part 5 drugs

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The ABCs of PASSING FOREIGN NURSING EXAMS...As prepared by R.A. Gapuz

PART V

THE

CHECK PRINCIPLE

APPLIED IN PHARMACOLOGY

Oftentimes PHARMACOLOGY is the most dreaded part of anursing exam. One reason could be that it requires you to memorizefacts, and more often than not, it is difficult to decide on WHAT TO

MEMORIZE. But not anymore, the CHECK PRINCIPLE provides youwith a framework.

It stands for

C heck why the medication is given and know the classification ofthe drug . In other words, you should know the purpose why themedication is given.

H ow will you know if the medication is effective. What are yourassessment parameters in monitoring the effects of the drug?

E xactly what time should the medication be given. Some drugsare best taken with meals, some after meals and some, on anempty stomach. Other drugs may also be taken without regardto meals. You should know all of these!

C lient teaching tips. What would you tell your patient to expect.You should be able to give instructions related to thetherapeutic and side effects of the drug.

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Remember totake your

Tagamet with

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K eys to giving it safely. You should be able to identifyinterventions to counteract the adverse/side effects of the drug.

So now, if youre ready lets CHECK the most commonlyasked drugs in the actual exam

A

Aldomet (Methyldopa)

C AntihypertensiveH Decreased BPE Take the drug regularly exactly as prescribedC Impotence can be expectedK Check the BP, the drug may cause hypotension

Sample question: In a hypertensive male patient who is taking

methyldopa (Aldomet) as a maintenance medication, the nurse wouldmost likely anticipate the patient to complain of:

a. photosensitivity c. urticariab. impotence d. tarry stool

Answer: (B)

Aminophylline (Theophylline)

C BronchodilatorH Ease ofbreathingE Best taken in the morning on an empty stomach, because the

drug causes insomniaC Stop smoking as it interferes with the drugs effectivenessK Check the heart rate, the drug may cause tachycardia

Maintain adequate urine output

Avoid caffeine containing foods

Sample question: A nurse should assess a patient who is receivingaminophylline for which of the following side effects of themedication?

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a. bradycardia c. tinnitus

b. tachycardia d. ecchymosis Answer: (B)

Amphogel (Aluminum Hydroxide gel)

C Antacid; it neutralizes orreduces gastric acidityH Decreased phosphate levelE Best taken between meals and at bedtime

C The drug may cause constipationK Administer the drug with a glass of water

Report black tarry stool.Monitor for signs and symptoms of hypophosphatemia.

Sample question: An adult has been taking aluminum hydroxide(Amphogel) for hyperphosphatemia. It is most important for the nurseto teach the patient:

a. to inform the physician if he has constipationb. the tablets tend to be more effective than the liquidc. to report signs of muscle weakness, anorexia, and malaised. to take large amount of water to ensure passage of the

medication to the stomachAnswer: (C)

Antabuse (Disulfiram)

C Antialcoholic agent; causes an unpleasant reaction whencombined with alcohol

H Patient avoids alcoholE Best taken afterabstaining from alcohol for 12 hoursC Instruct the patient to avoid alcohol based substances like:

M - OUTH WASH

O - VER THE COUNTER COLD REMEDIESF - RUIT FLAVORED EXTRACTSF - OOD SAUCES MADE UP OF WINEA - FTER SHAVE LOTIONV - INEGAR

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S - KIN PRODUCTS

K Inspect the patients belongings and confiscate alcohol basedsubstancesMonitor liver function tests

Sample question: Which of the following statements, if made by apatient who is addicted to alcohol, would indicate an adequateunderstanding of disulfiram (Antabuse) ?

a. I will read the labels on mouthwash before using it.

b. I need to take this medication on an empty stomach.c. This medication will decrease my desire for alcohol.d. I need to take precautions in the sun.

Answer: (A)

Apresoline ( Hydralazine)

C AntihypertensiveH Decreased blood pressureE Best taken with foodC Rise slowly from a lying or sitting positionK Monitor for signs and symptoms oforthostatic hypotension

Monitor the heart rate fortachycardia

Sample question: Prior to the administration of hydralazine(Apresoline) the nurse would evaluate for which of the following?

a. A decrease in the pulse pressureb. Pulse rate in excess of 110.c. A significant decrease in blood pressured. Presence of confusion and disorientation.

