PHARMACOLOGY HESI EXAM 2023/2024

PHARMACOLOGY HESI EXAM 2023/2024 increases force of contraction - CORRECT ANSWER-What is the positive inotrope for Digoxin do? decreases heart rate - CORRECT ANSWER-What is the negative chronotrope for Digoxin do? take apical pulse for one full minute - CORRECT ANSWER-How do you assess for the positive inotrope and negative chronotrope of digoxin? Normal digoxin level - CORRECT ANSWER-0.5-2 ng/mL Normal serum potassium (K+) level - CORRECT ANSWER-3.5-5.0 mEq/L YES - CORRECT ANSWER-Do low potassium or magnesium levels increase the risk for dig toxicity? S/S of dig toxicity - CORRECT ANSWER--anorexia -bradycardia -headache -dizziness -confusion -nausea -visual distrubances (blurred, yellow, halo vision) if apical pulse is lower than 60 bpm - CORRECT ANSWER-When do you want to hold digoxin? dig toxicity - CORRECT ANSWER-If a client has had a long history of digoxin and furosemide (lasix) use it could creates a high risk for what? Hypokalemia - CORRECT ANSWER-Furosemide (lasix) can cause _______ which can lead to dig toxicity. Verapamil (Calan) and Diltiazem (Cardizem) - CORRECT ANSWER--These 2 calcium channel blocker also affect the heart. So you wnat to monitor BP and for a decrease in HR. -SE: constipation -Avoid grapefruit juice -dipine ending drugs (like amlodipine) - CORRECT ANSWER--these calcium channel blockers affect vessels only (vasodilation) -SE: dizziness, facial flushing, edema, hypotension Furosemide (Lasix) - CORRECT ANSWER--loop diuretic -rapid acting -used foe rapid diuresis in emergencies (Pulmonary embolism) -may produce hypokalemia (assess for muscle craps or weakness) -Hypotension, F/E abnormalities, dehydration, SE of furosemide (Lasix) - CORRECT ANSWER--dizziness, -headache -tinnitus -Nausea, vomiting, diarrhea -decreased potassium -hyperglycemia -ototoxicity with aminoglycosides (-mycin drugs) Potassium sparing diuretics - CORRECT ANSWER--Spironolactone (Aldactone) -amiloride (Midamor) -triamterene (Dyrenium) -can cause increased potassium -blocks receptors for aldosterone -inhibits sodium and water reabsorption -take in the morning (diuretics in morning if possible) -avoid salt substitutes, ACE inhibitors, ARBs -often take with other (thiazide) diuretics to treat edema, hypertension, heart failure -can be taken with other meds that lower potassium - CORRECT ANSWER-what do you want to teach a patient who is on a potassium sparing diuretic? vasoconstriction - CORRECT ANSWER-What is the stimulation of alpha 1? you always want to check the apical pulse, hold if less than 60 - CORRECT ANSWERWhat do you want to always check when giving a beta blocker (-lol) respiratory conditions - CORRECT ANSWER-Since a beta blocker is cardio- selective you want to also assess what prior to administering? Mydriatics - CORRECT ANSWER-agents used to produce dilation of pupils for eye exams and ocular surgery Tamsulosin (Flomax) - CORRECT ANSWER--alpha 1 adrenergic blocker -decreases smooth muscle contraction of prostate capsules and bladder neck - used to treat BPH ***Alpha one blockers -zosin - antihypertensives*** Dopamine - CORRECT ANSWER-What drug is the only drug that can activate dopamine in the body? Extravasation - CORRECT ANSWER-Catecholamines (epinepherine, norepinepherine, dopamine, doubutamine, ect.) must be watched carefully for what? use a soft tooth brush, use electric razors, do not got without shoes - CORRECT ANSWER-What do you want to teach those on warfarin (Coumadin) to do to avoid bleeding? teaching for those on warfarin (coumadin) - CORRECT ANSWER--maintain vitamin K foods (greens, mustard greens,) in diet; do not increase or decrease them -PT/INR moitoring -avoid activities that may cause bleeding Clopidogrel (Plavix) - CORRECT ANSWER--Antiplatelet -you want to hold 7-10 days before the surgery (may not have to hold aspirin, contact MD) Pentoxifylline (Trental) - CORRECT ANSWER--for intermittent claudication -treats ischemic pain Heparin - CORRECT ANSWER--a