Pharmacology Quiz on Medications and Antidotes

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Questions and Answers

What is the antidote for heparin overdose?

Protamine Sulfate (correct)

Digoxin

Vitamin K

Adenosine

Which anticoagulant is safe to use during pregnancy?

Rivaroxaban

Warfarin

Enoxaparin (correct)

Clopidogrel

What condition is primarily treated with tPA (Alteplase)?

Hemorrhagic Stroke

Pulmonary Embolism

Ischemic Stroke (correct)

Deep Vein Thrombosis

Which of the following medications should be discontinued 5-7 days before surgery?

Aspirin Signup and view all the answers

What is a potential side effect of calcium channel blockers like Diltiazem?

Constipation Signup and view all the answers

Which medication is contraindicated in patients with glaucoma?

Atropine Signup and view all the answers

What is a common monitoring requirement for patients on ACE inhibitors?

Blood pressure Signup and view all the answers

What is a significant side effect associated with digoxin?

Bradycardia Signup and view all the answers

What is a common side effect of opioids that requires monitoring?

Respiratory depression Signup and view all the answers

Which medication is contraindicated for children under 16 due to the risk of Reye's Syndrome?

Aspirin Signup and view all the answers

What is the maximum recommended dosage of Acetaminophen in a day?

4 grams Signup and view all the answers

Which medication used to treat Alzheimer's can cause flu-like symptoms and weight loss?

Rivastigmine Signup and view all the answers

Which CNS stimulant should be avoided during administration due to its interaction with certain beverages?

Methylphenidate Signup and view all the answers

Which opioid is used specifically for pain management and also assists in opioid withdrawal?

Methadone Signup and view all the answers

What should be monitored when using Ibuprofen?

BUN/Creatinine levels Signup and view all the answers

Which class of medication is indicated for treating spastic muscles?

Muscle Relaxants Signup and view all the answers

Which antibiotic class should not be given to patients with a penicillin allergy?

Cephalosporins Signup and view all the answers

What is a common side effect associated with Tetracyclines?

Photosensitivity Signup and view all the answers

Which antibiotic is used to treat C. diff infections?

Vancomycin Signup and view all the answers

What is a known side effect of the anti-tuberculosis drug Isoniazid?

Hepatotoxicity Signup and view all the answers

Which medication causes body fluids to turn reddish orange?

Rifampin Signup and view all the answers

What should be monitored in patients taking Cephalosporins?

Signs of C. diff Signup and view all the answers

Which of these antibiotics should not be administered to individuals under 18 years of age?

Ciprofloxacin Signup and view all the answers

What class of drugs does Isotretinoin belong to, and what is its major contraindication?

Retinoids; teratogenic effects in pregnancy Signup and view all the answers

What condition can Metformin lead to that requires monitoring?

B12 Deficiency Signup and view all the answers

Which laxative is suitable for treating opioid-induced constipation?

Senna Signup and view all the answers

How should Sucralfate be administered for optimal effectiveness?

On an empty stomach Signup and view all the answers

What is a major side effect to monitor for when using Proton Pump Inhibitors (PPIs)?

Hypomagnesemia Signup and view all the answers

Which diuretic retains potassium, making it unique from others?

Spironolactone Signup and view all the answers

What should be avoided when administering Loop Diuretics like Furosemide?

Digoxin Signup and view all the answers

What is a common treatment for hypercalcemia that can result from Thiazide diuretics?

Allopurinol Signup and view all the answers

Which medication is an effective treatment for nausea and vomiting but should not be given via rapid push?

Ondansetron Signup and view all the answers

Which medication is specifically used to treat psoriasis and rheumatoid arthritis?

Etanercept Signup and view all the answers

What is a significant risk associated with taking Methotrexate?

Pancytopenia Signup and view all the answers

Which treatment should NOT be given to patients with a history of hypertension?

Sumatriptan Signup and view all the answers

What potential issue should a healthcare provider monitor for in patients taking Sitagliptin?

Pancreatitis Signup and view all the answers

Which drug combination poses a risk for hypotension when taken together?

Nitroglycerin and sildenafil Signup and view all the answers

Which of the following medications is contraindicated for patients with asthma?

Beta Blockers Signup and view all the answers

What is the recommended antidote for a patient with acetaminophen toxicity?

Acetylcysteine Signup and view all the answers

Which medication should be avoided in patients with chronic liver disease?

