Pharmacology Final Exam & NCLEX Suggestions
1. Cardiac Glycosides
a. Digoxin (Lanoxin)- Used for HF. .125 dose
i. Monitor pulse- Have patient demonstrate correct way to read pulse, verbally
repeat what we taught, answer questions correctly about process.
ii. Levels: 0.8 – 2.0 ng/ mL
b. Coumadin (Warfarin) (Blood thinner) – Cardiac Glycoside
i. INR
1. 2-3 if on warfarin
2. 0.8-1.2 normal person not on warfarin.
3. Would be very high if bleeding internally.
ii. Antibiotics
iii. Consistent amount of Vitamin K
2. ACE Inhibitors (Lisinopril) (Benazepril)
a. Dilate venules and arterioles, improving renal blood flow and decreasing blood fluid
volume.
b. Blood pressure meds (anti-hypertensive).
c. Monitor for dry cough
d. Given for HTN
e. Monitor BP.
3. BiDil
a. FDA approval for treating HF, especially in African Americans.
4. AntiHypertensives / Diuretics
a. Hydrochlorathiazide (HCTZ)- BP medicine. Potassium wasting drug not potassium
sparing.
i. Monitor BP.
ii. Peripheral edema.
iii. Orthostatic Hypotension.
iv. Dizziness, confusion.
v. Monitor potassium labs.
1. 3.5-5
** Patient will also be on potassium. Monitor hypokalemia. If low, give hold med, OJ and call the
doctor.
vi. Hypokalemia
1. Weakness, fatigue, arrhythmias, polyuria, polydipsia.
b. Diuretics (Lasix or Furosemide) – Diuretics produce increased urine output by inhibiting
sodium and water reabsorption from the kidney tubules.
i. Give AM, daily weight. (report weight changes above 2 pounds)
ii. Loop diuretic
iii. Potassium wasting drug (3.5-5)
c. Aldactone (Spironolactone) (Potassium Sparing Diuretic)
i. Also used to treat HF.
ii. No salt substitutes.
1. Hyponatremia
iii. Hyperkalemia
, 1. Fatigue, muscle weakness, paresthesia, confusion, dyspnea, cardiac
arrhythmias.
2. Hold Potassium supplements if potassium is above 5.
5. Calcium Channel Blockers (Amlodipine) (Nifedipine)
a. Don’t take with grapefruit.
b. Don’t take with antacids.
c. Monitor BP, monitor for edema, jugular vein distention.
d. Dilators.
6. Beta Blockers (Atenolol, Propanolol)
a. Masks hypoglycemia.
b. Can make wheezing worse.
c. Monitor vitals (pulse and blood pressure). Hold if pulse under 60.
d. First choice of drug category in anti-hypertensives.
7. Nitroglycerin spray and tablets
a. What would you educate the client on?
i. Change positions slowly.
1. First dose should be taken while in a sitting or reclining position,
especially in geriatric patients.
2. Expect a headache
ii. Notify HCP if dry mouth or blurred vision occurs.
iii. Tablets
1. Keep tablets in original container. Exposure to air, heat, and moisture
can cause loss of potency.
iv. Lingual Spray
1. Instruct patient to lift tongue and spray dose under tongue (Nitrolingual,
NitroMist) or on tongue (NitroMist).
2.
8. Cholesterol Drugs (Lipitor)
a. Side Effects
i. Rhabdomyolysis- a breakdown of muscle tissue that releases a damaging protein
into the blood.
ii. Rashes
iii. Abdominal cramps, constipation, heartburn.
iv. Contact doctor if muscle weakness and have liver enzymes checked.
b. Liver enzymes
c. Monitor CK (Creatine Kinase) levels if patient develops muscle tenderness during
therapy.
d. Notify HCP if unexplained muscle pain, tenderness, or weakness occurs, especially if
accompanied by fever or malaise.
9. Viagra
a. Contraindications
i. Nitrates
b. Education
i. Only take once per day.
10. Cardiac Dysrhythmias
a. Lidocaine—ventricular ectopy
i. Know how to use.
