PHARMACOLOGY NCLEX QUESTIONS
AND ANSWERS 2022 LATEST
ACE Inhibitor Drugs - ANS-Captopril (Capoten), Enalapril (Vasotec), Enalaprilat
(Vasotec IV),
... [Show More] Fosinopril (Monopril), Lisinopril (Prinivil)
ACE Inhibitors/ARBs Use - ANS-Uses: Hypertension, HF, MI, diabetic neuropathy.
Precautions/interactions: caution with diuretic therapy, monitor potassium levels.
Side effects of ACE inhibitor/ARBs - ANS-Persistent non-productive cough with ACE.
Angioedema (administer epinephrine), hypotension, should not be used in second
and third trimester of pregnancy
Captopril time to take - ANS-1 hour before meals
Calcium channel blocker drugs - ANS-Nifedipine (Adalat, Procardia), verapamil
(Calan), Diltiazem (Cardizem), Amlodipine (Norvasc)
Ca++ channel blocker Use - ANS-Angina, hypertension. Verapamil and diltiazem
used for a fib, atrial flutter, or SVT.
Use cautiously with digoxin and beta blockers, contraindicated for those with HF,
heart block, bradycardia. NO GRAPEFRUIT JUICE. IV injection over 2-3 minutes.
Slowly taper if discontinuing
Side effects of calcium channel blockers - ANS-Constipation, reflex tachycardia,
peripheral edema, toxicity
Alpha Adrenergic Blockers (Sympatholytics) - ANS-Selectively inhibit alpha,
adrenergic receptors, resulting in peripheral arterial and venous dilation that lowers
BP. Side effects: dizziness, fainting. Take at bed time to minimize effects of
hypotension.
Alpha Adrenergic Blockers Drugs - ANS-Prazosin (Minipress), Doxazosin mesylate
(Cardura)
Centrally Acting Alpha2 Agonists - ANS-Stimulate alpha-adrenergic receptors in the
brain to reduce peripheral vascular resistance, heart rate, and systolic and diastolic
blood pressure. Used for HTN, hypertensive crisis, severe cancer pain.
Centrally Acting Alpha2 Agonist Drugs - ANS-Clonidine (Catapres), Guanfacine HCl
(Tenex), Methyldopa (Aldomet)
Centrally Acting Alpha2 Agonist Drug Precautions - ANS-Contraindicated with
anticoagulant therapy, hepatic failure. Do not administer to clients taking MAOIs. Do
not administer methyldopa through IV line with barbiturates or sulfonamides. Use
cautiously in CVA, MI, DM, depression, or chronic renal failure. Do not use during
lactation
Centrally Acting Alpha2 Agonist Drug Side Effects - ANS-Dry mouth, drowsiness,
sedation, rebound HTN, black or sore tongue, leukopenia
Beta Adrenergic Blockers (Sympatholytics) - ANS-Inhibit stimulation of receptor
sites, resulting in decreased cardiac excitability, cardiac output, myocardial oxygen
demand, lower BP by decreasing release of renin by kidney. Hypertension, angina,
tachydysrhythmias, HF, MI.
Beta Adrenergic Blocker Medications (Cardioselective Beta1 meds) - ANSMetoprolol (Lopressor), atenolol (Tenormin), Metoprolol succinate (Toprol XL)
Beta Adrenergic Blocker Medications (Nonselective beta1 and 2 meds) - ANSPropranolol (Inderal), Nadolol (Corgard), Labetalol (Normodyne)
Beta Adrenergic Blocker Precautions - ANS-Contraindicated in clients who have AV
block and sinus bradycardia, do not administer nonselective beta blockers to clients
who have asthma, bronchospasm, HF, propranolol may mask effects of
hypoglycemia in DM, do not administer labetalol in same IV line with furosemide. Do
not administer if systolic less than 100 and pulse less than 60.
Beta adrenergic blocker side effects - ANS-Bradycardia, nasal stuffiness, AV block,
rebound myocardium excitation if stopped abruptly, bronchospasm
Vasodilators - ANS-Direct vasodilation of arteries and veins resulting in rapid
reduction of BP (decreased preload and afterload). Used for hypertensive
emergencies. Precautions: clients who have hepatic or renal disease, older adults,
electrolyte imbalances
Vasodilator medications - ANS-Nitroglycerin (Nitrostat IV): Enalaprilat (Vasotec IV),
Nitroprusside (Nipride), Hydralazine (Apresoline).
Vasodilator Side Effects - ANS-Dizziness, headache, profound hypotension, cyanide
toxicity, thiocyanate poisoning
Nitroprusside Interventions - ANS-Should not be mixed with any medication, apply
protective cover to container, discard unused fluid after 24 hour, provide continuous
ECG and blood pressure monitoring
Cardiac Glycosides - ANS-Used in the treatment of clients who have cardiac failure
or ineffective pumping mechanism of the heart muscle. Increase the force and
velocity of myocardial contractions to improve stroke volume and CO. Slow the
conduction rate, allowing for increased ventricular filling. Used for HF, a fib
Cardiac Glycoside Medication - ANS-Digoxin (Lanoxin, Lanoxicaps, Digitek)
Digoxin Precautions/interactions - ANS-Thiazide or loop diuretics increase risk of
hypokalemia and precipitate digoxin toxicity. ACE and ARBs increase risk of
hyperkalemia. Verapamil (Calan) increases risk of toxicity
Digoxin Toxicity - ANS-GI effects (anorexia, n/v, abdominal pain), CNS effects
(fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around
objects)
Digoxin interventions - ANS-Assess apical pulse for 1 min prior to administration.
