Download Medication Review: MOA and Contraindications and more Exams Nursing in PDF only on Docsity!
SCF RN Program: Level 2
Comprehensive Exam Review.
Diltiazem MOA - Correct Answers: ✅ ✅Check: HR & BP, Tx: HTN, & Prinzmetal Angina, Blocks calcium channel ions across the membranes of myocardial & arterial muscle cells, altering the action potential, blocking muscle cell contraction, relaxing arteriolar smooth muscle, reducing cardiac workload, bringing more O2 into the myocardium which slows electrical conduction, decreases contractility & dilates arterioles which lower BP,
Diltiazem Contraindications - Correct Answers: ✅ ✅R/T vasodilation; Hypotension, dizziness, H/A peripheral edema, cardiac arrhythmias, bradycardia, taper off drug, do not give with grapefruit juice, Drug/Drug: Digoxin & statin (can increase levels). Heart block may be caused by digoxin or beta-adrenergic blockers,
Cholestyramine MOA - Correct Answers: ✅ ✅Used to reduce elevated lipid levels, treat pruritus (itching) associated with partial biliary obstruction, Binds (sequesters bile into a ball) with bile acids to form an insoluble mass which is excreted in feces lowering cholesterol levels, Powder mix in liquids
Cholestyramine Contraindications - Correct Answers: ✅ ✅fatigue, drowsiness, GI issues Constipation/impaction, Vitamin A, D, E, K deficiencies, give 2 h. before or 4 h. after other meds. Drug/Drug: Malabsorption of fat soluble vitamins, Thiazide diuretics, Digoxin, Warfarin, Thyroid hormones, corticosteroids,
Atorvastatin MOA - Correct Answers: ✅ ✅Tx: Hyperlipidemia, Cholesterol & Lipids, reduce risk of MI & stroke, prevent CVD in pt's who are diabetic, smoke, have HTN, or family hx of HD, Inhibits HMG-CoA (an enzyme which helps create cholesterol in the liver) which lowers LDL & Triglyceride levels and increases HDL levels, Suggested take at night liver biosynthesis mostly at night.
Atorvastatin Contraindications - Correct Answers: ✅ ✅Rhabdomyolysis-breakdown of muscle tissue results in protein myoglobin in the blood (urine ice tea colored). Take w/Food, GI symptoms, fatigue, active liver disease, ETOH Liver, Preg X, Drug/Drug: Erythromycin, cyclosporine, niacin, Gemfibrozil & antifungal drugs, Digoxin, Warfarin, & Contraceptive effects increased by statin, do not give with Grapefruit Juice, excreted in feces
Nitroglycerin MOA - Correct Answers: ✅ ✅Nitrates: Act directly on vascular smooth muscle to cause relaxation & depress muscle tone, prevention & treatment of attacks of angina pectoris, decrease severity & frequency of episodes, not for unstable angina, short acting: SL 2-4 min,
Nitroglycerin Contraindications - Correct Answers: ✅ ✅H/A, dizziness, weakness, flushing, pallor, increased perspiration, GI issues, Pallor, flushing, increased perspiration, Severe anemia, trauma or cerebral hemorrhage, Preg, hypotension/hypovolemia, Drug/Drug: Phosphodiesterase-5 inhibitors & antihypertensive drugs, Use: Glass IV bottle reduce exposure to light, NO VIAGRA IT CAN KILL YOU. Glaucoma can take immediate release but not SR or ER
Digoxin MOA - Correct Answers: ✅ ✅Monitor HR ONLY NOT BP, Improves symptoms of HF, Cardiac Glycoside: increase the contractility or strength of myocardial contraction, a positive inotropic action which improves cardiac output, Increases intracellular calcium positive inotropic effect increased renal perfusion w/a diuretic effect & decrease in renin release, & slowed conduction through the AV node. This does nothing to improve mortality it just makes you feel better. Cardiac Glycoside
Digoxin Contraindications - Correct Answers: ✅ ✅Take the apical pulse for 1 full min, noting rate, rhythm & quality b4 administering. If pulse is below usually 60 withhold dose & notify provider, Check K+ levels it can cause dysrhythmias, Check serum levels narrow therapeutic margin, diuretics that cause hypokalemia, ACE Inhibitors, Spironolactone, potassium supplements can cause Hyperkalemia, & reduce therapeutic action. Concurrent use w/Beta Blockers can cause additive bradycardia, antacids & cholestyramine can decrease absorption of this drug
Metoprolol MOA - Correct Answers: ✅ ✅Check Pulse & HR hold if <60 bpm, reduces sympathetic stimulation of the heart thus decreasing HR, BP, & Cardiac Workload. It has been known to slow progression of HF when used to treat HF usually mixed w/ACE Inhibitors or ARB's. It is approved for Angina, HTN & cardiac implications following a MI, a selective beta- adrenergic blocker. Beta Blocker
Metoprolol Contraindications - Correct Answers: ✅ ✅Check Pulse & HR, if <60 or if Pt is hypotension, hold, need to taper off over 1 to 2 wks., concurrent use w/CCB's or Digoxin may result in bradycardia, may cause loss of glycemic control in diabetics & mask signs & symptoms of hypoglycemia, Safety in children <6 not established
Hydrochlorothiazide (HCTZ) MOA - Correct Answers: ✅ ✅Treat HTN, Edema associated w/HF, liver, or renal disease, Blocks chloride pump & keeps chloride sodium & potassium in the distal convoluted tubule to be excreted in urine, preventing their reabsorption into the vascular system. Thiazide Diuretic. PO 2 h. peak, 4 h. not immediate action
Hydrochlorothiazide (HCTZ) Contraindications - Correct Answers: ✅ ✅Allergy to thiazides or sulfonamides, fluid, electrolyte or acid-base imbalance, Hypotension, dizziness, photosensitivity, Renal, Liver disease, Hyperuricemia-elevated uric acid-Gout, SLE, DM,
Glyburide MOA - Correct Answers: ✅ ✅Sulfonylureas: Treat DM Type II, to reduce blood glucose Stimulates the release of insulin from pancreatic islet cells; increases sensitivity of insulin receptors on target cells. Dose: 2.5-5 mg PO daily w/breakfast, titrate to max dose 20 mg in divided doses, Duration up to 24 h. so monitor BS throughout the day, Peak: 1-2 h., onset: 15- 60 min
Glyburide Contraindications - Correct Answers: ✅ ✅Sulfonylureas: hypoglycemia, Heartburn, N/V, Pruritis-itching, weight gain, blurred vision, hepatoxicity, Not for Type I DM, Thyroid disease, Drug/Drug: Sulfa allergy, alcohol, oral anticoagulants, MAOI's Clarithromycin, Thiazides, Garlic, & Ginseng
Metformin MOA - Correct Answers: ✅ ✅Biguanides: Antidiabetic: Type 2 DM, Only drug in this class, 1st line of therapy can combine with oral insulin decreases hepatic production of glucose & reduces insulin resistance (decreases sugar absorption in liver), decreases cholesterol, triglycerides & increases HDL, and weight gain. Has nothing to do with insulin release from the pancreas, should take w/meal,
Metformin Contraindications - Correct Answers: ✅ ✅Biguanides: Approved for children >10, Dose: 500 mg titrate up to max 2,550 mg/daily in divided doses, BB Warn: has been associated w/potentially fatal lactic acidosis, metallic taste, sepsis, dehydration, Drug/Drug: ETOH increase risk lactic acidosis, Captopril, Lasix, nifedipine, vancomycin, digoxin, morphine,
Sitagliptin MOA - Correct Answers: ✅ ✅Incretin Enhancers: slows absorption of Glucose, Tx of DM II, slows break down of incretins by inhibiting DDP-4 Inhibitors, Antidiabetic: Give PO w/out regards to meals. Mimic effects of incretin hormones secreted into the small intestine in response to elevated BS levels, to signals the pancreas to stop producing glucagon, reduce food intake by decreasing gastric emptying & increase a sense of fullness.
Sitagliptin Contraindications - Correct Answers: ✅ ✅Incretin: DMI, renal impairment, elderly, hx of pancreatitis, slight risk of hypoglycemia, URI-upper respiratory infection, monitor periodic renal fx, fasting & postprandial glucose, A1C, Drug/Drug: interactions w/Digoxin levels
Exenatide MOA - Correct Answers: ✅ ✅GLP-1 receptor agonist, Treats DM II, mimics effect of incretins increases insulin release & decreases glucagon release & slows gastric emptying. ONLY TYPE II MED INJECTABLE, Helps secrete more insulin, By itself it will not cause hypoglycemia added w/sulfonylureas it will.
