Download Pharmacology Exam Questions & Answers: Antipsychotics, Alzheimer's, Antiepileptics and more Exams Nursing in PDF only on Docsity!
NSG 322 Pharm Final EXAM
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prototype for antipsychotic (trade/generic), treatment for schizophrenia - ANSWER haldol/haloperidol how long does it take the typical antipsychotic drug to reach its therapeutic effect? - ANSWER several days what would you say if a patient calls and states that the antipsychotic drug isn't working within the 1st couple of days? - ANSWER keep taking it (they don't work right away) what should we inform the patient about antipsychotics concerning taking the prescription? - ANSWER take consistently (doses need to build up in the body) what receptors do antipsychotics (haldol/haloperidol) block? - ANSWER dopamine, alpha, and serotonin is haldol/haloperidol highly protein bound? - ANSWER yes (92%) how does the nurse make sure that the patient is complying and adhering to the antipsychotic regimen? - ANSWER build a relationship (establish trust) adverse effects of haldol/haloperidol - ANSWER extrapyramidal effects (pseudoparkinsonism, tardive dyskinesia); seizures stop giving haldol/haloperidol if the patient has this disease - ANSWER parkinson's disease (avoid starts and stops) where is haldol/haloperidol metabolized? - ANSWER liver what population has a black box warning associated with haldol/haloperidol? - ANSWER elderly patients with dementia-related psychosis what is the prototype drug (trade/generic) used for alzheimer-type dementia? - ANSWER exelon/rivastigmine
what enzyme does exelon/rivastigmine inhibit? - ANSWER acetylcholinesterase enzyme what effect does exelon/rivastigmine have on acetylcholine? - ANSWER increases amount of acetylcholine (prevents breakdown of it) what is the most common adverse effect of exelon/rivastigmine? - ANSWER GI upset (take with food) what is the most serious side effect of exelon/rivastigmine? - ANSWER bradycardia is exelon/rivastigmine curative or palliative? - ANSWER palliative (does not cure the disease) what does acetylcholine help regulate (think about what the brain does)? - ANSWER regulates memory and cognition what metabolizes exelon/rivastigmine? - ANSWER AChE what is the main route/dosage of exelon/rivastigmine? - ANSWER PO; 1.5, 3, 4.5, and 6 mg is exelon/rivastigmine highly protein bound? - ANSWER no (40%) what is the prototype (trade/generic) antiepileptic drug that decreases sodium influx - ANSWER dilantin/phenytoin what pt education should the nurse provide when talking about the suspension form of phenytoin? - ANSWER must be shaken (before pouring, measure the dose) is phenytoin highly protein bound? - ANSWER yes (90-95%) if the pt is homeless and is an alcoholic, would dilantin/phenytoin be effective? - ANSWER no: malnourished (pt may have seizures because there is not enough protein in the body) what types of seizures does dilantin/phenytoin control? - ANSWER partial and generalized (grand mal) seizures where is dilantin/phenytoin mostly metabolized by? - ANSWER liver what is the primary site of action of dilantin/phenytoin? - ANSWER motor cortex
how does dilantin/phenytoin work? - ANSWER blocks inactive sodium channels (delays action-potential b/t synapses, which prevents excessive muscle contractions during a grand mal seizure) what must the nurse do when administering phenytoin via IV route? - ANSWER give slowly (black box warning for effects on ventricular automaticity) in terms of the mentality of the pt, what should the nurse assess for in a pt taking dilantin/phenytoin? - ANSWER increase in suicidal thoughts (also affects CNS w/ symptoms such as ataxia) what are 2 examples of the most serious adverse effects of dilantin/phenytoin? - ANSWER liver damage and blood dyscrasia can drug therapy of dilantin/phenytoin be stopped? - ANSWER no (doing so can cause status epilepticus) what is dilantin/phenytoin contraindicated with? - ANSWER alcohol intolerance and heart conditions (sinus bradycardia, SA or AV block) what can happen if dilantin/phenytoin is administered too quickly via IV? - ANSWER cardiovascular collapse (hypotension, cardiac arrhythmias) what are two essential ideas the pt must know when beginning seizure drug therapy? - ANSWER no alcohol and do not stop taking medication what are the two best drugs for acute seizures? (trade/generic) - ANSWER (benzodiazepines) ativan/lorazepam, IV and valium/diazepam rectally (choose IV first) what is the prototype benzodiazepine drug (trade/generic)? - ANSWER ativan/lorazepam what therapeutic effects does ativan/lorazepam have on the body? - ANSWER sedation: decreases anxiety and seizures is ativan/lorazepam highly protein bound? - ANSWER yes (85%) what do benzodiazepines do? - ANSWER increase effects of GABA (inhibitory neurotransmitter of the CNS) what is the site of action of ativan/lorazepam? - ANSWER brain
what are some contraindications of ativan/lorazepam? - ANSWER psychoses, glaucoma, intra-arterial use
increases effectiveness by 10%)
how long doe carbidopa-levodopa take to be fully effective in the patient? - ANSWER 1
- 2 months, maybe up to 6 months what effect does carbidopa-levodopa have when it affects the balance of the dopamine- acetylcholine system? - ANSWER balances the nerve impulse control what medication is contraindicated with carbidopa-levodopa? - ANSWER MAOIs what are some examples of contraindications that carbidopa-levodopa can cause?
