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Pharmacology Compendium: Drugs, Indications, and Mechanisms, Exercises of Nursing

Kingston University (KUL)Nursing

This comprehensive document covers a wide range of pharmacological agents, including their indications, mechanisms of action, adverse effects, contraindications, and interactions. It delves into the details of drugs used to treat various conditions, such as rheumatoid arthritis, crohn's disease, asthma, osteoporosis, anxiety, parkinson's disease, arrhythmias, cancer, and hiv/aids. A wealth of information for healthcare professionals and students interested in pharmacology, covering topics like urinalysis, laboratory tests, and medication administration routes. With its extensive coverage of drug profiles, this document can serve as a valuable reference for understanding the pharmacological management of diverse medical conditions.

Typology: Exercises

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NPLEX 2 Pharm questions and answers

5-fluorouracil - ANTI-NEOPLASTIC/ ANTI-METABOLITE

IND:

- Carcinoma of the breast, colon, head and neck, pancreas, rectum or stomach

- TOPICAL for management of actinic (solar) keratosis, superficial basal cell

carcinomas

ACT:

- Pyrimidine antimetabolite, blocks methylation of deoxyuridylic acid and

interferes with DNA synthesis

- Stops thymidilate synthase.

A/E:

- Dermatitis, vomiting, diarrhea, alopecia, heartburn, nausea, anorexia, stomatitis,

esophagitis, leukopenia, GI ulceration, myelosuppression

C/I:

- Poor nutritional status, depressed bone marrow fcn, thrombocytopenia, major

surgery w/in the previous month, PREGNANCY, enzyme deficiency

INT:

- Decreased effect from methotrexate

- Cimetidine, leucovorin increase levels

- Avoid ethanol

MONITOR: CBC w/ differential, platelet count, renal and LV fcn tests

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5-fluorouracil - ANTI-NEOPLASTIC/ ANTI-METABOLITE IND:

Carcinoma of the breast, colon, head and neck, pancreas, rectum or stomach
TOPICAL for management of actinic (solar) keratosis, superficial basal cell carcinomas ACT:
Pyrimidine antimetabolite, blocks methylation of deoxyuridylic acid and interferes with DNA synthesis
Stops thymidilate synthase. A/E:
Dermatitis, vomiting, diarrhea, alopecia, heartburn, nausea, anorexia, stomatitis, esophagitis, leukopenia, GI ulceration, myelosuppression C/I:
Poor nutritional status, depressed bone marrow fcn, thrombocytopenia, major surgery w/in the previous month, PREGNANCY, enzyme deficiency INT:
Decreased effect from methotrexate
Cimetidine, leucovorin increase levels
Avoid ethanol MONITOR: CBC w/ differential, platelet count, renal and LV fcn tests

Rx: IV or topical Acetaminophen - NON-NARCOTIC ANALGESIC/ ANTIPYRETIC (Tylenol) IND:

Mild pain, acute MSK pain, OA, RA, fever ACT:
Inhibits CNS prostaglandin synthesis, analgesic, anti-pyretic, NOT anti- inflammatory, Does not affect platelet agg or uric acid metabolism A/E:
MAY INHIBIT CARTILAGE FORMATION, HEPATITIS (BLACK BOX WARNING FOR HEPATOTOXICITY)
Preg B
OD can cause potentially lethal hepatotoxicity (overwhelms glutathione detox system in LV), or nephrotoxicity
ANTIDOTE; Charcoal, N-Acetylcysteine (glutathione precursor). C/I:
LV dz, LV failure, alcoholism INT:

Rx: Oral, topical, IV Adalimumab - DMARD (Antirheumatic, TNF-alpha inhib) IND:

RA, psoriatic arthritis, ankylosing spondylitis, Crohn's dz, severe psoriasis, JRA ACT:
Fully-humanized anti TNF-alpha IgG; anti-inflammatory and immunosuppressive A/E:
injection site rxn's, increased risk of dangerous ixn's (TB), herpes zoster re- activation, cancers (ESP LYMPHOMA IN CHILDREN)
Loss of efficacy over time, Liver failure (rare) C/I:
exposure to risky pathogens, receiving live vaccines INT:
Do not combine w/ other anti-TNF drugs
Combination w/ Methotrexate can cause serious ixns Rx: SubQ inj Adefovir - ANTIVIRAL

