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FINAL EXAM
| Question | Answer |
|---|---|
| what is the medication class of phenytoin? | anticonvulsants (hydantoins) |
| what is the therapeutic uses of phenytoin? | treats tonic-clonic seizures |
| what is the trade name of phenytoin? | Dilantin |
| what is the therapeutic range of phenytoin? | 10-20 mcg/mL |
| what are the toxicity symptoms of phenytoin? (CNS symptoms) | ataxia, nystagmus, gait unsteadiness, slurred speech, confusion, coma |
| what are the expected symptoms of phenytoin? | gingival hyperplasia |
| what is the hypersensitivity reaction of phenytoin? | stevens-johnson syndrome-->RASH that is painful, flu-like symptoms |
| what is the clinical action when a patient has a hypersensitivity reaction to phenytoin? | STOP the medication if these develop while taking phenytoin |
| what is the patient education of phenytoin? | to help with gingival hyperplasia-->good oral hygiene, use a soft-bristle toothbrush, visit the dentist regularly, folic acid supplementation |
| Is phenytoin a medication you can abruptly stop? If not, why? | NO!! may cause multiple seizures or even status epilepticus |
| what is the medication class of lithium? | mood stabilizer |
| what are the therapeutic uses of lithium? | treats bipolar disorder, regulate mood swings (depression & mania) |
| what type of therapy is lithium? think of L's | Lithium is a Long term maintenance therapy |
| what is the therapeutic range for lithium? | 0.6-1.2 mEq/L NARROW therapeutic range |
| what is the toxic range of lithium? | >1.5 mEq/L |
| what organs clear lithium? | kidneys |
| how does toxicity occur with lithium? (the four D's) | Dehydration Decreased renal function Diet low in sodium Drug interactions (NSAIDs & thiazide diuretics) |
| what are the S+S of lithium toxicity? | GI symptoms-->nausea, vomiting, diarrhea Neurological manifestations--> ataxia, confusion, agitation, neuromuscular excitably |
| what are the expected side of effects of lithium? | drowsiness, weight gain, dry mouth |
| what is the patient education for lithium? | DO NOT restrict SODIUM AND WATER intake-->maintain a consistent sodium intake and drink plenty of fluids to avoid dehydration To help with dry mouth, suck on ice chips, sugar-free gum or candy, and drink water |
| What must a patient be monitored for when on lithium? | Blood labs--> to monitor lithium levels Blood will be drawn every 1-2 months |
| what is the medication class for benzodiazepines ? | anti-anxiety (anxiolytics) |
| What are the therapeutic uses for benzos? | treats ACUTE anxiety, sedation/muscle relaxant, treats seizures, treats alcohol withdrawal |
| what medications is classified as a benzo? | diazepam & lorazepam |
| what is the trade name for diazepam? | Valium |
| what is the trade name for lorazepam? | Ativan |
| what is the antidote for benzos? | flumanezil |
| what are the ADVERSE REACTIONS of benzos? | Hypotension, RESPIRATORY ARREST, apnea, airway occlusion |
| what is the patient education for benzos? | not meant for long term therapy due to increased risk for physical and psychological DEPENDENCE, use of long term therapy leads to TOLERANCE take at bedtime since benzos cause sedation |
| Are benzos a drug that can be abruptly stopped? | NO! must be tapered |
| what medication are MAOIs (Monoamine oxidase inhibitors) in? | antidepressants |
| what are the therapeutic uses of MAOIs? | treats depressive episodes, bipolar disorder, OCD, neuropathy, and enuresis |
| What medications are classified as MAOIs? | tranylcypromine, isocarboxazid, phenelzine |
| what is the trade name for tranylcypromine? | Parnate |
| what is the trade name for isocarboxazid? | Marplan |
| what is the trade name for phenelzine? | Nardil |
| What medications can you NOT TAKE while on MAOIs? | SSRIs or TCAs |
| If a patient needs to take a SSRI or TCA while being on MAOIs, what must you educate? | WASHOUT PERIOD--> wait 14 days after being off MAOIs to start taking TCAs or SSRIs |
| What do ALL ANTIDEPRESSANTS put a patient at risk for ? | increased SUICIDE risk-->especially in children and young adults |
| what is the patient education for MAOIs? | Tyramine-restricted diet-->risk for HYPERTENSIVE CRISIS (fermented foods-->aged cheese, meats/liver, over-ripe fruit, sour cream, and yogurt) Take this medication in the morning-->cause sleep disturbance Can take up to 4 weeks to reach therapeutic level |
| what is the medication class for SSRIs? | antidepressants |
| what are the therapeutic uses for SSRIs? | treats depression, OCD, anxiety, eating disorders |
| What do SSRIs increase in the brain? | serotonin--> "Smiley Serotonin" |
| what medication is classified as an SSRI? | sertraline |
| what is the trade name for sertraline? | Zoloft |
| what are the side effects of SSRIs? (4 S's of SSRIs) | Serotonin syndrome Sexual dysfunction Stomach issues Swollen (weight gain) |
| what are the S+S of serotonin syndrome? | muscle rigidity, high HR & BP, muscle tightness, mental changes |
