ATI PHARMACOLOGY STUDY GUIDE B LATEST
2023 -/76 QUESTIONS AND ANSWERS
596 ANTIBIOTICS AFFECTING THE BACTERIAL CELL WALL- INTERVENTIONS
FOR CLIENT REACTING TO OTHER INHIBITORS - -...Ototoxicty- assess for
hearing loss
admin vanco slowly over 60 minutes. ↑risk when used with another ototox
med (loop diuretic or aminoglycoside (gentamicin).
-MED AFFECTING BP-TITRATING MED USE FOR HYPERTENSIVE CRISIS -
-1. Dose is titrated
2. Up or down depending
3. Want no higher then 130
4. 90
5. Remember to put which way
-MEDS AFFECTING BP-MED INTERACTION -
-1. Diuretics contribute to first-dose hypotension
-Temporarily stop diuretic 2-3 days before start of therapy w/ ACE
-Potassium supplements and potassium-sparing diuretics increase risk of
hyperkalemia
-Can increase levels of lithium carbonate (Eskalith)
-NSAIDs may decrease antihypertensive effect
-MEDS AFFECTING BP-EXPECTED RESPONSE OF ACE INHIBITORS - -
- pril
Vasodilation
Excretion of sodium and water, retention potassium
Adverse effect: Dry Cough
-CARDIAC GLYCOSIDES & HEART FAILURE-INCREASED RISK FOR TOXICITY - -
Dysrhythmias-caused by hypokalemia, increased serum drug levels, heart
ds. Monitor HR (contraindicated in pts c vent. dysrhythmias)
Bradycardia- sx of toxicity- hold if <60 & call doc
Avoid hypokalemia (increases risk of toxicity)
Monitor serum drug levels 0.5-2.0
Amiodarone greatly increases the risk for digoxin toxicity. Other
antidysrhythmics that increase this risk include quinidine, verapamil (Calan)
diltiazem (Cardizem), propafenone (Rythmol), and flecainide (Tambocor)
-MEDS AFFECTING CARDIAC RHYTHM -VENTRICULAR DYSRHYTHMIA - -1.
Procainamide
2. Lidocaine
3. Propafenone
4. Miodarone
, 5. Norpace
-NON-OPIOD ANALGESICS-RECOGNIZING OVER MEDICATION -
-Salicylism ASA -Sweating, HA, tinnitus, high fever w/ acidosis, dehydration,
electrolyte imbalances, coma, respiratory depression
NSAID - dyspepsia, abd pain, heartburn, nausea
TYLENOL - liver damage, n/v, diarrhea, sweating and abd discomfort followed
by hepatic failure, coma, death
-OPIOD AGONISTS & ANTAGONISTS-PRIORITY ASSESSMENTS OFF FINDINGS -
-...
-OPIOD AGONISTS AND ANTAGONISTS-TEACHING ABOUT A TRANSDERMAL
PATCH - -transdermal fentanyl patch first admin take several hours to
achieve therapeutic effect. Administer short-acting opioids prior to onset of
therapeutic effects and for breakthrough pain.
-OPIOD AGONIST AND ANTAGONISTS-CLIENT EDUCATION REGARDING NEW
PRESCRIPTIONS - -...Must have hand written prescrption
-UTI-IDENTIFYING CONTRADICTIONS - -SMZ-TMP, Bactrim
1. No folate deficiency
2. caution with renal dysfunction
3. Older adults on ACE inhibitors or angiotensin ARB(hyperkalemia)
4. Creatine clearance <40 = no
5. empty stomach
-MEDS AFFECTING URINARY OUTPUT- CLIENT TEACHING REGARDING
POTASSIUM-SPARING DIURECTECS -
-1. Avoid salt subs
2. Self monitor BP
3. Log weight
4. No ACE, arb's, or renin inhibitors
5. Impotence or menstrual irregularities
-MEDS AFFECTING URINARY OUTPUT-EFFECTS OF DIURECTECS -
-1. Diuresis
2. Hypercalcemia
3. BP control
4. Potassium sparing
5. Heart failure control
-ENDOCRINE DISORDERS-ADVERSE EFFECTS OF THYROID HORMONE –
-1. Hyperthyroidism
2. anxiety
3. Tachycardia
4. palpations
2023 -/76 QUESTIONS AND ANSWERS
596 ANTIBIOTICS AFFECTING THE BACTERIAL CELL WALL- INTERVENTIONS
FOR CLIENT REACTING TO OTHER INHIBITORS - -...Ototoxicty- assess for
hearing loss
admin vanco slowly over 60 minutes. ↑risk when used with another ototox
med (loop diuretic or aminoglycoside (gentamicin).
