Pharm Notes

Antacid Medication
Antacids work by counteracting (neutralising) the acid in your stomach that is used to aid digestion. This can reduce the symptoms of heartburn and relieve pain. Side effects include: diarrhea, constipation, flatulence (gas), stomach cramps, feeling sick or vomiting.

Aluminum/Magnesium Antacid
Neutralize gastric acid; constipation -with calcium antacids, diarrhea -with magnesium antacids, may effect absorption of some drugs; hypophosphatemia & hypomagnesemia

Prototypes drugs: Aluminum hydroxide -Amphogel; Magnesium Hydroxide -Milk of Magnesia; Calcium carbonate

Prostaglandin E Analog
Prevention of ulcers form NSAIDS; diarrhea, dysmenorrhea, uterine, cramping; DO NOT USE IN PREGNANCY.

Prototype drugs: Misoprotol -Cytotee

Act on brain to suppress appetite. May cause insomnia, DO NOT CRUSH OR CHEW medication, palpitations, arrhythmias, dry mouth, hair-loss. DO NOT USE IN PREGNANCY, HYPERTENSION OR HEART DISEASE.

Prototypes: Phentermine -AdipexP

Drug used for the alleviation or prevention of excessive intestinal gas. Chew tablets before swallowing; give after meals and at bedtime.

Prototype drugs: Simethicone -Alka-Seltzer Anti-Gas

Used to treat thrush(oral yeast infection); DO NOT USE IN PREGNANCY, nausea, vomiting diarrhea.

Prototype drugs: Nystatin -Mycostatin

Suppresses muscle spasm. Use with caution in glaucoma, urinary retention, DO NOT USE IN BOWEL OBSTRUCTION.

Prototype drug: Dicyclomine -Bentyl, glycopyrrolate (Robinul)

Anti-Ulcer Medication
Exclusive of the antibacterial agents, used to treat ulcers in the stomach and upper part of the small intestines. Diarrhea, HA, nausea vomiting, sore throat, constipation and fever.

Prototype drugs: Axid -nitzatidine, Carafate -sucralfate and Cytotec -misoprostol

H2 Receptor Antagonists
Blocks secretion of gastric acid, Impotence, loss of libido with Tagamet not Zantac; CNS effects more common.

Prototype drugs: Ranitidine hydrochloride -Zantac; cimetidine -Tagamet and famotidine -Pepcid

Proton pump inhibitor
Suppresses gastric acid production; limit drug therapy, ↑risk of bone loss in long term treatment. Administer daily on empty stomach.

Prototype drugs; Prilosec -Pantaprazole Protonix-Lansoprazole -Prevacid, Espmeprazole -Nexium

Mucosal Protectant
Treats acute duodenal ulcers; coats and protects gastric lining; could cause constipation; administer ½ hr ac; can effect absorption of some medications; caution with renal dysfunction.

Prototype drugs; Carafate

Bowel evacuants
Empty GI tract for tests, procedures, or surgery. Do not use in pregnancy or GI obstruction.

Prototype drugs; glycol electrolyte solution -Colyte,GoLYTELY,MoviPrep

Constipation Medications
Fiber Supplements
Bulk forming laxative; non- digestible, push fluids to prevent intestinal
obstruction, take with water and juice and drink immediately. Increase exercise and high fiber foods. Precaution with Diabetes

Prototype drugs; -Metamucil Calcium polycabopril -Fiber-Con and Methylcellulose -Citrucel

Stool Softeners
Surfactant laxative; monitor for severe dehydration and diarrhea; push fluids; increase exercise and high fiber foods.

Prototype drugs; sodium -Colace Docusate Sodium Senna -PeriColace

Stimulant Laxatives
Act on intestinal wall; possible laxative abuse potential; monitor of severe diarrhea or dehydration, proctitis; do not use in GI obstructions, perforations or undiagnosed abdominal pain.

Prototype drugs; Dulcolax; Senna -Sennakot, Ex-Lax

Diarrhea Medications
Decrease intestinal peristalsis and number of stools; sedation, dry mouth urinary retention. Do not use in inflammatory bowel disease; renal and liver dysfunction or BPH.

Prototype drugs; and atropine -Lomotil; Loperamide-Imodium

Gallstone solubilizing agents
Prevention of gallstones in patients post bariatric surgery or to dissolve pre-existing gall stones. Do not use in acute inflammatory conditions.

Prototype drugs -Actigall, Urso

Irritable Bowel Medications 1
Alosetron -Lotronex
Treats diarrhea in women only who have not responded to other IBD treatments; decreases peristalsis, visceral pain and increases absorption of water and sodium; must sign a treatment agreement; do not use in constipation.

Inflammatory Bowel Disease 1
5 Aminosalicylates
Mild to moderate IBD; Sulfa antibiotic which decreases intestinal inflammation; check stool for intact enteric coated pills and notify Dr to possibly order non coated pills to assure absorption. Possible orange- yellow discoloration of urine and skin. Possible arthralgia; report sore throat, fever, dizziness or dyspnea which could be a hematologic side effect, monitor CBC

Prototype drugs; Azulfadine -Mesalamine Asoacol,Rowasa

Lipase inhibitors
Used to reduce activity of lipase found in the intestines. Malabsorption syndrome, cholestasis, incontinence, oily stool.
Prototype drugs; -Xenical

Nausea Medications 1
Serotonin Antagonists
Treats nausea & vomiting in chemo therapy and post-op clients; block serotonin receptors; po, IV prior to chemotherapy, anesthesia or radiation; causes headaches and dizziness.

Prototype drugs; Zofram

Teats vertigo(whirling and loss of balance) and nausea; sedation and dry mouth, urinary retention, sedation; administer prior to predisposing activity; do not use in glaucoma or BPH; liver dysfunction.

