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What classification of diuretics is most frequently ordered by physicians?

Thiazide

Furosemide and bumetanide are examples of what type of diuretics?

Loop

What type of diuretic will usually be used to treat a patient suffering from pulmonary edema or edema associated with impaired renal function or hepatic function?

Loop, e.g., Lasix

Side effects of bumetanide and furosemide include?

Hypokalemia with weakness & vertigo.

Loop diuretics are contraindicated or used with caution in patients who have:

Kidney impairment

Aldactazide & Dyazide are classifed as what category of diuretics?

Combination potassium-sparing and thiazide

When administering the cardiac drug digoxin along with loop diuretics, the health care practitioner is aware that there is potential for:

Digitalis toxicity and arrhythmias to occur

The health care practitioner is aware that gynecomastic is a SE of what diuretics?

Spironolactone

When administering potassium-sparing diuretics to patients who also take medications such as ACE inhibitors, NSAIDs, angiotensin receptor blockers, and salicylates, the health care practitioner should be aware that what interactions may occur?

Hyperkalemia

The osmotic agent mannitol is most frequently used to:

Reduce intracranial or intraocular pressure

What diuretic interacts to increase urinary excretion of other mediations, lowering blood levels of lithium, salicylates, and barbiturates?

Mannitol

What diuretic is administered only via the parenteral route?

Mannitol

When a patient is taking a combination potassium-sparing and thiazide diuretic, the health care practitioner should emphasize the need for

periodic serum electrolyte checks

What diuretic can be administered via the PO, IM or IV route?

Loop diuretics

Uricosuric agents and allopurinal are used only to treat chronic gout because they

have no analgesic or anti-inflammatory effects in acute gout

What actions should the health care practitioner include when teaching patients who are receiving uricosuric agents?

Drink large amounts of fluid, preferably water, to avoid kidney stones and renal colic.

What medications used for chronic gout is also used to prevent renal calculi in patients with history of frequent stone formation, and prevent acute hyperuricemia during radiation of certain tumors or antineoplastic therapy?

Allopurinol

Antispsmodics such as propantheline are used to reduce the strength and frequency of contractions of the urinary bladder by :

...

The side effects of antispasmodics are anticholinergic in action and can include what?

Urinary retention and mental confusion, especially in older adults

Constipation can be a side effect of what antacid?

Aluminum or calcium carbonate

Osteoporosis can be a side effect of frequent use of what antacid?

Aluminum

When a patient uses over-the-counter antacids for over 2 weeks without medical supervision, there is a danger of:

Masking the symptoms of GI bleeding or GI malignancy

What antiulcer agent administered on an empty stomach reacts with hydrochloric acid in the stomach to form a paste that adheres to the mucosa providing protection to the ulcer from irriation?

Carafate

What antiulcer agents reduces gastric acid secretion by actin gas an H2 blocker?

Rantidine

Most peptic ulcer disease is related to what conditions?

Infection with Helicobacter pylori

Medications that reduce gastric juices and are taken on a regular basis for extended periods can deplete the intrinsic factor necessary for absorption of Vitamin

B12

Spontaneous abortion, dangerous uterine bleeding, and/or maternal or fetal death are all possible side effects of what medication?

Cytotec

Misoprostol (Cytotec) and magnesium-type antacids should not be given to patients because of the potential of exacerbating what adverse effects?

Diarrhea

Prilosec, Aciphex, Protonix, and Nexium, used in the short-term treatment of gastroesophagel reflux disease, gastric or duodenal ulcers, and erosive esophagitis, are classes in what category?

Proton pump inhibitors

What medications should be taken with food in order to minimize diarrhea?

Cytotec

Patients suffering from infection with Helicobacter pylori have been successfully treated with multiple drug regimens over a 14-day period such as Prevpac, which contains:

Amoxicillin, clarithromysic, and Prevacid

Diclomine is used as an adjunct therapy in the management of peptic ulcer disease and hypermotility disorders in the GI and lower urinary tracts and works by:

Decreasing the smooth muscle tone and motility

Older adults who take dicyclomine may develop what side effects?

Tachycardia and confusion

What proton pump inhibitors can be administered without regard to food?

Protonix

What medications have chemical structures similar to aspirin and exhibit anti-inflammatory activity in the GI tract?

Mesalamine and sulfasalazine

Interactions with the salicylate sulfasalazine include what?

Increased risk of hemorrhage with warfarin

What oral steroids are used to treat moderate-to-severe forms of inflammatory bowel disease that are poorly controlled with salicylates?

Prednisone and prednisolone

The acid-producing bacterium in culture, Lactobacillus, helps reestablish normal intestinal flora when given orally for sample diarrhea; however, it in contraindicated in patients with:

Prosthetic heart valves

Psyllium, cellulose derivatives, polycarbophil, malt soup extract, and bran are all examples of what type of laxative?

