Final Exam Study Guide
● Sildenafil (Viagra)
○ Class: erectile dysfunction agents, vasodilators (phosphodiesterase type 5
inhibitors)
○ Used for erectile dysfunction
○ Enhances effects of nitric oxide released during sexual stimulation
○ Contraindicated in hypersensitivity and concurrent use of nitrates or
riociguat
■ Concurrent use with nitrates = may cause life-threatening
hypotension
■ Concurrent use with riociguat = may result in severe hypotension
○ Most frequent side effects: headache, flushing, dyspepsia
○ Life-threatening side effects: myocardial infarction and sudden death
○ Dose = 25 mg taken 1 hour before sexual activity
○ Sildenafil offers no protection against STDs, advice patient that protection
against STDs and HIV should be considered
○ Sildenafil (viagra) = can be given to neonates with hypertension
○ Do not take with high fat foods = high fat foods delay absorption and
reduce peak effects
○ can exacerbate hypertension with BPH drugs
● EC aspirin education (enteric coated aspirin)
○ Class: antipyretics, nonopioid analgesics (pharm: salicylates)
○ Patients should not crush or chew enteric-coated tablets
○ DO NOT take antacids within 1-2 hours of enteric-coated tablets
● Bumetanide
○ Suffix: -ide
○ Class: diuretic/loop diuretic
○ Indications: Edema due to heart failure, hepatic disease, or renal
impairment (unlabeled use: reversal of oliguria in preterm neonates)
○ MOA: Inhibits the reabsorption of sodium and chloride from the loop of
Henle and distal renal tubule. Increases renal excretion of water, sodium
chloride, magnesium, potassium, and calcium. Effectiveness persists in
impaired renal function.
○ Routes: PO, IM, IV
○ Contraindications: Hypersensitivity, cross-sensitivity with thiazides and
sulfonamides may occur, hepatic coma or anuria
, ○ Life-threatening side effects: stevens-johnson syndrome, toxic epidermal
necrolysis
○ Most frequent side effects: dehydration, hypochloremia, hypokalemia,
hypomagnesemia, hyponatremia, hypovolemia, metabolic acidosis
○ Other info:
■ Assess patient for skin rash frequently during therapy
■ Discontinue medication at first sign of rash
○ High ceiling loop diuretics = can cause ototoxicity
■ Education on tinnitus and hearing loss
● Furosemide X 10 (Lasix)
○ Class: diuretics (pharm: loop diuretics)
○ Indication: Edema due to heart failure, hepatic impairment, or renal
disease; Hypertension
○ MOA: Inhibits the reabsorption of sodium and chloride from the loop of
Henle and distal renal tubule. Increases renal excretion of water, sodium,
chloride, magnesium, potassium, and calcium. Effectiveness persists in
impaired renal function.
○ Desired effects: Decreased BP
○ Route: PO, IM, IV
○ Contraindications: Hypersensitivity, cross-sensitivity with thiazides and
sulfonamides, hepatic coma or anuria, avoid in patients with alcohol
intolerance
○ Side effects:
■ (Life-threatening): erythema multiforme, stevens-johnson
syndrome, toxic epidermal necrolysis, aplastic anemia,
agranulocytosis
■ (Most frequent): Dehydration, hypoglycemia, hypochloremia,
hypokalemia, hypomagnesemia, hyponatremia, hypovolemia,
metabolic acidosis
○ Interactions:
■ Antihypertensives, nitrates, acute ingestion of alcohol = increased
risk of hypotension
■ Other diuretics, amphotericin B, stimulant laxatives, corticosteroids
= increased risk of hypokalemia
■ Aminoglycosides or cisplatin = increased risk of ototoxicity
■ Cisplatin = increased risk of nephrotoxicity
■ NSAIDs = decreased effects of furosemide
, ■ sucralfate, cholestyramine, or colestipol = decreased effects when
used at the same time as furosemide
■ Salicylate (high-dose therapy) = increased risk of salicylate toxicity
■ Cyclosporine = increase risk of gouty arthritis
○ Other info:
■ Monitor BP and pulse before and during administration
■ Asses for skin rash during therapy = discontinue drug at the first
sign of rash (may be life-threatening)
■ Encourage patient to change positions slowly to minimize
orthostatic hypotension
■ Advise patient to contact healthcare profession if they notice rash,
muscle weakness, cramps, nausea, dizziness, numbness, tingling of
extremities
○ Can cause orthostatic hypotension = monitor electrolyte panel
■ Hypomagnesemia
■ Hypokalemia
■ Black box warning for fluid and electrolyte loss
● Medication Calculations: 3
○ (Practice questions; answers will be at the end of the study guide ☺)
1. A patient has an order for Chloromycetin, 500 mg every 6 hours. The drug comes
in 250 mg capsules. What would the nurse administer?
2. A nurse is to administer 150 mg of a drug intramuscularly. The label on the
multidose vials reads 100 mg/mL. How much would the nurse give?
3. The client is to be given ascorbic acid 1 g daily by mouth. The medication comes
in a container labeled, "Ascorbic Acid 250 mg tablets." How much will the nurse
give?
4. The nurse is preparing to administer 80 mg of Solu-medrol intravenously (IV) to
a client with pneumonia. The vial states that it has 120 mg per 2 mL. The nurse
would correctly draw up which amount?
5. The health care provider prescribes gentamicin 4 mg/kg/day PO in three
divided doses for a client that weighs 132 lb. The label on the vial reads 8
mg/mL. How many mL does the nurse administer for each dose?
