Nclex-Rn Pharmacology Review

Front 1

Acetaminophen
(Tylenol)

Back 1

Therapeutic: 1-30 mcg/ml
Toxic: >200 mcg/ml
Contraindicated in:
Liver disease
Side Effects of Toxicity:
Hepatic Necrosis

Front 2

Alcohol
(Ethanol)

Back 2

Therapeutic Level: 100 mcg/ml
Toxic: >400 mcg/ml

Front 3

Amitriptyline
(Elavil)

Back 3

Therapeutic: 120-250 mcg/ml
Toxic: >500 mcg/ml
Contraindicated in: Narrow-angle glaucoma and potential fatal reactions when used with MAO inhibitors
Side Effects of Toxicity:
Drowsiness, sedation, lethary, fatigue, dry mouth and eyes, blurred vision, hypotension, and tachycardia.
Caution patients to use a sun screen.
Therapeutic effects within 2 to 6 weeks of initiating therapy.

Front 4

Carbamazepine
(Tegretol)

Back 4

Therapeutic: 8-12 mcg/ml
Toxic: >15 mcg/ml
Contraindicated in:
Bone marrow depression
Side Effects of Toxicity:
Drowsiness, dizziness, and ataxia.
Caution patients to use a sun screen and to carry a medical alert card.

Front 5

Chlordiazepoxide
(Librium)

Back 5

Therapeutic: 700-1000 mcg/ml
Toxic: >5000 mcg/ml
Contraindicated in:
Comatose patients with CNS depression, narrow-angle glaucoma
Side Effects of Toxicity:
Drowsiness and dizziness.
Alcohol Withdrawal Treatment: Assess patients for signs and symptoms of delirium tremors (DTs).

Front 6

Desopyramide
(Norpace)

Back 6

Therapeutic: Variable
Toxic: >7 mcg/ml
Contraindicated in:
Cardiogenic shock, 2nd and 3rd degree heart blocks, sick sinus syndrome
Side Effects of Toxicity:
Signs and symptoms of congestive heart failure.

Front 7

Diazepam
(Valium)

Back 7

Therapeutic: 100-1000 mcg/ml
Toxic: >5000 mcg/ml
Contraindicated in:
Comatose patients with CNS depression, narrow-angle glaucoma
Side Effects of Toxicity:
Sedation with ataxia, dizziness, and slurred speech.
Therapeutic effects within 1 to 2 weeks of initiating therapy.

Front 8

Digitoxin

Back 8

Therapeutic: 20-35 ng/ml
Toxic: >45 ng/ml
Contraindicated in:
Uncontrolled ventricular arrhythmias, AV block
Side Effects of Toxicity:
Abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias.

Front 9

Digoxin

Back 9

Therapeutic: 0.8-1.5 mcg/ml
Toxic: >2 mcg/ml
Contraindicated in:
Uncontrolled ventricular arrhythmias, AV block
Side Effects of Toxicity:
Abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias.

Front 10

Doxepin

Back 10

Therapeutic: 30-150 mcg/ml
Toxic: >500 mcg/ml
Contraindicated in:
Narrow-angle glaucoma
Side Effects of Toxicity:
Sedation, fatigue, blurred vision, hypotension, dry mouth, and constipation.
Caution patients to use a sun screen.
May cause hypotension, tachycardia, and potentially fatal reactions when used with MAO inhibitors
Therapeutic effects within 2 to 6 weeks of initiating therapy.

Front 11

Glucocorticoids

Back 11

Contraindicated in:
Serious infections
Signs of adrenal insufficiency: Hypotension, weight loss, weakness, nausea, vomiting, anorexia, lethargy, confusion, restlessness.
Side Effects:
Depression or euphoria, personality changes, hypertension, decreased wound healing, petechiae, ecchymoses, hyperglycemia, hypokalemia, hypernatremia, fluid retention, aseptic necrosis of joints, osteoporosis, cushingoid appearance (moon face, and buffalo hump)
Monitor blood sugars, BUN, creatinine.
Advise patients that medication should NOT be abruptly discontinued by tapered off over 2 to 4 weeks.

Front 12

Imipramine
(Tofranil)

Back 12

Therapeutic: 125-250 mcg/ml
Toxic: >500 mcg/ml
Contraindicated in:
Narrow-angle glaucoma
Side Effects of Toxicity:
Disturbed concentration, confusion, restlessness, agitation, convulsions, drowsiness, mydriasis, arrhythmias, fever, hallucinations, vomiting, and dyspnea.
Caution patients to use a sun screen.
Therapeutic effects within 2 to 6 weeks of initiating therapy.

