Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacotherapeutics II > Drug Review > Flashcards

Drug Review Flashcards

1
Q

Drug to give for hypokalemia

A

potassium chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do you give potassium by IV?

A

dilute; K is very irritating to veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What else is K irritating to?

A

GI tract; take with food and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If potassium chloride worked too well, what do you watch for?

A

hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are s/s of hyperkalemia?

A

peaked T waves, prolonged PR interval, bradycardia, dyspnea, dysrhythymias, fatigue, muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hypokalemia s/s

A

generalized weakness, fatigue, n/v, leg cramps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name four catagories of reasons to get hypokalemia?

A
  1. drugs (furosemide, hctz)
  2. vomiting and diarrhea/laxative abuse
  3. alkalosis and excessive insulin
  4. insufficient dietary intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what med do you give for overactive bladder?

A

oxybutynin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does oxybutynin work?

A

anticholinergic that blocks M3 receptors in smooth muscle of bladder. this decreases contractions and the urge to void

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

side effects of oxybutynin?

A 
tachycardia
anticholinergic effects (dry eye, photophobia, blurred vision, dry mouth, constipation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what conditions are oxybutynin contraindicated for?

A

glaucoma and myesthenia gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

symptoms of overactive bladder?

A

urgency
urge incontinence
frequency (8 + x per day)
nocturia (2+ x per night)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how to treat overactive bladder?

A 
behavior therapy (plan times to void, plan times to drink, limit caffeine, kegel exercises)
medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

two catagories of oral contraceptives and medications under each

A

combination
ethinyl estradiol/norethindrone
progestin only
norethindrone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how do the combo drugs work?

A

estrogen suppresses the release of FSH. Progestin suppresses the release of LH. this prevents ovulation, thins the lining of the uterus and thickens cervical mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does norethindrone alone work?

A

progestin suppresses the release of LH which thins the uterine lining and thickens cervical mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the other two convenient options for OC?

A

transdermal patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does the transdermal patch work

A

wear once a week for three weeks and no patch on the fourth week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the other option for OC?

A

vaginal contraceptive ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how does the contraceptive ring work?

A

wear for three weeks
no ring on the fourth week
if it falls out, wash with warm water and reinsert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the major problem with OC?

A

thromboembolic events…like PE, MI, DVT, or thrombotic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the risk factors for thromboembolic events?

A

heavy smoking, history of thromboembolism, thrombophilias, older than 35 years
we give lower doses now so not as big of a risk as in the past

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how do OC affect breast cancer?

A

can increase the growth rate of estrogen fed breast cancers…will not increaase the risk of breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the drug interactions with OC?

A

St John’s Wort
antiseizure meds (phenytoin, carbamazapine, phenobarbitol)
antibiotics (penicillans, cephalosporins, rifampin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the s/s of DVT?

A

redness,
warmth, (back of hand)
swelling,
and sometimes pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are some uses for OC?

A

contraception
acne
dysfxal uterine bleeding
menopausal hormone therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If you miss doses of OC how do you start back up? for combo?

A

combo- one of more pills in first week,
take one asap and then continue (use back up for 7 days)

1-2 missed pills in 2nd or 3rd week–
take 1 asap then continue; skip placebo pills and go straight to new pack after all active taken

3 or more pills missed in 2nd or 3rd week–
take 1 asap then continue; skip placebo pills; go straight to new pack after all active pills taken; use additional contraception for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

if you miss doses of OC in progestin only?

A

one of more pills in first week,
take as soon as remembered, use back up for 2 days

1-2 missed pills in 2nd or 3rd week
take 2 pills as soon as remembered; use back up for 2 days

3 or more pills missed in 2nd or 3rd week
stop
do not resume until menstration occurs or until pregnancy ruled out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

when do you start taking

A

begin on 1st day or 1st sunday after onset of menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what meds do you give for BPH? catagories and meds

A 
Alpha 1 blockers
tamulosin
doxazosin
5 Alpha reductase inhibitors
finasteride 
dutasteride
Saw Palmetto
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

alpha 1 blockers MOA

A

relax smooth muscle in the neck of bladder; allows urine to flow more freely thru the urethra; alpha 1 blockers also block receptors in the vasculature; decrease BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

which one is the nonselective alpha 1 blocker?

A

doxazosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

which one is the selective alpha 1 blocker?

