Shared Flashcard Set

Details

Level 2 pharm final
N/A
149
Nursing
Undergraduate 2
04/19/2012

Additional Nursing Flashcards

 


 

Cards

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
To treat irritability
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

Lithium

&

Depakene

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
Positive
Term
Thorazine controls manic symptoms in pt's with what disorder? 
Definition
Schizoaffective disorder
Term
Your pt asks how long it will take for Thorazine to work so they experience improvement, how do you respond?
Definition
7-8 weeks
Term
Your psychotic pt is extremely agitated, what do you give that will act in minutes and who do you administer it?
Definition

Thorazine

IM or IV

Term
Besides treating pychotic disorders, Thorazine may also be used in pt's experiencing what?
Definition
N/V
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
ortho hypotn
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
morphine is a category?
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
colorectal
Term
Platelet aggregation inhibition caused by aspirin is irreversible, therefore it should be d/c how long before elective surgery?
Definition
1 week
Term
Aspirin is prego category?
Definition
D
Term
Aspirin: adverse effects
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
dysrhythmias
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
Anectine: pharm class?
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
cholinesterase
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
what is cogentins MOA?
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
reduce the dose
Term
Therapeutic class: cogentin
Definition
antiparkinson
Term
Pharm class: Cogentin
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
Alzheimer's agent
Term
Pharm class: aricept
Definition
acetylcholinesterase inhibitor
Term
Aricept MOA?
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
6 months
Term
your pt receiving Aricept may see improvements as early as?
Definition
1 to 4 weeks
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
before bedtime
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
aldosterone
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
nucleoside analog
Term
Acyclovir is the drug of choice for what virus?
Definition
herpesvirus
Term
what is acyclovir's MOA?
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
nephrotoxicity
Term
Pt's with what virus have been known to have developed resistance to acyclovir?
Definition
HIV-AIDS
Term
HSV-1
Definition
infx of the eye, mouth, and lips. Genital infx are increasing
Term
HSV-2
Definition
genital infx
Term
therapeutic class: hydrocortisone
Definition
adrenal hormone
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
same time every day
Term
because hydrocortisone is a corticosteroid, what syndrome may develop?
Definition
Cushing's syndrome
Term
Hydrocortisone should be d/c gradually if taken longer than?
Definition
2 weeks
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

tachycardia

hypertn

Term
Your pt has been taking hydrocortisone for a very long time. You are concerned that the pt may develop what?
Definition
peptic ulcer disease
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
erectile dysfunction
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
spermatogenesis
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
X
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

acne

&

skin irritation

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
hair regrowth
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
osteoporosis
Term
Pharm class: Fosamax
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
1-3 months
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
GI problems
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
bone fx
Term
Fosamax is contraindicated in pt's with what other bone disorder?
Definition
osteomalacia
Term
Fosamax may be toxic to what organ?
Definition
kidney (nephrotoxic)
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
gout
Term
Colcrys is most effective if taken within how soon of the onset of sx?
Definition
24 hours
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
by reducing inflammation
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
NSAIDs
Term
Pt's with blood dyscrasisas should not receive colcrys
Definition
;)
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