Term
| What therapeutic drug class does Risperdal belong to? |
|
Definition
| Atypical antipsychotic; schizophrenic drug |
|
|
Term
| What are the therapeutic benefits of Risperdal? |
|
Definition
| treatment and prevention of schizophrenia relapse and expression of bipolar mania symptoms |
|
|
Term
| Risperdal is also used in autistic children, why? |
|
Definition
|
|
Term
| Your patient is being prescribed Risperdal, what results would you expect? |
|
Definition
| A reduction of excitement, paranoia, or negative behaviors associated with pyschosis |
|
|
Term
| Risperdal works by blocking receptors in the CNS, which receptors? |
|
Definition
dopamine type 2 (antagonist)
serotonin type 2 (antagonist)
alpha2 adrenergic (antagonist) |
|
|
Term
| For a full range of effectiveness, Risperdal is sometimes combined with one of two other drugs, what other drugs are these? |
|
Definition
|
|
Term
| Factoid: Risperdal is a long acting preparation, which following IM administration, releases only a small amount. After a 3 week lag, the rest of the drug releases and lasts for approximately 4-6 weeks |
|
Definition
|
|
Term
| Your pt is switching to a new antipsychotic, can they continue to take the old antipsychotic? |
|
Definition
| No, d/c meds to avoid overlap |
|
|
Term
| What are common adverse effects of Risperdal? |
|
Definition
Extrapyramidal effects!!!
hyperactivity
fatigue
nausea
dizziness
ortho hypotn
fever
visual disturbances
|
|
|
Term
| Your schizophrenic pt just happens to be diabetic. Is this going to be a problem when taking Risperdal? |
|
Definition
| It sure is! Risperdal may cause weight gain and hyperglycemia, thus worsening glucose control |
|
|
Term
| If older adults with dementia-related psychoses are given Risperdal, then they are at an increased for? |
|
Definition
heart failure
pneumonia
sudden death |
|
|
Term
| You have a pt with an underlying cardio disease and they are taking Risperdal. You know that pt teaching has been effective if they say ? |
|
Definition
| "Because I have a cardiovascular disease, I may be prone to dysrhythmias and hypotension." |
|
|
Term
| Risperdal should be avoided all together in pt's with a history of one of three things, what are they? |
|
Definition
Hx of seizures
suicidal ideations
kidney/liver disease |
|
|
Term
| A pt has been admitted to the ER and is complaining of pain. The doctor orders an opioid. Do you question this drug or administer it? |
|
Definition
| Question the HCP. Pt's taking Risperdal should avoid CNS depressants such as alcohol, antihistamines, sedative-hypnotics, or opioid analgesics. |
|
|
Term
| Your pt says, "I am looking forward to taking Risperdal for my schizophrenia, I finally found a cure." How do you respond? |
|
Definition
| Tell your pt that the meds are schizophrenia do not cure the disorder, but they improve positive to negative symptoms of the disorder |
|
|
Term
| Your pt with schizophrenia asks what would happen if they did not take their meds on a regular basis, like Risperdal. How do you respond? |
|
Definition
| Tell the pt that symptoms may return abruptly if regular administration is disrupted |
|
|
Term
| Besides extrapyramidal effects, what other rare, but serious side effect may occur in pt's taking Ripserdal? |
|
Definition
| Neuroleptic Malignant Syndrome |
|
|
Term
| What is the therapeutic class for Thorazine? |
|
Definition
| Conventional antipsychotic; schizophrenia drug |
|
|
Term
| Does thorazine provide symptomatic relief for positive or negative symptoms of schizophrenia? |
|
Definition
|
|
Term
| Thorazine controls manic symptoms in pt's with what disorder? |
|
Definition
|
|
Term
| Your pt asks how long it will take for Thorazine to work so they experience improvement, how do you respond? |
|
Definition
|
|
Term
| Your psychotic pt is extremely agitated, what do you give that will act in minutes and who do you administer it? |
|
Definition
|
|
Term
| Besides treating pychotic disorders, Thorazine may also be used in pt's experiencing what? |
|
Definition
|
|
Term
| you have just administered Thorazine IM. What position do you tell the pt to remain in, and for how long? |
|
Definition
| supine position for 30-60 minutes, and then rise slowly |
|
|
Term
| What are common adverse effects of Thorazine? |
|
Definition
dizziness
drowsiness
orthorstatic hypotn
|
|
|
Term
| EPS may occur when taking Thorazine, but they may occur more commonly in whom? (3) |
|
Definition
Elderly
female
pediatric kids who are dehydrated |
|
|
Term
| your pt taking Thorazine is heading to Miami in a couple of weeks to go to the beach for vacay. Why are you concerned about this? |
|
Definition
| D/t the pt being in a warmer client, she needs to be monitored for NMS |
|
|
Term
| Use of Thorazine is not advised during? |
|
Definition
alcohol withdrawl
pt's in comotose state
contraindicated in lactation |
|
|
Term
| Caution should be taken in pt's taking Thorazine with what conditions?(3) |
|
Definition
subcortical brain damage
Reye's syndrome
bone marrow depression |
|
|
Term
| Your pt is taking morphine and you note constriction of the pupils, is this normal? |
|
Definition
Yes it is.
