Pharmacology I Comprehensive Review
1. Role of the Nurse in pharmacology

If the medication is not for the right reason, the nurse’s responsibility is to hold
and contact the healthcare provider.

Only give medication for the right purpose.

It is okay if the drug has side effects because remember drugs aren’t perfect.
2. Over the counter drugs do not need a prescription.
3. New drugs developing:

For approval, go through randomized controlled trial (RCT).
4. Reviewing medication order:

Example: Tylenol 325 PO daily
i. Medication.
ii. Dose.
iii. Route.
iv. Time/frequency.
5. Narcotics for pain:

If dose is higher than recommended amount, RN would notice a tolerance to the
drug from frequent use due to a chronic condition.
6. Which of the following is a generic name?

acetaminophen (Trade would be Tylenol)
i. Remember, generic is mostly lowercase while trade/brand name is
uppercase.
7. New drug for application, which phase does approval from the FDA occur?

Phase III (right after).
8. Studying the side effects drug have on HUMANS is called:

Clinical pharmacology
9. Phase I of trial for gout medication

Randomized population of health patients involved (volunteers).
10. Pharmacodynamics

Selective drug with a specific effect.
11. Extended-release tablet:

Enteric coating cannot be crushed as the intended effect would be disrupted.

Overdose may occur
12. Drug selectivity

Drug used is affinitive to certain receptors on certain cells, thus targeting specific
organs/organ systems to produce effect.
13. Therapeutic index of 20, 10, 2

Monitor drug with therapeutic index of 2 the closest because it has the strongest
effect.

Lower the number, higher the potential to produce toxic effects.
14. Learning pharmacology, receptor sensitivity of med.

Hypersensitivity
i. Drug has greater effect than it should.
ii. Continuous exposure of agonist (enhances).
15. Priority of medication before giving:

Will it achieve the intended therapeutic effect?
16. Off label medication

Approved by FDA for one thing but used for something else
i. Benadryl
17. Patient asks if drug is safe

Tell them the FDA approved it.
18. Looking at risk for drug interactions, pt @ risk of drug/drug interaction due to

Polypharmacy
19. Phase 4: manufacturer’s responsibility

Continue to monitor and have providers contact if any adverse effects are noted.
i. Drug is on the shelf.
20. Phase 3: Giving to people while monitoring adverse effects.

Test on people and monitor for adverse effects.
21. Phase 2: small trial

Small group of people.
22. Schedule 2 narcotics

High potential for abuse and addiction.
23. Pharmacology

Study of drugs and effect on physiology of living organisms.
24. Pharmacokinetics

The way the drug moves through the body.
25. Teaching patient about opioids, which schedule is most likely to be abused

Schedule 2 b/c widespread availability and has medical use.
i. Ex: oxycodone/Percocet
26. New drug becomes available

Approved by FDA
27. Preparing oral medication, which form has most rapid onset?

Liquid

IV is the fastest route
28. Patient has broken leg, preadmission assessment involves

Check records

ID patient

Any allergies
29. Beer’s criteria

List of meds that the elderly should avoid to reduce risk of falls/increase safety
30. Nurse’s responsibility w/ narcotics

Double locked

Count inventory before and after shift

Signature as drug is given
31. Pharmacodynamics

All about receptor binding
32. Goal of treatment with medications

Therapeutic effect with no cause of harm or maximum benefit with minimal
harm.
33. Drugs removed from phase 2

Because a lot of side effects
34. New drug and a patient asks side effect of Viagra for women.

Can’t usually tell because trials usually involve men. Won’t be able to say side
effects on women for sure.
35. RN with appropriate knowledge of pharmacology would state that:

No drug is a safe drug

Drugs aren’t only selective; they always do something else

Most important property of drug is its effectiveness
i. True
36. Low therapeutic index

Monitor for adverse reaction and dangerous effects because medication is strong
37. We did not learn property name, do not select if it comes up

Same with legend.
38. Properties of an ideal drug.
39. Half-life

The time it takes the drug to be eliminated by 50%.
40. Potent: produces a high effect at a low dose
41. Gentamycin: ototoxicity is a key side effect to monitor.
42. If ototoxicity side effect occurs suddenly, we must stop giving the medication and let the
provider know.
43. We are giving antibiotic therapy to patient; we must tell patient to take all of the
medication if they are feeling better to:

Prevent resistance from occurring.
44. Patient is allergic to penicillin and the provider orders cephalosporin. In the real world
this would not happen because cephalosporins are derivatives of penicillin.

Example of cephalosporins:
i. Generation one: gram positive: Cephalexin (sef-a-lex-in) and Cefazolin
(sef-a-zoe-lin)
ii. Second generation: more active against gram negative: Cefotetan (sef-ohtee-tan) and cefaclor (sef-a-klor)
iii. Third and Forth: even more effectively
1. Third: Cefotaxime (sef-oh-taks-eem), ceftriaxone (sef-tray-ax-one)
2. Fourth: Cefepime (seff-e-peem)

Do not give cephalosporin because it is a derivative of penicillin (safety, safety,
safety).
45. Tetra genic medications cause birth defects, and they are the most dangerous during the

first trimester because that is when the fetus is developing.
46. You have an old patient and to make sure there are no drug-drug reactions, we must look
at how many medications the patient takes.

