Chapters 17-26 Final Review

Aminoglycosides: Effective in short-term treatment of many serious infections

Septicemia (e.g., bacteria in bloodstream causing low blood pressure) when less toxic drugs are ineffective or contraindicated

A patient on the birth control pill informs you that she had intercourse 20 hours ago without back up contraception while also taking antibiotics for a throat infection.

Ulipristal acetate (Ella)

Oseltamivir (Tamiflu) and zanamivir (Relenza) are prescribed to treat what type of illness?

Uncomplicated acute illness due to types A and B influenza

Statins

antilipemic medications are very effective in lowering LDL levels, improving HDL levels, and reducing cardiovascular morbidity and mortality.

Medications used to prevent coughing in clients not requiring a productive cough are called

antitussives

Anxiolytics are useful for the short-term treatment of

anxiety disorders, some psychosomatic disorders, insomnia, and alcohol withdrawal.

Use of decongestants can result in side effects such as

anxiety, nervousness, headache, and palpitations

"Arrhythmia" refers to

any change from the normal sequence of electrical impulses of the heart

Psychotropic

any substance that acts on the mind; drugs that can exert a therapeutic effect on a person's mental processes, emotions, or behavior

Neuromuscular blocking agents must be used with caution because they can produce respiratory

arrest

The oldest nonsteroidal anti-inflammatory drug with analgesic and antipyretic effects is

aspirin

Bronchodilators are used to treat symptoms of acute respiratory conditions such as

asthma and forms of chronic obstructive pulmonary disease (COPD).

Which of the following drugs is a statin?

atorvastatin (Lipitor) and zocor

Erythromycin, which the patient is taking for a recent infection, should not be taken with

atorvastatin calcium (Lipitor).

Side effects of anti-infectives can include

hypersensitivity reactions such as conjunctivitis, irritation, local burning, stinging, blurred vision, rash, and urticaria in persons with a history of allergy.

Calcium channel blockers are the initial therapy option for

hypertensive patients with diabetes or high coronary disease risk

Which of the following is a side effect of biguanides and incretin therapies ?

hypoglycemia

Oxygen is used therapeutically for the treatment of

hypoxia

crystal, ecstasy, crank

illegal amphetamines

Digoxin is the only clinical drug currently used

in the cardiac glycoside family•Used primarily in the treatment of heart failure in patients with symptoms that persist after optimization of treatment with an ACE inhibitor, a beta-adrenergic blocker, and/or a diuretic

Thiazide diuretics should be taken

in the morning

A major side effect of mydriatics is

increased IOP

The peripheral vasodilator hydralazine is effective in clients with congestive heart failure because it

increases the heart rate and cardiac output.

Oxytocin is used to

induce labor

Voltaren (diclofenac)

inflammation and pain

Conjunctivitis

inflammation of the conjunctiva -One of the most frequent causes of patient seeking help

Synthetic corticosteroids relieve

inflammation, reduce swelling, decrease bronchial hyper-responsiveness to triggers, and suppress symptoms in acute and chronic reactive airway disease

Zanamivir (Relenza) is administered by the

inhalation

Apply gentle pressure on the

inner canthus following administration of ophthalmic medications. Systemic absorption is thus minimized with medications such as corticosteroids, miotics, and mydriatics.

Type 1

insulin-dependent; characterized by destruction of pancreatic beta cells

When using a lidocaine patch, the client must be advised to apply it only to

intact skin

Anticoagulants Prevent formation of fibrin clot by

interfering with one of the steps leading to fibrin formation-Oral and injectable

Which of the following is a short acting anticholinergic agent used to treat bronchospasm?

ipratropium bromide

Tardive dyskinesia may become

irreversible

To treat asymptomatic tuberculosis, _____ (generic name) is administered daily for 6-12 months.

isoniazid

OA is wear and tear on the

joints while RA is an autoimmune disease.

When a client is using more than one ophthalmic medication at a time, the more viscous preparation should be administered

last

If thyroid replacement therapy is prescribed for true hypothyroidism, then it must be administered for

life

Mucolytics

liquefy pulmonary secretions

To reduce potentially serious side effects, corticosteroids are administered

locally if possible and for the shortest time possible.

Which of the following drugs is an ARB?

losartan

When instilling an anti-infective ophthalmic medication, the health care practitioner should place drops or ointment in the

lower conjunctival sac.

Third leading cause of death in the US

lung disease

Corticosteroids

makes the lungs and their airways less sensitive to inflammation and swelling that would close them off

During administration of oxytocin (Pitocin) , constant

maternal and fetal monitoring is required.

osteoporosis diagnosis is determined by

measuring bone mineral density -Therapy includes calcium, vitamin D, and prescription medications

Agents approved to treat HIV are classified by their

mechanisms of action

Testred

methyltestosterone

Covaryx

methyltestosterone with estrogen

Patients with hypertension should be instructed to

monitor BP daily

Clients who take lithium must have serum levels drawn initially and every few

months to ensure therapeutic levels are maintained.

Febrile seizures:

most common childhood seizure disorder; single, brief, and generalized

Angina pectoris

most common form of angina•Involves chest pain resulting from decreased blood supply to the heart muscle•Nitrates most commonly used for relief of acute angina pectoris (nitroglycerin and isosorbide)

Clients who take skeletal muscle relaxants should be instructed to

move slowly and have support available because hypotension is a common side effect.

Side effects of raloxifene (Evista) include

muscle cramps of the legs and hot flashes

Patients taking antilipemic therapy should call their physician immediately if they experience

muscle pain/weakness

Which of the following is a side effect of statins?

myalgia & muscle weakness

Escherichia coli is an example of a gram-

negative bacterium

Tricyclic antidepressants are used to treat

nerve pain

Pramipexole (Mirapex) and ropinirole (Requip) may have a

neuroprotective effect, leading to less dyskinesia in clients who have Parkinson's disease.

A patient with Type 2 diabetes should be cautioned to

never skip meals

Propranolol (Inderal) is considered to be a

non selective beta-blocker.

If a diabetic patient has nausea/vomiting, diarrhea, or an infection, he should

notify his doctor

Anticholinergics for the treatment of Parkinson's disease are used with caution in

older patients because of mental impairment and potential urinary retention.

Salicylates (e.g., aspirin) are the

oldest drug in this category with analgesic, anti-inflammatory, and antipyretic effects

Replax

only comes in tablets

Analgesics can be classified as

opioid, nonopioid, and adjuvant

For clients who require opioids for pain management,

opioid-induced constipation is not self-limiting

Aspirin and acetaminophen are frequently combined with

opioids or with other drugs for more effective analgesic action

Green zone

optimal; no symptoms, able to do daily activities with little difficulty

Which of the following is a major side effect of inhaled corticosteroids that can be prevented with mouth rinsing?

oral fungal infection

Oseltamivir (Tamiflu) is administered by the

oral route

Coumarin derivatives are administered

orally

Actonel (risedronate)

osteoporosis

The disease characterized by low bone mass and deterioration of bone tissue is called

osteoporosis

Pseudoephedrine (Sudafed)

otc agent used to make illegal meth

Hypoventilation can occur when

oxygen is delivered at too high a concentration.

Auralgan

pain medication

aminoglycosides are usually administered

parenterally (i.e., IM or IV). Because of poor absorption from the gastrointestinal (GI) tract,

What is the monitoring test patients can perform at home to assess their asthma called?

peak flow

Which of the following conditions is a contraindication of niacin?

peptic ulcer disease

Topical lidocaine provides pain relief through a

peripheral effect and generally has little if any central action.

-Inadequate production of androgens in the male may be due to

pituitary malfunction or to atrophy, injury to, or removal of the testicles, resulting in eunuchism or eunuchoidism

Staphylococcus aureus is an example of a gram-

positive bacterium

Oxytocin is secreted by

posterior pituitary

The ergot alkaloid, Methergine, is used to prevent and treat

postpartum and postabortion hemorrhage

The most common side effect of antihypertensive is

postural hypotension

Contraindications for calcium channel blockers apply to

pregnant women

A client whose blood pressure is 135/85 is considered to have

prehypertension

Nitric oxide

principal mediator in attaining and maintaining an erection

An intrauterine device containing a synthetic progestin is available and releases small amounts of

progesterone daily, providing five years of continuous contraception protection.

released as a natural part of the cervical ripening process

prostaglandins

Alcohol (ethyl alcohol, ethanol) is classified as a

psychotropic drug and a CNS depressant Number one drug problem in the U.S.

When administering ear drops in a young child, you should

pull the pinna donward and back

Decongestants should be used only on a short-term basis because

rebound congestion may occur within a few days.

Abrupt withdrawal of hypnotics may result in

rebound insomnia

Antiglaucoma Agent: Carbonic anhydrase inhibitors

reduce formation of hydrogen and bicarbonate ions •Diuretic effect; reduces production of aqueous humor

The monoamine oxidase inhibitors are usually reserved for use with clients who have

refractory or atypical depression.

In the emergency treatment of diabetic ketoacidosis or coma,

regular insulin is administered intravenously.

Anti-inflammatory ophthalmic agents are used to

relieve inflammation of the eye or conjunctiva in allergic reactions, burns, irritation from foreign substances or postoperatively.

Combining sulfonamides with other drugs to treat specific conditions allows

resistance to develop more slowly

When helping a person having a seizure, do not

restrain their extremities out anything in the mouth

used to treat infants and children with respiratory syncytial virus tract infections

ribavirin

Which of the following foods is a good dietary source of omega-3 fatty acids?

salmon

A peak flow reading in the red zone indicates the need to

seek medical help

Abrupt withdrawal of muscle relaxants, for example, Valium, after prolonged use can cause

seizures

Strattera is a

selective norepinephrine reuptake inhibitor and the first nonstimulant noncontrolled drug approved for the treatment of ADHD.

Clients who have bipolar disorder should be carefully monitored if they take

selective serotonin reuptake inhibitors (SSRIs).

contraindicated in a patient with Parkinson's disease who is on tricyclic antidepressants for a co-morbidity of major depression

selegiline (Eldepryl)

Which of the following is a long-acting beta-adrenergic maintenance agent in DPI form?

serevent

Pregnant women should AVOID taking estrogen because it can cause

serious fetal toxicity

Clindamycin is used to treat

serious respiratory tract infections, Pneumocystis jirovecii pneumonia, serious female pelvic infections, osteomyelitis, and septicemia

As migraine symptoms increase,

serotonin levels decrease

MAOIs and dextromethorphan together may cause

serotonin syndrome

a disease symptom that is treated with medical marijuana

severe decreased appetite

Which of the following is a symptom of hypoglycemia?

shakiness

Zostavax

shingles vaccine

Sedative-hypnotic medications should be prescribed for

short term use only

Skeletal muscle relaxants should be taken only on a(n

short-term basis.

Both conventional and atypical antipsychotic medications are associated with

significant adverse drug reactions. There is no "ideal" antipsychotic medication

Highly advertised examples of phosphodiesterase (PDE) inhibitors include

sildenafil, tadalafil, and vardenafil.

A combination drug of levodopa and carbidopa used for long-term treatment of Parkinson's disease is

sinemet

Which of the following is an example of an asthma prophylactic leukotriene agent?

singulair

Flexeril (cyclobenzaprine)

skeletal muscle relaxant

Lioresal (baclofen)

skeletal muscle relaxant

Soma (carisoprodol)

skeletal muscle relaxant

Use of prostaglandin analogs can result in

slow, gradual change in the color of the iris

Women on combined estrogen and progestin (HT) or estrogen-alone (ET) therapies should take the

smallest effective dose for the shortest possible time and annually review decisions to take hormones.

Magnesium Sulfate

used to control seizures associated with eclampsia

Antiglaucoma Agent: Beta-adrenergic blockers

used topically to lower intraocular pressure in open-angle glaucoma, Decreased rate of aqueous humor production

A patient with diabetes experiencing hypoglycemia

usually presents as sweating, shaking, and confused. Without treatment, they will become unresponsive.

Synthetic chemicals used to stimulate

uterine contractions are called oxytocics-Include oxytocin and prostaglandin E1 and E2

The hypotensive effect of beta-blockers can be potentiated by

various medications and alcohol

Antibiotics have no effect on

viral, fungal, or other types of infections.

Fluoxetine and dextromethorphan together may cause

visual hallucinations

Prior to doing a self-fingerstick blood glucose test, the patient should

wash hands

potential side effect for skeletal muscle relaxants

weakness, slurred speech, dry mouth

Which of the following drugs is a bile acid sequestrant?

welchol

Drink large amounts of water when taking

when taking sulfonamides

If a client who is taking digoxin has an apical heart rate of 56, then the dose should be

withheld until the physician is notified.

Marijuana

•Active ingredient: tetrahydrocannabinol (THC)•CNS depressant, euphoriant, sedative, and hallucinogen

Cocaine

•CNS stimulant •Produces euphoria and increased expenditure of energy•Highly addictive

Drugs used for maintenance/long-acting

-Albuterol sulfate (Ventolin HFA)-Cromolyn sodium-Fluticasone w/ salmeterol (Advair Diskus)-Montelukast (Singulair)-Salmeterol (Serevent Diskus)-Tiotropium (Spiriva)

Drugs used for rescue therapy/short-acting

-Albuterol sulfate (Ventolin HFA)-Ipratropium bromide (Atrovent)-Levalbuterol (Xopenex)

Analgesics, sedatives, and hypnotics

-Depress central nervous system (CNS) action to varying degrees-Some drugs can be classified into more than one category, depending on the dosage

Omega-3 fatty acids

-Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)-Prevent primary and secondary heart disease and reduce triglycerides

Menopause

-Natural life event, or can be artificially induced-Levels of estrogen and progesterone are reduced, leading to vasomotor symptoms and atrophic vaginitis

Amiodarone (Cordarone)

-Oral and injectable antiarrhythmic agent approved for treatment of refractory life-threatening ventricular arrhythmias-Widely used for preventing recurrence of atrial fibrillation

Buproprion

-Oral antidepressant drug (Wellbutrin) -Associated with decreases in cravings and lessening of nicotine withdrawal

Therapeutic measures for respiratory distress

-Oxygen therapy-Respiratory stimulants-Bronchodilators-Corticosteroids-Mucolyticsand expectorants-Antitussives-Smoking cessation

Colony stimulating factors (CSFs)

-A granulocyte colony-stimulating factor (G-CSF), filgrastim (Neupogen), is involved in the regulation and production of neutrophils in response to host defense needs-Lessens severity of myelosuppression in cancer patients; has allowed chemotherapy dose intensification or maintenance of dose intensity

What is osteoporosis?

