NUR 378 Pharmacology Exam 3
Module 7 (13 Q)
Dopamine Stimulation of PNS: Enhance renal blood flow, at higher doses increases HR and cardiac output as well
as vasoconstriction
Assessment: Monitor BP, HR, and urine output, assess for adequate perfusion, watch for ADRs
(tachycardia, arrhythmias, excess vasoconstriction, ECG monitoring and VS monitoring.
Epinephrine Use: Severe allergic reaction
Action: Stimulation alpha-1, beta-1, beta-2 adrenergic receptors, causes vasoconstriction, increases in
heart rate and contractility, and dilates airways
Phenylephrine ADR: Hypertension, reflex bradycardia, headache, nausea, restlessness, insomnia, arrhythmias, angina
and tissue necrosis. Can increase risk of cardiac complications.
Phentolamine Use: Pheochromocytoma (adrenal tumor that produces catecholamines), reverse local anesthetic
vasoconstriction, and hypertensive crisis.
ADR: Orthostatic hypotension, tachycardia, dizziness, headache, N/V/D, arrhythmias, chest pain, and
hypotension. Caution in patients with cardiovascular conditions
Metoprolol ADR: Hypotension, bradycardia, dizziness, fatigue, headache, bronchospasm, cold extremities,
insomnia, depression, heart failure, and heart block
Assessment: Monitor BP and HR, assess for signs and symptoms of heart failure (shortness of breath,
edema, weight gain), dizziness, fatigue or weakness, check BGL
Bethanechol Use: Urinary retention, gastric atony
Action: Stimulate bladder and gastric muscles
ADR: Bradycardia, hypotension, GI symptoms (N/V/D), muscle weakness, increased salivation,
sweating, difficulty breathing, and chest discomfort
Donepezil Assessment: Monitor for cognitive improvement, GI effects, insomnia, evaluate vital signs (bradycardia
and hypotension), monitor behavioral changes such as agitation or aggression
Physostigmine Use: Anticholinergic toxicity, such as from poisoning of antihistamines, TCAs or atropine. Manages
glaucoma by reducing IOP through increased Ach activity in the eye
Atropine Action: Anticholinergic, blocks effects of Ach at muscarinic receptors, increasing HR, decreasing
secretions and dilating the pupils
ADR: Dry mouth, blurred vision, tachycardia, urinary retention, constipation, flushing, increased IOP,
confusion, delirium and arrhythmias.
Diphenhydramine Action: Antihistamine, blocks H1 receptors, reducing effects of histamine, anticholinergic properties
, Module 8 (13 Q)
Acetylcysteine Use: Acetaminophen Overdose (Prevents Liver Damage), Mucolytic Agent (Thins And Loosens Mucus In
Lungs)
Propofol Action: General Anesthetic That Enhances GABA Leading To CNS Depression. Results In Sedation,
Hypnosis, And Anesthesia By Inhibiting Neurotransmission.
Succinylcholine Assessment: Monitor For Respiratory Arrest And Ensure Airway Management. Assess Muscle Rigidity
(Malignant Hyperthermia), And Fasciculation, Monitor Potassium Levels, Check For Bradycardia And
Hypotension. Monitor For Prolonged Paralysis.
Nitrous Oxide ADR: Hypoxia, N/V, Dizziness, Delirium, Confusion, Vit B12 W/ Extended Use, Respiratory Depression
Malignant Assessment: Muscle Rigidity, Increased Heart Rate, Tachypnea, Elevated Body Temp, Elevated
Hyperthermia CO2, Acidosis, Myoglobinuria
Treatment: Dantrolene, Cooling Measures, Oxygen Therapy, VS And Lfts
Baclofen ADR: CNS Depression Drowsiness, Dizziness, Weakness And Fatigue, N/V/C, Urinary Retention,
Withdrawal
Patient Teaching: No Haz Activities, Change Position Slowly, Take With Food/Milk, Increase Fluid
And Fiber, Adrs Will Decrease Over Time. Taper Slowly
Nursing Assessment: Baseline Strength, Cognition, VS, GI, Liver And Renal Function
Diazepam ADR: Dizziness, Drowsiness, Lethargy, CNS Depression, Impaired Recall, Respiratory
Depression, Hypotension, Tachycardia, Paradoxical Confusion And Anxiety, Tolerance, Overdose,
Withdrawal
Cyclobenzaprine Action: Inhibits Muscle Spasms Through Action On CNS At Brainstem
Use: Short-Term Relief Of Muscle Spasms And Discomfort Associated With Acute Musculoskeletal
Conditions
ADHD And ADHD Medications Mixed With Sumatriptan Increase Risk Of Serotonin Syndrome (Agitation, Confusion,
Sumatriptan Fever, Tachycardia)
Phenytoin Admin: Give W/ Food To Minimize GI Effects, Administer IV Med Slowly D/T Effects Of Phenytoin On
Influx Of Sodium In Neurons Of Brain And Heart. No More Than 50 Mg/Min. Monitor VS, EKG. Monitor
Plasma Levels Between 10-20 Mcg/Ml.
