Pharmacology Final Exam Questions And Answers, Exams of Pharmacology

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Pharmacology Final Exam Questions

And Answers

Phenothiazines, like chlorpromazine, are used to treat___________. - Psychosis A1 Blockers have __________ as an adverse effect. - Hypotension (They work too well) Which drug works on the hypothalamus to reduce fevers? - acetaminophen (Tylenol) Which drugs work to reduce symptoms of BPH? - A1 Blockers such as tamsulosin (Flomax) and 5-Alpha Reductase Inhibitors such as Proscar. Benzos and Antihistamines work to reduce__________. - Anxiety What are the signs and symptoms of a cholinergic crisis? - Circulatory collapse Hypotension Bloody Diarrhea Bronchoconstriction Shock Cardiac Arrest Clients with asthma or COPD should not receive __________________________. - Non-selective Beta Blockers Hydroxzine hydrochloride (Atarax), Hydroxine pamoate (Vistaril) and diphenhydramine (Benadryl) are all ______________________ and are used to treat ______________. - Antihistamines Anxiety Three catchecolamines are : - Epinephrine Norepinephrine Dopamine B1 Beta Adrenergic Receptors are located in________. - The Heart--When it comes to Beta Receptors remember: You have ONE heart and TWO lungs. Beta1 works in the heart and Beta2 works in the lungs. Cholinergic drugs mimic the ________ response which is __________ or __________.

• Parasympathetic rest digest Beta blocker drugs all end in what three letters? - LOL Propranololol, atenolol, carvedilol

Non-Benzos like Ambien can have ___________ as an adverse effect. - somnabulation (Sleep walking) The dopaminergic drug for Parkinson's disease is _____________' - carbida-levodopa (Sinemet) Diazepam (Valium), Alaprazolam (Xanax) and Lorazepam (Ativan) are all _________ to treat ____________. - Benzos Anxiety Pam is crazy and drives a Benz! Migraine headaches and glaucoma can be treated with B1 Blockers because they ___________________. - decrease pressure The Adrenergic drugs mimic the _______________ response which is _______ or ____________. - Sympathetic Fight Flight Cholinergic drug effects are: - Lower HR Lower BP (through vasodilation) Bronchial Constriction Increased GI secretions and motility Increased urinary frequency Increased Salivation Increased sweating (diphoresis) Pupils Constric (Miosis) Bethanechol (Urecholine) is used for ___________. - Urinary Retention (URE=urine) What conditions would cholinergic drugs be useful to treat? - Glaucoma Xerostomia (dry mouth) GI Motility Lowering HR Vasodilation Indirectly: Alzheimers What are B1 Blockers used to treat? - Angina, MI cardiac dysrhythmias, hypertension and heart failure. (B1 Blockers work on the heart so all of these are cardiac issues) What are the adverse effects of cholinergic drugs? - (Think that they suppress the parasympathetic nervous system too much.) Syncope

What factors effect absorption or drugs? - First-pass effect (how much drug is metabolized by liver) Food Milk Antacids Grapefruit juice Route of administration Coatings What are the seven "rights"? - Right Dose Right Documentation Right Drug Right Patient Right Route Right Time Right of Refusal What are the fastest to slowest routes of administration? - IV, SL, IM, SubQ, Oral, Topical When we think of excretion, we think of __________. - Kidneys If there is impaired excretion, it could lead to______. - Toxicity Explain a schedule C-1 Drug - Most addictive, high potential for abuse, no medical use With Warfarin, the patient should avoid________. Why? - Leafy Greens Due to the decreased anticoagulant effect Tetracycline and Quinolones patients should avoid______________. - Dairy Products due to the decreased treatment effect due to absorption Statin, Antidsyrhythmics and CCB patients should avoid____________________. - Grapefruit Juice MAO inhibitor patients and Linezolid patients should avoid_________________. - Foods with tyramine due to the raised blood pressure and a possible hypertensive crisis. Why is the enzyme cytochrome P450 important? - It is involved with a lot of drug to drug reactions because the drugs all bind to the same substrate. Either the drug has a lowered treatment effect or the drug becomes toxic because of the amount of free drug in the body.

How is hypertension treated in African Americans? - With CCB's and diuretics in combination therapy What do you need to be aware of with the Asian and Hispanic populations? - They can be slow acetylators. Antipsychotics and antianxiety drugs take longer to metabolize. Therefore, a lower dosage may be needed. Rapid Acetylators have higher levels of _______ and need ___________ doses of some drugs because otherwise the treatment will be ______. - Cytochrome P- 450 Higher (They metabolize the drug too fast) Sub-Therapeutic Slow Acetylators have lower levels of _____________ and need___________ doses of some drugs because otherwise the treatment will be __________. - Cytochrome P- 450 Lower (They metabolize drugs slower) Toxic _____________ dilate all blood vessels and relax smooth muscle. - Nitrates For angina (chest pain), whether prophylactically or to treat an attack, ______________ will be used. - Nitrates What are the four antidiarrheals? - Adsorbents (Pepto-Bismol) Anticholinergics (Bella Donna Alkyloid) Opiate Derivatives (Immodium, Lomotil) Probiotics How do bulk forming laxatives work? - Absorbs fluids Stimulates GI peristalsis How do Hyperosmotic and Saline Laxatives work? - Increase of Fecal Water Content How do Emollient/Softening laxatives, like Colace, work? - By mixing stool, fat and water content What do stimulant laxatives stimulate? - The nerves for peristalsis What needs to be ASSESSED when administering adrenergic agonists such as epinephrine? - 1) Photosensitivity

2. Nausea and Constipation
3. Urinary Output What needs to be MONITORED when administering adrenergic agonists? - 1) Vital Signs
4. Breath Sounds
5. Watch for IV infiltration

