Download Navigating the Path to Success: Your Ultimate Guide to Mastering NR293 Pharm Exam 2 at Ch and more Exams Nursing in PDF only on Docsity!
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
what are analgesics? - ansmedications that relieve pain without loss of consciousness What is nociception? - ansperception of pain what is a pain threshold? - ansstimuli needed to produce the sensation of pain what is a pain tolerance? - ansdifferent for everyone, amount of pain a person can endure without interfering with normal functioning somatic pain - ansoriginates from skeletal muscle, ligaments, and joints referred pain - anspain that is felt in a location other than where the pain originates visceral pain - ansoriginates from organs and smooth muscle central pain - ansmarked by chronic pain stemming from damage to CNS bradykinin - anscauses vasodilation What are adjuvant drugs? - ansassist primary drugs in relieving pain what are opioid drugs? - anssynthetic drugs that bind to the opiate receptors to relieve pain mild agonist opioid drugs - anscodeine and hydrocodone strong agonists - ansmorphine, hydromorphone, oxycodone, meperidine, fentanyl, and methadone Can a nurse dilute opioid drugs in an iv? - ansNo, not unless the pharmacy specifically says to and opioids should not be given through a normal saline device what is the opioid ceiling effect? - ansdrug reaches a maximum analgesic effect If you take 5 mg of a medication for pain, that 5 mg will go to receptor sites to block pain signals but let's say you take 10 mg, What will happen? - ans. Even if you increase the dose, it will have the same effect no matter how much you take, can have more of an adverse effect (why the pt may take more and more of something and then take more and then they begin to overdose. what do opioid agonists do? - ansbind to an opioid pain receptor site to block pain what do opioid agonists-antagonists do? - ansbind to a pain receptor but causes a mixed response, weaker than full agonist what do opioid antagonists do? - ansblocks or takes out the agonist effects ex: narcan reverses opioid overdose what is Equianalgesia? - ansability to provide equivalent pain relief by calculating dosages that provide comparable analgesia. opioid analgesics contraindications - ansknown drug allergy, severe asthma, COPD/respiratory insufficiency, pregnancy opioid analgesics indications - ansmoderate to severe pain (7+), cough center suppression, diarrhea, balanced anesthesia A patient is recovering from an appendectomy. She also has asthma and allergies to shellfish and iodine. To manage her postoperative pain, the physician has prescribed patient-controlled analgesia (PCA) with hydromorphone (Dilaudid). Which vital sign is of greatest concern? A.Pulse B.Blood pressure C.Temperature D. Respirations - ansD. respirations opioid analgesics adverse effects - ansCNS depression, GI upset, urinary retention (check bladder distention), diaphoresis/flushing, pupil constriction, constipation, itching what is a common opioid medication given for overdose? - ansNaloxone (Narcan) what do opioid analgesics interact with? - ansalcohol, antihistamines, barbiturates, benzos codeine sulfate - ansless effective, more commonly used as an antitussive fentanyl - ansnarrow therapeutic window; injection, patch, lozenges
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
Methadone Hydrochloride (Dolophine) - anssynthetic opioid analgesic, choice for detoxification for opioid addicts, prolonged QT interval and causes cardiac dysrhythmias morphine sulfate - ansopioid analgesic, prototype; used for severe pain Naxolone (Narcan) - ansopioid antagonist; for complete or partial reversal of opioid induced respiratory depression Acetaminophen (tylenol) - ansnon-opioid analgesic; can alter liver function, antipyretic and analgesic effects Acetaminophen MOA - ansblocks pain impulses peripherally by inhibiting prostaglandin synthesis Acetaminophen indications - ansmild to moderate pain (3-5), fever, alternative to aspirin Acetaminophen max dosage - ans<3000 mg/day <2000 mg/day for older adults Acetaminophen Contraindications - ansdrug allergy, liver dysfunction, liver failure A patient with a history of heavy alcohol use needs a medication for pain. The recommended maximum daily dose of acetaminophen for this patient would be A.1000 mg. B.2000 mg. C.3000 mg. 4000 mg. - ansB. 2000 mg Implications for Analgesics - ans-obtain thorough health history, medications, including herbals
- monitor I and O
- monitor liver enzymes
- monitor pain
- oral taken with food
