Adrenergic + Misc. Anti-infectives
A patient receiving vancomycin starts to display hypotension, flushing, and a rash. What is this called?
vancomycin infusion reaction or red man syndrome
True or false: it is recommended to avoid receiving any vaccines while pregnant.
False: anyone who is pregnant or might be pregnant during the influenza season should receive the inactivated influenza vaccine + a single dose of the Tdap vaccine is recommended for all pregnant patients (in each pregnancy)
True or false: a patient with diabetes may need to increase their insulin while taking phentermine.
True: people with diabetes may require increased doses of insulin while taking phentermine because the drug produces effects similar to those caused by stimulating the sympathetic nervous system.
Adenosine is administered via rapid bolus injection - what is the recommended push rate for this drug?
Quickly - 1-2 seconds (Half life is less than 10 seconds)
A nurse is about administer enalapril maleate - name two vital signs the nurse should check before giving the drug.
BP, HR
Several adverse effects of erythromycin may be remembered using the mnemonic QT GLIDE - list what each letter stands for.
QTc prolongation
GI side effects (pain, n/v)
Liver toxicity
Injection site reactions
Diarrhea
Ear toxicity (ototoxicity)
The calcium channel blocker nifedipine should be used with caution in combination with which other tocolytic?
IV magnesium sulfate - severe adverse reactions have occurred when used together
This drug given for hyperkalemia removes potassium through stool.
sodium polystyrene sulfonate, aka Kayexalate
Approximately 20% to 30% of patients receiving this drug will develop drug-induced lupus erythematosus–like syndrome.
procainamide
This is how the nurse would assess for therapeutic effectiveness of ivabradine.
reduction in heart rate - which reduces myocardial demand + adverse outcomes (at recommended doses, HR reduction is approx. 10 beats/min at rest)
Norepinephrine is predominately an alpha receptor agonist. What does this activation result in?
Vasoconstriction - increasing BP
In addition to oxytocin, name two other drugs that may be used in postpartum hemorrhage.
methylergonovine, carboprost tromethamine
Why might a provider order an EKG for a patient receiving ondansetron?
may lead to QT interval prolongation - risk for arrythmias
Serum levels of lidocaine should be monitored - name a potential sign of lidocaine toxicity.
Somnolence, confusion, tremors, paresthesia, seizures
It is recommended to wait at least 36 hours when switching between ACE inhibitors or ARBs and sacubitril/valsartan - why?
There should be a “washout” period between administrations of the two drugs to reduce the risk of angioedema.
A patient has been prescribed a long-term course of linezolid - why would the nurse expect to see weekly CBCs drawn?
Myelosuppression (bone marrow depression; e.g., anemia, leukopenia, pancytopenia, thrombocytopenia) may occur with linezolid therapy
How long should the nurse wait before starting oxytocin after last administration of misoprostol?
4 hours
What should the nurse say a patient who asks about how to minimize the adverse GI effects of orlistat?
To minimize GI effects, the nurse encourages patients to distribute fat calories over the three main meals and to avoid high-fat meals.
List an indication for diltiazem.
PSVT, AFIB RVR, A-flutter
Milrinone is indicated for intermediate- and long-term bridge therapy. What does the term bridge therapy refer to in this case?
Used to optimize cardiac function and stabilize heart failure patients prior to definitive treatment (e.g., coronary revascularization, mechanical circulatory device support, or heart transplantation)
List three potential adverse effects the nurse should be aware to monitor for when administering an adrenergic drug like norepinephrine.
Kidney/liver damage, limb ischemia/extravasation, hyperglycemia, hypokalemia, cardiac dysrhythmias
Use of indomethacin is not recommended for use after 32 weeks or for longer than 48 hours. Why?
Can cause constriction of ductus arteriosus, development of oligohydramnios
List three potential side effects of anticholinergic medications.
dry mouth, blurred vision, urinary retention, constipation, acute confusion
Antidysrhythmics are divided into five classes - name these five classes.
Sodium channel blockers, beta-adrenergic blockers, potassium channel blockers, calcium channel blockers, miscellaneous/"unclassified"
Name three potential signs of digoxin toxicity.
heart rhythm disturbances (slow or fast), PVCs, dizziness, n/v, abdominal pain, vision changes (yellow-green halos / problems with color perception), blurry vision, mental status changes