pharmacology
Anti-hypertensive drugs Ace inhibitors end in (and what is the mnemonic?) Beta-blockers end in? Calcium antagonists end in?
- Ace inhibitors (Tom Eats large Pizzas & Runs Fast In Benz Car) end in -pril -Beta blockers end in -(o)lol -Calcium antagonist end in in -mil -zem or -pine
MNEMONICS What is the mnemonic for Atrial Arrhythmias
ABCDE A: Anticoagulants - to prevent embolization B: Beta blockers - block the effects of certain hormones on the heart to slow the heart rate C: Calcium Channel Blockers - help slow the heart rate by blocking the # of electrical impulses that pass through the AV node into the lower heart chambers (ventricles) D: Digoxin - helps slow the heart by blocking the # of electrical impulses that pass through the AV node into the lower heart chambers (ventricals) E: Electrocardioversion - a procedure in which electric currents are used to reset the heart's rhythm back to regular pattern Atrial fibrillation is the most common sustained atrial arrhythmia. Variety of medicines are available to restore a normal heart rhythm i.e. beta-blockers such as bisoprolol, atenolol or a calcium channel blocker such as verapamil or diltiazem. Digoxin may be added to help control the heart rate further.
MNEMONICS What is the mnemonic for Parkinson's Medication
Ali Loves Boxing Matches A: Amantadine - Improves muscle control & reduce stiffness in Parkinson's disease, allows more normal movements of the body as the disease are reduced. It is also used to treat stiffness & shaking caused by certain medicines are used to treat nervous, mental & emotional conditions L: Levodopa - Most often prescribed. Body metabolizes Levodopa to produce dopamine, giving dopamine directly is ineffective, b/c the brain's natural defense blocks it from being used by the body. To Suppress nausea & other possible side effects, it's used in conjunction with a related drug call carbidopa B: Bromocriptine - It improves the ability to move & decrease tremors, stiffness, slowed movement & unsteadiness. It may also decrease the # of episodes of not being able to move ("on-off syndrome") M: MAO inhibitors - MAO Inhibitors - block the action of an enzyme that breaks down dopamine. They may be taken alone early in Parkinson's disease or with other drugs as the disease progresses. MAO inhibitors are often used alone b/c combining them with other drugs can cause unwanted side effects Most Parkinson's disease treatments aim to restore the proper balance of the neurotransmitter acetylcholine & dopamine by increasing dopamine levels. Muhammad Ali was diagnosed w/Parkinson's in '84 @ the age of 42.
Anti-retrovirals What does it do? Side effects?
Anti-retrovirals work by terminating viral replication, blocking DNA activity & preventing the maturation of the retrovirus. These drugs search for viruses & retroviruses that take different forms to escape the efficacy of standard anti-viral agents Side effects - GI upset - headache - rash
Difference between Antitussives, Expectorants & Mucolytics?
Antitussive - used to prevent or relieve a cough. This reduces the urge to cough which is beneficial for non productive coughs. Expectorant - promotes the secretion of sputum by the air passages, used especially to treat coughs. This irritates & stimulates the mucus membranes to induce the coughing reflex, facilitating the release of sputum from the respiratory tract. Mucolytic - acts to break down thick mucus. This works on breaking the links in the formation of phlegm so its easier to expel out of the lungs
MNEMONICS What is the mnemonic for Thiazides Indications:
CHIC C: Congestive Heart Failure H: Hypertension I: Insipidus C: Calcium calculi Thiazides affect the level of the nephron, inhibiting the reabsorption of sodium by the tubules at the cortical diluting segment of the nephron. It is the most commonly used oral diuretics & are widely used in the therapy of hypertension & CHF as well as the treatment of edema due to local, renal & hepatic causes.
A client with heart failure has Lanoxin (digoxin) ordered. What would the nurse expect to find when evaluating for the therapeutic effectiveness of this drug? Diaphoresis with decreased urinary output Increased heart rate with increase respirations Improved respiratory status & increase urinary output Decreased chest pain & decreased blood pressure
Correct answer:
The nurse has been teaching a client with Insulin Dependent Diabetes Melitus. Which statement by the client indicates a need for further teaching? "I use a sliding scale to adjust regular insulin to my sugar level" "Since my eyesight is so bad, I ask the nurse to fill several syringes" "I keep my regular insulin bottle in the refrigerator." "I always make sure to shake the NPH bottle hard to mix it well."
