Labor Inducers + Inhibitors
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.
This is the reversal agent for heparin + enoxaparin.
Protamine sulfate
(Note: does not completely neutralize LMWHs, but may reduce bleeding)
A nurse is about administer enalapril maleate - name two vital signs the nurse should check before giving the drug.
BP, HR
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)
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 is how a patient taking clomiphene citrate can assess for occurrence of ovulation.
Prior to beginning the drug regimen, the nurse instructs the patient about taking their basal temperature 5 to 10 days following administration. An incremental rise in temperature is an indication that ovulation has recently occurred.
This lab test is used to monitor the anticoagulation effects of heparin.
PTT/aPTT
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)
Approximately 20% to 30% of patients receiving this drug will develop drug-induced lupus erythematosus–like syndrome.
procainamide
In addition to oxytocin, name two other drugs that may be used in postpartum hemorrhage.
methylergonovine, carboprost tromethamine
This infertility drug is associated with the potential for development of arterial thrombosis.
hCG: human chorionic gonadotropin
Norepinephrine is predominately an alpha receptor agonist. What does this activation result in?
Vasoconstriction - increasing BP
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.
Serum levels of lidocaine should be monitored - name a potential sign of lidocaine toxicity.
Somnolence, confusion, tremors, paresthesia, seizures
How long should the nurse wait before starting oxytocin after last administration of misoprostol?
4 hours
This drug is contraindicated for those with medullary thyroid cancer.
Liraglutide
A patient asks, "How far in advance should I stop taking my clopidogrel before surgery?"
5-7 days
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 an indication for diltiazem.
PSVT, AFIB RVR, A-flutter
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
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 three potential foods or herbs that may interact with warfarin.
Chamomile, cranberry juice, garlic, ginkgo, green tea, turmeric, ginseng, St. John's wort
High in Vitamin K - broccoli, cauliflower, cabbage, kale, lettuce, peppers, spinach, tomatoes, brussels sprout
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
Antidysrhythmics are divided into five classes - name these five classes.
Sodium channel blockers, beta-adrenergic blockers, potassium channel blockers, calcium channel blockers, miscellaneous/"unclassified"