A

tamsulosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what do alpha 1 blockers treat?

A

BPH, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

problems for nonselective alpha 1 BPH meds?

A

hypotension, dizziness, nasal congestion, sleepiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

problems with selective alpha 1 BPH meds?

A

abnormal ejaculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

two 5 alpha reductase inhibitors are? MOA?

A

Dutasteride, Finasteride
Block enzyme that converts testosterone into DTH a more potent version of testosterone. This halts the growth of the prostate and even shrinks it (DTH triggers prostate to grow);
These drugs help regrow hair (DTH plays a role in male pattern baldness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

problems with 5 Alpha Reductase (name 5)

A 
Pregnancy catagory X -- pregnant women must not handle broken or crushed tabs
decreased libedo
abnormal ejaculation
falsely decreased PSA levels
Gynecomastia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is the herbal that is really not effective for BPH

A

saw palmetto

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are 5 alpha reductase drugs given for? do you remember names of these?

A

BPH and male pattern baldness

41
Q

what catagory and drugs are ED?

A

PDE5 inhibitors
Sildenafil
Verdenafil
Tadalafil

42
Q

Problems with these PDE5 inhibitors?

A

hypotension
priaprism
sudden hearing loss

43
Q

How do PDE5 inhibitors work?

A

MOA: block PDE5 increasing cGMP levels allowing for enhanced blood flow of corpus cavernosum and penile erection

44
Q

What drug can you not take with PDE5 Inhibitors and why?

A

nitrates
fatal hypotension
both nitrates and PDE5 inhibitors increase cGMP levels; wait at least 24 hours between these drugs

45
Q

How soon do you take these drugs

A

take about one hour before activity

46
Q

be careful combining PDE5 inhibitors with?

A

alpha blockers

47
Q

if erections last longer than __ hours seek medical attention

A

4

48
Q

Common causes of ED

A

vascular, neurologic, hormonal, drug-induced, psychogenic

49
Q

What can increase plasma concentrationsfor PDE5 inhibitors?

A

grapefruit juice

50
Q

ED by age? 50’s? 60’s? 70’s?

A

4%
17%
47%

51
Q

L&D meds?

A

Oxytocin
methylergonovine
terbutaline
magnesium sulfate

52
Q

MOA of oxytocin

A

increase strength, frequency and length of contractions

53
Q

what do you use with oxytocin

A

pump

54
Q

when do you stop the infusion of oxytocin?

A

resting uterine pressure of >15-20 mmHG
contractions lasting > 1 min
contraction frequency of > 2-3 min
pronounced alteration of FHR or rhythm

55
Q

methylergonovine controls what?

A

postpartum bleeding by causing powerful uterine contractions

56
Q

what is there an increased risk of with methylergonovine?

A

hypertension;

safer agents such as oxytocin are usually tried 1st

57
Q

terbutaline does what?

A

suppresses preterm labor by activating beta 2 receptors in the uterus causing uterine relaxation

58
Q

major side effects of terbutaline?

A

heart: tachycardia, hypotension
lungs: pulmonary edema (crackles)
hyperglycemia

59
Q

what is magnesium sulfate used for

A

preeclampsia to prevent seizures

60
Q

MOA of magnesium sulfate

A

inhibits release of Ach in synapes of skeletal muscle and uterus; relaxes smooth muscle

61
Q

why is magnesium sulfate not used anymore for preterm labor?

A

ineffective and dangerous

62
Q

what are the s/s of magnesium sulfate toxicity?

A

hypotension
loss of DTR
RR<12
UO <25-30 mL/hr

63
Q

preterm labor is before ___ weeks

A

37

64
Q

preterm labor is the leading cause of infant ___ & ___

A

mortality and morbidity (75% of neonatal deaths)

65
Q

more than ___% deliveries are induced

A

22

66
Q

when should you induce labor

A

if beyond term (42 weeks)

when early delivery reduces morbidity and mortality to infant and mother

67
Q

what are the type of drugs that affect uterine function?

A

Oxytocics (either promote cervix ripening or promote contractions)
Tocolytics (prevent preterm labor or stop preterm labor)

68
Q

What catagories and drugs are Beta Lactam antibiotics?

A

penicillins–amoxicillan/clavulanate
cephalosporins–cephalexin
carbapenems–imipenem

69
Q

Problems with beta lactam antibiotics?

