NUR2474 Pharmacology for Professional Nursing – Examination Blue Print – Final Exam Solved 2023/2024 Complete Guide

NUR2474 Pharmacology for Professional Nursing – Examination Blue Print – Final Exam Insulin: DM1 DM2, GESTATIONAL DIABETES ** HYPOGLYCEMIA IS A DANGEROUS ADVERSE EFFECT AND HIGH PRIORITY FOR TREATMENT ** • What types of insulin are ordered before meals and at bedtime? Why? ⁃ lispro and regular are not ordered before bedtime; lantus is given before bedtime; in the elderly especially lantus is sometimes split into a morning and evening dose.. why? sugar drops overnight and this can be dangerous so NO NPH at bedtime • What type of insulin is sometimes given at bedtime, has the longest duration of all the insulins, CANNOT BE MIXED WITH OTHER INSULINS, and for elderly patients is often split into two doses (one in the morning and one at bedtime)? ⁃ Insulin glargine (lantus) is usually given once a day at bedtime. elderly individuals often have their dose split in two and are administered one dose in the morning and one dose at night; in addition sometimes, insulin lisper is given in a sliding scale with a snack in the evening. It does NOT last throughout the night- thats what we want to avoid ⁃ ** insulin apart protamine in combo with insulin apart would NOT be given in the evening as it lasts TOO long ⁃ ** NPH would peak at exactly the WRONG TIME. do not give that one at bedtime • Why is a nurse concerned for a beta-blocker/insulin combination? beta blockers can mask some of the symptoms of hypoglycemia What do you assess for? What symptoms could be concealed by taking a beta blocker while on insulin? ⁃ symptoms of hypoglycemia ⁃ being nervous or anxious ⁃ sweating, chills and clamminess ⁃ irritability or impatience ⁃ confusion ⁃ fast heartbeat ⁃ feeling lightheaded or dizzy ⁃ hunger ⁃ feeling shaky • You will need to know the following chart: Onset: when the medicine starts to work (when the blood sugar is going to start to go down). Peak : usually when the medicine is at its highest level and you get the highest effect (in this case it equates to the times when you see the lowest blood sugars). Duration: how long the medication is going to last in effectiveness (how long is it going to affect blood sugars) Glipizide: • How does it work? What diagnosis is it effective for (be specific)? ⁃ • What classification(s) does it fit into? • What are the side/adverse effects? • What are contraindications? • Are there drug-drug interactions? • Are there drug-alcohol interactions? • Are there drug-food interactions? Metformin • How does it work? What diagnosis is it effective for (be specific)? works by reducing the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin • What classification(s) does it fit into? Type 2 diabetes, less than 5 years, no end organ damage young enough • What are the side/adverse effects? oral hypoglycemic, anti-diabetic • What are contraindications? can be harsh on end organs, esp. kidneys, it is best to take METFORMIN with a meal to reduce the side effects. IF SOMEONE IS GOING TO HAVE CONTRAST FOR A CT; THE METFORMIN IS STOPPED PRIOR TO HAVING THE CONTRAST IF THEY ARE TAKING METFORMIN, AND THEY COME INTO AN ER AND A CT WITH CONTRAST IS ORDERED, DO NOT BLINDLY SEND THE PATIENT TO CT, LET THE PROVIDER DECIDE • CONTRAINDICATIONS; KIDNEY DISEASE,HEART ATTACK, STROKE, DKA, COMA, HEART OR LIVER DISEASE Acarbose: • How does it work? What diagnosis is it effective for (be specific)? ⁃ by the slowing the action of certain chemicals that break down food to release glucose into the blood, slowing food digestion helps to keep the blood glucose from rising very high after meals • What classification(s) does it fit into? • What are the side/adverse effects? DIARRHEA • What are contraindications? • Are there drug-drug interactions? avoid taking digestive enzymes such as pancreatin, amylase, or lipase at the same time you take acarbose • Are there drug-alcohol interactions? do not mix it may cause sudden hypoglycemia NEVER WITH ANY ANTI_DIABETIC MEDS • Are there drug-food interactions?no grapefruit juice - IMPACT NEGATIVELY ⁃ D50W EMERGENCY MED GIVEN IV ⁃ how does it work: direct sugar for the body ⁃ classifications: hyperglycemic agent ⁃ side/adverse effects: hyperglycemia Glucagon: Emergency Med given IM or SUBQ - how does it work: glucagon role in the body is to prevent blood glucose levels dropping TOO low. acts on the liver in several ways; it stimulates the conversion of stored glycogen to glucose which can be released into he blood stream; this process is called glycogenolysis - classification: hyperglycemic agents - side effects: hyperglycemia Levothyroxine: • How does it work? What diagnosis is it effective for (be specific)? ⁃ hypothyroid; works as hormone replacement • What classification(s) does it fit into? ⁃ thyroid hormone replacement therapy • What are the side/adverse effects? ⁃ insomnia, tremors, increase HR • What are contraindications? • What laboratory value is used to manage dosing and hypothyroidism management? What is meant when it is high (usually) and what is meant when it goes down (usually)? • What would happen if a person took this medication with calcium? • What time of day should a person take this medication and why? • Are there drug-drug interactions and what are they? • Why is this medication important for a hypothyroid patient while pregnant? Sulfamethoxazole • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • What prefix tells you this belongs to the classification it is in? • Why does one teach patients to drink plenty of water with this? Cephalexin, Cefoxitin: • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • What are contraindications? • How does it interfere with warfarin? • Why is it important to observe for side effects if someone has had an allergic reaction to penicillins? This is not a penicillin. Metronidazole: • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • Can it be mixed with alcohol? Why or why not? Acyclovir: • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • Pregnancy implications? Nephrotoxicity (labs that indicate kidney function: creatinine, BUN)? How can one decrease the risk of kidney damage while on this medication? Amoxicillin • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • What are contraindications? • If one is allergic to one “cillin,” meaning a penicillin-like drug, they are allergic to all “cillins.” What is a cross-allergy? • What would be signs and symptoms of mild allergy and how is this mild allergy treated? What would be signs and symptoms of a sever reaction and how is it treated? Please note that allergies to penicillins are VERY common. Ciprofloxacin • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • What are contraindications? • What is the risk for tendons with this classification? Itraconazole: • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • Drug-Drug interactions Cimetidine • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • What suffix tells you this belongs to its classification? • Why does this drug interfere with many other drugs and needs to be given at a different time from many other medications. Pantoprazole • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • Administration implications? Sucralfate • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? Does this classification have many look alike/sound alike drugs? • What are the side/adverse effects? • Administration implications? Estrogen Therapy: • How does it work? What diagnosis is it effective for (be specific)? • What are the side/adverse effects? Are there specific routes that have less side effects? • What are contraindications? • Why might a patient be prescribed an estrogen/progestin combination rather than just estrogen? Compare and contrast the side/adverse effects of the two. • How is transdermal estrogen spray applied? Testosterone Gel 1% • How does it work? What diagnosis is it effective for (be specific)? • What are the side/adverse effects? • What are contraindications? • How is it applied to be most effective? Oral Androgens • How do they work? What are they effective for (be specific)? • What classification(s) does it fit into? • What are the side/adverse effects? Which side effects warrant a call to a provider to determine if they should be discontinued? • What are contraindications? Doxazosin • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? • What are the side/adverse effects? • What are contraindications? Sildenafil: • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? • What are the side/adverse effects? • What medication may cause profound hypotension if taken with it? Naloxone: • How does it work? What diagnosis is it effective for (be specific)? • What classification(s) does it fit into? • What are the side/adverse effects? • What is a normal dose and how is it administered