Term
| The goal of the endocrine system is: |
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Definition
|
|
Term
| Physiologic stability is done by communicating with 50 million target cells. The communication & language between (to achieve that physiologic stability) is done by _____________. |
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Definition
|
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Term
| What does a "negative feedback loop" mean? |
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Definition
When gland X releases hormone X, this stimulates target cells to release hormone Y. When there is an excess of hormone Y, gland X "senses" this and inhibits its release of hormone Y.
This process is used to achieve specific hormonal effects, then the cycle begins again. |
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Term
| The Pituitary gland has 2 distinct tissues. What are they? What connects them? |
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Definition
| anterior & posterior pituitary. Hypothalamus connects them. |
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Term
| What is the pituitary agent Somatotropin? What is it used for? |
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Definition
| It's the human GROWTH HORMONE. Given for hypopituitary dwarfism to stimulate skeletal muscle growth. |
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Term
| What is the pituitary agent Vasopressin given for? |
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Definition
|
|
Term
| What 3 symptoms does Vasopressin control for DI patients? |
|
Definition
| Polydipsia (excessive thirst), Polyuria (excessive urination) & Dehydration. |
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|
Term
| It is hard to keep up with the polyuria (large amounts of urine ) that occurs with Diabetes Insipidus patients The vasopressin mimics _____ to lessen the amount of urine. |
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Definition
| ADH (antidiuretic hormone) |
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Term
| What route is vasopressin given in? |
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Definition
|
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Term
| If you have a patient that is going to discontinue taking a pituitary agent drug (like Somatotropin or Vasopressin) then what is the correct way to do so? |
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Definition
| These drugs can not be abruptly stopped b/c of the negative feedback loop for pituitary hormones. There will be a question on the test about this. The answer is "tapering off" or something like that & that is the right answer. |
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Term
| A 66 lb child is exeriencing growth failure & is to receive Somatotropin therapy. The disage ordered is 0.20 mg/kg/wk to be given as daily injections. What is the dosage per week? |
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Definition
| 1st step: convert lbs to kilograms. (2.2 lbs:1kg=66 lbs:x kg) x=30 kg. 0.20 kg x 30 = 6 What is the dosage per week? 6 mg per week. |
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Term
| What is the dose per week? 6 mg in a week. We know there are 6 injections in a week. So, how much per injection? |
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Definition
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Term
| Where is your thyroid? What does it regulate? |
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Definition
| The thyroid lies across your larynx (in your throat). The 3 hormones are: Thyroxine T4, Triiodotyronine T3 & Calcitonin. Thyroid hormones do so many things... regulate metabolism, are essential for growth & development, control thermoregulation, and have affects on the neuromuscular system. |
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Term
| What are manifestations of Hypothyroidism? |
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Definition
| fatigued, experience weight loss, they're constipated, they're cold, have very heavy periods. |
|
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Term
| what are manifestations of hyperthyroidism? |
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Definition
| Nervous, agitated, experience wt loss without trying, have frequent bowel movements (diarrhea), short light periods or not at all. ex/ Graves Disease |
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Term
| levothyroxine (Synthroid) is a synthetic relacement for __________ functioning. |
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Definition
|
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Term
| What is levothyroxine (Synthroid) given for? |
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Definition
|
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Term
| What is the most significant sd effect of levothyroxine (Synthroid)? |
|
Definition
| Cardiac Dysrhythmias (probably a test question on this) |
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Term
| What is propylthiouracil (PTU) given for? |
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Definition
|
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Term
| propylthiouracil (PTU) has significant sd effects too. What are they? (definitely a test Q on this) |
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Definition
| PTU can cause LIVER PROBLEMS & BONE MARROW TOXICITY. |
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Term
| How would you know if your patient was having liver problems while on PTU? |
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Definition
| LAB VALUES - They'd have increased liver function tests & jaundice. Antithyroid side effects are: RBC (erythrocyte), leukocyte & thrombocyte. |
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Term
| Patient teaching with thyroid meds (Synthroid & PTU) is very important. What are the directions? |
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Definition
| It's very important for them to take thyroid meds exactly as presecribed, at the same time every day & DO NOT SWITCH BRANDS. No, you CAN NOT take generics on thyroid drugs. If you take it in the morning, always take it in the morning or if you take it in the evening, always take it in the evening. |
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Term
| Your patient has been taking thyroid drugs for about 16 months and has recently noted palpitations and some heat intolerance. Should you be concerned about this or is this a fairly benign reaction to thyroid replacement? |
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Definition
| YES, it is a problem. One of the most significant sd effects of thyroid medications is cardiac dysrhythmias. It is not a benign reaction & needs to be checked out. It is 16 months into taking the meds. Come in & have thyroid levels checked & may be do an EKG on them. |
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Term
| The pancreas is located behind the stomach. It control 2 hormones, what are they? |
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Definition
| insulin & glucagon (work in opposition of one another, like so many others we're talking about in endocrine). |
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Term
| Insulin & Glucagon work for the use, mobilization and storage of what? |
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Definition
| insulin/blood glucose levels |
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|
Term
| What is a normal blood glucose level? |
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Definition
|
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Term
