Pharm ATI Exam Cheat Sheet
System Drug Name Important Information
Heart - Failure Digoxin ● Therapeutic Levels 0.5-0.8 (Pg. 177) IV digoxin: infuse over AT LEAST 5min.WITHHOLD
(cardiac glycoside●, if HR LESS THAN 60/min
used to treat ● MUST auscultate apical pulse for one full minute
dysrhythmias and Toxicity: Yellowing vision, blurry vision, anorexia, fatigue, weakness, N/V, GI effects,
heart failure) ● tinnitus,
Narrow therapeutic range
● Positive inotrope (Increase force and efficiency of myocardial contraction), negative
● chronotrope (Decrease Heart rate)
Hypokalemia leads to toxicity, hyper K leads to decreased effectTreatment is
● cholestyramine (BAR) or Digibind (FAB)
● To prevent “Digoxin-induced dysrhythmias, avoid hypokalemia and increased serum
● digoxin levels
Watch for n/v and general weakness. (hypokalemic) and caution with potassium
supplements.
Avoid any drug that affect potassium (loop diuretics, ACE Inh and ARBs)
●
Brain - seizure Phenytoin ● Therapeutic levels 10-20 Narrow therapeutic range
(hydantoin class, ● Gingival hyperplasia (notify dentist, use soft brush); use of folic acid supplements
used to treat ● decreases occurrence
seizures) Hirsutism, acne
● Enzyme inducer- decreases effects of many drugs
● Serum level increased when used with valproic acid or methylphenidateToxic levels
● include nystagmus, ataxia, sedation, double vision, cognitiveimpairment
● Do not take with milk, decreases absorption of Vit D and CalciumMay cause
thrombocytopenia
● Check LFT’s
● Stop med if skin rash occurs
● Infuse no faster than 50mg/min to decrease dysrhythmias and hypotensionEncourage
● patients to consume adequate amounts of calcium and vit D
●
●
Brain - seizure Carbamazepine ● Therapeutic levels: 4-12
● Hepatic Autoinducer- oral contraceptives and warfarin
● Blood dyscrasias (leukopenia, anemia, thrombocytopenia, bone marrowsuppression)
/pancytopenia
● Stimulates posterior pituitary and promotes secretion of ADH so hypo-osmolarity -
essentially a medication induced SIADH
● Can cause SJS (treat minor reactions with antihistamine, wear sunscreen, and notify
provider)
● GI distress, drowsiness, rash, nystagmus, double vision, vertigo, staggeringgait, and
● headache
● Start with low dose and titrate up
1
, Pharm ATI Exam Cheat Sheet
● Administer at bedtime
● Obtain baseline CBC and platelets, and perform ongoing monitoringObserve for
● indications of bruising and bleeding of gums
● Monitor for sore throat, fatigue, or other indications of infection
● Hepatotoxicity- Evidenced by anorexia, nausea, vomiting, fatigue abdominal pain,and
jaundice
Brain - seizure Valproic Acid ● Monitor liver and pancreatic enzymes due to damageCan be used in any type of
● seizure
● Hepatotoxicity- anorexia, nausea, vomiting, jaundice, abdominal pain, fatigue
● Pancreatitis- nausea, vomiting, abdominal pain
● Thrombocytopenia- bruising; monitor platelet countTeratogenic
● Enzyme inhibitor
● N/V, indigestion- take with foodWeight gain
●
●
Chemo Methotrexate ● Used in chemotherapy, psoriasis, rheumatoid arthritis
● Interrupts cell production, so monitor for bleeds in GI/mucosa/gums. Use softbrushes.
Protect skin.
● Pregnancy Cat X (stops cell production) and is used to dissolve pregnancy. Momsneed
to be on strict birth control.
● Don’t give with folic acid
● Give with leucovorin (prevents side effects)
● Due to immunosuppression, report fever to provider statDosed weekly
● Sores in mouth (stomatitis) indicates toxicity.
