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Pharm Final Exam
Terms in this set (61)
Adverse effect of Testosterone:
DIZZINESS, headache, confusion
Antispasmodics: Oxybutynin: Adverse effects:
VISION CHANGES, dry mouth, urinary retention
What causes muscle spasms?
overstretching a muscle, wrenching a joint, or tearing a tendon or ligament
Centrally Acting Skeletal Muscle Relaxants: Baclofen (Lioresal): What's it used for?
used to treat muscle symptoms caused by multiple sclerosis, including spasm, pain, and stiffness
Centrally Acting Skeletal Muscle Relaxants: Baclofen (Lioresal): Adverse effects?
depression of the CNS, drowsiness, dizziness, headache, weakness, nausea, change in LOC, hypotension, and urinary frequency
Centrally Acting Skeletal Muscle Relaxants: Baclofen (Lioresal): How can it be administered?
can be administered via an intrathecal delivery pump to treat central spasticity
What's an example of a neuromuscular abnormality?
What causes muscle spasticity?
it results from damage to neurons within the CNS rather than injury to peripheral structures; it is a permanent condition (as with cerebral palsy)
What does muscle spasticity result in?
often results in hypertonia: excessive stimulation of muscles in opposing muscle groups at the same time
What does muscle spasticity lead to?
leads to loss of coordinated muscle activity
Direct-Acting Skeletal Muscle Relaxants: Dantrolene (Dantrium):
muscle relaxant that acts directly within the skeletal muscle fiber and not with the CNS; used to treat muscle spasticity (stiffness and spasms) caused by conditions such as a spinal cord injury, stroke, cerebral palsy, or multiple sclerosis; also used to prevent muscle stiffness and spams caused by malignant hyperthermia
Direct-Acting Skeletal Muscle Relaxants: Dantrolene (Dantrium): Adverse effect?
What do Narcotic-Agonist-Antagonist do?
relieve moderate to severe pain, relieve pain during labor and delivery, and adjuncts to general anesthesia
Who often obtains tolerance to opioids?
tolerance often occurs especially for patients with chronic pain
Why does tolerance to opioids occur?
tolerance occurs as a result of the body adapting to the opioid and requires more drug for the desired effect
Narcotic Agonist: Morphine: GI adverse effect?
Narcotic Agonist: Morphine: GU adverse effect?
How do you reduce potential effects of opioids?
1. increase fiber in diet and oral fluids
2. administering a stimulant laxative (ex. Senna or Senokot)
3. Monitor patient for physiologic withdrawal once opioid is discontinued
4. Administer Narcan for opioid overdose
Narcotic Antagonist: Naloxone (Narcan): What's it used for?
used to treat a narcotic overdose in an emergency situation
Narcotic Antagonist: Naloxone (Narcan): Effects?
prior to respiratory depression, patient may experience drowsiness and sedation; respirations may be less than 8 bpm
What do you always need to do for patients on narcotic analgesics?
provide safety measures (i.e. side rails up, bed low and locked)
Information about patient controlled analgesic pumps:
patients receiving meds via patient control analgesic devices will have preset dosages programmed into the device. They will be able to self medicate by pressing the hand-held button, usually every 10 minutes (the order will specify), but will not be able to administer addition medication before the lock out time is over
What do you have to do for post-op patients on narcotics?
a pain assessment tool may be used before and 30 minutes following the administration of narcotic analgesics to evaluate response to the medication
What do you need to monitor patients receiving narcotic antagonists for?
monitor for narcotic abstinence syndrome: tachycardia, hypertension, and vomiting
Antispasmodics: Oxybutynin: Adverse effects?
Alpha-Adrenergic Blockers (BPH): Tamsulosin (Flomax): What does it do/used for?
dilates arteries and veins and relaxes the muscles in the prostate and bladder neck, making it easier to urinate; used to improve urination in men with benign prostatic hyperplasia (enlarged prostate)
Testosterone Blocking Agent (BPH): Finasteride (Proscar): What does it do?
shrinks the prostate gland by blocking testosterone
Testosterone Blocking Agent (BPH): Finasteride (Proscar): Adverse effects?
impotence, decreased libido, and increased hair growth
Testosterone Blocking Agent (BPH): Finasteride (Proscar): Who shouldn't handle this medication?
pregnant women should not handle this medication
Woman should ovoid the use of _________ if they have a history of DVTs.