| What is the difference between Type 1 & Type 2 diabetes? |
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Definition
| Type 1=juvenile diabetes. There is a complete lack of insulin production & are insulin dependent. Type 2=older onset. There is insulin resistance & insulin deficiency. The pancreas DOES produce insulin, but not enough. Must be controlled with oral meds + diet/exercise. |
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Term
| The insulin lispro (Humalog) has what onset of action? When is the peak action time? |
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Definition
| lispro (Humalog) is RAPID. onset=5-15 mins. Peak action= 1-2 hours. |
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Term
| insulin Regular (Humulin R) is what type of insulin? when is its onset of action? when is its peak of action? |
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Definition
| Regular (Humulin) is short acting. Onset=30-60 minutes. Peak action=2-4 hours. |
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Term
| insulin isophane suspension (NPH) is what type of insulin? When is the onset? peak? |
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Definition
| NPH is an Intermediate insulin. Onset=1-2 hours. Peak=4-8 hours. |
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Term
| insulin glargine (Lantus) is what kind of insulin? When is the onset? When is the peak action time? |
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Definition
| Lantus is Long acting insulin. Onset is 2-4 hours. Action=8-14 hours. |
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Term
| If a diabetic is not eating, then you can ____ their blood sugar. We assume that they're eating, but they might not be. |
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Definition
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Term
| Hypoglycemia can lead to what? Why would we rather treat the high blood sugars then the ones in the 40s & 50s? |
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Definition
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Term
| Hypoglycemia is often considered ____ and below. What do you do when you find this? |
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Definition
| 70 and below. You have to act fast. Need to give them milk & crackers to bring their fluids up. May be hang fluids with dextrose in them. |
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|
Term
| What does peak effect mean? |
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Definition
| Highest therapeutic effect |
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Term
| If patients are NPO, then what will you do with their insulin? |
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Definition
| you will likely hold their dose of insulin. You know you're going to hold it if their sugar is low. |
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Term
| Sometimes a patients blood sugar is up, what do we do to control this? do we ever give insulin to pt's who are not diabetic? |
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Definition
| give them insulin. Yes, sometimes you will give insulin to patients who are not diabetic. |
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Term
| Is it okay to mix insulins? |
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Definition
| Yes, it is okay to mix insulins. CLEAR then CLOUDY (will be tested on). Insulins can be different colors: you DO NOT need to draw them up in separate needles (save diabetics some sticks!) |
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|
Term
| What is insulin given in? What is insulin measured in? |
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Definition
| Syringe. Insulin is measured in UNITS (not cc's or mL's) |
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Term
| We have 5 oral antidiabetic agents to know. what are they? |
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Definition
| glipizide (Glucotrol), repaglinide (Prandin), metformin (Glucophage), rosiglitazone (Avandia), acarbose (Precose). |
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|
Term
| What is the MOA of Sulfonylureas? |
|
Definition
| stimulate insulin secretion from beta cells |
|
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Term
| What is the MOA of Meglitinides? |
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Definition
| similar to sulfonylureas, they also stimulate insulin secretion from beta cells. |
|
|
Term
| What is the MOA of Biguanides? |
|
Definition
| they decrease glucose production and uptake |
|
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Term
| What is the MOA of Thiazolidinediones? |
|
Definition
| they decrease insulin resistance |
|
|
Term
| What is the MOA of Alpha-glucosidate inhibitors? |
|
Definition
| they delay glucose absorption |
|
|
Term
| When do you take Precose? |
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Definition
| Usually 3 times a day, with the first bite of each meal. |
|
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Term
| All of the oral diabetic medications are for Type 2 diabetes. So, once they are on these meds, they are good? |
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Definition
| No, ALWAYS remember that they are an aid to, not a substitute for, good diet and exercise. Also, stopping smoking. (Oral antidiabetic meds are an adjunct to diet, exercise & smoking for these patients) |
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|
Term
| Your client is on insulin every morning with sliding scale coverage as follows: NPH, 20 units every morning before breakfast, and Regular, sliding scale coverage, ac & hs, as follows: <200mg/fl=no coverage, 200-249=2 units Regular, 250-299=4 units Regular,>300=6 units Regular, > 350=Call for orders. How much will you give this patient, if it is before breakfast & the blood sugar is 275? |
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Definition
| 20 units NPH + 4 units Regular |
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|
Term
| How much before lunch if blood glucose is 196? |
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Definition
|
|
Term
| How much before dinner and blood glucose is 328? |
|
Definition
|
|
Term
| What color is NPH insulin? |
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Definition
| White opaque, cloudy solution. Intermediate acting insulin is cloudy. |
|
|
Term
| Where are the adrenal glands? What are the 2 different areas called here? |
|
Definition
| The adrenal glands sit on top of each kidney. They are composed of the adrenal cortex & the adrenal medulla. The Medulla is in the Middle (think M,M) and then the there is the cortex. |
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Term
| Predisone (Deltasone) is an _________________. |
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Definition
| Glucocorticoid (glucocorticoids are corticosteroids) |
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|
Term
| What is predisone (Deltasone) used for? |
|
Definition
|
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Term
| Corticosteroids (like Deltasone) will decrease the corticosteroid process. How is this med taken? How much is taken at first, and then later? |
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Definition
| Orally. A lot is taken at first, then taper down. This has to be tapered, you have to decrease slowly because of the negative feedback loop. |
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Term
| The side effects to corticosteroids are HUGE! What are they? |
|
Definition
