Pharm Quiz Bowl Study Set

Antidepressants end in:

"oxetine"

Proton pump inhibitors PPIs end in GI meds

"prazole" ex omeprazole

Prostaglandins agonists end in:

"prost" ex latanoprost

5ht3 Receptors

"setron" ---thing megatron for bad nausea FOR CHEMO patients ex ondasetron

H2 blockers end in: GI

"tidine" ex ranitidine

Common antiviral drugs end in?

"vir"--- for the most part but amantadine(symmetrel) as the exception

Alpha blocker end in:

"zosin" ex prazosin

a patient has a temp of 38.1 C. What is the conversion of this temp to F. Round to the nearest thenth!

(38.1*9/5)+32=100.6F

What are the appropriate tests to monitor with Coumadin or Heparin?

**ALWAYS check baseline Vitals and coagulation lab results For Heparin: Get current PTT and aPTT must be 1.5-2.5 higher than normal For Warfarin: INR lab results before and after administration *The normal INR value is 0.8-1.2 a THERAPEUTIC RANGE for these patients is: 2.0-3.0 if they have a mechanical heart valve+2.5-3.5 bc of the increased risk of clots forming on the valve have ready vitamin K (phytonadione) *teach to be consistent with vitamin K foods such green leafy veggies *Both are used as anticoagulants (they decrease the ability to form clots but DO NOT dissolve clots that already exists remember only thrombolytics do aka clot busters)

What would be appropriate teaching about furosemide (Lasix)?

**BEFORE: check BP --remeber this med will lower BP if in double digits HOLD CHECK K+ levels HOLD IF LOW Make sure they are not dehydrated UNDER NORMAL CIRCUMSTANCES DRINK NORMAL fluids unless CHF or any disease where they are drownings in their own fluid remember low BP= orthostatic hypotension **ADNIN: 20mg / minute!!!! if 40 mg in the syringe then admin over 2 min! RAPID onset!! 60 min if oral and 5 min if IV can lead to incontinence Limit alcohol and exposure to SUN, Take potassium supplements ( with food; Increase potassium in diet Report ototoxicity (decrease in hearing, or ringing in the ears tinnitus) IF Diabetic---monitor blood glucose levels regularly bc it can cause HyPERglycemia.

What physiological parameters should be monitored prior to the administration of furosemide (Lasix)? * used for any condition where they have too much fluid in the body

**Check K+ levels, if low HOLD, CALL HCP, bc K+ levels will only get lower! and Na+ levels inform HCP if low! DOSE is 20 mg/min or longer- SLOWLY to prevent ototoxicity and BP changes. MOA: stops the sodium pumps in the nephron, excretes the sodium and water follows = more fluid excretion

What physiological parameters should be monitored prior to the administration of digoxin (Lanoxin)?

**Must check APICAL heart rate with a stethoscope for ONE FULL MINUTE! IF <60 bpm HOLD do not admin and notify HCP or >100 bpm **CHECK K+ levels, if low potassium HOLD ( a low K+ level increases the risk for digoxin toxicity. Rationale: APICAL pulse with stethoscope bc this drug can decrease the HR

What are essential nursing implications for patients taking anticonvulsants? What are the implications specific to phenytoin (Dilantin)?

*AVOID grapefruit juice- bc they increase the action of the drug and can lead to more s/e and a/e. *Teach patients receiving any antileisure drug about the importance of keeping follow-up appointments with HCP to monitor control of the seizures and having periodic laboratory tests done to monitor blood levels of these drugs. -caution for bleeding--ie surgeries, dental work -avoid driving due to dizziness/ drowsiness -suggest medical alert bracelet. For phenytoin (Dilantin)- GINGIVAL HYPERPLASIA: can cause extra growth of gum tissues =. Patients taking phenytoin (Dilantin) should see their dentist regularly

Provide Examples of each of the following: -Enteral route -Percutaneous route - Parental route

*Enteral route: delivered from the outside of the body to the inside of the body using the GI tract: 1- via the mouth= Orally 2- feeding tube= nasogastric tube or PEG tube * Percutaneous route: applied & absorbed through skin and mucous membranes 1-transdermal =patches or ointments 2- mucous membranes= -buccal or sublingual - drops and ointments are applied to the EYES< NOSE OR EARS -suppositories and creams are used in the VAGINA * Parental Route: Injected 1- intradermally- between the layers of the skin 2- subcutaneous- injected into tissues between skin and muscle 3- intramuscular- injected deep into a muscle 4-intravenous IV- injected directly into a vein--quick action

What is the role of anti-inflammatory medications for asthma and/or COPD?

