NURS 5332 Final Exam Study Guide with Complete Solutions, Exams of Pharmacology

Download NURS 5332 Final Exam Study Guide with Complete Solutions and more Exams Pharmacology in PDF only on Docsity! NURS 5332 FINAL EXAM STUDY GUIDE WITH COMPLETE SOLUTIONS 2023 Final exam study Guide- 75 questions 1. Understand Pharmacodynamics a. How medication affects the body 2. What are the effects of Dobutamine a. Sympathetic nervous system mimicking; 3. Understand the actions and use of Dopamine a. B-1 agonist; contracts heart muscle, vasodilation; used for shock, HF, CHF, renal perfusion 4. patient teaching of clonidine (catapres) a. don’t stop abruptly; can cause rebound HTN b. used for HTN 5. The adverse effects and cautions of alpha-specific adrenergic agonists (phenylephrine, clonidine) a. Anxiety, restlessness, fatigue, HTN, arrhythmias, palpitations – ADVERSE b. Diabetes, pregnancy+lact, CV disease, thyrotoxicosis – CAUTION i. Women + childbearing age = pregnancy test 6. The indications and actions of labetalol – NONSELECTIVE BLOCKER a. HTN, lowers BP w/o reflex tachycardia b. Can be used in pregnancy c. Used for clonidine withdrawal 7. Cautions and adverse effect of Nonselective alpha-adrenergic blocking agents (phentolamine) a. Cautions: diabetes, bronchospasm, pregnancy, allergies b. Hypotensive episode, MI, tachycardia, pulmonary edema 8. The therapeutic actions of metoprolol (Lopressor) (B Blocker) a. Stable angina + HTN 9. agents used for Mysthenia Gravis- (indirect -Acting Cholinergic Agents) therapeutic actions (pyridostigmine) a. blocks acetylcholine @ synaptic cleft; transmission of neurotransmitter junction b. decreases muscle weakness + respiratory issues 10. Agents used for Alzheimer Disease. know the adverse effects a. Donepezil (cholinergic) b. insomnia, fatigue, dyspepsia, muscle cramps – ADVERSE 11. The use and adverse effects of atropine (anticholinergic) a. Adverse: tachycardia, blurred vision, palpitation, heart issues b. Decrease secretion for Intubation, Parkinson’s, cholinergic crisis 12. Hypertension first line therapy for African Americans a. Monotherapy w/diuretics b. Calcium channel blockers (DILTIAZEM) + alpha blockers (DOXAZOSIN, PHELNTOLAMINE) 13. Angiotensin II receptor Blockers (ARBs) Losartan adverse effects a. Losartan – dizziness, cough, syncope, back pain, fever, musc weakness (symptoms of URI) 14. The actions of ACE inhibitors (pril’s) (Captopril) a. Block angiotensin 1 from converting to angiotensin 2, decreasing BP; use for HTN 15. Vasodilators cautions and adverse effects (nitroprusside) a. Tachycardia, cardiovascular disease, HF, peripheral vascular disease, b. Adverse: cyanide toxicity 16. The therapeutic actions of droxidopa a. Raises BP for orthostatic hypotension 17. The use, cations and adverse effects of digoxin (p 761) (cardiac glycoside) a. Use for HF + AFib; i. lowers hr ii. increasing cardiac contractility iii. increase renal perfusion + output iv. decreased conduction velocity in av node (positive inotrope) b. Cautions – do not give to someone w/ sick sinus syndrome (AV node); can cause ventricular tachycardia + fibrillation  fatal arrhythmias; don’t give to pt with MI or STEMI b/c it can increase force of contraction causing more muscle damage c. Adverse – halos in vision, headache, weakness, drowsiness, vision change, GI upset, anorexia, arrhythmia 18. Nursing consideration when Pt are taking phosphodiesterase (milrinone) a. Short term for HF for pt nonresponsive to digoxin+diuretic; last resort b. Get EKG, monitor electrolytes, vitals c. can cause