| There is Cushing's MOON FACE, facial erythema, cataracts, acne, buffalo hump, psychosis, hair thinning, peptic ulcers, hyperglycemia, renal stones, central obesity, osteoporosis, tendency for fractures, vertebral collapse, purple striae, menstrual disturbance, proximal weakness, HTN, INCREASED RISK TO INFECTIONS IS IMPORTANT (this is b/c corticosteroids are antiinflammatory & when the inflammatory response is reduced, then the body is not fighting normally. |
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Term
| What happens if a person suddenly stops taking corticosteroids (like Deltasone)? |
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Definition
| Sudden discontinuation can precipitate an adrenal crisis caused by a sudden drop in the levels of serum cortisone. |
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Term
| Which of the following is true regarding corticosteroids? A) They cause weight loss, B) increased muscle strength, C)urinary retention D) or anti-inflammatory effects? |
|
Definition
| corticosteroids cause anti-inflammatory effects |
|
|
Term
| When a pt is receiving Vasopressin (pituitary agent, that mimics ADH) what therapeutic responses would you see? |
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Definition
| Decreased urinary output (going to mimic ADH). Given via intranasal spray. |
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Term
| An 8 year-old girl has been diagnosed with true pituitary dwarfism & she's given somatotropin. Her parents should be warned of what? |
|
Definition
| she'll have an increase in height. (she is NOT going to have an increase in muscle strength, NOT an increase in height when she reaches puberty). Just know she's going to get taller, don't read into it. |
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|
Term
| While discussing thyroid replacement therapy, the adverse effects to doing this are: |
|
Definition
| tachycardia, dysrhythmias (those 2 are the most significant sd effects to thyroid replacement meds) also might experience weight loss if given too much, we might put her into hyperthyroidism. |
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Term
| If a patient is taking thyroid replacement hormone (Synthroid), what are signs of an excessively high dose of the drug? |
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Definition
| Wt loss, agitation, palpitations, heat intolerance. Because synthroid is give for hypothyroidism, as a replacement thyriod drug... the signs of exccessive Synthroid amount are when they patient is in HYPERthyroidism. |
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|
Term
| The nurse is administering Lispro Insulin. Is this rapid acting? |
|
Definition
|
|
Term
| A pt has been taking Synthroid for hypothyroidism, she wants to get the same med in a generic form. The nurses best advice would be: |
|
Definition
| It is better NOT to switch brands unless you check with your doctor. It's not that you absolutely CAN NOT, but it needs to be done under supervision. |
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|
Term
| What's the name of the intermediate insulin? |
|
Definition
|
|
Term
| What's the name of the long acting insulin? |
|
Definition
|
|
Term
| Which one is given on blood glucose measured before meals? |
|
Definition
| Regular (short acting) like Humulin or Novolin |
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|
Term
| What are the early signs of hypoglycemia? |
|
Definition
|
|
Term
| Nurse is teaching about self-administration of Insulin, what's important? |
|
Definition
| When mixing insulins the clear should be drawn up first (clear --> cloudy). Abdomen is the favorite spot b/c it is the most absorptive. It can go anywhere there is sub-Q fat, but belly is the #1 choice. In general, insulin is increased during sickness b/c blood sugar gets higher, but just tell them to check it more (every 2-4 hours around the clock). never say something like "increase it by 25%" |
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|
Term
| A pt in the ER is showing signs of hypoglycemia before he went unconscious. His blood glucose is 34. What is appropriate? |
|
Definition
| Give him intravenous blood glucose |
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|
Term
| A pt in the ICU requires insulin. We know that only _______ insulin can be given IV. |
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Definition
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Term
| Drugs that affect the respiratory system can be give 4 ways, what are they? |
|
Definition
| orally, an elixir, inhaler and intravenous (think vowels!!! they all start with them or "eiio") |
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|
Term
| Antihistamines do 4 things. We know antihistamines are going to DILATE THE CAPILLARIES. They INCREASE CAPILLARY ___________. They STIMULATE ________ secretions. and _________ the heart. |
|
Definition
| PERMEABILITY. GASTRIC. ACCELERATE. |
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|
Term
| Antihistamines (specifically H1 blockers) have what affect on the nasal mucosa? |
|
Definition
| very drying! Antihistamine H1 blockers: DRY UP the nasal mucosa. |
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|
Term
| What category does Benadryl go under? What effects does Benadryl have? |
|
Definition
| Peripherally acting antihistamine. Benadryl has potent Anticholinergic & Sedative Effects. |
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|
Term
| What manifestations will Benadryl have on a patient? |
|
Definition
| Makes them very sleepy with the sedative effect. Causes drying & thirst with the anticholinergic effect. |
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|
Term
| What category does loratidine (Claritin) go under? What makes it different then Benadryl? |
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Definition
| It is also an antihistamine, but it does not cause the drowsiness. |
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|
Term
| What are Benadryl & Claritin used for? |
|
Definition
| allergies & the common cold, allergic reactions, rash, poison ivy |
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|
Term
| The key difference between Benadryl & Claritin is: |
|
Definition
| whether it makes you tired or not. (Benadryl is very sedating & Claritin is not) |
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|
Term
| What drug is given for dizziness (vertigo)? |
|
Definition
|
|
Term
| What drug is given for nausea? |
|
Definition
| Phenergan (Promethazine) relieves symptoms of motion sickness. |
|
|
Term
| WHat are the 3 categories of Decongestants? |
|
Definition
| Adrenergics, Anticholinergics, Intranasal Corticosteroids that are topical |
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|
Term
| What category is pseudoephedrine (Afrin) in? |
|
Definition
| Decongestants, it is a sympathomimetic (adrenergic). Pseudoephedrine is a decongestant used for temporary relief of nasal congestion. It constricts the blood vessels & promotes sinus drainage. |
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|
Term
| What happens if you take 2 pseudoephedrine (Afrin)? |
|
Definition
| taking 2 causes tachycardia then insomnia. |
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|
Term
| is it okay to take psuedoephedrine (Afrin) if you have HTN? |
|
Definition
| No, HTN patients should not take pseudoephedrine (Afrin) |
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|
Term
| What drug category is fluticasone (Flonase) in? |
|
Definition
| It is a decongestant, intranasal corticosteroid. It is taken intransally. |
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|
Term
| What is fluticasone (Flonase) taken for? how often? |
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Definition
