Pharmacology, Chemo, Resp, Gi, Hormone

Front 1

Challenges treating Endocrine
problems

Back 1

difficult to treat b/c endocrine affects multiple body systems

Front 2

Types of Endocrine Drug
Treatments

Back 2

Deficiency is treated by 1) replacing the lacking hormone or 2) stimulating an organ to produce
the deficient hormone; Excess is treated with drugs to inhibit the hormone

Front 3

Somatrem (Protropin)

Back 3

CLASS: Hormone replacement; Drug used to treat Growth Hormone Deficiency (Dwarfism);
this is a synthetically manufactured version of HGH (Human Growth Hormone). It is used to
stimulate growth in children who do not produce enough growth hormone of their own. SIDE
EFFECTS: pain at injection site. ROUTE: SubQ or IM

Front 4

Somatropin (Humatrope)

Back 4

CLASS: Hormone replacement; Drug used to treat Growth Hormone Deficiency (Dwarfism);
this is a synthetically manufactured version of HGH (Human Growth Hormone). It is used to
stimulate growth in children who do not produce enough growth hormone of their own. SIDE
EFFECTS: edema, hyperglycemia, pain at injection site. ROUTE: subQ or IM

Front 5

Octreotide (Sandostatin)

Back 5

CLASS: somatostatin analog; Drug used to treat Growth Hormone Excess (Gigantism &
Aeromegaly); also used to treat Chemotherapy-induced diarrhea; ACTIONS: suppresses
growth hormone release, inhibits gastic acid & smooth muscle motility SIDE EFFECTS:
gallstones, pain at injection site. ROUTE: subQ, IM, IV; Contraindicated for diabetics

Front 6

Bromocriptine Mesylate
(Parlodel)

Back 6

CLASS: dopamine receptor agonist; Drug used to treat Growth Hormone Excess (Gigantism &
Aeromegaly); ACTION: decreased growth hormone levels by inhibiting the release of growth
hormone; ROUTE: PO

Front 7

Vasopressin (Pitressin)

Back 7

CLASS: hormone replacement; Drug used to treat Diabetes Insipidus; ACTION: antidiuretic
hormone analog that promotes water reabsorption from renal tubules; ROUTE: Inj

Front 8

Diabetes Insipidus

Back 8

deficiency of ADH characterized by abnormally large amounts of urine output (problem with the
posterior pituitary gland). ADH is an important hormone because it can affect cardiac function

Front 9

Growth Hormone Excess

Back 9

gigantism and aeromegaly due to hypersecretion of growth hormone in the anterior pituitary
gland

Front 10

Growth Hormone Deficiency

Back 10

Dwarfism caused by lack of Growth Hormone (GH) produced in the anterior pituitary gland

Front 11

Hyporthyroidsim (Myxedema)

Back 11

Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid
hormone. Symptoms: weight gain, depression, fatigue.

Front 12

Levothyroxine Sodium (Synthroid
or Levothroid... Synthroid is
more common)

Back 12

DRUG OF CHOICE - CLASS: hormone replacement; Drug used to treat Hypothyroidism;
ACTION: increases levels of T3 and T4, drug of choice for goiter and chronic lymphocytic
thyroiditis (Hashimoto’s desease); NURSING INTERVENTION: teach Pt. that s/he must take
at same time every day in the morning. Do not take in the afternoon/evening because the drug
affects circadian rhythm, better to skip a dose than take too late.

Front 13

Liothyronine (Cyromel)

Back 13

CLASS: hormone replacement (synthetic T3); Drug used to treat Hypothyroidism; ACTION:
Has a short duration of ACTION, not used for maintenance therapy; only for initial therapy.
Teaching: must take thyroid replacement meds at same time every day in the morning. Do not
take in the afternoon/evening because the drug affects circadian rhythm, better to skip a dose
than take too late.

Front 14

Hyperthyroidism
(Thyrotoxicosis or Graves
Disease)

Back 14

Over active thyroid gland. Symptoms: weight loss, anxiety, tachycardia, goiter, thyroid eye
disease (buldging eyes)

Front 15

Goiter

Back 15

enlarged thyroid gland w/ nodules. Could be hypo/hyper active or normal

Front 16

Methimazole (Tapazole)

Back 16

Drug used to treat Hyperthyroidism; useful in treating thyrotoxic cases and preparation for
thyroid surgery. Pregnancy cat: D. CLASS: Thiomide (Thiauria Derivative)

Front 17

Propylthiouracil (PTU)

Back 17

Drug used to treat Hyperthyroidism; Pregnancy cat: D. CLASS: Thiomide (Thiauria Derivative)

Front 18

Hypoparathyroidism

Back 18

decreased function of the parathyroid glands, leading to decreased levels of parathyroid
hormone (PTH). The consequence, hypocalcaemia, is a serious medical condition.

Front 19

Calcitrol (Rocaltrol)

Back 19

CLASS: Vitamin D analog; Drug used to treat Hypoparathyroidism; ACTION: this vitamin D
analogue that promotes Ca absorption from GI tract and secretion of Ca from bone to blood
stream

Front 20

Ergocalciferol (Drisdol)

Back 20

CLASS: Vitamin D2 Analog; Drug used to treat Hypoparathyroidism; ACTION: enhances Ca
and phosphorous absorption

Front 21

Hyperparathyroidism (Paget’s
Disease)

Back 21

Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of
parathyroid hormone (PTH) which leads to hypercalcemia.

