Nclex Pharm Review

Front 1

Med: Inject into catheter to clear occlusion (dissolve clot)

Back 1

Urokinase (Abbokinase)

Front 2

Vasoconstrictor to increase blood pressure and CO.
Give for cardiac arrest, hypoT
*monitor urinary output
*infuse w/ dextrose solution (not NS)

Back 2

Norepinephrine (Levophed)

Front 3

Low-dose: dilates renal & coronary arteries
High-dose: vasoC; increases myocardial O2 consumption
*HA is early symptom of excess
*use infusion pump

Back 3

Dopamine (intropin)

Front 4

Give for anaphylaxis, cardiac arrest, syncope, excessive uterine contraction
*carefully aspirate syringe before IM and SC doses
*always check strength: 1:100 for inhalation, 1:1,000 for SC or IM
*ensure adequate hydration

Back 4

Epinephrine (Adrenalin)

Front 5

Used for heart block, ventricular arrhythmias, and bradyC
BronchoD used for asthma and bronchospasms
*Don't give at hs (interrupts sleep patterns)

Back 5

Isoproterenol (Isuprel)

Front 6

Dilates cardiac veins and arteries
Decreases preload and afterload
Increases myocardial perfusion
*SE: HypoT

Back 6

Sodium nitroprusside (Nitropress)

Front 7

In general, nursing considerations for meds to treat hypovolemic shock, cardiac arrest, and anaphylaxis

Back 7

Monitor VS
Measure urine output
Assess for extravasation
Observe extremities for color and perfusion

SE: serious rebound effect may occur

Front 8

"pams" and "lams" are frequently what kind of drug?

Back 8

Benzodiazepine Derivatives (Anti-anxiety) (example: DiazePAM)

Front 9

General SE of Anti-anxiety drugs

Back 9

Sedation
Depression, donfusion
Anger, hostility
HA
Dry mouth, constipation
BradyC
Elevations in LDH, AST, ALT
Urinary retention

Front 10

General NC for Anti-anxiety drugs

Back 10

Monitor liver function
Monitor for therapeutic blood levels
Avoid alcohol
Caution when performing tasks requiring alertness (driving car)
Benzos are also used as muscle relaxants, sedative, hypnotics, anticonvulsants

Front 11

Use: anxiety, sedation, alcohol withdrawal, seizures
*watch for toxic buildup in elderly
*potential for abuse/addiction
*can develop tolerance
*alcohol increases CNS depression
*cigarette smoking increases clearance of drug

Back 11

Diazepam (Valium)
Chlordiazepoxide (Librium)

Front 12

CNS depressant for Anxiety
*safer for elderly
*No alcohol/other CNS depressants
*check renal and hepatic fnct
*don't discontinue abruptly
*addictive potential
*Safety: Orthostatic HypoT

Back 12

Alprazolam (Xanax)
Clonazepam (Klonopin)
Lorazepam (Ativan)
Oxazepam (Serax)

Front 13

CNS depressant used for preop sedation, conscious sedation and dx tests

Back 13

Midazalam (Versed)

Front 14

Anti-anxiety med
* requires >3wks to be effective
*can't give PRN
*Good for GAD (generalized anxiety disorder)
*NO ABUSE POTENTIAL - use for pts w/ previous addiction
*No ETOH or grapefruit juice

Back 14

Buspirone (BuSpar)

Front 15

Anti-anxiety med
*No dependence, tolerance or intoxication
*can be used for anxiety relief for indefinate periods
SE: drosiness, ataxie, LEUKOPENIA, HypoT (safety)

Back 15

Hydroxyzine (Vistaril)
(Atarax)

Front 16

Herbal similar to a Benzo
*suppresses emotional excitability, gives mild euphoria
*don't take w/ CNS depressants
*NOT for pregnant or lactating women or kids <12yrs
SE: impaired thinking, judgement, motor reflexes, vision, dec plasma proteins, thrombocytopenia, leukocytopenia, dyspnea, pulmonary HTN

Back 16

Kava

Front 17

Herbal used for prevention and tx of "jet lag" and insomnia
*CI in hepatic insufficiency, hx of cerebrovascular dz, depression, and neurologic disorders

