Top 50 Drugs questions well answered, Exams of Nursing

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Top 50 Drugs- ATI Pharm Questions and

Answers 2023

Albuterol Aerosol - AnswerBronchodilator Beta 2 agonist Therapeutic Effects: Bronchodilation for asthma, COPD, acute bronchospasm A/R: Nervousness, restlessness, tremor, chest pain, palpitations. Assess lung sound before & after TX. Observe for paradoxical bronchospasm (wheezing). Consider aerochamber. Monitor K+ and glucose. Rinse mouth with water to minimize dry mouth. Zolpidem (Ambien) - AnswerSedative / hypnotic Therapeutic Effects: Sedation and induction of sleep A/R: Amnesia, daytime drowsiness, drugged feeling, physical & psychological dependence, tolerance, GI effects Assess sleep, mental status, potential for dependence. Don't use more than 7-10 days. Avoid ETOH & other CNS depressants Lorazepam (Ativan) - AnswerAntianxiety Sedative / hypnotic. Benzodiazepine. Therapeutic Effects:Management of anxiety, insomnia, Status Epilepticus. Preoperative sedation. Postoperative amnesia A/R: Dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST with rapid IVP Assess anxiety, mental status,. Avoid ETOH & other CNS depressants Rosiglitazone - AnswerClassification: Antidiabetic. Thiazolidinediones Therapeutic Effects: Decrease insulin resistance A/R: Edema, anemia, wt gain, increased cholesterol Monitor for fluid retention, hypoglycemia. Check PLFTs & CBC High Alert Medication! Diltiazem - AnswerAntianginal, antiarrhythimics, antihypertensive. (CA++ channel blocker) Therapeutic Effects: Decreased blood pressure. Coronary vasodilation. A/R: Arrhythmias. CHF. Peripheral edema, Postural hypotension

Assess for signs of CHF. Monitor BP &P, notify < 50 bpm. May cause drowsiness of dizziness. Avoid driving until response to medication is known. Gingival hyperplasia- teach good oral care Celecoxib - AnswerNSAIDs, COX-2 inhibitor Therapeutic Effects: Analgesic, anti- inflammatory, & anti- pyretic A/R: GI BLEEDING, dermal rash, GI effects Assess pain, ROM and swelling. Do not give if allergic to sulfonamides, aspirin or NSAIDs. Watch for tarry stools. Losartan - AnswerClassification: Angiotensin II receptor blocker Therapeutic Effects: Antihypertensive. Decreases risk of stroke. A/R & S/E: Orthostatic hypotension, diarrhea. Dizziness, ANGIOEDEMA. Use cautiously in CHF Nursing Implications & teaching: Assess orthostatic blood pressures. Use care when changing positions to prevent orthostatic hypotension. Monitor BUN/Creatinine for possible early renal failure. Warfarin - AnswerClassification:Anticoagulant. Interferes with hepative syntheses of Vitamin K- dependant clotting factors Therapeutic Effects: Prophylaxis/Treatment of venous &/or pulmonary embolism (PE) and atrial fibrillation w/ embolization. Antidote = Vitamin K Adverse Reactions & side effects: Bleeding. Numerous drugs and natural products affect the activity of warfarin! Nursing Implications & teaching: Asses for bleeding, or increased thrombosis. Check INR/PT before administration and regularly. PT may be 1.3-1.5 times greater than control. INR goal dependent on medical diagnosis. Maintain consistent vitamin K, Take in evening. Avoid ETOH & OTC medications. High Alert Medication Prednisone - AnswerAnti-inflammatory (intermediate acting) corticosteroid Therapeutic Effects: inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran. A/R: PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance, GI effects Monitor for: fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea. Do not D/C abruptly. Monitor serum electrolytes, cholesterol/lipids

