ATI pharm

How do SSRIs and SNRIs work?

- they block the neurotransmitter reuptake pumps located on the presynaptic membrane so that the neurotransmitter stays in the synapse longer - is considered the "energizer bunny" because energy level improves quickly

A nurse is providing teaching to a client who has a prescription for chlorpromazine, Which of the following instructions should the nurse include? A. Stop taking the drug immediately at the first sign of a sore throat. b. Wear sunscreen when exposed to sunlight. C. Take the drug with food to reduce GI distress D. Take the drug in the morning to prevent nocturia

Chlorpromazine is a conventional antipsychotic B. Chlorpromazine can cause photosensitivity

Five important uses of carbazepine CARBA

Classify as a traditional agent Autoinduces metabolism to decrease concentrations Reduce seizures Bipolar disorder treatment A long time to steady state. May take up to a month for full effectiveness.

-triptyline

"trips up depression" tricyclic antidepressant

A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The primary healthcare provider prescribes the antocholinergeric medication benztropine 2 mg. daily. When symptoms should the nurse inquire about when assessing the patient? A. Constipation B. Hypertension C. Increased salivation D. Excessive perspiration

A the anticholinergic activity of each medication is magnified and adverse effects such as paralytic ilus may occur. Hypotension, not hypertension, occurs with anticholinergic medications.

The nurse is teaching a client about trycyclic antidepressants. Which potential side effects would the nurse include? Select all that apply. A. Dry mouth. B. Drowsienss C. Constipation D. Severe hypertension E. Orthostatic hypotension

A, B, C, E

Which are the adverse effects of mirtazapine? Select all that aply? A. Asthenia B. Dyskinesia C. Drowsiness D. Gynocomastia E. Abnormal dreams

A, C, E

A nurse is caring for a client who is taking acetaminophen and codeine or pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (select all that apply) A. Client can achieve desired effects with the use of lower dosages. B. Taking the two drugs together can reduce the effects of one or both of the drugs. C. Taking the two drugs together can potentiate the effects of one or both of the drugs. D. The two drugs can produce an action neither would have produced alone. E. Both drugs have similar actions

A, E When two or more drugs are given at the same time and have similar actions, an additive effect will occur. Clients can take some drugs together for their additive effects, so they can take lower doses of each drug. Drugs that interact together to cause reduced effects are called antagonistic Drugs that interact together to cause greatly increased effects are synergistic. Two drugs given together can produce a unique effect neither would have produced when taken alone, However, this is not an additive effect. Additive effects occur when two or more drugs with similar actions are taken at the same time.

Which medications are used as the first-line treatment for PTSD? Select all that apply. A. Sertraline B. Paroxetine C. Phenelzine D. Venlafaxine E. Amitripyline

A,B

A nurse is caring for a client who has a new prescription for transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. The nurse should explain that this drug combination includes which of the following therapeutic effects? (Select all that apply) A. Reduces risk of ovarian cancer B. Relieves hot flashes C. Prevents osteoporosis D. Reduces the risk of breast cancer E. Reduces the risk of thromboembolism

A,B,C,E

A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? (Select all that apply) A. Rash B. Distorted taste C. Swelling of the tongue D. Photosensitivity E. Dry cough

A,B,C,E

Which antipsychotic medication has the highest risk of tardive dyskinesia? Select all that apply. A. Loxapine B. Quetipine C. Haloperidol D. Ziprasidone E. Olanzapine

A,C First-generation antipsychotic medications such as loxapine and haloperidol may cause tardive dyskinesia, and extrapyrimidal reaction

Which atypical antipsychotic is approved for longterm use to prevent the recurrence of mood episodes in clients with bipolar disease? Select all that apply. A. Olanzapine B. Quetiapine C. Ziprasidone D. Ripseridone E. Aripiprazole

A,C,E

A nurse is caring for a client who is experiencing an acute ischemic cerovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer? A. Alteplase B. Aspirin C. Clopidogrel D. Heparin

A. Alteplase is a Thrombolytics drugs, meaning is can dissolve existing thrombi.

A nurse is teaching a patient who has a new prescription for methotrexate. The nurse should instruct the patient to monitor for manifestations of which of the following conditions? A. Gout B. Constipation C. Insomnia D. Hirsutism

