Exam 2 Pharm

Front 1

List all ANTINEOPLASTIC AGENTS (categories)

Back 1

Alkylating agents

Antimetabolites

ANTINEOPLASTIC antibiotics

Mitotic Inhibitors

Hormones and hormone Modulators

Hint 1

All 4 major categories

Front 2

ANTINEOPLASTIC AGENTS:

Alkylating agents; what are their drug action ?

Back 2

Reacts chemically with portions of DNA , RNA or other cellular proteins

Front 3

ANTINEOPLASTIC AGENTS:

Alkylating agents; what are the indications ? (Normally used in what kind of patients)

Back 3

Lymphomas, leukemias, myelomas, and some ovarian testicular and breast cancers

Front 4

ANTINEOPLASTIC AGENTS:

Alkylating agents; pharmacokinetics ?

Back 4

Metabolized and activated in liver

Front 5

ANTINEOPLASTIC AGENTS:

Alkylating agents; Contraindications? Cautions ?

Back 5

Contraindication: Pregnancy and lactation due to potentially serious side effects on fetus and neonate.

Caution: pt with bone marrow suppression or pt with suppressed hepatic of renal functions

Front 6

ANTINEOPLASTIC AGENTS:

Alkylating agents; Chlorambucil (action)

Back 6

Alkylates cellular DNA, interfering with the replication of susceptible cells.

Front 7

ANTINEOPLASTIC:

Alkylating agents; Chlorambucil

What kind of patients is it used on ? (Indication)

Back 7

Palliative treatment for CLL, malignant lymphomas, and hodgkin disease

Front 8

ANTINEOPLASTIC:

Alkylating agents; Chlorambucil (Leukeran)

What is the normal dose ?

Back 8

0.1 -0.2 mg/kg/d

Front 9

ANTINEOPLASTIC:

Alkylating Agents; Chlorambucil (leukeran)

Special Considerations?

Back 9

-toxic time liver

-toxic to bone marrow

-dosing Based in bone marrow response

-carcinogenic

Avoid use in pregnancy

Front 10

ANTINEOPLASTIC:

Alkylating Agents; Chlorambucil (leukeran)

What are it’s adverse effects ?

Back 10

Tremors, muscle twitching, confusion, nausea, hepatotoxicity, bone marrow suppression, sterility, cancer

Front 11

ANTINEOPLASTIC:

Alkylating agents; Chlorambucil (leukeran)

Nursing dx associated with drug therapy ?

Back 11

Acute pain r/t GI, CNS and skin effects of the drug

Disturbed body image r/t alopecia, skin effect, impaired fertility

Fear and anxiety r/t diagnosis

Imbalanced nutrition less than body requirements

Front 12

ANTINEOPLASTIC:

Alkylating Agents; Chlorambucil (leukeran)

Nursing implementation for drug therapy ?

Back 12

-blood tests to monitor bone marrow function to aid in determining the correct dosing

-enduring Pt is well hydrated to decrease risk of renal toxicity (water diluted chemo drug)

Front 13

ANTINEOPLASTIC:

Antimetabolites; Action

Back 13

Inhibit DNA production in the S phase of the cell cycle. They are most effective in rapidly dividing cells, preventing cell replication and leading to cell death.

Front 14

ANTINEOPLASTIC:

Antimetabolites; indications (what kind of pt use them? )

Back 14

Various leukemias and some GI and basal cell cancers. Normally administered as a combination therapy because the cells develop a resistance quickly

Front 15

ANTINEOPLASTIC:

Antimetabolites; pharmacokinetics

Back 15

Metabolized in liver and excreted in urine

Front 16

ANTINEOPLASTIC:

Antimetabolites; pharmacokinetics

Back 16

Metabolized in liver and excreted in urine

Front 17

ANTINEOPLASTIC:

Antimetabolites; contraindications / cautions

Back 17

Contraindicated first use during pregnancy and lactation

Cautions: pt with bone marrow suppression, pt with renal and hepatic dysfunction, GI ulcerations or ulcerative diseases (might be exacerbated by the effects of these drugs)

Front 18

ANTINEOPLASTIC:

Antimetabolites; adverse effects

Back 18

Bone marrow suppression, GI effects, nausea, vomiting, diarrhea, mucous membranes deterioration, aphasia, headache, drowsiness, dizziness, fatigue

Front 19

ANTINEOPLASTIC:

Antimetabolites; Drug to Drug

Back 19

May adversely affect drugs that are metabolized in the liver or that act in the liver for example oral anticoagulants.

