PHARM QUIZ 2 REVIEW

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lauratwinoaks
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255248
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PHARM QUIZ 2 REVIEW
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2014-01-07 21:47:05
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PHARM QUIZ REVIEW
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PHARM QUIZ 2 REVIEW
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PHARM QUIZ 2 REVIEW
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  1. How would your patient present to the ER with an opioid overdose? Know signs and symptoms
    to look for.
    • Respiratory
    • depression, loss of consciousness, apathy, lethargy, listlessness, judgement,
    • psychomotor retardation or agiation, constricted pupils, slurred speech, delirium,
    • decreased heart rate, inability to urinate, decreases in body temperature, coma,
    • hypoxia, death.
  2. What is pancuronium (Pavulon), and what are the most important nursing facts to
    remember when administering it.
    • Long
    • acting non-depolarizing NMBD.  Commonly
    • used for surgery for prolonged muscle paralysis, contraindicated in cases of
    • known drug allergy.  Route IV, onset of
    • action 3-5 min, peak plasma concentration 5 min, elimination half-life 100min,
    • duration of action 45-60 min
  3. What instructions would you give a patient who reports drinking kava herbal tea to
    help him relax, any teaching needs?
    • Contraindications:  patients w/parkinsons, liver disease,
    • depression, alcoholism, operators of heavy machinery, pregnant or breastfeeding
    • women.

    • Potential drug
    • interactions:  alcohol, barbiturates,
    • psychoactive drugs

    • Side Effects:  skin discoloration (yellow), possible
    • accommodative disturbances and pupillary enlargement, scaly skin (with
    • long-term use)
  4. How would you teach a patient to self- administer Triptan, what teaching would occur with
    this medication.
    • The
    • earlier treated in the attack the more effective; one spray in one nostril and
    • may repeat if headache returns.  Do not
    • repeat if pain continues after 1st dose.  Max 2 doses/day or 12mg/day, allow at least 1
    • hour between doses.  Use contraception
    • when taking
  5. To give IV phenytoin (Dilantin), how exactly would you administer this drug? (Correct
    actions)
    • Patency
    • of the IV catheter should be tested with a flush of sterile saline.  Should be administered directly into a large
    • peripheral or central vein through a large gauge catheter.  Each injection of parentaeral Dilantin should
    • then be followed by a flush of sterile saline through the same catheter to
    • avoid local venous irritation due to the alkalinity of the solution.  Treatment can be initiated either with a
    • loading dose or an infusion.  In adults,
    • administered slowly at a rate not exceeding 50 mg per minute; in pediatric at a
    • rate not exceeding 1-3mg/kg/min
  6. What are the advantages to taking (COMT) inhibitors as treatment for Parkinson’s.
    • When
    • used with levodopa, they can reduce the daily “off time” and increase the “on
    • time”.  Often doses can be reduced.  Reduce motor fluctuations caused by the
    • wearing off effect of levodopa.  Improve
    • motor function and the ability to do daily activities without increasing the
    • dosage of levodopa in people taking levodopa who have not developed dose
    • related motor fluctuations.
  7. Know common adverse effects that can occur when taking Vicodin.
    Sedation, nausea, vomiting, lightheadedness and constipation
  8. What drugs classes interact with phenobarbital?
    • Anticoagulants,
    • glucocorticoids, estrogens, hormonal contraceptives: decreased effectiveness;

    • CNS
    • depressants:  increased effects

    • MAOIS’S,
    • skeletal muscle relaxants, sulfonamides: increased effects
  9. What medical conditions would a patient take central nervous system stimulants for.
    Narcolepsy, neonatal apnea, ADHD, appetite reduction
  10. SSRIS
    • fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (generic only;
    • formerly Luvox), citralopram (Celexa), and escitalopram (Lexapro).
  11. CONCURRENT USE OF SSRI'S
    CONCURRENT USE OF MAOIS AND SSRIS MAY LEAD TO SEROTONIN SYNDROM

    • 2-5 WEEK
    • WASH OUT PERIOD IN BETWEEN REQUIRED
  12. SSRI INDICATIONS
    • INDICATIONS:  Depression, bipolar disorder, obesity, eating
    • disorders, obsessive compulsive disorder, panic attacks orders, premenstrual
    • dysphoric disorder, the neurologic disorder myoclonus and various substance
    • abuse problems such as alcoholism
  13. SSRI CONTRAINDICATIONS
    • known drug
    • allergy, use of MAOI’s in the previous 14 days and therapy with certain
    • antipsychotic drugs such as thioridazine or mesoridazine.  A significant history of cardiac disease or
    • seizure may be due to relatively uncommon, cardiac effects and alterations in
    • seizure threshold
  14. ADVERSE EFFECTS OF SSRIS
    • ADVERSE
    • EFFECTS:  {fewer and less severe than 1st
    • generation}, insomnia, weight gain, and sexual dysfunction, serotonin syndrome
    • (agitation, tachycardia, sweating, and muscle tremors)
  15. ASSESS SSRI'S
    ASSESS:  neuromuscular and gastrointestinal and serotonin syndrome.

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