Prototype drugs; -Dramamine; Scopolamione -Transderm Scop

Control acid reflux. Empties stomach faster. Used in chemotherapy, radiation therapy, GERD. Increases esophageal sphincter tone and peristalsis, sedation, dry mouth. Discontinue immediately if symptoms occur. Do not use in breast cancer.
Prototype drugs; Reglan

Iron preparations


For iron deficiency anemia. Side effects: GI disturbances, constipation, black stools, staining of teeth. Food reduces absorption but decreases GI discomfort.

Prototype drugs; sulfate -Feosol

Vitamin B12 deficency drugs


For pernicious anemia. Monitor for hypokalemia. Administer orally, SQ, IM, or intranasal. In absence of intrinsic factor, give parenterally lifelong.

Prototype drugs; vitamin b12, cyanocobalamin

Folic Acid deficiency drugs


For megaloblastic anemia. Encourage diet high in folic acid. 400 mcg/day prior to & during 1st trimester of pregnancy to help prevent spina bifida.

Prototype drugs; folic acid -Folacin

Parenteral anticoagulants


Prevents blood clots that may occur in blood vessels. Give SQ or IV. SE: bleeding,hemorrhage. Keep PTT at 1.5 to 2 times baseline. Antidote is protamine sulfate. Don’t give NSAIDs.

Prototype drugs; warfarin -Coumadin

Salicylic antiplatelets


Prophylatic dose is 81 mg/day. Prevents blood clots by preventing platelets from sticking together to form clots and inhibits vasoconstriction.

Prototype drugs; aspirin -Ecotrin



Clot busters. SE: bleeding. Monitor for S & S of bleeding, PTT, PT, INR, bleeding time, H & H, platelet counts. Give within 3-6 hrs of symptoms.

Prototype drugs; Activase or TPA

Erythropoietic growth factor (RBC)


Promotes RBC growth. Side effects: hypertension, blood clots, malignancy progression. Give IV or SQ. Don’t shake the vial. Monitor BP and H & H

Prototype drugs; epoetin alfa -Epogen, Procrit

Leukopoietic growth factor (WBC)


Promotes WBC growth. Side effects: bone pain. Give IV or SQ. Don’t shake the vial. Continue therapy past nadir.

Prototype drugs; filgrastim -Neupogen

Beta 2 adrenerics


Dilates bronchials; inhale before inhaling steroids; can be used as rescue inhaler. Use with caution if client has diabetes mellitus.

Prototype drugs; albuterol -Proventil

Inhaled anti-cholinergics


Anitcholinergics relax and dilates the airways in the lungs, making breathing easier. Used mostly for COPD. Due to delay in onset of action do not use for acute asthma. Use with caution if client has glaucoma, BPH, urinary retention.

Prototype drugs; ipratropium -Atrovent



Relieves asthma but can cause tachycardia, restlessness and insomnia so check blood levels.

Prototype drugs; theophylline -Theolair

Inhaled Gluco-corticoids


Suppresses the immune system to decrease inflammation of respiratory tissue; give after inhaled bronchodilator inhaler; rinse mouth after to prevent candidiasis.

Prototype drugs; beclomethasone -Deltasone

Mast cell stabilizers


Use to prevent asthma attacks; takes 2 -6 weeks to start working; don’t use for acute asthma attack.

Prototype drugs; cromolyn -Intal



Treats allergies. Use with caution if client has glaucoma, urinary retention, asthma or hypertension.

Prototype drugs; diphenhydramine -Benadryl

Sympathomimetic Decongestants


Reduces swelling or inflammation and mucus formation in the nasal passage and makes it easier to breath. Constricts nasal blood vessels; abrupt stoppage of drug causes rebound nasal congestion; use with caution in diabetes, glaucoma and BPH

Prototype drugs; phenylephrine -Neo-Synephrine



Stops coughs by blocking the cough reflex.

Prototype drugs; dextromethorphan -Benylin



Thins respiratory secretions so they can be excreted through coughing; push fluids.

Prototype drugs; guaifenesin -Mucinex

ACE Inhibitors


Decreases BP by inhibiting the Angiotensin converting Enzyme; SE include hypotension and dry, nonproductive cough; pregnancy risk category D

Prototype drugs; captopril -Capoten



Prevents stroke & treats heart failure;decreases BP as a Angiotensin II Receptor Blocker; pregnancy risk category D

Prototype drugs; losartan -Cozaar

Calcium channel blocker


Treats hypertension and angina; SE include lightheadedness, facial flushing, hypotension due to vasodilation; do not crush/chew sustained-release form.

Prototype drugs; nifedipine -Procardia

Beta adrenergic blocker


Treats hypertension and angina; decreases cardiac output; monitor for heart rate <60 Prototype drugs; Lopressor, atenolol -Tenormin

Centrally acting alpha2 agonists


Lowers HR and Lowers BP. Do NOT stop abruptly to avoid rebound hypertensive crisis; available in transdermal patch. Remove old patch before applying new patch q 7 days.

Prototype drugs; clonidine -Catapres

Alpha/Beta Blockers


Used to treat hypertension. Monitor for heart rate < 60. Increases risk for hypoglycemia with insulin, may increase risk for digoxin toxcity. Prototype drugs; Coreg

Direct acting vasodilators


Applied topically this drug also treats male pattern baldness. Unlike most BP meds, it increases heart rate so it is often given with a beta blocker.

Prototype drugs; hydralazine -Apresoline

Thiazide diuretics


Used to treat hypertension and edema. May cause hyperkalemia & increases risk of dysrhythmia. This risk increases if client is also taking digoxin. Give before 3 p.m. to prevent nocturia.

