ATI Pharmacology Study Guide: Nursing Exam Topics

What factors affect the absorption of oral medications?

GI pH, emptying time, presence of food, and form of medications (liquid/XR).

How is medication absorbed through sublingual/buccal routes?

Quick absorption systemically through highly vascular mucous membranes.

What is the absorption rate of inhaled medications?

Rapid absorption through alveolar capillary networks.

What influences the absorption of SQ/IM medications?

Solubility of the medication and blood perfusion at the injection site.

What is the absorption characteristic of IV medications?

Immediate and complete absorption.

Where does metabolism of medications primarily occur?

In the liver, but can also occur in the kidneys.

What is the first pass effect?

The liver inactivates some medications on their first pass through, requiring alternative routes like sublingual or IV.

What is the significance of the therapeutic index (TI)?

A high TI indicates a wide safety margin, while a low TI requires monitoring of serum levels.

What is half-life in pharmacology?

The time it takes for the medication level in the body to drop by 50%.

What is the role of an agonist in pharmacology?

An agonist enhances the effect of a medication.

What is the role of an antagonist in pharmacology?

An antagonist blocks the effect of a medication.

What are the rights of safe medication administration?

Right client, right medication, right dose, right time, right route, right documentation, right client education, right to refuse, right assessment, right evaluation.

What should be done if a medication error occurs?

Report all errors immediately, complete an incident report, and do not reference it in the client's medical record.

What is the recommended position for administering suppositories?

Left lateral Sims position.

What is the procedure for administering inhaled medications using an MDI?

Shake vigorously, take a deep breath, exhale, inhale slowly for 3-5 seconds, and hold breath for 10 seconds.

What are common complications of IV therapy?

Infiltration, extravasation, hematoma, catheter embolus, phlebitis/thrombophlebitis, cellulitis, fluid overload.

What is the therapeutic use of benzodiazepines?

Seizures, muscle spasms, alcohol withdrawal, induction of anesthesia.

What is the action of buspirone?

It is an atypical anxiolytic that can take long-term and takes 1 week to take effect.

What are common complications of SSRIs?

Sexual dysfunction, weight gain, serotonin syndrome (agitation, hallucinations, tremors, fever, diaphoresis).

What is the therapeutic use of fluoxetine?

Depressive disorders, insomnia, OCD, trauma.

What should be monitored when administering medications with a low therapeutic index?

Serum levels of the medication.

What is the significance of pediatric dosing?

Pediatric doses are based on weight or body surface area.

What is the contraindication for live-virus vaccines in pregnant women?

Pregnancy is a contraindication for live-virus vaccines.

What should be done to prevent clogging of NG/gastrostomy tubes?

Flush the tube before and after each medication with 15-30ml of warm sterile water.

What is the nursing administration for medications that may lead to dependency?

Keep them in a secure place due to the risk of dependency.

What are the therapeutic uses of Amitriptyline?

Depression, neuropathic pain, fibromyalgia, anxiety disorders, insomnia

What are common complications associated with Tricyclic Antidepressants?

Anticholinergic effects, tachycardia, sedation, decreased seizure threshold, excessive sweating, orthostatic hypotension, cardiac toxicity

What nursing administration advice is given for patients taking Amitriptyline?

Chew sugarless gum, wear sunglasses, eat high fiber foods, increase fluid intake

What is the primary therapeutic use of Phenelzine?

Depression

What complications can arise from taking MAOIs like Phenelzine?

CNS stimulation, hypotension, hypertensive crisis

What dietary restrictions must be observed when taking MAOIs?

Avoid tyramine-rich foods such as aged cheese, salami, and red wine

What is a significant risk of sudden discontinuation of MAOIs?

Relapse of symptoms

What are the complications associated with Lithium Carbonate?

GI distress, fine hand tremors, polyuria, weight gain, renal toxicity, electrolyte imbalances, Lithium toxicity

What is the toxic level of Lithium?

Greater than 1.5 mEq/L

What complications can arise from Carbamazepine and Valproic Acid?

Blood dyscrasias, double vision, hepatotoxicity, pancreatitis

What are the common complications of first-generation antipsychotics?

Extrapyramidal symptoms, neuroleptic malignant syndrome

What is the nursing administration advice for managing EPS with antipsychotics?

Administer anticholinergics, beta-blockers, and benzodiazepines

What is the primary therapeutic use of Risperidone?

Controls both positive and negative symptoms of psychosis

What are the complications associated with second-generation antipsychotics?

Diabetes mellitus, weight gain, hypercholesterolemia, orthostatic hypotension

What are the common complications of CNS stimulants like Methylphenidate?

Insomnia, decreased appetite, weight loss

What are the symptoms of alcohol withdrawal?

Nausea, vomiting, tremors, increased HR/BP/RR, seizures

What medications are used to support withdrawal from alcohol?

Benzodiazepines such as Chlordiazepoxide, Diazepam, Lorazepam

What is the effect of Disulfiram when alcohol is consumed?

Nausea, vomiting, weakness, sweating, palpitations, hypotension

What is the therapeutic use of Methadone?

Substitution for opioid dependence

What are the complications of Cholinesterase Inhibitors like Neostigmine?

Cholinergic crisis, increased GI motility, diaphoresis, bradycardia

What are the adverse effects of Levodopa/Carbidopa?

Nausea, vomiting, drowsiness, dyskinesias, orthostatic hypotension

What are the complications of Phenytoin?

Nystagmus, sedation, gingival hyperplasia, hypotension

What is the primary treatment for Primary Open-angle glaucoma?

Timolol, a beta-adrenergic blocker

What complications can arise from Acetazolamide?

GI side effects, electrolyte depletion, flu-like symptoms

What is the nursing administration for Ciprofloxacin plus hydrocortisone otic drops?