Bulk-forming

What information should the patient receiving a bulk-forming laxative receive from the health care practitioner?

They should be stopped if acute abdominal pain develops

What laxative has an onset of action in 6 to 8 hours?

Mineral oil

What medication is categorized as a saline laxative and should not be used on a long-term basis?

Citrate of magnesia

What medication is categorized as a stimulant laxative with long-term resulting in loss of normal bowel function and/or laxative dependence?

Bixacodyl

What medications are related to the phenothiazines or antihistamines and are ordered to control nausea & vomiting?

Phenergan, Compazine, and Tigan

What drugs are used for prophylaxis of motion sickness?

Dramamine and scopolamine

What medication is an antihistamine and i used for the treatment of vertigo associated with motion sickness?

Meclizine (Antivert)

What medication is a dopamine-receptor antagonist, an antiemetic, and a stimulant of upper GI motility accelerating gastric emptying and intestinal transit?

Metoclopramide (Reglan)

Scopolamine in the form of the transdermal patch Transderm-Scop is ordered by the physician to prevent:

Motion Sickness

Pending the results of a culture and sensitivity (C & S) and the patient\'s history, the physician may order what?

An empiric anti-infection regimen

What is an example of an indirect toxic reaction to an anti-infective?

Inflamed tongue, stomatitis, vaginal yeast infection, and/or diarrhea

The most up-to-date information regarding vaccines, immunizations recommendations and requirements can be obtained by contacting the:

U.S. Centers for Disease Control and Prevention

Aminoglcosides are used to treat what gram-negative bacterial infection?

Escherichia coli

What aminoglycosides are used to combat serious infections?

Gentamycin & amikacin

What anti-infectives might be a component of the initial regimen for treatment of tuberculosis?

Streptomycin

For a patient receiving aminoglycosides serum levels (peak and trough) are drawn. What description of drawing peak and trough serum levels is correct?

Peak level should be drawn 1 hour after the start of the infusion of IM injection; trough level will be drawn 30 minutes before the next dose

An increased risk of nephrotoxicity occurs with cephalosporins when are administered with:

Loop diuretics and aminoglycosides

What antibiotic is used in patients allergic to penicillin and preferred in patients with renal disease, pregnant women, and small infants?

Erthromycin

What antibiotic is considered the drug of choice for treatment of syphilis and for prophylactic use in preventing recurrences of rheumatic fever?

Penicillin

The antibiotic piperarcillin used to treat organisms such as Pseudomonoas and is classified as a

Extended-spectrum semisnthetic penicillin

What anti-infective is effective against protozoa such as Trichomonas vaginalis and against amebiasis and giardiasis?

Metronidazole (Flagyl)

Patients taking antibiotics from what category should be taught to avoid strenuous exercise both during and several weeks after therapy because of the potential side effect of cartilage or tendon damage?

Quinolones

What anti-infective is used predominately in the treatment of herpes simplex, herpes zoster, and varicella zoster infections?

Acyclovir

What antifungal agents is widely prescribed because it is effective against many fungal pathogens without severe toxicity?

Flagyl

What antibiotic structurally unrelated to other available antibiotics is the drug of choice in the treatment of MRSA?

Vancomycin

What antibiotics is the newest agent approved to target both MRSA and is also effective in treating diabetic foot infections?

Linezolid

In high-risk patients, what antiviral agent is used for the prophylaxis and symptomatic treatment of respiratory infections caused by influenza A virus strains, yet has no effect on influenza B or other viruses?

Amantadine

The initial treatment for active tuberculosis includes:

A combination of INH, rifampin, pyrazinamide and either ethambuton or IM streptomycin until culture conversion and 3 months beyond

What vitamin is given with INH to reduce the risk of central nervous system effects and peripheral neuropathy?

Vitamin B6

What dosage is suggested for children taking INH and rifampin?

10mg/kg of INH and 15 mg/kg of rifampin

What medication is used to treat HIV/AIDS infections is classified as a non-nucleoside reverse transcriptase inhibitor (NNRTI)?

Nevirapine (Viramune)

The treatment of HIV infection consists of using highly active antiretroviral therapy (HAART). What is the usual therapeutic regimen for these agents?

Combination of three or more antiretroviral agents is used

The combination sulfonamides (Bactrim, Septra) are currently used alone or in combination for treatment of what clinical situation?

Acute uncomplicated UTIs

Of the following, which is most commonly used for initial or UTIs caused by susceptible organisms?

Nitrofurantoin

What medications are examples of opthalmic antibiotic preparations?

Gentamycin, erythromycin, and polymyxin B

What medications are examples of corticosteroid anti-inflammatory ophthalmic agents used to relieve inflammation of the conjunctiva?