- ANSWER malignant melanoma, cardiac disease (arrhythmias, pulmonary disease, peptic ulcer), and diabetes (disease can exacerbate) what should the nurse advise the pt to do when taking carbidopa-levodopa? - ANSWER take on empty stomach (reduce protein in diet) dosage of carbidopa-levodopa? - ANSWER 25 mg carbidopa, 100 mg levodopa what should the nurse know about carbidopa-levodopa in terms of titration? - ANSWER titrate upward to avoid the GI, titrate downward to avoid neuroleptic malignant syndrome what should the nurse be aware of in terms of BP when administering carbidopa- levodopa - ANSWER can cause (orthostatic) hypotension what is the prototype drug of respiratory stimulants? - ANSWER caffeine when should you take caffeine? - ANSWER daytime (don't take at night, will create a disturbed sleep pattern) besides being a respiratory stimulant, what other classifications does caffeine cover? - ANSWER CNS stimulant, mild diuretic what effects does caffeine have on the body? - ANSWER stimulates voluntary muscle and gastric acid secretion what is caffeine used to treat? - ANSWER asthma, drowsiness, and fatigue what are some of the benefits of caffeine? - ANSWER once daily administration, reliable oral absorption, wide therapeutic range adverse effects of caffeine? - ANSWER jittery, feelings of anxiety
what are some medications used to treat movement disorders such as MS or parkinson's - ANSWER cyclobenzoaprin baclofen, dantrolin (malignant hypothermia), and carbidopa-levodopa are medications used for movement disorders curative or palliative? - ANSWER palliative (tx of symptoms) what drug (trade/generic) is used to treat ADHD, narcolepsy, and obesity? - ANSWER ritalin/methylphenidate what drug classification does ritalin/methylphenidate fall under? - ANSWER CNS stimulant what should the nurse consider when administering extended release ritalin SR? - ANSWER pt must swallow whole what is the benefit of drug therapy tx of long acting ritalin LA - ANSWER all day treatment with morning dose (eliminates social stigma of medication) what should the nurse consider when administering ritalin/methylphenidate in terms of abuse potential? - ANSWER schedule 2 drug (potential abuse like amphetamine) what is the most lethal adverse effect with ritalin/methylphenidate? - ANSWER sudden death (if pt has hx of CV disease) antibiotic principles (1-3) - ANSWER 1. vaccinate 2. get catheters out 3. target the pathogen antibiotic principles (4-6) - ANSWER 4. access the experts 5. practice antimicrobial control 6. local data antibiotic principles (7-9) - ANSWER 7. treat infection, not contamination 8. treat infection, not colonization (treat pneumonia not tracheal aspirate, bacteria not cath tip)
- know when to say no to vancomycin (right bug right drug) what should the nurse know about vancomycin? - ANSWER unless the pt is allergic or has renal dysfunction, vancomycin should be saved because it is effective against resistant organisms antibiotic principles (10-12) - ANSWER 10. stop antimicrobial tx (infection cure, culture neg, infection not diagnosed, previous transmission) 11. isolate the
pathogen 12. break the chain of contagion (home when sick, hands clean, set example) what is the prototype sulfonamide (trade/generic)? - ANSWER sulfamethoxazole- trimethoprim (SMZ-TMP)
in order to promote therapeutic effect you should always encourage the pt to? - ANSWER take medication at prescribed time
what is the best way to prevent antimicrobial resistance? - ANSWER wash hands infants and elderly compared to normal people would need dosages of drugs
- ANSWER lower how much of the antibiotic tx should the pt take? - ANSWER take the whole course what should the nurse do if he/she forgets to give a pt a drug that needed to be given at a certain time? - ANSWER take missed dose immediately (unless it's close to the time of the schedule dose) principle associated with all antibiotics (e.g. vancomycin) - ANSWER right bug, right drug what must antibiotics due to fight against bacteria? - ANSWER achieve a steady state of defense what levels should the nurse/pt keep antibiotics at to fight bacteria and not let it replicate? - ANSWER high levels in an emergency, if a pt is admitted to the ER, what type of therapy should the nurse/med team give in regards to drug therapy - ANSWER prophylactic therapy (give pt common agent drug right away to preserve health until you find out what the organism is) if a pt comes from the nursing home (could be community acquired organism), what could the nurse do in an emergency situation? - ANSWER put pt on levaquin until nurse gets lab results, then use imperial tx what happens when you maintain a steady state with antibiotics? - ANSWER maintain toxic environment definition of imperial treatment? - ANSWER treating the known organism (using right drug for specific organism, found by culture & sensitivity) what is selective toxicity? - ANSWER when the medication harms the organism and not the host what is an example of non-selective toxicity? - ANSWER chemotherapy (race to see who dies first, organism or person) what should the nurse tell the diabetic who wants to buy insulin from an online pharmacy? - ANSWER encourage pt to clarify with doctor (and don't encourage