- monitor vitals, hold meds if abnormal WATCH RR what are sedatives? - ansCNS depressant drugs that have an inhibitory effect on the CNS; reduce: nervousness excitability irritability what do hypnotic sedatives do? - anscause sleep; these are dose dependent what are benzodiazepines? - ansCNS depressant drugs commonly prescribed for sedation or sleep benzodiazepines sedative hypnotic types (3) - anslong acting, intermediate acting, short acting what are the long acting benzodiazepines? - ansClonazepam (Klonopin) and Diazepam (Valium) what are the short acting benzodiazepines? - ansMidazolam (Versed), Eszopiclone (Lunesta) what are the intermediate acting benzodiazepines? - ansAlprazolam (Xanax), lorazepam (Ativa) when is clonazepam used? - ansfor alcohol withdrawal or extreme anxiety when is xanax used? - ansreduce anxiety when is ativan used? - ansclinical setting, sleep when is Versed used? - ansclinical setting, outpatient procedures, puts patient to sleep for 20- 30 minutes
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
the effective, safe dosage range is narrow. - ansD common barbiturates - ansPhenobarbital and Pentobarbital what are the 2 types of muscle relaxants? - ansdirect and indirect indications of muscle relaxants - anspainful musculoskeletal conditions, back spasms, cerebral palsy muscle relaxants adverse effects - ansdizziness, drowsiness, fatigue, common muscle relaxants - ansCyclobenzaprine (Flexaril) and Dantrolene (Dantrium) Which statement regarding muscle relaxants does the nurse identify as being accurate? A.Baclofen (Lioresal) is available as an injectable form for use with an implantable pump device. B.Cyclobenzaprine (Flexeril) produces little sedation. C.Patients taking muscle relaxants are at high risk of developing hypertension. D.Patients taking muscle relaxants should be told to stop taking the medication if they feel sleepy. - ansA what are CNS stimulants? - ansdrugs that stimulate a specific area of the brain or spinal cord CNS stimulant MOA - ansstimulate areas of the brain associated with mental alertness what conditions are CNS stimulants used for? - ansADHD, Narcolepsy, migraines, neonatal apnea what are the drug effects of CNS suppressants? - ansrelaxation of bronchial smooth muscle, increased respiration, dilation of pulmonary arteries adverse effects of CNS suppressants - anstachycardia, palpitations, angina, anxiety, urinary frequency, nausea, vomiting, dry mouth, insomnia What is an amphetamine used to treat? - ansADHD and narcolepsy - go to is amphetamine aspartate (Adderall) What is atomexetine? What is it used for? - ansIt is an amphetamine CNS depressant used to treat Adderall - has a black box warning for suicidal thoughts A teenage boy will be receiving atomoxetine (Strattera) as part of treatment for ADHD. Which statement about this drug therapy is accurate? A.Strattera is highly addictive. B.Psychotherapy is rarely helpful in cases of ADHD. C.The patient should be monitored for possible suicidal thoughts and behavior D.Strattera is used to treat narcolepsy as well as ADHD. - ansC What is methylphenidate? what is it used for? - ansRitalin, CNS suppressant, first drug of choice for treating ADHD ; can cause insomnia- give at least 6 hrs before bed, baseline height and weight what is Modafinil (Provigil) and what is it used for? - ansCNS suppressant used for narcolepsy/ excessive daytime sleepiness, less abuse potential, promotes wakefulness what suffix should you look for for Antimigraine drugs? - ans7 triptans Before administering a serotonin agonist, it is most important for the nurse to assess the patient for a history of A.hypertension. B.allergy to penicillin. C.chronic bronchitis. D.cataracts. - ansA Triptans MOA - anscause vasoconstriction in cerebral arteries
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
Triptans adverse effects - ansvasoconstriction, irritation at injection site, tingling, flushing What is Sumatriptan (Imitrex)? - ansIt is a antimigraine medication used for headaches. what are analeptics? - ansused for neonatal apnea ; caffeine; used for bronchodilation Analeptics-Caffeine (what does it do) - ansincreases HR and can cause palpitations what are adverse effects of Analeptics? - ansmuscle tension and tremors nursing implications for analeptics - ansassess for euphoria what is a seizure - ansbrief episode of abnormal electrical activity in nerve cells of the brain what is a convulsion - ansinvoluntary spasms of voluntary muscles-skeletal, facial, and ocular what is epilepsy? - anschronic, recurrent pattern of seizures what does idiopathic mean? - ansno know cause what is secondary epilepsy? - ansunderlying cause (ex-trauma, infection) During a seizure, what happens to the respiratory system? - ansSaO2 decreases due to ineffective breathing during the seizure Status Epilepticus - ansemergency situation, multiple seizures with no recovery time in between, can become hypoxic and have a tendency to choke; results in hypoxia, brain damage, and death What are antiepileptic/anticonvulsant drugs used for? - ansprevent seizures; likely to be on these for the rest of life what is the therapeutic drug level of valproic