Maryville University Nursing 615 Exam 3 Study Review 2025

Low-dose colchine - -1.2 mg at first sign of flare, followed by 0.6 mg one hour later for a total dose of 1.8 mg. High-dose colchine - -1.2 mg followed by 0.6 mg every 4-6 hours totaling 4.8 mg. Gout - -BUN, creatinine, and creatinine clearance should be monitored in the treatment of this disease Colchine - -This medication can cause severe diarrhea, nausea, vomiting, abdominal pain Febuxostat (Uloric) - -When prescribing this medication, patients should be taught that gout may worsen with therapy before it improves Corticosteroids - -These medications can cause the following adverse effects if taken for six months or more: Osteoporosis and poor diabetic control. Patients should report black, tarry stools or abdominal pain. Corticosteroids - -These medications should be tapered to avoid recurrent activity of the underlying disease and possible cortisol deficiency resulting from the hypothalamic pituitary-adrenal axis suppression during the period of steroid therapy. Black Box Warning on NSAIDS - -Increased risk of serious cardiovascular thrombotic events, such as myocardial infarction and stroke. These medications can also cause serious GI events such as bleeding, ulceration or perforation of stomach or intestines, which can be fatal. Pain management - -When treating this common issue, it is recommended to begin with NSAIDS and work up from there as needed Ibuprofen - -This medication works by inhibiting the COX enzymes; however, the exact mechanism of action for this particular medication is unknown. Acetaminophen - -A serious adverse effect related to this medication is referred to as "------------- poisoning" Symptoms of hypoglycemia - -Decreased LOC, hunger, diaphoresis, weakness, dizziness and tachycardia Nursing 615 Nursing 615 Symptoms of hyperglycemia - -Polyuria, polydipsia and polyphagia (weight loss) Symptoms of DKA - -Kussmaul's respiration, ketone odor of the breath (fruity breath), vomiting, dehydration, abdominal pain, and neurologic symptoms such as lethargy; can progress to coma in later stages if left untreated. Metformin - -This medication decreases hepatic glucose output inhibiting gluconeogenesis. It also increases insulin mediated glucose utilization in peripheral tissues. This medication decreases intestinal absorption of glucose. This medication may also be used in diabetics to decrease cholesterol and triglyceride levels. Metformin - -When patients are prescribed this medication, the primary care provider should assess serum creatinine, renal function, and creatinine clearance initially and annually. Gliptins (DPP4 inhibitors) - -These medications increase the incretin levels, which inhibit glucagon release; this subsequently increases insulin secretion, decreases gastric emptying and decreases blood glucose levels. GLP-1 agonists - -These medications bind directly to the GLP-1 receptor, which then slows gastric emptying and increases insulin secretion by pancreatic beta cells. Exenatide (Byetta) - -This medication should be administered 60 minutes before breakfast and dinner. PTU - -Adverse effects of this medication include fatal granuloctyopenia (presents as fever and slow throat), vasculitis, temporary alopecia, rash, aplastic anemia, and acute renal failure. Levothyroxine - -Adverse effects of this medication include tachycardia and angina, which are more noticable in the elderly. Methimazole - -This medication is the recommended treatment of toxic goiter Methimazole - -This medication is tetratogenic and may cause the fetus to get aplasia acutis. PTU - -Adverse effects of this medication includes fatal granuloctyopenia (presents as fever and slow throat), vasculitis, temporary alopecia, rash, aplastic anemia, and acute renal failure. alpha-glucosidase inhibitors - -Acarbose is the primary medication used in this class and has a dosing schedule of 50 mg TID when initiating therapy. Nursing 615 Nursing 615 Alpha-glucosidase inhibitors - -These medications are contraindicated in patients with inflammatory or irritable bowel syndromes. PTU - -This medication inhibits the enzyme thyroperoxidase, which normally acts in the thyroid hormone synthesis by oxidizing the anion iodide to iodine, facilitating iodine's addition to tyrosine residues on the hormone precursor thyroglobuin. This medication also acts by inhibiting enzyme 5 deiodenase which converts T4 to the active form T3. This medication works in the thyroid and peripherally in target tissues. Levothyroxine - -This medication should be taken on an empty stomach approximately 30 minutes before meals. Black Box Warning for TZDs - -This medication can lead to significant water retention, which can then create decompensation due to an unrecognized form of heart failure. In addition, if these medications are used for more than 