NIU NURS 316 PHARM HESI
QUESTIONS AND CORRECT ANSWERS
Basic Nursing Skills/Safety - Albuterol-Assess ✅Albuterol (Ventolin)
Drug Class: Short Acting Beta 2 Agonist
Indication: Prevention or relief of bronchospasm related to asthma, bronchitis, and other
pulmonary diseases
Adverse: Nausea, anxiety, palpitations, tremors, increased HR
Route: Oral, Inhalation
Assess: *Respiratory assessment, watch for tachycardia and rebound bronchospasm.
Sequence: Albuterol (short acting)> Salmeterol (long acting)> Prednisone
(corticosteroid)> Gentamicin (antibiotic)
Basic Nursing Skills/Safety - Allergic reaction ✅S/S: Skin erythema, mild rash, hives,
dizziness, flushing, shortness of breath, wheezing, facial swelling, itching, constriction of
bronchial airways, tachycardia
Treatment: Epinephrine
Leadership - Amlodipine - Evaluate ✅Amlodipine (Norvasc)
Drug Class: Calcium Channel Blocker
Indication: Angina (chronic stable) and hypertension, good for african american
Adverse: Reflex tachycardia, hypotension, peripheral edema, palpitations, constipation,
nausea, dyspnea, rash, flushing. **Gingivital hyperplasia, tenderness, and bleeding in
the gums
*Evaluate: Ensure stable vitals, HR, BP
(BP should decrease), monitor for S/S of reflex tachycardia, caution in those w/
hypotension
Considerations: Most popular CCB, only taken, only available orally, avoid grapefruit,
drink prune juice for constipation
Interactions: Nitrates, grapefruit
,Skills/Nutrition - Orlistat-Weight Management ✅Orlistat (Xenical)
Drug Class: Lipase inhibitor (Anorexiant) *Nonstimulant
Indication: Obesity
Action: Binds to and blocks gastric/pancreatic enzymes (lipase), inhibits absorption of
caloric intake from fatty foods
Contraindication: Chronic malabsorption syndrome (Crohn's, colitis, short bowel
syndrome) or cholestasis, pregnancy B
Adverse: Steatorrhea (oily stools), fecal incontinence, GI distress, headache, upper
respiratory tract infection, decreases vitamins A, D, E, and beta carotene **Causes
renal stones/gall stones. Interacts w/ clyclosporine and levothyroxine
Considerations: Supplement fat soluble vitamins, restrict dietary fats (to less than 30%
of total calories), monitor body weight and BMI
Skills/Safety - St. John's Wort ✅St. John's Wort (Hypericum perforatum)
Drug Class: Herbal (herbal prozac)
Indications: Depression, anxiety, sleep disorders, nervousness
Adverse: Photosensitivty, dry mouth, fatigue, dizziness, confusion, GI upset, allergy
Contraindication: Bipolar depression, schizophrenia, Alzheimer's, dementia
*Don't take w/ other antidepressants
Drug Interactions: MAOI's, SSRI's, TCA's, benzo's, cyclosporine/immunosuppressants,
tyramine-foods, opiods, digoxin, estrogen, warfarin, triptans, (AND MORE!!)
Nursing Skills/Safe administration/Safety - Clopidogrel - When to hold? ✅Clopidogrel
(Plavix)
Drug Class: Antiplatelet (ADP Inhibitor)
Indication: Reduce risk of thrombotic stroke, prophylaxis against TIA's, post MI
prevention of thrombosis
Adverse: *Bleeding, chest pain, edema, epitaxis, flulike symptoms, headache,
dizziness, fatigue, abdominal pain, diarrhea/nausea, rash, pruitis (itching)
, Contraindications: Thrombocytopenia, active bleeding, leukemia, traumatic injury, GI
ulcer, vitamin K deficiency, recent stroke, allergy
Considerations:
- Hold 5-7 days prior to surgery
- Effects reduced by amiodarone, CCB's, NSAID's, and PPI's
- Increased bleeding risk in pts >75 y/o, history of stroke, or weigh less than 60kg
(132lbs)
- Use of dipyridamole increases bleeding potential
- Hold if platelet counts are at or below 80,000 cells/mm3
- Platelet therapeutic range: 150,000-450,000
Nursing Skills/Safe administration/Safety - Imitrex Contraindications ✅Sumatriptan
(Imitrex)
Drug Class: SSRA (triptans)
Indication: Migraine headache
Adverse: Cardiovascular adverse effects, nervousness, insomnia, convulsions
Contraindication: Cardiovascular disease, angina, history of stroke, MI
Consideration:
- No more than 2 injections during 24-hour period, 1 hr between injections
- Contact prescriber/emergency if swelling around the eyes, pain or tightness in chest or
throat, wheezing, and/or heart throbbing
- Rapid relief if taken before headache worsens
- Monitor S/S of coronary artery vasospasm, mI, serotonin syndrome
Safety/Teaching - Cyclosporine-Grapefruit ✅Cyclosporine (Sandimmune)
Drug Class: Immunosuppressant
Indication: Prevention of organ rejection (kidney, liver, and heart)
Adverse: Hypertension, neurotoxicity (including tremor), hepatotoxicity (with cholestasis
and hyperbilirubinemia), nephrotoxicity (IS COMMON), posttransplant diabetes, gingival
hyperplasia, hirsutism, **HAND TREMORS
Consideration:
**Avoid vaccines & alcohol
**Grapefruit can cause cyclosporine toxicity
- Grapefruit can inhibit metabolizing enzymes and increase activity of cyclosporine
- Increases bioavailability of drug by 20-200% and should be avoided
