NURS180 Pharmacology Midterm Study Guide
Omeprazole
Proton Pump Inhibitor
o Decreases production on acids
o Treats: GERD, Zollinger-Ellison syndrome, NSAID ulcers, stress ulcers, H. Pylori
ulcers, erosive esophagitis
o H. pylori treatment: Omeprazole, clarithromycin, and amoxicillin
o Side Effects: Headache, Dizziness, Diarrhea, abdominal pain, and rash.
o Chronic use: Osteoporosis
o Interactions: Digoxin, oral anticoagulants, certain benzodiazepines and
phenytoin.
Nursing Implications
o The granules of pantoprazole capsules may be given via nasogastric (NG) tubes,
but the NG tube must be at least 16 gauge, or the tube may become clogged
o Capsule contents may be opened and mixed with apple juice, but do not chew or
crush delayed-release granules
Psyllium Mucilloid (Metamucil)
o Nondigestible and nonabsorbent sub
o Becomes a viscous solution when mixed with water.
o Excreted in the feces.
o Onset 12-72 hours- peak 1-3 days.
o Side Effects: Not systemically absorbed – no systemic effect.
o Overuse: Nausea, vomiting, flactus, or diarrhea. Abdominal cramps if not diluted.
Vitamin B9 (Folic Acid)
o R/T ETOH, poor diet, folic acid antagonists (methotrexate, triamterene,
trimethoprim)
o Symptoms of deficiency- Anorexia, nausea, stomatitis, diarrhea, fatigue,
alopecia, and blood dyscrasias (megaloblastic anemia, leukopenia,
thrombocytopenia).
o Needed during pregnancy to decrease neural tube defects.
Vitamin B12
o Absorbed by intrinsic factors.
o Helps hematopoiesis.
o Pernicious anemia
o Symptoms – BLEs paresthesia weakness, memory loss, mood changes, dementia,
psychosis
Vitamin D (Calciferol)
o Deficiency associated with bone diseases.
, NURS180 Pharmacology Midterm Study Guide
o Patient needs to be in the sun.
o Needed for calcium absorption from the intestines.
o Major role in regulation calcium and phosphorus.
o Can reduce fractures.
Vitamin K (Phytonadione)
o Most active form.
o Made by plants, and it represents the bulk of dietary vitamin K.
o Vitamin K is needed for synthesis or prothrombin and clotting factors VII, IX and
X.
o Used for oral anticoagulant overdose in hypoprothrombinemia of Vitamin K
deficiency.
o Spontaneous hemorrhage may occur with Vitamin K deficiency.
o Newborns are Vitamin K deficient – single dose is recommended immediately
after delivery.
o Oral and parenteral forms of phytoandine,
o Oral – most common.
o IV – Dangerous and may cause death.
Desmopressin (DDAVP)
o Synthetic analog of human ADH.
o Acts on the renal collecting tubules to increase their permeability to water, thus
enhancing water reabsorption.
o Fast onset but short half – life – requires it to be administered three to four
times per day.
o IV, IM, Intranasal.
o Used for diabetes insipidus and nocturia (off-label).
o Monitor Na levels.
Levothyroxine (Synthyroid, Levoxy)
o Treat all forms of hypothyroidism and after thyroidectomy or thyroid atrophy
after radioactive iodine in the treatment of thyroid cancer or hyperthyroidism
o Adverse effects - Cardiac dysrhythmia (most significant)
o May also cause (all ):
o Tachycardia, palpitations, angina, hypertension, insomnia, tremors,
headache, anxiety, nausea, diarrhea, menstrual irregularities, weight loss,
sweating, heat intolerance, fever, others
Propylthiouracil (PTU)
o Treatment of hyperthyroidism
o Same side effects as hypothyroidism
o Black Box Warning: Severe liver injury and acute hepatic failure
o Use on those unable to tolerate methimazole
, NURS180 Pharmacology Midterm Study Guide
o Monitor PT, AST, ALT
Prednisone
o Increase the level of blood glucose (hyperglycemic effect) by inhibiting insulin
secretion and promoting gluconeogenesis
o Suppress the inflammatory and immune responses (increased risk for infections)
o Increase the sensitivity of vascular smooth muscle to norepinephrine and
angiotensin II (increase BP)
o Increase the breakdown of bony matrix, resulting in bone demineralization
(osteoporosis)
o Promote bronchodilation by making bronchial smooth muscle more responsive
to sympathetic nervous system activation.
Insulins
Rapid Acting
o Onset = 5 to 15 minutes
o Peak = 30 min to 2.5 hours
o Duration = 3 to 6 hrs.
o Must eat a meal after injection (type 2)
o Insulins: Lispro Humalog), Aspart (Novolog), Glulisine (Apidra)
o May be given subcutaneously or via continuous subcutaneous infusion pump
(but not IV).
Short Acting
o Onset: 30 minutes
o Peak = 2 to 3 hours
o Duration = 4-12 hours
o Regular insulin (Humulin R)
o IV bolus, IV infusion, IM
Intermediate Acting
o Onset = 1-2 hours
o Peak = 4-12 hours
o Duration = 14-24 hours
o Insulin: Insulin isophane suspension (also called NPH)
Long acting (basal insulin)
o Onset = 1-1.5 hours
o NO PEAK
o Duration = 24 hours
o Usually dosed once daily
o Insulins: Glargine (Lantus), Detemir (Levemir)
Metformin (Glucophage) (Biguanides)
o Decrease production of glucose by the liver
Omeprazole
Proton Pump Inhibitor
o Decreases production on acids
o Treats: GERD, Zollinger-Ellison syndrome, NSAID ulcers, stress ulcers, H. Pylori
ulcers, erosive esophagitis
o H. pylori treatment: Omeprazole, clarithromycin, and amoxicillin
o Side Effects: Headache, Dizziness, Diarrhea, abdominal pain, and rash.
o Chronic use: Osteoporosis
o Interactions: Digoxin, oral anticoagulants, certain benzodiazepines and
phenytoin.