1 year there is an increased risk of bladder cancer. Thyroid replacement hormone - -Too much of these medications can cause Tachycardia, insomnia, or nervousness Levothyroxine - -When a patient is taking this medication, Blood free thyroxine and TSH levels should be monitored 4-8 weeks after the initiation of therapy or after a change in dose. When an adequate dose has been identified, TSH levels can be repeated at 6 and 12 months, unless there is a change in symptoms Rapid-acting insulins: Lispro (Humalog), Aspart (Novolog), and Glulisine (Apidra) - Onset: 5 minutes, Peak: 1 hour, Duration: 4-5 hours Short-acting insulin: Regular (Humulin) - -Onset: used around meal times and is taken 30-45 minutes before eating, Peak: 3-4 hours, Duration: 4-10 hours Intermediate-acting insulins: NPH - -This medication has to be mixed before administration. Onset: 60-90 minutes, Peak: 4-10 hours, Duration: 12-24 hours Long-acting: Glargine (Lantus) or Detemir (Levemir) - -Onset: 2-4 hours, Peak: little or no peak, Duration 24 hours. Glargine - -Initial dose of this medication should be reduced by 20% to avoid hypoglycemia when switching from NPH Insulin - -These medications have side effects of hypoglycemia and hypokalemia Antihypertensives - -A thorough renal and liver function assessment should be completed before prescribing these medications Nursing 615 Nursing 615 ACE inhibitors - -These medications are preferred in patients who are diabetic with hypertension as the reduce the adverse effects of diabetes on the kidneys. ACE inhibitors - -The most common side effect of these medications is a dry, hacking cough dihydropyridine-type calcium channel blockers - -These medications have adverse effects of reflex tachycardia, proteinuria, increased edema in the hands and feet, and headaches Statins - -These medications can cause Rhabdomyolysis, as well as an increased risk of diabetes, elevated liver enzymes, cognitive loss, neuropathy, pancreatic and hepatic dysfunction, and sexual dysfunction Statins - -The patient should report to the primary care provider if they have any muscle weakness or tenderness and dark urine immediately when taking these medications Fibric acid derivatives - -These medications are used mainly to treat elevated triglycerides. These medications can be used in combination with other hypercholesterolemia medications. bile acid sequestrants - -These medications bind to bile in the GI tract to prevent reabsorption. The conversion of cholesterol in a bile acid lowers plasma cholesterol levels. Niacin - -Providers should inform patients that flushing caused by this medication can be blocked by taking 300 milligrams of aspirin half an hour before taking this medication. Amlodipine - -This medication is metabolized in the liver to inactive metabolites via CYP3A4. This enzyme is inhibited by grapefruit juice which increases the amount of this medication in the blood stream. Amlodipine - -Adverse effects of this medication include: 1.) common and dose related are peripheral edema, dizziness, palpitations, flushing. 2.) common-not dose related are fatigue, nausea, abdominal pain, and somnolence. 3.) rare are blood disorders, impotence, depression, insomnia, tachycardia, gingival enlargement, hepatitis, and jaundice Amiodarone - -Patient may experience vision problems, a bluish-gray discoloration of the skin, photosensitivity, interstitial disease, as well as hypo and hyperthyroidism when taking this medication Digoxin - -This medication interacts with Verapamil, Amiodarone, Erythromycin, and Epinephrine (when injected as local anesthetic). The level of this medication should be monitored when the patient is taking albuterol. Nursing 615 Nitrate Tolerance - -Tolerance of these medications is described as the attenuation or loss of one or several of the effects after long-term administration Coumadin - -This medication is contraindicated in pregnancy, as it passes through the placental barrier and may cause bleeding in the fetus. Congestive heart failure - -First-line treatment for patients with this condition should include ACE inhibitors (or ARBs) and beta blockers Alternative treatment regimen for CHF - -In people who are intolerant of ACE inhibitors or ARBs or who have significant kidney dysfunction, the use of combined hydralazine and a long-acting nitrate such as isosorbide nitrate is an effective alternative strategy. This has been shown to reduce mortality in people with moderate heart failure, especially African Americans. Digitalis - -This medication can be used as a second-line medication for patients with congestive heart failure Procainamide - -This medication can cause ventricular dysrhythmias, bradycardia, hypotension, shock, drug-induced fever and other allergic responses; this medication can also cause systemic lupus, which may cause polyarthralgia,