Final Exam Flashcards
1
Q
Pharmacokinetics
A
effect of the body on the drug
2
Q
Pharmacodynamics
A
effect of the drug on the body
3
Q
Half-life
A
the time taken for blood concentration to decrease 50%
4
Q
Pharmacokinetics - absorption
A
- acidity of the stomach
- chemical properties of the drug
- presence of food in GI tract
- route of administration
- first-pass metabolism
5
Q
Pharmacokinetics - distribution
A
- protein binding
- blood flow
- chemical properties
6
Q
Pharmacokinetics - metabolism
A
occurs in the liver via enzymes
7
Q
Pharmacokinetics - excretion
A
primarily through the kidneys
8
Q
Difference between allergy and adverse drug reaction
A
allergy - immune reaction to medication
adverse drug reaction - unintended, at normal dose
9
Q
Schedule I
A
high abuse potential, no medical use, not safe, illegal, heroin
10
Q
Schedule II
A
high abuse potential, accepted medical use, Rx, no refills, oxycodone
11
Q
Schedule III
A
low-moderate abuse potential, accepted medical use, Rx, 5 refills, ketamine
12
Q
Schedule IV
A
low abuse potential, accepted medical use, Rx, 5 refills, Valium
13
Q
Schedule V
A
low abuse potential, accepted medical use, Rx, 5 refills, codeine
14
Q
What doe HIPAA stand for?
A
Health Insurance Portability and Accountability Act
15
Q
What does HIPAA mean in terms of practical application?
A
protected health information
16
Q
BID
A
twice a day
17
Q
QHS
A
every night at bedtime
18
Q
NPO
A
nothing by mouth
19
Q
PO
A
by mouth
20
Q
PR
A
through the rectum
21
Q
PRN
A
as needed
22
Q
q
A
every
23
Q
q2h
A
every 2 hours
24
Q
QID
A
four times a day
25
TID
three times a day
26
IM
intramuscular
27
IV
intravenous
28
Generic name
approved name or nonproprietary name
29
Brand or trade name
specific to manufacturer, protected by trademark
30
Chemical name
chemical makeup of the drug
31
Seven rights of drug administration
- right patient
- right dose
- right route
- right drug
- right time
- right technique
- right documentation
32
Lbs to kg
2.2 lbs = 1 kg
33
Medication reconciliation
process of obtaining the most accurate list of medications a patient is taking and comparing that list to the patient's medication orders
34
Water-soluble vitamins
B and C
35
Fat-soluble vitamins
A, D, E, K
36
Deficiency in Folate (B9)
megaloblastic anemia
37
Deficiency in cyanocobalamin (B12)
megaloblastic anemia
38
Deficiency in vitamin C
scurvy
39
Deficiency in vitamin A
night blindness, glare blindness
40
Deficiency in vitamin D
Rickets (brittle bones)
41
Deficiency in vitamin E
hemolytic anemia
42
Deficiency in vitamin K
rare
43
Dietary sources of vitamin K
green leafy vegetables, liver
44
Acetaminophen overdose adverse effects
early stages nausea and vomiting
| liver failure/death after 2-3 days
45
Acetaminophen antidote
acetylcysteine (acetadote)
46
Benzodiazepine overdose adverse effects
CNS depression, coma, respiratory depression
47
Benzodiazepine antidote
flumazenil
48
Opioid overdose adverse effects
euphoria, drowsiness, constricted pupils, hypotension, respiratory arrest, coma
49
Opioid antidote
nalozone
50
Digoxin overdose adverse effects
nausea, vomiting, visual changes, seizures, arrhythmias
51
Digoxin antidote
digibind
52
Warfarin overdose adverse effects
bleeding
53
Warfarin antidote
vitamin K
54
Difference between abuse and dependence
abuse - excessive use of a drug without medical justification
dependence - physical condition in which the body has adapted to the presence of a drug. If drug is taken away, withdrawals will occur
55
What medications for smoking cessation?
