ATI Pharmacology BB

Calcium Channel Blocker (nifedipine, amlodipine)
Therapeutic Use: Angina, HTN

Erectile Dysfunction


ACE Inhibitor (Captopril, lisinopril)
Therapeutic Use: HTN, HF, MI, Diabetic Neuropathy

-pam, -lam

Antilipidemic (lovastatin, simvastatin)
Therapeutic Use: Hypercholesterolemia, Prevention of Coronary Events, Protection against MI and stroke in clients with disbetes

-asone, -solone
Corticosteroid (prednisone, prednisolone)
Therapeutic Use: status asthmaticus, acute asthma attack, asthma attack PPX

Beta Blocker (propranolol, metoprolol)
Therapeutic Use: HTN, Angina, Tachydysrhythmia, HF, MI


Oral Hypoglycemic (Biguanides, glipizide)
Therapeutic Use: Used in conjunction of diet and exercise to control blood glucose levels in type 2 diabetes mellitus

Proton Pump Inhibitor (omeprazole, lansoprazole)
Therapeutic Use: gastric and peptic ulcer, GERD, Zollinger-Ellison syndrome



Antiemetic (promethazine)
Therapeutic Use: Postoperative, Chemotherapy, N/V associated with disease process

Bronchodilator (aminophylline, theophylline)
Therapeutic Use: Relief of bronchospasm, long-term control of asthma

Anticoagulant (heparin, enoxaparin)
Therapeutic Use: Evolving stroke, PE, DVT, Cardiac Cath, MI, DIC





Tricyclic Antidepressant (amitriptyline, imipramine, nortriptyline)

-pram, -ine
SSRIs (fluoxetine, sertraline, paroxetine, citalopram, escitalopram)

Alpha Adrenergic Blockers (Sympathomimetics) ((prazosin, doxazosin mesylate))
Therapeutic Use: HTN
*doxazosin mesylate may be used to treat BPH*

Antidote/Reversal Agent: Acetaminophen

Antidote/Reversal Agent: Benzodiazepine
flumazenil (Romazicon – GABA receptor antagonist)

Antidote/Reversal Agent: Digitalis
digoxin immune FAB

Antidote/Reversal Agent: Heparin and enoxaparin (Lovenox)
Protamine Sulfate

Antidote/Reversal Agent: Warfarin
phytonadione (vitamin k)

Antidote/Reversal Agent: Narcotics
naloxone (narcan)

can constrict blood vessels; causing Hypertension

tamoxifen (side effects)
menstrual irregularities
hot flashes


cefazolin allergic reaction (tx)
parenteral epinephrine (induce vasoconstriction and bronchodilation)

metoprolol use post MI (what to monitor)
bilateral crackles in the lungs (sign of heart failure)

over the counter drug to AVOID when taking Lithium
NSAIDs (increases lithium levels)

therapeutic value for INR
2 to 3; for coumadin

sulfa allergy (cross sensitivity to which drugs)
thiazide diuretics

enalapril use for Heart failure (what to monitor)

methotrexate (what to monitor/report)
fever, sore throat, sores in mouth, infection

Tx: glaucoma, Sjogren syndrome
Class: saliva production stimulator & glaucoma rx
Teaching: eye drops for glaucoma need to be taken for the rest of their life

When should Oxytocin IV post-term pregnancy be discontinued? (contractions)
uterine contractions last > 60 sec

when should Oxytocin IV post-term pregnancy be discontinued? (resting uterine pressure)
greater than 15-20mmHg

when should Oxytocin IV post-term pregnancy be discontinued? (uterine contraction frequency)
more than every 2-3 mins

trimethoprim/sulfamethoxazole (Bactrim) (adverse effect to report)
vesicular, crusty rash (Steven Johnson syndrome)

trimethoprim/sulfamethoxazole (teaching)
drink 8-10 glasses of water daily to prevent renal damage from CRYSTALLURIA

donepezil (adverse effects)
dyspnea (priority), dizziness, diarrhea, dyspepsia

spironolactone (adverse effect)
lethargy r/t HYPERKALEMIA

potassium-sparing diuretic (drug)

digoxin toxicity (sign to monitor and report)
yellow-tinged vision (halo), tinnitus