1. Cardiac Glycosides
a. Digoxin (Lanoxin)- Used for HF. .125 dose
i. Monitor pulse- Have patient demonstrate correct way to read pulse, verbally
repeat what we taught, answer questions correctly about process.
ii. Levels: 0.8 – 2.0 ng/ mL
b. Coumadin (Warfarin) (Blood thinner) – Cardiac Glycoside
i. INR
1. 2-3 if on warfarin
2. 0.8-1.2 normal person not on warfarin.
3. Would be very high if bleeding internally.
ii. Antibiotics
iii. Consistent amount of Vitamin K
2. ACE Inhibitors (Lisinopril) (Benazepril)
a. Dilate venules and arterioles, improving renal blood flow and decreasing blood fluid
volume.
b. Blood pressure meds (anti-hypertensive).
c. Monitor for dry cough
d. Given for HTN
e. Monitor BP.
3. BiDil
a. FDA approval for treating HF, especially in African Americans.
4. AntiHypertensives / Diuretics
a. Hydrochlorathiazide (HCTZ)- BP medicine. Potassium wasting drug not potassium
sparing.
i. Monitor BP.
ii. Peripheral edema.
iii. Orthostatic Hypotension.
iv. Dizziness, confusion.
v. Monitor potassium labs.
1. 3.5-5
** Patient will also be on potassium. Monitor hypokalemia. If low, give hold med, OJ and call the
doctor.
vi. Hypokalemia
1. Weakness, fatigue, arrhythmias, polyuria, polydipsia.
b. Diuretics (Lasix or Furosemide) – Diuretics produce increased urine output by inhibiting
sodium and water reabsorption from the kidney tubules.
i. Give AM, daily weight. (report weight changes above 2 pounds)
ii. Loop diuretic
iii. Potassium wasting drug (3.5-5)
c. Aldactone (Spironolactone) (Potassium Sparing Diuretic)
i. Also used to treat HF.
ii. No salt substitutes.
1. Hyponatremia
iii. Hyperkalemia
, 1. Fatigue, muscle weakness, paresthesia, confusion, dyspnea, cardiac
arrhythmias.
2. Hold Potassium supplements if potassium is above 5.
5. Calcium Channel Blockers (Amlodipine) (Nifedipine)
a. Don’t take with grapefruit.
b. Don’t take with antacids.
c. Monitor BP, monitor for edema, jugular vein distention.
d. Dilators.
6. Beta Blockers (Atenolol, Propanolol)
a. Masks hypoglycemia.
b. Can make wheezing worse.
c. Monitor vitals (pulse and blood pressure). Hold if pulse under 60.
d. First choice of drug category in anti-hypertensives.
7. Nitroglycerin spray and tablets
a. What would you educate the client on?
i. Change positions slowly.
1. First dose should be taken while in a sitting or reclining position,
especially in geriatric patients.
2. Expect a headache
ii. Notify HCP if dry mouth or blurred vision occurs.
iii. Tablets
1. Keep tablets in original container. Exposure to air, heat, and moisture
can cause loss of potency.
iv. Lingual Spray
1. Instruct patient to lift tongue and spray dose under tongue (Nitrolingual,
NitroMist) or on tongue (NitroMist).
2.
8. Cholesterol Drugs (Lipitor)
a. Side Effects
i. Rhabdomyolysis- a breakdown of muscle tissue that releases a damaging protein
into the blood.
ii. Rashes
iii. Abdominal cramps, constipation, heartburn.
iv. Contact doctor if muscle weakness and have liver enzymes checked.
b. Liver enzymes
c. Monitor CK (Creatine Kinase) levels if patient develops muscle tenderness during
therapy.
d. Notify HCP if unexplained muscle pain, tenderness, or weakness occurs, especially if
accompanied by fever or malaise.
9. Viagra
a. Contraindications
i. Nitrates
b. Education
i. Only take once per day.
10. Cardiac Dysrhythmias
a. Lidocaine—ventricular ectopy
i. Know how to use.
