Pharmacology ATI Test Info 4-08
Pharm. 2.0 (158066) [07S5371R70]





























Digoxin (lanoxin) [anti dysrhythmic]SE: blurred/double vision
Guaifenesin SE: can cause drowsiness
Estrogen (premarin) SE: ↑ risk of Thromboembolism with s/s: SOB, severe headache, vomiting,
sudden acute pain in the calves, legs, chest, abdomen.
Doxepin (Sinequan) [anticholinergic] SE: urinary retension, constipation, drying of nasal/oral secretons,
↑HR
Albuterol (Proventil) [sympathomimetic/ adrenergic beta-2 agonist] Contraindicated: with MAOIs (can↑
action of albuterol and → HTN crisis); β-blockers can inhibit the therapeutic effects Use: invert canister,
shake before use, rinse mouth after use, w/new inhaler perform test spray
Levothryoxine (T4) Indication: hypothyroidism RT dysfxn of hypothalamus, pituitary, or thyroid gland
Cephalosporins (Keflex)—allergy to cephalosporins is considered a precaution for taking penicillins
Phenobarbital [Barbiturates]; interventions for anticonvulsant therapy: assess for resp. depression,
excess sedation from toxic effects, IV at < 50mg/min, avoid extravasation (alkaline→skin damage)
Sumatriptan (Imitrex): Use: when migraine symptoms appear and again in 1 hr if symptoms persist
Route—fastest/most effective: intravenous
Narcan [opioid antagonist]: therapeutic action: improvement of respiratory rate.
Baclofen (Lioresal) Therapeutic action: ↓ frequency & severity of muscle spasms
Erythromycin (Erythrocin) [macrolide] SE: liver toxicity
Insulin: high dose (U-500) is 5 times stronger than U-100—divide dosage ordered by 5
Spironolactone (Aldactone) [K sparing diuretic]—avoid foods w/ ↑ K such as salt substitutes
Chloroquine phosphate (Aralen): Indic.: malaria prevention; Use: take weekly starting 1 week before
departure and continued for 4 weeks after return.
Heparin (anticoagulant) Use: w/alteplase for acute MI
Warfarin (Coumadin) Use:long-term prophylaxis of thrombosis [antidote—Vit K]
Clopidogrel (Plavix) Use: reduce long-term risk of clotting w/ atherosclerosis and recent MI of CVA
Alteplase (Activase) [antithrombolytic] Use: Acute MI/CVA (has short half-life)
Methylphenidate (Concerta) Use: marcolepsy Precaution: avoid caffeine use
Testosterone IM—If use to correct delayed puberty→assess bone maturation with bi-annual x-rays of
hand and wrist; monitor liver fxn (can ↑ hypoglycemia, potentiate sleep apnea, exacerbate heart failure
due to fluid retension.
Diphenoxylate & Atropine (Lomotil) Caution: With Renal impairment ↓ elimination of atropine → ↑
anticholinergic effects of atropine like confusion
Loperamide (Imodium) Use: anti-diarrheal (poorly absorbed from GI tract; difficulty crossing the bloodbrain barrier)
Methylcellulose (Citrucel): bulk-forming agent with minimal Side Effects (SE)
Psyllium (Metamucil): bulk-forming agent with minimal Side Effects (SE)
Acetazolamide (Diamox) [diuretic] Indic.: edema, epilepsy, acute mountain sickness, glaucoma (↓
intraocular pressure by ↓ amount of aqueous humor in the eye) Contra: allergy to sulfonamides
Metoprolol (Lopressor) [β-blocker] Hold dose for dyspnea (sign of exacerbation of CHF)
Propanolol
(Inderal) Use. Dysrhythmia, HTN, angina; SE: bronchoconstriction/bronchospasm; can block
glyconeogenesis
Norgestrel (Ovrette) Use: contraception; SE: excess progestin →weight gain from ↑ appetite; deficiency
of progestin: late breakthrough bleeding, amenorrhea; excess estrogen → edema
Medroxyprogesterone (Provera); Contra: smoking/tobacco products; Risks: Thromboembolism &
Cardiovascular complications; Interventions: use additional contraceptive measures w/antibiotic therapy



































IM injection site: locate dorsogluteal site
Nausea tx: antiemetic plus cool, damp cloth to forehead, neck, and wrists.
