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Pharmacology 218 > Final > Flashcards

Final Flashcards

1
Q

Results from either a poorly functioning thyroid gland or low secretion of TSH by the pituitary gland

A

Hypothyroidism

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2
Q

Hypothyroidism in adults

A

Myxedema

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3
Q

Symptoms of myxedema or hypothyroidism

A

General weakness
Muscle cramps
Dry skin

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4
Q

What is the treatment for hypothyroidism

A

Replacement therapy with T3 or T4

The standard treatment is levothyroxine (T4)

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5
Q

Disorder characterized by a dispondent mood, lack of energy, sleep disturbances, abnormal eating patterns, feelings of despair, guilt, and misery

A

Depression

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6
Q

The most common mental health disorder of elderly adults and also a common cause of disability

A

Depression

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7
Q

Types of depression

A 
Major depressive disorder
Dysthymic disorder
Postpartum depression
Seasonal affective disorder
Psychotic depression
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8
Q

Treatment of depression in patients unresponsive to pharmacotherpay and with serious life-threatening mood disorders

A

Electroconvulsive therapy (ECT)

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9
Q

Drugs for depression

A

Imipramine (Tofranil)
Sertraline (Zoloft)
Phenelzine (Nardil)

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10
Q

The more common form of the disorder, representing 90-95% of the people with diabetes

A

Type 2 diabetes mellitus

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11
Q

What is the primary physiological characteristic of type 2 diabetes when target cells become unresponsive to insulin due to a defect in insulin receptor functions, essentially the pancreas produces sufficient amounts of insulin but target cells do not recognize it. This can be reversed though with a healthy diet and regular exercise

A

Insulin resistance

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12
Q

Occurs in patients with type 2 diabetes
Acute condition with a mortality rate of 20-40%
Caused by an insufficient circulation of insulin
It has a gradual onset and it sometimes mistaken for a stroke

A

Hyperosmolar hyperglycemic state (HHS)7u

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13
Q

Insulin lispro (humalog) rate, color, onset, peak, and duration

A 
Rapid acting
Clear
Onset: 5-15 minutes
Peak: 30-60 minutes
Duration: 3-4 hours
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14
Q

Insulin lispro (humalog) administration

A

Subcutaneous 5-10 minutes before meals

Can give with NPH (Humalin N), draw up lispro first and give immediately

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15
Q

Insulin Humalin R color, rate, onset, peak, and duration

A 
Short acting
Clear
Onset: 30-60 minutes
Peak: 2-4 hours
Duration: 5-7 hours
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16
Q

Insulin Humalin R administration

A

Subcutaneous 30-60 minutes before a meal, IV

Can give with NPH (Humalin N), sterile water, or normal saline

DO NOT mix with Insulin glargine (lantus)

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17
Q

Insulin Humalin N (NPH) rate, color, onset, peak, and duration

A 
Intermediate acting
Cloudy
Onset: 1-2 hours
Peak: 4-12 hours
Duration: 18-24 hours
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18
Q

Insulin Humalin N (NPH) administration

A

Subcutaneous 30 minutes before first meal of the day and 30 minutes before dinner if necessary

Can mix with aspart (novolog), lispro (humalog), and regular (humalin R)

DO NOT mix with Insulin glargine (lantus)

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19
Q

Insulin Glargine (lantus) rate, color, onset, peak, and duration

A 
Long acting
Clear
Onset: 1.1 hours
Peak: 3-4 hours
Duration: 10-24 hours
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20
Q

Insulin Glargine (lantus) administration

A

Subcutaneous once a day, given at the same time each day

DO NOT mix with any other insulins

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21
Q

Disease in which the heart muscle cannot contract with sufficient force to meet the body’s metabolic needs

A

Heart failure

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22
Q

Heart failure occurs with aging and can also be accelerated by what 5 things

A

Coronary artery disease (CAD): plaque build up in or narrowing of the coronary arteries

Mitral stenosis: valves gets hard and don’t close/seal very well so when pumping some goes backwards so there isn’t enough moving forward to meet the bodies needs

Myocardial infarction (MI): damage to a heart muscle so some of the blood supply has been cut off because you lose the ability to pump

Chronic hypertension (HTN): high blood pressure

Diabetes mellitus (DM)

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23
Q

6 drugs for heart failure

A

Angiotensin-Converting Enzyme (ACE Inhibitor)
–increase cardiac output by lowering blood pressure and decreasing blood volume (lisinopril)
Angiotensin II receptor blockers (ARBs)
–increase cardiac output by lowering blood pressure and decreasing blood volume (lisinopril)
Diuretics: rid the body of excess fluid
–increase cardiac output by reducing fluid volume and decreasing blood pressure (furosemide)
Cardiac glycosides
–increase cardiac output by increasing the force of myocardial contraction (digoxin)
Beta adrenergic blockers
–decrease cardiac workload by slowing the heart rate (b1) and decreasing blood pressure (a1)
Vasodilators
–decrease cardiac workload by dilating vessels and reducing preload