Warfarin Signup and view all the answers

Study Notes

Anticoagulants

Heparin: Treats clots, like those caused by stroke or chronic atrial fibrillation.
Normal aPTT range for Heparin: 30-40 seconds.
Heparin Risk: Bleeding.
Heparin Complication: Heparin-induced thrombocytopenia (HIT). Stop heparin and administer platelets.
Heparin Antidote: Protamine Sulfate.
Enoxaparin: Low molecular weight heparin. Prophylaxis for DVT.
Enoxaparin Can Be Given During Pregnancy.
Warfarin: Treats clots, including DVT, PE, and atrial fibrillation. Monitor for bleeding.
Normal INR range for Warfarin: 0.9-1.2
Do Not Give Warfarin During Pregnancy.
Warfarin Antidote: Vitamin K.
Apixaban, Rivaroxaban and Fondaparinux: Treat clots. Monitor for bleeding.
Clopidogrel and Aspirin: Prevent ischemia. Discontinue 5-7 days before surgery.
tPA (Alteplase): Treats ischemic stroke only (not hemorrhagic). Treats established clots.

Beta Blockers

Beta-blockers (end in "lol" - ex: Propranolol, Carvedilol): Used to treat hypertension, angina, arrhythmias, myocardial infarction, and anxiety.
Beta-blockers Work By: Inhibiting the fight-or-flight response, decreasing heart rate.
Carvedilol: Specifically treats heart failure by decreasing heart rate and increasing ejection fraction.

Do Not Give Beta Blockers To:

Patients with Asthma

ACE Inhibitors

ACE inhibitors (end in "pril" - ex: Enalapril, Lisinopril, Captopril): Treat hypertension and congestive heart failure.
ACE Inhibitor Side Effect: Dry cough. Discontinue if dry cough develops.
Do Not Give ACE Inhibitors During Pregnancy.
Important Considerations: Monitor blood pressure, can increase potassium levels (monitor for hyperkalemia).
Lisinopril: Is the best ACE inhibitor for heart failure.

ARBs

ARBs (end in "sartan" - ex: Losartan): Treat hypertension and congestive heart failure.
ARB Considerations: Monitor blood pressure and fluid volume.
Do Not Give ARBs During Pregnancy.
Hyperkalemia Risk: Contraindicated with potassium-sparing diuretics.

Calcium Channel Blockers (CCBs)

Contraindication: (Heart failure) CCBs will lower cardiac output.

CCBs That Affect Heart & Vessels:

Diltiazem & Verapamil: Treat hypertension and arrhythmias (atrial fibrillation and atrial flutter).
Diltiazem & Verapamil Side Effect: Constipation.
Verapamil Toxicity: Bradycardia, hypotension, constipation.

CCBs That Affect Vessels (End in "dipine"):

Amlodipine & Nifedipine: Treat hypertension and angina.
Nifedipine Side Effect: Flushing, headache, tachycardia, hypotension.
Amlodipine Side Effect: Gingival hyperplasia.
Amlodipine and Nifedipine Do Not Cause Constipation.

Antiarrhythmics

Adenosine: Treats supraventricular tachycardia (SVT).
Adenosine Administration: Rapid push IV only.
Adenosine Side Effect: Asystole (brief period of no heartbeat).
Amiodarone: Treats ventricular tachycardia (V-tach) and premature ventricular contractions (PVCs) by blocking potassium channels.
Do Not Give Amiodarone During Pregnancy.
Atropine: Treats bradycardia.
Atropine Contraindication: Do not give to patients with glaucoma.
Atropine Additional Use: Treat excess secretions.
Digoxin: Treats heart failure, atrial fibrillation, atrial flutter, and cardiogenic shock.
Digoxin Important Consideration: Can cause vitamin B12 deficiency (pernicious anemia).

Gastrointestinal System

Cimetidine, Famotidine (end in "dine"): Treat gastric & duodenal ulcers, GERD, and GI distress from chronic NSAID use. Can be given with meals.
Cimetidine: Treats Heliobacter pylori (H. pylori).
Proton Pump Inhibitors (PPIs) (end in "prazole": Pantoprazole): Treat GERD and ulcers.
PPI Administration: Give 30 minutes before meals.
PPI Side Effects: Monitor for black tarry stools and hypomagnesemia.
Sucralfate: Treats peptic ulcer disease (PUD).
Sucralfate Mechanism of Action: Creates a paste when reacting with stomach acid, helping heal stomach ulcers.
Sucralfate Administration: Take on an empty stomach, one hour before meals (not immediately) or at bedtime.
Sucralfate Important Consideration: Do not give at the same time as other drugs (ex. Digoxin) because it decreases absorption.

