111 Questions
What is the primary mechanism of action of H1-receptor antagonists in the treatment of allergic rhinitis?
They block the actions of histamine at H1 receptors.
Which of the following is a common adverse effect of first-generation antihistamines?
Drowsiness
What is the primary action of mucolytics in the treatment of respiratory disorders?
They loosen thick, viscous bronchial secretions.
Which of the following is a contraindication for the use of intranasal corticosteroids?
Known infections
What is the primary mechanism of action of beta-adrenergic agonists in the treatment of asthma?
They relax bronchial smooth muscle.
Which of the following is a potential adverse effect of cough suppressants?
Hallucinations
What is the primary action of expectorants in the treatment of respiratory disorders?
They reduce the thickness of bronchial secretions.
Which of the following is a characteristic of second-generation antihistamines?
They have a less tendency for sedation.
What is the primary use of inhaled corticosteroids in the treatment of allergic rhinitis?
To reduce tissue edema and inflammation.
Which of the following is a nursing consideration for patients using mucolytics?
Teach patients proper administration techniques.
What is the primary cause of weakened bone in osteoporosis?
Calcium not being deposited into the bone
What is the therapeutic class of Colchicine?
Antigout
What is the most common site for gout to occur?
Big toe
What is the primary mechanism of action of calcium salts in the treatment of hypocalcemia?
Suppress the activity of osteoclasts
What is the primary reason Colchicine is reserved for?
Clients who cannot tolerate safer agents
What is the primary adverse effect of alendronate that is rare but serious?
Osteonecrosis of the jaw
What is the primary action of Colchicine in the treatment of gout?
Reduce the incidence of acute attacks
What is a common adverse effect of Colchicine?
GI toxicity
What is the primary mechanism of action of hydroxychloroquine in the treatment of autoimmune disorders?
Relieving severe inflammation
What is the primary adverse effect of methotrexate that is related to the gastrointestinal system?
Ulcerative stomatitis
What is the recommended route of administration for Colchicine?
Oral (with meals and a full glass of water)
What is the primary mechanism of action of allopurinol in the treatment of chronic gout?
Inhibiting the production of uric acid
What is the primary nursing consideration for patients taking calcium salts?
Taking the medication with a full glass of water
What is the primary contraindication for the use of alendronate?
Active upper GI problems
What is the primary adverse effect of xanthine oxidase inhibitors that is related to the kidneys?
Kidney injury
When is the pain typically worsened for patients with gastric ulcers?
30-60 minutes after eating
What is the primary action of proton pump inhibitors in the treatment of peptic ulcer disease?
Reducing acid secretion in the stomach
When should proton pump inhibitors be taken?
Before the first major meal of the day
What is the primary therapeutic use of alosetron?
Treatment of irritable bowel syndrome with diarrhea (IBS-D)
What is the primary mechanism of action of antacids in the treatment of peptic ulcer disease?
Neutralizing stomach acid
When should antacids be taken in relation to other medications?
At least 2 hours before or after other medications
What is the primary adverse effect of diphenoxylate with atropine?
Constipation
What is the primary indication for the use of alosetron?
Female patients with severe IBS-D lasting more than 6 months
How do antidiarrheal medications like diphenoxylate with atropine work?
By decreasing intestinal motor activity
What is the primary evaluation of effectiveness for proton pump inhibitors?
Reduced original symptoms
What is the effect of cardiac glycosides on the heart rate?
Decreased heart rate
What is the primary indication for the use of digoxin?
Heart failure
What is the effect of cardiac glycosides on the gastrointestinal system?
Decreased appetite
What is the significance of frequent serum checks in patients taking digoxin?
To monitor for toxicity
What is the contraindication for the use of digoxin in patients with ventricular dysrhythmias?
Due to increased risk of cardiotoxicity
What is the effect of verapamil on serum levels of digoxin?
Increased serum levels
What is the nursing consideration for patients taking digoxin?
Take apical pulse for 1 full minute
What is the interaction between digoxin and diuretics?
Increased risk of hypokalemia
What is the result of blood backing up into the lungs due to left-sided heart failure?
Pulmonary edema
What is the primary mechanism of action of cardiac glycosides in the treatment of heart failure?
Improving cardiac output
What is the recommended frequency of serum checks for patients taking digoxin?
Frequent
What is the primary adverse effect of cardiac glycosides that is related to the gastrointestinal system?
Nausea and vomiting
What is the interaction between digoxin and verapamil?
Increased serum levels of digoxin
What is the primary contraindication for the use of digoxin?
Ventricular dysrhythmias
What is the nursing consideration for patients taking digoxin?
Apical pulse for 1 full minute
What is the result of the interaction between digoxin and diuretics?
Increased risk of hypokalemia
What is the primary reason for monitoring INR levels in patients taking warfarin?
To assess the effectiveness of anticoagulation therapy
What is the therapeutic class of warfarin?
Anticoagulant
Which of the following herbal medications may interact with warfarin to increase the risk of bleeding?
All of the above
What is the normal range for aPTT levels in patients not on heparin?
30-40 seconds
What is the primary reason for monitoring platelet counts in patients with thrombocytopenia?
To detect bleeding complications
What is the primary contraindication for the use of warfarin in patients with recent trauma?
Bleeding complications
What is the pregnancy category of warfarin?
X
What is the primary mechanism of action of dabigatran?
Inhibits thrombin activity
Which of the following is a contraindication for the use of rivaroxaban?
All of the above
What is the primary action of heparin?
Inactivates several clotting factors
What is the primary adverse effect of heparin?
All of the above
What is the interaction between heparin and oral anticoagulants?
Increased risk of bleeding
What is the primary laboratory test used to monitor heparin therapy?
Activated partial thromboplastin time (aPTT)
What is the antidote for heparin overdose?
Protamine sulfate
What is the primary nursing consideration for patients taking dabigatran?
Monitor for bleeding
Which type of diabetes is characterized by insulin resistance?
Type 2
What is the therapeutic class of levothyroxine?
Thyroid hormone replacement
What is the adverse effect of corticosteroids that is characterized by buildup of fluid in the lower legs?
Buildup of fluid in the lower legs
What is the timing of administration for levothyroxine?
Same time every day before eating
What is the prototype drug for thyroid hormone replacement?
Levothyroxine
What is the mechanism of action of insulin aspart and lispro?
Lowering blood sugar levels
What is the onset of action for insulin glargine and detemir?
1-2 hours
What is the contraindication for the use of thyroid hormone in the treatment of obesity or weight loss?
Obesity or weight loss
What is the adverse effect of sulfonylureas that is characterized by weight gain?
Weight gain
What is the nursing consideration for patients taking insulin, in terms of evaluating effectiveness?
Blood glucose checks
What is the primary mechanism of action of levothyroxine in the treatment of hypothyroidism?
Replacing thyroid hormone
What is the primary adverse effect of corticosteroids that is related to bone health?
Bone pain
What is the onset of action of insulin aspart and lispro?
10-30 minutes
What is the primary contraindication for the use of thyroid hormone in the treatment of obesity or weight loss?
Use in the treatment of obesity or weight loss
What is the primary mechanism of action of fludrocortisone in the treatment of adrenocortical insufficiency?
Mimicking the effects of natural mineralocorticoids
What is the primary consequence of abrupt discontinuation of antiseizure medication?
Increased seizure frequency
What is the primary mechanism of action of phenobarbital in the treatment of seizures?
Enhancing the action of GABA
What is the primary adverse effect of diazepam (Valium) that is related to its use in the short term?
Tolerance and dependence
What is the antidote for benzodiazepine overdose?
Flumazenil
What is the primary reason for the importance of compliance with antiseizure medication regimens?
To maintain the correct amount of medication in the body
What is the primary consequence of increased levels of acetylcholine in patients with Parkinson's disease?
Decreased function of muscles and worsened posture and balance
What is the primary therapeutic class of phenobarbital?
Antiseizure drug
What is the primary mechanism of action of Levodopa in the treatment of Parkinson's disease?
Restores dopamine
What is the primary adverse effect of Pramipexole?
Sudden inability to stay awake
What is the primary mechanism of action of Latanoprost in the treatment of glaucoma?
Increase outflow of aqueous humor
Why is Latanoprost contraindicated in patients with closed-angle glaucoma?
It reduces the outflow of aqueous humor
What is the primary adverse effect of Timolol?
Blurred vision and stinging
What is the primary mechanism of action of Mementine in the treatment of Alzheimer's disease?
Reduce the levels of glutamate
What is the primary nursing consideration for patients taking Pramipexole?
Avoid activities that require alertness
What is the primary contraindication for the use of Timolol?
Asthma
What is the primary effect of androgens on male reproductive function?
Restore masculine characteristics
What is the primary contraindication for the use of testosterone in men?
Prostatic carcinoma
What is the primary mechanism of action of PDE-5 inhibitors in the treatment of erectile dysfunction?
Block PDE-5 enzyme
What is the primary adverse effect of testosterone therapy that is related to the liver?
Liver damage
What is the primary reason for monitoring BP and weight in patients taking testosterone therapy?
To monitor for fluid retention and edema
What is the primary indication for the use of testosterone therapy in men?
Hypogonadism
What is the primary nursing consideration for patients taking testosterone therapy?
Monitoring for fluid retention and edema
What is the primary mechanism of action of alpha 1 adrenergic blockers in the treatment of benign prostatic hyperplasia?
Relaxing the smooth muscle in the prostate to increase urine outflow
What is the primary consequence of not donating blood while taking 5-Alpha reductase inhibitors?
Increased risk of birth defects
What is the primary indication for the use of Antibiotics in the treatment of Chlamydia?
Treatment of chlamydial infections in newborns
What is the primary risk factor for the transmission of Human Papillomavirus?
Sexual intercourse
What is the primary mechanism of action of 5-Alpha reductase inhibitors in the treatment of benign prostatic hyperplasia?
Blocking the conversion of testosterone to dihydrotestosterone
What is the primary consequence of taking nitrates with phosphodiesterase inhibitors?
Hypotension, myocardial infarction, and sudden cardiac death
What is the primary indication for the use of Penicillin in the treatment of Syphilis?
Treatment of syphilis
What is the primary mechanism of action of phosphodiesterase inhibitors in the treatment of erectile dysfunction?
Rapid onset of action, lasting up to 4 hours
Study Notes
Respiratory Advantages/Disadvantages of Inhalation Route
- Antihistamines (H1-receptor antagonists) block actions of histamine at H1 receptor
- Widely used as OTC remedies for relief of allergy symptoms
- Examples: fexofenadine (Allegra), loratidine (Claritin), cetirizine (Zyrtec)
Antihistamines
- H1-receptor antagonists
- Examples: Diphenhydramine, Hydroxyzine
- Adverse effects: Anti-cholinergic effects, Sedation
Intranasal Corticosteroids
- Decrease secretion of inflammatory mediator
- Reduce tissue edema (inflammation)
- Cause mild vasoconstriction
- Treatment of perennial allergic rhinitis
- Prototype drug: Fluticasone (Flonase)
Mucolytics
- Directly loosen thick, viscous bronchial secretions
- Break down chemical structure of mucus molecules
- Mucus becomes thinner and can be removed more easily by coughing
- Prototype drug: Acetylcysteine (Mucomyst)
Cough Suppressants (Antitussives)
- Dampen cough reflex
- Used for coughs due to allergies or common cold
- Do not use for emphysema, bronchitis, liquid aspiration
- Prototype drug: Dextromethorphan (Delsym, Robitussin DM)
Asthma Rescue Drugs - Beta-Adrenergic Agonists
- Activate the sympathetic nervous system
- Relaxes bronchial smooth muscle
- Bronchodilation, widening the airway, making breathing easier
- Prototype drug: Albuterol (ProAir)
Musculoskeletal Disorders and Medications
- Gout
- Treatment: Colchicine (anti-gout drug, decreases inflammation caused by gout)
- Adverse effects: GI toxicity, bone marrow suppression
- Hypocalcemia
- Treatment: Calcium salts (calcium supplement)
- Adverse effects: Hypercalcemia, spasms
- Osteoporosis
- Treatment: Biphosphonates (suppress activity of osteoclasts, inhibit bone resorption)
- Adverse effects: Esophageal irritation, GI issues, hypocalcemia
- Prototype drug: Alendronate (Fosamax)
- DMARDs (Disease-modifying antirheumatic drugs)
- Examples: Hydroxychloroquine (Plaquenil), Methotrexate
- Adverse effects: GI upset, loss of hair, anorexia, headaches, mood changes, ocular effects
Gastrointestinal Disorders and Medications
- Peptic Ulcer Disease (PUD)
- Treatment: Proton pump inhibitors (reduce acid secretion in the stomach)
- Prototype drug: Omeprazole (Prilosec)
- Adverse effects: Generally minor
- Irritable Bowel Syndrome with Diarrhea (IBS-D)
- Treatment: Alosetron (selective blockade of 5-HT3 receptors)
- Adverse effects: Constipation, GI toxicity
- Contraindications: Chronic constipation, history of bowel obstruction
- Antidiarrheal
- Examples: Diphenoxylate with atropine, Loperamide
- Mechanism of action: Decrease intestinal motor activity, decrease fluid secretion, enhance mucosal absorption
Cardiovascular Disorders and Medications
- Heart Failure
- Treatment: Cardiac glycosides (positive inotropic effect, negative chronotropic effect, improved stroke volume and cardiac output)
- Prototype drug: Digoxin
- Adverse effects: Dysrhythmias, cardiotoxicity
- Anticoagulants
- Examples: Warfarin, Dabigatran (Pradaxa), Rivaroxaban (Xarelto)
- Adverse effects: Bleeding
- Interactions: Many medications and herbals
Coagulation Disorders and Medications
- Thrombocytopenia
- Treatment: Oral anticoagulants (inhibit action of vitamin K, synthesis of clotting factors)
- Prototype drug: Warfarin
- Adverse effects: Bleeding
- Interactions: Many medications and herbals
- Heparin (parenteral anticoagulant, indirect thrombin inhibitor)
- Adverse effects: Bleeding, heparin-induced thrombocytopenia (HIT)
Endocrine Disorders and Medications
- Diabetes Mellitus
- Treatment: Insulin (Type 1 and 2), Oral hypoglycemics (Type 2)
- Adverse effects: Hypoglycemia
- Prototype drug: Aspart (NovoLog), Lispro (Humalog)
- Thyroid Disorders
- Hypothyroidism
- Treatment: Thyroid hormone replacement
- Prototype drug: Levothyroxine (Synthroid)
- Hyperthyroidism
- Treatment: Beta blockers, thionamides
- Hypothyroidism
- Adrenal Disorders
- Cushing's syndrome
- Treatment: Corticosteroids (reduce inflammation)
- Prototype drug: Hydrocortisone
- Addison's disease
- Treatment: Mineralocorticoids (mimic effects of natural mineralocorticoids)
- Prototype drug: Fludrocortisone### Endocrine Disorders and Medications
- Cushing's syndrome
-
Diabetes Mellitus:
- Type 1: totally insulin dependent
- Type 2: insulin resistant
-
Cushing's Syndrome:
- ACTH production and corticosteroid medications
-
Hypo/Hyperthyroidism:
- Hyperthyroidism: excessive T3 and T4, leading to increased metabolism
- Hypothyroidism: insufficient T3 and T4, leading to decreased metabolism
-
Levothyroxine:
- Mechanism of action: thyroid hormone replacement
- Adverse effects: hyperthyroidism effects
- Nursing considerations: serum TSH levels, timing of administration, and black box warning
Corticosteroids
-
Hydrocortisone:
- Mechanism of action: reduces inflammation
- Adverse effects: fluid buildup, high blood pressure, and upset stomach
- Nursing considerations: monitor bone pain and bone health, toxicity, and long-term use
-
Fludrocortisone:
- Mechanism of action: mimics natural mineralocorticoids
- Adverse effects: retention of sodium and water
- Nursing considerations: monitor weight, BP, breath sounds, and urine output, and contraindications
Insulin
-
Type 1 Diabetes:
- Aspart, Lispro, Regular, NPH, Glargine, and Detemir
- Onset, peak, and duration for each type
- Adverse effects: hypoglycemic effects
- Nursing considerations: S/S of hypoglycemia, evaluation of effectiveness, and blood glucose checks
Neurological Disorders and Medications
-
Parkinson's Disease:
- Decreased dopamine and increased acetylcholine levels
- Medication classes: dopamine-enhancing drugs, NMDA receptor antagonists, and anticholinergics
-
Seizures:
- Medication classes: antiseizure drugs, sedatives, and antidepressants
- Adverse effects: rebound effects, adrenal gland atrophy
- Nursing considerations: compliance, timing of administration, and controlled substance schedule
Dopamine Enhancing Drugs
-
Levodopa:
- Mechanism of action: restores dopamine
- Adverse effects: uncontrolled movements, loss of appetite, nausea, and orthostatic hypotension
- Nursing considerations: may be unable to self-medicate, do not abruptly withdraw
Prostaglandin Analogs
-
Latanoprost:
- Mechanism of action: enhances outflow of aqueous humor to lower IOP
- Adverse effects: local effects within the ocular region
- Nursing considerations: remove contacts and avoid touching the eye or eyelashes with the dropper
Male/Female Reproductive Disorders
-
Hypogonadism:
- Lack of sufficient testosterone secretion
- Symptoms: diminished appearance of secondary sex characteristics, erectile dysfunction, and low sperm counts
-
Androgens:
- Mechanism of action: supports male reproductive function
- Adverse effects: increase/decrease libido, fluid retention, edema, liver damage, and virilization
- Contraindications: known/suspected prostatic carcinomas, pregnancy, and pre-existing prostatic enlargement
Erectile Dysfunction
-
PDE-5 Inhibitors:
- Mechanism of action: blocks PDE-5 enzyme to increase blood flow to the penis
- Adverse effects: hypotension, headaches, flushing, nasal congestion, priapism, and sudden hearing loss
- Nursing considerations: rapid onset, avoid high-fat meals and grapefruit juice
Benign Prostatic Hyperplasia
-
Alpha 1 Adrenergic Blockers:
- Mechanism of action: opens the prostate for outflow of urine and relaxes smooth muscle
- Adverse effects: hypotension
- Nursing considerations: monitor BP, rise slowly from sitting/lying position, and first dose phenomenon
Chlamydia
- Symptoms: silent symptoms, Chlamydial conjunctivitis, and Chlamydial pneumonia
- Assessment: risk factors, emotional support, partner awareness, and education
- Medications: antibiotics
Test your knowledge of respiratory medications, including antihistamines, mucolytics, cough suppressants, expectorants, inhaled corticosteroids, and asthma rescue drugs. This quiz covers their mechanisms of action, adverse effects, and nursing considerations.
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