Exam 1 Flashcards
1
Q
How are drugs classified?
S, TU
A
Structure and therapeutic use
2
Q
What are drugs that are never supposed to be crushed?
SR, SA, CR, XL, XT
A
Slow release
Sustained action
Controlled release
Extended length
Extended time
3
Q
What are the four processes in pharmokinetics?
ADME
A
Absorption
Distrution
Metabolism
Excretion
4
Q
What is function of absorption in ADME
A
The movement of a drug from site of admin to the blood stream
5
Q
What does the drug rate absorption rely on?
A
Route of admin
Amount of blood flow
The form of the drug
Food interactions
6
Q
What are the different routes of administration?
PERIT
A
Parenteral
Enteral
Rectal
Topical
Inhaled
7
Q
What is parenteral administration?
Parents are quick and direct
A
IV
8
Q
What is enteral administration?
A
Oral route
9
Q
What is rectal administration?
A
Through the rectum
10
Q
What is topical administration?
A
Applied to the skin like a cream
11
Q
What is inhaled administration?
A
Medicated directed inhaled to the lungs
12
Q
When drugs are absorbed in the GI where are they circulated first?
A
The liver, liver acts as filter system
13
Q
What happens to the rest of the drug that isn’t circulated by the liver?
A
Chemically transforms into inactive metabolites
14
Q
Why are drugs given at a higher dose orally and not IV
A
Because of the first pass effect
15
Q
What routes of administration is effected by first pass?
A
- PO ( limited)
16
Q
What PO drugs are NOT affected by first pass?
ODT, SL, B
A
- oral disintegrating
- sublingual
- buccal
17
Q
What is distribution in ADME?
A
Transport of a drug by the blood stream to its site of action
18
Q
What is the most common blood protein?
A
Albumin
19
Q
What organ/ system is in association with absorption in ADME?
A
Circulatory system / GI system
20
Q
What organ/ system is in association with distribution in ADME?
A
Circulatory system
21
Q
What organ/ system is in association with metabolism in ADME?
A
Liver
22
Q
What organ/ system is in association with excretion in ADME?
A
Kidneys
23
Q
What are the factors that affect drug metabolism?
A
Genetics, age, disease processes, drug interactions
24
Q
What is the main eliminating organ in the body?
A
Kidneys
25
What factors affect excretion?
RD, A, DP..
- renal dysfunction
- age
- diseases that involve renal blood flow
( cirrhosis and liver disease)
26
What is half life?
The time required for half of a given drug to me removed from the body
27
What is onset of action?
How quickly a medication will work
28
What is a peak?
Max therapeutic response ( highest blood level)
29
What is a trough?
Lowest blood level
30
What makes a drug non therapeutic?
Blood level is below the trough
31
What is an agonist?
When the drug binds to a receptor, there is a response
32
What is an antagonist?
When the drug binds to the receptor, there is no response
33
What indicates a toxic therapeutic index?
The closer to 1 the greater the danger of toxicity
34
What does a high therapeutic index (TI) mean?
Safer
35
What trimester of pregnancy has the greatest risk for drug induced developmental defects?
The first trimester
36
During which trimester is the fetus more susceptible to drug transfer?
The third trimester due to an enhanced blood flow to the fetus
37
What are category A drugs?
Safe
38
What are category B drugs?
Safe for animals unknown for humans
39
What are category C drugs?
Issues to animals but unknown for humans
40
What are category D drugs?
Risk vs. benefits only
41
What are category X drugs?
Never give to pregnant person
42
What are peripatetic drugs based on?
They are weight based
43
What non modifiable risk factors make pediatrics patients more susceptible to drug toxicity?
- small bodies
- immature organs
44
What is beers criteria?
Help ID drugs that could potentially cause harm to older adults ( risk such as falls, confusion, excessive drowsiness)
45
What needs to be assessed before medication is administered?
VS, H/ MH, AFA
- vital signs
- health and medication history
- assess for allergies
46
What is drug polymorphism?
Effect of a patient’s age, gender, size, and body composition
47
What is Pharmacogenomics?
The study of how certain genetic traits affect drug response
48
What is the responsibility of the FDA?
Approving drugs before they are brought to the market?
49
What is the responsibility of the DEA?
Enforcing controlled substance laws and regulations
50
When was HIPPA set in place?
1996
51
What is a schedule 1 ( c- I) drug?
Street drugs
Drugs that aren’t approved for medical use
52
What are schedule 2 drugs?
Drugs with high abuse potential like OxyCotin or addy’s
Written RX, no refills, must have a warning label
53
What are schedule 3 drugs?
Drugs with less abuse potential than category 1 and 2 like Tylenol w/ codeine
Written RX, 5 refills in a six month period, must have warning label
54
What are schedule 4 drugs?
Drugs with some abuse potential like Valium or Xans
Written RX, 5 refills in a six month period, must have warning label
55
What are schedule 5 drugs
Drugs with a limited abuse potential like lyrica or robitussin, written RX or over the counter
56
What are the 6 rights of medication?
D, D, P, RO, T, RE
Right:
- drug
-dose
-patient
-route
-time
- reason
57
What are adverse drug events?
Harm caused by appropriate or inappropriate use of a drug which can include med errors and adverse reactions
58
What are the two types of adverse reactions?
