Test 3 meds
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Procrit, EPO (erythopoietin) and Arnesp | Colony stimulating factor meds that stimulate erythrocyte production.
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| Celexa, Lexapro, Prozac, Paxil, Zoloft | SSRI selective seratonin reuptake inhibitors.
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| Decrease appetite = decreased nutrition with this type of antidepressant | SSRI's: celexa, lexapro, prozac, paxil, zoloft
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| Why is prozac (fluoretine) not suitable option for the elderly? | d/t the effects of weight loss
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| Which SSRI benefits elderly to increase appetite, wt gain | Remeron (mirtazapine)
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| Side effects of remeron | sleepiness, increased appetite, wt gain.
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| What nursing consideration ahould you consider when giving remeron | Give at HS r/t sleepiness
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| The action of this drug reuptakes serotonin and norepinephrine | Effexor
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| Effexor | increased b/p, GI upset & constipation, along with somnolence (sleepiness) are side effects of which anti-depressant?
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| This drug affects sleep due to Increase frequency and urgency | diuretics
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| This drug causes vivid dreams and insomnia | parkinson meds (levadopa/carbadopa & sinemet)
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| This drug acts like a stimulant, tremors, anxiety and effects sleep | Bronchodilators
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| This causes vivid dreams and extreme drowsiness or insomnia | Beta Blockers
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| A beverage that acts as a stimulate and diuretic causes sleeplisness | caffeine
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| This beverage causes pt to awaken earlier, unable to fall back asleep and causes nightmares | alcohol.
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| What type of drug causes sleepliness or insomnia. | antidepressants.
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| Ambien, Sonata, Lunesta, Rozerem | Sedative/hypnotics, benzo-benzo-like meds
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| This sedative hypnotic is the first choice of drug to help with insomnia | Ambien
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| How much ambien do you give at night? 5mg or 1-2mg | 5mg
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| why is ambien the 1st drug of choice? | Less hang-over effect
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| What is the onset of ambien? 5min, 30min, 1 hour | 30 minutes
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| What are the side effects of ambien | anxiety and agitation
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| Which sleeping medication has a rapid onset, and short duration. | Sonata
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| What time can you give sonata? | As late as 3am
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| 5mg | What dose do you give of Sonata? 1to2, 5mg?
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| What is the dosage amount can an elderly person recieve of the sleeping med Lunesta? 1 to 2mg, 5mg, 10mg? | 1 to 2 mg and 1 to 2 doses per elderly
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| What is the duration of lunesta? | Effects last about 8 hours
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| When should you take Lunesta? | Early in evening, d/t the drug interaction.
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| This affects melatonin | Rozerem (ramelteon) a little different class drug from the sleeping meds
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| Rozerem (Ramelteon) | This sleep aid is not a controlled substance and there is no risk for dependence.
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| Why is benadryl a bad drug for the elderly? | Can cause delirium, constipation, urinary retention.
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| This is an anticholingeric OTC drug that shoudl not be used by elderly. | benadryl
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| What does anticholinergic effects have on the body? | Dry mouth, urinary retention, blurred vision, constipation.
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| Pamelor (nortriptyline) Trazadone and remeron | Sedative antidepressants given to someone who is having trouble sleeping at night.
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| What are the benefits of nortriptyline, trazadone and remeron | decreases sleep latency, helps with depression and insomnia.
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| These sedative antidepressants cause orthostatic hypotension and daytime grogginess | nortriptyline, trazadone, remeron
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| Melatonin | natural hormone that affects the sleep/wake cycle.
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| levels of this natural hormone decreases in the elderly, therefore can be given as a sedative to help with sleep | melatonin.
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| Valerian Root | herbal med that decreases sleep latency and takes 1 to 3 weeks to take effect
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| MRS.K help with periodic limb movement disorder (nocturnal myoclonus) | mirapex, requip, sinemet, klonopin treat
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| Mrs. N helps with restless leg syndrome | mirapex, requip, sinemet,neurontin
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| Alpha Blockers that end in "-osin" that help in managing BPH | Cadura (doxazosin)
Hyrin (terazosin)
Flomax (Tamsulosin)
Urotraxal (alfuzosin)
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| The action of Alpha Blockers is to? | relax spinchter, relax smooth muscle to help effectiveness of prostate.
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| Which of the alpha blockers, block alpha receptors in prostate only? | Flomax (tamsulosin)
Uroxatral (alfuzosin)
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| What are the side effects of alfa blockers ("-osin")? | Decreases B/P, HA, fatigue, orthostasis/fainting, nasal congestion.
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| Should you check VS before giving alpha blockers? | Yes, it is recommended you check VS because it decreases B/P, and csn cause orthostatic hypotension and fainting.
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| Androgen HORMONE inhibitors that end in "-asteride" shrinks prostate so pressure is not on sphincter | Proscar (finasteride)
Avodart (dutasteride)
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| Proscar (finasteride) Avodart (dutasteride) | Shrinks prostate so pressure isn't on sphincter.
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| These BPH medications effect libido, can cause ED, and impotence? | Proscar (finasteride)
Avodart (dutasteride)
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| How long does it take Proscar and avodart to work? | One month
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| Which BPH med circultates in blood for at lease six months, there fore should not donate blood. | Proscar (finasteride)
Avodart (dutasteride)
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| What handling precautions should everyone consider, especially pregnant women,before handling proscar and avodart? | Should wear gloves since it absorbs through the skin.
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| This is a complimentary natural supplement to BPH medications | Saw Palmetto
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| Saw Palmetto actions | Decreases prostate size and relieves urinary symptoms, however mechanism of action is not known at this time.
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| B&O Suppositories | Controlled substance that help with Bladder spasms
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| This is given following a TURP surgery to eleviate discomfort and pain from bladder spasms | B&O suppositories.
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| A person is told that he has stage I prostate cancer. | This is found unexpectedly via PSA or DRE, person has few symptoms and cancer is confined within the prostate.
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| These hormone medications are given following a prostectomy | Lupron (leuprolide acetate)
Zoladex (goserelin)
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| This hormone therapy works on the pituatary to decrease luteinizing hormone, thus DECREASES testosterone production | Lupron and Zoladex actions
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| Men who are on a hormone therapy (Lupron or Zoladex) that decreases/removes testosterone may experience these type of side effects | Decreased libido, impotence, hot flashes (r/t removal of testosterone = estrogen effects), osteoporosis,
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| How is lupron administered? | Subq daily or IM qmonth or q3months. If taking subq daily, then patient is taught how to do them selves at home
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| Other medications that a man may recieve after prostectomy | Eulexin (flutamide)
Casodex (Bicalutimide)
(think "-timide")
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| What is the action of Eulexin (flutamide) and casodex (bicalutamide)? | Testorne is still there, it can bind because this med inhibits androgen uptake at the target tissues by blocking at the receptors to testosterone.
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| Which drugs blocks testosterone from binding to the receptor sites- (testoterone is still there, it just can't bind) | Eulexin (flutamide)
Casodex (bicalutamide)
Teste
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| As a nurse, what side effects would you warn the patient if taking either Eulexin or casodex? | Diarrhea, N&V,
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| This type of chemo therapy for breast cancer blocks the estrogen from binding to the tumor | Hormone receptors Tamoxifen (Nolvadex) or Raloxifene (Evista
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| Tamoxifen (Nolvadex) Raloxifene (Evista) | Doesn't cure breast cancer, it decreases tumor growth.
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| Tamoxifen (nolvadex) and Raloxifene (Evista) are hormone receptor blockers that deprive breast tumors of which hormone? | Estrogen.
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| Who is given tamoxifen or raloxifene (Evista) | used by pre and post-menopausal women
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| Nursing teaching for women taking tamoxifen and raloxifene | Side effects; Hotflashes, N&V, weight gain, vaginal dryness, irregular periods
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| It is okay to smoke if taking tamoxifen (nolvadex) or Raloxifene (Evista) | No, it is recommended not to smoke r/t increase risk of DVT
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| What action should a female take when on either tamoxifen (nolvadex) or raloxifene (Evista) and they have been having abnormal bleeding. | They need to report abnormal bleeding to their doctor.
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| letrozole (Femara) and anastrozole (arimidex) | These medications Inhibits aromatase enzyme inhibitors- deprive breast cancer of estrogen
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| This is a chemo drug that deprives breast cancer of estrogen by inhibiting armatase enzyme inhibitors | Letrozole (Femara)
Anastrozole (Arimidex)
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| Side effects of letrozole (femara) an anastrozole (arimidex) | Hot flashes, n&v, weight gain, bloating, difficulty eating, urinary frequency and urgency
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| How long do side effect last when taking letrozole (femara) & anastrozole (arimidex) | Side effects occur almost daily for greater than a few weeks.
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| Herceptin (Transtuzumab) | Bio therapy medication given to treat breast cancer.
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| The action of Herceptin (transtuzumab) | binds to HER2 nuegene and stops growth
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| This is a cytoxic drug that kills cancer | Herceptin (trastuzumab)
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| Will Herceptin (Transtuzumab) help with any type of breast cancer? | No, it only works if tumor has HER2 positive tumors
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| When is Herceptin (Transtuzumab) given | It is used for women who failed other tx, and is also used in combo with other drugs.
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| Weekly treatment for Herceptin (Trastuzumab) | IV infusion or large doses every 3 weeks.
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| side effects of Herceptin (Trastuzumab) | Causes cardiac damage, flu-like symptoms: FEver, chills, pain, N&V
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| How long do the side effects of Herceptin last (Flu like symptoms and cardiac damage) | They will diminish with subsequent transfusions.
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| Gardisil Vaccine | Girls 9 to 26 years and most effective if given before exposure to HPC
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| Procrit, EPO and aranesp | stimulates erythocyte production
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| Which labs should be monitored when taking pocrit, EPO and aranesp | Hgb and Hct
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| Uses for procrit, EPO and aranesp | anemia of chronic renal failure, HIV, chemotherapy and cancer.
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| When does therapeutic level take effect for procrit, EPO, and aranesp | Therapeutic in one month.
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| Neumega (Opreluekin) | Stimulates platelet production
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| How is Nuemega administered? | IV
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| What to monitor if on Nuemega? | Platelets.
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| Side effects of nuemega | fluid retention, tachycardia, and headache
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| Neupogen/filgastrim | Neutrophils given inpatient
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| Neulasta/Pegfilgastim | Neutrophils given 24 hours after chemo is done as one-time long lasting injection.
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| what meds stimulate neutrophil production? | Neupogen/filgastim
Neulasta/Pegfilgrastim
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| Deficiency in neutrophils | Neutropenia
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| ANC | Determines risk of infection by looking at number of neutrophils.
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| Normal ANC | > 1500
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| Moderate risk ANC | <1000
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| Severe risk of ANC | < 500
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| What does anc <500 mean | extremley low count of neutrophil....severe risk...and only symptom is fever of 100.5
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| What is sign of infection for neutropenic patient? | Fever of 100.5 or more.
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| what do you treat/prevent thrush for cancer patient | Rinse with HCO3 or NS or H20
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| what mouthwash do you give someone who has stomitis | Peridex, collins soln, tetra-myco-ben and artificial saliva
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| Anti-emiotic meds (n&V) | Drugs ending in "-setron", Zofran, kytril, anzemet and aloxi
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| Side effects of anit-emetic meds: zofran, kytril, anzemet, aloxi ("-setron") | HA, Sedation, dizziness
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| Med known as substance P (neurokinin)1 receptor antagonist : aprepitant (Emend) | give in combo with 5HT3 blocker and dexamethasone.
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| Name the medication given for sever N&V | Aprepitant (Emend)
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| Side effects of Aprepitant (Emend) | Dehydration, dizziness, fatigue
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| Antiemetics that end in "-zine" | works in the chemoreceptor zone in brain.
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| Prochloperazine (Compazine) & Promethazine (phenegran) | Antiemetics
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| Side Effects of Prochloperazine (Compazine) & promethazine (phenegran) | Sedation, tremors, dyskinesias, pseudoparkinsonism, decreased BP
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| Cyclophosphomide (Cytoxan) is an | Alkylating agents
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| Side effects of Cyclophosphomide (Cytoxan) | hemorrhagic cystitis & neutropenia.
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| Side effect of Cytoxan is hemorrhagic cystitis which is? | Infection/irritation causing bleeding
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| How to treat hemorrhagic cystitis (which is side effect of taking cytoxan) | Increase fluid intake before during and after chemo and give mesna
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| What is Mesna? | It protects bladder wall and given for hemorrhagic cystitis (s.e. of taking cytoxan)
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| What do you assess when giving pt cytoxan? | Monitor ANC because they are at risk for neutropenia (decreased neutrophils)
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| Platinol (cisplatin) is classifed as an | Alkalyting agent
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| What are the side effects of taking platinol (cisplatin)? | Neutropenia and nephrotoxicity.
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| What do you monitor when giving platinol (Cisplatin)? | Monitor ANC (Neutraphil count) and GFR (Renal function)
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| Oxalplatin (eloxatin) side effects | Neurotoxicity & exposure to cold is painful.
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| What do you monitor for Eloxatin (oxalplatin)? | Numbness, tingling, paresthesias (r/t side effects of taking this med neurotoxicity)
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| Nursing care or teaching for someone taking Eloxatin (Oxalplatin) | Advise to dress warmly, keep dry, avoid ice and ice water because exposure to cold is painful
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| Paraplatin (carboplatin) side effects | Neutropenia
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| What do you assess when taking paraplatin? | ANC...d/t risks of neutropenia
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| Methotrexate side effects | Stomatitis (Oral ulcers), Neutropenia, Leucovorin rescue
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| Leucovorin rescue | Given day later after high dose of methotrexate to protect cells from futher damage
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| At risk for fatality | Leucovorin rescue is given a day after high dose of methotrexate, must be given specific time and specific length of time...can be fatal if time and dose not correct.
