NU 578 Unit 3 Exam (2026/2027 Update)
University of South Alabama Advanced Practice
Nursing – Pharmacology Complete A+ Guide with
Rationales
Effects - ANSWER//Sedation, muscle relaxation, amnesia Local Anesthetics -
Side Effects - ANSWER//CNS Excitation followed by depression CV
suppression (bradycardia, heart block, hypotension) Allergic dermatitis &
anaphylaxis Methoglobinemia (benzocaine) Topical local anesthetics -
ANSWER//Lidocaine Tetracaine cocaine Local Anesthetics -
Contraindications/Warnings: - ANSWER//Inadvertent injection into an artery or
vein can cause severe toxicity Local Anesthetics - Drug Interactions -
ANSWER// Use of local anesthetic with vasoconstrictors -
ANSWER//Decreases local bloodflow, which decreases systemic absorption
of the anesthetic - Prolongs anesthesia - Decreases toxicity Parkinson's
disease - ANSWER//Caused by loss of dopaminergic neurons in the
substantia negra --> causes imbalance between dopamine and acetylcholine
Lewy Bodies - ANSWER//Neurotoxic fibrils, characteristic of parkinson's
pathology Types of drugs used for parkinsons - ANSWER//1) Dopaminergic
agents 2) Anticholinergic agents Dopamine Replacement - ANSWER//Drugs:
Levodopa/Carbidopa Action: Converted to dopamine in the brain, then
activates dopamine receptors Effects: Decrease muscle disorders Used for:
Parkinson's *** First Line tx for parkinsons*** Side Effects: Dyskinesias (80%)
- Can be disabling N&V Psychosis (20%) Postural hypotension Dysrhythmias
Behavioral changes / Impulsivity Drug Interactions: First gen antipsychotics -
decrease effect MAOI - HTN Crisis Contraindications/Important Notes:
Cardiac Disease Patient Education: - May take several months for full
therapeutic response - High protein foods decrease therapeutic effect
"Parkinson's "Off times" - ANSWER//- Abrupt loss of drug effect - Can occur at
any time - Last minutes to hours Dopamine agonists - ANSWER//Drugs:
Apomorphine Pramipexole (Mirapex) Ropinerol Bromocryptine Action: Directly
active dopamine receptors Effects: Used for: First Line Tx of Parkinson's Side
Effects: Hallucinations Drowsiness Postural hypotension Sleep attacks
Impulse control disorders Drug Interactions: Contraindications/Important
Notes: Should not be used during pregnancy Patient Education: Initial
Parkinson's Tx - ANSWER//- MAO-B inhibitors for milx sx - Levodopa or
dopamine agonist for more severe sx First-Line Parkinson's Tx -
ANSWER//Levodopa/carbidopa Pramipexole (Mirapex) Ropinerole Rescue tx
for parkinson's during "off" times - ANSWER//apomorphine Dopamine
Releasers - ANSWER//Drugs: Amantadine Action: - Promotes the release of
dopamine from neurons - May block dopamine reuptake - blockade of
cholinergic reeptors Effects: Used for: Levodopa-induced dyskinesia Side
Effects: Confusion, dizziness Anticholinergic sx Livedo reticularis - benign
mottling of skin Drug Interactions: Contraindications/Important Notes: Patient
Education: MAO-B Inhibitors - ANSWER//Drugs: Rasagiline Selegiline Action:
Inhibit breakdown of dopamine by MAO-B Effects: Prolong effects of levodopa
Used for: Newly diagnosed parkinsons Managing off times during therapy
Side Effects: Insominia HNT crisis (suprathrapeutic doses) Headache,
, arthralgia, dyspepsia, depression, and flu-like symptoms. Drug Interactions:
Foods high in tyramine increase HTN risk meperidine (Demerol) SSRI -->
Serotonin syndrome Sympathomimetics Analgesics
Contraindications/Important Notes: DO not take after 12:00 pm Patient
Education: Drugs for Cognitive Impairment in Alzheimers - ANSWER//-
Cholinesterase Inhibitors - MNDA Antagonist Cholinesterase Inhibitors (for
Alzheimers) - ANSWER//Primary: Donepezil (Aricept) rivastigmine (Exelon)
Galantamine (Razadyne) Cholinesterase Inhibitors (for Alzheimers) - Action -
ANSWER//Increases the availability of acetylcholine by preventing the
breakdown of a acetylcholine (ACh) by acetycholinesterase (AChE)
Cholinesterase Inhibitors (for Alzheimers) - Effects - ANSWER//- Improved
cognitive function - May slow disease progression Cholinesterase Inhibitors
(for Alzheimers) - Sides Effects - ANSWER//- Cholinergic effects (Nausea,
diarrhea, dizzines, headache) - Bronchoconstriction - Bradycardia & syncope
Cholinesterase Inhibitors (for Alzheimers) - Drug Interactions -
ANSWER//Anticholinergics, TCAs, antipsychotics --> Decrease efficacy
Cholinesterase Inhibitors (for Alzheimers) - Patient Education - ANSWER//Will
Take about 2 weeks to reach a steady state NMDA Antagonist for Alzheimers
- Drugs - ANSWER//Memantine (Namenda) NMDA Antagonist for Alzheimers
- Action - ANSWER//Modulates the effect of glutamate at NMDA receptors.
Blocks calcium influx when extracellular glutamate is low, but permits
glutamate when influx is high. NMDA Antagonist for Alzheimers - Effect -
ANSWER//Slows cognitive decline NMDA Antagonist for Alzheimers - Uses -
ANSWER//Moderate or severe Alzheimers NMDA Antagonist for Alzheimers -
Side Effects - ANSWER//Dizziness, headache, constipation NMDA Antagonist
for Alzheimers - Drug Interactions - ANSWER//Other NMDA antagonists
Sodium bicarb - Alkaline urine prevents excretion Drugs for neuropsychiatric
sx of Alzheimers - ANSWER//risperdone (Risperdal) olanzapine (Zyprexa)
Treatment of Acute MS Relapse - ANSWER//** High dose glucocorticoid IV
gamma globulin may also be used Immune Modulators for MS - Drugs -
ANSWER//** Interferon beta Dimethyl fumarate glatirimir acetate natalizumab
fingolimod teriflunomide Interferon beta - Action - ANSWER//Naturally
occurring glycoprotein which 1) inhibits migration of proinflammatory
leukocytes across blood/brain barrier 2)Supresse helper T cell activity
Interferon beta - Uses - ANSWER//Relapsing forms of MS Secondary
progressive MS Interferon Beta - Side Effects - ANSWER//Flu-like sx Injection
site erythema & itching Depression Interferon beta - Drug Interactions -
ANSWER//Bone-marrow suppressing drugs Hepatotoxic drugs Interferon beta
- Contraindications/Warnings - ANSWER//Can cause liver damage - check
LFTs per schedule Can suppress bone marrow - check CBC per schedule
Interferon beta - Patient Education - ANSWER// Immunosuppressants for MS
- ANSWER//mitoxantrone (Novantrone) mitoxantrone (Novantrone) - Action -
ANSWER//Suppresses production of immune cells, thereby decreasing
autoimmune destruction of myelin mitoxantrone (Novantrone) - Effect -
ANSWER//May delay the time to relapse and disability progression
mitoxantrone (Novantrone) - Uses - ANSWER//Secondary progressive MS
Progressive relapsing MS mitoxantrone (Novantrone) - Side Effects -
ANSWER//Myelosuppression --> High risk for infection Cardiotoxicity leading
to heart failure Hair loss Damage to GI mucosa Benign blue-green tint to skin
mitoxantrone (Novantrone) - Contraindications/warnings - ANSWER//Avoid in
University of South Alabama Advanced Practice
Nursing – Pharmacology Complete A+ Guide with
Rationales
Effects - ANSWER//Sedation, muscle relaxation, amnesia Local Anesthetics -
Side Effects - ANSWER//CNS Excitation followed by depression CV
suppression (bradycardia, heart block, hypotension) Allergic dermatitis &
anaphylaxis Methoglobinemia (benzocaine) Topical local anesthetics -
ANSWER//Lidocaine Tetracaine cocaine Local Anesthetics -
Contraindications/Warnings: - ANSWER//Inadvertent injection into an artery or
vein can cause severe toxicity Local Anesthetics - Drug Interactions -
ANSWER// Use of local anesthetic with vasoconstrictors -
ANSWER//Decreases local bloodflow, which decreases systemic absorption
of the anesthetic - Prolongs anesthesia - Decreases toxicity Parkinson's
disease - ANSWER//Caused by loss of dopaminergic neurons in the
substantia negra --> causes imbalance between dopamine and acetylcholine
Lewy Bodies - ANSWER//Neurotoxic fibrils, characteristic of parkinson's
pathology Types of drugs used for parkinsons - ANSWER//1) Dopaminergic
agents 2) Anticholinergic agents Dopamine Replacement - ANSWER//Drugs:
Levodopa/Carbidopa Action: Converted to dopamine in the brain, then
activates dopamine receptors Effects: Decrease muscle disorders Used for:
Parkinson's *** First Line tx for parkinsons*** Side Effects: Dyskinesias (80%)
- Can be disabling N&V Psychosis (20%) Postural hypotension Dysrhythmias
Behavioral changes / Impulsivity Drug Interactions: First gen antipsychotics -
decrease effect MAOI - HTN Crisis Contraindications/Important Notes:
Cardiac Disease Patient Education: - May take several months for full
therapeutic response - High protein foods decrease therapeutic effect
"Parkinson's "Off times" - ANSWER//- Abrupt loss of drug effect - Can occur at
any time - Last minutes to hours Dopamine agonists - ANSWER//Drugs:
Apomorphine Pramipexole (Mirapex) Ropinerol Bromocryptine Action: Directly
active dopamine receptors Effects: Used for: First Line Tx of Parkinson's Side
Effects: Hallucinations Drowsiness Postural hypotension Sleep attacks
Impulse control disorders Drug Interactions: Contraindications/Important
Notes: Should not be used during pregnancy Patient Education: Initial
Parkinson's Tx - ANSWER//- MAO-B inhibitors for milx sx - Levodopa or
