notebook LM flashcards

What is the primary contraindication for receiving a vaccine?

previous allergic reaction

The Zosters Vaccine is administered to boost the body's immune response to what virus?

The herpes zoster virus, which causes shingles.

What is the primary side effect of first- generation antihistamines like Diphenhydramine?

drowsiness

Corticosteroids, which often end in the suffix _, can cause immunosuppression at high doses.

sone

When discontinuing corticosteroids like prednisone, why must the dose be tapered?

To prevent adrenal suppression.

What is a significant metabolic side effect of corticosteroids like dexamethasone?

They will increase blood glucose levels.

What does the acronym DMARDs stand for?

Disease- Modifying Antirheumatic Drugs.

How long can it take for the DMARD Methotrexate to start working?

It can take 3 to 12 weeks to become effective.

The DMARD Adalimumab deactivates _ to decrease inflammation.

TNF (Tumor Necrosis Factor)

When a patient is taking Adalimumab, what organ toxicity should be monitored for?

Liver toxicity, with signs like abdominal pain, nausea, and jaundice.

The COX- 2 inhibitor Celecoxib (Celebrex) should be taken with food, milk, or water to prevent what side effect?

GI distress

What precaution should be taken when applying topical Capsaicin?

Wear gloves when applying and avoid contact with eyes.

Aspirin is an analgesic, antipyretic, and anti-inflammatory, and it is also used as a _____ inhibitor.

platelet

What is the classic sign of Aspirin toxicity?

Tinnitus (ringing in the ears).

Why is Aspirin not recommended for children under the age of 18?

Its use is associated with Reye's syndrome, a potentially fatal condition.

While Acetaminophen (Tylenol) is an analgesic and antipyretic, it is NOT an _.

antiinflammatory

What is the maximum recommended daily dose of Acetaminophen (Tylenol)?

4 grams per day.

What is the antidote for Acetaminophen overdose?

Acetylcysteine.

By inhibiting _____, Non-steroidal anti-inflammatory drugs (NSAIDs) decrease pain.

prostaglandins

Besides GI bleed and platelet inhibition, what is another serious side effect of NSAIDs like ibuprofen?

Nephrotoxicity (kidney damage).

Opioids work by stimulating _ receptors in the Central Nervous System (CNS).

opiate (specifically MU receptors)

What is the most critical adverse effect of opioids to monitor for?

Respiratory depression.

When a patient requires more of an opioid to achieve the same effect, this is known as _, which is not the same as addiction.

tolerance

What is the antagonist or reversal agent for opioids?

Naloxone (Narcan).

When administering an opioid, what is the minimum respiratory rate below which the medication should be held?

A respiratory rate less than 12 breaths per minute.

Due to its shorter half-life compared to most narcotics, what might be necessary after administering Naloxone?

Repeat dosing may be needed as the opioid can outlast the Naloxone.

The serotonin agonist Sumatriptan is a vasoconstrictor, making it dangerous for patients with what conditions?

High blood pressure (Hypertension) or coronary artery disease (Angina).

Benzodiazepines, which often end in the suffix 'pam', affect the levels of what neurotransmitter?

GABA (gamma--aminobutyric acid).

What is the antagonist for benzodiazepines like lorazepam?

Flumazenil.

SSRIs like Fluoxetine (Prozac) may take how long for patients to see results?

4 to 6 weeks.

A patient on an SSRI develops confusion, hyperreflexia, and diaphoresis. What condition should be suspected?

Serotonin syndrome.

Patients taking SSRIs should avoid mixing them with _ because it can exacerbate the risk for GI bleed.

ibuprofen

The atypical antidepressant Bupropion (Wellbutrin) is used for depression, seasonal affective disorder, and _.

smoking cessation

Due to its sedating effects, the SARI antidepressant Trazodone is typically given at what time of day?

At bedtime.

A key nursing observation for a patient taking Phenytoin (Dilantin) is to assess for what oral condition?

Gingival hyperplasia (overgrowth of gum tissue).

The anticonvulsant carbamazepine can cause bone marrow suppression, affecting WBCs and what other blood cell type?

Platelets, which increases the risk of bleeding.

Valproic Acid is highly toxic to the _, and can cause high ammonia levels.

liver

The Alzheimer's drug Donepezil (Aricept) works by increasing which neurotransmitter?

Acetylcholine.

The NMDA receptor antagonist Memantine should not be taken with over-the-counter ________

antacids such as sodium bicarbonates

Which Beta2-adrenergic agonist is the only one indicated for an acute asthma attack?

Albuterol (a short-acting beta agonist or SABA). (4-6 hours)

What are the primary side effects of beta2- adrenergic agonists like albuterol

Tachycardia, tremors, and angina.

