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Pharm Final Exam

1.

What type of diuretic is hydrochlorothiazide?

thiazide diuretic

2.

What kind of diuretic is furosemide?

loop diuretic

3.

What kind of diuretic is spironolactone?

potassium sparing diuretic

4.

Why are diuretics given and to what kind of patients?

given to lower blood pressure in patients who have fluid overload and congestive heart failure

5.

What might diuretics cause?

orthostatic hypotension

6.

Furosemide and hydrochlorothiazide may cause what?

hypokalemia

7.

If your patient is taking furosemide or hydrochlorothiazide what levels should you be checking?

potassium levels

8.

Spironolactone may cause what?

hyperkalemia

9.

If your patient is taking furosemide what should you tell them to report and why?

ringing in the ear because it can cause ototoxicity

10.

If your patient is taking furosemide what should you advise them to do and why?

limit sun exposure and wear sunscreen as it can cause photosensitivity

11.

What is a side effect of antihypertensives?

hypotension

12.

If your patient is taking antihypertensives what should you advise them to do and why?

change positions slowly because it can cause hypotension

13.

What should you do before giving antihypertensives to your patient?

check their blood pressure and if low withhold the medication

14.

What suffix do ACE inhibitors have?

pril

15.

What type of medication are captopril, enalapril and lisinopril?

ACE inhibitors

16.

What are side effects of ACE inhibitors?

hypotension, angioedema, hyperkalemia

17.

ACE inhibitors are contraindicated in what kind of patients?

pregnant patients

18.

What suffix do beta blockers have?

olol

19.

What kind of medications are atenolol and metoprolol?

beta blockers

20.

What is an adverse effect of beta blockers?

bradycardia

21.

What must you check before giving beta blockers?

blood pressure and pulse rate

22.

What are adverse effects of insulin and antidiabetic medications?

hypoglycemia

23.

What should you advise your patient to do when taking antidiabetic medications or insulin?

take with food

24.

What two types of insulin can you mix together?

NPH and regular

25.

What is the only way insulin can be given?

via injections

26.

If regular insulin is cloudy what should you do and why?

discard it because it should clear

27.

A nurse is preparing to administer 10 units of regular insulin and 15 units of NPH insulin to a patient. What is the sequence of events you should follow?

inspect vials for contaminants, roll NPH vial between palms of hands, inject air into NPH insulin vial, inject air into regular insulin vial, withdraw short acting insulin into syringe, add intermediate insulin to syringe

28.

If you need to give your patient 10 units of regular insulin and 15 units of NPH insulin, how many units are you giving in total?

25 units total

29.

What kind of medication is digoxin?

antidysrhythmic

30.

What are signs of symptoms of digoxin toxicity?

nausea, vomiting, anorexia, changes in vision, bradycardia

31.

When should you withhold digoxin?

if your patient has bradycardia

32.

What suffix do HMG-CoA reductase inhibitors have?

statin

33.

What are two adverse effects of statins?

hepatotoxicity and myopathy

34.

Patient's taking statins should avoid what kind of beverages?

grapefruit juice and alcohol

35.

When is the best time to take statins?

evening or at bedtime

36.

If your patient reports weak or sore muscles while taking statins what should you do?

withhold the medication and contact the healthcare provider

37.

When administering nitroglycerin ointment what should you do and why?

avoid touching it by wearing gloves to avoid absorbing the medication through your skin

38.

Where should you apply nitroglycerin transdermal patches?

hairless and clear area

39.

How long should you remove nitroglycerin transdermal patches for and why?

10 to 12 hours to prevent tolerance

40.

What should you advise your patient to do if they are taking nitroglycerin?

change positions slowly and rest feet on the floor for a few minutes before standing up

41.

What is a common side effect of nitroglycerin?

throbbing headache

42.

What kind of classifications are opioids?

high alert drugs and controlled substances

43.

What can opioids do to a patient?

lower blood pressure, heart rate and respiratory rate

44.

What are side effects of opioids?

nausea and vomiting and constipation?

45.

If your patient is taking opioids what side effect should you educate them on?

constipation so advise them to eat foods with high fiber if it doesn't help you may give laxatives

46.

What is the antidote of opioids?

naloxone

47.

What kind of medication are acyclovir and valacyclovir?

antivirals

48.

What should you ask your patient before giving acyclovir?

if they have an allergy to milk

49.

What is the treatment for a patient with HIV?

antiretroviral therapy

50.

If your patient is taking antiretrovirals for HIV and is pregnant what should you advise them to do?

continue taking antiretroviral as prescribed throughout entire pregnancy to prevent transmission to the baby

51.

