Nursing Pharmacology Final Exam Blueprint

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Questions and Answers

What are patient variables that should be considered when administering medications?

  • Age, weight, race
  • Medical history, genetics, and diet
  • All of the above (correct)
  • None of the above

What is the antidote for opioid overdose?

Naloxone

Chlorpromazine is a conventional or first-generation antipsychotic.

True (A)

What is the therapeutic range for lithium?

<p>0.6 - 1.2 mEq/L</p> Signup and view all the answers

Flumazenil is the antidote for benzodiazepine overdose.

<p>True (A)</p> Signup and view all the answers

Gentamicin has a narrow therapeutic window.

<p>True (A)</p> Signup and view all the answers

Aminoglycosides are generally considered potent antibiotics.

<p>True (A)</p> Signup and view all the answers

Aspirin is a medication that can cause Reye’s syndrome in children.

<p>True (A)</p> Signup and view all the answers

What is the antidote for insulin overdose?

<p>Glucagon</p> Signup and view all the answers

Peptic ulcers are a contraindication for anticoagulation therapy.

<p>True (A)</p> Signup and view all the answers

What is the primary mechanism of action for acetazolamide?

<p>Inhibition of carbonic anhydrase</p> Signup and view all the answers

Acetazolamide can cause metabolic acidosis.

<p>True (A)</p> Signup and view all the answers

Ondansetron (Zofran) is an antiemetic medication used to treat nausea and vomiting.

<p>True (A)</p> Signup and view all the answers

Proton pump inhibitors are medications used to reduce gastric acid production.

<p>True (A)</p> Signup and view all the answers

Digoxin is a medication that can cause increased heart rate.

<p>False (B)</p> Signup and view all the answers

Baroreceptors are pressure sensors located in blood vessels that help regulate blood pressure.

<p>True (A)</p> Signup and view all the answers

The renin-angiotensin-aldosterone system (RAAS) is activated when blood pressure is high.

<p>False (B)</p> Signup and view all the answers

Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia.

<p>True (A)</p> Signup and view all the answers

Misoprostol is a medication used to treat intracranial pressure.

<p>False (B)</p> Signup and view all the answers

Acetazolamide is a diuretic that can cause hypokalemia.

<p>True (A)</p> Signup and view all the answers

Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia.

<p>True (A)</p> Signup and view all the answers

Flashcards

What are opioids?

Opioids are a group of drugs that relieve pain by affecting the central nervous system, causing drowsiness and reducing feelings of pain.

What is Naloxone?

Naloxone is a medicine used to reverse the effects of opioid overdose, such as slowed breathing, sleepiness, and confusion.

What is Levodopa-Carbidopa used for?

Levodopa-Carbidopa is a medication used to treat Parkinson's disease by increasing dopamine levels in the brain.

What is Chlorpromazine?

Chlorpromazine is an antipsychotic drug used to treat conditions like schizophrenia and bipolar disorder by blocking dopamine activity in the brain.

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What is Lithium used for?

Lithium is a medication used to treat bipolar disorder. It affects the way nerve impulses are carried in the brain.

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What's the therapeutic level for lithium?

The therapeutic level for lithium is between 0.6 and 1.2 mEq/L. This range keeps the drug working effectively without causing harmful side effects.

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What are MAOIs?

MAOIs are a type of antidepressant that works by increasing the levels of certain neurotransmitters in the brain. They can interact with certain foods and medications, which can be dangerous.

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What is the benzodiazepine antidote?

Benzodiazepines are a class of drugs used for sedation, anxiety relief, and muscle relaxation. Flumazenil is the antidote for benzodiazepine overdose.

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What are antiseizure medications used for?

Antiseizure medications are used to prevent or control seizures, which are sudden bursts of electrical activity in the brain.

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What are antifungal medications used for?

Antifungal medications are used to treat fungal infections. They work by interfering with the growth and reproduction of fungi.

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What is Amphotericin B?

Amphotericin B is an antifungal drug used to treat serious fungal infections. It can cause side effects, such as fever, chills, and kidney problems.