Answer: (C)

Artane (Trihexyphenidyl HCL)

C Anti-parkinsonian; given with antipsychotics to preventpseudoparkinsonismEx. Amantadine Symmetrel

- dopaminergic agent

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- increases dopamine levelsTrihexyphenidyl (Artane)

Bipeviden HCl (Akineton)Benztropine Mesylate (Cogentin)

- Anticholinergics decreases acetylcholineH Muscles become less stiff; decreased pill-rolling tremorsE Best taken after mealsC Avoid driving, the drug causes blurred visionK Check the BP, the drug may cause hypotension

Sample question: The nurse monitors the therapeutic effectiveness

of trihexyphenidyl hydrochloride (Artane) in the treatment ofparkinsons disease by evaluating for a decrease in:

a. bradykinesia c. tremorsb. occulogyric crisis d. propulsive gait

Answer: (C)

ASA (Aspirin)

C Anti-inflammatory; reduces inflammationEx. Acetylsalicylic acid (Aspirin)

Ibuprofen (Motrin, Advil)Indomethacin (Indocin)

H (-) Fever, Inflammation, PainE Best taken on full stomachC Tinnitus indicates toxicity

Avoid other over-the-counter cold remedyK Assess the patient forbleeding tendencies

Induce vomiting if overdose occurs

Sample question: A patient is taking acetylsalicylic acid (Aspirin)four times daily. To minimize possible complications of this therapy,the nurse should give the patient which of these instructions?

a. Avoid taking the aspirin with dairy products.b. Drink a glass of water with the aspirin.c. Aspirin should be taken one hour before meals.d. Take the aspirin with food.

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Answer: (D)

Atropine Sulfate

C Anticholinergic; reduces salivation, reverse heartblocksEx. Atropine sulfate (Isopto atropine)

Propantheline bromide (Pro-Banthine)H It increases heart rate in a patient with heartblockE Best taken 30 minutes before mealsC - The drug may cause facial flushing

Avoid tasks that require acute vision

Avoid hot environmentK Check the BP, the drug causes hypotension, constipation and

drymouthSample question: Preoperatively, a patient is given atropine sulfate.Which of these findings would indicate that the desired effects of themedication have been achieved?

a. increase in heart rate c. onset of drowsinessb. dryness of the lips d. relief of nauseaAnswer: (B)

B

C

Ca Edta (Edetate Calcium Disodium)

C Antidote in lead poisoningH Increased urinary excretion ofleadE No specificC Report pain at injection siteK MonitorBUN levels, can damage the kidneys

Keep the patient supine

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Sample question: The side effect which is attributed to both thelead toxicity and the primary chelating agent, Ca Edta, is:

a. hypocalcemiab. bone-marrow depressionc. increased intracranial pressured. nephrotoxicity

Answer: (D)

Cephulac (Lactulose)

C Laxative; ammonia reduction agentH Decreased serum ammoniaE No specificC Report diarrheaK Monitor serum ammonia levels

Administer with juice to disguise the taste

Sample question: Lactulose (Cephulac) is ordered for a patient withliver cirrhosis. What is the purpose of this drug?

a. to stimulate secretion of reninb. to improve glucose utilizationc. to limit excretion of sodiumd. to decrease ammonia absorption

Answer: (D)

C Oral anticoagulants; depresses the synthesis of vitamin Kdependent clotting factorsEx. Warfarin sodium (Coumadin)

Dicumarol (Bishydroxycoumarin)H (-) ThrombusE No specificC Avoid green leafy vegetables as the Vitamin K content of these

vegetables interfere with the absorption of the drug.Avoid contact sportsK Assess for any sign ofbleeding

Keep vitamin K at the bedsideDo not give patient any IM injection

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Many factors (diet, fever, environment) may change the bodysresponse to the drug

Sample question: A nurse has given patient instructions abouttaking warfarin sodium (Coumadin). Which of the followingstatements, if made by the patient, indicates that the patientunderstands the instructions?a. I can expect to gain weight while taking this medication.b. I will take my pulse prior to each dose.c. I can take Aspirin when I have a headache.d. I will take the medication at the same time every day.

Answer: (D)

D

Demerol (Meperidine HCL)

C Narcotic Analgesic; used to relieve pain of nephrolithiasisH (-) PainE No specificC Avoid activities that requires alertness Avoid alcohol

It may cause facial flushingK Keep the antidote, naloxone HCL at the bedside

Sample question: For the first two days following thoracicsurgery, a patient received meperidine hydrochloride (Demerol) everythree hours. On the third day, three hours after receiving theDemerol, the patient refuses to cough because of pain in theoperative area and feeling nervous. The patients respirations areshallow. Based on the above data, which of these actions should thenurse take?

a. delay giving the medication to prevent the patient from becoming

addicted to the narcoticb. delay giving the medication to avoid further depressing the

patients respirationc. administer the medication to facilitate the patients respiratory

exercises

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d. administer the medication to relieve the patients tension

Answer: (C)

C Hypoglycemic agents; stimulate the pancreas to secrete insulinEx. Chlorpropamide (Diabinase)

Tolbutamide (Orinase)Tolazamide (Tolinase)

H Blood sugar level within normal rangeE Best given in the morning with food, so sleep will not be

disturbed by increased urinationC Take weight daily

Protect the skin from exposure to the sunK Assess for signs and symptoms of hypoglycemia like

drowsiness, diaphoresis, and dizziness.