Morphine causes euphoria, constriction of the pupils, and stimulation of cardiac muscle |
|
|
Term
| Morphine can be used as preanesthetic medication to relieve what? |
|
Definition
shortness of breath d/t heart failure and pulmonary edema
&
Acute chest pain d/t MI |
|
|
Term
| Because morphine causes peripheral vasodilation, you must be cautious for what in your patient? |
|
Definition
|
|
Term
| what are adverse effects of morphine? |
|
Definition
dysphoria
hallucinations
nausea
constipation
dizziness
itchiness
anaphylactoid reactions |
|
|
Term
| Your pt says they do not want to take morphine becuase they will become addicted. How do you respond? |
|
Definition
| Physical and psychological dependence develops when high doses are taken for prolonged periods |
|
|
Term
| Factoid:morphine may mask or intensify the pain of gallbladder disease, due to biliary spasms |
|
Definition
|
|
Term
| morphine should be avoided in cases of ? (4) |
|
Definition
acute or severe asthma
GI obstruction
severe hepatic or renal impairment |
|
|
Term
|
Definition
| B (D in long term use or w/ high doses) |
|
|
Term
| Aspirin works by inhibiting? |
|
Definition
| Prostaglandin synthesis involved in the process of pain and inflammation and produces mild to moderate relief of fever |
|
|
Term
| aspirin has limited effects on peripheral blood vessels, thus causing...? |
|
Definition
| vasodilation and sweating |
|
|
Term
| Aspirin has been found to reduce the risk of what cancer? |
|
Definition
|
|
Term
| Platelet aggregation inhibition caused by aspirin is irreversible, therefore it should be d/c how long before elective surgery? |
|
Definition
|
|
Term
| Aspirin is prego category? |
|
Definition
|
|
Term
|
Definition
| gastric discomfort and bleeding |
|
|
Term
| Lidocaine acts by blocking? |
|
Definition
| sodium channels located within membranes of neurons |
|
|
Term
| Besides being an anesthetic, lidocaine also treats? |
|
Definition
|
|
Term
| What is an early symptom of lidocaine toxicity ? |
|
Definition
| CNS excitement, leading to irritability and confusion |
|
|
Term
| what are serious side effects of lidocaine? |
|
Definition
convulsions
respiratory depression
cardiac arrest |
|
|
Term
| why are pt's that are given lidocaine at risk for injury? |
|
Definition
| biting or chewing areas of the mouth that have no sensation (especially after dental procedures) |
|
|
Term
| Lidocaine is contraindicated in the presence of ? |
|
Definition
severe trauma or sepsis
blood dyscrasias
dysrhythmias
sinus bradycardia
severe degrees of heart block |
|
|
Term
| Anectine: therapeutic class? |
|
Definition
| skeletal muscle paralytic agent; neuromuscular blocker |
|
|
Term
|
Definition
depolarizing blocker
acetylcholine receptor blocking agent |
|
|
Term
| Anectine acts on what receptor sites? |
|
Definition
| cholinergic receptor sites at neuromuscular junctions |
|
|
Term
| Effects of anectine are first noted as ? |
|
Definition
| muscle weakness and muscle spasms...eventually paralysis occurs |
|
|
Term
| Anectine is rapidly broken down by what enzyme? |
|
Definition
|
|
Term
| Because anectine is rapidly broken down by cholinesterase, when IV infusion stops, the duration of action is only a few minutes |
|
Definition
|
|
Term
| Why is mechanical ventilation is needed for the use of anectine? |
|
Definition
| because it can cause complete paralysis of the diaphragm and intercostal muscles |
|
|
Term
| what are EXPECTED adverse effects of anectine? |
|
Definition
Bradycardia
&
respiratory depression |
|
|
Term
| If your pt is receiving high doses of anectine, the ganglia are affected, causing? |
