Pharmacology - NCLEX Flashcards

Terms Definitions
Bleomycin(Blenoxane)
Antibiotic antineoplastic; pulmonary toxicity can occur with this medication ; pulmonary status is monitored.
Rx for Hyperthyroidism
1. PTU
Rx for Hepatic Encephalopathy
Lactulose(Constulose, Enulose)
Promotes increased perstalsis and bowel evacuation,expelling ammonia from the colon and lowering ammonia level; improves protein tolerance in clients with advanced hepatic cirrhosis; administered as oral syrup or rectally
Sulcralfate(Carafate)
Gastric protectant; creates a protective barrier against acid and pepsin; taken orally on an empty stomach; may cause constipation; can impede the absorption of warfarin sodium( Coumadin), phenytoin( Dilantin), theophylline, digoxin(Lanoxin) and some abx; should be administered at least 2 hours apart from these meds.
Rx for Psoriasis(Topical)
1. Anthralin(Dritho-Scalp,Psoriatec) ovrnight
2. Calcipotriene(Dovonex) vit D
3. Coal tar
4. Glucocorticoids
5. Keratolytics( salicylic,sulfur)
6. Tazarotene(Tazorac) vit A
phenylephrine indication (1)
to tx hypotension
Calcium gluconate
Antidote for magensium sulfate toxicity
Antidysrhytmics - Class IV
Verapamil (Calan)
Diltiazem hydrochloride (Cardizem)
SE: Bradycaria, hypotension, Dizziness and orthostatic hypotension, heart failure.
NSG:
Monitor apical HR and BP. INstruct clients about orthostatic precautions.
Antidysrhytmics - Class II
Propanolol (Inderal)
Acebutolol (Sectral)
Esmolol hydrochloride (Brevibloc)
Sotalol hydrochloride (Betapace)
SE: Bradycarida and Hypotension. Bronchospasm. Increase in Heart Failure. Fatigue and sleep disturbances.
NSG:
**Monitor Apical HR for 1 min before given
Monitor cardiac rhythm and BP
Assess for SOB and wheezing
Antacid
Neutralizes gastric acids (does not coat ulcer). Raises gastric pH
Inactivates pepsin.
Use: Peptic ulcers, prevent/tx indigestion reflex esophagitis
SE: Constipation, diarrhea, acid rebound after taking.
NSG: Interferex with absorption of Antibx, Iron Preps, INH (TB), Oral Contraceptives (decrease effectiveness).
*Take 1-2 hrs after other meds.
*Dont take with meals - causes delay in gastric emptying -> indigestion.
Rx for Hypothyroidism
1. Levothyroxine sodium(Synthroid); take on empty stomach
Rx for Psoriasis(Systemic)
1. Acitretin( Soriatane)
2. Cyclosporine ( Neoral)
3. Methotrxate
Systemic Biological
1. Alefacept( Amevive)
2. Ustekinumab( Stelara)
Cyclophosphamide( Cytoxan,Neosar)
Alkylating antineoplastic; May cause alopecia,gonadal suppression,hemorrhagic cystitis,and hematuria.
2. Administered without food
Colestipol(Colestid)
Bile acid Sequestrants; indicated for hyperchloesterolemia, biliary obstruction, and primeur associated with biliary disease
Absorb and combine with intestinal bile salts which are then secreted in the feces prevent intestinal reabsorption; side effects include nausea,bloating and constipation; stool softeners and other sources of fiber can be used to abate GI side effects; use caution with pts suspected to have bowel obstruction or severe constipation
risperdal s/s (4)
1. moderate orthostatic hypotension
2. moderate sedation
3. wt gain
4. tardive dyskinesia
what shouldyou monitor when giving heparin?
PTT
Antibiotic - Cephalosporin (Drug Names)
Cephalexin (Keflex)
Cefaclor (Ceclor)
Ceftriaxone (Rocephin)
Cefepime (Maxipine)
Adrenergic Response
Increased HR, sweating, and increased Blood Pressure.
Metoclopramide( Reglan)
Prokinetic agent; Indicated for GERD and paralytic ileus
Stimulates gastric motility of the upper GI tract and increases the rate of gastric emptying; may cause restlessness, drowsiness, insomnia,headache, hypertensive crisis in pt c pheochromocytoma,parkinsonian rx(discontinue)or extrapyramidal reactions; administered 30 minutes before meals and at bedtime; contraindicated in clients with mechanical obstruction,perforation,or GI hemorrhage
Alcohol,sedatives,cyclosporine,tranquilizers can cause additive effect
Anticholinergics and opiod analgesic can antagonize
Fmotidine(Pepcid) and Nizatidine(Axid)
H2Receptor Antagonists; similar to famotidine and cimetidine; do not need to be administered with food.
Cimetidine( Tagamet)
H2 Receptor Antagonist; can be administer orally,IV or IM; IV can cause hypotension and dysrhythmias;does not need to be taken with food; antacids can decrease the absorption of cimetidine so they need to be administered 1 hour apart from each other; dosage reduction in people with renal impairment; can cross blood-brain barrier to cause confusion,agitation,psychosis,depression,anxiety or disorientation.
Caution: if administer with warfarin sodium( Coumadin),phenytoin(Dilantin),theophylline, or lidocaine the dosages of these medications should be reduced.
name 8 anticholinergic drugs?
1. propatheline bromide
2. belladonna
3. atropine
4. atrovent
5. spiriva
6. cogentin
7. artane
8. scopolamine
what benzodiazepine carries the risk of causing cardiac arrest?
versed (midazolam)
what is lugols iodine and potassium iodide used for?
antithyroid
what does niacin do?
decreases cholesterol, ldl, triglyceride, and increases hdl
what are TCA drugs? (2)
1. ELAVIL
2. TOFRANIL
what s/s indicates early toxicity of phenobarbital?
nystagmus
Antibiotic Info
1. First sign of SE is allergy/hypersensitivity
Range: Mild rash/hives - Severe Sensitivity (anaphylactic shock)
SOB (usually first symptom within 20 min.
2. Superinfection - May destroy normal flora
3. Organ Toxicity (liver, kidney)
Rx for IBS( 5- Aminosalicylates)
1. Balsalazide( Colazal)
2. Mesalamine( Rowasa, Asacol, Pentasa, Canasa)
3. Olsalazine ( Dipentum)
4. Sulfalazine( Azulfidine)
Decrease GI inflammation; adverse effects include nausea,rash,arthralgia, and hematological disorders
when should you adminster folic acid derivatives (tricor and lopid)?
before meals
s/e of buspar? (3)
1. light headedness
2. hypotension
3. confusion
when should you expect results from MAOIs?
3-4 weeks
what is the late sign of lithium toxicity?
ataxia
Antibiotic - Aminoglycoside
Inhibits protein syntheis in Gram- neg bacteria
Use:
Psuodmonas, E. Coli, Severy systemic infection of CNS.
SE:
Ototoxicity (ears), Nephrotoxicity, Anorexia, N/V, Diarrhea ( Kills normal flora in GI)
NSG:
Check 8th cranial nerve fxn (hearing)
Check renal function (BUN, Creatinine) (Output - 600-1200ml)
Usually prescribed for 7-10 days
Encourage Fluids (3,000ml)
Rx for Diabetes Insipidus
1. Vasopressin tannate ( Pitressin)
2. Desmopressin acetate(DDAVP, Stimate)
s/e of SSRI? (10)
1. HA

2. nervousness (taken at day)

3. tremor

4. dry mouth (think all antidepressants have anticholinergic effects)

5. sore stomach (SS or sore stomach)

6. taste changes (s for sweet taste)

7. sweating (s for sweating

8. rash (r for rash)

9. wt loss

10. messes with blood cell count (leukopenia, thrombocytopenia, anemia) think IDIOPATHIC BLOOD DYSCRASIA
what should you instruct your clients to notify the health care provider if they experience it when taking folic acid derivatives like tricor?
muscle pain
what is important to monitor with tetracyclines?
monitor renal function
pt on digoxin should be encouraged to eat what kind of diet?
high potassium
nursing considerations for phenobarbital? (3)
1. folic acid supplements are indicated for long term use (think barbi doll licks her fo---folic)

2. tell pt drowsiness will decrease over time

3. should never be abruptly stopped b/c risk of withdrawal
what are bile acid sequestrants? (5)
1. cholestyramine
2. colestipol
3. folic acid derivatives
4. nicotinic acid
5. hmg coa reductase inhibitors
s/s of liver dysfunction is? (which might be applicable for the drug tegretol and divalproex (3)
1. malaise
2. fever
3. lethargy
what are nursing actions for neuroleptic syndrome? (5)
1. withdraw antipyschotics immed
2. control hyperthermia
3. hydrate them
4. give dantroline for rigidity
5. give bromocriptine for CNS toxicity
when should you assess your patient for adverse reaction of a regular acting insulin?what would you assess? (2)
midmorning or midafternoon

(reg acting is
0=1, peak=2)

check pt for adverse at peak--2 hrs later


assess for weakness and fatigue
what is the tx for digoxin toxicity?
digoxin immune fab (digibind)
what is important to do while admin with erythromycin?
monitor liver function
what are some anti-lipemic agents? (4)
1. bile acid sequestrants
2. statins
3. nicoltic acid
4. folic acid derivatives
what are the general side effectsof anti-cholinergic? (5)
sympathetic (aka anti-parasympathetic effects)

think DRY DRY DRY

1. dizziness
2. urinary retention
3. constipation
4. pupillary dilation
5. dry mouth
what foods may precipitate a hypertensive crisis when taking MAO inhibitors? (9)
1. bologne
2. pepperoni
3. salami
4. banana
5. figs
6. red wine
7. beer
8. raisins
9. cold medicines
how should you prepare adminstration of bile acid sequestrants?
sprinkle powder on noncarbonated drink or wet food
what are the normal blood levels of lithium?
when should you check lithium levels?
1-1.5mEq/l


check lithium levels 2-3x a week when star ted and monthly on maintenance
nursing education for TCA? (6)
1. effect will take several weeks
2. s/e will decrease over time
3. hypotension precautions
4. use candy for dry mouth
5. avoid sunlight
6. do not abruptly stop taking medications
what are nursing considerations for SSRI? (6)
1. Suicide precautions
2. take in the morning
3. takes 4 weeks for full effect
4. give good mouth care
5. monitor wt
6. never combine with MAO inhibitor
what are s/e of bile acid sequestrants? (4)
1. constipation (contributes to ab pain, bloating)
2. rash
3. fat soluble vitamin deficiency
when would you assess for adverse reaction for a patient taking ultralente?
what would you assess? (2)
early morning

assess for HA and confusion
what are the signs you would look for with lithium toxicity? (5)
1. vomiting

2. diarrhea

3. ataxia

4. muscle weakness

5. drowsiness

THINK VERY DIFFERENT APPEARANCE, MORE DEADLY for

1. vomit (very)
2. diarrhea (different)
3. ataxia (appearance)
4. muscle aches (more)
5. drowsiness (deadly)
what might happen if a pt abruptly stops taking TCA? (5)
1. HA
2. vertigo
3. nightmares
4. malaise
5. wt change
someone just inhaled anthrax, waht do you suspect will be given to them?
fluoroquinolones (cipro, levequin, or noroxin)
what is the onset, peak, duration of short acting insulin?
onset: 30-60 min

peak: 2-3 hr

duration: 4-6 hr
Nursing considerations for SSRI? (5)
1. suicide risk high after 2 week (s for suicide)

2. sunblock required (ss for sun sensitivity)

3. increase fluids, use sugarfree candy for dry mouth

4. there is a delay of 2-6 for effect
what are the nursing considerations for mao inhibitors? (3)
1. should not be taken with SSRI
2. lowers seizure threshold
3. monitor for urinary retention
it is important to check what 3 things for aminoglycosides (ex. neomycin)?
1. hearing nerve
2. BUN
3. creatinine
what might you tell a pt about adminstration of niacin?
feeling of flushing several hours after taking the med which will decrease over 2 weeks
for sulfonamides, it is important to montior what? (2)
1. feeling in periphery (think "so furry"
2. urine (for protein/crystals) (think sulfer in your urine)
what is important to know about buspar? (3)
1. requires more than 3 weeks to work
2. CANNOT be used as a PRN med
3. no abuse potential
what should you tell your pt to report when taking folic acid derivatives (tricor and lopid)
notify MD if muscle pain develops
abilify causes what to happen to sugar?
increases sugar and may lead to death an coma in dm pt
how should you instruct your pt taking statin drugs to take it?
take it at night and take it with food
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