Prednisolone, dexamethasone, fluorometholone

What categories of antiglaucoma drugs lower intraocular pressure by decreasing the formation of aqueous humor?

Carbonic anhydrase inhibitors

What antiglaucoma drugs act to lower intraocular pressure by increasing the aqueous humor outflow?

Miotics

Dipiverfrin, a pro-drug of epnephrine, is included in what category of antiglaucoma drugs?

Sympathomimetics

Latanoprost acts by increasing aqueous outflow and is considered a:

Prostaglandin analog

The effect of what medication is decreased when taken with carbonic anhydrase inhibitors?

Oral antidiabetics

Patients being treated with miotics should be taught to

Close the tear duct after instillation to avoid systemic absorption

Timolol (Timoptic) acts by decreasing the rate of aqueous humor production and is in what category of ophthalmic medications?

Beta-adrenergic blocker

When teaching a patients about administering more than one ophthalmic medication, the health care practitioner should emphasize allowing how much time between doses?

At least 5 minutes

When a topical ophthalmic beta-blocker is contraindicated, what alternative topical medication is often prescribed?

Brimonidine, a selective alpha agonist

The mydriatic atropine is the drug of choice for children during:

Detailed eye exams

What assessments should the health care practitioner make before administering an analgesic?

Is the patient in pain and need medicating?

What describes subjective pain?

\"My arm hurts when I left something heavy\"

What is a synthetic opioid?

Demerol

What preparations is a centrally acting synthetic analog of codene?

Tramadol (Ultram)

What medication is an opioid antagonist used in the treatment of opioid overdoses and in the delivery room and newborn nursery for opiate-induced respiratory depression?

Naloxone

What medication is a nonopioid analgesic and anti-inflammatory?

Acetylsalcyclic acid

For a more effective analgesic action, what drugs are most frequently combined with opioids or other drugs?

Aspirin and acetaminophen

High doses or prolonged usage of salicylates or NSAIDS may be discontinued for a period prior to surgery because of what side effects?

Prolonged bleeding time

health care practitioners should teach patients taking NSAIDs or salicylates that to minimize GI symptoms, the medications should be taken can be minimized administering:

With food or milk

NSAIDs and/or salicylates are contraindicated in any patient with which vitamin deficiency?

Vitamin D

What is the effect of administering an anticoagulant to a patient who is taking salicylates?

The action of the anticoagulant is potentiated

What of these is one of the most common side effects of salicylates, especially with prolonged use?

Tinnitus

Hypersensitivity or overdosage of salicylates, especially in children, may result in which of these conditions?

Coma and respiratory failure

While side effects of acetaminophen are rare, with high doses taken too frequently or with an overdose there is a risk of:

Severe liver toxicity

What statement about Tramadol (Ultram) is true?

It is not classified as a controlled substance

What medication is classified as adjuvant analgesics, enhancing analgesic effect with opioids and nonopioids, producing analgesia alone, or reducing the side effects of analgesics?

Amitriptyline and gabapentin

What adjuvant medication is the drug of choice for trigeminal neuralgia?

Carbamazepine (Tegretol)

What adjuvant medication is the drug of choice for post-herpetic neuralgia?

Gabapentin (Neurontin)

What statement about the treatment of migraine headaches is true?

Serotonin receptor agonists such as Imitrex are effective in the acute treatment of migraines

Hypnotic dosage should be gradually reduce because abrupt withdrawal of hypnotics, even after short-term therapy, may result in:

Rebound insomnia

Temazepam (Restoril) and triazolam (Halcion) are used for short term only and are categorized as:

Benzodiazepines

Eletriptian (Replax) and rizatriptan (Maxalt) are agents from what category?

Antimigraine

What statement about tricyclic antidepressants is true?

They are more effects than SSRIs in some severe depression

MAO inhibitors are typically reserved for use in treating in patients with

...

Selective serotonin reuptake inhibitors (SSRIs) selectively block the reabsorption of the neurotransmitter serotonin, and are considered to be the:

First-line drugs for treatment of depression because of fewer side effects and greater safety in cases of overdose and increased patient compliance

Symptomatic relief of depression for patients being treated with SSRIs occur approx how long after beginning treatment?

1 to 4 weeks

One advantage of treatment with SSRIs over other antidepressants is that the:

do not have a significant effect on cognition in older adults

Heterocyclic antidepressants such as Buproprion (Wellbutrin) are comparable in efficacy to first-generation tricyclics and are considered to be:

An activating antidepressant which can be useful in cases of severe depression

One advantage of treatment with heterocyclic antidepressants over other antidepressants is that they:

are less likely to affect sexual function

What medication is an antimanic agents used to treat bipolar disorders are requires monitoring of serum levels monitored long term to prevent toxicity?

