Cardiac/Renal
Which of the following medications is considered a calcium channel blocker?
Verapamil, Metoprolol, Benazepril, Losartan
Verapamil
Other calcium channel blockers include Cardizem, and medications ending in -pine (ex. amlodipine, nifedipine) these medications lower heart rate AND blood pressure
Which drug category is helpful in promoting sleep among patients with insomnia?
Sedative, SSRI, Analgesics, Corticosteroids
Sedatives
Which drug would you anticipate will be given to a patient who experienced an overdose of a benzodiazepine?
naloxone, activated charcoal, flumazenil, isoniazid, epinephrine
flumazenil
flumazenil (Romazicon) is a benzodiazepine receptor antagonist and is an antidote used to reverse an overdose of either a benzodiazepine sedative or a nonbenzodiazepine sedative. For adults, it is given intravenously with an initial dose of 0.2 mg. If there is no response after 45 seconds, the dose can be repeated. After that, it can be repeated every minute for a total of 4 doses.
which medications are used for pain management? SATA
clonidine, amitriptyline, gabapentin, zolpidem, codeine
clonidine, amitriptyline, gabapentin, codeine
Which of the following side effects is seen in patients taking angiotensin-converting enzyme inhibitors but not in angiotensin II receptor blockers?
cough, orthostatic hypotension, dizziness, hypotension
cough
A dry hacking cough is common amongst ACE inhibitors but not ARBS
Parkinson’s disease who takes a carbidopa/levodopa combination drug, you find that he now has almost constant muscle movements that look like uncoordinated dancing. What is this condition?
Dyskinesia, akathisia, tardive dyskinesia, pseudo-parkinsonism
Dyskinesia
The most common adverse reaction to carbidopa/levodopa is dyskinesia, involuntary muscle movements that look like uncoordinated dance movements. Dyskinesia is common in patients on long-term carbidopa/levodopa therapy (longer than 3 years).
Any of the following movement disorders should be reported to the physician.
Which of the following medications would be prescribed for a patient with bipolar disorder?
Sertraline, Lithium, Alprazolam, Chlorpromazine, Amitriptyline
Lithium
Sertraline- SSRI SSRIs (may cause thoughts of suicide, most likely in children and young adults)
Alprazolam- BNZ (short term- dependence/addiction)
Chlorpromazine- typical antipsychotic (treat pos. symptoms of schizophrenia) report sudden increases in temperature and blood pressure, and confusion. As well as movement disorders.
Amitripyline- TCA (diff urinating, blurred vision, and sob)
You are discharging a patient with an opioid analgesic. Which education is going to be priority?
This med can be used for mild pain, This medication can cause drowsiness, Avoid drinking alcohol, Be sure to drink plenty of water and eat foods high in fiber
Avoid drinking alcohol
Drinking alcohol while on a morphine agonist will make side effects worse and increase the risk for respiratory depression. Although preventing constipation is important, preventing respiratory depression is more important.
A CHF patient, taking digoxin, has the following vital signs: blood pressure 132/90 mm Hg, respirations 25 breaths/min, apical pulse 54 beats/min, and temperature 98.4°F. What action should the nurse take next?
Reassure the patient that these are expected findings, Hold the next dose of digoxin, Reassess the vitals in 30 minutes, Notify the physician
Notify the physician. The patient is showing signs of toxicity, which can be a result of a certain electrolyte being low.
Toxicity S/S include anorexia, nausea, vomiting, diarrhea, weakness, fatigue, vision changes, confusion, dizziness, and bradycardia.
What is the mechanism of action of a dopamine agonist?
Dopamine agonists work to increase dopamine levels in the brain to restore the balance between the actions of acetylcholine and dopamine. This action reduces muscle rigidity and tremors, to improve mobility.
Attaches to opioid receptors, concentrates serotonin and norepinephrine in the brain and spinal cord, inhibits sensory nerve impulses, reduces inflammation
concentrates serotonin and norepinephrine in the brain and spinal cord.
Elevation of serotonin is what puts patient at risk for serotonin syndrome while using this drug and other serotonin raising medication such as antidepressants
What is the cardinal sign of aspirin toxicity?
tinnitus
Patients on aspirin should be monitored for bleeding. Must be discontinued a week before procedures
How many sublingual tablets can you give a patient with chest pain? Within a 15 minute time frame.
3
The patient should take a nitroglycerin tablet below the tongue, DO NOT CHEW or swallow, when experiencing angina, and every 5 minutes if pain continues. Must call the ambulance after the first dose of nitroglycerin. Nitroglycerin is a vasodilator
What is the most important precaution to teach patients taking any monoclonal antibody or neurologic drug to manage multiple sclerosis?
This medication may cause suicidal ideation, avoid crowds and people who are sick, wear protective sun screen, avoid any weight bearing activities
Avoid crowds and people who are sick
The monoclonal antibodies (alemtuzumab, daclizumab, natalizumab) and neurologic drugs currently prescribed to help manage multiple sclerosis all reduce immunity and inflammation, increasing the risk for infection.
What is the therapeutic range for lithium?
0.8-1.2 initial dose
0.8-1 maintenance dose
Avoid activities that would cause salt/fluid imbalances
Patients taking lithium should refrain from sweating or activities that can cause dehydration, which then places them at risk for lithium toxicity.
Methocarbamol (Robaxin) and cyclobenzaprine are prescribed for pain management and can cause a decrease in seizure threshold, cardiac dysrhythmias, as well as urinary retention. What group of pain medication are these medications in?
Skeletal muscle relaxants
Which drinks should be avoided when taking a -statin medication? SATA
Alcohol, milk, grapefruit juice, orange juice
Alcohol and grapefruit juice
Patients need to avoid alcohol because drinking alcohol puts stress on the liver and adds to the stress of these drugs. Patients need to avoid grapefruit juice while taking statins because grapefruit juice increases the concentration of statins, and increases the risk of toxicity. Patients need to be instructed to report severe muscle aches, changes in urine color, or decreased urine output because statins can cause rhabdomyolysis, a disorder resulting from broken muscle cells that damage the kidneys. Patients need to be reminded to follow up with their healthcare provider to check cholesterol levels 4 to 12 weeks after starting the drug and after dose changes.
A patient has been prescribed phenazopyridine as part of treatment for a urinary tract infection. Which of the following is considered an adverse effect of this urinary analgesic?
red-orange urine, yellow sclera, nausea, vertigo
yellow sclera
Red-orange urine, nausea, and vertigo are expected side effects. May be taken with food to avoid GI upset.
The serotonin triad is used to describe the symptoms seen in a potentially life-threatening disorder called serotonin syndrome. The triad includes ___________, autonomic hyperactivity, and neuromuscular abnormalities
Mental status changes
Serotonin syndrome is a potentially life-threatening disorder characterized by confusion, restlessness, extremely high blood pressure, dilated pupils, increased sweating, seizures, and tremors.
What is the daily max dose for acetaminophen?
4g daily
When taken at higher doses or for prolonged periods, acetaminophen is toxic to the liver, which can be damaged or destroyed. The drug has a maximum daily dose to prevent liver toxicity and should not be taken with alcohol or other liver toxic drugs.