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Mount Saint Joseph University
NUR 521 Exam 3 LATEST 2024-2025 ACCURATE
FALL- SPRING TERM Pharmacology/Medication
Administration
What type of drug is Glipizide and Glyburide? Sulfonylureas/anti-diabetic agent How do Glipizide and Glyburide act? Lowers blood sugar by stimulating the release of insulin from the pancreas and increasing sensitivity to insulin at the receptor sites. What are some AEs of Glipizide and Glyburide? Hypoglycemia, anorexia, nausea, vomiting, heartburn, metallic taste How long does Glipizide or Glyburide take to onset? 2 hours What are some interactions for Glipizide and Glyburide? Alcohol, NSAIDS, beta blockers
Mount Saint Joseph University What allergies to you assess for with Glipizide and Glyburide? Sulfonamide allergies How should Glipizide and Glyburide be given? Give before 1st meal, may need a second dose before dinner What needs to be monitored with Glipizide and Glyburide? Monitor glucose levels, HbA1c levels, CBC, liver, renal What type of drug is Repaglinide? Meglitinide; anti-diabetic agent How does Repaglinide act? Stimulated release of insulin from pancreatic beta cells but more rapidly than Glipizide/Glyburide; secretagogue What are some AEs of Repaglinide? Hypoglycemia, hyperglycemia
Mount Saint Joseph University There is a low risk because of the indirect actions What are some drug interactions with Metformin? No alcohol What needs to be monitored with Metformin? Symptoms of lactic acidosis - should be reported; glucose levels; HbA1c What type of drug is Pioglitazone? Thiazolidinediones (glitazones); anti-diabetic agent How does Pioglitazone act? Improves insulin sensitivity in muscle and adipose What are some AEs of Pioglitazone? HF, angioedema, hypoglycemia, hepatic toxicity
Mount Saint Joseph University What are contraindications of Pioglitazone? Liver disease, kidney disease What are drug interactions of Pioglitazone? Rifampin, cimetidine, atorvastatin What needs to be monitored with Pioglitazone? CBC, lung sounds, blood glucose, liver function, lipid profile, renal function What type of drug is Acarbose? Alpha-glucosidase inhibitor; anti-diabetic agent How does Acarbose act? Lowers blood glucose by inhibiting alpha-glucosidase in the GI tract; slows digestion of carbohydrates What are some AEs of Acarbose? Flatulence, abdominal cramps
Mount Saint Joseph University What are contraindications of Exenatide? Hypersensitivity, no preg, severe renal failure What should be monitored with Exenatide? Glucose levels, LFT, weight What type of drug is Glucagon? Hormone; antihypoglycemic How does Glucagon act? Stimulates hepatic production of glucose from glycogen stores Where is Glucagon produced? Alpha cells of pancreatic cells What are AEs of Glucagon?
Mount Saint Joseph University Hypotension, resp distress, nausea, vomiting What are contraindications of Glucagon? Oral anticoagulants What needs to be monitored with Glucagon? Blood glucose level, LOC What is a normal dose of Glucagon? 0.5 - 1 mg What is D50? Dextrose 50% in water; glucose-elevating agent How does D50 work? Increases blood glucose in pts who are unable to take an oral form of glucose
Mount Saint Joseph University What type of drug is Codeine/Hydrocodone? Mild narcotic for mild to moderate pain How does Codeine/Hydrocodone act? Acts on opioid receptors in CNS and is absorbed in the GI tract What are some AEs of Codeine/Hydrocodone? Suppresses cough - need to have pts cough to maintain airway What type of drug is Butorphanol, Pentazocine, Buprenorphine, Nalbuphine? Opioid agonist antagonist How do Butorphanol, Pentazocine, Buprenorphine, Nalbuphine act? Binds to opiate receptors in CNS; has partial antagonist properties that can result in opioid withdrawal in physically dependent patients What are some AEs for Butorphanol, Pentazocine, Buprenorphine, Nalbuphine? Resp depression, hypotension, constipation, physical dependence
Mount Saint Joseph University What is the antidote for Butorphanol, Pentazocine, Buprenorphine, Nalbuphine? Naloxone What type of drug is Naloxone? Opioid antagonist to reduce withdrawal symptoms How does Naloxone act? Competitively blocks the opioid effects What are some AEs of Naloxone? VT, VFib, Htn, hypotension What are contraindications of Naloxone? Titrate carefully, not effective against barbituates, resp. depression can occur What type of drug is Aspirin?