Allergic reactions and idiosyncratic reactions
59
What are tall man letters used for?
Provide differentiation between drugs that sound alike
60
When are most medical errors made?
Transition care and medication reconciliation
61
What is medication reconciliation?
D/c and admission
Process in which medications are reviewed and reconciled at all points of entry and exit from a heath care facility
62
What do OTC drug labels must have?
Active ingredients , use warning, when to call a doc, directions for use, age/ weight based dosing, inactive ingredients, and storage considerations
63
NSAIDs are highly?
bound to protien
64
what is the mechanism of actiom of an NSAID?
decreasing prostagladin response
65
what is the theraputic purpose of an NSAID?
used for analgesic, antinflammatory, and antipyretic affects
66
why is asprin unique?
it can inhibit platelet activity on top of other effects
67
what are the condradictions of NSAIDs?
| A, PUD, VKD, PW, RP, AP
- allergy
- peptic ulcer disease
- vitamin K deficiency
- preganant women
- renal patients
- asthma patients
68
what are the interactions for NSAIDs?
| AI, S, A
- ace inhibtors
- steriods
- alcohol
69
what kind of tests have to be preformed before a patient is adminstered an NSAID?
CBC, BUN Creatine, liver enzymes
70
what should the patient be educated on before taking NSAIDs?
- unsafe for preganant women
- must be stopped at least one week prior to elective surgery
- taken with food
71
what are the adverse effects of NSAIDs?
| NSAID
N- not good for organs
S- sticky clots (increase risk for thlacemia)
A- asthma
I- increased risk of bleeding
D- decreased/ dead kidney function
S- sodium raises risk for high BP, and CVD
72
what is asprins condradictions?
- avoid in chilldren with viral infections?
73
if you give a child asprin what disease are they at risk for?
Reye's Syndrome
74
what are the chronic syptoms of ASA?
| T, HL, CNS, GIU
tinnitus, hearing loss, CNS changes (breathing), GI upset
75
when preforming an assesment before administering aspirin what should the nurse look for as an indication not to administer the medication to the patient?
| VS, AT
- vinegar smell
- aspirin triad
76
what is aspirin triad?
| a, np, r
- asthma
- nasal polyps
- rhinitis
77
what would you educate the patient on before adminstering Aspirin?
| SAU, BW/OT, H
- severe abdominal upset or pain
- bruising w/o trauma
- hematuria
78
what is ketorolac (Toradol)?
equivalent to morphine but doesnt cause any chnages in conciousness
79
what is the theraputic purpose of Ketorolac?
| toradol
pain treatment for ortho trauma and surgery
80
what are the adverse effects of Ketorolac (toradol)?
| RI, GIP, N
- renal impairment
- GI pain
- nausea
81
what is the limit days for ketorolac (toradol)?
5 days due to risk of GI bleed
82
what are the condradictions of ibuprofen?
ACE inhibtors
83
what is celecoxib (celebrex)?
used to treat diffrent kinds of arthritis
84
what are contraindications/ interactions of celecoxib (celebrex)?
| SA, ICVE
- sulfa allergy
- may increase CV events
85
what are the adverse affects of celecoxib (celebrex)?
| H, SI, D, HTN
- headache
- sinus irritation
- diarrhea
- HTN
86
what is the mechanism of action for Tylenol?
blocks peripheral pain by blocking prostaglandin synthesis
87
what is the theraputic purpose of tylenol?
| NOA, AP
- nonopiod analegisc: mild to moderate pain
- antipyretic
88
what are the interactions of tylenol?
| A, SLD, CA
- allergy
- severe liver disease or chronic alcoholic
89
what are the adverse effects of Tylenol?
| N, A, H
- nausea
- anemia
- hepatotoxcity ( toxic liver)
90
what should the patient be educated on before tylenol is administred?
- don't exceed dose limits
91
what is the dose limit of tylenol for a healthy person?
4,000
92
what is the dose limit of tylenol for a older person?
3,000
93
what is the dose limit of tylenol for a alcoholic person?
2,000
94
acetaminophen can be found in what OTC drug?
cough/ cold medication
95
what is the antidote for a tylenol overdose?
acetylcysteine
| acetyl sis tine
96
when should acetylcystenine be started for a acetaminophen OD?
within 10 hours of OD
97
what is Gout?
a form of arthritis caused by an overproduction of uric acid
98
what is the treatment for gout?
| DM, POF, N, A
- diet modification
- drink plenty of fluids
- NSAIDS
- allopurinol
99
what is allopurinol (zyloprim)?
prevents gout attacks
100
how does allopurinol (zyloprim) prevent gout attacks?
inhibits uric acid production
101
what are the contradictions of allopurinol ( zyloprim)?
| GI, D, R (SJS)
- GI upset
- drowsiness
- rash: stevens johnson syndrome
102
what should the patient be educated on before administration of allopurinol (zyloprim)?
| IFI, TWF, AD
- increase fluid intake
- take with food
- avoid driving
103
what is colchicine (colcrys)?
to prevent acute gout attacks?
104
what are the contradictions/ interactions of colchicine?
- decreases fertility
- many drug interactions
105
what are the adverse effects of colchicine?
| UGI, L, GIB
- GI upset
- leukopenia
- GI bleed
106
what drug has a low drug TI causing an increase risk of drug toxcity?
colchicine
| coltch a seen