Correct answer: "I always make sure to shake the NPH bottle hard to mix it well." The bottle should be rolled gently, not shaken
While providing home care to a client with congestive heart failure, the nurse is asked how long diuretics must be taken. What is the nurse's best response? "As you urinate more, you will need less medication to control fluid" "You will have to take this medication for about a year" "The medication must be continued so the fluid problem is controlled" "Please talk to your health care provider about medications & treatments."
Correct answer: "The medication must be continued so the fluid problem is controlled"
A client is being maintained on heparin therapy for deep vein thrombosis. The nurse must closely monitor which of the following laboratory values? Bleeding time Platelet count Activated PTT Clotting time
Correct answer: Activated PTT Activated PTT. Heparin is used to prevent further clots from being formed & to prevent the present clot from enlarging. The activated Prothrommboplastin Time (APTT) test is a highly sensitive test to monitor the client on heparin.
A parent asks the school nurse how to eliminate lice from their child. What is the most appropriate response by the nurse? Cut the child's hair short to remove the nits Apply warm soaks to the head twice daily Wash the child's linen & clothing in a bleach solution Application of pediculicides
Correct answer: Application of pediculicides Treatment of head lice consists of application of pediculicides. Pediculicides vary & the directions must be followed carefully
The nurse is caring for a client with clinical depression who is receiving a MAO inhibitor. When providing instructions about precautions with this medication which action should the nurse stress to the client as important? Avoid chocolate & cheese Take frequent naps Take the medication with milk Avoid walking without assistance
Correct answer: Avoid chocolate & cheese Foods high in tryptophan, tyramine & caffeine, such as chocolate & cheese may precipitate hypertensive crisis.
A client has received 2 units of whole blood today following an episode of GI bleeding. Which of the following laboratory reports would the nurse monitor most closely? Bleeding time Hemoglobin & hematocrit White blood cells Platelets
Correct answer: Hemoglobin & hematocrit Hemoglobin & hematocrit The post-transfusion hematocrit provides immediate information about red cell replacement & about continued blood loss
A client is recovering from a hip replacement & is taking Tylenol #3 every 3 hours to pain. In checking the client, which finding suggests a side effect of the analgesic? Brushing at the operative site Elevated heart rate Decreased platelet count No bowel movement for 3 days
Correct answer: No bowel movement for 3 days With opioid analgesics observe for respiratory depression, sedation & with constipation. Brushing is not related to the analgesic, but could be the result of corticosteroids or previously used anticoagulants. Elevated heart rate could be the result of bronchodilators. Some antibiotics can lower platelet count.
The nurse is teaching a client about precautions with Coumadin therapy. The client should be instructed to avoid which over the counter medication? Non-steroidal anti-inflammatory drugs Cough medicines with guaifenesin Histamine blockers Laxatives containing magnesium salts
Correct answer: Non-steroidal anti-inflammatory drugs Medications with NSAIDS may increase the response to Coumadin (warfarin) & increase the risk of bleeding
Although nonsteroidal anti-inflammatory drugs as ibuprofen (Motrin) are beneficial in managing arthritis pain, the nurse should caution clients about which of the following common side effects? Urinary incontinence Constipation Nystagmus Occult bleeding
Correct answer: Occult bleeding Nonsteroidal anti-inflammatory drugs taken for long periods of time may cause serious side effects, including bleeding in the gastrointestinal track
Why is it important for the nurse to monitor blood pressure blood pressure in clients receiving antipsychotic drugs? Orthostatic hypotension is a common side effect Most antipsychotic drugs cause elevated blood pressure This provides information on the amount of sodium allowed in the diet It will indicate the need to institute antiparkinsonian drugs
Correct answer: Orthostatic hypotension is a common side effect Clients should be made aware of the possibility of dizziness & syncope from postural hypotension for about an hour after receiving medication
The nurse has given discharge instructions to parents of a child on phenytoin (Dilantin). Which of the following statements suggests that the teaching was effective? "We will call the health care provider if the child develops acne." "Our child should brush & floss carefully after every meal." "we will skip the next dose if vomiting or fever occur.' "When our child is seizure-free for 6 months, we can stop the medication."
