C
LE
Pharmacology
ST
Comprehensive Study Guide with Rationales.
BE
Complete Pharmacology Review and Exam Preparation Material.
Table of Contents
Psychiatric Pharmacology
Anxiolytics and Sedative-Hypnotics (Benzodiazepines, Buspirone)
Antidepressants (SSRIs, TCAs, MAOIs, Atypical Antidepressants)
Mood Stabilizers (Lithium: Therapeutic Use, Toxicity, Monitoring)
Antipsychotics (Typical and Atypical, Clozapine, Ziprasidone)
Neuroleptic Malignant Syndrome and Serotonin Syndrome
ADHD Medications (Stimulants and Nursing Considerations)
Client Education, Safety, and Drug Interactions
Gastrointestinal and Nutrition Pharmacology
Antiemetics and Prokinetic Agents (Metoclopramide)
Acid-Reducing Medications (PPIs, H2 Blockers, Antacids)
Ulcer Protection Agents (Sucralfate, Misoprostol)
Laxatives and Hepatic Encephalopathy Management (Lactulose)
Inflammatory Bowel Disease Medications (Sulfasalazine)
Pancreatic Enzymes and Malabsorption (Pancrelipase)
Weight Management Medications (Orlistat)
Total Parenteral Nutrition (TPN) and Metabolic Complications
Cardiovascular Pharmacology
Antianginal Medications (Nitroglycerin: Sublingual and Transdermal)
Cardiac Glycosides (Digoxin: Pediatric Administration and Toxicity)
Antiarrhythmic Medications (Amiodarone)
Heart Rate and Rhythm Disorders (Bradycardia, Tachycardia)
Client Teaching and Emergency Management of Chest Pain
Neurologic Pharmacology
Central Nervous System Stimulants and Sedatives
Seizure Risk and Neurotoxicity Related to Medications
Movement Disorders and Extrapyramidal Symptoms
Anticholinergic Agents and Neurologic Side Effects
Endocrine Pharmacology
, C
LE
Insulin Therapy and Blood Glucose Management
Medication-Induced Electrolyte Imbalances
ST
Client Monitoring and Safety Considerations
Hematologic and Oncologic Pharmacology
BE
Anticoagulants and Bleeding Risk
Chemotherapy-Related Emergencies (Tumor Lysis Syndrome)
Supportive Medications and Monitoring
Respiratory Pharmacology
Bronchodilators (Beta-2 Agonists such as Albuterol)
Adverse Effects and Client Monitoring
Immune and Infectious Disease Pharmacology
Antibiotic Therapy and Safety Considerations
Drug Allergies and Cross-Sensitivity
Infection Risk Related to Immunosuppressive Effects
Urinary and Renal Pharmacology
Nephrotoxic Medications and Renal Monitoring
Fluid and Electrolyte Balance
Medication Adjustments in Renal Impairment
Reproductive, Maternity, and Newborn Pharmacology
Pregnancy-Related Medication Risks
Labor-Inducing Agents and Contraindications
Client Education and Safety
Integumentary, Visual, and Auditory Pharmacology
Medication Effects on Skin, Vision, and Hearing
Long-Term Adverse Effects and Monitoring
Comprehensive Client Safety and Nursing Considerations
Polypharmacy and Beers Criteria
Elderly Client Medication Risks
Client Education, Monitoring, and Exam-Focused Rationales
, C
LE
ST
● Benzodiazepines (eg, alprazolam [Xanax], lorazepam [Ativan], clonazepam, diazepam) are commonly used
antianxiety drugs.
BE
● They work by potentiating endogenous GABA, a neurotransmitter that decreases excitability of nerve cells, particularly in
the limbic system of the brain, which controls emotions.
● Benzodiazepines may cause sedation, which can interfere with daytime activities.
● Giving the dose at bedtime will help the client sleep.
● Benzodiazepines have a sedative effect and should be administered at bedtime when possible.
● Benzodiazepines should never be stopped abruptly in long-term users as this can precipitate withdrawal symptoms.
● Eliminating aged cheeses and processed meats, which contain tyramine, is necessary with monoamine oxidase inhibitors
(eg, tranylcypromine, phenelzine), which are used for depressive disorders.
● A benzodiazepine should never be stopped abruptly.
● Instead, it should be tapered gradually to prevent rebound anxiety and a withdrawal reaction characterized by increased
anxiety, confusion, and more.
● Lithium is a mood stabilizer most often used to treat bipolar affective disorders.
● It has a very narrow therapeutic serum range of 0.6-1.2 mEq/L (0.6-1.2 mmol/L).
● Levels >1.5 mEq/L (1.5 mmol/L) are considered toxic.
● Lithium toxicity usually occurs with the following:
○ Dehydration
○ Decreased renal function (eg, elderly clients)
○ Diet low in sodium
○ Drug-drug interactions (nonsteroidal anti-inflammatory drugs [NSAIDs] and thiazide diuretics)
● Lithium is cleared renally.
● Even a mild change in kidney function (as seen in elderly clients) can cause serious lithium toxicity.
● Therefore, drugs that decrease renal blood flow (eg, NSAIDs) should be avoided.
● Acetaminophen would be a better choice for pain relief.
● Sodium, water, and lithium are normally filtered by the kidneys.
● Restriction of dietary sodium/water or dehydration signals renal sodium and water reabsorption which will also increase
, C
LE
lithium absorption, resulting in toxicity.
ST
● Therefore, clients should never restrict their sodium or water intake while taking lithium; instead, they should
maintain a consistent sodium intake.
BE
● Blood should be drawn frequently to monitor for therapeutic lithium levels and toxicity.
● Dehydration, decreased renal function, diet low in sodium, and drug-drug interactions (eg, NSAIDs and thiazide
diuretics) can cause lithium toxicity.
● Bupropion hydrochloride (Wellbutrin) is an atypical antidepressant used to treat depressive disorders, including
major depressive disorder, seasonal affective disorder, and persistent depressive disorder (dysthymia).
● Preparations of bupropion hydrochloride include immediate-release, sustained release (SR), and extended-release (XL)
tablets.
● Any medication marked SR or XL should not be chewed, cut, or crushed due to the risk of adverse effects from too
rapid absorption of the drug.
● No form of bupropion hydrochloride should be altered; tablets should be swallowed whole, with or without food.
● Seizures are of particular concern if a client takes a high or toxic dose of bupropion hydrochloride.
● Clients on any kind of antidepressant need to be monitored closely for worsening depression, sudden or unusual behavior
or mood changes, and the emergence of suicidal thoughts and behaviors.
● Clients with a diagnosis of depression and/or their family members need education and information on the increased risk
of suicide.
● Additional instructions to a client about the use of bupropion hydrochloride include the following:
○ Limit alcohol; inform the health care provider if you are used to consuming large amounts of alcohol
○ Do not double up on the medication if a scheduled dose is missed
○ Take the medication at the same time each day
○ It may take several weeks to feel the effects of bupropion hydrochloride
○ Weight loss may occur when taking this medication
● No form of bupropion hydrochloride should be crushed, chewed, or cut due to the risk of seizures and other
adverse effects caused by the more rapid absorption and resulting higher serum levels of the drug.
● No medications labeled SR or XL should be altered before they are administered.
● This type of medication preparation should be swallowed whole.
LE
Pharmacology
ST
Comprehensive Study Guide with Rationales.
BE
Complete Pharmacology Review and Exam Preparation Material.
Table of Contents
Psychiatric Pharmacology
Anxiolytics and Sedative-Hypnotics (Benzodiazepines, Buspirone)
Antidepressants (SSRIs, TCAs, MAOIs, Atypical Antidepressants)
Mood Stabilizers (Lithium: Therapeutic Use, Toxicity, Monitoring)
Antipsychotics (Typical and Atypical, Clozapine, Ziprasidone)
Neuroleptic Malignant Syndrome and Serotonin Syndrome
ADHD Medications (Stimulants and Nursing Considerations)
Client Education, Safety, and Drug Interactions
Gastrointestinal and Nutrition Pharmacology
Antiemetics and Prokinetic Agents (Metoclopramide)
Acid-Reducing Medications (PPIs, H2 Blockers, Antacids)
Ulcer Protection Agents (Sucralfate, Misoprostol)
Laxatives and Hepatic Encephalopathy Management (Lactulose)
Inflammatory Bowel Disease Medications (Sulfasalazine)
Pancreatic Enzymes and Malabsorption (Pancrelipase)
Weight Management Medications (Orlistat)
Total Parenteral Nutrition (TPN) and Metabolic Complications
Cardiovascular Pharmacology
Antianginal Medications (Nitroglycerin: Sublingual and Transdermal)
Cardiac Glycosides (Digoxin: Pediatric Administration and Toxicity)
Antiarrhythmic Medications (Amiodarone)
Heart Rate and Rhythm Disorders (Bradycardia, Tachycardia)
Client Teaching and Emergency Management of Chest Pain
Neurologic Pharmacology
Central Nervous System Stimulants and Sedatives
Seizure Risk and Neurotoxicity Related to Medications
Movement Disorders and Extrapyramidal Symptoms
Anticholinergic Agents and Neurologic Side Effects
Endocrine Pharmacology
, C
LE
Insulin Therapy and Blood Glucose Management
Medication-Induced Electrolyte Imbalances
ST
Client Monitoring and Safety Considerations
Hematologic and Oncologic Pharmacology
BE
Anticoagulants and Bleeding Risk
Chemotherapy-Related Emergencies (Tumor Lysis Syndrome)
Supportive Medications and Monitoring
Respiratory Pharmacology
Bronchodilators (Beta-2 Agonists such as Albuterol)
Adverse Effects and Client Monitoring
Immune and Infectious Disease Pharmacology
Antibiotic Therapy and Safety Considerations
Drug Allergies and Cross-Sensitivity
Infection Risk Related to Immunosuppressive Effects
Urinary and Renal Pharmacology
Nephrotoxic Medications and Renal Monitoring
Fluid and Electrolyte Balance
Medication Adjustments in Renal Impairment
Reproductive, Maternity, and Newborn Pharmacology
Pregnancy-Related Medication Risks
Labor-Inducing Agents and Contraindications
Client Education and Safety
Integumentary, Visual, and Auditory Pharmacology
Medication Effects on Skin, Vision, and Hearing
Long-Term Adverse Effects and Monitoring
Comprehensive Client Safety and Nursing Considerations
Polypharmacy and Beers Criteria
Elderly Client Medication Risks
Client Education, Monitoring, and Exam-Focused Rationales
, C
LE
ST
● Benzodiazepines (eg, alprazolam [Xanax], lorazepam [Ativan], clonazepam, diazepam) are commonly used
antianxiety drugs.
