Adverse Drug Reactions and Therapeutic Uses, Exams of Nursing

Download Adverse Drug Reactions and Therapeutic Uses and more Exams Nursing in PDF only on Docsity! ATI Gastrointestinal System Drugs Q: What administration considerations apply to sulfasalazine? - correct answer ✔✔A: Monitor stool for intact pills. Make sure clients do not crush or chew the delayed-release tablets. Mesalamine available orally, as a retention enema, and in suppository form. Expect an orange-yellow discoloration of alkaline urine and skin (sulfasalazine). Q: What are adverse drug reactions associated with sulfasalazine? - correct answer ✔✔A: Headache Pneumonitis Anorexia, nausea, vomiting, diarrhea, drug-induced hepatitis Crystalluria, infertility, oligospermia, orange-yellow discoloration of urine Exfoliative dermatitis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, rash, photosensitivity, yellow discoloration of urine Agranulocytosis, aplastic anemia, blood dyscrasias, eosinophilia, hemolytic anemia, megaloblastic anemia, thrombocytopenia, Peripheral neuropathy Angioedema Hypersensitivity reactions including anaphylaxis Fever Q: What is the brand/trade name for sulfasalazine? - correct answer ✔✔A: Azulfidine Q: What administration considerations apply to alosetron? - correct answer ✔✔A: Make sure clients meet specific criteria and sign the required treatment agreement before administration. Risk management program Client, provider, pharmacist Outlines potential adverse effects Outlines criteria that must be met for treatment Only for women who did not improve with traditional therapies Give orally twice daily. Reevaluate after 4 weeks without improvement and recommend an increased dosage if the client is tolerating the drug. Stop therapy after 8 weeks if diarrhea persists. Q: What administration considerations apply to aluminum hydroxide? - correct answer ✔✔A: Administer orally up to four times a day. Make sure clients chew tablets thoroughly and follow with at least 8 oz of water Do not give within 1 to 2 hr of administering drugs that interact with antacids. Q: What administration considerations apply to dimenhydrinate? - correct answer ✔✔A: Give dimenhydrinate orally, IM, or IV. Give the initial dose 30 to 60 min before the activity that triggers nausea. Give subsequent doses before meals and at bedtime. Make sure clients do not swallow chewable tablets whole. Q: What administration considerations apply to psyllium? - correct answer ✔✔A: Give orally one to three times a day with at least 8 oz of fluid. Mix powdered forms with 8 oz of fluid. Expect soft, formed stools 1 to 3 days after initiating therapy. Tell clients that taking it before meals might reduce appetite. Q: What administration considerations apply to ranitidine hydrochloride? - correct answer ✔✔A: Give orally, IM, or IV. Give with or without food (given with meals, immediately afterwards, or at bedtime does prolong effect). Administer IV preparation slowly to avoid bradycardia. Q: What administration considerations apply to bisacodyl? - correct answer ✔✔A: Give orally or by rectal suppository. Expect semi-fluid stools within 6 to 12 hr with oral dosing and in 15 to 60 min with suppositories. Tell clients to take the oral form at least 1 hr after drinking milk or taking antacids and not to crush or chew the enteric-coated or delayed-release tablets. Q: What administration considerations apply to docusate sodium and docusate sodium and senna? - correct answer ✔✔A: Give orally with at least 8 oz of fluid. Expect soft stools several days after initiating therapy. Q: What are adverse drug reactions associated with alosetron? - correct answer ✔✔A: Constipation, which can result in impaction, perforation, obstruction Ischemic colitis Q: What are adverse drug reactions associated with aluminum hydroxide? - correct answer ✔✔A: Constipation (aluminum and calcium antacids) Diarrhea (magnesium antacids) Hypophosphatemia Q: What are adverse drug reactions associated with dimenhydrinate? - correct answer ✔✔A: Sedation Anticholinergic effects (dry mouth, urinary retention, constipation) Q: What are adverse drug reactions associated with psyllium? - correct answer ✔✔A: Esophageal or intestinal