Pharm Wrksht B

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Questions and Answers

A patient receiving filgrastim (Neupogen) prior to an invasive procedure is expected to experience which therapeutic effect?

  • Reduced inflammation at the incision site.
  • Increased red blood cell production.
  • Increased neutrophil count. (correct)
  • Decreased risk of bleeding.

Which of the following is a primary adverse effect associated with cholinergic drugs like donepezil and bethanechol, especially concerning patients with respiratory conditions?

  • Profound constipation.
  • Urinary retention.
  • Severe hypertension.
  • Bronchial constriction or spasms. (correct)

Protamine sulfate is administered following an overdose of heparin due to its ability to perform what action?

  • Increase the effects of heparin.
  • Increase the client's risk for clot formation.
  • Inhibit vitamin K synthesis.
  • Bind to and neutralize heparin. (correct)

When administering cyclobenzaprine (Flexeril), for muscle spasms, what therapeutic outcome indicates the medication's effectiveness?

<p>Reduced muscle spasticity and associated discomfort. (B)</p> Signup and view all the answers

What potential adverse effect should be closely monitored in a child taking methylphenidate (Ritalin) for ADHD?

<p>Sudden cardiac death. (B)</p> Signup and view all the answers

A patient prescribed sumatriptan (Imitrex) for migraines should be educated to report which adverse effect immediately?

<p>Severe chest pain or tightness. (D)</p> Signup and view all the answers

What is the expected primary therapeutic effect of orlistat (Xenical) for a patient with obesity?

<p>Decreased absorption of dietary fats, leading to weight loss. (D)</p> Signup and view all the answers

A patient taking carbamazepine (Tegretol) for seizures should be monitored for which severe adverse effect that requires immediate intervention?

<p>Signs of Stevens-Johnson syndrome. (D)</p> Signup and view all the answers

Temazepam (Restoril) is prescribed for insomnia. What is the main mechanism of action through which this medication promotes sleep?

<p>Enhancing the effects of GABA, leading to sedation. (D)</p> Signup and view all the answers

Valsartan (Diovan) is prescribed to manage hypertension. What is the primary mechanism of action by which valsartan achieves this therapeutic effect?

<p>Blocking angiotensin II receptors, leading to vasodilation. (B)</p> Signup and view all the answers

A patient taking lithium (Lithobid) for bipolar disorder should be monitored closely for signs of lithium toxicity. Which of the following early signs and symptoms would be most indicative of this condition?

<p>Coarse hand tremors, persistent nausea, and vomiting. (B)</p> Signup and view all the answers

Methotrexate (Trexall) is used in the treatment of rheumatoid arthritis. What is the primary mechanism through which methotrexate helps to manage this condition?

<p>Suppressing the inflammatory and immune response. (C)</p> Signup and view all the answers

Lorazepam (Ativan) is given for anxiety. What is its primary mechanism in the brain?

<p>Enhancing GABA effects. (A)</p> Signup and view all the answers

A patient taking hydrochlorothiazide (Hydrodiuril) should be monitored for which electrolyte imbalance?

<p>Hypokalemia (low potassium). (B)</p> Signup and view all the answers

A patient is prescribed phenytoin (Dilantin) for a seizure disorder. Regular monitoring of serum drug levels is essential. What is the primary reason for this monitoring?

<p>To ensure the drug remains within the therapeutic range and avoid toxicity. (B)</p> Signup and view all the answers

Enalapril (Vasotec) is prescribed for a patient with hypertension. What is the primary mechanism of action by which enalapril lowers blood pressure?

<p>Inhibiting the conversion of angiotensin I to angiotensin II. (B)</p> Signup and view all the answers

Metoprolol (Lopressor) is prescribed to manage hypertension and prevent myocardial infarction (MI). What is its primary mechanism of action?

<p>Blocking beta-adrenergic receptors, reducing heart rate and blood pressure. (D)</p> Signup and view all the answers

Digoxin (Lanoxin) is prescribed for a patient with heart failure and atrial fibrillation. What finding would be an early sign of digoxin toxicity?

<p>Blurred vision or yellow-green halos around objects. (C)</p> Signup and view all the answers

Amiodarone (Cordarone) is used to treat different arrythmias. What potentially severe adverse effect requires ongoing monitoring?

<p>Pulmonary toxicity. (B)</p> Signup and view all the answers

Diltiazem (Cardizem) is prescribed for a patient with hypertension and recurrent supraventricular tachycardia (SVT). What is the primary mechanism?

<p>Blocking calcium channels in the heart and blood vessels. (A)</p> Signup and view all the answers

Flashcards

Filgrastim (Neupogen)

Increase of white blood cell count

Cholinergic drugs (donepezil, bethanechol)

Stimulate PNS by increasing Acetylcholine.

