Pharmacology Test 4 Flashcards

Front 1

cautions regarding muromonab-CD3

Back 1

-contraindicated in patients with fluid overload
-monitor WBC counts throughout therapy; if the ocunt drops below 3000/mm3 the drug should be discontinued, but only after contacting the physician

Front 2

adverse effects of Imuran

Back 2

can cause leukopenia

Front 3

medication recommended prior to monoclonal antibodies

Back 3

methylprednisolone sodium succinate can be given to minimize reactions

Front 4

drug interactions with cyclosporine

Back 4

allopurinol may increase action of cyclosporine

Front 5

differences between muromonab CD3 and newer drugs basiliximab and sirolimus

Back 5

-muronmonab-CD3 is the only drug indicated for the reversal of graft rejection AND the only drug indicated for reversal of organ rejection once rejection of a transplanted organ has started

Front 6

immunosuppressant used with multiple sclerosis

Back 6

glatiramer acetate (copaxone)

Front 7

nursing care for stomatitis

Back 7

-examine mouth daily for bleeding, painful areas and ulcerations
-oral antifungal drugs are given to treat oral candidiasis that may occur
-observe the oral cavity often for white patches on the tongue, mucous membranes, and oral pharynx

Front 8

goal for GI adverse effects

Back 8

-oral immunosuppresants should be taken with food to minimize GI upset

Front 9

prevention of chemo induced N/V

Back 9

-give an antiemetic 30-60 minutes before administering chemo

Front 10

monitoring a patient with bone marrow suppression

Back 10

-monitor for fever
-neutrophil counts: normal range is 2500-7000 cells/mm3
-counts lower than this require the chemo dose to be withheld

Front 11

teaching regarding chemo

Back 11

-teach pt to adhere to a "low-microbe" diet washing all fresh fruits and vegetables and making sure all foods are well cooked
-teach pt to report black, tarry stools

Front 12

how to handle allergies to chemo

Back 12

supportive therapy will be given for patient experiencing possible allergy to the chemotherapeutic agent and the chemo drug will continue to be given

Front 13

What is "nadir"?

Back 13

nadir is the point at which the neutrophils reach their lowest levels

Front 14

dose limiting toxicity of cisplatin

Back 14

kidney damage

Front 15

assessment for daunorubicin

Back 15

monitor weight

Front 16

dose limiting factor to interferon

Back 16

side effect of fatigue

Front 17

advantages to monoclonal antibodies

Back 17

-fewer adverse effects than traditional antineoplastic medications
-minimal effect on healthy cells

Front 18

capillary leak syndrome

Back 18

indicates severe toxicity; capillaries become "leaky" and cause massive fluid retention leading to heart failure. Hold drug and notify physician if these symptoms occur

Front 19

drugs used to stimulate platelet production

Back 19

oprelvekin (neumega)

Front 20

sargramostim therapy

Back 20

-stimulates bone marrow precursor cells that make both granulocytes and phagocytic (cell-eating) cells, known as monocytes
-granulocyte-macrophage colony-stimulating factor (GM-CSF)
-start 24 hours after chemo ends

Front 21

patient instruction for any drug or group of drugs that causes bone marrow suppression?

Back 21

be careful when shaving or brushing teeth. any nick in the skin or vigorous brushing can lead to an opening for infection and the pt is already immunocompromised

Front 22

what is the goal of chemotherapy

Back 22

to decrease the size of the neoplasm so that the immune system can deal with it

Front 23

what are antineoplastic drugs often given in combination?

Back 23

to affect different stages of the cell at the same time

Front 24

side effects of interleukin drug therapy

Back 24

-lethargy, myalgia, arthralgia, fatigue, fever and respiratory difficulties
-capillary leak syndrome
-N/V, anorexia, diarrhea, hypoalbuminemia, liver enzymes, edema, dyspnea, cough, fever, chills, afthenia

Front 25

administration of interferon

Back 25

at bed time

Front 26

cautious uses of antacids

Back 26

-any condition that can be exacerbated by electrolyte imbalance
-Gi obstruction
-calcium containing antacids can cause kidney stones

Front 27

H2 antagonists interactions

Back 27

-may inhibit the absorption of other drugs especially those that require an acidic environment for absorption such as ketoconazole
-basically every drug as well as smoking