A. An adverse effect of methotrexate is hyperuricemia, which causes gout. Diarrhea is an adverse effect, not constipatoin Drowsiness is an effect, not insomnia Alopecia is an effect, not hirsutism

A nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. Which of the following findings should indicate to the nurse to monitor for lithium toxicity? A Furosemide for hypertension B. Acetaminophen for headaches C. Ciprofloxacinfor a UTI D. Montelukast for asthma

A. Furosemide increases sodium loss and can cause lithium reabsorption. The nurse should evaluate the client for lithium toxicity Acetaminophen does not increase lithium levels. However, NSAIDs such as ibuprofen can cause lithium reabsorption and toxicity Risk of toxicity increases with tetracyclines, not quinolone antibiotics

A nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions? A. Acute myocardial infarction B. Peripheral vascular disease C. Ulcerative colitis D. Ventricular tachycardia

A. Milrinone, a phosphodiesterase inhibitor, is contraindicated for clients who has had an acute MI and aortic or pulmonary valve disorders PVD is a contraindication for atenolol UC is a contraindication for resperdine V-tac is a contraindication for dobutamine

A nurse is teaching a client who has prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug. A. Begin taking the drug at a low dosage. B. Discontinue the drug immediately if diarrhea occurs C. Have serum glucose levels checked regularly D. Take the drug on an empty stomach

A. Visual disturbances, vertigo, and ataxia can result from taking carbamazepine. Dosages should be low to minimize or prevents these adverse effects. Carbamazepine alters liver function, not glucose

Which antidepressant medication is a selective monoamine oxidase-B inhibitor? A. Selegiline B. Phenelizine C. Isocarboxazid D. Tranylcypromine

A. The other 3 are non selective

A nurse is teaching a client who is about to begin sumtriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects. A. Chest pain. B. Polyuria C. Joint pain D. Insomnia

A. Can cause coronary vasospasm and chest pain. Client should report any pressure, pain, or tightness in the jaw, chest, or back. Sumatriptan is not an appropriate choice for clients who have a history of CAD Lithium causes polyuria Sumatriptan is more likely to cause muscle pain than joint pain Causes drowsiness and sedation, not insomnia

A nurse is caring for an older client who has kidney disease and a new prescription for cimetidine. The nurse should instruct the client to report which of the following manifestation. A. Lethargy B. Cellulitis C. Dry mouth D. Myalgia

A. Cimetidine is an H2 agonist that can potentially cross the blood brain barrier. Older clients are at risk of CNS depressive effects Does not cause cellulitis, but can cause risk, alopecia, and Steven's-Johnson syndrome Does not cause myalgia but can exacerbate joint pain in patients with arthritis.

A nurse is caring for a patient who is taking atorvastin and has a new prescription for gemfibroil. The nurse should recognize that this drug combination places the client at an increased risk for which of the following adverse effects? A. Myopathy B. Hypoglycemia C. Irregular pulse D. Kidney Failure

A. Concurrent use of statins and fabric acid derivatives can increase risk for myopathy Atorvastatin alone can cause hypoglycemia Atorvastatin can cause chest pain, not irregular pulse Atorvastatin can cause pancreatitis, not kidney failure

A nurse is preparing to administer dextromethorphan to a client with a common cold. Which symptom is this medication used to treat? A. Non-productive cough B. Chest congestion C. Rhinitis D. Watery Eyes

A. Dextromethorphan is an anti-tussive prescribed to treat a non-productive cough. It acts by suppressing the cough reflex at the level of the cough control center.

A nurse is caring for a client who has a new prescription for etanercept. Which of the following actions should the nurse take? A. Administer a tuberculin test prior to starting the medication B. Teach the client that fevers are common when taking this medication C. Determine if the client has chronic hypertension D. Mix the medication with methotrexate prior to administration

A. Etanercept is contraindicated for client who have a history of exposure to tuberculosis Fevers should be immediately reported to the provider Etanercept does not have cardiac effects Etanercept should not be mixed with other solutions because of syringe incompatibility

Which condition contraindicates the use of herbal ginseng therapy? A. pregnancy B. Schizophrenia C. Bipolar depression D. Alzheimer disease