To PREVENT or limit inflammatory responses to injury or invasion = reduce swelling of mucus membranes and reduces secretions, airway lumen open up and wheezing decreases, PERF remains in range. *do not induce/cause bronchodilation=NOT RESCUE DRUGS! that's albuterol (bronchodilator)

antiemetic drugs a/e

tardiness dyskenesia...lip smacking involuntary movement in the the face

Where do you mainly see PEAKs and Through's done?

with antibacterial IV meds and ESPECIALLY WITH THE AMINOGLYCOSIDES BC of of how toxic they can be

The patient diagnosed with hyperthyroidism is prescribed the thyroid-suppressing medication propylthiouracil (PTU). Which statement by the patient warrants immediate intervention by the nurse?

"I have a sore throat and have had a fever." *This is a thyroid suppressing along with methiamazole, these have an AE of bone marrow suppression which reduces the amount of blood cells. Both especially PROYLTHIOURACIL (PTU) can be HEPATOTOXIC!!---> check liver function tests before giving these drugs.

Which statement demonstrates a patient's understanding of therapy with cytoprotective drugs for a gastric ulcer?

"I must take this drug for as long as my doctor prescribes it." Patients must continue treatment even if they feel better!

A patient who was prescribed sertraline (Zoloft), one week ago for depression reports feeling no different now from one week ago and wants to stop taking the drug. What is the nurse's best response?

"Most drugs for depression may take up to 2 to 8 weeks to start making you feel better."

The nurse is teaching a patient about antihypertensive therapy. Which statement by the patient indicates the need for more teaching?

"Now that my blood pressure is normal, I won't need to take my medication anymore." Rationale: Patients must continue with prescribed treatment even if they have NORMAL BP readings. It is normal only bc they are taking the meds!

Corticosteroids end in?

"ONE" ex prednisone, cortisone, dexamethasone * prevent or limit inflammation by slowing or stopping all known pathways of inflammatory mediator production *Similar to our own natural cortisol ***Caution---slow the production of WBC in bone marrow=Be mindful of patient's immune response. Long term use=Adrenal gland suppression, must TAPER OFF, avoid crowds, sick people, if DIABETIC: Check blood glucose levels more often

Beta Blockers end in?

"Olol"

A patient who is prescribed simvastatin (Zocor) asks the nurse why liver function test must be drawn every 6 months. What is the nurse's best response?

"They are important because early liver problems do not cause symptoms." Rationale: "statins" can decrease liver function so liver function tests are ordered, which are important bc mild liver problems to don cause symptoms. Contraindicated in people who have more than 2 alcoholic drinks per day since it will put more stress on the liver. *Common AE is rhabdomyolysis (muscle breakdown) s/s: general muscle soreness, muscle pain, and weakness, vomiting, stomach pain, and brown urine (like coke)---The urine turns brown bc small reddish-brown pieces of broken-down muscles are removed form the body through the urine.

Aminoglycosides end in:

"cin" **these are VERY TOXIC! USED only for BAD DRUGS-- USED ONLY FOR SERIOUS INFECTIONS recall the memory card. Watch for ototoxicity and nephrotoxicity (kidney damage)- oliguria, pruritus' urticaria, tremors

A patient should never suddenly stop taking seizure drugs because this may increase the risk for having a seizure. T/F

True

If a loop diuretic is given IVP to rapidly, ototoxicity may occur.

True

Psyllium, a bulk-forming medication, is safe for daily use for older adults to prevent constipation. T/F

True

Testosterone hormone therapy has a very high likelihood of increasing the risk for birth defects so women should not come in contact with this medication during pregnancy.

True

When mixing two types of insulin, the clear insulin needs to be drawn up before the cloudy insulin.

True

Bisphosphonates generic suffix end in?

"dronate" aka as calcium modifying drugs bc they move calcium from blood to the bone. **are effective ONLY in people who have an adequate intake of both CALCIUM and VITAMIN D

Penicillin's end in

"cillin" these are antibacterial ex amoxicillin

What is the MOA, therapeutic responses and appropriate doses for aspirin?

*MOA: Inhibits the actions of the COX 1 enzyme that helps to make different prostaglandins which cause inflammation, swelling pain, fever *Therapeutic Response: -Redness and pain at the side of inflammation are reduced -swelling and warmth at the side of inflammation are reduced -Body function in the are affected by inflammation is increased -fever is reduced -can be used as suppression of platelet aggregation- (anti clotting) **Appropriate doses: -aches; pains; fever---------> 650 mg q 4 hrs -acute rheumatic fever------> 5-8 gm/day in divided doses -rheumatoid arthritis-----> 3.6-5.4 grams /day in divided doses -Suppression of platelet aggregation: Initial therapy---> 325 mg once/day chronic therapy---> 81 mg once/day Dosages for children are available however, contraindicated for anyone under 19 to take aspiring due to having the potential of causing Reye's syndrome in anyone younger than 19 years old! ***watch for tinnitus aspirin is OTOTOXIC!!!, can also cause thrombocytopenia, gi issues.

What are essential nursing implications for patients taking an antibacterial medication?

