ATI PROCTORED PHARMACOLOGY STUDY GUIDE
Antibiotics affecting the Bacterial Cell Wall: Priority Findings to report to the Provider
Antibiotics includes penicillin’s, cephalosporins, carbapenems, and monobactams
Complications: Allergies, anaphylaxis, renal impairment, Hyperkalemia, dysrhythmias, Hypernatremia
Notify Provider if allergies are present
Older Adults: Client teaching about insulin administration
Older adult clients might not be able to drive to the providers office, grocery store, or
pharmacy. Assess support systems available for older adult clients.
Older adults are at risk for altered metabolism of medication due to decreased kidney and
liver function because of the aging process
Older adults can have vision alterations (yellowing of the lens, decreased depth perception,
cataracts), which can affect ability to read information and administer medication
Airflow Disorders: Teaching about Theophylline
Methylanilines
Theoplylline purpose is relaxation of bronchial smooth muscle, resulting in bronchodilation.
Oral theophylline is used for long-term control of chronic asthma or COPD
Route: oral or IV
Interactions: Caffeine increases CNS and cardiac adverse effects of theophylline levels.
Nursing Considerations: Advise clients to avoid consuming caffeinated beverages (coffee,
caffeinated colas).
Phenobarbital, phenytoin, and rifampin decrease theophylline levels
Advise clients to take medication as prescribed. If a dose is missed, the following dose should
not be doubled.
Instruct clients not to chew or crush, these medications should be swallowed whole.
Advise patients to observe for manifestations of theophylline toxicity (N&V, Seizures), and notify
provider.
Antibiotics affecting the bacterial cell wall: Adverse reactions
Tetracyclines
adverse reactions
GI discomfort: cramping, N&V, diarrhea, and esophageal ulceration
Yellow or brown tooth discoloration, hypoplasia of tooth enamel – avoid administering to
children younger than 8yrs and pregnant women.
Hepatotoxicity (lethargy, jaundice)
Photosensitivity (intense sunburn)
Superinfection- pseudomembranous colitis(diarrhea), oral candidiasis, vaginal, pharynx and
bowels
Dizziness, lightheadedness (minocycline)
, Macrolides – Erythromycin Azithromycin
Adverse reactions: GI discomfort, prolonged QT intervals, ototoxicity with high-dose
therapy – monitor for and report hearing loss, vertigo, and tinnitus
Aminoglycosides – Tobramycin, Neomycin, Streptomycin, Paromomycin
Adverse Reactions: ototoxicity, nephrotoxicity, respiratory depression, muscle
weakness, rash, pruritic, parethesias of hands and feet, urticaria.
STREPTOMYCIN
Adverse Reaction: Peripheral neuritis, optic nerve dysfunction, tingling/numbness of the
hands and feet.
Cardiac Glycosides and Heart Failure: Monitoring for Digoxin Toxicity
Cardiac glycosides are indicated when Diuretics, ACE inhibitors, angiotensin II receptor blockers
(ARBs), and beta-adrenergic blockers are the unable to control manifestations of heart failure.
Digoxin – monitor digoxin levels periodically during treatment and maintain therapeutic levels
between 0.5 and 2 ng/mL to prevent digoxin toxicity.
Instruct clients to observe for indications of digoxin toxicity: These symptoms include fatigue,
malaise, and visual disturbances. The classic features of digoxin toxicity are nausea, vomiting,
abdominal pain, headache, dizziness, confusion, delirium, vision disturbance (blurred or yellow
vision).
Chronic Neurologic Disorders: Adverse Effects of Carbamazepine
Carbamazepine is used to prevent and control seizures. This medication is known as an
anticonvulsant or anti-epileptic drug. Administered also for bipolar disorder, trigeminal and
glossopharyngeal neuralgias.
Carbamazepine promotes secretion of ADH, which inhibits water excretion by the kidneys and
places clients who have heart failure at risk for fluid overload.
Carbamazepine causes a decrease in the effects of oral contraceptives and warfarin due to
stimulation of hepatic medication metabolizing enzymes.
adverse effects of carbamazepine (Tegretol)- Nystagmus, double vision, vertigo, staggering gait,
and headache. Cognitive function is minimally affected. Bloody dyscrasias, teratogenesis, risk for fluid
overload, and Stevens-Johnson syndrome
Pregnancy- Birth defects: associated with spina bifida, neural tube defect, and delays in growth.
Pregnancy Category D: Administer only if the benefits outweigh the risks
Chronic Neurologic Disorders: Adverse Effects of Cholinesterase Inhibitors
*neostigmine
ambenonium
pyridostigmine
edrophonium
Antibiotics affecting the Bacterial Cell Wall: Priority Findings to report to the Provider
Antibiotics includes penicillin’s, cephalosporins, carbapenems, and monobactams
Complications: Allergies, anaphylaxis, renal impairment, Hyperkalemia, dysrhythmias, Hypernatremia
Notify Provider if allergies are present
Older Adults: Client teaching about insulin administration
Older adult clients might not be able to drive to the providers office, grocery store, or
pharmacy. Assess support systems available for older adult clients.
Older adults are at risk for altered metabolism of medication due to decreased kidney and
liver function because of the aging process
Older adults can have vision alterations (yellowing of the lens, decreased depth perception,
cataracts), which can affect ability to read information and administer medication
Airflow Disorders: Teaching about Theophylline
Methylanilines
Theoplylline purpose is relaxation of bronchial smooth muscle, resulting in bronchodilation.
Oral theophylline is used for long-term control of chronic asthma or COPD
Route: oral or IV
Interactions: Caffeine increases CNS and cardiac adverse effects of theophylline levels.
Nursing Considerations: Advise clients to avoid consuming caffeinated beverages (coffee,
caffeinated colas).
Phenobarbital, phenytoin, and rifampin decrease theophylline levels
Advise clients to take medication as prescribed. If a dose is missed, the following dose should
not be doubled.
Instruct clients not to chew or crush, these medications should be swallowed whole.
Advise patients to observe for manifestations of theophylline toxicity (N&V, Seizures), and notify
provider.
Antibiotics affecting the bacterial cell wall: Adverse reactions
Tetracyclines
adverse reactions
GI discomfort: cramping, N&V, diarrhea, and esophageal ulceration
Yellow or brown tooth discoloration, hypoplasia of tooth enamel – avoid administering to
children younger than 8yrs and pregnant women.
Hepatotoxicity (lethargy, jaundice)
Photosensitivity (intense sunburn)
Superinfection- pseudomembranous colitis(diarrhea), oral candidiasis, vaginal, pharynx and
bowels
Dizziness, lightheadedness (minocycline)
, Macrolides – Erythromycin Azithromycin
Adverse reactions: GI discomfort, prolonged QT intervals, ototoxicity with high-dose
therapy – monitor for and report hearing loss, vertigo, and tinnitus
Aminoglycosides – Tobramycin, Neomycin, Streptomycin, Paromomycin
Adverse Reactions: ototoxicity, nephrotoxicity, respiratory depression, muscle
weakness, rash, pruritic, parethesias of hands and feet, urticaria.
STREPTOMYCIN
Adverse Reaction: Peripheral neuritis, optic nerve dysfunction, tingling/numbness of the
hands and feet.
Cardiac Glycosides and Heart Failure: Monitoring for Digoxin Toxicity
Cardiac glycosides are indicated when Diuretics, ACE inhibitors, angiotensin II receptor blockers
(ARBs), and beta-adrenergic blockers are the unable to control manifestations of heart failure.
Digoxin – monitor digoxin levels periodically during treatment and maintain therapeutic levels
between 0.5 and 2 ng/mL to prevent digoxin toxicity.
Instruct clients to observe for indications of digoxin toxicity: These symptoms include fatigue,
malaise, and visual disturbances. The classic features of digoxin toxicity are nausea, vomiting,
abdominal pain, headache, dizziness, confusion, delirium, vision disturbance (blurred or yellow
vision).
Chronic Neurologic Disorders: Adverse Effects of Carbamazepine
Carbamazepine is used to prevent and control seizures. This medication is known as an
anticonvulsant or anti-epileptic drug. Administered also for bipolar disorder, trigeminal and
glossopharyngeal neuralgias.
Carbamazepine promotes secretion of ADH, which inhibits water excretion by the kidneys and
places clients who have heart failure at risk for fluid overload.
Carbamazepine causes a decrease in the effects of oral contraceptives and warfarin due to
stimulation of hepatic medication metabolizing enzymes.
adverse effects of carbamazepine (Tegretol)- Nystagmus, double vision, vertigo, staggering gait,
and headache. Cognitive function is minimally affected. Bloody dyscrasias, teratogenesis, risk for fluid
overload, and Stevens-Johnson syndrome
Pregnancy- Birth defects: associated with spina bifida, neural tube defect, and delays in growth.
Pregnancy Category D: Administer only if the benefits outweigh the risks
Chronic Neurologic Disorders: Adverse Effects of Cholinesterase Inhibitors
*neostigmine
ambenonium
pyridostigmine
edrophonium
