Pharmacology Exam 1 - Rasmussen, Pharmacology Test 2 - Rasmussen College, Practical Nursing Pharmacology Test 3 Rasmussen College, Pharmacology Final - Rasmussen College

Pharmacology Exam 1 - Rasmussen, Pharmacology Test 2 - Rasmussen College, Practical Nursing Pharmacology Test 3 Rasmussen College, Pharmacology Final - Rasmussen College Metabolism (where it occurs) lungs, kidneys, liver side effects reactions to medicine other than the one intended otic medications administered into the ear different cultures - interview if you do not know what they need for their culture/religion ask them chemical name The name that describes the chemical composition and molecular structure of a drug. pregnancy categories A, B, C, D, X disadvantage of transdermal absorption less predictable and can lead to skin breakdown effects of agonist - on the medication (lock and key) effectiveness of an agonist drug depends on how tightly and how long it binds to its receptor effective teaching time when the patient is alert and awake oral administration - what to check for at any age check for proper swallowing technique Pt doesn't understand what Dr. said re-educate patient on the instructions until the patient can either demonstrate or tell how they would do doctors orders difference between drug and medication a medication is a prescribed or over the counter substance that is legal to own. A drug is illegal or mostly illegal substance that is not intended to improve the health of the user crushing pills only done on doctors orders administering a new drug - what to ask Do you understand what you are taking? most dangerous route of administration parenteral active listening Empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers' client-centered therapy. avoid drug errors use the eight rights: patient, drug, dose, route, time, documentation, diagnosis, response sublingual under the tongue increase risk for side effects - what disorder/disease steve johnsons syndrome therapeutic response - what is an example intended response or desired effect of a drug on specific body cells or tissues EX. Pain reliever relieves pain administration times bid, qid,q4h, hs, am half life length of time required to half the amount a drug is in a patients system STAT immediately, at once psychomotor domain The domain involved in the learning of a new procedure or skill; often called the doing domain. Has to do with the ways of learning (auditory, kinestetic, visual) dosage calculation errors - -what age group occurs mostly in the neonatal (0 - 1 year) allergic reaction An immunologic hypersensitivity reaction resulting from the unusual sensitivity of a patient to a particular medication; a type of adverse drug event. most dangerous - IV Intravenous injection is the most dangerous way to receive any medication potassium sparing medications - slow the sodium pumps so more sodium and water are excreted as urine spironolactone (Aldactone, Novospiroton), triamterene (Dyrenium), amiloride (Midamor) side effects for all diuretics (electrolytes) increased risk of dehydration (increased pule rate, low blood pressure, thirst, sunken appearance in eyeballs, dry mouth, constipation), increased urine output finasteride - side effects (male and female) men (erectile dysfunction, decreased seminal fluid, and reduced fertility), Women (decreased libido) Lasix - sign that it is effective urine output is increased, urine is lighter in color, blood pressure is lower ibuprofen and client teaching to decrease side effects to avoid GI side effects, teach the patient to always take any NSAID with food or on a full stomach. dont chew it up, check bowel movements for presence of bright red blood or dark, tarry-looking material that would indicate bleeding. hydromorphone and respirations respiratory depression is possible when opiods are used. Antidote to opiods naloxone (Narcan) What to tell patient when they are worried about addiction If you take the medications as prescribed you will not become addicted. SSRI how long it takes to work may to take from one to eight weeks before symptoms of depression improve Start on antidepressant - what is first priority find out if patient has a family history of depression. Ask about usual bowel pattern, fluid intake and diet. Ask about St. jon's wort relieve anxiety without too much sedation Benzodiazepines intended response to antipsychotic signs and symptoms of psychosis, including hallucinations and delusions, are decreased. behavior is improved schizophrenic behavior is decreased suicidal behavior decreased tonic-clonic seizure - primary intervention make sure that their airway is open Zarontin intervention for upset stomach give this drug with food what to avoid drinking with antidepressant St. Johns wort and alcohol advantage benzodiazepine vs SSRI for anxiety medication starts to work within 30 minutes versus 1 to 8 weeks how to treat severe pain typically going to be opioid if non-opioid drugs do not work overuse of Tylenol can cause this liver damage opioid pain control - what to measure monitor respiratory rate and exygen saturation for indications of repiratory depression client teaching with tylenol #3 there is a potential for abuse, you will have constipation ambien nursing interventions - avoid this Chapter 28 avoid