Exam 1 Flashcards
Agonist
Medication that enhances an effect
Antagonist
A medication that reverses an effect
Sympathetic nervous system
Adrenergic
Norepinephrine
“Fight it flight”
Parasympathetic nervous system
Cholinergic
Acetylcholine
“Rest and digest”
Oncotic pressure
Proteins maintain pressure to hold water in the capillary
W/O proteins, water leaves and 3rd spacing occurs
Hydrostatic pressure
Force of H2O in the capillary bed
This is what pushes H2O across the membrane into the interstitial space
Pharmacokinetics
How a drug moves
Liberation - into the body
Absorption - into the bloodstream
Distribution - moves around the body
Metabolism - broken down
Excretion - removed from the body
Pharmacokinetics for children and geriatrics
Children and geriatrics metabolize drugs slower than the average adult
Protein binding
Serum protein levels, if a drug binds to a protein, then that portion of the drug is unuseable
Half-life
The time it takes for half of the drug to be metabolized
First pass phenomenon
When the liver takes a cut of the drug
For PO meds, when being absorbed, a portion is taken by the liver and not used
Controlled substances
The scheduling system
1 - high potential for abuse, no medical use
2 - high potential for abuse, medical use
3 - moderate potential for abuse, medical use
4 - mild potential for abuse, medical use
5 - low potential for abuse, medical use
IV fluids
Hypertonic - above .9% saline or 5% dextrose
Isotonic - .9% saline and 5% dextrose
Hypotonic - below .9% and 5%
Reasons for variation in drug responses
Oral preparations
Tablet disintegration time, enteric coatings, sustained-release formulations
Changes in gastric pH, diarrhea, constipation, food in stomach
Lab values for sodium, potassium, and calcium
Na- 135-144
K- 3.5-5
Ca- 8.5-10.5
Causes of hypocalcemia
Low PTH
Poor oral intake
Acute pancreatitis
Low VD intake
Chronic kidney disease
Mobility issues
Body water composition variations between elderly and adults
Elderly
Less body water
GFR is lower
Increased fat in internal organs
Decreased muscle mass
Roughly 50% water in older patients
Edema
Increased capillary permeability
(Burns/ inflammatory response)
Increased capillary hydrostatic pressure
(Venous obstruction, salt and water retention, heart failure)
Lymph obstruction
Decreased capillary oncotic pressure
RAAS
Renin - low perfusion to kidneys, they release renin
Angiotensin - renin works on angiotensinogen. Angiotensin 1: inactive. Angiotensin 2: vasoconstriction and pituitary for aldosterone
Aldosterone - kidneys retain sodium. Water follows salt
FVE in infants
Swelling
High BP
Rapid weight gain
FVD in infants
Fontanelles are sunken
Rapid weight loss
Low BP
Aspirin
Salicylate prototype
Mechanism of action - antipyretic, anti-inflammatory, analgesic, anticoagulation
Classification - non-narcotic, salicylate
Adverse effects - nausea, GI bleeding, bruising, Tinnitus, confusion, tachypnea
Nursing implications - watch the dose for a given condition, give with food to protect stomach, monitor for signs of bleeding, false positive occult blood stool
Antidotes -
Teaching - don’t take more than prescribed, take with meals, watch for tennitis, stop taking prior to surgical, avoid alcohol
Ibuprofen
Mechanism of action - analgesic, anti-inflammatory, anticoagulant
Classification - NSAIDS
Adverse effects - GI bleeding, nephrotoxicity (elevated BUN and creatinine), dyspnea, Bronchospasm, tinnitus
Nursing implications - give with food, monitor bleeding time
Teaching - take with food, drink plenty of fluids, watch for bleeding, watch for changes in respiratory
Morphine
Mechanism of action - analgesic
Classification - opioid
Adverse effects - CNS depression, constipation
Nursing implications - monitor breathing, lowest dose and work up, cannot be crushed, PCA
Antidotes - naloxone
Teaching - high fiber diet, do not operate machinery, short term use will not cause addiction
Acetaminophen
Mechanism of action - antipyretic, analgesic
Classification - non narcotic
Adverse effects - liver damage
Nursing implications - acute or chronic overdose can result in liver damage or liver necrosis, therapeutic dose can harm those who abuse alcohol
Antidotes- acetylcysteine
Teaching - many different drugs have acetaminophen in them
4g - 4000mg
Opioids
Morphine is the prototype
Naloxone
Antagonist for opioids
Pain pathway
Transduction - activation of nociceptors
Transmission - conduction if pain signal to dorsal horn and up spinal cord
Perception - conscious awareness of pain
Modulation - increase or decrease in transmission (the body controlling how much or how little to feel the pain)
Chemical mediators
Histamine
Cytokines
Phases of Covid
Incubation - 5-6 days - time between entrance of pathogen and appearance of first symptoms
Prodromal - onset of nonspecific symptoms, microorganisms grow and multiply
Invasion or illness - symptoms specific to the illness
Convalescence - when infection disappears
