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pathopharm > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Stages of pharmocokinetics

A
  1. absorption
  2. distribution
  3. metabolism
  4. excretion
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2
Q

Explain excretion

A

Elimination of meds from body

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3
Q

Explain absorption

A

Transmission of meds from administration location to bloodstream

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4
Q

Explain metabolism

A

Changes meds into less active forms by actions of enzymes

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5
Q

Explain distribution

A

Transportation of meds to sites of action by body fluids

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6
Q

Oral route of administration

A

Barriers: meds need to pass through layer of epithelial cells that line GI track
Absorption pattern: varies greatly based on stability/solubility of med, GI pH, food in stomach, form of med (liquid/enteric encoated)

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7
Q

Sublingual route of administration

A

Barriers: swallowing before dissolution allows gastric pH to inactivate med
Absorption pattern: quickly through the highly vascular mucous membranes

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8
Q

Inhalation route of administration

A

Barriers: inspiratory effort
Absorption pattern: rapid through alveolor capillary networks

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9
Q

Subcutaneous route of admission

A

Barriers: no significant barrier, capillary walls have large spaces between cells
Absorption pattern: solubility of med in water (higher solubility = higher absorption) and blood perfusion at site of injection (higher perfusion = rapid)

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10
Q

Intravenous route of administration

A

Barriers: none
Absorption pattern: immediate (directly into bloodstream) and complete (reaches blood in its entirety)

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11
Q

Fastest route of administration

A

Intravenous

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12
Q

Slowest route of administration

A

Oral

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13
Q

10 “rights” to medication administration

A

Client
Medication
Dose
Time
Route
Documentation
Education
Refuse
Assessment
Evaluation

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14
Q

Phlebitis

A

Inflammation of the vein

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15
Q

Extravasation

A

Infiltration of vesicant (highly irritating) medication into tissues surrounding veins

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16
Q

Infiltration

A

Administration of non-vesicant solution into tissues surrounding vein

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17
Q

Colloids

A

Maintain a high osmotic pressure in the blood and stays in intravascular space longer

Ex: albumin, dextran

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18
Q

Crystalloids

A

Increase intravascular volume when it is reduced from hemorrhage, dehydration, or loss of fluids

Ex: 0.9% NaCl, DSW, LR

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19
Q

Isotonic

A

Balance of water and solutes

Ex: 0.9%NaCl, 5% dextrose in water, LR

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20
Q

Hypertonic

A

To move fluid out of cells

Ex: dextrose 10% in water (D5W), 3% NaCl

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21
Q

Hypotonic

A

To move fluid into cells

Ex: 0.45% NaCl

22
Q

What hormones are responsible for the regulation of fluid and electrolytes

A

Aldosterone, antidiuretic hormone (ADH) (vasopressin), natriuretic peptides (NPs)

23
Q

What is the primary function to help regulate blood pressure

A

Aldosterone

24
Q

What does aldosterone do in the body

A

Signals the kidney and colon to increase the amount of sodium sent into the bloodstream which causes the water to retain water in the blood which increases blood volume

25
Q

What does antidiuretic hormone (ADH) (vasopressin) do in the body

A

Affects fluid volume by reducing amount of water passed out in urine or returning more water to bloodstream; decreases blood pressure during dehydration or hemorrhage
high levels = retain water in body
low levels = excrete too much water

26
Q

What does natriuretic peptides (NPs) do in the body

A

Synthesized by heart, brain, and other organs and secreted in response to the increased blood volume and pressure usually in response to heart failure
actions = reduce arterial pressure by decreasing blood volume and systemic vascular resistance

27
Q

What happens when blood osmolarity decreases?

A

Supresses ADH

28
Q

Interventions if urine output is not enough (less than 30cc per hour)

A

Indicator of perfusion (post op/shock)
pharm therapy = diuretics, ACE inhibitors, ARBs, direct renin inhibitors

29
Q

s/s of fluid deficit in adults

A

Increased heart rate, weak peripheral pulses, orthostatic or postural hypotension, poor skin turgor, dry flakey skin, increased respiratory rate

30
Q

s/s of fluid deficit in infants and children

A

Dry mouth and tongue, lack of tears, no wet diaper for 3 hours, sunken eyes cheeks and fontanels, listlessness and irritability

31
Q

Causes of fluid deficit

A

vomiting, diarrhea, diaphoresis, burns, severe wounds, long term NPO, diuretic therapy, GI suction, diabetes, impaired thirst, fever

