Ex 2: Pharmacotherapy

Question 1

Pharmacotherapy

Answer 1

Treatment with prescription drugs to achieve a desired therapeutic objective w/minimum of adverse side effects

Question 2

Prevalence of Prescription drugs

Answer 2

50% of Americans take at least 1 ; 90% of adults age 60 or older take at least one p-medication; 40% of older Americans take five or more p-med/month

Question 3

During what time period is the risk of non-adherence the highest?

Answer 3

For the first 6 months

Question 4

Noadherence

Answer 4

1) not taking medication 2) not taking them correctly

Question 5

What is the most common reason for non-adherence?

Answer 5

Medication side-effects

Question 6

Drug

Answer 6

Substance that chemically alters biological function

Question 7

How many people in the U.S die from adverse drug effects?

Answer 7

150,000/year

Question 8

How long does it take to develop a drug?

Answer 8

Avg - 12 years ( 7-20 years)

Question 9

SJS

Answer 9

Stevens Johnson Syndrome: Most severe reaction to drug

Question 10

SJS symptoms

Answer 10

E: fever, headache, sore throat, itchy eyes 24-72 hours: inflammation and blistering of the eyes and mouth, skin,rash, nausea, and vomiting

Question 11

TEN

Answer 11

Toxic Epidermal necrolysis: similar to SJS but painful blistering of skin and mucous membrane involvement. involves 30% of total body surface area.

Question 12

Drugs are usually known by what type of name?

Answer 12

Their Brand “aka” trade name

Question 13

Indications

Answer 13

The reason for administering a medication or performing a treatment

Question 14

contraindications

Answer 14

A factor that prevents the use of a medication or treatment

Question 15

Which routes of drug administration are the quickest?

Answer 15

1) IV 2) Oral 3) subcutaneous

Question 16

Pharmacokinetics

Answer 16

Time course of drug absorption, distribution, metabolism, and excretion

Question 17

Measure of pharmacokinetics

Answer 17

1) Rate of bioavailability - max concentration in the blood 2) Total exposure of bioavailability- how long drug is active

Question 18

Acetaminophen

Answer 18

pain and fever; high dosage can cause damage the liver; no alcohol = no problem

Question 19

NSAIDS

Answer 19

Ibuprofen, naproxen, aspirin = inflammation, pain, and fever; can lead to both kidney and liver damage and cause GI bleeding

Question 20

pharmacodynamics

Answer 20

The biochemical and physiologic mechanisms of drug action; blood serum levels crucial. Drugs need to be bound to serum albumin. if less than 3.0 g/dL increases drug effect in the body

Question 21

Explain why patients may have different therapeutic effects among specific generic brands of the same active ingredient.

Answer 21

1) Genetics (different side effects, variation in how drugs are handled, ineffectiveness of a particular drug 2) age, gender, etc 3) different levels of bioavailability.

Question 22

Therapeutic window

Answer 22

Too little drug has no effect, too much drug has toxicity; (TW = between too much and too little)

Question 23

Discuss why medication administration is more complicated with pediatric patients and the best mechanism for determining medication dose.

Answer 23

1) higher proportion of water 2) lower plasma proteins 3) immature liver and kidneys

Question 24

Why are older adults at increased risk for interactions?

Answer 24

1) lower metabolism and excretion 2) multiple medications 3) lack of compliance

Question 25

Why is medication administration particularly challenging in pregnancy and lactation?

Answer 25

1) increased maternal HR and BV may effect absorption, distribuition and effectiveness 2) Because drugs can cross the placenta, into breast milk, 3) drugs can acts as teratogens

Question 26

Why is grapefruit juice eliminated from the menus of many hospitals and long-term care facilities?

Answer 26

Exacerbates side effects and toxicity; takes 2-3 days for new enzymes to be produced meaning efefect may persist for 48-72 hours after grapefruite digestion

Question 27

Why is Vitamin K intake a concern for the patient who is on anticoagulants? What types of food contain Vitamin K?

Answer 27

Involved in the production of blood platelets, antagonizes anti-coagulants; found in cruciferous, leafy vegetables.

Question 28

Why is natural licorice contraindicated for patients consuming diuretics or other antihypertensive medications?

Answer 28

Antagonizes anti-diuretics and anti-hypertensives; causes NA and H20 retention and K+ excretion; can create hypo kalemia

Question 29

Why are tyramine containing foods to be avoided for individuals taking MAOIs? What types of foods contain tyramine?

Answer 29

tyramine is a vasoconstrictor which in combinationof MAOIs may cause hypertensive crises; increased BP, HR, Flushing, headache, stoke and death; aged cheeses and meats, soy sauce, sauerkraut, fava beans, all disheses with cheese

Question 30

St. John’s Wort

Answer 30

Homeopathic; used in depression; diminshes ineffectiveness of drugs used in cancer and HIV/AIDS

Question 31

Ginkgo or Ginkgo Biloba

Answer 31

homeopathic; inhibits platelet activating factor - leads to excessive bleeding

Question 32

Glucosamine

Answer 32

homeopathic: linked to increased bleeding

Question 33

What drug type has the most side effects?

Answer 33

Corticosteroids: increased apetite and weight gain, hyper glycemia, hyperlipidemia, depresessed thyroid, increased risk for osteoporosis

Question 34

Corticosteroids

Answer 34

antiinflammatory, immunosuppressant ex: prednison cortisone, hydrocortisone; need to take w/food to decrease GI bleeding

Question 35

Diet concerns w/ corticosteroids

Answer 35

Low sodium, high protein, increased need for vitamins K A CDl increased need for Ca+ and P