A

Allergic reactions (penicillans are the most common cause of drug allergy–0.4-7%)
severity varies from rash to anaphylaxis
1% cross sensitivity to cephalosporins
most likely to occur within 30 min

70
Q

Name another problem with beta lactam antibiotics

A

superinfection–can cause c diff (cephalosporins); advise clients to report watery diarrhea; treat with metronidazole or vancomycin

71
Q

beta lactams MOA

A

interfere with enzyme within bacteria called penecillin binding protein…it is what helps bacteria make strong cell walls. By blocking PBP they can’t build strong cell walls…they swell and burst

72
Q

what are the other type of antibiotics? name the drugs within?

A 
protein synthesis inhibitors
tetracyclines--tetracycline
aminoglycosides--amikacin, neomycin, gentamicin, streptomycin, tobramycin
macrolides--erythromycin
azithromycin
73
Q

problems with tetracyclines?

A

esophogeal ulceration
teeth discoloration (<8 yrs)
photosensitivity
many food interactions (milk products, calcium, iron supplements, magnesium containing laxatives, antacids)

74
Q

problems with macrolides?

A 
distorted taste (metallic)
prolonged QT intervals
75
Q

problems with amiNOglycosides

A

nephotoxicity

ototoxicity

76
Q

which drug is inactivated by penicillins

A

aminoglycosides

77
Q

When do you draw peaks and troughs?

A

peaks-30 min after IM/IV dose

trough-right before the next dose

78
Q

MOA of protein synthesis inhibitors

A

bind to bacterial ribosomes blocking their ability to make proteins necessary for their survival (prevent protein synthesis)

79
Q

Which drug class disrupts DNA replication in bacterial cells?

A

Fluoroquinolones

80
Q

Name drugs within fluoroquinolone class

A 
Levofloxacin
Moxifloxacin
oflofloxacin
Norfloxacin
Ciprofloxacin
81
Q

what is the problem with fluoroquinolones?

A

achilles tendon rupture (avoid use in children <18 years)
photosensitivity
multiple food interactions (dairy products, aluminum magnesium antacids, iron)

82
Q

Ciprofloxacin treats?

A

UTI, traveller’s diarrhea, and anthax

83
Q

Instruct clients to report what with fluoroquinolones?

A

pain, swelling, redness or any tendons or joints

84
Q

what are the differences in human and bacterial cells

A

cell walls
ribosomes
unique enzymes

85
Q

bactericidal

A

kills microbes

86
Q

bacteriostatic

A

slows growth of microbes

87
Q 
treatment challenges:
difficult \_\_\_/\_\_\_ to treat
1.
2. 
3. 
\_\_\_ resistance
\_\_\_\_\_\_\_\_\_\_\_
A 
sites/infections
1. CNS infections
2. endocarditis
3. purulent abscesses
bacterial resistance
superinfection
88
Q

always collect…

A

specimens before starting antibiotics

89
Q

what type are preferred?

A

narrow spectrum antibiotics

90
Q

antibiotics don’t kill ___

A

viruses

91
Q

complete how much?

A

full course

92
Q

What is common with antibiotics?

A

GI disturbances

93
Q

What are the urinary tract medications

A

sulfamethoxazole-trimethoprim
nitrofurantoin
phenazopyridine

94
Q

MOA of sulfamethoxazole-trimethoprim

A

blocks 2 seperate enzymes bacteria need to create their own folic acid

95
Q

problems with sulfamethoxazole-trimethoprim

A

hypersensitivity SJS
crystalluria–precipitates in urinary tract (drink 8 plus cups water daily)
kernicterus (pregnant women and infants <2 months old can’t have)–jaundice, increased bilirubin, neurotoxic in newborns

96
Q

nitrofurantoin MOA

A

enters bacteria and is converted into toxic substances that destroy bacterial DNA

97
Q

Problems with nitrofurantoin

A

urine turns brown
food increases absorbtion (40%) and decreases GI discomfort
peripheral neuropathy (rare)
contraindicated if renal impairment (inc risk of toxiity)

98
Q

phenazopyridine MOA

A

analgesic that works directly on the mucosa of the GU tract

99
Q

problems with phenazopyridine

A 
urine orange-red color (stains)
GI discomfort (take with food)

Pharmacotherapeutics II (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions