road map

NUR2474 Pharmacology — Exam 1 Focused Roadmap

Official Exam Roadmap + Professor's Power Hour

Drug priority: MUST KNOW = specifically named by your professor. Prototype = representative drug for an emphasized class.

1. Foundations of Pharmacology

Chapter 1 — Introduction to Drugs

• Generic vs. brand names; FDA responsibilities

• Agonists vs. antagonists

• Therapeutic, adverse, and paradoxical effects

• Toxicity, tolerance, dependence, teratogens

Chapter 2 — Drugs and the Body | Power Hour: pp. 19–25

• Pharmacokinetics vs. pharmacodynamics

• ADME: Absorption, distribution, metabolism, excretion

• Protein binding, tissue perfusion, low albumin

• First-pass effect; enzyme induction/inhibition

• Therapeutic index, critical concentration, half-life

• Additive, synergistic, antagonistic interactions

• Power Hour named: St. John's wort — antidepressant interactions

Chapter 3 — Toxic Effects of Drugs

• Allergies, anaphylaxis, toxicity

• Hepatotoxicity, nephrotoxicity

• EPS, NMS, anticholinergic effects

• Stop offending medication; prioritize ABCs for serious reactions

Chapter 4 — Medication Safety

• Eight medication rights

• Assessment before administration

• Medication errors, reconciliation, barcode scanning

• High-risk interactions and special populations

2. Neurological & Psychiatric Medications

Chapter 20 — Anxiolytic & Hypnotic Agents | Power Hour: pp. 341–348

• Benzodiazepines

  • MUST KNOW — Both: Lorazepam

  • MUST KNOW — Power Hour: Diazepam

• Barbiturates

  • Prototype: Phenobarbital

• Nonbenzodiazepine hypnotics (Z-drugs)

  • Power Hour named: Zolpidem

• Other anxiolytics

  • Prototype: Buspirone

Focus: GABA, CNS/respiratory depression, falls, withdrawal, alcohol/opioid interactions, flumazenil, Z-drug sleepwalking.

Chapter 21 — Antidepressant Agents | Power Hour: pp. 363–371

• SSRIs

  • MUST KNOW — Roadmap: Sertraline

  • MUST KNOW — Power Hour: Fluoxetine

• SNRIs

  • Prototype: Venlafaxine

• MAOIs

  • MUST KNOW — Power Hour: Phenelzine

• TCAs

  • Prototype: Amitriptyline

• Atypical antidepressants

  • Prototype: Bupropion

Focus: Serotonin syndrome, MAOI–tyramine hypertensive crisis, suicide monitoring, delayed benefits, TCA cardiac toxicity, St. John's wort interactions.

Chapter 22 — Psychotherapeutic Agents | Power Hour: pp. 387–394; antipsychotics pp. 380–383

• Mood stabilizers

  • HIGHEST PRIORITY — Both: Lithium

• First-generation (typical) antipsychotics

  • MUST KNOW — Roadmap: Haloperidol

• Second-generation (atypical) antipsychotics

  • Prototype: Clozapine

• ADHD/narcolepsy stimulants

  • Prototype: Methylphenidate

Focus: Lithium toxicity, hydration, sodium balance, renal function, drug interactions and teaching; EPS, tardive dyskinesia, NMS, antipsychotic adverse effects.

Chapter 23 — Antiseizure Agents | Power Hour: pp. 400–403

• Hydantoins

  • MUST KNOW — Both: Phenytoin

• Valproates

  • MUST KNOW — Both: Valproic acid

• Succinimides

  • MUST KNOW — Power Hour: Ethosuximide

• Other antiseizure medications explicitly named

  • MUST KNOW — Power Hour: Levetiracetam

  • MUST KNOW — Power Hour: Carbamazepine

Focus: Seizure types, therapeutic drug levels, phenytoin toxicity, valproate hepatotoxicity/pancreatitis, ethosuximide for absence seizures, seizure precautions, pregnancy risks, avoiding abrupt withdrawal.

Chapter 24 — Antiparkinsonism Agents | Power Hour: pp. 420–426

• Dopamine precursors

  • MUST KNOW — Both: Levodopa

  • MUST KNOW — Both: Carbidopa-levodopa

• Dopamine agonists — class emphasized

• MAO-B inhibitors — class emphasized

• Anticholinergic antiparkinsonian drugs — class emphasized

Focus: Dopamine deficiency, carbidopa's role, medication timing, iron and high-protein meal interactions, wearing-off effects, orthostatic hypotension, falls, dyskinesia.

Chapter 25 — Muscle Relaxants

• Direct-acting skeletal muscle relaxants

  • MUST KNOW — Power Hour: Dantrolene

Focus: Skeletal muscle relaxation, severe NMS rigidity in selected cases, muscle weakness and safety.

3. Autonomic Nervous System Medications

Chapter 29 — Introduction to the Autonomic Nervous System

• Sympathetic vs. parasympathetic

• Alpha1, alpha2, beta1, beta2 receptors

• Muscarinic and nicotinic receptors

• Agonists vs. antagonists

Chapter 30 — Adrenergic Agonists | Power Hour: pp. 515–517

• Alpha/beta adrenergic agonists

  • MUST KNOW — Power Hour: Epinephrine

  • MUST KNOW — Power Hour: Dopamine

• Beta2-selective agonists

  • MUST KNOW — Both: Albuterol

• Alpha-selective agonists — class emphasized

• Beta-selective agonists — class emphasized

Focus: Receptor effects, dopamine in shock, epinephrine for anaphylaxis, albuterol bronchodilation, tachycardia, tremor.

Chapter 31 — Adrenergic Antagonists | Power Hour: pp. 535–543

• Alpha1-selective blockers

  • MUST KNOW — Power Hour: Doxazosin

• Nonselective beta blockers

  • Prototype: Propranolol

• Beta1-selective blockers

  • Prototype: Metoprolol

• Nonselective alpha blockers

  • MUST KNOW — Roadmap antidote: Phentolamine

Focus: Doxazosin for hypertension/BPH, beta blockers, bradycardia, hypotension, orthostatic falls, bronchospasm risk, beta blockers vs. albuterol.

Chapter 32 — Cholinergic Agonists | Power Hour: pp. 549–551, 555–563

• Direct-acting muscarinic agonists

  • MUST KNOW — Power Hour: Bethanechol

• Indirect-acting cholinergic agonists / acetylcholinesterase inhibitors

  • MUST KNOW — Both: Donepezil

Focus: Increased acetylcholine, bethanechol for nonobstructive urinary retention, donepezil for Alzheimer's, bradycardia, diarrhea, weight loss, falls.

Chapter 33 — Anticholinergic Agents | Power Hour: pp. 568–571

• Antimuscarinic / anticholinergic agents

  • Prototype: Atropine

• Inhaled anticholinergic bronchodilators

  • MUST KNOW — Roadmap: Ipratropium bromide

Focus: Muscarinic blockade, dry mouth, blurred vision, urinary retention, constipation, narrow-angle glaucoma, older-adult confusion/delirium.

Chapter 55 — Lower Respiratory Tract Drugs | Power Hour: pp. 990–994

• Sympathomimetic bronchodilators

  • MUST KNOW — Both: Albuterol

• Anticholinergic bronchodilators

  • MUST KNOW — Roadmap: Ipratropium

• Xanthines

  • MUST KNOW — Roadmap therapeutic monitoring: Theophylline

• Inhaled corticosteroids — beginning of section included in highlighted pages

Focus: Albuterol vs. ipratropium, beta2 activation vs. muscarinic blockade, bronchodilation, respiratory adverse effects, theophylline toxicity.

4. Therapeutic Drug Levels & Toxicity

ALL SIX — Official Roadmap MUST KNOW

Ranges vary by indication and laboratory/course standards.

5. Reversal Agents / Antidotes

ALL SEVEN — Official Roadmap MUST KNOW

6. Dosage Calculations

Power Hour: Approximately 4–5 questions

• Oral and injectable dosages

• Unit conversions

• Weight-based/pediatric calculations

• IV rates: mL/hr

• Gravity rates: gtt/min

• Rounding and medication safety

Priority: Study the specifically named drugs first, then understand the mechanisms and nursing risks of their classes. This is the focused instructor-based exam list, not a list of every assigned textbook medication.