Front 22

Calcitonin (Cibalcin) human

Back 22

Drug used to treat Hyperparathyroidism (Paget’s Disease); ACTION: decreases serum CA by
binding at receptor sites in osteoclasts; CLASS: hormone analog

Front 23

Calcitonin (Miacalcin) salmon

Back 23

DRUG OF CHOICE - Drug used to treat Hyperparathyroidism (Paget’s Disease); ACTION:
decreases serum CA by binding at receptor sites in osteoclasts. Salmon calcitonin resembles
human calcitonin, but is more active. CLASS: hormone analog

Front 24

Addison’s Disease

Back 24

adrenal hypo-secretion; symptoms: weakness, pallor, anorexia, hypotension. A decrease in
corticosteroid secretion can result in serious illness and death. Corticosteroids promote sodium
retention and potassium exertion. Also affects CHO, protein and fat metabolism. DRUGS
USED: Glucocorticoids, Mineralcorticoids (less popular)

Front 25

Cortisone acetate (Cortone
Acetate)

Back 25

Drug used to treat Addison’s disease (adrenal hypo-secretion aka. adrenocortical insufficiency)
CLASS: Glucocorticoid (Steroid Hormone) SIDE EFFECTS: Steroid hormones can cause
hyperglycemia, hypertension, edema; Nursing intervention: Important to taper discontinuation
to avoid rebound effect

Front 26

Hydrocortisone (Hydrocortone)

Back 26

Drug used to treat Addison’s disease (adrenal hypo-secretion aka. adrenocortical insufficiency)
CLASS: Glucocorticoid (Steroid Hormone) SIDE EFFECTS: Steroid hormones can cause
hyperglycemia, hypertension, edema; Nursing intervention: Important to taper discontinuation
to avoid rebound effect.

Front 27

Predisone

Back 27

Drug used to treat Addison’s disease (adrenal hypo-secretion aka. adrenocortical insufficiency)
CLASS: Glucocorticoid (Steroid Hormone) SIDE EFFECTS: Steroid hormones can cause
hyperglycemia, hypertension, edema; Nursing intervention: Important to taper discontinuation
to avoid rebound effect.

Front 28

Fludrocortisone acetate (Florinef)

Back 28

Drug used to treat Addison’s disease (adrenal hypo-secretion aka. adrenocortical insufficiency)
CLASS: Mineralcorticoid (Steroid Hormone) SIDE EFFECTS: Steroid hormones can cause
hyperglycemia, hypertension, edema; Nursing intervention: Important to taper discontinuation
to avoid rebound effect.

Front 29

Cushing’s Syndrome

Back 29

caused by adrenal hyper-secretion; Symptoms include rapid weight gain, particularly of the
trunk and face with sparing of the limbs (central obesity). Buffalo hump, Moon face.

Front 30

Aminoglutethemide (Cytadren)

Back 30

Drug used to treat Cushing’s Syndrome (adrenal hyper secretion); ACTION: blocks the
production and synthesis of steroids; CLASS: Glucocorticoid inhibitor (hormonal antagonist)

Front 31

Ketoconazole (Nizoral)

Back 31

DRUG OF CHOICE - Drug used to treat Cushing’s Syndrome (adrenal hyper secretion);
ACTION: inhibits glucocorticoid synthesis and is also an antifungal; CLASS: Glucocorticoid
inhibitor (hormonal antagonist)

Front 32

Anti Emetics

Back 32

prevents vomiting; inhibits the chemoreceptor (CTZ) zone & medulla

Front 33

Dimenhydrinate (Dramamine)

Back 33

Drug used to treat Nausea; ACTION: prevents vomiting by inhibiting the CTZ in the medulla;
CLASS: OTC Anti Emetic; NURSING IMPLICATION: this med is for PREVENTION of
nausea... take 30 minutes before onset of nausea NOT after vomiting

Front 34

Meclizine HCl (Antivert)

Back 34

Drug used to treat Nausea; ACTION: prevents vomiting by inhibiting the CTZ in the medulla;
CLASS: OTC Anti Emetic; NURSING IMPLICATION: this med is for PREVENTION of
nausea... take 30 minutes before onset of nausea NOT after vomiting

Front 35

Hydroxyzine (Vistaril)

Back 35

Drug used to treat Nausea; ACTION: Inhibits H2 from stimulating the vomiting center; SIDE
EFFECTS: drowsiness, dry mouth; CLASS: Prescription Anti Emetic / Anti Histamine

Front 36

Promethazine (Phenergan)

Back 36

Drug used to treat Nausea; ACTION: Inhibits H2 from stimulating the vomiting center; SIDE
EFFECTS: drowsiness, dry mouth; CLASS: Prescription Prescription Anti Emetic / Anti
Histamine / Dopamine Antagonist; ROUTE: tab, supp, IM

Front 37

Scopolamine (Transderm-Scop)

Back 37

Drug used to treat Nausea; ACTION: blocks cholinergic transmission to the vomiting center in
the CNS; CLASS: Prescription Anti Emetic / Anti Cholinergic; SIDE EFFECTS: dryness of the
mouth, drowsiness, pupil dilation, blurred vision, confusion, urinary retention, constipation,
tachycardia; NURSING IMPLICATIONs: contraindicated for Pt. with glaucoma, should not be
used with sedatives/alcohol; ROUTE: transdermal patch

Front 38

Prochlorperazine maleate
(Compazine)

Back 38

Drug used to treat Nausea, Anxiety; CLASS: phenothiazines; ACTION: It works by changing
the ACTIONs of chemicals in your brain. Prochlorperazine is used to treat psychotic disorders
such as schizophrenia. It is also used to treat anxiety, and to control severe nausea and
vomiting. - VERY COMMON

Front 39

Droperidol (Inapsine)

Back 39

CLASS: Dopamine antagonist; Droperidol is a sedative, tranquilizer, and anti-nausea
medication. Droperidol is used to reduce nausea and vomiting caused by surgery or other
medical procedures.