Heparin

Prevents venous thromboembolism.

Cyclobenzaprine (Flexeril)

Decreased spasticity and rigidity.

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Methylphenidate (Ritalin)

Improvement of ADHD symptoms.

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Sumatriptan (Imitrex)

Decreases incidence of migraine headaches or cluster headaches.

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Orlistat (Xenical)

Appetite suppression and weight loss.

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Carbamazepine (Tegretol)

Decrease seizure occurance and decrease pain due to DM neropathy

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Temazepam (Restoril)

Increased ability to sleep and more restful sleep.

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Valsartan (Diovan)

Lower BP, decreased workload of the heart.

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Lithium

Improvement/maintenance of manic episodes and stabilized mood.

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Methotrexate (Trexall)

Decreases symptoms of rheumatoid arthritis.

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Lorazepam (Ativan)

Decreases anxiety and alcohol withdrawal symptoms.

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Hydrochlorothiazide (Hydrodiuril)

Increase urine output, decrease BP.

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Phenytoin (Dilantin)

Decrease incidence of seizures and neuropathic pain.

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Enalapril (Vasotec)

Decreases BP

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Metoprolol (Lopressor)

Decreases HR and BP and increases cardiac output.

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Digoxin (Lanoxin)

Slow HR, increase cardiac output.

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Amiodarone (Cordarone)

Return to normal rhythm.

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Diltiazem (Cardizem)

Decrease BP, decrease angina, normal HR/ rhythm.

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Study Notes

  • Medication Name, Classification, Indications, Therapeutic Effects, and Adverse Effects for a range of pharmacology drugs.

Filgrastim (Neupogen)

  • Classification: Colony-Stimulating Factor
  • Indication: Administered before patient develops an infection.
  • Therapeutic Effects: Increases white blood cell count (neutrophils).
  • Adverse Effects: Bone pain, edema, nausea, vomiting, diarrhea, anorexia, alopecia, rash, cough, dyspnea, sore throat, fever, blood dyscrasias, and headache.

Cholinergic Drugs (donepezil, bethanechol)

  • Classification: Stimulate the Parasympathetic Nervous System (PNS) by increasing acetylcholine levels.
  • Indications: Includes Alzheimer's and urinary retention.
    • Donepezil increases acetylcholine in Alzheimer's patients.
    • Bethanechol addresses urinary retention.
  • Therapeutic Effects: Increases gastric secretions and GI motility, decreases heart rate, increases bronchial secretions, constricts the bronchioles/spasms, and lowers intraocular pressure.
  • Adverse Effects: Bradycardia, hypotension, syncope, headaches, dizziness, convulsions, ataxia, and abnormal heart rhythms, and increased urinary frequency.

Heparin (Antidote: Protamine Sulfate)

  • Classification: Anticoagulant
  • Indication: For DVT prophylaxis.
  • Therapeutic Effects: Prevents venous thromboembolism.
  • Adverse Effects: Bleeding, bruising, thrombocytopenia, and hyperkalemia.

Cyclobenzaprine (Flexeril)

  • Classification: Skeletal Muscle Relaxant
  • Indications: Muscle spasms related to musculoskeletal conditions or cerebral palsy.
  • Therapeutic Effects: Decreases spasticity and/or decreased rigidity.
  • Adverse Effects: Marked sedation, euphoria, lightheadedness, dizziness, drowsiness, fatigue, and muscle weakness.

Methylphenidate (Ritalin)

  • Classification: CNS Stimulant
  • Indications: ADHD and narcolepsy.
  • Therapeutic Effects: Improves ADHD symptoms.
  • Adverse Effects: Hypertension, palpitations, anorexia, hyperactivity, insomnia, and sudden death.

Sumatriptan (Imitrex)

  • Classification: Serotonin Receptor Agonist / Anti-Migraine (Triptan)
  • Indications: Migraines and cluster headaches.
  • Therapeutic Effects: Decreases incidence of migraine headaches or cluster headaches.
  • Adverse Effects: Drowsiness, weakness, numbness or tingling, and nausea.

Orlistat (Xenical)

  • Classification: Lipase Inhibitor / Anorexiant
  • Indication: Obesity
  • Therapeutic Effects: Appetite suppression and weight loss.
  • Adverse Effects: Increased heart rate, hypertension, palpitations, insomnia, anxiety, headaches, restlessness, dizziness, nausea, vomiting, constipation and tremors.