Mount Saint Joseph University What are NSAIDS? Ibuprofen, Naproxen (long acting), Ketorlac (IV), Meloxicam (arthritis), Celecoxib (last resort) How do NSAIDS work? Inhibit the COX-1 pathway which inhibits prostaglandin synthesis but it is reversible What are AEs of NSAIDS? Bleeding, hepatitis, constipation, blood dyscrasias What are contras of NSAIDS? Increases risk for MI/Stroke, stop in 3rd tri of preg, no before surgery, no alcohol, no aspirin What type of drug is Acetaminophen? Antipyretic; para-aminophenol How does Acetaminophen work? Inhibits prostaglandin synthesis in the CNS, has no effect on platelet aggregation
Mount Saint Joseph University What are AEs of Acetaminophen? Hepatotoxicity What is the antidote for Acetaminophen? Acetylcysteine What type of drug is Sumatriptan? Acute migraine medication How does Sumatriptan work? Causes vasoconstriction in the brain What are AEs of Sumatriptan? CA vasospasm, MI, cardiac ischemia, VFib, VT What are contras of Sumatriptan? No for CAD, antidepressants, no alcohol
Mount Saint Joseph University DMARD - rheumatoid arthritis How does Methotrexate act? Interferes with folic acid metabolism which inhibits lymphocytes which inhibits cytokines which inhibits TNF which then causes immunosuppression What are AEs of Methotrexate? Pulmonary fibrosis, bone marrow suppression, plaque erosions, hepatotoxicity, nephropathy What are education points for Methotrexate? Increase fluid intake to prevent nephrotoxicity What type of drug is Etanercept? Tumor Necrosis Factor Inhibitor (TNFI) How does Etanercept work? Inhibits TNF which is a mediator of inflammatory response
Mount Saint Joseph University What are AEs of Etanercept? Bone marrow suppression, infection, What are contras of Etanercept? Don't give to someone with immunosuppression, don't give to someone with demyelinating disease, don't give live vaccines What type of drug is Allopurinol? Xanthine oxidase inhibitor; #1 RA drug How does Allopurinol act? Inhibits production of uric acid by blocking xanthine oxidase What are AEs of Allopurinol? Bone marrow suppression, renal failure, hypersensitivity What are contras of Allopurinol? No alcohol, increase fluid intake, take with food
Mount Saint Joseph University What are AEs of Benemid? Headache, rash, kidney stones, GI upset What are contras of Benemid? Avoid beer, ale, wine, processed smoked meats What type of drugs are Filgrastim, Pegfilgrastim, Sargramostim? Colony stimulating factors; acceleration of bone marrow recovery How do Filgrastim, Pegfilgrastim, Sargramostim act? Stimulates neutrophils, used to treat chemo induced neutropenia What are AEs of Filgrastim, Pegfilgrastim, Sargramostim? Bone pain, weakness, edema, chills, fever What are contras of Filgrastim, Pegfilgrastim, Sargramostim?
Mount Saint Joseph University Hypersen to E.coli, not used for myeloid cancer What are nursing actions with Filgrastim, Pegfilgrastim, Sargramostim? Dilute in D5W, not NS; refrigerate, do not shake What type of drug is Oprelvekin? Colony stimulating factor; interleukin How does Oprelvekin act? Stimulates megakaryocytes and platelets What are AEs of Oprelvekin? Dyspnea, weakness, V arrhythmias, AFib, edema, palpitations, tachy, vasodilation, edema What are assessments with Oprelvekin? Assess for fluid retention, assess PC
