bulimia nervosa, depression | Phenelzine |
| A/E: Orthostatic Hypotension, CNS stimulation, Hypertensive crisis, rash | MAOIs |
| C/C: diabetes, seizure disorder, pregnancy, HF, CVD, renal insufficieny | Selegiline |
| D/D: TCAs, SSRIs, Meperidine, Vasopressors, caffeine, tyramine rich foods | Phenelzine |
| R/I: Avoid OTC cold/decongestants, monitor B/P, restrict tyramine enriched foods | MAOIs |
| Physotigmine | TCA antidote |
| R/I: take meds as prescribed 2 establish therapeutic level and maintain, monitor for toxicity, give at bedtime, changes positions slowly, evaluate effectiveness | TCAs |
| Treats Bipolar disprder, acute mania, return mania/depression, decreases incidence or suicide, alcohol disorder, bulimia nervosa, psychotic disorders | Lithium carbonate |
| A/E; GI distress, fine hand tremors, polyuria, weight gain, renal toxicity, goiter/hyperthyroidism,bradydysrhythmia, hypotension, electrolyte imbalance | Lithium |
| valproic acid, carbamazepine | AED- Anti-epileptic drugs |
| SSRI | Fluoxetine |
| C/C: Pregnancy, renal dysf, CVD, Na depletion, dehydration | Lithium |
| D/D: NSAIDs, Diuretics, Anticholinergincs | LITHIUM |
| Effexor | SNRI |
| Tx: nerve pain, depression, anxiety | Effexor |
| A/E: n/v, Anti-cholinerginc, CNS effects, libido/ ED, Serotonin synd | SNRI-Effexor |
| increases phenytoin effects | Alcohol, Diazepam, Cimetidine and Valproic Acid |
| Carbamazepine | decrease phenytoin effects |
| Grapefruit juice inhibits metabolism in | Carbamezipines |
| Phenytoin and phenobarbital | decrease carbamazepine effects |
| Gabapentin | Neuropathy |
| Ethosuximide, Valproic Acid and Lamotrigine | Treats absent seizures |
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