Front 28

contraindications to cimetidine

Back 28

binds with P-450 microsomal oxidase system in the liver, resulting in inhibited oxidation of many drugs and increased drug levels
-SMOKING

Front 29

teaching about omeprazole

Back 29

do not crush, chew or open

Front 30

sodium bicarb hazards

Back 30

pts with HF or hypertension should not use antacids with high sodium content

Front 31

proper administration of antacids

Back 31

-should be given at least 1 hour before or after other medications
-be sure that chewable tablets are chewed thoroughly, and liquid forms are shaken well before giving
-administer with at least 8 ounces of water to enhance absorption (except for the "rapid dissolve" forms)

Front 32

classification of different types of laxatives

Back 32

-chemical stimulants: chemically irritate the lining of the GI tract
-bulk stimulants: cause the fecal matter to increase in bulk
-lubricants: help the intestinal contents move more smoothly
-hyperosmotic: increase water content in the feces

Front 33

administration of bulk forming laxatives

Back 33

-should take them as directed by the manufacturer with at least 240 mL (8 ounces) of water

Front 34

drug interactions with pepto bismol

Back 34

-taking digoxin with pepto-bismol may result in decreased absorption of the digoxin leading to digtox

Front 35

senokot teaching

Back 35

given with water due to interations with milk, antacids and juices
-a bowel prep

Front 36

differences between lomotil and imodium

Back 36

imodium does not cause dependence; directly affects the muscle layers of the Gi tract-slowing peristalsis and allowing increased time for absorption of fluid and electrolytes

Front 37

safe home use of laxatives

Back 37

-don't take at the same time as other meds
-a healthy, high-fiber diet and increased fluid intake should be encouraged as an alternative to laxative use

Front 38

mineral oil absorption

Back 38

-forms a slippery coat on the contents of the intestinal tract and can interfere with absorption of Vitamin A

Front 39

anticholinergics action as antidiarrheal

Back 39

decrease intestinal muscle tone and peristalsis of GI tract, resulting in slowing the movement of the fecal matter through GI tract

Front 40

adverse effects of pepto bismol

Back 40

-can darken the stool

Front 41

treatment of diarrhea r/t long term antibiotic use

Back 41

probiotics or bacterial replacement drugs

Front 42

drugs used to promote gastric emptying

Back 42

prokinetic

Front 43

marinol indications

Back 43

used for nausea and vomiting associated with chemotherapy and anorexia associated with weight loss in AIDS patients

Front 44

action of prokinetic drugs

Back 44

act as antiemetics by blocking serotonin receptros located in the GI tract, CTZ, and VC

Front 45

teaching regarding antibistamine/antiemetics

Back 45

-causes drowsiness so avoid driving
-cardiac effects when taken with Quinidine

Front 46

proper administration of scopolamine patches

Back 46

should be changed every 3 days and applied at least 4 hours before traveling

Front 47

safe administration of iron dextran injections

Back 47

-give deep IM using Z-track method
-IV line is flushed with 10 mL of NS and the iron should be diluted with the recommended amount of diluents
-keep resuscitative equipment on hand during IV infusion in case of anaphylaxis
-keep pt recumbent for 30 minutes after infusion to prevent orthostatic hypotension

Front 48

adverse effects of iron supplements

Back 48

-oral: GI irritation (black harry stools) and CNS toxicity
-parenteral iron is associated with severe anaphylactic reactions, local irritation, staining of the tissues and phlebitis

Front 49

contrainidcations to iron supplements

Back 49

-allergy, hemochromatosis (excessive iron in the blood), hemolytic anemia, normal iron balance, peptic ulcer, colitis, and regional enteritis

Front 50

proper administration of liquid iron preparations

Back 50

follow manufacturer's guidelines on dilution and administration and instruct pt to take liquid iron preparations through a straw to avoid staining tooth enamel

Front 51

foods to increase iron absorption

Back 51

high vitamin C rich foods/juices with iron to enhance absorption

Front 52

vitamin necessary for pregnant women

Back 52

folate

Front 53

folic acid indications

Back 53

-prevention of neural tube defects of neonate. take during pregnancy
-folic acid is used as a rescue drug for cells exposed to some toxic chemotherapeutic agents.