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NURS 300 Pharmacology Test 1/Midterm
prep Exam 2025 Winter-Spring Semester
Graded A+ With Answers (Verified BYU
Exam)
What does Hydrochlorthiazide do to electrolyte channels? Blocks calcium pump in the distal convoluted tubule What does Hydrocholrothiazide do to the excretion of electrolytes? Increases excretion of potassium, sodium, chloride, and water. However they keep calcium, so they are good for the bones. What is another name for furosemide? Lasix (loop diuretics) How many pounds of weight can someone lose on furosemide? 20 pounds True/False: Furosemide is still effective with renal failure True True/False: Hydochlorthiazide is still effective with renal failure False
Where does anti-diuretic act? On the distal tubules What electrolyte is grapefruit juice high in? Potassium Why could grapefuit juice be contraindicated? It is full of Potassium, so drugs containing potassium could become toxic How soon do you begin to see delirium tremens after the last drink? Within 72 hours Name a few withdrawl symptoms resulting from dependency? Pupil dilation, diaphoresis, restlessness, agitation, goosebumps, tremor, violent yawning, tachycardia, increased BP, N&V, muscle cramps and spasms, involuntary kicking, weight loss, psycological craving Action of diuretics (5) To increase urine flow prevent reabsorption of sodium in the nephron excretion of excess fluid kidneys HTN/Heart failure/Pulmonary edema Liver failure/cirrhosis/Kidney failure What are the side effects of Diuretics? Fluid and electrolyte disturbances
Side effects of diuretic agents Fluid and electrolyte disturbances Dehydration Orthostatic Hypotension Potassium and sodium imbalances What type of drug is Hyrdochlorthiazide thiazide diuretic Is Aldactone very effective? No, because it is potassium sparing. Be very mindful of hyperkalemia True/False: Salt substitutes are rich in potassium TRUE! Do not give salt substitutes if a person is hyperkalemic Which drug should you be specifically worried if given with ACE inhibitors? Why? Aldactone, because BP will be too low if you give a diuretic and an ACE inhibitor at the same time. ACE inhibitors also contain potassium, so you could have hyperkalemia. What adverse effect does Tylenol have? Liver failure What adverse effect does Ibuprofen have? Renal failure
What adverse effect can NSAIDS have on bleeding Possible excess bleeding (especially with aspirin) What adverse effect can NSAIDS in general have on your organs? Kidney failure and renal insufficiency What is the max amount you can give of Potassium? 10 mEq/hr. DO NOT PUSH True/False: Take potassium on an empty stomach with a full glass of water False: Take with food True/False: Benzodiazapines are the main potassium affecting drugs FALSE! Diuretics affect potassium levels the most What are carbonic anhydrase inhibitors used to treat? Glaucoma to reduce IOP (intraocular pressure). It is a form of diuretic What is the carbonic anhydrase inhibitor prototype drug? Acetazolamide (Diamox) What are the 5 main things you monitor when someone is on diuretics? Turgor, HR, BP, LOC, electrolyte levels What is the mechanism of local anesthetics
a. Local anesthesia b. General anesthesia c. Nerve block drugs d. NSAIDS b. General anesthesia What two groups are at biggest risk for anesthesia. Why? The elderly: do not metabolize medication as well, so could be toxic Obese: anesthesia goes into fat cells, so they stay in the body longer. Again, toxicity What must a patient do before they can be given any anesthesia? sign a consent form What MUST be on standby when anesthesia is given? Resuscitative devices What are the most important things to do while assessing a patient in post op RESPIRATORY SYSTEM pain management VS LOC GI/GU musculoskeletal system What is balanced anesthesia? using multiple medications to get an an analgesic effect, muscle relaxation, unconsciousness, amnesia
What kind of drug is succinylcholine? neuromuscular junction blocker What is the action of succinylcholine? It blocks Sodium channels to prevent contraction. It acts on nicotinic and muscarinic receptors In what two cases is succinylcholine contraindicated? glaucoma (could increase intraocular pressure) severe burns (may cause hyperkalemia) Why is succinylcholine not commonly used? It can contribute to malignant hyperthermia What drug reverses the affect of malignant hyperthermia? Dantrolene What are the common early signs of Malignant Hyperthermia? (7) Increased end-tidal CO Masseter muscle rigidity Generalized muscle rigidity Metabolic acidosis Unexplained tachycardia and dysrhythmias Flushed skin hypoxemia
What are the two side effects for spinal anesthesia? spinal headache urinary retention Describe the mechanism for neuromuscluar junction blockers that are NONDEPOLARIZING Ach antagonist to prevent muscle contraction (most drugs end in "ium") Describe the neuromuscular juntion blockers that are DEPOLARIZING and the side effects. Ach agonists: they prevent repolarization by causing muscle stimulation. The side effects are muscle and respiratory paralysis (intubation needed) What are the four places in the body morphine is readily absorbed into? The GI tract, the nasal mucosa, the lung surfaces, and the peripheral tissues True/False: Morphine should be given synergisically with opioid drugs False: They should be given synergistically with non opioid drugs When should you be more cautious about using morphine? on the elderly, on pregnant women, on infants, in a head injury, when someone has an already depressed respiratory rate, on people with IBS True/False: Opioids cause vasodilation True
