Pharmacology Final Review

Diarrhea

To determine the type of bacteria and what can kill it

Because they interfere with the medication's absorption

Assess the patient

Photosensitivity

They are both fluoroquinolones and should not be administered together

Helps pull sugar out of the blood into cells for use

Lispro insulin

Triggers the liver to convert stored glycogen into an energy source

Glipizide

Antidepressants

6.0 or lower

Shaky and anxious

Lithium

Hold the patient's medications

Type 2 diabetes

GABA

Breaks through the blood-brain barrier

Acetylcholine

To slow the progression of the disease

Dopamine

Dopamine agonists

Dopamine

'Works with' or enhances effects

Relieving pain

Boost the effects of benzodiazepines

Airborne droplets from coughing or sneezing

1 year

They stop viral reproduction

Within 24-48 hours of symptom onset

Drowsiness

Bronchodilators

Discolored urine

Take the medications as prescribed daily

Increased blood sugar

Pancreas

Disulfiram

Antipsychotics

Complete Blood Count (CBC) with differential

All of the above

Antidepressants

Phenazopyridine

Monitor sodium and potassium levels

All of the above

Antipsychotics

Tetracyclines

Too much antibiotics can cause an overgrowth of flora = Yeast infection/secondary infection/superinfection Common side effect of penicillin = Diarrhea Patients with cephalosporin allergy may also be allergic to = Penicillin Sulfa drugs are associated with = Photosensitivity (stay out the sun)

Oral contraceptives are ineffective if taken while on antibiotic therapy = Do NOT SMOKE! Fluoroquinolones, such as Cipro, can cause tendon damage after prolonged use = Take with food to reduce stomach discomfort with administration Aminoglycosides require monitoring of labs for BUN and creatinine = Cipro and Levaquin are both examples of = Fluoroquinolones. Do not administer together!

Culture sensitivity involves taking a culture of bacteria to determine its type and reactions to medications = Broad-spectrum meds given initially / Narrow-spectrum meds given once organism is identified Whenever there is a change in a patient's status, the nurse's first step is to = Assess! Z-track method is used for = Intramuscular injections When administering Fluoroquinolones, patients should not take them with juices containing calcium and should avoid sun exposure due to = Photosensitivity

Antihistamines = Drowsiness Decongestants = Reduced swelling of nasal passages Steroidal inhalers = Thrush Antitussives = Cough suppression

Diabetes = Pancreas primarily Type 1 Diabetes = Resembles more of an auto-immune disease Type 2 Diabetes = Happens later in life Tuberculosis (TB) = Transmitted through the air (airborne droplets)

Flagyl (metronidazole) = Swallow pills whole, do not chew or crush Prednisone = Increases blood sugar Cromolyn sodium = Short acting beta adrenergic agonist (SABA) Zorivax (acyclovir) = Do not take with dairy

Instruct patient to drink plenty of water = When taking mucolytics Rinse and gargle after use. Do not swallow the water = Steroidal inhalers Warm cream before administration and have another person present during procedure = Best time to administer yeast infection cream is at night Notify doctor of any vision changes, worsening thyroid conditions or changes in renal or kidney functions = Flagyl (metronidazole)

Antivirals = Stop viral reproduction but do not kill viruses Antibiotics = Weakened immune system Antifungals (-azoles) = Liver impact/possible urine discoloration TB drugs = Reddish-orange urine discoloration is normal

Anaphylaxis = Call 911 immediately if occurs Diarrhea during pinworm anthelmintic treatment = Common side effect Changes in vision while on anti-TB drugs = Report immediately Adverse reaction to a medication = Hold next dose and notify the doctor

Increased eye pressure and high blood pressure = Contraindicated in patients with glaucoma Common side effect of steroidal inhaler usage = Rinse and gargle after use. Do not swallow the water Increased blood sugar = Notify doctor of any vision changes, worsening thyroid conditions or changes in renal or kidney functions Thrush from steroidal inhalers = Swallow pills whole, do not chew or crush

Continuing taking HIV meds even after getting pregnant = Instruct patient to continue taking HIV meds, even after getting pregnant Monitoring for low heart rate when taking Reyataz = Monitor for low heart rate when taking Reyataz (Trade) atazanavir Taking Tamiflu within 24-48hrs of onset of flu symptoms = Tamiflu (Trade) oseltamivir can only be taken within 24-48hrs of onset of flu symptoms Not cutting, tapering down, or abruptly stopping HIV drug therapy = Do not cut, taper down or abruptly stop taking HIV medications unless instructed by doctor

Avoid dairy products while on drug = (Antivirals) Zorivax (acyclovir) – don’t take with dairy (TB drugs) Isoniazid (INH) = (TB drugs) Commonly used drug for TB (Antihistamines) = (Antihistamines) Contraindicated in patients w/ glaucoma/ causes increased eye pressure/ high blood pressure (Decongestants) = (Decongestants) Rinse and gargle after use. Do not swallow the water. Thrush – common side effect of steroidal inhaler usage

NPH insulin = Peak: 4-12hrs, Duration: 12-24hrs Regular insulin = Peak: N/A, Duration: N/A Lispro = Peak: N/A, Duration: N/A

Polyuria = Increased urination Polydipsia = Increased thirst Polyphagia = Increased hunger Hemoglobin A1C = Test done to monitor blood sugar levels

Glucotrol = Lowers sugar levels for diabetes Glipizide = Works too fast without food to slow down body synthesis Metformin = Treats type 2 DM, gestational, and polycystic ovary syndrome Buspirone = Binds to serotonin and dopamine receptors

Glycogenolysis = Triggers liver to convert stored glycogen into an energy source Glucagon = Helps to increase blood sugar/produced in pancreas (combats hypoglycemia) Glycogen = Helps to increase blood sugar (stored in liver) Hemoglobin A1C = Test done to monitor blood sugar levels for the past three months

Amitriptyline = Take at bedtime/ do not stop abruptly Glipizide = Must give with food Insulin = Give within 30mins of mealtimes Glucotrol = Give within 30mins of meals

Weakness and lethargy = Lithium toxicity Cold clammy skin = Hypoglycemia Unstable BP, muscle rigidity, hyperpyrexia = Neuroleptic Malignant Syndrome (NMS) Shaky/anxious = Hypoglycemia

SSRIs = Weight gain Antidepressants = Contraindicated for patients with vision problems Lithium = **Note: avoid excessive exercise Metformin = (Trade) (glucophage -generic) – NEPHROTOXIC

Sodium glucose co-transport inhibitors = (monitor for potassium and dehydration) Metformin (biguanide) = (NEPHROTOXIC) Oral contraceptives = (lower the effect of antidiabetic medication) Anti-depressants = (take 10-14 days to work/ Contraindicated: patients w/ vision problems)

Inject air into cloudy (NPH) = $\rightarrow$ Withdraw from clear (Reg) Inject air into clear (Reg) = $\rightarrow$ Withdraw from cloudy (NPH) Withdraw from clear (Reg) = $\rightarrow$ Inject air into cloudy (NPH) Withdraw from cloudy (NPH) = $\rightarrow$ Inject air into clear (Reg)

Buspirone = (Increases norepinephrine metabolism in brain) Amitriptyline = (Pt teaching: do not stop abruptly) Benzo's (Xanax, Ativan, Valium, Klonopin) = (Common benzos) Insulin administration = (Monitor pt for hypoglycemia, especially during onset)

Serotonin = Decreased in depression Dopamine = Increased in schizophrenia/decreased in Parkinson's Acetylcholine = Decreased in Alzheimer's GABA = Decreased in anxiety

Aricept (Trade) = Main Alzheimer's med given to slow disease progression Buspirone (BuSpar) = Common benzo agonist for long-term anxiety use Haldol = Antipsychotic usually given for schizophrenia Narcan (Trade) / naloxone (generic) = Antidote for narcotics and benzos

Levodopa = Medication to help increase dopamine levels Carbidopa = Breaks through blood-brain barrier and drops blood pressure Rivastigmine = Given in a patch for dementia patients Oxcarbazepine = Anticonvulsant that can kick sodium out of the body

SSRI's = Decreases libido and causes sexual dysfunction in depression meds Tricyclic antidepressants = Can affect vision and contraindicated in patients with glaucoma Benzo's = Monitor for dizziness and orthostatic hypotension MAOIs = Last resort med for acute mental episodes, requires fasting before starting therapy

Don't take with cough syrup = Aricept (Trade) Avoid mixing classes of mental health drugs = MAOIs No bueno for alcoholism = Benzo's Can cause cardiac issues if taken with OTC meds, use with caution together = Aricept (Trade)

Dopamine agonist = Works with dopamine to enhance effect, can exacerbate depression and psychosis Benzo agonist = Enhances the effect of benzodiazepines like Xanax Benzodiazepine agonist = Enhances the calming effect of benzos, boosts serotonin and dopamine Upper vs. downer neurotransmitters = Dopamine is an upper, serotonin is a downer