TSH therapeutic level
0.5-2 microunits

T3 therapeutic level
0.0001-0.0002 mcg

T4 therapeutic level
4.5-11.2 mcg

methotrexate toxicity (sign to monitor and report)
sores in mouth (stomatitis)

oxybutynin (adverse effects)
dry mouth
blurred vision
TACHYCARDIA (anticholinergic effects)

urinary incontinence (tx drug)
oxybutynin (anticholinergic)

Isotretinoin (required test before use/obtaining a refill)
pregnancy test (teratogenic)

severe nodulocystic acne vulgaris (tx drug)

Dopamine IV (therapeutic use during cardiogenic shock)
increased blood pressure (catecholamine effect)
increased HR
increased renal output/voiding

candidiasis (tx drug)
Fluconazole (antifungal)

Sodium Polystyrene Sulfate (Kayexalate) (therapeutic use)
decrease serum potassium to prevent cardiac dysrhythmias r/t HYPERKALEMIA

warning for chemo Pt. trying to get pregnant
high risk of fetal malformations while on chemotherapy

Sucralfate (therapeutic use)
forms a protective barrier over ulcers (mucosal protectant); gel-like substance; PEPTIC ULCER tx

Isosorbide mononitrate
Tx: CHF, atherosclerosis
Class: nitrates
AE: hypotension (BP <90/60); hold drug; NOTIFY MD

Class: cholinesterase inhibitor
AE: increased salivation, bradycardia, ***NAUSEA, diarrhea

Tx: psoriasis, liver (organ) transplant (graft vs host disease), lupus, aplastic anemia
Class: immunosuppressant

serum creatinine therapeutic level
0.6-1.3 mg/dL

Allopurinol (drug to avoid)
Warfarin; CONTACT MD; risk for bleeding

Ferrous Sulfate (administration teaching)
take on an empty stomach (for better absorption)

Warfarin (antidote)
Vitamin K

Furosemide (lab findings of adverse effect/hold drug)
K+ level <3.5 mEq/L; HYPOKALEMIA; hold drug; NOTIFY MD

Magnesium therapeutic level
2 mEq/L

when Magnesium levels are HIGH
Calcium levels are LOW

Hypermagnesemia (s/s)
hypotension (LOW BP)
AV heart block
respiratory paralysis (Mg 12-15 mEq/L)
muscle weakness

Hypercalcemia (s/s)
kidney stones

Morphine Sulfate use 24hr post-op (adverse effect to monitor)
urinary retention

Tx: migraine headaches
Class: ergot alkaloids
Teaching: take one tablet at onset of MIGRAINE SL

Insulin Glargine for type 1 DM (administration instructions)
do not mix this medication in a syringe with other insulins

Risedronate (risedronic acid)
Class: bisphosphonate
Teaching: sit up for at least 30-60min after taking the drug to reduce adverse GI effects of esophagitis and dyspepsia

Tetracycline PO (adverse effect teaching)
take the medication with applesauce (food) to reduce GI distress

Aspirin toxicity/ salicylate poisoning (s/s to report to MD immediately)
hyperventilation (priority)/RESPIRATORY ALKALOSIS;

cholinergic crisis r/t MYASTHENIA GRAVIS (drug tx)
Atropine (anticholinergic); respiratory support

Insulin Lispro + Metoprolol (adverse effect)

Predisone/Glucocorticoids (long-term use adverse effect to assess)
edema d/t sodium and water retention

how to administer NPH insulin & Regular insulin in one syringe
1. inject air into the NPH insulin vial (cloudy)
2. inject air into the Regular insulin vial (clear)
3. draw up the Regular insulin into the syringe
4. draw up the NPH insulin into the syringe

Gentamicin antibiotic (adverse effect to report immediately)

Class: 5-HT agonist
AE: angina d/t coronary vasospasm

Levothyroxine (therapeutic use)

Indomethacin (therapeutic use)
reduces pain & inflammation

Chlordiazepoxide (therapeutic use r/t alcohol withdrawal)
prevents delirium tremens

Acetazolamide (adverse effect to monitor and report)
tingling of fingers (PARESTHESIA)

Acetazolamide (therapeutic use)