alcohol, other sedatives and antihistamines zyrtec and abnormal vital signs check pulse, BP and respiratory rate every 4 hourse withing the first 8 hours after given modafinil what it is ued for Chapter 28 CNS stimulant dry cough - what medication ACE Inhibitors metoprolol vital signs and when to hold or give hold if less than 50 bpm diltiazen (cardizem) calcium channel blocker- antiarrhythmic CAD- can cause decrease in contractility causing HF losartan (Cozaar) - adverse effect kidney failure and life-threatening angioedema. additional rare is liver toxicity or drug induced hepatitis. Rasugiline (Azilect) food to avoid with MAOI foods high in tyramine - aged cheeses, cured meats, pepperoni, salami, bacon, hot dogs, corned beef, luncheon meats Vasodilators - what they do/how they work relaxes blood vessel walls. Digoxin overdose - signs/symptoms loss of appetite, nausea, vomiting, diarrhea, vision problems, heart rate or rhythms problems, palpitations, fainting start to see halos, yellow spots Seizures medication - what not to include in client teaching you can take a double dose if you want corticosteroids - side effect (multiple side effects - not multile choice) acne, sodium and fluid retention, elevated blood pressure, sensation of nervousness, difficulty sleeping weight gain, fat redistribution, increased risk for gastrointestinal ulcers and bleeding, fragile skin, thinning scalp, increased facial and body hair, increased susceptility to colds and other infections, stretch marks anticholinergic - what system it works on central nervous system adrenergic - what system does it mimic Central nervous system cholinergic - what system does it mimic parasympathetic nervous system inhibit or block SNS (what type of medications) opioids IM injection in an infant into the thigh side effect of Nitro headache weakness dizziness what to avoid with all anti-hypertensive (drink) alcohol energy drinks positive inotropic agents makes the heart muscles contract with more force relax blood vessels keep blood circulating LOW HR, Low BP and increase in respirations - what medication to give corticosteroid enalapril - positive outcome ACE Inhibitor, lowers BP Amiodarone Adverse Reactions may cause thyroid problems (both hyper and hypothyroid) faster/slower/more irregular heartbeat severe dizziness fainting digoxin - what to check before administering check apical pulse (less than 60 or more than 100 notify doctor) if on a monitor make sure placement is correct ask if pregnant, breast feeding or planning on becoming pregnant check k+ (low level increase digoxin toxicity) HF, metoprolol XL - parmacy sends metoprolol what to do call pharmacy because they are two different medications contact doctor as well nitro patch and client teaching remove all traces of the drug rotate sites to avoid skin irritation or breakdown do not shave skin before applying trans-dermal drugs (may change absorption) apply to clean dry area leave on for 12-14 hours remove patch during hours of sleep before bedtime lipitor - how does it work (STATINS) inhibit HMG CoA reductase, an enzyme that controls cholesterol production in the body lower levels by slowing the production of cholesterol and increase the ability of the liver to remove LDL from the blood most effective group in lowering LDL simvastatin - nurse best action if side effect occurs lopid - what food, drink and supplement to avoid avoid foods high in fat or cholesterol avoid alcohol beconase, nasacor and servent - what are they used to treat allergies flunisolide (Nasalide) Corticosteroid nasal spray administration of nasal spray blow nose to clear mucus tilt head forward slowly squeeze the pump as you begin to breathe in slowly through your nose bronchodilator - pirbulterol - additional doses during an asthma attack corticosteroids, asthma and copd - what does it do reduces the inflammation of chronic COPD and help prevent and control asthma attacks effectiveness of montelukast (singulair) prevent wheezing and shotrness of breath caused by an asthma attack inhaler, prevent yeast infections it is called thrush rinse mouth by gargling water after use of an inhaler Ipratropium (atrovent) - what kind of medication is it Bronchodilator that relaxes muscles in the airway Guaifenesin (Mucinex) - purpose of the drug helps reduce chest congestion caused by colds, infections, or allergies acute asthma attack - what to take rescue inhaler short acting nerve endings intestinal tract to reduce diarrhea (medication) Immodium osmotic laxatives reduce constipation - how soften stool by allowing less water to be absorbed from it histamine H2 blockers heal gastric ulcers - how decrease stimulation of H2 in gastric cells that secrete hydrochloric acids, leading to decrease in gastric acid secretion proton pump inhibitors, elderly at risk for hip fracture (why) antacid - how to take them take an hour after eating but not with other medications difference between antacids and PPI Antacids - fastest working neutralizes acid in the stomach PPI - last longer, suppress gastric acid secretion carafate - what it does covers an ulcer and protects the open sore from further damage to allow healing NSAIDs gastric irritation - what will be prescribed celebrex Insulin - what syringe to use 12.7 - 4mm 27-29 Needle lesss, IV syringe - advantage of it elimination of broken needles consisten vaccine delivery lower vaccine volume higher antigen dispersion elmination of worker needle sticks elimination of needle disposal less pain and stress short and long acting insulin - how to draw it up draw air first place air in cloudy vial first without touching the insulin take needle out draw more air inject air into clear vial draw clear liquid first then draw cloudy second adding total insulin gather total of insulin before mixing D/H and D/H xQ dose divided by strength times quantity (ml or tablets) corticosteroid inhaler -(Shake well) Rinse mouth after use maxair - what to instruct for additional doses if needing additional doses seek medical attention for greater problem positive outcome for ACE inhibitors lower blood pressure block constriction for people with diabetes, especially those with protein (albumin) in their urine ACE inhibitors can slow kidney damage what medications to give to lower HR antidysrhymic drugs atropine (Atropine Sulfate) side effects include tachycardia, drowsiness, blurred vision, dry mouth and urinary retention Hormone Replacement Therapy (HRT) Adverse Effects: -Heat attacks -increase risk for blood clotting -different cancers -Uterine Bleeding Lumigan eye drops Client Teaching -Eye and eyelid color can change overtime -lashes may become thicker -Do NOT use in good eye Antineoplastics -Toxic -To all healthy, rapid growing cells What medication would be used to treat respiratory fungus Polyenes How long is therapy for TB 6 - 12 months Insulin by IV given by the subcutaneous route levothyroxine - what to monitor -blood pressure -heart rate -heart rhythm shortest acting insulin -Novalog -Humalog rosigilitazone (Avandia) - careful for what condition do not give to someone with severe heart failure Diamox - what to ask before 1st dose ask if they are allergic to sulfa drugs why anticoagulant is prescribed used to reduce clot formation or to prevent an existing clot from becoming bigger overdose for heparin Protamine sulfate used to counteract tetanus booster Adult immunization. Every 10 years antineoplastic drugs medication that blocks the development, growth, or proliferation of malignant cells nursing goal of immunosuppressant for patient to suppress the immune system so that transplants can acclimate to the body Penicillin allergy - what not to prescribe anything that has a penicillin base: -Any drug with the (-cillin) ending -Cefaclor -Cefadroxil -Cefazolin -Cefdinir -Cefotetan -Cefprozil -Cefuromixime -Cephalexin (Keflex) -Cefepime (Maxipine) antibiotic - when GI upset what to take to remedy Pro-biotics such as -yogurt -sourcrout -kimchi -pickles Tetracycline in pregnancy Interferes with bone and teeth development antiviral drug therapy - purpose used to treat viral infections rather than bacterial respiratory syntactical virus (Virazole) - who should avoid visiting with the aerosol treatment Pregnant women and children new antibiotic - what to watch for Signs of anaphylactic reaction: -tightness of the chest -trouble breathing -low blood pressure -hives around IV site -swelling of the face, mouth, and throat -hoarse voice -weak, thready pulse -a sense that something bad is happening Medical Antagonist An extrinsic drug that blocks the receptor site of a cell, preventing the naturally occurring body substance from binding to the receptor new medication - unwanted complaints anaphylactic shock affects dosing of medications -age -weight -other medications Vitamin B12 Sublingual - not orally (why) easier to give for someone who is using pepcid or zantac and cannot swallow pills educating on meds - what to remember about patient effectiveness speak when patient is not in pain, when alone, is calm, and other ways to make sure that they are attentive and not distracted how to administer meds safely use 8 rights -right patient -right drug -right dose -right route -right time -right documentation -right diagnosis -right response route with quickest onset Parenteral (injection) new med - what do you ask allergies Pregnancy Category C drugs - what to do not advised to use because there is no evidence as to whether or not they are safe high alert medications medications that have a high risk of causing patient harm when used in error 1/2 normal dose of pain med - why? psychomotor domain The domain involved in the learning of a new procedure or skill; often called the doing domain. lasix and electrolytes when on lasix you can lose electrolytes due to the excessive amount of water leaving the body. replenish electrolytes by consuming: -dairy products -bananas -coconut water -watermelon -avocado nsaids side effects GI upset, dizziness, headaches, bleeding, fluid retention Opioid reversal agent Naloxone (Narcan) antidepressant and black box warning Suicidal thoughts in young adults and teens < 24 yo what to give for stress and anxiety Benzodiazepines: -alprazolam -conazepam -clorazepate -chlordiazepoxide -diazepam -lorazepam -oxazepam Anxiolytics -busPIRone when to hold metoprolol ask for history of depression, can also hide signs of hypoglycemia so if already present do not give Norvasc Side Effects Peripheral edema, pulmonary edema, dizziness methylprednisolone what to avoid do not stop taking suddenly Ritalin side effects