Front 40

Lorazepam (Ativan)

Back 40

Drug used to treat Nausea, Anxiety (good effect on cancer Pt.); CLASS: Benzodiazepine

Front 41

Ondansetron HCl (Zofran)

Back 41

Drug used to treat Nausea (used on cancer Pt.); ACTION: affects the CTZ; CLASS: SSRI

Front 42

Dexanethasone (Decadron)

Back 42

Drug used to treat Nausea (used on cancer Pt. who cannot take Zofran); CLASS:
Glucocorticoid (Steroid Hormone); SIDE EFFECTS: hyperglycemia; Nursing intervention:
monitor Pt. blood glucose

Front 43

Methyprednisone (Solu-Medrol)

Back 43

Drug used to treat Nausea (used on cancer Pt. who cannot take Zofran); CLASS:
Glucocorticoid (Steroid Hormone); SIDE EFFECTS: hyperglycemia; Nursing intervention:
monitor Pt. blood glucose

Front 44

Dronabinol (Marinol)

Back 44

Drug used to treat Nausea & Anxiety; CLASS: Cannaboid;

Front 45

Diphenidol (Vontrol)

Back 45

Drug used to treat Nausea and Vertigo; CLASS: Misc.; SIDE EFFECTS: Vontrol may cause
hallucinations, disorientation, or confusion. For this reason, its use is limited to patients who are
hospitalized; ACTION: effects the vestibular apparatus to control vertigo and inhibits the
chemoreceptor trigger zone (CTZ)

Front 46

Metoclopramide HCl (Reglan)

Back 46

Drug used to treat Nausea; CLASS: Misc; ACTION: increases muscle contraction in the upper
digestive tract & affects the vestibular system. This speeds up the rate at which the stomach
empties into the intestines

Front 47

Trimethobenzamide HCl (Tigan)

Back 47

Drug used to treat Nausea; CLASS: Misc; ACTION: affects the vomiting center in the CNS;
SIDE EFFECTS: may affect thinking and reactions; Nursing intervention: advise Pt. not to
drive or drink alcohol while taking this drug

Front 48

Ipecac

Back 48

Drug used to induce vomiting to empty the stomach (eg. poisoning); CLASS: Emetic; ROUTE:
Syrup; ACTION: works by irritating the stomach lining and stimulating the vomiting center of
the brain; NURSING IMPLICATION: Do not use if you do not know what was swallowed, do
not use if a caustic substance was ingested

Front 49

Paregoric (Camphoratted Opium
Tincture)

Back 49

Drug used to treat diarrhea; CLASS: Anti-diarrheal / Opiate

Front 50

Diphenoxylate (Lomotil)

Back 50

Drug used to treat diarrhea (also makes Pt. feel well) combined with Atropine; CLASS:
Antidiarrheal / Opiate - OFTEN COMBINED WITH ATROPINE

Front 51

Loperamide (Immodium)

Back 51

Drug used to treat diarrhea combined with Atropine; CLASS: OTC Antidiarrheal / Opiate (does
not cause euphoria - less of a sedative effect than Lomotil)

Front 52

Bismuth salts (Pepto Bismol)

Back 52

Drug used to treat diarrhea; CLASS: OTC Anti-diarrheal / Absorbent; ACTION: coat the wall of
the GI tract, absorbs bacteria and toxins that cause diarrhea

Front 53

Kaolin-Pectin (Kaopectate)

Back 53

Drug used to treat diarrhea; CLASS: OTC Anti-diarrheal / Absorbent; ACTION: coat the wall of
the GI tract, absorbs bacteria and toxins that cause diarrhea

Front 54

Furazolindone (Furoxone)

Back 54

drug used to treat Diarrhea and enteritis caused by bacteria and protozoa; CLASS: Antidiarrheal
/ Misc. (not popular)

Front 55

Lactobacillus

Back 55

Drug used to treat diarrhea; CLASS: OTC Anti-diarrheal / misc.; ACTION: used to restore
normal oral, GI, and vaginal flora in those affected by antibiotics

Front 56

Parepectolin (Paregoric, Kaolin
and Pectin)

Back 56

Drug used to treat diarrhea; CLASS: OTC Anti-diarrheal / misc.; ACTION: work by adsorbing
the bacteria or germ that may be causing the diarrhea.

Front 57

Lactlose (Cephulac)

Back 57

drug used to treat constipation; CLASS: Osmotic (hyperosmolar laxative); ROUTE: PO;
NURSING IMPLICATION: do not administer laxatives if Pt. is experiencing abdominal pain

Front 58

Magnesium hydroxide (Milk of
Magnesia)

Back 58

drug used to treat constipation; CLASS: Osmotic (hyperosmolar laxative); ROUTE: PO;
NURSING IMPLICATION: can cause hypermagnesia esp. in elderly, do not administer
laxatives if Pt. is experiencing abdominal pain

Front 59

Magnesium Sulfate (Epsom
Salts)

Back 59

drug used to treat constipation; CLASS: Osmotic (hyperosmolar laxative); ROUTE: PO;
NURSING IMPLICATION: do not administer laxatives if Pt. is experiencing abdominal pain

Front 60

Sodium phosphate w/ Sodium
biphosphate

Back 60

drug used to treat constipation; CLASS: Osmotic (hyperosmolar laxative); ROUTE: enema;
NURSING IMPLICATION: may cause dehydration, do not use of Pt with FVD.

Front 61

Bisacodyl (Dulcolax)

Back 61

drug used to treat constipation; CLASS: Stimulant Laxative

Front 62

Castor Oil

Back 62

drug used to treat constipation; CLASS: Purgative / Stimulant Laxative (not popular due to bad
taste)

Front 63

Phenolthyhalein (Senokot,
Senna)

Back 63

drug used to treat constipation; CLASS: Stimulant Laxative

Front 64

Psyllium (Metamucil)

Back 64

drug used to treat constipation; CLASS: bulk forming laxative; Nursing intervention: do not
prepare ahead of time, drink right away, Pt. must drink at least 8 oz of fluid to avoid obstruction

Front 65

Docusate Calcium (Surfak)

Back 65

rug used to treat constipation; CLASS: Emollient / Stool Softener; ACTION: adds water to the
stool before it passes, making it soft

Front 66

Docusate Sodium (Colate)

Back 66

drug used to treat constipation; CLASS: Emollient / Stool Softener; ACTION: adds water to the
stool before it passes, making it soft - VERY COMMON FOR ELDERLY

Front 67

Mineral Oil

Back 67

drug used to treat constipation; CLASS: Emollient / Lubricant; ACTION: lubricates the
intestines; NURSING IMPLICATIONs: harmful effects on the lungs if accidentally aspirated,
blocks absorption of essential fat soluble vitamins DEAK

Front 68

Polyethylene glycol electrolyte
solution (GoLYTELY)

