Pharm Final

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Pharm Final
2014-05-01 17:45:55
Pharm Final
HESI Pharm Final
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  1. Normal range for digoxin.
  2. Major concerns with pts taking HydroDIURIL (a thiazide diuretic).
    • hypokalemia
    • hyperglycemia
    • hypercalcemia
    • hyperlipidemia
  3. Two most common SE of cholestyramine (Questran).
    • constipation
    • bloating
    • (avoid nicotinic acid (niacin) lowers lipid levels & can lead to liver abnormalities)
  4. How to decrease the SE of flushing & GI upset with nicotinic acid (Niacin), a med for hyperlipidemia.
    • take aspirin or an NSAID 30 min B4 Niacin
    • take with meals
  5. What are clay-colored stools a sign of?
    hepatic dysfunction
  6. Something to teach pts about Phenazopyridine hydrochloride (Pyridium), a med for lower UTIs.
    • may tint urine reddish orange & can stain fabric
    • take AFTER meals to reduce GI upset
    • headache is occasional SE
  7. What is bethanechol chloride (Urecholine)?
    • prescribed for urinary retention
    • -increases pressure in urinary tract, so don't use with pts w/ obstruction or weakness of bladder (could rupture bladder)
  8. Signs of toxicity of Bethanechol chloride (Urecholine), med for urinary retention.
    • bradycardia
    • salivation
    • sweating
    • incontinence
    • severe hypotension
  9. Treatment for Bethanechol chloride (Urecholine) overdose (med for urinary retention).
    atropine sulfate SQ or IV
  10. What is oxybutynin chloride (Ditropan XL)?
    • anticholinergic
    • used to treat incontinence & frequent urination
  11. Signs of toxicity of  oxybutynin chloride (Ditropan XL), an anticholinergic for incontinence & urinary frequency.
    • CNS effects
    • -hallucinations, irritability
    • -nervousness, resltlessness
    • -hypo or hypertension
    • -tachycardia, resp depression
  12. *AE of CYCLOSPORINE (Sand immune), an immunosuppressant.
    • *Nephrotoxicity
    • --monitor BUN & Creatinine
    • (also gingival hyperplasia, hepatotoxicity)
  13. Antidote for cholinergic crisis.
    atropine sulfate
  14. Antidote for heparin.
    protamine sulfate
  15. Why would edrophonium (Enlon) be used in a pt with myesthenia gravis?
    • If they are increasingly weaker - to identify whether the pt is in cholinergic crisis or myasthenic crisis.
    • -this drug would make the pt in cholinergic crisis temporarily worse (a negative test) An improvement of weakness would mean the pt was experiencing myasthenia gravis
  16. Therapeutic range of theophylline, acetaminophen, and pheytoin (Dilantin).
    10-20 mcg/mL
  17. What should pts be told about pregnancy/birth control who are taking Dilantin?
    it enhances estrogen metabolism which can decrease effectiveness of some birth control pills
  18. Two SE of etanercept (Enbrel).
    • infection
    • pancytopenia
    • (*labs checked B4 & during treatment*)
  19. What type of drug is baclofen (Lioresal)?
    CNS depressent
  20. How does Dantrium work?
    • suppresses calcium release, which relieves muscle spasticity in skeletal muscle
    • -prescribed for pts experiencing flexor spasms
  21. Most serious SE of dantrolene sodium (Dantrium), a med that reduces muscle spasticity.
    • Dose-related liver damage
    • (LFTs B4 & periodically throughout treatment)
    • *administer in lowest effective dose for shortest time necessary*
  22. What is the concern of seizure pts receiving baclofen?
    it may lower seizure threshold, so seizure meds may need to be increased
  23. Why should cyclobenzaprine (Flexeril) be used with caution in pts with urinary retention or glaucoma?
    • it has anticholinergic effects
    • *also only used for short-term (2-3 wks) therapy*
  24. Why should the nurse monitor gait in a pt taking stavudine (d4t, Zerit)?
    • It's an antiretroviral for HIV & 
    • can cause peripheral neuropathy
  25. Commen SE of therapy with zidovudine for AIDS.
    • leukopenia
    • anemia
  26. What would a significantly elevated serum amylase level indicate?
  27. What can didanosine (Videx) cause?
    • pancreatitis (monitor amylase)
    • -may need to be discontinued in AIDS pts if amylase elevated too much
    • liver failure
  28. Most "-cin" meds.
  29. Foscarnet is toxic to ______.
    • the kidneys! 
    • -monitor creatinine B4, & 2-3x/week during therapy
    • -also monitor Ca++, Mg++, PO4, & K+
  30. What is Saquinavir (Invirase)?
    • protease inhibitor (PI), antiretroviral
    • *take with high-calorie, high-fat meals
    • *photosensitivity SE
  31. Ketaconazole (antifungal) teaching points.
    • avoid alcohol 
    • avoid sun
    • take WITH food
    • avoid antacids 2 hrs after med
  32. Nevirapine (Viramune), a NRTI for HIV AE.
    • rash, SJS
    • hepatitis
    • Increased transaminase levels
  33. What should be checked prior to administering clozapine (Clozaril), for schizophrenia, and also monitored closely during use of the med?
    • WBCs
    • (hematological rxns can occur)
  34. Most common AE of fluoxetine (Prozac).
    CNS & GI dysfunction
  35. Therapeutic level of lithium.
  36. What could happen to a pt who was taking Nardil and consumed tyramine-containing foods?
    it could trigger a potentially fatal HTN crisis
  37. What is scopolamine (Transderm-Scop) used to treat?
    • prevention of nausea & vomiting
    • (anticholinergic)
  38. Oral iron can cause _____.
  39. AE of Lasix.
    • tinnitus (ototox)
    • hypotension
    • hypokalemia
  40. Megestrol acetate (Megace) SE.
    • thrombotic DO
    • (caution if h/o thrombophlebitis)
  41. Lab value specifically noted as a result of massive cell destruction of a pt with leukemia or lymphoma.
    increased uric acid
  42. What is the highest priority complication that can potentially affect clients managed with carbamazepine (Tegretol) therapy?
  43. Cholinesterase inhibitors work to increase the availability of _______ at cholinergic synapses, which aids in neuronal transmission and assists in memory formation.
    • acetylcholine  
    • (Improves nerve impulse transmission)