Laxatives

Docusate sodium (Surfactant): Used to treat constipation. Give with a full glass of water.
Bisacodyl & Senna (Stimulant): Used for opioid-induced constipation.
Bisacodyl & Senna Contraindication: Not for long-term use.
Polyethylene glycol (Osmotic): Treats chronic constipation.
Polyethylene Glycol Warning: Can cause dehydration.

Anti-Diarrhea

Loperamide: Treats diarrhea. Most effective anti-diarrheal.
Loperamide Important Consideration: Give naloxone (NARCAN) for overdose.

Anti-Vomiting

Ondansetron (end in "setron"): Treats nausea and vomiting.
Ondansetron Administration: Do not give via rapid push.
Promethazine: Treats nausea and vomiting.

### Renal/Urinary System

Diuretics (cause fluid diuresis/secretion and treat blood pressure)
- Loop Diuretics (Furosemide, Bumetanide): Treat congestive heart failure fluid overload and low urine output.
- Loop Diuretics Mechanism of Action: Excrete ALL electrolytes (sodium, potassium, chloride, calcium).
- Loop Diuretics Important Consideration: Do not give with Digoxin.
- Potassium-Sparing Diuretics (Spironolactone): Treat hypertension, edema, and heart failure.
- Potassium-Sparing Diuretics Mechanism of Action: Only retain potassium. Monitor for hyperkalemia.
- Potassium-Sparing Diuretics Important Consideration: Do not give with ACE inhibitors, ARBs, or potassium supplements (risk of hyperkalemia).
- Thiazide Diuretics (Hydrochlorothiazide): Treat hypertension and edema.
- Thiazide Diuretics Mechanism of Action: Excrete sodium, potassium, and water, but retain calcium, causing Hypercalcemia.
- Hydrochlorothiazide Side Effects: Can cause gout flare-ups which are treated with Allopurinol.
- Osmotic Diuretics (Mannitol): Most effective to treat high intracranial pressure (ICP).
- Mannitol Important Considerations: Tends to crystallize at room temperature, administer through a filtered IV tubing. If the patient's kidneys are not functioning properly, Mannitol will be ineffective.
ACE Inhibitors & ARBs: Decrease sodium resorption which causes diuresis.

Reproductive System & Maternity

Tocolytics (inhibit contractions):
- Terbutaline: Treats preterm labor and bronchoconstriction.
- Terbutaline Side Effect: Can cause metabolic syndrome (hyperglycemia, hyperlipidemia, hypertension, and weight gain). Monitor weight and neutrophils.
Ziprasidone: Treats schizophrenia.
Ziprasidone Side Effects: Can cause QT prolongation. Take with food.

CNS Stimulants (ADHD)

Methylphenidate: Treats ADHD.
Methylphenidate Administration: Administer during the day.
Methylphenidate Important Consideration: Avoid caffeine. Monitor for weight loss and anorexia.

Neurological System

Pain Medications
- Local Anesthetics (end in "caine"): (Lidocaine, Cocaine): Used for localized painful procedures.
- Local Anesthetic Administration: Give with vasoconstrictors to prevent systemic absorption.
- Opioids (Morphine, Codeine, Fentanyl, and end in "one"): Treat pain.
- Opioid Side Effects: Cause constipation and CNS depression. Monitor respiratory rate.
- Opioid Antidote: Naloxone (NARCAN).
- Codeine & Hydrocodone: Prevent cough (antitussive).
- Methadone: Treats pain and opioid withdrawal.
- NSAIDs (Naproxen, Ketorolac, Aspirin, Ibuprofen): Treat pain.
- Ibuprofen: Treats rheumatoid arthritis (RA) and osteoarthritis (OA).
- Ibuprofen Side Effects: Can cause GI ulcers and bleeding. Monitor BUN/Creatinine (renal impairment).
- Aspirin: Prevents myocardial infarction (MI) and stroke (antiplatelet).
- Aspirin Side Effects: Risk of bleeding.
- Aspirin Important Consideration: Do not give to children under 16 (Reye's Syndrome).
- Non-NSAID (Acetaminophen): Treats pain and fever.
- Acetaminophen Important Considerations: Do not take with alcohol (hepatotoxic). Maximum dosage is 4 grams.
- Acetaminophen Antidote: N-Acetylcysteine.