Back 68

Solution used to perpare Pt. bowels for colonoscopy; CLASS: Evacuant / Bowel Prep.,
ACTION: isotonic non absorbable solution cleanses the bowel. NURSING IMPLICATION:
does not affect K levels. Safe for kidneys and heart; ROUTE: PO

Front 69

Anti Ulcer Medication

Back 69

H-Pylori is treated with antibiotics

Front 70

Clindinium Bromide and
Chordiazepoxide (Librax)

Back 70

Anti-Ulcer drug; CLASS: tranquilizer; ACTION: decreases anxiety and vagal activity -
COMMON

Front 71

Propantheline bromide (Pro-
Banthine)

Back 71

Anti-Ulcer drug; CLASS: Anti-Cholinergic; ACTION: decreases gastric secretions (reduces HCl)
- COMMON

Front 72

Aluminum hydroxide (Amphojel)

Back 72

Anti-Ulcer drug; CLASS: Antacid; ACTION: neutralizes gastric acid

Front 73

Anti-Ulcer drug; CLASS: Antacid; ACTION: neutralizes gastric acid

Back 73

Anti-Ulcer drug; CLASS: Antacid; ACTION: neutralizes gastric acid

Front 74

Magnesium hydroxide and
Aluminum hydroxide with
Simethecone (Mylanta)

Back 74

Anti-Ulcer drug; CLASS: Antacid / Anti-Gas; ACTION: neutralizes gastric acid / Simethecone
relieves gas

Front 75

Ranatidine (Zantac)

Back 75

Anti-Ulcer drug; CLASS: H2 Blocker; ACTION: inhibits histamine at the receptor site

Front 76

Cimetidine (Tagamet)

Back 76

Anti-Ulcer drug; CLASS: H2 Blocker; ACTION: inhibits histamine at the receptor site

Front 77

Famotidine (Pepcid)

Back 77

Anti-Ulcer drug; CLASS: H2 Blocker; ACTION: inhibits histamine at the receptor site

Front 78

Esomeprazole Magnesium
(Nexium)

Back 78

Anti-Ulcer drug; CLASS: Proton Pump Inhibitor; ACTION: Inhibits gastric secretion; NURSING
IMPLICATION: administer before meals; caution for drug interACTIONs

Front 79

Lansoprazole (Prevacid)

Back 79

Anti-Ulcer drug; CLASS: Proton Pump Inhibitor; ACTION: Inhibits gastric secretion; NURSING
IMPLICATION: administer before meals; caution for drug interACTIONs

Front 80

Omeperazole (Prilosec)

Back 80

Anti-Ulcer drug; CLASS: Proton Pump Inhibitor; ACTION: Inhibits gastric secretion; NURSING
IMPLICATION: administer before meals; caution for drug interACTIONs

Front 81

Sucrafate (Carrafate)

Back 81

Anti-Ulcer drug; CLASS: Pepsin Inhibitor; ACTION: coats the ulder and protects it from acid
and pepsin secretion

Front 82

Misoprostol (Cytotec)

Back 82

Anti-Ulcer drug; CLASS: Prostaglandin; ACTION: suppresses gastric acid secretion and
protects the mucosa - NOT POPULAR due to high price

Front 83

Factors affecting anti ulcer drug
orders

Back 83

1) Price 2) condition of client 3) side effects

Front 84

Assessment
anti-ulcer

Back 84

Drug history, S/O data, hypermagnesia

Front 85

Diagnosis
anti-ulcer

Back 85

Pain r/t ulceration in the gastric area

Front 86

Interventions
anti-ulcer

Back 86

Administer meds AC

Front 87

Lifestyle factors
anti-ulcer

Back 87

Smoking increases rate of ulceration (important client teaching)

Front 88

Insulin

Back 88

used to treat type 1 and sometimes type 2. Used to be obtained from beef/pork pancreas
(rarely see this anymore due to allergic reACTIONs), insulin protein cannot be taken orally,
ROUTE: subQ. Best ROUTE: in arm and abdomen at 45 or 90 degrees.

Front 89

Humulin

Back 89

manufactured using DNA technology (not from a living being... lower incidence of allergic
reACTION)

Front 90

Rotate insulin injection site
(important client teaching)

Back 90

If you do not rotate sites, there can be the following changes in the skin: 1) lipodystrophy:
depression of subQ fat 2) hypertrophy: raised bumps/lumps. Do not give injection in these
areas.

Front 91

insulin pumps

Back 91

advantage eliminates needles and gives a steady dose of insulin injection

Front 92

classifications of insulin (3)

Back 92

rapid acting, intermediate acting, long acting

Front 93

rapid acting insulin

Back 93

rapid acting insulin is used in sliding scale; used when combining insulins

Front 94

Types of rapid acting insulin (3)

Back 94

regular insulin (only type of insulin ROUTE: IV), Lispro insulin, Asparte, insulin

Front 95

regular insulin

Back 95

this is the most frequently used insulin - rapid onset within 30-minutes - peak in 2-4 hours -
duration is 6-8 hours. possible hypoglycemia during peak ACTION - this is the only type of
insulin that can be ROUTE: IV

Front 96

Lispro insulin

Back 96

rapid acting insulin - onset within 15-minutes - peak 1-1.5 hours - duration 2-4 hours. possible
hypoglycemia during peak ACTION.

Front 97

Asparte insulin (NovoLog)

Back 97

rapid acting insulin - onset in 10-20 min - peak in 1-3 hours - duration 3-5 hours (make sure
that Pt. eats within 10-15 minutes) possible hypoglycemia during peak ACTION

Front 98

rapid acting insulin - Nursing
intervention

Back 98

Pt. needs to eat when administering rapid insulin because it can cause hypoglycemia.
Recommended that tray is already in the room.

