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BNPH700 > EXAM STUDY FLASHCARDS > Flashcards

EXAM STUDY FLASHCARDS

Credit to Ella.

1
Q

Anxiolytic drug effect

A

Reduce anxiety

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2
Q

Function + types of Benzodiazepine

A

Antianxiety, sedative and hypnotic drug that increases action of GABA and blocks nerve transmission in the CNS

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3
Q

Function + types of antipsychotics

A

Typical and atypical antipsychotics.
Inhibits dopaminergic receptor sites

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4
Q

Risk of typical antipsychotics

A

Extrapyramidal side effects

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5
Q

Risks of atypical antipsychotics

A

Increased risk of diabetes and metabolic syndrome (monitor weight)

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6
Q

Function of Selective Serotonin Reuptake Inhibitors (SSRI)

A

Blocks reuptake of serotonin to increase neurotransmitter levels

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7
Q

Agonists

A

Bind to receptors to activate/de-active response

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8
Q

Antagonists

A

Bind to receptor to inhibit other drugs from binding

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9
Q

Function of anticholinergic bronchodilators/muscarinic antagonists

A

Blocks the neurotransmitter acetylcholine (ACh) to promote relaxation of the smooth airways

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10
Q

Function of Beta-2 agonists

A

Stimulates the beta 2 receptors in the bronchial smooth muscle causing bronchodilation

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11
Q

MOA of penicillin and cephalosporins

A

Inhibits bacterial cell wall synthesis (disturbing cross-link structure) causing lysis and cell death

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12
Q

What is superinfection

A

Occurs during AB therapy when Abs destroy normal flora and create bacteria overgrowth

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13
Q

Example of superinfections

A

Vaginal yeast infection, thrush, C-diff

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14
Q

ADRs of Beta 2 agonists

A

Tachycardia, palpitations, headache, anxiety, tremor, hyperglycaemia

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15
Q

Suffix for SABA and LABA

A

Salbutamol + …terol

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16
Q

Suffix for SAMA and LAMA

A

…pium

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17
Q

MOA of Inhaled corticosteroids (ICS)

A

Mimic the stress hormone glucocorticoids (secreted from the adrenal gland) to reduce inflammation response and mucosal inflammation

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18
Q

What 2 inhaled respiratory medications complement each other?

A

Inhaled corticosteroids and beta 2 agonists.

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19
Q

ADR of systemic steroids

A

Altered fat on face, hyperglycaemia, muscle wasting, osteoporosis, peptic ulcers, psychosis etc.

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20
Q

MOA for nitrates

A

Direct-acting vasodilator that binds to the nitrate receptor to increase O2 to the myocardium

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21
Q

Example of a nitrate for treatment of angina

A

Glyceryl trinitrate (GTN)

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22
Q

Common ADR for ACE inhibitors

A

Persistent cough, hypotension, headaches, fatigue, dizziness

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23
Q

MOA for ACE inhibitors

A

Block the enzyme required for converting angio 1 into angio 2 which results in decreased aldosterone secretion = decrease BP

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24
Q

Class of diuretic that works on the loop of the nephron

A

Furosemide

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25
Q

Beta adrenoreceptor antagonists are also called

A

Beta blockers

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26
Q

MOA of beta blockers

A

Binds to beta receptor in the autonomic nervous system and prevents adrenaline/noradrenaline stimulating the receptors

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27
Q

Types of beta blockers

A

Selective (effects beta 1) and non-selective (effects beta 1 + 2)

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28
Q

What to be cautious of with beta blockers

A

Selective (effects beta 1) and non-selective (effects beta 1 + 2)
Asthma + falls related to postural hypotension

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29
Q

MOA of aspirin (antiplatelet)

A

Inhibits the COX 1 enzyme causing a decrease in synthesis of thromboxane A2 which then inhibits platelet aggregation and vasoconstriction

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30
Q

Antiplatelet example

A

Aspirin

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31
Q

MOA of warfarin

A

Inhibits synthesis of Vit K (dependent clotting factor)

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32
Q

LMWH example

A

Clexane/enoxaparin

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33
Q

MOA of both heparin and LMWH

A

Both result in inhibition of thrombin and preventing fibrin clot formation

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34
Q

Education for heparin and LMWH

A

Avoid over the counter NSAIDs + alternate injection sites

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35
Q

Thrombolytic example

A

Alteplase

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36
Q

Indication for thrombolytic meds

A

Treatment of thromboembolism (clots) to dissolve already formed clots

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37
Q

Where and what is glucose stored as?