-A systemic skeletal disease •Characterized by low bone mass and deterioration of bone tissue, leading to bone fragility and increased susceptibility to fracture, especially of the hip, spine, and wrist•Most commonly affects postmenopausal women

Aspirin

-Ability to inhibit platelet aggregation clumping-Used after myocardial infarction or recurrent transient ischemic attacks to reduce risk of recurrence-Used to reduce risk of myocardial infarction in patients with unstable angina

Procainamide, quinidine, and disopyramide (Norpace)

-Act by decreasing myocardial excitability, inhibiting conduction; may depress myocardial contractility-Possess anticholinergic properties

Gonadotropin-releasing hormones (GnRH)such as Lupron and Synarel

-Act in the pituitary to suppress ovarian and testicular hormone production and inhibit estrogen and androgen synthesis-GnRH analogs that inhibit gonadotropin secretion are used in the management of endometriosis

Adrenal glands secrete hormones called corticosteroids

-Act on the immune system to suppress the body's response to infection or trauma-Relieve inflammation, reduce swelling, and suppress symptoms in acute conditions-Corticosteroid therapy is not curative, but is used as supportive therapy with other medications

Serotonin receptor agonists (SRAs)

-Action: serotonin levels decrease, while vasodilation and inflammation of blood vessels in brain increase as migraine symptoms worsen •Effective in treating associated nausea and vomiting

•Amphotericin B

-Administered IV for the treatment of severe systemic and potentially fatal infections caused by susceptible fungi, including Candida

Unilateral seizures

-Affect only one side of the body

Incretin therapies

-Agents that mimic actions of incretin hormones may be beneficial•Examples: exenatide (Byetta), sitagliptin (Januvia), and saxagliptan (Onglyza)

Some conditions treated with corticosteroids

-Allergic reactions -Acute flare-ups of rheumatic or collagen disorders-Acute flare-ups of severe skin conditions -Acute respiratory disorders -Long-term prevention of symptoms in severe persistent asthma or chronic management of COPD-Malignancies-Cerebral edema -Organ transplant-Life-threatening shock -Acute flare-ups of ulcerative colitis

Beta-adrenergic blockers

-Antiarrhythmics that combat arrhythmias by inhibiting adrenergic (sympathetic) nerve receptors

Antithrombotic agents interfere with or prevent thrombosis or blood coagulation

-Anticoagulants, platelet inhibitors, and thrombolytics

Lidocaine patch (Lidoderm)

-Approved for management of postherpetic neuralgia-Can provide significant analgesia in other forms of neuropathic pain•Diabetic neuropathy and musculoskeletal pain such as osteoarthritis and low back pain-Provides pain relief through a peripheral effect and generally has little, if any, central action

Estrogen therapy (ET): estrogen alone

-Associated with increased risk of endometrial carcinoma in women with an intact uterus•When progestin is combined with estrogen, the risk of endometrial cancer is substantially reduced

Atypical antipsychotics

-Block both serotonin and transiently block dopamine receptors-Less potential for adverse effects

Inappropriate thrombus formation

-Can be caused by vessel-wall injury, circulatory stasis, increased blood coagulability, immobilization, obesity, cigarette smoking, medication therapy, and other factors

Neuromuscular blocking agents (NMBAs)

-Cause a direct effect on the muscles including the diaphragm-Used during surgical, endoscopic, or orthopedic procedures-Potentially very dangerous -Can result in respiratory arrest because of the potential to paralyze the diaphragm

Partial seizures

-Caused by a lesion in the temporal lobe of the brain and limited to one cerebral hemisphere-Last from 10 seconds to five minutes-Complex symptoms AKA as temporal lobe or psychomotor

COX-2 inhibitor

-Celecoxib (Celebrex): NSAID that exhibits anti-inflammatory, analgesic, and antipyretic activities -Selectively inhibits cyclooxygenase-2 (COX-2) prostaglandin synthesis-Does not inhibit COX-1 -Does not inhibit platelet aggregation (clotting) or inhibit production of mucosal-protective prostaglandins

Tramadol (Ultram)

-Centrally acting synthetic analog of codeine with a dual mechanism of action-Produces analgesia by weak inhibition of norepinephrine and serotonin reuptake; is an opioid receptor agonist-Less potential for abuse or respiratory depression (although both may occur)-Currently not classified as a controlled substance on the Federal level

Bile acid sequestrants

-Cholestyramine (Questran) and colesevelam (WelChol) -Bind bile acids in the intestine, interrupting the process by which bile acids are returned to the liver for reuse

Parkinson's disease (PD)

-Chronic neurological disorder characterized by fine, slowly spreading muscle tremors, rigidity, and generalized slowness of movement•Underlying pathology is not completely understood•Normal dopamine activity as it relates to acetylcholine is diminished, with resulting relative overactivity of cholinergic output

Terbutaline

-Classified as a bronchodilator drug -Also used with careful monitoring in the management of preterm labor. Used to inhibit uterine contractions (tocolysis)

Postcoital contraception such as Next Choice and ulipristal acetate

-Combined estrogen-progestin contraceptive pills used in case of emergency-Not without risk-Available option to women who are exposed to an unintentional risk of pregnancy-Examples: Next Choice and ulipristal acetate

Anticonvulsants (i.e., Neurontin and Tegretol)

-Commonly used for management of nerve pain associated with neuralgia, herpes zoster (shingles), and cancer-Implemented when patient describes pain as "sharp," "shooting," "shock-like pain," or "lightning-like"

Heterocyclic antidepressants

-Comparable efficacy to first-generation tricyclic antidepressants, -Differing effects on dopamine, norepinephrine, and serotonin-Distinctly different adverse effect profiles-Examples: bupropion (Wellbutrin) and mirtazapine (Remeron)

Second-generation anticonvulsants

-Compared to first-generation anticonvulsants •Not yet considered superior in efficacy for seizure control•Fewer adverse effects and drug interactions; does not require drug level monitoring; daily dosing

Sulfonylureas

-Consist of first-generation agents (e.g., chlorpropamide, tolbutamide) and second-generation agents (e.g., glipizide, glyburide)-Work by increasing insulin production from the pancreas and by improving peripheral insulin activity

Anticholinergics (parasympatholytics)

-Decrease the chemical that promotes bronchospasm-Example: Atrovent

Alpha-glucosidase inhibitors

-Delay digestion of complex carbohydrates (e.g., starch) and subsequent absorption of glucose, resulting in a smaller rise in blood glucose concentrations following meals

What hormones are involved in osteoporosis therapy?

-Estrogen before menopause helps to maintain a normal bone reabsorption rate in women •Hormone replacement therapy (HRT), estrogen with or without progestin, is recommended for postmenopausal osteoporosis prevention only when unable to take other agents, and when benefits outweigh risks

Cholesterol absorption inhibitor

-Ezetimibe (Zetia) moderately reduces LDL by inhibiting intestinal absorption of both dietary and biliary cholesterol, blocking its transport in the small intestine

Fibric acid derivatives (fibrates)

-Fibrates fenofibrate (TriCor) and gemfibrozil (Lopid) possess minimal LDL-reducing capacity-Especially effective in patients who have extremely high triglyceride levels, elevated cholesterol levels, and combined forms of hyperlipidemia

Angiotensin-converting enzyme inhibitors

-First- or second-line agents in the treatment of hypertension-Excellent alone or in combination with other antihypertensives (e.g., diuretics)

Selective serotonin reuptake inhibitors (SSRIs)

-First-line medications for treatment of depression-Selectively block reabsorption of serotonin, helping to restore the brain's chemical balance

Benzodiazepines (BDZs)

-For short-term treatment of anxiety disorders, some psychosomatic disorders and insomnia, and alcohol withdrawal -Examples: diazepam (Valium), clonazepam (Klonopin), and midazolam (Versed)

Nonsteroidal anti-inflammatory drugs (NSAIDS)

-Frequently given for lengthy time periods in maintenance doses as low as possible for effectiveness

Opioid analgesics

-Full or pure agonists, partial agonists, or mixed agonist-antagonists •Each bind to specific receptors with varying degrees of action •Classified as controlled substances•Potential for abuse and psychological dependence•Tend to cause tolerance and physiological dependence

Drug Therapy for Absence Seizures also include Second-generation anticonvulsants such as

-Gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine, topiramate (Topamax), etc.•For adjuvant treatment of partial (psychomotor) and generalized seizures

Skeletal Muscle Relaxants

-Given only on a short-term basis-Most affect the central nervous system•No direct effect on skeletal muscle•Reduces muscle spasm, causes alterations in the perception of pain, and produces a sedative effect, promoting rest and relaxation

Reproductive hormones categories

-Gonadotropic-Androgens-Estrogens-Progestins

Statins

-HMG-CoA reductase inhibitors (statins) inhibit the enzyme for cholesterol synthesis-Most potent lipid-lowering medications available for monotherapy -First choice in managing high cholesterol18

Role of the medical personnel

-Have a thorough knowledge of psychotropic drugs, action, and side effects-Be willing to participate in the education of the patient, patient's family, and others -Give competent care to those under the influence of drugs in a nonjudgmental way-Recognize drug abuse and make appropriate referrals without exception-Keep complete and accurate records of controlled stocks of drugs that could be considered potential drugs of abuse-Report any observed drug abuse to the proper person in authority

Caffeine

-Helps fight fatigue and drowsiness•Examples: NoDoz, Vivarin, and caffeine citrate (Cafcit)

Progesterone

-Hormone secreted by the corpus luteum and adrenal glands-Responsible for changes in uterine endometrium in the second half of the menstrual cycle •Preparation for implantation, development of maternal placenta after implantation, and development of mammary glands

Peripheral vasodilator

-Hydralazine is sometimes used in the treatment of moderate to severe hypertension

Intranasal corticosteroids

-Increasingly considered first-line therapy for most noninfectious types of rhinitis-Reduce congestion, edema, and inflammation

Selective norepinephrine reuptake inhibitors (SNRIs)

-Inhibit reuptake of serotonin and norepinephrine-Examples: Duloxetine (Cymbalta) and venlafaxine (Effexor)

Adenosine (Adenocard)

-Injectable antiarrhythmic agent -Multiple electrophysiologic activities •Restores normal sinus rhythm in paroxysmal supraventricular tachycardia by slowing conduction time through the atrioventricular (AV) node•Vasodilatory, antiadrenergic, and negative chronotropic (decrease in rate) properties that act to decrease cardiac oxygen demand

Benzodiazepines (BZDs) and nonbenzodiazepines

-Less abuse potential -Withdrawal effects are observed after long-term use and respiratory depression (when taken with alcohol) can be potentially fatal

Lidocaine

-Local anesthetic-Administered for antiarrhythmic effects and membrane-stabilizing action-Second choice for treatment of ventricular arrhythmias

Nonopioid analgesics

-Many available without prescription as over-the-counter (OTC) medications-Given for relieving mild to moderate pain, fever, and anti-inflammatory conditions-Used as a coanalgesic in severe acute or chronic pain requiring opioids

NMDA receptor antagonist

-Memantine (Namenda) is thought to selectively block the excitotoxic effects with abnormal transmission of the neurotransmitter glutamate-Can be used as monotherapy or in combination therapy with cholinesterase inhibitors

Varenicline (Chantix)

-Partial nicotine receptor agonist-antagonist-Alleviates symptoms of nicotine craving and withdrawal through agonist activity while inhibiting the effects of repeated nicotine exposure by its antagonist activity-Eliminates the pleasurable feelings associated with smoking

Thiazolidinediones

-Pioglitazone (Actos) and rosiglitazone (Avandia) lower blood glucose by decreasing insulin resistance and improving sensitivity to insulin in muscle, liver, and adipose tissue

Sympathomimetics (adrenergics)

-Potent bronchodilators that increase vital capacity and decrease airway resistance-Examples: albuterol, epinephrine, salmeterol, and others

Antiadrenergic agents

-Prazosin (Minipress) is a peripherally acting alpha-adrenergic blocker used primarily to treat hypertension-Other agents in this class are used to treat benign prostatic hypertrophy (BPH)

Cholinesterase inhibitors

-Prevent breakdown of acetylcholine in the synaptic cleft, thereby increasing acetycholine levels and improving cognitive function-Do not treat underlying pathology-May slow the progression, but do not cure the disease-Examples: donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)

Lithium

-Prevents manic episodes when compared with depressive episodes

Melatonin receptor agonist

-Ramelteon (Rozerem): first FDA-approved prescription medication that acts on melatonin receptor•Mimics action of melatonin to trigger sleep onset•Dependence and abuse potential are eliminated•Not classified as a controlled substance•Works quickly, generally inducing sleep in less than one hour

Nicotinic acid (Niacin)

-Reduces hepatic synthesis of triglycerides; inhibits the mobilization of free fatty acids from the peripheral tissues-Lowers serum total, LDL cholesterol, and triglyceride levels-Raises HDL cholesterol levels

Xanthines

-Relaxes the smooth muscle of the bronchial airways and pulmonary blood vessels-May possess anti-inflammatory actions-No longer a first-line treatment •Modest clinical effectiveness•Need for serum monitoring•Many adverse effects and drug interactions

Antipsychotic Medications/Major Tranquilizers

-Relieving symptoms of psychoses including delusion, hallucinations, agitation, and combativeness-Relieving nausea and vomiting

Insulin treatment and administration

-Required as replacement therapy for Type 1 diabetics with insufficient production of insulin from the islets of Langerhans in the pancreas-Required in patients with Type 2 who have failed to maintain satisfactory concentrations of blood glucose with therapy including dietary regulation and oral antidiabetic agents-Must be administered parenterally because it is destroyed in the GI tract

thyroid

-Responsible for regulating the rate of metabolism

Mast cell stabilizers like cromolyn

-Rupture or degranulation of mast cells and subsequent spilling of their chemical mediator contents cause an inflammatory response that can lead to asthma-Stabilizing the mast cell membrane has anti-inflammatory actions that modify the release of mediators from mast cells and eosinophils

Angiotensin receptor blockers

-Similar to ACE inhibitors (ACEIs) -Block angiotensin receptor that causes vasoconstriction when stimulated by angiotensin II

Antimigraine agents

-Simple analgesics, NSAIDs, and opioid analgesics can be effective, especially if taken at initial sign of migraine

Alcohol poisoning

-Symptoms include cold, clammy skin; stupor; slow, noisy respirations; and alcoholic breath-Mortality associated with acute alcohol poisoning alone is uncommon, but can be an important factor when mixed with recreational drugs

What is hypertension?