*Monitor effectiveness of therapy and s/e, condition of IV site Teach patients to take drugs EXACTLY as directed and for as long as they have been prescribed. Failure to complete treatment = infection could come back or create a resistance bacterial **PEAKS and THROUGHS!

What are the different classifications of pain medications and how do they differ?

*Opioids aka Narcotics: drugs that contain any ingredient derived from the poppy plant (or a similar synthetic chemical) that change a person's perception of pain and HAVE the POTENTIAL for psychologic and physical dependence. *Nonopioid pain control drugs aka adjuvant drugs bc they enhance the pain control features of other drugs: THEY REDUCE the perception of pain but not similar to opium and have little p[potential for physiologic of physical dependence. -Acetaminophen--dose should not EXCEED 3g/day -NSAID--the one type that can help manage pain associated with inflammation, bone pain, cancer pain and soft tissue trauma. *Act at the tissue where pain starts and do not change a person's perspective of pain. - Antidepressants-used to relieve chronic and cancer pain -Anticonvulsants-found to relieve some types of chronic pain and caner pain, ESPECIALLY NEUROPATHIC PAIN (nerve pain with tingling and burning) -Muscle Relaxants-used in combination with other drugs for pain control when pain includes MUSCLE SPASMS! =depress CNS! (central nervous system)

What are the colony stimulating factors (CSFs) for each: -RBC's -WBC's -platelets What are the contraindications for these?

*RBC's= Procrit/jRanesp/Epogin= they increase RBC's *WBC's= Neupogen/Neulasta= increase WBC's *Neumega= to increase platelets ***CONTRAINDICATED: in patients with LEUKEMIA (or any cancer in the blood, bc then helping create more of those cells will make that cancer worse) -these drugs are commonly used after chemotherapy to help with the recovery of the bone marrow

What are essential nursing implications for thyroid medications: -thyroid hormone agonists & - thyroid-suppressing

*Thyroid Hormone Agonists: levothyroxine sodium (Synthroid), liothyronine sodium (Cytomel, Triostat) -Beck BP and heart rate, these increase cardiac activity can over work the heart and lead to angina pain, heart attack and HF. Teach patients to take 2-3 hours before or at least 3 hours after a meal or taking a fiber supplement, increase effectiveness of warfarin (Coumadin) keep follow up appt for clotting tests *Thyroid Suppressing-- methimazole (northyx, Tapazole) ; propylthouracil (Propacil, PTU)* -----Check liver functions tests before giving these, meds. If liver issues= lower doses, increase effectiveness of warfarin (Coumadin) keep their follow up appts for clotting tests, avoid crowds and sick people -bc they suppress the production of WBCs

What abbreviations are on The Joint Commission's official do not use list?

*these are ALL DO NOT USE****** u - for units, (must spell units) IU -International Units Q.D./ Q.O.D. q.o.d./ qod--- must write "daily" or "every other day" -trailing zeros=big NO NO do not abbreviate medications < >--- must write greater than or less than @ cc beta u&g for mcg---must use mcg or write out micrograms.

The nurse is teaching a patient with hypertension about the use of over-the-counter (OTC) drugs. What does the nurse include in the teaching plan? Select all that apply.

-"Avoid allergy and cold remedies that contain phenylephrine or pseudoephedrine because they can increase your blood pressure." -"OTC nonsteroidal anti-inflammatory drugs (NSAIDs) can cause secondary hypertension." -"In general, be sure to discuss with your prescriber before taking any OTC drugs or herbal products."

What is the appropriate technique to administer eye drops as well as prevent systemic absorption for glaucoma medications?

-Create a pocket by lowering down the lower eye lid, placing drop and holding punctal occlusion =have the patient or you hold pressure in the corner of the eye next to the nose for about ONE minute to prevent systemic absorption. -Keep the eye closed for about ONE minute after instilling drug.

Insulin Teaching:

1. check blood glucose levels BEFORE anything make SURE THEY HAVE FOOD in the NEXT 15-30 min 2. Check Dr. orderfor exact type and amount 3. Inspect Vial for color and EXP date 4. Check and have another nurse double-check the amount and type of insulin you have on syringe ***CLEAR 1st CLOUDY 2nd!! 5. right patient 6. select appropriate site, remember to rotate sites. 7. Cleanse the site with alcohol swabs and grasp a fold of skin. **Insert needle at 90 degree if heavy patient or at 45 if thin patient. DO NOT ASPIRATE OR MASSASGE this site.

Which of the following orders for potassium are not appropriate and you would identify as not safe to administer? Select all that apply.

40 mEq of potassium in 100 mL of normal saline infused in 2 hours 20 mEq of potassium IV push daily

What is the exception for the maximum dose of donepezil (Aricept) that can be given to an older, frail female patient with Alzheimer's disease?

