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NUR 326 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Do not crush

A

SR, LA, ER, XL, XR, CR, DR: absorption into the body will be too quick

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2
Q

Routes of drug entry

A

Oral- slowest entry
Inhalation- fastest to brain
Injection- takes effects in seconds
Transdermal- released into blood stream over several hours
Intramuscular- Epi pens, vaccines

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3
Q

Drug half life

A

Time for concentration of drug to be 50%
If drug drug half like is 6 hrs and it is given at 10 am, at 8 pm 25% will be left in the blood stream

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4
Q

Agonist vs antagonist

A

Accelerates or slows normal cell processes- agonist
Blocks a response- antagonist

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5
Q

On receptor drugs

A

Antacids, osmotic diuretics, several anti cancer drugs, and mental chelating agents

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6
Q

Person related variables that effect drug actions

A

Age, body composition, genetics, ethnicity, sex, pre- existing conditions, psychological considerations, tolerance, and cross tolerance

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7
Q

Prostaglandin- found in most body tissues

A

Cox 1- protect GI, platelets, kidneys, and smooth muscle
Cox 2- increase inflammation ( vasoconstriction edema, pain, fevers

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8
Q

Salicylates: aspirin

A

Act centrally and peripherally to block the transmission of pain impulses and inhibits prostaglandin synthesis
- reduces fever, diminishes inflammation, low doses suppress platelet aggression
Low doses help to manage: ischemic stroke, trasnsient ischemic attack, angina, and acute MI
CONTRADICTIONS: children and adolescents (Reyes syndrome), high potential for toxicity in older adults
Adverse effects: epi gastric distress, GI symptoms common, increased risk of GI bleed or ulcer

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9
Q

Signs of aspirin overdose

A

Headache, confusion, drowsiness, vertigo, sweating, early respiratory alk, later respiratory acid, fluid and electrolyte imbalance, nausea, vomiting, fever

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10
Q

Acetaminophen (Tylenol)

A

Nonnarcotic analgesic antipyretic
- lacks anti inflammatory activity
- no n/v/GI bleeding like aspirin

Use: pain or fever
Action: fever relieved through action in the hypothalamic heat regulating center or pain from pain receptors in periphery
Contradictions: liver failure, other products containing acetaminophen
Caution: metabolized in the liver, overdose can result in liver damage
May cause liver damage in those how abuse alc, liver disease, chronic malnutrition, and renal impairment

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11
Q

Pharmacokinetics vs pharmacodynamics

A

Kinetics- study of drugs movement through the body
Dynamics- what the drug does to the body

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12
Q

Absorption (1)

A

Drug dissolves to cross cell membranes, drug moves into small intestine, and crosses cell membranes into the blood stream

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13
Q

Bioavailability

A

Drugs taken orally metabolized by the liver (most are any route)
Only part of the drug is distributed to rest if the body in unchanged form- this is called bioavailability
I’ve drugs are 100% bioavailable

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14
Q

Metabolism of drugs

A

Most metabolized in the liver CYP 1,2,3 metabolize drugs

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15
Q

Excretion of drugs

A

Kidneys (biggest), feces, liver, or sweat/lungs

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16
Q

Ibuprofen ( Motrin/advil)

A

Analgesic, antipyretic, anti inflammatory

Uses: osteoarthritis, rheumatoid arthritis, dysmenorrhea, fever, headache
Action: inhibits formation of prostaglandins by inhibiting COX, suppresses inflammation
Contradictions: GI ulcer or bleed, pregnant women, and post CABG
Black box warning: risk MI or stroke
Caution: renal insufficiency
Interactions: anticoagulant, codeine/oxy, and corticosteroids
Adverse effects: dyspepsia, anorexia, nausea and vomiting

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17
Q

Meloxicam (Mobic) piroxicam (Feldene)

A

NSAID
Use- reduces the production of hormones that help inflammation and pain develop
Caution: ace inhibitors, diuretics, anticoagulant, and lithium
Black box warning p- pt at risk for GI bleeds and cardiovascular issues