Number of drugs of the geriatric population.
47. For Gentamycin, we must monitor kidneys because medication is excreting through
kidneys

Creatinine tells us medication clearance.

BUN only tells us how dry a patient is.

GFR tells us how well your kidneys are filtering.
48. Erythromycin

Patients have a lot of stomach pain with this medication so to prevent this, instruct
the client to:
i. Take it with food.
49. Neomycin is an aminoglycoside: a strong medication

Given before abdominal surgery to suppress abdominal bacteria.
50. Rifampin: used for tuberculosis

Urine and sweat will turn yellowish orange.

Think fluids.
51. Amphotericin-B

An anti-fungal drug.

Amphotericin-B are strong and affect the kidneys.

Be careful because can cause kidney damage.
52. Antifungal medications upset the stomach

Tell them to eat it with food.
53. Ciprofloxacin: fluoroquinolone
54. Tetracyclines

Sunburn and photosensitivity

Given for UTIs
55. Transmission of TB

It is airborne
56. What do we use INH for? (acid hydrazide)

Used to treat TB

Teach patient to not drink alcohol.
57. Highest priority for a patient with active TB is to make sure:

They take that medication
58. Patient taking INH for latent tuberculosis (PPD was raised but it is dormant yet can wake
up whenever)

Monitor LFT: liver functioning
59. HAART therapy is used to treat:

HIV
60. Acyclovir: anti-viral used to treat herpes, varicella-zosters (chickenpox) and shingles

Fewer reoccurrences of outbreaks
61. Anti-viral medication does not kill viruses from tissue, instead they:

Try to keep the virus in a dormant state.

Virus is still in your dermatomes.
62. To prevent viral infections:

Vaccinations
63. Pregnant people, children under 8 and older adult should avoid tetracyclines.
64. Patient has active tuberculosis and is prescribed 4 medications, the rationale for this
medication regime is that:

The combinations of medication are the most effective way, and they prevent
resistance.
65. When applying fungal infections:

Wash area with soap and water and dry thoroughly before applying medication.
66. Infections acquired while in hospitals are considered:

Hospital acquired infections or nosocomial infections.
67. An individual on antibiotics has a hypersensitivity reaction, signs and symptoms of this
include:

Rashes and hives: think skin
68. Vancomycin side effect:

Redman syndrome (turns red).
69. INH therapy:

If the fluids turn yellow it is okay, but if they start experiencing jaundice (eyes
(sclera), skin, organs), we tell them to stop the medication and report it. This
indicates liver toxicity.
70. INH therapy:

We tell them to take Vitamin B6 to prevent neuropathy.
71. When a patient takes INH, we monitor AST and ALT
72. Tetracyclines patient teachings include:

Wearing sunscreen and wearing covering clothing
73. The microorganism of TB is attracted to the

lungs.
74. Varicella (Chicken Pox) is given

sub-q
75. Patient is receiving clindamycin, patient will complain of stomach pain, possibly has
C.diff, treat with:

Vancomycin Orally
76. Tuberculosis: medications given would be INH and Rifampin.

Normal occurrences would be orange bodily fluids such as urine and tears. Patient
might also have slight stomach pain.

If jaundice (yellowing of skin and sclera) is seen, contact the provider and stop
the medication! Hepatic damage is occurring.
77. The first pass effect occurs when the concertation of a drug is reduced before reaching
the systemic circulation for distribution.

Drugs that can be affected by the first pass effect include any oral (enteral)
medication that encounters the GI tract.

Sub-lingual medications are considered oral but is being absorbed under the
tongue, therefore being absorbed by the circulatory system.
78. Medication order states that a medication is to be taken every 6 hours. The half-life of the
medication is 8 hours. If the medication is given at 8am Tuesday, when on Wednesday
will the drug level plateau?

The answer is 4pm.

A drug achieves a steady state or plateau between 4-5 half-lives.
79. The food and cosmetic act and controlled substance act.

First addressed in 1938.

This act was all about protecting the public regarding controlled substances.
80. The antidote to opioids and in an opioid overdose is:

Narcan.
81. After taking a medication, a patient becomes dizzy, drowsy, and experience nausea.
These are all examples of:

Adverse or side effects.
82. Alcohol, antibiotics, and supplements, and over the counter drugs cause increased
drowsiness or other effects because of polypharmacy due to:

Drug to drug interactions.
83. Drugs moving through the interstitial spaces of cells is called:

Distribution
84. Drugs taken up by the cells for metabolism occurs through the process of:

Absorption
85. Elimination of the drug via the urinary or gastrointestinal system is called:

Excretion
86. Acetaminophen is the generic name of OTC Tylenol. The daily recommended allowance
of Acetaminophen should not exceed 4000mg. Not many other medications have
acetaminophen in it however must be cautious as excessive use can cause:

liver damage which can lead patients onto dialysis.
87. Acetaminophen is not an NSAID, so it does not decrease inflammation.

