Are we there yet?
This is the usual location of a first-pass effect
What is the liver?
Name a common side effect of the ACE inhibitor
What is dry cough?
Examples of metabolic effects (often adverse effects) associated with beta adrenergic receptor antagonists
What is decreases awareness of hypoglycemic symptom onset and increases blood lipid levels?
Yellow halos seen around light, bradycardia, blurred vision, nausea, vomiting, are common signs and symptoms associated with toxicity of this drug
What is digoxin?
This is the antidote to heparin
What is protamine sulfate?
What are the 3 stages of inflammation?
What is vascular and cellular response, exudate production, and reparative?
The movement of a drug from the site of administration to various tissues of the body is what kind of action?
What is absorption?
Which patient would the nurse use caution when giving a beta blocker?
GERD, COPD, CAD, or DVT
What is COPD?
Receptors that mediate most of epinephrine's cardiac effects
beta1 adrenergic
Ataxia, sedation, nystagmus, diplopia, cognitive impairment are signs/symptoms associated with toxicity of this drug
What is phenytoin (Dilantin)?
This is the antidote for Warafarin
What is Vitamin K
What are three causes of inflammation?
What is autoimmune disease, infection, and cellular injury?
The next step after a drug has been absorbed into the blood stream
What is distrubution?
When taking an ACE medication, what is the most life threatening side effect of this medication?
What is angioedema?
This medication is a sympathetic agonist that is used for bronchial asthma, exacerbation of some forms of COPD, allergic reactions and anaphylaxis.
What is epinephrine?
This is the antidote for acetaminophen overdose
What is acetylcysteine?
A client with a-fib is receiving coumadin. Which of the following test results indicate this medication is at it's therapeutic effect? INR 0.9, INR 2.5, or INR 4
What is INR 2.5 ?
List the 7 local manifestations of inflammation
What is pus, heat, redness, edema, pain, clot, and loss of function?
term describes the intended effects of a drug
What is therapeutic effect?
Name 3 nursing action the nurse should include when taking care of a patient that is taking the medication doxazosin (Cardura).
What is monitor BP including orthostatic hypotention, monitor intake and output, daily weights, assess for edema daily?
This drug classification physiological effects causes increased GI motility and increased urination
What is parasympathetic drugs?
The nurse is administering vancomycin to a patient. What is important to assess prior to administration?
What is a trough level? Normal is 5-15 mcg/mL
Give 3 food examples of food high in Vitamin k
What is asparagus, beans, broccoli, brussel sprouts, cabbage, kale, mustard greens, spinach, swiss chard ?
What is the normal BUN and Creatinine levels and how would sepsis affect these levels if there were decreased profusion?
What is normal BUN levels are 10-20 mg/dL and Creatinine 0.6- 1.2? What is increase these levels due to a decline in kidney function?
What is drug tolerance?
When taking Procardia the nurse should provide education to avoid which fruit and which herbal medication?
What is Grapefruit?
What is Ginkgo biloba ,ginseng, and St. John's wort?
Mechanism of action of atropine
What is blocks acetylcholine and inhibits parasympathetic stimulation?
Some signs and symptoms of toxicity for this mood stabilizing medication can include muscle stiffening, nausea, vomiting, tremors, and diarrhea
What is lithium?
A safe blood level of lithium is 0.6 and 1.2 milliequivalents per liter (mEq/L). Lithium toxicity can happen when this level reaches 1.5 mEq/L or higher. Severe lithium toxicity happens at a level of 2.0 mEq/L and above
Why does DIC occur in sepsis?
Sepsis injures blood cells, causing platelet aggregation and decreased blood flow. As a result, blood clots form throughout the micro circulation.
Provider orders a medication known to cause nephrotoxicity. Which element of pharmacokinetics does the nurse understand is critical when assessing this patient's response to this medication?
What is excretion?
Instructions the nurse will provide for a patient taking spironolactone
Don't take of potassium supplements or potassium containing salt substitutes. Report palpitations, muscle twitching, weakness, or paresthesias in extremities.
An example of cardiovascular adverse effect of cholinergic drugs
What is hypertension, syncope, bradycardia, hypotension, tachycardia, conduction abnormalities?