-Systolic blood pressure (SBP) of 140 or greater or diastolic blood pressure (DBP) of 90 or greater-Antihypertensives may control hypertension, but they do not cure it

Thrombolytic Agents•The body maintains a process to dissolve clots (fibrinolysis) after they have formed

-Tissue plasminogen activator (t-PA) is a natural peptide that initiates fibrinolysis-Thrombolytic agents dissolve and liquefy the fibrin of an existing clot-Thrombolytic drugs (e.g., reteplase and alteplase) potentiate t-PA, resulting in clot dissolution, reperfusion of organs, and restoration of blood flow to tissues

Propafenone (Rythmol)

-Treats symptomatic supraventricular arrhythmias or severe, life-threatening ventricular arrhythmias

Oxygen treatment

-Used therapeutically for hypoxia (insufficient oxygen supply to the tissues) -Decreases the workload of the heart and respiratory system (especially during distress)-Treats heart and lung diseases and some central nervous system (CNS) conditions with respiratory difficulty or failure

Antithyroid agents (e.g., methimazole or Tapazole and propylthiouracil or PTU)

-Used to relieve the symptoms of hyperthyroidism in preparation for surgical or radioactive iodine therapy, or for those who are not candidates for either procedure•Methimazole is generally considered the treatment of choice

Calcium channel blockers

-Verapamil (Calan) and diltiazem (Cardizem)-Indicated for treatment of atrial fibrillation/flutter and PSVT

Biguanides

-Work by decreasing hepatic glucose production and enhancing insulin update in muscle

Drugs used to treat asthma

-anticholinergics-corticosteroids-leukotriene inhibitors-mast cell stabilizers-sympathomimetics

Anticholinergics

-block the chemical in the parasympathetic system that promotes bronchospasm-blocks the specific part of the nervous system that wants to cause the airways to constrict

naltrexone (ReVia)

-can be used for opioid addiction - liver damage can occur in large doses - it has less side affects than Antabuse -it prevents the desire for alcohol

leukotriene inhibitors side effects

-cough-hypertension-hyperglycemia-nervousness or tremor-oral fungal infection-palpitations-throat irritation

corticosteroids side effects

-headache or dizziness-hypertension-hyperglycemia-nervousness or tremor-palpitations-throat irritation-oral fungal infection

anticholinergics side effects

-headache or dizziness-palpitations

mast cell stabilizers side effects

-hypertension-hyperglycemia-nervousness or tremor-oral fungal infection-palpitations

Azilect (rasagiline)

-is a monoamine oxidase-B (MAO-B) inhibitor. It works by increasing the levels of certain chemicals in the brain. -is used to treat the symptoms of Parkinson's disease (stiffness, tremors, spasms, poor muscle control). -is sometimes used with another drug called levodopa.

mast cell stabilizers

-prevent the rupture or degranulation of mast cells-prevents a cell that contains powerful chemicals from rupturing, preventing an chemical spill that leads to airway spasms

Leukotriene Inhibitors

-prophylactic drug to reduce or eliminate production of a chemical that causes inflammation-blocks the production of a specific chemical that causes the airway to constrict

sympathomimetics

-relax smooth muscle in the lungs to relieve bronchospasm-relaxes the smooth muscle around the airways and allows them to open up, making it less difficult to breathe

MDI device

-slow deep breath with hold is required-Available as a sympathomimetic bronchodilator-Uses a propellant-Available as an anticholinergic bronchodilator-Can be used in rescue situations

How is insulin administered?

-subcutaneously via intermittent injections or continuous infusion -Injected in upper arms, thighs, abdomen, buttocks -Sites need to be continuously rotated to avoid lipodystrophy

Selective serotonin reuptake inhibitors (SSRIs) may take from

1 to 4 weeks before clients experience symptomatic relief.

Topical ophthalmic antibiotic medications should not be used for more than

10 days

Most insulin used today is U-100, which means there are

100 units of insulin per milliliter

High blood pressure is when the top number (systolic pressure) is

130 or higher or the bottom number (diastolic pressure) is 80 or higher. Lifestyle changes and medicines may help treat high blood pressure. EX 142/90

The antifungal drug micafungin is contraindicated for patients younger than age

18

Fetal alcohol syndrome can result from having as little as

2 drinks early in pregnancy

Results of culture and sensitivity (C&S) tests from a particular specimen are available within

24 to 48 hours.

Herpes zoster (shingles) is BEST treated within

24-72 hours of onset of rash on the skin of one side of the trunk or head.

chemical dependency

A condition in which alcohol or drugs have taken control of an individual's life and affect normal functioning

Antabuse

A drug that, when combined with alcohol, causes violent nausea; it is used to control a person's drinking.

What is glaucoma?

A group of sight-threatening diseases of the eye in which there is increased intraocular pressure (IOP) due to obstruction of outflow of aqueous humor•Causes deterioration of and damage to the optic nerve resulting in vision loss

Postcoital contraceptive agents must be administered within

72 hours (use number) of unprotected intercourse.

The client is being admitted to the ambulatory surgery unit for cataract surgery. Prior to surgery, a pilocarpine eye solution is ordered. What contraindication does the health care practitioner know would prevent this client from receiving this medication?

A pilocarpine eye solution is contraindicated with a history of retinal detachment.

The health care practitioner is counseling a client on ophthalmic corticosteroid use. What is a potential side effect associated with this category of drug?

A potential side effect is the reduced resistance to bacteria, virus, or fungi.

A client with end-stage cancer has been on extended-release morphine sulfate (MS Contin) for bone cancer. The client has significant respiration depression, which is suspected to be caused by an added dose of medication. Narcan is administered to the client. What would the health care practitioner expect regarding the use of this narcotic antagonist?

Added doses may be required because MS Contin is a longer-acting drug than Narcan

In addition to heart and lung diseases, what are some of the conditions for which oxygen is prescribed?

Additional uses of oxygen include carbon monoxide poisoning and central nervous system conditions with respiratory difficulty or failure.

Nasal congestion is a side effect of which classification of medication?

ACE inhibitor

Ritalin (methylphenidate)

ADD/ADHD

Vyvanse (lisdexamfetamine)

ADD/ADHD

What are the goals of HIV therapy?

Achieve maximal and durable suppression of viral load, restore and/or preserve immunological function, improve quality of life, reduce HIV-related morbidity, prolong survival, and prevent vertical HIV transmission.

Bronchodilators

Act by relaxing smooth muscles of the bronchial tree, relieving bronchospasm and decreasing the work of breathing-For symptomatic treatment of acute respiratory conditions such as asthma and some forms of COPD-Can be given orally, parenterally, and by inhalation•Metered dose inhalers (MDIs), dry-powder inhalers (DPIs), and small volume nebulizers (SVNs)

Sulfamethoxazole and trimethoprim (Bactrim) are used to treat what health problems?

Acute and complicated urinary tract infections, enteritis, and otitis media

Precautions or contraindications with corticosteroids apply to:

Acute bacterial, viral, or fungal infections Primary open-angle glaucoma Pregnancy Prolonged use

Theophylline

Administered IV and orally to stimulate respiration in infants (as an alternative to caffeine)

Most common eye diseases in Americans 40 years and older

Age-related macular degeneration, glaucoma, cataracts, and diabetic retinopathy

Niacin interacts with which of the following?

Alcohol

A health care practitioner is trying to convince her client that mood-altering substances are dangerous to the client and others around her. Which of the following mood-altering substances accounts for nearly 100,000 deaths per year and is directly responsible for more than half of traffic accidents (one-third of all U.S. fatalities)?

Alcohol accounts for approximately one-third of all U.S. fatalities.

Adverse reactions to anti-infectives can be divided into what major categories?

Allergic hypersensitivity, direct toxicity, and indirect toxicity (superinfection)

Warfarin (Coumadin) is administered orally

Alters synthesis of blood coagulation factors in the liver by interfering with the action of vitamin K

Excelon (Rivastigmine)

Alzheimer's

Razadyne (galantamine)

Alzheimer's disease

A client in the cardiac care unit (CCU) has been ordered amiodarone (Cordarone), an antiarrhythmic, for atrial fibrillation. Under what circumstances would amiodarone be contraindicated?

Amiodarone is contraindicated in clients with second- or third-degree heart block and marked sinus bradycardia.

Which of the following antidepressants is not known to interact with the cough suppressant dextromethorphan?

Amitriptyline

Which of the following drugs is a calcium channel blocker?

Amlodipine

Metronidazole (Flagyl) is especially effective in the treatment of what systemic conditions?

Amoebiasis and giardiasis, anaerobic bacterial infections, Crohn's disease, and in combination with other drugs, H. pylori

Sulfonamides

Among the oldest anti-infectives -Increasing resistance of many bacteria has decreased the clinical usefulness of these agents •Used most effectively in combinations with other drugs -Example: sulfamethoxazole and trimethoprim -Resistance develops more slowly

The health care practitioner sees an order for a salicylate and knows that this type of drug is most commonly used for its analgesic and antipyretic properties. What property does an antipyretic contain?

An antipyretic contains fever-reducing properties.

A client receiving treatment at an intensive inpatient rehabilitation program for alcoholism is placed on disulfiram (Antabuse). What should the health care practitioner explain to the client about taking disulfiram in conjunction with alcohol as part of a behavior modification program?

An unpleasant reaction (e.g., headache, vomiting) can be expected if even a small amount of alcohol is ingested while taking disulfiram. This treatment is based on behavioral modification

Nonopioid analgesics: include

Anacin (ACA and caffeine) Fiorinal (butalbital, caffeine, and aspirin) Excedrin (ASA, acetaminophen, caffeine) Aspirin (acetylsalicylic acid (ASA) Tylenol (acetaminophen)

Precautions or contraindications for mydriatics apply to:

Angle-closure glaucoma Infants

Side effects from macrolides of a serious nature are rare, and mild side effects, usually dose related, can include:

Anorexia, nausea, vomiting, diarrhea, and cramps (take the medication with food or use smaller, more frequent doses) Urticaria and rash Superinfections Serious side effects can occur with some interactions.

A client is taking metformin (Glucophage), a biguanide oral antidiabetic agent, to treat Type 2 diabetes. Which symptom below is a known side effect of drugs in this class?

Anorexia, weight loss and hypoglycemia can be possible side effects of taking biguanides.

Vistaril (hydroxyzine)

Anti-Anxiety/Anti-Histamine Treats Anxiety, Tension, skin rashes and itching

Mifepristone

Anti-progestin agent used to terminate unwanted pregnancy

Ativan (lorazepam)

Antianxiety

Valium (diazepam)

Antianxiety

Xanax (alprazolam)

Antianxiety

Buspar (buspirone)

Antianxiety- serotonin 5-HT1A receptor partial agonist shows little potential for dependence; takes up to 4 weeks to be effective

only interfere with the coagulation process but do not dissolve clots

Anticoagulants such as coumarin and heparin

A client is scheduled for a short procedure in her health care provider's office that requires a neuromuscular blocking agent (NMBA). The health care practitioner explained the procedure and medication risks to the client before signing the consent. The client asks what would happen if he were to have an allergic reaction. What would be the BEST response?

Antidotes such as neostigmine (Prostigmin) may be indicated in the event of a serious adverse effect when using NMBAs.

A client has been diagnosed with hypertension and asks the health care professional if the prescribed antihypertensive medication will cure her hypertension. Which statement is the BEST response?

Antihypertensives do not cure hypertension; they only control it. After the withdrawal of the drug, blood pressure will return to levels similar to those before treatment with medication, if all other factors remain the same.

Cogentin (benztropine)

Antiparkinson Agent

Requip (ropinirole)

Antiparkinson/Restless Leg agent

Mifepristone (RU-486)

Antiprogesterone drug used to terminate an unwanted pregnancy (in conjunction with misoprostol)-Only for use very early in pregnancy

An older adult client's daughter expresses concern to the health care practitioner that her mother went to the emergency room with symptoms of dementia-related psychosis and was treated with antipsychotic medication. She asks the health care practitioner if the medication is safe. How should the health care practitioner respond?

Antipsychotic medications are not FDA approved for treatment of clients with dementia-related psychosis. Other management options should be considered.

Precautions or contraindications for anti-infectives apply to:

Anyone allergic to the drug Viral and fungal diseases of the ocular structure

The CDC recommends the annual influenza vaccine for what ages?

Anyone over 6 months

Which of the following is a type of rapid acting insulin?

Aspart

Which of the following drugs is a Beta Blocker?

Atenolol

Selective Norepinephrine Reuptake Inhibitor (SNRI) for ADHD

Atomoxetine (Strattera) -Selective norepinephrine reuptake inhibitor-First nonstimulant, noncontrolled drug approved for attention-deficit hyperactivity disorder (ADHD)-Structurally related to fluoxetine-Does not have a potential for abuse, has less insomnia, less effect on growth, and has been shown to be safe and effective

Antiarrhythmic agents act in different ways to suppress various types of cardiac arrhythmias

Atrial or ventricular tachycardias, atrial fibrillation or flutter, and arrhythmias that occur with digoxin toxicity or during surgery and anesthesia

Which of the following is a rescue therapy asthma medication?

Atrovent

A client is taking digoxin (Lanoxin), a cardiac glycoside. What is important for the health care professional to teach the client about taking this medication?

Avoid abrupt withdrawal of this medication after prolonged use. Digoxin must be reduced gradually, under a physician's supervision.

Pyridoxine

B vitamin given to reduce risk of CNS effects and peripheral neuropathy

Tetracyclines

Broad-spectrum antibiotics -Treats infections caused by rickettsia, chlamydia, or some uncommon bacteria -Some organisms are showing increasing resistance -Use only when other antibiotics are ineffective or contraindicated

Carbapenems

Belong to the beta-lactam class of antibiotics -Have a very broad spectrum of activity against gram-negative and gram-positive organisms -Primary treatments include pneumonia, febrile neutropenia, intra-abdominal infections, diabetic foot infections, and significant polymicrobial infections

empiric

Best guess therapy based on history and available clinical information.

Metropolol (Lopressor) is a beta-adrenergic blocker used for myocardial infarction. Which common side effect might occur if this medication were administered to a client with asthma?

Beta-adrenergic blockers block the beta-2 receptors in the lungs, which can lead to bronchospasms.

Penicillins

Beta-lactam antibiotics produced from certain species of a fungus -Treats many streptococcal and some staphylococcal and meningococcal infections -Drug of choice for treatment of syphilis -Used prophylactically to prevent recurrences of rheumatic fever

Boniva (ibandronate)

Bisphosphonate (osteoporosis)

A client is started on dorzolamide (Trusopt). What side effect can the health care practitioner inform the client about?

Bitter taste is one of many side effects that carbonic anhydrase inhibitors have, leading many clients to stop the medication on their own.

A client is receiving a thrombolytic agent for the onset of an acute myocardial infarction ST-elevation MI. What is the MOST serious complication of thrombolytic therapy?

Bleeding is the most serious complication of thrombolytic therapy and can occur at any site in the body.

CCR5 antagonists

Block a co-receptor required for HIV entry into human cells

Fusion inhibitors (FIs)

Block entry of HIV into cells, which may keep the virus from reproducing

Antihistamines/decongestants

Block histamine receptors in conjunctiva, relieving ocular pruritis associated allergic conjunctivitis-Cause vasoconstriction of blood vessels, providing relief from minor eye irritation and redness

Phosphodiesterase (PDE) inhibitors

Block phosphodiesterase type 5, found in the corpus cavernosum•Thought to impair the production of nitric oxide

Antiretroviral protease inhibitors (PIs)

Block the activity of the HIV enzyme essential for viral replication late in the virus life cycle

Adenine diphosphate receptor antagonists clopidogrel (Plavix)

Blocks activation of the platelet's receptor surface, thereby inhibiting platelet activation

A client with severe depression is placed on imipramine (Tofranil), a tricyclic antidepressant (TCA), after a careful history of suicidal ideation has been ruled out. When educating the client about the side effects of tricyclics, what anticholinergic side effects should the health care practitioner discuss?

Blurred vision, dryness of the mouth, and urinary retention are examples of anticholinergic side effects that may occur with TCAs.

Dantrium (dantrolene)

Peripheral acting skeletal muscle relaxant

Warning. Macrolides can cause abnormal, potentially fatal, cardiac arrhythmias when combined with the following drugs:

Calcium channel blockers—verapamil or diltiazem Antiarrhythmic agents (i.e., sotalol) Azole antifungals—fluconazole (Diflucan) Quinolones

Progestin-only contraceptives

Recommended for patients who do not tolerate estrogen or in whom it is contraindicated

Interactions of macrolides (erythromycin and clarithromycin; potentially less with azithromycin) may occur with potentiation of the following drugs and possible toxicity:

Carbamazepine (Tegretol) (ataxia, dizziness, and drowsiness) Cyclosporine (immunosuppressant with kidney or liver transplants) Theophylline Benzodiazepines (potentiation of sedative effects) Warfarin (may prolong prothrombin time and bleeding) Digoxin Statins (lead to myopathy)

Antiglaucoma Agent: Miotics: cause pupil to contract

Reduce intraocular pressure by increasing aqueous humor outflow

Cafcit (caffeine citrate)

CNS stimulant

Comtan (entacapone)

COMT inhibitor Antiparkinson Agent

What medications are classified as respiratory stimulants?

Caffeine citrate and intravenous theophylline are classified as respiratory stimulants.

A two-week-old infant client in the neonatal unit has apnea. What respiratory stimulant does the health care practitioner know may be used to treat this condition?

Caffeine citrate is used in the treatment of neonatal apnea.

A health care professional is caring for a client with diabetes and hypertension. Which class of antihypertensive is the treatment of choice for hypertension in a client with a comorbidity of diabetes?

Calcium channel blockers are an initial therapy option for clients who are hypertensive and have diabetes or high coronary risk.

A client is to be started on Diamox, a carbonic anhydrase inhibitor. Which condition does the health care practitioner know would prevent the client from using this medication?

Carbonic anhydrase inhibitors are contraindicated with sulfa allergy.

Cardiovascular drugs

Cardiac glycosides, antiarrhythmic agents, antilipemic agents, antihypertensives, vasodilators, vasoconstrictors, anticoagulants, platelet inhibitors, and thrombolytic agents

leading killer of men and women in the United States

Cardiovascular disease

Tuberculosis (TB)

Caused by a bacterium called Mycobacterium tuberculosis, which primarily attacks the lungs

A client has been prescribed levothyroxine (Synthroid) for hormone replacement therapy. Which advice does the health care practitioner know would be MOST useful in preventing errors in administering this medication?

Caution is advised with decimal point placement (e.g., 0.025 mg vs. 0.25 mg) and dose conversions between mg and mcg because medication errors frequently occur.

Yellow zone

Caution; sleep disturbed by symptoms, short of breathing/wheezing, difficulty doing normal activities

Acute (angle-closure) glaucoma

Characterized by a sudden onset of pain, blurred vision, and a dilated pupil Considered a medical emergency

Diabetes mellitus (DM) is a group of hormonal diseases

Characterized by impaired metabolism of carbohydrates, fats, and proteins that results in elevated levels of blood glucose

Fosamax (alendronate)

Classification: Bone resorption inhibitor. Bisphosphonate Therapeutic Effects: TX and prevention of post-menopausal and cortico-steroid-induced osteoporosis, Adverse Reactions & side effects: Altered taste, photosensitivity, rash, musculoskeletal pain, fluid overload, esophagitis. Common upset stomach & heartburn, GI effects

Estrogen-progestin oral contraceptives

Classified according to estrogen content and formulation•Monophasic, biphasic, triphasic, and four-phasic

A client has been taking carbidopa-levodopa (Sinemet), an antiparkonsonian drug, for many years and informs the healthcare provider that symptoms are increasing and the medication does not seem to work anymore. The health care practitioner knows this may be attributed to which of the following?

Clients receiving Sinemet for prolonged periods of time may develop a tolerance, resulting in ineffectiveness of the drug called "wearing off."

A health care practitioner is caring for a client taking antiparkinsonian medication. When giving instructions about taking antiparkinsonian drugs, it is important for the health care practitioner to educate the client about which of the following?

Clients taking antiparkinsonian drugs should be instructed to use caution when driving or operating machinery because of potential drowsiness, dizziness, or lightheadedness.

Patients being treated with macrolides should be instructed regarding:

Common GI side effects to be expected Importance of reporting side effects for possible dosage adjustment or prescription of medication for symptomatic relief Taking medication with full glass of water 1h before or 2h after meals, unless stomach upset occurs (some forms can be taken without regard to meals) Not taking with other medications

Antihistamines

Competitively antagonize the histamine1receptor sites-Combat the increased capillary permeability and edema, inflammation, and itch caused by sudden histamine release •To treat allergy symptoms

A client with the manic type of bipolar disorder is taking lithium carbonate. What advice should the health care practitioner give her client about taking lithium?

Compliance with routine blood level monitoring is imperative when taking lithium, as there is a narrow therapeutic range and lithium toxicity can occur rapidly. Because of this, lithium is monitored in hospitals as a high-risk drug.

When working with clients receiving oxygen, which of the following side effects the health care practitioner knows may be a sign of delivering too high a concentration?

Confusion

Treatment of HIV infection

Consists of using highly active antiretroviral therapy (HAART) combinations of three or more antiretroviral (ARV) agents

Decongestants such as phenylephrine (Neo-Synephrine) or pseudoephedrine (Sudafed)

Constrict blood vessels in the respiratory tract-Results in shrinkage of swollen mucous membranes and helps to open nasal airway passages-Frequently combined with antihistamines, analgesics, caffeine, and/or antitussives

A client diagnosed with an acute exacerbation of ulcerative colitis has been prescribed corticotropin hormone (ACTH) for its anti-inflammatory action. Which route of administration does the health care practitioner know is used to administer this medication?

Corticotropin hormone (ACTH) is administered IM.

Which of the following is a topical preparation for ear infections?

Cortisporin is a topical preparation.

The drug of choice for use in eye examinations for adults is

Cyclogyl (cyclopentolate)

Which condition does the health care professional know would be contraindicated with estrogen therapy in a postmenopausal woman?

Estrogens are contraindicated with thromboembolic disorders (DVT, PE), stroke, and myocardial infarction.

Amphetamines

Examples: methamphetamine ("crystal," "crank," "ice," "meth," "speed") and methylenedioxymethamphetamine (MDMA, "Ecstasy")

Thiazide diuretics

Most patients meeting the criteria for drug therapy should be started on thiazide-type diuretics•Either alone or in combination with a drug from one of the other drug classes-Appear to be as effective as other antihypertensive agents and are inexpensive

Namenda (memantine)

NMDA receptor antagonist - Alzheimer's

New oral anticoagulants

Dabigatran, rivaroxaban, and apixaban

Mucolytics like acetylcysteine

Decrease hypersecretion and increase thinning of pulmonary secretions

Extended- or continuous-cycle oral contraceptives

Decrease or eliminate hormone-free interval 12

A client with diabetes has arrived at the clinic for his regularly scheduled medication management appointment. He tells the health care practitioner that he has been extremely thirsty, has been urinating frequently, and has flu-like symptoms. The health care practitioner notes a fruity odor to his breath. What physical condition is this client most likely experiencing?

Dehydration and excessive thirst, polyuria, flu-like symptoms, and fruity breath are symptoms of hyperglycemia.

Opioid analgesics:

Demerol (meperidine) Dilaudid (hydromorphone) Percocet (oxycodone with acetaminophen) Oxycontin (oxycodone) Ultram (prostaglandin tramadol)

The antiglaucoma agent that is administered orally is

Diamox (acetazolamide)

The most commonly used cardiac glycoside is

Digoxin

A health care practitioner is attending to a client with restless leg syndrome (RLS). Which of the following statements about primary RLS is true?

Dopamine agonists used to treat Parkinson's disease are FDA approved for RLS treatment as well.

A client with a history of diabetes has been placed on a thyroid agent. Which of the following statements is accurate regarding the interaction of thyroid and insulin?

Dosage adjustment of insulin may be necessary.

An older adult client is being treated with pilocarpine eye drops. What advice should the health care practitioner share with this client?

Driving at night is of concern because quality of vision is decreased in poor light.

A client with a diagnosis of AIDS has been losing weight and has no appetite. What medication may be prescribed?

Drobinal is an oral synthetic medical marijuana used to treat decreased appetite.

Miotics

Drugs that cause the pupil to contract.

Mydriatics

Drugs that dilate the pupil.

Antilipemic Agents

Drugs that lower serum cholesterol and low-density lipoproteins (LDLs) and increase the high-density lipoproteins (HDLs).

Hypnotics

Drugs that promote sleep.

A health care practitioner is educating a client about the side effects of atomoxetine (Strattera), a selective norepinephrine reuptake inhibitor (SNRI) for ADHD. What are some side effects of SNRIs?

Dry mouth, reduced appetite, fatigue, and dyspepsia may be side effects of taking Strattera.

What common anticholinergic side effect might a client taking a first-generation antihistamine experience?

Drying of secretions is a common anticholinergic side effect while taking first-generation antihistamines.

Key risk factor for coronary heart disease

Elevated total blood cholesterol levels above 200 mg/dL

Cialis (tadalafil)

Erectile dysfunction, PDE-5 inhibitor

Levitra (vardenafil)

Erectile dysfunction, PDE-5 inhibitor

A client has come to the clinic requesting oral contraceptives for prevention of pregnancy. When obtaining her medical and surgical history, she informs the health care professional that 10 years prior she had a successful lumpectomy due to breast cancer. Which statement is TRUE about a history of breast cancer and oral contraceptives?

Estrogen products are absolutely contraindicated with known or suspected history of breast cancer or other estrogen-dependent malignancy or preexisting cervical cancer.

Evista (raloxifene)

Estrogen receptor modulator, Post-menopausal Osteoporosis

A client with nasal congestion has been prescribed pseudoephedrine extended release (Sudafed ER) for symptom relief. What instructions could the health care practitioner share with the client about taking this form of Sudafed?

Extended-release tablets should be swallowed whole. Do not crush, chew, or break extended-release preparation

Patients being treated with aminoglycosides should be instructed regarding:

Extreme importance of close medical supervision during therapy Careful observation of intake and urinary output Prompt reporting of any side effects, especially renal or hearing problems

Which of the following drugs is a cholesterol absorption inhibitor?

Ezetimibe

Adenosine (Adenocard) is an antiarrhythmic agent given to clients in supraventricular tachycardia (SVT). Which of the following are common side effects of Adenocard?

Facial flushing and light-headedness are common side effects of Adenocard.

A client has been prescribed phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI), for depression. What foods should the client avoid?

Foods containing tyramine, such as pickled herring, wine, salami, and cheese, are contraindicated when taking MAOIs.

Quinolones

For adult treatment of some infections of the urinary tract, sinuses, lower respiratory tract, GI tract, skin, bones, and joints, and in treating gonorrhea -Some organisms are showing increased resistance -Reserve for infections that require therapy with a fluoroquinolone

Magnesium sulfate

For prevention and control of seizures in eclamptic patients •Preeclampsia is characterized by new-onset hypertension, edema, and proteinuria during pregnancy

The two medications most commonly used for initial or recurrent urinary tract infections are

Furadantin and Macrodantin

Which of the following is a side effect of sulfonylureas and alpha-glucosidase inhibitors?

GI distress

a side effect that has been noted when taking cholinesterase inhibitor

GI upset

Considered a first line anticonvulsant for the treatment of neuropathic pain.

Gabapentin (Neurontin)

A client recently diagnosed with generalized seizure disorder was started on phenytoin (Dilantin). What possible side effects would be important to mention while educating the client about this medication?

Gingival hyperplasia is common, and it is important to mention to be aware of maintaining good oral hygiene. Stevens-Johnson syndrome and toxic epidermal necrolysis are rare, but they are very serious and require immediate medical attention.

