N121 Pharm Exam 1 (2025) With
Complete Solutions
category A risk - ANSWER Risk to the fetus in the first trimester (and in later
trimesters) has not been demonstrated in well-controlled studies in pregnant
women
category B risk - ANSWER Animal reproduction studies have not demonstrated
risk to the fetus, and there are no well-controlled studies in pregnant women
category C risk - ANSWER Animal reproduction studies have demonstrated risk
to the fetus, but there are no well-controlled studies in pregnant women;
however, potential benefits may outweigh potential risks in use of drug in
pregnant women
category D risk - ANSWER Evidence of risk to the human fetus has been
demonstrated. However, the benefits may outweigh risk in pregnant women if
the drug is needed in a life-threatening situation and other safer drugs cannot be
used or are ineffective
category X risk - ANSWER Studies in humans or animals have demonstrated
fetal abnormalities or evidence of fetal risk, and the risk clearly outweighs the
benefit. The drug is contraindicated in women who are pregnant or in those who
may become pregnant
antiemetics drug class - ANSWER • Phenothiazine
• Antihistamine
• 5-Hydroxytryptamine3 (5-HT3) or Serotonin receptor antagonists
• Miscellaneous agents
phenothiazines - ANSWER • Prochlorperazine (Compro, Compazine)
• Chlorpromazine (Thorazine)
• Metoclopramide (Reglan) - Prokinetic NOT a Phenothiazine
phenothiazines mechanism of action - ANSWER -Rapid Onset (20 minutes)
-Blocks dopamine from receptor sites in the brain and CTZ (chemoreceptor
trigger zone). Metoclopramide has same mechanism of action
,phenothiazines considerations - ANSWER -Safe to use in children older than 2
-Older adults may have increased adverse anticholinergic effects (dry mouth,
dizziness, drowsiness, tachycardia, urinary retention, blurred vision)
-Stop taking immediately if extrapyramidal symptoms occur (facial muscle
twitching, tremors)
-Pregnancy Class C
-Metabolized in liver and excreted in urine
-Special consideration for those with Hepatic and Renal Impairment
phenothiazines prevention and tx - ANSWER n/v associated with surgery,
anesthesia, migraines, chemotherapy and motion sickness
antihistamines - ANSWER • Hydroxyzine (Vistaril, Atarax)
• Meclizine (Dramamine)
antihistamines mechanism of action - ANSWER -Rapid Onset (30 minutes)
-H1 receptor blocking leading to decreased action of acetylcholine in the brain
antihistamines prevention and tx - ANSWER n/v due to motion sickness
antihistamines considerations - ANSWER -Used in kids; recommended dosage is
age and weight based
-Avoid using Hydroxyzine in older adults (Beers Criteria) as they are highly
anticholinergic (confusion, dry mouth, dizziness, drowsiness, tachycardia,
urinary retention, blurred vision)
-Pregnancy Class D
-Metabolized in liver and excreted in urine
-Special consideration for those with hepatic and renal impairment
5-Hydroxytryptamine3 (5-HT3) (Serotonin Receptor Antagonists) - ANSWER -
Ondansetron (Zofran)
-Dolasetron (Anzemet)
5-Hydroxytryptamine3 (5-HT3) considerations - ANSWER -Safe to use in older
adults with no increased side effects
, -First line drug for n/v caused by chemotherapy, radiation and post-op status
-Indicated for use in children
-Pregnancy Class B
-Metabolized in liver
>Half-life is increased in those with hepatic impairment which increases risk of
adverse effects
5-Hydroxytryptamine3 (5-HT3) mechanism of action - ANSWER -Rapid onset
(Immediate with IV, 30 min PO)
-Blocks Serotonin Receptors
corticosteroids - ANSWER - Dexamethasone (Decadron)
- Methylprednisolone (Solu-Medrol)
Benzodiazepine - ANSWER Lorazepam (Ativan)
Scopolamine - ANSWER Scopolamine (Transderm-Scop)
Cannabinoids - ANSWER Dronabinol (Marinol)
activated charcoal - ANSWER - "Universal antidote"
- If given within 30 minutes of drug ingestion it decreases absorption of toxic
drug by 90%; this drops to 37% if not given until 60 minutes of drug ingestion
- Multiple doses may be given if ingested drug is sustained release
- AE: include aspiration and bowel obstruction from impaction of charcoal-drug
complex
ipecac syrup - ANSWER -No longer routinely used in children in home settings
due to minimal effectiveness and potential complications
-Parents should call Poison Control (1-800-222-1222)
-May be given in health care setting if ingestion occurred less than an hour ago,
the patient is awake and monitored appropriately and the ingested substance
was NOT caustic
diarrhea causes - ANSWER ✓Intestinal Infections
