NSG 251 Pharmacology Exam 2 (New
info only)
acarbose (Precose) - Correct Answer alpha glucosidase inhibitor
-inhibits enzymes in GI tract, delaying digestion of complex carbs (starch blocker)
use: DM2
adverse: GI upset, bloating
nursing imp: doesn't cause hypo, must take w/meal
acetaminophen (Tylenol) - Correct Answer antipyretic effects, no inflammatory or platelet effects
used to reduce pain/fever
may use w/GI problems
additive effect w/other opioids
IV: Ofirmev
adverse: hepatic failure w/high doses and nephrotoxicity w/overdose
overdose treatment: mucomyst (orally)
nursing implications: read label, <4g/day
use: febrile children & elderly, impaired renal fcn, pregnancy, alternate w/ibuprofen for fever, duration, avoid alcohol
acute pain - Correct Answer results from injury or trauma to body tissue
"fast pain"
addiction (psychological dependence) - Correct Answer chronic neurologic disease influenced by genetic,
psychosocial, and environmental factors
adrenal gland - Correct Answer sits on kidney
2 parts
adrenal medulla--secretes catecholemines
--epinephrine and norepinephrine
adrenal cortex--secretes corticosteroids
--glucocorticoids and mineralocorticoids
Adverse effects of NSAIDs - Correct Answer gastrointestinal-mild symptoms to GI bleeding
cardiovascular-increase thrombolytic events, MI, stroke
increase longer use/higher doses
Afrezza - Correct Answer Inhaled Insulin
Caution: Hypoglycemia
Contra: Lung problems
allopurinol, colchicine (Zyloprim) - Correct Answer anti-gout agent
nursing imp: obtain baseline serum of uric acid, take w/food, increase fluids 3L/day, rest/immobilize area, avoid
alcohol, low purine diet: watch anchovies, sardines, game meats, organ meats & yeast, may cause drowsiness
Analgesic/Anti-pyretic/Anti-inflammatory - Correct Answer inhibits formation of prostaglandins or leukotriene
pathways
blocks chemical cyclooxygenase (COX)
COX-1 or COX-2
May have anti-inflammatory, anti-pyretic, or anti-platelet effect
non-steroidal anti-inflammatory drugs: NSAIDs
anti-thyroid drugs - Correct Answer use: hyperthyroidism, thyroid crisis
drugs suppress thyroid hormone and prevent conversion of T4 to T3
aspirin - Correct Answer "ASA"
use: mild to moderate pain, fever, inflammation, decrease risk of thrombus,
low dose ASA for MI (81-325mg), angina, stroke, primary prevention of MI, prevent thromboembolism, surgery
patients
, non-cyclooxygenase (COX) inhibitor
adverse: stomach irritation, bleeding
nurse imp: toxicity--salicyism, tinnitus, avoid OTC meds w/ASA, stop to weeks before/after, take w/food, increase
fluids, highly binds to albumin, watch for bleeding, increases effects of alcohol, anticoags, opioids,& steroids
contra: pregnant women, children, Reye's syndrome, alcohol
butorphanol (Stadol)
nalbuphine (Nubain) - Correct Answer -antagonist/agonist
-agonist at some receptors/antagonist activity at others
-reduced potential for abuse
-do not give to pt who has received opiod analgesics (due to antagonistic activity)
cancer pain - Correct Answer in relation to cancer, causes of, metastisis, or pressure from it
celecoxib (Celebrex) - Correct Answer selective COX-2 inhibitor
blocks prostaglandins associated w/pain and inflammation w/o gastric upset or GI bleeding
use: arthritis
BBW: Increased risk of adverse cardiovascular event, risk of GI bleeding w/long term use
patients need to be advised of risk
chronic pain - Correct Answer pain for >3 months
stress, irritability, sleeplessness, depression
not always obvious
codeine - Correct Answer treats moderate-severe pain
older opioid
packaged with acetaminophen
contra: codeine allergy--side effect
cosyntropin (Cortrosyn) - Correct Answer hypothalamic/anterior pituitary
stimulates secretion of cortisol
use: test for adrenal sufficiency
dexamethasone (Decadron) - Correct Answer corticosteroid
IV, PO
use: antiflammatory, immunosuppressive, anti-allergic, anti-stress, Lupus
does not cure, controls symptoms
short term treatment
adverse: moon face, obese trunk w/thin extremities, hyperglycemia, psychosis, osteoporosis, paper thin skin, slow
healing
nursing imp: many drug interactions, taper over weeks, stoppage: acute adrenocortical insufficiency, body image,
long-term osteoporosis, Ca2+ and Vit D needed, give w/food, increased risk of infection
exenatide (Byetta) - Correct Answer Incretin Mimetic
-hormone release by GI tract in response to food, slows gastric emptying, increases satiety
SQ
use: DM2
adverse: GI upset
fentanyl (Duragesic) - Correct Answer morphine
transdermal, epidural, intrathecal
use: anesthesia
glipizide (Glucotrol) - Correct Answer 2nd generation Sulfonylurea
increase insulin excretion from pancreas
use: DM2
adverse: hypoglycemia
contra: renal problems
glyburide (Diabeta) - Correct Answer sulfonylurea
increase insulin excretion from pancreas
use: DM2
