ATI pharmacology Tips Actual Practice Real Exam Questions And Detailed Answers.

Antiemetics: What is it? - correct answer The Trons!! An antiemetic is a medication used in the treatment and/or prevention of nausea and vomiting. Generic names are more consistent, because their endings may be the same, whereas brand names come and go What class are these drugs?: Dolasetron (Anzemet) Granisetron (Kytril, Sancuso) Ondansetron (Zofran) Tropisetron (Navoban) - correct answer Antiemetics Remember most antiemetics can cause sedation so watch out for additive effect if given with narcotic analgesics and protect your client from injury What is the action of Bronchodilators? - correct answer Bronchodilators are used to treat the symptoms of asthma that result from inflammation of the bronchial passages, but they do not treat the inflammation. The two most common classes of bronchodilators are beta2-adrenergicagonists and methylxanthines. What is the action of Beta2-adrenergic agonists? - correct answer act upon the beta2-receptors in the bronchial smooth muscle to provide bronchodilation and relieve spasm of the bronchial tubes, inhibit release of histamines and increase motility of bronchial cilia. These short-acting preparations provide short-term relief during an asthma exacerbation, while the long-acting preparations provide long-term control of asthma symptoms Med name hints for: Bronchodilators - correct answer The generic names for the inhaled form of these drugs end in"terol" = " T aking E ases R espiratory distress o r L abored breathing" The brand names of some drugs in this class provide a hint as well because they contain the words "vent " or " breth " referring to ventilation or breathing: What is the action of ACE inhibitors - correct answer The Prils!! block the production of angiotensin II which results in vasodilation, sodium and water excretion, and potassium retention. Drugs in this class are used for treating heart failure, hypertension, myocardial infarction, and diabetic or nondiabetic nephropathy. Clients taking captopril (Capoten) should be instructed to take med at least 1 hour before meals; all other ACE inhibitors are not affected by food. Adverse effects of ACE inhibitors - correct answer Orthostatic hypotension with first dose - Instruct client to monitor BP for at least 2 hours after first dose · Cough, rash or altered or distorted taste (dysgeusia) - Instruct client to notify health care provider · Angioedema - Treated with epinephrine and symptoms will resolve once medication is stopped · Neutropenia is rare but serious with captopril (Capoten) - Instruct client to report signs of infection Hyperkalemia can be life-threatening - Monitor potassium levels to maintain normal range of 3.5-5.0 mEq/L Interactions to be careful of for ACE inhibitors - correct answer Concurrent use with diuretics can lead to first-dose orthostatic hypotension · Concurrent use with other antihypertensives can lead to increase effect resulting in hypotension · Concurrent use with potassium supplements or potassium-sparing diuretics increases the risk of hyperkalemia · Concurrent use with lithium can increase serum lithium levels, leading to lithium toxicity · Concurrent use with NSAIDs can decrease the therapeutic effects of the ACE inhibitor Proton Pump Inhibitors (PPIs) - correct answer PPIs decrease stomach acid by inhibiting those gastric proton pumps that make the acid - they stop the acid at the pump!Think of a pump in your stomach just churning out the acid - 'Zole' is the nice guy who shuts off the pump. 'Zole' is very friendly (well-tolerated by most clients) but can cause vitamin B-12 deficiency if he stays around too long (with long-term use). Anticoagulants - correct answer Heparin , coumadin, lovenox Anticoagulants prevent the formation of blood clots by interfering with the clotting cascade, thereby preventing coagulation. The use of this class of medications is contraindicated with active bleeding, such as with bleeding disorders, ulcers, or hemorrhagic brain injuries Heparin: Acronym - correct answer H eparin sodium prevents thrombin from converting fibrinogen to fibrin. It is administered IV or SQ. E noxaparin (Lovenox) is a low-molecular weight heparin. It has the same action as heparin, but has a longer half-life. It is administered via subcutaneous injection. P rotamine sulfate is the antidote for heparin. A dminister heparin when there is the likelihood of clot formation, such as with myocardial infarction or deep-vein thrombosis. R isk for bleeding is the major side effect that clients should be alerted about. Clients should be alerted to monitor for bleeding, including bleeding gums, bruises, hematuria, and petechiae. I nstruct clients to avoid corticosteroid use, salicylates, NSAIDs, green leafy vegetables, and foods high in VitaminK. N ormal activated partial thromboplastin time (aPTT) is 20 to 36 seconds, but to maintain a therapeutic level of anticoagulation while on heparin, the aPTT should be 1.5 to 2 times the normal value (60 to 80 seconds). COUMADIN: acronym - correct answer C oumadin (generic name Warfarin sodium) interferes with coagulation factors by antagonizing vitamin K. O ral administration is typically used. Clients may need continued heparin infusion via IV until therapeutic effect of Coumadin is experienced (may take3-5 days). U se is contraindicated in clients with low platelet counts or uncontrolled bleeding. M ephyton (trade name vitamin K) is the antidote for Coumadin. A dvise clients to avoid foods that are high in vitamin K, and avoid the use of acetaminophen, glucocorticoids, and aspirin. Clients should wear a medical alert bracelet indicating warfarin use. D oses are typically taken once daily. I NR and PT are monitored for clients who are taking Coumadin. Depending on intent of therapy, PT should be 1.5 to 2 times control and INR should be 2-3. Target INR is 3 to 4.5 for clients with a mechanical heart valve. No Coumadin for pregnant women! Oral anticoagulants fall into Pregnancy Risk Category X. Heparin maybe safely used in pregnancy. Echinacea - correct answer Used to treat the common cold. With chronic use, echinacea can decrease positive effects of medications for TB, HIV, or cancer Ginger root - correct answer · Used to decrease nausea of morning sickness, motion sickness, and nausea induced by surgery. · May also decrease the pain and stiffness of rheumatoid arthritis. · These medications suppress platelet aggregation. · Should be used cautiously in pregnancy. Ginkgo biloba - correct answer · Promotes vasodilation and may be used to increase recall ability and mental processes. · Used commonly with dementia and Alzheimer's Disease. · May also be used for erectile dysfunction in clients who take SSRIs and experience impotence as a side effect. · May interact with medications that lower the seizure threshold, such as antihistamines, antidepressants, and antipsychotics. · May interfere with coagulation. Valerian - correct answer · Increases GABA to prevent insomnia. · Promotes sleep with increased effect over time. There is a risk of dependence. · May cause drowsiness and depression. · Should be used cautiously in clients with mental health disorders. · Avoid use in pregnancy or while breastfeeding Black cohosh - correct answer Acts on the female reproductive system as an estrogen substitute. · May be used instead of estrogen therapy during menopause. · Increases the effects of antihypertensive medications and may increase effect of estrogen medications. · Increases hypoglycemia in clients who are taking insulin or other medications for diabetes.