HESI Pharmacology Exit Exam
What is the indication for metoclopramide/reglan? - ✅✅✅Prevention of chemotherapy-induced emesis and diabetic
... [Show More] gastroparesis
Side effects of metoclopramide/reglan - ✅✅✅Drowsiness, EPS such as tremors
Notify MD if what occurs when using metoclopramide/reglan - ✅✅✅Tremors
What is the indication xenical (orlistat, Alli) - ✅✅✅For PTs with BMI of 30+; LT weight control
SE of xenical (orlistat or alli) - ✅✅✅Oily stool and flatulence
Nursing implications for a pt on xenical (orlistat or alli) - ✅✅✅Ask pt to describe dietary intake since SE are increased if greater than 30% of fat is in diet.
What can decrease side effects of xenical (orlistat or alli) - ✅✅✅Fiber laxatives like Metamucil help decrease SE by binding to the fat.
Which type of fluids need plenty of water? - ✅✅✅Bulk forming laxatives
Why do you need plenty of fluids when taking bulk forming laxatives - ✅✅✅Because they can produce esophageal and or intestinal obstruction
Laxative use assessment - ✅✅✅Last BM and characteristics, abdominal pain, fever and obstruction. Assess dietary and fluid intake.
With laxative use the nurse should - ✅✅✅Encourage fluids, fiber and exercise as tolerated/indicated
Laxative use and result in - ✅✅✅Lack of bowel tone which can lead to dependency
what is ondansetron (zofran) - ✅✅✅antiemetic
What is ondansetron (zofran)used for? - ✅✅✅Prevention of N/V associated with chemotherapy and radiation therapy.
Who should you use caution with when giving ondansetron/zofran? - ✅✅✅PTs with liver failure
Drugs for ulcerative colitis and crohns - ✅✅✅5 aminosalicylates; mesalamie, sulfasalazine.
How do 5 aminosalicylates; (mesalamie, sulfasalazine) work? - ✅✅✅They decrease GI inflammation
Side effects of 5 aminosalicylates; (mesalamie, sulfasalazine) - ✅✅✅Nausea, rash, arthralgia, hematological disorders
Which drug can cause colitis/c.diff - ✅✅✅Linezolid/zyvox
What kind of infection is c.diff - ✅✅✅Suprainfection
What is azithromycin/zithromax? - ✅✅✅An antibiotic
What does azithromycin/zithromax treat? - ✅✅✅STDs such as: gonorrhea and chlamydia
How much azithromycin/zithromax is usually required? - ✅✅✅One dose of 1g or 2g.
If a female pt has trichomonas (any STI) and is asymptomatic does the male need to be tested? - ✅✅✅Yes!
azithromycin/zithromax can cause what? - ✅✅✅Hepatotoxicity- elevated liver enzymes
What is nitrofurantoin/cipro used for? - ✅✅✅An antibiotic for UTI
nitrofurantoin/cipro side effect - ✅✅✅Hepatotoxicity, skin reactions, neuropathy
nitrofurantoin/cipro nursing considerations - ✅✅✅Give with milk or meals check LFTs. Watch for numbness or tingling of extremities this can be an irreversible peripheral neuropathy
Drug of choice for treating c.diff? - ✅✅✅Metronidazole/flagyl
When is metronidazole/flagyl to be taken? - ✅✅✅With food and around the clock
What should be avoided when taking metronidazole/flagyl and why? - ✅✅✅Alcohol; can cause a disulfiram-like reaction
aminoglycosides examples - ✅✅✅gentamicin(garamycin), neomycin, tobramycin(nebcin)
how are aminoglycosides ,(-mycin, -micin), administered? - ✅✅✅given IV for several days
what is an adverse effect of aminoglycosides (-mycin, -micin) - ✅✅✅decreased hearing/ototoxicity and nephrotoxicity
what labs need to be evaluated when given aminoglycosides (-mycin, -micin)? - ✅✅✅BUN and creatinine
DOC for MRSA - ✅✅✅vancomycin
what is MRSA - ✅✅✅severe staph infections that have become resistant to most antibiotics
implications for giving vancomycin - ✅✅✅acute care requires frequent monitoring og serum drug level for dose adjustment. peak and trough schedule. trough is drawn just prior to next dose.
risks when using vancomycin - ✅✅✅nephrotoxicity and ototoxicity
SE of vancomycin - ✅✅✅thrombophlebitis, red man syndrome if infused too rapidly: flushing or rash of upper body, dyspnea, itching, hypotension- can be lethal
how long should IV vancomycin infuse? - ✅✅✅greater than 60 minutes
what is trimethoprim/sulfamethoxazole? - ✅✅✅it is a sulfonamide for treatment of UTI. combination increases efficacy and inhibits metabolism of folic acid at two different points
what is trimethoprim/sulfamethoxazole known for? - ✅✅✅sulfa allergy
nursing implications for trimethoprim/sulfamethoxazole - ✅✅✅assess for rash due to potential for stevens johnson syndrome
penicillins have a ____ to ____ - ✅✅✅cross-sensitivity; cephalosporins. they are structurally similar.