Furosemide (adverse effects r/t HF)
dizziness (d/t LOW BP)
urinary frequency

Magnesium Sulfate (IV) for preterm labor Toxicity (s/s)
decreased LOC
CNS depression (LOW BP, lethargy)

Diazepam overdose (antidote)

Flumazenil (therapeutic use)
Benzodiazepine drugs (Diazepam) toxicity


Acute asthma attack (tx drug)

Phenytoin (lifestyle teaching)
inform the dentist about medication use; d/t gingival hyperplasia

Baclofen (therapeutic use)
decrease in flexor and extensor spasticity in tx of Spinal Cord Injury; improved muscle function

Enalapril (adverse effect to monitor r/t HF)
HYPERKALEMIA d/t Potassium retention/sparing diuretic effects

Salmeterol (therapeutic use)
improved breathing; prevents BRONCHOSPASM; long

Propylthiouracil/PTU (therapeutic use)
increased ability to focus; tx for GRAVES’ DISEASE
increased amount of sleep
decreased appetite

PTU myelosuppression (lab findings of adverse effect)
decrease in WBC

Oprelvekin (therapeutic lab findings in chemo tx)
increased platelet count

Platelet count (normal range)
150,000 – 400,000

Hemoglobin (normal range)
female: 12-16
male: 14-18

Hematocrit (normal range)
female: 37-47%
male: 42-52%

WBC (normal range)
5,000 – 10,000

RBC (normal range)
4.2 – 6.2 million

Calcium (normal range)
8.2 -10

Serum Osmolality (normal range)

Magnesium (normal range)
1.5 – 2.5

Potassium (normal range)
3.5 – 5.0

LDL level

HDL level

Oral contraceptives (medications to AVOID)
Carbamazepine (anticonvulsant)

Digoxin (adverse effect to monitor and report)
yellow-tinged vision r/t toxicity
levels > 2

Valproic acid/Depakote (therapeutic use)
Class: Anticonvulsants
AE: jaundice r/t liver failure

Class: antiestrogen
AE: menstrual irregularities, hot flashes, bruising

Fluticasone Propionate
Class: corticosteroid
Teaching: use spacer to minimize the risk of Candidiasis of the mouth; dysphonia (difficulty speaking)

Clindamycin (adverse effect Pt needs to report to MD)
watery diarrhea r/t C-diff

Tx: SVT, Afib, Aflutter, angina
Class: calcium channel blocker
AE: HYPOTENSION, palpitations, GI distress (take with food)
Teaching: change positions slowly r/t hypotension and dizziness, DO NOT D/C ABRUPTLY

metronidazole (Flagyl) (what to AVOID during course of tx)
Tx: bacterial vaginosis, vaginitis, trichomoniasis, pelvic inflammatory disease, seborrheic dermatitis, gastritis, diverticulitis
Class: antibiotic
Teaching: beer (alcohol); can cause Disulfiram-like reaction

Disulfiram-like reaction (s/s)
severe vomiting

Epoetin alfa
Tx: ANEMIA, chemotherapy-induced Anemia, chronic RENAL FAILURE, HIV Pts. taking Zidovudine
Class: colony-stimulating factor
Teaching: DO NOT shake vial

benztropine (Cogentin)
Tx: Parkinson’s
Class: anticholinergic
AE: TACHYCARDIA, blurred vision, dry eyes

Antiobiotics to AVOID during pregnancy
Doxycycline; Tetracycline antibiotics; d/t adverse effects on developing bones and teeth

Class: osmotic diuretic
MOA: decrease intraocular pressure by increase urine output
AE: peripheral edema r/t risk of HF (IV use)

TB (tx drugs)

TB 4 tx drugs (reason)
to eliminate various combinations of resistant strains of TB


diagnostic tests d/t long-term use of Prednisone
bone density scans r/t osteoporosis


Tx: high cholesterol, HLD, CAD, stroke
Class: statin
Teaching: monitor Creatinine Kinase (elevated CK = muscle injury)

Tx: psychosis, schizophrenia, bipolar disorder
Class: antipsychotic
AE: akathisia (EPS), acute dystonia, Parkinsonism, tardive dyskenesia

Fluoxetine (Prozac)
Tx: depression, OCD, bulimia nervosa, panic disorder
Class: SSRI
Teaching: DO NOT take St. John’s Wort, may cause RASH, DO NOT use NSAIDs