-Salmonella
-E. coli
Complete Solutions
category A risk - ANSWER Risk to the fetus in the first trimester (and in later
trimesters) has not been demonstrated in well-controlled studies in pregnant
women
category B risk - ANSWER Animal reproduction studies have not demonstrated
risk to the fetus, and there are no well-controlled studies in pregnant women
category C risk - ANSWER Animal reproduction studies have demonstrated risk
to the fetus, but there are no well-controlled studies in pregnant women;
however, potential benefits may outweigh potential risks in use of drug in
pregnant women
category D risk - ANSWER Evidence of risk to the human fetus has been
demonstrated. However, the benefits may outweigh risk in pregnant women if
the drug is needed in a life-threatening situation and other safer drugs cannot be
used or are ineffective
category X risk - ANSWER Studies in humans or animals have demonstrated
fetal abnormalities or evidence of fetal risk, and the risk clearly outweighs the
benefit. The drug is contraindicated in women who are pregnant or in those who
may become pregnant
antiemetics drug class - ANSWER • Phenothiazine
• Antihistamine
• 5-Hydroxytryptamine3 (5-HT3) or Serotonin receptor antagonists
• Miscellaneous agents
phenothiazines - ANSWER • Prochlorperazine (Compro, Compazine)
• Chlorpromazine (Thorazine)
• Metoclopramide (Reglan) - Prokinetic NOT a Phenothiazine
phenothiazines mechanism of action - ANSWER -Rapid Onset (20 minutes)
-Blocks dopamine from receptor sites in the brain and CTZ (chemoreceptor
trigger zone). Metoclopramide has same mechanism of action
,phenothiazines considerations - ANSWER -Safe to use in children older than 2
-Older adults may have increased adverse anticholinergic effects (dry mouth,
dizziness, drowsiness, tachycardia, urinary retention, blurred vision)
-Stop taking immediately if extrapyramidal symptoms occur (facial muscle
twitching, tremors)
-Pregnancy Class C
-Metabolized in liver and excreted in urine
-Special consideration for those with Hepatic and Renal Impairment
phenothiazines prevention and tx - ANSWER n/v associated with surgery,
anesthesia, migraines, chemotherapy and motion sickness
antihistamines - ANSWER • Hydroxyzine (Vistaril, Atarax)
• Meclizine (Dramamine)
antihistamines mechanism of action - ANSWER -Rapid Onset (30 minutes)
-H1 receptor blocking leading to decreased action of acetylcholine in the brain
antihistamines prevention and tx - ANSWER n/v due to motion sickness
antihistamines considerations - ANSWER -Used in kids; recommended dosage is
age and weight based
-Avoid using Hydroxyzine in older adults (Beers Criteria) as they are highly
anticholinergic (confusion, dry mouth, dizziness, drowsiness, tachycardia,
urinary retention, blurred vision)
-Pregnancy Class D
-Metabolized in liver and excreted in urine
-Special consideration for those with hepatic and renal impairment
5-Hydroxytryptamine3 (5-HT3) (Serotonin Receptor Antagonists) - ANSWER -
Ondansetron (Zofran)
-Dolasetron (Anzemet)
5-Hydroxytryptamine3 (5-HT3) considerations - ANSWER -Safe to use in older
adults with no increased side effects
, -First line drug for n/v caused by chemotherapy, radiation and post-op status
-Indicated for use in children
-Pregnancy Class B
-Metabolized in liver
>Half-life is increased in those with hepatic impairment which increases risk of
adverse effects
5-Hydroxytryptamine3 (5-HT3) mechanism of action - ANSWER -Rapid onset
(Immediate with IV, 30 min PO)
-Blocks Serotonin Receptors
corticosteroids - ANSWER - Dexamethasone (Decadron)
- Methylprednisolone (Solu-Medrol)
Benzodiazepine - ANSWER Lorazepam (Ativan)
Scopolamine - ANSWER Scopolamine (Transderm-Scop)
Cannabinoids - ANSWER Dronabinol (Marinol)
activated charcoal - ANSWER - "Universal antidote"
- If given within 30 minutes of drug ingestion it decreases absorption of toxic
drug by 90%; this drops to 37% if not given until 60 minutes of drug ingestion
- Multiple doses may be given if ingested drug is sustained release
- AE: include aspiration and bowel obstruction from impaction of charcoal-drug
complex
ipecac syrup - ANSWER -No longer routinely used in children in home settings
due to minimal effectiveness and potential complications
-Parents should call Poison Control (1-800-222-1222)
-May be given in health care setting if ingestion occurred less than an hour ago,
the patient is awake and monitored appropriately and the ingested substance
was NOT caustic
diarrhea causes - ANSWER ✓Intestinal Infections
-Salmonella
-E. coli