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What is Rifampin used for?

Rifampin is an antibiotic used to treat tuberculosis and other bacterial infections.

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What is Gentamicin?

Gentamicin is a powerful antibiotic used to treat serious bacterial infections. It has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small.

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What is Lactulose used for?

Lactulose is a medication used to treat constipation by drawing water into the intestines, making the stool softer and easier to pass.

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What are aminoglycosides?

Aminoglycosides are a group of antibiotics that can damage the kidneys (nephrotoxicity) and the ears (ototoxicity) when used for a long time.

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What is the antidote for Tylenol overdose?

Acetylcysteine is the antidote for acetaminophen (Tylenol) overdose. It helps protect the liver from damage caused by high levels of acetaminophen.

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What is Ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and inflammation. It can cause gastrointestinal problems and kidney damage.

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What is Reye's syndrome?

Reye's syndrome is a rare but serious condition that affects the brain and liver. It's linked to using aspirin in children with viral infections.

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What's the therapeutic effect of low-dose aspirin?

Low-dose aspirin is used to prevent heart attacks and strokes in people at risk. It helps to prevent blood clots from forming.

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What is Warfarin?

Warfarin is a blood thinner used to prevent blood clots. It's important to monitor blood clotting time (INR) and avoid foods high in Vitamin K while taking it, as that can affect its effectiveness.

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What is the antidote for insulin overdose?

Insulin is a hormone that helps regulate blood sugar levels. Glucagon is the antidote for insulin overdose.

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What is Levothyroxine used for?

Levothyroxine is a medication used to treat hypothyroidism by replacing the thyroid hormone that's not being produced by the body.

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What are baroreceptors?

Baroreceptors are tiny pressure sensors located in blood vessels. They send signals to the brain to help regulate blood pressure by adjusting heart rate and blood vessel width.

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What is Nitroprusside used for?

Nitroprusside is a medication used to lower blood pressure rapidly in emergencies, such as hypertensive crises.

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What are sustained-release medications?

Sustained-release medications are formulated to release the drug gradually over time, providing a longer lasting effect.

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What are ACE inhibitors?

ACE inhibitors are a class of drugs used to treat high blood pressure and heart failure by preventing the production of a substance that constricts blood vessels.

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What is Spironolactone?

Spironolactone is a potassium-sparing diuretic used to treat high blood pressure, heart failure, and other conditions by removing excess water and sodium from the body while preserving potassium.

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What are loop diuretics?

Loop diuretics are a powerful class of drugs that help remove excess water and salt from the body, which can help lower blood pressure and reduce swelling.

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What are metered-dose inhalers (MDIs)?

Metered-dose inhalers (MDIs) are devices used to deliver medication directly into the lungs, primarily for asthma and other respiratory conditions.

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What is Ranitidine?

Ranitidine is a medication used to reduce stomach acid, which can help relieve heartburn, indigestion, and ulcers.

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What are asthma medications used for?

Asthma medications are used to control and prevent symptoms of asthma, such as wheezing, coughing, and shortness of breath.

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What's important for managing hypothyroidism?

Hypothyroid dosing adjustments and lab monitoring are essential for managing hypothyroidism effectively. Regular thyroid hormone levels should be checked to ensure the medication dose is appropriate.

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What is a bowel management program?

A bowel management program helps people with neurological deficiencies maintain regular bowel movements by incorporating techniques like dietary modifications, exercise, and medication.

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What is Misoprostol?

Misoprostol is a medication used to prevent ulcers in people taking NSAID medications. It also helps induce labor and terminate pregnancy.

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What is Acetazolamide?

Acetazolamide is a medication used to treat high intracranial pressure (ICP) by reducing fluid buildup in the brain. It's also used for other conditions like glaucoma and mountain sickness.

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What is Hydrochlorothiazide?

Hydrochlorothiazide is a type of diuretic medication that helps remove extra water and salt from the body by affecting the kidneys, which can help lower blood pressure.

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What is Cimetidine?

Cimetidine is a medication used to reduce stomach acid. Common side effects include headache, drowsiness, and constipation.