Ferrous sulfate (teachings)
DO NOT take with Antacids;
take the tablet on an EMPTY STOMACH for best absorption; can take with food to minimize GI distress

Metoclopramide (Reglan)
Tx: GERD, gastroparesis, post-op nausea
Class: Antiemetic
AE: sedation (CNS effect), EPS, diarrhea

Class: chemotherapy
AE: low Hemoglobin, low Platelets, neutrophils; indicates toxicity to Hydroxyurea; report to MD

Desmopressin (lab values to monitor)
Tx: diabetes insipidus
Class: antidiuretic hormone
Teaching: monitor Specific Gravity, Creatinine clearance, Serum osmolality

Opioid addiction (drug tx)

Nicotine addiction (drug tx)

Alcohol addiction (drug tx)

Methamphetamine addiction (drug tx)

Pegfilgrastime (therapeutic use)
increased WBC; tx for CANCER

Tx: depression
Class: antidepressant
Teaching: move slowly; report Orthostatic HYPOTENSION

Lithium (over the counter drugs to AVOID)
Ibuprofen (NSAIDs)

Ciprofloxacin tx for UTI (contraindications)
tendonitis/deep tendon rupture

Spironolactone (adverse effects)
lethargy r/t HYPERKALEMIA

Tx: glaucoma
Class: beta blocker

Nitroglycerin patch (teachings)
check BP 1 hour AFTER applying patch
call MD to report headaches
rotate location of patch

diphenoxylate-atropine (Lomotil)
Tx: diarrhea
Class: antidiarrheal; anticholinergic
MOA: slows the movement of the intestines
AE: abdominal distention

Allopurinol (drug to AVOID)

zidovudine (Retrovir)
Class: antiretroviral
AE: paresthesia, N/V, lactic acidosis,
Teaching: monitor hemoglobin

-broad spectrum
-Similar to PCN/ don’t give if PCN allergy
-can cause bleeding w/ other bleeding meds monitor bleeding time (tonsil story)
– Disulfiram reaction (puke & puke & puke) just like Flagyl, the protozoal drug
– Store in fridge & take with food

ALL antibiotics have these side effects
– allergy, hypersensitivity
– suprainfection
– organ (kidney & ear) toxicity
– lowers oral contraceptive effectiveness

– serious infections like MRSA
– colitis by c-diff
– ototoxicity: get hearing test, tell dr. if hearing getting worse
-given over 60 minutes

– Sumycin, Doxycycline (Vibramycin)
– broad, rocky mtn fever, lyme disease, acne, GI infections by H. Pylori
– bad GI discomfort
– Don’t give to kids ≤8; teeth permanently yellow
– Bad photosensitivity- wear sunscreen!
– Can’t take with milk, iron, or antacids
– Take on empty stomach with a full glass of water

Tx: gonorrhea, pink eye, scarlet fever, strep throat, acne
Indication: When pt allergic to PCN and needs abx
Class: antibiotic
MOA: Bacteriostatic inhibitor
AE: GI issues

ototoxicity, Renal toxicity, Can’t take with PCN at all!
– gentamicin, neomycin, streptomycin

sulfamethoxazole/trimethoprim (Bactrim)
Class: antibiotic
Teaching: contains Sulfa; Blood problems (get CBC baseline); photosensitivity wear sunscreen and glasses; empty stomach with a full glass of water

Isoniazid (INH)
– take daily for 6-12 months and most likely with other meds too
-worked if 3 neg. sputum cultures, no temp.
– Liver toxicity (hepato) check liver fxn
– Don’t take with alcohol (liver fxn remember?)
– Take on empty stomach

Antiviral: Acyclovir, Ganciclovir
Teratogenic preg. X; put on rubber gloves if topical! remember my purple glove experience
-thrombocytopenia, lowers WBC

What class of drugs if Flagyl? What is the weird effect it has?
protozoal. works on C. diff & H. Pylori PUD. Antibuse effect if taken with alcohol

Amphotericin B
– infusion rxns (fever and chills)
– nephrotoxicity
– hypokalemia
– hepatoxicity
– gynecomastia
– C/I with aminoglycosides (just like PCN)


