EXIT EXAM HESI PHARMACOLOGY A+ GRADED

EXIT EXAM HESI PHARMACOLOGY A+ GRADED What is the indication for metoclopramide/reglan? - CORRECT ANSWER-Prevention of chemotherapy-induced emesis and diabetic gastroparesis Side effects of metoclopramide/reglan - CORRECT ANSWER-Drowsiness, EPS such as tremors Notify MD if what occurs when using metoclopramide/reglan - CORRECT ANSWERTremors What is the indication xenical (orlistat, Alli) - CORRECT ANSWER-For PTs with BMI of 30+; LT weight control SE of xenical (orlistat or alli) - CORRECT ANSWER-Oily stool and flatulence Nursing implications for a pt on xenical (orlistat or alli) - CORRECT ANSWER-Ask pt to describe dietary intake since SE are increased if greater than 30% of fat is in diet. What can decrease side effects of xenical (orlistat or alli) - CORRECT ANSWER-Fiber laxatives like Metamucil help decrease SE by binding to the fat. Which type of fluids need plenty of water? - CORRECT ANSWER-Bulk forming laxatives Why do you need plenty of fluids when taking bulk forming laxatives - CORRECT ANSWER-Because they can produce esophageal and or intestinal obstruction Laxative use assessment - CORRECT ANSWER-Last BM and characteristics, abdominal pain, fever and obstruction. Assess dietary and fluid intake. With laxative use the nurse should - CORRECT ANSWER-Encourage fluids, fiber and exercise as tolerated/indicated Laxative use and result in - CORRECT ANSWER-Lack of bowel tone which can lead to dependency what is ondansetron (zofran) - CORRECT ANSWER-antiemetic What is ondansetron (zofran)used for? - CORRECT ANSWER-Prevention of N/V associated with chemotherapy and radiation therapy. Who should you use caution with when giving ondansetron/zofran? - CORRECT ANSWER-PTs with liver failure Drugs for ulcerative colitis and crohns - CORRECT ANSWER-5 aminosalicylates; mesalamie, sulfasalazine. How do 5 aminosalicylates; (mesalamie, sulfasalazine) work? - CORRECT ANSWERThey decrease GI inflammation Side effects of 5 aminosalicylates; (mesalamie, sulfasalazine) - CORRECT ANSWERNausea, rash, arthralgia, hematological disorders Which drug can cause colitis/ - CORRECT ANSWER-Linezolid/zyvox What kind of infection is - CORRECT ANSWER-Suprainfection What is azithromycin/zithromax? - CORRECT ANSWER-An antibiotic What does azithromycin/zithromax treat? - CORRECT ANSWER-STDs such as: gonorrhea and chlamydia How much azithromycin/zithromax is usually required? - CORRECT ANSWER-One dose of 1g or 2g. If a female pt has trichomonas (any STI) and is asymptomatic does the male need to be tested? - CORRECT ANSWER-Yes! azithromycin/zithromax can cause what? - CORRECT ANSWER-Hepatotoxicityelevated liver enzymes What is nitrofurantoin/cipro used for? - CORRECT ANSWER-An antibiotic for UTI nitrofurantoin/cipro side effect - CORRECT ANSWER-Hepatotoxicity, skin reactions, neuropathy nitrofurantoin/cipro nursing considerations - CORRECT ANSWER-Give with milk or meals check LFTs. Watch for numbness or tingling of extremities this can be an irreversible peripheral neuropathy Drug of choice for treating ? - CORRECT ANSWER-Metronidazole/flagyl When is metronidazole/flagyl to be taken? - CORRECT ANSWER-With food and around the clock What should be avoided when taking metronidazole/flagyl and why? - CORRECT ANSWER-Alcohol; can cause a disulfiram-like reaction aminoglycosides examples - CORRECT ANSWER-gentamicin(garamycin), neomycin, tobramycin(nebcin) how are aminoglycosides ,(-mycin, -micin), administered? - CORRECT ANSWER-given IV for several days what is an adverse effect of aminoglycosides (-mycin, -micin) - CORRECT ANSWERdecreased hearing/ototoxicity and nephrotoxicity what labs need to be evaluated when given aminoglycosides (-mycin, -micin)? - CORRECT ANSWER-BUN and creatinine DOC for MRSA - CORRECT ANSWER-vancomycin what is MRSA - CORRECT ANSWER-severe staph infections that have become resistant to most antibiotics implications for giving vancomycin - CORRECT ANSWER-acute care requires frequent monitoring og serum drug level for dose adjustment. peak and trough schedule. trough is drawn just prior to next dose. risks when using vancomycin - CORRECT ANSWER-nephrotoxicity and ototoxicity SE of vancomycin - CORRECT ANSWER-thrombophlebitis, red man syndrome if infused too rapidly: flushing or rash of upper body, dyspnea, itching, hypotension- can be lethal how long should IV vancomycin infuse? - CORRECT ANSWER-greater than 60 minutes what