nicotine replacement therapy, Chantix, Bupropion
56
Structure of bacterial cell walls
gram positive - thick layer of peptidoglycan
| gram negative - thin layer of peptidoglycan
57
Structure of fungal cell walls
contain ergosterol
58
Penicillin common ending
end in -cillin
59
Penicillin mechanism
interfere with the synthesis of peptidoglycan
60
Penicillin adverse effects
hypersensitivity, diarrhea, rash
61
Cephalosporins common beginning
cef beginning of name
62
Cephalosprorins mechanism
inhibits peptidoglycan
63
Cephalosprorins adverse effects
hypersensitivity, diarrhea, rashes
64
Sulfonamides common beginning
sulf at beginning of name
65
Sulfonamides mechanism
inhibit bacterial folic acid synthesis
66
Sulfonamides adverse effects
diarrhea, sun sensitivity, kidney stones
67
Aminoglycosides common ending
-mycin or -micin
68
Aminoglycosides mechanism
disrupts bacterial protein synthesis
69
Aminoglycosides adverse effects
ototoxicity, nephrotoxicity, Red man's syndrome (vancomycin only)
70
Macrolides common ending
-thromycin
71
Macrolides mechanism
inhibit bacterial protein synthesis
72
Macrolides adverse effects
diarrhea
73
Fluoroquinolones common ending
-floxacin
74
Fluoroquinolones mechanism
interferes with bacterial DNA synthesis
75
Fluoroquinolones adverse effects
rash, photosensitivity, cartilage damage in children
76
Tetracyclines common ending
-cycline
77
Tetracyclines mechanism
prevents bacterial protein synthesis
78
Tetracyclines adverse effects
diarrhea, photosensitivity, dark pigmented teeth in children
79
Azole antifungals common
azole in name
80
Azole antifungals mechanism
block synthesis of ergosterol
81
Azole antifungals adverse effects
diarrhea, itching hepatitis
82
Antivirals common name
vir in name
83
Cell-mediated immunity
immunity obtained when cells attack the antigens directly rather than producing antibodies
84
Humoral immunity
immunity based on the antigen-antibody response
85
What immunization should adults receive? and how often?
influenza vaccine every year
pheumococcal vaccine every 5 years
tetanus and diphtheria booster every 10 years
hepatitis B vaccine for healthcare employees
Herpes Zoster vaccine 50+ years
86
What reference do you use to look up vaccine schedules?
Pinkbook
87
Aspirin properties
anti-inflammatory
88
Acetaminophen properties
analgesic and antipyretic
89
Opioids properties
analgesic
90
How is celecoxib different from other NSAIDs
only inhibits COX-2
91
Mechanism of action of alkylating agents
replace hydrogen in DNA with an alkyl
92
Mechanism of action of antimetabolites
replace nucleotides to alter DNA structure
93
Mechanism of action of mitotic inhibitors
inhibit DNA and RNA synthesis
94
Mechanism of action of antitumor antibiotics
inhibit DNA and RNA synthesis
95
What phase of the cell cycle do alkylating agents work?
G0
96
What phase of the cell cycle do antimetabolites work?
S-phase
97
What phase of the cell cycle do mitotic inhibitors work?
S and M phase
98
Adverse effects of chemotherapy
hair loss, bone marrow suppression, mucositis, nausea/vomiting
99
Effects of stimulants
increase alertness, wakefulness, endurance, productivity, motivation, self-confidence, euphoria
100
Adverse effects of stimulants
raise blood pressure/heart rate, abuse potentials, withdrawal after prolonged use
101
Effects of benzodiazepine overdose
respiratory depression, coma
102
Causes of Parkinson's disease
lack of dopamine in substantia nigra and imbalance of neurotransmitters acetylcholine and dopamine
103
What do Parkinson's medications do?
restore neurotransmitter balance
104
What medication classes treat Parkinson's disease?
dopaminergics and anticholinergics
105
Adverse effects of anticholinergic
anxiety, agitation, drowsiness, dry mouth, urine retention, constipation
106
How does carbidopa-levodopa work?
precursors of dopamine or dopamine agonists
107
What is carbidopa-levodopa brand name?
