1460C Medications - Module 1 & Module 2
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What is the primary classification of Fluoxetine (Prozac)?

  • Norepinephrine reuptake inhibitor
  • Monoamine oxidase inhibitor
  • Serotonin antagonist
  • Selective serotonin reuptake inhibitor (correct)

    • Match the following medications with their respective indications for use:

    Fluoxetine (Prozac) = Depression, anxiety, panic disorders Serotonin Syndrome = Adverse effect from SSRIs SSRIs = For treating anxiety and depression Discontinuation syndrome = Requires gradual tapering off

    Which of the following is a purpose for which Propranolol has been approved by the FDA?

  • Allergy relief
  • Muscle relaxation
  • Hypertension (correct)
  • Nausea

    • Propranolol can be used to treat anxiety and hypertension.

    <p>True</p> Signup and view all the answers

    What adverse effect may occur from the use of Kava in patients experiencing orthostatic hypotension?

    <p>Enhanced CNS effects</p> Signup and view all the answers

    What should be avoided when treating a patient with orthostatic hypotension and medications for this condition?

    <p>Grapefruit juice</p> Signup and view all the answers

    Which statement is true regarding the cumulative effect of multi-time dosing for orthostatic hypotension medications?

    <p>Relief of symptoms may take 3-4 weeks to become evident.</p> Signup and view all the answers

    Which of the following medications should not be combined with antifungal medications when considering treatment for patients with orthostatic hypotension?

    <p>St. John's wort</p> Signup and view all the answers

    Which lifestyle choice is particularly important for individuals with orthostatic hypotension?

    <p>Abstinence from alcohol</p> Signup and view all the answers

    Which condition is not commonly treated with Escitalopram?

    <p>Hypertension</p> Signup and view all the answers

    What is a potential serious effect indicated by a black box warning for Escitalopram?

    <p>Serotonin syndrome</p> Signup and view all the answers

    How long may it typically take before symptoms improve after starting Escitalopram?

    <p>3-4 weeks</p> Signup and view all the answers

    Which of the following is a common side effect associated with Escitalopram?

    <p>Visual changes</p> Signup and view all the answers

    What should be avoided due to interactions with SSRIs like Escitalopram?

    <p>St. John's Wort</p> Signup and view all the answers

    Which of the following symptoms could indicate serious side effects while taking Escitalopram?

    <p>Diaphoresis</p> Signup and view all the answers

    When should Escitalopram ideally be taken to minimize gastrointestinal side effects?

    <p>With meals</p> Signup and view all the answers

    What is a critical warning associated with Duloxetine (Cymbalta)?

    <p>Suicidal ideations</p> Signup and view all the answers

    Which of the following side effects might indicate a serious health risk while taking Duloxetine?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    Duloxetine is indicated for treating which of the following conditions?

    <p>Anxiety and depression</p> Signup and view all the answers

    What potential interaction should be avoided when taking Duloxetine?

    <p>St John's wort</p> Signup and view all the answers

    Which of the following gastrointestinal symptoms may occur when taking Duloxetine?

    <p>Nausea</p> Signup and view all the answers

    What is the approximate duration before symptoms may start to improve with Duloxetine?

    <p>3-4 weeks</p> Signup and view all the answers

    What effect can Duloxetine have on a person's heartbeat?

    <p>Irregular heartbeat</p> Signup and view all the answers

    Which of the following conditions is NOT treated by Duloxetine?

    <p>Hypertension</p> Signup and view all the answers

    Which of the following are common neurological side effects of Duloxetine?

    <p>Tremors and dizziness</p> Signup and view all the answers

    What is a risk associated with abruptly stopping the use of Lorazepam?

    <p>Increased anxiety symptoms</p> Signup and view all the answers

    Which of the following conditions may indicate the use of Diazepam?

    <p>Acute anxiety</p> Signup and view all the answers

    How should the dosage of Lorazepam be adjusted to prevent rebound disinhibition?

    <p>Slowly titrated</p> Signup and view all the answers

    What serious effects must be considered for patients with liver disease when taking Lorazepam?

    <p>Heightened sedation</p> Signup and view all the answers

    When is it inappropriate to consume alcohol while using Lorazepam?

    <p>At any time during treatment</p> Signup and view all the answers

    Why might a patient experience dependency when using Diazepam?

    <p>It has a high potential for abuse</p> Signup and view all the answers

    Which of the following indicates a common use for Lorazepam?

    <p>Treating acute anxiety</p> Signup and view all the answers

    What is a potential effect of using Lorazepam for status epilepticus?

    <p>Duration of seizure activity shortened</p> Signup and view all the answers

    Which effect is NOT typically associated with the use of benzodiazepines like Lorazepam?

    <p>Increased anxiety levels</p> Signup and view all the answers

    What is an important consideration when treating someone with both benzodiazepines and liver disease?

    <p>Lower standard doses</p> Signup and view all the answers

    What is an important warning associated with Venlafaxine usage?

    <p>Black box warning for suicidal ideations</p> Signup and view all the answers

    What potential side effect is specifically linked to Venlafaxine that may indicate a need for medical attention?