Alzheimer's

Cholinergics (end in "stigmine"): (Rivastigmine): Treat Alzheimer's, glaucoma, GERD, and urinary retention.
Cholinergic Side Effects: Monitor for bradycardia, flu-like symptoms, and weight loss.
Donepezil & Rivastigmine: Treat Alzheimer's and dementia.
Donepezil & Rivastigmine Mechanism of Action: Prevent the breakdown of acetylcholine.
Donepezil Side Effects: Can cause bradycardia and syncope.

Anti-Parkinson's

Carbidopa/Levodopa, Selegiline, & Benztropine: Increase dopamine levels.
Anti-Parkinson's Medication Mechanism of Action: Treat Parkinson's disease.
Anti-Parkinson's Medication Important Considerations: Can take months to work. Can cause orthostatic hypotension.
Anti-Parkinson's Medication Administration: Take with low-fat, low-protein foods.

Anticonvulsants

Phenytoin & Valproic Acid: Treat seizures.
Phenytoin Therapeutic Levels: 10-20.
Anticonvulsant Important Consideration: Do not give during pregnancy (phenytoin is a teratogen).

Benzodiazepines

Benzodiazepines (end in "lam" & "pam"): (Alprazolam, Diazepam, Midazolam): Treat anxiety and seizures.
Benzodiazepine Side Effects: Cause CNS & respiratory depression.
Benzodiazepine Antidote: Flumazenil.

Musculoskeletal System

Muscle Relaxants (Baclofen, Dantrolene, Cyclobenzaprine): Treat spastic muscles.
Muscle Relaxant Considerations: Monitor for orthostatic hypotension. Do not discontinue abruptly.
Dantrolene Sodium: Treats malignant hyperthermia.

Immune System

Antibiotics
- Penicillins (end in "cillin"): (Penicillin, Ampicillin, Amoxicillin):
- Penicillin Mechanism of Action: Treat infections.
- Penicillin Important Considerations: Allergies to penicillins are common (latex or other penicillins).
- Cephalosporins (start in "cef"): (Cefazolin, Ceftriaxone): Treat infections.
- Cephalosporins Important Considerations: Monitor for signs of C. difficile. Do not give to patients with a penicillin allergy.
- Ceftriaxone: Treats meningitis, give immediately after a lumbar puncture.
- Tetracyclines (end in "cycline"): (Tetracycline, Doxycycline): Treat Lyme disease, anthrax, chlamydia, etc.
- Tetracycline Side Effects: Causes teeth staining and photosensitivity.
- Tetracycline Important Consideration: Do not take with milk.
- Aminoglycosides (end in "mycin"): (Gentamicin): Treat serious infections.
- Aminoglycosides Important Considerations: Ototoxicity and nephrotoxicity.
- Macrolides: (Azithromycin, Erythromycin): Treat respiratory infections.
- Macrolide Administration: Give with meals to reduce GI discomfort.
- Sulfonamides (start in "sulfa"): (Sulfamethoxazole): Treat mostly UTIs.
- Sulfonamides Important Considerations: Avoid sunlight and do not give to infants or during pregnancy.
- Fluoroquinolones (end in "floxacin"): (Ciprofloxacin, Levofloxacin) Treat infections.
- Fluoroquinolones Side Effects: Cause tendon rupture and phototoxicity.
- Fluoroquinolone Important Consideration: Do not give to patients under 18.
- Vancomycin: Treats C. difficile and methicillin-resistant Staphylococcus aureus (MRSA).
- Vancomycin Side Effects: Nephrotoxic.
- Vancomycin Administration: Give over 60 minutes via central line.
Anti-Tuberculosis: (Isoniazid & Rifampin) Treat tuberculosis.
- Isoniazid Side Effects: Hepatotoxic.
- Rifampin Side Effects: Causes body fluids to turn reddish-orange.
Anti-Virals (end in "vir"): (Acyclovir, Oseltamivir) Treat viral infections such as HSV, varicella, CMV, influenza, hepatitis B, and hepatitis C.
- Acyclovir: Treats herpes and varicella.
- Oseltamivir: Treats influenza.
Antifungals (end in "azole"):
- Azoles Mechanism of Action: Treat fungal infections and can be given orally (PO).
- Amphotericin: Anti-fungal.
- Amphotericin Side Effect: Nephrotoxic.
- Amphotericin Administration: Give with 1 L of normal saline (NS).

