NCLEX NGN Pharmacology Flashcards
1
Q
What is the antidote for warfarin overdose?
A
Vitamin K (Monitor INR, therapeutic range: 2-3)
2
Q
What is the major side effect of ACE inhibitors (-pril)?
A
Dry cough, angioedema, hyperkalemia
3
Q
Which diuretic class can cause ototoxicity?
A
Loop diuretics (Furosemide, Bumetanide)
4
Q
What is the antidote for opioid overdose?
A
Naloxone (Narcan) – reverses respiratory depression
5
Q
What foods should be avoided with MAOIs (e.g., phenelzine, tranylcypromine)?
A
Tyramine-containing foods (cheese, wine, processed meats) → risk of hypertensive
crisis
6
Q
What lab value should be monitored with heparin therapy?
A
aPTT (1.5-2x normal); Antidote: Protamine sulfate
7
Q
What is the therapeutic range for digoxin?
A
0.5-2.0 ng/mL – Monitor for toxicity: bradycardia, halos around lights
8
Q
What insulin type is given before meals?
A
Rapid-acting insulin (Lispro, Aspart) – Onset: 15 minutes
9
Q
Which medication should be held before contrast dye due to risk of lactic acidosis?
A
Metformin
10
Q
What is the primary concern with fluoroquinolones (-floxacin)?
A
Tendon rupture, avoid dairy, avoid in children
11
Q
What is the antidote for benzodiazepines (e.g., lorazepam, diazepam)?
A
Flumazenil
12
Q
Which medication is used for SVT (supraventricular tachycardia)?
A
Adenosine – Administer rapidly, may cause a brief asystole
13
Q
What drug is used for bradycardia?
A
Atropine – Increases heart rate
14
Q
What is a serious adverse effect of clozapine (antipsychotic)?
A
Agranulocytosis – Monitor WBCs regularly
15
Q
Which medications should never be given in pregnancy (Category X)?
A
Warfarin, Isotretinoin, Methotrexate, ACE inhibitors
16
Q
What is the most serious side effect of amiodarone?
A
Pulmonary toxicity (Monitor for dyspnea, cough, chest pain)
17
Q
What is the first-line treatment for anaphylaxis?`
A
Epinephrine (IM) – Followed by antihistamines and steroids
18
Q
What electrolyte imbalance is associated with furosemide (Lasix)?
A
Hypokalemia – Watch for muscle cramps, arrhythmias
18
Q
Which medication is used to treat diabetic neuropathy pain?
A
Gabapentin, Pregabalin
19
Q
Which medication class should be avoided in asthma patients due to bronchospasm
risk?
A
Beta-blockers (-lol, e.g., propranolol, metoprolol)
20
Q
What are the signs of serotonin syndrome?
A
Mental status changes, hyperreflexia, tremors, fever, tachycardia, diarrhea – Can be
caused by SSRIs, SNRIs, MAOIs, and Tramadol
21
Q
What should you monitor for with spironolactone (potassium-sparing diuretic)?
A
Hyperkalemia – Avoid potassium supplements & salt substitutes
22
Q
Which drugs cause QT prolongation and risk for torsades de pointes?
A
Macrolides (Azithromycin, Erythromycin), Fluoroquinolones, Antipsychotics,
Amiodarone
23
Q
What is the antidote for acetaminophen overdose?
A
N-acetylcysteine (Mucomyst) – Protects the liver
24
Which medication requires INR monitoring?
Warfarin – Therapeutic INR: 2-3, avoid leafy greens
25
What is a major side effect of methotrexate (used for RA, cancer)?
Bone marrow suppression, hepatotoxicity, GI upset
26
What are the priority nursing actions for a patient taking lithium?
Monitor sodium levels, watch for toxicity (tremors, confusion, polyuria), avoid
dehydration
27
What foods interact with levothyroxine (Synthroid)?
Soy, calcium, iron supplements, high-fiber foods – Take on an empty stomach
28
29
What drug is used to stop preterm labor?
Terbutaline – Risk for tachycardia, tremors
30
What are the key side effects of statins (atorvastatin, simvastatin)?
Muscle pain (rhabdomyolysis), liver toxicity – Monitor LFTs
31
What is the first-line drug for heart failure?
ACE inhibitors (-pril) + Beta-blockers (-lol)
32
What should you monitor with clopidogrel (Plavix)?
Bleeding risk – Avoid NSAIDs, report bruising
33
Which drug is used for post-op urinary retention?
Bethanechol (cholinergic)
34
What drug is used for status epilepticus?
Lorazepam or Diazepam (Benzodiazepines)
35
Which diuretics should not be given in renal failure?
Potassium-sparing diuretics (Spironolactone), ACE inhibitors (-pril)
36
What is a severe side effect of sulfonylureas (Glipizide, Glyburide)?
Hypoglycemia – Avoid alcohol
37
Which drugs require peak and trough monitoring?
Vancomycin, Aminoglycosides (Gentamicin, Tobramycin)
38
What is a major risk with carbamazepine (seizure drug)?
Agranulocytosis (risk for infection)
39
What are the signs of hypoglycemia?
Sweating, tachycardia, confusion, tremors, irritability – Treat with glucose
40
What is the black box warning for fluoroquinolones (-floxacin)?
Tendon rupture, CNS effects – Avoid in kids
41
What are the key side effects of benzodiazepines (-pam, -lam)?
Sedation, respiratory depression, risk of dependence – Antidote: Flumazenil
42
Which opioid is 100x stronger than morphine and requires special handling?
Fentanyl – Risk of respiratory depression, patch takes 12-24 hours to work
43
What drug is used for opioid withdrawal?
Methadone or Buprenorphine
44
What medication is given to prevent gastric ulcers in long-term NSAID users?
Misoprostol (Cytotec) – Contraindicated in pregnancy
45
What are the two most serious risks of clozapine (Clozaril)?
Agranulocytosis (monitor WBCs), seizures
46
What is the therapeutic range for phenytoin (Dilantin)?
10-20 mcg/mL – Risk of gingival hyperplasia
47
Which medication should be given to reverse malignant hyperthermia?
Dantrolene – Treats muscle rigidity & hyperthermia
48
What is the major risk of isotretinoin (Accutane)?
Teratogenicity (Category X) – Requires two forms of birth control
49
Which electrolyte imbalance can occur with prolonged use of corticosteroids
(Prednisone)?
Hyperglycemia, osteoporosis, hypokalemia – Taper off slowly
50
Which medication can cause a disulfiram-like reaction with alcohol?
Metronidazole (Flagyl), Disulfiram (Antabuse), Cephalosporins
51
What should be avoided with tetracyclines (-cycline, Doxycycline)?
Dairy, antacids, sun exposure – Can stain teeth in children
52
What drug is used for Parkinson’s disease to increase dopamine?
Carbidopa-Levodopa (Sinemet) – Risk of orthostatic hypotension
53
What is the antidote for iron toxicity?
Deferoxamine
54
What should be monitored when administering amphotericin B (antifungal)?
Nephrotoxicity, infusion reactions (fever, chills, hypotension)
55
Which drug is given to increase neutrophil production in chemotherapy patients?
Filgrastim (Neupogen) – Increases WBCs
56
What is the first-line medication for C. difficile infection?
Oral Vancomycin or Fidaxomicin
57
Which drug is used for thyroid storm?
Propylthiouracil (PTU) or Methimazole
58
What drug is used for postpartum hemorrhage?
Oxytocin, Methylergonovine (Methergine), Misoprostol
59
Which drug is used to treat benign prostatic hyperplasia (BPH)?
Tamsulosin (Flomax) – Improves urine flow
60
What is the treatment for hypothyroidism?
Levothyroxine (Synthroid) – Take on an empty stomach
61
What should be avoided while taking anticholinergic drugs (Oxybutynin, Atropine)?
Heat exposure (risk of overheating, dehydration)
62
What is the primary side effect of hydralazine (vasodilator)?
Reflex tachycardia, hypotension
63
Which medication is used to treat alcohol withdrawal symptoms?
Benzodiazepines (Lorazepam, Diazepam, Chlordiazepoxide)
64
What is a major risk of glucagon (used for severe hypoglycemia)?
Nausea, vomiting – Turn the patient on their side
65
What is the recommended daily limit for acetaminophen (Tylenol)?
4000 mg/day – Risk of liver toxicity
66
What is the primary risk of prolonged use of proton pump inhibitors (PPIs)?
Osteoporosis, C. difficile infection, hypomagnesemia
67
Which drugs increase the risk of hyperkalemia?
ACE inhibitors (-pril), ARBs (-sartan), Potassium-sparing diuretics
(Spironolactone), NSAIDs
68
What is the first-line drug for status asthmaticus (severe asthma attack)?
Albuterol (beta-agonist) + IV steroids
69
Which medications should never be crushed or chewed?
Extended-release (XR, ER), Enteric-coated (EC), Sustained-release (SR) medications
70
What is the treatment for torsades de pointes (polymorphic ventricular tachycardia)?
IV Magnesium sulfate
71
Which drug should be given before surgery to prevent aspiration pneumonia?
Metoclopramide (Reglan) – Increases gastric emptying
72
What is the drug of choice for preeclampsia seizures?
Magnesium sulfate – Monitor deep tendon reflexes
73
Which drugs are ototoxic?
Aminoglycosides (-mycin), Loop diuretics, Vancomycin, Cisplatin
74
What is the antidote for beta-blocker overdose?
Glucagon
75
Which medication should be avoided in children under 8 years old?
Tetracyclines (-cycline) – Risk of permanent tooth discoloration
76
What is the black box warning for fluoxetine (Prozac) and other SSRIs?
Increased risk of suicide in young adults and adolescents
77
What should be avoided while taking MAOIs (Phenelzine, Tranylcypromine)?
Tyramine-rich foods (cheese, cured meats, wine) → Risk of hypertensive crisis
78
What is the drug of choice for bacterial vaginosis (BV)?
Metronidazole (Flagyl) – Avoid alcohol!
79
What is the most common side effect of nitrates (Nitroglycerin, Isosorbide)?
Headache, hypotension – Do not use with sildenafil (Viagra)
80
Which anti-tuberculosis drug can cause optic neuritis?
Ethambutol – Causes vision changes, requires regular eye exams
81
Which insulin type should never be mixed?
Long-acting insulin (Glargine, Detemir)
82
Which herbal supplement increases bleeding risk when taken with anticoagulants?
Ginkgo biloba, Garlic, Ginger
83
What is the main concern with clindamycin use?
C. difficile infection risk
84
What is the first-line drug for ADHD?
Methylphenidate (Ritalin), Amphetamines (Adderall) – Risk of insomnia, weight loss,
tachycardia
85
What is a major side effect of carbamazepine (Tegretol)?
Bone marrow suppression (risk for infection)
86
What is the antidote for methotrexate toxicity?
Leucovorin
87
What is the black box warning for pioglitazone (Actos)?
Heart failure, bladder cancer risk
88
What drug is used for diabetic gastroparesis?
Metoclopramide (Reglan) – Risk of tardive dyskinesia
89
What electrolyte imbalance does lithium toxicity cause?
Hyponatremia – Monitor sodium levels!
90
What is the antidote for cyanide poisoning?
Hydroxocobalamin (Vitamin B12), Sodium thiosulfate
91
What is the risk of prolonged PPI use (Omeprazole, Pantoprazole)?
Osteoporosis, C. difficile, hypomagnesemia
92
What drug is used for smoking cessation?
Varenicline (Chantix), Bupropion (Zyban)
93
Which medication is used for chemotherapy-induced nausea?
Ondansetron (Zofran)
94
What drug is used to treat hyperphosphatemia in CKD patients?
Sevelamer (Renagel)
95
What is the most common adverse effect of erythropoietin (Epoetin alfa)?
Hypertension, blood clots
96
Which drug class should never be taken with grapefruit juice?
Statins, Calcium Channel Blockers, Psych Meds (SSRIs, Benzos)
97
What is the black box warning for sodium-glucose co-transporter 2 (SGLT2)
inhibitors (Canagliflozin)?
Risk of Fournier’s gangrene (necrotizing fasciitis)
98
What is the antidote for anticholinergic toxicity (Atropine overdose)?
Physostigmine
99
What is a serious risk of IV potassium chloride administration?
Cardiac arrest – Never push IV potassium!
100
What is the most common side effect of dopamine agonists (Pramipexole,
Ropinirole)?
Impulse control issues (gambling, hypersexuality)
101
What drug is used to reverse neuromuscular blockade after surgery?
Neostigmine
102
What is the first-line medication for benign essential tremor?
Propranolol
103
What is the risk of chronic corticosteroid use?
Cushing’s syndrome, osteoporosis, hyperglycemia
104
What is the first-line drug for trigeminal neuralgia?
Carbamazepine (Tegretol)
105
Which drug is given to prevent NSAID-induced ulcers?
Misoprostol (Cytotec)
106
Which drugs cause gingival hyperplasia?
Phenytoin, Calcium Channel Blockers, Cyclosporine
107
What drug is used to treat hepatic encephalopathy?
Lactulose – Removes ammonia
108
What is the most serious risk of thiazolidinediones (Pioglitazone, Rosiglitazone)?
Heart failure, fluid retention
109
What is the first-line drug for asystole or pulseless electrical activity (PEA)?
Epinephrine
110
What drug is the first-line treatment for acute gout attacks?
Colchicine or NSAIDs (Indomethacin, Naproxen) – Avoid aspirin!
111
What is the black box warning for fluoroquinolones (-floxacin)?
Tendon rupture, QT prolongation, CNS toxicity
112
What is the antidote for methanol or ethylene glycol poisoning (antifreeze)?
Fomepizole or Ethanol
113
What is the primary side effect of antihistamines (Diphenhydramine, Hydroxyzine)?
Sedation, dry mouth, urinary retention
114
Which drug is used to treat anemia in chronic kidney disease (CKD)?
Epoetin alfa (Epogen, Procrit) – Risk of hypertension & thrombosis
115
What is a major risk of hydroxychloroquine (Plaquenil) used for lupus?
Retinal damage (Requires regular eye exams)
116
What is the most serious risk of TNF inhibitors (Infliximab, Etanercept,
Adalimumab)?
Serious infections & reactivation of TB – Must screen for TB before use
117
Which medication should be avoided with St. John’s Wort?
SSRIs, Warfarin, Oral Contraceptives – Reduces drug effectiveness
118
What is the drug of choice for syphilis?
Penicillin G IM
119
Which drug is used for preventing alcohol relapse?
Disulfiram (Antabuse) or Naltrexone
120
What is the primary side effect of cyclosporine (immunosuppressant)?
Nephrotoxicity, hypertension, increased infection risk
121
What drug is used for motion sickness prevention?
Scopolamine (Transderm Scop patch)
122
Which anti-arrhythmic drug can cause thyroid dysfunction?
Amiodarone – Causes hypo- or hyperthyroidism
123
What drug class is used for atrial fibrillation rate control?
Beta-blockers (-lol) & Calcium channel blockers (Verapamil, Diltiazem)
124
What medication is used to prevent migraines?
Propranolol, Topiramate, Amitriptyline, or CGRP inhibitors
125
Which class of drugs should not be given with erectile dysfunction medications (-
afil)?
Nitrates (Nitroglycerin, Isosorbide) → Causes life-threatening hypotension
126
What drug is given for severe preeclampsia to prevent seizures?
Magnesium sulfate
127
What is the black box warning for clozapine (Clozaril)?
Agranulocytosis (Requires routine WBC monitoring)
128
What drug is used to treat heparin-induced thrombocytopenia (HIT)?
Argatroban or Bivalirudin
129
Which diabetes medication has the highest risk of hypoglycemia?
Sulfonylureas (Glyburide, Glipizide)
130
What is the antidote for isoniazid (INH) toxicity?
Vitamin B6 (Pyridoxine)
131
Which medication is used to reverse neuromuscular blockade after surgery?
Neostigmine
132
What is the most serious side effect of metoclopramide (Reglan)?
Tardive dyskinesia
133
What is the treatment for aspirin overdose?
Activated charcoal + Sodium bicarbonate
134
Which class of drugs is used for alcohol withdrawal seizures?
Benzodiazepines (Diazepam, Lorazepam, Chlordiazepoxide)
135
Which drug is given for fibromyalgia pain?
Pregabalin (Lyrica) or Duloxetine (Cymbalta)
136
What is the first-line treatment for hypocalcemia?
Calcium gluconate IV
137
What drug is used to treat lead poisoning?
Succimer (DMSA) or EDTA
138
Which drug is the first-line therapy for peripheral artery disease (PAD)?
Cilostazol
139
What is the black box warning for metformin?
Lactic acidosis – Hold before contrast dye
140
What is the antidote for warfarin overdose?
Vitamin K + Fresh Frozen Plasma (if severe bleeding)
141
What drug is used for organophosphate poisoning (pesticide exposure)?
Atropine + Pralidoxime
142
What is the first-line medication for rheumatoid arthritis?
Methotrexate – Causes bone marrow suppression
143
Which class of antibiotics is safe during pregnancy?
Penicillins & Cephalosporins
144
What is the treatment for beta-blocker overdose?
Glucagon
145
What drug is used for Raynaud’s disease?
Calcium channel blockers (Amlodipine, Nifedipine)
146
What drug is used for cholesterol gallstones in patients who cannot undergo surgery?
Ursodiol (Actigall)
147
What is the treatment for iron overdose?
Deferoxamine
148
What is the antidote for dabigatran (Pradaxa)?
Idarucizumab (Praxbind)
149
What is the first-line treatment for hypertension?
ACE inhibitors (-pril), ARBs (-sartan), Thiazide diuretics, or Calcium Channel
Blockers (-dipine)
150
What is the antidote for beta-blocker overdose?
Glucagon
151
What are the major side effects of calcium channel blockers (-dipine)?
Hypotension, peripheral edema, constipation
152
What is the first-line drug for heart failure?
ACE inhibitors (-pril) + Beta-blockers (-lol)
153
What is the antidote for warfarin overdose?
Vitamin K + Fresh Frozen Plasma
154
What is the treatment for heparin-induced thrombocytopenia (HIT)?
Argatroban or Bivalirudin
155
What drug is used for supraventricular tachycardia (SVT)?
Adenosine – Administer rapidly
155
What is the most common side effect of nitrates (Nitroglycerin)?
Headache, hypotension – Avoid sildenafil (Viagra)
156
What is the first-line treatment for acute asthma attacks?
Short-acting beta-agonist (Albuterol) + Corticosteroids
157
What medication is given for status asthmaticus?
Albuterol + IV steroids (Methylprednisolone)
158
What is the first-line therapy for COPD exacerbations?
Bronchodilators (Albuterol, Ipratropium) + Corticosteroids
159
What is the first-line drug for tuberculosis (TB)?
Isoniazid (INH) + Rifampin + Ethambutol + Pyrazinamide
160
What are the side effects of isoniazid (INH)?
Hepatotoxicity, peripheral neuropathy (treat with Vitamin B6 - Pyridoxine)
161
What should be monitored with theophylline (bronchodilator)?
Toxicity (Therapeutic range: 10-20 mcg/mL) – Avoid caffeine
162
What is the first-line medication for hypothyroidism?
Levothyroxine (Synthroid) – Take on an empty stomach
163
What is the antidote for insulin overdose?
Glucagon or IV Dextrose
164
What medication is used for diabetes insipidus?
Desmopressin (DDAVP)
165
Which diabetes drug must be held before contrast dye?
Metformin – Risk of lactic acidosis
166
Which diabetes medications have the highest risk of hypoglycemia?
Sulfonylureas (Glyburide, Glipizide)
167
What is the black box warning for Pioglitazone (Actos)?
Heart failure, bladder cancer risk
168
What is the first-line drug for Parkinson’s disease?
Carbidopa-Levodopa (Sinemet)
169
What drug is used for trigeminal neuralgia?
Carbamazepine (Tegretol)
170
What is the antidote for benzodiazepine overdose?
Flumazenil
171
What is the antidote for opioid overdose?
Naloxone (Narcan)
172
What is the black box warning for SSRIs (Fluoxetine, Sertraline)?
Increased suicide risk in young adults
173
What is the major side effect of clozapine (Clozaril)?
Agranulocytosis – Monitor WBCs
174
What medication is used to treat H. pylori infections?
Amoxicillin + Clarithromycin + PPI (Omeprazole)
175
What is the antidote for acetaminophen overdose?
N-acetylcysteine (Mucomyst)
176
What is the black box warning for proton pump inhibitors (PPIs)?
Osteoporosis, C. difficile, hypomagnesemia
177
What is the first-line drug for diabetic gastroparesis?
Metoclopramide (Reglan) – Risk of tardive dyskinesia
178
What is the first-line treatment for constipation?
Bulk-forming laxatives (Psyllium, Metamucil)
179
What drug is used for sickle cell crisis?
Hydroxyurea
180
What drug is used to increase neutrophil production in chemotherapy patients?
Filgrastim (Neupogen)
181
What is the black box warning for erythropoietin-stimulating agents (Epoetin alfa)?
Increased risk of thrombosis and hypertension
182
What is the first-line treatment for benign prostatic hyperplasia (BPH)?
Tamsulosin (Flomax) – Alpha-blocker that relaxes prostate muscles
183
Which diuretics should not be given in patients with kidney failure?
Potassium-sparing diuretics (Spironolactone), ACE inhibitors (-pril), NSAIDs
184
What drug is used to reduce phosphorus levels in CKD patients?
Sevelamer (Renagel)
185
What is the treatment for hyperkalemia?
Calcium gluconate (stabilizes heart), Insulin + Dextrose, Kayexalate, Albuterol
186
What medication is used for overactive bladder?
Oxybutynin (Anticholinergic) – Causes dry mouth, urinary retention
187
What is the antidote for methanol or ethylene glycol poisoning?
Fomepizole or Ethanol
188
What medication is used for prevention of pregnancy (Emergency Contraception)?
Levonorgestrel (Plan B) – Best if taken within 72 hours
189
What is the black box warning for estrogen therapy?
Risk of blood clots, stroke, breast cancer
190
What drug is used to prevent preterm labor?
Terbutaline (Beta-agonist) – Causes tachycardia & tremors
191
What drug is used to induce labor?
Oxytocin (Pitocin) – Monitor for uterine hyperstimulation
192
What is the treatment for postpartum hemorrhage?
Oxytocin, Methylergonovine (Methergine), Misoprostol
193
What is the black box warning for testosterone replacement therapy?
Increased risk of MI, stroke, blood clots
194
What is the drug of choice for MRSA infections?
Vancomycin (Monitor peaks & troughs)
195
What is the most serious side effect of aminoglycosides (-mycin)?
Nephrotoxicity & Ototoxicity
196
What drug is used to treat Pneumocystis pneumonia (PCP) in HIV patients?
Trimethoprim-Sulfamethoxazole (Bactrim)
197
What drug is used to prevent HIV transmission from mother to baby?
Zidovudine (AZT)
198
What is the black box warning for TNF inhibitors (Etanercept, Infliximab)?
Serious infection risk & TB reactivation – Must screen for TB before starting
199
What should be avoided while taking rifampin (for TB)?
Oral contraceptives (reduced effectiveness), alcohol, soft contact lenses (orange
discoloration)
200
What antibiotic should be avoided in pregnant women & children?
Tetracyclines (-cycline) – Causes tooth discoloration
201
What is the black box warning for fluoroquinolones (-floxacin)?
Tendon rupture, CNS toxicity, QT prolongation
202
What is the treatment for C. difficile infection?
Oral Vancomycin or Fidaxomicin
203
What is the first-line treatment for osteoporosis?
Bisphosphonates (Alendronate, Risedronate) – Take on an empty stomach, stay
upright for 30 minutes
204
What is the black box warning for Raloxifene (Selective Estrogen Receptor Modulator
- SERM)?
Increased risk of DVT & Stroke
205
What is the drug of choice for acute gout attacks?
Colchicine or NSAIDs (Indomethacin, Naproxen) – Avoid aspirin!
206
What is the first-line treatment for chronic gout?
Allopurinol – Monitor for rash (SJS/TEN risk)
207
What drug is used for fibromyalgia pain?
Pregabalin (Lyrica) or Duloxetine (Cymbalta)
208
What is the black box warning for isotretinoin (Accutane)?
Teratogenic – Requires two forms of birth control
209
What should be monitored with prolonged corticosteroid use?
Osteoporosis, hyperglycemia, Cushing’s syndrome
210
What is the first-line treatment for psoriasis?
Topical steroids or Methotrexate for severe cases
211
Which drugs cause photosensitivity?
Tetracyclines, Sulfonamides, Fluoroquinolones, Amiodarone
212
What is the drug of choice for scabies and lice?
Permethrin (Topical) or Ivermectin (Oral)