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24
Q

The amount of blood pumped by each ventricle each minute

A

Cardiac output

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25
The amount of blood that fills the heart just before systole which is when the ventricle contracts
Preload
26
The pressure in the aorta that must be overcome in order for the heart to eject blood
Afterload (hypertension increases the afterload because the heart has to work harder)
27
A drug increases contractility of the heart | Makes the heart contract stronger, squeeze faster
Inotropic effect
28
``` A universal experience Physical and emotional experience Subjective 5th vital sign Nurses must assess, treat, and evaluate ```
Pain
29
Medications used to relieve pain
Analgesics
30
2 basic categories of analgesics
Opioids | Nonopioids
31
General term often USED TO DESCRIBE OPIOID DRUGS that produce analgesia and CNS depression
Narcotics
32
Consistent elevation of systemic arterial blood pressure High blood pressure Stage 1 greater than 140/90 Stage 2 greater than 160/100
Hypertension
33
Drugs used for hypertension
``` Diuretics: --first line of defense against hypertension --very effective in controlling BP --fewer side effects Angiostensin converting enzyme (ACE inhibitors) Angiostensin II receptor blockers (ARBs) Beta blocking agents Calcium channel blockers ```
34
Replacement therapy for patients with adrenocortical insufficiency and to dampen inflammatory and immune responses
Corticosteroids
35
Nursing actions with Propranolol (Inderall)
Check apical and radial pulses before each dose. Hold drug for changes from baseline Check blood pressure at least once a shift Observe for improvement in heart rate or rhythm Observe for hypotension Make sure to take drug as ordered --giving the average can have fatal consequences
36
The process of ____ is essential to protect the body from blood loss
Clotting
37
Vitamin __ is required for the liver to make 4 of the clotting factors
Vitamin K
38
Lab tests used to monitor Warfarin (Coumadin)
``` Prothrombin time (PT) --normal is 11 to 13.5 seconds ``` International normalized ratio (INR) --normal is 1.3 to 2
39
Lesions located in the stomach
Peptic ulcers
40
Lesions located in the small intestine
Duodenal ulcers
41
Peptic ulcer disease (PUD) is associated with the following risk factors..
- close family history - blood group O - smoking tobacco because it increases gastric acid secretion - consumption of beverages and food that contain caffeine - corticosteroids, NSAIDS, and platelet inhibitors such as aspirin - psychological stress
42
Associated with the formation of ulcers Diagnosed most often with a breathe test Testing positive means your treatment will involve some type of antibacterial
Helicobacter pylori
43
Common condition in which the acidic contents of the stomach move upward into the esophagus - burning sensation in the chest - associated with obesity - avoid alcohol, tobacco, and fatty spicy foods - should not eat before going to bed
Gastroesophageal reflux disease (GERD)
44
Symptoms of GERD
``` Burning Ab pain Bleeding Vomit bright red blood Black stool ```
45
Medication categories for GERD
H2- receptor antagonists (Zantac) Proton pump inhibitors (Prilosec) Antacids (AlternaGEL) Antibiotics
46
``` Also known as spastic colon or mucous colitis Common disorder of the lower GI tract Symptoms include: -abdominal pain -bloating -excessive gas -colicky cramping -altered bowel habits -alternating diarrhea and constipation ```
Irritable bowel syndrome (IBS)
47
Chronic inflammation of the GI tract Problems of the intestine Most often Caucasian women Characterized by the presence of ulcers in the distal (terminal) portion of the small intestine --Crohn's disease or mucosal erosions in the large intestine --Ulcerative colitis
Inflammatory bowel disease (IBD)
48
A drug that prevents vomiting
Antiemetics
49
A drug used to induce vomiting | -ipecac
Emetics
50
Organic compounds required by the body in small amounts for growth and for the maintenance of normal metabolic processes
Vitamins
51
Water soluble vitamins
C and B | *since these are not stored, they must be ingested daily or a deficiency will occur
52
Fat soluble vitamins
A, D, E, and K | *fat soluble vitamins are stored in the body so its easy to overdose on these
53
Too many vitamins
Hypervitaminosis
54
Calcium maintains its levels by..
Stimulating osteroclasts in the parathyroid hormone The thyroid gland releases calcitonin Vitamin D and calcium are closely related, they increase in the presence of each other
55
``` The most common metabolic bone disease Often no symptoms until a fracture occurs Responsible for as many as 1.5 million fractures annually Risk factors: menopause high alcohol or caffeine consumption tobacco use Lack of physical activity Alcohol and tabacco ```
Osteoporosis
56
