Pharmacology Exam: Anticoagulants, Opioids & More

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Questions and Answers

What is the therapeutic range for lithium plasma levels?

0.4-0.8 mEq/L

1.0-1.5 mEq/L

0.8-1.4 mEq/L

0.6-1.2 mEq/L (correct)

Which laboratory values are crucial to monitor in patients on lithium therapy?

Sodium, BUN, and creatinine (correct)

Calcium, magnesium, and phosphorus

Glucose, potassium, and chloride

Hemoglobin, hematocrit, and platelets

Which symptoms indicate possible lithium toxicity?

Diarrhea and tremors

Dizziness and fatigue

Elevated heart rate and anxiety

Coarse tremors and confusion (correct)

Why should tyramine-rich foods be avoided by patients on MAOIs?

They can cause hypertensive crisis. Signup and view all the answers

What should be monitored in patients taking disulfiram for alcohol withdrawal?

Liver enzymes and bilirubin levels Signup and view all the answers

What is a serious side effect associated with first-generation antipsychotics?

Neuroleptic malignant syndrome Signup and view all the answers

What action should be taken if a patient on mood stabilizing antiepileptics develops jaundice?

Withhold the medication and notify the provider Signup and view all the answers

What is a precaution patients should take when prescribed CNS stimulants?

Take them in the morning Signup and view all the answers

Why are drug holidays recommended for children using CNS stimulants?

To prevent dependence and side effects Signup and view all the answers

What is the primary therapeutic action of SSRIs in treating mood disorders?

Inhibiting serotonin reuptake Signup and view all the answers

What is one of the main benefits of using clonidine during opioid withdrawal?

It alleviates autonomic hyperactivity Signup and view all the answers

What role does buprenorphine play in treating opioid withdrawal?

It prevents withdrawal manifestations Signup and view all the answers

Which mechanism of action does varenicline utilize to aid in smoking cessation?

It promotes the release of dopamine Signup and view all the answers

What is a common complication of centrally acting anticholinergics?

Stinging eye and systemic effects Signup and view all the answers

Which medication is most effective for managing symptoms of Parkinson's disease?

Levodopa and carbidopa Signup and view all the answers

What common side effect is associated with levodopa and carbidopa therapy?

Nausea and vomiting Signup and view all the answers

Which side effect is commonly noted with the use of dopamine agonists?

Sudden inability to stay awake Signup and view all the answers

What is the primary action of diazepam in pharmacology?

To mimic GABA actions at receptors Signup and view all the answers

Which effect is primarily targeted by baclofen in clinical settings?

Relief of spasticity and muscle spasms Signup and view all the answers

Why is it crucial not to discontinue diazepam abruptly?

It can lead to withdrawal symptoms Signup and view all the answers

What antidote is used to reverse the effects of heparin?

Protamine sulfate Signup and view all the answers

What lab value is essential for monitoring the efficacy of heparin therapy?

aPTT Signup and view all the answers

What is the target PT/INR range for patients on warfarin?

2-3 Signup and view all the answers

What serious complication should be monitored in patients using opioids?

Respiratory depression Signup and view all the answers

Which herbal supplement is known to increase bleeding risk when taken with heparin?

Ginkgo biloba Signup and view all the answers

What laboratory test is monitored to evaluate the anticoagulation therapy of warfarin?

PT/INR Signup and view all the answers

What is the primary use of naloxone?

Reversal of opioid overdose Signup and view all the answers

What does a therapeutic aPTT range indicate for patients on heparin therapy?

1.5-2 times baseline Signup and view all the answers

Which complication is NOT associated with heparin therapy?

Infection Signup and view all the answers

What nursing intervention should be prioritized for a patient being treated with opioids?

Monitor pain level and respiratory status Signup and view all the answers

Study Notes

Anticoagulants

Heparin antidote: Protamine sulfate
Warfarin antidote: Vitamin K
Heparin therapy monitoring: aPTT
Therapeutic aPTT range: 1.5-2 times baseline
Warfarin therapy monitoring: PT/INR
Therapeutic PT/INR range: 2-3
Heparin complication: Hemorrhage
Herbal supplement interacting with heparin: Ginkgo biloba

Opioids

Nursing interventions for opioid patients: Monitor pain level and respiratory status
Opioid overdose reversal agent: Naloxone
Opioid complication: Respiratory depression

SSRIs

SSRI use: Anxiety and depression
SSRI mechanism of action: Inhibits serotonin reuptake

MAOIs

MAOI monitoring: Anxiety and agitation
MAOI food avoidance: Tyramine-rich foods
MAOI caffeine avoidance reasoning: Leads to hypertensive crisis
MAOI medication change requirement: Washout period of at least two weeks

Mood Stabilizers

Lithium toxicity signs: Coarse tremors and confusion
Lithium therapeutic range: 0.6-1.2 mEq/L
Lithium monitoring values: Sodium, BUN, and creatinine

Mood Stabilizing Antiepileptics

Antiepileptic precaution: Avoid operating heavy machinery
Antiepileptic toxicity signs: Nausea and jaundice
Stevens-Johnson syndrome action: Withhold medication and notify the provider

First-Generation Antipsychotics

Acute dystonia signs: Severe tongue and neck spasms
Akathisia symptoms: Constant pacing and agitation
Tardive dyskinesia features: Involuntary movements of tongue and face
First-generation antipsychotic complication: Neuroleptic malignant syndrome
Orthostatic hypotension instruction: Change positions slowly

Second-Generation Antipsychotics

Second-generation antipsychotic complications: Weight gain and diabetes mellitus
Dementia and second-generation antipsychotics: Increased mortality risk
Second-generation antipsychotic avoidance: Alcohol

Central Nervous System Stimulants

CNS stimulant timing: Morning administration
CNS stimulant drug holidays: Prevent tolerance and side effects

Medications to Support Withdrawal from Alcohol

First-line alcohol withdrawal treatment: Benzodiazepines
Disulfiram alcohol interaction: Nausea and vomiting
Naltrexone in alcohol withdrawal: Suppresses alcohol cravings

Medications to Support Withdrawal from Opioids

Methadone role: Replace opioid for long-term maintenance
Clonidine in opioid withdrawal: Alleviates autonomic hyperactivity
Buprenorphine in opioid withdrawal: Prevents withdrawal manifestations

Medications to Support Withdrawal from Nicotine

Bupropion in smoking cessation: Decreases nicotine cravings
Varenicline mechanism: Promotes dopamine release

Centrally Acting Anticholinergics

Centrally acting anticholinergic complications: Stinging eyes and systemic effects

Antiparkinson's Medication

Effective Parkinson's medication: Levodopa and carbidopa
Levodopa/carbidopa complications: Nausea and vomiting
Dopamine agonist side effects: Sudden inability to stay awake

Muscle Relaxants and Antispasmodics

Diazepam mechanism: Mimics GABA actions at receptors
Baclofen therapeutic uses: Relief of spasticity and muscle spasms
Dantrolene mechanism: Inhibits muscle contraction
Diazepam discontinuation risk: Withdrawal symptoms
Baclofen dietary recommendation: Increase high-fiber foods

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Description

This quiz covers essential pharmacological concepts related to anticoagulants, opioids, SSRIs, MAOIs, and mood stabilizers. Test your knowledge on antidotes, therapeutic monitoring, nursing interventions, and critical considerations for these medication classes. Perfect for nursing students and professionals looking to reinforce their understanding of pharmacology.