Sample question: Diabinase is most effective in which type ofdiabetes?

a. insulin dependent diabetes mellitusb. non-insulin dependent diabetes mellitusc. gestational diabetesd. diabetic ketoacidosis

Answer: (B)

C Carbonic anhydrase inhibitors; promotes sodium excretion

Ex. Acetazolamide (Diamox)H Increased urine output, decreased vertigo in menieres diseaseE Best taken in the morning with mealsC Avoid driving

Avoid exposure to sunlightK Assess for unusual bleeding

Sample question: A patient with menieres disease is prescribed

with Diamox. What observation shows that the drug is taking effect?

a. increased urinary outputb. patient is relieved of constipationc. patient has clearer vision

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d. vertigo is significantly lessened

Answer: (D)

Digoxin (Lanoxin)

C Cardiac Glycoside; increases myocardial contraction, decreasesheart rate; stones conduction through the AV nodeEx. Digoxin (Lanoxin)

Deslanoxide (Cedilanid)H Normal heart rate in patient with atrial fibrillation

E No specificC Report greenishvision, sign oftoxicity

Take pulse everydayK Assess the patients heartrate, it causes bradycardia

Assess for signs of toxicity (Nausea, Anorexia, Vomiting,Diarrhea)

Monitor serum K level.

Sample question: A patient who is receiving a digitalis preparationshould be observed for symptoms of toxicity, which include:

a. hypertension c. tinnitusb. oliguria d. vomiting

Answer: (D)

Dilantin (Phenytoin)

C Anti-convulsants; decreases spread of the seizure processEx. Phenytoin (Dilantin)

H (-) SeizureE Best taken with food to enhance absorptionC Massage the gums, it causes gingival hypertrophy

May turn the urine pink, red or reddish brown

K Monitor for signs and symptoms ofbone marrow depressionDo not discontinue abruptly Use saline flush before and after IV administration Report skin rash

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Sample question: Margaret Tempo is a 7-year-old who has been onphenytoin (Dilantin) and phenobarbital for control of chronic recurrent

seizures. In the physical exam, the nurse notes that Margaret hashyperplasia of the gums which is:

a. a common occurrence with chronic recurrent seizuresb. a common side effect of phenytoin (Dilantin)c. not related to the drug or the diseased. an unusual side effect of phenobarbital

Answer: (B)

Diuril (Chlorothiazide)

C DiureticH Increased urine outputE Best taken with food early in the day, so sleep will not be

disrupted by increased urinationC Protect the skin from exposure to the sun

Muscle weakness in the lower extremities indicatehypokalemiaIncrease K in the diet

K Monitor weight

Sample question: Mr. Backster should be instructed about the sideeffects of diuril which include:

a. insomnia b. dysuria c. diplopia d. weakness

Answer: (D)

E

Elavil (Amitriptyline)

C Tricyclic anti-depressant; prevents the reuptake ofnorepinephrine

H Increased appetite; adequate sleepE Best given after meals

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C Therapeutic effects may become evident only after 2-3weeks of intake

K Check the BP, it causes hypotension Check the heartrate, it causes cardiac arrythmias

Sample question: A community mental health nurse is caring for anelderly homebound patient who has a diagnosis of major depression.Which of the following observations would be typical of a patient whoreceived amitriptyline hydrochloride (Elavil) for a week?

a. elevated mood c. improved hygiene

b. increased social activity d. improved sleep pattern

Answer: (D)

F

Ferrous SO4

C Iron preparation; used in the prevention and treatment of irondeficiency anemia

H (-) PallorE Best taken on an empty stomachC Avoid milk, egg, coffee and tea, these decrease absorption

Take the drug with orange juice to promote absorptionK Keep the antidote, deferoxaminemesylate, at the bedside

Sample question: How should a patient take ferrous sulfate?

a. before taking the morning coffeeb. on an empty stomachc. with citrus juiced. after meals

Answer: (C)

G

Garamycin (Gentamicin)

C inhibits protein synthesis; bacteriostatic and bactericidal

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Ex. Gentamicin (Garamycin)Tobramycin (Nebcin)

StreptomycinH (-) InfectionE No specificC Increase fluid intake Tinnitus indicates ototoxicityK Monitor for signs and symptoms ofototoxicity, nephrotoxicity

and neurotoxicity.

Sample question: Nelson Hall is a 5-years-old in a pediatric

intensive care unit. He has a diagnosis of otitis media, dehydration,and tonsillitis. Nelson is receiving gentamicin via intravenouspiggyback every 8 hours. Which of the following statements byNelsons mother should alert the nurse to a potential problem?

a. He seems to be hungry today, always asking for ice cream.b. He still has some pain, but the shots seem to helpc. Sometimes he takes a nap and doesnt want to play.

d. Nelson is ignoring me. He did not look up when I called him.

Answer: (D)

H

Haldol (Haloperidol)

C Antipsychotics; blocks dopamine receptor sitesEx. Haloperidol (Haldol)

Chlorpromazine (Thorazine)Fluphenazine (Prolixin)

H Decreaseddelusions, hallucinations, looseness ofassociation

E Best taken after mealsC Avoid exposure to sunlight

K Monitor BP, it causes hypotensionThe long acting type (Haloperidol Decanoate) is given once amonth

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Sample question: After administering an injection of HaloperidolDecanoate (Haldol) to a patient, the nurse should instruct the patient

to:

a. stay recumbent for four hoursb. avoid foods containing tyraminec. return for the next injection in four weeksd. decrease salt intake

Answer: (C)

C Parenteral anticoagulants; prevents conversion of prothrombin tothrombinEx. Heparin Sodium

H Prolonged PTTE No specificC Report signs and symptoms of bleedingK Monitor the patient partial thromboplastin time Keep protamine SO4 (antidote) at the bedside

Do not give by IM injection

Sample question: A nurse should expect a patient who has a deepvein thrombosis to be given Heparin sodium (Heparin) to

a. dissolve the thrombus c. prevent clot enlargementb. decrease the pain d. reduce tissue edema

Answer: (C)

I

Inderal (Propanolol Hydrochloride)C Antianginal, Antiarrythmic, Antihypertensive; reduces portal

pressure and decreases the risk of bleeding from esophagealvarices

H Decreased BPE Best taken with mealsC Avoid driving; do not discontinue abruptlyK Check the BP, it may cause hypotension

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Sample question: A nurse should expect a patient who has been

diagnosed with hyperthyroidism to be prescribed propanolol (Inderal)in order to:

a. inhibit the synthesis of thyroid hormoneb. increase the effect of calcium on cardiac tissuec. enhance TSH secretion from the pituitary glandd. slow the sympathetic nervous system response

Answer: (D)

INH (Isoniazid)

C Antitubercular agents, inhibits mycolic acid thus causing atuberculostatic or tuberculocidal effectEx. Isoniazid (INH)

Rifampicin (Rifadin)

StreptomycinH (-) InfectionE Best taken on an empty stomachC Report tingling sensation in the lower extremities, it indicates

peripheral neuropathyAvoid alcohol

K Liver function studies should be done before the start of therapyTherapeutic effects generally occur in 2 3 weeks.

Administer with Vitamin B6 to prevent peripheral neuropathy.

Sample question: Mrs. Silvia is prescribed isoniazid (INH) fortreatment of tuberculosis. The nurse should instruct Mrs. Silvia onwhich of the following?

a. decreased niacin c. increased niacin storesb. increased folate stores d. decreased in vitamin A

Answer: (A)

C Parenteral hypoglycemic agents; aids glucose across the cellEx. 1. Rapid acting:

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RegularSemilente

2. Intermediate acting:NPHLente

3. Long actingUltra Lente

H Normal blood sugar levelE Best given before breakfastC Report signs and symptoms ofhypoglycemia (tremors,

nervousness)

K Serve meals on time to prevent hypoglycemiaWhen mixing these types of insulin, inject air into the NPHinsulin first before the regular insulin, but aspirate the regularinsulin first before the NPH insulin

Sample question: A patient who is receiving total parenteral nutritionhas an elevated blood glucose level and is to be administeredintravenous insulin. Which of the following types of insulin should a

nurse have available?

a. Isophane insulin (NPH)b. Regular insulin (Humulin R)c. Insulin zinc suspension (Lente)d. Semi-lente insulin (Semitard)

Answer: (B)

K

L

C Loop diuretic; blocks the reabsorption of sodium in the loop ofHenleEx. Furosemide (Lasix)Remember: Lasix its a loop diuretic which acts on the

ascending loopH Increased urine outputE Best given in the morning

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C Eat bananas and citrus fruits because they are good sources ofpotassium

K Monitor serum potassiumlevels, it can cause hypokalemia

Sample question: A patient in renal failure is being treated withfurosemide (Lasix) via a continuous IV infusion. The nurse knowsthat the dosage of furosemide (Lasix) to be delivered should notexceed:

a. 10 mg/min c. 4 mg/kgb. 4 mg/min d. 100mg/day

Answer: (B)

Lithium Carbonate

C AntimanicH Decreased hyperactivityE Best taken after meals

C Increase fluid intake (3 L /day) and sodium intake (3 gm./day)Avoid activities that increase perspirationK It takes 10-14 days before therapeutic effect becomes evident.

Antipsychotic is administered during the first two weeks tomanage the acute symptoms of mania until lithium takes effectMonitor serum level, normal is .5-1.5 meq/L.Nausea, Anorexia, Vomiting, Diarrhea and Abdominal crampsindicates lithium toxicityMannitol is administered iftoxicity occurs

Sample question: A nurse is caring for a patient who is receivingLithium carbonate (Eskalith). Prior to administration of the next dose,the nurse finds that the patients lithium blood level is 1.6 mEq/L.Which of the following actions should the nurse take first?

a. call the patients physicianb. withhold the dose

c.take the patients vital signsd. repeat the blood lithium levelAnswer: (B)

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M

Magnesium SO4

C AnticonvulsantH (-) ConvulsionE No specificC Diarrhea is a side effectK Keep the antidote, calcium gluconate at the bedside

Assess the patients respiratory rate, (should be at least

12/min.) deep tendon reflex and urine output, (should be atleast 30 ml./hr.)

Sample question: During labor a woman is receiving magnesiumsulfate intravenously. It is essential that a nurse have which of thefollowing drugs available to counteract potential adverse effects?

a. Oxytocin (Pitocin) c. Phenytoin sodium (Dilantin)

b. Sodium bicarbonate d. Calcium gluconate

Answer: (D)

C Osmotics; decreases water reabsorptionEx. Mannitol (Osmitrol)

H Increased urine outputE Best given in the morningC Avoid alcohol and prolonged exposure to sunlight

K Monitor BP and serum potassium

Sample question: A patient with a closed head injury is started on IVmannitol to decrease intracranial pressure. If the patient complains ofheadache or becomes confused several hours after the drug isadministered, the nurse should assess the patient for which of thefollowing?

a. elevated atrial blood pressureb. elevated serum electrolytesc. elevated intracranial pressured. elevated central venous pressure

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Answer: (C)

Mestinon (Pyridostigmine)

CCholinesterase inhibitor; used as treatment formyastheniagravis

H Increased muscle strengthE Usually administered before mealsC Report the development ofrash, the drug may increase

peristalsisK Monitor formuscle weakness

Keep the antidote, atropineSO4 at the bedside

Sample question: A diagnosis of myasthenia gravis is confirmed,and Ms. Gaddi is started on pyridostigmine (Mestinon) orally. Thenurse will be alert for which of the following adverse effect ofMestinon?

a. constipation c. diarrhea

b. urinary retention d. dry mouth Answer: (C)

Methergin (Methylergonovine Maleate)

C Oxytocic; used as a treatment forpostpartum atony andhemorrhage

H Firmly contracted uterus

E No specificC Report difficulty of breathingK Monitor the BP, it causes hypertension

Sample question: A potential side effect of Methergin is:

a. hypotension c. hypokalemiab. hypertension d. hyperphosphatemia

Answer: (B)

Monoamine Oxidase Inhibitor (MAOI)

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C AntidepressantH Increased appetite; adequate sleep

E Best taken after mealsC Report headache; it indicates hypertensive crisisAvoid tyramine containing foods like:

A-vocadoB-ananaC-heddar and aged cheeseS-oysauce and preserved foodsK Monitor the BP

Sample question: Which of the following foods, if chosen by apatient who is taking a monoamine oxidase inhibitor (MAOI),indicates that the patient is following the prescribed diet?

a. Prunes c. Fresh vegetablesb. Aged cheese d. Sausage

Answer: (C)

Morphine SO4

C Narcotic Agonist, Analgesic; given to decrease anxiety in apatient with pulmonary edema; promotes venous pooling of bloodin the periphery, so it decreases venous return to the heart

H Relief ofpainE Best taken with food

C Avoid driving,Report severe nausea and vomiting

K Keep Naloxone HCL (antidote) at the bedsideInstruct the patient to lie down during IV administration.Morphine causes more pain in pancreatitis because itincreases the spasm of the sphincter of oddi, so avoid givingit.

Sample question: A nurse should be aware that morphine sulfate isadministered to a patient who has pulmonary edema in order to:

a. diminish venous return to the heartb. decrease pain

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c. decrease the respiratory rated. reduce the glomerular rate

Answer: (A)

N

Nitroglycerin

C Antianginals; decreases oxygen demand, decreases preload bydilating veinsEx. Nitroglycerin (Nitrobid, Tridil, Transderm, Deponit)

H Relief ofchest painE Best taken before any strenous activityC Place a tablet under the tongue at the first sign of chest pain

Burning sensation under the tongue is a sign ofpotency ofthe drug. Facial flushing is a side effect.Do not chew the tablet.

Keep the tablets in a darkcontainer.K Monitor the BP and heart rate

Sample question: Which of these statements, if made by a patientwho has a prescription for sublingual nitroglycerin tablets, wouldindicate a correct understanding of the medication instructions?

a. I should take these pills with a full glass of water.

b. I should protect these pills from light.c. I should wait 30 minutes before taking the second pill.d. I should chew the pill for a faster effect.

