Term
| What symptoms does diphenhydramine (Benadryl) relieve? |
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Definition
| rhinitis caused by common cold, decrease nasal itching and tickling that causes sneezing |
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Term
| What is Diphenhydramine (Benadryl)? |
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Definition
| a first generation antihistamine commonly combined w/ other ingredients in cold remedies |
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Term
| Side effects of Diphenhydramine (Benadryl) |
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Definition
| Drowsiness, dry mouth, decreased secretions |
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Term
| Side effects of cetirizine (Zyrtec) and loratadine (Claritin)? |
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Definition
| 2nd generation antihistamines like these have little or no effect on sedation |
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Term
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Definition
| Nasal decongestant stimulates alpha-adrenergic receptors (sympathetic receptors) producing constriction of nasal blood vessels shrinking nasal tissues and decreasing fluid secretion; relieving the congestion and rhinorrhea [PREFERRED IN PTS. WITH HYPERTENSION AND CORONARY ARTERY DISEASE DOESN'T PRODUCE SYTEMIC EFFECTS] |
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Term
| pseudoephedrine (Sudafed) |
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Definition
| systemic decongestant (alpha adrenergic agonists) used primarily for allergic rhinitis; relieve nasal congestion for longer periodS; SIDE EFFECTS: Jittery, nervous, restless, may decrease the effect of beta blockers, if taken w/ MAOI's can increase the possibility of hypertension or cardiac dysrhythmias, caffeine in large amounts can increase restlessness, and palpitations; Stimulate alpha 1 receptors, blood pressure can increase due to systemic vasocontriction |
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Term
| beclomethasone (Beconase) |
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Definition
| intranasal glucocorticoids or steroids treats allergic rhinitis by reducing inflammation. Symptoms of rhinorrhea, sneezing, and congestion are relieved with these agents usually by the third day |
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Term
| dextramethasone (Decadron) |
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Definition
| more likely to cause systemic effects; intranasal glucocorticoids or steroid reduces inflammation relieving symptoms of rhinorrhea, sneezing, and congestion Should not be used for longer than 30 days to minimize the development of adrenal suppression, should be used for short courses of therapy for acute seasonal allergies |
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Term
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Definition
| – opioid antitussive minimal potential for dependence Schedule III, IV, or V reserved for more serious cough conditions, can cause drowsiness, dizziness, nausea, constipation, and respiratory depression |
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Term
| dextromethorphan (Benylin DM) |
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Definition
| most frequently used nonopiod antitussive; works on cough center in the brain like the opioids a=but do not cause respiratory depression |
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Term
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Definition
| another nonopioid antitussive works by a different mechanism. Suppresses the cough reflex by anesthetizing the stretch receptors in the lungs therefore, it is also does not cause respiratory depression If chewed can numb the mouth and pharynx this could affect swallowing |
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Term
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Definition
| most effective over-the-counter expectorant; most effective in treating dry, nonproductive coughs, but may also be useful for productive coughs to help expectorate the mucous |
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Term
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Definition
| may be indicated for the accompanying headache with sinusitis or to lower temperature and provide pain relief with acute pharyngitis |
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Term
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Definition
| selective beta-2 agonist short-acting inhaled drug or long-acting oral preparation; activate beta-2 receptors in the lungs relaxing the smooth muscles of the bronchi causing bronchodilator; Adverse effects can occur in high doses: may cause some degree of beta-1 response w/ nervousness, tremor and increased heart rate (more likely w/ oral preparations), may increase blood glucose [pts. w/ diabetes mellitus should be monitored carefully for hyperglycemia], tolerance may build to bronchodilating effect dose may need to be increased |
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Term
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Definition
| anticholinergic; blocks cholinergic receptors in the lungs, causing bronchodilation |
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Term
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Definition
| methylxathines a bronchodilator used to treat COPD; stimulate CNS including respiratory stimulation, bronchodilation cardiac stimulation vasodilation and diuresis; |
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Term
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Definition
