Chapter 13: Pharmacology Flashcards
Catecholamines and sympathomimetic medications should be administered with caution because they:
Can increase cardiac workload and myocardial oxygen demand
What is the primary physiologic effect of dobutamine
Increase inotropy (contractility)
What are the 10 patient rights
Right patient Right medication Right dose Right route Right time Right documentation Right assessment Right to refuse Right evaluation Right patient education
Chronotropic effect
Increased HR
Inotropic effect
Increased myocardial contractility
Dromotropic effect
Increased myocardial conduction
Paradoxical bradycardia may occur if atropine is given:
In doses less than 0.1 - 0.2 mg
What type of medication is used to eliminate certain toxins from the body?
Diuretic
In general, alpha-adrenergic receptor antagonists:
Lower blood pressure
Examples of schedule I substances
Heroin
marijuana
LSD
Examples of schedule II substances
fentanyl
methylphenidate
cocaine
Agonist effect for alpha 1 receptors
Vasoconstriction of arteries and veins
Agonist effects for alpha 2 receptors
Insulin restriction
Glucagon secretion
Inhibition of norepinephrine
Agonist effects for beta 1 receptors
Increased HR (chronotropic)
Increased myocardial contractility (inotropic)
Increased myocardial conduction (dromotropic)
Renin secretion for urinary retention
Agonist effects for beta 2 receptors
Bronchus and bronchiole relaxation
Insulin secretion
Uterine relaxation
Arterial dilation in certain key organs
Pinocytosis
The process that the cells of large medication molecules use to ingest intracellular fluids and their contents
What situation would you most likely administer a drug rectally
Seizure termination
What medications dissolve clots
Fibrinolytics (activase)
Patients with _________ are at significant risk for toxic effects of medications or metabolic waste products in the body.
Renal failure
What receptors does epinephrine stimulate
Alpha, beta 1, and beta 2 receptors
What receptors does norepinephrine stimulate
Alpha receptors
Cross-tolerance to a medication occurs when:
Repeated exposure to a medication within a particular class causes tolerance to other medications in the same class
Patients who are genetically predisposed to an immune-mediated medication response:
Had an initial exposure and sensitization to a particular antigen
When might massive doses of atropine be required
When acetylcholine increases dramatically due to acetylcholinesterase inhibition
The vagus nerve releases ________, which acts on ________ receptors.
acetylcholine, muscarinic-2
Why should beta-blockers be used with extreme caution in patients with a reactive airway
Beta-2 receptors can potentially be antagonized, resulting in bronchospasm
What classification of medication is ketorolac (Toradol)
NSAID
Physiologic drug antagonism occurs when:
Two medications, each producing opposite effects, are present simultaneously, resulting in minimal or no clinical changes
The percentage of an unchanged medication that reaches the systemic circulation is referred to as
Bioavailability
Metoprolol has the brand name ______, which may be a subtle reference to lowering the blood pressure.
Lopressor
Lipid-soluble medications require higher weight-based doses in elderly patients because
Elderly patients have a higher body fat percentage and fat distribution
At 5-10 mcg/kg/min, dopamine:
Activates beta-1 receptor sites, causing an increased heart rate and increased cardiac contractility
Assuming no ongoing blood loss, one unit of packed red blood cells will increase the hematocrit by
3%
The rectal route is preferred over the oral route for certain emergency medications because
Rectal medications are usually not subject to first-pass metabolism
Where does a medication undergo first-pass metabolism
Liver
What class of medication is typically used to control the heart rate in patients with atrial fibrillation or atrial flutter?
Calcium channel blocker
What are the 5 phases of cardiac cell activity
Phase 4: Cardiac cells at rest
Phase 0: Cells receives an impulse; sodium ion rapidly enter the cell
Phase 1: Sodium channels close while potassium exits the cell
Phase 2: Sodium and calcium slowly enter the cell; potassium continues to leave
Phase 3: Calcium channels slowly close and calcium leaves; potassium channels open, rapid movement of potassium out of the cell
Compared to succinylcholine, rocuronium
Has a rapid onset of action, a longer (15 to 60 minutes) duration of action, and fewer adverse effects
Fresh frozen plasma is used to
Replace critical clotting factors
Common medications administered intranasally
fentanyl
midazolam
naloxone
The therapeutic index of a medication is defined as the
Difference between the median effective dose and the median toxic dose
IV calcium is routinely used to treat:
Magnesium sulfate toxicity
A drug that possesses the same desired clinical effect in several smaller doses as it does in a larger single dose has demonstrated
A cumulative action
Fentanyl (Sublimaze) is the preferred opioid analgesic for patients in critical or unstable condition because:
It is not as prone to causing hypotension as morphine
Define tachyphylaxis
A condition in which repeated doses of medication within a short period rapidly cause tolerance, making the medication virtually ineffective
What is the MOA of anticoagulant medications
To prevent new clot formation and the growth of existing clots
What is the preferred IV fluid for Y-site tubing administration during a blood product transfusion
Normal saline
Acetylcholinesterase is an enzyme that:
Breaks down acetylcholine
What type of medication is used to decrease gastric acid secretion
Histamine-2 receptor antagonist
Tranexamic acid (TXA) has been shown to significantly decrease patient mortality when administered
within 3 hours of a traumatic injury
Unlike a nondepolarizing paralytic, a competitive depolarizing paralytic:
Causes muscle fasciculations
A patient recently began taking an antipsychotic medication and is experiencing a dystonic reaction. What drug is indicated?
Diphenhydramine
What is Stevens-Johnson syndrome
Severe, possibly fatal reaction that mimics a burn
The physical, emotional, or behavioral need for a medication in order to maintain a certain level of “normal” function is called:
Dependance
When is aspirin indicated for the treatment of a stroke
Only after an intracranial hemorrhage has been ruled out
Dopamine is commonly used in the prehospital setting as the primary medication for:
Nonhypovolemic hypotension
A medication that has a negative chronotropic effect will
Cause a decrease in the heart rate
A patient who overdosed on acetaminophen is at greatest risk for:
Liver failure
A malnourished patient with a history of long-tern alcohol abuse would most likely recieve:
Thiamine
Why might hypotension occur following the initiation of dobutamine infusion
It reduces cardiac afterload
How does ACE inhibitor medications lower blood pressure
They block the conversion of angiotension I to angiotension II
Newer medications are designed to target only specific receptor sites on certain cells in an attempt to:
Minimize the adverse effects
What is an abnormal susceptibility to a medication that is peculiar to an individual patient called
Idiosyncratic reaction
What is the physiologic effects of nitroglycerin when given to patients with cardiac related chest pain
Decrease preload and coronary vasodilation
How does the renin-angiotensin system function under normal conditions
Promote vasoconstriction and fluid retention in response to hypotension or hypoperfusion
At 15 mcg/kg/min, dopamine:
Causes vigorous vasoconstriction
First pass metabolism of a medication occurs when:
The bioavailability of a medication is reduced before it reaches the systemic circulation
Patients who take alpha-blocking medications at home are frequently prone to:
Postural hypotension
