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NCLEX REVIEW Pharmacology

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Title: NCLEX REVIEW Pharmacology


1
NCLEX REVIEWPharmacology
  • Rae Brooks RN MSN CCRN

2
Objectives
  • Student will be able to easily recognize prefixes
    and suffixes of medications
  • Student will identify these medications more
    easily
  • Student will be able to categorize side effects
    of medications

3
Antibiotics and Antivirals
4
Common Antibiotics and Antivirals
  • Cephalosporins
  • Tetracycline
  • Metronidazole (Flagyl)
  • Isoniazid (INH)
  • Aminoglycosides
  • Antiretrovirals
  • Quinolones

5
Ways to remember.
  • -micin Aminoglycosides
  • -mycin Aminoglycosides
  • -cillin Aminoglycosides
  • -oxacin Fluroquinolones
  • -vir Antivirals
  • -cef Cephalosporins

6
Important facts to remember
7
Tetracycline
  • Causes photosensitivity
  • Stains teeth (usually is not prescribed to
    children because of this)

8
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9
Aminoglycosides -cins
  • Nephrotoxicity
  • Ototoxicity
  • Drugs Amikacin, Neomycin, Tobramycin, Gentamicin

10
Cuties (QT) say no to OBs
  • Quinolones and Tetracyclines
  • Contranindicated during pregnancy. These drugs
    can cause birth defects or death.

11
Other common side effects of Antibiotics and
Antivirals
  • GI upset (nausea, vomiting, flatulence, anorexia,
    diarrhea)
  • Rash
  • Headache
  • Photosensitivity
  • Metallic bitter taste

12
Antipsychotics, neuroleptics, major tranquilizers
13
Antipsychotics, neuroleptics, major tranquilizers
  • Phenothiazine- compazine, thorazine, thioridazine
    (mellaril)
  • Butyrophenones- haldol, droperidol
  • Atypical- resperidone (Risperidal), olanzapine
    (zyprexia), seroquel, clozapine

14
Ways to remember.
  • -ine tricyclics and phenothiazines
  • Ine Crazy

15
Important facts to remember
16
Common side effects of antipsychotics
  • EPS (extrapyramidal symptoms)- extra movement of
    the skeletal muscles
  • Parkinsonism- shuffling gait, pill rolling, mask
    like face, tremors
  • Aystonia- muscle spasticity
  • Akathisia- restlessness, pacing, agitation,
    tapping
  • Tardive dyskinesia- exessive blinking, extra
    tongue movement, involuntary sucking, chewing,
    licking, pursing movements of tongue and mouth,
    rocking

17
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18
Antidepressants
19
-ine sad
  • I feel better on my antidepressants.

20
Antidepressants
  • Tricyclic antidepressants- TCA
  • Monoamine oxidase inhibitor MAOIs
  • Selective serotonin reuptake inhibitors- SSRIs

21
TCAs
  • imipramine, desiprmine, nortriptyline,
    clomipramine, amoxapine, wellbutrin, trazodone,
    elavil, amytriptyline,
  • Can cause- hypotension, sedation, tachycardia,
    dysrhythmias

22
MAOIs
  • Nardil, parnate, niamid
  • Remember. Beware of tyramine foods can cause
    hypertensive crisis.
  • Remember the foods high in tyramine???

23
SSRIs
  • Fluoxitine (prozac), paroxetine (paxil),
    setraline (zoloft), celexa

24
Antianxiety Agents
  • The pams -lams

25
Antianxiety agents
  • Benzodiazepines- lorazepam (ativan), librium,
    oxazepam, diazepam (valium), alprazolam (xanax),
    clonazepam (klonopin)

26
Analgesics, anesthetics, antiinflammatory
27
Opiate analgesics -done hurt me!!!
  • Hydromorphone, oxycodone, methadone, fentanyl,
    codeine

28
Anesthetic -aine
  • Lidocaine, benzocaine, bupivicaine, xylocaine,
    marcaine

29
Analgesics antiinflammatory
  • Acetaminophin, aspirin, ibuprofen, celebrex,
    naproxen, nubaine, toradol (ketorolac), indocin
  • -sones steroids beclomethsone, prednisone,
    cortisone, hydrocortisone, dexamethasone,
    methylprednisolone

30
Side effects of Analgesics, anesthetics,
antiinflammatory
  • Infections
  • Water retention
  • Weight gain (steroids)
  • Cushings syndrome (steroids)
  • Hyperglycemia (steroids)
  • GIB
  • Liver dysfunction (acetaminophen, ibuprophen)

