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Pharmacology 1 > final > Flashcards

final Flashcards

1
Q
  1. pharmacodynamics:

2. pharmacokinetics and the 4 pharmacokinetic processes:

A
  1. what drugs do to the body

2. what the body does to drugs (absorption, distribution, metabolism, and excretion)

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2
Q
  1. What are the rights of safe drug administration (8)?
A 
1. Right Patient
Right Drug
Right Storage
Right Route
Right Dosage
Right Preparation
Right Timing
Right Documentation
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3
Q
  1. Absorption is affected by what?
  2. What is distribution, and what has an affect on it?
  3. Drugs must be ……… soluable to absorb into tissues (deionized, non-charged). Drugs must be ………… soluble to be easily excreted by the kidneys (ionized, charged). Can drugs switch from deionized to ionized?
  4. How can drugs pass the blood-brain barrier?
  5. Which blood protein is most closely monitored in regard to protein bound drugs?
A
  1. route, food in stomach (for oral meds)
  2. The movement of a drug to the body’s tissues. Protein binding
    Ionization/pH
    Perfusion of the reactive tissue
  3. lipid, water. Yes, depending on the pH around them
  4. must be highly protein-bound
  5. albumin
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4
Q
  1. The ……… is the most important site for biotransformation (metabolism).
  2. ……….. play the most important role in excretion of medication
  3. What are 3 kidney function tests?
  4. Where in the body do drug-drug interactions take place (5)?
A
  1. liver
  2. Kidneys
  3. BUN 7-20 mg/dL, creatinine < 0.8 -1.4 mg/dL, and GFR > 60 ml/min
4. Site of absorption
During distribution
During biotransformation
During excretion
At the site of action
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5
Q
  1. what do NSAIDs (including salicylates) block?
  2. contraindications to nsaids:
  3. Drug to drug interactions:
  4. NSAID adverse effects:
  5. prototype:
A
  1. Prostaglandin synthesis by inhibiting cox 1 and 2 for mild to mod pain
  2. allergy (to nsaid or salicylate), hypertension, peptic ulcer, GI bleeding, pregnancy, lactation, renal or hepatic dysfunction, sulfonamide allergy (celecoxib)
  3. decreased diuretic effect of loop diuretics, decreased effect of beta-blockers, lithium toxicity
  4. nausea, dyspepsia, GI pain, constipation, diarrhea, GI bleed, platelet inhibition, hypertension, bone marrow depression, somnolence
  5. ibuprophen
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6
Q
  1. Describe pregnancy categories A - X
A

A. no risk to fetus in any trimester

B. No Adverse effects in animals; no human studies

C. animal studies have adverse effects. Given only after fetal risk considered

D. Definite fetal risk, yet may be given for a life-threatening condition

X. absolute fetal abnormality. Not to be used at all in pregnancy

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7
Q
  1. What are the characteristics of schedule 1 drugs?
  2. What are the characteristics of schedule 2 drugs?
  3. schedule 3
  4. schedule 4
  5. schedule 5
A
  1. High potential for abuse. No medical use
  2. High potential for abuse which leads to severe physical /psychological dependence. Has medical use.
  3. Less potential for abuse. Has a medical use. Moderate degree of dependence.
  4. Lower potential of abuse. Has a medical use. similar level of dependence as schedule 3.
  5. Low potential for abuse. Has a medical use. Least level of dependence
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8
Q
  1. What is the mechanism of action of narcotic (agonist) analgesics?
  2. What are the contraindications?
  3. With what should the nurse exercise caution?
  4. What are the adverse reactions?
  5. What is the narcotic agonist analgesic prototype?
  6. Name the drug we use to correct overdose? How does it work?
A
  1. act at specific opioid receptor sites in the CNS. Agonists use mu receptors
  2. allergy, pregnancy, labor, lactation
  3. closely monitor for respiratory dysfunction, GI or GU surgery, ulcerative colitis
  4. cardiac arrest from respiratory depression, constipation, urinary retention, orthostatic hypotension, emesis, and intracranial pressure
  5. morphine.
  6. naloxone (Narcan). It binds the opioid receptor but doesnt stimulate it (antagonist).
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9
Q
  1. migraine headaches:

2. What type of drugs treat migraines?

A
  1. severe throbbing headache on one side of head caused by vasodilation and inflammation of cranial arteries
  2. Ergot derivatives or triptans
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10
Q
  1. what is the prototype Ergot?
  2. mechanism of action:
  3. contraindications:
  4. caution:
  5. adverse effects:
  6. describe ergotism:
A
  1. Ergotamine
  2. blocks alpha-adrenergic and serotonin receptors in brain to constrict cranial blood vessels
  3. allergy, pregnancy, lactation, CAD, HTN, PVD
  4. pruritus, malnutrition
  5. nubmness, tingling of fingers/toes, muscle pain in extremities, tachycardia, bradycardia, ergotism
  6. nausea vomiting diarrhea caused by too much ergot derivative.
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11
Q
  1. What is another migraine drug (other than ergot)?
  2. Prototype
  3. mechanism of action:
  4. Adverse effects:
  5. contraindications:
  6. cautions:
  7. drug to drug:
A
  1. Triptans
  2. almsumatriptan (Imitrex)
  3. Bind to selective serotonin 5-HT 1B/1D receptors sites to cause vasoconstriction of cranial vessels. For Abortive treatment, NOT preventative
  4. dizziness, vertigo, weakness, myalgia, BP
    alterations, tightness of chest
  5. allergy, pregnancy, CAD
  6. elderly, lactation
  7. ergot-containing drugs and MAOI’s
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12
Q
  1. What is the action of acetaminophen?
  2. Can this be used prophylactically?
  3. contraindications?
  4. adverse reactions:
  5. drug to drug:
A
  1. acts directly on the hypothalmus (thermaregulatory cells) resulting in CNS analgesia
  2. yes, in babies prior to D-tap vaccine
  3. allergy, hepatic dysfunction or alcoholism
  4. Headache, hemolytic anemia, renal dysfunction, skin rash and fever
    Hepatotoxicity assoc with chronic use and overdose
  5. Oral anticoagulants increase bleeding
    Hepatotoxicity with barbiturates, carbamazepine, hydantoins, or rifampin
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13
Q
  1. What is the nursing process?

2. What are the 3 nursing interventions in regard to medications that nurses perform?

A
  1. a framework for making clinical decisions. ADPIE
  2. Drug administration
    Provision of comfort measures
    Patient/family education
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14
Q
      1. Name the types of drug induced tissue and organ damage:
  2. What happens in poisoning?
A
  1. dermatological reactions: rash, hives, most serious is Steven Johnson’s syndrome
  2. Stomatitis: inflammation of mucous membranes, canker sores etc
  3. Superinfections: think yeast infections or infections that come as an overgrowth of bad bugs from destruction of normal flora
  4. Blood Dyscrasia: bone marrow suppression (most common in chemo and malaria treatment) so blood cells are suppressed.
  5. Liver damage: always check lab work. Fever, nausea, jaundice (late sign), change in color of stool or urine, elevated liver enzymes ALT and AST
  6. Kidney damage: elevated BUN and creatine, change in urinary pattern.
  7. Ocular/Auditory
  8. Neurological
  9. Electrolyte Imbalances or altered glucose
  10. Teratogenicity
  11. Poisoning occurs when an overdose of a drug damages multiple body systems.
    Damage to multiple systems can lead to a fatal reaction.
    Treatment varies accordingly with drug
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15
Q
      1. Name the 3 types of adverse reactions/side effects:
      1. Name the types of drug allergies:
  3. how does a hypersensitivity differ from an allergic reaction?
A
  1. Primary Actions
    Overdose; extension of the desired effect
  2. Secondary Actions
    Undesired effects produced in addition to the pharmacologic effect
  3. Hypersensitivity Reactions
    Excessive response to primary or secondary effect of drug
  4. Anaphylactic Reaction
    Know Signs and Symptoms of anaphylaxis:
    SOB, Blood pressure changes (may be high initially, then low), rash, itch, tachycardia, severe anxiousness
  5. Cytotoxic Reaction:
  6. Serum Sickness Reaction:
  7. Delayed Allergic Reaction:
  8. allergy must involve the immune system - antibody, antigen reaction
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16
Q
  1. What are the 9 categories of antibiotics?