    <p>Irregular heartbeat</p> Signup and view all the answers

    What condition can Venlafaxine be used to treat?

    <p>Anxiety disorders</p> Signup and view all the answers

    Which medication should be avoided when taking Venlafaxine due to a risk of interaction?

    <p>St John's Wort</p> Signup and view all the answers

    What is a possible effect caused by the cumulative nature of Venlafaxine?

    <p>Relief that may take 3-4 weeks to manifest</p> Signup and view all the answers

    Which symptom is NOT commonly associated with Venlafaxine usage?

    <p>Weight gain</p> Signup and view all the answers

    Which of the following describes an important aspect of Venlafaxine dosing?

    <p>Should be taken with food</p> Signup and view all the answers

    What is a common concern regarding drug interactions with Venlafaxine?

    <p>Interacts with anticoagulants and antifungals</p> Signup and view all the answers

    What type of medications should be closely monitored when prescribed alongside Venlafaxine?

    <p>SSRIs</p> Signup and view all the answers

    What neurological side effect could be experienced by a patient taking Venlafaxine?

    <p>Anxiety and tremors</p> Signup and view all the answers

    Which of the following statements about Sodium Zirconium Cyclosilicate (Lokelma) is correct?

    <p>It exchanges hydrogen and sodium for potassium in the colon.</p> Signup and view all the answers

    When is the use of Sodium Zirconium Cyclosilicate contraindicated?

    <p>For patients experiencing severe hyperkalemia.</p> Signup and view all the answers

    What is an important monitoring parameter while using Sodium Zirconium Cyclosilicate?

    <p>Tracking potassium levels through serum measurements.</p> Signup and view all the answers

    What adverse effect may suggest a need for further evaluation in patients taking Sodium Zirconium Cyclosilicate?

    <p>Unusual tiredness and weakness.</p> Signup and view all the answers

    In patients treated with Sodium Zirconium Cyclosilicate, what symptom could indicate adverse effects?

    <p>Signs of respiratory distress like shortness of breath.</p> Signup and view all the answers

    What key adverse effect is associated with furosemide usage?

    <p>Electrolyte depletion</p> Signup and view all the answers

    Which patient condition should immediately disqualify the use of hydrochlorothiazide?

    <p>Sulfa allergies</p> Signup and view all the answers

    What is a potential serious side effect of furosemide that could warrant immediate medical attention?

    <p>Temporary hearing loss</p> Signup and view all the answers

    Which of the following is a potential consequence of electrolyte depletion due to diuretics?

    <p>Cold, clammy skin and confusion</p> Signup and view all the answers

    What dietary recommendation is suggested for patients taking furosemide?

    <p>Eat more potassium-rich foods</p> Signup and view all the answers

    What nursing implication is critical when administering furosemide to a patient?

    <p>Monitor for signs of lithium toxicity</p> Signup and view all the answers

    Which of the following is a characteristic effect of hydrochlorothiazide?

    <p>Increased urination and potassium depletion</p> Signup and view all the answers

    What is a primary therapeutic use of Spironolactone?

    <p>Hypertension management</p> Signup and view all the answers

    Which of the following side effects may indicate the need to discontinue Spironolactone?

    <p>Cold, clammy skin</p> Signup and view all the answers

    How does Spironolactone primarily affect the body's electrolyte balance?

    <p>Increases sodium and water excretion</p> Signup and view all the answers

    What condition is NOT an off-label use for Spironolactone?

    <p>Calcium containing calculi</p> Signup and view all the answers

    What should be monitored closely when administering diuretics like Spironolactone?

    <p>Potassium levels</p> Signup and view all the answers

    In what situation should Spironolactone not be combined with other medications?

    <p>NSAIDs for inflammation</p> Signup and view all the answers

    Which of the following symptoms might suggest lithium toxicity when taken together with certain medications?

    <p>Confusion</p> Signup and view all the answers

    What is a possible effect of sodium wasting in patients?

    <p>Decreased blood pressure</p> Signup and view all the answers

    What could be the expected outcome of careful dosing of diuretics?

    <p>Minimized risk of dehydration</p> Signup and view all the answers

    What is the primary function of Potassium Chloride (KCL) when administered orally?

    <p>To replace lost potassium due to renal failure</p> Signup and view all the answers

    Which dietary consideration should be taken into account when administering Potassium?

    <p>Give potassium with meals</p> Signup and view all the answers

    What severe complication can occur due to hyperkalemia?

    <p>Cardiac arrhythmias</p> Signup and view all the answers

    Which of the following should be avoided when taking potassium supplements due to the risk of hyperkalemia?

    <p>Potassium-sparing diuretics</p> Signup and view all the answers

    What is a concerning side effect of intravenous potassium administration?

    <p>Skin rash</p> Signup and view all the answers

    Which intervention is critical when administering intravenous potassium?

    <p>Administering in a large vein</p> Signup and view all the answers

    What is a common consequence of administering sodium polystyrene sulfonate for hyperkalemia?