Exenatide Contraindications - Correct Answers: ✅ ✅DM1, Gastroparesis, end stage renal, Hx of thyroid carcinoma, endocrine neoplasia, BB WARN: Risk of thyroid tumor, DO NOT GIVE W/Meal 60 min b4 AM & PM never after meals, may decrease oral absorption of oral meds
requiring GI absorption, injection site, hypoglycemia not by itself but w/other diabetic meds. GI, N/V/D/C
Finasteride MOA - Correct Answers: ✅ ✅Father's ONLY: Treatment of BPH, Promotes shrinkage of enlarged prostate & helps restore urinary function, Dose: 5 mg PO, Daily, 3- 6 months of therapy to achieve effect, 5 Alpha Reductase Inhibitor, blocks conversion of testosterone,
Finasteride Contraindications - Correct Answers: ✅ ✅Postural Hypotension, impotence, decreased libido, gynecomastia, erectile dysfunction, female, Preggo X-Cannot handle crushed drug, children, hepatic impairment, obstructive uropathy,
Alendronate MOA - Correct Answers: ✅ ✅Bisphosphonate: prevention & treatment of osteoporosis; for Paget's disease, Blocks bone resorption by inhibiting osteoclast activity, increases bone density, Take w/FULL GLASS OF WATER on empty stomach, first thing in AM & STAY UPRIGHT, Dose 1x wkly, onset: 3-6 wks, Peak: 3-6 months, Duration: 12 months after consumption,
Alendronate Contraindications - Correct Answers: ✅ ✅Bisphosphonate: HA/N/V/D, GI irritation, metallic taste perception, esophageal erosion, dental issues, femoral fx, myalgias, hypocalcemia, Femoral Fracture, muscle pain, Drug/Drug: Separate from MVI, FeSO4, Antacids, CA++; avoid ASA, Aspirin,
Raloxifene MOA - Correct Answers: ✅ ✅Selective Estrogen Receptor Modulators (SERM's): Prevention of osteoporosis in postmenopausal women, estrogen agonists or antagonists, depending on the drug or tissue involved, Increases bone mass, & density by acting through estrogen receptor, reduces vertebral fractures, decreases total cholesterol & LDL,
Raloxifene Contraindications - Correct Answers: ✅ ✅Hot flashes, migraine headaches, flu-like symptoms, endometrial disorder, breast pain, vaginal bleeding, Hx of venous thromboembolism or stroke esp in women with CAD or VTE
Hydroxychloroquine MOA - Correct Answers: ✅ ✅Antimalarial DMARD: Relieves severe inflammation caused by RA or SLE, Maximal benefit will not occur for 6 wks to 6 months, take w/food, Not 1st line of treatment, take as soon as possible w/diagnosis within 1st 2 y. if not within 1st 3 months. Not PRN everyday
Hydroxychloroquine Contraindications - Correct Answers: ✅ ✅hepatic or renal disease, ETOH, retinopathy, anorexia, GI disturbances, loss of hair, agranulocytosis, unusual skin pigmentation-blue black marks, loss of hair, thrombocytopenia,
vision, urinary retention, dry mouth, weight gain, low libido, CV disease, recent MI, liver dysfunction, angle-closure glaucoma, urinary retention, hx of seizures, photosensitivity, escalate manic disorder, Drug/Drug: MAOI's, St. John's Wart, CNS depressants, anti-hypertensive, sympathomimetics, oral anticoagulants, ETOH, dry mouth encourage fiber & gum/candy, not good with BPH, bladder problems, monitor suicidal ideation, paradoxical diaphoresis, avoid strong sunlight
Sertraline MOA - Correct Answers: ✅ ✅SSRI's inhibits CNS neuronal reuptake of serotonin w/little effect on norepinephrine, 1st line of tx in OCD, Panic, bulimia, PMDD, PTST, Social Phobias, or anxiety, take in the AM w/food, several wks to get full benefit, monitor LFT, weight, electrolytes, K+
Sertraline Contraindications - Correct Answers: ✅ ✅impaired renal or hepatic function, cardiac disease, diabetes, severely depressed or suicidal pt's, Risk of Serotonin syndrome-as early as 2 h. or couple wks, HA/drowsiness, dizziness, insomnia, anxiety, tremor, chest pain, agitation, sexual dysfunction-impotence, palpitations, increased appetite, hyponatremia, Drug/Drug: MAOI's, TCA, St. John's Wart, may increase seizures w/pt's/hx, discontinue syndrome
Phenelzine MOA - Correct Answers: ✅ ✅MAOI's Monoamine Oxidase inhibitors: Irreversibly inhibits MAOI's allowing norepinephrine, serotonin & dopamine to accumulate in the synaptic cleft, treats depression, for those unresponsive to or unable to take other anti-depressive agents, Therapeutic effect: 4-8 wks,
