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NR 293 Advanced pharmacology exam
Questions and answers and elaborations
updated 2024
Anti-inflammatory agents reduce the WHAT process? <> Inflammatory process TRUE or FALSE: anti-inflammatory agents are indicated when inflammatory process is inappropriate, abnormal, or persistent; or in presence of tissue destruction <> True aspirin, nonsteroidal anti-inflammatory drugs, corticosteroids are examples of? <> Anti-inflammatory agents what anti-inflammatory drug reduces inflammation by preventing prostaglandins from increasing the pain and edema produced by other substances released by damaged cells and suppresses platelet aggregation? <> aspirin what syndrome is rapidly progressive encephalopathy with hepatic dysfunction characterized by vomiting and confusion, rapidly evolving to seizures and coma <> Reye syndrome
acetaminophen slows the production of WHAT in the CNS? <> Prostaglandins aspirin, ibuprofen, naproxen, indomethacin, diclofenac, ketorolac, meloxicam are all examples of what type of NSAID? <> COX-1 and COX-2 inhibitors an example of a COX-2 inhibitor is? <> Celecoxib what is an antineoplastic drug? <> drugs used to treat cancer; like chemo what side effect of chemotherapy is characterized by inflamed mouth and gut? <> Mucositis what cancer drug is used in the treatment of breast cancer and is a selective estrogen receptor modulator? <> Tamoxifen what cancer drug is used to prevent or treat recurrence of estrogen responsive breast cancer in post menopausal women? <> Anastrozole
Tumor Lysis Syndrome is characterized as an? <> oncologic emergency what drug is administered to decrease inflammatory symptoms and alter immune response? <> Corticosteroid which corticosteroid is the most common; or the one Dr. Clapp said to know about? <> Glucocorticoids What is a common example of a corticosteroid? <> Hydrocortisone what type of drug is an anti-inflammatory or immunosuppressant agent in treatment of various diseases? <> Corticosteroids for people receiving chronic corticosteroid therapy, what form of dosage therapy may they receive? <> stress dosage therapy cyclooxygenase has WHAT abbreviation? <> COX
what does the phospholipid bilayer release? <> arachidonic acid Arachidonic acid makes what? <> Prostaglandins what is produced by arachidonic acid that is essential for the inflammatory process? <> Prostaglandins prostaglandins produce? <> inflammation what two enzymes are needed for arachidonic acid to make prostaglandins? <> COX-1 and COX- 2 which cyclooxygenase enzyme is present in small amounts in the BRAIN, kidneys, GI tract, and FEMALE REPRODUCTIVE SYS? <> COX- 2 which cyclooxygenase enzyme is inactive until activated by pain and inflammation? <> COX- 2 a decrease in platelet aggregation causes what? <> platelets to stick together and form clots or blockages
which cyclooxygenase enzyme leads to a decrease in platelet aggregation? <> COX- 2 which cyclooxygenase enzyme is present in all tissue types but is most notable in endothelial cells, GI tract, and kidneys? <> COX- 1 COX-1 does what to the stomach? <> decrease in gastric acid and increase in mucus secretion COX-1 does what to the kidneys? <> maintains adequate blood flow COX-1 does what to the cardiovascular system? <> regulates vascular tone and platelet function TRUE or FALSE: Overdosing can lead to liver failure and symptoms may not show up for days <> True NSAIDs stands for? <> nonsteroidal anti-inflammatory drugs
what type of NSAID is a COX-1 and COX- 2 inhibitors? <> Non-selective NSAIDs what type of NSAID is a COX-2 inhibitor? <> Selective NSAIDs ibuprofen is a WHAT NSAID? <> Non-selective NSAIDs naproxen is a WHAT NSAID? <> Non-selective NSAIDs ketorolac is a WHAT NSAID? <> Non-selective NSAIDs aspirin is a WHAT NSAID? <> Non-selective NSAIDs ketorolac is administered what two ways? <> IM and IV TRUE or FALSE: aspirin is almost never used as an anti- inflammatory because of its anti-platelet factor that can cause significant G.I. irritation or bleeding. <> True
