Pharmacology Final Exam Study Guide PDF

Neurological/Psychiatric Medications - **Amitriptyline** - *Desired effect*: Relief of depression, chronic pain, and insomnia. - *Adverse reactions*: Sedation, dry mouth, weight gain, orthostatic hypotension, arrhythmias, suicidal ideation. - *Interactions*: M...

Neurological/Psychiatric Medications - **Amitriptyline** - *Desired effect*: Relief of depression, chronic pain, and insomnia. - *Adverse reactions*: Sedation, dry mouth, weight gain, orthostatic hypotension, arrhythmias, suicidal ideation. - *Interactions*: MAOIs (hypertensive crisis), CNS depressants (enhanced sedation), anticholinergics (increased side effects). - **Phenytoin** - *Desired effect*: Prevention and control of seizures. - *Adverse reactions*: Gingival hyperplasia, ataxia, nystagmus, rash, hepatotoxicity, Stevens-Johnson syndrome. - *Interactions*: Decreased efficacy of oral contraceptives and warfarin; additive CNS depression with sedatives. - **Amantadine** - *Desired effect*: Relief of Parkinson's symptoms (rigidity, tremor); antiviral effects in influenza. - *Adverse reactions*: Dizziness, orthostatic hypotension, insomnia, livedo reticularis (mottled skin). - *Interactions*: Increased CNS side effects with anticholinergics; reduced efficacy with antipsychotics. - **Lithium** - *Desired effect*: Stabilization of mood in bipolar disorder. - *Adverse reactions*: Tremor, hypothyroidism, polyuria, nephrotoxicity, toxicity signs (nausea, confusion, seizures). - *Interactions*: NSAIDs and diuretics (increased lithium levels); ACE inhibitors (toxicity risk). - **Allopurinol** - *Desired effect*: Reduction of uric acid levels in gout and prevention of uric acid nephropathy. - *Adverse reactions*: Rash, nausea, hepatotoxicity, Stevens-Johnson syndrome, bone marrow suppression. - *Interactions*: Increased toxicity of azathioprine and warfarin; decreased efficacy with aluminum hydroxide. Pain Management Medications - **Morphine** - *Desired effect*: Relief of severe pain. - *Adverse reactions*: Respiratory depression, constipation, sedation, addiction risk, hypotension. - *Interactions*: Additive sedation with benzodiazepines, alcohol, and CNS depressants. - **Acetaminophen** - *Desired effect*: Reduction of pain and fever. - *Adverse reactions*: Hepatotoxicity (in overdose), rash, renal toxicity (chronic use). - *Interactions*: Increased hepatotoxicity with alcohol; affects warfarin metabolism. - **Ketorolac** - *Desired effect*: Relief of moderate to severe pain. - *Adverse reactions*: GI bleeding, nephrotoxicity, prolonged bleeding time. - *Interactions*: Additive GI risk with aspirin and corticosteroids; reduced efficacy with diuretics. GI and Musculoskeletal Medications - **Sulfasalazine** - *Desired effect*: Reduction of inflammation in rheumatoid arthritis or ulcerative colitis. - *Adverse reactions*: Rash, GI upset, bone marrow suppression, hepatotoxicity. - *Interactions*: Reduced absorption with iron supplements; increased methotrexate toxicity. - **Levodopa** - *Desired effect*: Improvement in Parkinson's motor symptoms. - *Adverse reactions*: Dyskinesia, orthostatic hypotension, nausea, hallucinations. - *Interactions*: Reduced efficacy with antipsychotics; increased toxicity with MAOIs. - **Prochlorperazine** - *Desired effect*: Relief of nausea and vomiting. - *Adverse reactions*: Extrapyramidal symptoms, sedation, dry mouth, hypotension. - *Interactions*: Additive CNS depression with alcohol, sedatives; increased QT prolongation risk with antiarrhythmics. - **Docusate** - *Desired effect*: Relief of constipation. - *Adverse reactions*: Abdominal cramping, diarrhea. - *Interactions*: Increased absorption of mineral oil (risk of toxicity). - **Omeprazole / Pantoprazole / Famotidine** - *Desired effect*: Reduction of gastric acid secretion to treat GERD, ulcers. - *Adverse reactions*: Headache, diarrhea, risk of osteoporosis (long-term use), C. difficile infection. - *Interactions*: Reduced absorption of antifungals and iron; increased diazepam and warfarin levels. Respiratory Medications - **Albuterol** - *Desired effect*: Bronchodilation in asthma/COPD. - *Adverse reactions*: Tachycardia, tremors, nervousness, palpitations. - *Interactions*: Increased cardiovascular effects with beta-blockers; additive stimulation with MAOIs. - **Beclomethasone** - *Desired effect*: Reduction of airway inflammation in asthma. - *Adverse reactions*: Thrush, hoarseness, growth suppression (in children). - *Interactions*: Additive effects with other corticosteroids. - **Guaifenesin** - *Desired effect*: Thinning of mucus for productive coughs. - *Adverse reactions*: Nausea, dizziness, rash. - *Interactions*: No significant interactions reported. - **Theophylline** - *Desired effect*: Bronchodilation in chronic asthma/COPD. - *Adverse reactions*: Tachycardia, seizures, GI upset. - *Interactions*: Increased toxicity with ciprofloxacin; reduced levels with phenobarbital. - **Cetirizine** - *Desired effect*: Relief of allergy symptoms. - *Adverse reactions*: Drowsiness, dry mouth. - *Interactions*: Additive sedation with alcohol and other antihistamines. Antimicrobial Medications - **Amphotericin B** - *Desired effect*: Treatment of severe fungal infections. - *Adverse reactions*: Nephrotoxicity, infusion reactions (fever, chills), hypokalemia. - *Interactions*: Increased nephrotoxicity with aminoglycosides and cyclosporine. - **Penicillin / Ceftriaxone** - *Desired effect*: Eradication of bacterial infections. - *Adverse reactions*: Allergic reactions, diarrhea, superinfection (e.g., C. difficile). - *Interactions*: Reduced efficacy with tetracyclines; increased bleeding risk with anticoagulants. - **Nystatin** - *Desired effect*: Treatment of candidiasis. - *Adverse reactions*: GI upset, skin irritation. - *Interactions*: No significant interactions reported. - **Prednisone** - *Desired effect*: Suppression of inflammation and immune response. - *Adverse reactions*: Hyperglycemia, weight gain, hypertension, osteoporosis. - *Interactions*: Increased risk of GI bleeding with NSAIDs; reduced efficacy with antidiabetic drugs. - **Vancomycin** - *Desired effect*: Treatment of severe bacterial infections (e.g., MRSA). - *Adverse reactions*: Nephrotoxicity, ototoxicity, "red man syndrome." - *Interactions*: Increased toxicity with aminoglycosides. - **Tetracycline** - *Desired effect*: Treatment of bacterial infections. - *Adverse reactions*: Photosensitivity, GI upset, discoloration of teeth (in children). - *Interactions*: Reduced efficacy with antacids, iron supplements; increased warfarin effect. Ophthalmic Preparations - **General Ophthalmic Preparations** - *Desired effect*: Treatment of eye infections, inflammation, or glaucoma; lubrication for dry eyes. - *Adverse reactions*: Eye irritation, blurred vision, allergic reactions. - *Interactions*: Enhanced effect with systemic corticosteroids; possible systemic absorption causing interactions depending on active components. - **Timolol** - *Desired effect*: Reduction of intraocular pressure in glaucoma. - *Adverse reactions*: Burning/stinging in the eye, bradycardia, hypotension (if absorbed systemically). - *Interactions*: Additive bradycardia with calcium channel blockers or digoxin; antagonism with beta-adrenergic agonists (e.g., albuterol). Lice Treatments (Pediculicides) - *Desired effect*: Kills lice and their eggs by acting on the nervous system of the parasites. - *Adverse reactions*: - Local skin irritation (itching, redness, burning). - Scalp irritation or temporary hair dryness. - *Interactions*: - No significant drug-drug interactions are typically noted with topical use. However, concurrent use of other topical agents (e.g., corticosteroids) may exacerbate irritation or reduce effectiveness. - *Desired effect*: Similar to permethrin; disrupts nerve function in lice, leading to paralysis and death. - *Adverse reactions*: - Skin irritation, redness, or swelling. - Allergic reaction if allergic to chrysanthemums or ragweed. - *Interactions*: - Enhanced irritation when combined with other topical treatments. Dermatological Medications - **Benzoyl Peroxide** - *Desired effect*: Reduction of acne lesions through antimicrobial and keratolytic effects. - *Adverse reactions*: Skin irritation, dryness, redness, peeling. - *Interactions*: Increased irritation with other topical retinoids or acne treatments. - **Topical Glucocorticoids** - *Desired effect*: Reduction of inflammation and itching in dermatological conditions. - *Adverse reactions*: Skin thinning, striae, local irritation, systemic absorption (rare, but possible with prolonged use). - *Interactions*: Enhanced systemic effects with other corticosteroids; reduced wound healing with concurrent NSAIDs. - **Isotretinoin** - *Desired effect*: Reduction of severe acne by decreasing sebaceous gland activity. - *Adverse reactions*: Dry skin, mucous membranes, teratogenic effects, depression, hepatotoxicity. - *Interactions*: Increased risk of toxicity with tetracyclines (pseudotumor cerebri); additive dryness with other acne treatments. Diabetes Medications - **Isophane Insulin (NPH)** - *Desired effect*: Intermediate-acting blood sugar control in diabetes. - *Adverse reactions*: Hypoglycemia, injection site reactions, lipodystrophy. - *Interactions*: Hypoglycemia risk with beta-blockers, sulfonylureas; hyperglycemia with corticosteroids, diuretics. - **Glargine** - *Desired effect*: Long-acting blood sugar control in diabetes. - *Adverse reactions*: Hypoglycemia, injection site reactions. - *Interactions*: Same as NPH insulin. - **Metformin** - *Desired effect*: Reduction of hepatic glucose production and insulin resistance in Type 2 diabetes. - *Adverse reactions*: GI upset, lactic acidosis (rare but serious), vitamin B12 deficiency. - *Interactions*: Increased risk of lactic acidosis with alcohol; reduced efficacy with corticosteroids. - **Synthroid (Levothyroxine)** - *Desired effect*: Replacement of thyroid hormone in hypothyroidism. - *Adverse reactions*: Hyperthyroid symptoms (tachycardia, tremor, sweating) if overdosed. - *Interactions*: Reduced absorption with calcium, iron, and antacids; increased anticoagulant effect of warfarin. - **Humulin R** - *Desired effect*: Short-acting blood sugar control in diabetes. - *Adverse reactions*: Hypoglycemia, weight gain, lipodystrophy. - *Interactions*: Same as NPH insulin. Cardiovascular Medications - **Amiodarone** - *Desired effect*: Treatment of arrhythmias by prolonging the cardiac action potential. - *Adverse reactions*: Pulmonary toxicity, thyroid dysfunction, hepatotoxicity, photosensitivity. - *Interactions*: Increased risk of bradycardia with beta-blockers or calcium channel blockers; increased warfarin and digoxin levels. - **Spironolactone** - *Desired effect*: Diuresis and potassium sparing in heart failure or hypertension. - *Adverse reactions*: Hyperkalemia, gynecomastia, menstrual irregularities. - *Interactions*: Increased hyperkalemia risk with ACE inhibitors, ARBs, or potassium supplements. - **Furosemide** - *Desired effect*: Diuresis and reduction of fluid overload in heart failure or hypertension. - *Adverse reactions*: Hypokalemia, dehydration, ototoxicity, hypotension. - *Interactions*: Increased toxicity of aminoglycosides; reduced diuretic efficacy with NSAIDs. - **Digoxin** - *Desired effect*: Increased cardiac contractility and rate control in atrial fibrillation/heart failure. - *Adverse reactions*: Toxicity (nausea, vomiting, bradycardia, visual disturbances), arrhythmias. - *Interactions*: Increased toxicity risk with amiodarone, diuretics (hypokalemia), and verapamil. - **Lisinopril** - *Desired effect*: Reduction of blood pressure and heart failure symptoms through ACE inhibition. - *Adverse reactions*: Hyperkalemia, dry cough, angioedema. - *Interactions*: Increased hyperkalemia risk with potassium supplements or spironolactone; reduced antihypertensive effect with NSAIDs. - **Metoprolol** - *Desired effect*: Reduced heart rate and blood pressure in hypertension, heart failure, and angina. - *Adverse reactions*: Bradycardia, fatigue, depression, hypotension. - *Interactions*: Additive bradycardia with digoxin or diltiazem; masked hypoglycemia symptoms with insulin. - **Nitroglycerin** - *Desired effect*: Relief of chest pain by dilating coronary arteries. - *Adverse reactions*: Headache, hypotension, reflex tachycardia. - *Interactions*: Severe hypotension with PDE5 inhibitors (e.g., sildenafil). - **Warfarin** - *Desired effect*: Prevention of thromboembolism by inhibiting vitamin K-dependent clotting factors. - *Adverse reactions*: Bleeding, bruising, purple toe syndrome. - *Interactions*: Increased bleeding risk with NSAIDs, antibiotics (e.g., metronidazole), and amiodarone; reduced efficacy with vitamin K-rich foods. - **Aspirin** - *Desired effect*: Reduction of platelet aggregation to prevent clots; pain relief. - *Adverse reactions*: GI bleeding, tinnitus (high doses), Reye's syndrome (in children). - *Interactions*: Increased bleeding risk with anticoagulants, corticosteroids, or alcohol. Pharmacology Final Exam **Section 1: Multiple Choice Questions (1--30)** 1. Which of the following is a common adverse reaction of **Amitriptyline**?\ a. Hyperglycemia\ b. Dry mouth\ c. Tachycardia\ d. Hypotension 2. What is the desired therapeutic effect of **Phenytoin**?\ a. Increase dopamine production\ b. Prevent seizures\ c. Treat anxiety\ d. Relieve acute pain 3. **Amantadine** is primarily used to:\ a. Relieve chronic pain.\ b. Manage Parkinson's disease symptoms.\ c. Treat bacterial infections.\ d. Lower blood pressure. 4. A key drug interaction with **Lithium** is:\ a. NSAIDs increase lithium levels.\ b. ACE inhibitors reduce lithium efficacy.\ c. Beta-blockers increase lithium toxicity.\ d. Antacids decrease lithium absorption. 5. Which condition is treated with **Allopurinol**?\ a. Rheumatoid arthritis\ b. Gout\ c. Asthma\ d. Seizures 6. What is the most serious adverse effect of **Morphine**?\ a. Nausea\ b. Respiratory depression\ c. Constipation\ d. Bradycardia 7. **Ketorolac** is contraindicated in patients with:\ a. Hypertension\ b. Renal impairment\ c. Diabetes mellitus\ d. COPD 8. Which of the following is a **glucocorticoid**?\ a. Fludrocortisone\ b. Prednisone\ c. Famotidine\ d. Isophane insulin 9. What is the mechanism of action of **Sulfasalazine**?\ a. Inhibits bacterial growth.\ b. Reduces inflammation in the colon.\ c. Increases dopamine levels.\ d. Acts as an opioid receptor antagonist. 10. Which drug is used for managing **diabetic ketoacidosis**?\ a. Metformin\ b. Glargine\ c. Regular insulin (Humulin R)\ d. Levothyroxine 11. **Levodopa** is combined with carbidopa to:\ a. Reduce peripheral metabolism of levodopa.\ b. Increase serotonin levels.\ c. Prevent seizures.\ d. Improve muscle relaxation. 12. What is the primary adverse effect of **Omeprazole**?\ a. Hypokalemia\ b. GI bleeding\ c. Headache\ d. Hypercalcemia 13. **Albuterol** is used for:\ a. Long-term asthma control.\ b. Emergency bronchospasm relief.\ c. Reducing airway inflammation.\ d. Treating pulmonary hypertension. 14. A patient on **Theophylline** is at risk for toxicity when taking:\ a. Beta blockers\ b. Macrolide antibiotics\ c. NSAIDs\ d. ACE inhibitors 15. What condition is treated with **Timolol**?\ a. Psoriasis\ b. Glaucoma\ c. Bacterial conjunctivitis\ d. Hypertension 16. Which medication is teratogenic and requires pregnancy testing before use?\ a. Isotretinoin\ b. Tetracycline\ c. Penicillin\ d. Spironolactone 17. The action of **Furosemide** involves:\ a. Potassium retention.\ b. Sodium and water excretion.\ c. Blocking calcium absorption.\ d. Inhibiting aldosterone. 18. **Nitroglycerin** is contraindicated with:\ a. Beta blockers\ b. Sildenafil\ c. Digoxin\ d. ACE inhibitors 19. **Warfarin** therapy is monitored by:\ a. aPTT\ b. INR\ c. Platelet count\ d. Hematocrit 20. What is the major risk of combining **Metformin** with alcohol?\ a. Hypoglycemia\ b. Lactic acidosis\ c. Hyperkalemia\ d. Hepatotoxicity (Questions 21--30 continue with similar MCQs based on other drugs in the list.) **Section 2: True/False Questions (31--40)** 31. **Benzoyl peroxide** causes systemic side effects when absorbed through the skin.\ True / False 32. **Glargine** is a long-acting insulin that can be mixed with regular insulin in the same syringe.\ True / False 33. **Digoxin** toxicity is increased in the presence of hypokalemia.\ True / False 34. **Vancomycin** can cause ototoxicity and nephrotoxicity.\ True / False 35. **Famotidine** is used to treat peptic ulcer disease.\ True / False 36. **Aspirin** should not be given to children with viral infections due to the risk of Reye's syndrome.\ True / False 37. **Cetirizine** is a first-generation antihistamine.\ True / False 38. **Isophane insulin (NPH)** has a peak effect of 12--14 hours.\ True / False 39. **Prednisone** can cause adrenal suppression with long-term use.\ True / False 40. **Amiodarone** can cause thyroid dysfunction as a side effect.\ True / False **Section 3: Matching (41--50)** Match the drug to its primary therapeutic use: 41. **Lisinopril** 42. **Prochlorperazine** 43. **Isotretinoin** 44. **Tetracycline** 45. **Guaifenesin** 46. **Ceftriaxone** 47. **Sulfasalazine** 48. **Beclomethasone** 49. **Pantoprazole** 50. **Allopurinol** a\. Antibiotic therapy\ b. Asthma control\ c. GERD treatment\ d. Uric acid reduction\ e. Hypertension treatment\ f. Ulcerative colitis treatment\ g. Acne treatment\ h. Cough relief\ i. Anti-nausea medication **Section 4: Multiple Choice Questions (51--60)** 51. A patient with severe acne is prescribed **isotretinoin**. What education should the nurse provide about pregnancy risks?\ a. Use sunscreen to prevent photosensitivity.\ b. Avoid all other acne treatments while on this medication.\ c. Use two forms of birth control and have regular pregnancy tests.\ d. Stop the medication if side effects occur, as it is safe to restart. 52. A patient with asthma is prescribed **Albuterol** and **Beclomethasone**. Which should be administered first and why?\ a. Albuterol, to reduce inflammation.\ b. Beclomethasone, to improve airflow.\ c. Albuterol, to open airways for better absorption of Beclomethasone.\ d. Beclomethasone, to prevent bronchospasm. 53. A patient taking **Digoxin** has a potassium level of 3.0 mEq/L. What is the nurse's priority intervention?\ a. Administer potassium supplements as ordered.\ b. Hold the Digoxin and notify the healthcare provider.\ c. Monitor for signs of digoxin toxicity and continue treatment.\ d. Administer a higher dose of Digoxin. 54. A diabetic patient is prescribed **NPH insulin**. When should the patient monitor for hypoglycemia based on the insulin's peak action?\ a. 30--60 minutes after administration.\ b. 2--4 hours after administration.\ c. 4--12 hours after administration.\ d. 18--24 hours after administration. 55. A patient on **Warfarin** has an INR of 5.0. What action should the nurse take?\ a. Administer Vitamin K as ordered.\ b. Administer the next dose of warfarin and recheck INR in 24 hours.\ c. Encourage the patient to consume more leafy greens.\ d. No action is needed, as this is within the therapeutic range. 56. A patient complains of dry skin and irritation after using **Benzoyl Peroxide**. What should the nurse suggest?\ a. Discontinue the medication immediately.\ b. Apply a light moisturizer to reduce dryness.\ c. Increase the frequency of application to improve skin tolerance.\ d. Switch to a prescription-strength acne treatment. 57. A patient with heart failure is started on **Spironolactone**. What electrolyte imbalance is most concerning?\ a. Hypokalemia\ b. Hypernatremia\ c. Hyperkalemia\ d. Hypocalcemia 58. A patient reports ringing in the ears after starting **Aspirin**. What should the nurse do?\ a. Advise the patient to continue the medication as prescribed.\ b. Recommend the patient take the medication with food.\ c. Notify the healthcare provider, as this may indicate toxicity.\ d. Suggest switching to a different pain reliever. 59. A patient on **Amiodarone** reports fatigue and cold intolerance. What lab test should be ordered?\ a. Complete blood count (CBC).\ b. Liver function tests (LFTs).\ c. Thyroid function tests (TFTs).\ d. Serum potassium levels. 60. A patient prescribed **Metformin** for diabetes develops muscle pain and difficulty breathing. What is the likely cause?\ a. Hypoglycemia\ b. Hyperkalemia\ c. Lactic acidosis\ d. Allergic reaction 1. b\. Dry mouth 2. b\. Prevent seizures 3. b\. Manage Parkinson's disease symptoms 4. a\. NSAIDs increase lithium levels 5. b\. Gout 6. b\. Respiratory depression 7. b\. Renal impairment 8. b\. Prednisone 9. b\. Reduces inflammation in the colon 10. c\. Regular insulin (Humulin R) 11. a\. Reduce peripheral metabolism of levodopa 12. c\. Headache 13. b\. Emergency bronchospasm relief 14. b\. Macrolide antibiotics 15. b\. Glaucoma 16. a\. Isotretinoin 17. b\. Sodium and water excretion 18. b\. Sildenafil 19. b\. INR 20. b\. Lactic acidosis 21. d\. Used topically to kill lice 22. a\. Prevents fungal growth 23. a\. Enhances mucosal protection 24. b\. Reduce airway inflammation 25. a\. Increases insulin secretion 26. c\. Blocks histamine-2 receptors in the stomach 27. b\. Binds to aldosterone receptors 28. d\. Stimulates beta-2 receptors 29. c\. Inhibits potassium secretion in the distal tubule 30. a\. Taper doses to avoid withdrawal effects 31. False 32. False 33. True 34. True 35. True 36. True 37. False 38. False 39. True 40. True 41. e\. Hypertension treatment (Lisinopril) 42. i\. Anti-nausea medication (Prochlorperazine) 43. g\. Acne treatment (Isotretinoin) 44. a\. Antibiotic therapy (Tetracycline) 45. h\. Cough relief (Guaifenesin) 46. a\. Antibiotic therapy (Ceftriaxone) 47. f\. Ulcerative colitis treatment (Sulfasalazine) 48. b\. Asthma control (Beclomethasone) 49. c\. GERD treatment (Pantoprazole) 50. d\. Uric acid reduction (Allopurinol) 51. c\. Use two forms of birth control and have regular pregnancy tests 52. c\. Albuterol, to open airways for better absorption of Beclomethasone 53. b\. Hold the Digoxin and notify the healthcare provider 54. c\. 4--12 hours after administration 55. a\. Administer Vitamin K as ordered 56. b\. Apply a light moisturizer to reduce dryness 57. c\. Hyperkalemia 58. c\. Notify the healthcare provider, as this may indicate toxicity 59. c\. Thyroid function tests (TFTs) 60. c\. Lactic acidosis