Sinemet
108
Adverse effects of carbidopa-levodopa
confusion, hallucinations, dyskinesia, loss of effectiveness
109
What drugs treat schizophrenia?
antipsychotics
110
Difference between atypical and typical antipsychotics
atypical - newer with better side effects
| typical - older ones with more side effects
111
What class of drugs is first line for depression?
SSRIs
112
Difference between sympathetic nervous system and parasympathetic nervous system
sympathetic - fight or flight
| parasympathetic - rest and digest
113
What drugs bind adrenergic receptors?
norepinephrine, dopamine, epinephrine
114
Alpha 1 and alpha 2
alpha 1 - agonists cause vasoconstriction
| alpha 2 - agonists cause vasodilation
115
Beta 1 and beta 2
beta 1 - agonists increase heart rate and force of contraction
beta 2 - agonists dilate coronary arteries and muscle blood vessels
-agonists relax bronchiolar smooth muscle
116
Cholinergic effects
SLUDGE
- salivation
- lacrimation
- urination
- defecation
- gastrointestinal upset
- emesis
117
Anticholinergic effects
low heart rate, motion sickness, urinary incontinence, bladder spasms
118
Three components that affect blood pressure
cardiac output, peripheral resistance, blood volume
119
How do antihypertensives work?
aimed at decreasing cardiac output, peripheral resistance, or blood volume
120
How do diuretics work to lower blood pressure?
decrease blood volume
121
How do beta blockers work to lower blood pressure?
reduce heart rate and dilate vessels
122
How do ACEIs work to lower blood pressure?
dilate blood vessels
123
How do ARBs work to lower blood pressure?
dilate blood vessels
124
How do calcium channel blockers work to lower blood pressure?
slow heart rate, dilate vessels
125
How do alpha blockers work to lower blood pressure?
dilate vessels
126
How do vasodilators work to lower blood pressure?
dilate vessels
127
Diuretics common ending
end in -ide
128
Beta blockers common ending
end in -olol
129
ACEIs common ending
end in -pril
130
ARBs common ending
end in sartan
131
Calcium channel blockers common ending
end in -ipine
132
Adverse effects of diuretics
increase urination, electrolyte imbalances, hypotension
133
Adverse effects of beta-blockers
hypotension, bradycardia, depression
134
Adverse effects of ACEIs
hypotension, cough, hyperkalemia, renal impairment
135
Adverse effects of calcium channel blockers
constipation, hypotension or bradycardia, edema of legs
136
Adverse effects of vasodilators
hypotension, tachycardia, headache, dizziness
137
Difference between ACEIs and ARBs
ACEIs cause coughing while ARBs do not
138
Difference between dihydropyridine and non-dihydropyridine
dihydropyridine - decrease blood pressure
| non-dihydropyridine - decrease heart rate
139
What class of medication treats hyperlipidemia?
HMG-CoA Reductase Inhibitors (statins)
140
Adverse effects of statins
muscle pain, muscle breakdown
141
Contraindications of statins
pregnancy and myopathy
142
Medications that are used for stable angina
nitrates, beta-blockers, verapamil
143
Identify a nitrate
has nitr in the name
144
What do inotropes do?
increase muscular contractions of heart to increase cardiac output
145
List all three inotropes
cardiac glycosides, beta-agonists, phosphodiesterase inhibitors
146
Difference between the antiarrhythmic classes in terms of mechanism
```
class 1 - sodium channel blockers
class 2 - beta blockers
class 3 - potassium channel blockers
class 4 - calcium channel blockers - nondihydrophyridine
```
147
Most commonly used antiarrhythmic agents
amiodarone, sotalol, dofetilide
148
Sotalol
class 2 and 3
149
Common adverse effects of antiarrhythmic
interstitial lung disease, hypo/hyperthyroidism, visual changes, liver dysfunction, blue-grey skin discoloration
150
How does heparin work?