TRUE or FALSE: Kids CAN have aspirin? <> False if a child were to take aspirin or anything with aspirin in it, what can that cause? <> Reye syndrome NSAIDs cannot be taken with what juice? <> grapefruit juice nonselective NSAIDs inhibit COX-1 and COX-2, which then leads to the inhibition or prevention of what? <> inflammation what is used to inhibit COX-1 and COX-2 and prevents inflammation? <> Nonselective NSAIDs Common side effects of non-selective NSAIDs include? <> G.I. irritation, decreased kidney function, change in blood pressure, and bleeding A nursing consideration for a patient who is going to take a non- selective NSAID would be what? <> Take it with food which type of NSAIDs is a COX-2 inhibitors? <> Selective NSAID
what is an example of a selective NSAIDs? <> Celecoxib By taking the Selective NSAIDs, Celecoxib, a patient is at an increased risk for what two things? <> heart attack and stroke why is someone taking Celecoxib at an increased risk for heart attack and stroke? <> it causes platelets to stick more and they form little clots which can inhibit blood flow and cause blockages Celecoxib is an example of a? <> Selective NSAIDs TRUE or FALSE: Celecoxib is not used often <> True kids cannot take which medication because it can cause Reye Syndrome? <> Aspirin which medication is a weak anti-inflammatory, analgesic, and antipyretic? <> acetaminophen
An analgesia is a? <> pain reducer An antipyretic is a? <> fever reducer the analgesia and antipyretic aspects of acetaminophen are mostly going to affect the WHAT system? <> CNS (central nervous system) an adverse effect of acetaminophen is? <> Hepatotoxicity the medical term for liver toxicity is? <> Hepatotoxicity acetaminophen is mostly metabolized by the? <> liver TRUE or FALSE: Acetaminophen is safe for use if taken as directed <> True TRUE or FALSE: Tylenol can be taken by people with liver disease/cancer/failure or heavy alcohol drinkers because it does not put them at an increased risk for hepatotoxicity <> False
Patients with liver disease/cancer/failure or heavy alcohol drinkers shouldn't take Tylenol because it puts them at a more increased risk for WHAT? <> Hepatotoxicity what is the maximum dose of Tylenol in a day that can come from all sources; which includes any medication containing Tylenol? <> 3g or 3000 mg what is the first choice of medication for older adults unless they present liver disease or are an alcoholic? <> acetaminophen an antidote for hepatotoxicity is? <> Acetylcysteine (Mucomyst) Acetylcysteine (Mucomyst) is available via what administration route now? <> IV TRUE or FALSE: acetaminophen can be given to children, but it is best to educate parents on dosage because there is a difference in newborn and pediatrics <> True
infant medication comes in what form or is administered by a what? <> dropper 1 g =? mg <> 1000 mg 1 mg =? mcg <> 1000 mcg 1 oz =? mL <> 30 mL 1 tsp =? mL <> 5 mL 1 L =? mL <> 1000 mL 1 kg =? lbs <> 2.2 lbs Dosage for pediatric patients depends on what? <> weight in kg the adrenal cortex produces? <> Corticosteroids what are the two types of corticosteroids? <> Mineralocorticoids and Glucocorticoids
Mineralocorticoids do what? <> Na+ retention Glucocorticoids do what? <> glucose metabolism corticosteroids are the main treatment for breathing issues like? <> Asthma glucocorticoids affect the what? <> phospholipid bilayer what corticosteroid stops phospholipid from producing arachidonic acid and has a potent anti-inflammatory effect <> Glucocorticoids A decrease in cytokines, neutrophils, fibroblast functions, and histamine and prostaglandin are outcomes from taking what? <> glucocorticoids if a patient has a decrease in neutrophils from taking Glucocorticoids, what are they more susceptible to? <> infection