May miscarry or have birth defects if Preggo's overdose = Pregnant patients who overdose on medications Hold med and call PCP if twitching or movement after crossing blood-brain barrier meds = Medications that are meant to cross the blood-brain barrier Never abruptly stop antidepressants due to jerky movements/restlessness risk = Antidepressants that affect the brain/nervous system Monitor sodium content and liver function for anticonvulsant meds = 'Most seizure meds' that require monitoring for sodium levels

Give until antidepressant builds up in patient's system = Benzo's given until another medication accumulates in the body Refrain from mixing classes of mental health drugs = 'Mental health drugs' instruction to avoid combining different classes of medications Monitor vitals, weight, and suicide risk for Tricyclic antidepressants = 'Tricyclic antidepressants' need close monitoring for vital signs, weight, and suicidal thoughts Monitor for muscle rigidity and have crash cart nearby = 'Any drug' that may lead to muscle rigidity requiring emergency measures

No bueno for preggo's, especially alcoholism = 'Benzo's' class that has negative effects on pregnant patients and those with alcoholism Caution due to potential effects on fetal tooth development = 'MAOIs' that require caution during pregnancy due to risks to fetal tooth development Do not mix with anything! = 'MAOIs' as a drug class that should not be combined with other medications Avoid taking Cipro and Levaquin together = 'Sulfa drugs' as a class known for causing side effects if combined

Clozapine = Monitor patient for any changes in WBC levels Valproate (valproic acid) = Monitor for liver function Phenazopyridine = Contraindicated in patients with liver issues Reglan = Take on empty stomach

Bactrim = Increase fluids to reduce crystallization (crystalluria) Nitro patch = Keep in original dark glass bottle Famotidine = Don't smoke Nitro = Before administration, shave patient

Anti-depressants = Can cause cardiac issues, do EKG prior to treatment Seizure meds = Monitor for rash/hives, can indicate life-threatening episode Hormone replacement for menopause = Headaches, breast pain/tenderness, unexpected vaginal bleeding or spotting, mood changes Common side effects of weed = Changes in mood, impaired body movement, impaired memory

Loop diuretics = Give in the morning, administer slowly via IV to prevent hypotension, monitor sodium and potassium levels Thiazides = Decrease sodium reabsorption Tetracycline = Permanently stains buds of teeth of baby, avoid in pregnant women Statins = Best to take at night, do not take with grapefruit juice or alcohol

Jaundice = Sign of liver issue Dehydration = Thirst, dark yellow urine, decreased urination, dizziness, lightheadedness, tiredness Signs of successful thyroid hormone therapy = Initial symptoms decrease Thyroid meds during pregnancy/breastfeeding = Given during pregnancy but not during breastfeeding, taken lifelong

EPI PENS = Around age 5 = age for patient teaching 6mo.old injection site = Upper thigh Vials = Push air into before withdrawal Narc patches = Document time and place of administration

Photosensitivity = Sulfa drugs Tendon damage = Fluoroquinolones Diarrhea = Penicillin Numbness and tingling in hands/feet = Cipro

Z-track method for injections = Intramuscular injections First step when patient's status changes = Assessing Common labs to monitor with aminoglycosides = BUN and creatinine Patient education for fluoroquinolones = Fluid intake, sun exposure, dairy products

Avoid smoking while on therapy = Oral Contraceptives Do not take with juices containing calcium = Fluoroquinolones Do not administer Cipro and Levaquin together = Fluoroquinolones Ineffective if taken with antibiotics = Oral Contraceptives

Cephalosporin allergy may lead to penicillin allergy = Patients allergic to penicillin may also be allergic to cephalosporins = Penicillin and cephalosporins share cross-allergenicity = Allergic reaction to cephalosporins indicates potential penicillin allergy =

Antibiotics = Treatment of bacterial infections Oral Contraceptives = Prevention of pregnancy Aminoglycosides = Treatment of specific infections Fluoroquinolones = Broad-spectrum antibiotic use

Caution during pregnancy due to fetal effects on tooth development = May cause weight gain and sexual dysfunction, monitor weight and cardiac function = Potential adverse effects on liver function, avoid in patients with liver issues = Can lead to photosensitivity reactions, protect skin from sun exposure =

Decongestants = Reduce swelling of nasal passages Steroidal inhalers = Rinse and gargle after use. Do not swallow the water Antihistamine = Blocks histamine receptors / can cause drowsiness Mucolytics = Drink plenty of water when taking

