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Calcium Channel Blockers

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Withhold drug is systolic pressure is less than 90

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Heparins

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activated partial thromboplasin time (APTT) should be maintained at approximately 1.5 to 2.5 times the control or baseline value. Normal control is 25 to 35 seconds.

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Vitamin K Antagonists

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Daily evalution of INR is necessary until stable daily dose is reached. Therapeutic PT value is 1.5 times control.

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Vitamin K Antagonists

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Nurse holds dose if INR is above 3.0 and notifies health care provider

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Thrombolytics

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Check INR, aPTT, platelet count and fibrinogen to establish baseline and to determine whether a blood coagulation disorder is present

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Thrombolytics

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Two or three hours after therapy is started fibrinogen level is measured. Alternatively nurse can check INR or aPTT for increased values.

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Thrombolytics

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During and following administration the nurse monitors BP frequently and ensures that it is well controlled.

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HMG-CoA Reductase Inhibitors (Statins)

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Administration normally takes place in evening or bedtime

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HMG-CoA Reductase Inhibitors (Statins)

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If serum aninotransferases are persistently 3 times upper limit of normal levels, it is necessary to reduce the dose or change the drug

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Bile Acid Sequestrants

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Other drugs should be taken 1 hour before or 4 to 6 hours after.

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Bile Acid Sequestrants

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Supplementation of fat soluble vitamins may be required.

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Fibrates

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Necessary to give with food to increase drug absorption.

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Cholesterol Absorption Inhibitor

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Administer at the same time of day, or at night if used in combination with statin.

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Erythrocyte Hematopoietic Drugs

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For patients with chronic renal failure adminster by bolus at end of dialysis.

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Granulocyte Colony-Stimulating Factors

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For cancer chemotherapy subcutaneous bolus injection, or IV infusion over 15 to 20 minutes

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Granulocyte Colony-Stimulating Factors

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For bone marrow transplantation give by IV infusion over 4 hours or by continuous IV or subcutaneous infusion

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Salicylates

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Should be taken with glass of water or other fluid and with food or just following food.

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Propionic Acid Derivatives

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Should be diluted in a concentration of 4 mg/ml or less using 0.9 sodium choloride, 5% dextrose, or lactated Ringers

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Oxicam Derivatives

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Should be administered with food or fluids to reduce gastric irritation.

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Oxicam Derivatives

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It is necessary to shake oral suspension gently

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Acetic Acid Derivatives

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Administer after meals or with antacid to decrease GI irritation

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Acetic Acid Derivatives

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IV administration requires dilution of 1 mg with 1mL of sterile water or normal saline

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Acetic Acid Derivatives

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It is necessary to administer dose over 5 to 10 seconds.

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Selective COX-2 Inhibitor

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Should be administered 2 hours or before antacids

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Mitotic Agent

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Should be administered with food to reduce gastric distress

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Uricosuric Agents

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Should be administered after meals to ensure absorption

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Corticosteroids

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Entire daily dose can be taken each morning.

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Nucleoside Reverse Transcriptase Inhibtors

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IV preparation should be mixed with 5% dextrose and water or normal saline

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Nucleoside Reverse Transcriptase Inhibtors

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Drug should be taken around the clock to avoid variations in serum peak and trough levels

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Nucleoside Reverse Transcriptase Inhibtors

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Infusion should take place over half hour in neonates and 1 hour in children and adults

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Non-nucleoside Reverse Transcriptase Inhibitors

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Patients who experience CNS depression should take at bedtime

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Non-nucleoside Reverse Transcriptase Inhibitors

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May take on empty stomach, should take 2 hours after consuming a high-fat meal.

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Protease Inhibitors

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Should be taken within 2 hours of a meal or on full stomach

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Protease Inhibitors

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Patients should have ECG prior to start of therapy and 3-4 days after start of therapy.

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Fusion Protein Inhibitors

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Rotation of injection sites is necessary.

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CCR5 Antagonists

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High-fat food enhances absorption.

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Second-Generation H1 Receptor Antagonists

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Fruit juices may decrease absorption.

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Indirect-Acting Cholinergics

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It is necessary to give drug with food or fluid.

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Indirect-Acting Cholinergics

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Important to administer IV slowly, and have atropine available as an antidote.

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Dopamine Receptor Agonists

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Administered with or just after food to reduce N/V

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Dopamine Receptor Agonists

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Do not give with iron preparations or multivitamin-mineral preparations that contain iron.

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Dopamine Receptor Agonists

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Do not administer with a high protein meal.