Back 17

Melatonin

Front 18

General SE for antacids

Back 18

Constipation, diarrhea
Acid rebound between doses
Metabolic acidosis

Front 19

NC for antacids

Back 19

Reduces absorption of tetracyclines, quinolnes, phenothiazides, iron preps, INH
May decrease effectiveness of oral contraceptives and salicylates
Monitor bowel fnct (can cause bowel addiction)
Give 1-2 hrs after eating and other meds
F&E balance

Front 20

Antacids
*contain sodium (monitor for sodium restricted diet)
*encourage fluids
*Monitor for signs of phosphate deficiency (malaise, weakness, tremors, bone pain)

Back 20

Aluminum hydroxide gel (Amphojel)
Calcium carbonate (Titralac)
Aluminum hydroxide and magnesium trisilicate

Front 21

NC for Magnesium hydroxide (Milk of Magnesia)

Back 21

Store at room temp w/ tight lid (prevent absorption of CO2)
Can lead to dependence with prolonged use
CAUTION w/ renal dz

Front 22

NC for Maalox

Back 22

slight laxative effect
encourage fluids
CAUTION w/ renal dz

Front 23

General SE for antidysrhythmics

Back 23

Hypotension (SAFETY with position change)
BradyC
Confusion

Front 24

Class 1A Antidysrhythmics
SE: HypoT and Heart Failure
NC: Monitor BP, widening PR, QRS or QT intervals
Toxic SE have limited use

Back 24

Procainamide (Pronestyl)
Disopyramine (Norpace)

Front 25

Class 1B Antidysrhythmics
SE: slurred speech, confusion, drowsiness, confusion, seizures, HypoT, BradyC
NC: Monitor for CNS SE
Monitor BP and heart rate and cardiac rhythm

Back 25

Lidocaine (xylocaine)
Mexiletine hydrochloride (Mexitil)
Tocainide hydrochloride (Tonocard)

Front 26

Beta blockers
SE: BRONCHOSPASM (airway issues), BradyC, HypoT (safety)
NC: monitor apical heart rate (for 1 min), cardiac rhythm, BP, assess for SOB and wheezing

Back 26

Propanolol (Inderal)
Acebutolol (Sectral)
Esmolol hydrochloride (Brevibloc)
Sotalol hydrochloride (Betapace)

Front 27

Class III Antidysrhythmics
*unique SE: photosensitivity and photophobia (need sunglasses and sunscreen)

Back 27

Amiodarone hydrochloride (Cordarone)
Ibutilide fumarate (Covert)
Dofetilide (Tikosyn)

Front 28

Antidysrhythmics
*apical pulse and BP
*orthostatic precautions
*report signs of HF

Back 28

Verapamil (Calan)
Diltiazem hydrochloride (Cardizem)

Front 29

Antibiotics: TX of severe systemic infections of CNS, respiratory, GI, urinary tract, bone, skin, soft tissues, acute pelvic inflammatory dz, TB (streptomycin)

Back 29

Gentamicin (Garamycin)
Neomycin
Streptomycin
Tobramycin (Tobrax)
Amikacin (Amikin)

Front 30

SE for Gentamicin, Neomycin, Streptomycin, Tobramycin, Amikacin (Antibiotics)

Back 30

Ototoxicity, Nephrotoxicity, Anorexia, nausea, vomiting, diarrhea

Front 31

NC for Gentamicin, Neomycin, Streptomycin, Tobramycin, Amikacin (Antibiotics)

Back 31

Check 8th cranial nerve fnct (HEARING)
Check renal fnct (BUN, creatinine)
Usually prescribed for 7-10 days (take till gone!)
Encourage fluids (3000mL/day)
Small, frequent meals
C&S prior to hanging med
Check expiration date (some become toxic)

Front 32

SE of cephalosporins (antibiotics)(general)

Back 32

Abdominal pin, NVD, inc risk of bleeding, hypoprothrombinemia, bone marrow depression, rash, superinfections, thrombophlebitis (IV), abscess formation (IM,IV)

Front 33

NC for cephalosporins (antibiotics) (general)