Notify HCP if HR less than 60 (adult), less than 70 (child), less than 90 (infant),
monitor for signs of digoxin toxicity, hypokalemia, and hypomagnesemia, notify
provider of any sudden increase in pulse rate that previously normal or low, maintain
therapeutic level
Management of Digoxin Toxicity - ANS-Discontinue digoxin and potassium-wasting
medications, treat dysrhythmias with phenytoin (Dilantin) or lidocaine, treat
bradycardia with atropine, for excess overdose, administer Digibind to prevent
absorption
Antianginal Medications - ANS-Organic nitrates, beta adrenergic-blocking agents,
and calcium channel blockers to treat pain related to imbalances between
myocardial oxygen supply and demand.
Organic Nitrates - ANS-Relax peripheral vascular smooth muscles, resulting in
dilation of arteries and veins, thus reducing venous blood return (reduced preload) to
the heart, which leads to decreased oxygen demands on the heart. Increase
myocardial oxygen supply by dilating large coronary arteries and redistributing blood
flow.
Organic Nitrates Meds - ANS-Nitrostat (sublingual), nitrolingual (translingual spray),
nitro-bid (topical ointment), nitro-dur (transderm patch)
Organic Nitrate Precautions/interactions - ANS-Contraindicated in clients with head
injury, hypotensive risk with antihypertensive meds, erectile dysfunction meds may
increase life-threatening hypotension
Organic Nitrates side effects - ANS-Headache, orthostatic hypotension, reflex
tachycardia, tolerance
Organic Nitrate Interventions - ANS-Sublingual: give, wait 5 mins, give again, if not
relief call 911, may take up to three doses. May be used prophylactically before
exercise.
Nitrobid (topical ointment) administration - ANS-Wear gloves, do not massage or rub
area, apply to area without hair, cover area where patch is placed with clear plastic
wrap and tape in place, gradually reduce over 4-6 weeks.
Nitro-Dur (transderm patch) - ANS-Skin irritation may alter medication absorption,
optimal locations for patch are upper chest or side, pelvis, inner/upper arm, rotate
skin sites daily
Antidysrhythmic Agents - ANS-Complex agents with multiple mechanisms of action.
They are classified according to their effects on the electrical conduction system of
the heart (class I, II, III, IV)
Antidysrhythmic Medications - ANS-Adenosine, amiodarone, atropine
Adenosine (Adenocard) - ANS-Antidysrhythmic agent. Slows conduction time
through the AV node, interrupts AV node pathways to restore NSR. Converts
supraventricular tachycardia (SVT) to sinus rhythm. Rapid IV (1-2 seconds) push,
flush immediately with normal saline.
Amiodarone (Cordarone) - ANS-Antidysrhythmic agent. Prolongs repolarization,
relaxes smooth muscles, decreases vascular resistance. For ventricular fibrillation
and unstable ventricular tachycardia. Incompatible with heparin, may be given in PO
maintenance dose, monitor for respiratory complications.
Atropine - ANS-Antidysrhythmic agent. Increases firing of the sinoatrial node (SA)
and conduction through the atrioventricular node (AV) of the heart, opposes the
action of the vagus nerve by blocking acetylcholine receptor sites. Used for
bradycardia and known exposure to chemical nerve agent (AtroPEN).
Antidysrhythmic agents precautions/interactions - ANS-Toxicity is a major concern
due to additive effects, caution is needed when used with an AV block, caution is
needed when using anticholinergic medications.
Adenosine (Adenocard) side effects - ANS-Flushing, nausea, bronchospasm,
prolonged asystole
Amiodarone side effects - ANS-Bradycardia, cardiogenic shock, pulmonary disorders
Atropine side efffects - ANS-When used for life-threatening emergency, has no
contraindications. Monitor for dry mouth, blurred vision, photophobia, urinary
retention, and constipation.
Antilipemic Medications - ANS-Aid in lowering low-density lipoprotein (LDL) levels
and increase high-density lipoprotein (HDL) levels. Therapy includes diet, exercise,
and weight control. Uses: primary hypercholesterolemia, prevention of coronary
events, and protection against MI and stroke in clients with diabetes. Should not be
used with pregnancy and used with caution in renal dysfunction.
Antilipemic Medication Side Effects - ANS-Muscle aches, hepatotoxicity, myopathy,
rhabdomyolysis, peripheral neuropathy
Antilipemic Nursing Interventions - ANS-Take medication in the eventing (when
cholesterol synthesis increases), monitor liver and renal function laboratory profiles,
low-fat/high-fiber diet, note dietary precautions with specific classes
Antilipemic Drugs - ANS-Simvastatin (Zocor), Lovastatin (Mevacor), Pravastatin
sodium (Pravachol), Rosuvastatin (Crestor), Fluvastatin (Lescol, Lescol XL)
Antilipemic Medication Precaustions and interactions - ANS-- Prolonged bleeding in
certain clientes also taking warfarin (coumadin).
- Has multiple drug interactions: digoxin, warfarin, thyroid hormones, thiazide
diuretics, phenobarbital, NSAIDs, tetracycline, beta-blocking agents, gemfibrozil,
glipizide, glyburide, oral contraceptives, and phenytoin.
- DO NOT ADMINISTER WITH GRAPEFRUIT JUICE.
Cholesterol Absorption Inhibitor - ANS-Inhibits the absorption of cholesterol secreted
in the bile and from food. Often used in combination with other antilipemic
medications. Med: Ezetimibe (Zetia). Take 1 hour before or 4 hours after other
antilipemics. Risk of liver damage increased when combined with statins... [Show Less]