Miscellaneous

Acamprosate: Treat alcohol addiction.
Allopurinol: Treats gout (lowers uric acid levels).
Venlafaxine: Antidepressant.
Venlafaxine Side Effects: Can cause suicidal thoughts, dry mouth, and insomnia.
Isotretinoin: Treats acne.
Isotretinoin Important Considerations: Teratogenic. Obtain a negative pregnancy test.
Dextromethorphan: Non-opioid antitussive.
Dextromethorphan Mechanism of Action: Used to prevent coughs.
Saline & Acetylcysteine (Mucolytic): Treat excess mucus.
Saline & Acetylcysteine Important Considerations: Do not give with antitussives.
Tamsulosin: Treats benign prostatic hyperplasia (BPH).
Tamsulosin Side Effects: Can cause vasodilation (orthostatic hypotension).
Etanercept: Treats psoriasis and rheumatoid arthritis.
Methotrexate: Treats rheumatoid arthritis (maintenance drug for RA), cancer, psoriasis, and Crohn's disease.
Methotrexate Side Effects: Can cause pancytopenia (low blood levels such as RBC, WBC, and platelets).
Methotrexate Important Considerations: Avoid crowds and wash hands.
Cyclosporine: Treats rheumatoid arthritis.
Cyclosporine Important Consideration: Can increase the risk of infection.
Sitagliptin: Diabetes type II medication.
Sitagliptin Important Consideration: Can cause pancreatitis (monitor abdominal pain).
Dulaglutide: Diabetes type II medication.
Dulaglutide Administration: Given once per week. Has no peak (does not need to be taken with food).
Buspirone: Anxiety medication.
Buspirone Important Consideration: Takes weeks to be effective.
Sumatriptan: Treats migraines.
Sumatriptan Contraindications: Do not give to patients with a history of hypertension, MI, or stroke.
Modafinil: Treat narcolepsy and ADHD.
Betamethasone: Helps with fetal lung development.
Disulfiram: Treat alcohol addiction.
Disulfiram Important Considerations: Causes severe reaction with alcohol-based products.
Progestin: Used for hormone replacement and contraception.
Progestin Important Considerations: Monitor for clots.
Colchicine: Treats gout and pericarditis.
Colchicine Important Considerations: Can impair the liver and kidneys.
Depot-medroxyprogesterone: Long-acting contraceptive.
Depot-medroxyprogesterone side effect: Can cause osteoporosis.

Antidotes

Acetaminophen Antidote: Acetylcysteine
Benzodiazepine Antidote: Flumazenil
Digoxin Antidote: Digoxin immune FAB
Heparin Antidote: Protamine Sulfate (aPTT)
Warfarin Antidote: Vitamin K (INR)
Magnesium Sulfate Antidote: Calcium Gluconate
Opioid Antidote: Naloxone (Narcan)
Aspirin Antidote: Sodium Bicarbonate

Interactions

ACE Inhibitors & Potassium-Sparing Diuretics: AVOID = Risk of hyperkalemia
- ACE inhibitors cause the kidneys to secrete water and sodium but not potassium.
Nitroglycerin & Erectile Dysfunction Medications (Sildenafil): AVOID = Risk of hypotension.
Metformin & Contrast Dye: AVOID = Risk of nephrotoxicity (increase fluid intake to prevent this).
MAOIs (Antidepressants) & Other antidepressants & Tyramine-based foods: AVOID = Risk of serotonin syndrome.
Calcium Channel Blockers, Statins, & Anticoagulants & Grapefruit: AVOID
Warfarin & Foods High in Vitamin K (leafy greens): AVOID = Risk of increased clotting.
Warfarin & Saw palmetto: AVOID = Risk of bleeding.

Do Not Give

Beta-blockers: To patients with asthma.
Warfarin: To patients with chronic liver disease.
Calcium Channel Blockers & NSAIDs: To patients with congestive heart failure (low cardiac output).
NSAIDs: To patients taking prednisone (risk of GI bleeding).
NSAIDs: To patients with kidney failure (nephrotoxicity).
ACE inhibitors & ARBs: During pregnancy.

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Test your knowledge on various medications, their uses, and important antidotes with this pharmacology quiz. Questions cover key topics like anticoagulants, side effects of drugs, and safe practices for medication use. Perfect for students and professionals in the medical and health fields.