NUR 334- PHARM EXAM QUESTIONS AND ANSWERS A
+ GRADED
Tylenol MOA
Inhibits prostaglandin synthesis in CNS
temp reg center of the brain in the hypothalamus
Tylenol indications
-mild to moderate pain, fever
- it is not a blood thinner
what are some examples of NSAIDs?
NSAID
- reduces inflammation via cox 1 and cox 2 inhibition
cox1&2: ketorolac, naproxen, ibuprofen
cox2 selective: celecoxib
cox1 selective: aspirin
What class of drug is Ibuprofen?
class: antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-
inflammatory agents (NSAIDs)
Ibuprofen indications
Action: Decreases pain and inflammation by inhibiting prostaglandins
mild to moderate pain, fever, inflammation
Ibuprofen MOA
Nonselective inhibitor of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2)
and reversibly alters platelet function and prolongs bleeding time
what does cox1 inhibition cause? what does this mean? what should we educate
our patient?
antiplatelet qualities
- platelet aggregation initiates the clotting cascade.
- increases the risk of bleeding
celecoxib (Celebrex) is cox-2 selective inhibition. what does this mean?
cox 2 inhibition only reduces inflammation without anti platelet effects
what is glyburide?
Oral hypoglycemic, sulfa derivative.
- for type 2 diabetes
- controls glucose levels
- sugar levels should start to fall w/i specified time range
how long does it take for oral meds to take effect, and when should we evaluate
for outcomes?
45-60 min
- this is also when we should evaluate outcomes
will NSAIDs affect the body's ability to coagulate?
, yes
- think GI bleed
- will NOT prevent healing
- cox1 inhibition causes anti platelet effects.
what is the difference between cox1 and cox2?
cox1: anti platelet and anti inflammatory
cox2: only anti inflammatory
what can happen with too much opioids? why?
respiratory depression
- overdose
t/f: alcohol is fine to take with opiates. why or why not?
false!
- synergistic effect of the two drugs together enhance the ability to depress the CNS
what is the max dose of morphine per day?
90 mEq (MME)
our patient is on 220 MME (mEq) of morphine per day. what do we do to lower
their dose to the normal maximum? what happens if we don't do that?
- taper them down to a manageable dose
- stopping them cold turkey (cutting the dosage) can initiate withdrawal symptoms
because of how high their tolerance is
Opioid withdrawal symptoms(morphine)
agitation, insomnia, flu-like symptoms, yawning, sweating, diarrhea
What are the steps you would take prior to placing a fentanyl patch
1. check for allergies
2. don gloves
3. check where the prior patch was and remove it
4. skin inspection
5. initial date and time the patch
how do we determine peak and trough? when is peak? when do we do trough?
why go through all of this trouble?
blood work
- p: 1 hr after admin
- t: 30 min prior to next dose
we want to determine if the patient is within the therapeutic range (window) for the drug
to be working
what is peak
highest acting level of drug
what is trough
lowest level of drug in the body
what is the max daily dose of ibuprofen? convert to grams.
3200 mg/day
- 3.2 g/day
what is ketorolac? where is it processed? who do we not want to give it to?
Toradol
- NSAID
+ GRADED
Tylenol MOA
Inhibits prostaglandin synthesis in CNS
temp reg center of the brain in the hypothalamus
Tylenol indications
-mild to moderate pain, fever
- it is not a blood thinner
what are some examples of NSAIDs?
NSAID
- reduces inflammation via cox 1 and cox 2 inhibition
cox1&2: ketorolac, naproxen, ibuprofen
cox2 selective: celecoxib
cox1 selective: aspirin
What class of drug is Ibuprofen?
class: antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-
inflammatory agents (NSAIDs)
Ibuprofen indications
Action: Decreases pain and inflammation by inhibiting prostaglandins
mild to moderate pain, fever, inflammation
Ibuprofen MOA
Nonselective inhibitor of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2)
and reversibly alters platelet function and prolongs bleeding time
what does cox1 inhibition cause? what does this mean? what should we educate
our patient?
antiplatelet qualities
- platelet aggregation initiates the clotting cascade.
- increases the risk of bleeding
celecoxib (Celebrex) is cox-2 selective inhibition. what does this mean?
cox 2 inhibition only reduces inflammation without anti platelet effects
what is glyburide?
Oral hypoglycemic, sulfa derivative.
- for type 2 diabetes
- controls glucose levels
- sugar levels should start to fall w/i specified time range
how long does it take for oral meds to take effect, and when should we evaluate
for outcomes?
45-60 min
- this is also when we should evaluate outcomes
will NSAIDs affect the body's ability to coagulate?
, yes
- think GI bleed
- will NOT prevent healing
- cox1 inhibition causes anti platelet effects.
what is the difference between cox1 and cox2?
cox1: anti platelet and anti inflammatory
cox2: only anti inflammatory
what can happen with too much opioids? why?
respiratory depression
- overdose
t/f: alcohol is fine to take with opiates. why or why not?
false!
- synergistic effect of the two drugs together enhance the ability to depress the CNS
what is the max dose of morphine per day?
90 mEq (MME)
our patient is on 220 MME (mEq) of morphine per day. what do we do to lower
their dose to the normal maximum? what happens if we don't do that?
- taper them down to a manageable dose
- stopping them cold turkey (cutting the dosage) can initiate withdrawal symptoms
because of how high their tolerance is
Opioid withdrawal symptoms(morphine)
agitation, insomnia, flu-like symptoms, yawning, sweating, diarrhea
What are the steps you would take prior to placing a fentanyl patch
1. check for allergies
2. don gloves
3. check where the prior patch was and remove it
4. skin inspection
5. initial date and time the patch
how do we determine peak and trough? when is peak? when do we do trough?
why go through all of this trouble?
blood work
- p: 1 hr after admin
- t: 30 min prior to next dose
we want to determine if the patient is within the therapeutic range (window) for the drug
to be working
what is peak
highest acting level of drug
what is trough
lowest level of drug in the body
what is the max daily dose of ibuprofen? convert to grams.
3200 mg/day
- 3.2 g/day
what is ketorolac? where is it processed? who do we not want to give it to?
Toradol
- NSAID