BE
● They work by potentiating endogenous GABA, a neurotransmitter that decreases excitability of nerve cells, particularly in
the limbic system of the brain, which controls emotions.
● Benzodiazepines may cause sedation, which can interfere with daytime activities.
● Giving the dose at bedtime will help the client sleep.
● Benzodiazepines have a sedative effect and should be administered at bedtime when possible.
● Benzodiazepines should never be stopped abruptly in long-term users as this can precipitate withdrawal symptoms.
● Eliminating aged cheeses and processed meats, which contain tyramine, is necessary with monoamine oxidase inhibitors
(eg, tranylcypromine, phenelzine), which are used for depressive disorders.
● A benzodiazepine should never be stopped abruptly.
● Instead, it should be tapered gradually to prevent rebound anxiety and a withdrawal reaction characterized by increased
anxiety, confusion, and more.
● Lithium is a mood stabilizer most often used to treat bipolar affective disorders.
● It has a very narrow therapeutic serum range of 0.6-1.2 mEq/L (0.6-1.2 mmol/L).
● Levels >1.5 mEq/L (1.5 mmol/L) are considered toxic.
● Lithium toxicity usually occurs with the following:
○ Dehydration
○ Decreased renal function (eg, elderly clients)
○ Diet low in sodium
○ Drug-drug interactions (nonsteroidal anti-inflammatory drugs [NSAIDs] and thiazide diuretics)
● Lithium is cleared renally.
● Even a mild change in kidney function (as seen in elderly clients) can cause serious lithium toxicity.
● Therefore, drugs that decrease renal blood flow (eg, NSAIDs) should be avoided.
● Acetaminophen would be a better choice for pain relief.
● Sodium, water, and lithium are normally filtered by the kidneys.
● Restriction of dietary sodium/water or dehydration signals renal sodium and water reabsorption which will also increase
, C
LE
lithium absorption, resulting in toxicity.
ST
● Therefore, clients should never restrict their sodium or water intake while taking lithium; instead, they should
maintain a consistent sodium intake.
BE
● Blood should be drawn frequently to monitor for therapeutic lithium levels and toxicity.
● Dehydration, decreased renal function, diet low in sodium, and drug-drug interactions (eg, NSAIDs and thiazide
diuretics) can cause lithium toxicity.
● Bupropion hydrochloride (Wellbutrin) is an atypical antidepressant used to treat depressive disorders, including
major depressive disorder, seasonal affective disorder, and persistent depressive disorder (dysthymia).
● Preparations of bupropion hydrochloride include immediate-release, sustained release (SR), and extended-release (XL)
tablets.
● Any medication marked SR or XL should not be chewed, cut, or crushed due to the risk of adverse effects from too
rapid absorption of the drug.
● No form of bupropion hydrochloride should be altered; tablets should be swallowed whole, with or without food.
● Seizures are of particular concern if a client takes a high or toxic dose of bupropion hydrochloride.
● Clients on any kind of antidepressant need to be monitored closely for worsening depression, sudden or unusual behavior
or mood changes, and the emergence of suicidal thoughts and behaviors.
● Clients with a diagnosis of depression and/or their family members need education and information on the increased risk
of suicide.
● Additional instructions to a client about the use of bupropion hydrochloride include the following:
○ Limit alcohol; inform the health care provider if you are used to consuming large amounts of alcohol
○ Do not double up on the medication if a scheduled dose is missed
○ Take the medication at the same time each day
○ It may take several weeks to feel the effects of bupropion hydrochloride
○ Weight loss may occur when taking this medication
● No form of bupropion hydrochloride should be crushed, chewed, or cut due to the risk of seizures and other
adverse effects caused by the more rapid absorption and resulting higher serum levels of the drug.
● No medications labeled SR or XL should be altered before they are administered.
● This type of medication preparation should be swallowed whole.