Progressive, degenerative joint disease caused by the break down of articular cartilage Pain/stiffness in joints Inflammation can occur In weight bearing joints Hips, knees, spine Treat with NSAIDS Watch for GI bleeding, gastric discomfort
Osteoarthritis
57
Chronic, progressive disease that is characterized by disfigurement and inflammation of multiple joints\Pain and stiffness of joints but much more serious Autoimmune type of disease Body turns on itself and causes tissue damage Can be very disfiguring and limit movement Analgesics for pain, meds to reduce inflammation, meds by IV, affect immune system and slow down response
Rheumatoid arthritis
58
A form of acute arthritis caused by Pain and stiffness of joints but much more serious Autoimmune type of disease Body turns on itself and causes tissue damage Can be very disfiguring and limit movement Analgesics for pain, meds to reduce inflammation, meds by IV, affect immune system and slow down response of urine
Gout
59
Calcium salts administration
Give oral medication with meals or within an hour of my meal | Administer IV slowly to avoid hypotension, dysrhythmias, and cardiac arrest
60
Hypersensitivity reaction characterized by hives, raised red areas, often accompanied by pruritus, or itching
Urticaria
61
General condition associated with dry, scaly skin, or a parasite infestation Itching
Pruritus
62
Redness of the skin, often with inflammation, and many other skin disorders
Erythema
63
Common disorder of the hair and sebaceous glands Lesions on the face Up to 80% of adolescents are affected Associated with increased levels of testosterone
Acne
64
An eye disease caused by damage to the optic nerve that results in a gradual loss of vision, problem of increased eye pressure, too much pressure can lead to blindness so if left untreated
Glaucoma
65
``` acute or narrow angled glaucoma rare (only 5% of all glaucoma) caused by stress or trauma to the eye -usually unilateral so only stress/injury to one eye laser or conventional surgery ```
Close angle glaucoma
66
more common (90% of all glaucoma) don’t know the cause bilateral so pressure on both sides medications work best to decrease pressure
Open angle glaucoma
67
Created in illegal laboratories for the purpose of profiting from illicit drug trafficking Synthetic
Designer drugs
68
an overwhelming compulsion that drives someone to take drugs repetitively despite serious health and social consequences
addiction
69
an altered physical condition caused by the adaption of the nervous system to repeated substance use
Physical dependence
70
a condition in which no obvious physical signs of discomfort are observed after the agent discontinued, but the users does still have an overwhelming desire to continue drug seeking behavior
Psychological dependence
71
``` A group of drugs that cause patients to feel relaxed or sedated Drugs in this group include: -barbiturates -nonbarbiturate sedative hypnotics -benzodiazepines -alcohol -opioids ```
CNS Depressants
72
One of the most commonly abused drugs Legal for adults Classified as a CNS depressant because it slows the region of the brain responsible for alertness and wakefulness Withdraw symptoms start within 4-12 hours
Alcohol
73
Treatment for alcohol abuse/maintaing abstinence
disulfiram (Antabuse) acamprosate calcium (Campral) naltrexone (ReVia)
74
Narcotic analgesics used for severe pain, cough, or diarrhea | Withdraw occurs within 1 hour to several days
Opioid
75
Substitution therapy- treatment for opioid addiction
Methadone Other treatments for opioid: oxycodone (Oxycontin) fentanyl (Duregesic)
76
Also known as tranquilizers | Prescribed for sleep disorders and certain forms of epilepsy
Sedatives
77
the most commonly used illicit drug in the United States (not illegal in all states now, but still a federal crime) slows motor activity decreases coordination causes disconnected thoughts, feelings of paranoia
Marijuana
78
Produce an altered dream-like state of conciousness
Hallucinogens
79
Sometimes considered a CNS stimulant Treatments: Replacement patches Gum
Nicotine
80
``` Taken to produce a sense of exhilaration, improve mental and physical performance, reduce appetite, prolong wakefulness Include: amphetamines cocaine methylphenidate caffeine ```
CNS stimulants
81
Sublingual administration of medicine
Assess that patient is alert Place tablet under the tongue and allow to dissolve Do not chew or swallow
82
Buccal administration of medicine
Assess that patient is alert Place medication in the side of the mouth Do not chew or swallow
83
Topical lotion administration of medicine
Clean and dry the skin before applying
84
Topical transdermal administration of medicine
- patch immediately applied to clean, dry, hairless skin - labeled with date, time, and initials * Changed on a regular basis * Rotate sites * Remove previous patch * Avoids first-pass effect