Front 99

time to eat after taking insulin

Back 99

regular insulin: eat within 30 minutes; Lispro insulin: eat within 5 minutes; Asparte insulin: eat
within 10-15 minutes

Front 100

Types of intermediate acting
insulin (2)

Back 100

1) NPH, 2) Humulin N (majority of Pt. on intermediate acting insulin)

Front 101

NPH, Humulin N insulin

Back 101

Intermediate acting insulin - peak ACTION 6-12 hours (most likely to see hypoglycemic
reACTION during peak); duration is 24 hours - these are both cloudy and take longer to begin
acting, typically ROUTE: in the AM, can be combined with regular insulin... never ROUTE: IV -
possible hypoglycemia during peak ACTION

Front 102

Types of long acting insulin (1)

Back 102

Ultralente

Front 103

Ultralente insulin

Back 103

long acting insulin, onset: 4-8 hours; peak: 14-20 hours; duration: 24-36 hours, ROUTE: at HS -
possible hypoglycemia during peak ACTION

Front 104

Combination insulins

Back 104

NPH and regular together - already mixed together so it is easier for Pt. to use at home - e.g.
Humulin 70/30, 50/50

Front 105

Insulin Pens

Back 105

Pt. does not need to draw insulin into syringe; easy to use esp. for children

Front 106

insulin sliding scale

Back 106

sliding scale insulin provides short acting insulin coverage for increases in blood glucose
between intermediate/long acting insulin; units of insulin are based on blood glucose range,
usually ordered AC and HS (4x/day) - some type 2 diabetics may just have a sliding scale order
without an intermediate/long acting insulin

Front 107

Oral hypoglycemic drugs

Back 107

used for type 2 diabetes; Pt. may be on more than one drug and possibly insulin

Front 108

Glipzide (Glucotrol)

Back 108

Oral drug used to treat Diabetes Mellitus. CLASS: Sulfonylurea. ACTION: stimulates
pancreated Beta cells to secrete more insulin. SIDE EFFECTS: hypoglycemia. NURSING
INTERVENTIONs: administer 30 minutes before breakfast or with breakfast, assess for
hypoglycemia

Front 109

Metformin (Glucophage)

Back 109

Oral drug used to treat Diabetes Mellitus. CLASS: Biguanide. ACTION: decreases hepatic
production of glucose from stored glycogen, decreases the absorption of glucose from the
small intestine. Nursing intervention: need to inform MD if there is a Hx of liver disfunction;
does not cause hypoglycemia if taken alone

Front 110

Acarbose (Precose)

Back 110

Oral drug used to treat Diabetes Mellitus. CLASS: Alpha glucosidase inhibitor. ACTION:
“starch blocker” inhibits the digestive enzyme in the small intestine responsible for the release
of glucose. Does not cause hypoglycemia if taken alone.

Front 111

pioglitazone (Actos)

Back 111

Oral drug used to treat Diabetes Mellitus. CLASS: Thiazolidendiones. ACTION: “insulin
sensitizer” decreases insulin resistance. Does not cause hypoglycemia if taken alone. SIDE
EFFECTS: can cause edema and heart failure.

Front 112

rosiglitazone (Avandia)

Back 112

Oral drug used to treat Diabetes Mellitus. CLASS: Thiazolidendiones. ACTION: “insulin
sensitizer” decreases insulin resistance. Does not cause hypoglycemia if taken alone. SIDE
EFFECTS: can cause edema and heart failure. Mostly taken off of the market due to risks -
only used on Pt. who have been on this treatment for a long time.

Front 113

care plan for type 2 diabetes

Back 113

medication, diet, exercise, assess liver enzymes, monitor blood glucose level and notify MD if
out of range; some type 2 diabetics will eventually need to go on insulin - some Pt. who are
able to lose weight can avoid medication altogether

Front 114

Antihistamines

Back 114

decrease nasopharyngeal secretions by blocking H1 receptor

Front 115

First generation
antihistamines

Back 115

cause drowsiness, dry mouth and other anticholinergic symptoms dizziness, fatigue, disturbed
coordination used for upper resp. disorders

Front 116

Diphenhydramine (Benadryl)

Back 116

First generation antihistamine (treats upper resp. disorders); Also used to motion sickness

Front 117

Chlorpheneramine Maleate
(Chlotrimeton)

Back 117

First generation antihistamine (treats upper resp. disorders)

Front 118

Brompheramine (Dimetane)

Back 118

First generation antihistamine (treats upper resp. disorders)

Front 119

Tripolidine and pseudoephedrine
(Actifed)

Back 119

First generation antihistamine (treats upper resp. disorders)

Front 120

Second Generation
antihistamines

Back 120

non-sedating and cause less anticholinergic symptoms

Front 121

Certirizine (Zyrtec )

Back 121

Second Generation antihistamine (treats upper resp. disorders)

Front 122

Fexofenadine (Allegra ).

Back 122

Second Generation antihistamine (treats upper resp. disorders) - popular

Front 123

Loratadine (Claritin)

Back 123

Second Generation antihistamine (treats upper resp. disorders) - very popular OTC

Front 124

Desloratadine (Clarinex)

Back 124

Second Generation antihistamine (treats upper resp. disorders)

Front 125

Decogestants

Back 125

2-types: Nasal and Systemic - RISK FOR REBOUND EFFECT

Front 126

Nasal Decongestants

Back 126

(Sympathomemetic Amines) - stimulate the alpha adrenergic receptors thus producing vascular
constriction of the capillaries within the nasal mucosa resulting in a shrinking of the mucous
membranes and a reduction in fluid secretion. Continued use may cause rebound congestion
due to vasodilation. - ADVANTAGE OVER SYSTEMIC DECONGESTANTS: LESS SIDE
EFFECTS

Front 127

Oxymetazoline HCl (Afrin)

Back 127

Nasal Decongestant (treats upper resp. disorders); ROUTE: spray or drops - OTC

Front 128

Phenylephrine HCl
(Neosynephrine)

Back 128

Nasal Decongestant (treats upper resp. disorders)

Front 129

Systemic Decongestants

Back 129

(Alpha Adrenergic Agonist) SIDE EFFECTS: B/P and blood sugar can increase, can also
cause vasoconstriction of the nasal capillaries. - ADVANTAGE OVER NASAL
DECONGESTANTS: LONGER ACTING - NEED MD Rx

Front 130

Ephedrine Sulfate (Efedron)

