Final Exam: NR293 / NR 293 (Latest Update 2024/2025) Pharmacology Review| Complete Guide with Questions and Verified Answers| 100% Correct -Chamberlain

Final Exam: NR293 / NR 293 (Latest Update 2024/2025) Pharmacology Review| Complete Guide with Questions and Verified Answers| 100% Correct -Chamberlain

Final Exam: NR293 / NR 293 (Latest Update
2024/2025) Pharmacology Review| Complete
Guide with Questions and Verified Answers|
100% Correct -Chamberlain
Q: beta lactam penicilins MOA
Answer:
safest class
bacteriocidal
inhibition of bacterial cell wall synthesis
Q: uses of penicillins
Answer:
strep
staph
pneumonia
meningitis
skin, bone, and joint infections
stomach infections
blood and valve infections
gas gangrene
tetanus
anthrax
sickle cell anemia in infants
Q: broad spectrum penicillin
Answer:
bacteriocidal
ecoli

salmonella
influenza
Q: adverse effects of penicillin
Answer:
allergy most common
rash
pruritus
fever
anaphylaxis
lowered WBC, RBC, platelet count
GI upset
Q: patient education for penicillins
Answer:
side effects
bleeding
increase fluid intake
take with food
Q: drugs for penicillin
Answer:
broad spectrum:
amoxicillin
combination:
piperacillin plus tazobactam (zosyn)
give 3 times a day infused over 4 hours or every 6 hours infused over 1 hour
Q: cephalosporins MOA

Answer:
largest class
interfere with bacterial cell wall synthesis, bind to the same penicillin binding proteins
Q: uses of cephalosporins
Answer:
treatment of gram positive and negative anaerobic bacteria
mostly gram negative
patients who cannot tolerate the less expensive penicillins
respiratory infections
urinary infections
skin infections
bone and joint infections
genital infections
Q: contraindications of cephalosporins
Answer:
may cause cross allergy potential with penicillin
Q: adverse effects of cephalosporins
Answer:
weakness
pruritus
GI distress
high doses can cause
bleeding
seizures
nephrotoxicity

Q: patient education of cephalosporins
Answer:
side effects
administration
monitor kidney function with 1st generation
Q: drugs for cephalosporins
Answer:
first generation
Cefazolin (ancef)
not effective for beta lactase
gram positive bacteria
may cause kidney toxicity
Q: macrolides MOA
Answer:
broad spectrum
inhibit protein synthesis
binds reversibly to 50S ribosomal subunits of microbes
Q: uses of macrolides
Answer:
whooping cough
legionnaires disease
Hpylori
streptococcus
influenza
mycoplasma pneumonia
generic use:
respiratory
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bacteriostatic drugs that do not kill the bacteria, but slows their growth
culture and sensitivity take a blood culture so we can determine where the bacteria is growing; sensitivity report determines the best treatment
antibiotic combos Additivepotentiativeantagonisitic
empiric therapy treatment of an infection before specific culture information has been obtained
definitive therapy antibiotic therapy tailored to treat organisms identified with cultures
prophylactic therapy treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma
MOA of sulfonamides Bacteriostaticinhibit bacterial growthprevent bacterial synthesis of folic acid
uses of sulfonamides Gramp positive and negative, broad spectrumrespiratory tract infectionsinfections of the small bowelUTIs: enterobacter, ecoli, klebsiella, proteus vulgaris, staphylococcus aureus
contraindications of sulfonamides drug allergypregnant womeninfants younger than 2 monthspotassiumoral contraceptives (ineffective)
Adverse effects of sulfonamides mild to moderate rashphotosensitivityGI distressstomatitis crystalluriafatiguedepression headachedizzinessblood dyscrasiasSteven Johnsons syndromerenal failurehyperkalemia
prototype for sulfonamides, and administration sulfamethoxazole combined with trimethropimAdministered IV, PO, Topical
patient education/ nursing interventions for sulfonamides Pt. Education:take with a full glass of waterincrease fluid intakereport sore throat, bruising, bleedingavoid direct sunlightNursing interventions:push fluidsMonitor CBCsigns of bleeding (liver damage)check for superinfection
beta lactam penicilins MOA safest classbacteriocidal inhibition of bacterial cell wall synthesis
uses of penicillins strepstaphpneumoniameningitisskin, bone, and joint infectionsstomach infectionsblood and valve infectionsgas gangrenetetanusanthraxsickle cell anemia in infants
broad spectrum penicillin bacteriocidalecolisalmonellainfluenza
adverse effects of penicillin allergy most commonrashpruritusfeveranaphylaxislowered WBC, RBC, platelet countGI upset
patient education for penicillins side effectsbleedingincrease fluid intaketake with food
drugs for penicillin broad spectrum:amoxicillincombination:piperacillin plus tazobactam (zosyn)give 3 times a day infused over 4 hours or every 6 hours infused over 1 hour
cephalosporins MOA largest classinterfere with bacterial cell wall synthesis, bind to the same penicillin binding proteins
uses of cephalosporins treatment of gram positive and negative anaerobic bacteriamostly gram negativepatients who cannot tolerate the less expensive penicillinsrespiratory infectionsurinary infectionsskin infectionsbone and joint infectionsgenital infections
contraindications of cephalosporins may cause cross allergy potential with penicillin
adverse effects of cephalosporins weaknesspruritusGI distresshigh doses can causebleedingseizuresnephrotoxicity
patient education of cephalosporins side effects administrationmonitor kidney function with 1st generation
drugs for cephalosporins first generationCefazolin (ancef)not effective for beta lactasegram positive bacteriamay cause kidney toxicity
macrolides MOA broad spectruminhibit protein synthesisbinds reversibly to 50S ribosomal subunits of microbes
uses of macrolides whooping coughlegionnaires diseaseHpyloristreptococcusinfluenzamycoplasma pneumoniageneric use:respiratoryGI tractskinsoft tissue
adverse effects of macrolides tinnitusototoxicitymild GI distressdiarrheaabdominal painsuperinfectionmhepatotoxicity
patient education/ nursing interventions Patient education:finish full regimenmonitor hepatic functionfood-drug interactions (fruit juices)take on empty stomachNursing interventions:monitor hepatic functionbleeding, bruising, dark tea looking urine, jaundice
drugs for macrolides we do not need peak or troughs forAzithromycin (Zithromax, Zpack)only take for 5 days due to its long half lifeadminister antacids 2 hours before or after on an empty stomach with full glass of water
tetracyclines MOA broad spectruminhibit protein synthesis
uses of tetracyclines acneRocky Mountain spotted fevertyphuscholeralymes diseasepeptic ulcers Hpylori
