Pharmacology Final

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jrodgers457
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Pharmacology Final
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2010-11-23 15:50:38
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Pharmacology Final
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  1. Two inhalers bronchodilator and corticosteroid, which should be taken first?
    Bronchodilator
  2. Adrenergic drugs
    1. Take decongestant for how long?
    2. Systemic effects with excessive use.
    • 1. Nasal decongestants should be used 3-5 days.
    • 2. Cardiovascular effects such as hypertension, and
    • palpitations, CNS such as headaches, nervousness and dizziness. The systemic effects are a result of the alpha-adrenergic stimulation of the heart, blood
    • vessels and CNS.
  3. Atropine sulfate adverse effects
    Cardiac dysrhythmias
  4. Diet plan with extended-release beta-blocker, patient teaching
    Well balanced diet is recommended without an excess of alkaline ash foods (citrus fruits, vegetable and milk) Fluid intake should increase to 3L/day (unless contraindicated)
  5. Patient teaching with atenolol drug
    Atenolol is a beta-blocker drug. It should be taken exactly as prescribed. Avoid caffeine and other CNS stimulants, contact prescriber in palpitations, chest pain, confusion or weight gain of 2lbs or more in 24 hours or 5 lbs in 1 week, change positions slowly to avoid dizziness, avoid excessive exercise or humid environments, constipation may occur - increase fiber and fluids. DO NOT take medicine if HR < 60.
  6. Patient teaching with Minipress to reduce urinary obstruction
    Lightheaded with standing after lying until tolerance is reached; is known to cause low BP.
  7. Aricept taken for A.D.
    Alzheimer's disease. This drug's mechanism of action is that it inhibits acetylcholinesterase; thereby increasing levels of acetylcholine. Adverse effects, such as GI upset, drowsiness, insomnia, and muscle craps, are generally mild and relieve themselves.
  8. Anticholinergic taken pre-surgery for what?
    Reduces secretions. Decreases smooth muscles.
  9. Nursing principles for pancuronium drug
    • NMBD - Neuromuscular blocking drugs. Used as an adjunct to anesthesia for long surgeries to provide muscle relaxation (smooth/skeletal), RN should ask about any OTC meds, alcohol use, getting
    • weight and height for proper dosage, neurological assessment, getting baseline vitals, check for gag reflex, RESPIRATORY ASSESSMENT is very important can cause respiratory distress. Check electrolyte levels such a K+ and Mg2+
  10. Reversal drug for succinylcholine is what?
    • Anitcholinestrase drugs – neostigmine, pyridostigmine,
    • and enrophonium.
  11. Phenobarbital
    • Long-acting barbiturate. Used for the prevention of generalized tonic-clonic seizures(grand mal) and fever induced convulsions and sleep induction. Also for
    • hyperbilirubinemia in neonates. Also has been used for Gilbert syndrome (elevated bilirubin levels). Rarely used for a sedative-hypnotic drug. It is available in Oral and injectable forms.
  12. Dilantin
    • It is primarily indicated for the management of
    • tonic-clonic and partial seizures. Contraindication are allergy, and heart conditions that involve bradycardia or blockage of electro cardiac function. Common Adverse effect are lethargy, abnormal movements, mental confusion and
    • cognitive changes. Gingival hyperplasia (overgrowth of gum tissue), acne,
    • hirstism (excessive
    • growth of thick dark hair in locations where hair growth in women usually is minimal)and hypertrophy of subq facial tissue (dilantin facies), osteoporosis (in women) are also well known adverse effect of long term use. Therapeutic level of 10-20 mcg/mL.
  13. Neurontin
    • Is analogous with the major neurotransmitter that inhibits brain activity called GABA. Indicated for partial seizures and for prophylaxis of partial
    • seizures, also works well with new-onset epilepsy, and to treat neuropathic pain.
    • Adverse effects – CNS and GI symptoms.
    • Drug interactions – Antacids, hydrocodone (reduces gabapentin levels) and cimetidine, morphine, naproxen, and oral contraceptives.
    • Mechanism of action – Mostly unknown. But it is believes that it works by increasing the synthesis and synaptic accumulation of GABA between neurons.
    • - Oral-use only.
    • Gabapentin - requires a thorough neurologic assessment with attention to baseline energy
    • levels, visual intactness, sensory and motor functioning, and any changes in speech.
  14. Cathechol-o-methyltransferase
    COMT –enzyme is the catalyzes the breakdown of the body’s catecholamines.

    Inhibitors block COMT

    The main positive effect of is that they prolong the duration of action of levodopa
  15. Tricyclic antidepressants patient teaching
    Patient needs to know it may take several weeks before a therapeutic level is reached and that they must continue to take the medication as prescribed.

    Take meds with food and at least 4 to 6 oz of fluids.

    • Contact prescriber if you have any blurred vision,
    • excessive drowsiness or sleepiness, urinary retention or constipation.
  16. Diet teaching for monoamine oxidase inhibitor
    • A major adverse effect of nonselective MAOIs is that they interact with tyramine-containing foods
    • (cheese, red wine, beer and yogurt) can cause severe hypotension.
  17. What is meridia taken for?
    Anorexiants – Class IV controlled substance - Appetite suppressant.
  18. Cemetidine for hyperacidity, what could influence the effectiveness?
    • - Cimetidine is an antihistamine given for acid reflux which would be highly influenced if taken with an anticholinergic which has effects such as (increased salivation, increased GI motility, emesis(vomiting) causing Cimetidine not to work as effective.
    • - Smoking decreases effectiveness.
  19. Antilipemic drug therapy
    - Fat soluble vitamins(A,D, E and K) may need to be prescribed for patients taking antilipemic drugs for long periods because the antilipemics have long term effects on the livers production of vitamins.
  20. Iron supplements
    For iron-deficiency anemia. For IM injections use Z-trac method. Take vitamin C with it for increased absorption.
  21. Loop diuretic
    • They have renal, cardiovascular, and metabolic effects. They act primarily along the thick ascending limb of the loop of henle, blocking chloride and, secondarily, sodium reabsorption.
    • They are useful when rapid diuresis is needed, because of the rapid onset of action.
    • Hypokalemia is a known adverse effect
  22. Manifestations of K+ deficiency
    • Early symptoms – Anorexia,
    • hypotension, lethargy, mental confusion, muscle weakness and nausea
    • Late symptoms – cardiac
    • dysrhthymias, neuropathy, paralytic ileus, and secondary alkalosis.
  23. Dobutamine drop for what?
    CHF. Similar to dopamine.
  24. Omeprazole administration
    • 30-60 min before meals.
    • Take omeprazole capsules or delayed-release capsules before a meal, preferably in
    • the morning. Omeprazole tablets may be taken with food or on an empty stomach.
    • Take omeprazole powder for oral suspension on an empty stomach at least 1 hour
    • before a meal. For patients receiving continuous feeding through a tube,
    • feeding should be temporarily stopped about 3 hours before and 1 hour after
    • administration of omeprazole powder for oral suspension. (mayoclinic)
  25. TPN
    Total parenteral nutrition.
  26. Tuberculosis - what drug/how long
    Rifampin. 24 months.
  27. Acyclovir patient teaching
    • Topical dosage forms should be applied using a finger cot or rubber glove to prevent autoinoculation (spreading of the microorganism)
    • 3L/24 hrs.
  28. Amphotericin B nursing actions
    • Antifungal – treatment for
    • severe systemic mycoses (fungus)
    • The main drawback is the
    • drug causes many side effects.
    • Almost all patients experience – Fever,chills, hypotension, tachycardia, malaise, muscle and joint
    • pain, anorexia, nausea and vomiting, and headache.
    • For this reason pretreatment of antipyretic (acetaminophen), antihistamines and antiemetics may be given to decrease the severity.
    • Monitor for adverse effects and pretreatment as ordered. Usually a 1 mg test dose is given over 20 to 30 mins to see if the patient can tolerate amphotericin.
  29. Antiprotozal patient teaching
    Metronidazole should be taken with food , alcohol or alcohol containing should be avoided, dizziness, avoid activities that require mental alertness.
  30. Cytotec taken with NSAIDs for what?
    It effectively reduces the incidence of gastric ulcers in patients taking NSAIDs.
  31. Antineoplastic patient teaching
    • Antiemetics 30-60 min before treatment. May cause alopecia.
    • Provide proper oral hygiene, keep lips moist, avoid harsh bristles toothbrush, avoid spicy foods, alcohol, caffeine, citrus foods/juices, & tobacco.
  32. Immunizations
    Active Immunization Drugs

    • DTap (diphtheria,tetanus and acellualr pertussis vaccine)
    • – 6 wks

    HibTiter H infuenzae) 2-6mths

    Recombivax HB (hep B) – Birth then 1mth and 6mths

    MMRII (mumps, measles, rubella) – peds older than 12 mths
  33. Interferon given when?
    • For the treatment of viral infections, various cancer,
    • and some autoimmune disorders.

    Boost the immune system
  34. Digoxin antidote is what?
    Digoxin immune fab –Digibind
  35. Which lab results can increase the toxicity of cardiac glycoside?
    Potassium.
  36. Selegiline
    • Selegiline is used to help control the symptoms of
    • Parkinson's disease
    • People who are taking levodopa and carbidopa combination
    • (Sinemet). Selegiline may help people with Parkinson's disease by decreasing the dose of levodopa/carbidopa needed to control symptoms, stopping the effects
    • of levodopa/carbidopa from wearing off between doses, and increasing the length of time that levodopa/carbidopa will continue to control symptoms. Selegiline is in a group of medications called monoamine oxidase type B (MAO-B)
    • inhibitors. It works by increasing the amount of dopamine (a natural substance
    • that is needed to control movement) in the brain.

    • •you should know that selegiline may cause dizziness,
    • lightheadedness, and fainting when you get up too quickly from a lying
    • position. This is more common when you first start taking selegiline. To avoid
    • this problem, get out of bed slowly, resting your feet on the floor for a few
    • minutes before standing up.
  37. Coumadin therapy
    Warfarin. Inhibits Vitamin K. Anticoagulant.

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