Pharmacology Exam 2 Study Guide
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Questions and Answers

What is the main action of sulfonamides in the treatment of bacterial infections?

  • Directly kill bacteria
  • Inhibit bacterial synthesis of folic acid (correct)
  • Enhance the absorption of nutrients
  • Inhibit bacterial cell wall synthesis

Which of the following is a significant nursing intervention when administering sulfonamides?

  • Monitor for rash and superinfection (correct)
  • Reduce monitoring of renal function
  • Administer with antacids to alleviate GI discomfort
  • Limit fluid intake to decrease urinary output

Why should patients avoid antacids while taking sulfonamides?

  • Antacids increase the risk of renal failure
  • Antacids interfere with the absorption of the drug (correct)
  • Antacids exacerbate photosensitivity
  • Antacids cause hematuria

Which of the following side effects is associated with sulfonamides?

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

What effect does sulfonamides have when taken with sulfonylureas?

<p>Increases the hypoglycemic effect (A)</p> Signup and view all the answers

What is the primary use of methylphenidate?

<p>Managing ADHD and narcolepsy (B)</p> Signup and view all the answers

Which of the following best describes the action of temazepam?

<p>Reduces neuron excitability through GABA interaction (C)</p> Signup and view all the answers

What is the therapeutic serum level for phenytoin?

<p>10 to 20 mcg/mL (B)</p> Signup and view all the answers

What are common side effects of lithium?

<p>Dry mouth and metallic taste (D)</p> Signup and view all the answers

How should neostigmine bromide be administered for optimal absorption?

<p>Before meals (C)</p> Signup and view all the answers

Which drug classification does levodopa belong to?

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

What major nursing intervention is necessary for a patient taking lorazepam?

<p>Monitor vital signs regularly (B)</p> Signup and view all the answers

What is a possible interaction with MAO inhibitors?

<p>Tyramine-containing foods can lead to hypertensive crisis (C)</p> Signup and view all the answers

What side effect is commonly associated with carbidopa levodopa?

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

Which statement about baclofen is correct?

<p>It is used for spasticity management. (C)</p> Signup and view all the answers

What assessment should be made for a patient taking phenytoin?

<p>Assess for gingival hyperplasia (D)</p> Signup and view all the answers

Which of the following is a side effect of alprazolam?

<p>Suicidal ideation (C)</p> Signup and view all the answers

What therapeutic effect is expected from rivastigmine?

<p>Increased cognitive function (B)</p> Signup and view all the answers

Which intervention should be taken when a patient shows signs of neuroleptic malignant syndrome?

<p>Immediate withdrawal of antipsychotics (A)</p> Signup and view all the answers

Which medication inhibits bacterial cell wall synthesis?

<p>Isoniazid (INH) (C)</p> Signup and view all the answers

What is a side effect associated with Isoniazid (INH)?

<p>GI distress (D)</p> Signup and view all the answers

Which medication is primarily indicated for fungal infections in the mouth?

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

What action does metronidazole perform against susceptible bacteria?

<p>Impairs DNA function (A)</p> Signup and view all the answers

Which of the following medications requires the patient to take pyridoxine (vitamin B6)?

<p>Isoniazid (INH) (C)</p> Signup and view all the answers

What should patients be warned about when taking Rifampin?

<p>Reddish-orange body fluids (D)</p> Signup and view all the answers

Which infection is metronidazole NOT typically prescribed for?

<p>Malaria (D)</p> Signup and view all the answers

How should INH be taken in relation to meals?

<p>1 hour before meals (D)</p> Signup and view all the answers

Which of the following is a classification of nystatin?

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

What should NOT be done when taking Isoniazid (INH)?

<p>Take with antacids (A)</p> Signup and view all the answers

What is the primary action of fluoroquinolones?

<p>Interfere with the enzyme DNA gyrase (C)</p> Signup and view all the answers

Which of the following antibiotics is indicated for treating UTIs?