acid (Depakote) - ans50-100 mcg/mL ; want to keep the therapeutic drug level at all time to prevent the seizure activity Antiepileptic drug effects - ans(MOA unknown) reduces nerve's ability to be stimulated-raise threshold ; suppress transmission of impulses from one nerve to another; decrease speed of impulses Antiepileptic adverse effects - ansblack box warning (suicidal thoughts/behavior); long term therapy with phenytoin (Dilantin); gingival hyperplasia; therapeutic range 10-20 mcg/mL what is Levetiracetam (Keppra) used for? - ansantiepileptic, Head trauma ; prophylactic what is Tiagabine (Gabitril) used for? - ansbinds to GABA receptors to stop seizure Common antiepileptic meds - ansTopiramate (Topamax), gabapentin (Neurontin), and pregabalin (Lyrica) What do amobarbital and pentobarbital do? - ansbarbiturates that help to break or stop seizures; serum drug levels 10-40 mcg/mL ; monitor liver ; no antidote what does phenytoin (Dilantin) do? - ansIV hydantoin; first line, prototype; therapeutic levels 10 - 20 mcg/mL ; stop seizures what are adverse effects of phenytoin (Dilantin)? - ansgingival hyperplasia, birth defects, osteoporosis what is carbamazepine (Tegretol) - ansantiepileptic; second most common; watch liver enzymes and for signs of jaundice A patient in a long-term care facility has a new order for carbamazepine (Tegretol) for seizure management. The nurse monitors for autoinduction, which will result in A.toxic levels of carbamazepine (Tegretol). B.lower than expected drug levels C.gingival hyperplasia. cessation of seizure activity. - ansB What is autoinduction? - ansspeeding up of drug clearance what does gabapentin (Neurontin) do? - ansincreases synthesis of GABA between neurons; for seizures and neuropathic pain
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
what is the antidote for Bethanechol (Urecholine) - a direct acting cholinergic drug? - ansAtropine what are indirect cholinergic drugs? - ansstimulate skeletal muscles; activate muscarinic and nicotinic receptors what do anticholinergic drugs do, MOA? - ansoccupy ACh receptors ; increase HR and have drying effects effects of anticholinergics - ansbronchodilation, dry up fluids, dilate pupils, relax smooth muscle what is Atropine? - ansan anticholinergic med; decreases motility of GI , decreases saliva; side effects/adverse: tachycardia, nasal congestion, urinary retention/hesitancy cholinergic drug effects - ansrecommended dose-primarily affects muscarinic receptors; at high doses it stimulates nicotinic receptors The nurse is assessing a patient who has been taking a cholinergic drug for 3 days. The patient has flushed skin and orthostatic blood pressure changes and is complaining of abdominal cramps and nausea. The nurse recognizes that the patient is most likely experiencing A.early signs of a cholinergic crisis. B.late signs of a cholinergic crisis. C.an allergic reaction to the drug. expected adverse effects. - ansA contraindications of cholinergic drugs - ansobstructions(GI), bradycardia, hypotension adverse effects of cholinergic drugs - ansbradycardia, hypotension, cardiac arrest, headache, convulsions, abdominal cramps, increased bronchial secretions, bronchial spasms what is a cholinergic crisis? - anscirculatory collapse, hypotension, bloody diarrhea; SLUDGE- salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis excessive fluid treat with atropine what do beta 1 adrenergics do? - ansincrease HR, heart contraction renin secretion what do Beta 2 adrenergics do? - ansdecrease GI tone and motility, bronchiodilation, relaxes uterus, activates glycogenesis central and peripheral A1 blockers MOA - ansblock A1 adrenergic receptors; dilate arterial and venous vessels doxazosin (Cardura) - ansprototype for A1 blockers indications for doxazosin - anshypertension, BPH, HF adverse effects of Alpha 1 blockers - ansorthostatic hypotension, possible GI upset non-selective peripherally acting alpha blockers indications - anshypertension, IV extravasation non-selective peripherally acting alpha blockers adverse effects - anstachycardia, dizziness, edema, necrosis from extravasation non-selective peripherally acting alpha blockers drugs of choice - ansphentolamine (Regitine) and reserpine (Serpasil) non-selective peripherally acting alpha blockers drug interactions - anserectile dysfunction drugs, increased hypotension with beta blockers non-selective peripherally acting alpha blockers drug side effects - ansdrowsiness, dizziness, depression, GI upset what do centrally acting alpha 2 receptor agonists do? - ansstimulate A2 receptors, vasodilation
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