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What is Clopidogrel?

Clopidogrel is a medication that prevents blood clots from forming. It's contraindicated in patients with a history of stroke, bleeding disorders, or recent surgery.

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What do corticosteroids do in asthma?

Corticosteroids are medications used to reduce inflammation in asthma. They work by suppressing the immune system.

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What are antiemetics used for?

Antiemetics are medications used to prevent and treat nausea and vomiting, often used in post-operative patients to help manage side effects from anesthesia.

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How do loop and potassium-sparing diuretics work?

Loop and potassium-sparing diuretics work together to remove excess water and salt from the body. Loop diuretics are more powerful, while potassium-sparing diuretics help preserve potassium levels.

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What are proton pump inhibitors used for?

Proton pump inhibitors are medications used to block the production of stomach acid. They're often prescribed for conditions like GERD, ulcers, and heartburn.

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What are glucocorticoids/steroids used for?

Glucocorticoids, also known as steroids, are medications used to control inflammation in a variety of conditions, including asthma. They can have significant side effects with long-term use, so careful monitoring is essential.

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What is Digoxin?

Digoxin is a medication used to treat heart failure by increasing the force and efficiency of the heart's contractions.

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What is Glipizide?

Glipizide is a medication used to help control blood sugar levels in people with type 2 diabetes. It stimulates the pancreas to release insulin.

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Study Notes

Nursing Pharmacology Final Exam Blueprint

  • The exam will contain 60 questions.
  • Each question will have 1.5 minutes to answer.
  • The exam blueprint covers core drug knowledge, core patient variables, and patient teaching.

Opioids

  • Side effects: Respiratory depression, central nervous system depression, headache, constipation, increased fluid intake, bradycardia, drowsiness.
  • Antidote: Narcan (naloxone)
  • Patient Variables: Age, weight, race, medical history, genetics, diet.
  • Teaching: Increase fiber intake, avoid alcohol, assess respiratory/cardiac before administering medication.

Levodopa-Carbidopa

  • Mechanism of action: Increase dopamine production in the brain by preventing levodopa from breaking down.
  • Use: Parkinson's disease (improves daily living activities).
  • Adverse effects: Tremor, dizziness, numbness, weakness, agitation, anxiety, anorexia, nausea, vomiting, dry mouth, dysphagia, urinary retention, flushing, cardiac irregularities, psychosis.
  • Contraindications: Angle-closure glaucoma, history of melanoma, psychosis, peptic ulcer disease, depression, bipolar disorder.

Cystic Fibrosis

  • The disease involves the epithelial lining of the respiratory, gastrointestinal, and reproductive tracts.
  • There is a defective gene on chromosome 7.
  • Results in thick secretions in the lungs, requiring low calorie/high protein diet and chest physical therapy.

Parkinson's Disease

  • A progressive neurodegenerative disorder affecting movement control.
  • It occurs due to dopamine-producing neuron loss in the brain.
  • Chlorpromazine (Antipsychotic) side effects include dry mouth, constipation, blurred vision, tachycardia, and photosensitivity.

Lithium

  • Therapeutic level: 0.6-1.2 mEq/L
  • Increased level (1.2-1.5mEq/L): Lethargy, CNS, muscle weakness, fine tremors, polyuria (renal toxicity), ECG changes, bradycardia.
  • Severe levels (2.0-2.5 mEq/L): CNS ataxia, clonic movements, cardiovascular changes in ECG.
  • Further increased levels (2.5+): Multi-system organ failure – keep patient hydrated.

Antipsychotic Care

  • Goal: Prioritize patient safety and encourage the patient to stay on their medication regimen.
  • Adverse Effects (Chlorpromazine): Anticholinergic effects (dry mouth, constipation, urinary retention, blurred vision, tachycardia), suppressed sexual drive, erectile dysfunction, severe dysrhythmias, dermatitis, photosensitivity. Neuroleptic malignant syndrome (NMS) is a serious condition of high fever, rigidity, VS instability, and loss of consciousness, and is more common with high potency medications than chlorpromazine.