Allopurinol (Zyloprim) Ind. Gout; MofA: ↓ serum uric acid levels & urinary uric acid secretion;
Precaution: avoid foods that acidify urine such as corn
TB—multi drug tx: Isoniazid(INH), Rifampin, pyrazinamide, ethambutol—to deal w/ resistant strains
ACE Inhib. Lisinopril (Zestril) SE: dry/persistent cough for 1-2 wks from ↑ bradykinin
Synergistic drugs: Effect of giving both drugs > than the drugs individually
Furosemide (Lasix) [loop diuretic] Intervention: check BP before giving to determine baseline; can
cause ↓ BP by ↓ circulatory volume or by relaxing venous smooth muscle
Ticlopidine (Ticlid) Indic: prevent coronary artery thombosis; Intervention: check platelet count
PRBC (packed red blood cells) used as blood replacement when fluid overload is a concern
IV medications: Intervention: assess site for redness/swelling before administration
Collagenase (Santy) Use: Debride ulcers
Interferon Use: Prevent viral replication
Isotretinoin (Accutane) Contra: pregnancy w/ 2 forms of birth control due to teratogenic effects
Vaccine—adv. of live vs attenuated/killed vaccine: long-lasting active immunity vs partial (passive)
Epoetin Alfa (Procrit) Indic: treat anemia; SE: headache, HTN, seizures RT Hct rises too quickly
Urofollitropin (Fertinex) Dosage: admin. IM based on dose in preceding cycles SE: ovarian
hyperstimulation syndrome.
Hypertensive crisis S/S: flushed skin, headache, visual changes
Acetylcysteine (Mucomyst) Indic: prevent liver damage following acetaminophen (Tylenol) overdose.
Most effective if given shortly after ingestion; some protection up to 24 hrs.
Montelukast (Singulair) Indic: prevent asthma exacerbations;Dose: daily at bedtime; SE: well tolerated
Metoclopramide (Reglan)—has increased sedation when given with Morphine
Mannitol—Caution with pts with heart disease (can precipitate CHF and pulmonary ededa)
Opiate overdose causes Respiratory depression. Narcan antidote shorter acting. May need > 1 dose.
Diphenhydramine (Benadryl) Precaution: avoid other CNS depressants such as: alcohol,
benzodiazepines, kava kava
Anaphylaxis rxn—S/S: bronchoconstriction, angioedema, hypotension
Mafenide acetate (sulfamylon) Interventions: Admin PRN analgesics 30 min prior to tx; apply after
daily tubbing to remove previous cream; Monitor fluid & electrolyte/acid-base balances; schedule
wound care > 1 hr before meals; wear sterile gloves when applying
Zidovudine (AZT)—Dose: take at the times prescribed to prevent resistance development
SE: bone marrow suppression, hepatotoxic, nephrotoxic
Thrombocytopenia (< 150,000) Assess: platelet count
Prothrombin time:Indic:evaluate adequacy of extrinsic system&common pathway in clotting mechanism
Sulfisoxazole (Gantrisin): Use: UTI
Cyclosporine (Neoral): Intervention: Mix w/ orange juice or milk to ↑ palatability; mixed & dispense in
a glass container(since drug binds to plastic); grapefruit juice ↑ cyclosporine levels & ↑ risk of toxicity;
administer immediately after mixing (can separate & settle)
Hexacholorphene (pHisoHex) [antiseptic solution] Caution: CNS stimulation if sufficient amts are
absorbed through skin or mucous membranes; avoid if pregnant/breastfeeding
Auranofin (Ridaura) [gold salt] Indic: slows the progression of rheumatoid arthritis; takes 4-6 months of
therapy to achieve therapeutic effect; SE: renal toxicity (less toxic through oral route than IM route),
severe blood dyscrasias, GI rxns,
Thiazides—SE: hyperuricemia (common SE); assess: uric acid levels
Simvastatin (Zocor)—SE: muscle weakness/aches; Assess: Creatine Kinase (released w/severe muscle
injury)
Amitriptyline (Elavil) [tricyclic antidepressant] SE: orthostatic hypotension, sedation, & confusion
