PHARMACOLOGY DRUGS for ATI Test,
ATI LPN Pharmacology Proctored
Exam Review Questions with Correct
Answers
Nitrates - ANSWER-Nitroglycerin/Nitrostat, Nitro-Bid, Nitro-Dur
Nitrates form nitric acid which is a relaxes smooth muscle and dilates venous and
arterial blood vessels
Open veins-blood pools in the legs-not as much blood returning to the heart-reduces
preload
Open arteries-heart does not have to work as hard to pump blood out of the heart-
reduces afterload
Opens the coronary arteries and helps supply blood to the heart tissue
Can be given sublingually, orally, topically, IV, buccal
Can be for acute or long term use
Nitroglycerin dilates any artery and vein-including yours if you touch it while
administering it-WEAR GLOVES
Nitroglycerin IV needs a glass bottle and covered from light-some hospitals still use
special tubing (nitro is absorbed in the tubing)
Short term-nitrostat-sublingually-1 tablet every 5 minutes x 3 for relief of chest pain-
still having chest pain call 911/physician
Long-term nitro-dur will last for up to 14 hours in the body
Side Effects:
Headache-dilates the cerebral arteries-do not give with head trauma or increased
intracranial pressure
Hypotension and reflex tachycardia-do not give with hypotension, monitor blood
pressure and HR when administering
Hypotension-correct hypervolemia prior to giving nitroglycerin
DO NOT GIVE WITH VIAGRA, LEVITRA, OR CIALIS (nitroglycerin and Viagra
increase nitric acid and relaxation of the smooth muscles-can kill a client with
hypotension with a combination of these drugs)
Digoxin - ANSWER-Cardiac Glycoside
Digoxin/Digitek, Lanoxin, Lanoxicaps (Dig)
Increases the contractility of the heart muscle - Inotropic effect-
Increases cardiac output
Also Suppresses the SA node and slows conduction through the AV node
Half-life is 3-4 days
Great Drug-real side effects
,Digoxin SE =
Dysrhythmias
Toxicity 0.5-1.8 normal level
Signs of toxicity-halos around objects, Nausea/Vomiting/Anorexia, blurred vision,
fatigue
Bradycardia-must take an apical pulse for one full minute, must be 60 or above to
give digoxin
Give with caution with pediatric and geriatric patients due to inadequate renal or
hepatic metabolic enzymes
Hyperkalemia can reduce effects of digoxin
Digoxin and Beta Blockers can really lower the pulse
Give with caution with renal failure-digoxin excreted via the kidneys
DIGIBIND IS THE ANTIDOTE FOR DIGOXIN TOXICITY
Digoxin
Decreases automaticity of the SA nose and slows conduction through the AV node
Atrial dysrhythmias
All the side effects and warnings are still important
Heparin - ANSWER-Naturally found in the liver and lining of blood vessels
Prolong coagulation time
IV immediate onset, Sub Q 1 hour
Destroyed by gastric enzymes
Weight based
aPTT (PTT also, but in the hospital we use the aPTT)
Sub Q
Thrombocytopenia occurs in 30% of client
Protamine Sulfate is the antidote, 1 mg for every100 units of heparin, works for
Lovenox also
Coumadin - ANSWER-Warfarin/Coumadin
Warfarin inhibits the action of Vitamin K, and without adequate Vitamin K the
synthesis of clotting factors 2, 7, 9, and 10 is diminished
INR/PT
Warfarin takes 2-3 days to achieve therapeutic effect-99% of warfarin is bound to
plasma proteins and unavailable to produce effects
Vitamin K is the antidote-green leafy veggies Aquamephyton-works within 6 hours
Normal INR therapeutic range is 2-3
Normal INR for everyone who is not taking an anticoagulant is around 1
Category X for pregnancy
Avoid alcohol, diuretics, SSRI's, Antidepressants, Steroids, Antibiotics, Vaccines,
Some Vitamins, Amiodarone-all can potentiate warfarin
Bleeding-
Amiodarone - ANSWER-Amiodarone (Cordarone/Pacerone)
Class III antidysrhythmic
Potassium channel blocker
Ventricular and Atrial Arrhythmias-especially with heart failure
IV onset or PO onset looks to be 2-3 days to 1-3 weeks
Half life can be greater than 100 days
,Check K and MG levels prior to starting therapy
Side Effects: Fibrosis of lungs, destruction of thyroid, Photosensitivity-Smurfs, Liver
destruction, N/V, Hypotension, Blindness, very hard on the stomach-GI Distress
Can increase serum digoxin levels by 70%, Increase warfarin levels, Increase
phenytoion (Dilantin), Stop BB and CCB?
