Pharmacology Mid-Term

What are the S/E of Heparin?

-bleeding -increased HR -decreased BP -bruising -petechiae -hematomas -black tarry stools

What are the S/E of ENOXAPARIN and FONDAPARINUX?

-hemorrhage -neurologic damage from hematoma formed during spinal or epidural anesthesia -thrombocytopenia -toxicity/overdose

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus and is starting repaglinide (Prandin). Which of the following statements made by the client indicates understanding of the administration of this medication? A. "I'll take this medicine with my meals." B. "I'll take this medicine 30 minutes before I eat." C. "I'll take this medicine just before I go to bed." D. "I'll take this medicine as soon as I wake up in the morning."

- "I'll take this medicine 30 minutes before I eat."

. A nurse is reinforcing teaching with a client who has a prescription for pramlintide (Symlin) for type 1 diabetes mellitus. Which of the following should the nurse reinforce in the teaching? (Select all that apply.) A. "Take oral medications 1 hr before injection." B. "Use upper arms as preferred injection sites." C. "Mix pramlintide with breakfast dose of insulin." D. "Inject pramlintide just before a meal." E. "Discard open vials after 28 days."

- "Take oral medications 1 hr before injection." - "Inject pramlintide just before a meal." -"Discard open vials after 28 days."

A health care professional administers pramlintide (Symlin) at 0800 to a patient who has type 1 diabetes mellitus. At which of the following times should the patient expect the drug to exert its peak action?

- 0820 (Pramlintide, an amylin mimetic, peaks 20 min after administration. The health care professional should monitor the patient for indications of hypoglycemia, such as diaphoresis and tremors.)

. What is the THERAPEUTIC USE of heparin?

prompts for anticoagulant activity i.e, stroke, pulmonary, embolism massive deep-vein thrombosis. -adjunct med. for open heart surg. OR renal dialysis. -prophylaxis against post-op venous thrombosis. -tx for disseminated iv. coag.

A nurse is caring for a client who has a prescription for metformin (Glucophage). The nurse should monitor the client for which of the following adverse effects? A. Lactic acidosis B. Hypoglycemia C. Hyperlipidemia D. Respiratory alkalosis

-Lactic acidosis

A health care professional is caring for a patient who is about ot begin alteplase (Activase) therapy to treat pulmonary embolism. Which of the following drugs should the health care professional have available in the event of a severe adverse reaction? a) Vitamin K b) Aminocaproic acid (Amicar) c) Protamine d) Deferoxamine (Deseferal)

Aminocaproic acid (Amicar)

A nurse is collecting data from a client who has chronic neutropenia and who has been receiving filgrastim. Which of the following actions should the nurse take to evaluate the client for an adverse effect of filgrastim? a. Check for right lower quadrant pain. b. Auscultate for crackles in the bases of the lungs. c. Ask about bone pain. d. Auscultate the chest for a heart murmur.

Ask about bone pain.

List the 4 diff. types of antiplatelets (less sticky platelets)

Aspirin abciximab clopidogrel pentoxifylline

A nurse is assessing a client who has chronic neutropenia and who has been receiving filgrastim. Which of the following actions should the nurse take to assess for an adverse effect of filgrastim? A. Assess for bone pain. B. Assess for right lower quadrant pain. C. Auscultate for crackles in the bases of the lungs. D. Auscultate the chest to listen for a heart murmur.

Assess for bone pain.

A nurse is reviewing the health record of a client who asks bout using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Glaucoma C. Hypertension D. Tachycardia

Asthma

Giving a patient pretnazone, causes an increase in what?

Blood glucose and appetite

What types of adverse side effects would you see in someone who has taken Mathimazole? A. Weight loss B. Insomnia C. Heat Tolerance D. Bradycardia

Bradycardia

What would you see in someone who has taken too much Methymazole?

Bradycardia

When do you give Levothyroxine?

On an empty stomach 30 min to 1 hour before breakfast

A health care professional is preparing to administer the prescribed dose of filgrastim (Neupogen) to a patient. The patient's laboratory results indicate that the patient has a WBC count of 12,000 mm3. Which of the following actions should the health care professional take? a) Clarify the prescription within the provider. b) Administer the drug with an analgesic c) Limit venipunctures d) Assess breath sounds

Clarify the prescription within the provider.

A health care professional is caring for a patient who is about to begin taking oprelvekin (Neumega) to treat thrombocytopenia. The healthc are professional should tell the patient to report which of the following idications of an adverse reaction? (select all that apply). a) Conjuctivitis b) Tinnitus c) Swollen ankles d) Jaundice e) Palpitations

Conjunctivitis Swollen ankles Palpitations

A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A. Contact provider if heart rate is less than60/min. B, Check pulse rate for 30 seconds and multiply result by 2. C. Increase intake of sodium. D. Take with food if nausea occurs

Contact provider if heart rate is less than60/min.