obstruction (when taking too little fluid with psyllium) Q: What are adverse drug reactions associated with ranitidine hydrochloride? - correct answer ✔✔A: Impotence, reduced libido with cimetidine (Tagamet), not ranitidine Confusion, aplastic anemia, agranulocytosis, and arrhythmia Increased susceptibility to pneumonia Q: What are adverse drug reactions associated with azathioprine? - correct answer ✔✔A: Progressive multifocal leukoencephalopathy Retinopathy Pulmonary edema Nausea, vomiting, diarrhea, anorexia, hepatotoxicity, mucositis, pancreatitis Alopecia, rash Anemia, neutropenia, thrombocytopenia, leukopenia, pancytopenia Arthralgia Malignancy (including post-transplant lymphoma, HSTCL, and skin cancer), serum sickness, chills, fever, Raynaud's phenomenon Q: What are adverse drug reactions associated with lubiprostone? - correct answer ✔✔A: Nausea, vomiting Diarrhea, flatulence Headache Q: What are adverse drug reactions associated with sucralfate? - correct answer ✔✔A: Constipation Q: What are adverse drug reactions associated with diphenoxylate/atropine and loperamide? - correct answer ✔✔A: Drowsiness (diphenoxylate/atropine) Anticholinergic effects (dry mouth) Cardiac arrest, QT interval prolongation, torsades de pointes, ventricular arrhythmias, syncope Constipation Allergic reactions Q: What are adverse drug reactions associated with metoclopramide? - correct answer ✔✔A: Sedation restlessness Diarrhea Extrapyramidal symptoms, especially tardive dyskinesia (long-term, high doses, irreversible) Neuroleptic malignant syndrome Q: What are adverse drug reactions associated with misoprostol? - correct answer ✔✔A: Monitor for severe diarrhea and abdominal pain. Monitor for excessive menstrual pain or mid-cycle bleeding. Q: What are adverse drug reactions associated with omeprazole? - correct answer ✔✔A: Bone loss (long-term use) Headache, abdominal pain, nausea, vomiting, and diarrhea Hypomagnesemia Q: What are adverse drug reactions associated with ondansetron? - correct answer ✔✔A: Serotonin syndrome, torsade de pointes, and Stevens Johnson syndrome Headache Dizziness Diarrhea Constipation Q: What are adverse drug reactions associated with bisacodyl? - correct answer ✔✔A: Diarrhea, mild abdominal cramps Burning sensation (suppositories) Proctitis (prolonged use of suppositories) Increase fluid and fiber intake. Increase activity and exercise. Report abdominal pain. Report severe diarrhea. Educate client on monitoring phosphate and sodium intake. Tell clients to report any signs of obvious or occult gastrointestinal bleeding, such as coffee-ground emesis. Instruct clients to not take aluminum hydroxide with 1 to 2 hr of other medications. Q: What instructions should be provided for a client taking dimenhydrinate? - correct answer ✔✔A: Do not take prior to driving or activities requiring mental alertness. Sit or lie down if feeling drowsy. Change positions gradually. Suck on hard candy or chew gum. Sip water. Increase fluid and fiber intake. Increase activity levels. Urinate every 4 hr and report any undesirable changes in urinary elimination. Q: What instructions should be provided for a client taking psyllium? - correct answer ✔✔A: Take with at least 8 oz of water or juice. Report difficulty swallowing, chest pain, or absence of bowel movements. Report persistent diarrhea. Drink plenty of fluids. Advise clients to increase exercise and fluid intake (at least 2 to 3 L/day) and consume high-fiber foods (bran, fresh fruits/vegetables). Q: What instructions should be provided for a client taking ranitidine hydrochloride? - correct answer ✔✔A: Take all medication as prescribed Avoid smoking Avoid foods or medications that irritate GI tract Tell clients to report any signs of obvious or occult gastrointestinal bleeding, such as coffee-ground emesis. Q: What instructions should be provided for a client taking azathioprine? - correct answer ✔✔A: Take the drug with food. Lie down when feeling nauseated. Report severe vomiting. Report fever, abdominal pain, or jaundice. Report sore throat, infections, fatigue, dyspnea, dizziness, easy bruising, or bleeding. Q: What instructions should be provided for a client taking lubiprostone? - correct