A. Schizophrenia, bipolar depression, and alzheimer's disease are contraindicated for st. john's wort therapy

A nurse is teaching a client who has a new prescription for quinidine. Which of the following teaching should the nurse include. A. Monitor your heart and pulse rate and report changes B. Remain upright for 30 minutes after taking this medication C. This medication can increase digoxin levels D. The medication can cause urinary incontinence

A. Sodium channel blockers can worsen dysrhythmias or cause new ones.

A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported? A. Facial edema B. Sleepiness C. Peripheral edema D. Constipatio

A. Losartan, an angiotensin II blocker can cause angioedema, which manifests as swelling around the eyes and lips Losartan causes insomnia, not drowsiness Losartan is used to treat peripheral edema Losartan can cause diarrhea

A nurse is caring for a client who has depressive disorder and requires a prescription drug to treat hypertension. The nurse should recognize that which of the following anti hyper intensive drugs is contraindicated for this client? A. Resperdine B. Captopril C. Hydralazine D. Eplerone

A. Severe depression and an increased risk for suicide are adverse effects of adrenergic neuron blockers.

A client is starting to take amtripyline. For which of the following should you instruct the client to watch for and report? A. Blurred vision B. Urinary hesitancy C. Diarrhea D. Joint Pain E. Tachycardia

Amtripyline is a tricyclic antidepressant that can cause effects such as blurred vision, urinary hesitancy, dry mouth, constipation, sedation, and tachycardia. It is more likely to cause constipation than diarrhea, and is more likely to cause headache than joint pain.

Andticholinergic side effects ABDUCT WATER

Anhidrosis, lack of sweating Blurry vision, secondary to dry eyes Dry mouth, or xerostomia Urinary retention Constipation Tachycardia

Which medication is contraindicated in a pregnant client? A. Sertraline B. Paroxetine C. Venlafaxine D. Desipramine

B

Which medications would the nurse identify as commonly used as an adjunct during conscious sedation for minor surgeries? A. Diazepam B. Midazolam C. Lorazepam D. Clonazepam

B When used in conjunction with an opioid analgesic, midazolam causes conscious sedation. Diazpam and lorazepam are used for anesthetic induction, preanesthetic medication, and the productino of conscious dedation when used in conjunction with opioid analgesics

When reviewing the indications for various antidepressants, a nurse should identify that buprion hydrochloride is an appropriate choice for clients who have which of the following (check all that apply) A. Motion sickness B. Seasonal affective disorder C. insomnia D. Nicotine Addiction E. Depression

B, D, E Bupropion can cause nausea, vomiting, and constipation. It does not treat or prevent motion sickness Bupropion helps prevent and treat seasonal affective disorder. Bupropion can cause insomnia and agitation. Bupropion is an appropriate adjunct for clients who are trying to quit smoking

A nurse is assessing a client who has a new prescription for oxybutynin to treat neurogenic bladder. Which of the following assessment findings should the nurse identify as an adverse effect of this drug? A. Diaphoresis B. Dilated pupils C. Dizziness D. Distended bladder E. Fever

B,C,D,E Oxybutynin, an anticholinergic, can suppress sweating

A client is discussing symptoms that occurred after taking montelukast, Which symptoms suggests that the client may be experiencing a common side effect of the medication? A. Bradycardia B. Headache C. Swollen neck lymph nodes D. Blue-tinged lips

B. Clients taking leukotriene modifiers may experience flu-like symptoms such as headache, fever, cough, or sore throat. Leukotriene modifiers slightly increase white blood cells in the body, which fight infection. The white blood cells produce the symptoms of the flu

A client with schiophrenia is given an antipsychotic medication. Which adverse effect would lead to this medication being discontinued? A. Akathisia B. Tardive dyskinesia C. Parkinsonian syndrome D. Acute dystonia reaction

B. Tardive dyskinesia is characterized by protrusion and vermicular movements of the tongue, chewing and puckering movements of the mouth, and a puffing of the cheeks. These side effects may or may not be reversible once the medication is withdrawn.

A nurse should recognize that clopidogrel is contraindicated for which of the following conditions? A. MI B. PUD C. Pancreatitis D. Myasthenia gravis

B. Clients who have PUD should not take clipidogrel because it can cause gastric bleeding Clopidogrel can be used to prevent clot formation for clients who have had recent MI or CVA Clopidogrel is contraindicated in clients who have hemophilia or other bleeding disorder, thrombocytopenia, or intracranial bleeding

A nurse should identify that a client who has DM and is taking etanercept is at an increased risk for which of the following adverse effects? A. Kidney toxicity B. Infection C. Gout D. Deep-vein thrombosis

B. Etanercept increases risk for infection, as does DM Kidney toxicity is associated with the use of methotrexate Raloxifene, a SERM, can cause deep vein thrombosis

A nurse should recognize that which of the following drugs is only used for the short-term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long-term use. A. Quinidine B. Procainamide C. Nitroglycerin D. Verapamil

B. Procainamide risks for long term use include cardio toxicity and arterial embolism

Which of the following is a therapeutic action of raloxifene? A. Blocks the effects of estrogen on endometrial tissue B. Mimics the effects of estrogen on bone tissue C. Stimulates secretion of parathyroid hormone. D. Stimulates menstruation

B. Raloxifene mimics the effect of estrogen on bone tissue, minimizing or stopping bone loss.

A nurse is caring for a patient who is about to begin taking folic acid to treat megaloblastic anemia. The nurse should monitor which of the following laboratory values to determine therapeutic effectiveness? A. Amylase level B. Reticulocyte count C. C-reactive protein D. Creatinine clearance

B. Reticulocyte counts measures the amount of immature RBCs. Folic acid is essential for erythropoiesis

A nurse is preparing to administer a first time dose of albuterol to a client with COPD. Which aspect of the client's health history is a reason to administer the medication with extra caution? A. Chronic Kidney Disease B. DM C. Asthma D. Constipation

B. Should be used with caution in patients with DM. Albuterol can increase the level of glucose in the body because the medication mimics epinephrine. Epinephrine causes the liver to release glucose in the blood stream.

A client is prescribed an MAOI for depression. The nurse includes teaching on foods and medications known to cause serious adverse effects when used in combination with MAOIs. Which adverse effect should the nurse include in the teaching plan? A. A serious drop in blood pressure B. serious increase in BP C. Significant increase in liver enzymes D. Significant increase in cholesterol levels

B. When taken with foods high in tyramine (eg pickled foods, beer, wine, aged cheeses), medications such as antidepressants, certain pain medications, and decongestants can cause a life-threatening increase in blood pressure or hypertensive crisis.

A client with schizophrenia is actively psychotic. Which medication will be the most helpful to manage the psychotic signs and symptoms? A. Citalopram B. Ziprasidone C. Bezotropine D. Acetaminophen with hydrocodone

B. Ziprasidone is a neuroleptic that reduces psychosis by affecting the action of both dopamine and serotonin.

A nurse is caring for a patient who is about to begin alteplase therapy to treat PE. Which of the following drugs should the nurse have available in the event of a severe adverse reaction? A. Vitamin K B. Aminocaproic acid C. Protamine D. Deferoxamine

B. Aminocaproic acid, a coagulator, inhibits fibrinolysis and stops excessive fibrinolytic bleeding

A nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine IV. Which of the following client findings should the nurse monitor after administering the medication? A. BUN B. Blood pressure C. Urine specific gravity D. Pedal pulse strength

B. risk of hypotensions during and immediately after IV administation. Client should remain supine for 30 minutes while the nurse monitors their BP

SNRI side effects BAD SNRI

BP increase anorexia Drowsiness/dry mouth Sexual dysfunction/serotonin syndrome Nausea/vomiting Reduction in sodium levels Increased suicidal thoughts/insomnia

-barbital

Barbiturates (sedative-hypnotics) CNS depressant

Local anesthesia mnemonic BLOCK

Benzocaine Lidocaine O Cocaine K Local anesthetics block action potentials traveling down an axon, so they prevent pain signals from going to and from your brain.

-zepam

Benzodiazepine

-zolam

Benzodiazepine

SSRI side effects: BAD SSRI

Body weight increase Abdominal Pain Drowsiness Sexual dysfunction serotonin syndrome REduction in Na+ Increased suicidal thoughts 18-24 years old

Which medication is used to treat both generalized anxiety disoder and depression? A. Fluoxetine B. bupropion C. Duloxetine D. Mirtzapine

C

A client diagnosed with schizophrenia was prescribed antipsychotic medications and developed extrapyrimidal symptoms. Which medication might be responsible for these symptoms? Select all that apply. A. Clozapine B. Olanzapine C. Perphenazine D. Fluphenazine E. Trifluoperazine

C,D,E First-generation antipsychotic medications with a high risk of extrapyrimidal symptoms Second-generation antipsychotics like clozapine and olanzapine have a lower risk of extrapyrimidal symptoms

Which laboratory tests should you monitor for a client who is taking interferon beta-1 to treat multiple sclerosis? A. Serum osmalality B. Blood glucose C. Thyroid hormone D. Liver function E. CBC

C,D,E interfereon beta 1b, an immunosuppresant, may cause hepatotoxicity and myelosuppression. Monitor liver studies and complete blood counts. The client should undergo thyroid function tests every 6 months. This drug is unlike to alter serum osmolality or glucose levels, but can elevate serum creatinine and alter serum electrolytes

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? (Select all that apply) A. Apply a new patch at the onset of anginal pain B. Apply the patch to dry skin and cover the area with plastic wrap C. Apply the patch to a hairless area and rotate sites. D. Apply a new patch when you start your day E. Remove patches for 10 to 12 hours each day.

C,D,E Hair can interfere with the adhesion of patch Therapeutic effects begin 30 to 60 minutes after application and last up to 14 hours. Removing the patches for 10 to 12 hours each day prevents the development of tolerance to the drug.

Which second generation antidepressant can worsen uncontrolled angle-closure glaucoma A. Trazodone B. Buprion C. Duloxetine D. Mirtzpine

C.

Which reason explains why so many psychiatric clients are given benzotropine or trihexyphenidyl in conjunction with phenothiazine-derivative neuropletic medications? A. They reduce postural hypotension B. They potentiate the effects of the neuroleptic medication C. They combat the extrapyrimidal side effects of the neuroleptic medicatio D. They ameliorate the depression that may accompany schizophrenia

C. Benzotropine and trihexyphenidyl control the extrapyrimidal (parkinsonian) manifestations associated with the neuroleptics that are classified as anti-parkinson's medication.

Which condition is contraindicated for St. John's wart therapy? A. Anxiety B. Seizures C. Dementia D. Cardiac Disease

C. I

A nurse caring for a client who has a new prescription for aldosterone to treat IBS. The nurse should instruct the client to report which of the following adverse effects of the drug? A. Headache B. Drowsiness C. Abdominal Pain D. Sore throat

C. Alosetron can cause ischemic colitis. The nurse should tell the client to report abdominal pain, bloody diarrhea, or rectal bleeding and to discontinue medication if these manifestations occur Ondansetron causes headaches Alosetron is more likely to cause anxiety than drowsiness Sulfasalazine has adverse effects including sore throat and fatigue

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of the following adverse effects? A. Slow heart rate B. Cough C. Diarrhea D. Hearing loss

C. Diarrhea, nausea, and vomiting are adverse effects of dantrolene. The client should report those and monitor fluid balance accodingly. Dantrolene is more likely to cause tachycardia than bradycardia Dantrolene causes difficulty swallowing, not coughing Causes blurred vision, not hearing loss

A nurse is obtaining a client's health history. The client reports no allergies, but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse take? A. itching is an expected adverse effect of amoxicillin B. itching can indicate amoxicillin toxicity C. Itching can indicate a hypersensitivity to amoxicillin D. Itching can result from dry skin, which is often caused by amoxicillin.

C. Itching can be an indication of drug hypersensitivity, and a more severe allergic reaction can develop with future exposures. The client might be allergic to amoxicillin and other penicillins.

During an assessment of a client taking chlorpromazine, you note a slow, shuffling gait, rigid facial expression, and fine tremors. These manifestations indicate which of the following? a. acute dystonia B. Tardive dyskinesia C. Parkinsonism D. Akathisia

C. Parkinsonism, an adverse effect of antipsychotic drugs, manifests as shuffling gait, drooling, and tremors. Acute dystonia manifests as acute muscle spasms of the face, neck, and back. Tardive dyskinesia manifests as involuntary movements that include smacking the lips and flicking the tongue. Akathisia manifests as constant, uncontrolled movement.

While obtaining a client's medical history, you find that the client is taking levodopa/carbidopa for Parkinson's disease. Which information in the client's health history alerts you to take further action. A. Bradycardia B. Pancreatic disease C. Glaucoma D. Impaired hearing

C. The combination of two dopamine-replacement drugs can cause changes in intraocular pressure. Pancreatic disorders are not contraindication for levodopa/carbidopa; instead, caution is required when using it with clients who have PUD. Hearing impairment is not a contraindication; instead it can cause a variety of vision disturbances.

A nurse is caring for a client who is taking codeine. The nurse should identify which of the following assessments is priority? A. Blood Pressure B. Apical heart rate C Respirations D. LOC

C. The greatest is to clients taking an opioid agonist is respiratory depression

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values indicates to the nurse that the therapy is effective? A. PT B. WBC C. HgB D. Platelets

C. Epoetin, an erythropoietic growth factor, increases the production of RBCs for clients who have anemia due to chronic renal failure or chemotherapy. HgB and Hct should increase with effective therapy

A nurse is teaching a client about methotrexate. The nurse should inform the client to monitor for which of the following as an adverse effect of this drug? A. Muscle Pain B. Peripheral Edema C. Black, tarry stools D. Redness in calf

C. Methotrexate can cause GI ulceration, which can lead to perforation and bleeding. Muscle pain is an adverse effect of methotrexate Peripheral edema can indicate heart failure, which is an adverse effect of etanercept, a DMARDII Redness in the calf is an adverse effect of raloxifene, a SERM

A client receiving fluphenazine decanoat develops dystoia early in therapy. Which medication would the nurse anticipate adminsitering to reverse this side effect? A. Nafarelin B. Fluoxetine C. Trandolapril D. Benztropine

D

Which medication is used for treating OCD? A. Imipramine B. Lithium Salts C. Amtriptyline D. Clomipramine

D

Which patient condition would contraindicate the use of the medication clozapine? A. Seizures B. Glaucoma C. Dysrhythmias D. Bone marrow depression

D

Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid? A. mydriasis B. Bradycardia C. Hypothermia D. Circulatory collapse

D

Which medication may lead to bruxism A. Vilazodone B. Isocarboxazid C. Clomipramine D. Levlomilnacipran

D SSRIs and SNRIs may lead to bruxisms.

A nurse is caring for a patient whohas been taking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following? A. Frequent urination B. jaundice C. Cellulitis D. Muscle rigidity

D Interaction can result in rigidity, stupor, agitation, and fever

Which medication is considered a typical antipsychotic? Select all that apply. A. Asenapine B. Lurasidone C. Aripiprazole D. Thioridazine E. Chlopromazine

D, E

A nurse is teaching a patient who has alzheimers disease and their caregiver about memantine. Which of the following instructions should the nurse include? A. Increase fluid intake to improve renal function B. Report memory loss or confusion C. Watch for signs of liver impairment, such as jaundice and abdominal pain D. Avoid taking over the counter antacids

D. Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity.

A nurse is reviewing the medication record of a client who is receiving alteplase following an acute myocardial infarction. Which of the following medications should the nurse expect the client to be taking in addition to the alteplase? A. Protamine B. Desmopressin C. Ferrous Sulfate D. Heparin

D. Heparin therapy should be initiated before alteplase therapy and continued for 48 to 72 hours after the fibronlytic therapy to reduce the risk of additional clot formation.

Which class of medication would the nurse anticipate preparing to administer to a client with alcohol dependance admitted to a detoxification unit? A. Opiate B. Antipsychotic C. Antidepressant D. Benzodiazepine

D. Benzodiazepines are indicated for the treatment of alcohol withdrawal because they help prevents seizures and calm the vital signs.

A nurse is teaching the family of a client who has a new diagnosis of alzheimer's disease about donepezil. Which of the following information should the nurse include? A. Monitor for constipation. B. The dosage will be increased after 1 to 3 months of taking the initial dose to minimize adverse effects C. Administering the drg first thing in the morning promotes effectiveness. D. Avoid the use of NSAIDs for pain

D. Combining NSAIDs with donepazil can cause GI bleeding. Donepezil causes diarrhea, not constipation Should be taken immediately before going to bed because it causes drowsiness and dizziness Donepezil's dose are only increased after 1 to 3 months of taking the initial dose to minimize adverse effects

A nurse is preparing to administer alendronate to a client who has osteoporosis. The nurse should recognize which of the following as an adverse effect of alendronate? A. Venous thromboembolism B. Ventricular dysrythmias C. Breast cancer D. Joint Pain

D. Alendronate causes joint pain which can be treated with analgesics Roloxifene increases risk of DVT Alendronate causes atrial fibrillation

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? A. Increases leukocyte activity B. Blocks muscarinic receptors C. Causes bronchodilation D. Reduces inflammation

D. Cromolyn sodium is a mast cell stabilizer that reduces inflammation by inhibiting the inflammatory response

A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? A. Tachycardia B. Dehydration C. Diarrhea D. Hypotension

D. Large amounts of grapefruit can raise blood level of verapamil by inhibiting its metabolism, causing hypotension

A nurse is caring for a client who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms? A. Activating thromoxane A2 B. Blocker adenosine disphosphate receptor agonists C. Suppressing specific clotting factors D. inhibiting cyclooxygenase action in platelets

D. Salicylates work by inhibiting platelet aggregation by blocking the action of cyclooxygenase on platelets. As a result, activation of thromboxane a2 does not occur

A nurse is teaching a client who has a prescription for calcium citrate about manifestations of hypercalcemia. Which of the following manifestations should the nurse include in the teaching? A. Muscle Twitching B. Laryngospasm C. Parenthesis D. Vomiting

D. The nurse should teach the patient that hypercalcemia can occur when taking this drug. Manifestations of hypercalcemia include nausea, vomiting, flank pain, lethargy and deep bone pain. Muscle twitching is a manifestation of hypocalcemia Laryngospasm is a manifestation of hypocalcemia Parenthesis is a manifestation of hypocalcemia

A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? A. Check apical pulse before taking the drug B. Take the drug only has needed before exercising C. Rinse mouth after using the drug D. Have laboratory tests performed at regular intervals

D. Zileuton is a leukotriene modifier than can cause liver injury. The nurse should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment

A nurse is teaching a client about raloxifene therapy to prevent osteoporosis. The nurse should instruct the client to monitor for which of the following indications of an adverse drug reaction? A. Loss of Hair B. Numbness of the fingers C. Blisters on mucous membranes D. Calf pain

D. Calf pain Raloxifene can increase the risk of deep vein thrombosis, which can lead to a pulmonary embolism of CVA. Clients should avoid any prolonged periods of inactivity and report any pain, redness, or swelling in the calf. Alopecia is an adverse affect of methotrexate Numbness in fingertips can indicate hypocalcemia from calcitonin-salmon use Blisters on mucous membranes can indicate Steven's-Johnson syndrome, a serious skin disorder associated with etancercept, not raloxifene

Tricyclic and Tetracyclic antidepressants without Dopamine DoPAMINE

Doxepin Protriptyline Amitriptyline Mirtazepine Imipramine Nortriptyline

SNRIs DVD

Duloxetine Venlafaxine Desvenlafaxine

Lithium Side Effects LITHIUM

Leukocytosis Ion on periodic chart, sodium intake. "where the salt goeth, the lithium goeth too." Teratogen Hypothyroid Increased urine Unstable Monitor levels (narrow therapeutic level)

Emergency Medicine LEAN

Lidocain Epinephrine Atropine Nalaxone

SNRIs indications

MDD panic disorder generalized anxiety disorder Neuropathic pain associated with diabetes Fibromyalgia

SSRIs indications

MDD, anxiety, panic disorder, OCD, PTSD, bulimia, premenstrual dysphoric disorder

Early clinical manifestation of lithium toxicity include which of the following? A. Seizures B. Nausea C. Hypotension D. Ataxia E. Muscle Weakness

Nausea and muscle weakness are early indications of lithium toxicity. Other early findings include vomiting, fine muscle tremors, and thirst. Clients should report these manifestations immediately. Also, you should check serum lithium levels periodically. Seizure activity, hypotension, and ataxia are signs of advanced lithium toxicity.

MAOI Depression is the PITS

Phenelzine Isocarboxazid Tranylcypromine Selegiline

A Nurse is providing teaching for a client who has a prescription for phenelzine. The nurse should instruct the client to avoid tyramine-enriched foods because of an increased risk for which of the following adverse reactions? A. Respiratory depression. B. Hypertensive crisis C. Neuroleptic malignant syndrome. D. Serotonin Syndrome

Phenelzine is an MAOI B. Tyramine-enriched foods, such as aged cheese and processed meats, can trigger severe hypertension in clients who are taking phenelzine. Manifestations include hypertension, headache and nausea. Phenelzine is not likely to cause respiratory distress, but it can cause fatigue and weakness. Neuroleptic malignant syndrome is a serious effect of some antipsychotic drugs, such as haloperidol, but not of MAOIs. Manifestations include high ever, rigidity, vital-sign instability, and loss of consciousness

A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes. The nurse should monitor for which of the following findings? A. Joint pain B. Constipation C. Weight gain D. Dilated pupils

Pioglitazone can cause fluid retentions. Nurse should monitor for weight gain and other indications of fluid retention or heart failure, including dyspnea, crackles, and wheezing It is more likely to cause muscle pain than joint pain It more liked lay to cause diarrhea than constipation It is more likely to cause dilated pupils than blurred vision.

-Faxine

SNRI

-nacipram

SNRI/DNRI

-oxetine

SSRIs

-talopram

SSRIs

-zodone

SSRIs

Tricyclic antidepressant side effects SOB TCAs

Sedation Orthostatic hypotension Bodyweight increase Tachycardia Cardiotoxicity Anticholinergeric side effects Sexual dysfunction/seizures

SSRIs Sir Par Flew over the CIty to Escape

Sertraline Paroxetine Fluoxetine Fluvoxamine Citalopram Escitalopram

sirolimus

Similar to Tacrolimus, but inhibits *mTOR*-->decreased T cell proliferation

A client with a peanut allergy comes to the emergency department with suspected anaphylactic shocks. Which of the following actions should you anticipate taking? (select all that apply) A. Initiate oxygen therapy to support respiratory function B. Administer epinephrine to increase blood pressure C. Give Diphenhydramine to stop histamine release. D.Establish and maintain an open airway to ensure oxygenation. E. Administer a drug agonist to neutralize the allergic reation.

a, B, c, D When a client has an anaphylactic reacion, your priority is to establish an open airway and then to administer oxygen immediately. Give epinephrine to increase blood pressure and diphenhydramine to stop the release of histamine. Do not administer a drug agonist, because it would elicit an action in the body instead of blocking an action.

The nurse is educating a client about the use of inhaled bronchodilators for use at home. Which instruction(s) should the nurse include in the teaching? A. Report heart palpitations or chest pain to the provider B. He matures, diarrhea, and epigastric pain are common side effects C. Rinse your mouth after using your inhaler D. If you use another inhaler, use your bronchodilator first.

a,c,d,e

A nurse is providing teaching to a client who is about to begin amtriptyline therapy to treat major depressive disorder. Which of the following instructions should the nurse include? (Select all that apply) A. Change positions slowly from sitting or lying down to standing. B. Do not stop taking the drug abruptly C. Avoid crushing the tablet D. Take the drug at bedtime to prevent daytime drowsiness E. Increase fiber and fluid intake

amtriptyline is a tricyclic antidepressant A, B, D, E Amtriptyline can cause orthostatic hypotension Relapse and withdrawal symptoms can happen with abrupt discontinuation. Amtriptyline can cause drowsiness. This medication may be crushed if thepatient has difficulty swallowing the tablets. Amtriptyline causes anticholinergic effects such as dry mouth, constipation, and urinary retention.

-zolam, -zepam

benzodiazepines (i.e. diazepam/Valium, aprazolam/Xanax, lorazepam/Ativan) *for ANXIETY and ALCOHOL W/D; CNS DEPRESSANT (sedation, drowsiness); give at BEDTIME; reduce excessive CNS stimulation; watch RR

-caine

local anesthetic

Distribution

movement of drugs by the circulatory system to the site of action

Excretion

removal of a drug from the body; primarily occurs in the kidneys, but can also occur through the skin, lungs, bile, or feces

Metabolism

the change of a drug into a more of less potent or more soluble form after it passes through the liver, kidneys, intestinal mucosa, or other body part.

Absorption

the movement of a drug from its site of administration into the blood

trough drug level

the point in time when a drug is at its lowest level in the body

-pramine

tricyclic antidepressant (TCA)