Nursing Implications
o The granules of pantoprazole capsules may be given via nasogastric (NG) tubes,
but the NG tube must be at least 16 gauge, or the tube may become clogged
o Capsule contents may be opened and mixed with apple juice, but do not chew or
crush delayed-release granules
Psyllium Mucilloid (Metamucil)
o Nondigestible and nonabsorbent sub
o Becomes a viscous solution when mixed with water.
o Excreted in the feces.
o Onset 12-72 hours- peak 1-3 days.
o Side Effects: Not systemically absorbed – no systemic effect.
o Overuse: Nausea, vomiting, flactus, or diarrhea. Abdominal cramps if not diluted.
Vitamin B9 (Folic Acid)
o R/T ETOH, poor diet, folic acid antagonists (methotrexate, triamterene,
trimethoprim)
o Symptoms of deficiency- Anorexia, nausea, stomatitis, diarrhea, fatigue,
alopecia, and blood dyscrasias (megaloblastic anemia, leukopenia,
thrombocytopenia).
o Needed during pregnancy to decrease neural tube defects.
Vitamin B12
o Absorbed by intrinsic factors.
o Helps hematopoiesis.
o Pernicious anemia
o Symptoms – BLEs paresthesia weakness, memory loss, mood changes, dementia,
psychosis
Vitamin D (Calciferol)
o Deficiency associated with bone diseases.
, NURS180 Pharmacology Midterm Study Guide
o Patient needs to be in the sun.
o Needed for calcium absorption from the intestines.
o Major role in regulation calcium and phosphorus.
o Can reduce fractures.
Vitamin K (Phytonadione)
o Most active form.
o Made by plants, and it represents the bulk of dietary vitamin K.
o Vitamin K is needed for synthesis or prothrombin and clotting factors VII, IX and
X.
o Used for oral anticoagulant overdose in hypoprothrombinemia of Vitamin K
deficiency.
o Spontaneous hemorrhage may occur with Vitamin K deficiency.
o Newborns are Vitamin K deficient – single dose is recommended immediately
after delivery.
o Oral and parenteral forms of phytoandine,
o Oral – most common.
o IV – Dangerous and may cause death.
Desmopressin (DDAVP)
o Synthetic analog of human ADH.
o Acts on the renal collecting tubules to increase their permeability to water, thus
enhancing water reabsorption.
o Fast onset but short half – life – requires it to be administered three to four
times per day.
o IV, IM, Intranasal.
o Used for diabetes insipidus and nocturia (off-label).
o Monitor Na levels.
Levothyroxine (Synthyroid, Levoxy)
o Treat all forms of hypothyroidism and after thyroidectomy or thyroid atrophy
after radioactive iodine in the treatment of thyroid cancer or hyperthyroidism
o Adverse effects - Cardiac dysrhythmia (most significant)
o May also cause (all ):
o Tachycardia, palpitations, angina, hypertension, insomnia, tremors,
headache, anxiety, nausea, diarrhea, menstrual irregularities, weight loss,
sweating, heat intolerance, fever, others
Propylthiouracil (PTU)
o Treatment of hyperthyroidism
o Same side effects as hypothyroidism
o Black Box Warning: Severe liver injury and acute hepatic failure
o Use on those unable to tolerate methimazole
, NURS180 Pharmacology Midterm Study Guide
o Monitor PT, AST, ALT
Prednisone
o Increase the level of blood glucose (hyperglycemic effect) by inhibiting insulin
secretion and promoting gluconeogenesis
o Suppress the inflammatory and immune responses (increased risk for infections)
o Increase the sensitivity of vascular smooth muscle to norepinephrine and
angiotensin II (increase BP)
o Increase the breakdown of bony matrix, resulting in bone demineralization
(osteoporosis)
o Promote bronchodilation by making bronchial smooth muscle more responsive
to sympathetic nervous system activation.
Insulins
Rapid Acting
o Onset = 5 to 15 minutes
o Peak = 30 min to 2.5 hours
o Duration = 3 to 6 hrs.
o Must eat a meal after injection (type 2)
o Insulins: Lispro Humalog), Aspart (Novolog), Glulisine (Apidra)
o May be given subcutaneously or via continuous subcutaneous infusion pump
(but not IV).
Short Acting
o Onset: 30 minutes
o Peak = 2 to 3 hours
o Duration = 4-12 hours
o Regular insulin (Humulin R)
o IV bolus, IV infusion, IM
Intermediate Acting
o Onset = 1-2 hours
o Peak = 4-12 hours
o Duration = 14-24 hours
o Insulin: Insulin isophane suspension (also called NPH)
Long acting (basal insulin)
o Onset = 1-1.5 hours
o NO PEAK
o Duration = 24 hours
o Usually dosed once daily
o Insulins: Glargine (Lantus), Detemir (Levemir)
Metformin (Glucophage) (Biguanides)
o Decrease production of glucose by the liver