Back 130

Systemic Decongestant (treats upper resp. disorders)

Front 131

Pseudoephedrine (Sudafed)

Back 131

Systemic Decongestant (treats upper resp. disorders)

Front 132

Intranasal Glucocorticoids

Back 132

effective for allergic rhinitis, has anti-inflammatory ACTION thus decreasing allergic rhinitis
symptoms (treats upper resp. disorders) - SHOULD ONLY BE USED SHORT TERM -
STEROIDAL SIDE EFFECTS

Front 133

Beclomethasone (Beconase)

Back 133

Intranasal Glucocorticoid (treats upper resp. disorders) - SHOULD ONLY BE USED SHORT
TERM - STEROIDAL SIDE EFFECTS

Front 134

Budesonide (Rhinocort)

Back 134

Intranasal Glucocorticoid (treats upper resp. disorders) - SHOULD ONLY BE USED SHORT
TERM - STEROIDAL SIDE EFFECTS - common

Front 135

Flunisolide (Nasalide)

Back 135

Intranasal Glucocorticoid (treats upper resp. disorders) - SHOULD ONLY BE USED SHORT
TERM - STEROIDAL SIDE EFFECTS - common

Front 136

Fluticasone (Flonase)

Back 136

Intranasal Glucocorticoid (treats upper resp. disorders) - SHOULD ONLY BE USED SHORT
TERM - STEROIDAL SIDE EFFECTS - common

Front 137

Triamcinolone (Nasacort)

Back 137

Intranasal Glucocorticoid (treats upper resp. disorders) - SHOULD ONLY BE USED SHORT
TERM - STEROIDAL SIDE EFFECTS - common

Front 138

Dexamethasone (Decadron)

Back 138

Intranasal Glucocorticoid (treats upper resp. disorders) - SHOULD ONLY BE USED SHORT
TERM - STEROIDAL SIDE EFFECTS

Front 139

Antitussives

Back 139

act on the cough control center in the medulla. 3-types: narcotic, non-narcotic and combiation

Front 140

Dextromethorphan
Hydrobromide (Robitussin DM,
Benylin)

Back 140

Non-Narcotic Anti-Tussive (treats upper resp. disorders) - OTC

Front 141

Promethazine (Phimergan)

Back 141

Non-Narcotic Anti-Tussive (treats upper resp. disorders) - MD Rx

Front 142

Guaifenesln and Codeine
(Robitussin A-C)

Back 142

Narcotic Anti-Tussive (treats upper resp. disorders)

Front 143

Hydrocodone bitartrate
( Hycodan )

Back 143

Narcotic Anti-Tussive (treats upper resp. disorders) - very effective - SIDE EFFECT:
grogginess

Front 144

Promethazine with
Dextromelhorphan ( Phenergan
DM )

Back 144

Combination Anti-Tussive (treats upper resp. disorders)

Front 145

Promethazine with Codeine
(Phenergan with Codeine)

Back 145

Combination Anti-Tussive (treats upper resp. disorders)

Front 146

Expectorants

Back 146

loosen the bronchial secretions so that they can be eliminated by coughing, NURSING
IMPLICATION: Pt must be properly hydrated otherwise there will not be enough fluid to
expectorate

Front 147

Guairenesin ( Robitussin )

Back 147

Expectorant (treats upper resp. disorders - NURSING IMPLICATION: Pt must be properly
hydrated otherwise there will not be enough fluid to expectorate

Front 148

Guaifenessin and
Dextromethorphan ( Robitussin
DM )

Back 148

Anti-Tussive / Expectorant (treats upper resp. disorders)

Front 149

Sympathomemetics

Back 149

increase cyclic adenosine monophosphate (CAMP). CAMP is a molecule that is responsible
for bronchodilation. Sympathomemetics are alpha- Adrenergic agonists and Beta 2 Adrenergic
agonist. These drugs are frequently ROUTE: by inhalation because onset is more rapid, dose
needed is less than oral, and has fewer side effects. They are also delivered directly to the
constricted bronchial site. (treat lower resp. disorders)

Front 150

Albuterol ( Proventil )

Back 150

newer beta adrenergic drug for asthma (Sympathomemetic drug) - COMMONLY USED W/
ATROVENT - short acting - DRUG OF CHOICE for an Asthma Attack

Front 151

Metaproterenol (Alupent)

Back 151

can relieve bronchospasm in lower resp. disorders eg. Asthma (Sympathomemetic drug) -
SIDE EFFECT: Nervousness

Front 152

Isoproterenol (Isuprel)

Back 152

first beta adrenergic drug used for bronchospasm. (treats lower resp. disorders eg asthma)
(Sympathomemetic drug) SIDE EFFECT: Nervousness

Front 153

formoterol fumarate (Foradil)

Back 153

beta adrenergic drug for asthma (Sympathomemetic drug) - inhalation capsule to be kept in
the refrigerator

Front 154

Tiotprimm (Spiriva)

Back 154

beta adrenergic drug for asthma (Sympathomemetic drug) - inhalation capsule does not need
to be refrigerated

Front 155

Ipatropium ( Atrovent )

Back 155

Anticholinergic drug used to treat asthmatic conditions. ACTION: dilation of the bronchioles.
Combination of Ipatropium and Albuterol is used to treat chronic bronchitis because it
provides longer duration of ACTION.