85
Opthalmic administration of medicine
Used for eye dryness, infections, glaucoma, and dilation of the pupil Nondominant hand under the eye Dominant hand on the forehead Instill eye ointment into lower conjunctival sac
86
Otic administration of medicine
Used for infections and blockages of the ear canal | Instill eardrops
87
Using an inhaler with a spacer
``` After breathing out gently: put the spacer between your teeth and close lips keep chin up start breathing through mouth Spray one puff Keep breathing in slowly and deeply Remove spacer from mouth Hold breath for count of 10 Pucker lips and breath out slowly Rinse mouth with water ```
88
Using an inhaler no spacer
``` Take off cap Shake inhaler hard Breathe out all the way Hold inhaler 1-2 inches in front of mouth Breathe in slowly and press down in inhaler Hold breath as you count to 10 Exhale slowly Rinse mouth with water ```
89
Using a dry powder inhaler
Turn to next dose | Place inhaler in mouth and take deep breaths
90
Using a respimat inhaler
``` Hold upright Turn until a click is heard Open cap Breathe out slowly Take a deep breath and press button Hold breath for count of 10 Breathe out slowly ```
91
Common sites for intradermal injections
inner lower arm | back beneath the scapulae
92
Technique for intradermal injections
Check order/MAR Check label 3 times Wash hands Draw medication into a 1mL (TB) syringe Introduce yourself to patient Explain what to expect Administering injection Select site and clean area in circular motion moving outward. Allow to dry Hold skin taut Insert needle, bevel up at 10- to 15- degree angle Inject medication to form a wheal (blister) Withdraw needle slowly at same angle that you went in Mark area with a pen
93
4 IM injection sites
Ventrogluteal (palm on hip, between the fingers) Dorsogluteal (top left corner of the butt) Deltoid (upside down triangle) Vastus Lateralis (outer thigh, midway)
94
IM injection equipment
Select a 1- 3 mL syringe 20 – 23 gauge 5/8 – 1 ½ inches long
95
Sites for a subcutaneous injection (fatty)
``` abdomen (most rapidly absorbed) upper hips upper back (subscapular) lateral upper arms (slower in arms) lateral thighs (even slower in thighs) dorsogluteal (slowest) ```
96
Subcutaneous injection equipment
``` 1 mL syringe or insulin pen (usually 0.5 mL to 1 mL injected) Needle ½ to 5/8 inch long 25-27 gauge ```
97
Procedure for starting an IV
``` Use a clean tourniquet or BP cuff Select vein Tie the tourniquet Clean the area Remove cover from catheter Anchor the vein Warn the patient Insert the catheter Look for flashback Lower the hub Advance just the catheter Stabilize the IV and release the tourniquet Apply pressure above the site Remove the needle Maintain pressure Apply dressing Avoid covering the site with tape Regulate the IV rate Throw everything away ```
98
Procedure for administration of blood
Confirm order Have patient sign written consent Explain procedure to patient Explain symptoms of transfusion reaction: Vital signs: pulse, BP, resp, and temp for baseline Make sure patient has an IV with at least a 20 gauge needle Once the IV is inserted and ready to go, obtain blood from blood bank Double-check the labels with another nurse: Start within 30 minutes of taking blood from blood bank First 15 minutes no faster than 5 mL/min Do not exceed 4 hours Change blood tubing after every 2 units Obtain another set of vital signs Dispose of used materials properly Document procedure Monitor the patient
99
Complications with TPN (total parenteral nutrition)
``` Fluid overload Air embolism Hyperglycemia Hypoglycemia Infection ```
100
Methods to ensure nasogastric tube placement
1. aspirate gastric contents 2. test pH of gastric contents 3. swoosh of air 4. xray 5. CO2 monitor testing
101
Central line catheters and their placements
Triple lumen (non tunneled) - subclavian vein Tunneled - subclavian vein Implanted port - subclavian vein PICC line - above the antecubital fossa
102
Major functions of the upper respiratory tract
Respiration | Filter oxygen
103
Differentiate between H1 and H2
Histamine 1- responsible for allergic symptoms, located in respiratory tract Histamine 2- found in gastric
104
O2 passes through the airways
Ventilation
105
blood flowing through the alveoli of the lung tissue so diffusion can take place, CO2 passed out
Perfusion
106
CO2 and O2 moving back and forth
Diffusion
107
emergency , prolonged and unresponsive to drug treatment
Status asthmaticus
108
group of respiratory disorder, irreversible problem
Chronic obstructive pulmonary disease
109
Narrowing of airways, mucous, inflammation, frequent infections, blue because not exchanging O2 very well
Chronic bronchitis
110
Destruction of alveoli Permanently inflated Walls break down Pinkish
Emphysema

Pharmacology 218 (13 decks)

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