Statins (Lipitor) - ANSWER-HMG-CoA reductace inhibitor-(liver is where the
cholesterol is made, it is where the HMG-CoA work)
LDL/Cholesterol is reduced
Give with food to reduce GI symptoms
Lipitor can be taken at anytime, most of the class of this medication needs to be
taken at bedtime-cholesterol is made by the liver at night
Up to 30 days to achieve full affect
Side Effects:
GI-constipation, bloating, gas, nausea
Liver-monitor enzymes-alt, ast, alk phas, bilirubin, jaundice, enlarged liver-ascites
Rhabdomyolysis-muscle destruction-CK elevation-muscle pain-MD has to be
notified.
Renal failure is very common with Rhabdomyolysis-need to make sure urine output
is 30 ml or greater an hour
No grapefruit juice
The statins are hard on the liver-you need to make sure other drugs the client is on is
not hard on the liver-Amiodarone and Nizoral are two drugs that come immediately
to my mind
furosemide/lasix - ANSWER-...Loop Diuretics-prevents Na/Cl reabsorption, thus Na
leaves the body, water follows Na and K follows the water
Furosemide/Lasix, Bumex/Bumetanide, Torsemide/Demadex
Work on the entire Loop of Henle-large volumes of water, Na, and K are removed
Works in renal failure
Hypovolemic and hypokalemia very common
Nursing interventions
Know your potassium level prior to administration
Assess Lung Sounds, Weight, I/O, Edema, SaO2, RR, Blood Pressure, K Level prior
to administration, assess all of these post administration, especially K Level and
Lung Sounds, Sao2, I/O. If you urine bag is not twice as full 30 minutes post IV Lasix
administration, check your IV site. If your client without a Foley has not called to
urinate within an hour of giving po Lasix, check your client
Warn your client to get up slowly after taking Lasix, watch for orthostatic hypotension
Lasix does have sulfa as a base component
May not be used with anuria, hepatic coma
Use with extreme caution with electrolyte depletion
Low K with Digoxin can equal lethal Dysrhythmias, know your potassium level-has a
digoxin level been ran
plavix - ANSWER-Anti-platelet drugs
ASA
, Persantine
ADP Receptor Blockers (Plavix, Ticlid, Effient)
Glycoprotein 2b./3a receptor antagonist (Repro, Integrillin, Aggrastat
ADP receptor blockers
Irreversibly alter the plasma membrane of platelets, alters the ability of platelets to
aggregate
Ticlid and Plavix are given orally
Ticlid can cause Agranulocytosis-only used when someone is allergic to Plavix
Glycoprotein is an enzyme necessary for platelet aggregation, IV only, Very
expensive used with MI's Strokes, and PTCA's
Clopidogrel (Plavix) Antiplatelet drug
ADP receptor blocker
Inhibits ADP binding to its receptor's-irreversible and will be with the platelet for their
lifespan (5-7 days)
Used for MI's, CVA's, PAD/PVD, Unstable Angina, PTCA's-first 6 months post ptca's
Bleeding is a problem
EXAM 2 DRUGS!!!!!!!!!!!! - ANSWER-..........
Vasopressin (pitressin) - ANSWER-The antidiuretic action of vasopressin is ascribed
to increasing reabsorption of water by the renal tubules
40u IV
Adverse = cardiac ischemia/angina
DDAVP (desmopressin) - ANSWER-Prevents or controls thirst and frequent urination
caused by diabetes insipidus and certain brain injuries.
Works on posterior pituitary....Treatment for: diabetes insipidus,
bedwetting(nocturia), brain injuries, hemophilia A w/ some factor VIII production
nasally, IV, oral/subling tab
up to 20 hours
Synthroid - ANSWER-Treats hypothyroidism. Also treats an enlarged thyroid gland
(goiter) and thyroid cancer.
Cortef - ANSWER-Naturally occurring glucocorticoids (hydrocortisone and
cortisone), which also have salt-retaining properties, are used as replacement
therapy in adrenocortical deficiency states. Their synthetic analogs are primarily
used for their potent anti-inflammatory effects in disorders of many organ systems.
Glucocorticoids cause profound and varied metabolic effects. In addition, they modify
the body's immune responses to diverse stimuli.
Hydrocortisone - ANSWER-Hydrocortisone belongs to the family of medications
known as corticosteroids. It is used to treat many different conditions. It works by
reducing swelling, inflammation, and irritation or as a replacement when the body
does not make enough cortisol. Hydrocortisone is more commonly used to treat
allergic reactions, some skin conditions, severe asthma, lupus, and arthritis.