answer ✔✔A: Take the drug with food or water. Lie down when feeling nauseated. Report severe vomiting. Report severe or persistent diarrhea immediately and stop taking the drug. Maintain hydration with clear fluids. Report headache. Take over-the-counter analgesics to relieve headache. Q: What instructions should be provided for a client taking sucralfate? - correct answer ✔✔A: Increase fluid and fiber intake. Increase activity and exercise. Drink plenty of clear fluids. Tell clients to report any signs of obvious or occult gastrointestinal bleeding, such as coffee-ground emesis. Q: What instructions should be provided for a client taking diphenoxylate/atropine and loperamide? - correct answer ✔✔A: Do not take prior to driving or activities requiring mental alertness. Sit or lie down if feeling lightheaded. Change positions gradually. Suck on hard candy or chew gum. Sip water. Urinate every 4 hr and report any undesirable changes in urinary elimination. Tell clients with diarrhea to avoid fluid and electrolyte imbalances by drinking clear liquids or a commercial oral electrolyte solution, and to avoid caffeine because it increases gastrointestinal motility. Q: What instructions should be provided for a client taking metoclopramide? - correct answer ✔✔A: Do not take prior to driving or activities requiring mental alertness. Sit or lie down if feeling drowsy. Change positions gradually. Report diarrhea. Drink plenty of clear fluids. Report restlessness, anxiety, or spasms of the face and neck, lip smacking, writhing motions, and involuntary movements. Q: What instructions should be provided for a client taking misoprostol? - correct answer ✔✔A: Report worsening diarrhea or abdominal pain. Expect diarrhea to resolve after the first week of drug therapy. Drink plenty of clear fluids. Take the drug with food to minimize gastrointestinal effects. Report menstrual changes. Do not ingest alcohol or any foods that may further irritate the GI tract. Q: What instructions should be provided for a client taking omeprazole? - correct answer ✔✔A: Perform weight-bearing exercise daily. Consume adequate calcium and vitamin D. Dysphagia Nausea, vomiting Appendicitis Undiagnosed abdominal pain Q: What contraindications are there for the use of ranitidine hydrochloride? - correct answer ✔✔A: Known sensitivity Some products may contain aspartame so avoid in clients with PKU Q: What contraindications are there for the use of azathioprine? - correct answer ✔✔A: Active infection or immunization with live virus vaccines Pancreatitis Anuria Q: What contraindications are there for the use of lubiprostone? - correct answer ✔✔A: Severe diarrhea Diverticulitis Crohn's disease Ulcerative colitis Volvulus Gastrointestinal obstruction Q: What contraindications are there for the use of sucralfate? - correct answer ✔✔A: Hypersensitivity to the drug Q: What contraindications are there for the use of diphenoxylate/atropine and loperamide? - correct answer ✔✔A: Children younger than 2 yr Inflammatory bowel disease Advanced hepatic disease Glaucoma Severe fluid and electrolyte imbalance Pseudomembranous enterocolitis Diarrhea due to poisoning Ileus Gastrointestinal bleeding Q: What contraindications are there for the use of metoclopramide? - correct answer ✔✔A: Gastrointestinal obstruction, hemorrhage, perforation Uncontrolled seizure disorders Pheochromocytoma Breast cancer Q: What contraindications are there for the use of misoprostol? - correct answer ✔✔A: Pregnancy - teratogenic effects Hypersensitivity to the drug Q: What contraindications are there for the use of omeprazole? - correct answer ✔✔A: Hypersensitivity to the drug Concurrent use of rilpirivine Q: What contraindications are there for the use of ondansetron? - correct answer ✔✔A: Phenylketonuria (oral disintegrating tablets) Congenital long QT syndrome Concurrent use with apomorphine Q: What contraindications are there for the use of bisacodyl? - correct answer ✔✔A: Gastrointestinal obstruction, perforation Anal or rectal fissures Ulcerated hemorrhoids Fecal impaction, ileus Proctitis Nausea, vomiting Undiagnosed abdominal pain Q: What contraindications are there for the use of docusate sodium and docusate