|
Definition
tachycardia
hypotn
urinary retention |
|
|
Term
| Factoid: Pt's with certain genetic defects may experience a rapid onset of extremely high fever with muscle rigidity- a serious condition known as malignant hyperthermia |
|
Definition
|
|
Term
| Use anectine with caution in pt's with fractures because of the initial muscles spasms can cause additional trauma |
|
Definition
|
|
Term
| Anectine is contraindicated in what pt's? |
|
Definition
family hx of malignant hyperthermia
conditions of pulmonary, renal, cardiovascular, metabolic or hepatic dysfunction |
|
|
Term
|
Definition
| acts by blocking excess cholinergic stimulation of neurons in the corpus striatum |
|
|
Term
| Cogentin is used for what? |
|
Definition
relief of parkinsonism symptoms and for the treatment of EPS brought on by antipsychotic pharmacotherapy.
SUPPRESSES TREMORS BUT DOES NOT AFFECT TARDIVE DYSKINESIA |
|
|
Term
| yor pt is experiencing muscle weakness while on cogentin. what would you expect the hcp to do? |
|
Definition
|
|
Term
| Therapeutic class: cogentin |
|
Definition
|
|
Term
|
Definition
| centrally acting cholinergic receptor antagonist |
|
|
Term
| what are typical adverse effects of cogentin? |
|
Definition
anticholinergic side effects such as:
dry mouth
constipation
tachycardia |
|
|
Term
| Cogentin is contraindicated in what pt's? |
|
Definition
narrow-angle glaucoma
myasthenia gravis
obstructive diseases of GU and GI tracts |
|
|
Term
| Therapeutic class: Aricept |
|
Definition
|
|
Term
|
Definition
| acetylcholinesterase inhibitor |
|
|
Term
|
Definition
| AchE inhibitor that improves memory in cases of mild to moderate Alzheimer's dementia by enhancing the effects of acteylcholine in neurons in the cerebral cortex that have not yet been damaged |
|
|
Term
| How long should your pt be on Aricept before evaluating the max benefits of the drug? |
|
Definition
|
|
Term
| your pt receiving Aricept may see improvements as early as? |
|
Definition
|
|
Term
| what are three common side effects of Aricept? |
|
Definition
vomiting
diarrhea
darkened urine |
|
|
Term
| Aricept also has CNS side effects, such as? |
|
Definition
insomnia
syncope
depression
HA
irritability |
|
|
Term
| what are the musculoskeletal side effects of Aricept? |
|
Definition
muscle cramps
arthritis
bone fx |
|
|
Term
| generalized side effects of Aricept? |
|
Definition
HA
fatigue
chest pain
increased libido
hot flashes
urinary incontinence
dehydration
blurred vision |
|
|
Term
| Factoid: Pt's with bradycardia, hypotn, asthma, hyperthyroidism, or active peptic ulcer disease should be monitored carefully while taking Aricept |
|
Definition
|
|
Term
| Your pt has GI bleeding and jaundice, can they still take Aricept? |
|
Definition
| Nope, it is contraindicated in these pt's |
|
|
Term
| When should Aricept be given? |
|
Definition
|
|
Term
| what are symptoms of f&e loss d/t chlorothiazide? |
|
Definition
thirst
weakness
lethargy
muscle cramping
hypotn
tachycardia |
|
|
Term
| chlorothiazide is contraindicated in pt's with? (4) |
|
Definition
anuria
hypokalemia
severe hepatic or renal impairment
hypersensitivity to sulfonamides |
|
|
Term
| Spironalactone acts by inhibiting? |
|
Definition
|
|
Term
| what are s/s to look for in a pt taking spironalactone who may have hyperkalemia? |
|
Definition
muscle wekaness
fatigue
bradycardia |
|
|
Term
| Men may experience what adverse effects while taking spironalactone? |
|
Definition
gynecomastia
impotence
diminished libido |
|
|
Term
| women may experience what adverse effects while taking spironalactone? |
|
Definition
menstrual irregularities
hirsutism
breast tenderness |
|
|
Term
| Should ibuprofen be given on an empty stomach or with food? |
|
Definition
| on an empty stomach as tolerated. with food if n/v, or abdominal pain occurs |
|
|
Term
| what are common adverse effects of ibuprofen? |
|
Definition
nausea
heartburn
epigastric pain
dizziness
GI ulceration or gross bleeding
chronic use may lead to renal impairment |
|
|
Term
| Ibuprofen has a FDA black box warning that its use is contraindicated for? |
|
Definition
| treatment of perioperative pain in the setting of coronary artery bypass graft surgery d/t potential for stroke or MI |
|
|
Term
| Pt's who are malnourished should not take tylenol (acetaminophen) d/t potential for acute toxicity because this can lead to renal failure. what are some signs of acute toxicity? |
|
Definition
n/v
chills
abdominal discomfort
fatal hepatic necrosis |
|
|
Term
| therapeutic class: acyclovir (zovirax) |
|
Definition
| antiviral for herpesvirus |
|
|
Term
| pharm class: acyclovir (zovirax) |
|
Definition
|
|
Term
| Acyclovir is the drug of choice for what virus? |
|
Definition
|
|
Term
|
Definition
| prevents viral DNA synthesis, and decreases duration and severity of acute herpes episodes |
|
|
Term
| what is an adverse effect of acyclovir when given IV? |
|
Definition
|
|
Term
| Pt's with what virus have been known to have developed resistance to acyclovir? |
|
Definition
|
|
Term
|
Definition
| infx of the eye, mouth, and lips. Genital infx are increasing |
|
|
Term
|
Definition
|
|
Term
| therapeutic class: hydrocortisone |
|
Definition
|
|
Term
| hydrocortisone is the drug of choice for treating what? |
|
Definition
| adrenocortical insufficiency |
|
|
Term
| when using hydrocortisone for replacement therapy the hcp must figure out the right dose unique to the pt. Once that is achieved then its therapeutic effects should mimic those of endogenous corticosteroids. |
|
Definition
|
|
Term
| How should hydrocortisone be administered time wise? |
|
Definition
|
|
Term
| because hydrocortisone is a corticosteroid, what syndrome may develop? |
|
Definition
|
|
Term
| Hydrocortisone should be d/c gradually if taken longer than? |
|
Definition
|
|
Term
| hydrcortisone does have mineralocorticoid activity, so what adverse effects may occur? |
|
Definition
| sodium and fluid retention |
|
|
Term
| A wide range of CNS effects have been reported while using hydrocortisone, such as? |
|
Definition
insomnia
anxiety
HA vertigo
confusion
depression |
|
|
Term
| Cardiovascular effects in the use of hydrocortisone include? |
|
Definition
|
|
Term
| Your pt has been taking hydrocortisone for a very long time. You are concerned that the pt may develop what? |
|
Definition
|
|
Term
| hydrocortisone is contraindicated in pt's with an active? |
|
Definition
| infx: unless they are being treated concurrently with anti-infectives |
|
|
Term
| What is the primary therapeutic use of testosterone? |
|
Definition
| treatment of delayed puberty and hypogonadism in males |
|
|
Term
| Testosterone is approved in treating what that is caused by low androgen levels? |
|
Definition
|
|
Term
| How can women benefit from receiving testosterone? |
|
Definition
| it is palliative treatment of inoperable breast cancer in women |
|
|
Term
| What is testosterones MOA? |
|
Definition
| stimulates RNA synthesis and protein metabolism |
|
|
Term
| high does of testosterone may suppress the genesis of what ? |
|
Definition
|
|
Term
| how often should you alternate the patch site? |
|
Definition
| Alternate patch site daily, rotating sites every 7 days |
|
|
Term
| Testosterone is prego category... |
|
Definition
|
|
Term
| Why may a diuretic be indicated in a pt taking testosterone? |
|
Definition
| because a side effect is salkt and water retention, causing edema |
|
|
Term
| What may the person's skin look like in a pt taking testosterone? |
|
Definition
|
|
Term
| Why did the male pt taking testosterone develop female features? |
|
Definition
| He was taking too high of a dose, and the excess testosterone was metabolized to estrogen |
|
|
Term
| Testosterone is contraindicated in men with? |
|
Definition
| known or suspected breast or prostatic carcinomaa |
|
|
Term
| Testosterone may potentiate the effects of oral anticoagulants and increase the risk of bleeding |
|
Definition
|
|
Term
| Proscar acts by inhibiting what? |
|
Definition
5-alpha-reductase, the enzyme responsible for converting testosterone to one of its meatabolites, 5-alpha-dihydrotestosterone
|
|
|
Term
| the active metabolite who's conversion is d/t proscar cause the prostate cells to do what? |
|
Definition
| the prostate cells proliferate and promotes enlargement of the gland |
|
|
Term
| Does Proscar promote the prostate gland to shrink or enlarge? |
|
Definition
| shrink; thus restoring urinary function |
|
|
Term
| Proscar is also marketed as Propecia, which is used for? |
|
Definition
|
|
Term
| Proscar causes various types of sexual dysfunction, including: |
|
Definition
impotence
impaired fertility
diminished libido
ejaculatory dysfunction |
|
|
Term
| Fosamax is a drug for what diease? |
|
Definition
|
|
Term
|
Definition
| biphosphonate; bone resorption inhibitor |
|
|
Term
| All doses of Fosamex must be taken how and when? (empty or with food) |
|
Definition
| MUST be on an empty stomach, and preferably in a fasting state two hours before breakfast |
|
|
Term
| Therapeutic effects of Fosamax may take how long to appear? |
|
Definition
|
|
Term
| What do you tell your pt to do after taking their dose of Fosamex? |
|
Definition
| remain upright for 30 minutes to reduce esophageal irritation |
|
|
Term
| What is the main adverse effect of Fosamax? |
|
Definition
|
|
Term
| The therpaeutic effects of fosamax may continue several months after the drug has been d/c |
|
Definition
|
|
Term
| what is your concern for the pt taking Fosamax longer than 3 months, or one who chronically overdoses on the drug? |
|
Definition
|
|
Term
| Fosamax is contraindicated in pt's with what other bone disorder? |
|
Definition
|
|
Term
| Fosamax may be toxic to what organ? |
|
Definition
|
|
Term
| What drug may decrease the effectiveness of Fosamax? |
|
Definition
| antacids containing aluminum and magnesium |
|
|
Term
| Colcrys is the drug of choice for what ? |
|
Definition
|
|
Term
| Colcrys is most effective if taken within how soon of the onset of sx? |
|
Definition
|
|
Term
| What is the MOA of colcrys? |
|
Definition
| inhibits the synthesis of microtubules, subcellular structures responsible for helping WBC infiltrate an area |
|
|
Term
| Colcrys does not have any analgesic effect, and yet it reduces pain. How? |
|
Definition
|
|
Term
| You tell your pt that what side effects are likely to appear when first starting to take colcrys? |
|
Definition
n/v
diarrhea
anorexia
abdominal pain |
|
|
Term
| What are some other very important and serious adverse effects of colcrys? |
|
Definition
APLASTIC ANEMIA
THROMBOCYTOPENIA
bone marrow toxicity
leucopenia
agranulocytosis |
|
|
Term
| If colcrys is used concurrently with what drug may increase risk of GI problems occur? |
|
Definition
|
|
Term
| Pt's with blood dyscrasisas should not receive colcrys |
|
Definition
|
|