inhibits clots from forming or growing larger
151
How does warfarin work?
inhibits the synthesis of vitamin-K dependent factors
152
Brand name of warfarin
Coumadin
153
How does low-molecular weight heparin work?
inhibits clots from forming or growing larger
154
How does enoxaparin work?
inhibit factor Xa to decrease clotting
155
Brand name of enoxaparin
Lovenox
156
What class of medication breaks up existing clots?
thrombolytics
157
Adverse effects of heparin
bleeding and low platelets
158
Adverse effects of enoxaparin
bleeding
159
Interactions of warfarin
alcohol, drug and food
160
Adverse effects of warfarin
bleeding and skin necrosis
161
Difference between anticoagulants and antiplatelets
anticoagulants - inhibits clots
| antiplatelets - bind receptors on platelets to inhibit platelet aggregation and prevent clot formation in arteries
162
Common antiplatelets
aspirin, Plavix, effient, brilinta
163
Adverse effects of antiplatelets
bleeding
164
How do thrombolytics work?
dissolve blood clots
165
Common thrombolytics
alteplase (tPA, Activase)
166
Adverse effects of thrombolytics
bleeding
167
Contraindications of thrombolytics
bleeding, recent surgeries/trauma, uncontrolled hypotension, current/recent anticoagulant use
168
Hyperthyroidism
high thyroid hormones
169
Hypothyroidism
low thyroid hormones
170
Symptoms of hyperthyroidism
nervousness, thin skin/hair, weight loss, heat intolerance
171
Symptoms of hypothyroidism
fatigue, poor memory, weight gain, cold intolerance
172
What medications treat hyperthyroidism?
methimazole and propylthiouracil
173
Mechanism of hyperthyroidism medication
inhibit synthesis of thyroid hormones
174
Adverse effects of hyperthyroidism medication
fever, rash, agranulocytosis, hypothyroidism
175
What medications treat hypothyroidism?
levothyrozine, liothyroine
176
Mechanism of hypothyroidism medication
provide thyroid hormones (T3/T4)
177
Adverse effects of hypothyroidism medication
hyperthyroidism, osteoporosis, coronary artery disease
178
What hormones are secreted by the pancreas?
insulin and glucagon
179
How do insulin and glucagon affect the body?
increase or decrease glucose in blood
180
Difference between type 1 and 2 diabetes
type 1 - autoimmune disorder destroys beta cells
| type 2 - insulin resistance
181
How does metformin work?
promote glucose uptake by cells
decrease glucose production by liver
slow glucose absorption
182
Adverse effects of metformin
weight loss, GI upset, diarrhea, lactic acidosis in renal failure
183
Contraindications of metformin
type 1 diabetes and renal failure
184
Common rapid-acting insulins
lispro (Humalog) or aspart (Novolog)
185
Common long-acting insulins
glargine (Lantus)
186
What hormones are secreted by adrenal glands?
corticosteroids
187
What do corticosteroids do?
anti-inflammatory, increase glucose, increase blood pressure
188
Adverse effects of corticosteroids
insomnia, hypertension, behavioral changes, stomach ulcers, increased appetite, diabetes, osteoporosis, infection, edema
189
Contraindications of corticosteroids
ulcers, severe infections, psychoses, diabetes
190
How do you treat diabetes?
insulin and blood glucose monitoring
191
How do you treat adrenal insufficiency?
corticosteroids
192
How do you treat hypogonadism?