IND: Chronic Hep B - any stage ACT: adenosine monophosphate nucleotide analog A/E: resistance with chronic use, NEPHROTOXICITY, hepatitis, lactic acidosis C/I: reduce dose in KD failure Monitor: creatinine, urine protein Albuterol/ Salbutemol - SHORT-ACTING BETA2 AGONIST IND:

Acute asthma attacks, acute and chronic bronchitis Alendronate - BISPHOSPHONATE DERIVATIVE IND:
Osteoporosis in posmenopausal women and males, Paget's dz of the bone ACT:
Inhibits bone resorption by binding to bone hydroxyapatite and INHIBITS OSTEOCLAST-MEDIATED BONE RESORPTION, also inhibits osteoclast precursors A/E:
Esophagitis, esophageal ulcers, HA, transient hypocalcemia, GI distress, abdominal pain, acid reflux, nausea C/I:

C/I:

Narrow angle glaucoma, Pregnancy (1st trimester)
Caution w/ seizure hx, suicidality hx, abrupt w/drawal, Liver dz INT:
DO NOT USE W/ KETOCONAZOLE OR ITRACONAZOLE Amantadine - ANTICHOLINERGIC/ ANTIPARKINSONIAN IND:
Extrapyramidal dz, Parkinsonism, Influenza A A/E:
LIVEDO RETICULARIS Amiodarone - ANTI-ARRHYTHMIC IND:
SERIOUS Ventricular arrhythmias, chemical cardioversion of atrial fibrillation: NOT A FIRST-LINE ANTIARRHYTHMIC BECAUSE OF SIGNIFICANT (POTENTIALLY FATAL) SIDE EFFECTS ACT:
Class 3 anti arrhythmic agent: SODIUM CHANNEL BLOCKER with affinity for inactive channels unlike quinidine.

A/E:

Acute: Hypotension, AV block, bradycardia
Chronic: Hypo/hyperthyroid, PULMONARY FIBROSIS, peripheral deposition (bluish discoloration to skin), Arrhythmias, CORNEAL DEPOSITION Amitriptyline - TRICYCLIC ANTIDEPRESSANT Same efficacy as an SSRI. IND:
Depression, enuresis, phobias, insomnia, cocaine withdrawal A/E:
Sedation, coma, seizures, arrhythmias, anticholinergic effects TOX:
LETHAL CARDIAC TOXICITY Amlodipine -"dip" in a blood pressure - CALCIUM CHANNEL BLOCKER (ANTI- HYPERTENSIVE) IND:
Hypertension, angina ACT:

URTI, LRTI, OM, osteomyelitis, chlamydia, typhoid, infective endocarditis, H. Pylori, UTI ACT:
Aminopenicillin inhibits peptidoglycan synthesis in bact cell wall A/E:
N/V, diarrhea, rash (hypersensitivity), black hairy tongue, glossitis, stomatitis, Pseudomembranous colitis (C.Diff ixn).
Anemia, thrombocytopenia, eosinophlia, neutropenia, leukopenia, agranulocytosis
Moderate rise in AST, ALP and LD
Aseptic meningitis (rare)
Acute intersitial nephritis/ renal failure (rare) C/I:
Hypersensitivity to amox, OTHER PENICILLINS OR BETA-LACTAM ANTIB'S.
Renal failure, caution in renal dz
Caution in EBV, CMV, ALL d/t increased risk of rash
PREG B INT:
Synergistic w/ Aminoglycosides

Bacteriostatic Antibiotics DECREASE EFFECTIVENESS (Chloramphenicol, erythromycin, tetracyclin)
Increased toxicity w/ METHOTREXATE (inhibits renal secretion)
Decreased effectiveness of OCP
Probenecid inhibits excretion Anastrozole - AROMATASE INHIBITOR IND:
Estrogen sensitive breast cancer Androstenedione - IND:
Used by wt lifters and athletes as androgen ACT:
Direct precursor to testosterone (via 17 or 3-beta hydroxysteroid dehydrogenase) A/E:
Poorly researched MONITOR: physical exam, change in pigment, monitor as with testosterone Aspirin - NSAID