| inhaled glucocorticoids; anti-inflammatory, reduces mucous production, edema and airway obstruction. Most common adverse effects are oropharyngeal fungal infections and dysphonia (hoarsness and difficulty speaking) pts. Should rinse their mouth and throat with water after each dose |
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Term
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Definition
| oral glucocorticoid; reserved for patients with severe asthma when symptoms cannot be controlled by other drugs occurrence of adverse effects increases the longer oral glucocorticoids are used so treatment should be as brief as possible |
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Term
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Definition
| a leukotriene modifier that blocks activation of leukotrienes that cause inflammation in the lungs, bronchoconstriction, mucous production, and airway edema. Used to prevent asthmatic attacks, not for quick relief of an attack |
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Term
| acetylcysteine (Mucomyst) |
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Definition
| mucolytic agent reduces stickiness and viscosity of pulmonary secretions by action directly on the mucous plugs; this drug should not be mixed with other drugs |
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Term
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Definition
| 2nd generation antihistamines has fewer side effects than 1st generation antihistamines |
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Term
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Definition
| during pregnancy the amount of iron needed to meet fetal and maternal daily requirements is about double that of a non-pregnant woman, especially during the third trimester. (ferrous sulfate, ferrous gluconate) generally not needed until the second trimester. Patient should increase fluid and fiber intake and exercise to minimize constipation. Best absorbed on an empty stomach when administered with water or juice. Some foods and medications should not be taken at the same time as iron because they decrease its absorption: dairy products, eggs, spinach, high-fiber foods, coffee, tea, antacids, and calcium supplements |
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Term
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Definition
| adequate intake of folic acid should begin before pregnancy deficiency can result in spontaneous abortion or birth defects, especially neural tube defects. Side effects are rare but may include allergic bronchospasm, rash, pruritus, erythema, and general malaise. May cause urine to turn more intensely yellow |
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Term
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Definition
| Histamine 2 receptor antagonists (H2 blockers) can be used during regnancy but only if treatment with antacids has failed and their use is recommended by a health care provider. |
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Term
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Definition
| bulk-forming laxative; this is safe during pregnancy because they are not absorbed systemically |
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Term
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Definition
| Beta-2 adrenergic agonsits suppress uterine contractions; commonly used for asthma due to its bronchodilating properties but can be used to delay preterm labor; Major adverse effects for the mother include pulmonary edema, tachycardia, and hyperglycemia. Fetal adverse effects include tachycardia and hypoglycemia (caused by increased fetal insulin due to maternal hyperglycemia) |
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Term
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Definition
| relaxes the smooth muscle of the uterus through calcium displacement; magnesium toxicity can occur with depression of deep tendon reflexes and a decrease in urinary output, respiratory rate, and blood pressure. Health care providers houl be notified and infusion discontinued if deep tendon reflexes are lost, urinary output is less than 25-30 ml per hour or respiratory rate is less than 12 breaths per minute |
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Term
| betamethasone (Celestone) |
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Definition
| given when preterm labor occurs before 33rd week of gestation; given to mother to mature the lungs of the fetus while in utero |
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Term
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Definition
| reduces anxiety but potentiate the analgesic effects of the opioids and reduces nausea and vomiting |
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Term
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Definition
| most widely used agent for promoting cervical ripening prior to induction of labor; prostaglandin (E2), after promoting cervical ripening it stimulates uterine contractions |
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Term
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Definition
| controls postpartum hemorrhage; a prostaglandin that causes intense uterine contractions and vasoconstriction |
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Term
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Definition
| treats infants after delivery to prevent respiratory distress syndrome by reducing the surface tension in the lungs and keeps the alveoli open during expiration; the newborn must have a patent endotracheal (ET) tube and be positioned precisely after administration to allow the drug to be distributed properly; Adverse effects: reflux of drug up the ET tube with resultant decrease in oxygenation (suctioning before dosing decreases the chance of reflux, but suctioning after dosing is not recommended unless obvious airway obstruction |