Micafungin (Mycamine)

Given IV -Provides new treatment options against Candida and Aspergillus species

Platelet inhibitors utilize a variety of mechanisms to interfere with activation pathways to prevent platelet clumping

Given as prophylactic therapy or as secondary prevention

Which of the following is a type of long-acting insulin?

Glargine

Follicle-stimulating hormone (FSH)

Gonadotropic hormone; Stimulates development of ovarian follicles in the female and sperm production in testes of the male

Luteotropic hormone (LTH)

Gonadotropic hormone; Stimulates secretion of progesterone by the corpus luteum and secretion of milk by the mammary gland

Luteinizing hormone (LH)

Gonadotropic hormone; Works in conjunction with FSH to induce secretion of estrogen, ovulation, and development of corpus luteum

Aminoglycosides Treats many infections caused by

Gram-negative bacteria (e.g., Escherichia coli and Pseudomonas) Gram-positive bacteria (e.g., Staphylococcus aureus)

A client has recently been prescribed carbamazepine (Tegretol), an anticonvulsant, for the management of a seizure disorder. What foods should the health care professional advise the client to avoid?

Grapefruit

A client has been prescribed a calcium channel blocker. What food should the health care professional educate this client to avoid while taking this medication?

Grapefruit juice with calcium channel blockers may potentiate adverse effects.

High-density lipoproteins

HDLs; "good cholesterol

What is the most common method to help break the chain of infection that is common to all six links?

Hand washing is the most common method to help break the chain of infection.

Leuprolide acetate (Lupron), a gonadotropin-releasing hormone, has been prescribed for a client who is prepubescent to slow down early signs of puberty in a suspected pituitary growth. About what potential side effects of Lupron should the health care professional educate the family?

Headache and insomnia may be possible side effects.

Daypro (oxaprozin)

NSAID

Mortin (Ibuprofen)

NSAID

An older adult client is on digoxin (Lanoxin), a cardiac glycoside, for the treatment of heart failure. What is important for the health care professional to assess prior to administering this medication?

Heart rate. If the apical pulse is less than 60, the digoxin may need to be withheld until the physician is consulted. The action taken should be documented.

Nicotine replacement therapy

Help lessen withdrawal symptoms by slowly lowering the level of nicotine in the body-Examples: Nicorette gum, Commit lozenges, Nicoderm CQ patch, and Nicotrol inhaler and nasal spray

Heparin and low-molecular weight heparins

Heparin is not absorbed from the GI tract and standard type (UFH) must be administered intravenously or subcutaneously-LMWH type is usually only administered subcutaneously but may be given IV

The antiviral drug acyclovir is used to treat what infections?

Herpes simplex, herpes zoster, and varicella zoster

Wellbutrin

Heterocyclic

Precautions or contraindications with penicillins apply to patients with:

History of serious allergy to penicillins or other beta-lactams (e.g., anaphylaxis, hives) (anaphylaxis has been reported with parenteral, oral, or intradermal skin testing) Treatment for severe reactions includes discontinuance of the drug, immediate administration of appropriate medications (e.g., epinephrine and corticosteroids), and maintenance of a patent airway. Administration of antihistamines with penicillin will not prevent hypersensitivity reactions.

endogenous chemical substances

Hormones that regulate reproductive system functions include

A client asks the health care practitioner what the strongest painkiller is, morphine or hydromorphone. How does the health care practitioner respond?

Hydromorphone is four to eight times more potent than morphine.

Serious side effects of penicillins can include:

Hypersensitivity reactions ranging from rash to fatal anaphylaxis Superinfections (especially with oral ampicillin) and pseudomembranous colitis (C. difficile) Nausea, vomiting, and diarrhea Blood dyscrasias, which are reversible with the discontinuance of the drug Renal and hepatic disorders (rare) CNS effects, for example confusion, anxiety, and seizures (especially with penicillin G)

What are the MAJOR side effects of cephalosporins?

Hypersensitivity, blood dyscrasias, renal toxicity, nausea, vomiting, and diarrhea

Side effects of cephalosporins can include:

Hypersensitivity, including rash, edema, or anaphylaxis (especially in those allergic to penicillin) Blood dyscrasias (e.g., increased bleeding time or transient leukopenia) Renal toxicity, especially in older patients Mild hepatic dysfunction Nausea, vomiting, and diarrhea Phlebitis with IV administration and pain at the site of IM injection Respiratory distress Seizures

A 76-year-old male client with atrial fibrillation is on metoprolol, 50 mg PO three times a day. He is being treated for glaucoma and is started on timolol maleate eye drops. What should the health care practitioner be aware of when administering this medication?

Hypotension is a concern because timolol is a beta-adrenergic blocker. Taking an added beta-blocker could aggravate preexisting cardiovascular or pulmonary disorders.

A client has been prescribed carbidopa-levodopa (Sinemet), an antiparkinsonian drug for Parkinson's disease. When providing client education for this medication, what should the health care professional include as a frequent side effect?

Hypotension is a frequent side effect of Sinemet

Side effects of erectile dysfunction medications

Hypotension, nasal congestion, hearing loss

A client with chronic obstructive pulmonary disease (COPD) has been ordered oxygen therapy. What can occur if a client with COPD receives high O2 concentrations?

Hypoventilation

In a client that has no medical history of allergies, what might the health care practitioner recommend for an over-the-counter (OTC) anti-inflammatory medication for an ankle sprain?

Ibuprofen (Motrin) is the only agent that has a true anti-inflammatory effect. It inhibits enzymes the body produces that stimulate the production of prostaglandins.

A postmenopausal female client who has a family history of osteoporosis has decided to start estrogen as a hormone replacement therapy (HRT). The client asks the health care practitioner about HRT. What would be the health care practitioner's BEST response?

If started soon after menopause, estrogen prevents the accelerated phase of bone loss that occurs in the first five years after the onset of menopause.

Norika was ordered injections to take when she felt a headache coming on as evidenced by nausea, visual disturbances etc. What drug was she ordered?

Imitrex

The first "triptan" approved was

Imitrex (sumatriptan)

A health care professional is working in the cardiac step-down unit and is required to have an understanding of the function of cardiac medications. What is the MAJOR function of cardiac glycosides?

In clients with heart failure, the cardiac glycosides act by increasing the force of the cardiac contractions without increasing oxygen consumption, thereby increasing cardiac output.

A male client has been prescribed a phosphodiesterase (PDE) inhibitor for the treatment of erectile dysfunction (ED). What warning should the health care professional educate the client about when taking this medication?

In the event of an erection persisting more than four hours, the client should be advised to seek medical assistance immediately (tissue damage and permanent loss of potency may result).

Expectorants like guaifenesin

Increase secretions, reduce viscosity and help to expel sputum

Interactions with cephalosporins can include:

Increased effectiveness with probenecid Disulfiram-like reactions (flushing, tachycardia, shock) with alcohol ingestion and cefotetan

Side effects of corticosteroids can include:

Increased intraocular pressure (IOP; depends on the drug, dose, frequency, and length of treatment; less likely with fluorometholone) Reduced resistance to bacteria, viruses, or fungi Delayed healing of corneal wounds, thinning of cornea, and corneal ulceration Stinging, burning, or ocular pain Increased risk of developing cataracts

What causes damage to the retinal nerve in glaucoma?

Increased pressure within the eye

Linezolid (Zyvox)

Indicated for gram-positive infections -Approved for the treatment of bacterial pneumonia skin, skin structure infections, and MRSA and VRE infections -Effective in treating diabetic foot infections -Administered by IV infusion or orally

Neuraminidase inhibitors

Indicated for the treatment of uncomplicated acute illness due to influenza types A and B

Which of the following statements is TRUE about inhaled corticosteroid therapy?

Inhaled corticosteroids have less systemic side effects than oral or injectable administration.

Anti-platelet agents

Inhibit aggregation (clumping) and release of thromboplastin from the platelets to begin the clotting process

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

Inhibit an enzyme responsible for viral replication early in the viral life cycle

Nucleoside reverse transcriptase inhibitors (NRTIs)

Inhibit an enzyme responsible for viral replication early in the virus life cycle

A young client was recently started on Ritalin LA, a CNS stimulant, for treatment of attention deficit/hyperactivity disorder (ADHD). His mother tells the health care practitioner that she is concerned because her son has had difficulty sleeping after he started taking the medication. What information can the health care practitioner share with her?

Insomnia may be a side effect from Ritalin LA and is sometimes remedied by taking the medication, as prescribed, early in the day.

When is insulin required for clients who have diabetes?

Insulin is required for clients who have diabetes as replacement therapy in Type 1 diabetes and in clients with Type 2 diabetes whose blood glucose is not controlled with diet or when illnesses develop.

What potentially lethal side effect can occur if the client consumes foods containing tyramine, tryptophan, or tryptamine while taking an MAOI?

Interactions of the MAOIs with some drugs, foods, and herbal supplements can cause a hypertensive crisis, manifested by severe headache, palpitation, sweating, chest pain, possible intracranial hemorrhage, and even death.

A client with depression was started on fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI). After one month, she reports that her mood has improved. The client asks the health care practitioner if she can stop taking the medication now that she is feeling better. How should the health care practitioner respond?

It is generally advisable to counsel clients to continue antidepressant therapy for 6 to 12 months to prevent relapse.

Which statement BEST indicates the rationale regarding the importance of taking and documenting a careful, detailed history about the type of seizure?

It is important to understand the differences between the various seizure types because treatment failure can be the result of inappropriate selection of an anticonvulsant for the specific type of seizure.

A client has been prescribed NSAID therapy for musculoskeletal-related aches and pains. The client asks the health care practitioner about NSAID medication. What is the health care practitioner's responsibility in terms of educating her client?

It is the health care practitioner's responsibility to stay informed of the latest developments in the area in which the health care practitioner works.

A client on vacation has come to the emergency Med-Stop office requesting postcoital contraception due to forgotten oral contraceptives. Which of the following statements is TRUE regarding postcoital contraception?

It must be administered within 72 hours of unprotected intercourse.

A client with a history of paraphilia (sexual deviancy in males) has been prescribed Depo-Provera and has come to the clinic for his monthly IM injection. He tells the health care professional that he has been itching a lot and thinks his skin is yellowish. What is the health care professional's BEST response?

Jaundice, rash, and pruritus may be side effects of the progesterone and warrant medical attention.

Precautions or contraindications with cephalosporins apply to:

Known allergies, especially to penicillin (3%-7% cross-sensitivity; more so with first-generation cephalosporins) Prolonged use, possibly leading to superinfections or severe colitis (Clostridium difficile)

What is the primary target of treatment in lipid management

LDL

Low-density lipoproteins

LDLs; bad cholesterol

Margret had developed a nasty case of shingles. Once the actual blisters went away, she could not believe the neuropathic pain that remained. It was as if her nerves were on fire and she could trace every nerve pathway in the affected areas. The type of local anesthetic patch that would be indicated is

Lipoderm

Precautions or contraindications with macrolides apply to patients with:

Liver dysfunction and GI disease Electrolyte imbalances, certain cardiovascular diseases (can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm)

Methylergonovine

Semisynthetic ergot alkaloid used for prevention and treatment of postpartum and postabortion hemorrhage

A client with a history of endometriosis and heavy menses has been started on oral contraceptives for symptom relief. The health care professional is providing the client information about the serious side effects of this medication. Which side effect would be considered the MOST serious?

Loss of vision is the most serious side effect listed of all the choices.

Nardil

MAO inhibitors

What classification of anti-infectives is considered to be among the LEAST toxic antibiotics?

Macrolides are considered to be among the least toxic antibiotics.

Indirect toxicity or superinfection

Manifested as a new infection due to absence of normal flora in the intestines or mucous membranes

Antimigraine drugs:

Maxalt (rizatriptan) Imitrex (sumatriptan) Zomig (zolmitriptan) Relpax (eletriptan)

Adjuvant analgesics

May enhance analgesic effect with opioids and nonopioids, produce analgesia alone, or reduce side effects of analgesics

Monamine oxidase inhibitors (MAOIs)

Mechanism of action involves increasing concentrations of serotonin, norepinephrine, and dopamine in the neuronal synapse by inhibiting the MAO enzyme that degrades or breaks down these nuerotransmitters

Tricyclic antidepressants

Mechanism of action involves potentiation of norepinephrine and serotonin activity by blocking their reuptake

A client has been prescribed megestrol acetate (Megace), a progesterone agent, for treatment of cachexia associated with acquired immunodeficiency syndrome (AIDS). He asks the health care professional why this has been prescribed for him. What is the health care professional's BEST response?

Megace is used to stimulate the appetite of clients who have had a significant weight loss.

Because of the increase in vancomycin-resistant enterococci (VRE), under what conditions should vancomycin be used as an anti-infective?

Methicillin-resistant Staphylococcus aureus (MSRA), potentially life-threatening infections caused by organisms not treatable with less-toxic agents, gram-positive infections in clients who are allergic to penicillin clients and some endocarditis

A client who is pregnant is being treated for hypertension. Which of the following antihypertensives is the drug of choice to treat hypertension in pregnant women?

Methyldopa is the drug of choice for chronic hypertension in pregnant women because of safety to the fetus.

A client has come to the health medical center experiencing an acute allergic response to poison ivy exposure. Which of the following medications would MOST likely be administered?

Methylprednisolone dose pack. Corticosteroid therapy is indicated in allergic reactions to poison plants. For acute episodes, some oral corticosteroids are available in dose packs to facilitate tapering.

Which of the following drugs is a beta blocker?

Metoprolol

The most common neurovascular headache and may include nausea, vomiting, and sensitivity to light and noise.

Migraine

A client with glaucoma is placed on a miotic drug and asks the health care practitioner how his medication will work. How does the health care practitioner respond?

Miotics act by increasing aqueous humor outflow and decreasing intraocular pressure. The goal is to decrease the eye fluid that cannot drain properly.

Progestin-containing intrauterine device

Mirena contains a reservoir of levonorgestrel, a synthetic progestin•Releases small amounts of progesterone daily, providing five years of continuous contraception protection

Wakefulness-promoting agents

Modafinil (Provigil) is a psychostimulant approved for narcolepsy, sleep apnea, and shift-work sleep disorder

What symptoms should the health care practitioner educate the client and his caregivers to monitor while taking Chantix?

Monitor for neuropsychiatric symptoms, including suicidal ideation, and report them immediately to the health care practitioner.

