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Advanced pharm final
| Question | Answer |
|---|---|
| Aspirin interactions (2) NSAIDs | ibuprofen & warfarin |
| Aspirin complications (4) NSAIDs | GI effects, bleeding, Reye's syndrome, & salicylism |
| Ibuprofen & celecoxib complications (3) Non-aspirin NSAIDs | GI irritation, increased risk for myocardial infarction, & impaired kidney function |
| Acetaminophen uses (2) | pain & fever reliever |
| Acetaminophen complication (1) | acetaminophen overdose |
| Tramadol complications (6) | sedation, dizziness, seizures, respiratory depression, nausea, & constipation |
| Butorphanol complications (6) Opioid agonist-antagonist | abstinence syndrome, headache, nausea, dizziness, respiratory depression, & sedation |
| Butorphanol contraindication (1) Opioid agonist-antagonist | physical dependence on opioids |
| Naltrexone use (1) Opioid antagonists | severe opioid-induced constipation |
| Naloxone use (1) Opioid antagonists | opioid overdose |
| Naltrexone & naloxone complications (4) Opioid antagonists | tachycardia, tachypnea, increased pain, & abstinence syndrome |
| Allopurinol use (1) Uricosurics | hyperuricemia |
| Dexamethasone interaction (1) Glucocorticoids | furosemide |
| Dexamethasone complications (6) Glucocorticoids | peptic ulcer disease, GI discomfort, fluid/electrolyte imbalances, osteoporosis, hyperglycemia, & infection |
| Dexamethasone administration considerations (2) Glucocorticoids | taper drug, let the patient know they'll be really hungry at first but that'll go away with time |
| Zolpidem complication (1) Non-benzodiazepines | memory impairment (r/t complex sleep behaviors) |
| Baclofen complications (2) Centrally-acting muscle relaxants | CNS depression & seizures |
| Valporic acid complications (5) Anti-epileptics | drowsiness, sedation, headache, rash (Steven-Johnson's syndrome), & hepatotoxicity (jaundice & abdominal pain) |
| Phenytoin patient instructions (3) Hydantoins | use a soft-bristle toothbrush, report rashes, & don't drive if CNS effects occur |
| Midazolam therapeutic effect (1) Anesthesia support | muscle relaxant |
| Ritalin & Adderall action (2) CNS stimulant | used to treat ADHD & narcolepsy by increasing focus |
| Ritalin & Adderall complications (3) CNS stimulant | CNS stimulation, cardiovascular effects, & weight loss |
| Modafinil administration considerations (1) Non-amphetamines | it's for narcolepsy, so take it in the morning so it can have the effect all day |
| Carbidopa-levodopa action (1) Anti-Parkinson's | produces dopamine |
| Carbidopa-levodopa complications (2) Anti-Parkinson's | nausea & orthostatic hypotension |
| Xanax complications (6) Benzodiazepines | CNS depression, respiratory depression, anxiety, tolerance, withdrawal symptoms, & amnesiac effects |
| Amitriptyline complications (3) Tricyclic antidepressants (TCAs) | orthostatic hypotension, sedation, & anticholinergic effects |
| Amitriptyline administration considerations (1) Tricyclic antidepressants (TCAs) | can take 2-3 weeks to work |
| Fluoxetine/Venlafaxine use (1) SSRIs/SNRIs | anxiety |
| Fluoxetine/Venlafaxine complications (4) SSRIs/SNRIs | decreased libido, weight changes, serotonin syndrome, & increased risk for suicide |
| Phenelzine sulfate complications (2) MAOIs | HTN & hypertensive crisis |
| Bupropion XL use (3) Atypical antidepressants | depression, smoking cessation, & seasonal affective disorder (SAD) |
| Lithium carbonate use (1) Mood stabilizer | bipolar disorder |
| Lithium carbonate interactions (2) Mood stabilizer | NSAIDs & LASIX |
| Chlorpromazine/Risperidone use (1) Antipsychotics | schizophrenia |
| Chlorpromazine complications (5) Antipsychotics | extrapyramidal symptoms, acute dystonia, photosensitivity, anticholinergic effects, & hypotension |
| Risperidone complications (3) Antipsychotics | dyslipidemia, extrapyramidal symptoms, & seizures |
| Betaxolol/Timolol use (1) Beta Blocker | glaucoma |
| Betaxolol/Timolol complications (2) Beta Blocker | ocular stinging & bradycardia |
| Insulin complications (2) | hypoglycemia & lipohypertrophy |
| Glargine (Lantus) Long-acting insulin onset, peak, & duration | onset: 70 mins no peak duration: 24 hrs |
| NPH (Humulin/Novolin) Intermediate-acting insulin onset, peak, & duration | onset: 1-2 hr peak: 6-14 hr duration: 16-24 hr |
| Regular (Humulin/Novolin) Short-acting insulin onset, peak, & duration | onset: 30 mins peak: 1-5 hr duration: 6-10 hr |
| Lispro (aspart/glulisine & Humalog/Novolog) Rapid-acting insulin onset, peak, & duration | onset: 15 min peak: .5-2.5 hr duration: 3-6 hr |
| Exenatide associated lab (1) Incretin mimetics | A1C blood sugar test |
| Glucotrol XL use (1) Sulfonylureas | type 2 diabetes |
| Glucotrol XL complication (1) Sulfonylureas | hypoglycemia |
| Repaglinide administration considerations (1) Meglitinides | take no more than 30 mins before meals |
| Metformin complication (1) Biguanides | lactic acidosis |
| Pioglitazone complications (3) Thiazolidinediones | fluid retention, lipid level elevation, & hepatotoxicity |
| Pioglitazone labs (2) Thiazolidinediones | liver function tests & lipids lab |
| Acarbose complications (3) Alpha-glucosidase inhibitors | hypoglycemia, anemia, & hepatotoxicity |
| Glucagon uses (2) | hypoglycemia & insulin overdose |
| Levothyroxine use (1) Thyroid replacements | hypothyroidism |
| Levothyroxine complication (1) Thyroid replacements | overmedication (hyperthyroidism) |
| Levothyroxine administration consideration (1) Thyroid replacements | take daily on an empty stomach 30-60 mins before breakfast |
| Levothyroxine associated labs (3) Thyroid replacements | TSH, T3, & T4 |
| Propylthiouracil (PTU) uses (2) Antithyroid drug | Grave's disease & thyrotoxicosis |
| Propylthiouracil (PTU) complications (3) Antithyroid drug | hypothyroidism, agranulocytosis, & myalgia |
| Antithyroid drug 131 use (1) | thyroid cancer |
| Antithyroid drug 131 patient instructions (2) | allow 2-3 months to reach full effect & increase fluids in 2-3L/day |
| Somatropin uses (2) Growth hormone | Turner's syndrome & Prader-Willis syndrome |
| Somatropin complications (2) Growth hormone | hyperglycemia & hypercalciuria |
| Somatropin labs (2) Growth hormone | blood glucose & urine calcium |
| Desmopressin use (1) Antidiuretic hormone | diabetes insipidus |
| Desmopressin measurement of effectiveness (2) Antidiuretic hormone | BUN/Creatinine & electrolyte labs |
| Hydrocortisone use (1) Glucocorticoid | Addison's disease |
| Heparin lab & range (1) Parenteral anticoagulants | aPTT (60-80 secs) |
| Difference between heparin & enoxaparin Parenteral anticoagulants | enoxaparin is a low-weight heparin whose results are more predictable than heparin |
| Warfarin action (1) Oral anticoagulants | prevents clots by antagonizing vitamin K |
| Warfarin use (1) Oral anticoagulants | prevents strokes in patients with a-fib |
| Warfarin labs & ranges (2) Oral anticoagulants | PT (11-13.5 secs) & INR (2-3) |
| How long can heparin & warfarin be used together | just until warfarin reaches the therapeutic level |
| Warfarin administration considerations (5) Oral anticoagulants | take at the same time each day, avoid foods high in vitamin K, avoid alcohol, avoid acetaminophen, & discontinue 7 days before surgery |
| Ecotrin complications (3) Salicylics | GI effects, GI bleeding, & salicylism |
| Clopidogrel action (1) ADP inhibitors | inhibits platelet aggregation |
| Clopidogrel complications (2) ADP inhibitors | bleeding & thrombocytopenia |
| Alteplase action & use (2) Thrombolytics | dissolves clots that are already formed & used to treat PE & ischemic stroke |
| Alteplase administration considerations (2) Thrombolytics | best if given within 3 hours of the onset of symptoms & patient should be at close observation for bleeding throughout treatment |
| Ferrous sulfate administration considerations (4) Iron deficiency drugs | best not to take oral tablet with meals (but can if absolutely needed) & for liquid meds: dilute with water, drink through a straw (no swish and swallow), & rinse mouth afterwards |
| Ferrous sulfate expected side effects (1) Iron deficiency drugs | expect dark tarry stools (that's ok with this med) |
| Cyancobalamin uses (2) Vitamin B12 deficiency drug | pernicious anemia & vitamin B12 deficiency |
| Folic acid administration considerations/patient education (2) Folic acid deficiency | expect warmth after IV administration & increase foods high in folic acid |
| Methotrexate complications (4) DMARDS I | increased risk for infection, bone marrow suppression, GI ulcers/bleeding, & mouth ulcers |
| Methotrexate administration considerations (5) DMARDS I | take with food, increase fluids, use reliable contraception, avoid alcohol, & take with folic acid |
| Etanercept complications (4) DMARDS II | irritation at injection site, sick for infection, skin rash (Steven-Johnson's syndrome), & heart failure |
| Raloxifene action (1) SERMs | mimics the effect of estrogen on the bone tissue |
| Raloxifene complications (3) SERMs | increased risk for PE, increased risk for DVT, & hot flashes |
| Raloxifene administration considerations (4) SERMs | increase calcium & vitamin D intake, monitor bone density & serum calcium levels, use reliable contraception, & increase weight-bearing activities |
| Alendronate action (1) Bisphosphonates | increases bone mass by decreasing osteoclast activity |
| Alendronate complications (4) Bisphosphonates | esophagitis, musculoskeletal pain, visual disturbances (blurred vision), & jaw pain |
| Alendronate administration considerations (3) Bisphosphonates | take 1st thing in the morning on an empty stomach, remain upright for 30 mins, & increase weight-bearing activity |
| Calcitonin action (1) | increases calcium excretion |
| Calcitonin complications (3) | hypersensitivity, hypocalcemia, & nasal irritation |
| Calcitonin administration considerations (4) | don't give to a patient with a salmon allergy, for intranasal: hold pump upright, prime the pump, & alternate nostrils |
| Calcium supplements action (1) | raises calcium levels |
| Calcium supplements complications (2) | hypercalcemia & kidney stones |
| Calcium supplements administration considerations (4) | take 1 hr apart from glucocorticoids, take 1 hr after meals, take with 8oz of water, & take no more than 600mg in a dose |
| Calcium supplements lab & range (1) | serum calcium lab 9-10.5 |
| Succinylcholine complications (3) Neuromuscular blocking agents | hyperkalemia, respiratory arrest, & malignant hyperthermia |
| Influenza vaccine contraindications (4) | sensitivity to eggs, anaphylactic reaction to previous vaccines, severe febrile illness, & immunocompromised (especially with live vaccines since they'll get the illness) |
| Varicella vaccine contraindications (2) | sensitivity to gelatin or neomycin |
| MMR vaccine contraindication (1) | pregnancy |
| Immunizations that are safe to administer during pregnancy (2) | Tdap & influenza |
| Acetaminophen antidote | Acetadote |
| Morphine antidote | naloxone |
| Insulin antidote | glucagon |
| Heparin antidote | protamine |
| Warfarin antidote | vitamin K |
| Alteplase antidote | aminocaproic acid (Amicar) |
| Neostigmine antidote | atropine (AtroPen) |
| Temazepam antidote (same as Xanax) | flumazenil |
| Xanax (alprazolam) antidote (same as Temazepam) | flumazenil |
| A patient beginning therapy with etanercept should be tested specifically for which 2 disorders? | HepB & TB |
| What are administration considerations for a patient who is prescribed 1500mg of calcium carbonate per day (4)? | Divide each dose into less than 600mg (so 3 doses of 500mg) Chew tablets before swallowing Take within 1 hour apart from other meds (bc it’s an antacid & it decreases the absorption of other meds) Drink at least 8oz of water with it |
| Which vaccines would be recommended for a 4-year-old child? (5) | Dr. Hip DTaP, RV, Hib, IPV, & PCV |
| Heparin lab | PTT |
| Warfarin lab | PT |
| Oprelvekin lab | platelets |
| Filgrastim lab | WBC |
| Epoetin alfa lab | Hmg/Hmt |
| At what ages is it recommended for an infant to receive the Hep B vaccine? (3) | birth, 2 months, & 6 months |
| What is the normal lab value range for serum calcium levels? | 9-10.5 |
| Onset for aspart | 15-30 mins |
| Onset for regular insulin | 30-60 min |
| Onset for NPH | 6-14 hr |
| Onset for glargine | 1.5-2 hr (70 mins usually) |
| Betaxolol is used to treat... | glaucoma |
| Bupropion is used to treat... | depression |
| Lithium is used to treat... | bipolar disorder |
| Risperidone is used to treat... | schizophrenia |
| What are the adverse effects associated with giving naloxone for a morphine overdose? (2) | respiratory depression & sedation |
| What are 2 complications associated with butorphanol? | HTN & respiratory depression |
| Which vaccines are safe to administer during pregnancy? | influenza & Tdap |
| Which adverse effects would you monitor in a patient receiving clopidogrel? (4) | bleeding, weakness, vision changes, & thrombocytopenia |
| What is the primary complication associated with Ambien (or zolpidem)? | memory loss r/t sleep-related complex behaviors |
| What are administration considerations when educating about levothyroxine? (2) | therapy is life-long & take it at the same time each day |
| Which time frame is alteplase most effective when given? | within 3 hours of the onset of symptoms |
| What is allopurinol used to treat? | gout & hyperuricemia r/t to gout and chemotherapy |
| What is the antidote for neostigmine? | atropine (AtroPen) |
| What is the best time of day for a patient to receive Provigil (modafinil)? | in the morning since it's used for narcolepsy, so it can work throughout the day |
| What would a nurse monitor to determine the effectiveness of desmopressin? | urine output |
| Which vaccine is a contraindication for a patient with an allergy to eggs? | influenza |
| What is the antidote for acetaminophen? | acetylcysteine or Acetadote |
| What is the antidote for heparin? | protamine |
| What is the antidote for benzos? | flumazenil |
| True or False: A patient who takes alendronate should lie flat following administration. | false, they should remain upright for 30 mins |
| What is the antidote for insulin? | glucagon |
| True or false: The influenza vaccine composition changes yearly. | true, to predict the strain of virus for that year |
| True or false: Acetaminophen can reduce fever, relieve mild pain, & reduce inflammation. | false, it is a pain and fever reliever, but it doesn’t reduce inflammation |
| True or false: A complication related to antidepressants is suicidal thoughts. | true |
| True or false: Heparin and warfarin can never be used together. | false, they can be used together until warfarin reaches its therapeutic level |
| True or false: Lactic acidosis is an adverse reaction associated with metformin. | true |
| GI effects, bleeding, Reye's syndrome, & salicylism | Aspirin complications (4) NSAIDs |