ATI LPN Pharmacology Proctored
Exam Review Questions with Correct
Answers
Nitrates - ANSWER-Nitroglycerin/Nitrostat, Nitro-Bid, Nitro-Dur
Nitrates form nitric acid which is a relaxes smooth muscle and dilates venous and
arterial blood vessels
Open veins-blood pools in the legs-not as much blood returning to the heart-reduces
preload
Open arteries-heart does not have to work as hard to pump blood out of the heart-
reduces afterload
Opens the coronary arteries and helps supply blood to the heart tissue
Can be given sublingually, orally, topically, IV, buccal
Can be for acute or long term use
Nitroglycerin dilates any artery and vein-including yours if you touch it while
administering it-WEAR GLOVES
Nitroglycerin IV needs a glass bottle and covered from light-some hospitals still use
special tubing (nitro is absorbed in the tubing)
Short term-nitrostat-sublingually-1 tablet every 5 minutes x 3 for relief of chest pain-
still having chest pain call 911/physician
Long-term nitro-dur will last for up to 14 hours in the body
Side Effects:
Headache-dilates the cerebral arteries-do not give with head trauma or increased
intracranial pressure
Hypotension and reflex tachycardia-do not give with hypotension, monitor blood
pressure and HR when administering
Hypotension-correct hypervolemia prior to giving nitroglycerin
DO NOT GIVE WITH VIAGRA, LEVITRA, OR CIALIS (nitroglycerin and Viagra
increase nitric acid and relaxation of the smooth muscles-can kill a client with
hypotension with a combination of these drugs)
Digoxin - ANSWER-Cardiac Glycoside
Digoxin/Digitek, Lanoxin, Lanoxicaps (Dig)
Increases the contractility of the heart muscle - Inotropic effect-
Increases cardiac output
Also Suppresses the SA node and slows conduction through the AV node
Half-life is 3-4 days
Great Drug-real side effects
,Digoxin SE =
Dysrhythmias
Toxicity 0.5-1.8 normal level
Signs of toxicity-halos around objects, Nausea/Vomiting/Anorexia, blurred vision,
fatigue
Bradycardia-must take an apical pulse for one full minute, must be 60 or above to
give digoxin
Give with caution with pediatric and geriatric patients due to inadequate renal or
hepatic metabolic enzymes
Hyperkalemia can reduce effects of digoxin
Digoxin and Beta Blockers can really lower the pulse
Give with caution with renal failure-digoxin excreted via the kidneys
DIGIBIND IS THE ANTIDOTE FOR DIGOXIN TOXICITY
Digoxin
Decreases automaticity of the SA nose and slows conduction through the AV node
Atrial dysrhythmias
All the side effects and warnings are still important
Heparin - ANSWER-Naturally found in the liver and lining of blood vessels
Prolong coagulation time
IV immediate onset, Sub Q 1 hour
Destroyed by gastric enzymes
Weight based
aPTT (PTT also, but in the hospital we use the aPTT)
Sub Q
Thrombocytopenia occurs in 30% of client
Protamine Sulfate is the antidote, 1 mg for every100 units of heparin, works for
Lovenox also
Coumadin - ANSWER-Warfarin/Coumadin
Warfarin inhibits the action of Vitamin K, and without adequate Vitamin K the
synthesis of clotting factors 2, 7, 9, and 10 is diminished
INR/PT
Warfarin takes 2-3 days to achieve therapeutic effect-99% of warfarin is bound to
plasma proteins and unavailable to produce effects
Vitamin K is the antidote-green leafy veggies Aquamephyton-works within 6 hours
Normal INR therapeutic range is 2-3
Normal INR for everyone who is not taking an anticoagulant is around 1
Category X for pregnancy
Avoid alcohol, diuretics, SSRI's, Antidepressants, Steroids, Antibiotics, Vaccines,
Some Vitamins, Amiodarone-all can potentiate warfarin
Bleeding-
Amiodarone - ANSWER-Amiodarone (Cordarone/Pacerone)
Class III antidysrhythmic
Potassium channel blocker
Ventricular and Atrial Arrhythmias-especially with heart failure
IV onset or PO onset looks to be 2-3 days to 1-3 weeks
Half life can be greater than 100 days
,Check K and MG levels prior to starting therapy
Side Effects: Fibrosis of lungs, destruction of thyroid, Photosensitivity-Smurfs, Liver
destruction, N/V, Hypotension, Blindness, very hard on the stomach-GI Distress
Can increase serum digoxin levels by 70%, Increase warfarin levels, Increase
phenytoion (Dilantin), Stop BB and CCB?