Front 13

Lithium

Back 13

Therapeutic: 0.6-1.2 mcg/ml
Toxic: >2 mcg/ml
Serum levels should be monitored twice weekly during initiation of therapy and every 2 to 3 months durgin chronic therapy.
Contraindicated in:
Severe cardiovascular or renal disease, dehydrated or debilitated patients
Side Effects of Toxicity:
Vomiting, diarrhea, slurred speech, decreased coordination, drowsiness, muscle weakness, and twitching.
Therapeutic effects within 1 to 3 weeks of initiating therapy.

Front 14

Lidocaine
(Xylocaine)

Back 14

Therapeutic: 1.5-6 mcg/ml
Toxic: >6-8 mcg/ml
Contraindicated in:
Advanced AV block
Side Effects of Toxicity:
Confusion, excitation, blurred or double vision, nausea, vomiting, ringing in ears, tremors, twitching, convulsion, difficulty breathing, severe dizziness or fainting, and slow heart rate.

Front 15

Magnesium sulfate

Back 15

Contraindicated in:
Hypermagnesemia, hypocalcemia, anuria, and heart block
Side Effects of Toxicity:
Decreased respiratory rate, bradycardia, arrhythmias, hypotension, drowsiness, flushing, sweating, and hypothermia.
Monitor neurologic status before and throughout therapy.
Institute seizure precautions.

Front 16

Methotrexate

Back 16

Therapeutic: Variable
Toxic: >454 mcg/ml (48 hours after high dose)
Contraindicated in:
Pregnancy and lactation (teratogenic effects)
Side Effects of Toxicity:
Hyperuricemia, abdominal pain, diarrhea, stomatitis, hepatotoxicity, pulcomary toxicity, nephrotoxicity, anemia, leukopenia, thrombocytopenia, and folic acid deficiency
Caution patients to use a sun screen.
Rescue Drug to Prevent Fatal Toxicity:
Leucovorin (folinic acid)

Front 17

Phenobarbital

Back 17

Therapeutic: 15-40 mcg/ml
Toxic: Varies 35-80 mcg/ml
Contraindicated in:
Comatose patients with CNS depression
Side Effects of Toxicity:
Confusion, drowsiness, dyspnea, slurred speech, and staggering.

Front 18

Phenytoin
(Dilantin)

Back 18

Therapeutic: 10-20 mcg/ml
Toxic: Varies with symptoms
Contraindicated in:
Sinus bradycardia and heart block
Side Effects of Toxicity:
Nystagmus, ataxia, confusion, nausea, slurred speech, and dizziness.
Caution patients to carry a medical alert card.

Front 19

Procainamide
(Promestyl)

Back 19

Therapeutic: 5-12 mcg/ml
Toxic: >15 mcg/ml
Contraindicated in:
AV block and myasthenia gravis
Side Effects of Toxicity:
Confusion, dizziness, drownsiness, decreased urination, nausea, vomiting, and tachyarrhythmias.

Front 20

Primidone
(Mysoline)

Back 20

Therapeutic: 5-10 mcg/ml
Toxic: >15 mcg/ml
Contraindicated in:
Porphyria
Side Effects of Toxicity:
Ataxia, lethargy, changes in vision, confusion, and dyspnea.
Caution patients to carry a medical alert card.

Front 21

Propranolol
(Inderal)

Back 21

Therapeutic: Varies
Toxic: Vaires
Contraindicated in:
Uncompensated congestive heart failure, pulmonary edema, cardiogenic shock, bradycardia, and heart block
Side Effects of Toxicity:
Bradycardia, severe dizziness or fainting, severe drowsiness, dyspnea, bluish fingernails or palms, and seizures.
Caution diabetic patients to monitor blood sugar.

Front 22

Quinidine

Back 22

Therapeutic: 2-6 mcg/ml
Toxic: >8 mcg/ml
Contraindicated in:
Conduction defects and digitalis glycoside toxicity
Side Effects of Toxicity:
Tinnitus, hearing loss, visual disturbances, headache, nausea, and dizziness.
Cardiotoxicity signs include QRS widening, cardiac asystole, ventricular ectopic beats, idioventricular rhythms, paradoxical tachycardia, and arterial embolism.