Toxicity: Nystagmus, Ataxia, Sedation, Blurred Or Double Vision
Levodopa/ Use: Dopamine Replacement To Relieve Parkinson's Disease Manifestations
Carbidopa
Teaching: Take With Food To Decrease GI Manifestations, Avoid High-Protein Meals, Urine And Sweat
May Darken, Get Up Slowly And Get Help With Ambulation If Necessary. Recognize Adrs (N/V,
Orthostatic Hypotension, Dyskinesias)
Amantadine Action: Increases Dopamine Release And Inhibits Dopamine Reuptake In Brain, Reducing Symptoms
Of Parkinson's Disease And Drug Produced EPS. Anticholinergic.
Assessment: Assess For Improvement In Tremors, Rigidity, And Bradykinesia, Confusion, Dizziness,
Hallucinations, Renal Function, Peripheral Edema, Liver Function
Interaction: With Benztropine: Increased Anticholinergic Effects (Dry Mouth, Constipation, Urinary
Retention, Blurred Vision And Confusion, CNS Effects (Dizziness, Confusion, Hallucinations)
Benztropine Action: Acts As Anticholinergic, Blocking Acetylcholine Receptors, Balancing Ach, Dopamine
Module 7 (13 Q)
Dopamine Stimulation of PNS: Enhance renal blood flow, at higher doses increases HR and cardiac output as well
as vasoconstriction
Assessment: Monitor BP, HR, and urine output, assess for adequate perfusion, watch for ADRs
(tachycardia, arrhythmias, excess vasoconstriction, ECG monitoring and VS monitoring.
Epinephrine Use: Severe allergic reaction
Action: Stimulation alpha-1, beta-1, beta-2 adrenergic receptors, causes vasoconstriction, increases in
heart rate and contractility, and dilates airways
Phenylephrine ADR: Hypertension, reflex bradycardia, headache, nausea, restlessness, insomnia, arrhythmias, angina
and tissue necrosis. Can increase risk of cardiac complications.
Phentolamine Use: Pheochromocytoma (adrenal tumor that produces catecholamines), reverse local anesthetic
vasoconstriction, and hypertensive crisis.
ADR: Orthostatic hypotension, tachycardia, dizziness, headache, N/V/D, arrhythmias, chest pain, and
hypotension. Caution in patients with cardiovascular conditions
Metoprolol ADR: Hypotension, bradycardia, dizziness, fatigue, headache, bronchospasm, cold extremities,
insomnia, depression, heart failure, and heart block
Assessment: Monitor BP and HR, assess for signs and symptoms of heart failure (shortness of breath,
edema, weight gain), dizziness, fatigue or weakness, check BGL
Bethanechol Use: Urinary retention, gastric atony
Action: Stimulate bladder and gastric muscles
ADR: Bradycardia, hypotension, GI symptoms (N/V/D), muscle weakness, increased salivation,
sweating, difficulty breathing, and chest discomfort
Donepezil Assessment: Monitor for cognitive improvement, GI effects, insomnia, evaluate vital signs (bradycardia
and hypotension), monitor behavioral changes such as agitation or aggression
Physostigmine Use: Anticholinergic toxicity, such as from poisoning of antihistamines, TCAs or atropine. Manages
glaucoma by reducing IOP through increased Ach activity in the eye
Atropine Action: Anticholinergic, blocks effects of Ach at muscarinic receptors, increasing HR, decreasing
secretions and dilating the pupils
ADR: Dry mouth, blurred vision, tachycardia, urinary retention, constipation, flushing, increased IOP,
confusion, delirium and arrhythmias.
