RASMUSSEN PHARMACOLOGY EXAM 2 EXAM
REVIEW STUDY NOTES
◉ Aminoglycosides (e.g., Gentamicin): Nursing Management & Lab
Values.
Answer: Mandatory monitoring of therapeutic peak and trough
blood levels. Assess baseline and serial renal function labs (BUN,
serum creatinine) and check urine for casts or protein.
◉ Urinary-Specific Anti-Infectives (Nitrofurantoin, Fosfomycin,
Trimethoprim): Focus.
Answer: Act locally within the urinary tract to destroy bacteria.
Contraindicated in severe renal dysfunction (prevents drug
concentration in urine and increases systemic toxicity risk),
pregnancy, and lactation.
◉ Phenazopyridine: Mechanism & Patient Education.
Answer: Local, non-infective urinary tract analgesic that exerts a
direct topical soothing effect on the urinary mucosa. Causes bright
reddish-orange discoloration of urine (stains clothes/contact
lenses). Limit use to 2 days maximum when combined with
antibiotics.
◉ Vancomycin: Clinical Indications & Infusion Safety Rule.
,Answer: Primary drug of choice for MRSA and severe Gram-positive
infections. Must be infused slowly over a minimum of 60 minutes via
an IV pump to prevent Red Man Syndrome (severe hypotension and
facial/neck flushing).
◉ Vancomycin: Nursing Management & Lab Monitoring.
Answer: Exclusively monitor blood trough levels to maintain
therapeutic range and prevent ototoxicity/nephrotoxicity. Ensure
adequate hydration (minimum 2 L/24 hours) to protect the kidneys.
◉ Fluconazole (Azole Antifungal): Indications & Contraindications.
Answer: Treats systemic and localized fungal overgrowths of
Candida albicans (vaginal yeast, oral thrush). Contraindicated or
used with extreme caution in hepatic and renal impairment.
◉ Fluconazole (Azole Antifungal): Severe Adverse Effects & Nursing
Priority.
Answer: Severe hepatotoxicity (requires monitoring LFTs). Priority
Safety: If a patient experiences itching or an active rash during an IV
infusion, stop the infusion immediately, take vital signs, and notify
the provider.
◉ Amphotericin B & Nystatin: Clinical Indications.
Answer: Amphotericin B is a highly toxic drug reserved for severe,
life-threatening systemic fungal infections in immunocompromised
, hosts. Nystatin is used for topical, oral (swish and swallow for
thrush), and cutaneous fungal infections.
◉ Rapid-Acting Insulin (Lispro, Aspart): Timing & Dosing Context.
Answer: Onset: 5-15 minutes; Peak: 1-2 hours; Duration: 3-5 hours.
Critical Safety: The patient must eat a meal immediately following
injection to avoid rapid, severe hypoglycemia. Never give IV.
◉ Short-Acting Insulin (Regular Insulin): Timing & Dosing Context.
Answer: Onset: 30-60 minutes; Peak: 2.5 hours; Duration: 6-10
hours. Dosing Context: Standard choice for sliding-scale protocols,
acute corrections, and the ONLY insulin configuration that can be
safely administered intravenously (IV).
◉ Intermediate-Acting Insulin (NPH): Appearance & Timing.
Answer: Appearance is cloudy (contains modifying proteins). Onset:
1-2 hours; Peak: 4-14 hours; Duration: 14-24 hours. Often combined
or co-administered in a single syringe with rapid or short-acting
clear insulins.
◉ Long-Acting Insulin (Glargine, Detemir): Timing & Mixing Rules.
Answer: Onset: 1-2 hours; Peak: None (flat basal delivery); Duration:
24 hours. Critical Safety: Maintained as a clear solution but can
NEVER be mixed in the same syringe with any other insulin
formulation.
REVIEW STUDY NOTES
◉ Aminoglycosides (e.g., Gentamicin): Nursing Management & Lab
Values.
Answer: Mandatory monitoring of therapeutic peak and trough
blood levels. Assess baseline and serial renal function labs (BUN,
serum creatinine) and check urine for casts or protein.
◉ Urinary-Specific Anti-Infectives (Nitrofurantoin, Fosfomycin,
Trimethoprim): Focus.
Answer: Act locally within the urinary tract to destroy bacteria.
Contraindicated in severe renal dysfunction (prevents drug
concentration in urine and increases systemic toxicity risk),
pregnancy, and lactation.
◉ Phenazopyridine: Mechanism & Patient Education.
Answer: Local, non-infective urinary tract analgesic that exerts a
direct topical soothing effect on the urinary mucosa. Causes bright
reddish-orange discoloration of urine (stains clothes/contact
lenses). Limit use to 2 days maximum when combined with
antibiotics.
◉ Vancomycin: Clinical Indications & Infusion Safety Rule.
,Answer: Primary drug of choice for MRSA and severe Gram-positive
infections. Must be infused slowly over a minimum of 60 minutes via
an IV pump to prevent Red Man Syndrome (severe hypotension and
facial/neck flushing).
◉ Vancomycin: Nursing Management & Lab Monitoring.
Answer: Exclusively monitor blood trough levels to maintain
therapeutic range and prevent ototoxicity/nephrotoxicity. Ensure
adequate hydration (minimum 2 L/24 hours) to protect the kidneys.
◉ Fluconazole (Azole Antifungal): Indications & Contraindications.
Answer: Treats systemic and localized fungal overgrowths of
Candida albicans (vaginal yeast, oral thrush). Contraindicated or
used with extreme caution in hepatic and renal impairment.
◉ Fluconazole (Azole Antifungal): Severe Adverse Effects & Nursing
Priority.
Answer: Severe hepatotoxicity (requires monitoring LFTs). Priority
Safety: If a patient experiences itching or an active rash during an IV
infusion, stop the infusion immediately, take vital signs, and notify
the provider.
◉ Amphotericin B & Nystatin: Clinical Indications.
Answer: Amphotericin B is a highly toxic drug reserved for severe,
life-threatening systemic fungal infections in immunocompromised
, hosts. Nystatin is used for topical, oral (swish and swallow for
thrush), and cutaneous fungal infections.
◉ Rapid-Acting Insulin (Lispro, Aspart): Timing & Dosing Context.
Answer: Onset: 5-15 minutes; Peak: 1-2 hours; Duration: 3-5 hours.
Critical Safety: The patient must eat a meal immediately following
injection to avoid rapid, severe hypoglycemia. Never give IV.
◉ Short-Acting Insulin (Regular Insulin): Timing & Dosing Context.
Answer: Onset: 30-60 minutes; Peak: 2.5 hours; Duration: 6-10
hours. Dosing Context: Standard choice for sliding-scale protocols,
acute corrections, and the ONLY insulin configuration that can be
safely administered intravenously (IV).
◉ Intermediate-Acting Insulin (NPH): Appearance & Timing.
Answer: Appearance is cloudy (contains modifying proteins). Onset:
1-2 hours; Peak: 4-14 hours; Duration: 14-24 hours. Often combined
or co-administered in a single syringe with rapid or short-acting
clear insulins.
◉ Long-Acting Insulin (Glargine, Detemir): Timing & Mixing Rules.
Answer: Onset: 1-2 hours; Peak: None (flat basal delivery); Duration:
24 hours. Critical Safety: Maintained as a clear solution but can
NEVER be mixed in the same syringe with any other insulin
formulation.