Avoid people w/contagious illnesses, TAKE WITH FOOD Dexamethasone - AnswerAnti-inflammatory (long acting) corticosteroid Therapeutic Effects: inflammation & modification of the normal immune response; replacement therapy in adrenal insufficiency. Management of cerebral edema. Potentiates anti-N/V action of Zofran. Adverse Reactions & side effects: PEPTIC ULCERATION, THROMBOEMBOLISM, mood changes, hypertension, anorexia, nausea, acne, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance, GI effects Nursing Implications & teaching:Monitor for fluid retention, hyperglycemia, infections, bleeding, steady weight gain, crackles, dyspnea. Do not D/C abruptly. Monitor serum electrolytes, cholesterol/lipids. avoid people w/contagious illnesses, TAKE WITH FOOD Phenytoin - AnswerAntiarrhythmic/ Anticonvulsant Therapeutic Effects: Decrease seizures & pain, control arrhythmias A/R: Aganulocytosis, aplastic anemia, Stevens-Johnson syndrome. diplopia, nystagmus, hypotension, gingival hyperplasia, nausea, rashes Nursing Implications & teaching: Assess for hypersensitivity syndrome; monitor CBC, platelet count, avoid driving till MD ok; avoid ETOH & OTC meds; maintain oral hygiene; urine can be pink/red; Diabetic-monitor glucose closely; Avoid taking within 2-3hr of antacids/antidiarrheals; decrease contraceptive(hormonal), TAKE WITH FOOD Metronidazole (Flagyl) - AnswerAntiinfective, antiulcer, Antiprotozoal Therapeutic Effects: Treatment of anaerobic and parasitic infections A/R: SEIZURES, dizziness, HA, anorexia, nausea, GI effects Monitor WBC, neurological status, and I/Os, TAKE WITH FOOD Tamsulosin (Flomax) - AnswerClassification: Peripherally acting anti-adrenergic. Therapeutic Effects: Decreased symptoms of prostatic hyperplasia, i.e. male urinary outflow obstruction Adverse Reactions & side effects: Dizziness, headache, orthostatic hypotension, retrograde/ diminished ejaculation. Cautious in patients at risk for prostate carcinoma Nursing Implications & teaching: Monitor for dizziness, hypotension. Have patient change positions slowly to minimize symptoms. Alendronate - AnswerBone resorption inhibitor. Bisphosphonate Therapeutic Effects: TX and prevention of post-menopausal and cortico-steroid-induced osteoporosis, A/R: Altered taste, photosensitivity, rash, musculoskeletal pain, fluid overload, esophagitis. Common upset stomach & heartburn, GI effects

Take first thing in the AM, before eating anything; then pt MUST remain upright for at least 30 mins! Take only with plain water. Monitor for GI side effects. Use sunscreen to prevent photosensitivity reactions. Gentamycin - AnswerAntiinfective/ Aminoglycoside Therapeutic Effects: Treatment for enterococcal infections Adverse Reactions & side effects: Ototoxicity and nephrotoxicity Do peak and trough levels, report to MD for dose adjusting. Assess hearing periodically throughout TX. Monitor for superinfections Metformin - AnswerAnti-diabetic (Biguanides) Therapeutic Effects: Decrease hepatic glucose production & intestinal absorption, increased receptor site sensitivity, GI effects A/R: Abdominal bloating. Lactic acidosis. Metallic taste Educate about lactic acidosis when food or fluid is decreased. (S/S - chills, diarrhea, dizziness, low BP, weakness, muscle pain, slow HR. Notify MD IMMEDIATELY). Stop drug before dye based studies. Check renal function. TAKE WITH FOOD Heparin - AnswerAnticoagulant Therapeutic Effects: Antithrombotic. Prevention of extension of existing thrombi Antidote = protamine sulfate A/R: BLEEDING. Thrombocytopenia, anemia. Has multiple drug reactions Assess for bleeding (nose, gums, urine, stool), anemia, thrombocytopenia. Closely monitor aPTT. High Alert Medication. Use heparin nomogram/protocol. Immediate onset when given IV Hydrochlorothiazide - AnswerAntihypertensive. (Non K+ sparing diuretic) Therapeutic Effects: Decrease Blood Pressure. Increase in Urine output A/R Hypokalemia. Drowsiness. Digoxin toxicity. Increased glucose levels Monitor blood pressure, I & O, daily wt, Monitor lytes. Administer in AM. Change positions slowly to minimize orthostatic hypotension. Azathioprine - AnswerImmunosuppressant Therapeutic Effects: Prevent renal transplant rejection. Treat Rheumatoid arthritis and Chron's A/R: Blood dyscryasias, hepatotoxicity, GI effects

