lOMoARcPSD|28964921
ATI Proctored Pharmacology Exam Notes
Intermediate Med Surg (Pasadena City College)
Studocu is not sponsored or endorsed by any college or university
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, lOMoARcPSD|28964921
NEURO / ANTIPSYCHOTICS
Haloperidol, chlorpromazine “antipsychotic”
○ For schizo, manic states, drug-induced psychosis, aggressive/ agitated patients
○ EPS symptoms
■ Dystonia - abnormal muscle movements, twitching
■ Akathisia- inability to sit still
■ Parkinsonism - tremor, slow movement, stiffness (rigidity)
■ NPS - fever, fluctuating BP
■ Tardive dyskinesia - movement of face, tongue sticking out, blinking of eyes
○ Anticholinergic symptoms (inhibits parasympathetic = increase sympathetic)
■ Tachycardia, palpitations, orthostatic hypotension
■ Sedation, hallucinations
■ Decreased sweating/ secretions
■ Blurred vision, mydriasis “pupil dilation”, dry eyes, dry mouth
■ Urinary retention
■ Constipation
■ Increased intraocular pressure (Risk for glaucoma)
● Monitor ECG
● Get up slowly
● Oral hygiene & sugar-free candy for dry mouth
● Stool softeners & bulk fiber diet for constipation
● Use sunscreen & sunglasses for photosensitivity
○ Contraindicated in BPH, glaucoma
○ Report abnormal movements & twitches
○ Avoid alcohol or CNS depressants (due to drowsiness)
○ Amantadine “antiParkinson” - relieves tremor & involuntary movements
○ Benztropine “anticholinergic” - control EPS symptoms
○ Dantrolene “muscle relaxant” - treat NMS (muscle rigidity, fever, BP fluctuations)
Clozapine, olanzapine, risperidone “2nd-gen Atypical antipsychotic”
○ Cause diabetes, weight gain, increased cholesterol (metabolic disturbances)
○ Monitor WBC - due to Agranulocytosis (severely low neutrophils) - Risk for infection
■ Monitor elevated temperature
■ Weekly WBC for first 6 months
■ Every 2 weeks up to 1 year
○ MYOCARDITIS (inflammation of heart muscle) within 30 days starting med
■ Report chest pain, palpitations, tachycardia, tachypnea, dyspnea, fever, arrhythmias,
edema, fatigue
Lithium “mood stabilizers”
● 0.6 - 1.2
● For bipolar / acute mania
● SEIZURE, ARRHYTHMIAS, FINE HAND TREMORS
● DO NOT LIMIT SODIUM (Maintain sodium levels)
● AVOID DIURETICS → HYPO-Na → toxicity
● Toxicity over 1.5 = COARSE TREMORS, ataxia, slurred speech
Downloaded by john gatheca ()
, lOMoARcPSD|28964921
NEURO / ANTIDEPRESSANTS
*** Higher risk for suicide
- Take a few weeks for therapeutic effect
MAOIs - Phenelzine, Isocarboxazid, Selegiline
○ ORTHOSTATIC HYPOTENSION
■ Get up slowly
○ Risk for HYPERTENSIVE CRISIS
■ Avoid tyramine food (aged cheeses, fermented meats, smoked meat, beer, soy sauce)
○ Avoid taken with SSRI
Fluoxetine “SSRI”
○ Risk for bleeding, if taken w/ NSAIDs
○ Avoid St. John’s Wort = cause serotonin syndrome
○ Risk for Serotonin Syndrome
■ Confusion, hallucinations, hyperreflexia, excessive sweating, fever ,restless
○ Avoid taken w/ MAOI, wait 14 days
○ Antidepressants take 1-4 weeks
Amitriptyline “tricyclic”
○ Anticholinergic symptoms (inhibits parasympathetic = increase sympathetic)
■ Tachycardia, palpitations, orthostatic hypotension
■ Sedation, hallucinations
■ Decreased sweating/ secretions
■ Blurred vision, mydriasis “pupil dilation”, dry eyes, dry mouth
■ Urinary retention
■ Constipation
■ Increased intraocular pressure (Risk for glaucoma)
○ OD *** Sodium bicarbonate can reverse effects of prolonged QRS”
Bupropion “antidepressant/ CNS depressant”
● Help SMOKING CESSATION
● Drowsiness & blurred vision
● Risk for SEIZURES !