Statins (Lipitor) - ANSWER-HMG-CoA reductace inhibitor-(liver is where the
cholesterol is made, it is where the HMG-CoA work)
LDL/Cholesterol is reduced
Give with food to reduce GI symptoms
Lipitor can be taken at anytime, most of the class of this medication needs to be
taken at bedtime-cholesterol is made by the liver at night
Up to 30 days to achieve full affect
Side Effects:
GI-constipation, bloating, gas, nausea
Liver-monitor enzymes-alt, ast, alk phas, bilirubin, jaundice, enlarged liver-ascites
Rhabdomyolysis-muscle destruction-CK elevation-muscle pain-MD has to be
notified.
Renal failure is very common with Rhabdomyolysis-need to make sure urine output
is 30 ml or greater an hour
No grapefruit juice
The statins are hard on the liver-you need to make sure other drugs the client is on is
not hard on the liver-Amiodarone and Nizoral are two drugs that come immediately
to my mind
furosemide/lasix - ANSWER-...Loop Diuretics-prevents Na/Cl reabsorption, thus Na
leaves the body, water follows Na and K follows the water
Furosemide/Lasix, Bumex/Bumetanide, Torsemide/Demadex
Work on the entire Loop of Henle-large volumes of water, Na, and K are removed
Works in renal failure
Hypovolemic and hypokalemia very common
Nursing interventions
Know your potassium level prior to administration
Assess Lung Sounds, Weight, I/O, Edema, SaO2, RR, Blood Pressure, K Level prior
to administration, assess all of these post administration, especially K Level and
Lung Sounds, Sao2, I/O. If you urine bag is not twice as full 30 minutes post IV Lasix
administration, check your IV site. If your client without a Foley has not called to
urinate within an hour of giving po Lasix, check your client
Warn your client to get up slowly after taking Lasix, watch for orthostatic hypotension
Lasix does have sulfa as a base component
May not be used with anuria, hepatic coma
Use with extreme caution with electrolyte depletion
Low K with Digoxin can equal lethal Dysrhythmias, know your potassium level-has a
digoxin level been ran
plavix - ANSWER-Anti-platelet drugs
ASA
, Persantine
ADP Receptor Blockers (Plavix, Ticlid, Effient)
Glycoprotein 2b./3a receptor antagonist (Repro, Integrillin, Aggrastat
ADP receptor blockers
Irreversibly alter the plasma membrane of platelets, alters the ability of platelets to
aggregate
Ticlid and Plavix are given orally
Ticlid can cause Agranulocytosis-only used when someone is allergic to Plavix
Glycoprotein is an enzyme necessary for platelet aggregation, IV only, Very
expensive used with MI's Strokes, and PTCA's
Clopidogrel (Plavix) Antiplatelet drug
ADP receptor blocker
Inhibits ADP binding to its receptor's-irreversible and will be with the platelet for their
lifespan (5-7 days)
Used for MI's, CVA's, PAD/PVD, Unstable Angina, PTCA's-first 6 months post ptca's
Bleeding is a problem
EXAM 2 DRUGS!!!!!!!!!!!! - ANSWER-..........
Vasopressin (pitressin) - ANSWER-The antidiuretic action of vasopressin is ascribed
to increasing reabsorption of water by the renal tubules
40u IV
Adverse = cardiac ischemia/angina
DDAVP (desmopressin) - ANSWER-Prevents or controls thirst and frequent urination
caused by diabetes insipidus and certain brain injuries.
Works on posterior pituitary....Treatment for: diabetes insipidus,
bedwetting(nocturia), brain injuries, hemophilia A w/ some factor VIII production
nasally, IV, oral/subling tab
up to 20 hours
Synthroid - ANSWER-Treats hypothyroidism. Also treats an enlarged thyroid gland
(goiter) and thyroid cancer.
Cortef - ANSWER-Naturally occurring glucocorticoids (hydrocortisone and
cortisone), which also have salt-retaining properties, are used as replacement
therapy in adrenocortical deficiency states. Their synthetic analogs are primarily
used for their potent anti-inflammatory effects in disorders of many organ systems.
Glucocorticoids cause profound and varied metabolic effects. In addition, they modify
the body's immune responses to diverse stimuli.
Hydrocortisone - ANSWER-Hydrocortisone belongs to the family of medications
known as corticosteroids. It is used to treat many different conditions. It works by
reducing swelling, inflammation, and irritation or as a replacement when the body
does not make enough cortisol. Hydrocortisone is more commonly used to treat
allergic reactions, some skin conditions, severe asthma, lupus, and arthritis.