dopamine agonist for more severe sx First-Line Parkinson's Tx -
ANSWER//Levodopa/carbidopa Pramipexole (Mirapex) Ropinerole Rescue tx
for parkinson's during "off" times - ANSWER//apomorphine Dopamine
Releasers - ANSWER//Drugs: Amantadine Action: - Promotes the release of
dopamine from neurons - May block dopamine reuptake - blockade of
cholinergic reeptors Effects: Used for: Levodopa-induced dyskinesia Side
Effects: Confusion, dizziness Anticholinergic sx Livedo reticularis - benign
mottling of skin Drug Interactions: Contraindications/Important Notes: Patient
Education: MAO-B Inhibitors - ANSWER//Drugs: Rasagiline Selegiline Action:
Inhibit breakdown of dopamine by MAO-B Effects: Prolong effects of levodopa
Used for: Newly diagnosed parkinsons Managing off times during therapy
Side Effects: Insominia HNT crisis (suprathrapeutic doses) Headache,
, arthralgia, dyspepsia, depression, and flu-like symptoms. Drug Interactions:
Foods high in tyramine increase HTN risk meperidine (Demerol) SSRI -->
Serotonin syndrome Sympathomimetics Analgesics
Contraindications/Important Notes: DO not take after 12:00 pm Patient
Education: Drugs for Cognitive Impairment in Alzheimers - ANSWER//-
Cholinesterase Inhibitors - MNDA Antagonist Cholinesterase Inhibitors (for
Alzheimers) - ANSWER//Primary: Donepezil (Aricept) rivastigmine (Exelon)
Galantamine (Razadyne) Cholinesterase Inhibitors (for Alzheimers) - Action -
ANSWER//Increases the availability of acetylcholine by preventing the
breakdown of a acetylcholine (ACh) by acetycholinesterase (AChE)
Cholinesterase Inhibitors (for Alzheimers) - Effects - ANSWER//- Improved
cognitive function - May slow disease progression Cholinesterase Inhibitors
(for Alzheimers) - Sides Effects - ANSWER//- Cholinergic effects (Nausea,
diarrhea, dizzines, headache) - Bronchoconstriction - Bradycardia & syncope
Cholinesterase Inhibitors (for Alzheimers) - Drug Interactions -
ANSWER//Anticholinergics, TCAs, antipsychotics --> Decrease efficacy
Cholinesterase Inhibitors (for Alzheimers) - Patient Education - ANSWER//Will
Take about 2 weeks to reach a steady state NMDA Antagonist for Alzheimers
- Drugs - ANSWER//Memantine (Namenda) NMDA Antagonist for Alzheimers
- Action - ANSWER//Modulates the effect of glutamate at NMDA receptors.
Blocks calcium influx when extracellular glutamate is low, but permits
glutamate when influx is high. NMDA Antagonist for Alzheimers - Effect -
ANSWER//Slows cognitive decline NMDA Antagonist for Alzheimers - Uses -
ANSWER//Moderate or severe Alzheimers NMDA Antagonist for Alzheimers -
Side Effects - ANSWER//Dizziness, headache, constipation NMDA Antagonist
for Alzheimers - Drug Interactions - ANSWER//Other NMDA antagonists
Sodium bicarb - Alkaline urine prevents excretion Drugs for neuropsychiatric
sx of Alzheimers - ANSWER//risperdone (Risperdal) olanzapine (Zyprexa)
Treatment of Acute MS Relapse - ANSWER//** High dose glucocorticoid IV
gamma globulin may also be used Immune Modulators for MS - Drugs -
ANSWER//** Interferon beta Dimethyl fumarate glatirimir acetate natalizumab
fingolimod teriflunomide Interferon beta - Action - ANSWER//Naturally
occurring glycoprotein which 1) inhibits migration of proinflammatory
leukocytes across blood/brain barrier 2)Supresse helper T cell activity
Interferon beta - Uses - ANSWER//Relapsing forms of MS Secondary
progressive MS Interferon Beta - Side Effects - ANSWER//Flu-like sx Injection
site erythema & itching Depression Interferon beta - Drug Interactions -
ANSWER//Bone-marrow suppressing drugs Hepatotoxic drugs Interferon beta
- Contraindications/Warnings - ANSWER//Can cause liver damage - check
LFTs per schedule Can suppress bone marrow - check CBC per schedule
Interferon beta - Patient Education - ANSWER// Immunosuppressants for MS
- ANSWER//mitoxantrone (Novantrone) mitoxantrone (Novantrone) - Action -
ANSWER//Suppresses production of immune cells, thereby decreasing
autoimmune destruction of myelin mitoxantrone (Novantrone) - Effect -
ANSWER//May delay the time to relapse and disability progression
mitoxantrone (Novantrone) - Uses - ANSWER//Secondary progressive MS
Progressive relapsing MS mitoxantrone (Novantrone) - Side Effects -
ANSWER//Myelosuppression --> High risk for infection Cardiotoxicity leading
to heart failure Hair loss Damage to GI mucosa Benign blue-green tint to skin
mitoxantrone (Novantrone) - Contraindications/warnings - ANSWER//Avoid in