Phenelzine Contraindications - Correct Answers: ✅ ✅MAOI's HTN, Glaucoma, increased intracranial pressure, pheochromocytoma-tumor on adrenal gland, CV disease, renal or hepatic impairment Tyramine containing foods: avocado, banana, raisins, cheese (expect cottage cheese), sour cream, yogurt, soy sauce, red wine, beer, pepperoni, sausage, bologna, chocolate, hot dogs, if mixed could cause a hypertensive crisis results in minutes-HA/N/V diaphoresis,
Benzodiazepine MOA - Correct Answers: ✅ ✅Lorazepam: Anxiety disorder, insomnia, pre- anesthesia for sedation, seizures binds to GABA receptor-chloride channel molecule, which intensifies GABA effects given PO or IV
Benzodiazepine Contraindications - Correct Answers: ✅ ✅Lorazepam depresses CNS, drowsiness, dizziness, respiratory depression, diplopia, amnesia, decreased BP, weakness, No ETOH
Disulfiram MOA - Correct Answers: ✅ ✅inhibits the enzyme that metabolizes alcohol when ingested highly unpleasant symptoms occur. Used to discourage relapse in alcohol abuse, only
good in highly motivated patients, initial dose 500 mg/day for 2 wks, then decreasing to 250 mg/day
Disulfiram Contraindications - Correct Answers: ✅ ✅Heart Disease, recent intake of alcohol or metronidazole, DM, Epilepsy, renal disease, cirrhosis, Adverse: drowsiness, fatigue, h/a tremor, hepatoxicity, severe effects w/ingestion of alcohol including respiratory depression, convulsions, death, reactions occur within 10-15 minutes of ingesting ETOH, alcohol sensitivity may last up to 2 wks after d/c
Thiamine MOA - Correct Answers: ✅ ✅responsible for oxidation of carbohydrates, abundant in whole grain foods, common deficiency in alcoholics IV/IM 50-100 mg TID, PO 15-30 mg/day
Thiamine deficiency - Correct Answers: ✅ ✅paresthesia, neuralgia, loss of feeling & reflexes
Methadone MOA - Correct Answers: ✅ ✅opioid does not cause euphoria, allows patient's to return to productive work & social relationships, should be started under supervision, decrease dosage approximately 20% when withdrawal is preferred, Side effects same as opioids
Chlorpromazine MOA - Correct Answers: ✅ ✅Thorazine: Antipsychotics: used to decrease agitation & psychotic symptoms of schizophrenia & other psychotic disorders, Typicals work in blocking postsynaptic dopamine receptors
Donepezil MOA - Correct Answers: ✅ ✅Treatment of mild to moderate Alzheimer's disease, reversible cholinesterase inhibitor that causes elevated ACh levels in the cortex, which slows the neuronal degradation of Alzheimer's disease
Donepezil Adverse Effects - Correct Answers: ✅ ✅Insomnia, fatigue, rash, nausea, vomiting, diarrhea, dyspepsia, abdominal pain, muscle cramps,
Memantine MOA - Correct Answers: ✅ ✅NMDA receptor antagonist: Moderate to late Alzheimer's Disease, Blocks the effects from high levels of glutamate thereby slowing the intracellular calcium accumulation & resultant nerve damage
Memantine Adverse Effects - Correct Answers: ✅ ✅HF, HTN, Fatigue, Dizziness, anxiety, confusion, insomnia, arthralgia, incontinence, combination w/Donepezil, do not drive until effects known
Hypertension Medications - Correct Answers: ✅ ✅ACE Inhibitors-Lisinopril, ARB's: Losartan, CA+ Channel Blocker: Nifedipine, Vasodilator: Hydralazine
Anti-hyperlipidemia Medications - Correct Answers: ✅ ✅Bile Acid Sequestrants: Cholestyramine, HMG-COA Inhibitors: Atorvastatin, Fibrate/Fibrin Acid: Gemfibrozil
Anti-Anginal Medications - Correct Answers: ✅ ✅Beta-Adrenergic blockers: Atenolol, Nitrates: Nitroglycerin, Ca+ Channel Blocker: Diltiazem
Diuretic Medications - Correct Answers: ✅ ✅Loop: Furosemide, Thiazide: Hydrochlorothiazide (HCTZ), K+ Sparing: Spironolactone
Lisinopril MOA - Correct Answers: ✅ ✅Check BP & K+ b4 admin, Tx of HTN, HF, diabetic neuropathy, to improve MI survival. Blocks ACE from converting to angiotensin I to angiotensin II leading to a decrease in BP, a decrease in aldosterone production & a small increase in serum potassium levels along with sodium & fluid loss, Reduces afterload & contractility. Improves survival rate if given w/in 24 h or MI
Lisinopril Contraindications - Correct Answers: ✅ ✅Check BP: ACE: Inhibitor: Angioedema- swelling of lips and tongue, DRY COUGH, Orthostatic BP, dizziness, Taste disturbances, HF, H/A/N/V/D, Salt/Volume depletion, Hyperkalemia, Pregnancy, Drug/Drug: NSAID's, WILL NOT EFFECT HR works in the lungs, CO, HR, Cardiac contractility,