HIGHLY PROTEIN BOUND (increase toxicity of methotrexate and valproic acid).
Vitamin C decreases aspirin excretion
Corticosteroids decrease aspirin's actions
Ethanol promotes aspirin's GI tox.
Synergistic w/ anticoags, other salicylates and insulin.
NOT synergistic w/ other NSAIDS (except for box)
Interferes w/ beta blockers and urine ketone and glucose levels Atenolol - SELECTIVE BETA BLOCKER IND:
HYPERTENSION (main), Angina, MI, SVT, Ventricular tachycardia, alcohol withdrawal ACT:
Selective B1 adrenergic receptor blocker A/E:
Type 2 DM, indigestion, constipation, dry mouth, impotence, dizziness, faintness, depression, confusion, nightmares C/I:
Bradycardia (<50), cardiogenic shock, ASTHMA, prinzmetal angina, PREG D INT:

Additive effects w/ catecholamine depleting drugs (reserpine) and antiarrhythmics (amiodarone)
Cardiac glycosides increase risk of bradycardia Atorvastatin - ANTIHYPERLIPIDEMIC (STATIN) IND:
Hypercholesterolemia (most effect on LDL), hypertriglyceridemia ACT:
HMG CoA reductase inhibitor, increases number of LDL receptors in liver INT:
DO NOT COMBINE WITH FIBRATES - INCREASED RISK OF RHABDOMYOLYSIS Atropine - ANTICHOLINERGIC IND:
Bradycardia ACT:
Anticholinergic Azithromycin - ANTIBIOTIC (MACROLIDE)

Antacids decrease azith absorption Bisacodyl - STIMULANT LAXATIVE IND:
Constipation, preparation of bowel for procedure ACT:
Stimulates enteric nerves to stim colonic mass movement A/E:
Atony of colon, diarrhea, proctitis C/I:
Appendicitis, intestinal obstruction
Gastroenteritis Bismuth Subsalicylate - PEPTOBISMOL IND:
Diarrhea, Heartburn, H. Pylori, indigestion, Nausea, upset stomach ACT:
Antisecretory, and inhibits secretion of prostaglandin responsible for intestinal inflammation and hyper mobility

Weak antacid A/E:
Constipation, diarrhea, nausea, vomiting, GREYISH BLACK STOOL AND TONGUE, Neurotoxicity (rare) C/I:
Children or teenagers w/ or recovering Bromocriptine - DOPAMINE AGONIST (Antidiabetic, Antiparkinsonian) IND:
Acromegaly (reduces serum GH by 50% in most pt), DM2, Female infertility, Hyperprolactinemia, Parkinsons and prolactinoma ACT:
Activates postsynaptic dopamine receptors to inhibit prolactin secretion, stimulates dopamine receptors to improve motor function A/E:
Hypotension, Constipation, Diarrhea, Nausea, Vomiting Bupropion - SSDRI (WELBUTRIN, ZYBAN) IND:
Depression and smoking cessation

HA (w/ aspirin or acetaminophen), Migraine (w/ ergotamine), where mild mental stimulation is needed ACT:
adenosine antagonist, diuretic, stimulant A/E:
insomnia, tachyarrhythmias, toleranc/ dependance w/ withdrawal sx, caffeinism (jitteriness, anxiety, overstimulation) from OD C/I:
caution in pregnancy INT:
Fluvoxamine and levofloxacin inhibit catabolism (increasing blood levels up to 5 times) Cannabis - APPETITE STIMULANT, PAIN RELEIF Capsaicin - TOPICAL ANALGESIC IND:
OA, RA, myalgia, post herpetic neuralgia, diabetic neuralgia, pruritic psoriasis, dialysis-related pruritis, phantom limb pain, cluster headache (intranasal) ACT:

Depletes substance P from nn endings to decrease pain and itching A/E:
Pain and burning at site of application, burning in eyes and mucous membranes C/I:
Wounds or burns INT:
INCREASES COUGH INDUCED BY ACE INHIBITORS. Carbamazepine - IMINOSTILBENE-TYPE ANTICONVULSANT IND:
SEIZURE (partial, grand mal, mixed), trigeminal neuralgia, neuralgia, BIPOLAR DISORDER, schizophrenia, restless legs syndrome,
withdrawal of ethanol, cocain or benzodiazepines
Exaggerated sexual behaviour from temporal lobe injuries. ACT:
Decreases neuron impulse transmission and reduces neuron excitability in CNS. BLOCKS voltage dependant sodium channels A/E:

Pharmacology Compendium: Drugs, Indications, and Mechanisms, Exercises of Nursing

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C/I:

A/E: