Pharmacology was very overwhelming to me while in nursing school
. During clinicals, a RN once told me that it gets easier when you practice, as you will learn (look up those drugs you are not familiar with) as you go. There will be some drugs that are given more often on your unit.
:typing For your exam, I would recommend you pull out your pharmacology text book and your drug book as well. Read up on each class of drugs and understand what and how each class of drugs work. Make a table so that you can compare similarities and differences (highlight them in different colors) to help you learn. No need to get wordy on your table; just focus on key facts.
Your drug book should have a "nursing impliclations" (or similar section). These usually show you what you need to look for before / during / after giving a drug. It helps RNs focus on what needs to be done and what needs to be taught to patients. At my school, they tend to focus on these types of questions. Also note to which population you are giving these drugs to, adults or children. Some drugs have toxicity levels, so consider these numbers when you study. :typing
As mentioned in previous posts, Digoxin, increases contractility of the ventricles and lowers heart rate. It's usually given to patients with heart failure or those with atrial fibrillation (dysrhythmia). You hold this drug if the pulse is less than 60 beats per minute for adults (or 100 bpm for children!). Make sure to check patient's pulse for a full minute if patient is not on telemetry.
All antihypertensive drugs and diuretics should be held if BP is low (i.e., <100 mmHg, again... I work with adults). Most often, doctors will write paramaters.
Why diuretics? These will make patients pee more, therefore lowers volume to heart. Review your diuretics to understand which are potassium-sparing, etc., as diuretics will affect your electrolytes.
Now focus on the different classes of antihypertensives: ACE inhibitors, Beta blockers, Calcium channel blockers, Nitrates, etc. and understand how each type works.
ACE inihitors should be avoided for those with renal insuficiencies or renal failure. These may cause a dry, annoying cough. [Again... Look at your "nursing implications" of your drug book!]
Beta blockers also lower heart rate, so you would hold if BP is low -OR- if pulse is < 50 bpm for adults. (I treat adults so I don't recall if there are parameters for children). These are often prescribed to post CABG or PTCA (stent placement) patients.
Calcium channel blockers... Look at your patient's calcium level. Typically not used in second or third degree heart blocks.
Nitrates are often used for anginas or acute chest pains. These may cause headaches. Avoid use if patients have taken erectile dysfunction meds (i.e., sildenafil (Viagra)). Don't discount female patients, as some may Viagra-type meds for pulmonary hypertension.
Hope this helps! Good luck on your exam.