What do A1 antagonists do? - ansreduce BP beta blockers MOA - ansreduce BP by reducing heart rate, reduced secretion of renin B1 cells act on the - ansheart B2 cells act in the - anslungs Beta blockers end in - ansolol Dual-action alpha1 and beta receptor blockers MOA - ansdecrease BP Dual-action alpha1 and beta receptor blockers drug of choice - anscarvedilol (Coreg) When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of: A.hypotension. B.hyperkalemia. C.oliguria. D.respiratory distress. - ansA what do Angiotensin-Converting Enzyme (ACE) Inhibitors do? - ansaffect the RAAS system to control fluid volume ACE inhibitors indications - anshypertension, HF, left ventricular hypertrophy after MI, reduce BP ACE inhibitors end in - ans"pril" ACE inhibitors MOA - ansreduce production of angiotensin, causing vasodilation, excretion of sodium and water, retention of K; prevent breakdown of bradykinin (for vasodilation) what is a prodrug? - ansa drug that needs liver enzymes to become active ACE inhibitor drugs of choice - anscaptopril and lisinopril ACE inhibitors adverse effects - ansfatigue, dizziness, dry, nonproductive cough, angioedema A patient with type II diabetes has a new prescription for the angiotensin-converting enzyme (ACE) inhibitor lisinopril. She questions this order because her physician has never told her that she has hypertension. What is the best explanation for this order? A.The doctor knows best. B.The patient is confused. C.This medication has cardioprotective properties. D.This medication has a protective effect on the kidneys for patients with type II diabetes - ansD A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? A.clonidine B.prazosin C.diltiazem D.captopril - ansD. captopril does not need to be metabolized by the liver to be effective Angiotensin II Receptor Blockers indications - anshypertension, adjuvant for HF Angiotensin II Receptor Blockers MOA - ansallow Angiotensin I to be converted to angiotensin II but block receptors that receive it ; block vasoconstriction Angiotensin II Receptor Blockers adverse effects - ansupper respiratory infections, increases potassium Angiotensin II Receptor Blockers end in - ans"sartan" Angiotensin II Receptor Blockers drugs - ansolmesartan (Benicar), valsartan (Diovan) Which statement about angiotensin II receptor blockers does the nurse identify as being true? A.Hyperkalemia is more likely to occur than when using ACE inhibitors. B.Cough is more likely to occur than when using ACE inhibitors. C.Upper respiratory infection is a common adverse effect.
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
B.If the pain becomes more severe C.If one sublingual tablet does not relieve the pain after 5 minutes D.If the pain is not relieved after three sublingual tablets, taken 5 minutes apart - ansC Beta Blockers drugs of choice - ansatenolol (Tenormin)-selective and metoprolol (Lopressor)-selective Beta blockers MOA - ansdecrease HR resulting in decreased myocardial oxygen demand and increase oxygen delivery ; decreases contractility- negative inotrope; blocks catecholamines Inotropes - ansStrengthen/weaken cardiac contraction chronotropes - ansanything that affects heart rate Dromatrope - ansaffect conduction beta blockers indications - ansangina, antihypertensive, cardioprotective beta blockers adverse effects - ansbradycardia, dizziness, fatigue, impotence, hyper/hypoglycemia A patient who has had a myocardial infarction is on a beta blocker. What is the main benefit of beta blocker therapy for this patient? A.Vasodilation of the coronary arteries B.Increased force of cardiac contraction C.Slowing of the heart rate D Maintaining adequate blood pressure - ansC calcium channel blockers MOA - anscause coronary artery vasodilation and reduce heart workload ; RELAX calcium channel blockers adverse effects - ansperipheral edema*, hypotension, GI upset antianginal drug implications - anscomplete health history, baseline vitals (including RR), assess drug interactions, report adverse effects to provider (P <60 and weight gain >2lbs/day) what occurs in the heart with RHF - ansloss of elasticity, peripheral edema what occurs in the heart with LHF - ansblood pumps out but left side cannot, back up of blood causing pulmonary edema (crackles, difficulty breathing) potent vasodilators for HF do what - ansdecrease afterload ACE inhibitors assist with HF by - ansdecreasing preload beta blockers assist with HF by - ansreducing HR what does the aldosterone antagonist spironolactone (Aldactone) do - anshelps the body not hold onto Na and water, potassium sparing diuretic what ethnicity is hydralazine/isosorbide dinitrate (BiDil) geared towards - ansafrican americans what does hydralazine/isosorbide dinitrate (BiDil) do - ansPRN med for uncontrolled hypertension if hypertensive between doses of beta blocker what does dobutamine do - ansB1 selective that increases the squeeze of heart= more CO but no increase in HR (positive inotrope) B-type Natriuretic Peptides MOA - ansincrease perfusion by vasodilation and suppression of renin-angiotensin system what is the B type natriuretic peptide nesiritide (Natrecor) used for - ansimprove CO in an acute emergency Which patient is the best candidate to receive nesiritide therapy? A.A patient with atrial fibrillation who has not responded to other drugs B.A patient needing initial treatment for heart failure C.A patient with reduced cardiac output D.A patient with acutely decompensated heart failure who has dyspnea at rest - ansD
