Pharmacology Exam 3

Biologic response modifiers Treats several cancer and hepatitis B&C flu-like symptoms / fever+fatigue CNS symptoms Bone marrow suppression USUALLY dosed in MILLION units not mg

Interferons

Airflow disorder used for COPD may increase intraocular pressure May cause urinary retention interaction: beta 2 adrenergic agonist (albuterol) enhance brochodilation

Ipratropium

Antibiotic narrow Spectrum antibiotic thrombophlebitis at injection site suprainfection

Aztreonam

A nurse is caring for a client who had poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouh associated with diphenhydramine? "Administer the medication with food" "Chew on sugarless gum or suck on hard, sour candies" "Place a humidifier at your bedside every evening" "Discontinue the medication and notify your provider"

"Chew on sugarless gum or suck on hard, sour candies"

a nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicate an understanding of the teaching? "If my breathing begins to feel tight, I will use cromolyn immediately" "I will be sure to take the albuterol before taking comolyn" "i will use both medications immediately after exercising" "I will administer the medications 10 minutes apart"

"I will be sure to take the albuterol before taking comolyn"

a nurse is caring for a client who has a fungal infection and has a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiation the medication? Sodium 140 mEq/L Potassium 4.5 mEq/L BUN 55 mg/dL Glucose 120 mg/dL

BUN 55 mg/dL

a nurse is teaching a client who has an urinary tract infection and is taking ciprofloxacin. which of the following instructions should the nurse give to the client? "If the medication causes an upset stomach, take an antacid at the same time" "Limit your daily fluid intake while taking this medication" "This medication can cause photophobia, so be sure to wear sunglasses outdoors" "You should report any tendon discomfort you experience while taking this medication"

"You should report any tendon discomfort you experience while taking this medication"

Upper Respiratory Disorder Decreases viscosity of mucus Side Effects/ GI bleeding Rotten egg smell reverses tylenol overdose

Acetylcysteine

Airflow disorder rescue med for asthma take 1st hold breath for 10 seconds after inhalation prevents wheezing, opens airways, decreases coughing

Albuterol

Antibiotic broad spectrum monitor for allergic reaction decreases Effectiveness for oral contraceptives chance for suprainfection

Amoxicillin

Hormonal Agent ER positive breast cancer in postmenopausal women ONLY Blocks synthesis of estrogen Muscle pain/weakness GI symptoms Increased risk of osteoporosis and fractures

Anastrazole

a nurse is caring for a client who has active pulmonary tuberculosis and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? constipation black colored stool staining of teeth body secretions turning a red-orange color

Body secretions turning a red-orange color

Upper Respiratory Disorder Non-sedating Not for infants under 6 months Monitor liver/kidney function May cause dry mouth, throat, and nose

Cetirizine

Antibiotic broad spectrum not for clients under 18 can cause tendon rupture

Ciprofloxacin

Chemotherapy Severe n/v bone marrow suppression Kidney toxicity - hydrate Ototoxicity Paresthesias of extremities Alaphylaxis - give epinephrine

Cisplatin

Airflow disorder asthma not for acute asthma attack use on a regular schedule used after albuterol

Cromolyn

Chemotherapy alopecia nausea and vomiting bone marrow suppression hemorrhagic cystitis with kidney toxicity - give mesna and increase fluid intake electrolyte imbalance - hyperkalemia and hyponatremia -- weakness, palpitations, muscle twitching

Cyclophosphamide

Chemotherapy nausea vomiting esophagitis bone marrow suppression headache and fever with intrathecal use

Cytarabine

a nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take? Document that the client had an anaphylactic reaction to the medication. Change the IV infusion site Decrease the infustion rate on the IV Apply cold compresses to the neck area

Decrease the infusion rate on the IV

Enzyme inhibitor Rash occurs frequently - may become stevens-johnson syndrome or erythema multiforme Gi symptomes Elevated liver enzymes

Delavirdine

Upper Respiratory Disorder Use at bedtime - causes sedation chew gum or sour candies for dry mouth Alcohol/CNS depressants = increased effects

Diphenhydramine [Benedryl]

Chemotherapy Severe bone marrow suppression [leukocytes] Alopecia RED Urine and Tears Cardiac toxicity Vesicant

Doxorubicin

Antibiotic ototoxicity - report ringing in ears

Erythromycin

Hormonal Agent For prostate cancer Works with Leuprolide Prevents increase of tumor size Liver toxicity Hot flashes, decrease in sexual urges, impotence

Flutamide

Upper Respiratory Disorder Thins thick mucus contraindications: DM and use of aspartame