18
Q

Low purine diet

A

Avoid alc, avoid organ, game meats, sardines, anchovies, scallops, asparagus, spinach, and peas

19
Q

Bronchi constriction characteristics

A

Airway inflammation, brocnhcoconstriction, airway hyper responsiveness, mucosal edema, and excessive mucus production

20
Q

Asthma

A

Characteristics- bronchoconstriction, inflammation, and hyper activity to stimuli
Symptoms- dyspnea, wheezing, chest tightness, cough, sputum
Pathophysiology: sphincter closes airway aggravated by inflammation and excessive mucus. Mast cells are released causing bronchoconstriction and inflammation

21
Q

Status asthmatics

A

Acute or severe attack that is not helped with bronchodilators

22
Q

Bronchodilator’s

A

PREVENT AND TREAT BRONCHOCONSTRICTION

23
Q

Anti-inflammatory aganets

A

PREVENT AND TREAT INFLAMMATION IF THR AIRWAYS, DECREASE MUCUS, AND DECREASE MUCUS SECRETIONS THAT NARROW AIRWAYS

24
Q

Albuterol (SABA) ( Proventil)

A

Class- adrenegric agonist beta 2 agonist short acting
Patho- stimulate adrenergic receptors in smooth muscle to produce AMP
Use- acute asthma exacerbation or prevent bronchospasms, lasts 3-4hrs
Adverse effects: muscle tremor, aging a, tachycardia, palpitations, agitation, anxiety, insomnia, and seizures
Contradictions- hypersensitivity, cardiac dysrhythmias p, severe CAD