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
B type natriuretic peptides adverse effects - anshypotension, headache, abdominal pain Phosphodiesterase Inhibitors MOA - ansinhibit enzyme phosphodiesterase to increase vasodilation; positive inotrope what is the Phosphodiesterase Inhibitor drug of choice - ansmilrinone (Primacor) Phosphodiesterase Inhibitors indications - ansshort term HF management Phosphodiesterase Inhibitors adverse effects - ansdysrhythmia, hypotension, angina, hypokalemia, tremor, thrombocytopenia Cardiac Glycosides drug of choice - ansdigoxin - negative chronotropic effect - CO Cardiac Glycosides MOA - ansincrease myocardial contractility , decrease electrical conduction (negative) Cardiac Glycosides drug effects - anspos ino- increase force w/o increase in oxygen consumption neg chrono- reduced HR neg dromo- decrease AV node conduction increase SV Cardiac Glycosides - ansheart failure, Afib and Aflutter A patient is in the emergency department with new onset atrial fibrillation. Which order for digoxin would most likely have the fastest therapeutic effect? A.Digoxin 0.25 mg PO daily B.Digoxin 1 mg PO now, then 0.25 mg PO daily C.Digoxin 0.5 mg IV push daily D.Digoxin 1 mg IV push now, then 0.25 mg IV daily - ansD digoxin therapeutic blood level - ans0.5-2 ng/mL (lowers potassium levels) Cardiac Glycosides adverse effects - ansslow HR- bradycardia, digoxin narrow therapeutic window, headaches, fatigue, confusion, halo vision, anorexia, vomiting, decreased appetite* digoxin toxicity - anslife threatening, dysrhythmias, hyperkalemia A patient is receiving digoxin 0.25 mg daily as part of treatment for heart failure. The nurse assesses the patient before medication administration. Which assessment finding would be of most concern? A. Apical heart rate of 58 beats/min B. Ankle edema +1 bilaterally C. Serum potassium level of 2.9 mEq/L D. Serum digoxin level of 0.8 ng/mL - anscx (hypokalemia) what occurs during the P wave of an EKG/ECG - ansSA node fires an impulse what occurs during the QRS complex of an EKG/ECG - ansAV node firing what occurs during the T wave of an EKG/ECG - ansventricular repolarization what occurs during a supraventricular dysrhythmia - ansHR goes up, BP goes down, occurs quickly, extreme-looks like you have passed out class I Antidysrhythmic drugs work on what electrolyte? - anssodium, slows from getting in and out of cell in order to slow conduction what is the drug of choice for class I Antidysrhythmic drugs? - ansprocainamide what is procainamide (Pronestyl) used for? - ansatrial and ventricular tachydysrhythmias procainamide (Pronestyl) adverse effects - ansventricular dysrhythmias, blood disorders, GI upset, maculopapular rash, flushing, prolonged QT interval Class IB Antiarrhythmics drugs of choice - ansphenytoin and lidocaine what do Class IB Antiarrhythmics drugs do? - ansblock sodium channels lidocaine is used for ventricular dysrhythmias only
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
A patient with a new prescription for a HMG-CoA (statin) drug is instructed to take the medication with the evening meal or at bedtime. The patient asks why it must be taken at this time of day. The reason is A.the medication is better absorbed at this time. B.this timeframe correlates better with the natural diurnal rhythm of cholesterol production. C.there will be fewer adverse effects if taken at night instead of with the morning meal. D. this timing reduces the incidence of myopathy. - ansB what do Bile Acid Sequestrants do? - ansstop bile acids from absorbing Bile Acid Sequestrants MOA - ansprevent bile from reabsorbing nutrients Bile Acid Sequestrants indications - anshigh cholesterol, pruritus Bile Acid Sequestrants adverse effects - ansconstipation, heartburn, nausea, belching, bloating Bile Acid Sequestrants considerations - ansall other drugs must be taken 1 hr before or 4- 6 hrs after admin; high doses decrease absorption of water soluble vitamins A patient has been ordered the powdered form of the bile acid sequestrant colestipol. Which of the following does the nurse identify as true? A.The nurse should have the patient swallow the dose of the colestipol powder one teaspoonful at a time. B.The powder should be dissolved and immediately administered. C.The colestipol should be administered 1 hour before or 4 to 6 hours after any other oral medication. D. The colestipol should be administered with meals - ansC Niacin (nicotinic acid) - anslowers lipids, side effect of flushing ; assess for GOUT Niacin (MOA) - ansincrease activity of lipase to break down lipids, helps body with normal activities Niacin indications - anslowering triglyceride, increase HDL levels Niacin adverse effects - ansflushing, pruritus, GI distress A patient will be taking niacin as part of antilipemic therapy. The best way to avoid problems with flushing or pruritus would be to A.take the medication at bedtime. B.take the medication with a small dose of a steroid. C.take the medication with a full glass of water on an empty stomach. D.start with a low initial dose and then increase it gradually. - ansD Fibric Acid derivatives MOA - anshelps lipase break down cholesterol Fibric Acid derivatives indications - anshyperlipidemias Fibric Acid derivatives contraindications - ansdrug allergy, cirrhosis of the liver, severe liver or kidney disease, gallbladder disease Fibric Acid derivatives adverse effects - ansabdominal discomfort, GI upset, increased bleeding, blurred vision Fibric Acid derivatives interactions - ansstatins, A patient wants to take garlic tablets to improve his cholesterol levels. Which condition would be a contraindication? A.Hypertension B.Bowel obstruction C.Sinus infection
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
D. Scheduled surgery - ansD. (garlic has antiplatelet properties) Before administering niacin, it is most important for the nurse to assess the patient for A.allergy to erythromycin. B.gout. C.coronary artery disease. D.hypothyroidism. - ansB how does nasal congestion work? - anscapillaries vasodilate and become permeable which causes congestion antihistamines - ansdirectly compete with histamine for specific receptors (H1 and H2) H1 antihistamines - ansreferred to as antihistamines ; Benadryl H2 blockers/antagonists - ansantihistamine; reduce gastric acid in peptic ulcer disease; ranitidine (Zantac) antihistamines indications - ansmanagement of nasal allergies, allergic reactions, motion sickness, parkinson's, sleep disorder, common cold symptoms antihistamines MOA - ansblock action of histamines at H1 receptor sites ; prevents vasodilation, increased GI and respiratory secretions, and increased capillary permeability antihistamines effects - ansreduce dilation of blood vessels, reduce salivary, gastric secretions, prevent histamine response, reduce itching, drying effect, drowsiness antihistamines adverse effects - ansparadoxical (more nervous); dry mouth, constipation, mild drowsiness 1st generation antihistamines - anshave drowsiness effect ; Benadryl-metabolized by liver, chlor trimeton 2nd generation antihistamines - ansno drowsy effect, fewer effects ; claritin, allegra, zyrtec antihistamine implications - ansmonitor for adverse effects-such as dizziness, chew gum to resolve dry mucous membranes, A client tells the nurse that he has started to take OTC antihistamine, diphenhydramine. In teaching him about side effects, it is most important for the nurse to tell the client: A.Not to take this drug at bedtime to avoid insomnia. B.To avoid driving a motor vehicle until stabilized on the drug. C.That nightmares and nervousness are more likely in an adult. D.To limit use to 1-2 puffs/sprays 4-6 times per day to avoid rebound congestion. - ansB what do nasal decongestants do? - ansshrink engorged nasal mucous membranes, decrease inflammation what is an anticholinergic effect? - ansdrying what do oral decongestants do? - ansno rebound congestion, decrease congestion but take longer to have effect; pseudoephedrine (sudafed) topical nasal decongestants - ansend in "ephrine" ; or "sone", sprays or nose drops ; phenylephrine (neo-synephrine) ; can cause excessive dryness nasal decongestants MOA - ansconstricts small blood vessels, nasal secretions better able to drain nasal steroids-antiinflammatory effect also in lower respiratory center nasal decongestant adverse effects - anssteroids-excessive dryness; nervousness, insomnia, palpitations, irritation The patient has been prescribed beclomethasone inhaler for allergic rhinitis. The nurse teaches the client that the most common side effect from continuous use is: A.Dizziness B.Rhinorrhea
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