Check CBC, LFT. Assess for infection, fluid retention, bleeding. Contraception and teratogenic concerns. Do not d/c abruptly Insulin glargine - AnswerAntidiabetic; pancreatic hormone. Long acting 24 hours Onset: 1H Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids. A/R: HYPOGYCEMIA, lipodystrophy, anaphylaxis Watch for interactions with beta blockers, thiazide diuretics, corticosteroids. Do not mix with any other insulin. No peak. High Alert Medications (Humulin 70/30) NPH/Regular insulin mixture - AnswerAnti-diabetic; pancreatic hormone. Onset 30 min- 1H Peak (regular): 2-3H (NPH): 4-12 H Duration (regular): 5-7 H (NPH): 18-24 H Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids. A/R: HYPOGYCEMIA, lipodystrophy, anaphylaxis Watch for interactions with beta blockers, thiazide diuretics, corticosteroids. Humulin 70/30: 2 Peaks. High Alert Medications Insulin lispro - AnswerAnti-diabetic pancreatic hormone Onset < 15 min Peak: 30min-1 H Duration: 3 H Therapeutic Effects: Lowers blood glucose by increasing transport into cells and promoting conversion of glucose to glycogen. Inhibits release of free fatty acids. A/R: HYPOGYCEMIA, lipodystrophy, anaphylaxis Watch for interactions with beta blockers, thiazide diuretics, corticosteroids Do not give sooner than 15 minutes before a meal. High Alert Medications Potassium Chloride - AnswerPotassium supplement Therapeutic Effects: Transmit nerve impulses; contraction of cardiac, skeletal, and smooth muscle; gastric secretion; renal function; tissue synthesis; and CHO metabolism.

A/R: ARRHYTHMIAS, ECG changes oral—abdominal pain, diarrhea, flatulence, nausea & vomiting, GI effects IV rate should generally not exceed 20 mEq/hr, unless closely monitored. Check for s/s hypokalemia/hyperkalemia, TAKE WITH FOOD Digoxin - AnswerAntiarrhythmic, cardiotonic & inotropic agent Therapeutic Effects: TX of CHF, tachyarrhythmia. Antidote immune Fab (Digibind) A/R: NARROW THERAPUETIC RANGE visual disturbances and fatigue, blurred vision, ECG changes, GI effects Monitor apical pulse for one full minute. Hold if pulse is < 60. Second person check calculations in IV & Peds. Monitor levels (0.5-2) Hypokalemia increases risk for toxicity Furosemide - AnswerLoop Diuretic Therapeutic Effects: Diuresis. Lowering of blood pressure and BG levels A/R: Dehydration, hypochloremia, hypokalemia, hypomagnesaemia, hyponatremia, hypovolemia, metabolic alkalosis Monitor for thirst, dry mouth, lethargy, weakness, hypotension, oliguria and notify physician. Monitor K+, Ca++, Mg. Can increase BUN, glucose and creatinine, TAKE WITH FOOD Levofloxacin - AnswerAntiinfective, Fluoroquinolone Therapeutic Effects: Broad spectrum against gram positive and gram negative A/R: Dizziness, drowsiness, headaches, GI effects Watch for anaphylactic rxn. Do not administer <4 hr before or 2 hr after giving an Al/Mg/ Fe or Zn preparation. Monitor for superinfections Atorvastatin - AnswerLipid-Lowering agent Therapeutic Effects: Decrease LDL/VLDL/Triglycer.; Increase HDL (slightly) A/R: RHABDOMYOLYSIS (muscle cell lysis), toxins into circulation, rashes, constipation, flatus, GI effects Avoid grapefruit & grapefruit juice. With unexplained muscle pain/tenderness-monitor CPK -- if it increases, d/c med = life threatening. Check LFTs

