HESI Pharmacology Exit Exam Terms in this set (232) What is the indication for metoclopramide/reglan? Prevention of chemotherapy-induced emesis and diabetic gastroparesis Side effects of metoclopramide/reglan Drowsiness, EPS such as tremors Notify MD

HESI Pharmacology Exit Exam Terms in this set (232) What is the indication for metoclopramide/reglan? Prevention of chemotherapy-induced emesis and diabetic gastroparesis Side effects of metoclopramide/reglan Drowsiness, EPS such as tremors Notify MD if what occurs when using metoclopramide/reglan Tremors What is the indication xenical (orlistat, Alli) For PTs with BMI of 30+; LT weight control SE of xenical (orlistat or alli) Oily stool and flatulence Nursing implications for a pt on xenical (orlistat or alli) 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) Fiber laxatives like Metamucil help decrease SE by binding to the fat. Which type of fluids need plenty of water? Bulk forming laxatives Why do you need plenty of fluids when taking bulk forming laxatives Because they can produce esophageal and or intestinal obstruction Laxative use assessment Last BM and characteristics, abdominal pain, fever and obstruction. Assess dietary and fluid intake. With laxative use the nurse should Encourage fluids, fiber and exercise as tolerated/indicated Laxative use and result in Lack of bowel tone which can lead to dependency what is ondansetron (zofran) antiemetic What is ondansetron (zofran)used for? Prevention of N/V associated with chemotherapy and radiation therapy. Who should you use caution with when giving ondansetron/zofran? PTs with liver failure Drugs for ulcerative colitis and crohns 5 aminosalicylates; mesalamie, sulfasalazine. How do 5 aminosalicylates; (mesalamie, sulfasalazine) work? They decrease GI inflammation Side effects of 5 aminosalicylates; (mesalamie, sulfasalazine) Nausea, rash, arthralgia, hematological disorders Which drug can cause colitis/ Linezolid/zyvox What kind of infection is Suprainfection What is azithromycin/zithromax? An antibiotic What does azithromycin/zithromax treat? STDs such as: gonorrhea and chlamydia How much azithromycin/zithromax is usually required? One dose of 1g or 2g. If a female pt has trichomonas (any STI) and is asymptomatic does the male need to be tested? Yes! azithromycin/zithromax can cause what? Hepatotoxicity- elevated liver enzymes What is nitrofurantoin/cipro used for? An antibiotic for UTI nitrofurantoin/cipro side effect Hepatotoxicity, skin reactions, neuropathy nitrofurantoin/cipro nursing considerations 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 ? Metronidazole/flagyl When is metronidazole/flagyl to be taken? With food and around the clock What should be avoided when taking metronidazole/flagyl and why? Alcohol; can cause a disulfiram-like reaction aminoglycosides examples gentamicin(garamycin), neomycin, tobramycin(nebcin) how are aminoglycosides ,(-mycin, -micin), administered? given IV for several days what is an adverse effect of aminoglycosides (-mycin, -micin) decreased hearing/ototoxicity and nephrotoxicity what labs need to be evaluated when given aminoglycosides (-mycin, -micin)? BUN and creatinine DOC for MRSA vancomycin what is MRSA severe staph infections that have become resistant to most antibiotics implications for giving vancomycin 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 nephrotoxicity and ototoxicity SE of vancomycin 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? greater than 60 minutes what is trimethoprim/sulfamethoxazole? 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? sulfa allergy nursing implications for trimethoprim/sulfamethoxazole assess for rash due to potential for stevens johnson syndrome penicillins have a ____ to ____ cross-sensitivity; cephalosporins. they are structurally similar. nursing considerations for penicillins 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? epinephrine nursing considerations for antibiotics 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? antiviral for treatment of hepatitis C that has failed other treatment ribavirin(copegus) SE hemolytic anemia what is ticarcillin/clavulanic acid (timentin)? broad spectrum/extended spectrum penicillins nursing considerations for ticarcillin/clavulanic acid (timentin) do not administer in same infusion with aminoglycosides what is the indicated use for rifampin? antitubercular for treatment of TB rifampin SE 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? LFTs what is the indicated use for isoniazid (INH) TB what does isoniazid (INH) interact with? foods containing tyramine; can produce life-threatening hypertensive crisis. what should be used with isoniazid (INH)? 