    <p>Intestinal necrosis</p> Signup and view all the answers

    What monitoring is essential when administering potassium supplements?

    <p>Serum potassium levels</p> Signup and view all the answers

    What symptom may indicate the need to evaluate the dosage of potassium supplements?

    <p>Excessive thirst</p> Signup and view all the answers

    Which interaction poses a significant risk when prescribing potassium supplements?

    <p>With NSAIDs</p> Signup and view all the answers

    What is the primary mechanism of action of Patiromer?

    <p>Binds to potassium in the colon</p> Signup and view all the answers

    Which of the following conditions is a contraindication for using Patiromer?

    <p>Severe hyperkalemia</p> Signup and view all the answers

    What is the recommended method of administration for Patiromer?

    <p>Orally as a powder suspension</p> Signup and view all the answers

    What is a potential onset time for Patiromer effect after administration?

    <p>Approximately 6 hours</p> Signup and view all the answers

    Which electrolyte does Patiromer primarily target to reduce levels in the blood?

    <p>Potassium</p> Signup and view all the answers

    Which statement is accurate regarding the use of Patiromer in hyperkalemia treatment?

    <p>It requires renal function monitoring.</p> Signup and view all the answers

    What is the primary concern associated with the administration of Patiromer?

    <p>Electrolyte imbalance</p> Signup and view all the answers

    How does Patiromer interact with other medications?

    <p>May reduce their effectiveness</p> Signup and view all the answers

    What class of patients should approach the use of Patiromer with caution?

    <p>Patients with chronic kidney disease</p> Signup and view all the answers

    What is a common side effect that may occur with Patiromer use?

    <p>Constipation</p> Signup and view all the answers

    Study Notes

    1460C Medications - Module 1

    • Serotonin Syndrome: A result of taking SSRIs; discontinuation must be slow. Flu-like symptoms, difficulty concentrating, and faintness are possible adverse effects. Gastrointestinal (GI) disturbances are also possible. Agitation, seizures, muscle stiffness may necessitate switching to another class of medication.
    • Patient Teaching: Notify PCP if symptoms such as delirium, agitation, tachycardia, muscle spasms, hyperreflexia, shivering, coarse tremors, and vital sign changes or encephalopathy or restlessness or sweating occur.

    Fluoxetine (Prozac)

    • Classification: Selective Serotonin Reuptake Inhibitor (SSRI).
    • Indications: Anxiety, panic disorders, depression, OCD, PTSD
    • Adverse Effects: Weight loss/gain, gastrointestinal (GI) symptoms, tremors, diaphoresis (sweating), sexual dysfunction, and nocturnal teeth grinding (possible). Hypotension.
    • Nursing Implications: Suicidal ideation. A black box warning. Avoid St. John's wort. Cumulative effect may take 3-4 weeks before symptoms are relieved; take with food.

    Paroxetine (Paxil)

    • Classification: Selective Serotonin Reuptake Inhibitor (SSRI).
    • Indications: Anxiety, panic disorders, depression
    • Adverse Effects: Weight loss/gain, gastrointestinal (GI) symptoms, tremors, diaphoresis (sweating), sexual dysfunction. Hypotension.
    • Nursing Implications: Suicidal ideation. Black box warning. Avoid St. John's wort. Take with food. Sexual dysfunction.

    Additional Medications

    • Sertraline (Zoloft): SSRI; weight gain possible. GI and sexual dysfunction. Orthostatic hypotension is possible.
    • Escitalopram (Lexapro): SSRI; weight gain possible. GI and sexual dysfunction and irregular heartbeat possible. Orthostatic hypotension is possible.
    • Duloxetine (Cymbalta): Serotonin/Norepinephrine Reuptake Inhibitor (SNRI). Includes weight loss/gain possible, Irregular heartbeat, and GI symptoms, including tremor and sweating (diaphoresis).Orthostatic hypotension is possible.
    • Venlafaxine (Effexor): SNRI; irregular heartbeat, weight loss/gain possible; includes GI symptoms, anxiety, tremor, diaphoresis. Orthostatic hypotension is possible.
    • Lorazepam (Ativan): Benzodiazepine; can cause over-sedation, orthostatic hypotension, serious effects on those with liver or renal disease.
    • Diazepam (Valium): Benzodiazepine. Causes over-sedation, orthostatic hypotension, serious effects on those with liver or renal disease.
    • Alprazolam (Xanax): Benzodiazepine; headache, dry mouth, over-sedation, orthostatic hypotension possible. Includes serious effects in those with liver or renal issues.
    • Chlordiazepoxide (Librium): Benzodiazepine. Dizziness and confusion, orthostatic hypotension possible in the elderly.
    • Buspirone (Buspar): Anxiolytic.
    • Bupropion (Wellbutrin, Zyban): Norepinephrine-dopamine reuptake inhibitor (NDRI). May cause headaches, seizures, hypotension, and orthostatic hypotension.
    • Flumazenil (Romazicon): Benzodiazepine antagonist. IV use (only). Re-sedation possible. Headaches, diaphoresis (sweating), seizures,possible. Orthostatic hypotension is possible.

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