2. What are the 5 types of adverse reactions that antibiotics usually cause?

A
  1. aminoglycosides, glycopeptides (vanco), B-lactams (penicillins), fluoroquinolones, Macrolides, lincosamides, sulfonamides, Oxazolidinones, and misc. like tetracyclines and metronidazole
  2. kidney damage, GI toxicity, Neurotoxicity, Hypersensitivity reactions, and superinfections
17
Q
  1. What is the prototype drug for aminoglycosides? What is their suffix and for what are they indicated?
  2. Mechanism of action:
  3. contraindications:
  4. Administration:
  5. Adverse effects:
  6. What should not be taken with this?
A
  1. Gentamicin. Suffix: “mycin” Serious infections and G neg.
  2. inhibition of bacterial protein synth
  3. allergy, renal or hepatic disease, or hearing loss.
  4. IV or IM
  5. ototoxicity, nephrotoxic (monitor urine output 30mL/hr to ensure kidney function)
  6. diuretics, neuromuscular blockers, succinylcholine, citrate, or anticoagulated blood
18
Q
  1. What is the prototype for Lipoglycopeptides (Glycopeptides)? For what is it indicated?
  2. Administration?
  3. Adverse effects:
  4. What special instructions must be followed when administering this medication?
A
  1. Vancomycin. MRSA and penicillin allergy
  2. Inhbits cell wall synth
  3. IV- slowly over 1 hour or “red man” syndrome can occur
  4. highly nephrotoxic - measure peak and trough
19
Q
  1. What is the prototype drug for B-Lactam and what is it indicated for? What is/are its suffixes?
  2. What is its mechanism of action?
  3. Contraindications:
  4. Adverse effects:
  5. Drug to drug:
A
  1. Penicillin. Indicated for severe infections. Broad spectrum use. Suffix is “cillin” or “pen” (Pfizerpen)
  2. Interferes with bacterial cell wall synthesis
  3. allergies to cephalosporins, renal disease. Caution in pregnancy and lactation
  4. GI discomfort
  5. tetracyclines, parenteral aminoglycosides
20
Q
  1. What group of antibiotics are a chemical modification to the penicillin structure?
  2. How many generations are there of this drug, and give a couple examples:
  3. Contraindications:
  4. Adverse effects:
  5. Drug to drug:
A
  1. Cephalosporins
  2. 4 Generations: 1st Keflex, 2nd Ceclor, 3rd Omnicef etc…
  3. penicillin allergies, hepatic and renal impairment
  4. GI issues, C-diff, superinfections (esp 3rd gen)
  5. Disulfuram reaction if mixed w/ alcohol. Aminoglycosides, oral anticoagulants, ETOH
21
Q
  1. Macrolides are similar to ………….. . Which one is more toxic?
  2. Name a prototype macrolide: Lincosamide:
  3. The mechanism of action for both types:
  4. Adverse effect:
  5. Macrolides are contraindicated for:
A
  1. Lincosamides. Lincosamides are more toxic.
  2. Macrolides: Erythromycin, Azithromycin. Lincosamides: Clindamycin
  3. Inhibit protein synthesis for G+ and G-
  4. Pseudomembranous colitis, Clindamycin can cause C-diff,
  5. heart problems because of QT prolongation
22
Q
  1. Which semisynthetic antibiotic is based on the structure of a common soil mold?
  2. Mechanism of action:
  3. Which drug does this commonly replace when someone has an allergy? What is a common indication?
  4. Contraindications:
  5. Important to remember with administration:
  6. Adverse reactions:
  7. Drug to drug:
A
  1. Tetracyclines
  2. inhibits protein synthesis
  3. Penicillin. Acne.
  4. kids under 8 (turns teeth brown and bone probs), allergy to Tartazine, pregnancy, lactation, renal and hepatic dysfunction.
  5. don’t take with food or any milk products. Empty stomach
  6. GI, possible tooth and bone damage
  7. Oral contraceptives (cancels effectiveness), Digoxin, Penicillin G
23
Q
  1. What class of drugs was first available to treat systemic bacterial infections?
  2. What is the prototype Sulfonamide?
  3. mechanism of action:
  4. Contraindications:
  5. Adverse Effects:
  6. Drug to drug:
  7. Special considerations for pateints receiving sulfonamides:
A
  1. Sulfonamides
  2. Cotrimoxazole, Bactrim
  3. inhibit folic acid synthesis
  4. thiazide diuretics and pregnancy
  5. GI symptoms, renal effects r/t filtration of the drug (need to drink more fluids)
  6. tolbutamide, tolazamide, glyburide, glipizide, chloropropamide, cyclosporin
  7. abdomen, renal function tests, complete blood count, photosensitivity
24
Q
  1. What is the prototype drug of Fluoroquinolones? What is their suffix? What are they indicated for?
  2. What is their mechanism of action?
  3. Contraindications:
  4. Adverse reactions:
  5. Drug to drug:
A
  1. Ciprofloxacin. “cin”. Gram negative infections of the urinary/respiratory tract, ear, eye, bone, skin infections. Anthrax exposure, typhoid fever
  2. Interferes w/ DNA replication in gram negative
  3. children, pregnancy, lactation, renal dysfunction
  4. tendon rupture, headache, dizziness, insomnia, depression
  5. Antacids (because of aluminum), quinidine, theophylline, heightened Warfarin effect
25
Q
  1. What is Metronidazole?
  2. What is the protoype antiprotozoal (*not for malaria), and its indications?
  3. mechanism of action?
  4. Contraindications:
  5. Adverse reactions:
  6. Drug to drug:
  7. special things for nurses to watch for:
A
  1. an Antiprotozoal
  2. Metronidazole. Amebiasis, giardiasis, trichamoniasis. GI infections and GU surgery
  3. DNA synthesis inhibition
  4. pregnancy, CNS or hepatic disease
  5. headache, dizziness, ataxia, nausea, vomiting, diarrhea
  6. alcohol - disulfuram. Anticoagulants
  7. CNS - check reflexes, muscle strength, skin, mucous membranes, liver function
26
Q
  1. Name a few drug that treat mycobacteria:
  2. What are these drugs indicated for?
  3. What is the mechanism of action?
  4. What is essential to remember for these drugs?
  5. Adverse effects:
A
  1. Rifampin, Mycobutin, Isoniazid, streptomycin ect.
  2. active and latent TB and leprosy
  3. Act on the DNA of the bacteria leading to lack of growth and eventual death of mycobacterium
  4. Effective treatment requires more than one prototype drug.
  5. Hepatotoxicity, hyperglycemia (famous side effect), Rifampin discolors bodily fluids, Isoniazid causes Vitamin B6 deficiency.
27
Q
  1. What are Azoles indicated for?
  2. Mechanism of action:
  3. Contraindications:
  4. Adverse effects:
  5. drug to drug:
A
  1. systemic fungal infections. Less toxic than amphotericin B, but less effective
  2. binds to sterols and inhibit glucan synthesis.
  3. hepatic and renal dysfunction, pregnancy and lactation, drugs that prolong QT interval
  4. liver toxicity, tetrogenic effects
  5. many
28
Q
  1. What is the most common antihelminth medication we will encounter?
  2. What are the nursing considerations for mebendazole?
A
  1. Mebendazole
  2. allergies to antihelminth drugs, physical assessment, obtain stool culture for eggs, reflex and muscle strength, liver and renal tests, examine skin and abdomen
29
Q
  1. Herpes and Cytomegalovirus antiviral prototype:
  2. Adverse effects:
  3. What to teach clients about Acyclovir:
A
  1. Acyclovir
  2. headache, vertigo, tremors, nausea, vomiting, rash
  3. emphasize hydration, expect symptom relief but not cure (herpes), topical administration, no sex while lesions are present
30
Q
  1. What are things nurses need to look out for in HIV/AIDS antiviral therapy?
  2. How do we evaluate the effectiveness of HIV meds?
  3. What is the significance of CD-4?
A
  1. history of allergy to antivirals, patient’s level of orientation, skin color, temp, lesions, temp (to monitor for infections), hepatic and renal function tests, and CBC
  2. metabolic panel, CBC, and CD4 counts
  3. CD-4 are T-helper cells. The more, the better effectiveness of the medication

Pharmacology 1 (4 decks)

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