3365 UTA Pharm Exam 2 With Correct
Answers
Allipuranol - ANSWER>>Antigout drug that prevents the build of uric acid in the
body by not letting it be produced
-Profalaxis and can be taken all of the time to help with onset of S/S
Colchine - ANSWER>>Antigout drug that is meant for acute attacks of gout
causing pain, its primary goal is to help reduce the overall inflammation of the
attack that is causing the pain in the joints of the toes.
-prolonged use of colchine can cause leukopenia
Probenacid - ANSWER>>Anti-gout drug that inhibits the overall re-absorption of
uric acid and urate in the kidneys, this leads to the kidneys excreting the uric acid
into the urine
-probenacid is also used to help with natural penicillin flora in the body
-a prophylaxis only
cholinergic drugs - ANSWER>>Drugs that stimaulate the PNS or Resting and
Digesting part of the ANS, attaching to the muscarnic receptors(smooth) or
nicotinic receptors(skeletal)
Opioid Analgesics - ANSWER>>Pain Drugs that bind to to opioid receptors in the
CNS. (Fentanyl, Morphine, Merperadine, Codiene Sulfate, hydrocodone)
-pain reduction
-cough suppressant
Common Side Affects of Opioids - ANSWER>>Constipation-GI inhibition
Vomiting- Antidiuretic
Nausa
Urinary Rentention
Orthostatic Hypotension-rise in stages
BP,RR,HR depression
Euphoria
Mental Clouding
,DON'T GIVE OPIOIDS IF: - ANSWER>>ASTHMA or COPD or BRADY CARDIA
Antidote for opioid Toxicity - ANSWER>>Noloxone or Narcan
Fentanyl (transdermal) - ANSWER>>Always wear gloves, dispose properly like in
the toilet at home of the hazard bins in a work place, delivered transdermally
because it is 100x stronger than Morphine, only for use in patients that are opioid
tolerant, always rotate sites of patch application, do not put heat on patch as this
can increase uptake.
Morphine Sulfate - ANSWER>>The most common opioid can be given in a pill or
IV. Commonly found in PCA as patients can request more depending on level of
pain- don't let the family press the button because that can cause an overdose.
Merperidine - ANSWER>>merperidine is a very hard to metabolize opioid in the
liver, merperidine also can lower the seizure threshold like tramadol-watch for
signs of seizure.
Hydromorphone (Dilaudid) - ANSWER>>Is a very strong opioid analgesic used for
severe chronic pain and is high addictive, it is 7x stronger than morphine and can
trigger toxicity. NARCAN for TOXICITY
NURSING PROCESSES FOR OPIOIDS - ANSWER>>A: Look for prior opioid use to see
if the patient is opioid naive or tolerant- this will dictate what kind of drug you can
suggest to administer(fentanyl vs. morphine), look for signs of contraindications
like COPD, Bradycardia, and asthma as opioids depress the CNS, check for what
level of pain 0-10 the patient is experiencing.
D&P: can you decreased the psot op pain from a 9 to a 4, or if there is some sort
of cough can you take it away
I:Give the medication slowly if the patient is receiving it IV, monitor for pupil
dilation, implement before severe pain onset, educate family and client on how to
use PCA and dangers associated with overdose
E: Pain is subsided and patient is comfortable, watch INO for urinary output and
content of fecal matter, if low urinary output check for retention and kindey
,failure- narcan, increase fluid intake, increase fiber intake- for constipation, rapid
ambulation- constipation, stool softeners can be suggested to the healthcare
provider if non-pharmacological process don't help, no adverse effects.
Non-opioid analgesics - ANSWER>>Acetaminophen (Tylenol)
Non-opioid analgesics do: Acetominophen - ANSWER>>Block the production of
prostaglandins to decrease binding to pain receptors in the dorsal horn.
Antipyretic property that helps decrease Fever.
-Normal dose 3,000mg/day
-Short dose 4,000mg/day
-Liver compromised dose 2,000mg/day
Side Effects of Acetaminophen - ANSWER>>-Hepatoxoicity- this is common for
acetomenophen and is labeled on most products containing it.
-Vomitting
-Anemia or increase chance of bleeding
DON'T DO WITH ACETOMENIPHEN - ANSWER>>Due to hepatoxoicity do not drink
alcohol as the liver is already in danger, the same goes for barbituates and
ribompin that can lead to liver damage.
signs of acetaminophen toxicity - ANSWER>>Jaundice, reduced liver function,
vomiting, anemia-if severe enough administer acetlycycline as the antidote for
acetaminophen toxicity
NURSING PROCESSES FOR ACETAMINOPHEN - ANSWER>>A: What kind of pain is
the patient in, what is the health history especially when it comes to liver issues,
is the patient taking acetaminophen for fever(antipyetic) or pain (non-opioid
analgeisic)
P&D:Overall pain reduction from a 6 to a 4, noticeable drop in temperature,
estabalish a time frame for improvement
I: Teach oral care, how much to take and how often(4 hours), learn how to read
levels and understand that the limits of daily dosing is based on compounding
amounts(cold and flu, pure acetaminophen, schedule 3 drugs)
, E: Noticeable drop in pain and/or fever, watch for signs of toxicity through the
INOS, look for signs of heptatoxicity (jaundice)-acetylcycline IV if overdosed.
Anti-inflammatory drugs "NSAIDS" - ANSWER>>Counteract inflammation
(pain,swelling,heat,redness,loss of function) and Fever/Pain
-Ibuprofen
-Aspirin
-Celecoxib
-Ketorolac
Common Side Effects of NSAIDS - ANSWER>>-GI ulceration/GI bleeding due to
COX-1 inhibition (excluding celecoxib)
-Increase Risk of Cardiac event (excluding 81mg/day of Aspirin in adult patient)
-Renal failure with Ibuprofen and Ketorolac
COX-1 and COX-2 - ANSWER>>are enzymes that convert arachidonic acid to
prostaglandin, resulting in pain and inflammation.
COX-1 is known to be present in most tissues and maintains the normal lining of
the stomach / GI tract. The enzyme is also involved in kidney and platelet
function.
COX-2 is primarily present at sites of inflammation.
Garlic and Nicotine - ANSWER>>are CYP 450 inducer that cause the liver to
process drugs faster meaning we made need a higher dose to reach the desired
therapeutic effect
Grapefruit - ANSWER>>Is a liver CYP 450 inhibitor that can result in lack of
breakdown(metabolism) leading to hepatoxicity
Aspirin - ANSWER>>NSAID that is commonly used for prophylaxis of heart attack,
inhibits both Cox1 and Cox2, common side affect and toxicity signal is tinitus or
ringing int he ears for aspirin
-don't take on empty stomach for fear of damaging stomach lining
-notify dentist or surgeon if currently taking and stop 72 hours in advance of
surgical event
Answers
Allipuranol - ANSWER>>Antigout drug that prevents the build of uric acid in the
body by not letting it be produced
-Profalaxis and can be taken all of the time to help with onset of S/S
Colchine - ANSWER>>Antigout drug that is meant for acute attacks of gout
causing pain, its primary goal is to help reduce the overall inflammation of the
attack that is causing the pain in the joints of the toes.
-prolonged use of colchine can cause leukopenia
Probenacid - ANSWER>>Anti-gout drug that inhibits the overall re-absorption of
uric acid and urate in the kidneys, this leads to the kidneys excreting the uric acid
into the urine
-probenacid is also used to help with natural penicillin flora in the body
-a prophylaxis only
cholinergic drugs - ANSWER>>Drugs that stimaulate the PNS or Resting and
Digesting part of the ANS, attaching to the muscarnic receptors(smooth) or
nicotinic receptors(skeletal)
Opioid Analgesics - ANSWER>>Pain Drugs that bind to to opioid receptors in the
CNS. (Fentanyl, Morphine, Merperadine, Codiene Sulfate, hydrocodone)
-pain reduction
-cough suppressant
Common Side Affects of Opioids - ANSWER>>Constipation-GI inhibition
Vomiting- Antidiuretic
Nausa
Urinary Rentention
Orthostatic Hypotension-rise in stages
BP,RR,HR depression
Euphoria
Mental Clouding
,DON'T GIVE OPIOIDS IF: - ANSWER>>ASTHMA or COPD or BRADY CARDIA
Antidote for opioid Toxicity - ANSWER>>Noloxone or Narcan
Fentanyl (transdermal) - ANSWER>>Always wear gloves, dispose properly like in
the toilet at home of the hazard bins in a work place, delivered transdermally
because it is 100x stronger than Morphine, only for use in patients that are opioid
tolerant, always rotate sites of patch application, do not put heat on patch as this
can increase uptake.
Morphine Sulfate - ANSWER>>The most common opioid can be given in a pill or
IV. Commonly found in PCA as patients can request more depending on level of
pain- don't let the family press the button because that can cause an overdose.
Merperidine - ANSWER>>merperidine is a very hard to metabolize opioid in the
liver, merperidine also can lower the seizure threshold like tramadol-watch for
signs of seizure.
Hydromorphone (Dilaudid) - ANSWER>>Is a very strong opioid analgesic used for
severe chronic pain and is high addictive, it is 7x stronger than morphine and can
trigger toxicity. NARCAN for TOXICITY
NURSING PROCESSES FOR OPIOIDS - ANSWER>>A: Look for prior opioid use to see
if the patient is opioid naive or tolerant- this will dictate what kind of drug you can
suggest to administer(fentanyl vs. morphine), look for signs of contraindications
like COPD, Bradycardia, and asthma as opioids depress the CNS, check for what
level of pain 0-10 the patient is experiencing.
D&P: can you decreased the psot op pain from a 9 to a 4, or if there is some sort
of cough can you take it away
I:Give the medication slowly if the patient is receiving it IV, monitor for pupil
dilation, implement before severe pain onset, educate family and client on how to
use PCA and dangers associated with overdose
E: Pain is subsided and patient is comfortable, watch INO for urinary output and
content of fecal matter, if low urinary output check for retention and kindey
,failure- narcan, increase fluid intake, increase fiber intake- for constipation, rapid
ambulation- constipation, stool softeners can be suggested to the healthcare
provider if non-pharmacological process don't help, no adverse effects.
Non-opioid analgesics - ANSWER>>Acetaminophen (Tylenol)
Non-opioid analgesics do: Acetominophen - ANSWER>>Block the production of
prostaglandins to decrease binding to pain receptors in the dorsal horn.
Antipyretic property that helps decrease Fever.
-Normal dose 3,000mg/day
-Short dose 4,000mg/day
-Liver compromised dose 2,000mg/day
Side Effects of Acetaminophen - ANSWER>>-Hepatoxoicity- this is common for
acetomenophen and is labeled on most products containing it.
-Vomitting
-Anemia or increase chance of bleeding
DON'T DO WITH ACETOMENIPHEN - ANSWER>>Due to hepatoxoicity do not drink
alcohol as the liver is already in danger, the same goes for barbituates and
ribompin that can lead to liver damage.
signs of acetaminophen toxicity - ANSWER>>Jaundice, reduced liver function,
vomiting, anemia-if severe enough administer acetlycycline as the antidote for
acetaminophen toxicity
NURSING PROCESSES FOR ACETAMINOPHEN - ANSWER>>A: What kind of pain is
the patient in, what is the health history especially when it comes to liver issues,
is the patient taking acetaminophen for fever(antipyetic) or pain (non-opioid
analgeisic)
P&D:Overall pain reduction from a 6 to a 4, noticeable drop in temperature,
estabalish a time frame for improvement
I: Teach oral care, how much to take and how often(4 hours), learn how to read
levels and understand that the limits of daily dosing is based on compounding
amounts(cold and flu, pure acetaminophen, schedule 3 drugs)
, E: Noticeable drop in pain and/or fever, watch for signs of toxicity through the
INOS, look for signs of heptatoxicity (jaundice)-acetylcycline IV if overdosed.
Anti-inflammatory drugs "NSAIDS" - ANSWER>>Counteract inflammation
(pain,swelling,heat,redness,loss of function) and Fever/Pain
-Ibuprofen
-Aspirin
-Celecoxib
-Ketorolac
Common Side Effects of NSAIDS - ANSWER>>-GI ulceration/GI bleeding due to
COX-1 inhibition (excluding celecoxib)
-Increase Risk of Cardiac event (excluding 81mg/day of Aspirin in adult patient)
-Renal failure with Ibuprofen and Ketorolac
COX-1 and COX-2 - ANSWER>>are enzymes that convert arachidonic acid to
prostaglandin, resulting in pain and inflammation.
COX-1 is known to be present in most tissues and maintains the normal lining of
the stomach / GI tract. The enzyme is also involved in kidney and platelet
function.
COX-2 is primarily present at sites of inflammation.
Garlic and Nicotine - ANSWER>>are CYP 450 inducer that cause the liver to
process drugs faster meaning we made need a higher dose to reach the desired
therapeutic effect
Grapefruit - ANSWER>>Is a liver CYP 450 inhibitor that can result in lack of
breakdown(metabolism) leading to hepatoxicity
Aspirin - ANSWER>>NSAID that is commonly used for prophylaxis of heart attack,
inhibits both Cox1 and Cox2, common side affect and toxicity signal is tinitus or
ringing int he ears for aspirin
-don't take on empty stomach for fear of damaging stomach lining
-notify dentist or surgeon if currently taking and stop 72 hours in advance of
surgical event