If your patient is taking acetaminophen what should you advise them to avoid?

alcohol, other hepatotoxic drugs and over the counter cold medications

52.

What are signs and symptoms of acetaminophen toxicity?

nausea and vomiting, abdominal pain, sweating, and diarrhea

53.

What is the antidote of acetaminophen?

acetylcysteine

54.

Why do you give anticoagulants?

to prevent clot formation

55.

What is a dangerous adverse effect of anticoagulants?

bleeding

56.

What are signs and symptoms of bleeding?

gum and nose bleeding, black tarry stool, tachycardia

57.

If your patient is taking heparin or warfarin what should you advise them to use?

soft toothbrush

58.

If your patient is taking heparin what should you be frequently be checking?

aPTT

59.

What is the antidote of heparin?

protamine sulfate

60.

What should you be checking if your patient is taking warfarin?

PT and INR

61.

What is the antidote of warfarin?

Vitamin K

62.

Why is heparin only given via injection?

it can not be absorbed PO

63.

If your patient is taking warfarin what should you advise them to avoid?

foods high in vitamin K

64.

What is an adverse effect of heparin?

Heparin induced thrombocytopenia (HIT)

65.

What does epoetin alfa treat?

anemia

66.

If your patient is taking epoetin alfa what else should they be taking for it to work?

iron supplements

67.

What does filgrastim do?

stimulates formation of white blood cells

68.

What should you monitor when taking filgrastim?

white blood cells twice a week

69.

When you withdraw a dose of filgrastim from a vial what should you do with the rest?

discard the entire vial after one use

70.

What is are side effects of filgrastim?

splenomegaly and bone pain

71.

What is Parkinson's disease?

low levels of dopamine in the brain

72.

What are symptoms of Parkinson's disease?

stooped posture, masked face, tremors, shuffling gait, back rigidity

73.

How do you know if medications for Parkinson's are working?

the patient experiences less tremors and rigidity

74.

What are adverse effects of insulin and antidiabetic medications?

hypoglycemia

75.

What should you warn your patient about when taking carbidopa and levodopa?

it may turn urine and saliva into a dark color

76.

What should patients avoid when taking MAO inhibitors and why?

foods that contain tyramine because it can cause severe high blood pressure

77.

What are examples of food that contain tyramine and should be avoided by patients taking MAO inhibitors?

cheddar cheese, aged cheeses, avocado, sourdough bread, beer, red wine

78.

What type of medication is Bupropion and what else can it be used for?

it is an antidepressant that is also used for smoking cessation

79.

How do you know bupropion is working when being taken for smoking cessation?

decreased urge to smoke

80.

What are signs and symptoms of hypothyroidism?

slow heart rate, slow respiration rate, always feels cold, weight gain, constipation, always tired

81.

What medication is used to treat hypothyroidism?

levothyroxine

82.

What are signs and symptoms of levothyroxine overdose?

tachycardia, tachypnea, nervousness, sweating, insomnia

83.

What are signs and symptoms of hyperthyroidism?

tachycardia, tachypnea, nervousness, sweating, intolerance to heat, weight loss, protruding eyes, diarrhea

84.

What medications are used to treat hyperthyroidism?

methimazole and propylthiouracil

85.

What might methimazole and propylthiouracil cause?

agranulocytosis (decreased number of white blood cells)

86.

What medication is used to treat osteoporosis?

alendronate

87.

What should you advise your patient to do when taking alendronate?

take with a full glass of water and remain sitting or standing for at least 30 minutes after taking it and don't take with milk or dairy

88.

What are adverse effects of alendronate?

jaw pain, blurred vision and dysphagia

89.

What are signs and symptoms of menopause?

hot flashes, depression, swinging moods, osteoporosis

90.

What can help treat symptoms of menopause?

hormone replacement therapy like medroxyprogesterone and conjugated estrogens

91.

What are side effects of medroxyprogesterone and conjugated estrogens?

increased risk of cervical cancer and clot formation

92.

What kind of medications are fluoxetine and paroxetine?

selective serotonin reuptake inhibitors (SSRIs)

93.

What should you tell your patient that is about to take SSRIs?

they make take 3-6 weeks to work so continue taking them

94.

What is an adverse effect of SSRIs?

increased risk of suicide within the first few weeks and sexual dysfunction

95.

What are the positive symptoms of schizophrenia?

hallucinations, delusions, disordered thinking

96.

What are negative symptoms of schizophrenia?

lack of motivation, lack of personal hygiene, lack of social interest

97.