Lithium

Medications in what category are used for short-term treatment of anxiety disorders, some psychosomatic disorders, insomnia, N/V, and neurosis while making the patient amenable to psychotherapy?

Anxiolytics

What medications are classified as benzodiazepines?

Xanax, Ativan, Librium, and Tranxene

Compounds with a long half-life, such a diazepam (Valium), should be avoided in what patients because of the accumulation of the medication?

Older adults and those with liver disease

Patients taking what heterocyclic antidepressants may develop weight gain as a SE of treatment?

Mirazapine or trazodone

The health care practitioner explains to the PT scheduled for an endoscopy that what medications will be used to relieve anxiety and provide sedation, light anesthesia, and amnesia during the procedure?

Midazolam (Versed)

Antipsychoctic medications are useful for treatment of

n/v

What class of antipsychotics differs from typical antispychotics by blocking both serotonin and dopamine receptors and has less potential adverse affects?

Atypical anyipsychotics

Treatment of chronic alcoholism in an intensive in-house rehabilitation program includes:

Administration of thiamine, multiple vitamins & folic acid

One treatment for alcoholism and/or opiate abuse includes the daily use of maintenance doses of naltrexone with is ordered. The health care practitioner understand that this treatment is ordered

To keep alcoholics sober after detoxification by robbing the alcohol or drugs ingested of the pleasurable effects

The street names \"Crystal,\" \"Crank,\" \"Meth,\" \"Speed\" are examples of:

Methamphetamines*

What action is correct for the health care practitioner to take if substance abuse is suspected in the workplace?

Report to the person in authority

Acute painful musculoskeletal conditions of the back or neck are initially treatment with:

Muscle relaxants, rest, hot and cold packs, and mild analgesics

A muscle relaxant used for spasticity resulting from upper neuron disoders such as occurs with MS or cerebral palsy is called

Dantrolene (Dantrium)

What neuromuscular blocking agents provides muscle relaxation during surgical, endoscopic, or orthopedic procedures and is administered only by anesthesiologists or specially trained personnel skilled in intubation and cardiopulmonary resuscitation?

Succinylcholine

What medication is an antidote for the neuromuscular blocking agents?

Neostigmine (Prostigmin)

Muscle relaxants must be used with caution in patients with a history of:

Drug abuse or liver disorders

What anti-inflammatory dugs are used to treat arthritis, bursitis, spondylitis, gout, and muscle strains and sprains?

Naproxen (Naprosyn) and indomethacin (Indocin)

What substances are responsible for the production of inflammation and pain of rheumatic conditions, sprains, and menstrual cramps?

Prostaglandins

Pts needing prolonged anti-inflammatory therapy after experiencing GI ulceration and bleeding can be switched to a partially selective NSAID such as:

Meloxicam

Pts who have experienced GI ulceration and bleeding by still required prolonged anti-inflammatory therapy can also be switched to a COX-2 inhibitor such as:

Celebrex

Both traditional NSAIDS and COX-2s can increase the risk of adverse events in patients who are at risk for what conditions?

Cardiovascular disease

The HCP will assess pts taking what medications for prolonged bleeding time, blood dyscrasias, and epigastric pain?

NSAIDs

The HCP explains to the patient who has just been diagnosed with gout that it is a metabolic manifested by swelling and pain due to accumulation of uric acid crystals in joints, especially the:

Big toe, ankle, knee, and elbow

The HCP teaches patients taking NSAIDs to discontinue the drug and report the physican is what occurs?

Epigastric pain or nausea

Pts taking biphosphonates such as Foxamax or Actonel should be instructed to take medication with a full glass of water:

In the morning at least 30 minutes prior to eating food, drinking a beverage, or taking another medication

Treatment for absence epilepsy includes what anticonvulsants?

Valproic acid (Depakene), clonazepam (Klonopin), and ethosuximide (Zarontin)

Absence seizures typically occur in what group?

Children

Less than half of epileptic seizures have an identifiable cause, such as

cerebral trauma

What symptoms are observed in pts who have temporal lobe seizures?

Confusion and impaired judgement

What medications are used for prophylactic treatment of generalized and partial seizures?

Phenytoin (Dilantin), frequently combined with phenobarbital or valproic acid

Stevens-Johnson sndrome is a SE of what anticonvulsant?

Phenytoin (Dilantin)

For febrile seizures in children, what is the current treatment recommended by the American Academy of Pediatrics?

Rectal diazepam gel for seizures lasting more than 5 mintes

What is a major advantage of second-generation anticonvulsants?

Drug level monitoring of therapeutic levels is usually not required

Second-generation anticonvulsants indicated for adjuvant treatment of partial and generalized seizures include:

Neurontin and Lamictal

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