Drug Drug Class Question & Answer Guide (With Explanation)
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What This Question Is About
This question relates to drug drug class and requires a structured academic response.
How to Approach This Question
Break the problem into smaller parts and analyze each logically.
Key Explanation
This topic involves drug drug class. A strong answer should include explanation, application, and examples.
Original Question
Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Naloxone Hydrochloride Naltrexone (ReVia) ____1___ ____2_______ Anxiety, irritability, chills, hot flashes, rhinorrhea, diarrhea, confusion, abdominal cramps, nausea vomiting Use with caution in patients with cardiac disease – Monitor for cardiac arrythmias. ****After the nurse had administered to a patient to reverse opioid effect, what should they look for ____3_____ Gabapentin, Venlafaxine, Bupivacaine, Baclofen, Cyclobenzaprine, Ketamine, Duloxetine, Nortriptyline ___4_____ Activate innate immune responses to produce a local immuno-competent environment at the injection site. respiratory depression, sedation, constipation urinary retention nausea Depending upon the medication used. ** Aspirin, Diclofenac, Ibuprofen, Ketoprofen, Ketorolac, Meloxicam, Naproxen, Celecoxib Non-Opioid analgesics NSAIDS-Inhibits COX-1 and COX-2, inhibits prostaglandins. ASA- causes irreversible inhibition of COX (different from NSAIDs) GI distress Peptic Ulcer disease Kidney and liver impairment Tarry stools Blood dyscrasias: thrombocytopenia, leukopenia, neutropenia, hemolytic anemias Bone marrow depression and impaired coagulation Monitor (labs): __5___ & __6___ (hint: look at Adverse effects) Teach Patient: Take with meals or milk to reduce GI irritation Avoid drinking alcohol, smoking and aspirin when taking other NSAIDs Morphine Fentanyl Hydromorphone Codeine Sulfate Meperidine (do not use in elderly) Methadone ____7___ ___8_____ 1. ___9_____* 2. ___10____* 3. ____11___* 4.Cough suppression 5. Itching 6. Pupil Constriction 7. Diaphoresis and flushing Antidote: ___12________ 1. Monitor vital signs (_13_ & _14__) 2. Teach patient to rise slowly. 3. Monitor for constipation Administered: IV, Transdermal, Transmucosal, Nasal Spray, PO, Sublingual spray Antidote: 15. ______ (opioid antagonist) “Morphine is the opioid of choice for decreasing pain from myocardial infarction. ” Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Acetaminophen 16. ____ and 17. ___ (not anti-inflammatory) Inhibits prostaglandin synthesis Can cause 18___ (which main organ) damage Dark urine rash Clay colored stools Antidote: 19. ____ Monitor: 20. _______ Teach: Careful when taking with other medications that already contains 21. ____ (i.e., Percocet) Buprenorphine (used to treat opioid addiction) Agonist-antagonist Indicated for: Used an 22. ___ and to treat 23. _____ addiction Headache Drowsiness Nausea, vomiting Increased sweating Inability to sleep Avoid driving or drinking when taking this medication. Do not take with other narcotics Pentazocine (nalbuphine, butorphanol Agonist-antagonist Antagonist: Acts on opioid receptor sites Agonist: produces an antagonistic effect when given to patients taking opioids Respiratory depression** Nausea, vomiting diarrhea 24. _____* Tachycardia 25. _____ Monitor vitals especially: (hint adverse reaction column) ___26__and ___27___ Naloxone (Narcan) ___28__ Blocks and reverses effects. Binds to receptors in the brain _29__ _30___ Administration: IV, intranasal, IM, subQ *if administered before opioid -blocks effects, if administered after opioid, it will reverse the effects of drug Adjuvant Medications Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Lidocaine (Lidoderm) Topical analgesic Local anesthetic used to relieve neuropathic pain (postherpetic neuralgia) Redness or irritation to skin Dizziness Confusion Cautioned in patients who are taking Class I antiarrhythmic drugs Treat: neuralgia due to herpetic Wash hands after handling Apply to area that is painful. Gabapentin (Neurontin) Treats: Neuropathic Pain Antiseizure 31._______ Drowsiness Dizziness Tiredness Tremors Indication (Used to Treat) 32. _______ 1. Teach patient medication is used to alleviate pain and not for the Rx’s original purpose. Pregabalin (Lyrica) Indicated for: neuropathic pain associated with diabetic neuropathy, postherpetic neuralgia Antiseizure/Antidepressant binds to calcium channels and decreases the inflow of calcium at nerve endings. dizziness* Somnolence* which often persist as long as the drug is being taken. 3. Blurred vision may develop during early therapy, but resolves with continued drug use” Pregabalin (33)does/does not interact with oral contraceptive. Does not alter any antiseizure drugs studied (carbamazepine, lamotrigine, phenobarbital, phenytoin, topiramate, valproic acid, and tiagabine)” Glucocorticoids Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Prednisone Prednisolone Glucocorticoids Decrease Inflammation Short term: Weight gain, hyperglycemia Long term: bone loss, adrenal suppression, exogenous glucocorticoid- Cushing Syndrome Monitor: __34___ in clients with diabetes Methotrexate Other DMARDS Hydroxychloroquine Leflunomide Sulfasalazine Non-biologic DMARDS Slows disease progress and decreased joint destruction (Methotrexate Only) Contraindicated in pregnancy. Can cause fetal death and congenital abnormalities. Blackbox Warning (Methotrexate): ______36_______ (Methotrexate Only) Should be taken with __35___(vitamin?) to reduce GI and hepatic toxicity. Teach: Patient should receive annual influenza. Avoid people who are sick and perform frequent handwashing Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Naloxone Hydrochloride Naltrexone (ReVia) ____1___ ____2_______ Anxiety, irritability, chills, hot flashes, rhinorrhea, diarrhea, confusion, abdominal cramps, nausea vomiting Use with caution in patients with cardiac disease – Monitor for cardiac arrythmias. ****After the nurse had administered to a patient to reverse opioid effect, what should they look for ____3_____ Gabapentin, Venlafaxine, Bupivacaine, Baclofen, Cyclobenzaprine, Ketamine, Duloxetine, Nortriptyline ___4_____ Activate innate immune responses to form a local immuno-competent environment at the injection site. respiratory depression, sedation, constipation urinary retention nausea Depending upon the medication used. ** Aspirin, Diclofenac, Ibuprofen, Ketoprofen, Ketorolac, Meloxicam, Naproxen, Celecoxib Non-Opioid analgesics NSAIDS-Inhibits COX-1 and COX-2, inhibits prostaglandins. ASA- causes irreversible inhibition of COX (different from NSAIDs) GI distress Peptic Ulcer disease Kidney and liver impairment Tarry stools Blood dyscrasias: thrombocytopenia, leukopenia, neutropenia, hemolytic anemias Bone marrow depression and impaired coagulation Monitor (labs): __5___ & __6___ (hint: look at Adverse effects) Teach Patient: Take with meals or milk to reduce GI irritation Avoid drinking alcohol, smoking and aspirin when taking other NSAIDs Morphine Fentanyl Hydromorphone Codeine Sulfate Meperidine (do not use in elderly) Methadone ____7___ ___8_____ 1. ___9_____* 2. ___10____* 3. ____11___* 4.Cough suppression 5. Itching 6. Pupil Constriction 7. Diaphoresis and flushing Antidote: ___12________ 1. Monitor vital signs (_13_ & _14__) 2. Teach patient to rise slowly. 3. Monitor for constipation Administered: IV, Transdermal, Transmucosal, Nasal Spray, PO, Sublingual spray Antidote: 15. ______ (opioid antagonist) “Morphine is the opioid of choice for decreasing pain from myocardial infarction. ” Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Acetaminophen 16. ____ and 17. ___ (not anti-inflammatory) Inhibits prostaglandin synthesis Can cause 18___ (which main organ) damage Dark urine rash Clay colored stools Antidote: 19. ____ Monitor: 20. _______ Teach: Careful when taking with other medications that already contains 21. ____ (i.e., Percocet) Buprenorphine (used to treat opioid addiction) Agonist-antagonist Indicated for: Used an 22. ___ and to treat 23. _____ addiction Headache Drowsiness Nausea, vomiting Increased sweating Inability to sleep Avoid driving or drinking when taking this medication. Do not take with other narcotics Pentazocine (nalbuphine, butorphanol Agonist-antagonist Antagonist: Acts on opioid receptor sites Agonist: produces an antagonistic effect when given to patients taking opioids Respiratory depression** Nausea, vomiting diarrhea 24. _____* Tachycardia 25. _____ Monitor vitals especially: (hint adverse reaction column) ___26__and ___27___ Naloxone (Narcan) ___28__ Blocks and reverses effects. Binds to receptors in the brain _29__ _30___ Administration: IV, intranasal, IM, subQ *if administered before opioid -blocks effects, if administered after opioid, it will reverse the effects of drug Adjuvant Medications Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Lidocaine (Lidoderm) Topical analgesic Local anesthetic used to relieve neuropathic pain (postherpetic neuralgia) Redness or irritation to skin Dizziness Confusion Cautioned in patients who are taking Class I antiarrhythmic drugs Treat: neuralgia due to herpetic Wash hands after handling Apply to area that is painful. Gabapentin (Neurontin) Treats: Neuropathic Pain Antiseizure 31._______ Drowsiness Dizziness Tiredness Tremors Indication (Used to Treat) 32. _______ 1. Teach patient medication is used to alleviate pain and not for the Rx’s original purpose. Pregabalin (Lyrica) Indicated for: neuropathic pain associated with diabetic neuropathy, postherpetic neuralgia Antiseizure/Antidepressant binds to calcium channels and decreases the inflow of calcium at nerve endings. dizziness* Somnolence* which often persist as long as the drug is being taken. 3. Blurred vision may develop during early therapy, but resolves with continued drug use” Pregabalin (33)does/does not interact with oral contraceptive. Does not alter any antiseizure drugs studied (carbamazepine, lamotrigine, phenobarbital, phenytoin, topiramate, valproic acid, and tiagabine)” Glucocorticoids Drug Drug Class Mechanism of Action Adverse Effects Nursing Implications Prednisone Prednisolone Glucocorticoids Decrease Inflammation Short term: Weight gain, hyperglycemia Long term: bone loss, adrenal suppression, exogenous glucocorticoid- Cushing Syndrome Monitor: __34___ in clients with diabetes Methotrexate Other DMARDS Hydroxychloroquine Leflunomide Sulfasalazine Non-biologic DMARDS Slows disease progress and decreased joint destruction (Methotrexate Only) Contraindicated in pregnancy. Can cause fetal death and congenital abnormalities. Blackbox Warning (Methotrexate): ______36_______ (Methotrexate Only) Should be taken with __35___(vitamin?) to reduce GI and hepatic toxicity. Teach: Patient should receive annual influenza. Avoid people who are sick and perform frequent handwashing 24.
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