A

Glucose is stored as glycogen in the liver

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38
Q

How and where is insulin produced

A

Insulin is produced by beta cells in the pancreas

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39
Q

Type 2 Diabetes Mellitus patho

A

T2DM is characterised by inadequate insulin secretion by the beta cells. Insulin resistance results in increased BSL and B-cell atrophy

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40
Q

Type 1 Diabetes Mellitus patho

A

Autoimmune disease that destroys insulin producing beta cells

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41
Q

ADR for metformin

A

Lactic acidosis, GI upset

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42
Q

How to reduce ADR for metformin

A

Slowly titrate metformin dosages

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43
Q

What type of medication is empagliflozin

A

SGLT-2 inhibitor or/and oral hypoglycaemic med used for T2DM

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44
Q

ADRs for SGLT-2/empagliflozin

A

Glucosuria (glucose in the urine), increase risk of UTIs, weight/water loss, hypotension, diabetic ketoacidosis

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45
Q

MOA of empagliflozin

A

Acts on the sodium glucose co-transporters I the renal tubules to inhibit reabsorption of glucose.

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46
Q

Pt education for empagliflozin

A

Keep genitals clean, avoid keto diet, healthy diet + exercise

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47
Q

Pt education for insulin therapy

A

Encourage a sick day plan, rotating sites, 90 degree angle, safe disposal

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48
Q

Where are nephrons?

A

In the kidneys

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49
Q

Purpose of RAAS

A

A hormone system that regulates BP and fluid balance by renal blood flow

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50
Q

Definition of parental

A

Any route of administration other than the mouth

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51
Q

Enzyme definition

A

A biological molecule that catalyses a chemical reaction or cause a chemical change in another substance

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52
Q

Adverse drug reaction Type-A

A

Predictable, unintended response to a drug

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53
Q

ADR type-B

A

Unpredictable, unintended response to a drug

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54
Q

Pro-drug

A

A drug that is converted to its active form after absorption

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55
Q

Steady state

A

The rate of the drug administration equals the rate of elimination (+plasma concentration remains constant)

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56
Q

Half-life

A

The time taken for the blood plasma concentration of a drug to fall by 50%

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57
Q

Two types of medications that control stomach acid

A

Proton pump inhibitors + antacids

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58
Q

Definition of dyspepsia

A

General name for any upper GI discomfort that lasts longer than 4 wks

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59
Q

Another name for heart burn

A

GORD (gastro-oesophageal reflux disease)

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60
Q

MOA of proton pump inhibitors (PPIs)

A

Inhibit gastric acid secretion by blocking hydrogen-potassium (proton pump) to decrease HCl

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61
Q

Indication for PPI

A

Dyspepsia, GORD, NSAID ulcers, gastric + duodenal ulcers

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62
Q

Cautions for PPI

A

Short term use, may mask gastric cancer symptoms, not to be used with diazepam or warfarin

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63
Q

Parietal cells function

A

Secrete HCl into the lumen of the stomach via the proton pump

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64
Q

ECL function

A

Secrete histamine which bind to H2 receptors to stimulate secretion of HCl

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65
Q

Heart burn could indicate either..

A

Heart complications or GORD/dyspepsia

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66
Q

MOA of antacids

A

Neutralises the acid in the lumen by inhibiting pepsin to increase pH

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67
Q

Indication for antacids

A

Peptic ulcers, gastritis, GORD,
dyspepsia

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68
Q

Pt education for antacids

A

Antacids delay absorption of other drugs so take 2hrs either side of meds

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69
Q

What is H. (helicobacter) Pylori

A

Bacteria that enters the digestive system & can penetrate the mucous lining leading to infection/ulcers/cancer