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Term
| Human D Immunoglobulin (Rho-GAM) |
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Definition
| prevents the production of D antibodies when Rh negative mother is potentially exposed to Rh positive fetus |
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Term
| Vitamin K (Aqua-Mephyton) |
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Definition
| one of two drugs given to newborns within one hour of birth to prevent hemorrhage |
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Term
| depot medroxyprogesterone (Depo-Provera) |
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Definition
| progestin product; thickens cervical mucous, thinning the endometrial lining, decreasing motility in the fallopian tubes and preventing ovulation. May cause loss of bone mineral density, loss is minimal, reversible and does not lead to postmenopausal osteoporosis |
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Term
| oral conjugated equine estrogens (Premarin) |
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Definition
| menopausal hormone replacement therapy; estrogen product; relieves symptoms of menopause in women without a uterus |
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Term
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Definition
| bisphosphonates reduces the breakdown of bones and can be used to treat osteopenia (reduced bone density) and osteoporosis (severe loss of bone density) Taken in the morning before breakfast with no food, liquids, or medications within 30 minutes. A full 8 ounces of water should be taken with alendronate and the patient should remain upright for 30 minutes after taking the medication |
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Term
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Definition
| androgens, male sex hormones, causes changes in that take place over several years- accelerated growth, enlarging penis, deepening voice and secondary sexual characteristics; does not restore fertility |
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Term
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Definition
| alpha 1 blocker; blocks alpha receptors in the prostate and the blood vessels. Causes vasodilation and a decrease in blood pressure useful for patients with BPH (benign prostatic hyperplasia) |
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Term
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Definition
| works by increasing blood flow to the penis; phosphodiesterase inhibitors; should not be used with other vasodilating drugs because severe hypotension can result. Men who take alpha adrenergic blockers and nitrates (nitroglycerin) should not take sildenafil. Side effects include priapism (prolonged erection), sudden hearing loss, blurred vision or loss of vision |
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Term
| What instructions should the nurse give to a patient with acute viral pharyngitis? |
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Definition
| Saline gargles and throat lozenges help with the throat discomfort and fluids keep secretions thin. Acetaminophen (Tylenol) may be taken to decrease the temperature and provide pain relief. |
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Term
| What are the three manifestations that present in all three types of COPD? |
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Definition
| Dyspnea (difficulty breathing), bronchoconstriction, and mucous secretion |
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Term
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Definition
| chronic inflammatory disease of the airways w/ intermittent periods of acute reversible airflow obstruction; bronchoconstriction, lining becomes inflamed, mucous secreted into airways. Causes: allergens, stress, pollutants, cold air, exercise, or tobacco smoke. S/S: sense of breathlessness and tightness in the chest, w/ wheezing, dyspnea,and cough |
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Term
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Definition
| progressive lung disease; bronchial inflammation and excessive mucous secretion result in airway obstruction. Caused by smoking or chronic lung infections. S/S: productive coughing occurs in response to excess mucous and chronic irritation |
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Term
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Definition
| progressive lung disease; alveoli enlarge and many of the alveolar walls are destroyed. Causes: smoking, pollutants, or lack of alpha 1-antitrypsin protein. Results in inadequate gas exchange. |
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Term
| inhalation device that requires hand-lung coordination |
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Definition
| Metered-dose inhaler (MDI) without spacer, small hand-held pressurized devices that deliver a measured dose when the canister is depressed: usually 1-2 puffs w/ at least a minute in between |
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Term
| What happens to the theophylline level when a patient stops smoking? |
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Definition
| Cigarette smoking (one to two packs a day) increases theophylline metabolism (decreasing levels), decreasing its half-life by 50%, possibly requiring a higher dose to be effective. If the same patient stopped smoking the dose would need to be adjusted to avoid toxicity. |
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Term
| What adverse side effects can occur when theophylline level is: |
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Definition
5-15 mcg/ml - appropriate for most pts.
