Nursing Pharmacology Exam Review: Modules 1–2, Endocrine and Reproductive Drugs

What is the nursing process?

A 5-step thinking habit that keeps patients safe during medication administration.

List the 5 steps of the nursing process.

1. Assessment, 2. Human Need Statement, 3. Planning, 4. Implementation, 5. Evaluation.

What is included in the assessment step of the nursing process?

Collecting facts such as vital signs, labs, allergies, current medications, and patient reports.

What is a Human Need Statement?

A statement that names the problem, its cause, and the evidence observed.

What should a planning goal be like?

Specific, measurable, and have a time frame.

What are the Nine Rights of medication administration?

1. Right drug, 2. Right dose, 3. Right time, 4. Right route, 5. Right patient, 6. Right reason, 7. Right response, 8. Right documentation, 9. Right to refuse.

What is the significance of a complete medicine order?

It must have 7 parts: patient name, date/time, drug name, dose, route, frequency, and prescriber signature.

What is QSEN?

Quality and Safety Education for Nurses, focusing on patient-centered care, teamwork, evidence-based practice, quality improvement, safety, and informatics.

Define pharmacology.

The study of how drugs interact with biological systems.

What are the three big ideas that control how medicines work?

1. How the drug is made and absorbed, 2. What the body does to the drug, 3. What the drug does to the body.

What does pharmacokinetics refer to?

What the body does to the drug, including absorption, distribution, metabolism, and excretion.

What is bioavailability?

The proportion of a drug that enters the circulation when introduced into the body and is available for action.

What is the first-pass effect?

The process where the liver metabolizes a drug before it reaches systemic circulation, often reducing its effectiveness.

What is half-life in pharmacology?

The time it takes for half of the drug to be eliminated from the body.

What is meant by 'steady state'?

The point at which the amount of drug administered equals the amount eliminated, typically achieved after 4-5 half-lives.

What is the therapeutic index?

The range between the minimum effective dose and the minimum toxic dose of a drug.

What is an agonist?

A substance that activates a receptor to produce a biological response.

What is an antagonist?

A substance that blocks or dampens a biological response by binding to a receptor.

What is pharmacodynamics?

What the drug does to the body, including the mechanisms of action and effects.

How do age and condition affect drug metabolism in older adults?

Liver and kidney function decline, leading to longer drug half-lives and increased risk of toxicity.

What is the dosing consideration for children?

Doses are typically calculated based on weight (mg/kg) or body surface area.

What is the highest risk period for birth defects during pregnancy?

The first trimester, when organs are forming.

What are the types of therapy for medications?

Acute, maintenance, supplemental/replacement, palliative, supportive, prophylactic, and empirical.

What is medication reconciliation?

The process of comparing a patient's current medications with new orders to prevent errors.

What is the main focus of culture in relation to medicine?

Culture shapes how individuals perceive and interact with medical practices and healthcare.

What do ethics in healthcare refer to?

The moral principles that govern a person's behavior or conducting of an activity in medicine.

What do ethics tell us?

What is right.

What should you always ask about regarding patient health beliefs?

Herbals, folk remedies, and health beliefs.

What is a Schedule I controlled substance?

High abuse, no accepted medical use (e.g., heroin, LSD).

What is a Schedule II controlled substance?

High abuse, accepted medical use, no refills (e.g., morphine, oxycodone).

What is the requirement for Schedule II drugs?

A new prescription is needed every time; no refills.

What does beneficence mean in ethical principles?

To do good.

What does nonmaleficence mean?

To do no harm.

What is the principle of autonomy?

The patient decides, including the right to refuse.

What is a medication error?

Any preventable mistake with a medicine that can hurt the patient.

What are high-alert medicines?

Medicines that can cause serious harm if used incorrectly (e.g., insulin, opioids).

What is one common cause of medication errors?

Look-alike or sound-alike names.

What is the first step to take when a medication error occurs?

Check the patient first (vital signs and how they look/feel).

What should you do after checking the patient in case of an error?

Tell the provider and your charge nurse right away.

What is the purpose of medication reconciliation?

To ensure accurate and complete medication information at transitions.

What is the antidote for dopamine leakage (extravasation)?

Phentolamine injected into the area.

What does the sympathetic nervous system do?

Speeds the heart, opens the lungs, and raises blood pressure (fight or flight).

What does the parasympathetic nervous system do?

Slows the heart, increases spit and gut activity, and aids in digestion (rest and digest).

What are adrenergic drugs used for?

To boost the sympathetic system for stronger heart function and open airways.

What does the beta₁ receptor do?

Works on the heart to increase rate and strength of contraction.

What effect does low-dose dopamine have?

Opens kidney blood flow and increases urine output.

What is the primary use of epinephrine?

Drug of choice for severe allergic reactions (anaphylaxis) and cardiac arrest.

What is the main action of norepinephrine?

Strongly squeezes blood vessels to raise blood pressure.

What is the effect of high-dose dopamine?

Squeezes vessels and raises blood pressure.

What is the use of dobutamine?

Strengthens heart squeeze with less effect on heart rate, used for heart failure.

What is a key consideration when administering high-alert medications?

Use independent double-checks and barcode scanning.

What should be documented after a medication error?

The facts in the patient chart without mentioning the incident report.

What is Midodrine used for?