Warm the container, keep client in side-lying position for 5 minutes after instillation

What are neuromuscular blocking agents?

Medications like Succinylcholine (depolarizing) and Pancuronium (nondepolarizing) that block acetylcholine at the neuromuscular junction.

What serious complication can occur with neuromuscular blocking agents?

Respiratory arrest and malignant hyperthermia, characterized by muscle rigidity and high temperature.

What is the nursing administration for malignant hyperthermia?

Administer 100% oxygen, cooling measures (iced 0.9% NaCl), and dantrolene to decrease skeletal muscle metabolic activity.

What is the purpose of Baclofen?

To produce sedative effects and depress hyperactive spasticity of muscles.

What are the therapeutic uses of Dantrolene?

Cerebral palsy, spinal cord injury, multiple sclerosis, and treatment of malignant hyperthermia.

What complications are associated with Baclofen?

Nausea and constipation; high fiber foods are recommended.

What is the pharmacological action of Bethanechol?

Stimulation of muscarine receptors in the genitourinary tract.

What are the therapeutic uses of Bethanechol?

Nonobstructive urinary retention, usually postoperative or postpartum.

What complications can occur with Bethanechol?

Sweating, urinary urgency, bradycardia, and hypotension.

What is the purpose of Oxybutynin?

To inhibit muscarinic receptors of the detrusor muscle of the bladder for overactive bladder treatment.

What complications are associated with Oxybutynin?

Anticholinergic effects; clients should be instructed to drink 2-3 liters of water daily.

What is the pharmacological action of Zolpidem?

Prolongs sleep duration and decreases awakenings.

What is the primary use of Zolpidem?

To treat insomnia.

What complications can arise from Zolpidem use?

Daytime sleepiness and lightheadedness.

What are the nursing considerations for intravenous anesthetics?

Monitor for respiratory arrest or hypotension; inject Propofol into a large vein to decrease pain at the injection site.

What are the complications of Theophylline?

GI distress, dysrhythmias, and seizures.

What is the therapeutic use of Ipratropium?

COPD and allergen-induced or exercise-induced bronchospasm.

What complications can occur with Ipratropium?

Dry mouth and hoarseness.

What is the purpose of Beclomethasone?

To prevent inflammation and provide long-term prophylaxis of asthma.

What complications are associated with Prednisone?

Suppression of adrenal gland function, bone loss, hyperglycemia, myopathy, peptic ulcer disease, infection, and hypokalemia.

What should be done if a client is on long-term oral therapy with steroids?

Additional doses of oral steroids are required in times of stress, infection, or trauma.

What are the therapeutic uses of Montelukast?

Long-term therapy of asthma in adults and children, and prevention of exercise-induced bronchospasm.

What complications can occur with Montelukast?

Depression and suicidal ideation.

What is the therapeutic use of Guaifenesin?

To thin mucous secretions.

What complications can occur with Guaifenesin?

GI distress, drowsiness, and allergic reactions.

What is the therapeutic use of Acetylcysteine?

To treat chronic pulmonary disorders exacerbated by large amounts of secretions.

What is the antidote for acetaminophen poisoning?

Acetylcysteine

What are common complications of acetylcysteine?

Bronchospasm, nausea, vomiting, rash

What do decongestants like Phenylephrine and Pseudoephedrine treat?

Rhinitis and sinusitis

What are potential complications of decongestants?

Rebound congestion, agitation, nervousness, palpitations

What therapeutic uses do antihistamines like Diphenhydramine and Loratadine have?

Mild allergic reactions and motion sickness

What complications can arise from antihistamines?

Sedation and anticholinergic effects

What is the pharmacological action of nasal glucocorticoids like Mometasone?

Decrease inflammation associated with allergic rhinitis

What are the complications of nasal glucocorticoids?

Sore throat, headache, burning in the nose

What is the action of high-ceiling loop diuretics like Furosemide?

Block reabsorption of sodium and chloride, preventing water reabsorption

What are the therapeutic uses of Furosemide?

Pulmonary edema and hypertension

What complications are associated with Furosemide?

Dehydration, hyponatremia, hypochloremia, hypotension, ototoxicity, hypokalemia, hyperglycemia

What should be monitored when administering Furosemide?

Electrolyte levels, blood pressure, I&Os, ECG

What is the pharmacological action of Thiazide diuretics like Hydrochlorothiazide?

Blocks reabsorption of sodium and chloride, preventing water reabsorption

What are the therapeutic uses of Hydrochlorothiazide?

Hypertension, heart failure, liver and kidney disease

What complications can arise from Thiazide diuretics?

Dehydration, hypokalemia, hyperglycemia

What is the action of potassium-sparing diuretics like Spironolactone?

Retains potassium and excretes sodium and water

What are the complications associated with Spironolactone?

Hyperkalemia, impotence, gynecomastia, irregularities of menstrual cycle

What is the pharmacological action of osmotic diuretics like Mannitol?

Reduces intracranial pressure (ICP) and intraocular pressure (IOP)

What complications can occur with Mannitol?

Heart failure, pulmonary edema, rebound increased ICP, fluid and electrolyte imbalances

What is the action of ACE inhibitors like Captopril?

Blocks the conversion of angiotensin I to angiotensin II

What are the therapeutic uses of Captopril?

Hypertension, heart failure, myocardial infarction, diabetic nephropathy

What complications are associated with ACE inhibitors?

Hypotension, cough, hyperkalemia, rash, angioedema

What is the action of Angiotensin II Receptor Blockers (ARBs) like Losartan?

Vasodilation

What are the therapeutic uses of ARBs?

Hypertension, heart failure, diabetic nephropathy