| It can be taken regularly, once a day. It is an intranasal spray. It helps prevent allergies & the symptoms that come along with it. |
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|
Term
| What is an antitussive used for? What are the 2 categories for these? |
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Definition
| They're to stop coughing. There is opiods & non-opioids. |
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|
Term
| What is an an expectorant? |
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Definition
| helps you cough it up. it breaks down & thins secretions so it's easier to cough out. Given when it's beneficial to cough out the secretions (like in pneumonia or bronchitis) |
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Term
| Guifenesin (Robitussin or Humabid) are both ____________. |
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Definition
|
|
Term
| Dextromethorphan (Vicks, Robitussin-DM is a combo of guaifenesin and dextromethorphan) is an _________________. |
|
Definition
|
|
Term
| If you are caring for a patient who has a dry, non-productive cough that is of not benefit, you can give _______________. |
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Definition
| dextromethorphan (Vicks or Robitussin-DM)... it suppresses the cough. It's especially important if the cough is potentially dangerous, i.e. abdominal surgery. The abdominal muscles are used in coughing & could cause the surgical incision to open. |
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|
Term
| What is the difference between codeine, hydrocodone (the opiates) and dextromethorphan (Vicks, Robitussin-DM)? |
|
Definition
| The opioids are antitussives that suppress the cough through the CNS and causes CNS depression. Dextromethorphan (Vicks & Robitussin-DM) is an antitussive that suppresses the cough, but because it is not an opioid, it does not cause addiction or CNS depression. |
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|
Term
| What are the 2 different MOAs of the expectorants? |
|
Definition
| First way irritates the GI track which causes the respiratory tract secretions to be loosened & thinned out. This GI irritation is how Robitussin works. The second MOA is direct stimulation of the secretory glands in the respiratory tract. |
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Term
| There is Robitussin + Dextromethorphan mixed together, what's that for? |
|
Definition
| It's to stop coughing at night, and when it's just so congested & thick you can't get it out. |
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|
Term
| Mr. Smith is a 76 y.o. man who states he has had a terrible cough for a week. He says his has a lot of phlegm in his chest but he just can't seem to cough it up. What medication? What patient teaching? |
|
Definition
| Robitussin: used for decongestion. Drink LOTS of fluids, force fluids. |
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|
Term
| Maggie is a 6 y.o. who has a hacky dry cough at night and her nose seems to run constantly. She is not sleeping well. What medication (s)? What patient teaching? |
|
Definition
| Phenylephrine for the runny nose. It is NOT pseudoephedrine b/c she is 6. Also, dextromethorphan (Vick's) for the antitussive/cough suppressant. Encourage fluids, call the doctor if not better in 3 days, give minimum amount of medicine as possible. |
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Term
| Mrs. Jung, age 57, has HTN & diabetes. She has been using Afrin for 2 weeks for a stuffy nose that won't go away. What medication. What pt teaching. |
|
Definition
| Benadryl (it will maker her sleepy so no heavy equipment or machinery) or Claritin. |
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|
Term
| Bill, your 46 year old neighbor, was just stung by a bee. He think he might be allergic to bees. He is complaining of itching and hives. What medication? What teaching? |
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Definition
| Benadryl. he could have an anaphylactic rxn, should stay & watch respirations, might need an ER trach. |
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|
Term
| A nursing student at RCN has a terrible cold, but doesn't want to miss class. He has a nagging cough, runny & stuffy nose and his chest feels congested. He doesn't want to take meds that will make him sleepy to actively participate in class. |
|
Definition
| nagging cough? cough suppressant that's a non-opioid antitussive like Dextromorphan. decongested + stuffy, runny nose? decongestant that is nonsedating is Claritin. |
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|
Term
| A client with pneumonia is complaining of inability to sleep due to frequent coughing with this sputum. Which OTC would be best? |
|
Definition
| ANTITUSSIVES! an opioid (like codeine or hydrocodone) or a non-opioid (Dextromethorphan) will suppress the cough reflex. |
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|
Term
| You are caring for a 5 year-old with hay fever. What OTC would you recommend? why? |
|
Definition
| diphenahydramine (Benadryl) because it has an excellent safety profile & efficacy. It has the greatest range of therapeutic indications of an antihistamine available. |
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|
Term
| An elder client needs an antihistamine. What would you recommend? Why? |
|
Definition
| Loratadine (Claritin) b/c it is a nonsedating antihistamine (does not cause drowsiness). Benadryl is not recommended for older patients b/c of its hangover effect and increased potential for falls. |
|
|
Term
| What are the 3 categories for Bronchodilators? |
|
Definition
| Beta-2 Adrenergic Agonists, Anticholinergics & Xanthine Derivatives. |
|
|
Term
| what section does Albuterol (Proventil) go under? It's given for what? |
|
Definition
| Bronchodilatory - Beta-2 adrenergic agonist. Given for asthma. Albuterol relaxes the smooth muscle in the bronchioles. AE=increase HR & contractility. |
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|
Term
| What category does ipratropium (Atrovent) go under? |
|
Definition
| Bronchodilator, ANTICHOLINERGIC... so it will decrease GI/GU activity, increase the HR & cause bronchodilation. |
|
|
Term
| What category does theophyslline (Slo-Bid, Theo-Dur) go under? |
|
Definition
| XANTHINE DERIVATIVE Bronchodilator |
|
|
Term
| How do Xanthine Derivative Bronchodilators work? |
|
Definition
| increase levels of cAMP (important in maintaining an airway). Also has some CNS stimulation properties. Also cardiovascular, causes increased contractility & HR. |
|
|
Term
| What are the AE of theophylline (Slo-Bid, Theo-Dur)? |
|
Definition
| mainly TACHYCARDIA (rapid HR). Sometimes these patients are confused, have n/v, anorexia, loss of appetite (if they're toxic on Theophyline). |
|
|
Term
| Your patient taking theophylline (Slo-Bid or Theo-Dur) has not been hungry and complains of not feeling well... kind of nauseous. You check their HR & it is 110. What do you suspect? |
|
Definition
| blood levels are toxic on theophylline. Check, the therapeutic range is 10-20 mcg/mL in blood. |
|
|
Term
| What is the therapeutic blood level range for theophylline (Slo-Bid or Theo-Dur)? |
|
Definition
| 10-20 mcg/ml in blood (anything above 20 is toxic!) |
|
|
Term
| What 2 substances will increase the metabolism of theophylline? What are the 2 things that theophylline interacts with? Will they need a higher or lower dose then? |
|
Definition
| Smoking & St. John's Wort both interact & increase the metabolism of theophylline. They will need a higher dose to have a therapeutic effect. |
|
|
Term
| What is the MOA of Beta-adrenergic agonists, anticholingergics & xanthine derivatives? |
|
Definition
|
|
Term