How long do opioids generally last?? (their duration) 4 - 6 hours What are important labs to get when administering opioids? Hepatic function and renal function (Actually study the different tests you would do) What are some possible severe opioid side effects? (4) Decrease or change in LOC, seizures, CNS effects, and respiratory distress What are 5 ways to reduce nausea and vomitting administer antiemetics, lie flat and still after med administration, raise the head of the bed, ambulate if tolerated, take meds with food True/False: It is not necessary to monitor I&O with opioid administration False, measure I&O and specifically look for constipation What is the function of NARCAN? To reverse opioid overdose What is the onset and duration of NARCAN? The onset is immediate and the duration lasts anywhere from 45-60 minutes What is the dosing of NARCAN? 0.1-0.2 mg IV per minute for 3 minutes
Angina possible ischemia What is the mechanism of Triptan? Bind to serotonin receptors to cause vasoconstriction What are some medications you cannot give with Triptans? Any vasoconstrictors, any medication that increases serotonin or epinephrine True/False: Triptans are used only in acute settings True How long must you wait between giving ergot alkaloids and serotonin? 24 hours What can be an adverse effect of migraine medication? Rebound headaches How many iburofens does it take to cause renal insufficiency in the elderly? One What is extrapyramidal associated with? Motor activity What is another name for adrengeric agonists? Sympathomatics
What are the three indirect actions of adrengeric agonists/sympathomatics? Block NE reuptake Promote release of NE inhibit NE activation In what instances/conditions would you use sympathomatics? In shock or hypotension Possibly in asthma or bronchospasms Which drug classes fall under the category "Catecholamines" in adrenergic agonists? Epinephrine, NE, isoproterenol, dobutamine, dopamine Which drug classes fall under the category "non catecholamines" in adrenergic agonists? ephedrine, phenylephrine, terbutaline Which has a longer half life, catecholamines, or non-catecholamines? non-catecholamines Which one can be given orally? Catecholamines, or non-catecholamines? Non-catecholamines Which one cannot pass the blood-brain-barrier? Catecholamines
UTI
Hyperthyroidism What is a good way to remember cholingergics? Wet What is a good way to remember anticholingerics? Dry Why are anticholingerics/parasympathomatics contraindicated in the elderly? The elderly already have decreased levels of Ach, and they will be decreased even more What is the prototype drug for anticholingerics? Atropine What is the way to remember what happens to someone when they have an atropine overdose? Hot as a hare, mad as a hatter, red as a beet, dry as a bone Why do Ach levels decrease with anticholingerics? The medication competes with Ach binding sites in the heart, eyes, exocrine glands, smooth muscles, and the CNS system What are the most common uses for anticholingers? They are used in preanesthesia to increase HR and dry secretions They are used in eye disorders: mydriasis, and ciliary muscle paralysis
Used in muscarinic agonist poisoning In what conditions are anticholinergics contraindicated? glaucoma, stenosing peptic ulcer, intestinal atropy, Paralytic ileus, GI obstruction, severe ulcerative colitis, benign prostatic hyperplasia (BPH), cardiac arrhythmia, tachycardia, Myasthenia gravis What are the three ways medications modulate the nervous system? Obstruct or delay transmitter release Inhibit storage Change the presynaptic synthesis What is the mechanism of bethanechol (muscarinic agonist prototype drug)? it binds to muscarinic receptors What is the action of bethanechol? To fix urinary retention (except in urinary obstruction) What are the RARE adverse effects of bethanechol? Hypotension, bradycardia, dysrhythmias excessive salavation increased gastric acid abdominal cramps exacerbation of asthma What is the action of mast cell stabilizers? prevent the release of inflammatory and bronchoconstrictive substances
What are the important things to monitor after Afrin administration? breath sounds, VS, thyroid function, visual changes, neurological status, renal status, serum glucose levels of DM, GI upset, anticholinergic effects What are the adverse effects of Afrin (3 specific)? Rebound congestion Necrosis if long term Can move centerally What is the other name for benadryl? Diphenhydramine What is the prototype for antihistamines? Benadryl True/False: Benadryl relieves all allergy systems except nasal congestion True: it does not relieve nasal congestion What is benadryl specifically used for? Allergic rhinitis What are the adverse effects of Benadryl? sedation, same as anticholingerics What can a benadryl overdose cause? CNS excitation and convulsions
True/False: INTRAnasal decongestants are available OTC True! How long does it take intranasal decongestants to take affect? Within minutes True/False: One of the biggest issues with intranasal decongestants is that it sometimes gets absorbed into circulation and causes a systemic infection FALSE! Almost NO intranasal decongestants get absorbed into circulation What is the worst side effect of intranasal decongestants? Rebound congestion after the decongestant wears off True/False: Do not use intranasal decongestants for more than 7 days False! Do not use it any longer than 5 days (three preferably) Why would you ever use oral decongestants over nasal decongestants, even though they have a longer onset and do not work as effectively? There is not a risk of rebound congestion What is the biggest adverse affect of oral decongestants? HTN and CNS stimulation that can lead to insomnia and anxiety What is the purpose of steroid therapy? It is to decrease inflammation and to PREVENT rhinitis