A patient is about to begin therapy with recombinant factor IX (BeneFix) to treat hemophilia B. The patient asks the health care professional about the risk of disease transmission with recombinant factor IX, as compared with plasma-derived factor IX. The health care professional should explain that recombinant factor IX eliminates the risk of which of the following? a) HIV b) Cytomegalovirus c) Creutzfeldt-jakob disease d) Anaphylaxis

Creutzfeldt-jakob disease

A patient who is taking ferrous sulfate (Feosol) to treat iron-deficiency anemia develops severe nausea and vomiting due to iron toxicity. Which of the following drugs should the health care professional use to treat this complication? a) Flumazenil (Mazicon) b) Acetylcysteine (Acetadote) c) Naloxone d) Deferoxamine (Desferal)

Deferoxamine

A health care professional is caring for patient who has mild hemophilia A and is about to begin taking desmopressin (DDAVP) to prevent bleeding. The health care professional should monitor for which of the following adverse reactions? a) Weight loss b) Edema c) Polyuria d) Tachycardia

Edema

A health care professional is caring for a patient who is about to begin taking filgrastim (Neupogen) to treat neutropenia. The health care professional should assess the patient for which of the following adverse effects? a) Dusky nails bed b) Petechiae c) Enlarged spleen d) Swollen calf

Enlarged Spleen

A health care professional is caring for a patient who has a known sensitivity to Escherichia coli-derived proteins. This sensitivity is a contraindication for which of the following drugs? a) Epoetin alfa (Erythropoietin) b) Oprelvekin (Neumega) c) Filgrastim (Neupogen) d) Alteplase (Activase)

Filgastrim

A health care professional is caring for a patient who is undergoing bone marrow transplantation following high-dose chemotherapy. Which of the following drugs should the health care professional expect the primary care provider to prescribe the reduce the patient's risk of infection? a) Epoetin alfa (Erythropoietin) b) Oprelvekin (Neumega) c) Filgrastim (Neupogen) d) Alteplase (Activase)

Filgastrim

A health care professional is caring for a patient who is about to begin factor III (Advate) therapy to treat hemophilia A. When administering factor VIII, which of the following actions should the health care professional take? a) Have emergency equipment ready b) Premedicate with aspirin (Ecotrin) c) Administer via rapid IV bolus d) Administer the powdered form orally

Have emergency equipment ready

A health care professional is caring for a patient who is about to begin alteplase (Activase) therapy. The health care professional should monitor the patient for which of the following indications of a possible adverse effect? a) Hives b) Headache c) Edema d) Hypertension

Headache

A health care professional is caring for a pa tient who is about to begin taking epoetin alfa (Epogen). Which of the following laboratory values should increase with effective therapy? a) PT b) WBC c) Hgb d) Platelets

Hgb

A nurse is planning to administer IV alteplase to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the following interventions should the nurse plan to take? A. Administer IM enoxaparin along with the alteplase dose. B. Hold direct pressure on puncture sites for up to 30 min. C. Administer aminocaproic acid IV prior to alteplase infusion. D. prepare to administer alteplase within 8 hr of manifestation onset.

Hold direct pressure on puncture sites for up to 30 min.

A health care professional administers epoetin alfa (Epogen) subcutaneously to a patient who has renal failure. The health care professional should monitor the patient for which of the following adverse effects? a) Hypertension b) Muscle pain c) Edema d) Dry mouth

Hypertension

A health care professional is caring for a patient who is about to begin taking warfarin (Coumadin). The health care professional should caution the patient about taking which of the following over-the-counter drugs? a) Diphenhydramine b) Dimenhydrinate (Dramamine) c) Calcium carbonate (Tums) d) Ibuprofen (Motrin)

Ibuprofen

When should you stop HEPARIN, aside from overdose?