●
Diuretic Mannitol ● Adverse effects: Peripheral edema, Pulmonary edema (can potentiate HF)
(Osmotic diuretic●
) ↓ intracranial and intraocular pressure - used in glaucoma
● Lung crackles should be recognized as an indicator of potential complications
GI Sucralfate ● Protects mucosa (ulcers)
(Mucosal ● Causes constipation, so teach patients to increase fiber and fluid
Protectant)
Pain Morphine Sulfate● Primary use is analgesia
● Teach patients about side effects:Respiratory Depression Constipation
Orthostatic HypotensionUrinary Retention
Can cause biliary colic
Diuretic Acetazolamide ● Diuretic - carbonic anhydrase
(Carbonic ● Used to decrease IOP in glaucoma patients
Anhydrase ● Adverse effects include paresthesias (tingling of the extremities), hyperglycemia
Inhibitor)
2
, Pharm ATI Exam Cheat Sheet
Airway Prednisone ● Prevent inflammatory response by suppression of airway mucus suppression,immune
(Glucocorticoid) responses, adrenal function
● Adverse Effects Hyperglycemia Water retention Peptic ulcer diseaseMyopathy
Delayed wound healing
Gradual reduction required, taper off when doneCauses demineralization of bones
Can lead to osteoporosis and stress fractures
Prednisone is a glucocorticoid. All glucocorticoids can lead to osteoporosis.
■
■
Metabolism - Sodium ● Fixes hyperkalemia (may have heard this as kayexalate in the hospital)Beware giving
electrolyte Polystyrene ● concurrently with Digoxin
Sulfate
Heart - HTN Atenolol ● Cardioselective, water soluble beta blocker
● Blocks beta 1 receptors on heart (You have ONE heart) and kidney
Diuretic Furosemide (Loop OTOTOXICITY!! (Watch for tinnitus, vertigo, or hearing loss)Take in the AM, with milk if
Diuretic) ● needed for stomach upset
● Diuretic + antihypertensive = additive hypotensiveCauses hypokalemia & OH
● Eat bananas to increase KAt risk for hyperglycemia
●
Pain Ketorolac ● Very powerful NSAID GI, kidney, CV issues. Contraindicated in ESRD
● Can not take more than 5 days
●
●
Pain Acetaminophen ● Maximum daily dose 4g/day
● Instruct patient not to exceed single dose of 325 mg (adult 4,000 mg/24 hr.) Percocet
● (Acetaminophen/Oxycodone) contains Acetaminophen, so taking bothconcurrently
increases the chances of Acetaminophen toxicity.
Antibiotic Doxycycline ● Tetracycline class ABX
● Consume at least 3L/day of fluid
● Bacteriostatic, do not give during pregnancy or it’ll turn the baby’s teeth weirdcolors
GI Docusate Sodium● Stool softener
● Works by lowering surface tension of stool to allow water in
GI Senna ● Stimulant laxative
DM Insulin Aspart ● Rapid acting
3
System Drug Name Important Information
Heart - Failure Digoxin ● Therapeutic Levels 0.5-0.8 (Pg. 177) IV digoxin: infuse over AT LEAST 5min.WITHHOLD
(cardiac glycoside●, if HR LESS THAN 60/min
used to treat ● MUST auscultate apical pulse for one full minute
dysrhythmias and Toxicity: Yellowing vision, blurry vision, anorexia, fatigue, weakness, N/V, GI effects,
heart failure) ● tinnitus,
Narrow therapeutic range
● Positive inotrope (Increase force and efficiency of myocardial contraction), negative
● chronotrope (Decrease Heart rate)
Hypokalemia leads to toxicity, hyper K leads to decreased effectTreatment is
● cholestyramine (BAR) or Digibind (FAB)
● To prevent “Digoxin-induced dysrhythmias, avoid hypokalemia and increased serum
● digoxin levels
Watch for n/v and general weakness. (hypokalemic) and caution with potassium
supplements.
Avoid any drug that affect potassium (loop diuretics, ACE Inh and ARBs)
●
Brain - seizure Phenytoin ● Therapeutic levels 10-20 Narrow therapeutic range
(hydantoin class, ● Gingival hyperplasia (notify dentist, use soft brush); use of folic acid supplements
used to treat ● decreases occurrence
seizures) Hirsutism, acne
● Enzyme inducer- decreases effects of many drugs
● Serum level increased when used with valproic acid or methylphenidateToxic levels
● include nystagmus, ataxia, sedation, double vision, cognitiveimpairment
● Do not take with milk, decreases absorption of Vit D and CalciumMay cause
thrombocytopenia
● Check LFT’s
● Stop med if skin rash occurs
● Infuse no faster than 50mg/min to decrease dysrhythmias and hypotensionEncourage
● patients to consume adequate amounts of calcium and vit D
●
●
Brain - seizure Carbamazepine ● Therapeutic levels: 4-12
● Hepatic Autoinducer- oral contraceptives and warfarin
● Blood dyscrasias (leukopenia, anemia, thrombocytopenia, bone marrowsuppression)
/pancytopenia
● Stimulates posterior pituitary and promotes secretion of ADH so hypo-osmolarity -
essentially a medication induced SIADH
● Can cause SJS (treat minor reactions with antihistamine, wear sunscreen, and notify
provider)
● GI distress, drowsiness, rash, nystagmus, double vision, vertigo, staggeringgait, and
● headache
● Start with low dose and titrate up
1
, Pharm ATI Exam Cheat Sheet
● Administer at bedtime
● Obtain baseline CBC and platelets, and perform ongoing monitoringObserve for
● indications of bruising and bleeding of gums
● Monitor for sore throat, fatigue, or other indications of infection
● Hepatotoxicity- Evidenced by anorexia, nausea, vomiting, fatigue abdominal pain,and
jaundice
Brain - seizure Valproic Acid ● Monitor liver and pancreatic enzymes due to damageCan be used in any type of
● seizure
● Hepatotoxicity- anorexia, nausea, vomiting, jaundice, abdominal pain, fatigue
● Pancreatitis- nausea, vomiting, abdominal pain
● Thrombocytopenia- bruising; monitor platelet countTeratogenic
● Enzyme inhibitor
● N/V, indigestion- take with foodWeight gain
●
●
Chemo Methotrexate ● Used in chemotherapy, psoriasis, rheumatoid arthritis
● Interrupts cell production, so monitor for bleeds in GI/mucosa/gums. Use softbrushes.
