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Lpn > Exam 1 Pharm Chpt 3 4 5 Bertha Chpt 43 > Flashcards

Exam 1 Pharm Chpt 3 4 5 Bertha Chpt 43 Flashcards

1
Q

Pharmacodynamics

A

Effect of the drug on the body

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2
Q

Pharmacodynamics

A

Effect of the drug on the body

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3
Q

Pharmacotherapeutics

A

How the drug is used to treat disease

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4
Q

Generic name

A

Same in all countries
Original name
Lowercase
Stays on after trade name expires

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5
Q

Trade name aka Brand name

A

Capitalized followed by ‘r’ symbol

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6
Q

Drug attachment

A

Drugs lock onto outside of cells-Receptor cells

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7
Q

Agonist

A

Attaches and activates receptor
Action mimics chemicals of body

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8
Q

Partial agonist

A

Drug partially attaches at receptor site
Only slight action results

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9
Q

Antagonist

A

Drug attaches at receptor site
No response is produced
Blocks activation of the receptor

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10
Q

Drug process- absorption

A

How fast a drug is dissolved and absorbed- form affects solubility How the drug gets into the body, bloodstream, target cells
Requires no energy-higher concentration to lower concentration- diffusion, filtration, osmosis
Requires energy- lower concentration to higher concentration-active transport

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11
Q

Drug process- distribution

A

Movement from the blood and lymph (after absorption)
Circulation (distributes) takes it to the target
Distribution is usually uneven depending on type of drug, type of tissue
Brain and placenta have barriers
May bind to proteins
May be attracted to fats(build ups)
Affects duration of action

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12
Q

Absorption and distribution

A

Route of administration influences absorption
ENTERAL- into GI tract PO by mouth, NG nasogastric, PEG, G tube
PARENTERAL-directly into tissue, mucous membranes, spinal fluid, or bloodstream
Intravenously, intramuscularly, subcutaneously (SQ), sublingual, buccal, intranasal, inhaled, epidural,PR,vaginally, eye drops
PERCUTANEOUS- topical ointments, patches, creams

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13
Q

Drug process- Metabolism

A

How body breaks down and gets rid of drugs
Once drug is absorbed and distributed the body alters (breaks down, metabolizes) the drug into active/inactive chemicals
This bio transformation happens in various sites mainly in the liver
Oral drugs- first pass ( GI tract to liver)
SL and IV avoid first pass (more potent)

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14
Q

Drug process-excretion

A

Elimination of metabolites(leftovers)
Usually feces or urine
Sometimes via lungs, skin, tears, saliva, breast milk
KIDNEY OR LIVER DISEASE???????

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15
Q

Variability

A

First time use of particular drug

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16
Q

Drug half life

A

Time it takes for 50% of drug to be 3xcreted
Long half life- dosed once daily
Short half life- dosed more frequently

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17
Q

Preparations

A

Never crush, chew, or open long acting or extended release forms

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18
Q

Desired action

A

Therapeutic goal
What you want the drug to do

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19
Q

Side effect

A

Expected mild and annoying result of the drug

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20
Q

Adverse reactions

A

NURSES MUST BE PREPARED TO REACT TO THESE
More severe symptoms that develop from drug
some require hospitalization/can be life threatening
Examples; Steven’s-Johnson syndrome (skin Condition) and anaphylactic shock
Severe adverse effects such as damage to kidney or liver, or bleeding develop the drug must be stopped

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21
Q

Hypersensitivity (unexpected reaction)/Allergic reaction

A

Increased reaction to a drug
Antibody response to drug
When an individual has taken a drug and the body has developed antibodies to it when the patient takes the drug again the antigen antibody reaction produces hives, rash, itching, or swelling of the skin. This type of allergic reaction is very common so you must ask the patient about whether they have ever had a drug reaction . 

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22
Q

Drugs more likely to produce allergic reactions

A

Aspirin, Sulfa, and Penicillin

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23
Q

Idiosyncratic reactions (not expected)

A

Rare, strange, peculiar- may be caused by genetic or hormonal variation in that individual
Paradoxical effect is an idiosyncratic response- reaction is opposite of what would be expected (rare)

24
Q

Drug interactions

A

One drug changes the other drug
ADDITIVE EFFECT-increases effect.
Probenecid added to pcn for added effectiveness
ANTAGONISTIC EFFECT- interferes with the expected effect (such as oral contraceptives and antibiotics), antidotes
SYNERGISTIC EFFECT- effect of both are increased

25
Q

Food alcohol and drug interactions

A

Most medications interact with at least one other med
MOIs (antidepressant drugs) noted for food drug interactions
Foods: grapefruit, fatty meals, milk products
Pregnancy
Caffeine, nicotine
Alcohol and other drugs

26
Q

Factors influencing drug therapy

A

Hydration, low BP, shock, heart failure, reduced blood flow, use of ETOH,and drugs,
Liver or kidney problems
Age, size, body fat composition (body water)
Genetics (enzymes)

27
Q

Drug therapy in older adults

A

Drugs are absorbed, metabolized, and excreted more slowly
Decreased body water volume ( more fat less water)
Decreased liver mass, slowed kidney function
Low albumin
Vision, arthritis, finances

28
Q

Drug card should contain the following info

A

Generic and trade name, dosage range
Desired action, expected side effects, adverse effects
Administration and usual routes
Important info/nursing considerations

29
Q

Parts and sizes of needles

A
30
Q

Needles

A

Gauge=diameter
Larger #=smaller needle 17G is larger than 25G
Viscosity of liquid, amount of liquid
Smaller gauge for smaller amounts Smaller

31
Q

SQ( subcutaneous) sites

A

Skin between dermis and muscle
Less blood in this area- slow but long duration
45 degree angle, rotate injection sites
Do not aspirate to prevent bruising
apply slight pressure after injection
Thigh=vastus laterus

32
Q

I M injection Z track method

A

Pull tissue laterally
Insert needle straight down into muscle
Release tissue as needle is withdrawn, this allows skin to slide e over injection track and seal drug inside

33
Q

I M sites

A

Upper arm=deltoid for vaccinations in adolescents and adults
Ventrogluteal= hips. children over 7 and adults
Vatus lateralis=thigh

34
Q

Nitroglycerin paste

A
35
Q

Buccal, sublingual, ear and eye drugs

A
36
Q

Buccal, sublingual, ear, and eye drops

A
37
Q

Chapter 5 p71-72 planning and intervention ANTIBIOTICS

A

Immediately all provider for rash, itching, SOB, lump in throat, or drop inB/P
Diarrhea is a common side effect not an allergic reaction
If bloody, watery, fever or cramps could be c diff
Yeast can be vaginal or oral
Consistent timing- tid=q8h, qid=q4h, q6h etc
Timing side effects interactions
Must finish course unless instructed otherwise

38
Q

Penecillins.Amoxicillin (pink liquid). Mouth throat skin ears heart lungs
Fewer side effects

A

Bactericidal
Sometimes mixed with other ingredients to increase duration(last longer) or decrease resistance (prevent it from being destroyed)
5 generations (1929)
Used prophylaxis (prevent endocarditis) before surgery or dental procedure
Broad spectrum
Most common side effect is simple diarrhea (kills some normal flora), also N/Vand GI distress
If diarrhea is severe notify HCP
ADVERSE EFFECT-Rash;redness or inflammation,
Urticaria; hives,
Angiodema; swelling of the skin and mucous membranes,
Laryngeal edema; swelling of the larynx
Anaphylaxis;shock
Reduces effectiveness of oral contraceptives
Antacids decrease absorption

39
Q

Cephalosporins. Lower respiratory tract, CNS, genitourinary, sepsis, skin, soft tissue, skeletal

A

Bactericidal, broadspectrum spectrum, similar to PCN, 5 generations
Expected side effects/V/D
Adverse reactions-allergy/ acute hypersensitivity from mild to anaphylaxis
CAUTION- cross sensitivity pts. W/PCN allergy
NEPHROTOXICITY in older adults and kidney diagnosis
Usual response is REDMANS SYNDROME; deep red rash on upper body response (slow infusion)
Avoid alcohol mimics Antabuse (vomitting HA, SOB, low B/P,

40
Q

POWERFUL
vancomycin and Carbapenems treat MRSA and other superbugs

A

Usually IV, PO to treat MRSA, cell wall inhibitor

ADVERSE REACTIONS
NEPHROTOXICITY and OTOTOXICITY Kidneys and ears are biologically related
Vanco: Low B/P, RED MANS SYNDROME (histamines)
Carbapenems: confusion SEIZURES
AVOID PROENICID