<p>Levofloxacin (C)</p> Signup and view all the answers

What side effect is associated with the use of acyclovir?

<p>Gingival hyperplasia (D)</p> Signup and view all the answers

Penicillins primarily act by inhibiting which physiological component in bacteria?

<p>Cell wall synthesis (B)</p> Signup and view all the answers

What is a common nursing intervention when administering fluoroquinolones?

<p>Infuse IV over 60-90 minutes (D)</p> Signup and view all the answers

What is the therapeutic range for theophylline?

<p>5-15 mcg/mL (B)</p> Signup and view all the answers

Which side effect is commonly associated with diphenhydramine?

<p>Dry mouth (D)</p> Signup and view all the answers

Which medication is specifically contraindicated in patients with narrow-angle glaucoma?

<p>Ipratropium (D)</p> Signup and view all the answers

What action does guaifenesin have in the body?

<p>Loosens bronchial secretions (A)</p> Signup and view all the answers

Which of the following is a side effect of leukotriene modifiers?

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

What should be avoided when taking fluoroquinolones?

<p>Antacids (D)</p> Signup and view all the answers

Which of the following medications is recommended for managing alcohol withdrawal symptoms?

<p>Chlordiazepoxide (D)</p> Signup and view all the answers

Which of the following medications is classified as a bronchodilator?

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

What is an expected therapeutic effect of glucocorticoid inhalers?

<p>Reduced airway inflammation (D)</p> Signup and view all the answers

What is the primary action of amitriptyline in treating major depression?

<p>Blocks uptake of neurotransmitters norepinephrine and serotonin (C)</p> Signup and view all the answers

Which of the following side effects is commonly associated with the use of amitriptyline?

<p>Orthostatic hypotension (D)</p> Signup and view all the answers

What is the therapeutic use of infliximab?

<p>Management of rheumatoid arthritis (C)</p> Signup and view all the answers

What is the mechanism of action of colchicine?

<p>Inhibits migration of leukocytes to sites of inflammation (A)</p> Signup and view all the answers

Which nursing intervention is essential for patients taking allopurinol?

<p>Increase fluid intake to promote uric acid excretion (C)</p> Signup and view all the answers

What effect does ibuprofen have on platelet aggregation?

<p>Inhibits platelet aggregation (D)</p> Signup and view all the answers

Which of the following is a common side effect of naproxen?

<p>Gastric distress (D)</p> Signup and view all the answers

What is the therapeutic serum level for salicylate when using aspirin?

<p>15 to 30 mg/dL (B)</p> Signup and view all the answers

In which situation should aspirin be avoided due to the risk of Reye's syndrome?

<p>In children with flu or virus symptoms (D)</p> Signup and view all the answers

What classification does acetaminophen fall under?

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

What major risk is associated with the overdose of acetaminophen?

<p>Hepatotoxicity (C)</p> Signup and view all the answers

What is a significant characteristic of fentanyl compared to morphine?

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

Which of the following medications is classified as a beta-lactam antibiotic?

<p>Zosyn (D)</p> Signup and view all the answers

What is the primary mechanism of action for opioid medications?

<p>Act on CNS to suppress pain impulses and respiration (A)</p> Signup and view all the answers

Which side effect is specifically associated with rapid intravenous administration of vancomycin?

<p>Red man syndrome (A)</p> Signup and view all the answers

What nursing intervention is essential for patients taking trimethoprim-sulfamethoxazole?

<p>Administer with a full glass of water (A)</p> Signup and view all the answers

Which antibiotic class does azithromycin belong to?

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

What action should be taken to minimize the risk of nephrotoxicity when administering vancomycin?

<p>Rotate IV sites frequently (B)</p> Signup and view all the answers

What should patients taking sulfasalazine be advised to do regarding sun exposure?

<p>Avoid direct sunlight (C)</p> Signup and view all the answers

What is a critical nursing intervention before starting antibiotic therapy, such as vancomycin?

