Exam 1 Flashcards by Monique Amaya

What are the three different names for each drug

Chemical
Generic
Trade (Brand)

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Lethal/ Effective Dose

Higher therapeutic index= Safer
Lower therapeutic index= Less safe

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Therapeutic Index (TI) Equation

Lethal Dose(50) / Effective Dose(50)

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Different ways of of absrption

Oral / Gastric mucosa
Small intestine
Rectum

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Sublingual/ Buccal Route

Tongue and back of cheeks
Bypasses the liver

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Parenteral Route

Fastest route
ID, IM, SubQ, IV, intrathecally (epidural)

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Topical Route

Skin, eyes, ears, nose, rectum, vagina, lungs
Slow onset prolonged offset

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Transdermal Route

Adhesive drug patch
Consistent delivery
Bypasses liver

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Most common side effects of medications

Nausea and Vomiting

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How long does IV media take to work?

5-15 min

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How long do PO MEDS take to work

30min- 1hr

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When are you most likely to make a mistake in your shift?

1st and last 30 min of shift

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Meds that do not want you to take with food, what is the rule?

No food 1 hour before or 2 hours after

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Why are meds more toxic to infants? Especially topical?

Due to small Body Surface Area

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Rules for Transdermal (patches)

Put on near area of pain
Do not put over bone
Put in gloves
Change places

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GI issues and Meds

Diarrhea- less absorption
Constipation- more absorption

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Organs for metabolism

Liver
Kidneys
Skeletal muscle
Lungs
Plasma
Intestinal Mucosa

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How do we Excrete drugs?

Urine
Sweat
Saliva
Expelled air
Breast milk

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Organs for Excretion

Kidneys and liver
Bowel
Biliary excretion
Enterohepatic recirculation

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Highest blood level

Peak level

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Lowest blood level in therapeutic range

Trough Level

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Grapefruit

No MAOIs
Stop 3 days before and 3 days after
Can cause malignant hypertension

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Antihistamines make you drowsy, which also….

Slows down peristalsis.. GI movement

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Benadryl

Diphenhydramine
-traditional
-peripheral and central acting

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Other traditional Antihistamines

Chloroheniramine (Chloe-Trimeton)

Claritin

Loratidine -Non-sedating -Peripheral -Does not work centrally( doesn’t cause drowsiness)

Other Nonsedating Antihistamines

Zyrtec-cetirizine Clarinet- desloratadine Allegra- fexofenadine

For allergy testing you should stop taking allergy meds…

4 days prior

What medical condition do you watch out for with use of nasal sprays?

Can increase glaucoma

Afarin is a …

Decongestant -Can get rebound congestion for 24-48hrs -Don’t take more than 3 days

This kind of spray does not make glaucoma worse

Intra-nasal Steroid -no rebound congestion -can suppress immune system & cause nasal infection

Fluticasone nasal spray and inhaler

Nasal- Flonase Inhaler- Flovent

If you have to take a PO allergy med and a nasal spray, what time do you take each?

Po allergy in AM Nasal spray- PM

Honey has …… which breaks down mucus

Amylase

Generic name for Vicks and Robitussin

Dextromethorphan -dizziness, drowsiness, nausea

Tessalon Perles

Benzonatate -dizziness, drowsiness, nausea, sedation

What do expectorants do?

Break down mucus and thin out secretions

Mucinex & Robitussin

Guaifenesin - N/V and gastric irritation

Retractions start…. then as they …, the retractions go…….This means the symptoms are …..

Retractions start at the top , then as they get worse, the retractions go down. This means the symptoms are worsening.

Bronchodilator classes

1. B-adrenergic antagonist 2. Anticholinergics 3. Xanthine derivatives

Short active Beta Agonists

Rescue (asthma & sports) Albuterol (Proventil, Ventolin, ProAir) Inhaled ( Inh or Neb) *Best Oral PO

Long Acting Beta Agonists

Maintenance (Asthma & COPD) 12-24 hrs Salameterol Use with steroid (salmetrol & fluticasone= Advair)

At risk for asthma related deaths

African American HTN

Steroids do what to the body?

Suppress immune system and slow down bone production

Rinse mouth and spit after…

Steroid inhaler so you don’t get thrush

Medications with -ide and -one are?

Steroids

Anticholinergics

Slow down -dry mouth, constipation -bronchodilator

Atrovent

Ipratropium -Anticholinergic -can use with albuterol (short acting) to make a Duoneb (active attack)

Spiriva

Tiotropium - anticholinergic -longer effect on bronchial trees

Xanthine Derivative

Used for Severe asthmatic Metabolizes into caffeine Speeds up pulse

Theo-Dur

Theophylline -xanthine derivative -Therapeutic range 10-20 mcg/mL

Another Xanthine Derivative

Aminophylline -prodrug (needs good liver)

Leukotrienes

-Causes inflammation, -bronchoconstriction & mucus production -coughing, wheezing, SOB

Singular

Montelukast -blocks leukotrienes -causes nausea Behavioral changes in children -aggression, nightmares, depression

Corticosteroids do what?

Reduces inflammation Bronchodilation Slows remodeling of lungs -can get dry mouth

You can develop COPD from

Smoking Environmental Uncontrolled asthma

Inhaled Corticosteroids

Fluticasone- Flovent Budesonide- Pulmicort Beclomethasone- Qvar Mometasine- Asmanex Triamcinolone- Azmacort

Risks for Corticosteroids

Bone loss Growth issues (pediatric) Infection risk (lowers immune) Blood sugar

Oral & IV corticosteroids

-Methylprednisolone (Solu-Medrol Injection & Medrol Tablet) -Prednisone (Orapred, Deltasone) -Dexamethasone (Decadron)

What do Adrenergic Antagonists do?

Bronchodilates so you can breathe and stops Vasoconstriction bringing blood pressure back up.

Do you blow or suck for a peak flow?

Blow out

Inhaler Facts

90% of dose will get in lungs with spacer Breathe in and out for 30 sec Wait 1 min before each puff Wait 5min between two inhalers Albuterol before steroid

Kidney levels 1-10-100

Serum Creatinine 0.7-1.2 mg/dL (1) Bun 7-20 (10) Creatinine clearance 96-140 (100)

A reaction that is genetic

Idiocentric Reaction