Endocrine
How close to a meal should a rapid acting insulin be administered?
How close to a meal should a regular insulin be administered?
15 minutes before
30 minutes before
Food/drug interaction for HMG-COA reductase inhibitors (statins)
Grapefruit juice
First line for asthma prevention?
inhaled corticosteroids
Which diuretic does not cause hypokalemia? Name the drug class and prototype
Potassium sparing- spironolactone
what is the adverse effect that is specific to long acting nitrates and what is the prototype?
tolerance
isosorbide dinitrate
Lab(s) and antidote for heparin and warfarin
heparin: aPTT and protamine sulfate
warfarin: PT/INR and vitamin K
Name the contraindications of metformin and why
Impaired renal function and IV radiographic contrast
alcohol
All increase the risk of lactic acidosis
Common adverse effect of niacin and how it can be reduced.
Intense flushing and hot flashes
- take ASA 30 min before
MOA and adverse effects of varenicline?
MOA: activates nicotinic acetylcholine receptors in the brain and blocks nicotine from reaching the brain (reduces cravings and withdrawal)
Adverse effects: common- N/V, constipation, vivid dreams. Serious- depression, risk for suicide, angioedema, MI, serious skin reactions
Common adverse effect of lisinopril?
Dry cough
Which 3 drug classes should patients go home on post MI?
ASA, ACE inhibitors, and beta blockers
Prototype for thrombolytics and who should not take them
Prototype: alteplase
Contraindications: BLEEDING
Name the MOA and prototype for sulfonylureas
MOA: stimulates the pancreas to release insulin and increases sensitivity of insulin receptors on target cells
Prototype: glyburide
MOA of fabric acid drugs and therapeutic use?
MOA: activates lipoprotein lipase which breakdown and eliminates triglycerides
Use: preferred drug for hypertriglyceridemia (often combined with a statin for greater reduction in triglycerides)
Prototype, adverse effects, and teaching of inhaled corticosteroids?
Adverse effects: hoarseness, sore throat, dry mouth, oral candidiasis. Long term use can cause decreased growth in kids and osteoporosis in adults.
Teaching: rinse mouth after using, take Calcium and vitamin D (adults). Need to take this daily for it to work
What are the fluid and electrolyte imbalances seen with loop diuretics
hypovolemia, hypokalemia, hyponatremia (can also cause loss of calcium and magnesium)
what is the prototype for Class I anti-dysrhythmics and the adverse effects?
lidocaine
hypotension, arrhythmias, nausea, CNS depression, respiratory depression
What is disulfiram used for and what are the drug interactions?
Used for treating alcohol use disorder. It is a deterrent because if you drink while on this (and 2 weeks after) you will vomit and have other symptoms
Interaction: anything with alcohol (so no cough syrup, mouthwash, liquid vitamins if they have alcohol and of course no alcohol)
Name the 3 pharmacotherapy options/classes for hyperthyroidism and the prototypes (if any).
1. antithyroid agents: thioamides: PTU and methimazole
2. Iodine solutions
3. ablation: radioactive iodine: 131I
Prototype of bile acid sequestrates?
How long do you need to wait to give other meds
Cholestyramine
give other meds 1 hour before or 4-6 hours after cholestyramine
MOA of intranasal decongestants and teaching needed?
MOA: activates alpha 1 receptors in the nose (vasoconstriction in the nose leads to shrinking of swollen mucus membranes)
teaching: discontinue after 3 to 5 days to avoid rebound congestion
Contraindications of nonselective beta blockers
COPD and asthma
(Bradycardia and heart failure)
Black box warning for amiodarone
causes pneumonia-like syndrome in the lungs. Can lead to fatal pulmonary toxicity
so they need a pulmonary lung function test before starting.
what is naltrexone used for
to decrease the craving for alcohol and block the pleasurable effects
What is the difference between 1st and 2nd generation sulfonylureas?
2nd generation have fewer drug-drug interactions
Common adverse effects of statins?
Severe adverse effects of statins and nursing considerations?
Common: GI effects (flatulence, abdominal pain, cramps, N/V, constipation)
Severe: liver failure (monitor LFTs), myopathy and rhabdomyolysis (monitor CK levels and discontinue if any muscle or joint pain)
Drug class and common adverse effects of albuterol
class: SABA (short acting beta agonist)
adverse effects: tachycardia, palpitations, nervousness, tremors
Name 3 of the S/S of cyanide toxicity from nitroprusside
metabolic acidosis, hypotension, blurred vision, lethargy, faint heart sounds, loss of consciousness
Name the 3 ways medications help with heart failure
1. improves myocardial contractility
2. increases myocardial efficiency
3. Improves Perfusion to all body tissues
Reduction of preload
Reduction of systemic vascular resistance (afterload
reduction)
Inhibition of both the RAAS and vasoconstrictor
mechanisms of the SNS
whaMOA and use of buprenorphine with naloxone
Used to manage opioid use disorder
MOA: reduces cravings and prevents unpleasant symptoms of withdrawal