<p>Check culture and sensitivity (C&amp;S) (C)</p> Signup and view all the answers

Which of the following medications is classified as an oxazolidinone?

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

What is a major reason to administer azithromycin 1 hour before or 2 hours after meals?

<p>To minimize interactions with antacids (C)</p> Signup and view all the answers

Which of the following symptoms might indicate an adverse reaction to trimethoprim-sulfamethoxazole?

<p>Sore throat and bruising (B)</p> Signup and view all the answers

What is the recommended administration time for IV vancomycin?

<p>Over 1-2 hours (B)</p> Signup and view all the answers

What is the primary use of sulfasalazine?

<p>Management of autoimmune diseases (B)</p> Signup and view all the answers

What adverse effect is NOT associated with vancomycin use?

<p>Photosensitivity (D)</p> Signup and view all the answers

In which situation should the nurse specifically monitor renal function tests?

<p>When giving trimethoprim-sulfamethoxazole (C)</p> Signup and view all the answers

What interaction should be avoided while on trimethoprim-sulfamethoxazole?

<p>Antacids (C)</p> Signup and view all the answers

Flashcards

Methylphenidate (Ritalin)

A Category II stimulant used to treat ADHD and narcolepsy; modulates serotonergic pathways by affecting dopamine transport.

Methylphenidate Side Effects

Includes tachycardia, palpitations, hypertension, dizziness, heart attack, restlessness, tremors, irritability, seizures, euphoria, confusion, insomnia, anorexia, dry mouth, diarrhea, and weight loss.

Methylphenidate Nursing Interventions

Administer before breakfast and lunch; monitor heart rate, weight, and growth; avoid alcohol and caffeine; use sugarless gum for dry mouth; and taper off to avoid withdrawal.

Temazepam (Restoril)

A benzodiazepine hypnotic used to treat insomnia; interacts with GABA to reduce neuron excitability.

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Midazolam (Versed)

A benzodiazepine used for prolonged seizures, administered intravenously.

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Phenytoin (Dilantin)

A hydantoin that suppresses sodium influx; therapeutic range is 10-20 mcg/mL.

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Phenytoin Side Effects

Gingival hyperplasia, nystagmus, headache, diplopia, dizziness, slurred speech, decreased coordination, alopecia, thrombocytopenia, and Stevens-Johnson syndrome.

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Phenytoin Drug Interactions

Increased effects with cimetidine, INH, sulfonamides, anticoagulants, and aspirin; decreased effects with antacids, calcium, sucralfate, antineoplastics, primrose, ginkgo, and oral contraceptives.

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Carbidopa-levodopa (Sinemet)

A Dopaminergic used for Parkinson's disease that converts to dopamine to increase mobility.

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Rivastigmine (Exelon)

An AChE inhibitor used for mild to moderate Alzheimer's; increases ACh at cholinergic synapses.

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Neostigmine Bromide (Prostigmin)

An AChE inhibitor used to treat Myasthenia Gravis by preventing the destruction of ACh, increasing its availability for muscle contraction.

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Lithium Therapeutic Range

0.8 to 1.2 mEq/L; levels above 1.5 mEq/L are toxic.

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Lithium Side Effects

Headaches, drowsiness, dizziness, hypotension, dysrhythmias, restlessness, dry mouth, metallic taste, GI distress, tremors, muscle weakness, peripheral edema, increased urination, and memory impairment.

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Neuroleptic Malignant Syndrome

A rare, potentially fatal condition triggered by antipsychotic drugs; characterized by altered mental status, seizures, muscle rigidity, high fever, and other serious symptoms.

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MAOI Food Interactions

Tyramine-rich foods (e.g., cheeses, cured meats, beer) can cause hypertensive crisis with MAOIs.

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Vancomycin Side Effects

Red man syndrome (rapid IV), hypotension, red blotching, ototoxicity (CN VIII), nephrotoxicity, blood dyscrasias, Stevens-Johnson syndrome.

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Red Man Syndrome

A reaction caused by too-rapid IV vancomycin administration, characterized by flushing and redness.