Correct answer: Our child should brush & floss carefully after every meal. Phenytoin causes lymphoid hyperplasia that is most noticeable in the gums. Frequent gum message & carefully attention to good oral hygiene may reduce the gingival hyperplasia
A client diagnosed with cirrhosis of the liver & ascites is receiving Spironolactone (aldactone). The nurse understands that this medication spares elimination of which element? Sodium Potassium Phosphate Albumin
Correct answer: Potassium If ascites is present in the client with cirrhosis of the liver, potassium-sparing diuretics such as Aldactone should be administered because it inhibits the actin of aldosterone on the kidneys
A client is receiving intravenous heparin therapy. What medication should the nurse have available in the event of an overdose of heparin? Protamine Amicar Imferon Diltiazem
Correct answer: Protamine Protamine binds heparin making it ineffective
A client is being discharged with a prescription for chlorpromazine (Thorazine). Before leaving for home, which of these findings should the nurse teach the client to report? Change in libido, breast enlargement Sore throat, fever Abdominal pain, nausea, diarrhea Dsypnea, nasal congestion
Correct answer: Sore throat, fever A sore throat & fever may be symptoms of agranulocytosis, a side effect of chlorpromazine (Thorazine)
The nurse is caring for a client receive a blood transfusion who develops urticarial one - half hour after the transfusion has begun. What is the first action the nurse should take? Stop the infusion Slow the rate of infusion Take vital signs & observe for further deterioration Administer Benadryle & continue the infusion
Correct answer: Stop the infusion This is an indication of an allergy to the plasma protein. The first action of the nurse to stop the transfusion.
Discharge instructions for a client taking alprazolam (Xanax) should include which of the following? Sedative hypnotics are effective analgesics Sudden cessation of alprazolam (Xanax) can cause rebound insomnia & nightmares Caffeine beverages can increase the effect of sedative hypnotics Avoidance of excessive & high temperature is recommended
Correct answer: Sudden cessation of alprazolam (Xanax) can cause rebound insomnia & nightmares
An antibiotic IM injection for a 2 year old child is ordered. The total volume of the injection equals 2.0 ml. The correct action is to? administer the medication in 2 separate injections give the medication in the dorsal gluteal site call to get a smaller volume ordered check with pharmacy for a liquid form of the medication
Correct answer: administer the medication in 2 separate injections Intramuscular injections should not exceed a volume of 1ml of small children. Medication doses exceeding this volume should be split into 2 separate injections of 1.0ml each. In adults the maximum intramuscular injection volume is 5 ml per site
A client with amyotrophic lateral sclerosis has percutaneous endoscopic gastrostomy (PEG) tube for the administration of feeding & medications. Which nursing action is appropriate? pulverize all medications to a powdery condition squeeze the tube before using it to break up stagnant liquids cleanse the skin around the tube daily with hydrogen peroxide flush adequately with water before & after using the tube
Correct answer: flush adequately with water before & after using the tube Flushing the tube before and after use not only provides for good flow & keeps the tube patent, it also provides water to maintain hydration. While medications should be crushed to pass through the tube, it is flushing that moves them through. Stagnant liquids are reduced by flushing after tube use. Cleansing is important, but soap & water are sufficient without the added irritation of hydrogen peroxide.
The nurse receives an order to give a client iron by deep injection. The nurse know that the reason for this route is to? enhance absorption of the medication ensure that the entire dose of medication is given provide more even distribution of the drug prevent the drug from tissue irritation
Correct answer: prevent the drug from tissue irritation Deep injection or Z-track is a special method of giving medications via the intramuscular route. Use of this technique prevents irritating or staining medications from being tracked through tissue. Use of Z-track does not affect dose, absorption or distribution of the drug.
MNEMONICS What is the mnemonic for Bradycardia & hypotension
IDEA I: ISOPROTERENOL - Acts on beta2-adrenergic receptors, causing relaxation of bronchial smooth muscle; acts on beta1-adrenergic receptors in heat, causing positive inotropic & chronotropic effects & increasing cardia output. Also lowers peripheral vascular resistance in skeletal muscle & inhibits antigen-induced histamine release D: DOPAMINE - Causes norepinephrine release (mainly on dopaminergic receptors) leads to vasodilation of renal & mesenteric arteries. Also exerts inotropic effects on heart, which increases the heart rate, blood flow, myocardial contractility & stoke volume. E: EPINEPHRINE - Stimulates Alpha & beta-adrenergic receptors, causing relaxation of cardiac & bronchial smooth muscle & dilation of skeletal muscles. Also decreases aqueous humor production, increases aqueous outflow, & dilates pupils by contracting dilator muscle. A: ATROPINE SULFATE - Acts on beta2-adrenergic receptors, causing relaxation of bronchial smooth muscle, acts on beta1-adrenergic receptors in heart, causing positive inotropic & chronotropic effects & increasing cardiac output. Also lowers peripheral vascular resistance in skeletal muscle & inhibits antigen-induced histamine release.
MNEMONICS What is the mnemonic for Emergency Drugs to "LEAN" on
LEAN L: LIDOCAINE - ACTION: Suppresses automaticity of ventricular cells, decreasing diastolic depolarization & increasing ventricular fibrillation threshold. Produces local anesthesia by reducing sodium permeability of sensory nerves, which blocks impulse generation & conduction. USES: Ventricular arrhythmias, topical/local anesthetic E: EPINEPHRINE - ACTION: Stimulates alpha & beta -adrenergic receptors, causing relaxation of cardiac & bronchial smooth muscle & dilation of skeletal muscles. USES: Bronchodilation; anaphylaxis; hypersensitivity reaction; acute asthma attack; chronic simple glaucoma A: ATROPINE SULFATE - ACTION: Inhibits acetylcholine at parasympathetic neuroeffector junction of smooth muscle & cardiac muscle, blocking sinoatrial (SA) and atrioventricular (AV) nodes to increase impulse conduction & raise heart rate. USES: Decreases respiratory secretions, treats sinus bradycardia, reverses effects of anticholinesterase medication N: NARCON - ACTION: Used to treat an opioid emergency such as an overdose or a possible overdose of a narcotic medicine. USES : Opioid-induced toxicity, opioid-induced respiratory depression; used in neonates to counteract or treat effects from narcotics given to mother during labor,
MNEMONICS What is the mnemonic for Morphine
MORPHINE M: Myosis O: Out of it (sedation) R: Respiratory depression P: Pneumonia (aspiration) H: Hypotension I: Infrequency (constipation, urinary retention) N: Nausea E: Emesis Morphine interacts with opioid receptor sites, primarily in limbic system, thalamus & spinal cord, this alters neurotransmitter release, altering perception of & tolerance for pain. If side - effects occur, opioid rotation may be used for managing opioid induced adverse effects.
Nitroglycerin Why is it used? Quick methods? Slow methods?
Relaxes the vascular smooth muscle to decrease blood pressure & maintain an effective coronary perfusion pressure Quick - sublingual tabs - translingual spray Slow - nitro-bid (Patch) - nitro oinments - sustained release tabs
MNEMONICS What is the mnemonic for Lidocaine
SAMS S: SLURRED SPEECH A: ALTERED CENTRAL NERVOUS SYSTEM M: MUSCLE TWITCHING S: SEIZURES Lidocaine is a class IB antiarrhythmic used as a second-line agent & after a myocardial infarction. Therapeutic drug range for lidocaine is 1.5-5.0 mcg/ml. While generally safe lidocaine can be toxic if administered inappropriately & in some cases may cause unintended reactions even when properly administered. Lidocaine toxicity is seen at levels greater than 5 mcg/ml.
MNEMONICS What is the mnemonic for Oral Birth Control Pills
Sea Cash S: SEVERE LEG PAIN E: EYE PROBLEMS A: ABDOMINAL PAIN C: CHEST PAIN A: ACNE S: SWELLING OF ANKLES & FEET H: HEADACHES (SEVERE) Some women experience side effects with "the pill" such as irregular periods, nausea, headaches or weight change.
MNEMONICS What is the mnemonic for Medication administration checklist
TRAMP T: TIME - check the order for when it would be given & when was the last time it was given R: ROUTE - oral, IV, SQ, IM etc A: AMOUNT - check medication sheet & the doctor's order before medicating. Be aware of the difference of an adult & pediatric does M: MEDICATION - check & verify if it's the right name & form. Beware of look-alike & sound-alike medication names P: PATIENT - Ask the name of the client & check their ID band before giving the medication. Even if you know the patient's name, you still need to ask just to verify. Medical administration errors (MAEs) shows an error rate of 60%, 34% mainly in the form of wrong time, wrong rate or wrong does. Before dispensing medication, ensure the correct TRAMP
Aldactone What to watch for? What does it do? Why is it important?
Watch for - headache - diarrhea - kyperkalemia - electrolyte imbalance - fatigue - GI distrurbance Blocks the aldosterone in the kidneys, get rid of the sodium & water but saves the potassium Too little or too much potassium will cause weakness in muscle including the heart