Pharm. 1.0 (158065) [07S5381R69]







































Drug dosage error—all care providers involved are responsible
Narcotic (opiate) analgesic—SE: papillary constriction, ↓BP, ↓HR, ↓ GI mobility
Antihistamines—Indic: allergy-induced symptoms
Mucolytic—Indic: ↓ viscosity of mucus plugs making them easier to expel
Antitussive—Indic: used to suppress a cough
Decongestant—Indic: used to treat nasal congestion
Bulk-forming laxatives (Metamucil) Use: take w/lg amounts of water to prevent a gel-like mass to ↑
constipation
Gentamicin (Garamycin) [aminoglycoside antibiotic]; SE: nephrotoxicity & ototoxicity
Digoxin [cardiac glycoside] that ↓ HR. Interv: assess apical HR for 1 min. Contact DR if HR < 60bpm
Lorazepam (ativan) [benzodiazepine]: SE: adbrupt cessation can →seizures RT physical addiction
Dantrolene sodium (Dantrium)—SE: hepatitis (highest risk for women 35yrs or taking lg doses)
Synergistic effect—effect of combined drugs greater than either of drugs alone
Zidovudine (AZT)—only anti-retroviral drug that reduces maternal-fetal transmission of HIV virus
Didanosine (Videx)—
Nevirapine (Viramune)—
Saquinavir (Fortovase)—
Acetaminophen (Tylenol)—SE: Liver damage w/ high doses
Diuretic therapy—Assess: K+ values to prevent dysrhythmias; ↓ Na+, ↓ Cl-, & ↓ Mg 2+
Gold Salts—bind to erythrocytes; SE: fatal bone marrow suppression, leucopenia, thrombocytopenia,
anemia; assess: Lab-CBC
Psuedoephedrine (Sudafed) [sympathomimetic/decongestant]—increases BP, HR, RR; Contraindication:
HTN
Sustained-release medication—Use: do not open, crush, or chew the medication
K+--necessary for: nerve & muscle cells (esp. those in the heart), impulse transmission
Anticonvulsant drugs—MofA: increase seizure threshold
Asthma therapy—Use: use albuterol (sympathomimetic drug) first to open up airways and allow other
inhaled drugs to be dispersed further down the bronchial tree
Ipratropium bromide (atrovent)
Beclomethasone dipropionate (Beclovent)
Greatest absorption of drug by IV route
Acyclovir (Zovirax)—SE: nephrotoxicity (crystallization of drug in nephron→renal tubular obstruction)
Digoxin toxicity—can be from ↓K+ (hypokalemia)
Fluoxetine (Prozac) [SSRI]—Teach: effects may not be seen for weeks; Dosage starts at 20mg, can be
increased after 2 wks gradually up to 80mg/day divided into 2 doses
Succinylcholine [depolarizing NMBA] common SE: muscular pain/stiffness
HCTZ (HydroDIURIL) [thiazide diuretic]—SE: may induce hyperglycemia (diabetics need to ↑ insulin)
Hypoglycemics—MofA: increase insuling produced by pancreas; Contra: ineffective w/Type 1 DM RT
inadequate production of insulin by pancreas
Vecuronium (Norcuron) [nondepolarizing NMBA]—MofA: causes relaxation of muscles & total flaccid
paralysis, but does not affect CNS, diminish pain, or consciousness
Insulin duration (Regular-6-8hrs); Onset ½ - 1hr; peaks 2-4hrs
Tolerance—body develops natural resistance to drug effects, need to increase dosage
Addiction—physical or psychological need for a drug
Substance abuse—inappropriate, excessive, self-admin of drug for non-medical purposes
Tissue dependence---occurs when actual changes in cells, secondary to physical addition causes body to
need the drug for homeostasis






































Metabolism of 95% of all drugs occurs in the liver. Other sites—lungs, skin; kidney excretes most drugs
Acetylcysteine (Mucomyst)—used in treatment of Acetaminophen (Tylenol) overdose
MAOI—interactions: foods w/ tyramine (causes release of NE→ hypertensive episode)
Antidysrhythmic agents—alter the dysfunction in the electrical system of the heart.
