Brainscape's Knowledge GenomeTM

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


See full index

Pharm 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Menarche

A

The start of menstruation, ends at menopause

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

What does estrogen do in CHC

A

Prevents: Formation of dominant follicle, ovulation, LH surge
Stabilizes uterine endometrium
Inhibits proliferation and secretory changes
Decreases irregular/heavy menstruation

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

Where is mestranol used in CHC

A

Used in older products or ones with high concentrations of estrogen (higher doses only in certain cases)

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

Preferrable dose of estrogen
What are other doses associated with (3)
What is preferred

A

Low!
Higher doses are associated with MI, VTE, and strokes
Low estrogen products with estradiol are preferred

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

Progestin

A

Natural or synthetic with progesterone-like effects
Most are derivatives of testosterone
Balance estrogen effects
Make endometrium less favorable for implantation
Suppress LH surge, prevent ovulation and pregnancy

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

Progesterone

A

Naturally occurring hormone produced in the ovaries

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

Progestin in CHC (1st gen 3 examples and what to remember)

A

Norethindrone, norethindrone acetate, ethynodiol
ETHIN or ETHYN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Progestin in CHC (2nd gen example)

A

Norethisterone and levonorgestrel (LNG)
MOST COMMON

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

Progestin in CHC (3rd gen 3 examples, perks, and what to remember)

A

Desogestrel, gestodene, norgestimate
Higher efficacy, fewer effects on lipids and carb metabolism, fewer androgenic side effects
ESO or EST

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

SE of increased estrogen in CHC (5)

A

cyclic breast changes (soreness and tenderness)
dysmenorrhea
menorrhagia (increased bleeding)
chloasma (hyperpigmentation of skin)
VTE (clots)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SE of decreased estrogen in CHC (2)

A

Amenorrhea
Spotting

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

SE of increased progestin in CHC (4)

A

Weight gain, depression, fatigue, decreased libido

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

SE of decreased progestin in CHC (2)

A

breakthrough bleeding (between cycles)
headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can CHC be administered

A

Orally (most common)
Transvaginal and transdermal (not used for high-risk patients, but there is less N/V, heart and circulatory risks, and easier compliance?)

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

Effectiveness of oral CHC

A

99.3% if completely correct
92% with typical use

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

Advantages of oral CHC

A

Decreases blood loss, cramps, less pain on ovulation (mittelschmerz)
Reduction of ovarian cysts, benign breast disorders, pelvic inflammatory disease, ectopic pregnancy, endometrial and ovarian CA

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

Monophasic (non-phasic) CHC

A

Fixed ratio of estrogen:progesterone

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

Biphasic CHC and example

A

Fixed amount of estrogen but less progestin in beginning of cycle: this allows for normal physiologic process of menstruation without ovulation
Ex: ortho-novum

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

Triphasic CHC, perk and 1 example

A

Low estrogen and progestin, ratios change during 3 phase in the cycle
LEAST SIDE EFFECTS BC LOW HORMONES
Ex. Ortho tri-cyclenLo (Also for acne)

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

Four phasic CHC

A

Ratios change 4 times in cycle

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

Yasmin

A

Monophasic pill with ethinyl estradiol and drospirenone (K+ sparing, hyperkalemia, vfib and v-tach)

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

Yasmin contraindications

A

Contraindicated in liver, kidney, or adrenal insufficiency, NSAIDS, k+ sparing meds, ACE, ARBS

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

Oral CHC pack

A

21 or 28 day packs (in the 28 day, 7 of them are empty or inactive)
Last 7 days are decreasing estrogen to cause withdrawal bleeding (not true menses)

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

what does Loestrin FE do

A

Gives iron during withdrawal bleeding to prevent anemia

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

Mircette

A

2 days of Fe and 5 days low-dose estrogen to help prevent HA from estrogen withdrawal

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

Extended cycle products and 3 examples

A

shortened period of inactive pills reduces number of withdrawal bleeding days
Ex. Loestrin 24, YAZ, beyaz
YAZ and 24 because 24 hours in a day and days are long so it’s a longer period of active pills idk

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

Continuous dosing products

A

Seasonale (jolessa): 91 days with 84 active days and 7 inactive. Withdrawal bleeding only 4x/year
Lybrel: 28 days with no withdrawal bleeding

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

Ortho-evra transdermal patch (where and how is it worn, advantages)

A

Worn on stomach, buttocks, outer arm, upper torso (fatty areas)
Worn for 3 weeks, 1 week off for withdrawal bleeding
Similar advantages to oral

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

Ortho-evra transdermal patch disadvantages and who shouldn’t use it

A

skin irritation, menstrual cramps, change in vision or inability to wear contact lenses, not as effective in women over 198 lbs, weight gain or loss, nausea
Increased risk of VTE
Do not use women >35, smoke bc of constricted arteries and clots easily form

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

NuvaRing

A

2 inch indwelling ring with estrogen/progesterone
Inserted during first 5 days of menstruation
Indwelling for 3 weeks, removed for 1 for withdrawal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

NuvaRing considerations

A

1st 7 days after insertion, use backup method
If it falls out, must be put in within 3 hours. If not, use backup for 7 days
Increased risk for: VTE, vaginal irritation, discharge or infection
Risks increased if pt smokes

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

Who uses progestin-only pills

A

Used for women who can’t take estrogen:
History of VTE
Heart disease
Breast feeding (estrogen can be excreted in breast milk)
Smokers (Spasms of blood vessels)
Over 35
HTN
Or those who experience HA, chloasma, Lipid changes

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

Progestin pill side effects (5)

A

Higher incidence of irregular bleeding
Fatigue
Decreased libido
Depression/mood changes
Weight gain

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

Routes of progestin only (4)

A

Oral, IM, SQ, implantable

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

3 oral progestin only

A

Micronor, nor QD, aygestin
NOR or ends in estin just like progestin

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

injectable progestin only rules

A

depo-provera (depo=deep like an injectable)
Injected every 11-13 weeks (negative test needed for next injection)
Suppresses ovulation
If late injection, 13 weeks and one day must be ruled out for pregnancy

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

Progestin only considerations (injectable)

A

Stop after 2 continuous years (risk of decreased bone density)
Increase intake of Ca and vit d

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

Implantable progestin only

A

Nexplanon similar to implanon
Inserted for up to 3 years
Nexeplon contains barium which shows up on X-rays, US, CT, and MRI
Not used in women with BMI>30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What to do with 1-3 missed doses of BC

A

Missed 1: take as soon as you remember
Missed 2: take 2 when you remember and 2 the next day
Missed 3: discard pack, use backup, and restart

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

What hormone is in plan B

A

Progestin only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does a copper-releasing IUD do

A

prevents implantation, not fertilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Perimenopause S&S

A

Cycles can become longer or shorter, irregular, insomnia, hot flashes, irritability, H/A, memory lapse, decreased libido, vaginal dryness, joint aches and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Premarin

A

Conjugated estrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Indications of premarin and MOA

A

HRT for menopause symptoms
Mod-severe vasomotor symptoms of menopause, vaginal dryness/atrophy
MOA: develops and maintains female genital system, breasts, and secondary sex characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Contraindications of premarin

A

Known drug allergy
Any estrogen dependent cancers
Undiagnosed abnormal vaginal bleeding
Pregnancy, lactation
Active thrombolytic disorder (Stroke, thrombophlebitis, hypercoagulable states, CVD, smokers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Adverse effects of premarin

A

Most serious: thromboembolic events
Common: N/V/D/C, photosensitivity, HTN/thrombophlebitis, amenorrhea/breakthrough bleeding, chloasma/hirsutism/alopecia, tender breasts/fluid retention/HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Interactions of premarin

A

Decreased activity of oral anticoagulants
Concurrent use of rifampin and St. John’s wort can decrease effectiveness
Use with tricyclic antidepressants (TCA) can cause toxicity of TCA
Smoking can increase risk of thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

SSRI for menopause

A

Reduce severity of vasomotor symptoms, reduce depression, may relieve irritability, and mood changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Clonidine for menopause

A

reduces vasomotor symptoms, sedative effect, must monitor BP (antihypertensive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Gabapentin for menopause

A

May relieve vasomotor symptoms, should be limited to those who can not take HRT, may cause drowsiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Soy, red clover, black cohosh for menopause
caution in who (2)

A

Helps decrease hot flashes. Caution with women who have breast cancer and liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

11 therapies for menopause

A

SSRI, clonidine, gabapentin, soy, red clover, black cohosh, Vit E, primrose, St. John’s wort, ginseng, melatonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

WHI and their opinion on HRT

A

Some ppl are having bad reactions so lets completely get rid of HRT. Oh wait, there’s a pattern with the people who had bad reactions, ok nvm only SOME people get HRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What do the testes do

A

produce male sex hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What happens in the seminiferous tubules

A

Spermatogenesis (mature sperm cells are produced)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Androgens

A

Primarily testosterone which is an anabolic steroid
Controls the development and maintenance of male primary and secondary sex characteristics
Decreases fat mass, helps with hair placement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Testosterone

A

Produced from interstitial cells between the seminiferous tubules
Androgenic activity
Anabolic activity
Involved in development of bone and muscle tissue
Inhibition of protein catabolism
Erythropoietic effects (produces RBCs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Synthetic derivatives of testosterone

A

Improves pharmacokinetics/dynamics of endogenous hormone
Combined esters with testosterones, poor PO absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Uses of synthetic derivatives of testosterone

A

Decreased libido and fatigue due to low levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Examples of synthetic derivatives of testosterone

A

Testosterone propionate: oily solution lasting 2-3 days, administered every 2-4 weeks
Methyltestosterone/fluoxymesterone: effective with oral administration, buccal tablet, or injectable
Transdermal forms: Gel and skin patches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Anabolic steroids

A

Possess high anabolic activity
Not used in US a lot bc of potential for misuse in muscle people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Indications of anabolic steroids

A

Anemia, hereditary angioedema, metastatic breast cancer, wasting syndrome due to HIV
Four products available in the US
Schedule III drug: can lead to psychological or physical dependence (DEA number needed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

4 names of anabolic steroids

A

Anadrol-50
Oxandrin
Winstrol
Nandrolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Indications of testosterone (androgen)

A

Primary and secondary hypogonadism
Treatment of oligospermia
Inoperable breast cancer in women (relieving symptoms, not a cure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Why are androderm and testoderm patches used

A

to mimic natural circadian cycles in males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Where are andro and testoderm patches applied

A

Androderm: not scrotal skin
testoderm: scrotal skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Who shouldn’t touch androderm patches and why

A

Children
Inappropriate enlargement of genitalia, premature development of pubic hair, advanced bone aging, increased libido, aggressive behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Nursing considerations of androderm patches

A

Baseline lab testing BUN/Cr, LFT, CE/s, lipids (MI or CVA)
Watch for weight gain or electrolyte disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What do androgens maintain

A

Secondary health characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

When does BPH process start

A

30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

MOA of 5-Alpha reductase inhibitor (Proscar) finasteride

A

Reduces prostate size by inhibiting the enzyme that converts testosterone to 5-alpha dihydrotestosterone (DHT)
Eases the passage of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is 5-Alpha reductase inhibitor (Proscar) finasteride used for

A

BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Additional effects of 5-Alpha reductase inhibitor (Proscar)

A

May increase hair growth in men
teratogenic in pregnant women and children (Don’t touch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Indications of 5-Alpha reductase inhibitor (Proscar)

A

Androgenic alopecia in men
BPH shrinks prostate in 3-6 months

75
Q

Contraindications of 5-Alpha reductase inhibitor (Proscar) (2)

A

Hypersensitivity
Pregnant women, category X

76
Q

Examples and pattern of erectile dysfunction medications

A

Sildenafil (viagra), vardenafil (levitra), tadalafil (cialis)
Ending -afil

77
Q

What does sildenafil (viagra) do

A

Inhibits the enzyme phosphodiesterase, causing the buildup of guanosine monophosphate, causing the relaxation of smooth muscle in the penis and permits inflow of blood
Nitric oxide is released inside the corpora cavernosa during sexual stimulation and contributes to the erectile effect

78
Q

Indications of sildenafil (viagra)

A

Take 1 hour before intercourse

79
Q

Contraindications of sildenafil (viagra)

A

Hypersensitivity
Can potentiate hypotensive effects of nitrates, avoid concurrent use
NO NITROGLYCERINS because of significant hypotension (vasodilator)

80
Q

Adverse effects of sildenafil (viagra)

A

Hypotension
headache
Dyspepsia
Priapism (erection for >4 hours)
Visual loss

81
Q

Oxytocin (Pitocin) use and mode of action

A

Use: To induce labor
MOA: increases uterine contractility

82
Q

SE and AR of oxytocin (pitocin)

A

SE: HTN, dysrhythmias, hypercontraction of uterus
AR: Seizures, water intoxication

83
Q

Terbutaline use and SE

A

Use: Decreases uterine contractions to stop preterm labor
SE: tachycardia in mother and fetus, SOB

84
Q

Magnesium sulfate

A

Can be used for preterm labor to decrease contractions
may be safer than terbutaline because it increases blood flow to uterus (less tachy)
Can also be used for preeclampsia (high BP and proteinuria)

85
Q

Cholinergic drugs (which part of the CNS)

A

Parasympathetic (rest and digest)

86
Q

neurotransmitter of PNS

A

acetylcholine
CHOLINE for CHOLINErgic drugs

87
Q

Direct acting cholinergic drugs

A

Stimulate postsynaptic nerve cell release of acetylcholine at the receptor site (agonists)

88
Q

Indirect acting cholinergic drugs

A

has something helping it
inhibits acetylcholinesterase (breaks down acetylcholine)

89
Q

cholinergic stimulation (GI and urinary)

A

frequent gastric secretions, mobility, urinary frequency (bladder contracts, sphincter relaxes)

90
Q

Cholinergic stimulation (miosis)

A

constriction of pupil, opening of canal of schlemm, decreased intraocular pressure

91
Q

cholinergic stimulation (cardiovascular)

A

decreased HR, vasodilation

92
Q

cholinergic stimulation of lungs

A

increased secretion and restriction

93
Q

cholinergic stimulation (skeletal)

A

increased contraction (nicotonic)

94
Q

Bethanechol (urecholine) use

A

cholinergic
Direct acting
post-op and post-partum non obstructive urinary retention
urinary retention r/t neurogenic atony of the bladder

95
Q

Routes of bethanechol

A

PO/SQ
IV and IM contraindicated

96
Q

contraindications of bethanechol

A

intestinal or urinary obstruction
bradycardia
hypotension
peptic ulcer bc of increased GI secretions
active bronchial asthma and COPD (bc of bronchoconstriction)
parkinsonism (bc we want a DECREASE in acetylcholine, not in increase)

97
Q

side effects of bethanechol

A

N/V/D
abd cramps, salivation, sweating, frequent urination, blurred vision, miosis

98
Q

adverse effects of bethanechol

A

orthostatic hypotension, bradycardia, muscle weakness, heart block/cardiac arrest, acute asthma attacks

99
Q

drug interactions of bethanechol

A

Decreased effect of bethanechol with antidysrhythmics, ganglionic blocking agents cause significant hypotension, atropine counteracts

100
Q

nursing considerations of bethanechol

A

ambulation and increased fluid intake
monitor VS, urine output >1500ml
atropine antidote
change position slowly, 1 hr before or 2hrs after meals

cholinergic crisis: muscular weakness and increased salivation

101
Q

pilocarpine

A

cholinergic

102
Q

reversible cholinesterase inhibitors

A

produce pupillary constriction in glaucoma
cholinergic

103
Q

cholinesterase

A

breaks down into acetylcholine
small amount needed
cholinergic effects
smooth muscle stimulation

104
Q

Physostigmine (antilirium) what is it and indications

A

anticholinesterase (indirect-acting)
myasthenia gravis, reversal of anticholinergic drug effects

105
Q

Physostigmine (antilirium) contraindications

A

known drug allergy, prior severe cholinergic reactions, asthma gangrene, hypothyroidism, CAD, mechanical obstruction of GI or GU tracts

106
Q

adverse reactions of Physostigmine (antilirium)

A

GI upset, excessive salivation

107
Q

interactions and routes of Physostigmine (antilirium)

A

anticholinergics (opposites)
IM or IV

108
Q

parasympatholytics

A

opposite of parasympathetic
anticholinergic
sympathetic nervous system

109
Q

Cardio effects of anticholinergics

A

increased HR, dysrhythmias (used for symptomatic brady)

110
Q

CNS effects of anticholinergics

A

restlessness, irritability, disorientation, hallucinations, delirium

111
Q

Eye effects of anticholinergics

A

dilates pupils, decreased visual accommodation, increased intraocular pressure

112
Q

GI and GU effects of anticholinergics

A

GI: decreased salivation, gastric secretions, and motility
GU: increased retention

113
Q

glandular and resp effects of anticholinergics

A

glandular: sweating
resp: decreased secretions

114
Q

atropine indications

A

bradycardia (bradycardia ends in A)
pre-op control of secretions, treatment of insecticide poisoning
code or rapid response

115
Q

contra of atropine

A

closed angle glaucoma
adhesions between iris and lens
certain types of asthma
severe hepatic and renal dysfunction
reflux esophagitis
intestinal atony
hiatal hernias
obstructive GI or GU conditions
severe ulcerative colitis

116
Q

side effects of atropine

A

dry mouth, nausea, headache, constipation, dry skin, blurred vision, palpitations, urinary retention

117
Q

adverse effects and life threatening of atropine

A

AE: tachy and hypotension
LT: v-fib, stevens johnson, coma

118
Q

Dicyclomine (Bentyl) use

A

antispasmodic cholinergic blocker
treatment of IBS, colic and enterocolitis in infants

119
Q

contraindications of Dicyclomine (Bentyl)

A

KDA
angle closure glaucoma
GI tract obstruction
myasthenia gravis
paralytic ileus
GI atony
toxic megacolon

120
Q

indications of Cogentin

A

anticholinergic
decreases rigidity, tremors of parkinson
inhibits release of acetylcholine

121
Q

side effects of Cogentin

A

dry mouth, dry secretions, urinary retention, constipation, blurred vision, increased HR, restlessness, confusion

122
Q

life threatening and contra of Cogentin

A

LT: paralytic ileus
contra: glaucoma

123
Q

indications of Oxybutynin (ditropan)

A

overactive bladder, antispasmodic for neurogenic with spinal injuries

124
Q

contra of Oxybutynin (ditropan)

A

KDA, GI/GU retention, uncontrolled angle-closure glaucoma

125
Q

Oxybutynin (ditropan) nursing considerations

A

PATCH!
and take 1 hr before meals or 2 hours after w fluids

126
Q

Tolterodine (detrol) indications

A

urinary frequency, urgency, urge incontinence caused by bladder overactivity
Used more often bc less dry mouth since it’s more specific to bladder