5mg/day

In general, the duration of action for oral furosemide (Lasix) is ____

6 hours

Which of the following statements about promethazine (Phenergan), a common phenothiazine is TRUE? Select all that apply.

A potential serious adverse effect is tardive dyskinesia Deep IM injection is the preferred route of administration to avoid potential tissue damage according to the provided FDA video. A typical side effect is sedation. A potential serious adverse effect is tissue necrosis after undiluted IV administration

+ACE Inbibitors (Angiotensin II Converting Enzymes end in?

ACE Inhibitors (Angiotensin-Converting Enzyme) are meds for Hypertension and also help slow kidney damage. **END IN-----> "pril" S/E: hypotension, protein in the urine (frothy like beer), taste disturbances, INCREASED serum K+ (hyPERkalemia), headachhe, and a PERSISTENT DRY COUGH!!

Due to the progressive effects of Alzheimer's disease, what must the nurse assess in a patient with this disease before administering oral medications?

Ability to swallow

Antidote for Acetaminophen?

Acetylcysteine (Mucomyst)

The nurse is scheduled to administer a dose of digoxin (Lanoxin) to an adult client with heart failure. The client has a potassium level of 4.3 mEq/L. The nurse should perform which of the following activities next?

Administer dose as ordered Rationale: Normal K+ level is 3.5-5, therefore 4.3 is with in NORMAL range and safe to administer Digoxin. If it was low HOLD as it can increase risk for Digoxin toxicity.

A patient has a serum potassium level of 2.9 mEq/L. Which of the following is an appropriate action for the nurse to take?

Administer the ordered sustained-release potassium tablets (K-Dur).

What is the MOA and appropriate teaching issues for Albuterol?

Albuterol is a Bronchodilator used to STOP asthma attacks *Classification: Short-acting beta2-agonist (SABA) =RESCUE DRUG for asthma attacks, also used for COPD when the patient feels more breathe less than usual MOA: In short: they relax smooth muscle, opening airways. Bind to the beta2-adrenergic receptors and act like adrenalin, causing an increase in the production of a substance (cyclic adenosine monophosphate aka cAMP) that triggers pulmonary smooth muscle relaxation ***** Appropriate teaching issues:*** -appropriate administration -always carry rescue inhaler with enough meds as precaution for an attack -must continue taking LABA aka long acting beta adrenergic agonists to prevent an attack -report any chest pain on exertion **IF TAKING 2 or more inhalation drugs for asthma at the same time: GIVE THE BRONCHIDILATOR FIRST and wait 5 minutes before giving the @nd and 3rd drugs.

A medication regimen has controlled the seizures of an adult inpatient newly diagnosed with epilepsy and includes the medication phenytoin (Dilantin). Prior to discharge home, the nurse should include which information in the teaching plan? Select all that apply.

Be sure to practice good oral hygiene and visit a dentist regularly. Side effects may include drowsiness and/or dizziness. Be sure to take the medication exactly as prescribed and do not miss any doses. Immediately contact the prescriber for any appearance of a spreading rash or blisters.

Which class of drugs is most likely to lead to dependence when prescribed?

Benzodiazepines

Aminoglycosides:

Carefully monitor for ototoxicity and kidneys this drug is VERY VERY OTOTOXIC and NEPHROTOXIC!!

A nurse is speaking with a patient who is taking glipizide to treat type 2 diabetes mellitus and has called to report feeling shaky, hungry, and fatigued. Which of the following actions should the nurse instruct the patient to take?

Check their blood glucose level Rationale: glipiZIDE (Glucotrol) is an Insulin secretagogues which is a noninsulin antidiabetic drug knows as stimulators that work by STIMULATING the BETA cells of the pancreas to release preformed insulin. The increased insulin then lowers blood glucose levels.

furosemide (Lasix) Classification? Indications? MOA?

Class: Loop Diuretics --aka "high ceiling diuretics'---MOST POWERFUL DIURETICS! MOA: Acts on ascending loop of Henle to block reabsorption, cause more Na+, K+ and Calcium to be excreted in the urine. ****RAPID ONSET!! 60 min oral and 5 min if IV--can lead to incontinence Indications: treatment of edema due to CHF, hepatic or renal disease, and HTN, cause increased urine output Contraindications: anyone with low K+ levels, or taking other ototoxic meds like amino glycosides such as gentamicin. **DO NOT ADMIN if HyPOkalemic low potassium always check K+ levels, or HyPOnatremic, Na+ also check for hearing loss, and HYPERglycemia, PHOTOSENSITIVITY- rash with skin and sunlight **Remember: LA-SIX---can last 6 hours!

A patient with diabetes who takes glucophage (Metformin), a Biguanide insulin sensitizer, has postoperative orders to "resume all pre-operative medications." He had a CT scan with contrast prior to surgery completed. What is the priority action for the nurse?

Contact the prescriber to obtain an order to hold the glucophage for 48 hours.