| What category does montelukast (Singulair) go under? what's it used for? |
|
Definition
| antileukotrienes, they are used to PREVENT asthma (it does NOT help with acute attacks). it's for long-term treatment of asthma. Good thing=can give Singulair to very young children. |
|
|
Term
|
Definition
| in people with asthma, they are what causes inflammation, bronchoconstriction and mucus production. This is what leads to the coughing, wheezing & SOB. |
|
|
Term
| Corticosteroids have anti-_____________ effects. what patients would these be good for? |
|
Definition
| inflammatory. Pulmonary patients (maybe COPD). |
|
|
Term
| What route can corticosteroids be given? |
|
Definition
| orally, intravenously, inhaled or nasal spray. |
|
|
Term
| fluticasone (Flovent) is given what route? How is it different then Flonase? |
|
Definition
| Flovent is given via an INHALER. only difference is Flonase is given intranasally. |
|
|
Term
| You have a patient on Albuterol & FLovent inhalers. What do you give first & why? |
|
Definition
| You give the Albuterol first (it's a bronchodilator that opens it up) then Flovent second (it's a corticosteroid that works topically on the bronchioles though it's given as an inhaler, can get to the source & do their work as an anti-inflammatory) |
|
|
Term
| Patients who take Flovent (a corticosteroid) regularly at risk for developing ________. What patient teaching is necessary for a patient on Flovent to prevent this? |
|
Definition
| FLUSH, it kills the normal bacteria in the mouth. They need to RINSE MOUTH AFTER THEY USE IT. |
|
|
Term
| the antileukotriene that is used to PREVENT asthma is: |
|
Definition
|
|
Term
| What is the inhaled steroid used for asthma? |
|
Definition
| Flovent (it's a corticosteroid) |
|
|
Term
| What is the anticholinergic used for asthma? |
|
Definition
|
|
Term
| What is the xanthine derivative used for asthma? |
|
Definition
| Theophylline (Slo-Bid, Theo-Dur) |
|
|
Term
| What drug is given for the quick relief of asthma that works fast? |
|
Definition
| Albuterol (not a key drug, but works fast for asthma) |
|
|
Term
| Xena is a 72 y.o. female who was admitted to the ICU with exacerbation of COPD. She has a 15 yr history of pulmonary disorders; a 94 pack year smoking history. She quit smoking 15 years ago when the COPD was diagnosed. The physician has ordered aminophylline at 20 mg/hr IV. What statement correctly identifies the MOA of aminophylline (same as theophylline but less potent & shorter acting, they're xanthine derivatives)? |
|
Definition
| causes bronchodilation by increasing levels of cAMP. |
|
|
Term
| Previously her HR was 82, now it is 120. What's happening? What are you going to do? |
|
Definition
| Tachycardia, it's an AE of Xanthine derivatives (they cause positive inotropic & positive chronotropic effects.) You should decrease it & notify the physician. |
|
|
Term
| The physician orders labs to run a serum drug level. The results are 25 mcg/mL. Is this therapeutic or toxic? |
|
Definition
| Toxic. Therapeutic is 10-20. |
|
|
Term
| What are some signs of infection? |
|
Definition
| fever, chills, pain, redness, swelling, increased WBCs, pus |
|
|
Term
| _____infections can happen when antibiotics reduce or completely eliminate the normal bacterial flora. (these are really important to talk about) Can you think of any examples of these? |
|
Definition
| SUPERinfections. ex/ yeast infections or C. Diff |
|
|
Term
| Explain some about antibiotic resistance & why it is such a concern. |
|
Definition
| Prescribing TOO MANY ANTIBIOTICS & people MISUSING ANTIBIOTICS (not finishing their prescription) is a public health concern now. We have organisms that used to respond to 3 antibiotics, but now only respond to 1. Some examples are: MRSA & VRE. What happens is at one time, those organisms were succeptible to the antibiotics. |
|
|
Term
| Sulfonamides are _______ spectrum antibiotics, given to treat gram _____ & gram _______ bacterias. |
|
Definition
| broad, treats gram positive & negative bacterias. |
|
|
Term
| Sulfonamides are very often used to treat ____. |
|
Definition
|
|
Term
| Who is contraindicated in the use of sulfonamide drugs? |
|
Definition
| people who have allergies to "sulfa like" drugs probably can't take sulfonamides. |
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|
Term
| People with sulfa allergies have delayed _____________ reactions. what's this mean? |
|
Definition
| cutaneous. it's not an immediate reaction, but a reaction that frequently begins with a fever followed by a rash. |
|
|
Term
| Sulfamethoxazole-trimethoprim (Bactrim) is very often used to treat ________. What patient teaching is necessary? What drug category is this drug in? |
|
Definition
| Sulfonamides, Bactrim is given for UTIs. Really need to encourage pt to drink LOTs of fluids to prevent the precipitation of crystals in the kidneys. |
|
|
Term
| UTIs and forcing ________ is really important. like how much? |
|
Definition
| fluids, they NEED to DRINK FLUIDS (like 2-3 L/day) to prevent the crystals forming in the kidneys. |
|
|
Term
| Penicillins are antibiotics that treat _______. |
|
Definition
| gram + (streptococcus, enterococcus, staphylococcus) |
|
|
Term
| The most common treatment of Penicillins though is for ___________ reactions. |
|
Definition
| allergic - can be anaphylactic |
|
|
Term
| If you're allergic to Penicillins, what else are you likely allergic to? |
|
Definition
|
|
Term
| What is Penicillin G used to treat? How is it given? |
|
Definition
| IM injection, treats syphillis |
|
|
Term
| Often times antibiotics make what ineffective? Really need to know this & make SURE you patient teach this! |
|
Definition
| oral birth control pills can be ineffective when on antibiotics. Really need to patient teach to women of child bearing age. |
|
|
Term
| Cephalosporins are structurally and pharmacologically r/t penicillins (cross sensitivity). What are the 4 generations of cephalosporins. what are they? what do they treat? what's hardest to treat? |
|
Definition
| First generation cephalosporins, second generation cephalosporins, etc... They treat gram +, gram - or anaerobic). Gram - are the hardest to treat. |
|
|
Term
| Cephalosporins have an acute interaction with what? |
|
Definition
| alcohol. It will make you puke! not just tired & drowsy, it's bad.. |
|
|
Term
| cephalexin (Keflex) is given how? for what? |
|
Definition
|
|
Term
| Ceftriazone (Rocephin) is a very special cephalosporin, why? What infection does it treat? How often is it given? Is it long or short acting? |
|
Definition
| Rocephin crosses the BBB, treats meningitis. Given ONCE a day. It is LONG acting. |
|
|
Term
| Carbapenems are the _________ antibacterial action of any antibiotic. |
|
Definition
|
|
Term
| Carbapenems key drug is imipenem-cilastatin (Primaxin), it is reserved for what kind of infections? Why is it reserved/what is Primaxins major sd effect? |
|
Definition
| Reserved for complcated body cavity and connective tissue infections. Reserved b/c there is a 10% chance of seizures so we only use for unique circumstances. Primaxin can cause drug induced seizures. |
|
|
Term
| Macrolides also treat a wide range of infections. What is the therapeutic effect outisde of the antibiotic action for macrolide drug Erythromycin (E-mycin)? ***know this for the test, it will be on there!!! |
|
Definition
| E-mycin is an antibiotic that also HAS ABILITY TO IRRITATE THE GI TRACK. Perhaps, E-mycin is used for post-op constipation to remove gastric contents. Think about this in clinicals. E-mycin is NOT only taken for infection. |
|
|
Term
| Tetracyclines have a strong affinity for ___________. |
|
Definition
|
|
Term
| What are the contraindications for tetracyclines? |
|
Definition