127
Q

Tolterodine (detrol) contra

A

angle-closure glaucoma, urinary retention, decreased hepatic function

128
Q

what to do if Tolterodine (detrol) is taken with cytochrome P-340 3A4 (ketoconazole, erythromycin)

A

start with 1mg 2x day (1/2 normal dose)

129
Q

how to take Tolterodine (detrol) and side effects

A

PO without food and no grapefruit juice
SE: dry mouth, eyes and skin, HA, dizziness, vertigo, nervousness, N/V/D/C, abdominal pain, urinary retention

130
Q

anticholinergic for motion sickness and side effects

A

scopolamine
-patch behind ear or wrist band
-Used for 3 days

Dramamine, antivert, marzine

SE: dry mouth, blurred vision, constipation, urinary retention

131
Q

nursing considerations for anticholinergics

A

assess urinary output (bc it causes retention)
check hx (contra of glaucoma)
monitor VS (HR increases)
bowel sounds (decreased peristalsis)
mouth care (dry)

132
Q

What do agonists of a drug do

A

increase activity

133
Q

neurotransmitters of sympathetic nervous system

A

norepinephrine, epinephrine, dopamine

134
Q

Beta 1

A

heart

135
Q

beta 2

A

lungs

136
Q

dopaminergic receptors

A

arterial dilation, increasing blood flow to organs

137
Q

sympathomimetic drugs indirect acting

A

causes a release of catecholamine from storage site in nerve endings, then binds to receptors

138
Q

sympathomimetic drugs mixed acting

A

acts directly by binding to receptor site and then indirectly by stimulating release of neurotransmitters

139
Q

+ inotrope

A

increases contractility, increases CO

140
Q

(-) inotrope

A

decreases contractility and CO

141
Q

+ chronotrope

A

HR increases

142
Q

(-) chronotrope

A

HR decreases

143
Q

alpha-1 locations and responses (3)

A

pupils: dilation
GU: constriction of bladder
vessels: constriction

144
Q

beta 1 locations and responses (4)

A

cardiac: increased contractility (+ inotrope)
AV node: increased HR (+ chronotrope)
SA node: increased HR
kidney

145
Q

beta-2 locations and responses (2)

A

lungs: vasodilation
bronchial muscles: dilation

146
Q

alpha-1 beta-1 location and response

A

GI muscle: decreased motility (relaxation of muscle)

147
Q

alpha-1 beta-2 location and response

A

liver: glycogenolysis

148
Q

Dobutamine (dobutrex) class and indication

A

class: beta-1 adrenergic
cardiac decompensation (increases)

149
Q

dobutamine (dobutrex) MOA and AE

A

MOA: increases CO by increasing contractility (+ inotrope), increases SV and perfusion to kidneys
AE: H/A, restlessness, HTN, tachy, palpitations, dysrhythmias

150
Q

dopamine (inotropin) use (low vs high dose)

A

beta-1 adrenergic
low dose dilates vessels in kidneys, brain, heart, mesentery, increasing blood flow
high dose increases contractility and CO

151
Q

dopamine (inotropin) indications, contra and antidote

A

indications: shock, cardiopulmonary arrest
contra: catecholamines secreting tumor of adrenal gland
if extravasation: phentolamine (alpha blocker)

152
Q

epinephrine (adrenaline) use

A

acts on receptors by the SNS, strengthens cardiac contraction, bronchodilation, increased HR and CO
beta-1 (increased HR), beta-2 (bronchodilation)

153
Q

epinephrine (adrenaline) indications

A

anaphylaxis, cardio shock, severe hypotension, cardiac arrest

154
Q

epinephrine (adrenaline) side and adverse effects and LT

A

SE: anorexia, N/V, nervousness, tremors, agitation, HA, weakness, pallor, sweating, dizziness
AE: palpitations, tachy, HTN, dyspnea, necrosis (vasoconstrictor), gangrene if infiltration
LT: vfib and pulmonary edema