32
Q

s/s of fluid overload

A

increased pulse, high BP, decreased pulse pressure, elevated central venous pressure, distended neck and hand veins, weight gain, increased RR, SOB, shallow RR, moist crackles, pitting edema, AMS, paresthesia, enlarged liver, increased motility

33
Q

Causes of fluid overload

A

excessive fluid replacement, kidney failure (end stage), heart failure, long term corticosteroid therapy, psychiatric disorders with polydipsia, water intoxication

34
Q

Common type of fluid overload

A

hypervolemia

35
Q

Interventions for fluid deficit

A

fluid replacement (oral fluids, pedialyte, IV fluids), drug therapy (antiemetics, antipyretics, desmopressin for diabetes), monitor I and O to ensure it is working

36
Q

Interventions for fluid overload

A

remove excess fluid (diuretics like furosemide - loop diuretic), fluid restriction, watch for skin breakdown, I&O and weight to ensure it is working

37
Q

Postural hypotension

A

change in bp from lying to sitting or sitting to standing
can be from hypoglycemia

38
Q

Manifestations of hyponatremia

A

SALT LOSS
seizure/stupor
abdominal cramping/confusion
lethargic
tendon reflexes diminished/trouble concentrating
loss of urine and appetite
orthostatic hypotension/overactive bowel sounds
shallow respirations (later on)
spasms of muscle

39
Q

Interventions for hyponatremia

A

drug and nutrition therapy to restore sodium (bring up slowly)
drugs = reduce drugs like diuretics (those increase sodium loss), prescribe IV saline, drugs that promote excretion of water instead of sodium
for mild hyponatremia oral sodium intake and restrict fluid intake

40
Q

s/s of hypernatremia

A

vary depending on if hyper or hypovolemia is present

short attention span, agitated, confused, stupor, lethargy, muscle twitching, muscle contractions, weaker muscles over time, deep tendon reflexes reduced, increased pulse for hypotension, descreased heart rate for hypertension

41
Q

Interventions for hypernatremia

A

diuretics to promote sodium loss (furosemide, bumetanide) - typically when others ineffective, heavy hitter

nutrition therapy - dietary sodium restriction

42
Q

biggest concern for hyponatremia

A

neuro and dehydration

43
Q

risk factors for hypokalemia

A

excessive fluid loss, diuretic drugs (loop like lasix), kidney disease, corticosterioids, cushings syndrome, wound drainage (GI), HF,

44
Q

risk factors for hyperkalemia

A

over ingestion of potassium, rapid infusion, burns, crush injuries, kidney failure, adrenal insuffiency, acidosis, diabetes, MI, salt substitutes

45
Q

hyperkalemia manifestations

A

bradycardia, hypotension, ECG changes of tall peaked T waves, asystole, and V-fib, twitching, tingling, burning sensations, numbness, increased motility with diarrhea, hyperactive bowel sounds, watery bowel movements

46
Q

temporary fixes for hyperkalemia

A

first administer insulin 10-15 units of regular along with 50mL of 50% dextrose to prevent hypoglycemia, if ECG changes to tall peaked T waves, give calcium gluconate first to stablize cardiac muscle.

also give bicarbonate (1 ampule over 5 min) to stimulate na/k pumps

albuterol as nebulizer by lowering levels of k by promoting its movement into cells

47
Q

Interventions for hypokalemia

A

give PIV potassium 20mEq/100mL or postassium supplements (with plenty of water and sitting up for 30 min to prevent esophagitis)

48
Q

more permanent fixes for hyperkalemia

A

loop diuretics (furosemide), sodium polystyrene sulfonate (kayexalate), dialysis, hemodialysis

49
Q

Hypocalcemia history

A

orthopedic surgery, bone healing, thyroid surgery, irradiation of the upper middle chest and neck area, recent anterior neck injury

50
Q

hypocalcemia s/s

A

paresthesia, frequent muscle spasms, trousseaus sign, chvosteks sign, weak and thready pulse, hyperactive BS, cramping, diarrhea, osteoporosis, scoliosis

51
Q

2 clinical manifestations of hypocalcemia

A

trousseaus sign (spasm or palmer flexion after BP cuff inflation)
chvosteks sign (facial twitching after tapping the ipsilateral cheek)

52
Q
A

pathopharm (1 decks)

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