Summary HESI PHARMACOLOGY STUDY GUIDE with Q&A

HESI PHARMACOLOGY STUDY GUIDE
HESI version 1


- Community: PARKINSON medication
 Assess for signs and symptoms of PD
 Masklike expression
 Speech problems
 Dysphagia
 Rigidity of arms, legs, and neck
 Main med is Sinemet: Levodopa/Carbidopa
 Levodopa  converted to dopamine.
 Carbidopa  increase its effectiveness and prevents or les sens levodopa
side effects
 Levodopa side effects: nausea, vomiting, heart rhythm disturbance
 TEACHINGS: Take on empty stomach at least 30 minutes, or one hour
before meals
o There are two forms of Sinemet, controlled-release or immediate-release
Sinemet. Controlled-release (CR) Sinemet and immediate-release Sinemet
are equally effective in treating the symptoms of Parkinson's disease, but
some people prefer the controlled release version.

- Cardio vascular - Nitroglycerin- Decreases BP
 Nitroglycerin – Anti ANGINA Meds, chronic heart failure
 Prototypical nitrate : POTENT VASODILATOR
 Large first-pass effect with oral forms
 Used for symptomatic treatment of ischemic heart conditions (angina)
 IV form used for BP control in perioperative hypertension, treatment of
HF, ischemic pain, pulmonary edema associated with acute MI, and
hypertensive emergencies
 Available form: Sublingual tablets, sprays and patches

 Nitroglycerin Teaching
 Instruct patients in proper technique and guidelines for taking
sublingual nitroglycerin for anginal pain
 Instruct patients never to chew or swallow the sublingual form
 Instruct patients that a burning sensation felt with sublingual forms
indicates that the drug is still potent
 Instruct patients to keep a fresh supply of sublingual medication on
hand; potency is lost in about 3 months after the bottle has been
opened
 To preserve potency, medications should be stored in an airtight, dark
glass bottle with a metal cap and no cotton filler

 If anginal pain occurs:
 Stop activity and sit or lie down, and take a sublingual tablet
 If no relief in 5 minutes, call 911/Emergency Services immediately and
take a second sublingual tablet
 If no relief in 5 minutes, take a third sublingual tablet
 Do not try to drive to the hospital

,- Med Administration
o Doses
o Secondary infusion (drip rates)
o Peak & Trough schedule
 Peak level
 ˜Highest blood level
 Trough level
 ˜Lowest blood level
o Tetracycline – is a form of ANTIBIOTICS
 Bacteriostatic—inhibit bacterial growth
 Inhibit protein synthesis
 Stop many essential functions of the bacteria
 Dairy products, antacids, and iron salts reduce oral absorption of
tetracyclines
 Should not be used in children under age 8 or in pregnant/lactating
women because tooth discoloration will occur if the drug binds to the
calcium in the teeth
 Instruct patients to take antibiotics exactly as prescribed and for the
length of time prescribed; they should not stop taking the medication
early when they feel better
 Assess for signs and symptoms of superinfection: fever, perineal
itching, cough, lethargy, or any unusual discharge
 The most common adverse effects of antibiotics are nausea, vomiting,
and diarrhea
 All oral antibiotics are absorbed better if taken with at least 6 to 8
ounces of water
 Tetracyclines
 Avoid milk products, iron preparations, antacids, and other dairy
products because of the chelation and drug-binding that occurs
 Take all medications with 6 to 8 ounces of fluid, preferably water
 Because of photosensitivity, avoid sunlight and tanning beds

o Transdermal Fentanyl (DURAGESIC) – OPIOID ANALGESIC Chapter 10
 Fentanyl Transdermal System is indicated for the management of pain
in opioid-tolerant patients, severe enough to require daily, around-the-
clock, long-term opioid treatment and for which alternative treatment
options are inadequate.
 Patients considered opioid-tolerant are those who are taking, for one
week or longer, at least 60 mg of morphine daily, or at least 30 mg of
oral oxycodone daily, or at least 8 mg of oral hydromorphone daily, or
an equianalgesic dose of another opioid.

- Nutrition
o Orlistat - ALLI (side effects : weight loss/poop)

- Med Administration
o Aldactone – heart failure meds: Aldosterone agonist chp 24.
 Potassium-sparing diuretic
 Also acts as an aldosterone antagonist, which has been shown to
reduce the symptoms of heart failure

,  Treats high blood pressure. Also treats fluid retention and related
conditions such as heart failure. Used to treat high levels of
aldosterone and low potassium levels. This medicine is a potassium-
sparing diuretic.
 Diuretic drugs – take in the morning.
Primary hyperaldosteronism
o Long test: ALDACTONE is administered at a daily dosage of 400 mg for three to
four weeks.
o Short test: ALDACTONE is administered at a daily dosage of 400 mg for four days.
o ALDACTONE may be administered in doses of 100 to 400 mg daily in preparation
for surgery.
Edema in adults (congestive heart failure, hepatic cirrhosis, or nephrotic
syndrome)
o An initial daily dosage of 100 mg of ALDACTONE administered in either single or
divided doses is recommended, but may range from 25 to 200 mg daily.
Essential hypertension
o For adults, an initial daily dosage of 50 to 100 mg of ALDACTONE administered in
either single or divided doses is recommended.
Hypokalemia
o ALDACTONE in a dosage ranging from 25 mg to 100 mg daily is useful in treating a
diuretic-induced hypokalemia, when oral potassium supplements or other
potassium-sparing regimens are considered inappropriate.


Severe heart failure (NYHA class III – IV)
- Treatment should be initiated with ALDACTONE 25 mg once daily if the patient's
serum potassium is ≤ 5.0 mEq/L and the patient's serum creatinine is ≤ 2.5 mg/dL.
Patients who tolerate 25 mg once daily may have their dosage increased to 50 mg
once daily as clinically indicated. Patients who do not tolerate 25 mg once daily
may have their dosage reduced to 25 mg every other day.

o Antihistamine: PRECAUTIONS
 Interacts with OPIOID ANALGESICS
 Interacts with barbiturates
 Anticholinergic properties – blocks neurotransmitters
 Sedative properties
 Dries up most glands
 Best tolerated when taken with meals—reduces GI upset
 If dry mouth occurs, teach patient to perform frequent mouth care,
chew gum, or suck on hard candy (preferably sugarless) to ease
discomfort

o Boniva (side effects)
 Used for osteoperosis
 that is, the drug is taken at least 30 minutes before the first morning
beverage, food, or other medication and with at least 6 to 8 oz of
water.
 Emphasize the importance of remaining upright for at least 30 minutes
after taking the medication to prevent esophageal and GI adverse
effects.