contraindications of tetracyclines drug allergychildren under 8 pregnancy category D, fetal growth/develeopment milkantacidsirondecrease effect of oral contraceptivesincreases effect of digoxin
adverse effects of tetracycline discoloration of teethretard fetal skeletal development if taken during pregnancyphotsensitivityalteration of intestinal and vaginal florareversible bulging fontanelles in neonatesthrombocytopeniaheolytic anemiahepatotoxicity (IV or high doses)nephrotoxicity (outdated meds)GI distress
patient education of tetracyclines use sunblockstore out of light/heatgood oral hygeinefood-drug interactionslabsadministration times
drugs for tetracyclines tetracycline (achromycin)administer 1-2 hours after meals
aminoglycosides MOA prevent protein synthesis in bacteria
uses of aminoglycosides serious gram negative bacteria:ecoliserratiaproteuspsuedomonasmycobacteriasome protozoanscommon category to treat klebsiellacombined with penicillin, cephalosporins, or vancomycin for enterococcal infectionsmay be given to sterilize bowel prior to surgery
contraindications for aminoglycosides renal patients
adverse effects of aminoglycosides nephrotoxicityototoxicity: hearing impairment dizzyloss of balancepersistant headacheringing in earspossible deafsuperinfectionphotosensitivityanaphylaxisGI distressrash
patient education/nursing interventions for aminoglycosides Pt. educationmonitor hearinguse sunblock lab worknursing interventionsmonitor drug levelsmonitor serum levels
drugs for aminoglycosides gentamicin (garamycin)if GI can not absorb, give IVgive deep into leg muscle IMwithhold if peak levels are above normal range
quinolone (fluroquinonlones) MOA broad spectrum (bacteriocidal) destroy bacteria by altering their DNA, interfere with bacterial enzymes DNA gyrase and topoisomerase
uses of quinolones wide variety of gram negative and selected gram positive (strep, salmonella)complicated UTISrespiratory infectionsskin infectionsGI infectionsbone and joint infectionsSTISfood poisoninganthrax (ciprofloxacin treats)
contraindications of quinolones drug allergychildren under 18caffeine and caffeine like drugs such as theophylline (increase serum levels)calcium, magnesium, iron, or zinc (reduce absorption of quinolones by as much as 90%)
adverse effects of quinolones rashuritcariatinnitusheamturaiphotosensitivtyGI upsetsuperinfectiontendon inflammation or rupture (achilles, increase risk: less than 60 years old and taking corticosteroids)
patient education on quinolones increase fluid intake to more than 2 litersfood drug interaction s
drugs for quinolones ciprofloxacin (cipro)levofloxacin (levaquin)
bacteria resistant to quinolones pseudomonas aeruginoseStaph auereus pneumonococcusenterococcusenterobacteriacae, including ecoli
Nitrofurantoin (macrodantin) MOA bacteriostatic or bactericidal depends on dose
uses of nitrofurantoin gram positive and negative bacteria:ecolistaph aureusklebsiellaenterbacterUTI is the primary use
contraindications of nitrofurantoin impaired renal function
adverse effects of nitrofurantoin anorexianausea vomitdiarrheaabdominal painrust/brown color urinerashpulmonary reactions:dyspnealchest painfevercoughhepatotoxicity
metronidazole (flagyl) uses amebiasisanaeorbic bacteriarespiratory infectionsbone infectionsskin infectionsCNS infectionsC.diff
adverse reactions of metronidazole anorexianauseadiarrheaheadachedry mouthmetallic tastebone marrow suppression
contraindications of metronidazole oral anticoagulantshypoprothombinemiaalcohol (deathly sick if they drink)lithium (increases levels)
how to administer metronidazole topical: treats rosaceacombination: treat h pylori infection
vancomycin MOA bacteriocicdalinhibits cell wall synthesis
uses of vancomycin gram positive bacteriabone infectionskin infectionlower respiratory infectionMRSA (Most effective drug for MRSA)
adverse effects of vancomycin flushinghypotensionototoxicitynephrotoxicitySteven Johnsons syndromered man syndrome (occurs, when rapid IV admin, large amounts of histamine are released and dace, neck, trunk of body turn red)blood dycrasiaspseudomembranous colitis
nursing interventions for vancomycin peak and trough levels are drawn after 3 dosesLabs (BUN, Cr)monitor hearingadminister over 1-2 hours
nursing role for antibiotics cultures prior to antibiotic therapymonitor 1/2nd dose for allergymonitor labs (kidney, liver, peak and trough)increase fluidscheck for superinfection (fever, perineal itching, cough, lethargy, unusual discharge)educate patient to finish prescription even if they feel better
amphotericin B MOA broad spectrum anti fungal medicationbinds to ergosterol in fungal cell membranes
uses of amphotericin B severe systemic infections
adverse effects of amphotericin B feverrashchillshypotensiontachycardiamalaisemuscle and joint painanorexianausea and vomitheadachehypokalemiahypomagesemianephortoxicityliver failureanaphylaxisMIthombocytopenialeukopeniaagranulocytosisanemia
administration of amphotericin B premedicate:1st dose: 1 mg over 20-30 minadminister slowly via IV, can cause cardiovascular collapsewithhold if BUN is over 40mgwithhold if serum creatinine rises about 3mg
nursing interventions for amphotericin B monitor labs Cr, BUN, ALKAST and ALT may increaseK, Ca, Mg may decreasepremeditate with antipyretics, antihistamines, antiemetics and corticosteroidsmonitor vital signspromote hydrationliquid form of drug causes fewer side effects but is more expensive
antiviral acyclovir (Zovirax) MOA prevents viral DNA synthesis
acyclovir uses herpes virusdecreases duration and episodes
contraindications of acyclovir renal impairment
adverse effects of acyclovir PO: nausea/ vomitanorexiaheadacheelevated hepatic enzymesIV:nephrotoxicityneurotoxicity
patient education of acyclovir start as soon as signs and symptoms beginvirus may be activated by stress, trauma, fever, sunlight, sex menstruation, immunosuppressive drugsrefrain from sex when you have visible lesiondrowsiness in older adults may increase fall risk
CNS depressants dose dependents low: calms without inducing sleephigh: calms with sleep
main groups of CNS depressants: benzodiazepines MOA depress CNS activityaffects hypothalamic, thalamic, and limbic systems of the brain:calming effectcontrols agitation and anxiety (panic attack)reduce sensory stimuli. inducing sleepinduce skeletal and muscle relaxationdoes not suppress REM sleep as much as baribituratesdoes not increase metabolism of other drugs
what receptor is used for benzodiazepines? GABA: gamma aminobutyric acid