<20 mcg/ml - adverse effects are Uncommon
>20 mcg/ml - Toxicity is most likely to Occur
20-25 mcg/ml -mild reactions: nausea, vomiting, diarrhea, insomnia, restlessness
>30 mcg/ml - severe dysrhythmias and seizures that are resistant to treatment may occur |
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Term
| What adverse effects can occur with oral glucocorticoids such as prednisone? |
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Definition
| With oral glucocorticoids, adrenal suppression can be profound; when used acutely for less than 10 days, even at high doses, adverse effects usually do not occur. Prolonged therapy, even at moderate doses can cause adrenal suppression, osteoporosis, hyperglycemia, peptic ulcer disease, and growth suppression in children |
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Term
| Which drugs are effective in relieving an acute asthmatic attack? |
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Definition
| Beta-2 adrenergic agonists are used for quick relief as needed for an ongoing attack and also to help control bronchospasm, for instance can be taken before exercise to prevent EIB |
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Term
| Which leukotriene modifier can be used to prevent asthmatic attacks in a patient with liver disease? |
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Definition
| Zileuton and zarfirlukast may cause liver injury by inhibiting liver enzymes, but Montelukast is not associated with liver injury. |
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Term
| What drug interactions can occur with zileuton (Zyflo) and zafirlukast (Accolate)? |
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Definition
| Because Zileuton and zafirlukast inhibit liver enzymes they could cause levels of theophylline and warfarin to increase. |
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Term
| Which drug can be given to prevent liver injury in an acetaminophen (Tylenol) overdose? |
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Definition
| Acetylcysteine (Mucomyst) can be used as an antidote for acetaminophen overdose if given within 12-24 hours after ingestion. For overdose give orally, mixed with juice or soft drinks |
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Term
| What are nonpharmacologic measures to decrease nausea and vomiting? |
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Definition
| Nonpharmacologic measures to decrease nausea and vomiting include: eating crackers or dry toast before rising, avoiding fatty of highly seasoned foods, eating small frequent meals, drinking fluids between meals instead of with meals, drinking apple juice or flat carbonated beverages, eating a high-protein bedtime snack, stopping smoking, and taking iron supplements at bedtime |
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Term
| What drugs can be used to reduce acid secretion in a patient experiencing heartburn during pregnancy? |
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Definition
| Antacids may be used to treat heartburn if nonpharmacologic measures are inadequate. They should be low sodium to avoid water retention. Aluminum and magnesium antacids may be used in combination to avoid diarrhea or constipation. However antacids containing magnesium should not be used long term or in large doses because fetal renal, respiratory, cardiovascular and muscle problems may result. Calcium based contribute to constipation antacids neutralize acid, H2 blockers reduce acid secretion |
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Term
| Which analgesics can be taken during the first and second trimesters of pregnancy? |
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Definition
| Acetaminophen (Tylenol) can be used during all three trimesters and is a category B drug; its use should be short term and dosage should not exceed 3000 mg in a 24 hour period. Aspirin is a pregnancy category C drug in the 1st and 2nd trimester and category D in the 3rd trimester; can cause hemorrhage and bleeding in the newborn should not be used in the last 2 months of pregnancy. Ibuprofen (Motrin) is a pregnancy category C except in the last trimester when it is a category D; it can increase bleeding risks but its effect on platelets is less than aspirin’s effect on platelets. |
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Term
| What adverse effects can occur with terbutaline (Brethine) when given IV to stop premature labor? |
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Definition
Beta 2 adrenergic agonists suppress uterine contractions. Terbutalin (Brethine) is primarily used for asthma due to its bronchodilating properties; however it can be used to delay preterm labor, although it is not approved by the FDA for this use.
Given IV or SubQ for up to 48 hours in preterm labor; major adverse effects for the mother include pulmonary edema, tachycardia, and hyperglycemia. Fetal adverse effects include tachycardia and hypoglycemia (caused by increased fetal insulin due to maternal hyperglycemia) |
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Term
| Which assessment findings indicate magnesium toxicity? |
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Definition
Magnesium toxicity can occur with depression of deep tendon reflexes and decrease in urinary output, respiratory rate, and blood pressure. Frequent monitoring of these parameters is necessary. Adverse effects on the newborn include respiratory depression, diminished reflexes, and lethargy for 24 to 48 hours.
Health care provider should be notified and infusion discontinued if deep tendon reflexes are lost, urinary output is less than 25-30 ml per hour, or respiratory rate is less than 12 breaths per minute. |
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Term
| Three main signs of preeclampsia |
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Definition
| Hypertension w/ proteinuria, and edema |
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Term
| Why is magnesium sulfate given to a pregnant patient who is preeclamptic? |
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Definition
| To prevent and treat seizures related to eclampsia, magnesium sulfate is given IV via an infusion pump; acts as a CNS depressant to control seizures but also decreases blood pressure through vasodilation and inhibits uterine contractions. |
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Term
| Which medications will reduce anxiety and help with nausea and vomiting? |
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Definition
| Systemic medications used during labor include sedatives, opioid agonists, and opioid agonist-antagonists. Sedatives do not relieve pain: Secobarbital (Seconal) and pentobarbital (Numbutal) are most commonly used. These two drugs only reduce anxiety, do no reduce N&V Other drugs that decrease anxiety include promethazine (Phenergan) and hydroxyzine (Vistaril); these drugs not only reduce anxiety, but they potentiate the analgesic effects of the opioids and reduce nausea and vomiting |
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Term
| Why is a pregnant patient given 500 to 1000 ml of IV fluid before a spinal block is administered? |
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Definition
| With spinal and epidural blocks primary concern is maternal hypotension (drop of systolic blood pressure greater than 20% to 30% of baseline or below 100 mm Hg. |
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Term
| What effects does dinoprostone (Prepidil) have when given during the last month of pregnancy? |
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Definition
| Prostaglandin (E2) available as a gel or insert promotes cervical ripening (changes in the cervix that occur before normal delivery causing the cervix to thin, soften, and dilate) Dinoprostone (Prepidil, Cervidil) is the most widely used agent. Adverse effects of prostaglandins include uterine hyperstimulation. |
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Term
| A patient with a history of blood clots who takes carbamazepine for seizures should avoid which contraceptive methods? |
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Definition
| Etonogestrel (implanon) a long term reversible contraception has reduced effectiveness when it interacts with drugs that induce hepatic enzymes such as carbmazepine. And combination oral and intradermal contraceptives due to blood clots |
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Term
| 44. What are the disadvantages of progestin-only oral contraceptives compared to combination oral contraceptives? |
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Definition
| Progestin-only oral contraceptives only sometimes suppress LH unlike combination oral contraceptives that suppress both LH and FSH with are hormones that allow ovulation. Less effective, irregular bleeding, must be taken same time each day |
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Term
| Which hormone replacement therapy can be used for a woman with hot flashes who has had a hysterectomy? |
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Definition
| Transdermal applications (gels, emulsions, sprays) used to treat vasomotor symptoms (hot flashes), require once daily dosing only available with estrogen (estradiol) (EstroGel) (Estrasorb) (Esvamist); FemRing the first vaginal application used to treat hot flashes, night sweats, and vaginal dryness |
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Term
| Why are specific instructions given on how to take alendronate (Fosamax)? |
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Definition
| The most serious adverse effect of aledronate (Fosamax) is esophagitis, sometimes resulting in ulceration. This occurs if the drug does not pass completely through the esophagus; specific instructions for administration of the drug are meant to reduce this effect. |
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Term
| What are adverse effects of androgens? |
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Definition
The most common adverse effect of androgens is virilization. When women take high does androgens can cause acne, deepening of the voice, facial and body hair growth, male pattern baldness, increased libido, clitoral enlargement and menstrual irregularities.
Some androgens can cause hepatotoxicity including hepatitis and liver cancer; lower HDL or good cholesterol and raise LDL or bad cholesterol increasing risk of atherosclerosis, and contraindicated for men with diagnosed prostate cancer |
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Term
| Which drugs used for benign prostatic hyperplasia require blood pressure monitoring? |
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Definition
| Alfuzosin, terazosin and doxazosin block alpha receptors in the prostate and blood vessels this causes vasodilation and a decrease in blood pressure main side effect is hypotension |
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