______ causes malignant hyperthermia. Use ____ to stop it
succinylcholine, Dantrium/Dantrolene.

Morphine adverse effects
– Constipation
– Resp depression
– Urinary retention
– Sedation
– Orthostatic HTN
– Cough suppression

Morphine drug-drug interactions (think of what morphine does to the body)
-CNS depressants
-hypotensive drugs
-opiod antagonists (narcan)
– antihistamines

Morphine patient education re how to take
Take with food for N/V, lie still will help

Opioid withdrawal sx (if stopped abruptly after ≥ 6 weeks). Is it life-threatening? Will it subside?
sweating, restless, agitated, dilated pupils, tremors, tachycardia, increased BP, N/V, cramps, muscle spasms with kicking movements. NO, subside in 7-10 days.

Migraine medications? Can you take them right after each other?
vasoconstriction, ergot’s and triptans.
NO, space out ergot and triptan by at least 24 hours.


What pain med reduces platelet aggregation?
NSAIDS (aspirin), reduce thrombus but will bleed easier, too

What pain med reduces fever but has NO anti-inflammatory effect and NO platelet effect?

What can give child Reye’s syndrome if they have viral illness?

NSAIDS education w/ how to take med. NSAIDS=
with food, milk, or full glass of water to reduce gastric discomfort. Ibuprofen, Celebrex, Naproxen, Aspirin

acetaminophen max dose/day?
4 grams

When to withhold morphine/opiates
RR <12/min & notify Dr

Triptans (for migraines) & pregnancy
Triptan= Teratogenic. Pregnancy X

Rheumatoid Arthritis Drugs name potent toxic drug
DMARDs, 1st choice: methotrexate. Bone Marrow Suppression and Fetal Death

Methotrexate: most concerned about…
bone marrow suppression; Baseline CBC and platelet counts,

What are the s/s of circulatory overload? Seen if giving too much fluids
flush, SOB, cough, heart palpitations

What type of diuretic is not effective in renal failure?
Thiazide – HCTZ

Bumex is ___x more potent than lasix

Thiazide diuretics are good for the ___ and perfect for the eldery __ with HTN
bones, woman

Lasix drug-drug interaction: for manic depressive ppl it’ll get to toxic levels in the body
Lithium will become toxic

Signs of hypokalemia
weakness, dysrhythmias, increased cardiac sensitivity of digoxin, ileus, Flat T wave

Aspirin toxicity symptoms
Tinnitus, HA

Glucocorticoids adverse effects
potent; suppress adrenal glad fxn, hyperglycemia, osteoporosis, if taken with NSAIDS, increase risk of GI ulcer, mask infection and suppress immune system

Reo Pro (-mab) what is it for & adverse effects. What other use does Reo Pro have?
Immunosuppressant for RA, Lupus. toxic to bone marrow, acute pulm edema, infection risk, neoplasia risk. Antiplatelet action.

Classic CNS depressant drug classes and what they’re used for
Benzodiazepines, Barbituates. Anxiety.

-lam & -pam are the endings for ________

Benzodiazepine Lorazepam (ativan) increases the possibility of ______.


Other anxiolytics: and what they’re for
-Valproic Acid: anti-seizure, bi-polar
-Phenergan: NV, anxiety, extrapyramidal effects

Amitriptiyline (Elavil) drug drug interactions and how to take med
Anticholinergics b/c TCA already have anticholinergic effects
– void prior to dosing & take at bedtime to sleep through fatigue side effect

MAOI’s ___ line of choice for depression b/c of the adverse effects with ___, which can cause ___
2nd or 3rd, tyramine, hypertensive crisis

MAOI adverse effects are related to stimulation of the _____ and include:
SNS, CNS stimulation,
CV-hypertensive crisis, palpitations, Liver toxicity

1st drugs of choice for depression ___, which is equally as effective as ___, but without the SE of ___ & ___
SSRI, TCA, hypotension and sedation

SSRI drug examples: prototype and 2 popular drugs
Prozac, Celexa, Zoloft

Atypical antidepressant _______ better use in elderly

SSRI uses
Panic attacks
Social phobias

What time of day to give SSRI
Give in the AM for optimal effects

Lithium is used for
Bipolar Disorder


Lithium and Diuretics
toxicity if taking diuretics

Anti-depressants have ___________ effects
anticholinergic: dry mouth, constipation, lack of sweat, lack of voiding