Prototype drugs; hydrochlorothiazide -Hydrodiuril

Loop diuretics


Act on the loop of Henle in the kidneys to treat hypertension and edema often due to COPD. Can cause hypokalemia, hypotension, ototoxicity, hyperglycemia and hyperuricemia. Give IV slowly to prevent ototoxicity. Give K+ rich foods.

Prototype drugs; furosemide -Lasix

Potassium-sparing diuretics


Diuretic drugs that do not promote the secretion of potassium into the urine. May cause hyperkalemia & increase risk of dysrhythmia. A weak diuretic given with Thiazide/Loop diuretics to balance K* loss from Thiazides/Loops.

Prototype drugs; spironolactone -Aldactone

Cardiac glycosides


S & S of toxicity: visual disturbances, anorexia, GI disturbances, confusion. Narrow therapeutic range 0.5 to 0.8 ng/ml. Hold if apical <60. Prototype drugs; digoxin -Lanoxin

HMG-CoA reductase inhibitors (Statins)


Drugs used to treat hyperlipidemia. Used to lower LDL levels. Increases HDL & decreases LDL; myopathy can progress to rhabdomyolysis; take in the evening; do NOT take with grapefruit juice

Prototype drugs; simvastatin -Zocor



Increases blood flow by dilating arteries to the heart. Causes coronary artery vasodilation; vasodilation also causes headache, orthostatic hypotension, flushing. Don’t touch transdermal form of drug.

Prototype drugs; nitroglycerin -Nitrostat



Confusion is a symptom of toxicity; make sure you use the correct type. Continuous cardiac monitoring is required during infusion.

Prototype drugs; lidocaine -Xylocaine

Hypoglycemia is low blood sugar.
hypoglycemia is low blood sugar.

Cushing’s disease is caused by too much thyroid hormone.
Cushing’s disease is caused by the
oversecretion of the adrenal cortex. Graves’
disease is caused by too much thyroid hormone.

Lack of insulin causes hypoglycemia.
too much insulin causes hypoglycemia.
Lack of insulin causes hyperglycemia.

A goiter(swelling of the neck resulting from enlargement of the thyroid gland) may be a symptom of Graves’ disease.
True; goiter is a symptom of Graves’ disease.(swelling of the neck and protrusion of the eyes resulting from an overactive thyroid gland. Also called exophthalmic goiter)

Ketoacidosis is the inefficient burning of fat.
True; ketoacidosis is the inefficientburning of fat.

Different categories of insulin cannot be mixed in one injection.
False; different categories of insulin -short-, mid-and long-acting, can be mixed and given in one injection.

Insulin pumps are used for 8 hours of every day.
insulin pumps are worn and used

Regular short-acting insulin can be used on a sliding scale.
True; regular short-acting insulin can be used on a sliding scale, based on the blood sugar levels.

Anabolic steroids are never legal to use.
in certain wasting illnesses, such as AIDS,
anabolic steroids are used to help build tissue.

Addison’s disease is caused by too little adrenal cortex hormone.
Addison’s disease is caused by low levels
of adrenal cortex hormones.

Which of the following is a symptom or sign of Addison’s disease?
A. Tremor
B. Dehydration
C. Restlessness
D. Weight loss
D. Weight loss is a symptom of Addison’s disease. (disease characterized by progressive anemia, low blood pressure, great weakness, and bronze discoloration of the skin)

Which organ secretes insulin?
A. Pancreas
B. Renal
C. Adrenal
D. Thyroid
A. The pancreas is an organ that secretes insulin.

What hormone triggers the release of hormones from the thyroid gland?
B. TSH the release of hormones from the thyroid gland.

When should insulin be refrigerated?
A. Before opening (while storing)
B. After opening
C. Never
D. Always
A. Refrigerating insulin will extend the shelf life
significantly. After it is opened, it should be stored at room temperature to decrease the pain of injection and discarded after one month.

Which is a common reason for an insulin pump to be prescribed?
A. Patient’s aversion to shots
B. Good insurance
C. History of hyperglycemia
D. Poor control of blood sugar
D. Poor control of blood sugar, along with a history of hypoglycemia, is the main reason for the use of an insulin pump.

Barbara is a 10-year-old patient with newly diagnosed diabetes. Her mom wants to know why Barbara needs to have injections three to five times a day while her father just has to take pills. Explain the reason for this.
Insulin-dependent diabetics produce no insulin and must have complete replacement through injection. Gastric secretions will destroy insulin if it is given by mouth. Her father is most likely a non-insulin-dependent diabetic, in which case, insulin is still being produced, but the pancreas needs help to produce enough, good quality insulin, and this can happen with oral medications.

Steve was in a devasting car accident. He is taking anabolic steroids to help repair the body tissues injured in the accident. His wife is concerned about the serious side effects of these drugs. What are the side effects, and is she justified in being concerned? What would
you say to her?
The side effects are aggressive behavior, rage, aterosclerosis, sterility, and liver cancer. Yes she is justified in being concerned. She should be encouraged to discuss these concerns with the trauma surgeon and maybe encouraged to participate in the decision as to whether the benefits outweigh the risks in this situation.

David has been recently diagnosed with IDDM. He is a traveling salesman and states that he leaves his insulin and injection supplies in the car for convenience. Explain to him the reason this is a bad idea and give him some suggestions on better ways to handle his insulin needs.
Insulin will be severely damaged when stored at high temperatures. Advise him on ways to keep it at a steady temperature -such as a plug-in climate-controlled cooler. Possibly encourage him to talk to the physician about this issue. He may be a candidate for an insulin pump,which will negate the need to have insulin stored in his car.

Cindy is told that she has hyperparathyroidism. She has had two episodes of kidney stones. She is confused about how these two things are connected; what would you say to her?
The parathyroid gland pulls calcium out of the bones into the bloodstream. If the parathyroid gland is pulling too much calcium into the bloodstream, it will pass through the kidneys to be filtered and will build up, causing the formation of

Anticoagulants increase clot formation.
anticoagulants decrease clotting of blood.