Noncatecholamines - anslonger duration; used for ICU, code, HF, and sepsis (catecholamines too) epinephrine - ansnonselective; (adrenaline) , A12 increases BP, B1 increases HR, B bronchodilation used for anaphylactic shock, bronchospasms, cardiac arrest *need filter needle ; interacts with digoxin ; nursing implications for epinephrine - ansmonitor IV site for infiltration, monitor for dysrhythmias, may have reflex tachycardia considerations for adrenergic agonists - ansrecord VS to compare, check I and O, check blood glucose non catecholamine- Albuterol (Proventil) - ansacts on B2 adrenergic receptors ; bronchodilation; activated in liver ; side effects-tremors, nervousness,tachycardia (excitability) A patient has two inhalers that are due to be taken at the same time. One is a bronchodilator; the other is a corticosteroid. Which inhaler should the patient take first? A.The bronchodilator B.The corticosteroid C.It does not matter which one is taken first. - ansA-will result in a more open airway A patient is experiencing bronchospasms after running half a mile. He has several inhalers with him. Which one would be appropriate for treatment at this time? A.albuterol B.salmeterol C.fluticasone D.salmeterol and fluticasone combination (Advair Diskus) - ansA-bronchodilation and for acute bronchospasms indications for adrenergic agonists - ansasthma, nasal congestion, conjunctival congestion, reduction of intraocular pressure and dilating pupils what is dobutamine - ansman made dopamine what does dobutamine do? - ansB1 selective; increase CO by increasing contractility (positive inotropy), increases SV what does epinephrine (adrenalin) do? - ansacts directly on A and B adrenergic receptors ; nonselective; emergency situations; vasoactive what does norepinephrine do? - ansstimulates alpha-adrenergic receptors; vasoconstriction; take to get BP up but small vessels in hands will not get perfusion and can die what does phenylephrine (Neo-synephrine) do? - answorks exclusively on the alpha- adrenergic receptors ; short term treatment for patient in shock ; vasoconstriction A patient on a dobutamine drip starts to complain that her intravenous line "hurts." The nurse checks the insertion site and sees that the area is swollen and cool. What will the nurse do first? A.Slow the intravenous infusion. B.Stop the intravenous infusion. C.Inject the area with phentolamine. D.Notify the physician health care provider. - ansB alpha adrenergic adverse effects - ansheadache, palpitations, tachycardia, dry mouth, decreased peristalsis
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
beta adrenergic adverse effects - ansmild tremors, headache, nervousness, increased HR, sweating, GI upset A patient on a dobutamine drip starts to complain that he feels a "tightness" in his chest that he had not felt before. What will the nurse do first? A.Check the infusion site for possible extravasation. B.Increase the infusion rate. C.Check the patient's vital signs. D. Order an electrocardiogram. - ansC Adrenergic drug implications - anscheck IV site for infiltration, use an infusion pump, monitor cardiac rhythm, encourage fluids (up to 3000 mL/day), educate pt about proper dosages, overuse of nasal decongestants can cause rebound congestion, monitor for therapeutic effects A 10-year-old child is brought to the emergency department while having an asthma attack. She is given a nebulizer treatment with albuterol. The nurse's immediate assessment priority would be to A.determine the time of the child's last meal. B.monitor Spo2 with a pulse oximeter. C.monitor the child's temperature. D.provide education on asthma management. - ansB what do adrenergic blockers do? - ansbind to adrenergic receptors but inhibit or block stimulation of the SNS; also known as adrenergic antagonists (A blockers, b- blockers, or alpha-beta blockers) indications of alpha blockers - ansused for BPH; arterial and venous dilation reducing BP; hypertension; raynaud's disease what is the drug of choice alpha blocker adrenergic antagonist? - ansPhentolamine what does phentolamine do? - ansquickly reverses vasoconstrictive effects of vasopressors (epinephrine and norepinephrine), restores blood flow and prevents tissue necrosis When phentolamine is used to diagnose the presence of pheochromocytoma, the nurse will assess for what indicative finding? A.Rapid decrease in blood pressure B.Steady increase in blood pressure C.Slower heart rate D. Reduced cardiac ectopy - ansA Alpha blockers adverse effects - ansorthostatic hypotension, tachycardia, GI upset When administering an alpha blocker for the first time, it is most important for the nurse to assess the patient for the development of A.renal failure. B.hypotension. C.blood dyscrasia. D.dysrhythmias. - ansB common alpha blockers - ansphentolamine, Tamsulosin (Flomax), Doxazosin (Cardura) what does tamsulosin (Flomax) do? - ansa-blocker; treats mainly BPH, exclusive for male patients; contra-concurrent use of ED meds ; adverse- headache, abnormal ejaculation, rhinitis
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