Front 156

Methylxanthine (Xanthine
Derivatives)

Back 156

Relaxes the smooth muscles of the bronchi, bronchioles, and pulmonary blood vessel by
inhibiting the enzyme phosphodisterase resulting in an increase of CAMP which promotes
bronchodilation has low therapeutic index and narrow therapeutic range. - lower resp. disorders

Front 157

Theophylline ( Theo-Dur)

Back 157

CLASS: Methylxanthine (Xanthine Derivatives). ACTION: Relaxes the smooth muscles of the
bronchi, bronchioles, and pulmonary blood vessel by inhibiting the enzyme phosphodisterase
resulting in an increase of CAMP which promotes bronchodilation NURSING IMPLICATION:
low therapeutic index and narrow therapeutic range. - lower resp. disorders

Front 158

Aminophylline- Theophylline
(Somophyphyllin)

Back 158

CLASS: Methylxanthine (Xanthine Derivatives). ACTION: Relaxes the smooth muscles of the
bronchi, bronchioles, and pulmonary blood vessel by inhibiting the enzyme phosphodisterase
resulting in an increase of CAMP which promotes bronchodilation NURSING IMPLICATION:
low therapeutic index and narrow therapeutic range. - lower resp. disorders

Front 159

Leukotrine Receptor
Antagonist and Synthesis
Inhibitors

Back 159

this therapy works to PREVENT bronchoconstriction - not to be used for an acute asthma
attack

Front 160

Montelukast ( Singulair)

Back 160

newer, short half life and safe to use in children (Leukotrine Receptor Antagonist and Synthesis
Inhibitor) - this therapy works to prevent bronchoconstiction and is not for an acute asthma
attack

Front 161

Zafulukast (Accolate)

Back 161

first drug, acts as a leukotrine receptor antagonist thus reducing the inflammatory process and
decreasing brochoconstriction - good for prevention but not for an acute asthma attack

Front 162

Glucocorticoids (Steroids)

Back 162

given to Pt unresponsive bronchodilator therapy - watch for steroid side affects in PO meds;
inhalationshave less side effects

Front 163

Beclomethasone (Vanceril)

Back 163

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: via Intranasal or aerosol inhalation

Front 164

Flunisolide (Aerobid)

Back 164

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: via Intranasal or aerosol inhalation

Front 165

Fluticasone (Flonase)

Back 165

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: via Intranasal or aerosol inhalation

Front 166

Triamcinolone (Nasacort)

Back 166

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: via Intranasal or aerosol inhalation

Front 167

Dexamethasone ( Decadron )

Back 167

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: PO; SIDE EFFECT: risk for hyperglycemia

Front 168

Cortisone Acetate ( Cortone
Acetate)

Back 168

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: PO SIDE EFFECT: risk for hyperglycemia

Front 169

Methyprenisolone ( Solu-Medrol )

Back 169

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: PO SIDE EFFECT: risk for hyperglycemia

Front 170

Prednisolone ( Delta-Cortef)

Back 170

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: PO SIDE EFFECT: risk for hyperglycemia

Front 171

Prednisone

Back 171

Glucocorticoids (Steroids) used to treat lower respiratory disorders
ROUTE: PO SIDE EFFECT: risk for hyperglycemia

Front 172

Prophylactics

Back 172

Prophylactic - used for prevention of asthma attack, not for acute asthmatic attack - used daily,
reduces the release of H1

Front 173

Cromolyn ( lntal )

Back 173

commonly used Prophylactic - used for prevention, not for acute asthmatic attack - used daily,
reduces the release of H1

Front 174

Nedocronll Sodium ( Alocril )

Back 174

more effectlive than Cromolyn - Prophylactic - used for prevention, not for acute asthmatic
attack - not common due to expense - used daily prevents the relase of H1

Front 175

Mucolytics

Back 175

acts as detergents by liquefying and loosening mucous - used to treat lower respiratory
disorders

Front 176

Acetylcystelne ( Mucomyst )

Back 176

Class: Mucolytic - acts as detergent by liquefying and loosening mucous - used to treat lower
respiratory disorders - comes in a vial and administered as an inhalation

Front 177

Antimicrobials

Back 177

used only if an infection results from retained mucus (example: Ceflacor (Ceclor))

Front 178

Reasons for cancer drug therapy
(3)

Back 178

1. Cure 2. Control tumor growth 3. Palliation of symptoms

Front 179

Classifications of cancer
chemotherapy drugs (2)

Back 179

1. Cell cycle specific 2. Cell cycle non specific

Front 180

Cell cycle specific

Back 180

Only have action during one specific phase of the cell cycle

Front 181

Cell cycle non specific

Back 181

Can have action during any phase of the cell cycle

Front 182

Drug resistance

Back 182

This limits the effectiveness of cancer chemotherapy. Similar phenomenon to antibiotics...
Most resistant cancer cells survive and cause tumor to become resistant to drug therapy.

Front 183

Common Chemo Side-Effects

Back 183

Cancer cells replicate very rapidly as do some of the normal cells in the body. Chemotherapy
drugs cannot differentiate between cancer cells and normal cells in the body that replicate
rapidly. This causes chemo side effects seen in the Bone marrow, GI tract cells, hair cells,
gonads

Front 184

Low RBC

Back 184

Anemia (need to follow hemoglobin and hematocrit... Need to transfuse if hematocrit falls
below 25%), nursing intervention: assess for anemia and monitor hemoglobin and hematocrit
levels. Nursing diagnosis: fatigue.

Front 185

Leucopenia / Neutropenia

Back 185

Below 50%, leucocytes below 1000. Nursing diagnosis: risk for infections. Intervention:
reverse isolation. No flowers or plants in the room. Low bacteria diet. Nurse needs to assess
for signs of infection (assess at catheter sites), avoid injections (if possible), avoid rectal
temperatures & suppositories, monitor for temperature increase, chills. Often Pt will go on
Cepholasporin and Aminoglycoside even before lab results come back because Pt is at high
risk for sepsis. Hand washing is paramount.

Front 186

Thrombocytopenia

Back 186

When platelet count of dips to 10,000 or below. Assess for bruising, petehaie, bleeding gums
(Pt should not use a toothbrush or dental floss with a low platelet count), nose bleeds, GI
bleeding (black tarry stools, etc.), cerebral bleed. Nursing implication: put pressure on injection
site to avoid hematoma (sometimes pressure dressing/sandbag is necessary)

Front 187

Nausea and vomiting

Back 187

Administer anti-emetics PRN (Zofran, Etc.)

Front 188

Diarrhea

Back 188

Administer meds PRN. Nursing diagnosis: FVD, nutrition less than body requirements

Front 189

Anorexia

Back 189

altered taste sensation, Nursing interventions: Nutritional supplements (Ensure), high calorie
foods

Front 190

Stomatitis / Mucosititis

Back 190

Very painful. High risk for nutritional deficit. No treatment. Can sometimes see legions on the
lips.