● Report suicidal ideation
● Less sexual dysfunction than SSRI “antidepressant”
Downloaded by john gatheca ()
ATI Proctored Pharmacology Exam Notes
Intermediate Med Surg (Pasadena City College)
Studocu is not sponsored or endorsed by any college or university
Downloaded by john gatheca ()
, lOMoARcPSD|28964921
NEURO / ANTIPSYCHOTICS
Haloperidol, chlorpromazine “antipsychotic”
○ For schizo, manic states, drug-induced psychosis, aggressive/ agitated patients
○ EPS symptoms
■ Dystonia - abnormal muscle movements, twitching
■ Akathisia- inability to sit still
■ Parkinsonism - tremor, slow movement, stiffness (rigidity)
■ NPS - fever, fluctuating BP
■ Tardive dyskinesia - movement of face, tongue sticking out, blinking of eyes
○ Anticholinergic symptoms (inhibits parasympathetic = increase sympathetic)
■ Tachycardia, palpitations, orthostatic hypotension
■ Sedation, hallucinations
■ Decreased sweating/ secretions
■ Blurred vision, mydriasis “pupil dilation”, dry eyes, dry mouth
■ Urinary retention
■ Constipation
■ Increased intraocular pressure (Risk for glaucoma)
● Monitor ECG
● Get up slowly
● Oral hygiene & sugar-free candy for dry mouth
● Stool softeners & bulk fiber diet for constipation
● Use sunscreen & sunglasses for photosensitivity
○ Contraindicated in BPH, glaucoma
○ Report abnormal movements & twitches
○ Avoid alcohol or CNS depressants (due to drowsiness)
○ Amantadine “antiParkinson” - relieves tremor & involuntary movements
○ Benztropine “anticholinergic” - control EPS symptoms
○ Dantrolene “muscle relaxant” - treat NMS (muscle rigidity, fever, BP fluctuations)
Clozapine, olanzapine, risperidone “2nd-gen Atypical antipsychotic”
○ Cause diabetes, weight gain, increased cholesterol (metabolic disturbances)
○ Monitor WBC - due to Agranulocytosis (severely low neutrophils) - Risk for infection
■ Monitor elevated temperature
■ Weekly WBC for first 6 months
■ Every 2 weeks up to 1 year
○ MYOCARDITIS (inflammation of heart muscle) within 30 days starting med
■ Report chest pain, palpitations, tachycardia, tachypnea, dyspnea, fever, arrhythmias,
edema, fatigue
Lithium “mood stabilizers”
● 0.6 - 1.2
● For bipolar / acute mania
● SEIZURE, ARRHYTHMIAS, FINE HAND TREMORS
● DO NOT LIMIT SODIUM (Maintain sodium levels)
● AVOID DIURETICS → HYPO-Na → toxicity
● Toxicity over 1.5 = COARSE TREMORS, ataxia, slurred speech
Downloaded by john gatheca ()
, lOMoARcPSD|28964921
NEURO / ANTIDEPRESSANTS
*** Higher risk for suicide
- Take a few weeks for therapeutic effect
MAOIs - Phenelzine, Isocarboxazid, Selegiline
○ ORTHOSTATIC HYPOTENSION
■ Get up slowly
○ Risk for HYPERTENSIVE CRISIS
■ Avoid tyramine food (aged cheeses, fermented meats, smoked meat, beer, soy sauce)
○ Avoid taken with SSRI
Fluoxetine “SSRI”
○ Risk for bleeding, if taken w/ NSAIDs
○ Avoid St. John’s Wort = cause serotonin syndrome
○ Risk for Serotonin Syndrome
■ Confusion, hallucinations, hyperreflexia, excessive sweating, fever ,restless
○ Avoid taken w/ MAOI, wait 14 days
○ Antidepressants take 1-4 weeks
Amitriptyline “tricyclic”
○ Anticholinergic symptoms (inhibits parasympathetic = increase sympathetic)
■ Tachycardia, palpitations, orthostatic hypotension
■ Sedation, hallucinations
■ Decreased sweating/ secretions
■ Blurred vision, mydriasis “pupil dilation”, dry eyes, dry mouth
■ Urinary retention
■ Constipation
■ Increased intraocular pressure (Risk for glaucoma)
○ OD *** Sodium bicarbonate can reverse effects of prolonged QRS”
Bupropion “antidepressant/ CNS depressant”
● Help SMOKING CESSATION
● Drowsiness & blurred vision
● Risk for SEIZURES !
● Report suicidal ideation
● Less sexual dysfunction than SSRI “antidepressant”
Downloaded by john gatheca ()