Antidepressants and anti-anxiety meds may take ___ to ___ weeks to take effect
2-3 weeks

all anti-depressants have _____ ______ effect and pt must have their __ monitored
orthostatic hypotension. BP

If patient taking an antihypertensive and just got ordered MAOI, Nardil, Marplan, or Parnate, then…
monitor their BP and call the Dr if theres a significant drop and may need to reduce the anti-htn dosage

Lithium and Triptans? Safe in pregnancy?
NO both lithium and triptans are teratogenic

Therapeutic Levels of Lithium
0.4-1.0 mEq/L. Take 2-3 times a day.

Chemotherapy Agents
neosar (cyclophosphamide), methotrexate, doxorubicin, tamoxifen

Cyclosporine is an _________
immunosuppressive drug

PTT lab value should stay at >_________ for what medication? What is the therapeutic PTT level?
2 times the baseline, Heparin. 60-80 seconds

To prevent HIT, stop heparin at platelet count of <________

How to inject heparin, starting from drawing up
draw up with 22-25 ga needle from vial, then use 25 or 26 ga to put into abdomen 2in from umbilicus.

Drug to help with heparin overdose
Protamine Sulfate

Warfarin C/I (2)
liver failure (no clotting proteins will lead to too much bleeding), alcoholism (additive risk of bleeding)

Lab values to watch with Warfarin
-PT (18-24 sec)
-INR (2-3)

patient education with aspirin (food-wise)
take with food

Prevention of strokes, MI, and reinfarctions can be accomplished with low-dose aspirin of ___mg
81 mg

Thrombolytic drug prototype
Streptokinase, dissolves clots that have already been formed

When should thrombolytics, streptokinase, be given?
4-6hr of onset of symptoms

Do/Do not mix any medications in IV with thrombolytic agents

What medications are usually given with thrombolytics, streptokinase? (think when this drug is used)
Beta-blockers to lower myocardial oxygen consumption
H2 antagonists like Zantac or
PPI like Prilosec to prevent GI bleeding


Ferrous Sulfate
Tx: iron deficiency anemia
Class: mineral & electrolytes
– GI distress however can’t take with food b/c that will decrease it’s absorption greatly;
– Teeth staining (drink w/ straw or dilute in water or juice and rinse mouth after swallowing);
– Don’t take with tetracycline or antacids;
– Poop will be a harmless dark green or black color;
– Drink more water and exercise more to counter constipation effects

why would a patient be given vitB12-cyanocobalamin
pernicious anemia, partial removal of stomach

What vit/min masks the signs of Vit b12 deficiency?
folic acid

E-alfa, hematopoietic growth factor, is dependent on adequate levels of ___ ___ & ___
Iron, Folic acid, Vitamin B12

In giving whole blood, what do you do before and during?
obtain vital signs, stay with the client and monitor VS q5 min for 15 minutes

When giving whole blood, what do you need the 2nd person for?
check identification of the donor blood and recipient, blood compatibility and expiration date.

Only give blood products with what type of IV fluid?
0.9% NS. anything else will cause lysis of the RBC

Bronchodilator albuterol: therapeutic uses
Prevention of asthma attack
long-term control of asthma
Short acting treatment for asthma attack

Bronchodilator side effects; overall stimulation of the B2-adrengeric receptors…
tachycardia, angina

How to use a MDI (metered dose inhaler)
shake the inhaler, 1/2-2 in away from mouth and tilt head back slightly and open mouth wide. press inhaler same time you breath in deep. Hold breath for 10 seconds. Wait 1 full minute b4 another puff.

When prescribed a beta-2 agonist and an glucocorticoid, which do they inhale first?
the beta-2 agonist promotes bronchodilation and enhances absorption of the glucocorticoid

What does the med theophylline do? short term or long-term control?
relaxes bronchial smooth muscle and does bronchodilation. Long-term control of asthma attacks.