Front 23

Salicylate

Back 23

Therapeutic: Varies
Toxic: Varies
Contraindicated in:
Hypersensitivity to aspirin or other salicylates, bleeding disorders or thrombocytopenia
Side Effects of Toxicity:
Tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy, diarrhea, and sweating.
May take 2 to 3 weeks for maximum effectiveness.

Front 24

Theophylline

Back 24

Therapeutic: 10-20 mcg/ml
Toxic: >20 mcg/ml
Contraindicated in:
Uncontrolled arrhythmias and hyperthyroidism
Side Effects of Toxicity:
Anorexia, nausea, vomiting, stomach cramps, diarrhea, confusion, headache, restlessness, flushing, increased urination, insomnia, tachycardia, arrhythmias, and seizures. Tachycardia, ventricular arrhythmias, or seizures may be the first sign of toxicity.

Front 25

Valproic Acid (Depakene)

Back 25

Therapeutic: 50-100 mcg/ml
Toxic: >100 mcg/ml
Contraindicated in:
Hepatic impairment
Side Effects of Toxicity:
Anorexia, severe nausea an dvomiting, yellow skin or eyes, fever, sore throat, malaise, weakness, facial edema, lethargy, unusual bleeding or bruising, or seizures.

Front 26

Amikacin

Back 26

Troughs Peaks
5 mcg/ml 35 mcg/ml

Front 27

Gentamicin

Back 27

Troughs Peaks
2 mcg/ml 10 mcg/ml

Front 28

Kanamycin

Back 28

Troughs Peaks
5 mcg/ml 35 mcg/ml

Front 29

Neomycin

Back 29

Troughs Peaks
2 mcg/ml 16 mcg/ml

Front 30

Streptomycin

Back 30

Troughs Peaks
Varies 25 mcg/ml

Front 31

Tobramycin

Back 31

Troughs Peaks
2 mcg/ml 20 mcg/ml

Front 32

Vancomycin

Back 32

Troughs Peaks
5-10 mcg/ml 25 mcg/ml

Front 33

What is the antitdote for:
Acetaminophen

Back 33

Acetylcysteine

Front 34

What is the antitdote for:
Anticholinesterases (Cholinergics)

Back 34

Atropine, Pralidoxime

Front 35

What is the antitdote for:
Antidepressants
(MAO inhibitors and tryamine-containing foods may lead to hypertensive crisis including symptoms of chest pain, severe headache, nuchal rigidity, nausea and vomiting, photosensitivity, and enlarged pupils)

Back 35

Phentolamine

Front 36

What is the antitdote for:
Benzodiazepines

Back 36

Flumazenil

Front 37

What is the antitdote for:
Cyanide

Back 37

Amyl nitrite, sodium nitrite, sodium thiosulfate

Front 38

What is the antitdote for:
Digoxin, digitoxin

Back 38

Digoxin immune Fasb (Digibind)

Front 39

What is the antitdote for:
Fluorouracil (5FU)

Back 39

Leucovorin calcium

Front 40

What is the antitdote for:
Heparin

Back 40

Portamine sulfate

Front 41

What is the antitdote for:
Ifosfamide
(Adverse effects cause hemorrhagic cystitis)

Back 41

Mesna

Front 42

What is the antitdote for:
Iron

Back 42

Deferoxamine

Front 43

What is the antitdote for:
Lead

Back 43

Edetate calcium disodium, dimeraprol, succimer

Front 44

What is the antitdote for:
Methotrexate
(Adverse effects cause folic acid deficiency)

Back 44

Leucovorin calcium

Front 45

What is the antitdote for:
Opioid analgesics, heroin

Back 45

Nalmefene, Naloxone

Front 46

What is the antitdote for:
Thrombolytic agents

Back 46

Aminocaproic acid (Amicar)

Front 47

What is the antitdote for:
Tricyclic antidepressants

Back 47

Physostigmine

Front 48

What is the antitdote for:
Warfarin (Coumadin)

Back 48

Phytonadione (Vitamin K)

Front 49

Regular Insulin IV

Back 49

Onset: 10-30 min
Peak: 15-30 min
Duration: 30-60 min

Front 50

Regular SC

Back 50

Onset: 30 min-1hr
Peak: 2-4 hr
Duration: 5-7 hr

Front 51

NPH

Back 51

Onset: 1-4 hr
Peak: 6-12 hr
Duration: 18-28 hr

Front 52

Lente

Back 52

Onset: 1-3 hr
Peak: 8-12 hr
Duration: 18-28 hr

Front 53

Ultralente

Back 53

Onset: 4-6 hr
Peak: 18-24 hr
Duration: 36 hr