Antianginals destroy clots.
antianginals relieve chest pain -angina.

HDLs are the best kind of lipids.
HDLs are the best type of lipids.

Diet can decrease blood lipid levels.
diet can decrease lipid levels.

Infarction is tissue death.
True; infarction means death

Which keep platelets from aggregating and forming clots?
A. Anticoagulants
B. Antiplatelets
C. Antifibrinolytics
D. Thrombolytics
B. Antiplatelets keep platelets from aggregating
and forming clots.

Aspirin is an _____.
A. Antipyretic
B. Anticoagulant
C. Analgesic
D. All of the above
D. Aspirin is an antipyretic-used to prevent or reduce fever), anticoagulant, and analgesic-painkiller)

Which are used to treat hypertension?
A. Anticoagulants
B. Diuretics
C. Anti-infectives
D. Thrombolytics
B. Diuretics are used to treat hypertension.

Which drug is indicated within 60 minutes of the onset of stroke symptoms?
A. Digoxin
B. Lasix
D. Cozaar
C. TPA is used within 60 minutes of appearance
of stroke symptoms.

Antihypertensives include which of the following?
A. ACE inhibitors
B. Calcium channel blockers
C. Beta blockers
D. A and B
D. ACE inhibitors and calcium channel blockers are both antihypertensives.

Nicotine has what effect on blood pressure?
C.Has no effect
B. Nicotine increases blood pressure.

Digoxin(steroid glycoside used in small doses as a cardiac stimulant) has been in use since _____.
D. Digoxin(steroid glycoside used in small doses as a cardiac stimulant) has been in use since the 1700s.

Dysrhythmias can be caused by all EXCEPT patients with _____.
B.Cardiac disease
C.Potassium level alterations
D. Dysrhythmias can be caused by hypertension, cardiac disease, potassium level alterations, and diet.

All of the following are types of lipids EXCEPT ______.
B. HDL, LDL, and VLDL are all types of

Which of the following does not affect blood pressure?
A.Heart rate
B.Stroke volume
C.Peripheral resistance
10. D. Heart rate, stroke volume, and peripheral

Sherrie has just had a stroke. Although she agrees to take the medications the physician prescribes, she asks you what behaviors she could adopt to reduce the risk of another stroke further. What do you teach her?
Dietary restrictions, such as low sodium, low fat; monitor blood pressure and lipid levels.

Henry has just been given a prescription for Lipitor. Does he need to make lifestyle changes?
Henry should follow the low fat diet that his doctor prescribes and begin an exercise program approved by his prescriber.

Richard has just been hospitalized for a pulmonary embolism. He wants to know why he has to wear such tight stockings and also take medications. What do you tell him about his antiembolic stockings and medication therapy?
Anti-embolic(prevents blood clots) stockings increase blood return to the heart, preventing blood from pooling and possibly forming clots. The medications he is on will also inhibit further clot formation and should be taken as ordered.

Anthony has congestive heart failure. He has been prescribed Digoxin. What are some of the symptoms to watch for closely as an indication of toxicity?
Yellow-green halos around lights, heart rate less than 60, nausea, vomiting, diarrhea, stomach pain.

Barbara has been prescribed a diuretic and is now having heart arrhythmias. She asks why this is happening and what she can do to prevent this in the future.
After the prescriber determines that teaching is appropriate and nothing else is occurring, you should explain the relationship of potassium to a normal heart rhythm. Diuretics can cause the loss of potassium, and she can avoid the arrhythmias by eating foods high in potassium, such as bananas.

Glucocorticoids are used during severe asthma attacks.
True; although glucocorticoids are used primarily as prophylaxis(action taken to prevent disease), they can be used at higher doses during a severe asthma attack to open up the airways.

Mucolytics are used to suppress cough.
False; antitussives suppress coughing; mucolytics break up very thick secretions.

Cystic fibrosis(thick, sticky mucus to build up in the lungs) is treated with antiviral medications.
False; cystic fibrosis is treated with prophylactic antibiotics and mucolytics, among other medications.

Apnea(suspension of external breathing) is most common in athletes.
apnea is most common in premature infants.

Alveoli(small air sacs in the lungs) are where O2 and CO2 are exchanged.
True; the exchange of oxygen and carbon dioxide takes place at the alveolar level

Asthma medications can be given via which of the following routes?
A. Oral
B. Inhalation
C. Intravenously
D. All of the above
D. Asthma medications are given via the oral,
inhalation, and IV routes.

Caffeine is given to prevent ________.
A. Asthma
B. Pneumonia
C. Apnea
C. Caffeine and theophylline are drugs used to prevent apnea in premature infants.

Which class of pulmonary medications suppresses coughing?
A. Antitussives
B. Mucolytics
C. Expectorants
D. Mast cell stabilizers
A. Antitussives suppress coughing.

Which class of medications is given to prevent asthma attacks?
A. Antitussives
B. Mucolytics
C. Expectorants
D. Mast cell stabilizers
D. Mast cell stabilizers are used to prevent asthma attacks, but will not work on an acute attack.

Which of the following medications are used in the treatment of tuberculosis?
B. Rifampin
C. Both A and B
D. None of the above
C. INH(isonicotinylhydrazine) and rifampin is the most common combination of drugs used to treat tuberculosis.

Harold calls the office complaining that ever since he was prescribed rifampin at the TB clinic, his urine is orange. How would you explain this to him, and is it of concern?
Explain that this is a normal side effect of rifampin and that he should not be too concerned. Explain that other body secretions, such as sweat and tears, will also be discolored and may stain clothes.