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70
Q

Treatment for H. Pylori

A

Triple therapy of PPI + antibiotics

71
Q

Neurotransmitters involved in vomiting

A

Histamine, acetylcholine, serotonin and dopamine

72
Q

Sites of antiemetic drug action

A

Chemoreceptor trigger zone (CTZ), vestibular apparatus, and gastric

73
Q

Action on chemoreceptor tigger zone (CTZ) receptors

A

Dopamine antagonist(metoclopramide)
Serotonin antagonist (ondansetron)

74
Q

Action on Vestibular apparatus (brain) receptors

A

Cholinergic receptors:
Antihistamine (H1) receptors (cyclizine)
Anticholinergic receptors (hyoscine)

75
Q

Action on Gastric receptors

A

Serotonin antagonist (ondansetron)
Dopamine antagonist(metoclopramide)

76
Q

MOA of Ondansetron

A

Binds to 5-HT receptor in the GI tract, CTZ & vomiting centre to inhibit stimulation of these receptors

77
Q

Indications for ondansetron

A

Chemotherapy induced nausea or vomiting + post op nausea or vomiting

78
Q

Interaction cautions of ondansetron

A

Lessened effect of tramadol, opioids also cause constipation, increase risk of serotonin syndrome w CNS depressants

79
Q

ADRs of ondansetron

A

Constipation, headaches, anxiety, dizziness

80
Q

MOA of Metoclopramide

A

Blocks D2 receptors in the CTZ and vomiting centre to decrease vomit reflex + increases gastric motility

81
Q

ADRs of Metoclopramide

A

Diarrhoea, drowsiness, headache, extrapyramidal effects

82
Q

Contraindications of Metoclopramide

A

Bowel obstruction, Parkinson’s.
SHORT TERM med.

83
Q

Indications for Metoclopramide

A

Post-op nausea + vomiting

84
Q

Cyclizine indication

A

Motion sickness, vertigo, palliative care

85
Q

MOA of Cyclizine

A

Blocks H1/histamine receptor + has anticholinergic effects

86
Q

ADR of Cyclizine

A

Drowsiness, GI upset, some anticholinergic effects

87
Q

ADR of hyoscine

A

Decreases water availability in the body

88
Q

MOA of hyoscine

A

Blocks Ach at the muscarinic receptors at the inner ear (motion sickness)

89
Q

ADRs of GTN

A

Postural hypotension, dizziness, fainting, headache

90
Q

MOA of GTN

A

Binds to nitrate receptors in vascular smooth muscles resulting in relaxation

91
Q

Pt education for GTN

A

Must know the action plan, sit down when taking it, how to take sublingually

92
Q

ADRs of beta blockers

A

Bradycardia, dizziness, hypotension, arrythmias

93
Q

ADRs of warfarin (anticoagulant)

A

Bleeding, chest pain, dyspnoea, headache

94
Q

ADRs of statins (HMG-CoA inhibitors)

A

Report any muscle pain or weakness, GI upset, headache, sleep disturbances

95
Q

MOA of statins

A

Inhibit the synthesis of cholesterol in the liver by inhibiting the HMG-CoA enzyme. Results in lower LDL levels

96
Q

Pt education for statins

A

Reduce cholesterol, smoking cessation, avoid alcohol, take at night

97
Q

ADRs of Aspirin

A

Bleeding, bruising, GI bleeding, dyspepsia

98
Q

Pt education for Aspirin

A

Avoid additional NSAIDs, caution with surgery, monitor for GI bleeds

99
Q

Pt education for Salbutamol

A

Use for acute attacks, use spacer, action plan for managing symptoms

100
Q

ADRs of Salbutamol

A

Tachycardia, palpitations, headaches, restless/anxiety

101
Q

Pt education for Fluticasone (ICS)

A

Take consistently, ICS given with a spacer, rinse mouth and throat to decrease risk of oral thrush

102
Q

ADRs for Penicillin

A

GI upset, candidiasis (yeast infection), allergic reaction

103
Q

Pt education for Ipratropium (SAMA)

A

Use in acute exacerbations with salbutamol, inhaler technique, action plan for managing symptoms

104
Q

MOA of Salbutamol (SABA)

A

Short acting beta 2 agonist receptors in the bronchial smooth muscle causes bronchodilation

105
Q

Pt education for Salmeterol (LABA)

A

Use continuously, use spacer, action plan, use with ICS

106
Q

ADRs of fluticasone (ICS)

