NURS 6015 LATEST QUESTIONS AND ANSWERS. Buy Quality Materials!

NURS 6015 LATEST QUESTIONS AND ANSWERS. Buy Quality Materials! Corticosteroids Used to suppress inflammation (plus mediators), treat respiratory distress syndrome in pre-term infants, and adrenocortical insufficiency Side effects: High blood sugar, fluid retention, crushings syndrome (if dose is too high), "moon face," osteoporosis, growth stunt in children, myopathy, peptic ulcer disease (inhibition of prostaglandins in stomach), rarely pituitary carcinoma Special: patient is immunocompromised, watch for signs of adrenal insufficiency, may need more insulin, wean off gradually, don't use with drugs that waste K+, don't use in pregnant women (breast feeding is OK in low doses) Aspirin Cox-1 Inhibitor (suppresses synthesis or prostaglandins), 1st Gen NSAID; ALSO INHIBITS COX-2; Used to suppress inflammation and platelet aggregation, relieve pain, reduce fever, and protect against MI, colorectal cancer, and stroke Irreversible inhibitor if cyclooxygenase; bound to albumin Side effects: gastric ulceration (all gastric distress, heartburn, nausea), bleeding, renal impairment, salicylism with toxicity, ED Special: monitor for toxicity (tinnitus, weating, headache, dizziness), don't use in children (Reye's syndrome) or pregnant women (Cat D), watch for hypersensitivity, DO NOT USE WITH other anticoagulants, glucocorticoids (gastric ulceration), alcohol, other NSAIDS, ACE inhibitors, ARBS (renal function), vaccines (less response) Ibuprofen Cox-1 Inhibitor (AND COX-2); Non-aspirin 1st Gen NSAID; used for RA, osteoarthritis, fever, bursitis, tendinitis; mild to moderate pain, and dysmenorrhea (superior) Reversible inhibitor if cyclooxygenase; NOT indicated for MI and stroke (INCREASED risk via vascoconstriction); no suppression of platelet aggregation; LESS gastric irritation than aspirin Side effects: GI disturbance, Reye's syndrome in children, low risk of causing Stevens-Johnson syndrome (via hypersensitivity) Special: Do not give to patients that are pregnant or children, safer to use with other anticoagulants Celecoxib Cox-2 Inhibitor (selective); 2nd Gen NSAID; Indicated for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, acute pain, dysmenorrhea, and off-label for familial adenomatous polyposis (lower risk of colorectal cancer) NOT for long-term use; could increase risk for CV events Side effects: renal impairment, could still cause GI issues (even without Cox-1 effects) Special: Do not use with patients that are hypertensive, have edema, HF, have kidney disease, avoid with patients allergic to sulfa, are pregnant **May increase anticoagulant effects of WARFARIN Diphenhydramine 1st Generation Antihistamine; Histamine 1 Antagonist (selectively); Can also block muscarinic receptors (causing sympathetic response); Used for mild allergy, motion sickness, insomnia, common cold Side effects: HIGHLY SEDATING, but can cause CNS stimulation with higher doses and children, dizziness, incoordination, confusional states, and fatigue Special: Take with food to reduce feelings of neursea, vomiting, loss of appetite, diarrhea or constipation, sympathetic response may occur due to blocking muscarinic receptors (assist with dry mouth, etc.), don't take with other CNS depressants, alcohol Use with caution with pregnancy (weigh risk/benefit) and don't use if breast feeding p. 847 Fexofenadine 2nd Generation Antihistamine; Histamine 1 Antagonist; Used for seasonal allergic rhinitis and chronic idiopathic urticaria ***Best combo of efficacy and safety in 2nd gen NONSEDATING (cross BBB poorly and low affinity for H1 receptors in the CNS) and do not cause anticholinergic effects Special: Doseage should be reduced for patients with renal impairment, fruit juices can reduce absorption (within 4 hours before dosing or 1-2 hours after) p. 847 Allopurinol For Hyperuricemia (secondary to chemo)/Gout; Reduces uric acid levels by inhibiting uric acid formation as a Xanthine Oxidase Inhibitor (and causes regression of already formed tophi); For chronic tophaceous gout Long-term use; Lack antiinflammatory and analgesic actions Side effects: rare toxicity (hypersensitivity syndrome), acute gouty attach with initial