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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
Q

The amount of blood that fills the heart just before systole which is when the ventricle contracts

A

Preload

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26
Q

The pressure in the aorta that must be overcome in order for the heart to eject blood

A

Afterload (hypertension increases the afterload because the heart has to work harder)

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27
Q

A drug increases contractility of the heart

Makes the heart contract stronger, squeeze faster

A

Inotropic effect

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28
Q 
A universal experience
Physical and emotional experience
Subjective
5th vital sign
Nurses must assess, treat, and evaluate
A

Pain

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29
Q

Medications used to relieve pain

A

Analgesics

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30
Q

2 basic categories of analgesics

A

Opioids

Nonopioids

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31
Q

General term often USED TO DESCRIBE OPIOID DRUGS that produce analgesia and CNS depression

A

Narcotics

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32
Q

Consistent elevation of systemic arterial blood pressure
High blood pressure
Stage 1 greater than 140/90
Stage 2 greater than 160/100

A

Hypertension

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33
Q

Drugs used for hypertension

A 
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
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34
Q

Replacement therapy for patients with adrenocortical insufficiency and to dampen inflammatory and immune responses

A

Corticosteroids

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35
Q

Nursing actions with Propranolol (Inderall)

A

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

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36
Q

The process of ____ is essential to protect the body from blood loss

A

Clotting

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37
Q

Vitamin __ is required for the liver to make 4 of the clotting factors

A

Vitamin K

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38
Q

Lab tests used to monitor Warfarin (Coumadin)

A 
Prothrombin time (PT)
--normal is 11 to 13.5 seconds

International normalized ratio (INR)
–normal is 1.3 to 2

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39
Q

Lesions located in the stomach

A

Peptic ulcers

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40
Q

Lesions located in the small intestine

A

Duodenal ulcers

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41
Q

Peptic ulcer disease (PUD) is associated with the following risk factors..

A
  • 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
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42
Q

Associated with the formation of ulcers
Diagnosed most often with a breathe test
Testing positive means your treatment will involve some type of antibacterial

A

Helicobacter pylori

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43
Q

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
A

Gastroesophageal reflux disease (GERD)

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44
Q

Symptoms of GERD

A 
Burning
Ab pain
Bleeding
Vomit bright red blood
Black stool
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45
Q

Medication categories for GERD

A

H2- receptor antagonists (Zantac)
Proton pump inhibitors (Prilosec)
Antacids (AlternaGEL)
Antibiotics

46
Q 
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
A

Irritable bowel syndrome (IBS)

47
Q

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

A

Inflammatory bowel disease (IBD)

48
Q

A drug that prevents vomiting

A

Antiemetics

49
Q

A drug used to induce vomiting

-ipecac

A

Emetics

50
Q

Organic compounds required by the body in small amounts for growth and for the maintenance of normal metabolic processes

A

Vitamins

51
Q

Water soluble vitamins

A

C and B

*since these are not stored, they must be ingested daily or a deficiency will occur

52
Q

Fat soluble vitamins

A

A, D, E, and K

*fat soluble vitamins are stored in the body so its easy to overdose on these

53
Q

Too many vitamins

A

Hypervitaminosis

54
Q

Calcium maintains its levels by..

A

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
Q 
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
A

Osteoporosis

56
Q

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

A

Osteoarthritis

57
Q

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

A

Rheumatoid arthritis

58
Q

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

A

Gout

59
Q

Calcium salts administration

A

Give oral medication with meals or within an hour of my meal

Administer IV slowly to avoid hypotension, dysrhythmias, and cardiac arrest

60
Q

Hypersensitivity reaction characterized by hives, raised red areas, often accompanied by pruritus, or itching

A

Urticaria

61
Q

General condition associated with dry, scaly skin, or a parasite infestation
Itching

A

Pruritus

62
Q

Redness of the skin, often with inflammation, and many other skin disorders

A

Erythema

63
Q

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

A

Acne

64
Q

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

A

Glaucoma

65
Q 
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
A

Close angle glaucoma

66
Q

more common (90% of all glaucoma)
don’t know the cause
bilateral so pressure on both sides
medications work best to decrease pressure

A

Open angle glaucoma

67
Q

Created in illegal laboratories for the purpose of profiting from illicit drug trafficking
Synthetic

A

Designer drugs

68
Q

an overwhelming compulsion that drives someone to take drugs repetitively despite serious health and social consequences

A

addiction

69
Q

an altered physical condition caused by the adaption of the nervous system to repeated substance use