31
Antihyperlipidemics
32
-statins
  • Atorvastatin, simvastatin
  • Side effects- liver dysfunction, monitor liver
    function regularly, GI distress

33
Antiulcer
34
-dines and -zoles
  • Famotadine, cimetidine, ranitidine,
  • Lansoprazole, omeprazole
  • Side effects- constipation and GI distress

35
Cardiac drugs
36
Antihypertensives
  • Calcium Channel blockers
  • ACE inhibitors
  • Beta blockers
  • Diuretics

37
ACE inhibitors
  • Ends in pril captopril, enalapril, benazepril

38
Diuretic and Beta blockers
  • -zides Hydrichlorothiazide
  • -olol metropolol, carvedilol, labetalol,
    atenolol, propranolol

39
Calcium Channel Blockers
  • VERY, NICE, DRUGS
  • V- verapamil
  • N- nifedipine
  • D- diltiazem

40
Side effects of antihypertensives
  • Dysrhythmias, dizziness, light headedness,
    headache, fatigue, hypotension, renal impairment
  • Bronchospasm, impotence, bradycardia

41
Digitalis
  • Cardiac Glycoside digoxin
  • Antidote Digibine
  • Must memorize the digoxin serum therapeutic
    levels!!! Digoxin 0.5 2.0 ng/ml
  • Get a baseline apical pulse for a full minute

42
Drugs for bradycardia and low BP
  • IDEA
  • I isoproterenol
  • D dopamine
  • E epinephrine
  • A atropine

43
Nitroglycerin
  • Sublingual, translingual, patch, ointment
  • Side effect- severe headache, dizziness, syncope

44
Emergency drugs to LEAN on
  • LEAN
  • L lidocaine
  • E epinephrine
  • A atropine
  • N Nitroglycerine, Narcan

45
Therapeutic Drug Levels
  • Digoxin
  • Lithium
  • Dilantin
  • Theophylline

46
MEMORIZE!!!
  • Digoxin 0.5 2.0 ng/ml
  • Lithium 0.6 1.5 mEq/L
  • Dilantin 10 20 mcg/dl
  • Theophylline 10 20 mcg/ml

47
Ways to remember
  • Short-cuts

48
Ways to remember!!!
  • -mide Diuretics
  • -nium Neuromuscular Blocking Agents
  • -olol Beta Blockers
  • -oxacin Antibiotics
  • -pam Anti-Anxiety Agents
  • -pril ACE Inhibitors
  • -sone Steriods
  • -statin Antihyperlipidemics
  • -vir Antivirals
  • -zide Diuretics

49
Ways to remember
  • -caine Local Anesthetics
  • -cillin Antibiotics
  • -dine H2 Blockers (Anti-Ulcers)
  • -done Opioid Analgesics
  • -ide Oral Hypoglycemics
  • -lam Anti-Anxiety Agents
  • -micin Antibiotics
  • -mycin Antibiotics

50
Insulin administration
  • Category Agent Onset Peak Duration
  • Humalog Rapid 30-60 minutes 3-4 hours
  • Regular 30-60 minutes 2-4 hours 5-7 hours Rapid
    Acting
  • Regular IV 10-30 mintes 15-30 minutes 30-60
    minutes
  • Fast Acting NPH/Regular (70/30) 30 minutes 4-8
    hours 24 hours
  • Lente 1-3 hours 8-12 Intermediate Acting hours
    18-28 hours
  • NPH 1-4 hours 6-12 hours 18-28 hours
  • Long Acting Ultra-Lente 4-6 hours 18-24 hours 36
    hours

51
INSULINSLispro, regular, lente, NPH, lantus
The longer acting insulins are closest to the
needle, the fastest acting insulins are Closest
to the plunger.
52
Ready to test your pro-skills???
53
A nurse is monitoring a client with frequent PVCs
(premature ventricular contractions) of more than
6/min. The nurse prepares to bolus the client
with lidocaine as ordered. Which of the
following is important for the nurse to monitor
after administering the medication?
  • A. Skin temperature and neurological status
  • B. Vital signs, ECG, and neurological status
  • C. Kidney and liver function and neurological
    status
  • D. Visual changes and kidney and liver function

54
A client with acute pulmonary edema is prescribed
a medication to reduce preload and afterload.
Which of the following drugs will the nurse
anticipate administering?
  • A. Digoxin
  • B. Nitroprusside
  • C. Morphine sulfate
  • D. Furosemide

55
A client with myesthinia gravis arrives to the
emergency room and crisis is suspected. The
nurse prepares to administer which of the
following medications if the client is in
cholinergic crisis?
  • A. Atropine sulfate
  • B. Morphine sulfate
  • C. Pyridostigmine bromid (Mestinon)
  • D. Isoproterenol (Isuprel)

56
A client is seen in the clinic with ascites and
jaundice. The nurse assess the client for
chronic use of which of the following medications?
  • A. Acetaminophen
  • B. Aspirin
  • C. Advil
  • D. Ranitidine (Zantac)

57
A nurse notes that the bag of TPN (total
parenteral nutrition) has become empty. The
nurse calls the pharmacy, but the next bag will
not be delivered for another 30 minutes. The
nurse hangs which of the following solutions
until the TPN arrives?
  • A. 5 dextrose
  • B. 10 dextrose
  • C. 50 dextrose
  • D. 5 dextrose in 0.45 saline

58
A nurse caring for a client who is receiving
Lithium. The measured level is 1.8 meq/L. The
nurse analyzes this result as
  • A. Within normal limits
  • B. Higher than normal limits
  • C. Lower than normal limits
  • D. Insignificant

59
A client has a pH of 7.5 with a bicarbonate of 29
meq/L. The nurse prepares to administer which of
the following medications?
  • A. Sodium bicarbonate
  • B. Furosemide (lasix)
  • C. Acetazolamide (Diamox)
  • D. Spironolactone (Aldactone)

60
A home health nurse is visiting a client that was
discharged home on coumadin (warfarin sodium).
On assessment which of the following questions is
the highest priority?
  • A. Have you been eating green leafy vegetables?
  • B. Do you have constipation?
  • C. Do you have nausea or vomiting?
  • D. Do you have bleeding gums or bruises?

61
Mannitol (osmitrol) is administered to the client
with a closed head injury with loss of
consciousness. The nurse would evaluate the
effectiveness of this medication by which of the
following outcomes?
  • A. Diuresis of 500ml in 2 hours and BUN level of
    15
  • B. Improved level of consciousness
  • C. Weight loss of 1 kg and serum creatinine of
    0.8
  • D. Serum creatinine of 2.0 and normal
    intracranial pressure

62
A client with acute renal failure has been
treated with kayexelate by mouth. The nurse
would evaluate which of the following lab results
to check the effectiveness of this medication?
  • A. Potassium 4.9
  • B. Sodium 143
  • C. Phosphorus 3.9
  • D. Calcium 10

63
A client with multiple sclerosis is treated with
diazepam (valium) for painful muscle spasms. The
nurse assesses the client for side effects of the
medication and monitors the client for
  • A. Urinary frequency
  • B. Headache
  • C. Increased salivation
  • D. Incoordination

64
A client with a seizures is taking phenytoin
(dilantin). The dilantin blood level drawn is
35. Which of the following effects would be
expected as a result of this laboratory result?
  • A. No results since this lab value is normal
  • B. Slurred speech
  • C. Tachycardia
  • D. Nystagmus

65
A nurse is caring for a client with Parkinsons
disease. The client is taking benztropine
mesylate (cogentin) po daily. The nurse needs to
monitor the client for which of the following
side effects
  • A. Hemoglobin levels
  • B. PTT partial prothrombin time
  • C. Intake and output
  • D. Prothrombin time

66
A nurse is caring for a client who is newly
diagnosed with a SCI spinal cord injury. The
nurse would anticipate to administer which of the
following medications?
  • A. Propranolol (inderal)
  • B. Dexamethasone (Decadron)
  • C. Furosemide (lasix)
  • D. Morphine

67
A client with diabetes recieves regular insulin
at 0730. The nurse would be most alert to the
signs of hypoglycemia at what time during the day?
  • A. 0930-1130
  • B. 1200-1400
  • C. 1300-1600
  • D. 1530-1730

68
A nurse is about to administer topic
nitroglycerine as ordered to a client with an
inferior wall MI. The nurse also plans to
administer the prescribed acetaminophen ordered
because
  • A. Headache is a common side effect of nitrates
  • B. It potentiates the effects
  • C. It does not interfere with aspirin
  • D. Fever usually accompanies myocardial
    infarction
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