Inhaled atrovent what class of medication is it
anti-cholinergic used for long term control of asthma

Glucocorticoids for asthma are used for _____ and oral glucocorticoids are only give for ___-___ days
long-term control of asthma attacks. 3-10 days

Codeine is used for ___. classification of drug?
Tx: chronic, non-productive cough
Class: opioid
AE: CNS effects, GI effects (take with food)
Teaching: increase fluids

Mucomyst (Acetylcysteine) is a mucolytic and it’s therapeutic effect is to:
Tx: cystic fibrosis, emphysema, bronchitis, pneumonia, TB
Class: mucolytic
MOA: make nasal and bronchial secretions watery to enhance their passage
AE: aspiration and bronchospasm
Teaching: smells like rotten eggs, dilute with water or juice

What do nasal decongestants like phenylephrine do to the body?
CNS stimulation b/c they stimulate alpha-1 adrenergic receptors.
Vasoconstriction-watch HTN and CAD patients!

How fast do you infuse K chloride in IV pump?
no faster than 10 mEq/hr

You should dilute ___and give no more than 40 mEq/L to prevent vein irritation
KCl. remember in clinical he said it was really burning his vein.

SERMS raloxifene is used for _______
osteoporosis and prevent bone fractures

raloxifene (Evista)
Tx: osteoporosis
Class: estrogen modulator
AE: hot flashes, DVTs

Bisphosphonates, like Fosamax or Boniva
sit or stand for 30 minutes after taking
-have enough vit d and calcium

phenytoin (Dilantin)
Tx: epilepsy, subarachnoid hemorrhage, trigeminal neuralgia
Class: anti-seizure
AE: gingivial hyperplasia, blurred vision, bad rash, beardy chesty, teratogenesis, dysrhythmias

Which vitamin promotes iron absorption but increases its side effects?
Vit C

Carbamazipine (Tegretol) 1) Use 2) cannot be used with _____ ______ (all of these meds can’t)
-oral contraceptives

PTU is given for ______ & clinically see its working by:
lowered Hr, weight gain, lowered T4 levels

-opril -april
ACE inhibitor

All ACE inhibitors cause: (2)
dry, persistant, cough AND hyperkalemia (increases body’s uptake of K+)

70% of patients on an SSRI experience _____ ______
sexual dysfunction

Fentanyl is used for:
severe cancer pain, will cause constipation

____ will increase the toxicity of Lithium
NSAIDS, tylenol is NOT an NSAID

Carbonic Anhydrase inhibitor use

Ulcers, GERD,

Bupropion (Zyban) to help stop smoking has what action on the CNS system?

Therapeutic level of Digoxin?

Gold Salts for RA toxicity. RA drugs dosing
rash, sores in mouth, intense itching
– once-a-week at first then down to once-a-month

HBA1c goal for DM

Amitryptyline (Elavil) has _______ effects. What is Elavil drug class?
“-triptyline or -pramine”
anticholinergics. Tricyclic antidepressant (TCA)

Lithium adverse effects
hand tremors, thirst, GI upset

Digoxin toxicity can occur in the presence of ________ which can happen with what medication?
Hypokalemia, Lasix

Aspirin, celebrex, ibuprofen, naproxen

Antidote/Reversal Agent: Neostigmine

Dilantin (phenytoin) is used for _____ and it’s side effects are
seizures, double vision, hirsuitism, skin rash, teratogenesis, dysrhythmias,

Dilantin (phenytoin) cannot be used with what two other drugs?
oral contraceptives and warfarin

Beta 1 heart meds are used to treat
Heart Failure and Cardiac arrest

Alpha 1 agonists like epinepherine is used for __
raising BP

Beta 1 activation in the heart can cause ________

Dopamine is used for ____ and ____
Heart Failure

Multiple drug interactions with Heart medications:
MAOI, TCA enhance epinephrine effect (vasocontriction)
– Phentolamine -A blocker
– Propanolol B blocker

Alpha Adrenergic Blockers (“-zosin;” prazosin/Minipress) all have a first-dose ___ effect. What OTC analgesics counteracts the anti-hypertensive effect?
orthostatic hypotension b/c venous dilation

Clonidine (catapress) does what to the pt’s BP and CO?
decrease BP and CO

Clonidine (catapress) and ______ (alpha blocker) counteract each other
Prazosin (Minipress)

Which Beta blocker is non-selective and causes bronchoconstriction, too?

