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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
Q

Salmeterol (LABA) (serevent)

A

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
Q

Ipratropium (short acting) (atrovent)

A

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
Q

Tiotropium (spiriva)

A

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
Q

Theophylline ( short acting) (Theocron)

A

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
Q

Theophylline (long acting) (Theocron)

A

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
Q

Beclomethasone (Qvar RediHaler)

A

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
Q

Montelukast (Singulair)

A

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
Q

Omalizumab (Xolair)

A

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
Q

Cromolyn (NasalCron)

A

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
Q

Fluicasone/ salmeterol

A

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
Q

Inhaler no spacer

A

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
Q

Chronic bronchitis

A

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
Q

Emphysema

A

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
Q

Indomethicin

A

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
Q

Celecoxib

A

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
Q

Colchicine

A

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
Q

Allopurinol

A

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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