Enoxaparin - AnswerAnticoagulant Causes the inhibitory effect of anti-thrombin on factor Xa and thrombin Therapeutic Effects: Prevention of DVT/PE. Antidote = protamine sulfate A/R: Bleeding, anemia, thrombocytopenia, erythema at injection site, pain. Use only 1 heparin product at a time Assess for bleeding, CBC, platelet count, neurological impairment. Note pkg info for prefilled syringe- keep air lock. NO aspiration or massage. High Alert Medication Glyburide - AnswerAntidiabetic (Sulfonylurea) Therapeutic Effects: Stimulates release of insulin from the pancreas, increase receptor site sensitivity A/R: Photosensitivity, low bg, aplastic ANEMIA Observe s/s of hypoglycemia. High Alert Medication. Do not take glyburide if you are unable to eat. Avoid alcohol. Morphine sulfate - AnswerOpioid analgesic (agonist) Therapeutic Effects: Decrease pain, pulmonary edema, pain with MI A/R: Respiratory depression, confusion, sedation, low BP, constipation Typical opioid precautions. Dilute for IV push. Give over 4-5 minutes Gabapentin - AnswerAnalgesic adjunct/ Anticonvulsant. Therapeutic Effects: Decrease seizures, neuralgias, chronic pain A/R: Drowsiness, ataxia. Avoid in pregnancy/breastfeeding TID dosing should not exceed 12 hr between doses. Do not D/C abruptly; do not take within 2hr of antacid. avoid driving-till MD OK; Avoid use with other CNS depressants Esomeprazole - AnswerAntiulcer agents (proton pump inhibitors) Therapeutic Effects: Decrease acid accumulation in the gastric lumen which decreases GI reflex Healing of duodenal ulcers A/R: Headache, constipation, dry mouth, GI effects Give 1hr before meals Do not crush or chew pellets Assess for epigastric/abdominal pain, blood in stool, emesis, or gastric aspirate Give slow IVP over 5-6 minutes, diluted with 0.9% NS

Nitroglycerin - AnswerAntianginal, Nitrate Therapeutic Effects: Increases coronary blood flow to decrease angina attacks. Decrease BP. Increase cardiac output. A/R: Dizziness. HA. Blurred Vision. Low BP, High HR, Flushing, GI effects. Tablets should be kept in original container & cotton should be removed. Do not open bottle frequently or handle tablets. Replace q 6 months after opening Transderm Nitro, nitroglycerin - AnswerAntianginal Therapeutic Effects: Relief or prevention of anginal attacks; increase cardiac output; decrease blood pressure Adverse Reactions & side effects: dizziness, headache, restlessness, syncope, hypotension, contact dermatitis, blurred vision Wear gloves during removal/application, Remove patches before cardioversion or defibrillation. D/C if low BP. Rotate sites of application to prevent skin irritation Oxycodone - AnswerOpioid agonist Therapeutic Effects: Controlled release for moderate to severe pain, Not for PRN A/R: confusion, sedation, constipation RESPIRATORY DEPRESSION, GI effects Administer q12 hours for Chronic pain. Typical opioid precautions. Do not crush or chew. TAKE WITH FOOD Famotidine - AnswerHistamine (H2) Antagonist Antiulcer Therapeutic Effects: Inhibits the action of histamine at H2-receptor site (gastric parietal cells), decreases gastric acid A/R: ARRHYTHMIAS, APLASTIC ANEMIA, AGRANULOCYTOSIS, confusion, dizziness, headache, nausea, black tongue, diarrhea Monitor CBC, Dilute IV, rapid administration may cause hypotension. TAKE WITH FOOD Promethazine - AnswerAntiemetic. Antihistamine (H1). Sedative / hypnotic. Therapeutic Effects: Decrease symptoms of excess histamine, sedation, decrease N/V A/R: neuroleptic malignant syndrome, confusion, disorientation, sedation, dizziness Monitor for extrapyramidal side effects; educate on techniques to help dry mouth; oral care, photosensitivity; orthostatic hypotension risk; avoid ETOH & other CNS depressants; monitor sedation. A known Vesicant (CAUSES BLISTERING)