Wilma has cystic fibrosis. She complains about the frequency of treatments and dislikes taking medication. She wonders why she has to take antibiotics if she is not sick. What would you tell her?
One of the complications of cystic fibrosis is pneumonia. As a result, many patients are put on routine antibiotics to prevent the development of this serious disease, which could be devastating to someone with already weakened lungs.

Sandi is a busy working mother. She is asking for antibiotics because she cannot afford to get sick and is quite angry that the physician will not prescribe them for her. What would you say to her?
Antibiotics should not be indiscriminately taken, because bacteria may become resistant to that antibiotic. They should only be given when a bacterial infection is present.

Julian has COPD. He wants to know why the more oxygen he uses, the worse he feels. What would you say to him?
More O2 is not better. The amount of oxygen given should be at the most 4L/min. Each patient should be assessed individually and given the least amount of oxygen possible. Too much oxygen leads to “air trapping,” increases carbon dioxide to dangerous levels, and changes the acid/base balance in the body.

Charlotte has a cold with a productive cough. She has been prescribed an antitussive to be used only at bedtime. She states that it helps so much that she is going to use it around the clock. How would you counsel her?
If a patient has a productive cough, it is important that the body expels this mucus out of the lungs and upper airway. If the cough is suppressed all of the time, the mucus will sit in the lungs, perhaps leading to the development of an infection such as pneumonia. It is prescribed only at time of sleep to allow the patient to obtain much-needed rest.

Flatulence is intestinal gas.
True; flatulence is intestinal gas.

H. pylori is the bacterium responsible for causing GERD.
H. Pylori is the bacteria responsible for causing many peptic ulcers.

Type AB blood is a risk factor for the development of ulcers.
those with type O blood are at higher risk for developing ulcers.

Anthelmintics are used to treat intestinal parasites.
anthelmintics are medications used to kill intestinal parasites.

Halitosis means bad breath.
halitosis means bad breath.

High-fat meals are allowable when taking lipase inhibitors such as orlistat.
False; high-fat meals cause unpleased GI side effects.

Laxatives may be prescribed when a patient is taking anthelmintic medications.
True; laxatives are used to expel eggs and dead worms in patients taking anthelmintic medications.

Cholelithiasis is a condition in which stones are present in the gallbladder.
cholelithiasis refers to stones in the gallbladder.

Medication taken for gallstones is effective within 6 weeks.
medication for gallstones takes up to 2 years to work.

Thrush is oral candidiasis.
thrush refers to candidiasis of the mouth

A crack at the end of the rectum is called a .
A. Halitosis
B. Pica
C. Peristalsis
D. Fissure
D. A fissure is a crack at the end of the rectum.

Intestinal gas is called .
B. Halitosis
C. Helicobacter pylori
D. Flatulence
D. Flatulence is intestinal gas.

Which of the following is NOT a type of antiemetic?
A. Phenothiazines
B. Antihistamines
C. Prostaglandins
D. Cannabinoids
C. Antiemetics include phenothiazines, antihistamines, and cannabinoids.

Which medication is used to treat GERD?
B.Proton pump inhibitors
B. Proton pump inhibitors are used treat GERD.

Which causes a reduction in spasms associated with GI disorders?
A. Anticholinergics reduce GI spasms.

Inflamed varicose veins located in the rectum are called?
C. Hemorrhoids are inflamed varicose veins
located in the rectum.

The medication prescribed for oral thrush is?
D.Activated charcoal
A. Nystatin is a drug commonly used to treat oral thrush (yeast infection of the mucus of the mouth and tongue).

The medication prescribed for H. pylori is?
D.Activated charcoal
C. Amoxicillin is a drug prescribed for ulcers caused by H. pylori.

The medication taken for flatulence is?
D.Activated charcoal
B. Simethicone is a medication prescribed for flatulence (gas).

A medication administered to treat a drug overdose is?
D.Activated charcoal
D. Activated charcoal is a drug used to treat overdose or poisoning

Butler is having gastric bypass surgery, and the surgeon is removing most of
Mr. Butterworth’s stomach. How will that affect the absorption of drugs he takes?
With removal of most of the stomach, many medications the patient takes may not be absorbed. He needs to evaluate risk versus benefit of the procedure.

Cliff wants to lose weight. He wants to be put on Xenical but continue his lifestyle. What do you teach him?
In order for weight loss medications to be effective, the patient needs to make lifestyle changes, such as increasing exercise and decreasing consumption of processed, sugary foods and saturated fats.

Marilyn takes Dulcolax every night to have a bowel movement. Is this a good practice? Why, or why not?
It would be preferred if she could have bowel movements naturally. If she continues to take laxatives, she may reduce her body’s own ability to defecate without medications.

Joyce says that her mother always drank milk to treat her stomach ulcer. She does not understand why she is taking antibiotics and told not to use milk to treat the ulcer. What would you say?
Scientists used to think that drinking alkaline milk
would reduce the acidity of the stomach and soothe ulcers. We now know that milk provides an excellent environment for the H. pylori to grow and reproduce.

Testosterone is used to treat breast cancer.
testosterone provides a hostile environment
for the growth of breast cancer.

Luteinizing hormone regulates testosterone production.
False;ICSH regulates testosterone. LH triggers the release of the egg and helps with secretion of estrogen and progesterone.

Birth control pills can cause women to experience the symptoms of pregnancy.
True; symptoms such as breast tenderness, nausea, and weight gain are common.

Human chorionic gonadotropin is used to treat male infertility.
HCG increases the testosterone levels, which increase sperm production.

Diuretics cause the retention of potassium.
False; diuretics cause the depletion of potassium unless they are the potassium-sparing diuretics.

The minipill contains both estrogen and progestin.
False; the mini pill contains only the hormone progestin.

BPH is a disease that is usually terminal.
BPH is not terminal, thus, the name “benign.”