Prednisone (Deltasone) [corticosteroid] suppresses endogenous cortisol production, so abrupt stopping
of drug can result in acute adrenal insufficiency can occur
FDA pregnancy categories: A—human studies safe; B- animal studies safe, but no human studies have
been done; C- Animal studies unsafe, no human studies, D- evidence of fetal risk, X-cause abnormalities
Tamoxifen citrate (Nolvadex)—type of hormonal antineoplastic agent: anti-estrogen
Aluminum hydroxide (amphojel)—long term use SE: constipation (antiacids w/Mg alone cause
diarrhea; Often Al & Mg are combined to balance their side effects)
Corticosteroids—can interfere with effect of a vaccine since they depress the immune system and can
interfere with body’s ability to produce antibodies
Furosemide (lasix)—used for treatment of HTN in clients with renal dysfunction
Mannitol (Osmitrol) is an osmotic diuretic and is not used in the treatment of HTN
Triaterene/hydrochlorthiazide (maxzide)—a thiazide diuretic that is ineffective when ureine output is
low or renal dysfnx is present
Levothyroxine (synthroid)—overdose s/s: those that mimic hyperthyroidism: tremor & wt loss ;
undermedicated s/s: cold,dry,scaly skin; depression; slow cognitive ability
Liver & kidney disease—causes increase in length of duration of action of medication
Auditory canal in children—straighten by holding pinna of ear down & back
H. pylori—4 medications needed to eradicate the pathogen & ↓ risk of recurrence of ulcer (2 different
antibiotics; bismuth; medication to ↓ gastric acidity in the stomach)
Dopamine (Intropin)—Dose for cardiac shock: Intermediate doses ↑ CO; other uses: low doses ↑ renal
perfusion & urine output; high doses (>10mcg/kg/min) α effects predominate→vasoconstriction & ↑BP
Parkinson’s—associated with ↓ of dopamine in the substantia nigra (brain)
Terbutaline (Brethine)—SE: tachycardia
Gout treatment: drugs that lower uric acid level in the blood→ ↓ doposition of urate crystals in joints
Dexamethasone (Decadron)—effects on blood glucose: glucocortoid steroids & stress ↑ blood glucose
Narcotics—MofA: alter perception of pain at the spinal cord & higher levels in the CNS
Diuretics—pt. education: take during the day, report any changes in daily wt.
Oral Iron supplement—adverse SE: gastric irritation→anorexia, nausea, vomiting, constipation
Amphotericin B (Fungione)—SE: ↓K; ↓Mg; ↓Cl; ↓ Ca; nephrotoxicity (80% of pts)
Anti-hypertensive medications—SE: orthostatic hypotension
Trimethoprim/Sulfamethoxazole (Bactrim)[sulfonamide antibiotic]—SE: crystalluria that can clog the
kidneys; to prevent ↑ fluids to 2-3 liters per day unless contraindicated
Triazolam (Halcion)[benzo]—use: do not take with alcohol
Theophylline—therapeutic serum level: 10-20mcg/mL
Drug distribution via IV altered with CHF
Diphenhydramine (Benadryl)—SE: drowsiness
Treatment for constipation in children—glycerine suppositories (↑ osmotic pressure-draws fluid into
colon) castor oil-distasteful & ↓ absorption of fat-soluble vitamins;
Intradermal route used to admin: tuberculin test (PPD)
Cromolyn sodium (Intal)—indication: asthma prophylaxis (mast cell stabilizer→↓ release of histamine,
bradykinin, and serotonin that start a cascade of aqllergy symptoms)
IM site for 18 month old child: vastus lateralis
Metronidazole (Flagyl)—education: avoid alcohol (drug inhibits alcohol metabolism→accumulation)
Fluticasone (Flovent)[inhaled steroid]—Indic.: decrease inflammation of the bronchi
Status epilepticus: tx given via IV route










































Fexofenadine [2nd generation antihistamine]: differs from 1st generation by ↓ sedation
Neostigmine (Prostigmin)—MofA in pt w/ myasthenia gravis: ↑ level of Ach at neuromuscular junction
increases strength of muscle contraction
Calcium therapy need adequate amts of : vit. C
Naloxone (Narcan): narcotic antagonist
Barbiturate overdose RT: respiratory depression
Penicillin allergy may ↑ risk for allergy to : cephalosporins
Transdermal patch—education: rotate the site each time you change the patch
Proton pump inhibitors for treatment of: GERD
Acetaminophen Tylenol: safe for children with flu-like symptoms
Ibuprofen (Motrin)—Most common SE: GI distress
Maximum IM injection into dorsogluteal site: 3 mL
Phenobarbital (Luminal)—assess: respiratory depression
Insulin—oral hypoglycemic agents are contraindicated during pregnancy—use insulin instead
Drug absorption—affected by route of administration
Eye drop administration: depress the lower lid and place the medication in the lower conjunctival sac.
Pain medication admin in terminally ill: give medication on a regular time interval rather than PRN
Ventricula dysrhythmias in emergency setting—drug of choice: lidocaine hydrochloride (Xylocaine)
Diltizem (Cardizem)—used for SVT
Tocainide HCl (Tonocard)—used to prevent ventricular arrhythmias
Propranolol (Inderal)—used to prevent/control SVT (esp. assoc. w/ excessive catecholamines)
Unconscious type 1 diabetic—best intervention: admin glucagons IM
Anti-convulsant for infants/children: Phenobarbital (often admin w/ phenytoin)
Types of immunity: passive—immune: globulins/serums; active: illness or vaccination; innate: present
at birth; artificial-active: conveyed from one person to another (meternal-fetal transmission)
Bipolar—drug of choice: lithium
Tricyclic drugs—used in treatment of depression
MAOI drugs—used in treatment of depression
Benztropine mesylate—used to treat extrapyramidal effects w/ use of phenothiazines
Nasal congestion—treat with decongestant
Anti-tussive—treat cough
Mucolytic—used to decrease the viscosity of mucus plugs making them easier to expel
Antibiotics—SE: ↑ risk for fungal infection (destroys good bacteria & allows overgrowth of fungus)
Niacin—SE: vasodilation & facial flushing
Atropine—use: severe symptomatic bradycardia
Verapamil (Calan)—use: ↓ HR
Phenytoin (Dilantin)—therapeutic level: 10-20 mcg/mL
Decreased biotransformation of drugs in children→slowing the metabolism of many drugs
(biotransformation = metabolism)
Insulin—peak: NPH—6-12 hrs
Penicillin—most common SE: nausea/vomiting/diarrhea
Sympathomimetics: mimic SNS → ↑ BP
Beta-adrenergic blockers: block SNS →↓BP, ↓HR, ↓ arterial pressure, ↓ CO
Muscarinic antagonist AKA anticholinergic agents: block PSNS→ SNS responses
Diphenoxylate HCl (Lomotil)—SE: dry mouth (from added atroprine to discourage abuse)