-MED AFFECTING BP-TITRATING MED USE FOR HYPERTENSIVE CRISIS -
-1. Dose is titrated
2. Up or down depending
3. Want no higher then 130
4. 90
5. Remember to put which way
-MEDS AFFECTING BP-MED INTERACTION -
-1. Diuretics contribute to first-dose hypotension
-Temporarily stop diuretic 2-3 days before start of therapy w/ ACE
-Potassium supplements and potassium-sparing diuretics increase risk of
hyperkalemia
-Can increase levels of lithium carbonate (Eskalith)
-NSAIDs may decrease antihypertensive effect
-MEDS AFFECTING BP-EXPECTED RESPONSE OF ACE INHIBITORS - -
- pril
Vasodilation
Excretion of sodium and water, retention potassium
Adverse effect: Dry Cough
-CARDIAC GLYCOSIDES & HEART FAILURE-INCREASED RISK FOR TOXICITY - -
Dysrhythmias-caused by hypokalemia, increased serum drug levels, heart
ds. Monitor HR (contraindicated in pts c vent. dysrhythmias)
Bradycardia- sx of toxicity- hold if <60 & call doc
Avoid hypokalemia (increases risk of toxicity)
Monitor serum drug levels 0.5-2.0
Amiodarone greatly increases the risk for digoxin toxicity. Other
antidysrhythmics that increase this risk include quinidine, verapamil (Calan)
diltiazem (Cardizem), propafenone (Rythmol), and flecainide (Tambocor)
-MEDS AFFECTING CARDIAC RHYTHM -VENTRICULAR DYSRHYTHMIA - -1.
Procainamide
2. Lidocaine
3. Propafenone
4. Miodarone
, 5. Norpace
-NON-OPIOD ANALGESICS-RECOGNIZING OVER MEDICATION -
-Salicylism ASA -Sweating, HA, tinnitus, high fever w/ acidosis, dehydration,
electrolyte imbalances, coma, respiratory depression
NSAID - dyspepsia, abd pain, heartburn, nausea
TYLENOL - liver damage, n/v, diarrhea, sweating and abd discomfort followed
by hepatic failure, coma, death
-OPIOD AGONISTS & ANTAGONISTS-PRIORITY ASSESSMENTS OFF FINDINGS -
-...
-OPIOD AGONISTS AND ANTAGONISTS-TEACHING ABOUT A TRANSDERMAL
PATCH - -transdermal fentanyl patch first admin take several hours to
achieve therapeutic effect. Administer short-acting opioids prior to onset of
therapeutic effects and for breakthrough pain.
-OPIOD AGONIST AND ANTAGONISTS-CLIENT EDUCATION REGARDING NEW
PRESCRIPTIONS - -...Must have hand written prescrption
-UTI-IDENTIFYING CONTRADICTIONS - -SMZ-TMP, Bactrim
1. No folate deficiency
2. caution with renal dysfunction
3. Older adults on ACE inhibitors or angiotensin ARB(hyperkalemia)
4. Creatine clearance <40 = no
5. empty stomach
-MEDS AFFECTING URINARY OUTPUT- CLIENT TEACHING REGARDING
POTASSIUM-SPARING DIURECTECS -
-1. Avoid salt subs
2. Self monitor BP
3. Log weight
4. No ACE, arb's, or renin inhibitors
5. Impotence or menstrual irregularities
-MEDS AFFECTING URINARY OUTPUT-EFFECTS OF DIURECTECS -
-1. Diuresis
2. Hypercalcemia
3. BP control
4. Potassium sparing
5. Heart failure control
-ENDOCRINE DISORDERS-ADVERSE EFFECTS OF THYROID HORMONE –
-1. Hyperthyroidism
2. anxiety
3. Tachycardia
4. palpations