Anticholinergic inhalers like ipratropium can cause _ and hoarseness, which can be mitigated by rinsing the mouth after use.

mouth dryness

Why should patients rinse their mouths with water after using an inhaled glucocorticoid like budesonide?

To prevent the growth of yeast or candida (oral thrush).

When a patient is prescribed both an inhaled glucocorticoid and a beta- 2 agonist, which one should be used first?

The beta-2 agonist should be used first to bronchodilate the airways.

For exercise induced bronchospasm, the leukotriene modifier Montelukast should be taken how long before exercise?

2 hours before exercise

The expectorant Guaifenesin works by increasing and thinning mucous secretions, and its effectiveness is maximized by taking it with _.

a full glass of water

The mucolytic Acetylcysteine has a characteristic odor that smells like what?

Rotten eggs.

While taking the methylxanthine Theophylline, patients should be educated to avoid consuming what common substance?

Caffeine, as it can increase the risk of CNS and cardiac adverse effects.

Oseltamivir, an influenza neuraminidase inhibitor, should be started within how many days of symptom onset?

Within 2 days.

ACE Inhibitors, which typically end in 'pril', can cause a life threatening adverse effect called _.

angioedema

What is a common, non- life-threatening side effect of ACE inhibitors like lisinopril that patients should be monitored for?

A persistent, dry cough.

Beta blockers, which end in 'lol', should not be given if the patient's heart rate is below what value?

Below 60 beats per minute.

The non- selective beta blocker Propranolol is contraindicated in patients with what respiratory condition?

Asthma, due to the risk of bronchospasm.

A common complication of nitroglycerin administration is a _, which can be treated with aspirin or acetaminophen.

headache

Patients taking sublingual nitroglycerin can take one tab every 5 minutes for up to how many doses?

Up to three tabs (over 15 minutes).

To reduce the risk of tolerance, a transdermal nitroglycerin patch should be removed for how long each day?

It should be removed at night to be medication

HMG- CoA reductase inhibitors, known as 'statins', can cause muscle aches and require monitoring of what organ's function?

the liver

Patients taking 'statins' like atorvastatin should be advised to avoid drinking what type of juice?

Grapefruit juice.

The loop diuretic Furosemide can be _, so the nurse must monitor for tinnitus and ringing in the ears.

ototoxic

What is the antidote for the anticoagulant Warfarin?

Vitamin K.

What laboratory value must be monitored for a patient on Warfarin therapy?

The INR (International Normalized Ratio), with an optimum range of 2

How is the thrombin inhibitor Enoxaparin administered?

As a deep subcutaneous injection in the abdomen, at least 2 inches from the umbilicus.

The sulfonylurea drug Glipizide works by stimulating islet cells in the _ to produce insulin.

pancreas

Kidney insufficiency in a patient taking Metformin increases the risk for what serious condition?

Lactic acidosis.

The thiazolidinedione Pioglitazone reduces insulin resistance and requires monitoring for signs of what condition?

Heart failure (e.g., fluid retention, edema, weight gain).

The alpha- glucoside inhibitor Acarbose slows the absorption of carbohydrates and should be given when?

at the beginning of meals

Which type of insulin is considered rapid acting?

Lispro (Humalog) or Novolog.

Which type of insulin is considered long acting?

Glargine (Lantus) or Detemir.

When mixing short- acting and long acting insulins, you should draw up _____ before _____.

clear before cloudy (or short-acting before long-acting)

The hyperglycemic agent Glucagon raises blood sugar levels and can cause _ as a side effect after administration.

nausea and vomiting

The thyroid replacement medication Levothyroxine should be given on an empty stomach how long before meals?

30 minutes before meals.

Tachycardia, tremors, and insomnia are signs of an overdose of what thyroid medication?

Levothyroxine.

If a patient taking penicillin develops a rash, hives, or wheezing, what is the primary concern?

An allergic reaction.

Vancomycin is used to treat methicillin- resistant staphylococcus aureus (MRSA) and _

C- diff

If a patient develops flushing of the face and trunk, tachycardia, and a rash during a vancomycin infusion, what is the likely cause?

Red man syndrome, caused by too rapid infusion

Tetracycline antibiotics are not given to children under age 8 because they can cause what?

Permanent discoloration of teeth (brown or yellow).

Both Erythromycin (a macrolide) and Gentamycin (an aminoglycoside) can be _, requiring monitoring for hearing loss, vertigo, and tinnitus.

ototoxic

The fluoroquinolone Ciprofloxacin is associated with a risk of pain and rupture of which tendon?

The Achilles tendon.

Patients taking sulfonamides like sulfamethoxazole (Bactrim) should be instructed to _ to prevent complications.

increase fluid intake