This Bundle consists of two(2) sets of Study Guide for NURS 6521 Advanced Pharmacology Midterm & Final Exam – Walden University
NURS6521 Advanced Pharmacology
Midterm Exam Study Guide
Anti-diarrheals
Stops further occurrence of diarrhea. Notable medicines are Loperamide “Imodium”,
Diphenoxylate Hcl with Atropine “Lomotil”, Bismuth subsalicylate “Pepto bismul”
Pepto s/e: black stools and tongue
Laxatives
Used to ease or stimulate defecation
Soften the stool
Increase stool volume
Hasten fecal passage through the intestine
Facilitate evacuation from the rectum
*Misuse comes from misconceptions of what constitutes normal bowel function
Fiber Laxatives
Absorbs water, softening feces and increasing their mass. Can be digested by colonic
bacteria, whose subsequent growth increases fecal mass. ex. Bran, veggies and
fruits.
Meds: methylcellulose, psyllium, polycarbophil
Surfactant Laxatives
Meds: Docusate sodium (Colace)
Docusate calcium (Surfak)
temporary treatment of constipation
- avoid if narrowing of intestines
Give with a full glass of water or juice
Stimulant Laxatives
Bisacodyl: (tablets: give at night to have BM in am , no crushing or chewing, no
milk or antacids; Suppositories: BM within 15-60 min, may cause proctitis);
Senna: BM 6-12 hours after. May cause pink or brown urine.
castor oil: acts on small intestine 2-6-hour BM. Limit to only when prep for
radiology procedures. Chill and mix in juice. - easily abused,
Give with a full glass of water.
Osmotic Laxatives
Salts draw water into the intestine causing fecal mass to soften and swell
stimulating peristalsis. Low dose 6-12 hours, high dose 2-6 hours.
Magnesium hydroxide,
Magnesium citrate,
Polyethylene glycol,
Lactulose (can be used to lower blood ammonia in liver disease) - Increase fluid intake. Not good for kidney disease. Sodium phosphate exacerbates
cardiac disease.
Miscellaneous Laxatives
Lubiprostone, mineral oil, glycerin suppository, polyethylene glycol- electrolyte
solution, Sodium picosulfate / magnesium oxide/anhydrous citric acid
Antiemetic
A medication that is administered to prevent or relieve nausea and vomiting
Ondesetron
Class: 5HT3 receptor antagonist
Zofran
Indication: Chemotherapy N/V, postoperative N/V, radiation induced N/V
Oral or Parental
- Prolonges QT interval (leading to torsades de pointes)
Glucocorticoids used as antiemetic
Not approved by FDA. Solumedrol and dexamethasone. Given IV.
Metoclopramide (Reglan)
Controls post-op NV
Suppresses emesis and increases upper GI mobility
Cannabinoids
Dronabinol (marinol) and Nabilone (cesamet). Suppresses CINV.
NURS6521 Advanced Pharmacology
Final Exam Study Guide
First generation antipsychotics
A group of medications originally developed to combat psychotic symptoms by
reducing dopamine levels in the brain; also called conventional or typical
antipsychotics
Block receptors for dopamine, acetylcholine, histamine, and norepinephrine
Ex.
(low potency): Chlorpromazine, Thioridazine
s/e orthostatic hypotension, long Q-T syndrome, high sedation
(medium potency): Loxapine, perhenazine,
s/e moderate sedation
(high potency): fluphenazine, haloperidol, pimozide, thiothoxene, frifluoperizine
s/e movement problems
Second generation antipsychotics
Drugs that alleviate schizophrenia with less likelihood of movement problems
S/E: are associated with metabolic adverse effects (eg. weight gain, dyslipidemia,
hyperglycemia, and increased risk of diabetes). As such they should be monitored
for changes. Olanzapine and clozapine carry the greatest risk.
Ex. apripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone,
lurasidone, olanzapine (Zyprexa), Quetiapine (Seroquel), Risperidone,
Antipsychotic medications
Prescription drugs that are used to reduce psychotic symptoms; frequently used in
the treatment of schizophrenia; also called neuroleptics.
Block dopamine, acetylcholine, histamine, and norepinephrine receptors in the
brain and periphery. Acute and chronic psychosis, schizophrenia, manic phase of
bipolar disorders, Tourette’s syndrome, delusional and schizoaffective disorders,
dementia. Conventional (typical) or atypical.
Patient education: s/s of orthostatic hypotension – move slowly when standing up.
Sedation – avoid hazardous activities such as driving until sedation wears off.
Impairs libido and erection / ejaculation
*avoid anticholinergic drugs, barbiturates, benzos and alcohol.
Potency
The size of the dose needed to elicit a given response
Neuroleptic Malignant Syndrome (NMS)
A rare and sometimes fatal reaction to high-potency neuroleptic drugs. Symptoms
include muscle rigidity, fever, and elevated white blood cell count. It is thought to
result from dopamine blockage at the basal ganglia and hypothalamus.
Treatment: support body through withdrawal.
Clozapine (Clozaril)
Second Generation (Atypical) Antipsychotic
Low affinity to D2 dopamine receptors
Treats schizophrenia and suicidal behavior. Not many EPSs.
S/E weight gain, orthostatic hypotension, sedation, cholinergic, urinary retention,
constipation, tachycardia.