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Mood-Stabilizing Agents

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Serum drug levels should not exceed 1.5 mEq/L because of serious drug toxicity.

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Biguanides

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Drug should be taken with meals.

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Inotropes (Cardiac Glycosides)

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Therapeutic serum level is 0.8-2.0 ng/mL

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Inotropes (Cardiac Glycosides)

answer

Apical pulse should be taken before administration. If rate is less than 60 (adults), 70 (older children), 100 (younger children), the dose is omitted and provider notified.

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Ace Inhibitors

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Should be taken 1 hour before or 2 hours after meals.

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Angiotensin II Receptor Blockers

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Nurse assesses kidney and liver function tests, as well as serum electrolyte levels, particularly potassium.

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Class I Sodium Channel Blockers

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IV prep will have 800 mg in 50 mL of 5% dextros

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Class I Sodium Channel Blockers

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IV solution is injected slowly at rate of 1 mL a minute

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Class I Sodium Channel Blockers

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Is not compatible with furosemide in IV preperation

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Class 1B Sodium Channel Blockers

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Give IV bolus over 2 min

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Loop Diuretics

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IV injections are given over 1-2 minutes

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Loop Diuretics

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Continuous IV infusions are given at a rate of 4 mg/min or less

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Loop Diuretics

answer

It is necessary to mix drug with normal saline or lactate Ringer's

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Aminoglycosides

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With conventional dosing peak levels should be taken 30 minutes after IV or 1 hour after IM

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Aminoglycosides

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With ODA take level 12 hours after start of infusion

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Aminoglycosides

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Administer penacillin-class agent 1 hour before or after drug.

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Iminostilbenes

answer

Drug should not be administered within 14 days of MAO inhibitor

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Iminostilbenes

answer

Suspension should not be mixed with other liquid medications.

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Iminostilbenes

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Medication should be taken with food to reduce GI upset.

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Tetracyclines

answer

Medication should be taken on empty stomach (1 hour before or 2 hours after meals)

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Tetracyclines

answer

Do not take with dairy products, antacids or iron supplements.

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Tetracyclines

answer

If patient has consumed dairy or antacids, withold drug for 2 hours.

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Macrolides

answer

Drink 6-8 ounces of water when taking medication

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Macrolides

answer

Should not be taken after taking antacids

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Macrolides

answer

Drug should be infused over 30-60 minutes

question

Penicillins

answer

Give drug on empty stomach (1 hour before or 2 hours after meal)

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Cephalosporins

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Oral formulations can be administered with food or milk to minimize adverse effects

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Carbapenems

answer

Avoid administering to patients with life-threatening allergic reactions to penicillin

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Carbapenems

answer

IM administration is not recommended for people with severe or life-threatening infections such as endocarditis shock, or spticemia.

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Carbapenems

answer

Lidocaine is added to IM injection to decrease pain.

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Thyroid drugs

answer

Drug should be taken in morning on and empty stomach.

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Thyroid drugs

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If PR prior to administering drug is >100, notify the prescriber

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Proton Pump Inhibitors

answer

Should be administered before food intake.

question

Atypical Antipsychotics

answer

If drug is discontinued it must be tapered over 2 weeks. Monitor for acute psychosis during this period.

question

Reversible Indirect-Acting Cholinergics

answer

Should be taken at bed time.

question

Typical Antipsychotics

answer

Oral administration should be given with full glass of water or milk.

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Typical Antipsychotics

answer

IM administration of long acting form requires deep IM in ventrogluteal muscle.

question

Typical Antipsychotics

answer

When discontinuation of drug is required, drug must be tapered.

question

Beta-Adrenergic Blockers

answer

Withhold if HR is less than 50 and notify provider.

question

Beta-Adrenergic Blockers

answer

Take oral forms with meals.

question

Fluroquinolones

answer

Give IV infusion over at least 1 hour.

question

Fluroquinolones

answer

Enteral feedings may affect concentration. Give tube feedings 1 hour before and 2 hours after administering the drug.

question

Rifamycins

answer

Drug should be taken on empty stomach 1 hour before or 2 hours after meal. May take with meal or large glass of water if not tolerated.

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Rifamycins

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Final concentration of IV preparation should not exceed 6 mg/mL

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Isoniazid

answer

Drug should be taken 1 hour before or 2 hours after meal, with a full glass of water. May be taken with food if it causes GI upset.

question

Isoniazid

answer

If given IM it is necessary to rotate injection site.

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Biphosphonates

answer

Hypocalcemic patients require correction of low serum calcium levels before beginning therapy.

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Biphosphonates

answer

Drug should be taken at least 30 minutes before breakfast and before taking other drugs.

question

Biphosphonates

answer

Patient must remain upright (head of bed elevated 90 degrees, sitting in chair, or standing) for at least 30 minutes after administration.

question

Selective Serotonin Reputake Inhibitors

answer

Typically taken once daily in morning to prevent interference with sleep.

question

Selective Serotonin Reputake Inhibitors

answer

Drug may be taken with food to prevent GI upset.

question

5-Alpha Reductase Inhibitors

answer

Pregnant caregivers, nurses or pharmacists should not handle crushed drug.

question

Sulfonamides

answer

Take drug before or after meals with 8oz water

question

Sulfonamides

answer

Store drug in a light resistant container at 59-86 degrees F (15-30 degrees C).

question

Gamma-Aminobutyric Acid Structural Analogs

answer

Drug may be taken with food to relieve GI upset.

question

Serotonin Receptor Antagonists

answer

Use of drug may mask a progressive ileus and gastric distension following abdominal surgery.

question

Sulfonylureas

answer

Drug should be taken before breakfast or in divided doses before meals if patient experiences gastric distress.

question

Dipeptidyl Peptidase-4 Inhibitors

answer

Should be taken once daily with or without food.

question

Azoles

answer

Drug should never be mixed with any other medications

question

Azoles

answer

Continuous administration occurs at a maximum rate or 200 mg per hour.

question

Azoles

answer

Administer with food to decrease gastric upset.

question

Thiazide Diuretics

answer

Monitoring for transient or irreversible hearing impairment, tinnitus, or dizziness is important.

question

Loop Diuretics

answer

Patient should be monitored for diminished hearing, a sign of ototoxicity.

question

Potassium-Sparing Diuretics

answer

Drug should be administered at the same time each day, preferably in the morning.

question

Tricyclic Antidepressants

answer

Drug should be taken at bedtime to aid sleep and decrease daytime sedation.

question

Purine Analougues

answer

It is necessary to infuse parenteral form over 1 hour to prevent renal damage.

question

Purine Analougues

answer

Nurse ensures patient is well hydrated with 2-3 L of fluid per 24 hours.

question

Antithyroid Drugs

answer

Drug can be taken with or without food, but it must remain consistent.

question

Antithyroid Drugs

answer

Drug should be taken around the clock in evenly divided doses.

question

Benzodiazepines

answer

Overdose is reversed with Flumazenil

question

Benzodiazepines

answer

Administer IV form undiluted at a rate of 5 mg/min

question

Adrenergics

answer

Drug should be used before other inhalants, and 5 minutes shall elapse before using additional inhalants.

question

Adrenergics

answer

Drug should be used as needed due to decreased effectiveness with overuse.

question

Anticholinergics

answer

Drug can be mixed in nebulizer with albuterol or metaproterenol if mixture is used within 1 hour.

question

Xanthines

answer

It is necessary to monitor serum drug levels (therapeutic levels 5-15 mcg/mL)

question

Xanthines

answer

Drug should be taken before meals with a full glass of water, at regular intervals around the clock.

question

Xanthines

answer

Crushing of sustained release tablets causes immediate release of potentially toxic doses.

question

Inhaled Corticosteroids

answer

After inhalation patient should rinse mouth and throat to prevent fungal infection.

question

Gastrointestinal Anticholinergics

answer

Patient must void before administration of drug.

question

Centrally Acting Anticholinergics

answer

Patient must void before administration of drug.

question

Centrally Acting Anticholinergics

answer

If GI upset is present administer with food.

question

Centrally Acting Anticholinergics

answer

Drug may be taken with meals in presence of dry mouth and after meals if drooling or nausea occurs.

question

Catechol-O-Methyltransferase Inhibitors

answer

It is necessary to administer the drug with carpidopa/levidopa. Addition of the drug may require a decrease in the levodopa usage.

question

Catechol-O-Methyltransferase Inhibitors

answer

Abrupt withdrawal of tocapone can lead to serious complication Tapering of drug over 2 weeks is necessary.

question

Direct-Acting Cholinergics

answer

Administration should occur 1 hour before or 2 hours after meals.

question

Beta-Blocking Opthalmics

answer

When administering more than one opthalmic medication, wait 10 minutes between each medication.

question

Beta-Blocking Opthalmics

answer

Always invert bottle and shake before use.

question

Beta-Blocking Opthalmics

answer

Patients who wear contact lens should wait at least 15 minutes before reinsertion.

Nursing Implications: Administration – Flashcards

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