It is an oral alpha₁ drug for people who experience dizziness due to orthostatic hypotension.

When should the last dose of Midodrine be taken?

By 6 PM or at least 4 hours before bed to prevent high blood pressure during sleep.

What is Mirabegron (Myrbetriq) used for?

It is a beta₃ agonist for treating overactive bladder.

What is a key instruction regarding the Mirabegron tablet?

Do not crush or chew the extended-release tablet.

What are common side effects of adrenergic agonists?

Headache, restlessness, excitement, trouble sleeping, fast or irregular heart rate, chest pain, high blood pressure, nausea, dry mouth, and tremors.

What should be assessed when administering adrenergic agonists?

Vital signs, heart and lung sounds, pulses, skin color and temperature, urine output, and history of heart problems or asthma.

What is the first-dose effect of alpha blockers?

The first dose can cause a significant drop in blood pressure, potentially leading to fainting.

What are common alpha blockers?

Phentolamine, prazosin, terazosin, doxazosin, tamsulosin, alfuzosin, silodosin.

What is the special use of Phentolamine?

It is an antidote for dopamine, norepinephrine, or epinephrine leakage from an IV and is also used for pheochromocytoma.

What are beta blockers primarily used for?

To slow the heart rate, reduce oxygen demand, and lower blood pressure.

What are cardioselective beta blockers?

Beta blockers that mainly affect the heart, such as metoprolol and atenolol.

What are nonselective beta blockers?

Beta blockers that affect both the heart and lungs, such as propranolol and nadolol.

What are the side effects of beta blockers?

Slow heart rate, low blood pressure, tiredness, depression, sexual problems, and wheezing (nonselective).

What should be monitored when administering beta blockers?

Blood pressure and heart rate, and watch for signs of low blood sugar.

What are the two types of cholinergic drugs?

Direct-acting and indirect-acting cholinergic drugs.

What is Bethanechol used for?

To help the bladder empty when there is no physical blockage.

What are common side effects of Bethanechol?

Low blood pressure, slow heart rate, drooling, sweating, stomach cramps, diarrhea, and wheezing.

What is the purpose of Donepezil?

It is used for Alzheimer's disease to raise the chemical that helps with memory.

What is Pyridostigmine used for?

It is the main medicine for myasthenia gravis and helps reverse certain muscle relaxants after surgery.

What is SLUDGE in relation to cholinergic crisis?

It stands for Salivation, Lacrimation, Urination, Diarrhea, GI cramps, Emesis (vomiting).

What is the antidote for cholinergic crisis?

Atropine.

What should be assessed when administering cholinergic drugs?

Vital signs, heart and lung sounds, bowel and bladder function, and muscle strength.

What is a critical instruction regarding beta blockers?

Never stop a beta blocker suddenly; it must be tapered.

What are the signs of cholinergic crisis?

Early signs include stomach cramps, drooling, and nausea; late signs include very low blood pressure and shock.

What do cholinergic blockers do?

They block the parasympathetic nervous system, drying secretions, speeding the heart, dilating pupils, slowing gut activity, and causing urinary retention.

What is a classic mnemonic for the side effects of anticholinergics?

Can't see, can't spit, can't pee, can't ****.

What are some common side effects of anticholinergic drugs?

Blurred vision, dry mouth, urinary retention, constipation, confusion, and overheating.

What is atropine used for?

To speed up a dangerously slow heart, dry secretions before surgery, and as an antidote for cholinergic crisis.

What is scopolamine primarily used for?

To prevent motion sickness and dry secretions.

What condition is ipratropium used to treat?

COPD and asthma.

What is the purpose of oxybutynin?

To calm an overactive bladder.

What are benztropine and trihexyphenidyl used for?

To help with Parkinson's tremors and side effects from certain medications.

What is dicyclomine used to treat?

Irritable bowel syndrome by reducing stomach spasms.

What is glycopyrrolate used for?

To dry secretions before surgery and for treating ulcers.

Who should avoid anticholinergic drugs?

Patients with narrow-angle glaucoma, myasthenia gravis, blocked gut or bladder, severe ulcerative colitis, or unstable heart problems.

What are signs of anticholinergic overdose?

Hot, dry, flushed skin; confusion; fast heart rate; and dilated pupils.

What is the antidote for serious anticholinergic toxicity?

Physostigmine, along with cooling and supportive measures.

What should be monitored in patients taking anticholinergics?

Heart rate, blood pressure, bowel and bladder function, vision, and mental status.

What teaching should be provided for dry mouth caused by anticholinergics?

Use sugar-free gum or candy and practice frequent mouth care.

What should patients do to manage constipation while on anticholinergics?

Increase fluid and fiber intake.

What precautions should be taken regarding driving while on anticholinergics?

Wear sunglasses and be cautious due to blurred vision.

What is the first drug for anaphylaxis?

Epinephrine.

What is the main use of dopamine?

To treat shock, heart failure, and low urine output.

What is the key side effect of dobutamine?

Fast heart rate and irregular rhythms.

What is the main use of norepinephrine?

To treat septic shock and severe low blood pressure.

What is the main side effect of phenylephrine?

High blood pressure and slow heart rate (reflex).

What is mirabegron used for?

To treat overactive bladder.

What is the first dose effect associated with alpha blockers?

First-dose fainting and dizziness.