● Potassium Chloride
○ Class: electrolyte supplements (parenteral electrolytes)
○ Do not administer potassium chloride undiluted
● Sildenafil (Viagra)
○ Class: erectile dysfunction agents, vasodilators (phosphodiesterase type 5
inhibitors)
○ Used for erectile dysfunction
○ Enhances effects of nitric oxide released during sexual stimulation
○ Contraindicated in hypersensitivity and concurrent use of nitrates or
riociguat
■ Concurrent use with nitrates = may cause life-threatening
hypotension
■ Concurrent use with riociguat = may result in severe hypotension
○ Most frequent side effects: headache, flushing, dyspepsia
○ Life-threatening side effects: myocardial infarction and sudden death
○ Dose = 25 mg taken 1 hour before sexual activity
○ Sildenafil offers no protection against STDs, advice patient that protection
against STDs and HIV should be considered
○ Sildenafil (viagra) = can be given to neonates with hypertension
○ Do not take with high fat foods = high fat foods delay absorption and
reduce peak effects
○ can exacerbate hypertension with BPH drugs
● EC aspirin education (enteric coated aspirin)
○ Class: antipyretics, nonopioid analgesics (pharm: salicylates)
○ Patients should not crush or chew enteric-coated tablets
○ DO NOT take antacids within 1-2 hours of enteric-coated tablets
● Bumetanide
○ Suffix: -ide
○ Class: diuretic/loop diuretic
○ Indications: Edema due to heart failure, hepatic disease, or renal
impairment (unlabeled use: reversal of oliguria in preterm neonates)
○ MOA: Inhibits the reabsorption of sodium and chloride from the loop of
Henle and distal renal tubule. Increases renal excretion of water, sodium
chloride, magnesium, potassium, and calcium. Effectiveness persists in
impaired renal function.
○ Routes: PO, IM, IV
○ Contraindications: Hypersensitivity, cross-sensitivity with thiazides and
sulfonamides may occur, hepatic coma or anuria
, ○ Life-threatening side effects: stevens-johnson syndrome, toxic epidermal
necrolysis
○ Most frequent side effects: dehydration, hypochloremia, hypokalemia,
hypomagnesemia, hyponatremia, hypovolemia, metabolic acidosis
○ Other info:
■ Assess patient for skin rash frequently during therapy
■ Discontinue medication at first sign of rash
○ High ceiling loop diuretics = can cause ototoxicity
■ Education on tinnitus and hearing loss
● Furosemide X 10 (Lasix)
○ Class: diuretics (pharm: loop diuretics)
○ Indication: Edema due to heart failure, hepatic impairment, or renal
disease; Hypertension
○ MOA: Inhibits the reabsorption of sodium and chloride from the loop of
Henle and distal renal tubule. Increases renal excretion of water, sodium,
chloride, magnesium, potassium, and calcium. Effectiveness persists in
impaired renal function.
○ Desired effects: Decreased BP
○ Route: PO, IM, IV
○ Contraindications: Hypersensitivity, cross-sensitivity with thiazides and
sulfonamides, hepatic coma or anuria, avoid in patients with alcohol
intolerance
○ Side effects:
■ (Life-threatening): erythema multiforme, stevens-johnson
syndrome, toxic epidermal necrolysis, aplastic anemia,
agranulocytosis
■ (Most frequent): Dehydration, hypoglycemia, hypochloremia,
hypokalemia, hypomagnesemia, hyponatremia, hypovolemia,
metabolic acidosis
○ Interactions:
■ Antihypertensives, nitrates, acute ingestion of alcohol = increased
risk of hypotension
■ Other diuretics, amphotericin B, stimulant laxatives, corticosteroids
= increased risk of hypokalemia
■ Aminoglycosides or cisplatin = increased risk of ototoxicity
■ Cisplatin = increased risk of nephrotoxicity
■ NSAIDs = decreased effects of furosemide
, ■ sucralfate, cholestyramine, or colestipol = decreased effects when
used at the same time as furosemide
■ Salicylate (high-dose therapy) = increased risk of salicylate toxicity
■ Cyclosporine = increase risk of gouty arthritis
○ Other info:
■ Monitor BP and pulse before and during administration
■ Asses for skin rash during therapy = discontinue drug at the first
sign of rash (may be life-threatening)
■ Encourage patient to change positions slowly to minimize
orthostatic hypotension
■ Advise patient to contact healthcare profession if they notice rash,
muscle weakness, cramps, nausea, dizziness, numbness, tingling of
extremities
○ Can cause orthostatic hypotension = monitor electrolyte panel
■ Hypomagnesemia
■ Hypokalemia
■ Black box warning for fluid and electrolyte loss
● Medication Calculations: 3
○ (Practice questions; answers will be at the end of the study guide ☺)
1. A patient has an order for Chloromycetin, 500 mg every 6 hours. The drug comes
in 250 mg capsules. What would the nurse administer?
2. A nurse is to administer 150 mg of a drug intramuscularly. The label on the
multidose vials reads 100 mg/mL. How much would the nurse give?
3. The client is to be given ascorbic acid 1 g daily by mouth. The medication comes
in a container labeled, "Ascorbic Acid 250 mg tablets." How much will the nurse
give?
4. The nurse is preparing to administer 80 mg of Solu-medrol intravenously (IV) to
a client with pneumonia. The vial states that it has 120 mg per 2 mL. The nurse
would correctly draw up which amount?
5. The health care provider prescribes gentamicin 4 mg/kg/day PO in three
divided doses for a client that weighs 132 lb. The label on the vial reads 8
mg/mL. How many mL does the nurse administer for each dose?
● Potassium Chloride
○ Class: electrolyte supplements (parenteral electrolytes)
○ Do not administer potassium chloride undiluted