If platelet count is <100,000/mm

A health care professional is caring for a patient who is about to begin taking oprelvekin (Neumega). The health care professional should explain to the patient that the drug has which of the following effects? a) Stimulates leukocyte maturation b) Causes myelosupression c) Increases platelet production d) Destroys blood clots

Increases platelet production

A health care professional is caring for a patient who is about to begin taking asprin (Ecotrin) to reduce the risk of a cardiovascular event. The health care professional should understand that the drug inhibits platelet aggregation by which of the following mechanisms? a) Activating thromboxane A2 b) Blocking adenosine diphosphate receptor agonists c) Supressing specific clotting factors d) Inhibiting cyclooxygenase action in platelets

Inhibiting cyclooxygenase action in platelets

A health care professional is administering epoetin alfa (Epogen) subcutaneously to a patient who has renal failure. The health care professional should take which of the following actions? a) Shake the vial before using b) Insert the needle into vial once c) Dilute the drug first with normal saline d) Save the used vial for the next dose b) Insert the needle into vial once

Insert needle into the vial once

A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take? A. Expel the air bubble from the prefilled syringe before injecting. B. Insert the needle completely into the client's tissue. C. Administer the injection in the client's thigh. D. Aspirate carefully after inserting the needle into the client's skin.

Insert the needle completely into the client's tissue.

A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A. Calcium 9.2 mg/dL B. Calcium 10.3 mg/dL C. Potassium 3.4 mEq/L D. potassium 4.8 mEq/L

Potassium 3.4 mEq/L

Which drug should you administer in case of HEPARIN TOXICITY/OVERDOSE?

Protamine

A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? A. Vitamin K1 B. Atropine C. Protamine D. Calcium gluconate

Protamine reverses the anticoagulant effect of heparin.

A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? A. Bruising B. Report of metallic taste C. Muscle pain D. Report of anorexia

Report of anorexia

A health care professional is caring for a patient who is about ot begin taking folic acid to treat megaloblastic anemia. The health care professional should monitor which of the following laboratory values? a) Amylase level b) Reticulocyte count c) C-reactive protein d) Creatinine clearance

Reticulocyte count

A nurse is caring for a client who is receiving daily doses of oprelvekin. Which of the following laboratory values should the nurse monitor to determine effectiveness of this medication? A. Hemoglobin B. Absolute neutrophil count C. Platelet count D. Total white blood count

The expected outcome for oprelvekin is to have a platelet count greater than 50,000/mm3.

A health care professional is caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent stent stenosis. The health care professional should monitor the patient for which of the following adverse reactions? a) Thrombocytopenia b) Hyponatremia c) Lymphocytopenia d) Uricemia

Thrombocytopenia

A nurse is caring for a client who is receiving daily doses of oprelvekin. Which of the following laboratory values should the nurse monitor to determine effectiveness of this medication? a. Hemoglobin b. Absolute neutrophil count c. Platelet count d. Total white blood count

Total white blood count

your patient is taking methymazole, what does it treat?

Treats Hypothroidism

What is the THERAPEUTIC USE of low molecular weight heparins OR ENOXAPARIN?

prevent DVT -tx DVT and pulmonary emb. -prevent complications in angina, non-Q wave MI, & ST elevation MI

What is the THERAPEUTIC USE of dabigatran?

prevents stroke/embolism in pts who have atrial fib not caused by valvular heart disease. Also to treat DVT and prevent pul. embolism

A health care professional should assess a patient who has megaloblastic anemia for indications of which of the following vitamin deficiencies? a) Vitamin B12 b) Vitamin K c) Vitamin C d) Vitamin D

Vit B-12

A patient who is taking warfarin (Coumadin) arrives at the emergency department and reports rectal bleeding. Which of the following drugs should the health care professional have available? a) Filgrastim (Neupogen) b) Deferoxamine (Desferal) c) Protamine d) Vitamin K

Vit. K

A nurse is taking a history for a client who reports that he is taking aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin? A. Digoxin B. Metformin C. Warfarin D. Nitroglycerin

Warfarin

A health care professional is caring for a patient who is about to begin taking alteplase (Activase) to treat acute myocardial infarction. The health care professional should understand the drug is most effective when the patient receives it a) 24 hour after clot formation b) After initiation of anticoagulation c) Prior to clot formation d) Within 3 hour of symptom onset

Within 3 hour of symptom onset

A patient who is taking metformin (Glucophage) to treat type 2 diabetes mellitus plans to undergo angiography using iodine-containing contrast dye. The health care professional should recognize that an interaction between metformin and the IV contrast dye can increase the patient's risk for which of the following?

_ Acute Renal Failure

Which drugs are C/I when using WARFARIN?

anticoagulants i.e. - heparin - aspirin - acetaminophen - glucocorticoids - sulfonamides - parenteral cephalosporins

Metformin (Glucophage) to treat type 2 diabetes mellitus contacts the health care professional to report muscle pain. The health care professional should suspect which adverse reactions?

