ATI Pharmacology Proctored Exam - 2023

Airflow Disorders: Beta-2 Adrenergic Agonists - Albuterol: Asthma, bronchospasm - C: Pregnancy, hypertension, hyperthyroidism, tachydysrhythmias - AE: Angina, tachycardia, tremors - NC: Use as a rescue inhaler or prior to physical exercise Airflow Disorders: Inhaled Anticholinergics - Ipratropium: Asthma, COPD - C: Pregnancy, peanut allergy, glaucoma, BPH - AE: dry mouth, hoarseness - NC: Not a rescue inhaler! Rinse mouth after inhalation to decrease unpleasant taste Airflow Disorders: Inhaled Glucocorticoids - Beclomethasone, Budesonide: Asthma - C: Pregnancy, live virus vaccine, diabetes, systemic fungal infection - AE: Candidiasis, hoarseness, difficulty speaking - NC: Rinse mouth after use, do not use as a rescue Airflow Disorders: Leukotriene Modifiers - Montelukast: Asthma - C: pregnancy/lactation, liver issues - AE: Depression, suicidal thoughts - NC: Not a rescue, take once daily at bedtime unless for excersize - take 2 hours before. Airflow Disorders: Methylxanthines - Theophylline: Asthma, COPD - C: Pregnancy, heart disease, hypertension, diabetes, liver/kidney issues - AE: GI upset, restlessness - NC: Do not chew or crush sustained-release tablets, not a rescue medication!, do not take with caffiene Airflow Disorders: Oral Glucocorticoids - Prednisone: Asthma - C: Pregnancy, live virus vaccine, systemic fungal infection, diabetes, kidney issues - AE: Suppression of adrenal function, bone loss, hyperglycemia, peptic ulcer disease, infection, weight gain, insomnia - NC: Taper drug off if taken long term, not a rescue, may require additional doses during times of stress Antilipemic Agents: Anticoagulants - Enoxaparin (low-molecular weight heparin): prophylaxis for DVT, reduction in stroke risk - C: Pregnancy, thrombocytopenia, bleeding disorders, peptic ulcer disease - AE: Hemorrhage, toxicity, epidural or spinal hematoma, thrombocytopenia -NC: Monitor lab levels, same as heparin. Antilipemic Agents: Antiplatelet - Aspirin, clopidogrel, Dipyridamole: Primary prevention of MI, prevents stroke (prevents platelets from clumping - blood thinner) - C: Pregnancy, bleeding disorders, peptic ulcer disease, renal/liver impairment - AE: Bleeding, diarrhea, dyspepsia - NC: Discontinue 5-7 days before surgery, avoid OTC NSAIDs, observe for bleeding Antilipemic Agents: Bile Acid Sequestrants - Colesevelam, Colestipol: treats high choelsterol - C: Pregnancy, bowel obstruction, dysphagia - AE: Constipation - NC: Take with food and water, may be combined with statins, don't crush or chew ER tablets, increase dietary fiber. Antilipemic Agents: Cholesterol Absorption Inhibitors - Ezetimibe: treats high cholesterol - C: Pregnancy/lactation, liver disease - AE: Hepatitis, myopathy - NC: May be combined with statins, monitor liver/kidney function, follow low fat and low cholesterol diet Antilipemic Agents: Direct Inhibitor of Factor Xa - Rivaoxaban: Prophylaxis for DVT, reduces stroke risk - C: Pregnancy, bleeding disorders, peptic ulcer disease, renal/liver impairment - AE: Elevated liver enzymes, bleeding - NC: Monitor hemoglobin, hematocrit, liver, and kidney function Antilipemic Agents: Direct Thrombin Inhibitors - Dabigatran: Prophylaxis for DVT, reduces stroke risk - C: Pregnancy, bleeding disorders, peptic ulcer disease - AE: Nausea, vomiting, bleeding - NC: Observe for bleeding, avoid OTC NSAIDs, use electric razor for shaving Antilipemic Agents: Fibrates - Gemfibrozil: Treats high triglycerides - C: Pregnancy, liver disease - AE: GI upset, gallstones, myopathy, hepatotoxicity - NC: Take 30 minutes prior to breakfast and dinner, monitor liver function Antilipemic Agents: HMG-CoA Reductase Inhibitors (statins) - Atorvastatin, Simvastatin: Lower's cholesterol, protection against MI and stroke - C: Pregnancy/lactation, liver disease - AE: Hepatotoxicity, myopathy/myalgia - NC: Monitor liver function every 6 months, avoid alcohol, report muscle aches, take in the evening. Antilipemic Agents: Thrombolytic Medications - Alteplase (TPA): Acute MI, massive PE, ischemic stroke (disolves clots) - C: Pregnancy, bleeding disorders, prior intracranial hemorrhage, severe hypertention - AE: Bleeding - NC: Administer within 3 hours of manifestations Antilipemic Agents: Vitamin K Inhibitors - Warfarin: Prophylaxis for DVT, reduction in stroke risk - C: Pregnancy/lactation, vitamin K deficiency, bleeding disorders, peptic ulcer disease - AE: Hemorrhage, hepatitis, toxicity - NC: Monitor PTT/INR (2-3 therapeutic), teach about dietary food interactions (foods with vitamin K), avoid OTC NSAIDs Cardiac Glycosides and Heart Failure: Adrenergic Agonists - Epinephrine: Anaphylactic shock, bronchodilation, management of superficial bleeding, slows absorption of local anesthetics - C: Hyperthyroidism, angina, hypertension - AE: Hypertension, dysrhythmias, tachycardia - NC: Monitor ECG and BP, monitor for hyerglycemia in diabetics Dobutamine: Heart failure - C: Hyperthyroidism, angina, hypertension - AE: Hypertension, dysrhythmias, tachycardia - NC: Administered IV, monitor ECG and BP, older adults are more likely to experience adverse effects