NUR3196 - Comprehensive Final Exam Drugs|
Questions and 100% Correct Verified Answers
Heparin - Answer - Therapeutic class: anticoagulant (parenteral)
- Pharmacologic class: indirect thrombin inhibitor
- Mechanisms of action: Prolong coagulation time which prevents excessive clotting
within blood vessels. Prevents enlargement of existing clots and formation of new
ones. Binds to antithrombin III to inactivate several clotting factors and inhibit
thrombin activity. Used at low doses to prevent thromboembolic events arising from
open heart and vascular surgery, dialysis procedures, or in patients with unstable
angina or in the acute stages of MI. Used at high doses to treat conditions in which
immediate anticoagulation is needed, such as confirmed DVT and pulmonary embolism.
- Administration alerts: Use of nomogram decreases chance of medication calculation
errors and over- or under therapeutic doses. When administering heparin subcut, never
draw back the syringe plunger once needle has entered the skin and never massage the
site after injection. IM admin is contraindicated for bleeding risk. Pregnancy category C.
- Pharmacokinetics: Onset: 30-60m; Peak: 2h; Duration: 8-12h
- Adverse effects: Abnormal bleeding, Heparin- induced thrombocytopenia
(HIT), increase in adverse thromboembolic events
- BLACK BOX WARNING: epidural or spinal hematomas may occur when heparin is
used in patients receiving spinal anesthesia or lumbar puncture, may lead to long-term
or permanent paralysis
- Contraindications: Patients with active internal bleeding, bleeding disorders,
severe hypertension, recent trauma, intracranial hemorrhage, bacterial endocarditis
- OD treatment: protamine sulfate can be administered IV to neutralize
,Warfarin (Coumadin) - Answer - Therapeutic class: anticoagulant
- Pharmacologic class: vitamin K-antagonist
- Mechanisms of action: Prevention of stroke, MI, DVT and pulmonary embolism.
Prevent thromboembolic events in high risk patients.
- Administration alerts: If life-threatening bleeding occurs, can do IM or subcut admin
of vitamin K1. Pregnancy category X.
- Pharmacokinetics: Onset: 2-7 days; Peak: 0.5-3 days; Duration: 3-5 days
- Adverse effects: Abnormal bleeding
- BLACK BOX WARNING: can cause major or fatal bleeding, and regular monitoring of
INR is required
- Contraindications: Patients with recent trauma, active internal bleeding, bleeding
disorders, intracranial hemorrhage, severe hypertension, bacterial endocarditis,
severe liver or kidney disease
- OD treatment: Vitamin K given PO or IV
Bethanechol (Urecholine) - Answer - Therapeutic class: non-obstructive urinary
retention drug
- Pharmacologic class: muscarinic cholinergic receptor drug
- Mechanism of action: direct-acting parasympathomimetic that stimulates
parasympathetic activity by interacting with muscarinic receptors. Stimulates smooth
muscle contraction in the digestive and urinary tract. Used to treat urinary retention.
- OD treatment: atropine
- Adverse/side effects: increased salivation, sweating, abdominal cramping,
hypotension. Used with caution when used to treat patients with disorders that may
become aggravated with an increase in stimulation of smooth muscle contractions of
GI tract (obstruction, active ulcer, inflammatory disease). Used with caution with a
urinary obstruction or COPD.
- Contraindications: asthma, epilepsy, parkinsonism, hyperthyroidism, peptic ulcer
disease, and bradycardia
,Furosemide (Lasix) - Answer - Therapeutic class: drug for heart failure and HTN
- Pharmacologic class: diuretic (loop type)
- Mechanism of action: Treatment of acute heart failure by removing large amounts of
excess fluid in a short time period. Prevents reabsorption of sodium and chloride in
the nephron loop.
- OD treatment: replacement of fluids and electrolytes, possible administration
of vasopressor, such as norepinephrine.
- Adverse/side effects: potential electrolyte imbalances (hypokalemia), dehydration,
hypotension (orthostatic), syncope, ototoxicity is rare but may result in permanent
hearing deficit.
- BLACK BOX WARNING: if given in excessive amounts, may lead to profound
diuresis with water and electrolyte depletion.
- Contraindication: hypersensitivity to furosemide, anuria, hepatic coma, and
severe fluid or electrolyte depletion
- Administration alerts: Check serum potassium levels before administering, if below
normal then notify HCP. Use with precaution in infants and neonates due to prolonged
half-life. Older adults may need lower doses. Pregnancy category C.