nursing considerations for penicillins - ✅✅✅observe respiratory status for first 30 minutes when administering for the first time. watch for anaphylaxis if allergic to one or the other may have cross sensitivity
what can a nurse treat penicillin anaphylaxis with? - ✅✅✅epinephrine
nursing considerations for antibiotics - ✅✅✅do not take for viral illnesses. take entire prescription as ordered. don't take if not needed as it can produce resistance.
what is ribavirin(copegus) indicated for? - ✅✅✅antiviral for treatment of hepatitis C that has failed other treatment
ribavirin(copegus) SE - ✅✅✅hemolytic anemia
what is ticarcillin/clavulanic acid (timentin)? - ✅✅✅broad spectrum/extended spectrum penicillins
nursing considerations for ticarcillin/clavulanic acid (timentin) - ✅✅✅do not administer in same infusion with aminoglycosides
what is the indicated use for rifampin? - ✅✅✅antitubercular for treatment of TB
rifampin SE - ✅✅✅turns: body fluids; tears, saliva, urine, soft contacts red/orange/brown. (ADVISE PT THIS IS NORMAL). Teratogenic- may decrease effectiveness of oral contraceptives; advise to use nonhormonal form of conception throughout therapy. Hepatotoxicity
what labs need to be monitored with rifampin? - ✅✅✅LFTs
what is the indicated use for isoniazid (INH) - ✅✅✅TB
what does isoniazid (INH) interact with? - ✅✅✅foods containing tyramine; can produce life-threatening hypertensive crisis.
what should be used with isoniazid (INH)? - ✅✅✅2nd form of birth control
flu vaccine SE - ✅✅✅for anyone 6 months and older every season; soreness, redness and swelling at site of injections, low grade fever, aches.
what is the indicated use for fluconazole (diflucan)? - ✅✅✅antifungal for vaginal candidiasis
what labs should be monitored with fluconazole (diflucan)? - ✅✅✅many antifungals can cause liver injury monitor LFTs
what is antifunal terbinafine (lamisil) used to treat? - ✅✅✅superficial dermatologic infections (athlete's foot) and onychomycosis (nail fungus).
nursing considerations for terbinafine (lamisil) - ✅✅✅avoid alcohol, monitor LFTs, report: nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools and jaundice
how do you know if an antibiotic is effective? - ✅✅✅decrease in WBC, decrease in fever, better cultures, pt feels better
nursing considerations for antidepressants. - ✅✅✅can cause addiction, pts experience withdrawal symptoms. ALWAYS GET MEDICATION HISTORY SINCE MANY DRUGS CAN INTERACT WITH ANTIDEPRESSANTS
what is the indicated use for benztropine/cogentin? - ✅✅✅parkinson's disease and treatment of extrapyramidal symptoms (EPS) AKA parkinsonism
what is benztropine/cogentin? - ✅✅✅anticholinergic
SE of benztropine/cogentin - ✅✅✅blurry vision, urinary retention
how does levodopa-carbidopa (sinemet) work? - ✅✅✅stimulates dopamine production or increases sensitivity of dopamine receptors
what does levodopa-carbidopa (sinemet) treat? - ✅✅✅parkinson's
S/S of levodopa-carbidopa (sinemet) toxicity - ✅✅✅involuntary muscle twitching, facial grimacing, spasmodic eye winking, exaggerated protrusion of the tongue. NOTIFY PRESCRIBER.
what foods should a pt on levodopa-carbidopa (sinemet) avoid? - ✅✅✅high protein meals! can impair effects!
what is lithium (lithobid, lithotabs) indicated for? - ✅✅✅to treat pts with bipolar disorder.
what kind of therapeutic index does lithium have? - ✅✅✅low/narrow; toxicity can occur at blood levels only slightly greater than therapeutic levels monitoring lithium is mandatory
lithium (lithobid, lithotabs) levels - ✅✅✅below 1.5 mEq/L; anything greater causes toxicity
initial lithium therapy levels - ✅✅✅0.8-1.4 mEq/L
maintenance lithium levels - ✅✅✅0.5-1.5 mEq/L
when should lithium levels be drawn? - ✅✅✅in the morning 12 hours after evening dose
how often during maintenance therapy should lithium levels be checked? - ✅✅✅every 3-6 months
normal sodium level - ✅✅✅136-145 mEq/L
how does an increased sodium level effect serum lithium levels? - ✅✅✅increase in sodium causes increase in renal excretion which will lower serum lithium levels
early S/S of lithium toxicity - ✅✅✅D/N/V, drowsiness, muscle weakness.
what happens with lithium toxicity? - ✅✅✅life-threatening dysrhythmia, coma, convulsions, and death
nursing considerations for lithium - ✅✅✅keep salt consistent in diet; no diuretic
haloperidol/haldol produces what? - ✅✅✅severe extrapyramidal symptoms (EPS) or reactions including tardive dyskinesia
what are EPS - ✅✅✅movement disorders resulting from effects of anypsychotic drugs on the extrapyramidal motor system.
what is the extrapyramidal system? - ✅✅✅same neuronal network whose malfunction is responsible for movement disorders of parkinson's disease. [Show Less]