What should the patient be educated on when giving opioid painkillers? - Disposing for patches properly (Fold and Flush) Avoid activities requiring mental awareness Increase fiber and water in diet What does the nurse need to be aware of when administering opioid painkillers? - The antidote for overdose is NARCAN. (Have on hand if respiratory depression occurs.) There are multiple routes for adminstration. Use the equianalgesic chart when using different routes/drugs/doses to find the right dose. Know immediate release versus extended release forms. Why is methadone good for detox? - It has a long half life that lasts longer than the action How to administer bronchodilators: - Give bronchodilator before inhaled steroid. Wait 2- 5 minutes between medications. Wait 1-2 minutes between puffs. After using an inhaled steroid, what should the patient do? - Rinse their mouth with water to prevent fungal infection. What is the route of administration of thrombolytic drugs? - IV-it is always given as an IV to quickly break up clots that cause stroke but has risky side effects because ALL clots in the body break up and the patient could bleed out. With Heparin the _________ should be monitored and kept in the _________________ range. - aPTT Norm=25-35 seconds Therapeutic range =45-70 seconds With Heparin injections, what are the nursing activities? What is the overdose antidote? - Do not rub Rotate Sites Do not aspirate SubQ injections IV infusion with a pump Protamine Sulfate What ranges are we looking at when administering warfarin (Coumadin) and what are the therapeutic levels? What is the overdose antidote? - INR=2-3. PT=18 Seconds (norm=11-13 seconds) Vitamin K All antiplatelet, antifibrinolytic, thrombolytic and anticoagulants have the same adverse effect that the nurse should monitor for. What is it and what should be done? - Bleeding

Implement bleeding precautions such as use of an electric razor, minimize dangers, etc. Diuretics, like the Loop Diuretic furosemide (Lasix), should be administered ___________. - Early in the day If the serum potassium level is low what should you do when administering the next dose of diuretics? - HOLD it until the potassium level increases or hypokalemia can occur Potasssium supplements and eating potassium rich foods would all be advised for patients taking ___________. - Diuretics With potassium-sparing diuretics, like spironolactone, they can keep too much potassium in the body which is a condition called_________. - Hyperkalemia With all diuretics, what should be monitored? - Urine output Weight Edema Blood Pressure (can go too low) Potassium levels Loop Diuretics, like furosemide, can have a cross-sensitivity allergic reaction in patients allergic to _______ drugs. - Sulfa Any stimulating growth factor, like Filgrastim (Neupogen), should not be administered within 24 hours of __________________. - Antineoplastics (Chemotherapy) Filgrastim (Neupogen) stimulates the productions of _____________________. - WBC's When do you discontinue use of Filgrastim (Neupogen)? - When the Absolute Neutrophil Count (ANC) is greater than 1000/mm3 for 3 or more consecutive days. When monitoring Epoetin Alfa (Epogen), use the _____________ because it changes faster. - Hemoglobin level Epoetin Alfa (Epogen) will not create RBC's without ___________________________ in the body. - Adequate stores of iron If Epoetin Alfa (Epogen) is working, the patient will feel less ______________. - Fatigue (Oxygen levels will increase) What should patients taking insulin be educated about? - Types and Routes of administration Site Rotation Types of Insulin

b. Call the patient by name when entering the room to verify the drug is for the right person. c.Check the patient's armband before administering the medication. d.Prepare medications for all patients first, then administer by room to manage time appropriately. - c.Check the patient's armband before administering the medication. Checking the patient's armband is the most accurate method of determining identity. All the other answers leave room for error. The nursing process is important as a well-established, research-supported framework for professional nursing practice. Which is the correct order for the steps of the nursing process? a.Evaluation, Planning, Diagnoses, Assessment, Implementation b.Planning, Assessment, Diagnoses, Implementation, Evaluation c. Diagnoses, Assessment, Planning, Evaluation, Implementation d.Assessment, Diagnoses, Planning, Implementation, Evaluation - d.Assessment, Diagnoses, Planning, Implementation, Evaluation The typical organization for the nurse process is assessment, nursing diagnoses, planning, implementation, and evaluation. The nurse should check a medication how many times before administration of a medication under the "right drug" part of the Six Rights? a.One time b. Three times c.Five times d.Depends on the drug being administered - b. Three times The nurse should check the medication three times and confirm each time that the medication is the right drug before to administration of the medication. Pharmacokinetics involves the study of a. physiologic interactions of drugs. b.distribution rates among various body compartments. c.interactions between various drugs. d. adverse reactions to medications. - b.distribution rates among various body compartments. Pharmacokinetics involves the study of how the drug moves through the body, including absorption, distribution, metabolism, and excretion. Highly protein-bound drugs a. increase the risk of drug-drug interactions. b. typically provide a short duration of action. c.must be administered with 8 ounces of water.

d. have a decreased effect in patients with a low albumin level. - a. increase the risk of drug-drug interactions. When administering two medications that are highly protein bound, the medications can compete for binding sites on plasma proteins. This competition results in either less of both or less of one of the drugs binding to the proteins, thus increasing the risk of toxicity. The nurse is preparing to administer an injection of morphine to a patient. Assessment notes a respiratory rate of 10 breaths/min. Which action will the nurse perform? a.Administer a smaller dose and record the findings. b.Notify the physician and delay drug administration. c.Administer the prescribed dose and notify the physician. d.Hold the drug, record the assessment, and recheck in 1 hour. - b.Notify the physician and delay drug administration. Respiratory depression is a side effect of narcotic analgesia. Therefore since the patient's respiratory rate is below normal, the nurse should withhold the morphine and notify the physician.