HoTN 19. Ivabradine actions and cautions (HCN blocker) p771 a. Blocks HCN; slows heart (sinus node) in repolarization of AP  reduces HR, treating CHF in stable pts, prevents repolarization, optimize B-blocker doses(whatever this means) b. Cautions – allergy, bradycardia, Afib, HTN, visual changes – get vitals 20. The different classes of antiarrhythmic drugs their therapeutic actions 781-782 a. Class 1  lidocaine  i. acute ventricular arrhythmia during cardiac surgery ii. Adverse – dizziness, lightheadedness, cardiac arrest, n/v, fatigue, arrhythmias b. Class 2  propranolol  i. decreases HR + output, use for HTN + migraine + arrhythmia, supraventricular tachycardia, ventricular tachycardia, ii. Adverse – bradycardia, HF, arrhythmia, pulmonary EDEMA, HEART BLOCK, CVA, BRONCHOSPASM c. Class 3  amiodarone  i. Life threatening ventricular arrhythmias ii. Slows potassium in phase 3 of Action Potential; slow outward movement of potassium d. Class 4  Diltiazem  Cardizem? i. Blocks calcium, delays phase 1+2 of repolarization ii. Proximal supraventricular tachycardia; afib + atrial flutter 40. Pt and family teaching about penicillin’s a. Drink a lot of fluids; take empty stomach w 8 oz of water b. 1 hour before meal OR 2-3 hours after meal c. Do not use fruit juice, soft drinks, or milk to take drug i. can interfere w effectiveness 41. Cautions and contraindications with sulfonamides (trimethoprim-sulfamethoxazole) a. Pregnancy (crosses placenta)- + lactation (liver, jaundice, diarrhea, rash to baby) b. 42. Nursing considerations with tetracyclines a. Don’t give to kids under 9, can stain teeth b. Hypersensitivity w respiratory functions 43. Adverse effects with lincosamides – clindamycin a. n/v, diarrhea, bone marrow suppression, b. can cause CDiff 44. Pt teaching about Tamiflu- when to start the meds and how does it work a. Start within first 48h of symptoms starting b. Shortens duration of flu 45. Acyclovir treatment use and adverse effects – nucleoside analogue a. Shingles, cold sores, herpes infections b. Headache, vertigo, tremors, n/v, rash 46. Fixed combination drugs for treatment of HIV infection a. Compliance – easier to take 1 drug than 2 47. Treatment uses and actions of clotrimazole – anti fungal (imidazoles) a. Use for TINEAS – Candidiasis, thrush, yeast infection, ringworm, athletes foot, etc b. Binds to fungal cell membrane, changes permeability, causes cell death 48. Nursing considerations with Pt taking antimalarial agents – chloroquine a. Safety – slowly changing position, avoid driving and hazard b. Take drug with meals c. Affects liver * i. Jaundice ii. Abdominal pain, n/v iii. Obtain cultures prior to starting to ensure using right meds for right issue 49. Use and adverse effects of metronidazole – antiprotozoal agent a. Amebiasis, trichomonas b. Headache, dizziness, ataxia, gait c. Teach pt don’t drink alcohol with it – will be very sick 50. Pt teaching about mebendazole a. Obtain stool cultures for ova+parasite (o+p) – determine what type of worm is present b. Causes diarrhea, ab pain, transit fever c. Pinworm, roundworm, hookworm 51. Adverse effects of methotrexate - antimetabolite a. Anti-rheumatic; inhibits cell replication b. Use for gestational carcinoma, leukemia, rheumatic arthritis, psoriatic arthritis c. Adverse: Fatigue, malaise, rash, alopecia, hepatic toxicity, bone marrow suppression, anaphylaxis 52. Therapeutic actions and indications of H2 antagonists (cimetidine) a. Block release of HCl in response to gastrin b. Used for benign gastric ulcers, prophylaxis of GI bleed, erosive gastroesophageal, dyspepsia 53. Adverse effects of antacids – sodium bicarbonate a. Neutralize stomach acids by direct chemical reaction b. Acid rebound, gastric rupture, weakness, tetany, hypokalemia i. Check electrolytes 54. How do bulk stimulants work? Magnesium citrate a. Increase bulk of fecal matter to increase motility i. Use with water 55. 5 HT3-Receptor Blockers use and cautions – ondansetron (Zofran) a. Nausea, vomiting b. Cautions – hypersensitivity, pregnancy (cleft palate to babies; this has not been proven IRL but for exam purposes) c. Adverse: Headache, dizziness, drowsiness, constipation, urinary retention 56. Cautions to take with benzodiazepines- pt safety (diazepam) a. Used for anxiety b. don’t use with alcohol or rec. drugs bc it causes sedation c. safety – dependency, opiate use 57. Adverse effects with barbiturates – phenobarbital a. Drowsiness, ataxia, n/v, HoTN, bradycardia, physical dependency i. Get vitals 58. Pt teaching with Lunesta a. Sleeping driving, memory loss, lack of memory/awareness when conscious 59. MAoIs and food restrictions a. Tyramine- do not eat with MAOIs (wine, cheese, meats, etc) i. Can cause spike in BP 60. SSRIs syndrome (Fluoxetine) a. Can cause respiratory changes, cardiac issues, HoTN i. Too much serotonin in brain ii. Do not use w/MAOIs or st johns wort 61. Adverse effects of antipsychotic-extrapyramidal side effects a. Parkinsonism – shuffling gait, tardive dyskinesia 62. Lithium serum levels a. Toxicity – dangerous levels b. Less than 1.5 – lethargy, slurred speech, n/v c. 1.5-2 – above + ekg changes d. 2-2.5 – above + ataxia, clonic movement, hyperreflexia, seizures e. 2.5+ - above + multi organ toxicity and death 63. Nursing considerations for Pt receiving Nervous System Stimulants p388 a. Pulse, bowel sounds, administer prior to 6pm to reduce insomnia, 64. Adverse effects of phenytoin / dilantin – antiseizure p392 – amphetamines? a. Steven Johnson syndrome + myocarditis, slurred speech, ataxia 65. Levodopa- therapeutic actions a. Parkinson’s – works by increasing dopamine levels in the brain i. Acts as replacement of dopamine 66. Baclofen- Pt teaching – muscle relaxer a. Do not drive while using meds, do not drink or use drugs i. Fall risk b. Taper drug slowly to prevent psychosis or hallucinations – do not stop abruptly 67. Naloxone- used for and adverse effects a. Opioid overdose b. n/v, sweating, tachycardia, irritability, bp fluctuation, pulm edema c. vitals, hydration 68. Midazolam- actions& adverse effects – benzodiazepine a. Sedative for procedures or surgeries b. Hypnotic amnesic effect c. Adverse  drowsiness, lethargy, bradycardia, decreased respiration, urinary retention i. Put pt on monitor, suction nearby, ambu bag for supplemental o2, code cart 69. Pt teaching about neuromuscular Junction blocking agents a. General anesthesia i. Monitor vitals, can cause bradycardia, musc pain, musc contractions, apnea 70. Somatropin- actions and use – growth hormone a. Dwarfism b. give to children pt prior to epiphyseal growth plates closing c. Growth hormone deficiency i. Not for adults after growth plates close 71. Prednisone-use and action a. Did not go over this 72. Levothyroxine- use and adverse effects a. Hypothyroidism – replaces thyroxine b. Tachycardia, heat intolerance, weight loss, anxiety (s+sx of hyperthyroid) 73. Insulin- Pt teaching and adverse effects a. Hypoglycemic events are biggest adverse effect i. Cold + clammy needs candy b. Teach pt to check blood sugar prior to administering insulin i. S+sx of both hypo+hyperglycemia