Answer: (B)

O

P

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Penicillin

C interferes with division of bacteriaEx. Penicillin

MethicillinAmoxicilin

H (-) InfectionE Best taken on an empty stomach with a full glass of waterC Report the development of rashK Keep the antidote, epinephrine at the bedside

Sample question: A child who is being treated for rheumatic fever isgiven instructions about her penicillin therapy. The childs parents askthe nurse, What is the purpose of our child being on penicillin for anindefinite time? the nurse should respond that the purpose of thepenicillin regimen is to:

a. stimulate the immune system

b. prevent a recurrence of the diseasec. alter the flora in the respiratory tractd. prevent permanent pathologic changes in the joints

Answer: (B)

Phenergan ( Promethazine Hydrochloride)

C AntihistamineH (-) AllergyE No specificC Avoid alcohol and prolonged exposure to sunlightK Do not administerSC, tissue necrosis may occur

Sample question: A patient is scheduled for surgery and is toreceive promethazine hydrochloride (Phenergan) 35 mg

intramuscularly. The drug is available in ampules containing 50 mg./1 ml of solution. The patient should receive how many milliliters ofsolution?

a. 0.3 b. 0.7 c. 1.0 d. 1.4

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Answer: (B)

Pitocin (Oxytocin)

C Oxytocic; used to induce labor after artificial rupture of themembranes

H Firmly contracted uterusE No specificC Report the development ofrashK Monitor the BP

Discontinue ifhypertension develops

Sample question: Because a woman is receiving oxytocin (Pitocin)for induction of labor, it is essential for the nurse to monitor:

a. fundal height c. cervical changesb. patellar reflexes d. level of consciousness

Answer: (C)

Probenecid (Benemid)

C AntigoutEx. Colchicine (Novocolchine)

- control inflammation of the attackProbenecid (Benemid)- increases excretion of uric acid

Allopurinol (Zyloprim)- decreases production of uric acid

H Decreased uric acid levelsE Best taken with mealsC Change position slowlyK Increase fluid intake

Sample question: Mr. Ray states that he is taking a medication for

gout but cannot remember the name. He states that it is especiallyimportant that he drinks eight glasses of water daily to keep theexcreted uric acid dilute. This drug is contraindicated in patients withrenal failure or with a history of renal stones. Which drug is Mr. Raymost probably taking?

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a. Probenecid c. Colchicine

b. Allopurinol d. Tylenol Answer: (A)

Prostigmin (Neostigmine)

C Anticholinesterase; increases muscle strength by inhibitingacetylcholinesteraseEx. Endrophonuim chloride (Tensilon)

Neostigmine methylsulfate (Prostigmin)

Pyridostigmine bromide (Regonol)H Increased muscle strengthE No specificC Report diarrhea, abdominal pain and muscle weakness

Avoid hot and excessively humid environmentK Keep the antidote, pralidoxime chloride (PAM) oratropine at

the bedside

Sample question: In a patient receiving prostigmin (Neostigmine) fortreatment of Myasthenia Gravis, the nurse should plan to have whichof the following drugs at the bedside ?

a. lidocaine c. atropineb. epinephrine d. procainamide

Answer: (C)

PTU (Propylthiouracil)

C Antithyroid; inhibits synthesis of thyroid hormoneH Decreased heart rate; adequate sleepE Take the drug around the clock at 8 hour intervalC Treatment is lifelong

Report the development of sorethroat, it indicatesagranulocytosisK Monitor the heart rate, it causes tachycardia contraindicated in

pregnant patients

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Sample question: A patient with hyperthyroidism is started onpropylthiouracil (PTU). When should the nurse expect noticeable

improvement in the patients condition?a. in 24 to 48 hrs c. in 2 to 4 weeksb. in 6 to 7 days d. in 6 months

Answer: (C)

R

RhoGAM (Rho Immune Globulin)

C Prevents sensitization to the Rho factorH (-) Erythroblastosis FetalisE Administer within 72 hours after Rh incompatible deliveryC Report pain and soreness at injection siteK Given to Rh (-) motherwith an Rh (+), Coombs (-) Baby

Sample question: An Rh negative mother would need to receiveRho (D) immune globulin (RhoGAM) within 72 hours after delivery ifher newborn had which of the following blood test results?

a. Rh negative, Coombs positiveb. Rh negative, Coombs negativec. Rh positive, Coombs negatived. Rh positive, Coombs positive

Answer: (C)

C Stimulants; increases attention span thus decreasinghyperactivityEx. Methylphenidate (Ritalin)

Amphetamine (Benzedrine)H Decreased hyperactivityE Best given after meals because it suppresses the appetite if

given before meals;Give it in the morning or at least 6 hours before bedtime since

it causes insomniaC May cause growth retardationK Monitorgrowth and development

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Sample question: Methylphenidate (Ritalin) calms impulsiveness,

hyperactivity and restlessness of attention deficit disorder (ADD) orhyperactive children by a paradoxical calming effect. The nurseknows that this means:

a. Ritalin is an anxiolytic and calms the childb. Ritalin is a stimulant and calms the childc. Ritalin is an analgesic and calms the childd. Ritalin is a relaxant and calms the child

Answer: (B)

S

Streptomycin

C Aminoglycoside; used to destroy the vestibular apparatus todecrease vertigo in a patient with menieres disease

H (-) InfectionE Best taken after meals, to decrease GI upsetC Report oliguria, it indicates nephrotoxicityK Increase fluids

Monitor BP and pulseThe drug causes ototoxicity, nephrotoxicity and neurotoxicity

Sample question: If a patient is receiving Streptomycin, which of

the following should the clinic nurse report immediately to thephysician?

a. drooping of the eyelids c. inflammation of the jointb. stoma of the mouth d. loss of hearing

Answer: (D)

Symmetrel (Amantadine)

C Antiparkinsonian, Dopaminergic, AntiviralH Muscles become less stiffE No specific

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C Report swelling offingersK Do not discontinue abruptly

Sample question: Amantadine hydrochloride (Symmetrel) isprescribed for a patient with Parkinsons disease. The patient askshow the drug works. In formulating a response, the nurse recalls thatthe drug:

a. Allows accumulation of dopamineb. Corrects mineral deficienciesc. Elevates the patients mood

d. Blocks dopamine receptorsAnswer: (A)

C Thyroid agents; replace missing thyroid hormonesEx. Levothyroxine sodium (Synthroid)

Thyroglobulin (Proloid)Liotrix (Euthroid)

H Normal T4 levels; in female patients there will be resumption ofmenstruationE Best taken in the morning, to prevent insomniaC Treatment is lifelongK MonitorBP and pulse

Sample question: A female patient is ordered to take Synthroid 0.4mg daily. She has been taking this medication for 4 days. Which ofthe following statements would indicate that the nurse should

recommend a change in the patients medication?

a. develops nervousness and difficulty sleepingb. states she has NO ENERGY and is just tiredc. patient has coarse hair and skind. has a persistent weight gain

Answer: (A)

T

Tagamet (Cimetidine)

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C Histamine antagonist; inhibits gastric acid secretionH Relief of symptoms ofheartburn, acid indigestion

E Best given with food, when administering it with an antacid, givethe antacid one hour before cimetidineC Avoid smoking, it decreases drug efficacyK Administer IM dose undiluted deep into large muscle

Infusion should be diluted in at least 50 cc of D5W

Sample question: Mr. Ojastro is receiving cimetidine (Tagamet) 300mg every 6 hours IVPB for a duodenal ulcer. The nurse shouldadminister the medication using which of the following methods?

a. undiluted, IV push over 1 minuteb. diluted in 20 cc of compatible solution and IV push over 1 minutec. diluted in 50 cc of compatible solution and infused over 15 to 20

minutesd. undiluted and infused over 15 to 20 minutes

Answer: (C)

Timolol Maleate (Timoptic)

C Antihypertensives; lowers the blood pressureEx. Beta adrenergics blockers

- decreases cardiac outputAtenolol (Tenormin)Timolol (Blocadren)

H Decreased BP; IOP

E No specificC Avoid drivingK Administer ophthalmic eye drops in the lower conjunctival sac

The drug may cause hyperglycemia or hypoglycemia

Sample question: A patient is given a prescription for timololmaleate (Timoptic) eyedrops. The nurse should instruct the patient toinstill the eyedrops at which of these areas of the eyes?

a. in the inner canthus c. in the conjunctival sacb. on the cornea d. on the center of the pupil

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Answer: (C)

V

C Antianxiety agents; anxiolytics- depresses the reticular activating system

Ex. Diazepam (Valium)Chlordiazepoxide (Librium)

Oxazepam (Serax)H Decreased anxiety, adequate sleepE Best taken before meals, food in the stomach delays absorptionC Avoid driving, intake of alcohol and caffeine containing foods,

since it alters the effect of the drugK - Administer it separately, it is incompatible with any drug

Sample question: The nurse is caring for a patient with severe backstrain. The nurse administers diazepam (Valium) 10 mg qid. Which

observation is most indicative of the need to reassess this order?

a. drowsinessb. hyperesthesia of the armsc. loss of appetited. severe muscle spasms

Answer: (D)

Vitamin K (Phytonadione)

C Antidote, promotes formation of prothrombin, given in neonatesto prevent bleeding

H (-) BleedingE No specificC Report the development ofrashK Monitorprothrombin time, to determine dosage effectiveness

Sample question: A newborn receives vitamin K (Aquamephyton)to:

a. protect the eyes from infection

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b. prevent bleeding problemsc. boost the immune response

d. stimulate growth of gastrointestinal flora

Answer: (B)

X

Xylocaine (Lidocaine)

C Antiarrhythmic, Anesthetic; used to treat premature ventricularcontractions

H Normal heart rateE No specificC Tinnitus is a side effectK Monitor BP and serum electrolytes

Convulsion is the first sign of toxicity

Sample question: The nurse will plan to assess for the followingside effects related to intravenous lidocaine therapy:

a. disorientation c. dry mouthb. photophobia d. abdominal cramps

Answer: (A)

Y

Yutopar (Ritodrine)

C Tocolytic, used to treat pre-term labor by decreasing the intensityand frequency of uterine contractions.

H Relaxed uterusE No SpecificC Report increase in pulse rate, it causes palpitation

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K Contraindicated before 20th week of pregnancy, in patients withhemorrhage, hypertension, infection, bleeding disorders and

spontaneous abortion.

