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198 terms

Pharm Final

STUDY
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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
What instructions should be given to patients taking anticonvulsant medications?
Wear a Medic-Alert tag or bracelet at all times in case of accident or injury
When Sinemet is prescribed for patients who have Parkinson\'s disease, the HCP should observe them for what SEs?
Dyskinesias, behavior changes, and psychosis
Parkinson-like tremors associated with long-term use of antipsycholtics are treated with synthetic atropine-like drugs such as:
Benztropine (Cogentin)
What antiparkinsonian drugs are dopamine agonists used in conjunction with levodopa to delay the onset of levodopa-caused motor complications?
Bromocriptine (Parlodel)
The HCP explains to patients taking cholinesterase inhibitors such as donepezil (Aricept) that what SE may occur?
GI upset, nausea, vomiting, and anorexia
What medications is the first N-methyl-D-aspartate (NMDA) antagonist approved for the treatment of moderate-to-severe dementia of the Alzheimer\'s type?
Memantine (Namenda)
Restless legs syndrom (RSL) can be primary, involving the CNS, or secondary, related to other causes such as
iron deficiency
The hormones that act on the immune system to suppress the body\'s response to infection or trauma and relieve inflammation are called:
Corticosteroids
When pts are on corticosteroids for extended duration, serious side effects may occur, such as:
Osteoporosis with fractures, especially in older women
Corticosteroids are contraindicated in what pts?
A 30-year=old with nonlife-threatening bacterial infection
When corticosteroids are administered to a pt who has diabetes, the HCP would expect the blood glucose level to:
Increase to a state of hyperglycemia
What medications increase the effects of corticosteroids?
Estrogens and oral contraceptives
What toxic side effects would the HCP observe in a pt who is taking a thyroid agent for treatment of hypothyroidism?
Hypertension, tachycardia, and nervousness
What antithyroid agents are used to relieve the symptoms of hyperthyroidism in preparation for surgical or radioactive iodine therapy?
Tapazole and propylthiouracil
Prior to administrating insulin, theHCP should always have someone else check:
The dosage ordered with the insulin drawn up in the syringe in order to prevent a medication error
What insulin preparation should not be mixed with any of the other available types of insulin?
Glargine (Lantus)
What insulin has an onset of action within 15 minutes?
Humalog
What insulin has no pronounced peak of action?
Glargine (Lantus)
When teaching the pt and family about insulin, the HCP will advise that open vials of insulin may be stored at room temp without loss for potency for:
28 days
What insulins have peak action of 30 minutes to 1 hour and last for approx 3 hours?
Humalog and Novolog
The HCP should teach the pt with diabetes and the pt\'s family that hyperglycemia may result from:
Infections or emotional stress
Symptoms of hyperglycemia include:
Dehydration & excessive thirst
The HCP should teach the pt and family that hypoglycemia may result from:
Overdose of insulin and insufficient food intake
Symptoms of hypoglycemia include:
Irritability, confusion, or bizarre behavior
What medications antagonize the action of insulin, necessitating increased insulin dosage?
Corticosteroids
What medications interact with insulin to potentiate hypoglycemia effects?
Salicylates and alcohol
Appropriate treatment of a conscious patient with hypoglycemia includes:
10-30 mL of 50% dextrose solution IV or administration
If the physician orders metformin (Glucophage) for a pt who has Type 2 diabetes, the pt should be taught that this medication falls into what category or oral antidiabetic agents?
Alpha-glucosidase inhibitors
Metformin (Glucophage) works by:
Delaying digestion of carbohydrates and subsequent absorption of glucose
If a pt is taking metformin (Glucophage) is scheduled for a special diagnostic procedure requiring contrast media, the hcp should instruct the pt to hold this medication the day of the procedure and for how long following completion of the procedure?
24 hours
Repaglinide (Prandin), which stimulates beta cells of the pancreas to produce insulin and can be used as monotherapy or in combination with metformin, is categorized as a
Sulfonylurea
The patient taking repaglinide (Prandin) shoudl be instructed to take the medication:
Before meals to maximize the absorption
What medication can be ordered to lower blood glucose in a pt who has insulin resistant Type 2 diabetes by decreasing insulin resistance and improving sensitivity to insulin in muscle and adipose tissue?
Actos or Avandia
When teaching pts who are learning to self-administer insulin, it is important for pts to understand what info about injection sites is true?
Exercise will increase absorption, especially when insulin is injected in the arm or thigh
What insulin is to be drawn into the syringe first if regular insulin is to be mixed with NPH?
Draw up the regular first
What factors could affect the blood glucose level sufficiently to decrease the amount of insulin a patient is required to takes?
Increased regular exercise
What statement about estrogen therapy is true?
Combined estrogen/progestin therapy should not be used for prevention of cardiovascular disease
What hormone secreted by the posterior pituitary lobe stimulates the uterus to contact for childbirth then acts on the mammary gland to stimulate the release of milk?
Oxytocin
what medication is used for prevention and treatment of postpartum and postabortion hemorrhage?
Methylergonovine
What medication is used for severe pre-eclampsia or eclampsia to control or prevent seizures by depressing the CNS and blocking neuromuscular transmission?
Magnesium sulfate
Administration of what medications requires constant maternal and fetal monitoring to prevent dangerous side effects such as uterine rupture or fetal trauma?
Oxytocin
What medication is contraindicated in a pt with congestive heart failure?
Procainamide
What type of antihypertensive drug is a good choice for patients who have nephropathy, heart failure, diabetes, and cerebrovascular disease?
Angiotensin-converting enzyme inhibitors
what SE of immediate release preparations of nictonic acid (niacin) can be troublesome for the patient?
Skin flushing, itching, & irritation
Albuterol, epinephrine, and salmeterol are all rapid-acting bronchodilators of what classification?
Sympathomimetics
Theophylline is an example of what type of bronchodilator?
Xanthines
Acetylcysteine (Mucomyst) liquefies pulmonary secretions and is classified as what type of respiratory medication?
Mucolytic
Anticholinergic SEs of first-generation antihistamines include:
Drying of the eyes and hypotension in the older adult
The health care practitioner should instruct patients with respiratory conditions taking respiratory system drugs to:
Avoid combining prescribed medications with other prescription or over-the-counter drugs or alcohol