Exam (elaborations)
NURS 615 Advanced Pharmacotherapeutics Test 3 Study Guide Latest 2024 Updated.
- Course
- Institution
NURS 615 Advanced Pharmacotherapeutics Test 3 Study Guide Latest 2024 Updated.
[Show more]
Content preview
lOMoAR cPSD| 42147428NURS 615 Advanced
Pharmacotherapeutics Test 3 Study
Guide Latest 2024 Updated.
, lOMoAR cPSD| 42147428
Gout
Drugs used to manage the pain are non-steroidal anti-inflammatory drugs and corticosteroids
Monitor for effectiveness of therapy/clinical progress (Inflammation of the great toe)
Classic description (cannot stand to have a sheet on top of toe)
Anyone on Gout medication should have serum uric acid levels, BUN, and creatinine monitored
(Allopurinol, Colchicine, Probenecid, and Sulfinpyrazone)
Antigout Drugs (Xanthine Oxidase Inhibitors)
• Allopurinol and Febuxostat
o Reduce the inflammatory process or prevent the synthesis of uric acid
o Prevents formation of uric acid by inhibiting xanthine oxidase
▪ DO NOT ADMINISTER WITH xanthine oxidase metabolism medication
• Azathioprine, mercaptopurine, or theophylline
o Both medications require a week or more of treatment before full effects can be seen
(Goal serum uric acid levels less than 6)
o Febuxostat
▪ may be taken without regard to food
▪ Risk of liver function abnormalities
▪ Labs- Hepatic function test
o Allopurinol
▪ Widely distributed to tissues
▪ Associated with Hepatotoxicity, not recommended in patients with severe
hepatic dysfunction
• If patients develop anorexia, weight loss, or purities, evaluation of
liver function is needed
▪ Associated with maculopapular skin rash scaly or exfoliative (increases with
the presence of renal failure)- DISCONTINUE AT THE FIRST SIGN OF
RASH
▪ Severe reactions include fever, chills, arthralgia, cholestatic jaundice,
eosinophilia, mild leukocytosis, or leukopenia
▪ Labs- liver and renal function test (BUN, serum creatinine, and CrCL –
reassess dosages based on results)
o Patient education- can causes drowsiness and dizziness- avoid driving or activities
that require alertness
• Colchicine
o Decreases inflammation by decreasing movement of leukocytes into tissues
containing urate crystals (decreases the inflammatory response)
▪ Reduces lactic acid production by granulocytes, which decreases deposition of
uric acid, and it interferes with kinin formation and reduces phagocytosis
o FOR ACUTE ATTACKS- not an analgesic or a uricosuric/antipyretic
o Concentrated mainly in white blood cells
o Not effective in the presence of renal failure
, lOMoAR cPSD| 42147428
▪ DOSE ADJUSTMENT NEEDED WITH RENAL OR HEPATIC
DYSFUNCTION
o Associated with Hepatotoxicity, not recommended in patients with severe hepatic
dysfunction
▪ If patients develop anorexia, weight loss, or purities, evaluation of liver
function is needed
o Use cautiously in the presence of peptic ulcer disease or spastic colon- can make
disorders worse
▪ Adverse effects- Nausea, vomiting, diarrhea (at any dose), abdominal pain
o In a low-dose, patients are going to get diarrhea both ways, but the GI side effects are
fewer and the colchicine will help decrease inflammation. The high-dose is no longer
recommended.
o Labs- Vitamin B12 levels, liver function
o Patient Education
▪ Medication taken as prescribed- take missed dose as soon as possible
▪ Serious adverse events call provider
• Diarrhea/vomiting- unable to keep hydrated or keep electrolytes
up/unable to eat
• Not getting better within expected amount of time/worsening gout
symptoms
• Neuropathic, muscle pain/weakness needs to be reported immediately
▪ Take medication with food/milk to decrease GI upset
▪ Do not suddenly stop medication
▪ Alkaline diet (reduction in sodium, refined sugar, oxalate-rich foods (liver,
kidney. Anchovies, sardines, herring, mussels, bacon, codfish, scallops, trout,
haddock, veal, venison, turkey) – avoid high dose calcium supplements, drink
plenty of fluids, avoid alcohol, hypersensitivity should be reported
Uricosuric Drugs
• Increase the rate of uric acid secretion
• Probenecid
o Inhibits renal tubular reabsorption of urate and increases renal excretion of uric acid,
and decreases serum uric acid levels
o Lacks anti-inflammatory activity
o Most useful for patients with chronic reduced urinary excretion of uric acid
o NOT INTENDED FOR TREATMENT OF ACUTE ATTACKS/only for chronic gout
o Crosses the placenta without adverse effects in the fetus or infant
▪ Highly protein-bound, displaces other drugs that have a high affinity for the
same binding sites
o Dose may need to be reduced in the presence of renal impairment
o Use cautiously in the presence of peptic ulcer disease or spastic colon- can make
disorders worse
▪ Adverse effects- Nausea, vomiting, diarrhea, abdominal pain
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller saraciousstuvia. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
80189 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now