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Vancomycin Administration

Administer over 1-2 hours intravenously; rotate IV sites, monitor vital signs, fluid intake, and labs (kidneys & hearing).

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MRSA Drugs

Fifth-generation cephalosporins, lincosamides, oxazolidinones, glycopeptides (vancomycin, telavancin), and tetracyclines.

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Azithromycin (Zithromax) Class

Macrolide antibiotic

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Azithromycin Nursing Intervention

Report diarrhea (possible pseudomembranous colitis); advise full regimen (5 days); and administer 1 hour before or 2 hours after meals.

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TMP-SMZ Action

Synergistic effect; slows bacterial resistance development

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TMP-SMZ Uses

Urinary, intestinal, and lower respiratory infections; otitis media; prostatitis; Pneumocystis carinii prevention (AIDS).

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TMP-SMZ Side Effects

Rashes, anorexia, N/V/D, stomatitis, crystalluria, photosensitivity, agranulocytosis, aplastic anemia, allergic myocarditis, and blood dyscrasias.

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Sulfonamide Antibiotic Use

Treatment of ulcerative colitis, Crohn's disease and rheumatoid arthritis.

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Sulfonamide Administration

Administer with full glass of water 1 hour before, or 2 hours after, meals.

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Nursing Intervention for difficult drugs.

Assess for allergies, perform C&S before starting therapy, and assess renal & liver function.

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Drug interactions

Alcohol and anticoagulants can interact with some drugs.

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Increased Bleeding

A potential side effect of some medications.

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Sulfonamide Side Effects

Sulfonamides can cause GI distress, stomatitis, photosensitivity, headaches, edema, crystalluria, renal failure, hematuria, blood disorders, anaphylaxis, and Stevens-Johnson syndrome.

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Sulfonamide Nursing Interventions

Increase fluid intake, monitor CBC and renal function, watch for rash and infections, be aware of increased warfarin and sulfonylurea effects, avoid in 3rd trimester, and advise sun protection.

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Mechanism of Sulfonamides

Sulfonamides prevent bacteria from creating folic acid, which is important for bacterial growth; humans get folic acid from diet, not produced by the body.

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Sulfonamide Bacterial Action

Sulfonamides are bacteriostatic and effective against gram-negative bacteria and some gram-positive bacteria.

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Sulfonamide Interactions

Sulfonamides reduce the absorption of antacids, increase the anticoagulant effect of warfarin, and increase the hypoglycemic effect of sulfonylureas.

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Amitriptyline (Elavil)

A tricyclic antidepressant used for major depression, it blocks neurotransmitter reuptake and histamine receptors, leading to sedation and mood elevation.

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Tricyclic Antidepressants

Class of antidepressants that block the reuptake of neurotransmitters (like norepinephrine and serotonin) in the brain.

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Infliximab (Remicade)

An immunomodulator that neutralizes tumor necrosis factor, disrupting inflammatory processes and delaying disease progression.

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Colchicine (Colcrys)

Anti-gout medication that inhibits the migration of immune cells to inflamed areas, relieving acute gout attacks.

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Allopurinol (Zyloprim)

Anti-gout medication that decreases uric acid production and increases its excretion, preventing gout attacks.

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NSAID

Non-Steroidal Anti-Inflammatory Drug, inhibits prostaglandin synthesis, reducing inflammation, fever, and pain.

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Ibuprofen (Motrin)

NSAID that inhibits prostaglandin synthesis and platelet aggregation to relieve pain, fever, and inflammation.

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Aspirin (ASA)

Salicylate NSAID that inhibits prostaglandins, reduces inflammation, fever, and pain, and has antiplatelet effects.

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Acetaminophen (Tylenol)

Analgesic that inhibits prostaglandin synthesis, relieving pain and fever.

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Opioid

Type of analgesic that works by acting on the central nervous system to suppress pain.

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Naloxone (Narcan)

Opioid antagonist used to reverse the effects of opioid overdose.