Type 1 Diabetes = Resembles more of an auto-immune disease Type 2 Diabetes = Happens later in life Gestational Diabetes = Occurs during pregnancy LADA (Latent Autoimmune Diabetes in Adults) = Slow onset, autoimmune-related diabetes

TB drugs = Take 1 hour before or 2 hours after eating or taking an antacid HIV drug therapy = Do not cut, taper down or abruptly stop taking unless instructed by doctor Antitussive = Cough suppressant Bronchodilator = First, Steroid - Second

Increased blood sugar = Prednisone Thrush = Steroidal inhalers Reddish-orange urine discoloration = TB drugs Drowsiness / eye pressure increase = Antihistamine

Monitor for anaphylaxis and call 911 if occurs = Sinus infection treatment No alcohol while on drug = Flagyl (metronidazole) Swallow pills whole, do not chew or crush = Penicillin with potassium Notify doctor of vision changes or thyroid conditions = Flagyl (metronidazole)

NPH insulin = Onset: 30mins - 4hrs, Peak: 4-12hrs, Duration: 12-24hrs Regular insulin = Onset: 30-60min, Peaks: 2hrs, Duration: appro. 2hrs Lispro insulin = Onset: 15mins Glucagon = Produced in pancreas, triggers liver to convert stored glycogen into an energy source

Glipizide = Must give with food to slow down body synthesis Glucotrol = Give within 30mins of meals to lower sugar levels Metformin = Treats type 2 DM, gestational, and polycystic ovary syndrome Amitriptyline = Take at bedtime and do not stop abruptly

Sodium glucose co-transport inhibitors = Monitor for potassium and dehydration Insulin = Monitor for hypoglycemia, especially during onset Lithium = Monitor sodium levels for toxicity Buspirone = No specific side effect monitoring required

Lithium = Main drug for bipolar disorder Buspirone = Binds to serotonin and dopamine receptors Amitriptyline = Anti-depressant that requires tapering off Benzo's (Xanax, Ativan, Valium, Klonopin) = Commonly used for anxiety disorders

Polydipsia = Increased thirst Polyuria = Increased urination Polyphagia = Increased hunger Hemoglobin A1C test result of 6.0 in diabetics = Lower sugar levels for diabetes

Nephrotoxic = (Trade) (glucophage -generic), class: biguanide, treats type 2 DM, gestational, and polycystic ovary syndrome Neuroleptic Malignant Syndrome (NMS) = Life-threatening neuro emergency caused by antipsychotic agents Antidepressants = Require tapering off and can cause withdrawal symptoms if stopped abruptly SSRIs adverse effect = Changes to brain chemistry including weight gain and libido issues

Darkening skin patches in groin, armpits, neck = Undiagnosed Diabetes Cold clammy skin, weakness, headache = Hypoglycemia (below 60) Frequent thirst, urination, fruity breath = Complications of poorly managed diabetes Unstable BP, muscle rigidity, hyperpyrexia = Neuroleptic Malignant Syndrome (NMS)

INR - 1.1 or lower = (International Normalized Ratio) clotting measurement Sodium - 135-145mEq/L = (Electrolyte balance) concentration in blood WBC - 4.5K - 11K = (White Blood Cell count) immune system function test Hemoglobin A1C of 5.6 or lower in non-diabetic individual = (Blood sugar monitoring) over past three months

Metformin (glucophage) = (Biguanide class), nephrotoxic risk - frequent labs required if nephrotoxic drug used Insulin administration without checking blood sugar first = (Hypoglycemia risk), monitor for signs especially during onset Oral contraceptives and antidiabetic medication interaction warning = (Decreases antidiabetic effect), monitor blood sugar closely Cipro and Levaquin combination caution for patients due to vision problems = (Avoid taking together), contraindicated in patients with vision issues

Inject air into cloudy (NPH), Withdraw from clear (Reg) = Inject air into clear (Reg), Withdraw from cloudy (NPH) = Withdraw from clear (Reg), Inject air into cloudy (NPH) = Withdraw from cloudy (NPH), Inject air into clear (Reg) =

Antidepressants = Cardiac issues Anti-seizure meds = Rash/hives indicating life-threatening episode Multiple sclerosis meds = Affects immune system Thyroid meds = Monitor liver function

Drink a lot of water with enteric coated capsules, DO NOT CRUSH = Bactrim Apply transdermal patches with gloves on to avoid skin absorption = Nitro patch Rotate injection sites always = Epi pens Take Reglan on an empty stomach = Reglan