Front 20

ANTINEOPLASTIC:

Antimetabolites; Drug to Drug

Back 20

May adversely affect drugs that are metabolized in the liver or that act in the liver for example oral anticoagulants.

Front 21

ANTINEOPLASTIC; Methotrexate

Indications?

Back 21

Treatment of gestational choriocarcinoma, severe psoriasis, rheumatoid arthritis, meningeal leukemia

Front 22

ANTINEOPLASTIC:

Antimetabolites; Drug to Drug

Back 22

May adversely affect drugs that are metabolized in the liver or that act in the liver for example oral anticoagulants.

Front 23

ANTINEOPLASTIC; Methotrexate

Indications?

Back 23

Treatment of gestational choriocarcinoma, severe psoriasis, rheumatoid arthritis, meningeal leukemia

Front 24

ANTINEOPLASTIC: Methotrexate

Actions

Back 24

Inhibits folic acid redutase, leading to Inhibition of DNA synthesis and inhibition of cellular replication; affects the most rapidly dividing cells

Front 25

ANTINEOPLASTIC:

Antimetabolites; pharmacokinetics?

Back 25

Metabolized in liver , crosses blood brain barrier, and is excreted unchanged in the urine.

Front 26

ANTINEOPLASTIC:

Antimetabolites ; adverse effects ?

Back 26

Fatigue, malaise, rashes, alopecia, ulcerative stomatitis, hepatic toxicity , severe bone marrow suppression , chills, fever, anaphylaxis

Front 27

ANTINEOPLASTIC:

Route for Methotrexate ?

Back 27

15-30mg

P.O. or IV *dose depends on disease

Front 28

ANTINEOPLASTIC :

fluorouracil (Adrucil, Carac, Efudex, Fluoroplex) ;

INDICATIONS

Back 28

Palliative treatment of various GI cancers, topical treatment of basal cell carcinoma

Front 29

ANTINEOPLASTIC :

fluorouracil (Adrucil, Carac, Efudex, Fluoroplex) ;

CAUTIONS / SPECIAL CONSIDERATIONS

Back 29

GI toxicity, bone marrow suppression, alopecia, skin rash, wash hands thoroughly after coming in contact with drug

Front 30

ANTINEOPLASTIC :

fluorouracil (Adrucil, Carac, Efudex, Fluoroplex) ;

pharmacokinetics?

Back 30

Cannot be absorbed well in GI tract and needs to be administered parenterally.

Front 31

ANTINEOPLASTIC :

Antimetabolites; Nursing dx

Back 31

Acute pain

Disturbed body image

Imbalanced nutrition, less than body requirements

Fear,anxiety related to diagnosis and treatment

Risk for infection

Deficient knowledge regarding drug therapy

Front 32

ANTINEOPLASTIC:

Antineoplastic Antibiotics;

Action?

Back 32

Cell cycle specific that interfere with DNA causing cell death. They are cytotoxic, and interfere by inserting themselves between base pairs in the DNA

Front 33

ANTINEOPLASTIC:

Antineoplastic Antibiotics;

Indications ?

Back 33

Specific to disease but treats a number of leukemias and cancers

Front 34

ANTINEOPLASTIC:

Antineoplastic Antibiotics; pharmacokinetics

Back 34

Metabolized in the liver and excreted in urine.

**given through PIC line or central line because it is so toxic**

Front 35

ANTINEOPLASTIC:

Antineoplastic Antibiotics;

Contraindications ?

Back 35

GI Ulcerations, pt with bone marrow suppression, pregnancy or lactating

Front 36

ANTINEOPLASTIC:

Antineoplastic Antibiotics;

Adverse effects ?

Back 36

Bone marrow suppression, GI, renal or hepatic toxicity, alopecia

Front 37

ANTINEOPLASTIC:

Antineoplastic Antibiotics;

Doxorubicin

Back 37

Will turn urine red

**vinegar will cause the medicine in the urine to change color, that’s will distinguish it from blood in urine**

Front 38

ANTINEOPLASTIC:

Antineoplastic Antibiotics; Doxorubicin

Indications ?

