NCLEX Pharmacology Prep

What are the four processes of pharmacokinetics, often remembered by the acronym ADME?

Absorption, Distribution, Metabolism, and Excretion

Which ACE inhibitor side effect is a medical emergency requiring immediate intervention due to potential airway compromise?

Angioedema

A patient taking furosemide, a loop diuretic, is at risk for which two major adverse effects?

hypokalemia and ototoxicity

This antibiotic class, which includes gentamicin, is known for causing nephrotoxicity and ototoxicity.

aminoglycosides

A patient prescribed ciprofloxacin, a fluoroquinolone, should be educated about the risk of ______ and photosensitivity.

Tendon rupture

What is the antidote for an opioid overdose, such as with morphine or hydromorphone?

naloxone (narcan)

A patient with acetaminophen toxicity should be treated with which antidote?

Acetylcysteine (Mucomyst)

Patients taking MAOIs, such as phenelzine, must avoid tyramine-rich foods to prevent what life-threatening condition?

hypertensive crisis

The therapeutic serum level for lithium is in the range of ______.

0.6-1.2 mEq/L

After using a corticosteroid inhaler like fluticasone, what is a crucial patient teaching point to prevent oral thrush?

Rinse the mouth with water

Long-term use of Proton Pump Inhibitors (PPIs) like omeprazole increases the risk of which condition?

osteoporosis

What is the antidote for heparin?

Protamine sulfate

A patient on warfarin therapy requires monitoring of which lab value?

INR (International Normalized Ratio)

Signs of magnesium sulfate toxicity include decreased deep tendon reflexes (DTRs) and ______.

Respiratory depression

What is the antidote for benzodiazepine overdose?

Flumazenil

What is the antidote for digoxin toxicity?

Digoxin immune fab (Digibind)

What is the term for the percentage of a drug that reaches the systemic circulation and is available to act on body cells?

Bioavailability

The ______ is the single most important organ for drub metabolism.

liver

The _____ are the primary site for drug excretion from the body.

kidneys

A patient taking metformin who is scheduled for a test with contrast media must stop the medication 48 hours before and after the test due to the risk of what condition?

Lactic acidosis

What is the only type of insulin that can be administered intravenously (IV)?

regular insulin

A patietn experiencing hypoglycemia who is conscious and has a gag reflex should be given ______ of fast-absorbing carbohydrates.

15 grams

The medication ______ is a synthetic thyroid hormone used to treat hypothyroidism and should be taken in the morning on an empty stomach.

levothyroxine

What is the black box warning for desmopressin (DDAVP), used to treat Diabetes Insipidus?

risk of severe hyponatremia

Grapefruit juice can cause taxicity when consumed with which class of antihypertensive medications?

Calcium Channel Blockers (CCBs)

A patient taking the potassium-sparing diuretic spironolactone is at risk for developing which electrolyte imbalance?

hyperkalemia

Before administering digoxin, the nurse must assess the patient’s _______ for one full minute.

Apical pulse

What are the classic signs of digoxin toxicity?

Anorexia, GI upset, blurred vision with halos, and irregular heartbeat

A patient is prescribed a nitroglycerin sublingual tablet for angina. How should they be instructed to take it?

Take one tablet every 5 minutes for up to 3 doses; call 911 if pain still persists after the third dose.

Patients taking nonselective beta-blockers should be monitored closely if they have which pre-existing conditions?

asthma or COPD

Patients on statin medications for hyperlipidemia should be instructed to report which adverse effect immediately?

Muscle pain or cramping (rhabdomyolysis)

This medication is given to reverse respiratory depression caused by opioid overdose, but it wears off quickly, so multiple doses may be needed.

Naloxone

Taking SSRIs with MAOIs can lead to _____, a life-threatening condition caused by excess serotonin.

serotonin syndrome

Long-term use of typical antipsychotics like haloperidol can cause ______, which includes tardive dyskinesia and pseudoparkinsonism.

Extrapyramidal effects (EPS)

When a patient is prescribed both a bronchodilator and a corticosteroid inhaler, which one should be administered first?

The bronchodilator (e.g., albuterol) should be administered first to open the airways.

This medication coats the stomach lining to protect ulcers and should be administered 1 hour before or 2 hours after meals.

Sucralfate

This laxative is used to treat hepatic encephalopathy by pulling ammonia from the blood into the intestine for excretion.

Lactulose

What is the therapeutic range for phenytoin levels?

10-20 mcg/mL

A common and bothersome side effect of phenytoin that requires regular dental visits is ______.

Gingival hyperplasia

This direct-acting muscle relaxant is used to treat the life-threatening condition known as malignant hyperthermia.

Dantrolene

This medication combination works together to increase dopamine levels in the brain for patients with Parkinson’s disease.

Carbidopa-levodopa

Which antibiotic class is associated with a risk of photosensitivity and tooth discoloration in children under 8 years old?

Tetracyclines

A patient receiving vancomycin IV too rapidly may experience a reaction characterized by a rash and hypotension, known as _____.

Red man syndrome

This urinary analgesic can turn the urine reddish-orange.

Phenazopyridine

This antiviral medication is used for herpes simplex, shingles, and chicken pox, but can cause renal failure.

Acyclovir

What is the most common side effect of ACE inhibitors like lisinopril, which is not considered an emergency?

Dry cough

What is the primary difference in side effect profile between ACE inhibitors and ARBs (e.g., losartan)?

ARBs do not cause a dry cough

Patients taking beta-blockers like metoprolol should be monitored for bradycardia, fatigue, and changes in _____.

blood sugar

A patient taking the calcium channel blocker amlodipine may experience ______ and dizziness.

edema

Thiazide diuretics like HCTZ can cause hypokalemia and ______.

hyperglycemia

What is a potential adverse effect of macrolide antibiotics like azithromycin?

QT prolongation

A key patient teaching point for taking NSAIDs like ibuprofen is the risk of GI bleeding and ______.

kidney damage

Besides sedation, a major side effect of first-generation antihistamines is ______.

Dry mouth (anticholinergic effect)

An INR of 4.5 in a patient on warfarin indicates the level is _____, and the priority action is to administer vitamin K.

Above the therapeutic range (too high).

A patient is receiving gentamicin. The nurse should prioritize monitoring for signs of ______ and ______.

Ototoxicity and nephrotoxicity

What is the purpose of the Beers Criteria list?

It identifies medications that have potential safety issues for older adults.

According to the principles of pharmacokinetics, patients with liver disease will have slower drug _____, causing the drug to stay in their system longer.

metabolism

It is important to never crush or have a patient chew any medication that is enteric-coated or labeled as ______.

sustained/extended-release

What is the goal of therapy for a diabetic patient in terms of their HbA1c level?

An HbA1c level less than 7%

Patients experiencing _____ may present with a moon-like face, central obesity, and protein breakdown.

Cushing’s disease

When prescribed glucocorticoids are to be discontinued, they must be ______ to prevent adrenal insufficiency.

Tapered off slowly

Which diuretic is contraindicated for patients with allergies to sulfa medications?

Hydrochlorothiazide (HCTZ)

What type of diuretic, such as mannitol, is primarily used to decrease increased intracranial pressure (ICP)?

Osmotic diuretics

This antiarrhythmic drug is used for life-threatening dysrhythmias and maintenance after conversion of atrial arrhythmias.

Amiodarone

This anticoagulant prevents new clot formation, is given IV, and its dosage is adjusted based on aPTT levels.

Heparin

This thrombolytic drug, also known as tPA, is given to dissolve existing clots in conditions like acute ischemic stroke.

Alteplase

Aspirin should not be given to children for fever reduction due to the risk of developing ______.

Reye’s syndrome

All antidepressants carry a black box warning for an increased risk of ______ in children, teens, and young adults.

Suicide

Overuse of nasal spray decongestants can lead to a condition known as ______.

Rebound congestion

This mucolytic agent is given as an inhalation to break down thick respiratory secretions and orally as the antidote for acetaminophen overdose.

Acetylcysteine

The short-acting beta-agonist (SABA) is used as a rescue medication for acute asthma attacks.

Albuterol

This leukotriene receptor antagonist is an oral, long-term preventative medication for asthma and is not used for emergencies.

montelukast

Long-term use of which class of GI medications can interfere with calcium absorption and increase the risk of fractures?

Proton Pump Inhibitors (PPIs)

This antiemetic, a serotonin receptor blocker, is commonly used for nausea and vomiting but can cause headache and QT prolongation.

Ondansetron

A patient on the anti-seizure medication lamotrigine who develops a rash should contact their provider immediately due to the risk of ______.

Stevens-Johnson Syndrome (SJS)

What is the most dangerous type of seizure, where seizures occur repeatedly with no recovery period in between?

Status epilepticus

This medication class, including cefazolin, is similar in structure and activity to penicillin and is often used for surgical prophylaxis.

Cephalosporins

This common antibiotic is used to treat C. diff infections.

Metronidazole

This class of medications, including sertraline and fluoxetine, is known for causing dysfunction and requires monitoring for serotonin syndrome.

SSRIs (Selective Serotonin Reuptake Inhibitors)

Tricyclic antidepressants (TCAs) like amitriptyline are associated with _____ effects, such as dry mouth, blurred vision, and urinary retention.

Anticholinergic

Rapid-acting insulin, like Lispro, has an onset of 5-15 minutes and a peak of _____.

30-60 minutes

Which type of insulin has no peak and provides a long duration of action (16-24 hours)?

Long-acting insulin (e.g., Lantus, Levemir)

This oral hypoglycemic reduces glucose production in the liver and has a boxed warning for lactic acidosis in patients over 80.

Metformin

This condition, resulting from a lack of ADH, leads to the production of copious amount of glucose-free urine.

Diabetes Insipidus (DI)

Adrenal insufficiency, or _____, occurs when there is a shortage of adrenocortical hormones.

Addison’s disease

Patients with a penicillin allergy may have a cross-sensitivity to which other class of antibiotics?

Cephalosporins

This powder-form bile acid sequestrant is mixed with fluids to lower LDL levels but can cause GI upset and constipation.

Cholestyramine

This drug, often given with acetaminophen for cough suppression is an opioid.

Codeine

What is the mnemonic to remember the signs of hypoglycemia?

“Cold and clammy, give some candy.”

This direct-acting cholinergic agonist is used for urinary retention by increasing bladder tone and contractility.

Bethanechol

This anticholinergic medication is used to treat Parkinson’s symptoms by blocking acetylcholine, thereby lessening tremors and rigidity.

Benztropine

What is the drug of choice for surgical prophylaxis, especially for knee/hip replacements and bowel procedures?

Cefazolin