ATI Pharm Prep

1. Medication Administration & Safety

Know the 6 Rights of Medication Administration

• Right patient

• Right medication

• Right dose

• Right route

• Right time

• Right documentation

Other safety concepts:

• High-alert medications

• Look-alike/sound-alike drugs

• Medication reconciliation

• Therapeutic index

• Peak and trough levels

• Half-life

• First-pass effect

2. Autonomic Nervous System Drugs

Cholinergic (Parasympathomimetics)

Example: Bethanechol

Use:

• Urinary retention

• GI motility

Side effects:

• Bradycardia

• Hypotension

• Increased secretions

• Diarrhea

Antidote:

• Atropine

Anticholinergics

Example: Atropine

Effects:

• Dry mouth

• Constipation

• Urinary retention

• Tachycardia

• Blurred vision

Adrenergic (Sympathomimetics)

Example: Epinephrine

Effects:

• Increased HR

• Increased BP

• Bronchodilation

Uses:

• Anaphylaxis

• Cardiac arrest

Beta Blockers

Example: Metoprolol

Uses:

• ↓ HR and BP

• Hypertension

• Heart failure

• Angina

Side effects:

• Bradycardia

• Hypotension

• Bronchospasm

• Mask hypoglycemia

Important:

• Do not stop abruptly

3. Cardiovascular Medications

ACE Inhibitors

Example: Lisinopril

Key points:

• Treat HTN & heart failure

• Side effects:

  • Dry cough

  • Hyperkalemia

  • Angioedema

• Avoid during pregnancy

Diuretics

Loop Diuretics

Example: Furosemide

Monitor:

• Potassium (hypokalemia)

Side effects:

• Dehydration

• Hypotension

• Ototoxicity

Potassium-Sparing

Example: Spironolactone

Key risk:

• Hyperkalemia

Cardiac Glycosides

Example: Digoxin

Therapeutic level:

• 0.5–2 ng/mL

Hold if:

• HR < 60

Toxicity signs:

• Yellow/green halos

• Nausea/vomiting

• Bradycardia

Antidote:

• Digoxin immune fab

4. Anticoagulants & Antiplatelets

Heparin

Example: Heparin

Monitor:

• aPTT 1.5–2.5x normal

Bleeding precautions

Antidote:

• Protamine sulfate

Warfarin

Example: Warfarin

Monitor:

• INR (2–3)

Antidote:

• Vitamin K

Teaching:

• Maintain consistent vitamin K intake

• Bleeding precautions

5. Antibiotics

Aminoglycosides

Example: Gentamicin

Major risks:

• Nephrotoxicity

• Ototoxicity

  • Symptoms:

    • Hearing loss

    • Tinnitus

Monitor:

• Peak & trough levels

Tetracyclines

Example: Doxycycline

Important:

• Photosensitivity

• Avoid in pregnancy

• Avoid in children

6. Diabetes Medications

Hypoglycemia symptoms:

• Sweating

• Shaking

• Confusion

Rapid-Acting Insulin

Example: Insulin lispro

Onset:

• ~15 minutes

Give:

• Right before meals

Long-Acting Insulin

Example: Insulin glargine

Key rule:

• Never mix with other insulin

Biguanides

Example: Metformin

Important:

• Risk of lactic acidosis

• Hold before contrast dye

7. Psychiatric Medications

SSRIs

Example: Sertraline

Key risks:

• Serotonin syndrome

Symptoms:

• Hyperthermia

• Agitation

• Diarrhea

• Tremor

Antipsychotics

Example: Haloperidol

Side effects:

• EPS

• Tardive dyskinesia

• Neuroleptic malignant syndrome

  • Symptoms:

    • High fever

    • Muscle rigidity

    • Altered mental status

8. Pain Medications

Opioids

Example: Morphine

Monitor:

• Respiratory depression

Antidote:

• Naloxone

9. Respiratory Medications

Short-Acting Beta Agonists

Example: Albuterol

Use:

• Rescue inhaler

Side effects:

• Tachycardia

• Tremor

Inhaled Corticosteroids

Example: Fluticasone

Teaching:

• Rinse mouth after use (prevents thrush)

🚨 Common Antidotes

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