41
Q

TETRACYCLINE doxycycline minocycline(usually for acne) UTI Lyme dx anthrax

A

Take on empty stomach**
SIDE EFFECTS V/N/D (dose related), PHOTOSENSITIVITY**, yeast infection
ADVERSE EFFECTS use contraindicated in pregnant women/breast feeding and children under 8 yrs
causes inadequate bone and tooth formation cause permanent yellow brown tooth discoloration
Permanent damage to fetus skeletal retardation
Can cause LIVER TOXICITY and High doses can decrease kidney function

42
Q

Macrolides erythromycin azithromycin Mouth throat skin ears

A

Alternative for PNC if allergic effective against same
Action similar to tetracycline
Take on empty stomachs
SIDE EFFECTS PHOTOSENSITIVITY GI upset
ADVERSE REACTION. LIVER DAMAGE** phlebitis w/ IV
Has numerous drug interactions that can be LIFE THREATENING CHECK DRUG BOOK**

43
Q

Gentamicin streptomycin. Amika in. To serious gram negative bacteria E. coli proteus pseudomonas

A

Weight based
Weakens bacteria
SIDE EFFECTS IRRITATES VEINS N/V, Fever, rash, lethargy
SERIOUS ADVERSE EFFECTS. NEPHROTOXICITY OTOTOXICITY persistent HA dizziness
Narrow therapeutic range (based on pt. Weight)
Monitor peak(after dosing) and trough (just before next dose) check BUN and CREATINE
VNCO INCREASES RISK OF NEPHROTOXICITY *
OTOTOXICITY increased w/ aspirin and diuretics **
Poorly absorbed from GI tract
Monitor labs. Frequent urine/ hearing screenings*

44
Q

Sulfonamides Bactria, Sentra spectrum pre and post bowel surgery. UTI bladder infection (cystitis), Renal infection (pyelitis

A

Take with lots of water and or food increase to 1.5 L water daily to prevent crystals
Photosensitivity
Expected side effects HA. Fatigue,dizziness. Insomnia tinnitus
ADVERSE EFFECTS CAN CRYSTALLIZE IN KIDNEY RASH THAT BEGINS WITH FEVER PHOTOSENSITIVITY
DRUG INTERACTIONS. Interacts with/blood, then a Coumadin and seizure medication CAN INCREASE EFFECT OF DIABETIC DRUGS


45
Q

Cipro, levo,are fluor. Treats anthrax STI Respitory bone and skin

A

Side effects N/V/D and Abd pain incontinence can irritate skin** urine crystals
ADVERSE REACTION not for children under **18 causes tendon rupture
TINGLING BURNING AND NUMBNESS IN FEET AND HANDS
INTERACTONS No dairy no vitamins minerals antacids take w food keep older pts. Well hydrated

46
Q

Macrolides

A

ACE Macrolides= azithromycim,clarithromycin, erithromycin

47
Q

Super toxic- vancomycin, gentamicin, neomycin

A

Report signs of vertigo, tinnitus=OTOTOXICITY
Report immediately=creatine over 1.3=bad kidney
Bun over 20, urine output less than 30mL= kidney distress

48
Q

Pregnancy

A

Childcare=clillins, cyclins
Penicillin, amoxicillin
Doxycycline, tetracycline

49
Q

No sun- Avoid fun the sun

A

F-fluoroquinolones
T-tetracycline-
S-sulfa

50
Q

Psoriasis

A

Inflammatory! autoimmune
Rapidly replicating skin cells and keratin
Flare ups and remissions
Tx- photo chemotherapy, methotrexate (immunosuppressant)
and biological agents ending in imab

51
Q

Acne vulgaris

A

Inflammation of sebaceous glands; pustules
Tx - Isotretinoin (accutane) dangerous for fetus
Tropical antibiotics and hormones
Side effects photo sensitivity, dry cracked skin (mouth area)

52
Q

Scabies aka Pediculosis

A

Caused by human itch mite, burrows under the skin and lays eggs especially on hands and arms, Brown wavy lines
CONTAGIOUS Tx all comities and patient

53
Q

Malignant tumors of the skin. BASIL CELLL

A

Basil cell carcinoma. Metastasis is rare. Good out come***
Small, translucent meaty

54
Q

Papules- pop

A

Larger than 1 cm small solid
Ex.plantar warts, elevated moles, lichen plants

55
Q

Malignant melanoma- Melanocytes

A

Exposure to sunlight increase risk
Invade layers of the skin
Deadliest skin cancer
Warning signs are ABCDE asymmetrical border, diameter, and evolving

56
Q

Atopic dermatitis

A

Caused by allergies and dry skin

Lpn (18 decks)

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