if a patient has a decrease in fibroblast function from taking Glucocorticoids, what are they more susceptible to? <> Impaired wound healing adverse effects from taking a glucocorticoid include? <> risk for infection, impaired wound healing, adrenocortical excess, adrenocortical insufficiency, a decrease in calcium, and increased glucose the adverse effect of increased glucose when taking a glucocorticoid is mainly a worry in what patients? <> diabetics an increase in the amount of glucose is called? <> hyperglycemia a decrease in the amount of calcium is called? <> Hypercalcemia hypercalcemia leads to an increased risk of what? <> fractures
We can minimize side effects of glucocorticoids by what type of application as opposed to systemic application? <> local application taper the dose, shortest time possible on drugs, take med in the morning, stress dosing, and take with food are all ways we can WHAT side effects of glucocorticoids? <> minimize Starting a client off with a high dose and then gradually decreasing dosage refers to what? <> tapering the dose taking glucocorticoids between 0600 and 0900 can help minimize side effects how? <> by matching up with the body's natural production of hormones taking glucocorticoids with food can help minimize the side effects of what? <> GI irritation What targets rapidly dividing cells? <> chemotherapy Chemotherapy dosage is based on what? <> BSA (body surface area)
to find a patient's BSA, we have to know what two things? <> height and weight chemotherapy targets what to rapidly dividing cells? <> cancer cells and "normal" cells "Normal" cells that chemotherapy targets include? <> bone marrow, hair, mucous membranes, and G.I. tract when chemotherapy targets bone marrow, what happens? <> decrease in white blood cell count, hemoglobin, platelets A decrease in white blood cells can lead to what? <> Leukopenia leukopenia causes WHAT, which can lead to a risk for infection <> immunosuppression A decrease in hemoglobin counts can lead to what? <> Anemia
A decrease in platelet counts can lead what? <> Thrombocytopenia The medical term for hair loss is? <> allopecia when chemotherapy attacks mucus membranes, what can that lead to? <> Mucousitis When chemotherapy attacks the G.I. tract what can that lead to? <> Anorexia, nausea, vomiting, diarrhea The abbreviation for nausea, vomiting, diarrhea is? <> N/V/D what do you look at to find blood counts? <> complete blood count (CBC) What term describes drugs that can cause tissue necrosis or formation of blisters if accidentally infused into tissue? <> vesicant TRUE or FALSE: chemotherapy meds can be vesicant <> True
because chemotherapy medication can be vesicant, what is the most common way chemotherapy is administered? <> central line What are the two most popular ways to administer chemotherapy that is vesicant? <> through a central line or a pick line Who places the central or pick line in a patient for chemotherapy? <> surgeon Who takes care of the central or pick line in a patient who is receiving chemotherapy? <> nurse safe drug admin., appropriate assessment and monitoring, and providing necessary patient education are what? <> Nursing Responsibilities the top prescribed medication in america is? <> Cholesterol what is the second prescribed medication in america? <> antibiotics
what is the third prescribed medication in america? <> blood pressure medication what are the top prescribed medications in america? in order? <> Cholesterol, antibiotics, blood pressure, thyroid, breathing, diabetes, pain (anti-inflammatory), inflammation meds, stomach acid, anti-depressants, and diuretics what is an example of a pain reliever drug? <> ibuprofen and meloxicam what is an example of an inflammatory corticosteroid drug? <> Prednisone when taking what medication should you advise your patients to drink lots of fluids and you as the nurse should know to check the urine for blood? <> Cyclophosphamide hyperglycemia means? <> high blood sugar for patients going through chemotherapy, What medication reduces nausea and vomiting? <> antiemetic
