pharm exam 1

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rhinitis

inflammation and irritation in the mucous membrane of the nose

UR- mucolytics adverse effects

nausea (smells like rotten eggs), increase secretions difficult to mobilize unless has strong cough

what would a pt show signs of hyperglycemia

nausea, polydipsia,

UR- expectorants teachings

no eating, drink 30 mins after taking, hydrate

Define euglycemia.

normal blood sugar

structures of the upper respiratory tract

nose, nasal cavity, pharynx, paranasal sinuses

UR- antiasthmatics teachings

not to be used as a rescue med, may take several weeks to feel full effects, do not use during pregnancy, eliminates asthma triggers

when should a medical reconciliation be completed

on admission to the hospital and before transporting to another facility

UR/LR - corticosteroids (systemic) adverse effects- route IH/IN

oral thrush, throat irritation, hoarseness

UR-decongestant generic prototype

oxymetazoline (Afrin), pseudoephedrine (Sudafed)

UR/LR - corticosteroids (systemic) generic prototype- route PO/IV

prednisone (deltasone), methylprednisolone (soul-medrol)

LR- bronchodilators teachings

proper use, take as directed, limit caffeine, no OTC meds, no smoking

for which condition is an oral hypoglycemic agent indicated

reduced insulin production

LR- parasympathetics (anticholinergic) moa

relaxes airways by blocking action of Ach in bronchial smooth muscle

LR-bronchodilators (sympathomimetics or adrenergic) moa

relaxes airways by stimulating beta 1 receptors in the smooth muscle of bronchi and bronchioles

LR- methylxanthines teachings

report persistent GI, check blood level (can easily OD), watch for signs of toxicity due to narrow therapeutic window

define insulin aspart

reverse rapid acting insulin (within 10-20 minutes) for ketoacidosis

LR- parasympathetics teachings

same as bronchodilators

UR- mucolytics therapeutic effects

secretions thinner, increase in mobilizing secretions, treats acetaminophen overdose, increase renal clearance of contrast dye

UR-antitussives adverse effect: non-opioids

sedation, dizziness, mild GI effects

UR-antihistamine adverse effect- central nervous system

sedation, dizziness, muscular weakness, seizures, restlessness, nervousness

Define thyroid storm

severe hyperthyroidism where the temp increases, heart rate increases, fever develops, and tachycardia occurs (can lead to congestive heart failure)

albuterol is what type of beta?

short acting beta agent that relax the smooth muscle

define glyburide

stimulates insulin production by the beta cells of the pancreas

pt teachings for levothyroxine

take dose same time each day, check blood levels often, refrain from switching brands

what happens when the body serum glucose drops below normal levels

the liver releases stored glycogen

LR- methylxanthines generic prototype

theophylline (easily OD), aminophylline

structures of the lower respiratory tract

trachea, bronchi, lungs

adverse effect of albuterol

tremors, palpitations, tachycardia

UR-antitussives teachings

use caution with pt with respiratory disease, no alcohol, take with meals

UR/LR- corticosteroids teachings

use properly IN, may take several wks to feel full effects

purpose of the lower respiratory tract

ventilation and gas exchange

when should a pt stop taking medication?

when the pt doctor who prescribe those meds tells them to stop

UR-1st generation antihistamine

works inside the CNS, dose 4-6 hours

UR-2nd generation antihistamine

works outside the CNS and takes longer duration of action, dose one a day, non-sedating

LR- methylxanthines moa

inhibits endogenous catecholamines (similar to caffeine), inhibits calcium movement into the smooth muscle, inhibits release of bronchoconstrictive substances

which insulin would a nurse prepare for emergency treatment of ketoacidosis

insulin aspart

which insulin has the slowest onset

insulin glargine

which insulin has the fastest onset

insulin lispro

why does insulin need to be stored in a room temperature room

insulin that is close to body constriction prevents vasocontraction at the site and decreases irritation of tissue

define prophylactic

intended to prevent disease

define NPH insulin

intermediate acting insulin (within 1-2 hrs) for ketoacidosis, safe for when mixing insulin

LR- parasympathetics generic prototype

ipratropium (atrovent)

UR/LR - corticosteroids (systemic) generic prototype- route IH/IN

beclomethasone (QVAR, beconase) ,budesonide (pulmicort)

what could be a predisposing factor of type 2 diabetes

being overweight

UR-antihistamine moa

blocks effects of histamines , blocks constrictions of bronchial, Suppresses exocrine gland secretions, suppresses cough

UR- antiasthmatics (leukotriene modifiers- antileukotriene) moa

blocks leukotriene receptors to decrease inflammation

what is used for isotonic solution?

lactate ringers and ringers

define glargine

long acting insulin (within 1.5 hrs) for ketoacidosis

define detemir insulin

long acting insulin for ketoacidosis

salmeterol is what type of beta?

long-acting beta agent that prevents/ maintenance

define hypoglycemia

low blood sugar

UR-antihistamine 2nd generation generic prototype

cetirizine (zyrtec)

what is the type of nursing intervention needed when there is a blood transfusion

check pt vital signs, check typing and crossmatching of blood, use Y type infusion set to initiate 0.9% saline

UR-decongestants moa

mimics the sympathetic system, constricts arterioles, decreases blood flow, decreases edema to nasal mucosa

UR- antiasthmatics generic prototype

monelukast (singulair)

adverse signs of steroid therapy

mood changes, increased appetite, weight gain

UR/LR - corticosteroids (systemic) adverse effects- route PO/IV

cushing syndrome, becomes dependent

UR-expectorants (help secretions exit) moa

decrease mucous adhesiveness and surface tension

UR/LR- corticosteroids adverse effects

nasal burning, nasal bleeding

UR- mucolytics (lysis mucous) moa

decrease viscosity of resp. secretions by altering molecular composition of mucous

LR/UR- corticosteroids (systemic) moa

decreases airway swelling, decrease mucous secretion, increases sensitivity to beta adrenergic receptors

UR- antiasthmatics therapeutic effect

decreases frequency of asthma attacks

UR-antihistamine teachings

0 alcohol uses, a CNS depressant, hydrate,

what are signs that a pt has diabetes insipidus

dehydration, dry mucous membranes, decrease urine specific gravity, poor skin turgor

signs a pt would have when they have a hyperfunctioning thyroid gland

diarrhea and weight loss

when should you obtain a blood sample to determine the peak level when administering meds by intravenous piggybacking

30-60 mins after

Define dyspnea

difficulty breathing

UR-antihistamine 1st generation generic prototype

diphenhydramine (benadryl)

UR/LR - corticosteroids (systemic) teachings- route PO/IV

do not abruptly stop taking, if do you can damage adrenals

UR/LR - corticosteroids (systemic) teachings- route IH/IN

do not overuse, rinse mouth after

UR-antihistamines adverse effect

dryness of mouth, nose, throat, urinary retention, vertigo, visual disturbances, tinnitus, headache

UR-antitussives (cough suppressants) moa

CA- suppresses cough PA- suppresses cough receptors in the throat, trachea, lungs

lethargy has what type of adverse effect

CNS depression

UR-antitussives adverse effect: opioids

CNS depression, N, V, C

LR- bronchodilators adverse effects

CNS stimulation, CV stimulation

LR- parasympathetics adverse effects

Cough, limits systemic absorption

what are signs of hyperthyroidism in pts

fatigue, dry skin, and progressive weight gain

what would a pt show signs of hypoglycemia

fatigue, weakness, nervousness, increased perspiration

UR- antiasthmatics adverse effect

HA, cough, nasal congestion, N, hepatotoxicity

UR-antihistamine adverse effect- cardiovascular system

HT, palpations, synacope

UR/LR- corticosteroids generic prototype

fluticasone (flonase, sensimist)

UR-expectorants generic prototype

guaifenesin (musinex)

insulin must be kept away from

heat and sunlight because it decrease its stability

define hyperglycemia

high blood sugar

LR- methylxanthines adverse effects

N, V, CNS stimulation, CV stimulation

UR-antihistamines adverse effect- GI system

N, V, D, constipation

Define hypotonic solution

higher osmolarity than body fluids, 5% dextrose in normal saline

purpose of the upper respiratory tract

humidify and filter air before it enters the lower respiratory tract

UR-antitussives generic prototype

Opioid: codeine, non-opioid: dextromethorphan (delsym, robitussin DM)

What does potassium chloride serve for pts with diabetic keto acidosis

Prevents hypokalemia

UR- mucolytics teachings

hydrate, often given with bronchodilator, active

what are the therapeutic effects of LR drugs

improve resp. status, increase O2 levels, lungs sound clear, decrease in anxiety, decreases bronchospasms

UR-decongestant adverse effect

increase blood flow of vital organs, decrease blood flow of non-vital organs, rebound congestion with IN route

T/F- Albuterol is used for acute asthma attack

T

T/F- avoid crowded areas when taking steroids

T

T/F- steroids can depress your immune system

T

T/F- steroids should be taken with foods or antacid to prevent ulcer formation

T

UR- expectorants adverse effects

increase drowsiness in large doses, N, V, D

UR- mucolytics generic prototype

acetylcysteine (mucomyst, acetadote)

LR- bronchodilators generic prototype

albuterol, salmeterol, epinephrine (epipen)

signs a pt would have when they have a hypofunction thyroid gland

anemia, decreased heart sounds and distant heart sounds

UR/LR- corticosteroids moa

anti-inflammatory- decreases nasal mucosal swelling, decreases nasal secretions

UR-decongestant teachings

avoid using more than 7 days, use with caution if have CVR disease, stay hydrated


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