1. Antacids are used to treat GERD and peptic ulcer disease. Their main mechanism of action is to change the pH of the stomach and small intestine. 2. The most important nursing consideration when administering antacids is to give them 1 hour before or 2 hours after meals to prevent interactions that can decrease drug absorption. 3. H2 receptor antagonists work by decreasing hydrochloric acid production in the stomach. Examples include ranitidine.

1. PHARMACOLOGY
Final Exam Review
Antacids
-GERD and Pepticulcerdisease
-NursingConsideration
= changesph of stomach / small intestine
Give 1hr before or2hrs after meal
Decreasesdigoxinandantibioticsabsorption
Increase Levodopa
= effectsoccurby alteringpH
H2 Receptor Antagonists
- Dec hydrochloricacid
- Ex. Ranitidine(Zantac)
GI Prostaglandin
-inhibitgastricacidandpepsin
-usedforgastric ulcerscausedby
NSAID/Salicylates
-Ex.Misoprostol (induce abortion)
Proton Pump Inhibitor(PPI)
- Inhibitgastricacidsecretion
- Ex. Omeprazole (Losec)
Pantoprazole (Tecta)
Anti-emetics
- Blockdopamine receptorsalongvomit
centers(&also at otherCNSsites)
- For Nauseaandvomiting
- Usedfor nausearelatedto chemo/rad,
motionsickness,intoxication
- 2 types:
1. Dopamine antagonist
-alsousedas Anti-Psychotic
-Ex.Metoclopramide (Maxeran)
-incgastricemptying
-Ex.Prochlorperazine (Stemetil)
2. Anticholinergics
- decacetylcholine onvomitcenter,
associatedwithvestibularapparatus
-usedinpregnancy& motionsickness
-Ex.Scopolamine
Diphenhydramine (Benadryl),
Gravol- side effects=Sedation,
dry mouth,urinaryretention
Locally acting anti-diarrheal
- Action= absorbsexcesswater,irritants,
bacteria
- Producessoftstool
- Ex. Bismuthsubsalicylate(PeptoBismal)
KaolinandPectin(kaopectate);
Psyllium(Metamucil)
SystemicAnti-diarrheal
-decautonomicstimulationof peristalsis
- decGI motility,dectransittime,inctime for
intestinal waterabsorption,prodformedstool
-Ex.Loperamide (Immodium)
UTI
-2nd
mostcommon conditiontreatedwith
antibiotics
-Anatomy= kidney,ureter,urinarybladder,
urethra,prostate (male)
-Riskof UTI = W>M
-E coli = mostcommoncause
-Norfloxacin=drug of choice,broadspectrum;
inhibitsDNA synthesis
= s/e = GI upset
-Nx consideration=incOFI 2L/day
= assessurine,evaluate s/sx of UTI
= finishcomplete course of antibiotic
*Broad Spectrum – killsalotof bacteria
Oxybutynin/Ditropan
-anticholinergic
-foroveractive urinarybladdersyndrome
-action= relaxesdetrusormuscle inwall of
bladder,inccapacityof bladderto holdurine
-adverse effect= SNS(drymouth)
Betanechol
-cholinergic=for nonobstructive urinary
retention
-usedwhenthere islack of bladdermuscle tone
resultingtourine retention
Oral Contraceptive Pills
-preventfertilization byinhibitingovulation

2. Cont.. PHARMA FINAL EXAM REVIEW
Hormone ReplacementTherapy
-treatsx of menopause (delaysx)
-some use itto treat prostate/breastca
-s/e=DVT,Pulmembolism, incriskof bloodclot
Oxytocin
-incuterine contractions
-s/e=intracranial hemorrhage (fetal
complication)
Uterine rupture/seizure (maternal
complication)
-interactwithvasoconstrictors=leadtoHPN
Tocolytics
-s/e = tachycardia
Ex = Terbutaline (B2adrenergicagonists)
Viagra (Sildenafil)
-forerectile dysfunction
-vasodilator
- whenusedwithNitrates=Dec BP
4 Typesof Muscle Relaxants
1. Centrallyacting– Robaxin
For acute muscle spasms
2. Directacting- Dantrolene,Botox
For spasticity,hyperreflexiaassociated
withUMN lesion(Cerebral palsy,MS,
Spinal cordinjury)
3. Blockingagents – gen.anesthesia
4. Miscellaneous –Baclofen
Bone resorptioninhibitors
-Tx for Osteoporosis
-Ex.alendronate (Fosamax)
-preventosteoclastactivity
-give 30minutesbefore othermeds,food
-give 8ozof water
-stayuprightfor 30minsaftertakingdrug
Arthritis
-Osteoarthritis=NSAIDS,COX2inhibitor
-RheumatoidArthritis(RA) =autoimmune
= corticosteroids,sulfasalazine,methotrexate
-Gout= indomethacin,COX2inhibitor,
colchicine,Allopurinol
JSy
*Ulcerative colitisrelatedtoRA
2 Main UsesofChemotherapy
-tocontrol/cure the disease
-Palliationtocontrol sx
-majors/e = monitorN/V,diarrhea,bone
marrow suppression
-Nx Consideration=VS,s/sx of infection(BM
suppression),bleeding,anemia,
manage pain,manage N/V
BM Suppression
-BM= bloodcell are manufactured
-deccell production,responsible forproviding
immunity(leucocytes),carryingO2(rbc),
bloodclotting(thrombocytes)
Timolol
-adrenergicblocker
-decaqueoushumorwhichdecintraocular
pressure inopenangle glaucoma
-adeverse effects=dec HR/BP,arrhythmia,
Bronchospasm
-notblockingthe lacrimal ductduring
instillationcanleadtosystemicabsorption
of meds
NSAIDS
-Ex.ASA,ibuprofen,naproxen,celecoxib,
diclofenac
-forfever,pain,inflammation
SystemicCorticosteroids
-Ex.Prednisone,Betamethasone,Cortisone
-action= suppresshistamine releaseandinhibit
synthesisof prostaglandinbyCOX2
-adverse effects=suppressadrenal gland
function;incbloodglucose,mood
changes,elecimbalance,Pepticulcer
dse,osteoporosis,maskinfection
Tx of fever= antipyretics,NSAIDS(withanti
bloodclottingeffects) /Tylenol (forpainand
fever)

3. Cont.. PHARMA FINAL EXAM REVIEW
Diphenhydramine
- antihistamine
-blockshistamineatH1 receptor
-usedforallergies
-“Zantac” = blocksH2 (acid),can be addedfortx
of allergy
-Adveffect–CNSdepression,drowsiness
-Contraindication=pxsw/dysrhythmias,HF,
narrow angle glaucoma(due to
anticholinergiceffects)
Nasal Glucocorticoid
-Ex.Fluticasone
-locallyactingtotreat inflammation
Pseudoephedrine(Pseudofed)
-adrenergic
-tx of allergies
-relievenasal congestion
-Major s/e = Reboundcongestion
-donot take more than 3-5days
-s/e = adrenergic= HPN,CNSstimulation,
anxiety/Insomnia
Anaphylaxis
-Tx = Epinephrine
-usedinBronchial asthmaandcardiac arrest
Epinephrine Action
-alphareceptor– vasoconstrictors
-B1 = cardiac
-B2 = lungs
-blockshistaminerelease
-adrenergicsx = palpitation,tremor,HPN
-Nx consideration=VS,monitoradverse effects,
DM = monitorforincbloodglucose
Bronchial asthma= raise HOB
Monitorchest/resp
1. What are antacidsusedfor?
2. What isthe mostimportantnursing
considerationtorememberwhen
administeringantacid
medication?Why?
3. What do histamine (H2) receptor
antagonistsdo?
4. How doGI prostaglandinswork?
5. How doproton pumpinhibitorswork?
6. What do antiemeticsdo?
7. What are the twomain typesof
antiemetics?
8. How dothe dopamine antagonist
antiemeticswork?
9. How dothe anticholinergicantiemetics
work?
10. What are commonside effectsof
Gravol?Rememberitisan
anticholinergic.
11. What are importantnursing
considerationsrelatedtoantiemetic
administration?
12. What isthe actionof a locallyacting
antidiarrheal?
13. What isthe actionof systemic
antidiarrheal meds?
14. What isthe secondmostcommontype
of infectiontreatedwithantibiotics?
15. What part of the anatomymightbe
includedinaUTI?
16. Why are womenat greaterriskof UTI
than men?
17. What bacteriamostoftencausesUTI?
18. What medicationiscommonly
prescribedforUTI? Answer:Norfloxacin
19. What isthe actionof Norfloxacin?
20. What are nursingconsiderationtotake
intoaccount whentreatingaUTI?
21. What doesbroadspectrummean?
22. What adverse effectsare likelyoccur
withNorfloxacin?
23. What type of medicationis
oxybutynin/Ditropan?
24. What isthe actionand use of
oxybutynin?
25. What potential adverse effectsmight
yousee withoxybutynin?(it’san
anticholinergic)
26. What isbethanechol usedfor?
27. How doesbethanechol work?
28. How dooral contraceptiveswork?

4. 29. What ishormone replacementtherapy
(HRT) usedfor?
30. What are the potential side effectsof
HRT?
31. What isoxytocinusedfor?
32. What are potential adverseeffectsof
oxytocin?
33. What are tocolytics,suchas
Terbutaline,usedfor?
34. What isViagra (sildenafil) usedfor?
35. What isa potentiallydangerousside
effectformentakingViagraand
nitratesforangina?
36. What type of medicationsare often
usedto treatrenal failure?
37. What are the 4 typesof muscle
relaxants?
38. What are centrallyactingmuscle
relaxantsusedfor?
39. What are directmuscle relaxantsused
for?
40. What are bone resorptioninhibitors?
41. What are importantnursing
considerationsforalendronate?
42. What are commontreatmentsfor
arthritis?
43. What are the twomain usesof
chemotherapy?Hint –it isn’tusedjust
to cure cancer
44. What are the majoradverse effectsof
chemotherapy?
45. What are the majornursing
considerationsforapatienton
chemotherapy?
46. What isbone marrow suppression?
47. What type of drug is timolol?
48. What are potential adverseeffectsof
timolol?Rememberitisa betablocker.
49. How couldthese occurfrom eye drops?
50. What are NSAIDSusedfor? Examples
include ASA,ibuprofen,celecoxib,
diclofenac,naproxen
51. What are some examplesof systemic
glucocorticoids?
52. What isthe actionof the systemic
glucocorticoids?
53. What are potential adverseeffectsof
glucocorticoids?
54. What typesof medicationsare usedto
treat fever?
55. What type of medicationis
diphenhydramine?
56. What isthe actionof diphenhydramine?
57. What are the adverse effectsof
antihistamines?
58. Give an example of anintranasal
glucocorticoid?
59. What type of drug is pseudoephedrine?
60. What isthe majoradverse effectof
intranasal pseudoephedrine?
61. What are potential side effectsof oral
pseudoephedrine? Whatdowe use to
treat anaphylaxis? Rememberitisan
adrenergic.
62. What else mightepinephrine be used
for?
63. What type of medicationis
epinephrine?
64. What isthe actionof epinephrine?
65. What adverse effectsmightyouexpect
to see?Rememberitisan adrenergic.
66. What are nursingconsiderationsfora
clientwhohasreceivedepinephrine?