How do you know if treatment for schizophrenia is working?

decreased hallucinations, better personal hygiene, better social interaction

98.

What does haloperidol treat?

schizophrenia

99.

What is an adverse effect of haloperidol?

pseudo parkinsonism

100.

What are signs and symptoms of pseudo parkinsonism?

shuffling gait, tremor, stooped posture

101.

What are signs and symptoms of neuroleptic malignant syndrome?

fever, muscle rigidity, unstable blood pressure, dilated pupils

102.

What kind of medications are risperidone and quetiapine?

atypical antipsychotics

103.

What should you advise your patient to do if they are taking atypical antipsychotics and why?

check their weight because they can cause weight gain

104.

What do benzodiazepines cause?

sedation and drowsiness

105.

What suffix do benzodiazepines have?

pam or lam

106.

What kind of medication is lorazepam?

Benzodiazepine

107.

When should you withhold benzodiazepines?

if your patient is experiencing increased anxiety (paradoxical excitement)

108.

What is lithium used to treat?

bipolar disorder

109.

What is bipolar disorder?

episodes of mania and depression

110.

What are signs and symptoms of lithium toxicity?

tremor, slurred speech, nausea and vomiting

111.

You should you make sure your patient has enough intake of in their diet when taking lithium?

sodium

112.

Aspirin increases the risk of what?

GI bleeding

113.

What can be a contraindication for aspirin?

history of vitamin K deficiency

114.

What is salicylism?

aspirin toxicity

115.

What are signs and symptoms of salicylism?

fever, tinnitus, headache, sweating, dizziness, respiratory depression

116.

What patients should you not give aspirin to and why? What should you give them instead?

young children because it can cause Reye's syndrome so acetaminophen should be given instead

117.

How do first generation antihistamines work?

they reach the brain and cause sedation and drowsiness

118.

What are examples of first generation antihistamines?

chlorpheniramine and promethazine

119.

When should you take first generation antihistamines?

at bedtime because they cause sedation and drowsiness

120.

What are examples of second generation antihistamines?

loratadine, fexofenadine, cetirizine

121.

What generation of antihistamines won't make you drowsy?

second generation

122.

What suffix do proton pump inhibitors (PPI) have?

prazole

123.

When is the best time to take proton pump inhibitors (PPI)?

once a day usually 30-60 minutes before breakfast

124.

What are side effects of proton pump inhibitors (PPI)?

increased risk of pneumonia, osteoporosis, photosensitivity

125.

What kind of medication is prednisone?

Corticosteroid

126.

What should you be checking often in a patient that is taking corticosteroids?

blood sugar levels because they can be increased

127.

What suffix do penicillin's have?

cillin

128.

What is an adverse effect of penicillin?

anaphylaxis

129.

What are signs and symptoms of anaphylaxis?

swelling of lips and tongue, difficulty breathing, low blood pressure

130.

What is the treatment for a patient experiencing anaphylaxis?

epinephrine injection subcutaneously

131.

What medications are used to treat tuberculosis?

isoniazid, pyrazinamide, rifampin, ethambutol

132.

How long should patients take medications to treat tuberculosis?

9-12 months

133.

What should you check before giving treatment for tuberculosis and why?

liver function because the medications are hepatoxic

134.

What can rifampin cause?

orange urine, saliva and other body secretions

135.

Your patient develops urticaria, rash and itching during blood transfusion. What is your priority action?

stop the transfusion

136.

What should you give to a patient that is experiencing an asthma attack?

short acting beta2 agonists

137.

What suffix do short acting beta2 agonists have?

buterol

138.

What are contraindications for receiving the varicella vaccine?

pregnancy, immunocompromised, allergy to gelatin and neomycin

139.

What age should a patient receive the meningococcal conjugate polysaccharide vaccine (MCV 4)?

age of 6-12 and a booster at age 16

140.

Who can receive yearly flu vaccines?

everyone including pregnant patients

141.

Who can receive live attenuate influenza vaccines?

patients between the ages 2 and 50

142.

Who can not receive the live attenuate influenza vaccine?

children 2-17 who are taking aspirin, patients who are taking antiviral medication, patients under the age of 2 and patients over the age of 50, and patients that are pregnant

143.

What age should the measles, mumps and rubella (MMR) vaccine be given?

12-15 months and booster at age of 4-6 years

144.

How should you take carbidopa and levodopa?

on an empty stomach but if discomfort is experienced they may be taken with applesauce

145.

What are adverse effects of insulin and antidiabetic medications?

hypoglycemia