MAOIs and Food/Drug Interactions

  • Avoid certain foods and drugs with Monoamine oxidase inhibitors (MAOIs) to prevent hypertensive crisis.

Benzodiazepine

  • Antidote: Flumazenil
  • Signs and symptoms of overdose: Respiratory depression

Antifungal Medication Management

  • Safe medication regimen for patient taking Antifungal (e.g., Amphotericin B).
  • Patient education on harmful side effects like orange colored urine, tears, and sweat.

Rifampin

  • Use: Treats TB and other bacterial infections.
  • Side effect: Urine, tears and sweat may change color to orange.

Gentamicin

  • Usage precautions: Type 2 diabetic patients, chronic renal failure, nephrotoxicity, ototoxicity.
  • Monitoring: Peak (30-90 min) and trough serum levels.
  • Do not accumulate the drug to toxic levels.

Aminoglycoside

  • Strong antibiotic and broad spectrum: Narrow therapeutic window.
  • Monitor urine output to avoid toxicity.
  • Labs: checking for normal range to prevent toxicity.

Tylenol (Acetaminophen)

  • Antidote: Acetylcysteine
  • Toxicity: Monitor levels for liver toxicity.

Ibuprofen

  • Monitoring/Assessment: Monitor BUN and creatinine (kidney function).
  • Reye's syndrome: linked in pediatric populations, should not give aspirin.

Acetylsalicylic Acid (Aspirin)

  • Low dose used as anti-platelet/anticoagulant.

Antibiotics

  • Patient teaching: Full course of antibiotics, take at the same time each day with food and full glass of water, some medications should not be taken with food.
  • Drug-to-drug interaction monitoring (Warfarin): Avoid foods high in vitamin K, avoid NSAIDS and fish oil.

Warfarin

  • Antidote: Vitamin K
  • Monitoring: INR (goal range usually 2-3), APTT or WBCT
  • Precautions: Recognize bleeding signs, avoid activities with high risk of injury, avoid alcohol, avoid IM injections unless necessary, do not rub injection site.

Diabetic Type I

  • Insulin replaces Beta cells. Rotate injection sites to prevent fatty lumps.

Levothyroxine

  • Lab Monitoring: TSH, T3, T4
  • Therapeutic Levels: Adjust initial dosage based on patient response.

Hyperthyroid

  • Goal: Lower thyroid hormone levels to manage hyperactivity.

Anticoagulation

  • Purpose: Prevent clots or manage conditions like deep vein thrombosis or atrial fibrillation.
  • Administration: Specific instruction for oral vs. injectable anticoagulants, like heparin.
  • Monitoring: Regular blood tests to monitor clotting times.
  • Precautions: Teach patients to recognize signs of bleeding and avoid risky activities.

Hypertensive Crisis

  • Medication administration (e.g., Nitroprusside) may be used.

Loop Diuretics

  • Used to treat fluid imbalances.

Asthma Management

  • Inhaler administration instruction.
  • Take with food if needed.

Neurological Deficient Patient Care

  • Bowel management: Laxatives, stool softeners, digital evacuation.

Misoprostol

  • Indications: Glaucoma, edema, and acute mountain sickness. It helps lower intraocular pressure.

Acetazolamide

  • Indications: Glaucoma, edema, and acute mountain sickness. It helps lower intraocular pressure.
  • Mechanism: Inhibits carbonic anhydrase for aqueous humor formation and promotes urine production.
  • Precautions: Allergy to acetazolamide or sulfonamides. Chronic noncongestive angle-closure glaucoma, pregnancy. Avoiding use in fluid/electrolyte imbalances, renal or hepatic disease, respiratory acidosis, COPD.

Hydrochlorothiazide

  • Uses: Management of hypertension, edema.
  • Monitor for adverse effects.

Cimetidine

  • Adverse effects: Gynecomastia (men), confusion, joint and muscle pain, elevated liver enzymes.

Clopidogrel

  • Contraindications: Patient history with certain diseases. Stop administering it 5 days before a procedure.

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