Clopidogrel - AnswerAnti-platelet Therapeutic Effects: Decrease atherosclerotic events A/R: GI bleed, neutropenia, thrombotic thrombocytopenic purpura Monitor for bleeding, CBC, diff, platelet count, Do not double dose, Avoid NSAIDs. Watch for fever, chills, sore throat, bleeding/bruising. Caution in brushing/flossing teeth Ceftriaxone - AnswerAntiinfective (3rd generation cephalosporin) Therapeutic Effects: Bactericidal for bone & joint and lower resp. tract infections; skin infections, some STDs and UTIs Adverse Reactions & side effects: PSEUDOMEMBRANOUS COLITIS (c-diff), SEIZURES, phlebitis at IV site, pain at IM site, GI effects Monitor for superinfections. Obtain specimens for culture and sensitivity before starting. Instruct patient to notify MD if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Levodopa - AnswerAntiparkinson agent. Dopamine agonist Therapeutic Effects: Relief of tremor & rigidity in Parkinson's A/R: Involuntary movements, Avoid with MAOIs, narrow angle glaucoma, GI effects Monitor CBC, hepatic & renal function; avoid driving-till MD OK; orthostatic hypotension; oral hygiene-dry mouth; skin lesions-changes; avoid OTC meds, TAKE WITH FOOD Levothyroxine - AnswerThyroid replacement Therapeutic Effects: Restoration of hormonal balance, suppression of cancer A/R: Insomnia, arrhythmias, tachycardia, wt. loss. Avoid use in thyrotoxicity Assess apical pulse and BP prior to admin & during therapy, & for chest pain, tachyarrhythmia. Give prior to breakfast. Monitor T3 and TSH. Important drug interactions Metoprolol - AnswerBeta blocker Therapeutic Effects: Antihypertensive Antianginal, Prev & decr mortality in recent MI pts A/R: BRADYCARDIA, PULMONARY EDEMA, CHF. fatigue, weakness, impotence Hold HR <60. Monitor I & O, daily weight. Assess for HF, bronchospasm hydrocodone/acetaminophen (Vicodin) - AnswerOpioid agonist

Therapeutic Effects: Binds to opiate receptors in the CNS—decreases moderate pain. Suppresses cough reflex A/R: confusion, sedation, hypotension, constipation, HEPATOTOXICITY, GI effects Monitor respiratory status. Should not exceed 4 grams of acetaminophen in 24 hrs. Typical opioid precautions. TAKE WITH FOOD Ezetimibe/Simvastatin (Vytorin) - AnswerLipid-Lowering agent Eze = inhibits intestinal absorption of chol & inhibits chol synthesis Therapeutic Effects: Lowers Total and LDL chol and triglyc. with slight increase in HDL A/R: Abdominal pain, diarrhea, epigastric pain, HA, dizziness, anemia, alopecia Nursing Implications & teaching: Administer once daily in the evening, without regard to food. Wear sunscreen to prevent rare photosensitivity reaction. Check LFTs Bupropion - AnswerAntidepressant Smoking deterrent Therapeutic Effects: Diminished depression Decreased craving for cigarettes A/R: SEIZURES, agitation, HA, dry mouth, nausea, vomiting, tremor Monitor mood changes. Assess for suicidal tendencies. Monitor hepatic/ renal function in pts with liver or kidney impairments to prevent increased serum levels. Lisinopril - AnswerAntihypertensive (ACE inhibitor) Therapeutic Effects: Lowers BP, decreases afterload in CHF & LV remodeling & mortality A/R: Cough, proteinuria, taste impairment, clinically significant inc. K, ANGIOEDEMA Monitor BP, pulse, fluid retention, dry persistent cough, rash, mouth sores, swelling of face, dizziness Ondansetron - AnswerAntiemetic. 5-HT3 receptors antagonist Therapeutic Effects: Prevention of nausea & vomiting associated with chemotherapy or radiation therapy. Prevention/treatment of postop nausea/vomiting. A/R: HA, dizziness, diarrhea Advise patient to notify MD for involuntary movement of eyes, face, or limbs. Sertraline (Zoloft) - AnswerAntidepressant SSRI Therapeutic Effects: Decreases panic attacks, OCD, intense fear and helplessness

A/R: Dizziness, drowsiness, fatigue, HA, insomnia, dry mouth, tremor, sweating, Avoid use with any MAO Inhibitors, GI effects Monitor weight, mood changes, and suicide risk. No alcohol or other CNS depressants. Do not D/C abruptly. Wear sunscreen to prevent photosensitivity reaction. Cetirizine - Answer2nd generation (non-sedating) Antihistamine Therapeutic Effects: Relief of seasonal and perennial allergic rhinitis A/R: Dizziness, fatigue, dry mouth Administer once daily without regard to food Atropine - AnswerAntiarrhythmic (Anticholinergic) Therapeutic Effects: TX for symptomatic bradycardia & heart block. Decrease GI & respiratory secretions A/R: Dry mouth, urinary hesitancy, blurred vision, tachycardia Monitor urinary output esp. in BPH. Assess VS and EKG