Carbamazepine (Tegretol)

  • Classification: Anticonvulsant/Antimanic/CNS Agent
  • Indications: Seizures, DM neuropathy pain associated with trigeminal neuralgia.
  • Therapeutic Effects: Decreases seizure occurrence and pain due to neuropathy/neuralgia.
  • Adverse Effects: Suicidal thoughts, Stevens-Johnson syndrome, agranulocytosis, aplastic anemia, and thrombocytopenia.

Temazepam (Restoril)

  • Classification: Benzodiazepine (intermediate acting)
  • Indication: Insomnia
  • Therapeutic Effects: Increased ability to sleep and more restful sleep.
  • Adverse Effects: Bradycardia, hypotension, respiratory depression, sedation and "hangover effect" (daytime sleepiness).

Valsartan (Diovan)

  • Classification: Angiotensin II Receptor Blocker
  • Indications: Hypertension and CHF (alternative for patients that do not tolerate ACE inhibitors).
  • Therapeutic Effects: Lowers blood pressure and decreases workload of the heart.
  • Adverse Effects: Nausea, vomiting, diarrhea, dizziness, headache, hyperkalemia, and hypotension.

Lithium (Lithobid)

  • Classifications: Lithium Salt and Mood Stabilizer
  • Indications: Bipolar I disorder – mania
  • Therapeutic Effects: Improvement/maintenance of manic episodes, stabilized moods
  • Adverse Effects: Lithium toxicity i.e. seizures, arrhythmias, fatigue, confusion, nausea, anorexia, tremors hypothyroidism

Methotrexate (Trexall)

  • Classifications: Antineoplastic agent & Antirheumatic
  • Indications: Rheumatoid Arthritis
  • Therapeutic Effects: Symptoms of RA.
  • Adverse Effects: Bone marrow suppression, i.e. infection (sore throat, nausea, vomiting, fever), decreases WBC, RBC, and platelets, and hair loss.

Lorazepam (Ativan)

  • Classifications: Benzodiazepine
  • Indications: Anxiety, alcohol withdrawal, sedation
  • Therapeutic Effects: Decreases anxiety, decreased withdrawal symptoms
  • Adverse Effects: Confusion, drowsiness, sedation, weakness, respiratory depression, ataxia, dizziness

Hydrochlorothiazide (Hydrodiuril)

  • Classifications: Thiazide Diuretic
  • Indications: Hypertension, CHF, renal dysfunction, cirrhosis
  • Therapeutic Effects: Increases urine output, decreases BP
  • Adverse Effects: Hypokalemia, hyponatremia, hypophosphatemia, hypomagnesemia, increased digoxin toxicity if the patient is taking Digoxin.

Phenytoin (Dilantin)

  • Classifications: Anticonvulsant
  • Indications: Tonic-clonic seizures and arrhythmias, neuropathic pain
  • Therapeutic Effects: Decreases incidence of seizures, normal rhythm, decreased pain
  • Adverse Effects: Suicidal ideations, ataxia, extrapyramidal symptoms, hypotension, decreased heart rate, nausea, arrhythmias, gingival hyperplasia, rash, and DIH (Drug-Induced Hepatitis)

Enalapril (Vasotec)

  • Classifications: ACE inhibitor
  • Indications: HTN, management of CHF
  • Therapeutic Effects: Decreases BP.
  • Adverse Effects: Dry mouth, dry cough, fatigue, dizziness, headaches, and neutropenia.

Metoprolol (Lopressor)

  • Classifications: Beta-blocker
  • Indications: HTN, angina, tachyarrhythmias, prevention of MI, HF
  • Therapeutic Effects: Decreased HR, increased cardiac output, decreased BP
  • Adverse Effects: Bradycardia, headache, hypotension, fatigue, bronchoconstriction, hypoglycemia, and pulmonary edema

Digoxin (Lanoxin)

  • Classifications: Cardiac glycoside / inotropic
  • Indications: CHF, Afib, Aflutter
  • Therapeutic Effects: Slows the Heart Rate, increases cardiac output
  • Adverse Effects: Bradycardia, electrolyte abnormalities, blurred vision, yellow/green vision disturbances

Amiodarone (Cordarone)

  • Classifications: Anti-arrhythmic / Potassium Channel blocker
  • Indications: Atrial fibrillation, SVT, V-fib, V-tach
  • Therapeutic Effects: Return to normal rhythm
  • Adverse Effects: ARDS, pulmonary toxicity, CHF, bradycardia, hypotension, increased risk for QT prolongation.

Diltiazem (Cardizem)

  • Classifications: Calcium Channel blocker
  • Indications: HTN, angina, SVT, Afib, A flutter
  • Therapeutic Effects: Decreases BP, Decreases Angina, Normal Heart Rate/Rhythm
  • Adverse Effects: Arrhythmias, CHF, bradycardia, peripheral edema, gingival hyperplasia may increase digoxin levels.

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