Nursing Pharmacology High-Yield Exam Guide Flashcards

High-yield nursing pharmacology flashcards covering fluid/electrolytes, GI medications, hormones, and reproductive health based on examination guide notes.

Isotonic IV Solutions

Intravenous fluids like $0.9\%$ Normal Saline and Lactated Ringer's that match normal blood concentration and stay inside blood vessels to raise blood pressure.

Lactated Ringer's (LR)

An isotonic crystalloid containing electrolytes and lactate; it should never be given to patients with liver disease as the liver cannot process the lactate into bicarbonate.

Hypotonic IV Solutions

Fluids like $0.45\%$ Normal Saline that have less salt than blood, moving water into cells to treat severe cellular dehydration; contraindicated in patients with head injuries or brain swelling.

Hypertonic IV Solutions

Fluids like $3\%$ Normal Saline or D5NS that suck water out of swollen cells and into blood vessels; must be given very slowly in an ICU setting to avoid pulmonary edema.

Dextran 40 / Albumin

Colloids or volume expanders containing large molecules that pull water into the bloodstream; used for severe hypovolemic shock, massive blood loss, or severe burns.

Potassium Chloride (KCl)

An electrolyte supplement for hypokalemia that must NEVER be given IV push; it must be diluted and administered at a max rate of $10\,mEq/hr$ via an IV pump.

Sodium Chloride (NaCl)

An electrolyte restorer for hyponatremia with a normal serum range of $135-145\,mEq/L$; low levels cause confusion and seizures.

Sodium Bicarbonate

An alkalinizing agent used to neutralize excess acid in the blood during Metabolic Acidosis; monitoring requires Arterial Blood Gases (ABGs).

Omeprazole

A Proton Pump Inhibitor (PPI) that shuts down stomach acid pumps; must be taken $30\,minutes$ before breakfast and increases risk for osteoporosis and C. diff infections with long-term use.

Ranitidine / Famotidine

H2 receptor antagonists that turn down stomach acid production; safer for long-term use but can cause confusion or delirium in elderly patients.

Aluminum Hydroxide

An antacid that neutralizes stomach acid on contact and commonly causes constipation; must be spaced $1-2\,hours$ away from other medications.

Sucralfate

A GI mucosal protectant that forms a thick, sticky gel over ulcers; must be taken on an empty stomach and should not be given with antacids as it needs acid to activate.

Psyllium

A bulk-forming laxative that is a major choking hazard; it must be mixed with at least $8\,oz$ of liquid and swallowed immediately.

Docusate Sodium

A stool softener that prevents straining by allowing water and fat to penetrate stool; it takes $1-3\,days$ to work and is commonly used after surgery or heart attacks.

Diphenoxylate with Atropine

An antidiarrheal opioid/anticholinergic combination; it is contraindicated in infectious diarrhea (like C. diff) because it traps toxins in the gut.

Bismuth Subsalicylate

An antidiarrheal containing salicylate (aspirin) that can turn the tongue and stool black; it must not be given to children with viral illnesses due to Reye's Syndrome risk.

Ondansetron

An antiemetic that blocks serotonin signals to stop vomiting; it should be given $30\,minutes$ before chemotherapy and can cause heart rhythm changes (QT prolongation).

Pancrelipase

A pancreatic enzyme replacement that must be taken with EVERY meal and snack to break down nutrients; success is marked by a decrease in fatty, foul-smelling stools (steatorrhea).

Orlistat

A lipase inhibitor for weight management that blocks $30\%$ of dietary fat; it causes oily stool and urgency and blocks fat-soluble vitamins (A, D, E, K).

Methylnaltrexone

A peripherally-acting opioid antagonist that treats opioid-induced constipation without blocking pain relief in the brain as it does not cross the blood-brain barrier.

Sulfasalazine

A 5-aminosalicylate anti-inflammatory for IBD that can turn skin and urine yellow-orange; requires drinking $2-3\,liters$ of water daily to prevent kidney crystals.

Total Parenteral Nutrition (TPN)

High-concentrated nutrient solution given via a central vein; requires glucose checks every $6\,h$ and should never be stopped abruptly without hanging $10\%$ Dextrose (D10W).

Finasteride

A drug that shrinks the prostate (BPH) or stimulates hair growth; pregnant women must never touch crushed pills because it can be absorbed through the skin and cause birth defects.

Medroxyprogesterone (Depo-Provera)

A progestin contraceptive given every $12\,weeks$; long-term use ($> 2\,years$) carries a Black Box Warning for Bone Mineral Density Loss.

Sildenafil (Viagra)

A PDE-5 inhibitor for ED that has a fatal contraindication with nitrates (Nitroglycerin), resulting in severe hypotension and cardiac arrest.

Testosterone

An androgen hormone that can cause liver toxicity and high red blood cell count (polycythemia); topical gels can accidentally transfer to others via skin contact.

Estradiol / Conjugated Estrogens

Estrogen replacement therapy that increases the risk for thromboembolism (blood clots) and endometrial cancer if used without progestin in women with a uterus.

Norethindrone / Oral Contraceptives

Hormonal birth control that carries a high blood clot risk when combined with smoking; patients should monitor for ACHES (Abdominal pain, Chest pain, Headaches, Eye problems, Severe leg pain).

Levonorgestrel

Emergency contraception most effective within $72\,hours$ of unprotected sex; it will not terminate an existing pregnancy and should be repeated if vomiting occurs within $2\,hours$ of the dose.

Oxytocin

A hormone used to induce labor; the infusion must be stopped if contractions are less than $2\,minutes$ apart or last longer than $90\,seconds$.

Misoprostol

A prostaglandin used for cervical ripening or preventing NSAID ulcers; it is an absolute contraindication for GI use in pregnant women as it causes abortion.

Terbutaline

A tocolytic used to delay preterm labor; the medication should be held if the maternal heart rate exceeds $120\,bpm$.

Magnesium Sulfate

A CNS depressant used to stop seizures in preeclampsia; toxicity signs include a drop in BP, urine output below $30\,mL/hr$, respiratory rate below $12\,breaths/min$, and loss of patellar reflex.

Calcium Gluconate

The specific antidote for magnesium sulfate toxicity that should be kept at the bedside.

Folic Acid (Vitamin B9)

A vitamin required for DNA synthesis; taking $400-800\,mcg$ daily before and during pregnancy is crucial for preventing neural tube defects like Spina Bifida.

Vitamin A

A fat-soluble vitamin essential for vision; it is teratogenic in high doses and can accumulate in the liver causing toxicity.