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Cyclooxygenase Enzymes (COX-1 & COX-2)

Enzymes in the body that create prostaglandins and thromboxanes, which are important molecules for inflammation and other bodily processes, COX-1 is involved in homeostatic processes; COX-2 is involved in inflammation.

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Controlled Substance Schedule

Classification system for drugs based on potential for abuse and addiction.

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INH (Isoniazid) Action

Inhibits bacterial cell wall synthesis.

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Rifampin Side Effect

Causes body fluids to turn reddish orange.

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INH (Isoniazid) Patient Teaching

Take INH 1 hour before meals or 2 hours after and complete the full treatment plan.

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Nystatin Classification

Antifungal medication.

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Nystatin Administration

Can be taken orally or topically (e.g., in the mouth).

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Metronidazole Action

Disrupts DNA function in susceptible bacteria.

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Metronidazole Use

Treats infections related to the GI system and other conditions like trichomoniasis, bacterial vaginosis.

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INH (Isoniazid) Interaction

Alcohol increases risk of neuropathy and hepatotoxicity.

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INH (Isoniazid) Side effects

GI distress, constipation, blurred vision, photosensitivity, tinnitus, dizziness, peripheral neuropathy, psychotic behavior, seizures, blood dyscrasias, hepatotoxicity.

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Patient Teaching for INH

Report numbness, tingling, and burning to your doctor. Take pyridoxine (vitamin B6) as prescribed, and follow the prescribed regimen.

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Fluoroquinolones Action

Interfere with DNA gyrase enzyme in bacteria, fighting both gram-positive and gram-negative bacteria.

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Fluoroquinolones Broad Spectrum

Effective against a wide range of bacteria, meaning they are bactericidal.

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Ciprofloxacin Brand

A fluoroquinolone antibiotic sold under the brand name Cipro.

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Ciprofloxacin Use

Used commonly for UTI, lower respiratory, skin, soft tissue, and bone/joint infections.

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Penicillins Action

Prevent bacterial cell wall synthesis, affecting both bacteriostatic and bactericidal processes.

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Penicillins Beta-lactam

The beta-lactam ring is the critical structural component of penicillins.

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Expectorants Action

Loosen bronchial secretions by reducing their surface tension, allowing elimination through coughing.

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Antihistamines Action

Compete with histamine for receptor sites to reduce symptoms like nasal secretions, itching, and sneezing.

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Bronchodilators Action

Cause dilation of bronchioles, making it easier to breathe.

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Leukotriene Modifiers Use

Preventative treatment for chronic asthma, not for acute attacks

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Ipratropium Use

Used in combination with albuterol (e.g., Combivent) for treating chronic bronchitis.

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Theophylline Action

Relaxes bronchiole muscles, increasing cAMP and promoting bronchodilation.

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Glucocorticoid Inhalers Use

Not for acute asthma attacks; take time to build full effects.

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Alcohol Withdrawal Drug

Benzodiazepines (e.g., chlordiazepoxide) treat alcohol withdrawal.

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Study Notes

Pharmacology Exam 2 Study Guide

  • Methylphenidate (Ritalin):

    • Classification: Amphetamine, Category II
    • Action: Modulates serotonergic pathways, affecting dopamine transport
    • Uses: ADHD, narcolepsy
    • Side Effects: Tachycardia, palpitations, hypertension, dizziness, heart attack, restlessness, tremors, irritability, seizures, euphoria, confusion, insomnia, anorexia, dry mouth, diarrhea, weight loss
    • Nursing Interventions: Administer before breakfast and lunch, report irregular heartbeat, record height, weight, and growth of children, avoid alcohol and caffeine, use sugarless gum for dry mouth, taper off dose to avoid withdrawal symptoms, pt’s attention span will increase, patient will behave calmly
    • Interactions: Caffeine may increase effects, decreased effects of antihypertensives, may alter insulin effects

  • Temazepam (Restoril):