What do you need to have a patient do before giving them oral contraceptives?
patient should be able to verbalize how and when to take this medication even if a pill is missed
Women taking estrogen products could have what?
could have drug-drug-food interactions with smoking, antibiotics, and steroids
Women who receive estrogen replacement therapy should what?
they should report a weekly weight gain of 5 or more lbs
Treatment for Penile Erectile Dysfunction: Sildenafil (Viagra): When should this be taken?
1 hour before attempting intercourse
Treatment for Penile Erectile Dysfunction: Sildenafil (Viagra): Information
1. this drug has potential adverse effects associated with alpha-adrenergic blockers and nitroglycerine
2. organic nitrates may have deadly drug interaction with Viagra; they also may cause an extremely low BP
Antineoplastic Agents: what do they do?
destroy normal cells that are rapidly turning over
Antineoplastic Agents: what's the most common dose?
myelosuppression is the most common dose - limiting adverse effect of antineoplastic therapy
Combination Neoplastic Drugs: targets and decreases what?
-targets different phases of the cell cycle
-decreases the development of cell resistance
-decreases the side effects of each medication
Infection Prevention measures for antineoplastic agents:
-monitor patients with severe bone marrow suppression for fever, sore throat, and cough
-avoid contact with people who recently had a vaccination
-practice good hand washing
Mitotic Inhibitors Antineoplastic Agents: what do they do?
mitotic inhibitors - drugs that kill cells as the process of mitosis begins
Mitotic Inhibitors Antineoplastic Agents: Nurse precautions:
avoid skin, eye, or mucous membrane contact with these drugs
category of cancer treatment that uses one or more anti-cancer drugs (chemotheurapeutic agents) as part of a standardized chemotherapy regimen
Why is chemotherapy given?
chemotherapy may be given with a curative intent (which almost always involves combination of drugs) or it may aim to prolong life or to reduce symptoms (palliative chemotherapy)
What will using multiple chemo drugs do?
using multiple chemo drugs may affect different stages of the cancer cells life cycle
When is chemotherapy most effective?
most effective in a tumor that is detected early
True or false: When using chemotherapy you want to avoid becoming pregnant.
What should you monitor on a patient receiving chemotherapy?
monitor WBC, hemoglobin, and platelets
For a patient on chemotherapy, you want to promote what?
encourage fluids and promote hydration (reduces risk of hemorrhagic cystitis)
What should you take 30-60 minutes before chemotherapy?
taken an antiemetic 30-60 minutes before chemo treatment
What should you inform a chemotherapy patient about?
inform patient about expected hair loss (alopecia) and refer for a wig
What should you teach the chemo patient about?
teach to report signs and symptoms such as excessive bruising or bleeding or sore throat and fever
Chemotherapy patients may experience what?
patient may experience mucositis, teach to eat a bland diet and brush teeth with a soft toothbrush
leakage of certain drugs called vesicants out of a vein into the tissue around it. Vesicants cause blistering and other tissue injury that may be severe and can lead to tissue necrosis (tissue death)
Vesicants: Nursing Care:
-PRIORITY: monitor IV site for signs of infiltration: redness, swelling, and c/o pain
-monitor the access for patency and adequate blood return
-become familiar with infiltration antidote and protocol
Tamoxifen: What's it used for?
blocks the action of estrogen, a female hormone. Certain types of breast cancer require estrogen to grow
Tamoxifen: Adverse effects?
cerebral vascular accident (CVA)
Tamoxifen: Patient education?
patient should understand that antiestrogen antineoplastic therapy deprives the tumor of the growth-promoting influence of estrogen
Leucovorin: What does it do?
rescue drug that is used to enhance the immune system
Leucovorin: May be used..?
may be used in combination with high doses of methotrexate and in patients experiencing severe bone marrow suppression
Allopurinol: What's it used for?
-used to treat elevated uric acid associated with tumor lysis; reduces the production of uric acid in your body. Uric acid buildup can lead to gout or kidney stones
-Allopurinol is used to treat gout or kidney stones and to decrease levels of uric acid in people who are receiving cancer treatment
Allopurinol: Adverse effects?
ankle, knee, or great toe joint pain; joint stiffness or swelling; rash; rash with flat lesions or small raised lesions on the skin
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