Back 33

W/FOOD (unique for antibiotics)
liquid form to kids
Vitamin K available for hypoprothrombinemia
No ETOH during & 3 days post med
Cross allergy w/ penicillins
Monitor renal & hepatic fnct
Monitor for thrombophlebitis

Front 34

SE for Antibiotics to treat infection by E. coli, chronic bacteria, post-exposure to anthrax:
Ciprofloxacin (Cipro), Levofloxacin (Levequin), Norfloxacin (Noroxin)

Back 34

HA, Nausea, Diarrhea (destroys normal flora), Elevated BUN, AST, ALT, serum creatinine, alkaline phosphatase
Dec WBC and hematocrit
Rash
Photosensitivity

Front 35

NC for Antibiotics to treat infection by E. coli, chronic bacteria, post-exposure to anthrax:
Ciprofloxacin (Cipro), Levofloxacin (Levequin), Norfloxacin (Noroxin)

Back 35

C&S prior to starting
1h before or 2h after meals w/ glass of water
Fluids (3,000mL/day)
Full course of therapy
Iron prep and antacids interfere w/ absorption

Front 36

SE of Vancomycin (antibiotic)

Back 36

Thrombophlebitis
Abscess formation
Nephrotoxicity
Ototoxicity

Front 37

NC of Vancomycin (antibiotic)

Back 37

Renal & Hearing fnct (monitor)
Give IV; peak 5 min, duration 12-24 hrs
Avoid extravascation
"Red man syndrome" -> give antihistamine - dec BP, flushing of face and neck
Contact MD if signs of superinfection (sore throat, fever, fatigue)

Front 38

Antibiotics given when pt is allergic to PCN

Back 38

Erthromycin (Erythrocin)
Azethromycin (Zithromax)

Front 39

NC for Erthromycin (Erythrocin) &
Azethromycin (Zithromax) - (Antibiotics given when pt is allergic to PCN)

Back 39

*Confusion (unique for antibiotics)
1h before or 2-3h after meals w/ full glass of water
take around the clock
monitor liver fnct

Front 40

NC for Penicillins

Back 40

C&S prior to tx
if IV -> monitor lytes & cardiac status
rotate injection sites
mouth care
if diarrhea -> give yogurt or buttermilk
**Airway mgmt if allergic reaction

Front 41

SE unique to antibiotics for Sulfonamides
Sulfisoxazole (Gantrisin)
Sulfasalazine (Azulfidine)
Trimethoprim/Sulfamethoxazole (Bactrim, Septra)

Back 41

peripheral neuropathy
crystalluria, proteinuria
photosensitivity

Front 42

General NC/SE for antibiotics

Back 42

GI upset/Stomatitis
nephrotoxcity
C&S prior to starting
empty stomach with water (all but cephlosporins)
Fluids
Take full course

Front 43

Unique SE for Tetracyclines (antibiotics)

Doxycycline (Vibramycin)
Minocycline (Minocin)
Tetracycline HCL (Panmycin)

Back 43

Don't take during pregnancy: discoloration and inadequate calcification of primary teeth of fetus
phototoxic reactions (sunburn type)
Don't take w/ antacids, milk, iron preps (separate by 3h)
Protect from sunlight
Use additional contraception method in addition to oral contraceptives

Front 44

Important NC for anti-impotence (vasoD's)

Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)

Back 44

Never take with nitrates - could have fatal hypoT
No grapefruit juice
CI w/ glaucoma

Front 45

General SE/NC for Anticholinergics

Back 45

Blurred vision
Dry mouth
Urinary retention
Changes in heart rate
CI w/ glaucoma

Front 46

Heparin antidote

Back 46

Protamine sulfate w/in 30 min

Front 47

Warfarin (Coumadin) antidote

Back 47

Vitamin K
(avoid foods high in vitamin K: GLV, pork, rice, yogurt, cheeses, fish, milk)

Front 48

Herbal and vitamin interactions with anticoagulants

Heparin
Lovenox
Warfarin (Coumadin)