Medications that antagonize histamine-1 receptor sites are called

antihistamines

Serious side effects from aminoglycosides, especially in older adults, dehydrated patients, or those with renal or hearing impairment, can include:

Nephrotoxicity, generally reversible upon discontinuation Ototoxicity, both auditory (hearing loss) and vestibular (vertigo), may be permanent Neuromuscular blockade, including respiratory paralysis CNS symptoms, including headache, tremor, lethargy, numbness, and seizures Blurred vision, rash, or urticaria

An older adult client had been treated for herpes zoster virus with an antiviral medication and is also on pain medication for postherpetic neuralgia. The client presents to his health care provider's office because he has seen no improvement of pain while on the narcotic medication. The health care practitioner prescribes the addition of a regime of Neurontin (gabapentin). How can the health care practitioner BEST explain the reason for adding this medication to the client's regiment?

Neurontin will work as a coanalgesic or adjunct to the pain medication.

A contraindication to PDE inhibitors

Nitrates

Dipyridamole (Persantine)

Non-nitrate coronary vasodilator that inhibits platelet aggregation

Aleve (naproxen)

Nonsteroidal Anti-inflammatory

Cardiac Glycosides (Digoxin)

Occur widely in nature or can be prepared synthetically-Act directly on the myocardium to increase the force of myocardial contractions

A pediatric client is being treated for bacterial conjunctivitis. Bacitracin, an anti-infective ophthalmic antibiotic, is prescribed. The health care practitioner knows that the preferred form of this treatment for a pediatric client is which of the following?

Ointment is the preferred method for pediatric clients and clients with poor compliance.

What is the only type of insulin that can be administered intramuscularly, intravenously, and subcutaneously?

Only regular insulin can be administered intramuscularly, intravenously, and subcutaneously.

Leukotriene inhibitors like Zafirlukast (Accolate) and Montelukast (Singulair)

Oral leukotriene receptor antagonists for asthma prophylaxis, prevention of exercise-induced bronchoconstriction, and treatment of chronic asthma•Help control inflammatory process of asthma caused by leukotriene production, thus helping to prevent asthma symptoms and acute attacks

Interactions of aminoglycosides may occur with:

Other ototoxic drugs (e.g., amphotericin B, polymixin B, bacitracin, and vancomycin) General anesthetics or neuromuscular blocking agents (e.g., succinylcholine; can cause respiratory paralysis) Antiemetics (may mask symptoms of ototoxicity)

Allergic hypersensitivity

Over-response of the body to a specific substance

A health care practitioner is caring for a client with a known diagnosis of diabetes mellitus. When the health care practitioner enters the client's room, she notes that the client is perspiring, irritable, confused, and acting in a bizarre manner. The health care practitioner suspects these may be symptoms of hypoglycemia and offers the client four ounces of orange juice, followed by a protein bar. Which of the following situations would NOT result in hypoglycemia?

Overeating. Delayed or insufficient food intake (e.g., dieting) may result in hypoglycemia.

Oxandrin

Oxandrolone

The hormone that contracts the pregnant uterus is

Oxytocin

A male client has been placed on a phosphodiesterase (PDE) inhibitor for the treatment of impotence. Which statement is TRUE regarding the frequency of dosing?

PDE inhibitor cannot be taken more frequently than once daily.

Stendra (avanafil)

PDE5 Inhibitor Treats Erectile Dysfunction

Therapeutic levels of coumarin are measured by the

PT/INR

Restless leg syndrome is often treated with medications used to treat

Parkinson's

Sinemet (carbidopa/levodopa)

Parkinson's disease

What medication is used for the prophylactic treatment of rheumatic fever?

Penicillin

Which of the following medications are contraindicated for a client with an aspirin allergy?

Percodan, which is a combination of oxycodone terephthalate and aspirin.

A client is prescribed morphine after back surgery. In which of the following conditions would the administration of morphine be appropriate?

Perforated duodenum secondary to ulcer disease would be an indication for morphine.

Culture and sensitivity (C&S) tests

Performed by medical institutions to reveal what antibiotic class or specific antibiotic will be effective in treating a certain infective organism.

Patients being treated with cephalosporins should be instructed regarding:

Possible allergic reactions Avoidance of alcohol Reporting any side effects to the physician Taking the medication without regard to meals but with food if stomach upset occurs Attention to signs of abnormal bleeding checking stools and urine for blood

Interactions of penicillins include

Potentiation of penicillin with probenecid (may be desirable) Potentiation with anti-inflammatory drugs such as methotrexate and salicylates given concomitantly (at the same time; monitor for increased side effects) Antagonistic effect (delayed absorption) of oral penicillins when given with antacids or with food Antagonistic effect of some other anti-infectives on penicillin Penicillin V or ampicillin may inhibit the action of estrogen-containing oral contraceptives.

Inhaled corticosteroids (SVN aerosol, DPI, MDI)

Preferred drug therapy in long-term prophylactic management of persistent asthma of various severities

A client with epilepsy has been treated for years with phenytoin (Dilantin), an anticonvulsant medication. While waiting to see the health care practitioner, the client reveals to the office manager that she and her husband are trying to conceive. Which of the following statements about taking phenytoin and pregnancy are TRUE?

Pregnancy and lactation are considered contraindications of phenytoin.

A client diagnosed with myxedema has been placed on thyroid replacement therapy. Which of the following statements is TRUE?

Prescribed dosage should be taken on an empty stomach 30-60 minutes before meals.

Antitussives

Prevent coughing in patients not requiring a productive cough-Most produce cough suppression by acting centrally on the cough center located in the brainstem

Progestin-only contraceptives

Prevent pregnancy by inhibiting ovulation, changing cervical mucus, and creating a thin, atrophic endometrium not conducive to sustaining the fertilized ovum

Acyclovir

Primarily treats herpes simplex, herpes zoster (shingles), and varicella zoster (chickenpox) infections

Estrogens are female sex hormones that

Produced mainly by the ovary and secondarily by the adrenal glands-Responsible for development of female secondary sexual characteristics -Produce an environment suitable for fertilization, implantation, and nutrition of the early embryo-Affect secretion of hormones FSH and LH from the anterior pituitary gland

Ophthalmic lubricants

Provide a barrier function at the level of the conjunctival mucosa-Help to dilute and flush various allergens and inflammatory mediators that may be present on the ocular surface

What medication was once commonly used in OTC cold remedies, but was targeted by the Combat Methamphetamine Act of 2005, and is now only sold under special conditions by pharmacies?

Pseudoephedrine, a popular and effective oral nasal decongestant, was the primary target of the Combat Methamphetamine Act of 2005, and can now only be stored and sold in limited quantities under special conditions by pharmacies.

Which of the following is a selective estrogen receptor modifier?

Raloxifene is a selective estrogen receptor modifier.

Integrase inhibitor

Raltegravir (Isentress): first ARV designed to slow the advancement of HIV infection by blocking the enzyme needed for viral replication

A client has been prescribed an antithyroid agent to relieve the symptoms of hyperthyroidism in preparation for surgery. What rare but serious side effect of antithyroid agents should the health care practitioner educate the client to report?

Rash, urticaria, and pruritis are rare side effects of antithyroid agents and should be reported to the physician immediately

A health care practitioner frequently comes to work late exhibiting poor hygiene and has been increasingly irritable and argumentative with the staff and clients. In addition, her pupils appear to be pinned (constricted) and when approached, she seems confused. The staff suspect substance abuse. What is their responsibility regarding her behavior?

Recognizing drug abuse and reporting any observed drug abuse to the proper individual in authority is the best answer choice. There are many services available to help medical personnel deal with drug-abuse problems.

A child has been placed on androgen therapy for congenital hypogonadism. What instructions should the health care professional give the client and family?

Report side effects of edema, jaundice, nausea, or vomiting.

Which of the following is the MOST serious side effect associated with opiate use?

Respiratory depression is a major concern with opiate use.

Erythropoiesis-stimulating agents (ESAs)

Responsible for regulation of the production and development of blood cells, normally in the bone marrow-Example: epoetin alfa (Epogen or Procrit)

Direct toxicity

Results in tissue damage

A client has been prescribed an HMG-CoA reductase inhibitor (statin), an antilipemic agent for monotherapy to manage high cholesterol. What condition is a rare but serious side effect of statins?

Rhabdomyolysis can be a rare but serious side effect of statins. It involves the destruction of muscle tissue and can lead to renal failure.

Tetracyclines are used in the treatment of what type of infections?

Rickettsia, chlamydia, and uncommon bacterial infections such as Rocky Mountain spotted fever

Sedatives/Hypnotics

Rozerem (ramelteon) Lunesta (eszopicione) Restoril (temazepam) Ambien (zolpidem) Halcion (triazolam)

Celexa

SSRI antidepressant

A client with Parkinson's disease (PD) is prescribed a selective MAO type-B inhibitor as monotherapy for early PD. Which category of medications does the health care practitioner know is contraindicated while taking MAO-B inhibitors?

SSRIs can interact with MAO-B inhibitors, resulting in severe CNS toxicity, hyperpyrexia, hypertensive crisis, and even death.

A client has been prescribed contraceptives for the treatment of painful, heavy menses. Which minor side effect would be considered a benefit for this client?

Scanty menstrual flow would be considered a benefit in treating a client for painful, heavy menses.

A client has been prescribed a first-generation anticonvulsant for the treatment of partial seizure disorder. Upon visiting the clinic, she revealed to the health care professional that she has not been compliant with the medication because she has experienced uncomfortable cognitive side effects. After discussing this with the team, a decision was made to start the client on a second-generation anticonvulsant. What is the rationale behind this?

Second-generation anticonvulsants have fewer side effects and usually do not require drug level monitoring.

Which of the following statements about second-generation antihistamines does the health care practitioner know is TRUE?

Second-generation antihistamines are not effective in the treatment of cough.

Androgens are male sex hormones that are

Secreted mainly in the interstitial tissue of the testes in the male and secondarily in the adrenal glands of both sexes

Cymbalta

Selective Serotonin and norepinephrine re-uptake inhibitor (SSNRI) Used for the treatment of major depressive disorder. -Common side effects: nausea, dry mouth, sleepiness, fatigue, constipation, dizziness, decreased appetite, and increased sweating.

Cephalosporins

Semisynthetic beta-lactam antibiotic derivatives produced by a fungus -Related to penicillins •Some patients allergic to penicillin are also allergic to cephalosporins

Amphotericin B is considered to be the drug of choice for treating what conditions?

Severe fungal infections resulting from immunosuppressive therapy, AIDS, or severe illness such as meningitis

An older adult client with rheumatoid arthritis has been taking a nonsteroidal anti-inflammatory drug (NSAID) for the past five years. While waiting to see the rheumatologist, she tells the health care practitioner that she thinks she may be developing an ulcer. Why does the health care practitioner regard this information as important to report to the treating physician?

Signs and symptoms of GI bleeding need to be reported without delay because most reports of fatal GI events are in the debilitated or older adult population.

When providing medication education to a client who has been given a prescription for skeletal muscle relaxants, what would be an appropriate instruction?

Skeletal muscle relaxants can potentially have side effects of drowsiness, dizziness, and blurred vision, and clients are advised to avoid driving or be extremely careful while driving.

Makes a woman on BCP at risk for deep vein thrombosis (DVT)

Smoking, Over 35, Obese, History of DVT

A client's spouse calls the clinic with concerns that the client may be taking amphetamines. The spouse asks the health care practitioner what signs and symptoms to look for with amphetamine use. What are some signs of amphetamine intoxication that the health care practitioner can share with the client's spouse?

Social withdrawal and decreased appetite may be seen with chronic abuse.

Which of the following drugs is a long-acting maintenance anticholinergic DPI?

Spiriva

An example of an organism resistant to most antibiotics is methicillin-resistant

Staphylococcus aureus (MRSA)

For clients who have hepatic or renal disease and high cholesterol levels, the use of

Statins is contraindicated.

A client is in status epilepticus. He was given IV lorazepam (Ativan) simultaneously loading with IV phenytoin (Dilantin), anticonvulsants with efficacy. Which of the following statements BEST describes the rationale behind this pharmaceutical intervention?

Status epilepticus is considered to be a true neurological emergency. The treatment of choice is IV lorazepam. Simultaneous loading with IV phenytoin or fosphenytoin is also recommended.

Nystatin

Structurally related to Amphotericin B -Orally treats oral cavity candidiasis -Also used as a fungicide in the topical treatment of skin and mucous membranes

Vancomycin

Structurally unrelated to other available antibiotics -IV vancomycin is used in the treatment of potentially life-threatening infections caused by susceptible organisms

INH

daily treatment for asymptomatic TB

A client is admitted to the hospital with a reported history of taking diazepam (Valium), a benzodiazepine, for the treatment of anxiety. What should the attending health care practitioner be aware of regarding diazepam?

Sudden withdrawal after prolonged use can result in seizures.

Beta-adrenergic blockers are Suitable for

Suitable for initial therapy in some patients with angina, postmyocardial infarction, ischemic heart disease, heart failure, and certain arrhythmias

Contraceptive agents

Suppress release of pituitary hormones, follicle-stimulating hormone (FSH), and luteinizing hormone (LH)•Results in ovulation prevention

Which of the following is a drug classification used to treat asthma?

Sympathomimetics

Urinary tract infection (UTI)

Symptomatic inflammatory response from the presence of microorganisms in the urinary tract -One of the most common bacterial infections for which patients seek treatment -First-line urinary anti-infectives for empiric treatment of uncomplicated lower UTI are sulfamethoxazole-trimethoprim and nitrofurantoin

A young adult male client arrives at the clinic and the health care practitioner notices that his breath smells of alcohol, his skin is cold and clammy, and he appears to be in a stupor. His friend reports that they were at the park celebrating his 21st birthday. The health care practitioner reports this to the physician and knows that these symptoms could be signs of what?

Symptoms of alcoholic poisoning include cold, clammy skin; stupor; slow, noisy respirations; and alcoholic breath.

Metronidazole (Flagyl)

Synthetic antibacterial and antiprotozoal agent -Effective against protozoa -One of the most effective drugs against anaerobic bacterial infections -Also useful in treating Crohn's disease, antibiotic-associated diarrhea, rosacea, and H. pylori infection

Which of the following is a side effect of hydralazine?

