Pharmacology Exam 3
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Lorazapam | Treat anxiety and insomnia (short term), sedation, procedural amnesia
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| Lorazepam Contraindicated | Psychoses, acute narrow glaucoma, children under 6m
Pregnancy D
Low dose for older ptns
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| Lorazepam Adverse Effects | (CNS) confusion, ataxia, drowsy, GI
SERIOUS:
paradoxical
reaction
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| Lorazepam Patient Ed | Avoid alcohol & CNS depressants
CNS side effects
2-3 doses/day
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| Lorazepam Nursing Needs | Monitor P,RR,BP, consciousness
Safety: low bed, side rails up, call button
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| Zolpidem | Treat short and long term insomnia
DFA, EMA
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| Zolpidem Contraindicated | ½ dose for elderly
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| Zolpidem Adverse Effects | (CNS)
Headache, drowsy, dizzy
Sleep walking and eating
Weird dreams
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| Zolpidem Patient Ed | 7hrs of sleep
Take on empty stomach (avoid high fat foods)
Avoid CNS depressants
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| Nortriptyline | Treat symptoms of depression, chronic pain (neuropathy)
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| Nortriptyline Contraindicated | Preexisting cardiovascular
Elderly: ½ dose
BLACK BOX:
Children-risk for suicidal thoughts/ behaviors
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| Nortriptyline Adverse Effects | Anticholinergic
Constipation, dry eye/mouth
Hypotension, drowsy
SERIOUS:
Arrhythmias
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| Nortriptyline Patient Ed | Give at bed time
Lag: 3 months
Storage
Sexual dysfunction
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| Nortriptyline Nursing Needs | Monitor serum levels (toxicity)
Check therapeutic levels
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| Lithium Carbonate (LiCO3) | Prevent severe mood swings, mania and depression
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| Lithium Carbonate (LiCO3)Contraindicated | Severe Cardiovascular and kidney disease, pregnant, lactating, Na+ imbalance
Elderly: risk of hypothyroidism
Nephrogenic diabetes insipidus
Drug Induced Goiter
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| Lithium Carbonate (LiCO3)Adverse Effects | Increase thirst, frequent urination, nausea, coarse hand tremors
SEVERE: Lithium toxicity
Seizure, Coma, neuro arrhythmias
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| Lithium Carbonate (LiCO3)Patient Ed | Avoid alcohol and too much salt
Fluids, weather, activity
Regular AE and toxicity
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| Lithium Carbonate (LiCO3)Nursing Needs | Monitor kidneys and thyroid
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| Sertralin | Treat long-term anxiety, depression
PTSD, OCD premenstrual dysphonic (mood swings)
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| Sertralin Contraindicated | Patients with decreased liver function
SERIOUS/ BLACK BOX
Increased risk of suicide for children, adolescents and young adults
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| Sertralin Adverse Effects | GI DISTRESS
Sleep disturbance, abnormal ejaculation
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| Sertralin Patient Ed | Avoid UV light
lag time take w/ food
Avoid alcohol/drugs
Serotonin Discontinuation Syndrome:
Flu-like
Light-headed
Uneasy
Sleep
Headache
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| Sertralin Nursing Needs | Create therapeutic relationship
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| Haloperidal | High-potency Typical Anti-psychotics
Treat psychotic disorder and schizophrenia
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| Haloperidal Contraindicated | Parkinson Disease
Young males: r/o dystonias
Older women: r/o tardive dyskinesia
BLACK BOX:
Increased risk of mortality in elderly dementia patients
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| Haloperidal Adverse Effects | acute dystonias, akathesias, tardive dyskinesia , EPS
CNS
SERIOUS:
NMS (medical emergency)
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| Haloperidal Patient Ed | Avoid starting and stopping
Take with anticholinergic drugs
Continue therapy/ coping
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| Haloperidal Nursing Needs | Direct Observation Therapy (DOT)
Keep does low
Monitor serum
Ask about thought process (TP) Thought Content (TC)
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| Olanzapine | Atypical Anti-psychotic
Psychotic symptom
Short term bipolar/ mania and schizophrenia
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| Olanzapine Contraindicated | Elderly increased r/o adverse effects
BLACK BOX:
Increased risk of mortality in elderly dementia patients
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| Olanzapine Adverse Effects | (CNS)
Drowsy, hyperglycemia, sedation, appetite and weight
SERIOUS:
Tardive dyskinesia (TD) Neuroleptic Malignant Syndrome (NMS)
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| Olanzapine Patient Ed | Avoid alcohol
Diet/exercise
Take doses regularly and at bedtime
Lag time
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| Olanzapine Nursing Needs | Monitor glucose levels
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| Rivastigmine | Ace Inhibitors
Mild to moderate Alzheimer-type dementia
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| Rivastigmine Adverse Effects | (GI)
CNS: peripheral edema, urinary retention, joint pain, agitation
SERIOUS:
Bradycardia
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| Rivastigmine Patient Ed | Small frequent meals
Not a cure burnout
Preserve memory/slow progression
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| Rivastigmine Nursing Needs | Monitor heart, weight
Assess and correct any treatable factors that may impair cognition
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| Phenytoin | Antiepileptic drugs that decrease sodium influx
Used to control partial and (tonic-clonic grand mal) seizures
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| Phenytoin Contraindicated | Bradycardia
Heart block
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| Phenytoin Adverse Effects | Ataxia, dizzy, nausea, gingival hyperplasia, blurred vision
SERIOUS: Liver damage blood dyscrasia
Lifethreatening
Dermatalogic reaction
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| Phenytoin Patient ED | Pregnancy D
take with food, caution with diving
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| Phenytoin Nursing Needs | Monitor blood levels of drug (narrow therapeutic range)
Administer slow
Monitor mood
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| Ehosuximide | Antiepileptic that decreases Ca+ influx
Used to treat absent (petit mal) seizures
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| Ehosuximide Contraindicated | Hyper-sensitivity
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| Ehosuximide Adverse Effects | Drowsy, dizzy, lethargy, n/v
SERIOUS:
Blood dyscrasia
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| Ehosuximide Patient Ed | Take w/ milk/ food
Notify provider about adverse effects (rash, joint pain, infection unusual bleeding)
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| Ehosuximide Nursing Needs | Assess allergies, history of renal or hepatic dysfunction
Assess CBC, UA, LFT
Taper dose slowly
Monitor drug levels
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| Cyclobenzaprine | Centrally acting muscle relaxants
Manage muscle spasms associated with acute Musculoskeletal disorders
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| Cyclobenzaprine Contraindication | Hyperthyroidism
14 days w/in use of MAOI’s
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| Cyclobenzaprine Adverse Effects | CNS depression
Anticholinergic activity, MI’s, sedation (ptn safety) seizure, arrhythmias
SERIOUS:
Auditory/visual hallucinations, psychotic Sx, agitation seizure
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| Cyclobenzaprine Patient Ed | Do not take with OTC drugs
Avoid alcohol and other CNS depressants
Take with H2O and at even intervals
Coordinate physical therapy administration
Do not stop abruptly
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| Cyclobenzaprine Nursing Needs | Evaluate patient
safety
Monitor levels of sedation
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| Baclofen | Centrally Acting Spasmolytics
Relieves some components of spinal spasticity and MS, CP trauma to spinal cord
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| Baclofen Contraindicated | Hypersensitivity
Spasticity of cerebral origin (balance/ posture)
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| Baclofen Adverse Effects | (CNS)
Sedation, h/n/v
Hypotension
SERIOUS:
Agitation, auditory/ visual hallucination, seizures or psychotic Sx upon abrupt with drawl
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| Baclofen Patient Ed | Take with full glass of H2O
Take with meals
Do not take with Alcohol
Do not stop abruptly
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| Baclofen Nursing Needs | Ensure Patient safety
Monitor for hallucinations or psychotic episodes
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| Dantrolene | Peripherally acting Spasmolytic
Used to treat malignant hyperthermia, skeletal muscle relaxant for spasticity
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| Dantrolene Contraindicated | Liver disease
Patients who use spasticity to maintain posture/ balance (CP)
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| Dantrolene Adverse Effects | GI, Muscle weakness, CNS sedation, acne, photosensitive
SERIOUS:
Fetal Hepatitis, seizures,pleural
Effusion w/ pericarditis
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| Dantrolene Patient Ed | Take with food or milk
Do not crush XR capsules
Use sunscreen, know symptoms of hepatitis
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| Dantrolene Nursing Needs | Patient safety, assist with ambulation
Titrate dose slowly
Monitor adverse effects
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| Carbidopa- Levodopa | Antiparkinson Drug Dopaminergics
Used to treat Parkinson disease
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| Carbidopa- Levodopa Contraindicated | Closed angle glaucoma
Hypersensitivity
Melanoma
Undiagnosed pigment lesions
Breastfeeding
Allergy to tartrazine
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| Carbidopa- Levodopa Adverse Effects | Orthostatic hypotension
Abnormal movements
GI effects
SERIOUS:
Neuroleptic Malignant Syndrome
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| Carbidopa- Levodopa Patient Ed | Take on empty stomach at even intervals
Low protein and pyridoxine diet
Not a cure
Avoid Vitamin B6
On – Off syndrome and hypotension
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| Carbidopa- Levodopa Nuring Needs | Titrate dose
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| Riluzole | Anti-ALS Drugs
Centrally Acting Anticholinergic
Indicated to treating ALS because it slows down the disease progression (not a cure)
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| Riluzole Contraindicated | Hypersensitivity
Liver Disease
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| Riluzole Adverse Effects | Muscle fatigue, nausea, dizzy, diarrhea, anorexia, vertigo, somnolence
SERIOUS:
Neutropenia, hepatic injury
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| Riluzole Patient Ed | Take with H20 on empty stomach
Caution with driving
Expensive
Decrease protein intake, avoid caffeine, charcoal-broiled food, tobacco and alcohol
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| Riluzole Nursing Needs | Follow up care
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| Glatiraramer | Anti-MS drugs
Used to delay progression of MS, used to reduce frequently on MS attacks slows development of new lesions on myelin sheath
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| Glatiraramer Contraindicated | IV administration
Hypersensitivity to mannitol
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| Glatiraramer Adverse Effects | Chest pain or tightness, breathing difficulties, hives or severe rash, injection site, GI, weakness
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| Glatiraramer Patient Ed | Store in Refrigerator, administer at room temp
Avoid accidental IVadministration
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| Glatiraramer Nursing Needs | Rotate injection site
Evaluate progression of disease
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| Captopril | Antihypertensive ACE inhibitor
Used for HTN, HF, Left ventricular dysfunction (LVD), prevents diabetic neuropathy and retinopathy
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| Captopril Contraindicated | none
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| Captopril Adverse Effects | Angioedema, rash, decreased BP, K+ sparring, neutropenia, dyspnea, annoying cough
(symptomatic)
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| Captopril Patient Ed | Take at night (1st dose syncope)
Talk about K+
Warn about cough
Mention angioedema (swelling in face throat)
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| Captopril Nursing Ed | Monitor electrolytes (K+) (Na+)
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| Losartan | Antihypertensive Angiotensin II receptor blockers ARBS
Used for HTN, HF, LVD, prevent diabetic neuropathy
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| Losartan Contraindicated | Pregnancy
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| Losartan Adverse Effects | Decrease BP, diarrhea, asthenia, dizzy, fatigue, K+ sparring
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| Losartan Patient Ed | Avoid grapefruit juice (speeds up metabolism)
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| Eplerenone | Antihypertensive Selective Aldosterone Receptor Blocker
Used for HTN, decrease death from CV in patients with HF and previous MI
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| Eplerenone Contraindicated | Abnormal K+ level and creatinine clearance (kidney function)
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| Eplerenone Adverse Effects | Increase K+, diarrhea, albuminuria, gynecomastia, increase cholesterol, abnormal vaginal bleeding
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| Eplerenone Patient Ed | safety
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| Nitroprusside | Antihypertensive ER Drug (IV)
Used for hypertensive crisis
Systolic >or= 210
Diastolic >or=120
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| Nitroprusside Contraindicated | Women of childbearing years
Elderly (orthostatic hypertension)
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| Nitroprusside Adverse Effects | Dizzy, HA (drop in BP), nausea, decrease CO and BP
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| Nitroprusside Patient Ed | Safety
Adverse Effects
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| Nitroprusside Nursing Needs | Cyanide toxicity
Decrease CO, BP
Rate of infusion (stay w/ patient)
NURSING CARE
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| Eplerenone Nursing Needs | Check for normal K+ level and creatinine clearance (Kidney function)
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| Hydrochlorothiazide (HCTZ) | Antihypertensive(Diuretics)MAMA
1st Line Drug for HTN
Used for HTN, HF, DI (diabetes insipidus)
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| Hydrochlorothiazide (HCTZ)Contraindicated | Caution: hypersensitivity to sulfonamides.
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| Hydrochlorothiazide (HCTZ)Adverse Effects | Change in electrolytes, decrease BP, dizzy, hyperglycemia, fluid shedding 1st 2 weeks
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| Hydrochlorothiazide (HCTZ)Patient Ed | Signs and Symptoms to report
TLC
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| Hydrochlorothiazide (HCTZ)Nursing Need | Monitor electrolytes
(K+ sparring)
decrease BP
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| Furosemide | Potent loop diuretic Hospital Drug PAPA
Used for HTN, HF, edema
Used when HTN goes with HF
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| Furosemide Contraindicated | none
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| Furosemide Adverse Effects | Electrolytes, ototoxic (fluid loss in ears), hyperglycemia, dizzy, vertigo, hypokalemia
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| Furosemide Patient Ed | TLC (fruits and veggies)
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| Furosemide Nursing Needs | Monitor blood glucose, serum level, IV rate (I’s and O’s) foley catheter
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| Triamterene | Weak Potassium sparring diuretics BABY
Used for Edema, adjunt HTN (used to boost drugs for HTN or HF)
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| Triamterene Contraindicated | none
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| Triamterene Averse Effects | Weak potassium sparring, nephrotoxic, thrombocytopenia, HA, photosensitive, LFT (CBC)
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| Triamterene Nursing Needs | Monitor BP, edema, K+ supplement
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| Mannitol | Osmotic Diuretics ER/ICU drug
Acute renal failure, increased intracranial pressure (ICP) secondary to cerebral edema, decreased intraocular edema
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| Mannitol Contraindicated | none
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| Mannitol Adverse Effects | Electrolyte loss, tachycardia r/t decrease BP, dehydration > dizzy, dry mouth, thirst, n/v
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| Mannitol Nursing Needs | Monitor I&Os renal function, vitals, electrolytes
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| Acetazolamide | Carbonic anhydrase inhibitor(Hospital drug)
Used for heart failure related to edema, open angle glaucoma
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| Acetazolamide Contraindicated | none
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| Acetazolamide Adverse Effects | (CNS,GI)
a/n/c, dizzy, drowsy, tinnitus, ataxia
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| Acetazolamide Nursing Needs | Monitor kidneys, I&O’s, CBC(rare bone marrow), RENAL, electrolytes
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| Lovastatin | Antihyperlipidemics (statins)
#1 drug for high cholesterol and hyperlipidemia
Used for hyperlipidemia
Lowers LDLs raises HDL
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| Lovastatin Contraindicated | Pregnancy X
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| Lovastatin Adverse Effects | GI, muscle aches, cramps (coenzyme Q10)
Weakness, liver damage (treat every 12 months)
RARE: rhabdomylosis (muscle tissue breakdown)
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| Lovastatin Patient Ed | Decrease fats, increase fiber
Take coenzyme Q10, take at night, TLC, exercise
Avoid grapefruit juice
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| Lovastatin Nursing Needs | Monitor liver and muscles
Check lipids
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| Digoxin | Cardiac Glycosides (Maintenance drug)
Used for CHF, afib
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| Digoxin Antidote | Digibind
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| Digoxin Adverse Effects | (GI, CNS)
a/n/v/d/ha
TOXICITY: dysrhythmias, confusion, seizures, delirium
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| Digoxin Patient Ed | Hold and call for pulse <60 (check everyday before meals)
S&S of toxicity
Take everyday
Daily weighs, edema
Come back
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| Digoxin Nursing Needs | Monitor serum levels, EKG
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| Nesiritide | Natriuretic peptides (Hospital drug)
Used for acute HF
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| Nesiritide Adverse Effects | Hypotension, injection site reaction, sweating, itchy, leg cramps, confusion, renal, cough, apnea, repiratory
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| Nesiritide Nursing Needs | Continuous cardiac monitoring, CO, BP, P
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| Nitroglycerine | Used for angina (heart pain from lack of O2)
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| Nitroglycerine | Directions:
Open door, have phone, sit down. Take dose wait 5 mins if doesn’t work take another (do twice) if unresolved after 3 call 911
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| Nitroglycerine | HEADACHE, postural hypotension, tachycardia, syncope, vertigo, CNS
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| Nitroglycerine | Patch: ½ on, ½ off
Cream: postop at risk of Heart disease
Take before activities
Should sting
Can Overdose
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| Nitroglycerine | Wear gloves
🗑
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| Lidocain | ICU/ER drug
Used for acute ventricular arrhythmias
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| Lidocain Adverse Effects | Arrhythmias, decreased BP, dizzy, CNS
🗑
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| Lidocain Nursing Needs | Continuous cardiac monitoring
Monitor CNS side effects
Check liver and kidney function
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| Lidocain Contraindicated | none
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| Procainamide | Used for ventricular arrhythmias, ACLS, ECC, systemic lupus
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| Procainamide Contraindicated | none
🗑
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| Procainamide Patient Ed | Avoid alcohol
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| Disopyramide Contraindicated | Patients having MI or non-emergency adverse effects
🗑
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| Verapamil | Calcium Channel Blocker
Used for HN, afib flutter
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| Verapamil Contraindicated | Heart failure patients
🗑
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| Verapamil Adverse Effects | *constipation*
Gingival hyperplasia, headache, nausea, CNS (dizzy), decreased BP, peripheral edema
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| Verapamil Patient Ed | Oral hygiene, flossing, dentist X’s 4/year
No grapefruit juice, fluids and fiber
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| Verapamil Nursing Needs | Follow-up EKG, electrolytes
Monitor BP, P
Check for peripheral edema
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| Sodium Polystyrene Sulfate (resin) | Hospital drug
Used for hyperkalemia
🗑
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| Sodium Polystyrene Sulfate (resin)Contraindicated | none
🗑
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| Sodium Polystyrene Sulfate (resin) Adverse Effects | Hypokalemia, electrolyte imbalance, GI (n/v/c)
🗑
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| Sodium Polystyrene Sulfate (resin)Patient Ed | GI side effects
🗑
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| Sodium Polystyrene Sulfate (resin)Nursing Needs | Assess diet and drugs high in K+
Treat constipation
Monitor K+
🗑
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| Clopidogrel | Antiplatelet (ASA)
Used decrease atherosclerosis, patients at risk for MI, cardiovascular disease with ischemic stroke
🗑