Sample question: Richelle is admitted to the labor and delivery unitat 22 weeks gestation. She is evaluated for abruptio placenta. Thenurse knows that ritodrine HCl (Yutopar) is indicated in this case toprevent labor. Which of the following is not a contraindication forritodrine HCl?

a. pregnancy induced hypertension

b. chorioamnionitisc. maternal cardiac diseased. multiple fetuses

Answer: (D)

Z

Zyloprim (Allopurinol)

C Antigout; used to prevent ortreat attacks ofgoutH Decreased uric acid levelsE Best taken with foodC Instruct the patient to report sore throat, it signals the

development ofagranulocytosis

K Increase fluid intake to facilitate excretion of uric acid crystalsAvoid over the counter medications, most of these containvitamin C which can increase the likelihood of renal stoneformation

Sample question: Inez is 9-years-old, and newly diagnosed withleukemia. She is just starting her chemotherapy. The physician alsoorders Allopurinol for her. This drug has been ordered for Inez todecrease the possibility of:

a. infection c. nausea and vomitingb. hyperuricemia d. bone narrow depression

Answer: (B)

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N.B.

To facilitate easier recall the brand names of the drugs werewritten ahead of the generic names.

Lets SYNTHESIZE!

After going through that list, Im sure you would agree with meif I tell you that we can still make things MORE SIMPLE. Letsstart

Drugs with ANTIDOTE

Acetaminophen.AcetylcysteineBenzodiazepine..FlumazenilCoumadin...Vitamin KCurare.....Endrophonium (Tensilon)Cyanide poisoning.........Methylene blueDigitalis.....DigibindEthylene poisoning.....Fomepizol (Antizol)Heparin.......Protamine SulfateIron...Deferoxamine Mesylate (Desferal)Lead.......Edetate Disodium (EDTA)

Dimercaprol (BAL)Succimer (CHEMET)

Lovenox...Protamine SO4Magnesium sulfate..Calcium GluconateMorphine sulfate.....Naloxone Hydrochloride

Methotrexate.....LeucovorineMestinon..Atropine SulfateNeostigmine...Pralidoxime Chloride (PAM)Penicillin.....Epinephrine

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Drugs which are BEST TAKEN WITH MEALS

Allopurinol FlagylApresoline InderalASA Morphine

Azulfidine PancreatinBenemid SerpasilDilantin TagametDiuril Tylenol

Drugs which are BEST TAKEN BEFORE MEALS

Atropine Sulfate Dalmane MestinonBactrim Insulin Valium

Drugs which are BEST TAKEN AFTER MEALS

Artane Haldol RitalinCogentin Lithium Streptomycin

Clozaril MAOI ThorazineDeltasone Nardil Tofranil

Elavil Pyridium

Drugs which are BEST TAKEN ON AN EMPTY STOMACH

Ampicin Ferrous Sulfate PenicillinChloromycetin INH RifadinErythrocin Isordil

Drugs which need to be taken in the MORNING

Accutane Diabinase Sudafed

Adriamycin Diamox SynthroidAminophylline Epinephrine TamofenCytoxan Mannitol Theodur

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Drugs which can be taken WITHOUT regard to MEALS

Ancef Demerol PhenerganAZT Dexasone PitocinCa EDTA Gentamicin PovanCardiazem Heparin ProstigmineCefoxitin Na Methergin RobaxinCephulac Neomycin Sulfate RocephinCodeine Nipride SulfamylonCoumadin Oncovin Symmetrel

Drugs which can cause URINE DISCOLORATION

Adriamycin...ReddishBactrimRed OrangeDilantin..Pink tingedFlagyl..Brownish

AzulfidineOrange YellowRifabutinRed OrangeRifampicin.Red OrangeRobaxinBrown, Black or Greenish

Drugs which should be TAKEN FOR THE REST OF THEPATIENTS LIFE

Anticholinesterase (MESTINON)..Myasthenia GravisAntithyroid drugs (PTU)..HyperthyroidismAspirin...ArthritisAZT .. AIDSDopaminergic agents (L-DOPA).Parkinsons DiseaseGlucocorticoids (DELTASONE).. ..Addisons DiseaseGlucocorticoid synthesis inhibitors (Mitotane) ... Cushings diseaseInsulin (NPH,REGULAR).. Diabetes Mellitus

Miotics(PILOCARPINE).GlaucomaPenicillin....Rheumatic Heart DiseaseThyroid Supplement ( SYNTHROID)..HypothyroidismVitamin B 12..Pernicious Anemia

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Common SIDE EFFECTS associated with certain DRUGS

Anaphylactic Shock.PenicillinBone Marrow suppressionChloramphenicol, AZTHepatotoxicity...INHRenal Toxicity....AminoglycosidesOtotoxicity..AminoglycosidesPhotosensitivity..Antipsychotics

part 5 drugs

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