high alert medication -requires another nurse to check the dosage -a potential SE would be bleeding protamine sulfate - CORRECT ANSWER-What is the antidote/reversal agent for Heparin? chronic pain - CORRECT ANSWER-What is morphine sulfate continued release used for? produce CNS depression and respiratory depression - CORRECT ANSWER-What can opioids do? Common opioids - CORRECT ANSWER--morphine -hydrocodone -oxycodone -hydromorphone [dilaudid] -codine Naloxone (Narcan) - CORRECT ANSWER-What do you want to give as the antidote for opioids (like to reverse respiratory depression and analgesia)? -may need to be titrated SE of opioids - CORRECT ANSWER--constipation -pruritis -urinary retention -decreased BP and heart rate Methadone (Dolophine) - CORRECT ANSWER-treatment of breakthrough pain. Half-life is longer than duration of action. With repeated doses drug accumulates in the tissues, which is then slowly released. Allows for 24-hour dosing. Aspirin (ASA) - CORRECT ANSWER--Antiplatelet -cautions with peptic ulcer disease (PUD) -cautions with children younger than the age of 18 with recent viral illness (Reyes syndrome) -interacts with other antiplatelets, anticoagulants, NSAIDs (etc) ***WATCH FOR BLEEDING!!!!*** Pregabalin (Lyrica) - CORRECT ANSWER--Nonopioid analgesic for peripheral neuropathy, postherpetic (shingles) neuralgia, fibromyalgia. -SE: suicidal thoughts, dizziness, drowsiness, edema, dry mouth, abdominal pain, constipation. Ketorolac (Toradol) - CORRECT ANSWER--NSAID (causes gastric irritation) -should e]be given with meals or snacks -has pain relief like morphine but is not a opioid -it is used for post-op pain not chronic pain -do not give this med for more than 5 days Diclofenac (Zipsor) - CORRECT ANSWER--NSAID -can increase LFTs (hepatotoxicity) -like other NSAIDs may increase the risk of MI and stroke -SE are the same as NSAIDs, including GI bleeding -S/S of anemia Celecoxib (Celebrex) - CORRECT ANSWER--COX-2 inhibitor (NSAID) for decreasing inflammation, reducing pain and fever -has a cross sensitivity reaction if someone is allergic to sulfa drugs -there is a increased risk of MI and stroke coffee-ground emesis or black stool - CORRECT ANSWER-What may indicate a GI bleed? Topical/inhaled adrenergics (decongestants) - CORRECT ANSWER--do not want to use longer than 3-5 days -can produce rebound congestion -taper by alternating nostrils Tiotropium (Spiriva) - CORRECT ANSWER-bronchodilator used in LT maintenance of COPD; given by inhaler; rinse mouth after inhaler use produce ease of breathing and decrease wheezing - CORRECT ANSWER-What should bronchodilators do? Montelukast (Singulair) - CORRECT ANSWER--This is a anti-inflammatory that can be given to children greater than 2 years of age -take PO once daily in the evening -SE: headache and dizziness -check LFTs Antihistamines - CORRECT ANSWER--ex: diphenhydramine (Benadryl) -dcreases nasopharyngeal secretions by blocking H1 receptors -use cautiously with elderly, COPD, asthma, pneumonia -A major SE is sedation theophylline (methylxanthine bronchodilator) - CORRECT ANSWER--indicted for treatment of COPD -IV form (aminophylline) for status asthmaticus -avoid caffeinated beverages, as caffeine is a methylxanthine -Monitor plasma drug levels -Toxicity can produce life threatening dysrhythmias radioactive iodine - CORRECT ANSWER--given for thyroid gland ablation -given as large capsules that are odorless and tasteless -can dry up salivary glands -excreted in urine, so FORCE FLUIDS!!! -patient is radioactive until this is removed from the body -Isolation, -you want to double flush toilets, etc. -administered by the nuclear medicine physician Methimazole (Tapazole) or Propylthiouracil (PTU) - CORRECT ANSWER--These are for the treatment of hyperthyroidism (Graves disease). -May be referred to as "antithyroid" medication. -Take at same time every day with meal or snack. -Avoid foods high in iodine (iodized salt; seafood). -May take 2 weeks to be effective.