Digoxin antidote:

DIGIBIND!! digoxin immune Fab (Digibind)

A nurse administering Selective Alpha-1 Blockers to a patient with benign prostatic hyperplasia would expect to note which therapeutic outcome of drug therapy? Select all that apply.

Decreased Urinary Frequency Increased Urine Flow

What opioid drug should be avoided in older adults:

Demerol (Meperidine)

What are essential teaching issues for patients taking benzodiazepines?

Don't take with GRAPEFRUIT JUICE ( will slow down drug metabolism and lead to increased blood concentration in blood) *Take exactly as prescribed, avoid alcohol and sleeping pills *Do NOT suddenly stop, must wean off drugs gradually *don't take with antacids (will decrease effectiveness) Don't take with GRAPEFRUIT JUICE

What specific neurotransmitter is decreased with Parkinson's disease and medication treatment is based upon?

Dopamine

A patient is taking an oxybutynin transdermal patch (Oxytrol) to treat an overactive bladder. What activity is the most important to advise the patient to avoid?

Exercising in hot, humid weather

Antacids should be taken at the same time as other drugs to ensure the medication is appropriately absorbed. T/F

FALSE

Stevens Johnson Syndrome is a common side effect of all seizure medications. T/F

FALSE

5HT3-Receptor Antagonists, such as ondansetron (Zofran), prevent nausea by moving food in the intestinal track more quickly. T/F

FALSE Rationale: 5HT3- Receptor Antagonists bind to and block serotonin receptors in the intestinal tract and the chemotrigger zone of the brain. By blocking the receptors in both of these sites, at least 2 pathways of the vomiting reflex are interrupted. *These drugs are commonly used to manage the nausea and vomiting resulting from cancer CHEMOTHERAPY!!

Prior to administering a cardiac glycoside, the nurse should assess the patient's radial pulse for at least 10 full minutes. T/F

FALSE Rationale: Digoxin is THE drug for heart failure and a cardiac glycoside, must listen and get apical pulse with stethoscope for ONE full minute! *HOLD if <60 bpm or >100 bpm.

If a patient has been prescribed a diuretic for their high blood pressure, the nurse should encourage the patient to also decrease their fluid intake to minimize side effects. T/F

False

Selective serotonin reuptake inhibitors (SSRI's) work by decreasing the amount of serotonin in the brain

False Rationale: SSRI's work by INCREASING the amount of serotonin in the brain by inhibiting reuptake.

Antidote for benzodiazepines?

Flumazenil (Romazicon) *Commonly used to treat anxiety *End in "lam" or "pam"

A patient tells the nurse that she is thinking about becoming pregnant. The nurse teaches the patient that which vitamin should be her priority for supplementation before planning a pregnancy to prevent brain and spinal cord birth defects?

Folic acid

A patient is taking levothyroxine sodium (Synthroid). Which of the following changes should you report to the prescriber as an indication that the dose may be too high? Select all that apply.

Frequent diarrhea Nightly insomnia

What are life span considerations for older patients when administering drugs for insomnia?

Give lower doses!---> INCREASED RISK for FALLS!! bc they are more sensitive to the effects of these drugs and more likely to experience side effects (drowsiness, dizziness, dry mouth, headache, GI discomfort)

The home health nurse visits a patient with heart failure. In reviewing the patient's medications, the nurse notes that they take the following daily oral medications: digoxin 0.25 mg, furosemide 80 mg, and captopril 0.625 mg. After speaking to the patient and their family, the nurse suspects digitalis toxicity. Which question helps the nurse gather more information specific to digitalis toxicity?

Have you had any nausea, vomiting, or diarrhea? Rationale: Digoxin is a cardiac glycoside. It INCREASES heart CONTRACTRILITY and CARDIAC OUTPUT and DECREASES Hear rate. * has a very NARROW therapeutic window 0.8- 2ng/ml AE is digoxin toxicity s/s: anorexia (loss of appetite, nausea, vomiting, diarrhea or vision problems (seeing halos around lights). **MUST check apical pulse rate for ONE full minute and must be <60bpm or > 100 HOLD THE DRUG!!! *Check Electrolytes, a LOW POTASSIUM level can INCREASE the risk for digoxin toxicity!

How do you know when to draw the peak and through of an antibacterial medication?

How to monitor for peaks and throughs: 30 min AFTER med has been completely infused, you will draw blood and send off as the peak. Wait for labs to come back..... IF they come back and the patient is in a toxic level inform HCP and get a lower dose... IF dose/PEAK was at normal level, then 30 min BEFORE their next dose you will draw blood again and send it off as the THROUGH; wait for results to come back, if they are below the therapeutic level=they are not getting enough med to be therapeutic. *note: this is typically only done once unless something needs to be adjusted might have to start peak & through labs over with adjusted doses. Recall: *peak= point in time when they have the MAX amount of med in their blood *through= the point where have the LEAST amount of med in their blood

The client diagnosed with coronary artery disease is prescribed atorvastatin (lipitor). Which statement by the client warrants the nurse notifying the the Dr?