Protect skin.
● Pregnancy Cat X (stops cell production) and is used to dissolve pregnancy. Momsneed
to be on strict birth control.
● Don’t give with folic acid
● Give with leucovorin (prevents side effects)
● Due to immunosuppression, report fever to provider statDosed weekly
● Sores in mouth (stomatitis) indicates toxicity.
●
Diuretic Mannitol ● Adverse effects: Peripheral edema, Pulmonary edema (can potentiate HF)
(Osmotic diuretic●
) ↓ intracranial and intraocular pressure - used in glaucoma
● Lung crackles should be recognized as an indicator of potential complications
GI Sucralfate ● Protects mucosa (ulcers)
(Mucosal ● Causes constipation, so teach patients to increase fiber and fluid
Protectant)
Pain Morphine Sulfate● Primary use is analgesia
● Teach patients about side effects:Respiratory Depression Constipation
Orthostatic HypotensionUrinary Retention
Can cause biliary colic
Diuretic Acetazolamide ● Diuretic - carbonic anhydrase
(Carbonic ● Used to decrease IOP in glaucoma patients
Anhydrase ● Adverse effects include paresthesias (tingling of the extremities), hyperglycemia
Inhibitor)
2
, Pharm ATI Exam Cheat Sheet
Airway Prednisone ● Prevent inflammatory response by suppression of airway mucus suppression,immune
(Glucocorticoid) responses, adrenal function
● Adverse Effects Hyperglycemia Water retention Peptic ulcer diseaseMyopathy
Delayed wound healing
Gradual reduction required, taper off when doneCauses demineralization of bones
Can lead to osteoporosis and stress fractures
Prednisone is a glucocorticoid. All glucocorticoids can lead to osteoporosis.
■
■
Metabolism - Sodium ● Fixes hyperkalemia (may have heard this as kayexalate in the hospital)Beware giving
electrolyte Polystyrene ● concurrently with Digoxin
Sulfate
Heart - HTN Atenolol ● Cardioselective, water soluble beta blocker
● Blocks beta 1 receptors on heart (You have ONE heart) and kidney
Diuretic Furosemide (Loop OTOTOXICITY!! (Watch for tinnitus, vertigo, or hearing loss)Take in the AM, with milk if
Diuretic) ● needed for stomach upset
● Diuretic + antihypertensive = additive hypotensiveCauses hypokalemia & OH
● Eat bananas to increase KAt risk for hyperglycemia
●
Pain Ketorolac ● Very powerful NSAID GI, kidney, CV issues. Contraindicated in ESRD
● Can not take more than 5 days
●
●
Pain Acetaminophen ● Maximum daily dose 4g/day
● Instruct patient not to exceed single dose of 325 mg (adult 4,000 mg/24 hr.) Percocet
● (Acetaminophen/Oxycodone) contains Acetaminophen, so taking bothconcurrently
increases the chances of Acetaminophen toxicity.
Antibiotic Doxycycline ● Tetracycline class ABX
● Consume at least 3L/day of fluid
● Bacteriostatic, do not give during pregnancy or it’ll turn the baby’s teeth weirdcolors
GI Docusate Sodium● Stool softener
● Works by lowering surface tension of stool to allow water in
GI Senna ● Stimulant laxative
DM Insulin Aspart ● Rapid acting
3