| GI irritation, increased risk for myocardial infarction, & impaired kidney function | Ibuprofen & celecoxib complications (3) Non-aspirin NSAIDs |
| acetaminophen overdose | Acetaminophen complication (1) |
| sedation, dizziness, seizures, respiratory depression, nausea, & constipation | Tramadol complications (6) |
| abstinence syndrome, headache, nausea, dizziness, respiratory depression, & sedation | Butorphanol complications (6) Opioid agonist-antagonist |
| tachycardia, tachypnea, increased pain, & abstinence syndrome | Naltrexone & naloxone complications (4) Opioid antagonists |
| peptic ulcer disease, GI discomfort, fluid/electrolyte imbalances, osteoporosis, hyperglycemia, & infection | Dexamethasone complications (6) Glucocorticoids |
| memory impairment (r/t complex sleep behaviors) | Zolpidem complication (1) Non-benzodiazepines |
| CNS depression & seizures | Baclofen complications (2) Centrally-acting muscle relaxants |
| drowsiness, sedation, headache, rash (Steven-Johnson's syndrome), & hepatotoxicity (jaundice & abdominal pain) | Valporic acid complications (5) Anti-epileptics |
| CNS stimulation, cardiovascular effects, & weight loss | Ritalin & Adderall complications (3) CNS stimulant |
| nausea & orthostatic hypotension | Carbidopa-levodopa complications (2) Anti-Parkinson's |
| CNS depression, respiratory depression, anxiety, tolerance, withdrawal symptoms, & amnesiac effects | Xanax complications (6) Benzodiazepines |
| orthostatic hypotension, sedation, & anticholinergic effects | Amitriptyline complications (3) Tricyclic antidepressants (TCAs) |
| decreased libido, weight changes, serotonin syndrome, & increased risk for suicide | Fluoxetine/Venlafaxine complications (4) SSRIs/SNRIs |
| HTN & hypertensive crisis | Phenelzine sulfate complications (2) MAOIs |
| extrapyramidal symptoms, acute dystonia, photosensitivity, anticholinergic effects, & hypotension | Chlorpromazine complications (5) Antipsychotics |
| dyslipidemia, extrapyramidal symptoms, & seizures | Risperidone complications (3) Antipsychotics |
| ocular stinging & bradycardia | Betaxolol/Timolol complications (2) Beta Blocker |
| hypoglycemia & lipohypertrophy | Insulin complications (2) |
| hypoglycemia | Glucotrol XL complication (1) Sulfonylureas |
| lactic acidosis | Metformin complication (1) Biguanides |
| fluid retention, lipid level elevation, & hepatotoxicity | Pioglitazone complications (3) Thiazolidinediones |
| hypoglycemia, anemia, & hepatotoxicity | Acarbose complications (3) Alpha-glucosidase inhibitors |
| overmedication (hyperthyroidism) | Levothyroxine complication (1) Thyroid replacements |
| hypothyroidism, agranulocytosis, & myalgia | Propylthiouracil (PTU) complications (3) Antithyroid drug |
| hyperglycemia & hypercalciuria | Somatropin complications (2) Growth hormone |
| GI effects, GI bleeding, & salicylism | Ecotrin complications (3) Salicylics |
| bleeding & thrombocytopenia | Clopidogrel complications (2) ADP inhibitors |
| irritation at injection site, sick for infection, skin rash (Steven-Johnson's syndrome), & heart failure | Etanercept complications (4) DMARDS II |
| increased risk for PE, increased risk for DVT, & hot flashes | Raloxifene complications (3) SERMs |
| esophagitis, musculoskeletal pain, visual disturbances (blurred vision), & jaw pain | Alendronate complications (4) Bisphosphonates |
| hypersensitivity, hypocalcemia, & nasal irritation | Calcitonin complications (3) |
| hypercalcemia & kidney stones | Calcium supplements complications (2) |
| hyperkalemia, respiratory arrest, & malignant hyperthermia | Succinylcholine complications (3) Neuromuscular blocking agents |
Created by:
tiffhales
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