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| What do you monitor when giving methotrexate? | Assess for infection: fever and ANC d/t risk of becoming neutropenic
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| Teaching for someone who takes methotrexate? | Thorough oral assessment, treatment for stomitis, swish and spit, soft toothbrush
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| Cytarabine (Ara-C)side effects | tumor lysis syndrome, neurotoxicity and neutropenia
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| Tumor lysis syndrome | Side effect of taking Cytarabine (Ara-C) in which toxic substances and waste products end up in blood stream....this medication causes cells to die too fast and lead to kidney failure.
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| what drug would you give if Tumor lysis syndrome develops (Side effect of taking cytarabine (Ara-C)) | Allopurinol (zloprim) is given prophylactically (gout med...uric acid)
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| What do you monitor when giving cytarabine (Ara-C)? | (neutropenia) ANC, Fever, and (neurotoxicity) numbness, tingling and confusion.
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| 5-Fluroacil (5-FU) side effects | Stomatitis, Diarrhea, and thrombocytopenia
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| What do you monitor when giving 5-fluroacil (5-fu) | Oral ulcers, oral care, eval hydration d/t diarrhea and platelet count & bleeding (r/t thrombocytopenia)
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| Doxorubicin (Adriamycin) side effects | Cardiac toxicity and neutropenia
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| What test needs to be given before administering doxorubicin (Adriamycin)? | MUGA scan - tests cadiac function ejaculation fraction d/t risks of cardiac toxicity.
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| Belomycin (Blenoxane) side effects | Pulmonary toxicity and Anaphylaxis
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| What would you monitor or test prior to administration of Belomycin (Blenoxane)? | PFT (pulomary function test) for base line and intraderma test (skin test) before each dose.
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| Pulmonary toxicity | side effect of Bleomycin (Belnoxane) - will see pulmonary fibrosis and pneumonitis later down the road
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| Vincristine (Oncovin) side effect | Neurotoxicity and constipation.
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| Paclitaxal (Taxol) side effects | Neutropenia and neurotoxicity
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| Estrogen targeted meds | Tamoxifen (nolvadex)/Raloxifene (Evista)
Letrozole (Femara)/ Anastrozole (Arimidex)
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| Side effects of Tamoxifen and raloxifene, letrozole and arimedex? | Hot flashes, n&v, wt gain, vag dryness, irregular periods, risk of DVT if smoker.
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| Testosterone targeted meds | Eulexin, casodex, lupron and zoladex
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| Rituxin (rituximab) | MoAbs med that is given for non-hodgkins lymphoma, targets the CD20 protein
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| Herceptin (trastuzumab) | MoAbs med given for breast cancer, tarkets the HER2 protein.
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| Mylotarg (Gemtuzumab ozogamicin) | MoABS med given for AML, targets Cd33 protein, not used commonly.
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| MoAbs | antibody medication that targets one specific cell
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| Side effects of Herceptin, Rituxin and Mylotarg | Fever, chills, rigors (tremors) diaphoresis, malaise, urticaria (hives) and N&V
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| Serious side effect of Herceptin, Rituxin and Mylotarg | Hypoxia, hypotension, Hypertension, dyspnea
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| What medication shoudl be given before administering MoABS? | Steroids and benadryl to help decrease reactions
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| Interferon | Protects cells that have not been infected yet, slows tumor growth, stimulates natural killer cell suppresses oncogenes
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| Interferon uses | Hep C, melanoma, Karposi's sarcoma, and Hairy cell leukemia
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| Interferon Side Effects | HA, Mylagia (muscle pain), Athralgia (joint pain), Malaise, Fatigue, anorexia, wt loss, rigors (shaking)
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| When giving interferon, what med should be given to decrease side effects? | Tylenol
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| Interleukin | Stimulates T cell to destroy cancer, helps recognize immune cells and destroys abnormal cells.
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| Interleukin side effects | Fatigue, GI, Skin, CNS side effects, chills, fever, rigors, capillary leadk syndrome
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| Capillary lead syndrome | potential fatal side effect from taking interleukin.
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| Release of protein out of vascular system: fluid follows protein, body becomes edamatous leading to respiratory failure. | Capillary leak syndrome
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| A lot of toxicity and given in patien where ICU is available. | Interleukin
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| Angiogensis inhibitors | Stop nutrients taht supply tumor growth, stops cells from growing
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| Angiogenisis inhibitor side effects | Can affect good tissue growth and could lead to complications such as delayed wound healing.
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