| don't give to people who are pregnant, nursing and children under age 8. Tetracyclines cause discoloration of the permanent teeth in fetuses and children. It can retard fetal skeletal development also if taken in pregnancy. |
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|
Term
| Tetracyclines who are given to women of child bearing age need to be warned about what? |
|
Definition
| The decreased calcium with their birth control. |
|
|
Term
| What happens if tetracyclines are taken with antacids, dairy products or iron? |
|
Definition
| The absorption of tetracycline is reduced. Takes tetracycline away & so you don't get the benefits of tetracycline. |
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|
Term
| People who take tetracyclines have huge ____________. |
|
Definition
| photosensitivity. they need to wear sunscreen all the time. |
|
|
Term
| Doxycycline (Vibramycin) is contraindicated in who? why? |
|
Definition
| People who are pregnant, nursing and children under 8 years old. Do not coadminister Vibramycin with milk, antacids or iron. Women who are of child bearing age who take Vibramycin need to be warned about the decrease calcium with their birth control. People who take Vibramycin will have huge photosensitivity & need to wear sunscreen ALL the time. |
|
|
Term
| Aminoglycosides are given for SERiOUS gram - infections. We do not give them orally b/c of poor oral absorption. How do we give gentamicin (Garamycin)? |
|
Definition
| injection, topical & even eye drops. |
|
|
Term
| We really need to monitor serum levels of patients on Garamycin. Why? Remember the 3 amino mice with aminoglycosides. |
|
Definition
| There are very serious side effects. The three amino mice help remember: one can't hear, one can't pee & one can't feel. THe side effects are ototoxicity, nephrotoxicity & neurotoxicity. |
|
|
Term
| Fluorquinolones give extensive gram - coverage. The drug is ciprofloxacin (Cipro). What organ excretes this drug? |
|
Definition
| The kidneys. Cipro is given to any post-op urinary patient gets IV Cipro. |
|
|
Term
|
Definition
| Used for COMPLICATED UTIs. Can also be used for anthrax. |
|
|
Term
| Metronidazole (Flagyl) is taken for what? |
|
Definition
| interabdominal GYN infections & prophylactically when we take out a womans parts (hysterectomy) |
|
|
Term
| What is Vancomycin (Vancocin) given for? |
|
Definition
|
|
Term
| What sd effects can Vancomycin (Vancocin) cause? |
|
Definition
| Ototoxicity (loss of hearing) & Nephrotoxicity (damage to kidneys). (Aminoglycosides also have the neurotoxicity, that's the difference). Need to be careful about the peak & trough of Vancomycin. |
|
|
Term
| What lab value are you going to be looking at to monitor your patients kidney function while they are on Vancomycin? |
|
Definition
| creatinine. We hold Vancomycin if the pt's creatinine is too high. |
|
|
Term
| With antibiotics, it is best practice to treat if what is obtained first? |
|
Definition
| Do the CULTURE FIRST to get the bacteria. (can't culture everything unfortunately). It will be a test question though: BE SURE YOU DO THE CULTURE FIRST. |
|
|
Term
| Your patient is ticked off the physician didn't give them an antibiotic. What can you tell them? |
|
Definition
| It is to prevent antibiotic resistance. You can talk to them about the difference between viral & bacterial infections & why we do this. |
|
|
Term
| If your patient is prescribed an antibiotic, what teaching is necessary? |
|
Definition
| Very important to tell people to take the ENTIRE DOSE OF ANTIBIOTICs. Do NOT STOP WHEN YOU FEEL BETTER. Promote the patients role of using supportive measures like LOTS OF FLUIDS. |
|
|
Term
| What is an antivirals MOA? |
|
Definition
| Impairing viral replication |
|
|
Term
| What are the 2 types of antivirals? |
|
Definition
| non-retroviral & retroviral |
|
|
Term
| What are non-retrovirals? |
|
Definition
| Think Non-HIV. Treats influenza, Herpes Simplex Virus (HSV), VSV, CMZ ( i don't think we need to know this..) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| No, we just make it dormant |
|
|
Term
| Antiviral key drug: Acyclovir (ovirax) is used for what? |
|
Definition
| herpes (cold sores & venereal herpes) |
|
|
Term
| Our retroviral key drug: zodivudine (AZT) is given for what? why is compliance so bad? |
|
Definition
| AZT is given for HIV infection. Biggest problem AZT has is compliance with meds b/c side effects are so severe. |
|
|
Term
| How is AZT used prophylactically? |
|
Definition
| AZT is used as prophylactic therapy when people are exposed to HIV. Say you are a nurse & you're stuck with a needle given to a pt with HIV. We give it to HIV mom's to prevent giving it to newborns too. |
|
|
Term
| What is the biggest side effect of why we have to change medications from AZT? |
|
Definition
|
|
Term
| Sally is a 30 y.o. teacher who has come to the clinic with clusters of vesicles on her perineum and perianal area that she has ha for 2 days. Some of the vesicles have ruptured, leaving painful erosions. She also has a headache and fever. Based on her symptom history and physical examination, the physician suspects genital herpes. What med do you expect to be prescribed? |
|
Definition
| Zovirax - used for herpes (cold sores & venereal) |
|
|
Term
| Sally asks how long it will take for the medication to cure her herpes. what is your best response? |
|
Definition
| "This med will keep the virus under control." We know that a virus is never really cured, just dormant. done by lowering the viral load. The antiviral agent is impairing viral replication, which results in decreased viral concentrations. |
|
|
Term
| What should needs to be patient taught to Sally about reducing the spread of Herpes? |
|
Definition
|
|
Term
| Antituberculars are to fight tuberculosis. Key drug: isoniazid (INH) is given for 2 reasons... |
|
Definition
| used for PROPHYLAXIS and for TREATMENT. |
|
|
Term
| If the husband is diagnosed with TB, then the family will be prescribed what too? |
|
Definition
| isoniazid (INH) b/c it is for the fathers treatment and the families prevention (prophylactic therapy) |
|
|
Term
| Most antituberculars are excreted by what organ? |
|
Definition
|
|
Term
| What needs to be done during assessment & what test needs to be screened for a patient on antituberculars like isoniazid (INH)? |
|
Definition
| Assessment: do a liver palpation & a Liver Function Test too. Test worthy: MONITOR LIVER FUNCTION & know that the treatment is long-term. |
|
|
Term
| What drug is also recommended to antitubercular medications like isoniazid (INH) to combat the liver toxicity? |
|
Definition
|
|
Term
| How often to patients take TB meds like isoniazid (INH)? So what's important? |
|
Definition
| long-term (often taken for 2 years). compliance is important. |
|
|
Term
| Who is at risk for getting TB? |
|
Definition
| homeless in shelters, prisoners, mental health facilities, immigrants, HC providers are always at risk |
|
|
Term
| What lab tests are done before starting TB therapy? |
|
Definition
|
|
Term
| Antifungals often cause __________toxicity. |
|
Definition
| Hepatotoxicity. they're metabolized in the liver & they end up accumulating & causing an infection. |
|
|
Term
| Amphotericin B (Amphocin) is an antifungal often given in the ____ setting. Explain... |
|
Definition
| ICU, b/c Amphocin is for life-threatening fungal infections. |
|
|
Term
| There are many AE to Amphocin, what are they? |
|
Definition
| fever, n/v, itching. B/c of these the are often pretreated with an antipyretic (Tylenol), given Benadryl prior to help itching and an antiemetic of some kind. If you get an order for Amphocin, there is likely pretreatment needs. |
|
|
Term
| If your patient is prescribed to take Amphocin, remember "Amphoterrible"... he is a monster that reminds you the patient is going to need: |