Diphenhydramine Action: Antihistamine, blocks H1 receptors, reducing effects of histamine, anticholinergic properties
, Module 8 (13 Q)
Acetylcysteine Use: Acetaminophen Overdose (Prevents Liver Damage), Mucolytic Agent (Thins And Loosens Mucus In
Lungs)
Propofol Action: General Anesthetic That Enhances GABA Leading To CNS Depression. Results In Sedation,
Hypnosis, And Anesthesia By Inhibiting Neurotransmission.
Succinylcholine Assessment: Monitor For Respiratory Arrest And Ensure Airway Management. Assess Muscle Rigidity
(Malignant Hyperthermia), And Fasciculation, Monitor Potassium Levels, Check For Bradycardia And
Hypotension. Monitor For Prolonged Paralysis.
Nitrous Oxide ADR: Hypoxia, N/V, Dizziness, Delirium, Confusion, Vit B12 W/ Extended Use, Respiratory Depression
Malignant Assessment: Muscle Rigidity, Increased Heart Rate, Tachypnea, Elevated Body Temp, Elevated
Hyperthermia CO2, Acidosis, Myoglobinuria
Treatment: Dantrolene, Cooling Measures, Oxygen Therapy, VS And Lfts
Baclofen ADR: CNS Depression Drowsiness, Dizziness, Weakness And Fatigue, N/V/C, Urinary Retention,
Withdrawal
Patient Teaching: No Haz Activities, Change Position Slowly, Take With Food/Milk, Increase Fluid
And Fiber, Adrs Will Decrease Over Time. Taper Slowly
Nursing Assessment: Baseline Strength, Cognition, VS, GI, Liver And Renal Function
Diazepam ADR: Dizziness, Drowsiness, Lethargy, CNS Depression, Impaired Recall, Respiratory
Depression, Hypotension, Tachycardia, Paradoxical Confusion And Anxiety, Tolerance, Overdose,
Withdrawal
Cyclobenzaprine Action: Inhibits Muscle Spasms Through Action On CNS At Brainstem
Use: Short-Term Relief Of Muscle Spasms And Discomfort Associated With Acute Musculoskeletal
Conditions
ADHD And ADHD Medications Mixed With Sumatriptan Increase Risk Of Serotonin Syndrome (Agitation, Confusion,
Sumatriptan Fever, Tachycardia)
Phenytoin Admin: Give W/ Food To Minimize GI Effects, Administer IV Med Slowly D/T Effects Of Phenytoin On
Influx Of Sodium In Neurons Of Brain And Heart. No More Than 50 Mg/Min. Monitor VS, EKG. Monitor
Plasma Levels Between 10-20 Mcg/Ml.
Toxicity: Nystagmus, Ataxia, Sedation, Blurred Or Double Vision
Levodopa/ Use: Dopamine Replacement To Relieve Parkinson's Disease Manifestations
Carbidopa
Teaching: Take With Food To Decrease GI Manifestations, Avoid High-Protein Meals, Urine And Sweat
May Darken, Get Up Slowly And Get Help With Ambulation If Necessary. Recognize Adrs (N/V,
Orthostatic Hypotension, Dyskinesias)
Amantadine Action: Increases Dopamine Release And Inhibits Dopamine Reuptake In Brain, Reducing Symptoms
Of Parkinson's Disease And Drug Produced EPS. Anticholinergic.
Assessment: Assess For Improvement In Tremors, Rigidity, And Bradykinesia, Confusion, Dizziness,
Hallucinations, Renal Function, Peripheral Edema, Liver Function
Interaction: With Benztropine: Increased Anticholinergic Effects (Dry Mouth, Constipation, Urinary
Retention, Blurred Vision And Confusion, CNS Effects (Dizziness, Confusion, Hallucinations)
Benztropine Action: Acts As Anticholinergic, Blocking Acetylcholine Receptors, Balancing Ach, Dopamine