Front 191

Alopecia (hair loss)

Back 191

Not life threatening but can affect Pt psychologically. Good news is that the hair will grow back
but sometimes it grows back another color or texture. Nursing diagnoses: Distorted body
image, self esteem. Nursing implication: discuss with Pt what they can do before the hair falls
out.

Front 192

Fatigue

Back 192

Major problem. Nursing diagnosis: activity intolerance... Fatigue can last for months after
chemotherapy has ended.

Front 193

Infertility

Back 193

May or may not be permanent. Men can use sperm bank. More complicated for women...
Women should go on birth control before starting chemo b/c getting knocked-up during chemo
is a bad situation.

Front 194

Venue for chemo

Back 194

Majority of chemotherapy is provided on an outpatient basis.

Front 195

Alkalyting drugs

Back 195

Cross link wih DNA strands and prevent DNA from replicating. These are mostly cell cycle
specific drugs.

Front 196

Cytoxan - Cyclophosphamide

Back 196

ROUTE: PO or IV. Can cause hemorragic Cystitis (inflamed bladder, gross hematuria).
Prevent this complications by keeping Pt. very well hydrated (via IV in hospital, and hydrate at
home... 2-3 liters/day). Can also prevent with meds. Important Pt teaching... this causes very
severe pain. CLASS: Alkalyting drugs

Front 197

Antimetabolites

Back 197

Drug fools cancer cell into thinking that this is something that the cancer call needs and then
inhibits cancer cell replication. Cell cycle specific usually in the S phase.

Front 198

5-FU Flurouracil

Back 198

Side effects: diarrhea, stomatitis, dark veins. This is given in a lot in combination
chemotherapy treatments. CLASS: Antimetabolite

Front 199

Anti tumor antibioitics

Back 199

Bind to DNA and prevent cell replication. Inhibit protien and RNA synthesis. Main effect in the
G2 ohase of the cell cycle.

Front 200

Adriamycin

Back 200

Deep red color. Dose limitation due to cardiac toxicity. Guidelines: before starting this med, Ot
must have a cardiac study. Hx of cardiac problems probably disqualifies Pt from taking this
med. Lifetime maximum dosage range. Must maintain a dose record. Cannot administer
without knowing dose record. Limit is 550 m2. Before every dose nurse must assess for
Cardiac toxicity, pitting edema, CHF, SOB.

Front 201

Bleomycin

Back 201

Can cause pulmonary toxicity. Before Pt starts drug, Pt must have a pulmonary assessment.
Pt may be disqualified from treatment with this drug if pulmonary issues exist. Limit is 330 m2.
Nurse must assess respiration before administering each dose.

Front 202

Plant alkaloids

Back 202

Derived from plants.

Front 203

Vinchristine

Back 203

Can cause neurotoxicity. Nurse needs to asess tendon reflex.

Front 204

Taxol

Back 204

Side effect: neuropathy (numbness, tingling, burning in legs). Neurontin can help control pain.

Front 205

Angiogenesis Inhibitors

Back 205

Inhibits blood vessel growth in the tumor.

Front 206

Avastin

Back 206

In theory this should be effective, however, in practice, this drug has not been very effective
thus far.

Front 207

Hormone Agents

Back 207

Used in tumors that are hormonally dependent. Eg. breast cancer. Alternate hormonal
environment to inhibit the tumor growth.

Front 208

Tamoxifen

Back 208

Anti-estrogen drug used to inhibit breast cancer.

Front 209

Targeted Drugs

Back 209

Target exact genetic problem is in the cancer cell... Hopefully not affect other tissues. Very
promising new therapy.

Front 210

Gleevec

Back 210

Used for chronic mogoinous leukemia (CML). Excellent results. Very promising new therapy.

Front 211

Note about chemotherapy
nausea.

Back 211

Administer anti-emetics at same time as chemo... Don't wait for nausea. Also eat crackers,
drinks soda

Front 212

Biological Response Modifiers

Back 212

Enhance and stimulate the immune system (Immune system plays an important part in fighting
cancer). In theory, this sounded good, but currently there has not yet been great success when
used on patients.

Front 213

Interferon

Back 213

Stimulates the immune system but has had limited success in treating cancer. Still being
researched. Side effect: causes flu-like symptoms. Pre medicate with Tylenol or Demerol to
help against Rigors. Also very severe fatigue... this can be a dose limiting factor.

Front 214

Vaccines

Back 214

Vaccine is custom engineered for the Pt from his own cancer cells to stimulate the immune
system. Very experimental.

Front 215

Colony Stimulating Factors

Back 215

Used to mitigate the side effect bone marrow suppression. These are administered outpatient...
Helps keep Pt from having to come to the hospital for transfusions. These are very
expensive, however, less expensive than hospitalization for transfusions and complications.

Front 216

Erythropoetin (Epogen)

Back 216

Administered subQ. Used widely for cancer and also kidney dialysis. Possible adverse affects
currently being investigated by the FDA. CLASS: Colony Stimulating Factor used for RBC
stimulation.

Front 217

Granulocyte (WBC) Stimulating
Factor (Neulasta)

Back 217

Administered IV and subQ. Can prevent neutorpoenia. Side effect: bone pain. Pain treated
issuing non narcotic analgesics (Tylenol, Ibuprofen). Reminder: nurse cannot tell Pt to use
Tylenol, etc. even though it is OTC. CLASS: Colony Stimulating Factor used for WBC
stimulation.

Front 218

Platelet Stimulating Factor
(Neumega)

Back 218

Stimulates platelet productions. Side effect: fluid retention. Cannot use on Pt with CHF or
renal problems. CLASS: Colony Stimulating Factor used for Platelet stimulation.

Front 219

precautions when preparing
chemotherapy

Back 219

IV’s prepared under a ventilated hood (very important), special gloves, face shield, dedicated
chemo trash receptacles, special gowns, gloves worn and toilet flushed twice when emptying
urinal, verification policy to double check for chemo meds due to toxicity, precautions regarding
vesicants (chemicals that can cause skin necrosis)