155
Q

epinephrine (adrenaline) interactions

A

Increased effect with TCA, MAOI, decreased effects with BB, methyldopa, digoxin may cause dysrhythmias

156
Q

Norepinephrine (levophed)

A

Beta-1
not used during allergic reaction, for hypotensive states

157
Q

Neo-synepherine (phenylephrine)

A

alpha adrenergic
hypotension and SVT
alpha-1 (vasoconstrictor)
more pressure=decreased secretions

158
Q

albuterol (proventil, ventolin)

A

beta-2 adrenergic agonist
treats bronchospasm, asthma, bronchitis, COPD

159
Q

contra of albuterol

A

dysrhythmias, CAD

160
Q

caution, SE, AR, LT of albuterol

A

caution: cardiac disease, HTN, hyperthyroidism, DM, renal dysfunction, elderly, pregnancy
SE: tremor, nervousness, dizziness, restlessness, sweating, blurred vision, flushing, HA, hoarseness, insomnia
AR: palpitations, tachy, HTN, hallucinations, seizures, hyperglycemia
LT: increased effects w sympathomimetics, TCA, MAOI, decreased BB

161
Q

2 centrally acting alpha 2 agonists

A

clonidine and methyldopa (both for HTN) bc alpha 2 is a vasodilator

162
Q

alpha 1, alpha 2, beta 1, beta 2

A

alpha 1: vasoconstrictor
alpha 2: vasodilator
beta 1: heart
beta 2: lungs

163
Q

adrenergic blockers

A

blocks effects of receptors (and SNS at alpha 1 receptors)
vasodilation, reduced BP, miosis (pupil constrict), reduced muscle tone

164
Q

indications of alpha-adrenergic blockers

A

HTN, BPH, raynauds

165
Q

endings of alpha blockers

A

-zosin

166
Q

tamsulosin (flomax)

A

treats BPH
not used with ED drugs, alpha blockers, or Ca+ blockers

167
Q

beta blockers for glaucoma?

A

yes!

168
Q

beta blockers ending

A

-olol

169
Q

selective vs non selective BB

A

selective just for one part
beta-1 selective
beta-1 and 2 for non selective

170
Q

alpha blockers use

A

HTN except flomax

171
Q

beta and alpha blockers

A

vasodilate to lower BP, decrease HR, contractility, CO, release of renin

172
Q

indications of BB

A

MI, angina, dysrhythmias, HTN, heart failure
prevents migraines

173
Q

contra of BB

A

KDA, uncompensated HF, shock, heart block, brady, pregnancy, pulmonary disease, raynauds

174
Q

SE of BB and acute withdrawal

A

SE: mild and transient brady, AV block, hypotension, bronchoconstriction, mask hypoglycemia, inhibit glycogenolysis
acute withdrawal: HTN crisis, angina, MI

175
Q

African americans and BB

A

don’t respond well bc low renin

176
Q

asian americans and BB

A

works very well

177
Q

indian americans and BB

A

resistance

178
Q

salt amount for HTN

A

<2g/day

179
Q

stages of HTN

A

normal: 90/60-119/79
pre: 120/80-139-89
stage 1: 140/90-159/99
stage 2: >160/100

180
Q

6 types of antihypertensives

A

diuretics
sympatholytics
vasodilators
ACE
ARBS
Ca+ blocker

181
Q

hydrochlorothiazide

A

diuretic for HTN
avoid in renal insufficiency

182
Q

alpha and beta for HTN

A

beta-adrenergic blockers
centrally acting alpha 2
alpha adrenergic
adrenergic neuron blockers
alpha 1 beta 1 blockers

183
Q

beta blockers

A

used for HTN and also decreases HR
for asthma pts, use selective BB

184
Q

metoprolol (lopressor, toprol)

A

decreases CO
decompensated HF don’t use
beta-1 blocker
not for pregnant women
taper down

Pharm 2 (5 decks)

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