Guaifenesin

Hormonal Agent for advanced prostate cancer ONLY Palliative treatment - controls pain/slows progression Reduces testosterone production

Leuprolide

Targeted therapy Normal cells are not harmed Drug resistance can occur gi symptoms Musculoskeletal pain and muscle cramps rash Bone marrow suppression Fluid retention

Imatinib

Airflow disorder asthma not for acute asthma attack Inhaled: use spacer on a regular schedule [not PRN] Oral: suppresses immune system, taper dose Nasal: takes 2-3 weeks, take full dose to begin, then taper to effective dose

Inhaled: beclomethasone dipropionate Oral: prednisone nasal: beclomethasone

Chemotherapy nausea vomiting ulceration bone marrow suppression liver toxicity mild

Mercaptopurine

Chemotherapy bone marrow suppression - leucovorin as antidote liver damage Oral and gi ulcers pulmonary fibrosis

Methotrexate

Airflow disorder chronic asthma monitor for liver and behavior changes May cause suicidal ideations + depression Administer 2 hours before exercise

Montelukast

Upper Respiratory Disorder opioid: constipation/respiratory depression ; use short term ; potential for abuse ; ST Johns Wart increases sedation Non-opioid: chronic non-productive cough

Opioid: codeine Non-opioid: dextromethorphan

Chemotherapy Bradycardia - usually during infusion Peripheral neuropathy Bone marrow suppression Allergic reaction USE SPECIAL NON-PVC TUBING AND FILTER

Paclitaxel

Upper Respiratory Disorder not meant for long term use Can increase BP

Phenylephrine

macrobacterium Used with other drugs to treat tuberculosis may turn bodily fluids red- Orange can cause hepatoxicity

Rifampin

Enzyme inhibitor Hyperglycemia and increased risk of diabetes fat redistribution - buffalo hump Increased cholesterol and triglycerides reduced bone density liver toxicity

Ritonavir

a nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and he feels dizzy and short of breath. Which of the following actions should the nurse take first? Stop the infusion Call the client's provider Elevate the head of the bed Auscultate the client's breath sounds

Stop the infusion

Hormonal Agent for ER positive metastatic breast cancer helps maintain bone density and increase HDL Causes endometrial proliferation and blood clotting N/V, hot flashes, cataracts and retinopathy, increased risk of uterine cancer/ thrombophlebitis/thromboembolism

Tamoxifen

Airflow disorder Asthma monitor plasma drug levels, hr, rhythm use activated charcoal to absorb if therapeutic levels are passed and become toxic - may cause seizures Symptoms: restlessness and insomnia

Theophylline

Targeted Therapy Breast tumors with human epidermal growth factor receptor 2 (30% of breast cancer) allergic reaction - stop infusion Infusion reaction cardiac symptoms cns symptoms GI symptoms

Trastuzumab

Antibiotic treats c-diff. Give orally nephrotoxicity- monitor kidney function red man syndrome- decrease rate of infusion

Vancomycin

Chemotherapy Peripheral neuropathy - decrease dose Vesicant Alopecia SEVERE constipation and upper colon impaction

Vincristine

Antibiotic please for urinary tract infection- nothing else might stain teeth permanent peripheral neuropathy

nitrofurantoin

Antiviral Treats herpes Hydrate 2 hours after infusion Infuse slow to avoid thrombophlebitis

acyclovir

a nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? Hyperglycemia Adrenocortical insufficiency Severe dehydration Rebound pulmonary congestion

adrenocortical insufficiency

Antifungal Cause red blood cell suppression Toxic drug

amphotericin b

Antibiotic do not drink alcohol contraindicated in people with allergies to penicillin and milk protein treats Gram and infections

cephalexin

Antibiotic nausea and vomiting if infused too quickly cilastin increases imipenem half life

imipenem and cilastin

Macrobacterium used with other drugs for active tuberculosis used alone for latent tuberculosis

isoniazid

Antifungal Works best with acid medium in stomach ( coffee tea juice)

ketoconazole

Anti-parasitic only works on anaerobic organisms Suprainfection with candida

metronidazole

a nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? Check the pulse after medication administration. take the medication with meals rinse mouth after administration limit caffeine intake

rinse mouth after administration

Antibiotic drink lots of water decreases effectiveness of oral contraceptive

trimethoprim + sulfamethoxazole

Enzyme inhibitor Treat HIV and Prevent fetal disease transfer during delivery Bone marrow suppresion GI symptoms CNS symptoms Fever, myalgia

zidovudine