-pril ACE inhibitors block Ang I from becoming II resulting in:
vasodilation, excretion of water & sodium, retain K,


Angiotensin II Receptor Blockers (ARBs)

Cholesterol drugs

-pine, -amil (verapamil: non-selective)
Ca channel blocker


The main difference between ARB’s and ACE inhibitros is that ______ and _______ are not side effects of ARB
– hyperkalemia

Ca Channel Blocker (-ipine/-amil) vasodilate and adverse effects (2)
– reflex tachycardia
– Peripheral edema

Dysrhythmias are seen as a ________ QRS interval

Action of Digoxin (2)
increase myocardial contraction
Lower Heart Rate giving ventricles more time to fill

The most dangerous adverse effect of Digoxin is it’s ability to create ________, particularly in patients who have _______
– hypokalemia

ACE inhibitors (-prils), ARBs (-sartan), Thiazide & looop diuretics increase the likelihood of ________ and it’s level should be monitored when taking _______ with these meds.

Cimetidine (tagamet) is for

cyclosporine is an

Clonidine (catapress) is a alpha agonist and has what two adverse effects
dry mouth
drowsiness & sedation

Ca Channel Blockers adverse effects are related to __________ & the immediate-acting drugs can cause _____ ________
vasodilation: headache, dizziness, edema, flushing
-reflex tachycardia

Ranitidine Hydrochloride (Zantac) is a __ ____ ______ and is used for _____ and _____
H2 receptor antagonist
-PUD and GERD by suppressing the secretion of gastric acid

-tidines and -prazole’s lowers gastric pH which promotes bacteria in the stomach and _______ _______ so use cautiously in pts who are at high risk for ______
-respiratory tract

H2 receptor antagonist used for ulcers and GERD

-prazole. is the gastric acid lowering reversible?
PPI. Irreversible inhibiting of gastric acid

Don’t take -prazoles with ____ and ____
antibiotics and digoxin

Aluminum hydroxide gel (amphojel), Milk of Mag, Sodium Bicarb are all

Aluminum and Calcium cause ______ while milk of mag causes _______
– diarrhea

How many times does the patient take antacids?
7 times a day! it’ll relieve their pain and heal the ulcer

Take all medications at least ___hr b4 or after antacids
1 hour

Misoprostol: who used them & intended use
-ppl taking long-term NSAID therapy and pregnant women
-prevent ulcers and induce labor

examples of anti-emetics
-Ondansetron (zofran)
– Prochlorperazine (Compazine)
– Dramamine prevents motion sickness
– metoclopradmie (reglan)

All anti-emetics should not be used with these 3 medications b/c they intensify anti-emetic side-effects
opiods- intensify CNS depression

diphenoxylate (lomotil)
loperamide (Imodium)

Caffeine makes diarrhea worse or better?

Insulin moves __ into cells along with Glucose

Can synthroid be given to a pregnant woman?
yes- its a pregnancy level A

Is PTU safe to use in pregnancy? What side effects are there for PTU
NO c/i b/c neonatal hypothyroidism can occur
– overmedication goes to hypothyroidism
-can increase anticoagulant effects

Estrogens can decrease the effectiveness of ______, an anticoagulant drug

What medication class lower the effectiveness of birth control? (4)
-benzodiazepines/ phenobarbital
-phenytoin (dilantin)
– rifampin (TB drug)

True/False: TSH at 2 micro units indicates good treatment of hypothyroidism

True/False: Photosensitivity and blurred vision are anti-cholinergic side effects?

What are signs of an “infusion reaction” with amphotericin B?
fever and chills

Antifungals are safe to use with Warfarin?
False; antifungals inhibit the degradation of warfarin

for pancreative enzyme deficiency used every time they eat

Stevens-Johnson Syndrome
dry,crusty rash and should be reported to the PCP

INR therapeutic range: what about mechanical heart valve patients?

PTT therapeutic range

What is the only immunization given at birth?
Hepatitis B vaccine

It could take __ to __ months for a person on RA drugs to start to feel better
4 to 6 months

Anticholinergic effects
dry mouth
blurred vision

Bisphosphanates for osteoporosis should be taken with food or on an empty stomach?
Empty stomach

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