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Pharmacology 283 > Exam 1 General > Flashcards

Exam 1 General Flashcards

1
Q

5 rights

A
  1. Right Client
  2. Right Drug
  3. Right dose
  4. right route
  5. right time

1st clap during disorientation rousing them

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2
Q

5 other rights

A
  1. assessment (labs/info)
  2. documentation
  3. evaluation (ther/sE/ar)
  4. education
  5. refusal
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3
Q

High Alert Meds

A 
IV/cardiac drips/push
chemo
warfarin/ AC/heparin
IV sedation
anesthetic
parenteral nutrition
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4
Q

Type of med prescriptions

A 
routine
single
stat
PRN
standing
TOR
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5
Q

4 phases of pharmacokinetics

A

body to drug

  1. Absorption
  2. Distribution (blood flow/protein bound/ drug/recpetor complex)
  3. Metabolism (1st pass, ETOH, prodrugs)
  4. Excretion: via kidneys/lungs/milk/saliva. beware RF

ADME

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6
Q

pharmacodynamics (MOA!)

A

drug to body

  • MOA (stimulation/suppression/replacement/inhibition or cytotoxic/irritation/immune modifier)
  • therapeutic effect (antipyretic/analgesic/antiinflammation)
  • side effect (secondary usage/off label)
  • adverse effect
  • allergic rxn
  • paradoxical effect
  • potency
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7
Q

Drug-interaction

A
  1. food
  2. serum proteins/electrolytes (protein bound/competing drugs/electrolytes=toxic)
  3. uv light (phototoxic/allergy)
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8
Q

Drug-drug interaction (types)

A

additive
synergist/potentiation
antagonist

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9
Q

substance abuse levels

A
  1. high risk of abuse. no medical use (weed/cocaine)
  2. high risk. some use. (morphine/oxy)
  3. Risk of abuse, maybe dependence (hydrocodone)
  4. may cause dependence (benzos)
  5. limited risk (cough suppressants)
    OTC
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10
Q

DTs

A

delirium tremens from withdrawal. can lead to agitation, tremors, HA, hyperthermia, hallucinations, seizures, disorientation, tachycardia, dysrhythmia, coma/death.

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11
Q

stimulants

A

inc dopamine in the limbic system

caffeine/nicotine

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12
Q

depressants

A

depress CNS/cardiac/resp systems

alcohol, sedatives (barbituates/benzos), opioids, anesthetic agents (hairspray/spray paint)

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13
Q

psychedelics

A

hallucinogens

LSD/ecstasy (rape drug)/shrooms

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14
Q

Rx drugs (dependence)

A

at risk: patient, family, health care workers.

beware drug diversion

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15
Q

ETOH dependence

A

-withdrawal 12 hrs to 1 week (DTs)
CAGE questionnaire (cut/annoyed/guilty/eye opener)
-physiological: scheduled and prn benzos: chlordiazepoxide
-behavioral: disulfiram

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16
Q

Nicotine

A

withdrawal within hours
PRN nicotine, buproprion, varenicline
withdrawal s/s: irritability, nervousness, restlessness, insomnia, concentration

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17
Q

geriatric population. common issues

A
  1. low gi motility/acidity (slow onset). M
  2. poor renal and kidney fxn (metabolism and R/K
    excretion prob-> inc toxicity, longer duration)
  3. low serum proteins (more free drugs, inc toxicity) P
  4. few receptors (low drug sensitivity) R
  5. slower reflexes (FALL) R

MARKPRR
markiplier
6. polypharmacy
7. Geriatric syndrome

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18
Q

pregnancy. be aware of: x4

A
  • placenta is a weak barrier
  • test HcG serum for pregn
  • give no live vaccines
  • teratogenic drugs
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19
Q

teratogenic drugs

A

cause fetal congenital malformations. (high risk in 1st tri)

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20
Q

FDA pregnancy classes

A

A: Tested on humans
B: tested on animals or no risk in humans
C. animals=adverse, none in human. or n/a but pros outweigh
D. human fetal risk
X. contraindicated

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21
Q

Fluid imbalance

A

FVD: at a deficit. give fluids. Hypovolemia
FVE: excess. give diuretics. hypervolemia

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22
Q

Tonicity

A

The concentration of IV fluids vs body serum
Isotonic
Hypertonic (cells shrink). More solutes in fluid
Hypotonic (cells swell). More solutes in cell

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23
Q

Crystalloids

A

water with electrolytes

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24
Q

Isotonic Crystalloids

A

Isotonic: NS (.9%), LR (Na, cl, K, Ca, lactate), Ringers (same with bicarb- for ACIDOSIS), D5W

