Final Exam

• Do not take antitussives if the cough is productive, as you want the client to be able to get the mucus out of the body.
• Expectorants loosen mucus in the respiratory tract by drawing fluid into the mucus membranes and reducing its stickiness.
• Mucolytics are used to treat chronic diseases with excessive, sticky mucus. An example is cystic fibrosis.
• Fluticasone propionate must be taken for multiple days to reach the full therapeutic effect.
• Albuterol is a short-acting rescue medication for asthma.
• Short Acting Beta Agonists (SABAs) are rescue medications for asthma attacks (albuterol).
• Long acting Beta Agonists (LABAs) are maintenance medications for asthma (salmeterol)
• Beta-2 agonists can cause tachycardia, angina, and tremors due to the activation of alpha/beta receptors in the heart/skeletal muscles.
• Inhale beta-2 agonists before inhaling glucocorticoids, as they can enhance absorption of glucocorticoids.
• Inhaled corticosteroids can cause oral flush or candidiasis, as well as difficulty speaking and hoarseness. Rinse mouth after use and monitor for redness, sores, or white patches.
• Monitor blood levels of beclomethasone and taper the dose to prevent suppression of adrenal gland function.
• Clients who take insulin may need to increase their dosage when taking concurrently with beclomethasone.
• If a client experiences muscle weakness when taking beclomethasone, the dose may need to be lowered. Report this.
• Beclomethasone can cause Peptic Ulcer Disease, so avoid NSAIDs and report black, tarry stools.
• Report signs of infection when taking beclomethasone.
• Beclomethasone can cause fluid retention, edema, hypokalemia, and weight gain. Report this!
• zafirlukast (Accolate) is the prototype for leukotriene modifiers.
• Zafirlukast can cause depression and suicidal ideation-- report to the provider.
• Zafirlukast can cause liver damage, so obtain a baseline function test and monitor periodically.
• Baclofen should be taken with meals to improve absorption.
• Do not take baclofen with other CNS depressants, such as alcohol.
• Cyclobenzaprine is the most commonly prescribed muscle relaxant.
• Obtain a baseline liver function panel and monitor for jaundice when administering cyclobenzaprine.
• Phenytoin has a narrow therapeutic index (10-20 mcg/mL).
• Phenytoin is irritating to the veins, so it must be administered slowly via IV through a large catheter with only normal saline (NS).
• Phenytoin is highly protein bound, so it will eventually increase in levels at a later time than expected.
• Administer phenytoin IV at a rate of 50mg/min.
• Carbamazepine is the next line of defense after phenytoin.
• Carbamazepine can cause bone marrow suppression, so it is important to monitor WBC count and fever.
• Report to the provider if a rash occurs when administering carbamazepine, as it could indicate Steven-Johnson syndrome.
• Grapefruit juice increases carbamazepine levels.
• Take carbamazepine at night with food for best effects.
• Valproic acid can damage the liver (hepatotoxicity) and the pancreas (pancreatitis).
• Valproic acid can cause bone marrow suppression, so monitor WBC count and fever.
• Do not administer valproic acid with other antiepileptic drugs.
• Take valproic acid with food to decrease GI effects.
• Valproic acid can cause hyperammonemia, so monitor and report impaired cognitive function, vomiting, and altered LOC.
• Diazepam and lorazepam are are the benzodiazepines used to treat status epilepticus.
• Levodopa/carbidopa (Sinemet) is used to treat Parkinson's Disease -- carbidopa protects the levodopa from absorption so it can take a fuller effect in the brain.
• Monoamine oxidase inhibitors can cause hypertensive crisis when combined with drugs that also affect dopamine levels.