nervousness, insomnia, nausea, headaches, dizziness, heart palpitations, temporary growth retardation patient pain med after surgery (doesnt want to take it) - what to ask why do you not want to take it? Spironolactone (Aldactone) potassium sparing diuretic morphine and when to hold it main opioid -hold if signs of dependency are present Side effects of Tegretol -Ataxia -dizziness -light-headedness -drowziness -loss of cordination -sedation -nausea -vomiting -hypotension foods to avoid on MAOI tyramine(dried fruit, organ meats, red wine, cheese, alcohol) Too much Tylenol can cause what organ in older person to shut down? liver and kidneys positive inotropes Heart pump drugs that make the heart muscle contract more forcefully. They also relax blood vessels so blood can flow better Nitroglycerin side effects Headache, burning under tongue, hypotension, nausea metoprolol - what to check before giving -check blood glucose levels regularly -can mask the signs of hypoglycemia ACE inhibitors - fall prevention quickly standing or sitting up quickly can lower blood pressure Lipitor effectiveness it is a statin - lowers blood lipid levels by slowing the production of cholestrol and increasing the ability of the liver to remove LDL cholesterol from the blood Asthma (Acute Attacks) Treatment (s) 1. Inhaled bronchodilator (metered dose inhaler or nebulizer). 2. IV Fluids 3. Supplemental O2 4. Immediate evacuation (if in field environment). stomach coating medication sucralfate (Carafate) Zyrtec (side effects) -drowsiness -fatigue -tired feeling -dizziness -dry mouth -sore throat -cough -nausea Lomitol side effects -Euphoria -Depression -Lethargy or drowsiness -restlessness -headache -nausea -vomiting -loss of apetite Bronchodilators Action Facilitate respirations by dilating the airways Digoxin (Lanoxin) teaching -Check heart rate every day before taking -remind them to tell prescriber if their heart rate drops below 60 beats per minute or greater than 100 -describe signs and symptoms of overdose -remind to weigh every day and report a wight gain of greater than 2 pounds -take exactly as ordered -take at same time every day -avoid antacids within 2 hours what lowers blood pressure regular exercise statins side effects Muscle pain and damage, liver damage, digestive problems, rash and flushing, increased blood sugar for type 2 diabetes,Decreased cognition. OTC laxatives 3 weeks - best nurse action -reinforce that increasing fluid intake often rlieves constipation without the need for laxatives -take additional electrolyte balancing Prilosec before breakfast - why -it is a proton pump inhibitor -it is more effective to take before breakfast as it can stop the pumps from producing before food ACE Inhibitor side effects Dry hacking cough, angioedema coumadin - Discontinue teaching (select all that apply) you should not stop taking if you are not told to by your doctor acetaminophen overdose acetylcysteine Kilogram to gram Multiply by 1000 Gram to Kilogram divide by 1000 Gram to Microgram Multiply by 1000000 Ounce to Milliliters 1 ounce is 30 ml Kilogram to Pounds 1 kg = 2.2 lbs Millileter to teaspoon 1 tsp = 5 mL Tablespoon to mL 1 tablespoon = 15 mL Cups to ounces 1 cup = 8 oz mL to L divide by 1000 grains to mg 65 D/H and D/HxQ dose divided by strength times quantity Rights of Medication Administration Right medication Right patient Right dosage Right route Right time Right reason Right assessment data Right documentation Right response Right to education Right to refuse Insulin A hormone produced by the pancreas or taken as a medication by many diabetics dose by weight - get weight into Kg - Lb to Kg is 1 kg to 2.2 lbs - weight in Kg X dosage per Kg = required dosage reading and transcribing orders - date of the order - full name of drug - dose form and amount - administration route - time schedule - date to start -date to stop Drip Rate Formula drops/min = # of mL/hr X drop factor, divided by 60 Excretion waste products and excess sodium and potassium stay in the urine along with just enough water to allow them to be urinated out from the body Absorption movement of a drug from the outside of the body into the bloodstream Distribution the extent that a drug absorbed into the bloodstream spreads into the three body water compartments Metabolism Chemical reaction in the body that changes the chemical shape and content of a drug, preparing the drug for inactivation and elimination intra-arterial injection injection into an artery intravenous injection (IV) made directly into a vein intradermal injection injection placed just below the epidermis subcutaneous injection injection into the subcutaneous tissue that lies between the epidermis and the muscle intramuscular injection an injection into deep muscle tissue, usually of the buttock, thigh, or upper arm intracavitary injection this injection is made into a body cavity, such as the peritoneal or pleural cavity intra-articular injection injection into a joint intrathecal injection injection in the spinal cord (meninges) Standing order an order written when a patient is to receive a drug on a regular basis. also called a routine order singe-dose order an order written to administer a drug one time only PRN order "as needed" order for medication STAT order single order carried out immediately