Use caution with this antibiotic in patients with renal impairment, advanced age, dehydration, and prolonged use of this medication.
What is gentamacin?
This medication has the potential for nephrotoxicity and ototoxicity
While on antiplatelet medications, patients should expect to see increased bruising, petechiae, purpura, and bright red blood in their stool. These are not abnormal findings, and do not need to be reported to the physician.
What is false?
Name the phase in the inflammatory response where there is a combination of fluid and leukocytes that arrive to injury site from circulation present during this phase of the inflammatory response.
What is exudate formation?
Place the elements of pharmocokinetics in order from first step to last as a medication moves from its entry to its exit from the body?
Excretion, Absorption, Distribution, Biotransformation
What is : Absorption, Distribution, Biotransformation, and Excretion
Drugs that increase the force of the heart muscle contractions
What is cardiac glycosides?
This drug has the greatest effect in the vascular system
What is alpha adrenergic blocking drugs?
This seizure medication has the potential to cause toxicity if too much medication is in the blood stream. The Total Therapeutic Range: 50-125 μg/mL of this medication and the Toxic: Greater than 150 μg/mL
What is valproic acid?
The nurse is preparing to administer Plavix what past medical history would the nurse be concerned with?
What is GI bleed, history of hemorrhage stroke, peptic ulcer disease, recent surgery?
This is the term used to describe an increase in the quantity of blood flow to a body part; engorgement
What is hyperemia?
Term that refers to the relationship between toxic and therapeutic dosing
What is therapeutic index?
what is rebound hypertension?
This drug has the greatest effect on adrenergic nerves in the heart
This medication is used for treatment of lung conditions and interacts with and could decrease the metabolism of this drug when taking with cinemet, birth control, and erythomycin. This can result in toxicity of this medication.
These herbal remedies have anti-platelet properties
What is gingko biloba, garlic, feverfew, primrose oils?
Which systemic responses are related to an increased metabolic rate?
What are increased pulse and respiratory rate?
Drug A has a half life of 2 hours. If the initial plasma level of the drug, given as a single dose, is 1200 mg/L. what will its plasma level be after 8 hours?
What is 75 mg/L?
2 hours - 1 half life 1200 /2 = 600 mg/L
4 hours- 2 half life 600/2 = 300 mg/L
6 hours 3 half life 300/2 = 150 mg/L
8 hour - 4 half life 150/2= 75 mg/L
The nurse is preparing to administer nitroglycerin paste to a patient. What equipment must the nurse have when giving this medication?
What is gloves, the measuring paper, and an occlusive dressing?
This drug is contraindicated for a patient taking an adrenergic drugs for hypertension
What is nasal decongestants?
This diabetic medication needs to be held 48 hours prior to a cardiac catherization. If not held can cause renal failure
What is metformin?
What is the indication for the use of Eliquis?
Treat PE, DVT, used to reduce the risk re- occurrence of PE or DVT
List the clinical manifestations of systemic response
What is increased WBC, count, malaise, nausea, and anorexia, increased pulse and respiratory rate, and fever?
The term used to describe the change or biotransformation that occurs in a drug into a more or less patent soluble, or inactive form is what kind of pharmacokinetic action
What is metabolism?
A patient is receiving a high dose of nitroglycerin IV . What side effect would the nurse anticipate the client may complain of?
What is a headache?
What is the priority nursing diagnosis for a client receiving a cholinergic (parasympatholytic drugs)?
Risk for injury related to excessive CNS stimulation, Impaired gas exchange related to thickened respiratory secretions, Urinary Retention related to loss of bladder tone, or Knowledge deficit related to pharmacology regimen
What is impaired gas exchange related to thickened respiratory secretions?
This can occur when a patient is taking an SSRI medication and there is an accumulation of medication in the patient's system
The nurse is caring for a patient with a pulmonary embolism. The physician orders heparin to infuse at 14mL/hr and the available concentration is 40,000 units in 500 mL. How many units/hr will the patient receive?
1120 units/hr
What are the SIRS criteria?
What is temperature above 100.4 or below 96.8, heart rate above 90, respiratory rate above 20 bpm, white blood cell count outside of the 4-12 range?