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25
Hypertonic crystalloids
D5NS, D51/2NS, 3% NS
26
Colloids
water, electrolytes, proteins. very hypertonic. ex. parenteral nutrition, albumin/PRBC/FFP/platelets (blood products)
27
When infusing IV monitor for:
``` breathing sounds-crackling (alveoli) VS (inc BP/HR) I/Os (+ balance) Weight Electrolytes ```
28
Fat-soluble vitamins
A: epithelial E: antioxidant K : clotting D: absorption of Ca++/Phos
29
Water-soluble vitamins
C, B9, B12 Ascorbic Acid, Folic Acid, Cyancobalamin Caution with renal disease
30
Trace Elements
Iron (ferrous sulfate/iron sucrase) - hemoglobin and myoglobin regeneration - enzymes
31
Electrolyte imbalances (fxn) x5
``` fluid balance electroneutrality nerve impulses muscular contractions acid/base balance ```
32
Maintaining electrolyte balance
Suck My Penis Kyle, Caught Bitches Copying Notes mEq/L S 1, Mg++ 1.5 Phos 1.7-2.6 K+ 3.5-5 Ca++ 8.5-10.5 dl BiC 22-26 Cl- 96-106 Na+ 135-145
33
NaCl
electrolyte fxn in neuro NI: I/O, neuro, ECG IV: NS/LR/R
34
Hyperkalemia
Sodium Polystyrene Sulfonate (long term) Insulin and D50 Sodium Bicarb
35
Hypokalemia
Potassium Chloride Potassium Phosphate -always dilute. infuse slowly. NEVER IV push, phlebitis
36
hypomagnesia
Neuro/GI related. Mag Up, body down. | Magox, MagSulfate, Banana bag
37
hypocalcemia
MS/GI related. Basic! Calcium Citrate, Calcium Carbonate EMERGENCY: Calcium Chloride
38
biphosphates
alendronate/ibandronate (bones)
39
hyperphosphatemia
sevelamer/calcium acetate. with meals. too acidic.
40
FXNs of nutrients
cell growth, metabolism, organs healing, immune
41
Enteral
tube feeding Nasogastric/nosduodenal/nasojejunal Gastronomy/jejunostomy -scheduling/cyclic (16 hrs)/bolus (5x/day)
42
parenteral
- d5w (short term) - TPN- central line (high osmolality) - PPN- peripheral line - ----look for BG, CMP, RF, I/O, weight, breath sounds - reaching goal rate slowly - tapering off
43
Higher need nutrients *who*
1. Pregnancy/lactation 2. growth spurts 3. hypermetabolism (acute phase of diseases/exercise/hyperthyroidism) 4. Higher loss- hemodialysis
44
Oz to ml tsp to ml tbsp to ml lb to kg
1 oz= 30 ml 1 t= 5 ml 1 T=15 ml 2.2 lb= 1 kg
45
basic doasage formula
H/D=V/X
46
Types of bacteria and strength
Gram +, Gram 1, Mycobacterium
47
antibiotics mechanism of action x5
``` cell wall cell membrane protein synthesis DNA/RNA synthesis Metabolism ``` inhibits last 3 enzymes
48
Natural/inherent resistance
No prior exposure. Ie beta lactam. cell wall, etc
49
Acquired resistance
- passed on via evolution/mutation - resistance via abx for viruses/inflammation or If used incorrectly - cross resistance
50
Hypersensitivity: degrees and ex
Mild: rash/pruritis (itching)/hives Severe: anaphylaxis/shock (angioedema, bronchospasm, resp arrest, cardiac arrest)
51
treatment for hypersensitivity
antihistamines, glucocorticoids (inhibit inflammation), Epinephrine, bronchodilator, vent
52
superinfection and treatments
2ns infection due to loss of flora - Prophylactic treatment-lactobacillus acidophilus - fungal/thrush- nystatin - c-diff: metronidizole
53
organ toxicity
1. CNS: 2. Ototoxicity (hearing loss/disequilibrium) 3. Hepatotoxicity 4. nephrotoxicity: 5. Photosensistivy:
54
CNS toxicity
confusion/seizure/NM block (paralysis)/neuropathy (nerves)/encephalopathy (brain disease)
55
hepatotoxicity
liver toxicity (Jaundice/itching/ab pain upper right, loss of appetite, nausea) -no ETOH/acetaminophen
56
Nephrotoxicity
Kidney tox (pain in chest/fluid retention/dec output/dysrhythmia) -monitor I/Os/creatinine/GFR, inc fluids -avoid IV contrast dye/NSAIDS (nonsteroid antiinflammatory), ACE, ARB
57
Beta-Lactam ABX
Use BL to target/kill bacteria | -cillins/cephs/penems
58
Bacteria with BL
-ESBL/MRSA
59
Multiantibiotic therapy vs monotherapy
inc effectiveness. Prevent pathogen from building resistance. Severe infections. -lower dose of abx to red. toxicity neg: reaction to many agents/superinfection/antagonistic/cost
60
Purified Proteins Derivative
``` Test for tuberculosis ID: intradermal wheel Read 48-72 hrs -measure induration Positive PPD: -5 mm immunosuppressed -10 mm normal Problems: 2-10 weeks, all positive results ```
61
Fungal infections
often opportunistic/superinfections
62
High risk for fungal infections
immunocompromised: HIV, glucocorticoids use, organ transplant, chemo
63
Antimycotics
AZOLES, NYSTATIN, amphotericin SE: flushing, fever, chills, headache, phlebitis NI: premedicate: antipyretics, antihistamines, glucocorticoids, inc fluids AE: neuro/hepato/nephro tox -penias CI: lactation treatment adherence! PREMEDICATE TOX PENIAS

Pharmacology 283 (6 decks)

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