|
Definition
| Amphoterrible is a monster who treats terrible life threatening fungal infections, X marks the spot on the liver (Heptotoxicity), 80% patients get nephrotoxicity & so you need to be monitoring BUN, creatining and I & O. Do an EKG b/c it causes arrhythmias. |
|
|
Term
| Previously antifungals were OTC & supppositories that you took for 7 days, NOW we have ONE PILL! What is the 1 pill that is an alternative for vaginal suppositories? How is it given? |
|
Definition
| fluconzole (Diflucan). Given PO & injectable. |
|
|
Term
| The nurse is assessing a patient who is about to receive antifungal drug therapy. What problem is of the most concern? |
|
Definition
| Hepatic Disease. Antifungals are metabolized in the liver. They accumulate there anyway & easily cause hepatoxicity. |
|
|
Term
| When reviewing the allergy history, the patient is allergic to penicillin. If they are allergic to that, then they are probably sensitive to: |
|
Definition
|
|
Term
| When teaching a pt taking tetracycline, what instruction is needed? |
|
Definition
| Avoid direct sunlight & tanning beds when on this medication (want to avoid coadministration with milk too) |
|
|
Term
| Pt on tetracycline complains of N/V when taking it. What is your best advice? |
|
Definition
| Drink each dose with a full glass of water. Avoid milk b/c it reduces effectiveness. |
|
|
Term
| The 4 generations of cephalosporins are differentiated by: |
|
Definition
| antimicrobial activity... as the generations increase, the level of gram negative coverage increases. |
|
|
Term
| Patient is on drug therapy for pneumonia & they get a superinfection. What is this caused by? |
|
Definition
| Large doses of antibiotics killing the normal flora. Examples of superinfections that are often obtained: yeast infections & C. Diff. |
|
|
Term
| _______________ is used to treat C. Diff. |
|
Definition
|
|
Term
| A pt is hospitalized for 2 weeks, has pressure ulcers from MRSA.. what med is given? |
|
Definition
|
|
Term
| What is the med with the ability to irritate the GI track? |
|
Definition
|
|
Term
| What is the SD effect of antiviral drugs? |
|
Definition
| delayed progression of HIV to AIDs |
|
|
Term
| Pt is taking INH & Vitamin B6, why are they taking the vitamin B6? |
|
Definition
| to combat the pyridoxine deficiency that is often noted with INH. |
|
|
Term
| If a patient is on antitubercular treatment, we need to monitor for signs of __________ impairment. |
|
Definition
|
|
Term
| How long should a patient starting drug therapy for TB plan to be on the treatment? |
|
Definition
| You should expect to take it for up to 24 months/2 years |
|
|
Term
| During administration of Ampotericin B, severe sd effect may occur. What action should the nurse taken when this happens? |
|
Definition
| Anticipate these side effects & should have pretreated them with antipyretics, antihistamines & antiemetics + warned them. |
|
|
Term
| Pt is on 2 week course to treat a vaginal infection, what is the possibly alternative? |
|
Definition
| A single dose of Fluconzole (Diflucan) |
|
|
Term
| The GASTROINTESTINAL system begins in the mouth & ends in the rectum, these drugs effect the: |
|
Definition
| Esophagus, Stomach & Intestines |
|
|
Term
| ___________ cells are what produces and secretes HCL acid. HCl acid aids in digestion & acts as a barrier to infection. There needs to be a balance, otherwise hyperacidity occurs. |
|
Definition
|
|
Term
| Parietal Cells are the source of ______ ______ production so it's often the target of our drugs in the GI system. |
|
Definition
|
|
Term
| The pH of the stomach is normally very acidic, between 1-4. What do antacids do to the stomachs pH? |
|
Definition
| increase the pH... make it more basic. |
|
|
Term
| aluminum hydroxide (Amphojel) is an _________ used to treat ___________. |
|
Definition
| antacid, heartburn (chest pain b/c of increased acid) |
|
|
Term
| What is the big deal with antacids? What is so important with these like Amphojel? (Definitely a test question) |
|
Definition
| DRUG INTERACTIONS are the big importance with antacids. B/c so many drugs are broken down in the stomach, if we're taking antacids that alter the stomach pH then it will alter the other drugs too. |
|
|
Term
| Antacids goal is to _________ the pH of the stomach. |
|
Definition
|
|
Term
| If your patient is taking antacids, what needs to be patient taught about when to take all their other medications? |
|
Definition
| Patients should not take any other meds within 1-2 ours after taking an Antacid |
|
|
Term
| How do H2 antagonists like Pepcid & Zantac work? |
|
Definition
| by competing with histamine for binding sites on the surface of parietal cells and they block 90% of acid secretions. (know the difference between Antacids & H2's - it is a test question) |
|
|
Term
| famotidine (Pepcid) is an H2 antagonist given for: |
|
Definition
| GERD, ulcers, indigestion |
|
|
Term
|
Definition
|
|
Term
| How does H2 antagonist ranitidine (Zantac) work? |
|
Definition
| they work exactly the same as Pepcid (by competing with histamine for binding sites on the surface of parietal cells and they block 90% of acid secretion). |
|
|
Term
| What is ranitidine (Zantac) used for? |
|
Definition
| erosive esophagitis (ulcer formation in the esophagus) |
|
|
Term
| What is the MOA of PPI's? |
|
Definition
| Bind irreversibly to the proton pump & block ALL (1005) gastric acid secretion |
|
|
Term
| omeprazole (Prilosec) is under what category? what's it used for? |
|
Definition
| Proton Pump Inhibitor (PPIs). Used for erosive esophagitis & GERD. |
|
|
Term
| What is the big difference between H2 antagonists (Pepcid, Zantac) and Proton Pump Inhibitors (Prilosec)? |
|
Definition
| The % of acid secretion that is blocked. PPI's like Prilosec block 100% gastric acid secretion. H2 antagonists block 90% of gastric acid secretion. |
|
|
Term
| Sucrafate (Carafate) treats: |
|
Definition
| active stress ulcers in the stomach |
|
|
Term
| How does Sucrafate (Carafate) work? |
|
Definition
| Carafate coats the actual lining of the stomach. It is not fixing the ulcer, just covering it so it can heal. |
|
|
Term
| Misoprotol (Cytotec) does what? |
|
Definition
| reduces the instance of gastric ulcers in patients taking NSAIDs. |
|
|
Term
| What drug would a patient with Peptic Ulcer Disease take long-term or also for an active peptic ulcer? |
|
Definition
|
|
Term
| Are there any concerns regarding the use of antacids in patients with decreased renal function? |
|
Definition
| Yes, patients with decreased renal function cannot excrete extra Magnesium... So HYPERMAGNESIA can occur. If renal function occurs, excreting the regular, much less the extra is a problem. ANTACIDS ARE NOT A GOOD MED FOR RENAL PATIENTS B/C OF RISK FOR HYPERMAGNESIA. |
|
|
Term
| There are 4 types of antidiarrheas? How do adsorbents work? |
|
Definition
| binding of bacterial toxins that cause the diarrhea. Adsorbents pick up the toxins & help you get rid of it. |
|
|
Term
| There are 4 kinds of antidiarrheals. How do the anticholinergics work? |
|
Definition
| slows peristalsis (remember the anticholinergics are the can't see, can't spit, can't SHIT! they slow the GI) |
|
|
Term
| There are 4 kinds of antidiarrheals. How do the Opiates work? |
|
Definition
| opiates reduce bowel mobility |
|
|
Term
| There are 4 kinds of antidiarrheals. How do the intestinal flora modifiers work? |
|
Definition
| Replenish the normal bacterial flora |
|
|
Term
| We only need to know 2 drugs for antidiarrheals: diphenoxylate (Lomotil) & loperamide (Imodium A-D). They are both in what antidiarrhea drug category? so what's the MOA? |
|
Definition
| Opiates, work by decreasing the bowel motility |
|
|
Term
| (Definitely a test Question) If your pt had C. Diff, what is the good antidiarrheal type? |
|
Definition
| Intestinal flora modifiers... one that works by replenishing the normal bacterial flora. B/c C. Diff comes after excess antibiotics that wipe out our normal flora. |
|
|
Term
| Laxatives are given for contipation and are one of the most _____ OTC meds. |
|
Definition
|
|
Term
| There are 4 kinds of Laxatives. What is the MOA of Bulk-forming laxatives? |
|
Definition
| increases bulk (increases the size so you have more sensation & want to move the bowel through) |
|
|
Term
| There are 4 kinds of Laxatives. What is the MOA of Emollients? |
|
Definition
|
|
Term
| There are 4 kinds of Laxatives. What is the MOA of Hyperosmotic Saline? |
|
Definition
| Increases fecal water content |
|
|
Term
| There are 4 kinds of Laxatives. What is the MOA of Stimulants? |
|
Definition
|
|
Term
| Docusate sodium (Colace) is what kind of laxative? What is Colace used for? |
|
Definition
| Emollient/Stool Softener. Treats constipation & fecal impactions. Also to facilitate BM's in people who have had hemmorhoids. A soft stool is less likely to disturb hemorrhoids. |
|
|
Term
| psyllium (Metamucil) is what kind of laxative? Why would this be a really great choice as a laxative? |
|
Definition
| Bulk-forming Laxative. The action is limited to the GI track. There are NO SIDE EFFECTS to Metamucil - IT IS THE SAFEST LAXATIVE YOU CAN TAKE (def a test question) |
|
|
Term
| In acute care settings, physicians will write prescriptions for magnesium hydroxide (MOM) to treat __________. Need to know MOM can cause _________. |
|
Definition
| MOM treats constipations, causes diarrhea. |
|
|
Term
| MOM is a laxative & an _________. |
|
Definition
|
|
Term
| Laxatives are very commonly overused. It is very important for people to know & you to teach that: |
|
Definition
| CHRONIC & INAPPROPRIATE USE OF LAXTIVES MAY RESULT IN DEPENDENCE, DAMAGE TO THE BOWEL OR LEAD TO INTESTINAL PROBLEMS. |
|
|
Term
| When we have GI losses, we lose K+ very easily and people need to be very careful about: |
|
Definition
|
|
Term
| What can happen if we use stimulants for awhile (overuse laxatives)? |
|
Definition
| the bowel will become dependent... laxatives should NOT be used for long periods of time (need to know that) |
|
|
Term
| If you're a nurse with a patient about to have a colonoscopy, then what is important? |
|
Definition
| make sure their bowel is completely clear! There will be orders for an enema until clear. Very important that patients have NO stool in their bowel. |
|
|
Term
| Antiemetics are drugs to relieve: |
|
Definition
|
|
Term
|
Definition
| by blocking one of the vomiting pathways in the brain |
|
|
Term
| Dimenhydrinate (Dramamine) is an __________ for motion sickness. Take before a road trip. |
|
Definition
|
|
Term
| Prochlorperazine (Compazine) is an ___________ antiemetic. A lot of times Compazine is given what route? |
|
Definition
| neuroleptic. rectal suppository. |
|
|
Term
| What are the sd effects of the antiemetic neuroleptic Compazine given to treat N/V? |
|
Definition
| SD effect of neuroleptics is EPS. (same sd effects can happen here) |
|
|
Term
| What is ondansetron (Zofran) given for? What category is it in? |
|
Definition
| Serotonin Blockers. Given for post-op nausea & chemotherapy nausea. |
|
|
Term
| When is ondansetron (Zofran) given? |
|
Definition
|
|
Term
| Reglan is a _________ that stimulates peristalsis. When is Reglan given? |
|
Definition
| prokinetic. It is also given BEFORE meals to stimulate the GI track. Given to get food to go through. |
|
|
Term
| dronabinol (Marinol) is also given for N/V, but what is it really given for? |
|
Definition
| It's THC that is given to stimulate the appetites of AIDs and Chemotherapy patients with cancer. |
|
|
Term
| The nurse recognizes that prokinetic antiemetic drugs are given for what? |
|
Definition
| delayed gastric emptying (could be mass of hard stool, but could also be a tumor) need to evaluate why there is an obstruction before we start treating with laxatives. |
|
|
Term
| Antacids that contain aluminum can result in ______________. |
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Definition
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Term
| Which type can result in diarrhea? |
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Definition
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Term
| MOM is a laxative that is also an _________. |
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Definition
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Term
| Antacids should NOT be used in _________ failure patients. |
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Definition
| renal. (They can't get rid of the Mg+, hypermagnesia results) |
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Term
| What kind of non-pharmacological solutions should be done before giving reflux/GI drugs? |
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Definition
| avoid spicy foods, sit up after you eat, avoid alcohol, no smoking or chew, no caffeine (have decaf coffee) |
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Term
| Always want to do the non-pharm solutions first. What should be done for constipation before the use of drugs? |
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Definition
| high fiber, lots of fluid & get up & move |
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Term
| 75 y.o. woman with indigestion, tummy pain & frequent belching. Taking sodium bicarbonate (Antacid) 5-6 times a day. What hazard exists for sodium bicarbonate? |
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Definition
| Metabolic ALKALOSIS b/c sodium bicarbonate is a BASE |
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Term
| When deciding which OTC antacid to use, why is calcum carbonate not often an antacid? |
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Definition
| b/c calcium makes up a lot of kidney stones |
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Term
| 2 daily antacids, what instruction should be taught.. |
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Definition
| Antacids should be taken at least one hour before or after other medications. |
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Term
| What drug induces a total cleansing of the bowel & is taken before an enema? |
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Definition
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Term
| Which antidiarrhea works by decreasing muscle tone & intestinal peristalsis? |
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Definition
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Term
| never give a patient with diarrhea _______________. |
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Definition
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Term
| Pt on antibiotic therapy for 2 weeks has persistent diarrhea, what drug will be prescribed? |
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Definition
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Term
| A pt with a tube feed gastrostomy is going to take what drug to promote gastric emptying? |
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Definition
| Prokinetic (example is Reglan for prokinetics) |
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Term
| What drug is taken for anorexia associated with AIDS? |
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Definition
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Term
| What antiemetic is best for a patient having chemo? |
|
Definition
| serotonin blockers (example is Zofran) |
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