loop diuretic indications - ansedema associated with HF, hepatic or renal disease, increase renal secretion of calcium (hypercalemia) loop diuretic adverse effects - anstinnitus, hypertension, SJS, agranulocytosis, thrombocytopenia, hyperuricemia Patients who take Loop Diuretics long-term should be assessed for what conditions? A. Abnormal Bleeding B. Increased A1C levels C. Increased risk for infections D. Cardiac Dysrhythmias E. Gout-like Symptoms F. All of the above - ansF When administering a loop diuretic to a patient, it is most important for the nurse to determine if the patient is also taking which drug? A.lithium (Eskalith) B.acetaminophen (Tylenol) C.penicillin D.theophylline - ansA (NSAIDS) loop diuretic drugs of choice - ansbumetanide (Bumex) and furosemide (Lasix) thiazide and thiazide-like drugs MOA - ansdiuretic, inhibit reabsorption of Na, Cl, and K; watch for drop in potassium thiazide and thiazide-like drug of choice - anshydrochlorothiazide (Esidrix) thiazide and thiazide-like drug effects - anslower peripheral vascular resistance ; should not be used if creatinine is <30-50 mL/min (normal is 125 mL/min) thiazide and thiazide-like drugs indications - ansHTN, diabetes insipidus, HF thiazide and thiazide-like drugs adverse effects - ansdizzy, headache, jaundice, leukopenia, photosensitivity, hypokalemia, hyperglycemia potassium sparing diuretics - ansspirolactone (Aldactone); also called aldosterone inhibiting diuretics; MOA potassium sparing diuretics - ansnot as strong, interfere with potassium-sodium exchange, competitively bind to aldosterone receptors, block reabsorption of sodium and water potassium sparing diuretics drug effects - ansprevent potassium excretion, promote Na and water secretion potassium sparing diuretics indications - anshyperaldosteronism , HTN potassium sparing diuretics adverse effects - anshormonal* ;cramps, urinary frequency,*gynecomastia, amenorrhea (absence of menstruation), irregular menses, *premenopausal bleeding osmotic diuretics - anspulls water out due to osmosis effect ; water goes from area of lesser tm greater concentration osmotic diuretics MOA - anspulls water into the renal system from surrounding tissues, inhibit H20 reabsorption osmotic diuretics drug effects - ansprevent kidney damage during acute renal failure, reduces ICP, reduces excessive intraocular pressure osmotic diuretics indications - anskidneys not pulling out waste, not***** for peripheral edema
Pharm Exam 2 at Chamberlain.
A Comprehensive Exam Study Guide for Top Success.
Current Updated Edition 2025/
osmotic diuretics adverse effects - anspulmonary congestion, convulsions, thrombophlebitis; need filtered need-watch it can create sugar crystal mannitol (Osmitrol) - ans(think Manray from spongebob (osmotic because he lives in the ocean)) IV infusion only, may crystallize need filter needle While preparing an infusion of mannitol (Osmitrol), the nurse notices small crystals in the IV tubing. The most appropriate action by the nurse is to A.administer the infusion slowly. B.discard the solution and obtain another bag of medication. C.obtain a filter, and then infuse the solution. D.return the fluid to the IV bag to dissolve the crystals. - ansB what are Carbonic Anhydrase Inhibitors (CAIs) used for - ansICU, life threatening situations Carbonic Anhydrase Inhibitors (CAIs) MOA - ansCarbonic Anhydrase helps make H+ ions available for exchange with Na and water ; CAN DEVELOP METABOLIC ACIDOSIS ; increased secretion of HCO3, Na, H2O, and K due to inhibition of CA Carbonic Anhydrase Inhibitors (CAIs) indications - ansopen angle glaucoma, lower IOP, edema; edema due to HF Carbonic Anhydrase Inhibitors (CAIs) adverse effects - ansmetabolic acidosis, photosensitivity, hypokalemia, drowsiness nursing implications of Carbonic Anhydrase Inhibitors (CAIs) - ansmonitor serum K levels, maintain foods high in potassium (raisins are highest); monitor digitalis toxicity if taking with a diuretic; keep daily weight log ; licorice can lead to additive hypokalemia with thiazides what can bronchitis result from? - ansprogressive lung infections, increased mucus what is emphysema? - ansair transport issue, air trapped in alveoli ; bronchioles must be dilated to allow air through Bronchodilators: beta agonists - ansB1-heart, HR increases, blockage=HR down B2 lungs Both increase HR and vasodilate beta agonists MOA - ansspecific receptor stimulated; relaxation of smooth muscles beta agonists indications - ansrelief of bronchospasms, treatment and prevention of acute asthma attacks, hypotension, uterine relaxation beta agonists adverse effects - ansmetaproterenol
- tremor
- angina
- vascular headache hypotension Albuterol
- tremor
- HTN or hypotension beta agonists implications - ansadequate fluid intake, avoid excessive fatigue, extreme temps, caffeine; central cyanosis; assess that patient can administer inhaler properly anticholinergics - ansprevent bronchoconstriction, NOT for acute asthma exacerbation ; dry you up! not for emergencies anticholinergics MOA - ansACh causes bronchial constriction and narrowing of airways- Anticholinergics bind to ACh receptors and prevent ACh from binding anticholinergics adverse effects - ansdry mouth, nasal congestion, palpitations, GI distress, anxiety