uses or benzodiazepines sedationsleep inductionskeletal muscle relaxationanxiety relief/ depressionacute seizure disordersalcohol withdrawlagitation reliefbalanced anesthesia (before they give you actual anesthesia they will give this to you to calm you down)
side effects of benzodiazepines headache, drowsiness, dizzycognitive impairementvertigo lethargyfall hazard for older adultshangover effect
toxicity and OD for benzodiazepines somnolenceconfusioncomadiminished reflexes
contraindication of benzodiazepines other CNS depressants (alcohol, opioids): hypotension and respiratory depressionazalea antifungalsverapamildiltiazemprotease inhibitorsmacrolide antobioticsgrapefruit juiceolanzapinerifampin
overdose treatment of benzodiazepines Flumazenil (romazicon)administered IV
drugs for benzodiazepines long acting clonazepam (klonopin)diazepam (valium) first benzo drug, varied uses including anxiety
drugs for benzodiazepines intermediate acting alprazolam (xanax)lorazepam (Ativan)temeazepam (restoril):used for sleepinduces sleep within 20-40 mintake 1 hour before bed
drugs for benzodiazepines short acting eszophiclone (lunesta)zolpidem (ambien)
nonbenzodiazepine zolpidem (ambien) short actingdecrease daytime sleepinesssomnambulation
nonbenzodiazepine eszopiclone (lunesta) provides full 8 hours of sleepshort actingavoid taking if they do not plan to sleep for less than 8n hours
barbiturates MOA habit forming, low therapeutic indexincreases the action of GABA, which inhibits the nerve impulses traveling in the cerebral cortexsite of action: brainstem
drug effects of barbiturates low doses: sedativehigh doses: hypnotic, lowers respiratory rate
uses of barbiturates sedativesanticonvulsantsanesthesia for surgical procedures
adverse effects of barbiturates vasodilationhypotensiondrowsinesslethargyvertigorespiratory depressioncoughnausea/vomitdiarrhea/ constipationagrunlocytosisthrombocytopeniareduced REM sleep
toxicity and OD of barbiturates leads to respiratory depression and respiratory arrest, CNS depression (sleep to coma to death)can be used therapeutically for uncontrollable seizurestreatment:maintain adequate airwayassisted ventilation or oxygen therapypush fluidspressure supportactivated charcoal to absorb drug via NG tube
drugs for barbiturates pentobarbital (nembutal)prevents tonic clonic seizuresprevents fever induced convulsionstreats hyperbilirubiemia in neonatesshould not be used anymore as a sedative/hypnotic drug
uses of muscle relaxants relieve pain associated with skeletal muscle spasmsmanagement of spasicity of severe chronic disorders:MS, cerebral palsycentral acting: similar to CNS depressants, Direct acting: similar to GABA
adverse effects of muscle relaxants euphorialightheaddizzydrowsinessfatiguemuscle weakness
drugs for muscle relaxants baclofen (lioresal) PO, injectcyclogenzaprine (flexural)reduce spasms followed by musculoskeletal injuries, side effect: sedation
nursing interventions for muscle relaxants obtain baseline vitals, plush orthostatic BPhypnotics must be given 30-60 min before bedtimebenzodiazepines cause REM rebound and a tired feeling the next dayavoid alcohol, and other CNS depressantscheck previous meds including OTCrebound insomnia: few nights after 3-4 regimen has been stoppedno smokingassist with ambulationsafety: side rails up, bed alarms etc
CNS stimulants therapeutic uses ADHDanti narcolepticanorexiantanti migraineanaleptic
CNS stimulants amphetamines MOA mood elevation or euphoriaincreased mental alertness/ work capacitydecreased fatigue/ drowsinessprolonged wakefulnessrelaxes bronchioles of smooth muscleincreases respirationdilates pulmonary arteries
uses of CNS stimulants amphetamines ADHDnarcolepsyobesitymigraineCOPD
adverse effects of CNS stimulants amphetamines palpitationstachycardiahypertensionanginadysrhythmiasnervousnessrestlessnessanxietyinsomnianausea/ vomitdiarrheadry mouthincreased urinary frequencytends to speed up body systems
ADHD and narcolepsy drugs methylphenidate (ritalin); schedule 4modafinil (provigil); schedule 4
nursing interventions for CNS stimulants amphetamines last dailym dose should be given 4-6 hours before bed to reduce insomniatake 30-45 min before meals on empty stomachdrug holidays- providers taper off the drug to see S/Sparents should keep a journal to monitor responsemonitor Childs growth/weight since these meds can stunt their growththerapeutic response:ADHD: decrease hyperactivity, increased attention span, and concentrationNarcolepsy: decrease sleepiness
anti migraine MOA stimulate 5-HT receptors in cerebral arteriesvasoconstriction and reduce headache symptomsreduce the production of inflammatory neuropeptides
adverse effects of anti migraine vasoconstrictionirritation at injection sites:tinglingflushing
drugs for anti mirgraine sumatriptan (imitrex)serotonin agonistother name (tiptans)
nursing implications of anti migraine medications admin: dissolvable wafers, nasal spray, self injectable formskeep a journal to monitor response to therapytherapeutic effect: decrease in frequency, duration, and severity of migrainesbefore administering serotonin agonists assess pt for history of HTN
analeptics MOA stimulate CNS areas that control respirations (medulla and spinal cord)relax smooth muscle in respiratory tract, dilation of pulmonary arterioles, and stimulates CNS
uses of analeptics neonatal and post op respiratory depression
drugs for analeptics methylxanthines:aminophyline, Theophyline and caffeine relax smooth muscles, dilation of pulmonary arterioles. Aminophyline is hydrolyzed to theophylline in the body, theophylline is metabolized caffeine
adverse effects of analeptics vagal: stimulation of gastric secretions, diarrhea, and reflex tachycardiavasomotor:flushing, sweating, respiratory elevated, musculoskeletal muscular tension and tremors
nursing implications of analeptics ABCs: airway, breathing, circulationtherapeutic effects: patient will breath deeper and faster to blow off CO2conditions such as abnormal cardiac rhythms, seizures, palpitations, liver problems assess children weight and height
seizure brief episode of abnormal electrical activity in nerve cells of the brain
convulsion involuntary spasmodic contractions of any or all voluntary muscles throughout the body, including skeletal, facial and ocular muscles
epilepsy chronic recurrent pattern of seizures
primary (idiopathic) cause is undetermined, but makes up 50% of epilepsy cases
secondary (symptomatic) distinct cause is identified, trauma, infection, cerebrovascular disorder
generalized onset seizures grand mal seizures, tonic clonic seizures, absence seizures
partial onset seizures petit mal seizures, complex, secondary generalized tonic clonic seizures
status epilepticus multiple seizures occur with no recovery time between resulting in hypotension, hypoxia, brain damage, and deathtrue medical emergency
drugs for anti-epileptics benzodiazepinesbarbiturates (phenobarbital and primidone (mysoline))
benzodiazepines uses for antiepileptics short term control of absence or myoclonic seizureside effects of IV:hypotensionmuscle weaknesstachycardiarespiratory depression
barbiturates for antiepileptics, MOA, uses, admin, adverse effects, contraindications MOA: intensify the effect of GABA in the brain and depress firing of CNS neuronsprimidone is metabolized in the liver to Phenobarbital Uses:partial seizurestonic clonic seizuresadmin:PO, IV, IMadverse effects: sedationdrowsinessvitamin deficiencieslaryngospasmscardiovascularOD may cause; severe respiratory and CNS depression, coma, deathcontraindications:drug allergyporphyrialiver/kidney impairmentrespiratory illness
therapeutic index of barbiturates 10-40mcg/mL
phenobarbitural therapeutic plasma level 15-40 mcg/mL
primidone therapeutic plasma level 5-12 mcg/mL
hydantoins: phenytoin (dilantin) adverse effects bradycardiaventricular fibrillationhypotensionhyperglycemiaheadachenystagmusataxiaconfusionslurred speachinsomniagingivitisgingival hyperplasiaSteven johsnons syndromelupus
contraindications of phenytoin primrose and borage (lower seizure threshold when taken with anticonvulsantsgingko may decrease phenytoin effectivenesslow serum albumin levels are a concern
administration IV of phenytoin may irritate veinsadminister slowly through large veinfilter must be usedsaline flushdo not administer on back of hand could cause purple glove syndrome
therapeutic serum levels for phenytoin 10-20 mcg/mLmonitor closely during pregnancy because seizures tend to become more frequent due to increased metabolic rates
carbamazepine (tegretol)(anti epileptic) uses 2nd most commonly prescribed antiepileptic after phenytointonic clonic seizurespartial mixed seizure patterns
adverse effects of carbamazepine aplastic anemiaagranulocytosisSteven Johnsons syndrome
side effects of carbamazepine nausea/ vomitdiarrheadrowsyataxiaconfusionblurred visionlethargyaffects vitamin K metabolism
contraindications of carbamazepine grape fruit juice
therapeutic plasma levels of carbamazepine 4-12 mcg/mL
gabapentin (neuron tin) MOA chemical analogue of GABAincreases synthesis and synaptic accumulation of GABA between neurons
adverse effects of gabapentin CNS and GI symptoms
antiparkinson goal to increase patients ability to perform normal ADLs
uses of antiparkinson drugs reduce distressing symptomstremors: pill rolling like movement, shakiness at restmuscle rigiditybradykinesia: difficulty chewing, swallowing, or speakingpostural instability: humped over slightly, lose of balanceakinesia: masked like face expressionEPS: extrapyrimidial symptoms caused by antipsychotic drugs decreasing amount of dopamine in the striatum
selective MAOI MOA break down fo catecholamines in the CNS primarily in. the brain
contraindications of selective MAOI drug allergyconcurrent use with meperidine
selegiline (eldepryl) MAOI inhibitors MOA increase dopamine levels in the CNSdo not elect the cheese effect of the nonselective MAOIS used to treat depression (if 10mg or less is used)used with levodopa
dopamine modulator amantadine (symmetrel) antiviral drug
amantadine use influenzadyskinesia associated with carbidopa-levodopa
MOA of amantadine releases dopamine and other catecholamines from storage sites in the nerve cells within basal gangliablock the repute of dopamine in nerve fibershigher levels of dopamine in the synapses between nerves and improves dopamine neurotransmission
adverse effects of amantadine dizzinessinsomnianausea
drug interactions with amantadine increased anticholinergic adverse effects when given with them
(COMT) inhibitors: entacapone (comtan) MOA prolonged duration of action of levodopareduce wearing off phenomenon
adverse effects of entacapone GI upseturine discolorationmay worsen dyskinesia
dopamine replacement: levodopa precursor or fopaminebiologic precursor of dopamine required by the brain for dopamine synthesis
MOA of levodopa works presynaptically to increase brain levels of dopamineable to cross BBB and convert into dopamine, but this requires large doses in which can cause adverse effectsmust be administered PO as levodopa cannot pass BBBB
MOA of cabidopa (Lodosyn) given with levodopa but does not cross the BBBprevents levodopa breakdown in the intestine and periphery which leads to more levodopa crossing the BBBincreases plasma levels and half life of levodopadecreasing dopamine production in peripheral lowers nausea and vomitting and cardio response to levodopaalso used to treat nausea associated with sinemet
adverse effects of cabidopa confusioninvoluntary movementsGI distresshypotensioncardiac dysrhythmias
cabidopa-levodopa take on empty stomach, take with food to decrease GI distresscombined these are the best used for tremors, bradykinesia, gaits and muscle rigidity
side effects of cabidopa-levodopa orthostatic hypotensionvausea/ vomitanorexiaflatulancedysphagiaabdominal distressnightmaresheadachesurinary retentiondry mouthdystonia
adverse effects of cabidopa-levodopa agranulocytosis, leukopenia, hemolytic anemiapsychosis
drug interactions for cabidopa-levodopa MAOIs, glaucoma
drug- food interactions cabidopa-levodopa high protein, vitamin B6
anticholinergic therapy MOA block the effects of ACH
uses of anticholinergic therapy muscle tremors/ rigidity
SLUDGE: anticholinergic therapy ACH is responsible for causing increased salivation, lacrimation, urination, diarrhea, and increased GI mobility, and possible emesisanticholinergics can cause dry mouth, decreased salivation, urinary retention, decreased GI mobility and smooth muscle relaxtion
drugs for anticholinergic therapy, uses, caution, adverse effects benztropine (cogentin)uses: PD and extrapyrimdial symptoms from antipsychotic drugscaution: hot weather or exercise Amy cause hyperthermia avoid alcoholadverse effects: tachycardia, confusion, disorientation, toxic psychosis, urinary retention, dry throat, constipation, nausea and vomititng
anxiety unpleasant state off mind by a sense of dread or fear
anxiety disorders OCDPTSDgeneralized anxiety disorderpanic disordersocial phobiasimple phobia
drugs for anxiety; psychotherapeutic drugs anxiolyticbenzxodiazepinesbuspirone (buspar)alprazolam (xanax)diazepam (valium)
MOA of anxiolytic reduce overactivity in CNS
affective disorders definition changes in mood that range from mania to depression
drugs for mood disorders lithium carbonate and lithium citrate