    • Classification: Benzodiazepine, Category IV
    • Uses: Hypnotic for insomnia
    • Action: Interacts with GABA to reduce neuron excitability
    • Side Effects: Drowsiness, tolerance, dependence, depression, respiratory depression, vivid dreams, nightmares

  • Midazolam (Versed):

    • Classification: Benzodiazepine, Category IV
    • Use: Prolonged seizures
    • Nursing Interventions: Administer slowly to avoid respiratory depression

  • Phenytoin:

    • Classification: Hydantoins, Category IV
    • Action: Suppresses sodium influx
    • Therapeutic Serum Level: 10-20 mcg/mL
    • Side Effects: Gingival hyperplasia, nystagmus, headache, diplopia, dizziness, slurred speech, decreased coordination, alopecia, thrombocytopenia, Stevens-Johnson syndrome
    • Nursing Interventions: Shake suspensions well (5 minutes), monitor serum drug levels, protect from environmental hazards, and advise against driving, warn against taking certain herbs, alcohol, and other CNS depressants. Warn patients to avoid certain herbs, alcohol, or other CNS depressants. Warn patient not to discontinue abruptly. Patients will need frequent oral hygiene & dental check-ups, Teach patients to report sore throat, bruising, nosebleeds. Diabetics must monitor glucose levels. Tell each patient to take drugs at the same time every day. Warn of harmless pinkish red or brown urine, encourage patients to wear medical-alert identification.

  • Carbidopa levodopa (Sinemet):

    • Classification: Dopaminergics
    • Uses: Parkinson's disease
    • Action: Converts to dopamine to increase mobility
    • Side Effects: Nausea, vomiting, involuntary abnormal movement, psychotic behavior, angioedema, palpitations, orthostatic hypotension, insomnia, blurred vision, dizziness, headache

  • Rivastigmine (Exelon):

    • Classification: Acetylcholinesterase (AChE) Inhibitor
    • Action: Increases amount of ACh at cholinergic synapses

  • Neostigmine bromide (Prostigmin):

    • Classification: Acetylcholinesterase Inhibitor
    • Action: Transmission of neuromuscular impulses (prevents destruction of ACh), cholinesterase inhibitors inhibit ACh enzyme action, results in more ACh to activate cholinergic receptors, promoting muscle contraction
    • Use: Control and treat Myasthenia Gravis (MG)
    • Side Effects: Gl disturbances, N/V/D, abdominal cramps, increased salivation, tearing, miosis, blurred vision, bradycardia, hypotension
    • Nursing Interventions: Administer doses on time, take before meals, monitor drug effectiveness, have antidotes available for a cholinergic crisis (Atropine), encourage patients to wear a medical ID.

  • Lithium (Lithobid):

    • Classification: Mood Stabilizer
    • Therapeutic Serum Range: 0.8-1.2 mEq/L
    • Action: Alteration of ion transport in nerve cells, increased receptor sensitivity to serotonin, Increased receptor sensitivity to serotonin
    • Use: Treat manic episodes in bipolar psychosis
    • Interactions: Increased lithium levels with thiazides,methyldopa, haloperidol,NSAIDs, antidepressants, spironolactone, phenothiazines, ACE inhibitors , Decreased level with caffeine, loop diuretics,theophylline
    • Side Effecs: Headache, drowsiness, dizziness , hypotension, dysrhythmias, restlessness, dry mouth, metallic taste, GI distress, tremors, muscle weakness, peripheral edema, increased urination, memory impairment
    • Nursing Interventions: Monitor vital signs, sodium levels, for drug effectiveness, suicidal tendencies, monitor urine output and renal function tests

  • And many more...

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Pharmacology Exam 2 Study Guide PDF

Description

Prepare for your pharmacology exam with this comprehensive study guide focused on key medications such as Methylphenidate (Ritalin) and Temazepam (Restoril). Learn about their classifications, actions, uses, side effects, and important nursing interventions. This guide is essential for nursing students aiming to excel in pharmacology.

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