pharm midterm

General therapeutic effects of diuretics

Increased urination and decreased blood pressure.

Major safety concern and patient teaching for diuretics

Major safety concern is orthostatic hypotension; teach patients to change positions slowly.

Optimal time of day to take a diuretic

Morning (to prevent nocturia).

Potassium effect and classification of spironolactone

Potassium-sparing diuretic that can cause hyperkalemia.

Key patient dietary teaching for spironolactone

Avoid foods high in potassium.

Pharmacologic class and site of action of furosemide

Loop diuretic that works in the Loop of Henle.

Major electrolyte concern associated with furosemide

Hypokalemia.

Two major clinical concerns associated with hydrochlorothiazide

Hypokalemia and hyperglycemia.

Effect of combining loop and thiazide diuretics on blood glucose

Increased blood glucose leading to hyperglycemia.

Clinical signs of hypokalemia

Fatigue, anorexia, and muscle weakness.

Pharmacologic class of mannitol

Osmotic diuretic.

Target organ and indications for mannitol therapy

Brain; used to treat cerebral edema and elevated intracranial pressure (ICP).

Mechanism of action of mannitol in brain injury

Uses osmotic force to draw fluid from brain tissue, reducing cerebral edema and intracranial pressure (ICP).

Indication for mannitol administration in severe burns

Helps flush the kidneys when myoglobin is released from damaged muscle tissue.

Indication and line of therapy for tamsulosin

First-line treatment for benign prostatic hyperplasia (BPH).

Major adverse effect associated with initial tamsulosin administration

First-dose phenomenon, which causes severe orthostatic hypotension.

Patient teaching for tamsulosin regarding position changes

Move slowly when changing positions to avoid injury from orthostatic hypotension.

Classification and indication for saw palmetto

Herbal supplement used to treat benign prostatic hyperplasia (BPH).

Pharmacologic class of phenazopyridine

Urinary analgesic.

Primary therapeutic purpose of phenazopyridine

Relieves pain and burning symptoms caused by urinary tract infections (UTIs).

Expected harmless side effect of phenazopyridine on urine

Discoloration of urine to an orange or red color.

Pharmacologic class and indication for nitrofurantoin

Antibiotic used to treat urinary tract infections (UTIs).

Expected urine discoloration for nitrofurantoin vs. phenazopyridine

Nitrofurantoin turns urine dark yellow or brown (fights infection), whereas phenazopyridine turns urine orange or red (relieves pain).

Antidote for hypermagnesemia

Calcium gluconate.

Primary indication for emergency D50 administration

Severe symptomatic hypoglycemia.

Route of administration for D50 in emergency hospital settings

Intravenous (IV).

Emergency medication that increases blood glucose when IV access is unavailable

Glucagon.

General principle for mixing two types of insulin in one syringe

Draw up clear insulin before cloudy insulin.

Order of drawing up Regular and NPH insulin

Regular insulin (clear) first, followed by NPH insulin (cloudy).

Evaluation of patient statement: 'I will draw up NPH before regular insulin.'

Needs further teaching; regular insulin (clear) must always be drawn before NPH insulin (cloudy).

Pharmacologic class of dantrolene

Muscle relaxant.

Indication for dantrolene in a post-operative patient with high fever and muscle rigidity

Malignant hyperthermia.

Pharmacologic class and indication for baclofen

Muscle relaxant used for spasticity and muscle spasms.

Significant adverse effect of baclofen requiring monitoring

Urinary retention.

Primary indication for donepezil

Alzheimer's disease.

Therapeutic expectation regarding donepezil and Alzheimer's disease

It does not cure Alzheimer's disease; it only slows the progression of symptoms.

Primary clinical indication for carbidopa/levodopa

Parkinson's disease.

Two prominent adverse effects of carbidopa/levodopa

Orthostatic hypotension and dry mouth.

Most critical life-threatening adverse effect to monitor with opioid administration

Respiratory depression.

Essential nursing assessments prior to opioid administration

Pain level rating (1 to 10 scale) and respiratory/CNS status.

Cardiovascular adverse effect common to opioids

Orthostatic hypotension.

Patient safety instruction regarding opioid-induced orthostatic hypotension

Change positions slowly.

Risk of administering aspirin to children or teenagers with viral illnesses

Reye syndrome.

Earliest sign of aspirin toxicity (salicylism)

Tinnitus (ringing in the ears).

Key systemic adverse effect to monitor during aspirin therapy

Bleeding and bruising.

Primary indication for ergotamine

Treatment of acute migraine headaches.

Mechanism of action of ergotamine

Vasoconstriction.

Dietary restriction for patients taking ergotamine

Limit caffeine intake, because caffeine also causes vasoconstriction.

Prototype medication class for sumatriptan

Migraine treatment (triptan / vascular headache suppressant).

Optimal timing for taking sumatriptan for a migraine

At the first onset of migraine symptoms.