I am feeling pretty good except. I am having muscle pain all over my body! Remember a/e of Statins==Rhabdomyolysis

Metabolism inhibitors of antibacterial

Inhibit folic acid

A nurse is planning care for a patient who is receiving furosemide (Lasix) daily for peripheral edema. Which of the following nursing implications should the nurse include in the plan of care? Select all that apply.

Instruct the patient to sit on the side of the bed before standing up to prevent dizziness Recommend the patient eat high potassium foods daily Advise the patient to take their medication early in the day Monitor potassium levels

Why should parents be taught never to give bismuth subsalicylate (Pepto-Bismol) to a child?

It contains aspirin that can cause Reye's syndrome.

Statins: What are they ? When do you take them?

Lipid lowering meds =cholesterol lowering MOA- block the enzyme that controls cholesterol production s/e---GI discomforts A/E-----RHABDOMYOLYSIS---muscle breakdown and can decrease liver function!!! Teaching: take at BED time or with EVENING meal!! Contraindicated: liver disease or muscle issues

What is MOA of H2 Blockers (Histamine H2 Blockers)?

MOA: Histamine H2 antagonists cause DECREASED stimulations of H2, receptors in gastric cells that secrete hydrochloric acid (parietal cells), leading to a DECREASE in gastric acid secretion. When histamine binds to receptors in the stomach lining, acid pumps are activated, releasing acid into the stomach. H2 blockers PREVENT histamine form stimulating the pumps in the stomach that produce hydrochloric acid. ******INDICATIONS***** Histamine H2v Blockers are used to heal ulcers or relieve the symptoms and pain that occur with GERD. *remember PPI's = BLOCK gastric acid secretion H2 Blockers= DECREASE by preventing Histamine (inhibit/stop) from stimulating the pumps

What is the MOA of Proton Pump Inhibitors (PPIs)

MOA: work by completely BLOCKING the production of stomach acid, these drugs block the action of "pumps" located in the acid-secreting cells, which TOTALLY BLOCKS stomach acid secretion. ******INDICATIONS***** PPI's are most prescribed powerful drugs used for treating PUD OR GERD and should be used for limited periods of time. ***INTENDED RESPONSE*** Gastric acid secretion is decreased, Acid reflux is decreased Ulcers are healed

Hos can the nurse safely administer Potassium?

Memory Trick: Rule for K+ 1-10-100 IN ONE hour the heart can ONLY take 10 mEq of potassium, and it must be diluted in AT LEAST 100 mL of fluid!!! *Never IV bolus or IV push *give no more than 40 mEq/l and No FASTER THAN the 1-10-100 RULE!!!

The health care provider is treating a patient with a duodenum ulcer and confirmed infection with H. pylori. Which of the following medication combinations would the nurse anticipate the health care provider to order?

Metronidazole (Flagyl), esomeprazole (Nexium), and bismuth (Pepto-Bismol)

General teaching for all antibacterial meds:

Must take EXACTLY as prescribed as directed even if they feel better!! Make you if 2x a day they must be equally spaced apart!!!! q 12 hours, of if 3x a day is q 8 hours. BC WE NEED A steady state of that medication Take with food EXCEPT tetracyclines!!!!!!

What type of drug is naproxen sodium?

NSAID

What type of drug is fentanyl (Duragesic)?

Narcotic

A patient on the psychiatric unit is being monitored for adverse effects of antipsychotic medications. What are the adverse effects of these drugs? Select all that apply.

Neuroleptic malignant syndrome Seizures

What is neuroleptic malignant syndrome?

Neuroleptic malignant syndrome is a rare and life threatening a/e in which DANGEROUSLY HIGH body temperatures can occur. s/s: fever, respiratory distress, tachycardia, seizures, diaphoresis (increased sweating), BP changes, pallor, fatigue, sever muscle stiffness and loss of bladder control.

A nurse is administering a fat-soluble vitamin to a patient. What comment about fat-soluble vitamins is correct?

Not lost when the foods containing them are cooked

The nurse is working with a nursing student while caring for a patient receiving enteral nutritional supplements. The student should be corrected if they attempt which action?

Placing the head of the bed flat while the supplement is running.

Which drug is more likely prescribed to treat a patient's pain and burning form diabetic neuropathy?

Pregabalin (Lyrica) Rationale: Nerve pain (neuropathy) can be treated with anticonvulsants like pregabalin (Lyrica) or gabapentin (Neurontin)

What are the different insulins:

Rapid- Acting- usually given just before or with meals. they act quickly to minimize the rise in blood sugar due to the intake of food ex: asparat (Novolog) and lispro (Humalog) Regualr short acting Insulin---aka regular insulin ually taken 15-30 min before meals. not as quick acting as rapid acting insulin. ex: regualr human insulin (Humilin R) or (Novolin R) Intermediate Acting-- often taken in combo with shot acting type insulin. They start working within the hour of being administered. LONGER LASTING EFFECTS ==== CONTROL blood glucose levels between meals. ex: Isophane or NPH ---(Humulin N) or (Novolin N) or (Levemir) or (Novolog mix 70/30) Long acting--acts for 24 hours, NO PEAK ACTIVITY ex Insulin glargline (Lantus)

PRN meds

Remember those time frames must still be listed that is fine as needed but every how many hours? this still needs to be written on the order

What are the adverse effects of fentanyl (Duragesic)?

Respiratory depression

What are the 8 rights of medication administration?

Right PATIENT/CLIENT Right DRUG Right DOSE Right ROUTE Right TIME Right DOCUMENTATION Right DIAGNOSIS Right RESPONSE

ARBs end in: genral info

Sartan ex metropolol General info

What is serotonin syndrome?

Serotonin syndrome is a rare a/e that occurs when levels of serotonin are VERY HIGH! s/s: anxiety, agitation, sweating, confusion, tremors, restlessness, lack of coordination, and rapid heart rate.

What is Steven- Johnson's syndrome?

Steven-Johnson's syndrome is a rare and severe skin reaction that can occur with any drug therapy. =MED EMERGENCY, treat like burn patients! s/s: rashes, and skin blistering, patient may lose body fluid and become dehydrated, the skin can slough, and patient will then require skin grafts to restore skin integrity

Angiotensin-converting enzyme (ACE) inhibitors have the potential effect of a persistent dry cough. T/F

TRUE Rationale: ACE Inhibitors (Angiotensin-Converting Enzyme) are meds for Hypertension and also help slow kidney damage. **END IN-----> "pril" S/E: hypotension, protein in the urine (frothy like beer), taste disturbances, INCREASED serum K+ (hyPERkalemia), headachhe, and a PERSISTENT DRY COUGH!!

Lipid-lowering drugs should not be given if a woman is pregnant or plans to become pregnant. T/F

TRUE Rationale: Fats are needed for fetal develpment.

Thyroid-suppressing medications may initially take as long as 3 weeks to be effective as they do not affect hormones already stored in the thyroid gland. T/F

TRUE Rationale: They do not affect the already stored production. *Teach to take on empty stomach or at least 2-3 hours before or after a meal or taking a fiber supplement.

If you're allergic to penicillin you are more then like allergic to cephalosporins? T/F

TRUE they are very similar

What are essential teaching issues for patients taking bisphosphonates?

Take EARLY in the MORNING BEFORE breakfast ask for clarification as book has diff info

A patient taking a nicotinic acid agent reports episodes of flushing and hot flashes to the nurse. What action does the nurse tell the patient to do to reduce these symptoms? Select all that apply.

Take a nonsteroidal anti-inflammatory drug (NSAID) 30 minutes before taking nicotinic acid. Take nicotinic acid with meals.

What would be appropriate teaching about digoxin (Lanoxin)?

Take pulse daily before taking digoxin Take at the SAME time everyday Report any weight gain greater than 2lb per day Report s/s of toxicity: s/s of digoxin toxicity: loss of appetite (anorexia), nausea, vomiting, diarrhea, or vision problems (will see halos around lights), dysrhythmias, fatigue

For relief of urinary obstruction due to benign prostatic hyperplasia, the nurse would anticipate which of the following medications ordered to help relax the smooth muscles in the urethra?

Tamsulosin (Flomax)

What is tardive dyskinesia?

Tardive dyskinesia is a chronic disorder of the nervous system, caused as an a/e of antiemetic drugs long term use. s/s: uncontrolled rhythmic movement of the mouth, face or extremities; lip smacking or puckering; puffing of cheeks; uncontrolled chewing ; and rapid or wormlike movements of the tongue.

The nurse is administering 0900 meds to the following clients. Which medication should the nurse question administering?

The client receiving an antiplatelet med who has a platelet count of 33,000 NORMAL at least 50,000

The nurse is caring for a patient taking propranolol (Inderal), a noncardioselective beta blocker. Which assessment finding indicates the patient is experiencing a potential adverse complication?

The development of audible wheezes and cough Rationale: There are two types of beta blockers Cardioselective-affect the heart ONLY NON-Cardioselective= systemic effect. S/E: impotence, decreased sexual ability, dizziness, or light-headedness, drowsiness, trouble sleeping (insmnia) and fatigue or weakness. **Less common S/E and must be reported to HCP= difficulty breathing or wheezing, cold hands or feet, mental depression, SOB, slow heart rate <50 bpm and swelling in: ankles, feet or lower legs. *Beta Blockers can make DEPRESSION WORSE or CAUSE 1st time onset of depression. *Contraindicated on anyone with Asthma, COPD, CAUTION diabetics: Beta Blockers can mask s/s (tachycardia) associated with HypOglycemia, must check blood glucose levels more often!