| what medication do you NOT take at the same times as SSRIs? Why? | St. John's Wort-->increases serotonin levels in the brain, may cause serotonin syndrome |
| what is the patient education for SSRIs? | educate that medication may take effect 4-6 weeks (importance of compliance) Take medication in MORNING (SSRIs at Sunrise) eat a healthy diet and exercise regularly |
| Are SSRIs a medication that needs to be tapered? | YES |
| what medication can you NOT COMBINE with SSRIs? | MAOIs-->risk for serotonin syndrome |
| what medication class are TCAs in? | antidepressants |
| what are the therapeutic uses of TCAs? | treats depressive episodes, bipolar disorder, OCD, neuropathy, enuresis |
| what are the suffixes of TCAs? | -triptyline, -pramine |
| what are side effects of TCAs? | dizziness, orthostatic hypotension, dry mouth, constipation |
| what is the patient education for TCAs? | may take 2-3 weeks to take effect WAIT 14 days after being off MAOIs to start taking TCAs get up slowly from bed or sitting position-->due to orthostatic hypotension |
| what is the medication class of aspirin? | analgesics, anti-platelet, salicylate acid |
| what are the therapeutic uses of aspirin? | treats mild-moderate pain, decreases body temp, treats inflammatory conditions (RA, OA, rheumatic fever), decreases the risk of an MI or CVA |
| what is the antidote of aspirin? | sodium bicarbonate |
| what must you do with aspiring before surgery? | STOP taking acetylsalicylic acid 1-week prior |
| what does aspirin put that patient at risk for? | bleeding |
| what is the patient education for aspirin? | educate parents-->DO NOT give to children with a recent viral infection-->risk for reyes syndrome |
| what is the medication class of carbidopa/levodopa? | dopaminergic |
| what is the therapeutic use for carbidopa/levodopa? | treats/manages Parkinson's disease |
| what is the trade name for carbidopa/levodopa? | Stalevo |
| what is a harmless side effect of carbidopa/levodopa? | may cause dark color in saliva, urine, or sweat |
| what is the therapeutic response of carbidopa/levodopa? | DOES NOT improve memory or cure Parkinson's disease, but does help to make the disease more manageable |
| what is the patient education of carbidopa/levodopa? | take with food, FULL therapeutic effect may take several months, change positions slowly |
| what medications are NOT TO BE TAKEN with carbidopa/levodopa? | MAOIs due to risk of HYPERTENSIVE CRISIS |
| what medication class is clozapine and risperidone in? | ATYPICAL antipsychotics (second generation antipsychotic ) |
| what are the therapeutic uses of clozapine and risperidone? | helps diminish positive symptoms of schizophrenia & helps negative symptoms as well |
| what is the trade name of clozapine? | Clorazil |
| what the side effects of clozapine and risperidone? | NMS (lower risk than FGA), increased weight, increased cholesterol, increased triglycerides, increased BS |
| what is the BIG side effect of clozapine? | Agranulocytosis |
| what can ALL antipsychotics cause? (mainly TYPICAL antipsychotics) | NMS |
| what are the S+S of NMS? | high fever, muscular rigidity, altered mental status, autonomic disturbance-->sweating, high BP & HR |
| what is the patient education of clozapine and risperidone? | may take 6-10 weeks to take effect, to decrease the risk of gaining weight-->exercising, low-calorie diet, monitor weight. Report if any signs of infection |
| what is the trade name of risperidone? | Risperdal |
| what lab monitoring would be done with a patient on clozapine or risperidone? | BS, Lipid panel |
| what is the medication class of haloperidol? | TYPICAL antipsychotics (First generation antipsychotic) |
| what is the therapeutic use of haloperidol? | helps diminish POSITIVE symptoms of schizophrenia |
| what is the trade name of haloperidol? | Haldol |
| what is the side effects of haloperidol? | NMS |
| what is the patient education of haloperidol? | educate that it may take 6-10 weeks to take effect, tell client about adverse reactions and emphasize that adherence is very important |
| what is the medication class of valproic acid? | Carboxylic acid derivatives |
| what are the therapeutic uses of valproic acid? | treats epilepsy, migraines, headaches, and mania |
| what is the trade name of valproic acid? | Depakote |
| what is the therapeutic range of valproic acid? | 50-100 mcg/mL |
| what are the expected side effects of valproic acid? | nausea, vomiting, diarrhea, and heartburn |
| what are adverse reactions of valproic acid? | hepatotoxicity and prolonged bleeding time |
| what is the patient education for valproic acid? | swallow capsules whole, take with meals to decrease GI upset |
| is valproic acid a medication that needs to be tapered? If so, why? | YES, to prevent convulsions |
| what medication class is cephalosporins in? | antibiotics |
| what are the therapeutic uses for cephalosporins? | treats otitis media, respiratory infections, bone infections, UTIs, used for prophylactically pre-op, intra-op & post-op to prevent infections during surgery |
| what medications are classified as cephalosporins? | cefazolin, cephalexin, cefoxitin |
| what is the trade name for cefazolin? | Ancef |
| what is the trade name for cephalexin? | Keflex |
| what is the trade name for cefoxitin? | Mefoxin |
| what must you ask the patient before administering the first dose of a penicillin or cephalosporin? | ask about allergies to either-->cross sensitivity |
| what is the patient education for cephalosporins? | cephalosporins make ORAL CONTRACEPTIVES INEFFECTIVE-->use additional contraceptives DO NOT drink alcohol while on this medication |
| what is the medication class for vancomycin? | glycopeptide antibiotic |
| what is the therapeutic uses for vancomycin? | treats bacterial infections--> MRSA and C.DIFF in the gut |
| what is the trade name for vancomycin? | Vancocin |
| what is the therapeutic TROUGH levels for vancomycin? | 10-20 mg/L |
| what therapeutic levels of vancomycin will you hold the med for? | >20 mcg/L |
| How is vancomycin infused? | infuse over at least 60 minutes, 100 minutes if infusing >1 gram |
| What must you monitor for when a patient is on IV vancomycin? | peak & trough, BP, respiratory status, ANAPHYLACTIC REACTION, thrombophlebitis or extravasation (vancomycin is an irritant to the veins) |
| what are the S+S of an anaphylactic reaction? | hives, wheezing, angioedema, itching |
| What can occur if vancomycin is infused TOO FAST? | red man syndrome-->facial & upper body flushing and itching, red rash on chest, extremities, or face, hypotension |
| what must happen if red man syndrome occurs while infusing vancomycin? | STOP or SLOW the infusion |
| what are ADVERSE REACTIONS of vancomycin? | nephrotoxicity and ototoxicity (monitor hearing function) |
| what lab monitoring will be done on a patient thats on vancomycin? | Monitor kidney values, BUN & creatinine |
| what is the medication class of fluoroquinolones? | antibiotics |
| what are the therapeutic uses of fluoroquinolones? | treats lower respiratory infections, bone & joint infections, UTIs, STIs, skin infections, ophthalmic solutions for eye infections |
| what medication is considered a fluoroquinolone? | ciprofloxacin |
| what is the trade name for ciprofloxacin? | Cipro |
| what is the BIG RISK of fluoroquinolones? | increased risk for tendonitis & achilles tendon rupture (especially in elderly taking corticosteroids) |
| what is the patient education for fluoroquinolones? | drink 2-3 liters of water per day-->Sulfas can DRY OUT the body causing crystalluria wear sunblock and avoid the sun |
| what is the medication class of penicillin? | antibiotics |
| what are the therapeutic uses of penicillin? | treats UTIs, treats septicemia, meningitis, intra-abdominal infections, STIs (syphilis), treats respiratory infections (pneumonia) |
| what medication is classified as a penicililn? | amoxicillin |
| what is the trade name of amoxicillin? | Amoxil |
| what are penicillins commonly used for? | penicillins are commonly used as Prophylaxis (prevention) against secondary infections |
| what is the patient education for penicillin? | take additional contraceptives-->makes oral contraceptives ineffective |
| What medication class are aminoglycosides in? | antibiotics |
| what are the therapeutic uses of aminoglycosides? | bowel preparation-->decrease normal flora in the GI for those having abdominal surgery manages hepatic coma-->decreases the ammonia in the intestines |
| what medications are considered aminoglycosides? | gentamicin and neomycin |
| what ADVERSE EFFECTS can aminoglycosides cause? | nephrotoxicity-->proteinuria, hematuria, and increased BUN & creatinine ototoxicity--> tinnitus, vertigo, hearing loss, may be permanent neurotoxicity-->numbness, tumors, convulsions, muscular paralysis |
| what is benzatropine? | an anticholinergic medication (ANTIDOTE) to treat extrapyramidal symptoms associated with some antipsychotic medications |
| what is the trade name for benzatropine? | Cogentin |
| what are examples of EPS? | dystonia, akathisia, Parkinsonism, tardive dyskinesia |
| what medication class are SNRIs/DNRIs in? | antidepressants |
| what are the therapeutic uses of SNRIs/DNRIs? | treats depressive episodes, fibromyalgia, anxiety disorders, diabetic neuropathic pain |
| what medications are classified as SNRIs/DNRIs? | bupropion and duloxetine |
| what is the trade name for bupropion? | Wellbutrin |
| what is the trade name for duloxetine? | Cymbalta |
| what is the medication administration for bupropion? | DO NOT chew, cut, or crush this medication, swallow whole |
| what is the patient education for SNRIs/DNRIs? | educate that it may take 4-6 weeks to take effect |
| What medications can you NOT mix SNRIs/DNRIs with? | DO NOT mix with TCAs or MAOIs |
| Is carbidopa or levodopa the gold standard for Parkinson's disease? | Levodopa |
| Does carbidopa or levodopa cross the BBB and change dopamine in the brain? | levodopa |
| Can levodopa be administered alone? | NEVER, always administered with carbidopa |
Created by:
mkozej001
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