which of the following patients would you expect to have alterations in drug metabolism? - ANSWER 50 year old with cirrhosis what is the prototype drug of beta-adrenergic agonists? (beta-1 agonist) (trade/generic)
- ANSWER intropin/dopamine what is unique about beta-adrengergic agonists? - ANSWER mimics SNS (aka sympathomimetic agents) what are the therapeutic effects of intropin/dopamine? - ANSWER increased cardiac output; increased BP, and improved renal blood flow what does intropin/dopamine treat? - ANSWER hypotension (resulting from shock, stemming from MI, renal failure, trauma, etc) what is a priority consideration for the nurse when the pt is on tx with intropin/dopamine? - ANSWER constant monitoring (pt should be on cardiac/heart monitor) how does intropin/dopamin affect the blood vessels? - ANSWER vasopressor (vasoconstrictor) what is the onset of intropin/dopamine? - ANSWER 5 minutes (may be good in an emergency situation) what is the antidote for an overdose of intropin/dopamine? - ANSWER regitine (adrenergic blocking agent, vasodilator) or reducing rate or stop what are some common adverse effects of intropin/dopamine? - ANSWER arrhythmias or hypotension what does an inotropic drug affect? - ANSWER contractions (e.g. dopamine, digoxin for
- action) what does a chronotropic drug affect? - ANSWER rate/time (+ when increasing rate of impulse formation at SA node) what does a dromotropic drug affect? - ANSWER speed (+ actions increase speed from SA node, e.g. phenytoin) what is the prototype drug for beta-adrenergic antagonists? (trade/generic) -
ANSWER lopressor/metoprolol (beta blocker) what is the mechanism of action of lopressor/metoprolol? - ANSWER blocks stimulation of beta-1 and sometimes beta-2 receptors
vasodilation) what are the therapeutic effects of capoten/captopril? - ANSWER tx of hypertension (lowers BP, could be combined with diuretics, also used with treating HF) what effect does capoten/captopril have on cardiac output - ANSWER increase CO (HR remains unchanged)
what is the major adverse effect associated with ACE inhibitors? - ANSWER dry cough if a pt comes in with a dry cough, and the nurse knows the pt is prescribed capoten/captopril, should the nurse rule that the cough is due to ACE inhibitors? - ANSWER no: could be pneumonia, bronchitis (don't mask other illnesses when a pt walks in w/ a cough claiming that it's just their "ACE cough") what is the most common adverse effect of capoten/captopril besides the dry cough? - ANSWER rash what is the major black box warning associated with capoten/captopril - ANSWER cause injury/death to fetus (in 2nd or 3rd trimester) what is the prototype drug used in hypertensive crisis? (trade/generic) - ANSWER nitropress/nitroprusside (causes immediate reduction of BP, administered IV) what is the mechanism of action of nitropress/nitroprusside? - ANSWER produces peripheral vasodilation by a direct action on venous and arteriolar smooth muscle what are the therapeutic effects of nitropress/nitroprusside? - ANSWER rapidly lowers BP (decreased cardiac preload/afterload = lowers BP, slight increase HR, slight decrease in CO) in terms of time, how long does it take for nitropress/nitroprusside to take its effect? - ANSWER max effects in 1-2 minutes (half-life is about 2 minutes) what is the major adverse effects of nitropress/nitroprusside? - ANSWER severe hypotension (from too rapid infusion); ischemic stroke what is the lethal adverse effect of nitropress/nitroprusside? - ANSWER cyanide toxicity what is the black box warning associated with nitropress/nitroprusside - ANSWER not suitable for direct injection after initial reconstitution (must be further diluted) what is the standard BP associated with an emergency hypertensive crisis? - ANSWER BP > 180/120 (lower NO more than 25% within 2-6 hours, avoid use of sublingual nifedipine) what drug is classified as a lipid-lowering agent (HMG-CoA reductase inhibitors) (trade/generic)? - ANSWER zocor/simvastatin