sodium and senna? - correct answer ✔✔A: Gastrointestinal obstruction, perforation Concurrent use of mineral oil Fecal impaction Nausea, vomiting Undiagnosed abdominal pain Q: What are potential interactions for sulfasalazine? - correct answer ✔✔A: Iron and antibiotics affect absorption (sulfasalazine) Decreases absorption of digoxin (mesalamine) Q: What are potential interactions for alosetron? - correct answer ✔✔A: Drugs that interfere with cytochrome P450 enzymes, such as phenobarbital, carbamazepine, cimetidine, quinolone antibiotics Q: What are potential interactions for aluminum hydroxide? - correct answer ✔✔A: Interferes with absorption of many drugs including: tetracyclines, digoxin, fluoroquinolones, iron salts, salicylates, and chlorpromazine Q: What are potential interactions for dimenhydrinate? - correct answer ✔✔A: Other CNS depressants increase sedative effects. MAO inhibitor antidepressants increase anticholinergic effects. Monitor temperature. Monitor for rash. Monitor for joint pain. Monitor CBC periodically. Q: What interventions should be planned for a client taking alosetron? - correct answer ✔✔A: Monitor bowel patterns. Stop drug therapy until constipation resolves. Monitor for indications of ischemic colitis. For clients who develop these indications, stop drug therapy immediately. Q: What interventions should be planned for a client taking aluminum hydroxide? - correct answer ✔✔A: Monitor bowel function. Administer stool softeners. Monitor for severe diarrhea. Monitor phosphorus and magnesium levels. Q: What interventions should be planned for a client taking dimenhydrinate? - correct answer ✔✔A: Monitor clients when ambulating. Monitor for anticholinergic effects. Monitor bowel elimination patterns. Monitor vital signs as well as signs of anaphylaxis Q: What interventions should be planned for a client taking psyllium? - correct answer ✔✔A: Emphasize the importance of taking at least 8 oz of fluid with each dose. Monitor intake and output and bowel function. Monitor for retrosternal pain. Monitor for severe diarrhea and dehydration. Q: What interventions should be planned for a client taking ranitidine hydrochloride? - correct answer ✔✔A: For clients who develop impotence or reduced libido, recommend switching to ranitidine. For clients who develop CNS effects, recommend switching to ranitidine. Monitor older clients for confusion. Q: What interventions should be planned for a client taking azathioprine? - correct answer ✔✔A: Monitor for persistent nausea or vomiting. Monitor liver function. Monitor CBC before initiating therapy and periodically thereafter. Stop therapy for decrease in WBC count and institute neutropenic precautions. Q: What interventions should be planned for a client taking lubiprostone? - correct answer ✔✔A: Monitor for worsening nausea and vomiting. Monitor for severe diarrhea. For clients who develop these indications, stop drug therapy immediately and notify provider. Monitor for persistent headache. Q: What interventions should be planned for a client taking sucralfate? - correct answer ✔✔A: Monitor bowel function. Administer stool softeners as needed. Q: What interventions should be planned for a client taking diphenoxylate/atropine and loperamide? - correct answer ✔✔A: Monitor clients when ambulating. Recommend the lowest effective dose for the shortest period of time. Monitor for anticholinergic effects. Monitor urinary elimination patterns, especially in older adults. Q: What interventions should be planned for a client taking metoclopramide? - correct answer ✔✔A: Monitor clients when ambulating. Monitor for severe diarrhea and dehydration. Recommend the lowest possible dose for the shortest duration of time. Monitor for restlessness, anxiety, spasms of the face and neck, lip smacking, writhing motions, and involuntary movements. Discontinue the drug for extrapyramidal symptoms. Monitor for muscle rigidity, hyperthermia, tachycardia, diaphoresis and altered consciousness. Q: What interventions should be planned for a client taking misoprostol? - correct answer ✔✔A: Diarrhea, abdominal pain Dysmenorrhea, uterine cramping, spotting (women), miscarriage Q: What interventions should be planned