Lithium carbonate and lithium citrate uses, MOA, adverse effects Uses: maniaMOA: potentiates the serotonergic neurotransmissionAE:cardiac dysrhthmias, drowsiness, slurred speech, epilepsy, involuntary wavelike movement of extremities, hypotension
therapeutic range for lithium carbonate and lithium citrate starting: 0.8-1.4during maintenance: 0.4-1toxicity 1.5 or greater
definition of psychosis impairs the function of the affected individual to the point that they cannot participate in ADLsloss of contact with realityschizophrenia depressive and drug induced psychoses
MOA of antipsychotics block dopamine receptors in the limbic systems nd basal gangliadopamine levels are decreased resulting in a tranquilizing effect
uses of antipsychotics schizophreniaanxiety and mood disorders
adverse effects of antipsychotics angrulocytosis hemolytic anemiaCNS: drowsiness, neuroleptic malignant syndrome
tardive dyskinesia (TD) involuntary contraction of oral and facial muscle, wave like movements of extremeties
drugs for antipsychotics uses, contraindications, admin haloperidol (haldol)uses: long term treatment for psychosiscontraindications: hypersensitivity, PD, CNS depressantsadmin: PO, IV, IM
tricyclic anitdepressants replaced by SSRIs, considered second line
amitriptyline (elavil) (antidepressant) use depression, insomnianeuropathic pain
MOA of amitriptyline (antidepressant) blocks repute of neurotransmitters, causing accumulation at the nerve endingsincreasing concentration of neurotransmitters will correct the low levels that lead to depression
adverse effects of amitriptyline (antidepressant) dizzinesspostural hypotensionconstipationdelayed micturitionedmeamuscle tremors
overdose of amitriptyline (antidepressant) CNS and cardio are mainly affecteddeath results from seizures or dysrhythmiasno specific antidotesdecreasing drug with activated charcoalspeed elimination by alkalinizing urinemanage seizures and dysrhymias provide basic life support
nonselective MAOI: phenilzine use parkinsons depression
MAOI and tyramine eating foods or drinks with tyramine may lead to hypertensive crisiscerebral hemorrhagestrokecomadeath
foods that contain tyramine cheddar, bleu, or Swiss cheeesmoked, pickled, or aged meats, fish, poultryyeast extractsred winesItalian brand beans: fava beans
fluoxetine (prozac): prototypical SSRI uses depressionbulimiaOCDpanic disorderpremenstural dysphoric disorder
contraindications of fluoxetine drug allergyconcurrent MAOI therapy
adverse effects of fluoxetine anxietydizzinessdrowsinessinsomnia
alzheimers symptoms impaired memory and judgementconfusion and disorientationinability to recognize family and friendsaggressive behaviordepressionparanoia/delusionsanxiety
pharmacology goals for alzeheimers slow memory loss and dementia symptomsimprove ADLs behavior and cognition
nursing interventions for alzheimers bathroom schedule to prevent incontinencemonitor nutritional status drugs may cause anorexia nausea vomit diarrheadrug loses effectiveness as Alzheimers progressessleep disorders are commom
drugs for alzheimers acetylcholinesterase inhibitors
MOA for acetylcholinesterase inhibitors (alzheimers drug) prevent breakdown of acetylcholine enhances transmission of cholinergic neuronsonly slows progression, does not cure it
prototype of alzheimers drug; admin, adverse effects donepezil hydrochloride (aricept)admin: 5-10 mg before bedadverse effects:nauseavomitdizzinessheadachebronchoconstrictionlivier injury
drug-drug interaction for donepezil hydrochloride aricept decreases effectiveness of anticholinergics phenobarbital, phenytoin, dexamethasone increase elimination of aricept
antidote for donepezil hydrochloride atropine
ophthalmic drug administration avoid touching eye with the tip of dropper or containerapply ointments as a thin layer in the conjunctival sachave patient look up to the ceiling and play drum in conjunctival sacpressure may be applied to the inner canthus for at least one minute to reduce systemic absorption
otic drug administration remove cerumen by irrigation before instilling ear dropswarm ear drops to approximately body temp before instillationcold ear drops may cause vomiting and dizzinessadults: hold pinna down and backchildren under 3: hold pinna down and backhave patients lie the the opposite side of the affected ear for 5 minutes aftermassage the trigs to encourage flow of medication
when reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?a. tetracyclinesb. sulfonamidesc. cephalosporins d. quinolones c. cephalosporins
the nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?a. “avoid direct sunlight and tanning beds while on this medications”b. “milk and cheese products result in increased levels of tetracycline”c. “antacids taken with this medication help to reduce gastrointestinal distress”d. “take the medication until you are feeling better” a. “avoid direct sunlight and tanning beds while on this medication”
when reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs?a. the penicillin will cause an enhanced anticoagulant effect of the warfarinb. the penicillin will cause the anticoagulant effect of the warfarin to decreasec. the warfarin will reduce the anti infective action of the penicillind. the warfarin will increase the effectiveness of the penicillin a. the penicillin will cause an enhanced anticoagulant effect of the warfarin
a patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling “anxious” and is having trouble breathing. What will the nurse do first?a. notify the prescriberb. take the patients vital signsc. stop the antibiotic infusiond. check for allergies c. stop the antibiotic infusion
a patient is admitted with a fever of 102.8 F, origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber color. Orders have just been written to obtain stat urine and blood cultures and to administer antibiotic intravenously. The nurse will complete these orders in which sequence?a. blood culture, antibiotic dose, urine cultureb. urine culture, antibiotic dose, blood culturec. antibiotic dose, blood and urine culturesd. blood and urine cultures, antibiotic dose d. blood and urine cultures, antibiotic dose
during drug therapy with a tetracycline antibiotic, a patient complains of some nausea and decreased appetite. Which statement is the nurses best advice to the patient?a. “take it with cheese and crackers or yogurt”b. “take each dose with a glass of milk”c. “take an antacid with each dose as needed”d. “drink a full glass of water with each dose” d. “drink a full glass of water with each dose”
the nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature 101F. Based on these findings, which conclusion will the nurse draw?a. the patients original infection has not responded to the antibiotic therapyb. the patient is showing typical adverse effects of antibiotic therapyc. the patient needs to be test for c.diffd. the patient will need to take a different antibiotic c. the patient needs to be tested for C.diff
the nurse is monitoring for therapeutic effects of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?a. increased red blood cell countb. increased hemoglobin levelc. decreased white blood cell countd. decreased platelet count c. decreased white blood cell countdecrease means no infection, increase means infection is present
A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy.a. empiricb. prophylactic c. definitived. resistance b. prophylacticpreventative before surgery
a patient has a UTI. The nurse knows that which class of drugs is especially useful for such infections?a. macrolidesb. carbapenemsc. sulfonamidesd. tetracyclines c. sulfonamidesexcreted through kidneys and highly unchanged in kidneys
during drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by:a. large doses of antibiotics that kill normal florab. the infection spreading from her lungs to the new site of infectionc. resistance of the pneumonia causing bacteria to the drugsd. an allergic reaction to the antibiotics a. large doses of antibiotics that kill normal flora
the nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants?a. antiseptics are used to sterilize surgical equipmentb. disinfectants are used as preoperative skin preparationc. antiseptics are used only on living tissue to kill microorganismsd. disinfectants are used only on nonliving objects to destroy organisms d. disinfectants are used only on nonliving objects to destroy organisms
a patient with a long term intravenous catheter is going home. The nurse knows that if he is a allergic to seafood, which antiseptic agent is contraindicated?a. chlorhexidine gluconate (hibiclens)b. hydrogen peroxidec. povidone-iodine (betadine)d. isopropyl alcohol c. povidone-iodine (betadine)iodine is found in fish
during antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction (select all that apply)a. wheezingb. diarrheac. shortness of breathd. swelling of the tonguee. itchingf. black, hairy tongue a. wheezingc. shortness of breathd. swelling of the tonguee. itching
the nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (self all that apply)a. opioidsb. oral contraceptivesc. sulfonylureasd. antihistaminese. phenytoin (dilantin)f. warfarin (Coumadin) b. oral contraceptivesc. sulfonylurease. phenytoin (dilantin)f. warfarin (Coumadin)
the nurse reads in the patient medication history that the patient is taking buspirone (buspar). The nurse interprets that the patient may have which disorder?a. anxiety disorderb. depressionc. schizophreniad. bipolar disorder a. anxiety disorder
before beginning a patients therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class?a. aspirinb. anticoagulantsc. dirueticsd. non steroidal anti-inflammatory drugs b. anticoagulants
when a patient is reviewing a second generation antipsychotic drug, such as risperidone (risperdal), the nurse will monitor for which therapeutic effect?a. fewer panic attacksb. decreased paranoia and delusionsc. decreased feeling of hopelessnessd. improved tardive dyskinesia b. decreased paranoid and delusions
a patient has been taking haloperidol (haldol) for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects?a. increase paranoiab. drowsiness and dizzinessc. tremors and muscle twitchingd. dry mouth and constipation c. tremors and muscle twitching
a patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzineu (Nardil) for 6 months. The patient wants to go to a party and asked the nurse, “will one beer be problem?” which advise from the nurse is correct?a. “you can drink beer as long as you have a DD”b. “now that you’ve had the last dose of that medication, there will be no further dietary restrictions”c. ” if you begin to experience a throbbing headache, rapid pulse, or nausea, you’ll need to stop drinking”d. “you need to avoid all foods that contain tyramine, including beer, while taking this medication” d. “you need to avoid all foods that contain tyramine, including beer, while taking this medication”
a 22 year old patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory results is correct?a. the lithium level is therapeuticb. the lithium level is too lowc. the lithium level is too highd. lithium is not usually monitored with blood levels a. the lithium level is therapeutic
a patient with the diagnosis of schizophrenia is hospitalized and is taking a phenothiazine drug. Which statement by this patient indicated that he is experiencing a common adverse effect of phenothiazines?a. “I cant sleep at night”b. “I feel hungry all the time”c. “look at how red my hands are”d. “my mouth has been so dry lately” d. “my mouth has been so dry lately”
a patient has been taking the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft) for about 6 months. At a recent visit, she tells the nurse that she has been interested in herbal therapies and wants to start taking St. Johns wort. Which response by the nurse is appropriate?a. “that should be no problem”b. “good idea! hopefully you’ll be able to stop taking the Zoloft”c. “be sure to stop taking the herb if you notice a change in side effects”d. “taking St. Johns wort with Zoloft may cause severe interactions and is not recommended” d. “taking St. Johns wort with Zoloft may cause severe interactions and is not recommended”
while monitoring a depressed patient who has just started SSRI antidepressant therapy, the nurse will observe for which problem during the early time frame of his therapy?a. hypertensive crisisb. self injury or suicidal tendenciesc. extrapyrimidial symptomsd. loss of appetite b. self injury or suicidal tendencies
a patient has been admitted to the emergency department with a suspected overdose of a tricyclic antidepressant. The nurse will prepare for what immediate concern?a. hypertensionb. renal failurec. cardiac dysthymiad. GI bleeding c. cardiac dysrhythmias
the wife of a patient who has been diagnosed with depression calls the office and says “its been an entire week since he started that new medicine for his depression, and theres no change! whats wrong with him” what is the nurses best response?a. “the medication may not be effective for him. He may need to try another type”b. “it may take up to 6 weeks to notice any therapeutic effects. Lets wait a little longer to see how he does”c. “it sounds like the dose is not high enough. Ill check about increasing the dosage”d. “some patients never recover from depression. He may not respond to this therapy” b. “it may take up to 6 weeks to notice any therapeutic effects, lets wait a little longer to see how he does”