Examples of NSAIDs include Motrin, Advil, and Naproxen.
88. Fluoroquinolones

Use caution with geriatric patients and young children.

The most alarming adverse effect is the Achilles tendon rupture.

Examples are Ciprofloxacin and Levaquin.
89. A nurse commits a medication error, and the priority would be to:

Assess the patient for any adverse reactions!
90. Medication comes up from the pharmacy and is not the correct amount, what right is
jeopardized:

Right dose
91. Patient underwent a knee replacement, and the nurse notes the patient is on various
medications (polypharmacy). The nurse would:

Assess hepatic functioning through the assessment of LFTs which include ASTs
and ALTs.
92. A doctor orders Percocet around the clock after surgery:

Assess pain by using a pain scale
93. A patient is on a PCP pump and is confused as to why they must press the button,

We can instruct the patient that they can self-administer medication using the
button before the pain gets worse.
94. When it comes to drug trials the two groups that are not used are:

Pregnant women and children
95. When we see a patient with polypharmacy or poly-medication, we must think:

Drug to drug interaction
96. Patient is taking 2 drugs together and combined decrease the functioning of the CNS.

These two medications are working together, known as synergism
97. If a medication that is an antagonist to opioids in which a patient is dependent on is
given, what symptoms would the patient experience?

Withdrawal symptoms
i. Patient is combative
98. Opioids are administered differently:

Hydromorphone is administered via IV

Fentanyl is administered via a dermal patch

Codeine and morphine are administered via IV
99. Imitrex is a medication given for headaches

This medication is given sub-q in pregnant women: this administration is
considered safe.
100.
If a sustained released tablet is crushed and given to a patient:

The patient is at risk for overdose.
101.
Long term use of steroids puts a patient at risk for

102.
osteoporosis
Short term use of steroids puts a patient at risk for

103.
Infection, impaired wound healing, and increased sugar levels
A child with serve asthma is given medication. Which medication would cause
undesirable effects?

104.
Prednisone
The type of medication that causes oral candidiasis (thrush or whiteness on the
tongue caused by fungus)

Steroids (ends with -one).
i. Can cause fungi

Dexamethasone

Beclomethasone
105.
Immunization refers to the production of active and/or passive immunity:

Vaccination is the act of introducing a vaccine into the body to produce immunity
to a pathogen.
106.
Patients with a history of Myocardial infarction, colon resection, in labor or with a
head injury should not receive:

Morphine
i. Due to their neurological compromise
107.
A patient has migraines and has already been given medication. What other
interventions can the nurse perform to promote dissipation of the headache?

Dim lights, lower noise, and have the patient relax.
108.
If a patient has bad teeth, sores on skin, and bleeding gums, what vitamin would
be given?

109.
Vitamin C
Patient has a severe allergic reaction to bees, what would be given?

110.
An anaphylaxis such as epinephrine.
A patient has asthma and is put on protozoan for a month. What is the most
important thing to educate the patient on?

Take all prescribed doses, try not to skip a dose, and at the end of the regimen, the
dose gets tapered.
111.
Amphotericin B is:

112.
an antifungal and therefore with use we monitor the kidneys.
As a nurse performs a wet to dry dressing, they note that the wound looks like it
has an infection. What should the nurse do next?

113.
Ask provider to order wound culture
Superinfection:

when normal flora is obstructed: triggered by a resistant strand.

This resistance emerges because of not adhering to the medication regimen.
You are a visiting nurse, and you arrive to a patient’s house to check medication.
114.
What would you perform?

Check if the medication bottle is full and count pills to see if they are taking the
medication.
115.
Which trimester is the baby most vulnerable for birth defects?

First trimester is when the baby most vulnerable
116.
A concerned mom has child who suffers from asthma. Child is on protocone but
not continuously. Every time the child is off the medication, breathing gets bad. The
mother asks why the child cannot be on the medication continuously. What is the nurse’s
best response?

Bones will get weak from prolonged steroid use and the child is at risk for
decreased growth
117.
Beta 1 functions on the heart while Beta 2 functions on heart and lungs. If a
patient is on beta 2 and steroid inhalers, what is the reasoning behind this?

Steroid manages inflammation and obstructions of the airway while beta 2 causes
increased absorption of air.
118.
Tagamet is an antihistamine and antacid (Think TUMs)

119.
A GI medication that reduces acid in the stomach
Non-resistant TB treatment

Four drugs for 2 months, then two drugs for another 4 months
i. Total of six months
120.
Latent tuberculosis treatment:

Isoniazid only: daily for 9 months, or isoniazid and rifampin once week for 3
months.
121.
Active TB treatment:

Treatment for at least 6 months or 3 months after culture becomes (-)