25
Salmeterol (LABA) (serevent)
Class- adrenergic agonist beta 2 agonist long acting Patho- maintains prophylactic control of persistent asthma Use- long term control (12hrs) Adverse effects- urticaria, rash, bronchospasm, headaches, chest tightness, cough with mucus Contradictions- hypersensitivity
26
Ipratropium (short acting) (atrovent)
Bronchodilator anticholinergrics Patho- blocks the action of acetylcholine in smooth muscle ( absorbed in 5-15mins, lasts 2-5hrs) Use- use with other adrenergic bronchodilator’s, long term use. CANNOT RELIVE BRONCHOSPASMS ALONE Adverse effects- cough, nervousness, nausea, GI upset, headache, dizziness Contradictions- hypersensitivity to drug or atropine, narrow angle glaucoma, BPH, bladder neck obstruction
27
Tiotropium (spiriva)
Anticholinergic Bronchodilator Long acting muscarnic antagonist Patho- reduces bronchospasms, COPD exacerbation, maintenance therapy for bronchitis , emphysema Use- maintains bronchoconstriction associated w bronchitis and emphysema, CANNOT RELIEVE ACUTE BRONCHOSPASM EXACERBATION Adverse effects- dry mouth, headache, abdominal pain, constipation , chest pain, flu like symptoms Contradictions- hypersensitivity, narrow angle glaucoma, can’t take w ipratropium
28
Theophylline ( short acting) (Theocron)
Class- alkaloid bronchodilator Patho- relaxes smooth muscle promoting bronchodilation Uses- second line for asthma that cannot be controlled by first line drugs (lasts 6-8hrs) Adverse effects: MONITOR SERUM DRUG LEVELS, tachycardia, dysrhythmias, palpitations, restlessness, agitation, insomnia, nausea, forming, convulsions Contradictions- acute gastritis, peptic ulcer disease, take caution with patients with seizures, a heart diseases
29
Theophylline (long acting) (Theocron)
Alkaloid bronchodilator Patho- relaxes bronchial smooth muscle Use- treats symptoms of asthma as a second defense, take every 12 hrs, NOT FOR ACUTE ASTHMA adverse effects- MONITOR SERUM DRUG LEVELS, tachycardia, dysrhythmias, palpitations, restlessness, agitation, insomnia, nausea, vomiting, convulsions Contradictions- acute gastritis, peptic ulcer disease, caution in patients with seizures and heart disorders
30
Beclomethasone (Qvar RediHaler)
Corticosteroids Patho- suppresses airway inflammation decreases mucus, edema repair and damaged epithelium Use- use with SABA, prophylactic management of asthma, RINSE AND SPIT AFTER USE Adverse effects: headache, pharyngitis, cough, dry mouth, hoarseness, fungal, infection and nausea Contradictions- allergies, recent nasal surgery, injury or ulcers interfere with healing
31
Montelukast (Singulair)
Leukotriene modifier Patho- prevent leukotrienes from binding to receptors, reducing bronchoconstriction and inflammation Use- long term treatment of asthma, exercised induced and allergic rhinitis Adverse effects- headache, nausea, vomiting, diarrhea, hyperkinesis, infection Contradictions- hypersensitivity
32
Omalizumab (Xolair)
Immunosuppressant monoclonal antibody Patho- limits activation and releases mediators in the allergic response Use- adjunctive therapy to severe persistent allergic asthma twitch other meds. Given sub q Adverse effects: headache, fatigue, anaphylaxis, injection site irritation Contradictions- hypersensitivity and allergic reaction
33
Cromolyn (NasalCron)
Mast cell stabilizer Patho- prevents the release of bronchoconstriction and inflammatory substances Use- alternative for prophylaxis of acute asthma in pts with mild persistent asthma, inhaled, NOT EFFECTED FOR ACUTE BRONCHOSPASM OR STATUS ASTHMATICUS adverse effects: dysrhythmias, hypotension, chest pain, restlessness, dizziness, convulsions, CNS depression, anorexia, nausea and vomiting Contradictions- hypersensitivity
34
Fluicasone/ salmeterol
Combine regimen Patho- treats inflammation and bronchoconstriction Use- smaller doses of each decrease adverse effects and increase exacerbation RINSE AND SPIT AFTER USE Adverse effects- headache, nausea, hoarseness, oral thrush, BP may rise Contradictions- hypersensitivity
35
Inhaler no spacer
Use: point away and spray 3-4times, shake inhaler 10-15 times, exhale to end of normal breath, breath it in 3-5secs, hold breath for 10 secs , pucker a blow of threw lips, wait 3-5 mins error enext inhalation, rinse mouth with water, gargle and spit
36
Chronic bronchitis
Blue bloater, barrel chest Frequent cough and sputum production for 3 months - year Increase in number and size of goblet cells Results in narrowed airways and cough w sputum
37
Emphysema
Pink puffer Enlargement or destruction of alveoli distal to terminal bronchioles. Alveolar walls decrease for available area of gas exchange. Lung elasticity also decreases Chronic air trapping
38
Indomethicin
Indocin (nsaid) Patho- results in the stimulation of the myometrium to start contracting. Use- does not allow prostaglandins to produce Adverse effects: heartburn, N/V, headaches, dizziness, increased bleeding Contradictions: skin rash, sob, anemia Black box warning, may cause cardiovascular events or GI bleeds
39
Celecoxib
CeleBREX (nsaid) Patho- cartilage degenerates resulting in a loss of thickness from inflammation Use- prevents production of COX 2, which creates prostaglandins, pain and inflammation will be inhibited Black box warning- cardiac and vascular risks Contradictions: renal impairment, allergy in sulfa drugs or nsaids Adverse effects- stomach pains, dizziness, insomnia
40
Colchicine
Colcrys- anti gout agent Use- Inhibits migration of WBC into tissues that include urate crystals Adverse effects- abdominal pain, dyspepsia, and N/V Contradictions- don’t take with cyclosporine or ranolazine, administer with caution for pregnant patients
41
Allopurinol
Zyloprim ( anti gout agent) Xanthine is inhibited which converges hypoxanthine into uric acid. Adverse effects- rash, drowsiness, N/V/D, kidney/ liver problems Contradictions- avoid alc, may impair thinking it actions, may decrease blood cells

NUR 326 (2 decks)

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