Pharmacology Common missed ?'s

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  1. What is the reversal agent of Benzo's
    Flumazenil
  2. When does Serotonin Syndrome generally occur
    2-72 hours of taking it
  3. What are common symptoms of Serotonin Syndrome
    • Agitation
    • Fever
    • Diaphoresis
    • Tremor
    • Hallucination
  4. What lab value should be monitored for patient on SSRI and why?
    Sodium due to risk of hyponatremia
  5. When should you instruct patient to take SSRI
    Morning
  6. Number one side effect of SSRI
    sexual dysfunction
  7. What antidepressant has a side effect of bruxism
    SSRI
  8. What medication can be used in adjunct to SSRI to control bruxism?
    buspirone
  9. What are the main two side effects of Bupropion
    • Appetite suppression
    • Seizures
  10. 3 main side effects of TCA
    • Anticholinergic
    • Orthostatic hypotension
    • Profuse sweating
  11. What is a serious complication of TCA
    Cardiac toxicity r/t overdose (fatal)
  12. When should you instruct patient to take TCA
    at night
  13. Number one complication of MAOI and what is cause
    • HTN crisis
    • Too much tyramine
  14. What is number one symptom of HTN crisis following MAOI
    Headache
  15. What drug in combination with MAOI (aside from other antidepressants) can lead to hyperpyrexia
    Demerol (meripidine)
  16. What are early indications of Lithium toxicity and what would the value be in the blood
    • <1.5
    • GI issues
    • Muscle weakness
    • Fine hand tremors
    • Slurred speech
  17. What symptom in addition to early indication symptoms occur with advanced toxicity of Lithium? What would the value be?
    • Coarse tremors
    • 1.5-2
  18. What are 5 symptoms of severe Lithium toxicity and what would the level be
    • Extreme polyuria w/t dilute urine
    • Tinnitus
    • Ataxia
    • Seizures
    • Severe hypoTN
    • 2-2.5
  19. At what level is hemodialysis indicated for lithium toxicity
    >2.5
  20. What electrolyte imbalance increases the risk of Lithium toxicity
    Hyponatremia
  21. What medication should be AVOIDED with Lithium (not closely monitored)
    NSAID
  22. What is the maintenance level of lithium
    0.8-1.4
  23. What labs should be monitored with Carbamazepine
    CBC due to blood dyscrasias
  24. What two organs can be affected by Valproic Acid
    • Hepatotoxic
    • Pancreatitis
  25. What labs should be monitored with Valproic Acid (besides liver/pancreas)
    CBC due to risk of thrombocytopenia
  26. What Generation of antipsychotics control positive symptoms only
    1st
  27. What generation of antipsychotics control positive and negative symptoms
    2nd
  28. #1 side effect of 1st Generation Antipsychotics
    EPS
  29. What is severe spasms of tongue, neck, face (EMERGENT)
    Acute dystonia
  30. What is it called when client is unable to stand still or sit, continually pacing and agitated
    Akathisia
  31. Involuntary movement of tongue and face (lip smacking), can cause speech/eating disturbances
    Tardive dyskinesia
  32. What is are 2 complications of 1st generation Antipsychotics
    • Neuroleptic Malignant syndrome
    • Agranulocytosis
  33. What are symptoms of neuroleptic malignant syndrome
    • High grade fever
    • BP fluctuations
    • Muscle rigidity
    • Change in LOC
  34. What do you give to treat neuroleptic malignant syndrome
    Dantrolene
  35. 3 classes of medications used to control symptoms of EPS
    • Benzos
    • Beta blockers
    • Anticholinergics
  36. 2 main side effects of 2nd generation Antipsychotics
    • New onset DM
    • Hypercholesterolemia
  37. What additional labs should be monitored for lithium besides level?
    Thyroid
  38. What 2nd generation antupsychotic can lead to cataracts and what do you instruct patient to do
    • Quetipine
    • Eye exam q 6 months
  39. Which antipsychotic can cause Agranulocytosis
    Clozapine
  40. When should CNS stimulants such as Methylphenidate an Amphetamine be administered
    no later than 4pm
  41. What medication used for alcohol withdrawal maintenance serves as aversion therapy and can lead to Acetaldehyde syndrome
    Disulfiram
  42. What 3 things do you teach the client to do if on disulfiram
    • Wear medical alert bracelet
    • 12 step program
    • No cough syrups, mouthwash, aftershave lotion
  43. What medication suppresses craving and pleasurable effects of alcohol (and opioids)
    Naltrexone
  44. What medication used for alcohol withdrawal maintenance decreases unpleasant withdrawal effects
    Acamprosate
  45. What symptom can occur with Acamprosate
    diarrhea
  46. When can Alcohol delerium occur
    2-3 days after last drink
  47. What medication can decrease craving of Opioid
    Buprenorphine
  48. What medication decreases nicotine craving
    Buproprion
  49. What 3 things do you teach the patient about using nicotine gum
    • Don't use longer than 6 months
    • Chew over 30 minutes
    • No drink prior and 15 min during chew
  50. What should the patient do with nicotine patch if undergoing an MRI
    take patch off and replace when scan is complete
  51. What can occur if patient takes to much neostigmine and what should they be given to counteract it
    • Cholinergic crisis
    • Atropine
  52. What can occur in SEVERE cholinergic crisis if left untreated
    respiratory depression from neuromuscular blockade
  53. How should patient with MG be instructed to take neostigmine
    Same time each day to prevent weakness of respiratory/swallowing muscles
  54. What are 5 unique side effects of Sinamet
    • Dyskinesias
    • CVS effects
    • Psychosis
    • Discolored Sweat/Urine
    • Activation of malignant melonoma
  55. What is 2 major side effects of bromocriptine
    • Impulse control disorder
    • Sudden inability to stay awake
  56. 3 symptoms of Amantadine
    • CNS effects
    • Anticholinergic
    • Discolored skin
  57. What symptom can occur with Entacapone
    yellow/orange urine
  58. When should you instruct patient to take selegine
    no later than noon
  59. What two vitamins are decreased with Phenobarbital and Primidone
    Vit K and D
  60. Name 4 side effects of phenobarbital/primidone toxicity
    • Nystagmus
    • Ataxia
    • Pinpoint pupils
    • HypoTN
  61. What vitamin is affected with Phenytoin and what should you instruct client on it to do
    • Vitamin D
    • Adequate amount of Vit D and Calcium
  62. 2 side effects of Hydantoin
    • Gingival hyperplasia
    • Teratogenic
  63. What are two major side effects of Topiramate
    • Metabolic Acidosis
    • Angle-closure glaucoma
  64. What is first line medication used to treat angle-closure glaucoma until surgery can be performed
    mannitol
  65. What two vaccines will reduce acute otitis media in infants and children
    Influenza and Pneumococcal
  66. What is a MAJOR complication of Succinylcholine
    Malignant Hyperthermia
  67. What is the reversal agent of Pancuronium
    neostigmine
  68. What medication SHOULD NOT be used with succinylcholine due to it increasing effects
    Neostigmine
  69. What medication is used to treat nonobstructive urinary retention
    bethanechol
  70. What medication is used to treat an overactive bladder
    oxybutynin
  71. In what order should you instruct a patient with asthma to administer a glucocorticoid and beta 2 agonist?
    FIRST B2 Agonist THEN Glucocorticoid
  72. What are mild toxicity side effects of Theophylline (at what range will these symptoms appear)
    • GI distress
    • Restlessness
    • >20 mcg/ml
  73. What are severe toxicity side effects of Theophylline
    • Dysrhythmias
    • Seizures
  74. What is the therapeutic range of Theophylline
    5-15 mcg/ml
  75. What 3 medications are used to treat theophylline toxicity
    • Activated charcoal (< absorption)
    • Lidocaine (dysrhythmias)
    • Diazepam (seizures)
  76. What are inhaled anticholinergic medications contraindicated with (type of allergy)
    peanuts
  77. How long should client wait to take the second puff of inhaled anticholinergic if prescribed 2 puffs
    5 min
  78. What are 3 side effects of Betamethasone
    • Hoarseness
    • Difficulty speaking
    • Candidiasis
  79. When should patient be instructed to take montelukast
    Once daily at bedtime
  80. What upper respiratory medication is used to suppress a chronic nonproductive cough
    Codeine (ANTITUSSIVE)
  81. What medication is used to increase cough production through increased mucus secretion?
    Guaifenesin (Expectorant)
  82. What MUST client be instructed to do when on Guaifenesin
    INCREASE FLUIDS
  83. What medication is used to treat acute and chronic pulmonary disorders exacerbated by large amounts of secretions (such as Cystic Fibrosis)
    Acetylcysteine (mucolytic)
  84. What is the antidote of acetaminophen poisoning?
    Acetylcysteine
  85. What should you instruct the client about the smell of acetylcysteine
    smells like rotten eggs
  86. If a client is taking oral acetylcysteine what should the nurse be alert for and what should she be prepared to do
    • aspiration or bronchospasm,
    • Suction
  87. How long should you tell client on a decongestant to take it for if they need it and why?
    no more than 3-5 days due to rebound congestion
  88. How should the client be positioned when administering nasal drops
    lateral, head low position
  89. What is normal creatinine? BUN?
    • 0.6-1.2
    • 10-20
Author:
jwhughes
ID:
313665
Card Set:
Pharmacology Common missed ?'s
Updated:
2016-01-03 14:29:46
Tags:
pharm
Folders:
nursing
Description:
Pharm questions I usually miss
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