Back 38

To produce regression in acute lymphoblastic lymphoma, AML, Wilms rumor, Hodgkin lymphoma and non-Hodgkin, Kaposi sarcoma

Front 39

ANTINEOPLASTIC:

Antineoplastic Antibiotics; Doxorubicin

Action?

Back 39

Binds DNA and inhibits DNA synthesis in susceptible cells, causing cell death

Front 40

ANTINEOPLASTIC:

Antineoplastic Antibiotics; Doxorubicin

Adverse effects ?

Back 40

Cardiac toxicity, complete alopecia, nausea, vomiting, mucositis, red urine, myelosupression, fever, chills, rash

Front 41

ANTINEOPLASTIC:

Antineoplastic antibiotics; Doxorubicin

Special Considerations ?

Back 41

-complete alopecia is common

-GI toxicity and bone marrow suppression

-severe necrosis May occur at sites of local extravasation

-immediate treatment with corticosteroids, normal saline and ice may help;

Front 42

ANTINEOPLASTIC:

Mitotic inhibitors; action ?

Back 42

Block or alter DNA synthesis thus causing cell death. They work in the M phase of cell cycle

Front 43

Goal 4 hypertensive pt

Back 43

Resume responsibility for self care

Front 44

Goal 4 hypertensive pt

Back 44

Resume responsibility for self care

Front 45

Pt teaching if taking captopril?

Back 45

Rise slowly from a supine position

Front 46

Goal 4 hypertensive pt

Back 46

Resume responsibility for self care

Front 47

Pt teaching if taking captopril?

Back 47

Rise slowly from a supine position

Front 48

Calcium channel blockers used in which pts ?

Back 48

African Americans

Front 49

Goal 4 hypertensive pt

Back 49

Resume responsibility for self care

Front 50

Pt teaching if taking captopril?

Back 50

Rise slowly from a supine position

Front 51

Calcium channel blockers used in which pts ?

Back 51

African Americans

Front 52

Pt taking antihypertensives says he had sexual dysfunction what teaching is necessary

Back 52

Advise sexual dysfunction is a normal side effect and that he should not abruptly stop taking medication.

Front 53

Goal 4 hypertensive pt

Back 53

Resume responsibility for self care

Front 54

Pt teaching if taking captopril?

Back 54

Rise slowly from a supine position

Front 55

Calcium channel blockers used in which pts ?

Back 55

African Americans

Front 56

Pt taking antihypertensives says he had sexual dysfunction what teaching is necessary

Back 56

Advise sexual dysfunction is a normal side effect and that he should not abruptly stop taking medication.

Front 57

Treatment for hypertensive crisis

Back 57

Nitroprusside (nitropress)

Front 58

Assess for S&S of hyperkalemia if taking wht medication ?

Back 58

Spirnolactone

Front 59

Apical pulse is 70 can you administer digoxin ?

Back 59

Yes

Front 60

Severe side effect of “statin”

Back 60

Rhanbdomylosis

Front 61

Ace inhibitor

Back 61

Angiotensin 2

Front 62

Side effect of atorvastatin

Back 62

Unexplained muscle pain

Front 63

Persistent cough for 2 weeks

Back 63

Got to clinic to be evaluated

Front 64

Epinephrine

Back 64

Causes myocardial excitation and stimulation

Front 65

Teaching is needed regarding angina when pt says what?

Back 65

I will use tablet every 4 hours to prevent

Front 66

Vasoconstriction

Back 66

Decongestant

Front 67

Anticholinergic causes what ?

Back 67

Prostatic hypertrophy

Front 68

Usual protocol for acute anginal episode ?

Back 68

Take a sublingual nitrate

Front 69

Over use of oxymetazoline (Afrin)

Back 69

Rebound congestion

Front 70

What will a pt be prescribed if he has a non productive cough and bronchitis?

Back 70

Mucinex (guaifensin)

Front 71

Propranolol decreased BP And ?

Back 71

Heart rate

Front 72

Adverse effect of Xantine derivatives ?

Back 72

Palpitations

Front 73

Adverse effect of Xantine derivatives ?

Back 73

Palpitations

Front 74

78 year old to ER with digoxin toxicity

Back 74

Administer digoxin immune Fab

Front 75

Adverse effect of Xantine derivatives ?

Back 75

Palpitations

Front 76

78 year old to ER with digoxin toxicity

Back 76

Administer digoxin immune Fab

Front 77

Pt feels nervous after nebulizer

Back 77

This is normal, but I will check your pulse

Front 78

Adverse effect of Xantine derivatives ?

Back 78

Palpitations

Front 79

78 year old to ER with digoxin toxicity

Back 79

Administer digoxin immune Fab

Front 80

Pt feels nervous after nebulizer

Back 80

This is normal, but I will check your pulse

Front 81

Angina pectoris modifications

Back 81

Smoking cessation

Weight loss

Stress management

Front 82

Adverse effect of Xantine derivatives ?

Back 82

Palpitations

Front 83

78 year old to ER with digoxin toxicity

Back 83

Administer digoxin immune Fab

Front 84

Pt feels nervous after nebulizer

Back 84

This is normal, but I will check your pulse

Front 85

Angina pectoris modifications

Back 85

Smoking cessation

Weight loss

Stress management

Front 86

Severe persistent cough is associated with what drugs

Back 86

Ace Inhibitors

Front 87

Adverse effect of Xantine derivatives ?

Back 87

Palpitations

Front 88

78 year old to ER with digoxin toxicity

Back 88

Administer digoxin immune Fab

Front 89

Pt feels nervous after nebulizer

Back 89

This is normal, but I will check your pulse

Front 90

Angina pectoris modifications

Back 90

Smoking cessation

Weight loss

Stress management

Front 91

Severe persistent cough is associated with what drugs

Back 91

Ace Inhibitors

Front 92

Pt teaching for “statin”

Back 92

Monitor liver function

Front 93

What can affect “statin” meds

Back 93

Alcohol use

Front 94

What can affect “statin” meds

Back 94

Alcohol use

Front 95

Action of catapress

Back 95

Outflow of epinephrine and norepinephrine are diminished centrally

Front 96

What can affect “statin” meds

Back 96

Alcohol use

Front 97

Action of catapress

Back 97

Outflow of epinephrine and norepinephrine are diminished centrally

Front 98

Pt frustrated nasal meds aren’t working what should you teach pt

Back 98

Inform pt it can take 2 weeks for effects

Front 99

What drug do you administer if pt has acute asthma attack ?

Back 99

Albuterol

Front 100

Nitrates go where ?

Back 100

Under the tongue

Front 101

When do you take HMG-CoA

Back 101

Take at bedtime because body makes lipids at night

Front 102

Chronic bronchial asthma prescription?

Back 102

Nedocromil or cromolyn

Front 103

What should you not drink while in calcium channel blockers ?

Back 103

Grapefruit juice

Front 104

Adverse effects of antihypertensive drugs ?

Back 104

Impotence

Front 105

If pt complains of nausea after taking losartan

Back 105

Inform to talk with food

Front 106

Propranolol might cause

Back 106

Hypoglycemia

Front 107

Ditazem might cause what ?

Back 107

Peripheral edema and bradycardia

Front 108

Common side effect of nitrate

Back 108

Headache

Front 109

What can happen if seizure meds are abruptly stopped ?

Back 109

Status epileptic

Front 110

What should you take if seizure occurs ?

Back 110

Vilium diazepam

Front 111

Which drug is a beta specific blocker?

Back 111

Atenolol

Front 112

Heart failure s/s?

Back 112

Crackles and pulmonary edema

Front 113

Heart failure s/s?

Back 113

Crackles and pulmonary edema

Front 114

What lowers the effects of parkanism disease ?

Back 114

Vitamin b6

Front 115

What does an adrenergic agonist do ?

Back 115

Increases HR RR BP

Front 116

What does a cholinergic agent do ?

Back 116

Lowers HR RR BP

Front 117

Anticholinergics cause decreased wht ?

Back 117

Salivation, mucus, and intraoccular pressure

Front 118

Anticholinergics cause what the happen to pupils ?

Back 118

Dilation

Front 119

Drug for Parkinson’s disease

Back 119

Amantadine

Front 120

Turns body fluids orange and is used for TB

Back 120

Refampin

Front 121

Turns body fluids orange and is used for TB

Back 121

Refampin

Front 122

What drug is administered during a cholinergic crisis?

Back 122

Atropine

Front 123

What is prescribed for orthostatic hypotension ?

Back 123

Midodrine

Front 124

What does a sympathometic do ?

Back 124

Increase HR RR BP