A patient receives NPH and regular insulin every morning. The nurse is verifying that the patient understands that there are two different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress?

The risk for hypoglycemia is greatest around the peak of insulin activity.

Digoxin (Lanoxin) Classification? Indications? MOA?

UNDERSTAND it lowers the HR and INCREASES contractility = pushed out more blood with each heart beat===increasing cardiac output CHECK DIGOXIN level ----> 0.5-2 if below 0.5-2 not enough med if above === too much med Classification: Cardiac Glycoside for Heart Failure Indications: Heart Failure MOA- Improve Heart Failure by SLOWING DOWN a heart rate that is too fast, allowing more time for the LEFT ventricle to fill====*Work on the muscle fibers of the heart and INCREASE the force of each heart beat/contraction and Improve cardiac output. **Caution: Has a very NARROW therapeutic range of 0.8 to 2 ng/mL ( easily cause toxicity if too much) *Watch for HYPOKALEMIA

Antidote for warfarin (Coumadin) is?

Vitamin K

Which of the following are associated with perimenopausal hormone replacement drugs? Select all that apply.

Women who take these drugs have an increased risk of blood clotting and should avoid smoking. The medication therapy is effective if the symptoms of hot flashes and night sweats lessen. The use of conjugated estrogens lowers the blood levels of follicle-stimulating hormone.

Is it okay for a patient to continue to take the naproxen sodium at the same time she takes the fentanyl?

Yes, not unusual to combine, they work in different ways.

A nurse is providing teaching to a patient who is about to begin levothyroxine (Synthroid) therapy due to removal of her thryoid gland. Which of the following instructions should the nurse include?

You will need to take this medication daily for the rest of your life

Which is a proper dietary instruction for a patient with a new prescription of a potassium-sparing diuretic?

avoid salt substitutes

Antifungals end in:

azole ex fluconazole

Drugs associated with possible Steven Johnson's syndrome?

allopurinol carbamazepine lamotrigine nevirapine the "oxicam" class of anti-inflammatory drugs (including meloxicam and piroxicam) phenobarbital phenytoin sulfamethocazole and other sulfa antibiotics sertraline sulfasalazine

antidote for thrombolytics

aminocaproic acid

The nurse admits a 69-year-old client with HF. The physician orders furosemide 60 mg IV STAT, digoxin 0.25 mg PO, and KCL 20 mEq PO now. Which assessment finding is most indicative of an ineffective response two hours after the administration of all of the medications? a) Pulse 89, irregular b) Urine output 60 mL c) Pulse oximetry 94% d) Pitting edema in the lower extremities

b) Urine output 60 mL

Barbiturate's end in:

barbitol ex pentobarbital

If blood vessels relax=

better blood flow---Decreases Blood pressure VS Constriction===higher BP

A patient who is prescribed simvastatin (Zocor) asks the nurse why liver function test must be drawn every 6 months. What is the nurse's best response? a) "They are important because early liver problems do not cause symptoms." b) "They help your prescriber decide what your dose of simvastatin should be." c) "They tell your prescriber how well your body is responding to the therapy." d) "They indicate how much cholesterol is being produced by your liver."

c) "They tell your prescriber how well your body is responding to the therapy."

The home health nurse visits a client with HF. In reviewing the client's medications, the nurse notes that the client takes the following daily oral medications: digoxin 0.25 mg, furosemide 40 mg, and captopril 0.625 mg. After speaking to the client and wife, the nurse suspects digitalis toxicity. Which question helps the nurse gather more information specific to digitalis toxicity? a) Do you get light-headed when you get out of bed? b) Do you need to sleep with more than one pillow? c) Do you have to get up to urinate more frequently? d) Have you had any nausea, vomiting, or diarrhea?

d) Have you had any nausea, vomiting, or diarrhea?

DPP-4 inhibitors NON insulin diabetic meds

gliptin

Fluroquinolones

is a DNA synthesis inhibitor end in "Floxacin" inhibit the DNA synthesis of that bacateria

Fibrates:

main benefit decrease Triglyceride levels a/e higher increase for gall stones affect kidneys and lots of drug interactions AVOID grapefruit juice!!

Antidote for Narcotics?

nolaxone (Narcan)

Benzos end in

pam ex diazepam Remember crazy pam drives a pens used to anxiety psychosis

How is fentanyl (Duragesic) 100 mcr administered?

patch, must be that specific dosage patch

Antidote for Heparin is ?

protamine sulfate

Teachin g with tetracyclines (antibacterial drugs)

s/e photosensitivity a/e increase ICP watch for dizziness, blurred vision, confusion and tinnitus TAKE On an EMPTY stomach avoid dairy products.