Loop diuretics = Muscle relaxation and increased blood flow Statins = Best taken at night, avoid grapefruit juice/alcohol Thiazides = Decrease sodium reabsorption Phenazopyridine = Contraindicated in liver issues

Drowsiness, Photosensitivity, Affect sleep patterns, Ortho hypotension = Antidepressants Sexual dysfunction, Weight gain = Antipsychotics Changes in mood, Impaired body movement, Impaired memory = Weed Headaches, Breast pain/tenderness, Unexpected vaginal bleeding, Mood changes = Hormone replacement for menopause

Give in the AM, Administer slowly via IV to prevent hypotension, Monitor sodium and potassium levels = Loop diuretics Check for allergy first, Stay with patient during administration = 9 rights of drug admin Document time and place of administration = Narc patches Push air into vials before withdrawal = Vials

Nitro - keep in original dark glass bottle = Nitro patch Famotidine - don’t smoke = Famotidine Thyroid meds - take lifelong, No breastfeeding = Thyroid meds Anti-thyroid - monitor liver function/check eye color = Anti-thyroid meds

Diuretics - Causes dilations and muscle relaxation to lower BP = Diuretics Lasix - Don’t miss doses due to frequent urination = Lasix Tetracycline - Photosensitivity and teeth staining in babies = Tetracycline Jaundice - Sign of liver issue in response to meds = Jaundice

Valproate (valproic acid) = Monitor for liver function Lactulose for patients with liver issues = Brings down ammonia levels Thyroid meds = Monitor liver function/check eye color Blood levels test = Determine if drug is at therapeutic range

Disulfiram = Given for alcohol dependency/avoid alcohol while on drug Clozapine = Antipsychotic/monitor WBC levels for changes Lorazepam = Benzodiazepine that causes sedation Bactrim = Increase fluids to reduce crystallization

Thyroid meds = Do not take during breastfeeding but necessary during pregnancy Antidepressants = Can cause cardiac issues in developing fetus if taken during pregnancy Hormone replacement for menopause = May lead to unexpected vaginal bleeding or spotting Lactulose for patients with liver issues = Not recommended during pregnancy due to potential effects on fetal tooth development

Serotonin = Decreased in depression Dopamine = Increased in schizophrenia/decreased in Parkinson’s Acetylcholine = Decreased in Alzheimer's GABA = Decreased in anxiety

Aricept (Trade) = Main Alzheimer’s med Rivastigmine (generic) = Med for dementia given in a patch Oxcarbazepine (generic) = Anticonvulsant Haldol = Antipsychotic usually given via injection

Dopamine = Upper Serotonin = Downer GABA = Relaxation to sleep Acetylcholine = Parasympathetic system

Never abruptly stop antidepressants = May present with jerky movements/restlessness Give benzos until antidepressant builds up in system = Monitor for dizziness, orthostatic hypotension SSRIs for depression = Decrease libido Tricyclic antidepressants for depression = Can affect vision

Narcs and benzos = No bueno for pregnant individuals MAOIs = Last resort med for acute mental episodes, wait 2 weeks before starting therapy Haldol = Usually given for schizophrenia via injection Lamotrigine = Notify PCP if patient presents with hives

Antidepressants = Monitor for suicidal thoughts Seizure medications = Monitor sodium levels Sedatives = Monitor for drowsiness and sedation Benzo agonists like Buspirone (BuSpar) = Enhance the effect of benzos

SSRIs and Tricyclic antidepressants = Cause sexual dysfunction Antidepressants in general = Can cause weight gain Tricyclic antidepressants specifically = Affect vision and contraindicated in glaucoma patients Benzo agonists like Buspirone (BuSpar) = Boost serotonin/dopamine

Aricept (Trade) = Don’t take with cough syrup, caution with OTC meds due to cardiac issues Rivastigmine (generic) = Put in a place dementia patients can't reach, usually on the back as a patch Oxcarbazepine (generic) = Monitor sodium content and liver function, can kick sodium out of the body Haldol = Usually given via injection, for schizophrenia

Acetylcholine = Works on parasympathetic system Epinephrine = Works on sympathetic system Dopamine = Helps with Parkinson’s rigidity / increased in schizophrenia/decreased in Parkinson’s GABA = Relaxation to sleep / decreased in anxiety

Narcan (Trade) / Naloxone (generic) = Antidote for narcotics like opioids / Flumazenil is for benzodiazepines Narcs and benzos interaction warning = No bueno for pregnant individuals Pregnant individuals overdose risk warning = May miscarry or baby may have birth defects Narcan overdose risk warning = Might cause twitching or movement after meds that cross blood-brain barrier