Back 48

Garlic, ginger, ginko INC effect (inc bleeding)
Vitamin E INC warfarin's effect

Ginseng, alfalfa and Vit C may DEC effect
Chamomile may interfere

Front 49

General SE for Anticonvulsants

Back 49

Cardiovascular DEPRESSION
Respiratory DEPRESSION
Agranulocytosis
Aplastic anemia

Front 50

General NC for Anticonvulsants

Back 50

Tolerance w/ long-term use
WEEN, don't discontinue abruptly
CAUTION w/ MAOI's, antipsychotics (lowers seizure threshold)
CNS/Resp DEPRESSANT (safety)

Front 51

Important NC for Fosphenytoin (Cerebyx) (Anticonvulsant)

Back 51

Contact HCP if rash develops

Front 52

Important NC for Levetiracetam (Keppra) (anticonvulsant)

Back 52

Watch for suicidal ideation

Front 53

Important/unique NC for Phenytoin sodium (Dilantin)**
(anticonvulsant)

Back 53

IV admin: may lead to CARDIAC ARREST - have resuscitation equipment at hand
Never mix w/ any other drug or dextrose IV (own port)
Oral hygiene
Inc vitamin D intake - exposure to sunlight may be necessary w long-term use
Take w/ at least 1/2 glass water or meals to minimize GI irritation
Inform: red-brown or pink discoloration of sweat and urine

Front 54

Important NC for Phenobarbital (Luminal) (anticonvulsant)

Back 54

Nystagmus ("dancing eyes" - involuntary eye movements) may indicate early toxcity
Folic acid supplements for long-term use

Front 55

Important NC for Magnesium sulfate (anticonvulsant)

Back 55

Evaluate deep tendon reflexes
Before each dose, knee jerks should be tested
HyptoT is a SE (safety)

Front 56

Unique NC for Valporic acid (Depakote) (anticonvulsant)

Back 56

Don't take with carbonated drinks
Monitor platelets, bleeding time, and liver fnct

Front 57

Important NC with Lamotrigine (Lamictal) (Anticonvulsant)

Back 57

Life-threatening rash when given with Valporic acid (Depakote)

Front 58

Important/unique NC for Topiramate (Topamax) (anticonvulsant)

Back 58

Increased risk for renal calculi
Stop drug immediately if eye problems - could lead to permanent damage

Front 59

General NC for antidepressants (SSRIs)

Fluoxetine (Prozac)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertaline (Zoloft)

Back 59

Take in AM
4 wks for full effect (suicide precautions)
DO NOT give w/ MAOI's (serotonin syndrome risk)
pink urine
Monitor for thrombocytopenia, leukopenia, anemia

Front 60

Unique NC/SE for Tricyclics (antidepressants)

Amitriptyline (Elavil)
Imipramine (Tofranil)
Norpramin (Desipramine)

Back 60

Orthostatic HypoT
Bone marrow depression
photosensitivity
anticholinergic effects
sedation

Front 61

Info for Rapid-acting insulin
Lispro (Humalog)
Aspart (NovoLog)

"Logs roll rapidly"

Back 61

Onset:5-15min (should eat w/in this time)
Peak: 40min-1hr
Duration: 3-6hr

Front 62

Info for short-acting insulin (Regular)

Humulin R, Vovolin R, Iletin II Regular

Back 62

Only type of insulin that can be given IV
Clear solution
Give 20-30 min before meal
Onset: 30-60min
Peak: 2-3hr
Duration: 4-8hr

Front 63

SE of Glucagon (med given for HypoG)

Back 63

HypoT
Bronchospasm
Dizziness

Front 64

Lithium (for manic episode in bipolar disorder) info & therapeutic blood target level

Back 64

1-1.5 mEq/L
Check 2-3x/wk when started and monthly on maintenance
draw in AM prior to dose
FLUID (2,500-3,000mL/day) & SODIUM intake important

Front 65

Digoxin (Lanoxin) digitalizing dose (oral)

Back 65

0.5-0.75mg po
Then 0.25 mg po q 6-8hrs to a total dose of 1-1.5mg

Front 66

Digoxin (Lanoxin) digitalizing dose (IV)

Back 66

0.25-0.5mg IV
Then 0.25mg IV to a total dose of 1.0mg

Front 67

Therapeutic blood level for Digoxin

Back 67

0.5-2 nanograms/mL
(Toxic = >2)

Front 68

Antidote for Digoxin

Back 68

Digibind (give for toxicity)