A

Oral thrush, dysphonia (voice impairment), hyperglycaemia

107
Q

MOA of Salmeterol (LABA)

A

Long-acting stimulating beta 2 receptors in the bronchial smooth muscle causing bronchodilation

108
Q

ADRs of Salmeterol

A

Tachycardia, palpitations, headaches, restlessness/anxiety

109
Q

MOA of Ipratropium (SAMA)

A

Blocks the parasympathetic stimulation of the Vagus nerve resulting in smooth muscle relaxation and bronchodilation

110
Q

Pt education for Penicillin

A

Complete full course, hand washing after handling, do not share ABs

111
Q

Pt education for Tiotropium (LAMA)

A

Daily + continuous use, inhaler technique, action plan, use with ICS

112
Q

MOA for Tiotropium (LAMA)

A

Blocks the parasympathetic stimulation of the Vagus nerve resulting in smooth muscle relaxation and bronchodilation

113
Q

ADRs of Tiotropium (LAMA)

A

Dry mouth, metallic taste, nausea, constipation

114
Q

What do long acting respiratory meds have in common?

A

Both use with ICS, technique, action plan for managing symptoms

115
Q

Neurotransmitter that is blocked in the Vagus nerve for bronchodilation

A

Acetylcholine (ACh)

116
Q

Respiratory PNS receptor MOA

A

Acetylcholine (ACh) works on the muscarinic to bronchoconstrict. Results in decreased HR and contractility

117
Q

Respiratory SNS receptor MOA

A

Adrenaline + noradrenaline works on adrenergic receptors to bronchodilate, results in increase HR and contractility

118
Q

5HT is what type of receptor?

A

Serotonin receptors

119
Q

Chemicals released at transduction

A

Prostaglandin, serotonin, histamine, potassium, bradykinin

120
Q

Effect of NSAIDS on COX enzyme

A

Inhibits COX enzyme, therefore decreases prostaglandin production

121
Q

Pain Pathway

A

Transduction – transmission – perception of pain - modulation

122
Q

Where does transmission of pain occur

A

Dorsal horn of the spinal cord

123
Q

What is Gate Control Theory

A

Theory that inhibits the pain receptors with non-painful stimuli e.g touch

124
Q

Opioid receptors

A

Mu, Kappa, Delta

125
Q

MOA of spinal level opioids

A

Stimulates opioid receptors and inhibits substance P release from dorsal horn neurons

126
Q

MOA of supra level opioids

A

Close dorsal horn gate inhibiting afferent transmission to the cortex (alters pain perception)

127
Q

ADRs of Opioids

A

Suppression of cough + resp. centre, nausea/vomiting, constipation, itching

128
Q

First line opioid

A

Morphine

129
Q

Considerations for IV morphine

A

Have naloxone + O2 available, if via infusion count resp every hr, stay with pt for first 5mins + check after 10mins

130
Q

Common ADR for Codeine + Dihydrocodeine

A

Constipation

131
Q

MOA of codeine

A

Converted to morphine by the liver enzyme (pro-drug)

132
Q

MOA of tramadol

A

Stimulates the mu receptors + inhibits uptake of noradrenaline + serotonin

133
Q

ADR of tramadol

A

Euphoria, addiction, nausea/vomiting, risk of serotonin syndrome

134
Q

MOA of Naloxone

A

Reverse effect of agonist opioids

135
Q

Consideration with Naloxone

A

Watch for respiratory distress, half-life is shorter than agonists

136
Q

MOA of ibuprofen

A

Inhibit COX enzyme, results in decrease prostaglandin production

137
Q

Prostaglandin actions

A

Increase body temp, pain, inflammation, blood flow, formation of blood clots, induction of labour

138
Q

ADRs of NSAIDs

A

Gastric irritation, decrease GF (fluid retention), prolonged bleeding, increase risk of MI + asthma attacks

139
Q

Loperamide indication

A

Diarrhoea

140
Q

Function of NSAIDs

A

Analgesic, antiplatelet, anti-inflammatory, antipyretic

141
Q

Most targeted opioid receptor

A

Mu receptor

142
Q

Effects of inhibiting Prostaglandin

A

Regulate body temp, alter smooth muscle contraction (uterus), influence blood clot formation

143
Q

Explain reason for itchy skin with morphine

A

All opioids case some histamine release causing ADR of itching

144
Q

Complications of morphine overdose

A

Sedation, resp. depression, need naloxone + O2

145
Q

Pt education for paracetamol

A

Take 1g every 4-6hrs, avoid alcohol + other meds containing paracetamol

146
Q

Reasoning for codeine not working on a pt

A

Codeine is a prodrug that must be metabolised to its active form, some people lack the metabolising enzyme

147
Q

MOA of paracetamol

A

Inhibits the COX enzyme (responsible for the synthesis of PG in the CNS)

148
Q

Drug interactions between tramadol and fluoxetine

A

Fluoxetine is a SSRI, tramadol inhibits reuptake of serotonin, may lead to serotonin syndrome

149
Q

Drug interactions between tramadol and ondansetron

A

Ondansetron is a serotonin agonist, tramadol inhibits reuptake of serotonin, may lead to serotonin syndrome

150
Q

Long acting + short acting Morphine pt education

A

Take m-Elson routinely, take RA as pain relief, safe storage, driving precaution, ADRs

151
Q

Laxative advised for opioids

A

Laxsol as it stimulates mobility and softens the stool to prevent straining.

152
Q

Assessments before giving ibuprofen

A

Hx of peptic ulcers or GI bleeding, renal impairment, asthma, over 65yrs old

153
Q

Why can drugs effect the foetus more than the mother?

A

Foetus has immature drug metabolising enzymes, slower rate of excretion, extended drug exposure

154
Q

Recommended antiemetic drug for pregnancy

A

Metoclopramide

155
Q

Indication for Bisacodyl (stimulant laxative)

A

Severe constipation

156
Q

Non-pharmacological intervention for type 2 diabetic

A

Diet management (low fat, salt, high protein), increase physical activity, smoking cessation advice

157
Q

MOA of metformin

A

Increase glucose uptake + utilisation in skeletal muscle, reduce glucose production, increase insulin sensitivity, reduces LDL

158
Q

Reasoning for Metformin as first line med for T2DM

A

Effective for those overweight, has HDL profile, doesn’t cause weight gain

159
Q

Contradictions of metformin

A

Poor renal/liver function, GI disturbance, pregnancy, hypoxemia

160
Q

Metformin pt education

A

Take with food, start on lower dose, stop taking if unwell, stop prior surgery

161
Q

Hb1AC blood test purpose

A

Measures glycated haemoglobin over 2-3months

162
Q

Rationale for basal bolus regime (insulin)

A

Mimics the body’s natural rhythms of insulin release

163
Q

Pt advise for administering short acting insulin

A

Take 15mins before or 20mins after starting a meal

164
Q

Storing insulin pt education

A

Never freeze, keep in 2-8 degrees, discard insulin 1 month after opening, gently roll insulin - don’t shake

165
Q

Diabetic ketoacidosis signs/symptoms

A

Lack of insulin, body burns adipose tissue, hyperventilation, polyuria

166
Q

Difference between propranolol and metoprolol (antagonists)

A

Propranolol is not cardio selective (greater risk of bronchoconstriction)
Metoprolol is cardio selective (B1)

167
Q

MOA of furosemide

A

Inhibits reabsorption of sodium and chloride in the loop of Henle (nephron)

168
Q

How do spacers effect inhaled medications

A

A spacer will decrease the amount of medication deposited in the throat + more effective distribution

169
Q

Treatment for anaphylaxis

A

Adrenaline, fluids, O2, antihistamines, corticosteroids, bronchodilators

170
Q

ADR of systemic corticosteroids

A

Elevated BGLs

171
Q

Inhaled vs oral corticosteroids

A

Inhaled have a larger surface area + rich blood supply which reduces ADRs

172
Q

Pt education for prednisone

A

Take in the morning as it mimics the body’s corticosteroid secretion + may cause insomnia

173
Q

Mechanisms of antibiotic resistance

A

AB unable to reach target site, ABs pumped out by bacteria efflux pump, micro-organisms produce enzyme making Abs ineffective

174
Q

Preventing AB resistance requires prescriptions if bacterial infection is..

A

Not resolving, using first-line ABs, handwashing, symptoms are severe

BNPH700 (9 decks)

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