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Pharm Final-Kandy
everything...mostly
| Question | Answer |
|---|---|
| Sympathetic does? | fight or flight, adrenergic |
| Parasympathetic does what? | rest, digest, cholinergic |
| Which drugs enhance sympathetic response? | adrenergic |
| Which drugs inhibit sympathetic response? | adrenergic blockers |
| Which drugs stimulate parasympathetic response? | cholinergic |
| Which drugs inhibit parasympathetic response? | anticholinergic |
| Adrenergic stimulated by what? | catecholamines: epi & norepi from adrenals. |
| Location of Norepi ? | at nerve terminals |
| Locations of Dopamine? | is in brain. |
| ANS receptor types (2)? | alpha and beta |
| Action of Beta blockers? | act against inotropics to slow HR, against dilation of peripheral vessles and bronchial walls |
| What do Dopaminergics do? | - stimulates to improve symptoms of Parkinsons |
| Action of Adrenergics? | increase HR, dilate bronchi |
| Beta blockers do what? | Block beta recepters, cause vasodilation. |
| Beta blockers end in what? | End in olol |
| Pt ed for beta blockers includes ? | check HR & BP before taking med. |
| Don’t’ give beta blocker to asthmatics why? | bc constricts bronchi. |
| Example of cholinergic which reverses muscle relaxants, post op, urinary retention & Counters neuromuscular blocking agents | neostigmine |
| Anticholinergic, classic example? | atropine |
| SE of anticholinergics? | Dry mouth, urinary retention, caution in BPH, narrow angle glaucoma |
| Cardiac use for atropine? | Increases HR, used for brady. |
| BP aka? | systemic arterial pressure |
| Normal BP treatment? | none |
| PreHTN Tx? | just below stg 1, dietary & exercise |
| Tx HTN Stage 1: | diuretics |
| Tx Stage 2 HTN: | drug combo (diuretics plus beta blocker, ace inhibitors, etc) |
| ACE inhibitors & ARBs work on what? | kidneys |
| Drugs for HTN: | diuretics, ACE, ARB, beta blockers, ca channel blockers, central acting alpha agonist, direct renin inhibitor, alpha 1 adrenergic blockers, |
| Sx Systolic dysfx: | decreased exercise intolerance, poor peripheral tissue perfusion |
| Sx Diastolic dysfx: | pulmonary congestion, pulmonary edema |
| Body compensate for inadequate output by: | epi & norepi, retain water & Na…increases workload of heart |
| RAAS stimulates renal tubules to? | retain water & Na to increase preload. |
| Goals of HF treatment: | reduce fluid overload, increase exercise tolerance, prolong life |
| Drugs to reduce preload? | loop diuretics, ACE, beta blockers, phosphodiesterase inhibitors, nitrates, nesiritide, nitroprusside |
| Drugs to reduce afterload: | ACE, beta blockers, ca channel blockers, phosphodiesterase inhibitors, hydralazine, nesiritide, nitroprusside |
| “prils” are what? | ACE inhibitors |
| Ca channel blockers action? | slow HR, diltiazem Phosphodiesterase inhibitors interaction? |
| Angina is caused by what? | vasoconstriction |
| Variable presentations of anigina: | squeezing, pressure, tightness, chocking, burning, heaviness, may radiate to neck |
| Precipitating factors for angina: | physical activity, exposure to cold, caffeine, smoking, stress, sex, large meals |
| Chronic stable angina sx: | angina with exertion, relieved by rest or nitro |
| Unstable angina sx: | unpredictable not relieved by rest, serious come for treatment |
| Treatment goal: | prevent MI & death, pain relief. |
| Alternative treatments for angina: | angioplasty, CABG |
| Drugs for angina: | nitrates, beta blockers, ACE inh, Ca channel blockers, fatty oxidase enzyme inhib, statins, platelet active agents (prevent clotting) |
| Common cold Tx: | decongestants, antihistamines, analgesics, antipyretics, expectorants, antitussive |
| Tx for allergic rhinitis: | antihistamines, inransal anti-inflammatory |
| Rhinitis medicamentosa: | rebound congestion, overuse of intranasal steroids |
| Lower resp diseases: | COPD, chronic airflow disease, asthma, chronic bronchitis, emphysema |
| Main cause of COPD: | smoking |
| Chronic Bronchitis caused by what? | smoking |
| COPd retain what? | CO2 |
| Asthma is what frequency? | intermittent |
| Antiemetics: | anticholinergics, sedative hypnotics, benzos, phenothizines, antihistamines, |
| Antispasmodics | atropine, belladonaa, robinul, bentyl |
| Bentyl action: | anticholinergic |
| Bentyl use: | IBS Bentyl contraindication: |
| Aluminum hydroxide & Ca carbonate Antacid SE: | constipation |
| Antacid interactions: | tertacyclines, digoxin, iron, cipro, sucralfate |
| CHF need what kind of antacid? | low sodium |
| H2 receptor antacids? | tidiness (cimetidine, ranitidine, famotidine) |
| Which H2RA may cause heptatoc with other drugs? | cimetidine |
| What do H2 receptor ant do? | lower acid in stomach |
| GI Prostaglandin? | cytotec (misoprostol) |
| Use of GI prostaglandins? | used in pt with issues from taking NSAIDs |
| PPI do what? | interfere with pump in parietal cell to produce HCL |
| PPI treats? | GERD, gastritis |
| PPI eg: | prazoles…omeprazole (Prilosec), esomeprazole (nexium), lansoprazole, pantoprazole (protonix) |
| Ulcer Coating Agent? | Carafate (sulcrafate) |
| When to take Carafate? | on empty stomach, 30 min before antacid |
| Prokinetic? | metoclopramide (reglan) |
| Action of metoclopramide? | increases stomach contractions, relaxes pyloric sphincter SE metoclopramide? |
| Interaction for metoclopramide? | alcohol |
| Gram neg cause of UIT? | e coli |
| Sx of uti? | burning, urgency, frequency |
| Antibiotics for UTI’s: | mandelamine, nitrofurantoin |
| Spasms for UTI: | anticholinergic agent |
| Uercholine action? | stimulates parasym nerve that causes contraction in bladder |
| Prostigmin use? | postop urinary retention |
| Pyridium use? | anesthsic, stopd burning, turns urine orange |
| Centrally acting skeletal muscle relaxants? | Baclofen, flexeril |
| Baclofen use: | spasms from MS, spinal injury, cerebral palsy |
| Direct Acting: | Dantolene (also for malignant hypethermia) |
| Neuromuscular blocking agent: | Sux, anesthesiologist, resp failure risk |
| What is primary response to alpha 1 receptor stimulation? | vasoconstriction |
| Why are beta adrenergic blockers used cautiously in pt with resp conditions like asthma or COPD? | may produce severe bronchoconstriction |
| What common adverse effect are adrenergic drugs known to cause? | tremors |
| Body fx such as BP, HR, and temp are regulated by which nervous sys | autonomic |
| Which term describes the collective sx of blurred vision, constipation, urinary ret, dry nose mouth & throat? | anticholinergic effects |
| Pt prescribed aticholinergic for IBS; for which adverse effect must the nurse teach the pt to be aware when beginning this drug? | orthostatic hypotension |
| Pt with recent MI is given a beta adrenergic blocking agent, which sx would be of concern? | decrease in HR from 88 to 46 |
| Pt with Parkinsons has difficulty performing movements, which is called? | dyskinesia |
| Pt on levodopa for 4 mo has been instructed to take drug holiday for 10 d, what should he expect? | possible stay in hospital while not taking the drug |
| What range of systolic BP is classified as preHTN? | 120-139 |
| What would be a non-pharm method of controlling BP? | restrict sodium intake, reduce wt, exercise |
| Which ethnic group has highest incidence of HTN? | African American |
| Pt with HTN, what would initial recommendation be? | Diet & exercise |
| Pt with elevated BP is being treated with loop diuretic; what must be periodically assessed? | potassium loss |
| Up to 1 | 3 of pt who take ACE inhibitors for HTN report which sx after beginning therapy? |
| A pt has been placed on a loop diuretic to reduce fluid in the lungs. Which statement indicates a need for further teaching? | I’ll be sure to take my med with supper |
| The use of diuretics in the treatment of heart failure may lead to what? | hypotension |
| Pt with a Hx of HF is prescribed furosemide (Lasix). Several days after starting, the pt has confusion, tremors, cramps & nausea; what does nurse suspect? | hypokalemia |
| Digoxin & Lasix have risk for what? | Dig toxicity |
| Pt receiving furosemide for a month has pain in toes. Pt states he has had it for years. What does nurse suspect? | gout |
| Which is a common finding with combination diuretic products? | increase risk of hyperkalemia and hyponatremia |
| Pt is on niacin; which common and avoidable adverse effect does nurse included in education? | flushing, itching, & headache |
| Pt in ER has dyspnea, severe ankle swelling, & BP of 210 | 110. The nurse will administer which drug? |
| What type of anti-HTN agent requires assessment for resp conditions before starting because this class of drugs may cause a chronic cough? | ACE inhibitors |
| What are the Sx of dig tox? | anorexia, N&V, blurred vision (yellow aura) |
| When administering SL nitro for emergency tx of angina, monitor for which SE? | HA (dt vasodilation in head) |
| Someone at picnic is holding chest and looking pale & diaphoretic. He reaches for nitro & placed under tongue. Ambulance is already called but picnic is in rural location. What other measure does nurse inititate? | Have the person chew an aspirin |
| For what reason is a pt who is using transdermal nitro instructed to remove the patch at bedtime and apply a new one in the morning? | to prevent tolerance |
| Which class of drugs should not be used when taking nitrates? | ED drugs |
| Beta blockers are very effective at reducing the O2 demand of the heart but with what disorder must they be used with caution? | chronic respiratory disease |
| A pt presents with a runny nose, sneezing, congested throat, chills, fever; what endogenous chemical is responsible? | histamine |
| A pt has a severe HA and pressure over the eyes, is congested, no temp, & Hx of sinus infection. What Rx agent does the nurse expext? | decongestant |
| When a person uses a topical decongestant frequently, the stops and notices even more congestions, what is happening? | Rebound effect (rhinitis medicamentosa) |
| What is the action of antihistamines? | occupy the receptor site for histamine |
| A pt is being treated with intranasal corticosteroid; which sever effect does the nurse teach? | bronchospasm |
| Human lungs consist of millions of alveolar sacs, if spread flat how big? | tennis court |
| Person who smoked 1.5 packs for 30 years has how many pack years? | 45 |
| Pt has harsh nonproductive cough and muscle aches for 5 days. No sore throat, temp, or swollen lymph nodes, but pt coughs too much to sleep. What med? | antitussive |
| Pt with Hx of emphysema has been coughing for a prolonged period after waking in the morning. Pt is having difficulty clearing the thick mucus from the lungs. What med? | mucolytic |
| 8 yo newly diagnosed with asthma has inhaler. What instructions for use does the nurse give? | use spacer between inhaler and lips to control med |
| Where is the vomiting center of the body? | medulla |
| Drug if stomach not emptying? | Reglan (prokinetic) |
| Which population is more prone to long-lasting effects of anesthetics? | obese (anesthetics stored in fat) |
| A pt with postop nausea vomited 20 min after arriving in recovery and now is retching. Pt is dizzy & light headed and has very slow pulse. What is happening? | vasovagal response |
| Pt reporting nausea & dizziness has inner ear infection. In addition to antibitics, what med? | meclizine (antivert) |
| What antiemetic is especially helpful in treating N & V from chemo | Zofran (ondansetron) |
| What percentage of US has GERD daily? | 5-7% |
| Pt has severe abd pain 45-60 min after eating. Dairy alleviates pain but Mexican food and alcohol worsen it. What med? | antacid |
| What common adverse effect of large amounts of aluminum based antacids? | constipation |
| Pt has PPI for GERD; what statement indicates need for further teaching? | This med will coat my stomach |
| Correct statement for Reglan? | will make GI move faster |
| An increase in which characteristic of urine may decrease the risk of bladder infections? | acidity |
| Pt has chronic urinary incontinence. What statements indicate needs for more teaching? | I am reducing the amount of fluids I drink during the day so I don’t leak as much |
| Which sx is an adverse effect of anticholinergic agents? | dry mouth |
| Which organism is most responsible for UTI? | e coli |
| Pt with traumatic spinal injury who just rcd a neuromuscular blocking agent. Which statement by student requires correction? | Pt has rcd neuromuscular agent and that is all that is needed |
| Pt with cerebral palsy has significant stiff involuntary muscle movements, which med? | Dantrolene |
| What is fx of centrally acting skeletal muscle relaxants? | treat muscle spasms with associated muscle spasms |
| Important action of neuromuscular blocking agent | |
| Which statement by MS pt indicate needs for teaching? | stopped taking my Baclofen 2 days ago |
| Sympathomimetics aka? | Adrenergic |
| Adrenergics do what? | stimulate the sympathetic system “fight or flight” |
| Alpha 1 controls what? | vasoconstriction of smooth muscle walls of arteries |
| Alpha 2 controls what? | negative feedback loop to prevent over-release of norepinephrine |
| Beta 1 does what? | increases HR and contractility |
| Beta 2 does what? | dilation of bronchial walls peripheral blood vessels |
| Indications for adrenergic meds? | anaphylaxis, cardiac arrest |
| Adrenergic med? | epinephrine |
| Action of adrenergic? | dilation of bronchi, vasoconstriction, increased HR & contractility |
| Define inotropic? | increases HR and contractility |
| SE of adrenergic? | ↑HR, ↑BP, angina |
| Adrenergic blocking agents do what? | block alpha or beta receptor sites |
| Non-selective adrenergic blockers do what? | block beta 1 AND beta 2 |
| Selective adrenergic blockers block what? | block beta 1 in heart but not beta 2 in bronchi |
| Adrenergic Blocking agent? | Dopamine |
| Dopamine indications? | heart failure and shock |
| Dopamine action: | inotropic plus vasoconstriction |
| Dopamine SE: | ↑BP, tachy or dysrhythmia, angina, extravation |
| Cholinergics do what? | act on parasympathetic |
| Cholinergic med? | prostigmine, urecholine |
| Prostigmine use: | reverse muscle relaxants in surgery, myasthenia gravis, prevent postop urinary retention |
| Prostigmine action: | ↑GI motility, contractions of urinary sphincter, contraction of skeletal muscle. |
| SE prostigmine: | diarrhea, cramping, bradycardia, ↓BP, bronchoconstriction |
| Urecholine use? | nonobstructive urinary retention |
| Urecholine action? | stimulates muscles of the bladder resulting in urination |
| Urecholine antidote? | atropine |
| Anticholinergics do what? | inhibit parasympathetic |
| Anticholinergic meds? | atropine |
| Atropine use? | preop to dry secretions, treat bradycardia, reversal of vagal stim caused by muscle relaxants or intubation |
| 2 treatments for bronchoconstriction | Direct (adrenergic), Indirect (anticholinergic) |
| Direct bronchodilators (4 adrenergics): | albuterol, metaproterenol, salmeterol, terbutaline |
| Indirect bronchodilators (2 anticholinergic): | ipotropium bromide (Atrovent), tiotropium bromide (Spiriva) |
| Treatment of pre-term labor? | brethine (adrenergic), relaxes uterine muscles |
| Treatment for overactive bladder? | Ditropan (oxybutynin), Detrol (tolterodine) |
| Parkinsons drug to slow progressive deterioration of dopamine producing cells? | MAOI-Eldepryl |
| Main interactions: | SSRIs, TCAs, meperidine, tyramine foods |
| Parkinsons drug to stimulate dopamine receptors in the brain | dopamine agonist: Mirapex, requip, parlodel, symmetrel, levodopa |
| Dopaminergic drug:. | Levodopa |
| SE Levodopa: | Orth hypoTN, N&V, tachy & dysrhythmias, discolored urine & sweat, malignant melanoma, nightmares, hallucinations, head bobbing, tics |
| Dopamine interactions: | B6. Benzos, phenothiazines, antipsychotics |
| Parkinsons drug that inhibits enzyme that destroys dopamine | carbidopa |
| SE carbodopa | ortho hypoTN, sleep attacks |
| Parkinsons drug that ↓ destruction of dopamine in peripheral tissues: | Comtan, only used in combo with levodopa-carbidopa |
| Parkinsons dopamine agonist | Symmetrel (antiviral med) |
| Parkinsons anticholinergics | Cogentin & arcane |
| Cogentin and Arcane do what? | reduce hyperstimulation caused by excess ACH. |
| What condition in the older adult male contraindicates Cogentin or arcane? | BPH |
| Adrenergic drugs that stimulate beta 1 receptors do what? | increase HR |
| Adrenergic drugs that stimulate beta 2 receptors do what? | bronchodilation, uterine relaxation, and vasodilation |
| Dopminergic drugs do what? | stimulate dopamine receptors, increases urine output by stimulating receptors in the kidneys |
| Common SE of adrenergics | hypotension |
| Adrenergic drugs | albuterol, dopamine, epi, norepi, terbutaline |
| Adrenergic blockers aka? | alpha and beta blockers |
| Non-selective beta blockers do what? | block both Beta 1 and 2 receptors |
| Non-selective beta blocker example? | propranolol |
| Selective beta 1 blockers do what? | act on heart but not on bronchi |
| Selective beta 1 blocker drug example? | metoprolol |
| Non-selective Beta blockers should be used cautionsly in which pt? | asthma, resp issues |
| What precaution is necessary with diabetics & beta blockers? | may mask signs of hypoglycemia |
| Action of cholinergics? | slow HR, increase GI motility, increased contractions of urinary bladder, relaxation of muscle sphincter, increased secretions and contractility of bronchi, sweating, tears. Cholinergic meds? |
| Which cholinergic treats myasthenia gravis? | prostigmine |
| Which cholinergic treats nonobstructive urinary retention (e.g. postpartum)? | urecholine |
| SE of anticholinergics? | dry mouth, dry eyes, decreased motility of GI, increased HR, decreased sweating |
| Anti-cholinergics should not be used in which condition? | narrow angle glaucoma |
| Anticholinergics drug examples? | atropine, belladonna, bentyl |
| What is atropine used for? | presurgery to reduce salivation and bronchial secretions & for intubation |
| Vasodilators Digoxin is in what drug class? | digitalis glycoside (originally derived from foxglove) |
| What actions does digoxin have on the heart (2)? | slows rate and increases force of contraction |
| Premedication assessment for digoxin? | apical pulse |
| Sx of dig tox? | N & V |
| Combination of digoxin & some antibiotics, corticosteroids, Lasix, or thiazide diuretics may cause what? | hypokalemia |
| Combo of digoxin and ACE inh, beta blockers, ARBs, heparin, potassiums, spironolactone, or succinylcholine may cause what? | hyperkalemia |
| How do Beta adrenergic blockers result in vasodilation? | inhbit renin release from kidneys and stopping the RAAS that would lead to vasoconstriction |
| Recommendation for initial drug therapy for stage 1 & 2 HTN? | thiazide diuretics and beta blockers or ACE inh |
| Pre-med assessment for beta-blockers? | BP & apical pulse |
| ACE inhibitors do what? | inhibit conversion of angiotensin 1 into 2, this reducing vasoconstriction; they reduce BP, preserve cardiac output, and increase renal blood flow |
| Premed assessment for ACE inh? | BP & HR, BUN, creatinine |
| SE of ACE inhibitors: | hypotension, chronic cough, angioedema, possible hyperkalemia |
| Examples of ACE inh? | all ending in “pril” |
| How do Ca channel blockers reduce HTN? | slow HR, relax smooth muscles of blood vessles |
| Examples of Ca Channel blockers? | all the “pines” plus diltiazem and verapamil |
| What is a benefit of Ca channel blocker over ACE inh? | can be used with asthma & other resp conditions, gout, & PVD |
| What do bile acid-binding resins do? | binds to bile acids in the intestine, preventing reuptake of bile, causing liver to produce more (uses cholesterol to make) & thus lowering cholesterol |
| Examples of bile acid binding resins? | cholestyramine, colestipol, and colesevelam (hint to remember chole is bile, styra sounds like Styrofoam which must be some kids of resin) Se of bile acid binding resins? |
| Drug interactions of bile acid binding resins? | digoxin, warfarin, thyroid h, thiazide diuretics, phenobarbital, NSAIDs, Glipzide, oral contraceptives, fat soluble vit |
| What does niacin do? | B vit which inhibits VLDL synthesis by the liver |
| What form of niacin is approved by FDA? | nicotinic acid |
| SE of niacin? | skin flushing |
| HMG-CoA inhibitors aka? | statins |
| What do statins do? | most powerful antilipemic, inhbits LDL synthesis in liver |
| What tests should be performed with statins? | LFT, q 4-6 for 1st 3 months, then q6months; pregnancy test |
| SE of statins | liver dysfx; myopathy, rhabdomyopathy; HA will usually go away |
| What food should be avoided with statins? | grapefruit juice |
| What are fibric acids? | lower triglycerides by 20-40% by unknown action, most effective triglyceride lowering agent |
| Examples of fibric acids? | gemfibrozil, fenfibrate (look for “FIBR”) |
| Labs for fibric acids? | LFT, blood glucose (may cause hyperglycemia) |
| What does ezetimbe do? | blocks absorption of cholesterol in the sm intestine without binding to it |
| What does Lovaza do? | omega 3, can’t be used in fish allergy |
| Diuretics What do sulfonamide loop diuretics do? | inhibit Na & Cl reabsorption in the loop of Henle, promoting diuresis & increases renal bf |
| What is a common loop diuretic? | Lasix (names means lasts six hrs) |
| Labs for Lasix? | daily wts, electrolytes |
| SE of Lasix? | dry mouth, hypotension, gout, hyperglycemia |
| Which electrolyte imbalance is most likely with Lasix? | hypokalemia |
| Lasix interactions? | Digoxin, cisplatin, NSAIDs, corticosteroids, aminoglycosides |
| What is ethacrynic acid? | prevents Na & Cl reabsorption, aka edecrin |
| What are thiazide diuretics? | act on distal tubules to block reabsorption of Na & Cl, which take water molecules along with them out of the body, aka benzothiadiazides |
| SE of thiazides? | hypotension, hypokalemia, hyperglycemia |
| Thiazide interactions? | normal stuff for diuretics plus lithium |
| What does spironolactone do? | blocks sodium retaining and potassium excreting properties of aldosterone, aka potassium-sparing |
| Most likely electrolyte imbalance with spironolactone? | hyperkalemia |
| SE of spironolactone? | hyperkalemia, gynecomastia Pt teaching with spironolactone? |
| Drug interaction spironolactone? | antihypertensives like ACE inh, ARBs |
| Antihistamines aka? | H1 receptor antagonists |
| If for alleriges, when should antihistamines be taken? | 45 to 60 min before exposure to allergen |
| Action of antihistamine? | do not block release of histamine but reduce the symptoms |
| Drug of choice for allergic rhinitis and conjunctivitis? | antihistamines |
| Antihistamine examples: | zyrtec, chlor-trimeton, Benadryl, allegra, atrovent, Claritin, phernegan |
| Antihistamines that can be injected? | Benadryl & Phenergan |
| SE of antihistamine: | sedation, drying effects |
| Antitussives do what? | suppress cough |
| Antitussive examples? | tessalon perles, dextromethorphan, diphenhydramine, codeine SE of antitussive? |
| Beta adrenergic Bronchodilator action? | stimulate beta receptors in smooth muscle of bronchi to relax & open airways |
| Examples of beta adrenergic bronchodilators? | albuterol, ephedrine, epinephrine, salmeterol, terbutaline |
| Spiriva? | once daily bronchodilator, not a rescue inhaler |
| Xanthine derivative example? | theophylline |
| SE of bronchodilators? | tachy, jittery |
| Corticosteroids inhaled for resp conditions? | pulmicort, fluticasone, mometasone |
| SE of steroid inhalers? | dry mouth, fungal inf |
| Phenothiazines as Antiemetics for chemo, surgery, & radiation? | prochlorperazine, promethazine (Phenergan) |
| Butyrophenones as antiemetics for surgery & chemo? | haloperidol, droperidol |
| Med for N&V rt GI Ca, gastritis, ulcers, radiation sickness, migraine? | metoclopramide |
| Serotonin antagonist as antiemetic? | ondansetron |
| What is benefit of ondansetron over metoclopramide? | more effective in cisplatin induced N & V, no EPS |
| SE of dopamine antagonist antiemetics? | extrapyramidal sx |
| Anticholinergics for motion sickness? | Dramamine, vistaril, antivert |
| Locally acting Anti-diarrheals? | charcoal, pectin, psyillium |
| Systemic anti-diarrheals | lomotil, immodium, paregoric, pepto bismol |
| Stimulant laxatives? | exlax (sennosides); causes irritation that stimulates perstalsis |
| Osmotic laxatives? | (lactulose, polyethylene glycol, glycerin) hypertonic compounds that draw water into the intestines |
| Which are faster acting osmotic laxatives? | polyethylene glycol and glycerin suppositories act in 1-2 hrs |
| Saline laxatives | Mg Citrate, fleet phosphasoda, Mg hydroxide |
| Lubricant laxatives? | mineral oil, lubricates intestinal wall & softens stool |
| Bulk-forming laxative? | psyllium…must be administered with full glass of water. Considered safest |
| Stool softener? | Docusate |
| Antispasmodic agents? | Ditropan, Detrol |
| Proton pump inhibitors action? | inhibit gastric acid secretion from the parietal cells |
| PPI drug examples? | “azoles” |
| PPI interactions? | warfarin, administer PPI 30 min before sucralfate |
| Histamine 2 blockers action? | blocks H2 receptors which decreases acid and increases pH of stomach |
| H2 blocker examplets? “tidines” like cimetidine | |
| H2 SE? | dizziness, somnolence, HA…usually resolve w continued therapy. Also, gynecomastia |
| Antibiotics for urosepsis? | |
| Medications for nonobstructive urinary retention? | bethanechol (urecholine) |
| Med for postop or post delivery urinary retention? | neostigmine |
| Bladder & ureter anesthetic? | pyridium (orange urine) |
| Drug classess for BPH? (2) | alpha 1 blockers, antiandrogens |
| Alpha1 adrenergic blocker for BPH? | Flomax, SE drowsiness, HA |
| Antiandrogens for BPH? | Avodart, Proscar, & Propecia |
| SE of antiandrogens for BPH? | decreased libido, impotence, decreased ejaculate vol |
| Centrally acting muscle relaxants do what? | act by CNS depression |
| Examples of centrally acting M relax? | flexeril, norflex |
| Serious SE of centrally acting m relax? | hepatotox |
| Direct Acting Muscle relaxants do what? | acts directly on muscle |
| Drug for spasticity rt cerebral palsy, MS, spinal cord injury, and also NMS? | dantrolene |
| Neuromuscular blocking agent does what? | interrupts impulses from motor nerves to muscles, eg for use in intubation |
| Neuromuscular blocking agent SE? | histamine leading to bronchospasm, resp distress |
| Examples of nm blocking agents (2)?? | succinylcholine & pancuromium |
| Which statement is the rationale for admin of a PPI to a pt with GERD? | PPI meds inhibit the enzyme that generates gastric acid |
| Which SE would the RN review with the pt who is prescribed cimetidine, a histamine blocker? | Med can cause impotence and gynecomastia |
| Pt w IBD is prescribed sulfasalazine, a sulfa antibiotic. Which intervention would the RN implement when administering? | ensure the pt drinks at least 2000 mL per day |
| Pt w IBD is taking mesalamine & co NVD. Which action should RN take? | Advise pt to keep taking but notify MD |
| Pt Dx w PUD & has H. pylori. What discharge instructions should the RN include? | take the combo of meds for 14 days as directed |
| Pt w severe CHF co indigestion. What antacid? | Riopan |
| Elderly pt Rx psyllium; what is most important question to ask? | do you have trouble swallowing? |
| Would you question admin of spironolactone to pt w K level 5.9? | yes, too high & spironolactone will increase K |
| Pt co diarrhea after trip to Mexico. What action should RN implement first? | ask how long she has had diarrhea and when she returned from Mexico |
| Chemo w cisplatin; what to prevent severe N & V? | Zofran 1 hr before chemo, ondansetron oral for next 4 days |
| Pt asks why he is Rx Flomax? | to increase urinary flow |
| Why must caution be used in Rx Phosphodiesterare inh to enhance male sexual fx? | interaction with cardio drugs...nitrates |
Created by:
wvc