Pharmacology Review (NCLEX)

Introduction

• Presenter: Dr. Sharon
• Topic: Pharmacology 4 (Video 4 in Series)
• Recommendation: Watch previous videos for additional context

Case Study: AFib with RVR

• Patient: Admitted with AFib RVR, on continuous Cardizem IV drip
• Key Point: Cardizem (Diltiazem) is the drug of choice for AFib with RVR
  • Slows heart rate
  • Can convert rhythm back to sinus
• Rhythm Analysis:
  • Irregular rhythm, no distinct P wave, narrow QRS → AFib (not RVR anymore)
• Priority Intervention:
  • Do not titrate Cardizem up (slows heart rate more)
  • Do not administer Atropine (used for symptomatic bradycardia)
  • Correct Action: Titrate Cardizem drip down

Discharging a Patient with Furosemide

• Furosemide: Potassium-wasting diuretic
• Patient Education: Select all that apply
  • Do not take medication in the evening
  • Report increased fatigue or weight gain
  • Possible potassium supplement
  • No need for weekly blood draws for furosemide levels
  • Continue medication even if swelling improves (typically due to underlying condition)

Matching Drugs with Common Side Effects

• Drugs and Uses:
  • Digoxin: Inotropic agent
  • Fentanyl: Pain management
  • Lithium: Bipolar disorder
  • Vancomycin: Severe infections
  • Methylprednisolone: Steroid
  • Adenosine: Supraventricular tachycardia (SVT)
  • Sertraline: Antidepressant
  • Albuterol: Bronchodilator
• Side Effects:
  • Tachycardia: Albuterol
  • Bradycardia: Digoxin
  • Red Man Syndrome: Vancomycin
  • Hyperglycemia: Methylprednisolone
  • Paresthesia: Lithium
  • Drowsiness: Fentanyl
  • Xerostomia (Dry Mouth): Sertraline
  • Asystole: Adenosine

Status Epilepticus Management

• Definition: Seizure lasting more than 8 minutes
• Medication Choices:
  • Lorazepam orally (wrong route)
  • Phenytoin rectally (wrong med)
  • Correct Choice: Lorazepam IV

Toxic Drug Levels

• Drugs and Toxic Levels:
  • Lithium: >2
  • Phenytoin: >20
  • Digoxin: >2
  • Acetaminophen: >20

Updates and Closing

• Clinic Reviews is updating for Next Gen NCLEX
• Check clinicreviews.com for review schedules and updates
• Additional details on upcoming changes will be provided soon