A

Physical dependence

70
Q

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

A

Psychological dependence

71
Q 
A group of drugs that cause patients to feel relaxed or sedated
Drugs in this group include:
-barbiturates
-nonbarbiturate sedative hypnotics
-benzodiazepines
-alcohol
-opioids
A

CNS Depressants

72
Q

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

A

Alcohol

73
Q

Treatment for alcohol abuse/maintaing abstinence

A

disulfiram (Antabuse)
acamprosate calcium (Campral)
naltrexone (ReVia)

74
Q

Narcotic analgesics used for severe pain, cough, or diarrhea

Withdraw occurs within 1 hour to several days

A

Opioid

75
Q

Substitution therapy- treatment for opioid addiction

A

Methadone

Other treatments for opioid:
oxycodone (Oxycontin)
fentanyl (Duregesic)

76
Q

Also known as tranquilizers

Prescribed for sleep disorders and certain forms of epilepsy

A

Sedatives

77
Q

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

A

Marijuana

78
Q

Produce an altered dream-like state of conciousness

A

Hallucinogens

79
Q

Sometimes considered a CNS stimulant
Treatments:
Replacement patches
Gum

A

Nicotine

80
Q 
Taken to produce a sense of exhilaration, improve mental and physical performance, reduce appetite, prolong wakefulness
Include:
amphetamines
cocaine
methylphenidate
caffeine
A

CNS stimulants

81
Q

Sublingual administration of medicine

A

Assess that patient is alert
Place tablet under the tongue and allow to dissolve
Do not chew or swallow

82
Q

Buccal administration of medicine

A

Assess that patient is alert
Place medication in the side of the mouth
Do not chew or swallow

83
Q

Topical lotion administration of medicine

A

Clean and dry the skin before applying

84
Q

Topical transdermal administration of medicine

A
  • 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
Q

Opthalmic administration of medicine

A

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
Q

Otic administration of medicine

A

Used for infections and blockages of the ear canal

Instill eardrops

87
Q

Using an inhaler with a spacer

A 
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
Q

Using an inhaler no spacer

A 
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
Q

Using a dry powder inhaler

A

Turn to next dose

Place inhaler in mouth and take deep breaths

90
Q

Using a respimat inhaler

A 
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
Q

Common sites for intradermal injections

A

inner lower arm

back beneath the scapulae

92
Q

Technique for intradermal injections

A

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
Q

4 IM injection sites

A

Ventrogluteal (palm on hip, between the fingers)
Dorsogluteal (top left corner of the butt)
Deltoid (upside down triangle)
Vastus Lateralis (outer thigh, midway)

94
Q

IM injection equipment

A

Select a 1- 3 mL syringe
20 – 23 gauge
5/8 – 1 ½ inches long

95
Q

Sites for a subcutaneous injection (fatty)

A 
abdomen (most rapidly absorbed)
upper hips
upper back (subscapular)
lateral upper arms (slower in arms)
lateral thighs (even slower in thighs)
dorsogluteal (slowest)
96
Q

Subcutaneous injection equipment

A 
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
Q

Procedure for starting an IV

A 
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
Q

Procedure for administration of blood

A

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
Q

Complications with TPN (total parenteral nutrition)

A 
Fluid overload
Air embolism
Hyperglycemia
Hypoglycemia
Infection
100
Q

Methods to ensure nasogastric tube placement

A
  1. aspirate gastric contents
  2. test pH of gastric contents
  3. swoosh of air
  4. xray
  5. CO2 monitor testing
101
Q

Central line catheters and their placements

A

Triple lumen (non tunneled) - subclavian vein
Tunneled - subclavian vein
Implanted port - subclavian vein
PICC line - above the antecubital fossa

102
Q

Major functions of the upper respiratory tract

A

Respiration

Filter oxygen

103
Q

Differentiate between H1 and H2

A

Histamine 1- responsible for allergic symptoms, located in respiratory tract
Histamine 2- found in gastric

104
Q

O2 passes through the airways

A

Ventilation

105
Q

blood flowing through the alveoli of the lung tissue so diffusion can take place, CO2 passed out

A

Perfusion

106
Q

CO2 and O2 moving back and forth

A

Diffusion

107
Q

emergency , prolonged and unresponsive to drug treatment

A

Status asthmaticus

108
Q

group of respiratory disorder, irreversible problem

A

Chronic obstructive pulmonary disease

109
Q

Narrowing of airways, mucous, inflammation, frequent infections, blue because not exchanging O2 very well

A

Chronic bronchitis

110
Q

Destruction of alveoli
Permanently inflated
Walls break down
Pinkish

A

Emphysema

Pharmacology 218 (13 decks)

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