Hydrochlorothiazide (Mirozide) - Answer - Therapeutic class: drug for hypertension and
edema
- Pharmacologic class: thiazide diuretic
- Mechanism of action: Acts on kidney tubule to decrease reabsorption of Na+. Blocks
reabsorption so more Na+ is sent into urine. Sodium moves across tubule, water
flows with it, so blood volume decreases and blood pressure falls.
- OD treatment: infusions of normal saline
, - Adverse/side effects: potential electrolyte imbalances due to excessive loss of K
and Na, cardiac conduction abnormalities, gout attacks due to hyperuricemia
- Contraindications: anuria, hypersensitivity to thiazides or sulfonamides, pre-
eclampsia or other pregnancy-induced hypertension
- Administration alerts: Administer early in the day to prevent nocturia. Pregnancy
category B
Spironolactone (Aldactone) - Answer - Therapeutic class: antihypertensive, drug
for reducing edema
- Pharmacologic class: potassium-sparing diuretic, aldosterone antagonist
- Mechanism of action: Inhibits aldosterone (hormone secreted to increase renal
reabsorption of Na in exchange for K) which causes water retention. When aldosterone is
blocked, Na and water excretion are increased and body retains more potassium.
- OD treatment: normal saline to replace fluids and electrolytes, and a vasopressor
like norepinephrine to raise blood pressure.
- Adverse/side effects: hyperkalemia, muscle weakness, fatigue, bradycardia. In
men, gynecomastia, impotence, diminished libido. In women, menstrual
irregularities, hirsutism, breast tenderness.
- BLACK BOX WARNING: has been found to cause tumors in animals, so should be
used only for specified indications.
- Contraindications: anura, serious CKD, hyperkalemia, pregnancy, lactation.
- Administration alerts: Give with food to increase absorption of drug. Do not give K
supplements. Pregnancy category C.
Regular insulin (Humulin R, Novolin R) - Answer - Therapeutic class: Parenteral drug
for diabetes; pancreatic hormone
- Pharmacologic class: Short-acting hypoglycemic drug
- Mechanisms of action: maintain normal blood glucose. Promote cellular uptake of
glucose, amino acids and K+. Promote protein synthesis, glycogen formation and
storage, and fatty acid storage as triglycerides. Promote using glucose for energy and
Questions and 100% Correct Verified Answers
Heparin - Answer - Therapeutic class: anticoagulant (parenteral)
- Pharmacologic class: indirect thrombin inhibitor
- Mechanisms of action: Prolong coagulation time which prevents excessive clotting
within blood vessels. Prevents enlargement of existing clots and formation of new
ones. Binds to antithrombin III to inactivate several clotting factors and inhibit
thrombin activity. Used at low doses to prevent thromboembolic events arising from
open heart and vascular surgery, dialysis procedures, or in patients with unstable
angina or in the acute stages of MI. Used at high doses to treat conditions in which
immediate anticoagulation is needed, such as confirmed DVT and pulmonary embolism.
- Administration alerts: Use of nomogram decreases chance of medication calculation
errors and over- or under therapeutic doses. When administering heparin subcut, never
draw back the syringe plunger once needle has entered the skin and never massage the
site after injection. IM admin is contraindicated for bleeding risk. Pregnancy category C.
- Pharmacokinetics: Onset: 30-60m; Peak: 2h; Duration: 8-12h
- Adverse effects: Abnormal bleeding, Heparin- induced thrombocytopenia
(HIT), increase in adverse thromboembolic events
- BLACK BOX WARNING: epidural or spinal hematomas may occur when heparin is
used in patients receiving spinal anesthesia or lumbar puncture, may lead to long-term
or permanent paralysis
- Contraindications: Patients with active internal bleeding, bleeding disorders,
severe hypertension, recent trauma, intracranial hemorrhage, bacterial endocarditis
- OD treatment: protamine sulfate can be administered IV to neutralize
,Warfarin (Coumadin) - Answer - Therapeutic class: anticoagulant
- Pharmacologic class: vitamin K-antagonist
- Mechanisms of action: Prevention of stroke, MI, DVT and pulmonary embolism.
Prevent thromboembolic events in high risk patients.
- Administration alerts: If life-threatening bleeding occurs, can do IM or subcut admin
of vitamin K1. Pregnancy category X.