- Lactic acidosis

A health care professional is caring for a patient who is about to begin iron dextran (INFeD) therapy. When administering the drug IM, the health care professional should take which of the following actions? (Select all that apply) a) Administer a test dose b) Monitor blood pressure c) Have epinephrine available d) Premedicate with atropine e) Use the Z-track technique

- Administer a test dose - Monitor blood pressure - Have epinephrine available - Use the Z-track technique

. A nurse in an outpatient facility is caring for a client who has been taking acarbose (Precose) for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor? A. WBC B. Serum potassium C. Platelet count D. Liver function tests

- Liver function tests

A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran to prevent development of thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? A. Vitamin K1 B. Protamine C. Omeprazole D. Probenecid

Omeprazole

WARFARIN is C/I in which patients?

- Low platelet counts/uncontrollable bleeding - Following surg. of the eyes, brain, spinal cord, lumbar puncture, regional anesthesia - Vit K deficiencies - Liver disorder - Alcohol use disorder

What is the EXPECTED PHARMACOLOGICAL action of ANTIPLATELETS?

- Prevent platelets from clumping together - Alter bleeding time

What is the EXPECTED PHARM. ACTION of WARFARIN?

- Antagonizes vit. K preventing the synthesis of 4 coagulation factors: VII, IX, X, and prothrombin.

ANTICOAGULANTS INTERACT with which drugs?

- Anti-platelet agents aspirin & NSAIDS

A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy? (Select all that apply.) A. Hypertension B. Coffee-ground emesis C. Tinnitus D. Paresthesias of the extremities E. Nausea

- Coffee-ground emesis - Tinnitus - Nausea

What is the EXPECTED PHARMACOLOGICAL action of dabigatran?

- Directly inhibit thrombin and prevent a thrombus from developing

A health care professional is caring for a patient who is about to begin taking ferrous sulfate (Feosol) to treat iron-deficiency anemia. When talking with the patient about the drug, the health care professional should include which of the following instructions? (Select all that apply) a) Eat iron-enriched foods b) Spread the dosage across each day c) Take the drug on an empty stomach d) Report dark green or black stools e) Increase dietary fiber intake

- Eat iron-enriched foods - Spread the dosage across each day - Take the drug on an empty stomach - Report dark green or black stools

A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply) A. Fatigue B. Constipation C. Anorexia D. Rash E. Diplopia

- Fatigue - Anorexia - Diplopia

Which one is okay to use during pregnancy warfarin or heparin?

- Heparin

A nurse is reinforcing teaching with clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration? A. Insulin glargine (Lantus) B. NPH insulin (Humulin N) C. Regular insulin (Humulin R) D. Insulin lispro (Humalog)

- Regular insulin has a peak effect around 1 to 5 hr following administration

What should you warn patients about shaving and brushing their teeth when taking PARENTERAL ANTICOAG.?

- Use electric razor and soft tooth brush

What should you administer if OVERDOSE occurs when taking WARFARIN?

- Vit. k **IV vit. K slowly

Is dabigatran taken with or without meals?

- With meals to reduce GI effects

A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? (Select all that apply) A. Leukocytosis B. Hypertension C. Edema D. Blurred vision E. Headache

-Hypertension - Headache

What is the PROTOTYPE for an ORAL ANTICOAGULANT?

-Warfarin

What are the side effects of Levothyroxine

1.) Hypotension 2.) Decreased HR

A client is taking Somatropin, what do you need to be looking for in there urine? A. Bilirubin B. Calcium C. Potassium D. Protein

Calcium

You are caring for a client who has a prescription for somatropin, somatropin stimulates what? what would it cause an elevation of?

Calcium

A nurse is preparing to administer filgastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate? a. Administer intramuscularly in a large muscle mass to prevent injury. b. Ensure that the medication is refrigerated until just prior to administration. c. Shake vial gently to mix well before withdrawing dose. d. Discard vial after removing one dose of the medication.

Discard vial after removing one dose of the medication

A nurse is preparing to administer filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate? A. Administer IM in a large muscle mass to prevent injury. B. Ensure that the medication is refrigerated until just prior to administration. C. Shake vial gently to mix well before withdrawing dose. D. Discard vial after removing one dose of the medication.

Discard vial after removing one dose of the medication.

A health care professional is caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent thrombus formation. The health care professional should question the use of clopidogrel by a patient who has which of the following? a) Myocardial infarction b) Peptic ulcer disease c) Pancreatitis d) Myasthenia gravis

Peptic Ulcer Disease

Which foods can DECREASE anticoagulant effect?

dark green leafy veg. -lettuce, cooked spinach -cabbage -broccoli -brussel sprouts -mayo -canola and soybean oil

Use PARENTERAL ANTICOAGULANTS CAUTIOUSLY in which patients?

hemophilia increased capillary permeability dissecting aneurysm PUP severe hypertension H/K disease abortion