Tachycardia

now rarely prescribed for Alzheimer's disease because it is associated with significant hepatotoxicity

Tacrine (cognex)

Clients receiving antipsychotic medications should be assessed for tardive dyskinesia (TD) at the start of treatment and at least every six months with which of the following tools?

The Abnormal Involuntary Movement Scale (AIMS) is a standard test used by health care practitioners for clients receiving psychotropic medication.

A health care professional is on duty on the psychiatric floor of a hospital. The FDA advises health care professionals to closely monitor clients taking anticonvulsants because of what psychiatric concern?

The FDA has alerted health care professionals of an increased risk of suicidal ideation and behavior in clients receiving anticonvulsants.

What is indicated for gram-positive infections and is approved for the treatment of bacterial pneumonia skin and skin structure infections, and MRSA and VRE infections?

The antibiotic linezolid

A client asks the health care practitioner why he is being put on an antidepressant for back pain when he does not suffer from depression. How does the health care practitioner respond?

The antidepressant is used as an adjunct medication to enhance the effect of the pain medication.

A client has been on prolonged corticosteroid therapy for COPD and is now taking an anti-infective ophthalmic agent. The health care practitioner knows the client is at risk for which of the following?

The client is at risk of secondary ocular infections caused by the suppression of the immune response.

What is hematopoiesis?

The formation, differentiation, and maturation of blood cells into specific cell lines

Antiglaucoma Agent:

The greatest reduction in IOP by increasing outflow of aqueous humor •May be used concomitantly with other topical ophthalmic drugs to lower IOP

A health care professional is caring for a client taking antihypertensive pharmacotherapy. She will be monitoring the client's blood pressure and vital signs. What is the MOST common side effect of antihypertensives?

The most common side effect of antihypertensives is hypotension, especially postural hypotension.

Otitis Media

The most common type of otic infection, located in the middle region of the ear.

A client taking NSAIDs long-term developed a GI ulcer, and the medication was stopped until the ulcer had healed. Together with the health care practitioner, it was decided that the client could resume the NSAID along with lansoprazole (Prevacid), a proton pump inhibitor. How can the health care practitioner BEST explain to the client the rationale of adding the proton pump inhibitor with NSAIDs?

The proton pump inhibitor has most likely been prescribed to protect the gastric muscosa from further GI ulceration.

A young adult male client recently started sertraline (Zoloft), a SSRI for depression. He returns to the clinic for his one-month follow-up visit. When the health care practitioner asks him how he is doing, he responds that he cannot take the medication anymore because it "is not good" for him and refuses to explain in more detail upon further questioning. Of the known side effects of SSRIs, which side effect might the health care practitioner consider exploring further?

The side effect of sexual dysfunction is often seen when taking SSRIs and can be disturbing to the client, thereby triggering this kind of response and refusal to continue the medication.

A client who is obese tells the health care practitioner that her friend was recently placed on thyroid medication and lost weight. She asks the health care practitioner if she can take thyroid agents to help her lose weight. Which statement is the health care practitioner's BEST response?

The use of thyroid agents for weight reduction is contraindicated, ineffective, and dangerous, leading to a decrease in normal thyroid function and possibly life-threatening cardiac arrhythmias.

A client with refractory treatment of chronic schizophrenia has been treated with many antipsychotic medications with little effect. The treatment team has made a decision to start the client on clozapine (Clozaril), an atypical antipsychotic. What information should the health care practitioner share with the client regarding clozapine?

The white blood count (WBC) requires close monitoring due to the rare side effect of developing agranulocytosis.

PCA pump

There is a lock out period to prevent abuse or overdose.

A male client with advanced inoperable prostate cancer has been considering estrogen therapy after discussing this option with the medical team. He asks the health care professional about the side effects of estrogen therapy. Which potential side effects should the health care professional include when educating this client?

There is an increased risk of thromboembolic disorders, hypertension, myocardial infarction, and stroke.

A client with complaints of muscle rigidity, shuffling gait, and muscle tremors has been newly diagnosed with Parkinson's disease. She was started on carbidopa-levodopa (Sinemet), an antiparkinsonian drug used for dopamine replacement. The client asks the health care professional if this medication will cure her disease. Which of the following would be the health care practitioner's BEST response?

There is no cure for Parkinson's disease, and the treatment goal is to relieve symptoms and maintain mobility.

risk factors associated with post-coital contraception

There is no medical condition in which the risks outweigh the benefits

A client has just had an endoscopic procedure at the gastroenterologist to rule out a hiatal hernia. During the procedure, she was administered a neuromuscular blocking agent (NMBA) as a muscle relaxant. Upon recovery, what should the health care practitioner watch for in terms of possible serious side effects?

These drugs can be very dangerous and possibly result in respiratory arrest because of the potential to paralyze the diaphragm muscle.

Which medication classification is often the first used to treat hypertension?

Thiazide-type diuretics.

DOT

type of therapy usually preferred used for all regiments administered 2 or 3 times a week

The health care practitioner needs to give an intramuscular injection to a client for treatment of a sexually transmitted infection. A cephalosporin, Rocephin, is ordered IM. The health care practitioner knows that cephalosporins prescribed for STDs belong to which generation?

Third generation

The health care practitioner is educating her client regarding the use of Tylenol, an OTC analgesic. What precaution is NOT necessary to tell the client regarding this medication?

This medication does not need to be taken with food. DO: Monitor for the many side effects due to the interaction with other medications. Be aware of the danger of overdose. Be aware of the danger of poisoning.

A client is evaluated in the emergency department with a chemical splash to the face and eyes. Following eye irrigation and evaluation of visual acuity, the client is started on an anti-inflammatory agent. How does the health care practitioner explain the mode of action to the client?

This medication is used to relieve irritation of the conjunctiva.

Prostaglandins are released as a natural part of the cervical ripening process

Those causing contraction of the myometrial muscle include dinoprostone or prostaglandin E2 (Prostin E2, Cervidil, Prepidil), and the oral synthetic prostaglandin E1 analog, misoprostol (Cytotec), and the prostaglandin F2-alpha analog carboprost (Hemabate)

A client comes to the clinic with complaints of ringing in the ears. Upon taking a careful history of the client's current medication regime, the health care practitioner discovers that the client has been taking salicylates, an over-the-counter NSAID for heart disease prophylaxis. What are some potential side effects of NSAIDs that the health care practitioner can share with her client?

Tinnitus and hearing loss can be a side effect of long-term NSAID therapy.

Precautions or contraindications with aminoglycosides apply to

Tinnitus, vertigo, and high-frequency hearing loss Reduced renal function Dehydration Pregnant or nursing women Infants or older adults

For what purposes are antituberculosis agents administered?

To treat asymptomatic infection and to treat active clinical tuberculosis or prevent relapse

Antituberculosis agents are administered for two purposes

To treat latent or asymptomatic infection (no evidence of clinical disease) -For treatment of active clinical tuberculosis and to prevent relapse

increases tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation

Topical cyclosporine (Restasis)

A client receiving thyroid replacement therapy came to the health clinic with complaints of heart palpitations, menstrual irregularity, and insomnia. The health care practitioner notes that she has exophthalmos. What could these signs of hyperthyroidism possibly indicate?

Toxic effects result from overdosage of thyroid and are manifested in the signs of hyperthyroidism.

Anti-Inflammatory Drugs

Treat disorders in which the musculoskeletal system is not functioning properly due to inflammation-Examples: arthritis, bursitis, spondylitis, gout, and muscle strains and sprains

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Treat postoperative inflammation following cataract surgery-Alternative to corticosteroids if a contraindication exists

Antifungals

Treat specific susceptible fungal disease -Medications are quite different in action and purpose

Amphetamine/methylphenidate preparations

Treats attention-deficit hyperactivity disorder (ADHD) in children over age six and for narcolepsy•Examples: Adderall and Ritalin

Tricyclic antidepressants

Treats fibromyalgia and nerve pain associated with herpes, arthritis, diabetes, and cancer, migraine or tension headaches, insomnia, and depression

Macrolides

Treats many infections of the respiratory tract, skin conditions, or for some sexually transmitted infections -Considered among the least toxic antibiotics •Preferred for treating susceptible organisms under conditions in which more toxic antibiotics might be dangerous

Clindamycin

Treats serious respiratory tract infections, septicemia, osteomyelitis, serious infections of the female pelvis caused by susceptible bacteria, and for Pneumocystis jirovecii pneumonia associated with AIDS -Prophylactic use in dental procedures for penicillin-allergic patients -May be a viable therapeutic option for community-acquired MRSA

Norpramin

Tricyclic Antidepressant. Blocks reuptake of norepinephrine and serotonin. Second line antidepressant. Side effects: Blurred vision, dry mouth, tachycardia, urinary retention, constipation, drowsiness, sedation.

DPI device

Used for maintenance on asthma onlyAvailable as a sympathomimetic bronchodilatorFast deep breath with hold is requiredAvailable as an anticholinergic bronchodilator

Very low-density lipoproteins

VLDLs; triglycerides

one of a small number of drugs effective against MRSA.

Vancomycin IV

A female client has come to the gynecologist requesting oral contraceptives (estrogen combined with progestin). Which common side effect should the health care professional educate the client about oral contraceptives?

Weight gain is a common side effect when initiating oral contraceptives.

A client has been prescribed a corticosteroid eye drop and is fearful of taking any medications that will be absorbed into her body. How does the health care practitioner respond?

When administering eye drops, gently apply pressure to the inner canthus. This will minimize absorption into the systemic circulation.

A client was recently prescribed losartan (Cozaar), an angiotensin receptor blocker (ARB), for the treatment of hypertension. When compared to ACEIs, ARBs are associated with a lower risk of which of the following?

When compared to ACEIs, ARBs are associated with a lower incidence of drug-induced cough.

A client with Type 2 diabetes has been taking chlorpropamide, a first-generation sulfonylurea oral hypoglycemic agent, for many years with good effect. Recently, the client was started on a six-month course of isoniazid for a positive PPD test. Which of the following statements is TRUE about taking isoniazid while receiving sulfonylureas?

When isoniazid is administered or discontinued in clients receiving sulfonylureas, the client should be observed closely for loss of diabetic control.

When oxygen is being used, what activities, supplies, and equipment are prohibited in the client area?

When oxygen is being used, smoking and electrical equipment that may spark, such as electric razors and hair dryers, are prohibited.

A client who is currently on valproic acid (Depakote), an anticonvulsant for a seizure disorder, has come to the neurologist for routine blood work. He asks the health care professional why he has to have his blood drawn. Which statement below BEST answers this question?

When taking valproic acid, blood work is done routinely to monitor the potential development of blood dyscrasias, hepatotoxicity, and therapeutic levels.

A client is started on ziprasidone (Geodon), an antipsychotic, for the treatment of schizophrenia. The health care practitioner has ordered a baseline electrocardiogram (EKG) prior to starting the medication. The client asks the health care practitioner why this test is being ordered. Which of the following responses is BEST?

When taking ziprasidone, there is a greater risk of cardiac disorders, therefore, a baseline test of cardiac function is indicated.

A teenage client who is obese visits her health care provider's office for her annual physical exam. While the health care practitioner is taking the client's blood pressure and collecting pertinent data, the client asks about the use of Ritalin, a CNS stimulant, for weight loss. How can the health care practitioner BEST respond to her question?

While Ritalin may decrease the appetite, it is not recommended, because it can lead to physical and psychological dependence.

A client in need of long-term anti-inflammatory medication has been tried on NSAID and NSAID combination therapy with anti-ulcer medications, but continues to have recurring GI ulcerations. The treating physician discusses the possibility of switching to a different NSAID known as celecoxib (Celebrex), a cyclooxygenase-2 (COX-2) inhibitor. What is the health care practitioner aware of when educating the client about the rationale for switching medications?

While this medication selectively inhibits COX-2 prostaglandin synthesis, it does not inhibit COX-1 and therefore does not inhibit platelet aggregation (clotting) or the production of mucosal protective prostaglandins.

Quinolones such as ciprofloxacin (Cipro) should be reserved for use under what circumstances?

With infections that require therapy with a fluoroquinolone, such as Pseudomonas infections

When educating a client that has been prescribed long-term corticosteroids, which of the following should the health care practitioner caution the client about?

Withdrawal of corticosteroids following long-term therapy should always be gradual with step-down dosage to allow the body's normal hormone production and regulation to return.

Fluconazole

Works against many fungal pathogens, including most Candida, without the serious toxicity of amphotericin B

Which of the following drugs can be used for rescue treatment of asthma?

Xopenex

Alendronate

a bisphosphonate

Provigil (modafinil)

a medication used to treat narcolepsy, shift work sleep disorder, and daytime sleepiness associated with sleep apnea

Teriparatide

a parathyroid hormone

In which of the following locations can insulin be injected?

abdomen

Tonic-clonic:

abrupt loss of consciousness; falling, with tonic extension of trunk and extremities, followed by alternating contractions and relaxation of the muscles (former name: grand mal)

Absence epilepsy:

absence of convulsions; sudden onset; brief loss of consciousness with no falling

Psychotropic are classified

according to the purpose for administration: CNS stimulants, antidepressants, anxiolytics, antimanic, and antipsychotic medications

The neurochemical substance that is lacking in the brain in Alzheimer Disease is

acetylcholine

Aricept (donepezil)

acetylcholinesterase inhibitor

Lysergic acid

active ingredient in a powerful hallucinogen

Atropine (which is a mydriatic)

acts as a cycloplegic (paralyzes the muscles of accommodation)•Drug of choice in eye examinations for children •Often used for adults because of fast action and fast recovery time

Corticosteroids are useful in

acute stages of eye injury •Prevent scarring, for severe symptoms, or when condition is unresponsive to other medications

Drugs intended for the treatment of disease states other than pain that enhance analgesic effects are called

adjuvant

Which population does Type 1 diabetes usually affect?

adolescents

Which population does Type 2 diabetes usually affect?

adults

Because decongestants are often combined with other ingredients such as antihistamines and analgesics, the possibility of

adverse side effects is increased.

A client, status post recurrent transient ischemic attacks (TIAs), has been prescribed acetylsalicylic acid (aspirin) therapy and a platelet aggregate inhibitor to reduce the risk of recurrence and to prevent thrombosis. What instructions should the health care professional provide to this client about taking aspirin?

advise client to take aspirin with food, milk, antacid, or a large glass of water to reduce unpleasant GI reactions.

Which of the following is a short-acting sympathomimetic agent indicated for rescue treatment of asthma?

albuterol sulfate

Red zone

alert; symptoms are worse even while resting, very short breath, trouble walking or talking, unable to do normal activities

peak flow meter measures the _____

amount of flow from the large airways

Adderall

amphetamine/dextroamphetamine

Buspirone (BuSpar)

an anxiolytic; Indicated for the treatment of generalized anxiety disorder, but not other anxiety disorders (or depression)

Hydroxyzine (Vistaril)

an anxiolytic; Used IM as a pre- and postoperative antiemetic and sedative

After administering local ophthalmic anesthetics, the client should wear

an eye patch

Teriparatide (Forteo)

an injectable form of parathyroid hormone approved for postmenopausal women and men who are at high risk for fracture.

There is a risk of developing psychosis with delusions, paranoia, depression, mania, and aggression with violence with

anabolic steroid use

Acetaminophen has

analgesic and antipyretic properties, but very little effect on inflammation

Androgel (testosterone)

androgen

Coronary Vasodilators treat

angina. Acute pain resulting from insufficient blood supply (ischemia) to a part of the heart

Which of the following drugs is a fibric acid derivative?

antara

Zarontin (ethosuximide)

anti-convulsant, for absence epilepsy

Which of the following is the drug class of choice for treating hypertension in pregnant women?

antiadrenergic

Cipro

antibiotic

Ciprodex

antibiotic and a steroid

which of the following drug classes causes bronchial relaxation

anticholinergic

In which of the following locations can insulin be administered?

back of arm

Urinary anti-infectives are usually

bacteriostatic in action

Asthma maintenance treatment drugs should

be long acting

Questran is what type of antilipemic?

bile acid sequestrant

Paget's disease is managed with the use of

bisphosphonate

A patient taking Lipitor should be instructed to immediately call his doctor if he experiences which of the following?

bleeding

Antipsychotic Medications/Major Tranquilizers work primarily by

blocking dopamine receptors-Results in unbalanced cholinergic activity•Causes frequent extrapyramidal side effects to include tardive dyskinesia

Miacalcin (calcitonin-salmon)

bone resorption inhibitor

Which of the following is a side effect of beta blockers?

bradycardia

Which classification of antihypertensive medications is used as initial therapy for patients with diabetes?

calcium channel blockers

Which of the following drugs is an ACE inhibitor?

captopril

Avoid grapefruits when taking

carbamazepine

There is a strong, consistent relationship between blood pressure and the risk of

cardiovascular disease

Chickenpox

caused by varicella-zoster virus

Most narcotic analgesics act upon the

central nervous system. Non-narcotics typically work at the level of the peripheral nervous system at the pain receptor sites.

Type 2

characterized by insulin resistance and deficiency

Preeclampsia

characterized by new-onset hypertension, edema, and proteinuria during pregnancy.

Ointments are preferable to drops in

children and patients with poor adherence, but preferred in adults

Lipoproteins transport

cholesterol and other fats through the blood stream

Which of the following drugs is a Bile Acid Sequestrant?

cholestyramine

The first class of agents that are effective in delaying symptoms of Alzheimer's disease are the

cholinesterase inhibitors

Which of the following is a common side effect of ACE inhibitors?

chronic dry cough

The stimulant medication used to treat neonatal apnea is caffeine

citrate

A client admitted to the hospital for schizophrenia has recently started taking quetiapine (Seroquel), an atypical antipsychotic. As with many antipsychotic medications, what should the health care practitioner educate the client about?

clients taking antipsychotics should be taught to rise slowly or change position slowly because of the potential for orthostatic hypotension, which can lead to falls

Which of the following drugs is an antiadrenergic agent?

clonidine

A narcotic antitussive widely used as a cough suppressant due to its reduced incidence of side effects is

codeine

Narcotic antitussive example

codeine

American Academy of Pediatrics Subcommittee on Febrile Seizures does not recommend

continuous or intermittent antiepileptic drug (AED) therapy for children with one or more simple febrile seizures

The antiarrhythmic disopyramide (Norpace) acts by decreasing myocardial excitability and inhibiting conduction, and may depress myocardial

contractility

Diabetes therapy with insulin focuses initially on

controlling fasting plasma glucose with the use of a long-acting insulin analog (Lantus or Levemir)

Which drug classification is used to reduce airway inflammation in asthma?

corticosteroid

For most noninfectious rhinitis, nasal

corticosteroids are considered first-line therapy.

Which of the following drugs is an inhaled mast cell stabilizer prophylactic?

cromolyn sodium

Antihypertensives do not

cure hypertension

Medications that constrict respiratory tract blood vessels, reducing swollen mucous membranes and opening nasal passages are called

decongestants

Sympathomimetics are bronchodilators that increase vital capacity and

decrease airway resistance

A health care practitioner is assisting the nurse with monitoring a client who has received IV morphine for a procedure to reduce a dislocated shoulder. What sign should the health care practitioner watch for and inform the physician if it occurs?

decreased respiratory rate to 8 is indicative of respiration depression, a side effect of opiate analgesics that can potentially lead to respiratory distress.

Antiglaucoma Agent: Alpha agonists

decreases formation and increases outflow of aqueous humor•Minimal effects on cardiovascular or pulmonary hemodynamics

The MOST serious side effect of midazolam (Versed) is

depressed respirations

Nonnarcotic antitussive example

dextromethorphan

Under what condition is meglitinides contraindicated?

diabetic ketoacidosi

First generation Antihistamines

diphenhydramine (Benadryl)

Clients who take tetracyclines should be advised to AVOID

direct sunlight

Sustained release tablets

do not chew or crush

A patient with Alzheimer's disease is ordered memantine 5 mg. per day. Memantine side effects involve the CNS and are

dose-dependant

Ribavirin

drug used to treat RSV

You are working in a long-term care facility and notice a client with PD coughs every time he takes a drink. Based on your knowledge of PD, you are concerned about him developing

dysphagia

Debrox (carbamide peroxide)

ear wax remover

Endorphins

endogenous analgesics produced within the body as a reaction to severe pain or intense exercise (e.g., "runner's high"). Endorphins block the transmission of pain.

The recurrence of unprovoked seizures characterized by sudden attacks of altered consciousness, motor activity, or sensory impairment is called

epilepsy

Viagra (sildenafil)

erectile dysfunction

The most commonly used type of macrolide is

erythromycin

Drug of choice for management of absence epilepsy is

ethosuximide (Zarontin)-Effective only for this type of epilepsy-Lacks idiosyncratic hepatotoxicity of valproic acid•Other drugs in use include clonazepam (Klonopin), valproic acid (Depakene), and lamotrigine (Lamictal)

Which of the following helps control Type 2 diabetes?

excercise

In addition to taking medications as prescribed, patients with hypertension should be instructed to

exercise regularly

Hypertension medications that are

extended release should not be crushed or chewed.

Second-generation Antihistamines

fexofenadine (Allegra) and loratadine (Claritin)

Gemfibrozil is a(n)

fibric acid derivative

Cephalexin (Keflex)

first generation cephalosporin anti infective

Cephalosporins Classified as

first, second, third, or fourth, or fifth generation -According to organisms susceptible to their activity

Which of the following drugs is a fibric acid derivative (fibrate)?

gemfibrozil

a beta-adrenergic blocker used to lower intraocular pressure in open-angle types of

glaucoma.

Aminoglycosides, in combination with other antibiotics, are used to treat infections caused by what type of bacteria?

gram-negative and gram-positive bacteria

Which of the following foods should not be eaten while taking a statin?

grapefruit juice

Somatropin

growth hormone

Which of the following is a side effect of nicotinic acid?

hepatoxicity

Shingles is caused by

herpes zoster virus

PCA is a

high-risk procedure.

The drug calcitonin is reserved for women who refuse or cannot tolerate

hormone replacement therapy

Danocrine (Danazol)

hormone, tx of moderate endometriosis thats unresponsive to conventional tx., palliative tx of fibrocystic breast disease, prophylaxis of hereditary angioedema, SE incl. emotional lability, deeping of voice, edema, acne, hirsutism, oiliness, amenorrhea, anovulation, dec. breast size, weight gain, assess pt for s/s of endometriosis and fibrocystic brease disease, use sunscreen, emphasize monthly BSE

Ibuprofen is a non steroidal anti-inflammatory medication that should not be taken with

hydrochlorothiazide (Microzide) due to potential renal insufficiency and reduced blood pressure control.

Crestor is a

statin

Which of the following is the most potent class of antilipemics?

statins

When seizures occur so frequently that the client does not regain consciousness between seizures, the condition is known as

status epilepsy

Provigil is a

stimulant used for shift-work sleep disorder.

Serotonin also treats the nausea because it

stimulates GI serotonin receptors

Oxytocin is a hormone that

stimulates the uterus to contract, thus inducing childbirth-Also acts on the mammary gland to stimulate the release of milk

For the duration of quinolone therapy and several weeks following, clients should avoid

strenuous exercise

Penicillins are used to treat infections produced by many

streptococcal and some staphylococcal and meningococcal bacteria.

Hydrochlorothiazide (Microzide) is contraindicated in patients with

sulfonamide hypersensitivity.

Combivent is a combination of a

sympathomimetic and anticholinergic

Under what condition is Actos contraindicated?

symptomatic heart failure

NSAIDs, such as ibuprofen, inhibit

synthesis of prostaglandins-Substances responsible for producing much of the inflammation and pain of rheumatic conditions, sprains, and menstrual cramps•No cure has been found for rheumatic disorders, but many medications are used to alleviate pain

Spice, skunk, fake weed

synthetic cannabinoids

Progestins are

synthetic drugs that exert progesterone-like activity

Synthetic corticosteroids are administered

systemically for short-term "bursts" during exacerbations, and occasionally at the beginning of treatment until symptoms are controlled

Which of the following is a possible side effect of sympathomimetics?

tachycardia

Which of the following is one of the major side effects of adrenergic or sympathomimetic bronchodilators?

tachycardia

Clients receiving antipsychotic medications should be assessed for

tardive dyskinesia when treatment is started and at least every 6 months

Second-generation antihistamines cause less sedation

than first-generation antihistamines

Clients for whom tricyclics are prescribed should be informed

that it will be 2-4 weeks before these medications are fully active.

THC

the major active ingredient in marijuana; triggers a variety of effects, including mild hallucinations

Depression can result from the deficiency of

the neurotransmitters norepinephrine, dopamine, and serotonin

Salicylates (aspirin) are most commonly used for

their analgesic and antipyretic properties, as well as for their anti-inflammatory action

A female client is prescribed amantadine (Symmetrel), an antiviral agent, to treat extrapyramidal reactions associated with carbon monoxide poisoning. She complains of GI distress, constipation, and urinary retention. What should the health care practitioner know about these side effects?

these side effects of Symmetrel are usually dose-related and reversible.

Which of the following is a drug classification used to treat diabetes?

thiazolidinediones

Prolonged, high intake of caffeine in any form may produce

tolerance, habituation, and psychological dependence

Types of generalized seizures include

tonic-clonic and absence

Nystatin is used as a fungicide in the______ treatment of skin and mucous membranes.

topical

While taking theophylline, what might symptoms of tachycardia, anorexia, nausea, vomiting, diarrhea, restlessness, irritability, and headache indicate?

toxicity

Diflucan

trade name for Fluconazole, one of the most widely prescribed antifungal agents

Caffeine citrate

treats neonatal apnea of prematurity

Because of the increase in obesity, more children and young adults are developing

type 2 diabetes

Drug Therapy for Generalized and Partial Seizures include

•First generation anticonvulsants-Prophylactic treatment of generalized and partial seizures should start with a single drug such as valproate, lamotrigine, levetiracetam, carbamazepine, oxcarbazepine, or phenytoin•Aim of therapy is to prevent seizures without oversedation

Chronic (open-angle) glaucoma

•Much more common•Often bilateral•Develops slowly over a period of years with few symptoms except a gradual loss of peripheral vision (typically bilaterally) and possibly blurred vision

-Bisphosphonates

•Nonhormonal agents •Act directly to inhibit bone reabsorption, increasing bone mineral density at the spine and hip, and decreasing incidence of first and future fracture•Bind strongly to and accumulate in bone, creating a reservoir of drug that is released back into systemic circulation gradually over a period of months or years after treatment is stopped

Flunitrazepam (Rohypnol)

•Potent benzodiazepine approved for use in Central and South America for ethanol withdrawal•Known on the street as "roofies" and the "date-rape drug"

Hallucinogens

•Produce bizarre mental reactions and distortion of physical senses•Examples: lysergic acid (LSD) and phencyclidine (PCP)

Selective estrogen-receptor modifiers (SERMs)

•Raloxifene (Evista) is a selective estrogen receptor modifier with estrogen agonist activity on bone and lipids and estrogen antagonist activity on breast and uterine tissue•Increase bone mineral density, decrease bone reabsorption, and reduce fracture risk without promoting breast or endometrial cancer

Drug Therapy for Febrile Seizures

•Routine treatment of febrile seizures -Involves searching for the cause of the fever and taking measures to control it-Most children with febrile seizures do not require anticonvulsant drugs•Those that do may be treated with rectal diazepam gel if the seizure lasts longer than five minutes

Dextromethorphan (DXM)

•Semisynthetic morphine derivative•Safe, effective, nonaddictive, OTC cough suppressant when used appropriately•Often abused by teens because of its phencyclidine-like euphoric effect

Pituitary gland

•Somatotropin (human growth hormone): regulates growth and insufficient production will result in abnormalities •Adrenocorticotropic hormone (ACTH): cosyntropin (Cortrosyn), a synthetic peptide of ACTH, is used mainly for diagnosis of adrenocortical insufficiency

Calcitonin-salmon

•Synthetic form of the hormone calcitonin is available as a nasal spray (Miacalcin) or as a subcutaneous injection•Involves with calcium regulation, increases spinal bone density, and provides an analgesic effect in acute vertebral fractures•Reserved for women who refuse or cannot tolerate HRT or in whom HRT is contraindicated

Parathyroid hormone

•Teriparatide (Forteo) is an injectable form of parathyroid hormone approved for postmenopausal women and men with osteoporosis at a high risk for having a fracture •Increases GI calcium absorption and renal tubular reabsorption of calcium, increasing bone mineral density, bone mass, and strength