- Pharmacokinetics: Onset: 2-7 days; Peak: 0.5-3 days; Duration: 3-5 days
- Adverse effects: Abnormal bleeding
- BLACK BOX WARNING: can cause major or fatal bleeding, and regular monitoring of
INR is required
- Contraindications: Patients with recent trauma, active internal bleeding, bleeding
disorders, intracranial hemorrhage, severe hypertension, bacterial endocarditis,
severe liver or kidney disease
- OD treatment: Vitamin K given PO or IV
Bethanechol (Urecholine) - Answer - Therapeutic class: non-obstructive urinary
retention drug
- Pharmacologic class: muscarinic cholinergic receptor drug
- Mechanism of action: direct-acting parasympathomimetic that stimulates
parasympathetic activity by interacting with muscarinic receptors. Stimulates smooth
muscle contraction in the digestive and urinary tract. Used to treat urinary retention.
- OD treatment: atropine
- Adverse/side effects: increased salivation, sweating, abdominal cramping,
hypotension. Used with caution when used to treat patients with disorders that may
become aggravated with an increase in stimulation of smooth muscle contractions of
GI tract (obstruction, active ulcer, inflammatory disease). Used with caution with a
urinary obstruction or COPD.
- Contraindications: asthma, epilepsy, parkinsonism, hyperthyroidism, peptic ulcer
disease, and bradycardia
,Furosemide (Lasix) - Answer - Therapeutic class: drug for heart failure and HTN
- Pharmacologic class: diuretic (loop type)
- Mechanism of action: Treatment of acute heart failure by removing large amounts of
excess fluid in a short time period. Prevents reabsorption of sodium and chloride in
the nephron loop.
- OD treatment: replacement of fluids and electrolytes, possible administration
of vasopressor, such as norepinephrine.
- Adverse/side effects: potential electrolyte imbalances (hypokalemia), dehydration,
hypotension (orthostatic), syncope, ototoxicity is rare but may result in permanent
hearing deficit.
- BLACK BOX WARNING: if given in excessive amounts, may lead to profound
diuresis with water and electrolyte depletion.
- Contraindication: hypersensitivity to furosemide, anuria, hepatic coma, and
severe fluid or electrolyte depletion
- Administration alerts: Check serum potassium levels before administering, if below
normal then notify HCP. Use with precaution in infants and neonates due to prolonged
half-life. Older adults may need lower doses. Pregnancy category C.
Hydrochlorothiazide (Mirozide) - Answer - Therapeutic class: drug for hypertension and
edema
- Pharmacologic class: thiazide diuretic
- Mechanism of action: Acts on kidney tubule to decrease reabsorption of Na+. Blocks
reabsorption so more Na+ is sent into urine. Sodium moves across tubule, water
flows with it, so blood volume decreases and blood pressure falls.
- OD treatment: infusions of normal saline
, - Adverse/side effects: potential electrolyte imbalances due to excessive loss of K
and Na, cardiac conduction abnormalities, gout attacks due to hyperuricemia
- Contraindications: anuria, hypersensitivity to thiazides or sulfonamides, pre-
eclampsia or other pregnancy-induced hypertension
- Administration alerts: Administer early in the day to prevent nocturia. Pregnancy
category B
Spironolactone (Aldactone) - Answer - Therapeutic class: antihypertensive, drug
for reducing edema
- Pharmacologic class: potassium-sparing diuretic, aldosterone antagonist
- Mechanism of action: Inhibits aldosterone (hormone secreted to increase renal
reabsorption of Na in exchange for K) which causes water retention. When aldosterone is
blocked, Na and water excretion are increased and body retains more potassium.
- OD treatment: normal saline to replace fluids and electrolytes, and a vasopressor
like norepinephrine to raise blood pressure.
- Adverse/side effects: hyperkalemia, muscle weakness, fatigue, bradycardia. In
men, gynecomastia, impotence, diminished libido. In women, menstrual
irregularities, hirsutism, breast tenderness.
- BLACK BOX WARNING: has been found to cause tumors in animals, so should be
used only for specified indications.
- Contraindications: anura, serious CKD, hyperkalemia, pregnancy, lactation.
- Administration alerts: Give with food to increase absorption of drug. Do not give K
supplements. Pregnancy category C.
Regular insulin (Humulin R, Novolin R) - Answer - Therapeutic class: Parenteral drug
for diabetes; pancreatic hormone
- Pharmacologic class: Short-acting hypoglycemic drug
- Mechanisms of action: maintain normal blood glucose. Promote cellular uptake of
glucose, amino acids and K+. Promote protein synthesis, glycogen formation and
storage, and fatty acid storage as triglycerides. Promote using glucose for energy and