is trimethoprim/sulfamethoxazole? - CORRECT ANSWER-it is a sulfonamide for treatment of UTI. combination increases efficacy and inhibits metabolism of folic acid at two different points what is trimethoprim/sulfamethoxazole known for? - CORRECT ANSWER-sulfa allergy nursing implications for trimethoprim/sulfamethoxazole - CORRECT ANSWER-assess for rash due to potential for stevens johnson syndrome penicillins have a ____ to ____ - CORRECT ANSWER-cross-sensitivity; cephalosporins. they are structurally similar. nursing considerations for penicillins - CORRECT ANSWER-observe respiratory status for first 30 minutes when administering for the first time. watch for anaphylaxis if allergic to one or the other may have cross sensitivity what can a nurse treat penicillin anaphylaxis with? - CORRECT ANSWER-epinephrine nursing considerations for antibiotics - CORRECT ANSWER-do not take for viral illnesses. take entire prescription as ordered. don't take if not needed as it can produce resistance. what is ribavirin(copegus) indicated for? - CORRECT ANSWER-antiviral for treatment of hepatitis C that has failed other treatment ribavirin(copegus) SE - CORRECT ANSWER-hemolytic anemia what is ticarcillin/clavulanic acid (timentin)? - CORRECT ANSWER-broad spectrum/extended spectrum penicillins nursing considerations for ticarcillin/clavulanic acid (timentin) - CORRECT ANSWER-do not administer in same infusion with aminoglycosides what is the indicated use for rifampin? - CORRECT ANSWER-antitubercular for treatment of TB rifampin SE - CORRECT ANSWER-turns: body fluids; tears, saliva, urine, soft contacts red/orange/brown. (ADVISE PT THIS IS NORMAL). Teratogenic- may decrease effectiveness of oral contraceptives; advise to use nonhormonal form of conception throughout therapy. Hepatotoxicity what labs need to be monitored with rifampin? - CORRECT ANSWER-LFTs what is the indicated use for isoniazid (INH) - CORRECT ANSWER-TB what does isoniazid (INH) interact with? - CORRECT ANSWER-foods containing tyramine; can produce life-threatening hypertensive crisis. what should be used with isoniazid (INH)? - CORRECT ANSWER-2nd form of birth control flu vaccine SE - CORRECT ANSWER-for anyone 6 months and older every season; soreness, redness and swelling at site of injections, low grade fever, aches. what is the indicated use for fluconazole (diflucan)? - CORRECT ANSWER-antifungal for vaginal candidiasis what labs should be monitored with fluconazole (diflucan)? - CORRECT ANSWERmany antifungals can cause liver injury monitor LFTs what is antifunal terbinafine (lamisil) used to treat? - CORRECT ANSWER-superficial dermatologic infections (athlete's foot) and onychomycosis (nail fungus). nursing considerations for terbinafine (lamisil) - CORRECT ANSWER-avoid alcohol, monitor LFTs, report: nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools and jaundice how do you know if an antibiotic is effective? - CORRECT ANSWER-decrease in WBC, decrease in fever, better cultures, pt feels better nursing considerations for antidepressants. - CORRECT ANSWER-can cause addiction, pts experience withdrawal symptoms. ALWAYS GET MEDICATION HISTORY SINCE MANY DRUGS CAN INTERACT WITH ANTIDEPRESSANTS what is the indicated use for benztropine/cogentin? - CORRECT ANSWER-parkinson's disease and treatment of extrapyramidal symptoms (EPS) AKA parkinsonism what is benztropine/cogentin? - CORRECT ANSWER-anticholinergic SE of benztropine/cogentin - CORRECT ANSWER-blurry vision, urinary retention how does levodopa-carbidopa (sinemet) work? - CORRECT ANSWER-stimulates dopamine production or increases sensitivity of dopamine receptors what does levodopa-carbidopa (sinemet) treat? - CORRECT ANSWER-parkinson's S/S of levodopa-carbidopa (sinemet) toxicity - CORRECT ANSWER-involuntary muscle twitching, facial grimacing, spasmodic eye winking, exaggerated protrusion of the tongue. NOTIFY PRESCRIBER. what foods should a pt on levodopa-carbidopa (sinemet) avoid? - CORRECT ANSWERhigh protein meals! can impair effects! what is lithium (lithobid, lithotabs) indicated for? - CORRECT ANSWER-to treat pts with bipolar disorder. what kind of therapeutic index does lithium have? - CORRECT ANSWER-low/narrow; toxicity can occur at blood levels only slightly greater than therapeutic levels monitoring lithium is mandatory lithium (lithobid, lithotabs) levels - CORRECT ANSWER-below 1.5 mEq/L; anything greater causes toxicity