what is the normal temperature in degrees Celsius? <> 36 - 38 What is a placebo effect? <> psychological response to an inert medication that has no actual effect if creatine levels are high, what organ is not working? <> kidneys hypoxic means? <> low O2 levels what are the three ways to give medication via IV? <> IV Push (IVP), IV continuous (drip), and IV bolus which IV route is only allowed to be used when giving isotonic solutions? <> IV bolus which IV Route administers medication at little amounts overtime? <> IV continuous/drip what term describes fluid volume deficit? <> Hypovolemia
What term describes fluid volume excess? <> Hypervolemia What term describes normal fluid volume? <> normovolemia TRUE or FALSE: oral rehydration is superior to IV rehydration, so if you can orally hydrate, do it. <> True How many calories are in an IV bag? <> Zero NPO stands for? <> nothing by mouth Is giving medication through an IV systemic or metabolic? <> systemic IV push (IVP) is used for? <> Medication Administration IV continuous/drip is used for? <> maintenance IV continuous/drip is also used for? <> Replacement
IV bolus is used for? <> Resuscitation What can a patient get from an IV? <> infiltration another thing a patient can get from having an IV that deals with the inflammation of the vein is? <> phebitis TRUE or FALSE: Hypervolemia can happen from an IV <> True What are the two types of IV fluids? <> crystalloids and colloids what is the most common IV fluid type? <> crystalloids what are the three types of crystalloid IV fluids? <> Isotonic, hypotonic, hypertonic Crystalloid IV fluids are composed of what two things? <> Electrolytes and sterile water
what term defines osmolar concentration? <> osmolality what term defines effective solutes producing osmotic force that pulls water out of the cell? <> Tonicity Which crystalloid IV fluid is given if someone is dehydrated? <> isotonic What are the two types of isotonic IV fluids? <> 0.9% sodium chloride (normal saline) and lactated ringers (LR) TRUE or FALSE: isotonic IV fluids stay in the intravascular space and goes through our circulation because it has the same tonicity as the surrounding tissues <> True what are the two types of hypotonic IV fluids? <> 0.45% sodium chloride (1/2 normal saline) and 5% dextrose in water (D5W) which hypotonic IV fluid do you not bolus? <> D5W (5% dextrose in water)
what is the name of the hypertonic IV fluid? <> 3% sodium chloride (3% saline) hypertonic IV fluids should only be given in what types of situations? <> critical care or emergency hypertonic 3% sodium chloride is most commonly used during what event? <> cerebral swelling hypertonic IV fluids can cause what? <> Hypervolemia which IV fluid type is a human plasma derivative? <> Colloids what is the most common colloid IV fluid? <> albumin normal serum Na+ <> 135 - 145 a Na+ level less than 135 is? <> Hyponatremia a Na+ level greater than 145 is? <> Hypernatremia normal serum K+ <> 3.5-5.0
a K+ level less than 3.5 is? <> Hypokalemia when a person is hypokalemic, you should give them? <> Potassium a K+ level greater than 5.0 is? <> hyperkalemia You should never ever ever give potassium via what? <> IV Push potassium can be given in what two ways? <> potassium pill and SLOW IV infusion adverse effects of isotonic IV fluids include? <> fluid overload, acid base imbalance, hypernatremia, hyperchloremia adverse effects of hypotonic IV fluids? <> can cause fluids shifts from vascular system into cells adverse effects of hypertonic IV fluids? <> can cause intravascular volume overload and pulmonary edema
With IV continuous/drip, maintenance is the idea. what is goal of maintenance? <> preserve water and electrolyte balance With IV continuous/drip, maintenance is the idea. when is this performed? <> used if patient not expected to eat/drink normally for a prolong period of time With IV continuous/drip, replacement is the other idea. what is goal of placement? <> preserve water and electrolyte balance the rate of replacement depends on what? <> severity when is replacement used? <> used if volume deficit or electrolyte abnormality what is the goal of IV bolus? <> resuscitation how does an IV bolus administer meds? <> large volume of fluid given rapidly at one time