Chlorpromazine (thorazine) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. The nurse includes which information?a. the patient needs to avoid caffeine while on this drugb. the patient needs to wear sunscreen while outside because of photosensitivityc. long-term therapy may result in nervousness and excitabilityd. the medication may be taken with an antacid to reduce GI upset b. the patient needs to wear sunscreen while outside because of photosensitivity
the nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?a. orange juiceb. fried eggs over easyc. salami and Swiss cheese sandwichd. biscuits and honey c. salami and Swiss cheese sandwich
a patient wants to take a ginseng dietary supplement. The nurse instructs the patient to look for which potential adverse effect?a. drowsinessb. palpitations and anxietyc. dry mouthd. constipation b. palpitations and anxiety
the nurse is reviewing medications used for depression. Which of these statements is a reason for SSRIs are more widely prescribed today than tricyclic antidepressants?a. SSRIs have fewer sexual side effectsb. unlike tricyclic antidepressants, SSRIs do not have drug-food interactionsc. tricyclic antidepressants cause serious cardiac dysrhythmias if an overdose occursd. SSRIs cause a therapeutic response faster than tricyclic antidepressants c. tricyclic antidepressants cause serious cardiac dysrhythmias if an overdose occurs
a patient who has been taking a SSRI is complaining of “feeling so badly” when he started taking an OTC St. Johns wort herbal product at home. The nurse suspects that he is experiencing serotonin syndrome. Which of these symptoms of serotonin symdrome. (select all that apply)a. agitationb. drowsinessc. tremorsd. bradycardiae. sweatingf. constipation a. agitationc. tremorse. sweating
which statements are true regarding the SSRI? (select all that apply)a. avoid foods and beverages that contain tyramineb. monitor the patient for extrapyramidal symptomsc. therapeutic effects may not be seen for about 4-6 weeks after the medication is startedd. if the patient has been on an MAOI, a 2-5 week or longer time span is required before beginning and SSRI medicatione. these drugs have been anticholinergic effects, including constipation, urinary retention, dry mouth, and blurred visionf. cogentin is often prescribed to reduce adverse effects that may occur c. therapeutic effects may not be seen for about 4-6 weeks after the medication is startedd. if the patient has been on an MAOI, a 2-5 week or longer time span is required before beginning and SSRI medication
the nurse is reviewing the dosage schedule for several different anti epileptic drugs (AEDs) which anti epileptic drug allows for once-a-day dosing?a. levetiractem (keppra)b. phenobarbitalc. valpiric acid (depakote)d. gabapentin (neurontin) b. phenobarbital
the nurse has given medication instructions to a patient reviewing phenytoin (dilantin). Which statement by the patient indicates that the patient has an adequate understanding of the instructions?a. “I will need to take extra care of my teeth and gums while on this medication”b. “i can go out for a beer while on this medication”c. “I can skip doses if the side effects bother me”d. “I will be able to stop taking this drug once the seizures stop” a. ” I will need to take extra care of my teeth and gums while on this medication”
when teaching a patient about taking a Newley presided antiepileptic drug (AED) at home, the nurse will include which instruction?a. ” driving is allowed after 2 weeks of therapy”b. “if seizures recur, take a double dose of the medication”c. “antacids can be taken with AED to reduce GI adverse effects”d. “regular, consistent dosing is important for successful treatment” d. “regular, consistent dosing is important for successful treatment”
a patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin (dilantin) therapy. He is to be NPO for surgery in the morning. What will the nurse do about his morning dose of phenytoin?a. give the same dose IVb. give the morning dose with a small sip of waterc. contact the prescriber for another dosage form of the medicationd. notify the operating room that the medication has been withheld c. contact the prescriber for another dosage form of the medication
the nurse is monitoring a patient who has been taking carbamazepine (tegretol) for 2 months. Which effects would indicate that auto induction has started to occur?a. the drug levels for carbamazepine are higher than expectedb. the drug levels for carbamazepine are lower than expectedc. the patient is experiencing fewer seizuresd. the patient is experiencing toxic effects from the drug b. the drug levels for carbamazepine are lower than expected
the nurse is giving an IV dose of phenytoin (dilantin). Which action is correct when administering this drug?a. give the dose as a fast IV bolusb. mix the drug with normal saline; and give it slow IV pushc. mix the drug with dextrose, and give it as a slow IV pushd. mix the drug with any available solution as long as the admin rate is correct b. mix the drug with normal saline; and give it slow IV push
the US food and drug administration has issued a warning for users of anti-epileptic drugs. based on this report, the nurse will monitor for which potential problems with this class of drug?a. increased risk of suicidal thoughts and behaviorsb. signs of bone marrow depression c. indications of drug addiction and dependencyd. increased risk of cardiovascular events, such as strokes a. increased risk of suicidal thoughts and behaviors
a patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?a. diazepam (valium)b. midazolam (versed)c. valproic acid (depakote)d. carbamazepine (tegretol) a. diazepam (valium)
phenytoin (dilantin) has a narrow therapeutic index. The nurse recognizes that this characteristics indicates which of these?a. the safe and the toxic plasma levels of the drug are very close to each otherb. the phenytoin has a low chance of being effectivec. there is no difference between safe and toxic plasma levelsd. a very small dosage can result in the desired therapeutic effect a. the safe and toxic plasma levels fo the drug are very close to each other
a patient has been taking an AED for several years as part of his treatment for partial seizure. His wife has called because he ran out of medication this morning and wonders if he can go without it for a week until she has a chance to go to the drugstore. What is the nurses best response?a. “he is taking another antiepileptic drug, so he can go without the medication for a week”b. “stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away”c. “he can temporarily increase the dosage of his other anti seizure medications until you get the refill”d. “he can stop all medications because he has been treated for several years now” b. “stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away”
during a routine appointment a patient with a history of seizures is found to have a phenytoin (dilantin) level of 23 mcg/mL. What concern will the nurse have if any?a. the patient is at risk for seizures because the drug level is not at a therapeutic levelb. the patients seizures should be under control because this is a therapeutic drug levelc. the patients seizures should be under control if she is also taking a second antiepileptic drugd. the drug level is at a toxic level, and the dosage needs to be reduced d. the drug level is at a toxic level, and the dosage needs to be reduced
a patient is taking gabapentin (neuron tin) and the nurse notes that there is no history of seizures on his medical record. What is the best possible rationale for this medication order?a. the medication is used for neuropathic painb. the medication is helpful for the treatment of MSc. the medication is used to reduce the symptoms of PDd. the medical record is missing the correct info about the patients history of seizures a. the medication is used for neuropathic pain
the nurse is reviewing antiepileptic drug (AED) therapy. Which statements about AED therapy are accurate? (select all that apply)a. AED therapy can be stopped when seizures are stoppedb. AED therapy is usually lifelongc. consistent dosing is the key to controlling seizuresd. a dose may be skipped if the patient is experiencing adverse effectse. do not abruptly discontinue AEDs because doing so may cause rebound seizure activity b. AED therapy is usually lifelongc. consistent dosing is the key to controlling seizuresd. a dose may be skipped if the patient is experiencing adverse effects
a patient has been taking selegiline (eldepryl) 20mg/day for 1 month. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and “felt awful”. What did the patient most likely experience?a. hypotensionb. hypertensionc. urinary discomfortd. GI upset b. hypertension
a patient has been given a prescription for levodopa- carbidopa (sine met) for her newly diagnosed PD. She asked the nurse, “why are there two drugs in this pill?” the nurse best response reflects which fact?a. carbidopa allows for larger doses of levodopa to be givenb. carbidopa prevents the breakdown of levodopa in the peripheryc. there are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapyd. carbidopa is the biologic precursor of dopamine and can penetrate into the CNS b. carbidopa prevents the breakdown of levodopa in the periphery
when a patient is taking an anticholingeric such as benzotripine (cogentin) as part of the treatment for PD, the nurse should include which information in the teaching plan?a. minimize the amount of fluid taken while on this drugb. discontinue the medication if adverse effects occurc. take the medication on an empty stomach to enhance absorptiond. use artificial saliva, sugarless gum, or hard candy to counteract dry mouth d. use artificial saliva, sugarless gum, or hard candy to counteract dry mouth
a patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?a. decreased appetite b. gradual development of cogwheel rigidityc. newly developed dyskinesiasd. improved ability to perform ADLs d. improved ability to perform ADLs
carbidopa-levodopa (sine met) is prescribed for a patient with PD. The nurse informs the patient that which common adverse effects occur with this medication?a. drowsiness, headache, weight lossb. dizziness, insomnia, nauseac. peripheral edema, fatigue, syncoped. heart palpitations, hypotension, urinary retention d. heart palpitations, hypotension, urinary retention
the nurse is assessing the medication history of a patient with a new diagnosis of PD. Which condition is a contraindication for the patient, who will be taking tolcapone (tasmar)?a. glaucomab. seizure disorderc. liver failured. benign prostatic hyperplasia c. liver failure
the nurse is developing a care plan for a patient who is taking an anticholinergic drug. Which nursing diagnosis would be appropriate for this patient?a. diarrheab. urinary retentionc. risk for infectiond. disturbed sleep patter b. urinary retention
a patient has a new order for a catechol ortho-methyltransferase (COMT) inhibitor as part of treatment for PD. The nurse recognizes that which of these is an advantage of this drug class?a. it has a shorter duration of actionb. it causes less GI distressc. it has a slower onset than traditional PD drugsd. it is associated with fewer wearing off effects d. it is associated with fewer wearing off effects
a patient taking entacapone (comtan) for the first time calls the clinic to report a dar discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation?a. this is a harmless effect of the drugb. the patient has taken this drug along with red wine or cheesec. the patient is having an allergic reaction to the drugd. the ordered dose is too high for this patient a. this is a harmless effect of the drug
while a patient is receiving drug therapy for PD, the nurse mentions for dyskinesia, which is manifested by which finding?a. rigid, tense musclesb. difficulty in performing voluntary movementsc. limp extremities with weak muscle toned. confusion and altered mental status b. difficulty in performing voluntary movements
when treating patients with medications for PD, the nurse knows that the wearing off phenomenon occurs for which reason?a. there are rapid swings in the patients response to levodopab. the patient cannot tolerate the medication at timesc. the medications being to lose effectiveness against PDd. the patients liver is no longer able to metabolize the drug c. the medications being to lose effectiveness against PD
when assessing the medication history of a patient with a new diagnosis of PD, which conditions are contraindications for the patient who will be taking carbidopa-levodopa? (select all that apply)a. angle closure glaucomab. history of malignant melanomac. hypertensiond. benign prostatic hyperplasiae. concurrent use of monoamine oxidase inhibitors (MAOIs) a. angle closure glaucomab. history of malignant melanomae. concurrent use of monoamine oxidase inhibitors (MAOIs)