Reduced libido may occur as a result of daily medication taken by both men and women.
reduced libido can occur as a result of
emotional or physiological changes, the physical
changes of aging, or as a side effect of medication.

One risk of fertility drugs is multiple births.
fertility drugs may cause the release and
fertilization of multiple eggs, resulting in multiple

Cervical ripening refers to the ability of the uterus to accept a fertilized egg.
cervical ripening refers to applying topical
medications to the cervix of the uterus to prepare
it for labor.

Which of the following is NOT a type of diuretic?
A. Loop
B. Potassium-sparing
C. Tocolytic
D. Thiazide
C. Types of diuretics include loop, potassium-
sparing, and thiazide diuretics.

Which drug is used to treat vaginal herpes?
A. Zovirax
B. Pitocin
C. MetroGel
D. Monistat
B. Zovirax is used to treat vaginal herpes.

Which drug induces uterine contractions?
A. Tocolytics
B. Pitocin
C. Dinoprostone
D. B and C
D. Pitocin and dinoprostone are drugs used to
induce uterine contractions.

Which is a medication that can lead to decreased libido?
C.Vitamin C
D.None of the above
A. Benadryl can cause decreased libido (sexual desire).

Which type of diuretic is used to treat moderate hypertension?
D. Thiazide diuretics treat moderate

Which of the following hormones are part of the reproductive system?
A.Luteinizing hormone (LH)
B.Interstitial cell-stimulating hormone (ICSH)
C.Follicle stimulating hormone (FSH)
D.All of the above
D. LH, ICSH, and FSH are hormones associated
with the reproductive system.

Which of the following birth control pills contains a consistent amount of both progestin
and estrogen in every pill for a period of 3 weeks?
A. Monophasic birth control pills contain a con-
sistent amount of progestin and estrogen in
each pill for three weeks.

Which of the following medications is used as birth control?
D. Implanon is a type of birth control.

What hormone may be given to treat male infertility?
C.Human chorionic gonadotropin
C. HcG is used to treat male infertility.

DDAVP is used to treat what disorder?
C.Benign prostatic hypertrophy
D.None of the above
B. DDVAVP is a medication used to treat

Martin calls the office to state that every since he started taking Rocephin, his urine is orange. He is worried that his kidneys are being damaged. Explain to Mr. Moulder why this is happening and what he should do.
Rifampin turns urine red or orange normally. Advise him that this effect is normal and explain to him how to tell if his kidneys are functioning normally -normal output in a day, etc..

Charlotte is going through menopause. She is concerned about HRT and wants to know
why she needs this and whether there is anything else she can do to alleviate the symptoms.
Explain the risks and benefits of HRT to her, as well as potential alternative therapies
HRT decreases bone loss and cardiovascular
dysfunction, however, studies show that there is
an increased risk of breast cancer. Assist her in
exploring alternative therapies such as diet. Give
her any educational materials available. Advise her
to discuss alternative therapies with her physician
to ensure she is not endangering her health.

Mr. Stephens faithfully donates blood every 8 weeks at his local blood bank. Ever since he
has begun taking Avodart, he has been denied as a donor. He is upset and wants to know
why this is happening. Explain to Mr. Stephens why taking Avodart makes him ineligible
to donate blood.
Avodart is a known risk for birth defects. Women should not handle the medication when pregnant. Men are advised not to donate blood until 6 months after cessation of Avodart

Irritable Bowel Medications 2
Lumbiprostone -Amitza
Works opposite of Alosetron; increases peristalsis, increases secretion of sodium and water but still decreases visceral pain; Take with food or water. Stop taking with severe nausea, vomiting or abdominal pain and call Dr.

Inflammatory Bowel Disease 2
Decrease immune response; Hepatitis, bone marrow depression; monitor liver function and CBC; Caution with liver and renal dysfunction. Risk for infections.

Azathioprine -Imuran, Cyclosporine -Sandimmune; Methotrexate -Rheumatre

Nausea Medications 2
Dopamine Antagonist, 4 severe nausea from anesthesia and chemotherapy; diphenhydramine -Benedryl); hypotension, dry mouth urinary retention, constipation. Redish brown discoloration of urine; photosensitivity

Prochlorperazine -Compazine; Promethazine -Phenergan; Metroclopramide -Reglan

a. Bulk-forming agents
b. Lubricants
c. Osmotics
Increase the water to fecal mass to ease the passage of stool; are usually suppositories and oily. B

​Increase bulk and water content of stool, resemble dietary fiber, and are the laxative of choice during pregnancy and for long-term use. A

Given rectally; exert an immediate action that draws water into the stool and irritates the bowel to increase peristalsis, which leads to evacuation of stool within 15 to 60 minutes. C

d. Stimulants
e. Stool softeners
f. Bowel evacuators
Cleansing solutions used before diagnostic tests to remove stool. F

Decrease the consistency of stool by decreasing surface tension and attracting water and fat to the stool. E

Stimulate peristalsis as they act directly on the intestinal mucosa and irritate the bowel; typically effective within 6 to 8 hours. D

a. Mylanta
b. Pepto-Bismol
c. Thorazine
d. Mylicon
e. Nystatin
Antidiarrheal. b. Pepto-Bismol
Antifungal. e. Nystatin
Antiflatulent. d. Mylicon
Antiemetic. c. Thorazine
Antacids. a. Mylanta

f. Robinul
h. Actigall
i. Reglan
j. Tagamet
H2-receptor antagonist. j. Tagamet
GI stimulant. i. Reglan
Antispasmodic. f. Robinul
evacuant. g. GoLYTELY
Gallstone solubilizing agent. h. Actigall

k. Xenical
l. Cytotec
m. Prevacid
n. Carafate
o. Biltricide
Proton pump inhibitor. m. Prevacid
Mucosal protectant. n. Carafate
Prostaglandin. l. Cytotec
Lipase inhibitor. k. Xenical
Anthelmintic. o. Biltricide

alpha vs beta (1)
Alpha blockers work on the blood muscles to open up the blood vessels while the Beta medications work on the heart to ease the flow of blood.
Alpha meds work on the hormone of norepinephrine or noradrenaline while the Beta works on the epinephrine or adrenaline.

alpha vs beta (2)
3.Alpha blockers work for the blood pressure levels alone while the Beta blockers can work for both heart and the blood pressure.
4.Beta blockers can cause weight gain while Alpha medications do not.

Addison’s disease
gradual, progressive failure of the adrenal glands and insufficient production of steroid hormones

hormone produced by the human thyroid gland that is important for maintaining a dense,strong bone matrix and regulating the blood calcium level

congenital condition caused by a lack of thyroid hormones and characterized by arrested physical and mental development, myxedema, dystrophy of the bones and soft tissues, and lowered basal metabolism.

Cushing’s disease
condition in which the pituitary gland releases too much adrenocorticotropic hormone (ACTH). Upper body obesity (above the waist) and thin arms and legs, Round, red, full face (moon face), Slow growth rate in children

enlarged thyroid

Graves’ disease
distinct type of hyperthyroidism caused by an autoimmune attack on the thyroid gland.

diabetes mellitus (IDDM)
chronic metabolic disorder marked by hyperglycemia, Insulin-dependent for life.

faulty fat metabolism

peptide hormone produced by the pineal gland; influences sleep-wake cycles and other circadian rhythms

clinical and metabolic manifestations of hypothyroidism in adults, adolescents, and children

Negative feedback system
result of a process that reverses or shuts off a stimulus

diabetes mellitus (NIDDM)
Type 2, chronic condition that affects the way your body metabolizes sugar (glucose), Non—insulin-dependent.

hormone produced by the parathyroid; increases blood calcium

Thyroid storm
life-threatening situation resulting from untreated hyperthyroidism and characterized by hyperthermia, tachycardia, chest pain, sweating, weakness, heart failure, anxiety, shortness of breath, and disorientation.

Angina pectoris
oppressive pain or pressure in the chest caused by inadequate blood flow and oxygenation to heart muscle

Angiotensin receptor blockers (ARBs)
Angiotensin II receptor blockers help relax your blood vessels, which lowers your blood pressure and makes it easier for your heart to pump blood.

absence of oxygen

the most common form of arteriosclerosis, marked by cholesterol-lipid-calcium deposits in the walls of the arteries

Cerebrovascular accident (CVA)
stroke, loss of brain function due to a disturbance in the blood supply to the brain.

Congestive heart failure (CHF)
heart’s pumping power is weaker(SLOWER) than normal.

having the ability to contract or shorten

blue, gray, slate, or dark purple discoloration of the skin or mucous membranes caused by deoxygenated or reduced hemoglobin in the blood

Deep vein thrombosis (DVT)
a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs.

abnormal heart rhythms

mass of undissolved matter present in a blood or lymphatic vessel and brought there by the blood or lymph

arrest of bleeding or of circulation

High-density lipoprotein (HDL)
HDL cholesterol is the well-behaved “good cholesterol.” cholesterol is an essential fat. It provides stability in every cell of your body.

Hypertension (HTN)
the blood pressure in the arteries is elevated.

abnormally high lipids in the blood

oxygen deficiency in body tissues

temporary deficiency of blood flow to an organ or tissue

Low-density lipoprotein (LDL)
LDL is the bad one. LDL collects in the walls of blood vessels, causing the blockages of atherosclerosis.

Myocardial infarction (MI)
heart attack. An MI occurs when blood stops flowing properly to a part of the heart, and the heart muscle is injured because it is not receiving enough oxygen.

Pulmonary circulation
the portion of the cardiovascular system which carries deoxygenated blood away from the heart, to the lungs, and returns oxygenated (oxygen-rich) blood back to the heart.

clinical syndrome marked by inadequate perfusion and oxygenation of cells, tissues, and organs; usually a result of marginal or markedly lowered blood pressure

blood clot that adheres to the wall of a blood vessel or organ

Very low-density lipoprotein (VLDL)
(VLDL) is a type of lipoprotein made by the liver. VLDL is one of the five major groups of lipoproteins. Because it contains a high level of triglyceride, having a high VLDL level means you may have an increased risk of coronary artery disease, which can lead to a heart attack or stroke.

plural of alveolus; an air sac in the lungs

cessation(STOP) of breathing

Chronic obstructive pulmonary disease (COPD)
a progressive lung disease that makes it hard to breathe. “Progressive” means the disease gets worse over time.

difficult breathing

death or end of usefulness; relaxation of lungs causing the exhalation of waste in the form of CO2

inhalation, breathing in

Latent tuberculosis (TB)
a contagious bacterial infection that involves the lungs.TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.

Purified protein derivative (PPD)
is an antigen used in the diagnosis of Tuberculosis infection.

interchange of gases (CO2 and O2)

Respiratory syncytial virus (RSV)
a virus that causes infections of the lungs and respiratory tract.

Alimentary canal
another name for the gastrointestinal tract

stone commonly formed from calcium found in the gallbladder or kidneys

purging the body quickly; example, cleaning the bowels of stool

stool with lowered liquid content and less frequent

increased frequency of stool and higher fluid content

the process of converting food into chemical substances that can be used in the body

evacuation of stomach contents

cracks in the anus

air in the gastrointestinal system (GAS)

Gastroesophageal reflux disease (GERD)
a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

H. pylori
bacterium responsible for the majority of ulcers

bad breath

pain in the area of the heart caused by irritation of refluxed acid into the esophagus

varicose veins found in the anus

Hydrochloric acid (HCl)
clear, colorless, highly pungent solution of hydrogen chloride (HCl) in water.