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| Clopidogrel Contraindicated | Bleeding disorders
🗑
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| Clopidogrel Adverse Effects | Bleeding
GI upset
Neutropenia
🗑
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| Clopidogrel Patient Ed | Safety (medical alert)
GI side effects
Come back for CBC
Routine labs for bleeding time and platelets
🗑
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| Clopidogrel Nursing Need | Monitor CBC
Labs bleeding time and platelets
🗑
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| Heparin | Anticoagulant
Stops clotting
Only anticoagulant for pregnant women
🗑
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| Heparin Antidote | Protamine Sulfate
🗑
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| Heparin Contraindicated | Bleeding disorders
🗑
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| Heparin Adverse Effects | Bleeding
Thrombocytopenia (HIT)
🗑
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| Heparin Patient Ed | Safety
Frequent labs
🗑
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| Heparin Nursing Needs | Adjust according to protocol
🗑
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| Warfarin | Anticoagulant Prototype
🗑
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| Warfarin Antidote | Vitamin K
🗑
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| Warfarin Contraindicated | bleeding disorders
🗑
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| Warfarin Adverse Effects | BLEEDING
GI
🗑
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| Warfarin Patient Ed | Frequent lab
Drug-drug, food, herb
Avoid vt.K leafy greens, citrus, organ meat, green tea
🗑
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| Warfarin Nursing Needs | Lab PT with INR (2.5 – 3.5)
>or= 5 danger
🗑
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| Alteplase recombinant | CLOT-BUSTING ER
Thromboembolic events
Thrombus- brain, pulmonary embolism, MI
🗑
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| Alteplase recombinant Contraindicated | None
🗑
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| Alteplase recombinant Adverse Effects | Bleeding (internal bleeding, chest/ joint pain, diff. bleeding)
🗑
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| Alteplase recombinant Nursing Needs | Stay with patient
Check labs
Continuous monitoring
Give within 3hrs of stroke symptoms
🗑
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| Epoetin Alfa | Used to treat anemia, chronic kidney disease (CKD), HIV, cancer
Protocol for patients who reject blood infusion
Immune compromised ptns, ptns on dialysis
Needs normal BP
🗑
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| Epoetin Alfa Contraindicated | Chronic hypertension, hypersensitivity
🗑
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| Epoetin Alfa Adverse Effects | Hypertension, fever, headache, n/v/d, edema
🗑
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| Epoetin Alfa Patient Ed | Injectable drug
Eat iron rich foods
🗑
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| Epoetin Alfa Nursing Needs | Monitor CBC, increase in Hgb, BP
Slow to see rise
🗑
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| Filgrastin | Expensive
Used to increase neutrophils (WBCs)
Patients with cancer
🗑
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| Filgrastin Contraindicated | none
🗑
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| Filgrastin Adverse Effects | #1 long bone pain
Fever, rash, epitaxis (nose bleeds)
🗑
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| Filgrastin Patient Ed | Avoid crowds, sick people
Hand washing
Immunization update
🗑
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| Filgrastin Nursing Needs | Monitor LFT
CBC with diff
Monitor for signs and symptoms of infection
🗑
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| Oprelvekin | Used to prevent severe thrombocytopenia
🗑
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| Oprelvekin Contraindicated | Caution with heart failure patients
🗑
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| Oprelvekin Adverse Effects | Fluid retention > weight gain
Tachycardia (84% of peds)
Arrhythmias, palpatations, vasodilation, syncope, rash
🗑
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| Oprelvekin Patient Ed | Infection
Adverse effects of vasodilation
$$
🗑
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| Oprelvekin Nursing Needs | Labs
CBC w/ diff., weighs
Deal with n/v
Monitor for infection
🗑
|
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You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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serenity5234
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