for a client taking omeprazole? - correct answer ✔✔A: Limit drug therapy to the lowest dose and shortest duration possible. For longer-term therapy, monitor for bone loss via bone density scanning at recommended intervals. Monitor for severe vomiting or diarrhea. Monitor magnesium levels Q: What interventions should be planned for a client taking ondansetron? - correct answer ✔✔A: Monitor for persistent headache. Administer analgesics for pain relief. Monitor for dizziness. Monitor for severe diarrhea and dehydration. Q: What interventions should be planned for a client taking bisacodyl? - correct answer ✔✔A: Monitor for severe diarrhea and dehydration. Tell clients to expect rectal or anal burning. Q: What precautions are there for the use of metoclopramide? - correct answer ✔✔A: Heart failure Hypertension Asthma Parkinson's disease Hypokalemia Porphyria Seizure disorders Liver or kidney dysfunction Older adults Q: What precautions are there for the use of misoprostol? - correct answer ✔✔A: Children younger than 18 yr Q: What precautions are there for the use of omeprazole? - correct answer ✔✔A: Liver dysfunction Pregnancy and lactation Q: What precautions are there for the use of ondansetron? - correct answer ✔✔A: Liver dysfunction Recent Abdominal surgery Pregnancy/lactation Children under the age of 3 Q: What precautions are there for the use of bisacodyl? - correct answer ✔✔A: Eating disorders or other factors that increase the risk of abuse Q: What precautions are there for the use of docusate sodium and docusate sodium and senna? - correct answer ✔✔A: Use cautiously with clients prone to developing a laxative dependency. Q: What are the therapeutic uses for sulfasalazine? - correct answer ✔✔A: Mild to moderate inflammatory bowel disease Q: What are the therapeutic uses for alosetron? - correct answer ✔✔A: Women with severe irritable bowel syndrome with diarrhea (IBS-D) that has lasted 6 months or more Q: What are the therapeutic uses for aluminum hydroxide? - correct answer ✔✔A: Peptic ulcer disease, gastrointestinal reflux disease (GERD) Q: What are the therapeutic uses for dimenhydrinate? - correct answer ✔✔A: Antiemesis, vertigo, motion sickness Q: What are the therapeutic uses for psyllium? - correct answer ✔✔A: Constipation Diverticulosis Irritable bowel syndrome Stool regulation for diarrhea and with fecal ostomies Q: What are the therapeutic uses for ranitidine hydrochloride? - correct answer ✔✔A: Gastric and duodenal ulcers Heartburn, dyspepsia Erosive esophagitis Gastrointestinal reflux disease (GERD) Aspiration pneumonitis Hypersecretory disorders such as Zollinger-Ellison syndrome (gastrin), systemic mastocytosis (histamine) Q: What are the therapeutic uses for azathioprine? - correct answer ✔✔A: Inflammatory bowel disease (unlabeled use) Q: What are the therapeutic uses for lubiprostone? - correct answer ✔✔A: Irritable bowel syndrome with constipation (IBS-C) in women age 18 yr or older. Chronic idiopathic constipation (CIC) in men and women. Q: What are the therapeutic uses for sucralfate? - correct answer ✔✔A: Acute duodenal ulcers Q: What are the therapeutic uses for diphenoxylate/atropine and loperamide? - correct answer ✔✔A: Diarrhea. Reduction of volume of ileostomy effluent (loperamide/ atropine). Q: What are the therapeutic uses for metoclopramide? - correct answer ✔✔A: Nausea and vomiting from chemotherapy, opioids, radiation therapy, toxins Gastroesophageal reflux disease (GERD) Diabetic gastroparesis Q: What are the therapeutic uses for misoprostol? - correct answer ✔✔A: Prevention of gastric ulcers from long-term NSAID use Q: What are the therapeutic uses for omeprazole? - correct answer ✔✔A: Gastric and duodenal ulcers Prolonged dyspepsia Gastrointestinal reflux disease (GERD) Erosive esophagitis Hypersecretory disorders such as Zollinger-Ellison syndrome, systemic mastocytosis Q: What are the therapeutic uses for ondansetron? - correct answer ✔✔A: Nausea, vomiting from chemotherapy, radiation therapy, postoperative recovery Q: What are the therapeutic uses for bisacodyl? - correct answer ✔✔A: Constipation from opioid use or from slow intestinal transit. Colon evacuation prior to elective procedures.