Morbidly obese
weight 20% or more above the recommended ideal weight; usually associated with increased health risks

feeling of impending vomiting

movement of food and stool through the gastrointestinal tract

regurgitation of acid up into the esophagus from the stomach

inflammation of the mouth including the gums, lips, and tongue

candidal (yeast) infection of the mouth where white patches are noted

lesion of the skin or mucous membranes

substance producing or stimulating the development of male characteristics, such as the hormones testosterone and androsterone

Benign prostatic hypertrophy (BPH)
benign increase in size of the prostate.


any natural or artificial substance that induces estrus and the development of female sex characteristics; more specifically, an estrogenic hormone produced by the ovaries

Hormone replacement therapy (HRT)
substitute other hormones for naturally occurring hormones.

corpus luteum hormone that prepares the endometrium for implantation of the fertilized ovum; a term used to cover a large group of synthetic drugs that have a progesterone-like effect on the uterus.

capable of relieving uterine contraction by reducing the excitability of myometrial muscle

Education for patients taking anticoagulants
Use an electric razor to avoid injury. Reduce intake of green leafy vegetables, in vitamin K. Watch for signs of abnormal bleeding, such as frequent bruising, bleeding gums, and black, tarry stool. Have blood drawn to monitor the effect of anticoagulants.

Test to assess anticoagulant therapy.
Prothrombin Time (PT), Normal range for an adult: 9.9-13 seconds.

International Normalized Ratio (INR)
Normal level for an adult: 0.9 – 1.2. Your doctor will determine your therapeutic range.

Although prevention of influenza through vaccination is preferred, anti-influenza agents can reduce the duration of the illness. Examples of drugs used to treat influenza include zanmivir, -Relenza) and oseltamivir phosphate, -Tamiflu). Medications are usually taken for
2 to 5 days.

Treatment for most respiratory infections. 10 to 14 days. Occasionally, a patient is given an injection of an antibiotic, followed by an oral medication course. This injection jump starts the healing process without the need for IV infusions and hospitalization.

Mycobacterium tuberculosis TB
Pharmacological treatment of TB requires exact adherence to a regimen of several drugs over 6 to 12 months because TB heals very slowly. drugs consists of INH, -isoniazid) and Rifadin, -rifampin).

What is the difference between having the disease and having latent TB?
TB test (purified protein derivative [PPD]), the skin test result is positive in both TB disease and latent TB. Latent TB pts have no signs of active disease. Such as changes to their chest radiographs. Prophylactic administration of antibiotics helps to keep the disease from becoming active.

Respiratory stimulants – Infants
Meds stimulates respiratory center of the brain. Apnea (periods of breathing cessation), most common in premature infants whose brain is not developed to the degree of a normal newborn. These infants require a nudge to breathe, done with medications such as caffeine citrate -Cafcit) or theophylline.

Short-acting insulin
Prescribed on a sliding scale, depending on the assessed blood glucose level. It may also be
taken before meals so that it starts to work as food is being digested.

Regular, Velosulin (pump only)

Intermediate-acting insulin
Insulin mixed with a substance that makes the body absorb the insulin more slowly. This type of insulin looks cloudy in the bottle and must be mixed before injection.

NPH, Lente

Long-acting insulin
Long-acting insulin can last up to a day and a half. It is usually taken in the morning or at bedtime.

Levemir, Lantus, Ultralente.

Anabolic steroids
Can be used to prevent muscle wasting in patients with AIDS or to help patients with severe trauma to rebuild tissue. Oxandrolone and nandrolone decanoate. Side effects are aggressive behavior, rage, atherosclerosis, sterility, and liver cancer.

Hypoglycemia treatment
Hypoglycemia is normally treated with a small dose of glucose such as hard candy, but patients may also choose to carry glucose preparations such as Insta-Glucose (gel) or BD Glucose (chewable tablet) that they take by mouth at the first sign of hypoglycemia.

Corticosteroid meds are used to treat Addison’s disease, autoimmune diseases, inflammatory reactions, cerebral edema, dermatologic disorders, allergies, asthma, cancer, Crohn’s disease, dermatitis, edema, rashes, rheumatoid arthritis, rhinitis, shock, transplant rejection, and ulcerative colitis.

Adrenocorticotropic hormone
Release of cortisol and glucocorticoids to control the fight
or flight response.

Oral Hypoglycemic
Given orally, these drugs are approved for use only in patients with type 2 diabetes and are used in patients who have not responded to diet, weight reduction, and exercise. They are not approved for the treatment of women who are pregnant with diabetes.

Complications of insulin therapy
Swelling of the face and/or feet; Weight gain; Lumps of fat; Shrinking of fat under the skin; Scarring of tissue under the skin; Allergy.

Drugs for thyroid disorders
Levothyroxine -T4), -Levothroid), desiccated thyroid -T3, T4) -Armour). Side effects, Palpitations, fast heart rate, irregular heartbeat, increased blood pressure nervousness,
tremor, headache, insomnia, weight loss, diarrhea, abdominal cramps, intolerance of heat, fever, menstrual

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Synthroid (Levothyroxine) monitor pulse before each dose during dosage adjustment notify MD > 100 monitor weight teach / report signs of toxicity Ampicillin (Omnipen) Antibiotic Anti-infective of the penicillin type SE – gastritis – diarrhea, n/v – rash – anaphylaxis …

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amiodarone (Cordarone)/potassium channel blocker (antidysrhythmic) Treats: dysrythmias adverse effects: slow the heart rate resulting in bradycardia and hypotension, worsen dysrythmia monitoring: for dsyrthmias, older adults with heart failure for cardiac cardiac effects teaching: causes sun sensitivity, corneal deposits, visual disturbances, …

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