2nd form of birth control flu vaccine SE 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)? antifungal for vaginal candidiasis what labs should be monitored with fluconazole (diflucan)? many antifungals can cause liver injury monitor LFTs what is antifunal terbinafine (lamisil) used to treat? superficial dermatologic infections (athlete's foot) and onychomycosis (nail fungus). nursing considerations for terbinafine (lamisil) 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? decrease in WBC, decrease in fever, better cultures, pt feels better nursing considerations for antidepressants. 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? parkinson's disease and treatment of extrapyramidal symptoms (EPS) AKA parkinsonism what is benztropine/cogentin? anticholinergic SE of benztropine/cogentin blurry vision, urinary retention how does levodopa-carbidopa (sinemet) work? stimulates dopamine production or increases sensitivity of dopamine receptors what does levodopa-carbidopa (sinemet) treat? parkinson's S/S of levodopa-carbidopa (sinemet) toxicity 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? high protein meals! can impair effects! what is lithium (lithobid, lithotabs) indicated for? to treat pts with bipolar disorder. what kind of therapeutic index does lithium have? low/narrow; toxicity can occur at blood levels only slightly greater than therapeutic levels monitoring lithium is mandatory lithium (lithobid, lithotabs) levels below 1.5 mEq/L; anything greater causes toxicity initial lithium therapy levels 0.8-1.4 mEq/L maintenance lithium levels 0.5-1.5 mEq/L when should lithium levels be drawn? in the morning 12 hours after evening dose how often during maintenance therapy should lithium levels be checked? every 3-6 months normal sodium level 136-145 mEq/L how does an increased sodium level effect serum lithium levels? increase in sodium causes increase in renal excretion which will lower serum lithium levels early S/S of lithium toxicity D/N/V, drowsiness, muscle weakness. what happens with lithium toxicity? life-threatening dysrhythmia, coma, convulsions, and death nursing considerations for lithium keep salt consistent in diet; no diuretic haloperidol/haldol produces what? severe extrapyramidal symptoms (EPS) or reactions including tardive dyskinesia what are EPS movement disorders resulting from effects of anypsychotic drugs on the extrapyramidal motor system. what is the extrapyramidal system? same neuronal network whose malfunction is responsible for movement disorders of parkinson's disease. early reaction of haloperidol(haldol). acute dystonia, parkinsonism, akathisia/constantly moving/tapping the foot late haloperidol(haldol) symptoms tardive dyskinesia- the most troubling EPS what is tardive dyskinesia characterized by? involuntary choreoathetoid (twisting writing wormlike) movements of the tongue and face. pts may present lip-smacking movements and their tongues may flick out in a fly- catching motion. earliest manifestation of TD slow worm-like movement of the tongue what may result with TD malnutrition and weight loss; movements can interfere with chewing, swallowing and speaking what may be used to treat EPS? benztropine(cogentin) and diphenhydramine (benadryl) selective serotonin reuptake inhibitors prozac, zoloft, paxil assessment when using selective serotonin reuptake inhibitors (prozac, zoloft, paxil) neuromuscular and GI symptoms selective serotonin reuptake inhibitors (prozac, zoloft, paxil) nursing considerations may take 4-6 weeks to see therapeutic effects. take meds as prescribed. carefully monitor pt for self-harm or suicide. obtain list of all other meds what is olanzapine/zyprexa? what is it used to treat? antipsychotic medication that affects chemicals in the brain. it is used to treat symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression) in adults and children who are at least 13 years old. can be used with other antipsychotics or antidepressants HESI Pharmacology Exit Exam common side effects of zyprexa asthenia, dizziness, drowsiness, extrapyramidal reactions, hyperkinesia, akinesia, cogwheel rigidity, drug-induced parkinson's disease, dyspepsia, mask-like face, xerostomia, abnormal gait, back pain, constipation, fever, orthostatic hypotension, weight gain, myoclonus and personality disorder examples of opioids barbiturates (barbital), benzodiazepines (lam/pam), antiepileptics (AEDs), skeletal muscle relaxants what is clonazepam/klonopin? what does it treat? anticonvulsant, benzodiazepine to treat panic disorder