testosterone replacement
193
Adverse effects of estrogen
changes in libido, edema, breast enlargement, cardiovascular disease, stroke, clots, dementia
194
Contraindications of estrogen
breast cancer, clots, pregnancy, breastfeeding
195
Adverse effects of progestins
weight gain, clotting, breakthrough bleeding, cycle irregularity
196
Contraindications of progestins
pregnancy, breast feeding, active clots
197
Effects of oxytocin
increases uterine smooth muscle contraction and promote milk ejection from mammary glands
198
What medication classes treat osteoporosis?
bisphosphonates and hormonal agents
199
Band name of bisphosphates
Fosamax and Actonel and Boniva
200
Generic name of bisphosphates
have -dronate
201
How do hormonal therapies work for osteoporosis?
inhibit bone resorption
202
What medication classes are used for rheumatoid arthritis?
analgesics, anti-inflammatory, and DMARDs
203
How does hydroxychlororquine work?
inhibits movement of white blood cells
204
Adverse effects of hydroxychloroquine
agranulocytosis/thrombocytopenia, weakness/myopathy, visual loss
205
Contraindications of hydroxychloroquine
visual changes while on therapy and hepatic dysfunction
206
How does sulfasalazine work?
unknown anti-inflammatory
207
Adverse effects of sulfasalazine
headache, nausea, dyspepsia, rash, fatal rashes, oligospermia, agranulocytosis, infections
208
Contraindications of sulfasalazine
sulfa allergies, hepatic failure
209
How does methotrexate work?
unknown for RA
210
Adverse effects of methotrexate
bone marrow suppression, GI upset/stomatitis, renal and hepatic toxicity
211
Contraindications of methotrexate
immunosuppressed patient, liver failure, renal failure, pregnancy
212
What medications are used to treat gout?
diet, NSAIDs, colchicine
213
What medications are used to prevent gout?
colchicine, allopurinol, uricosuric agents
214
What 3 classes of medications treat glaucoma?
prostaglandin agonists, beta-blockers, and carbonic anhydrase inhibitors
215
Prostaglandin agonists common ending
-prost
216
Carbonic anhydrase inhibitors common ending
-ide
217
Adverse effects of Prostaglandin agonists
blurred vision/vision changes, redness, lacrimation, eyelash growth, change in iris pigmentation
218
Adverse effects of beta-blockers
burning/stinging
219
Adverse effects of carbonic anhydrase inhibitors
burning, blurred vision, rashes
220
Contraindications of beta-blockers
angle-closure glaucoma
221
Contraindications of carbonic anhydrase inhibitors
closed-angle glaucoma
222
Three intentions of general anesthesia
amnesia, analgesia, skeletal muscle relaxation
223
Amnesia
lack of memory
224
Analgesia
lack of pain
225
Skeletal muscle relaxation
lack of movement
226
What medications at inhaled anesthetics?
end in -flurane
227
Common names of general anesthetics
local and amide anesthetics
228
Mechanism of action of general anesthetics
block sodium channels to prevent neurotransmitter conduction
229
Typical treatment of dermatitis
topical or oral corticosteroids
230
How do corticosteroids work?
prevent white blood cells from migration to inflammation site
231
Adverse work of corticosteroids
irritation, skin burning, atrophy, thinning skin
232
Common name ending of corticosteroids
end in -sone
233
What is psoriasis?
chronic immune system related disease where there is rapid growth of skin with scaly, red or white itchy plaques or patches
234
Common treatments for psoriasis
topical medication, UV light, oral medications
235
Use of corticosteroids for psoriasis vs. dermatitis
psoriasis - skin thinning
| dermatitis - anti-inflammatory
236
Common side effects of methotrexate
renal/hepatic failure, bone marrow suppression, GI toxicity, infertility, NOT used in pregnancy
237
Cause of acne
plugged sebaceous glands
238
Topical side effects
itching, burning, stinging, redness, excessive drying
239
Tetracyclines side effects
photosensitivity, pediatric tooth discoloration, GI discomfort
240
Isotretionoin (Accutane)
suicidal ideation, NOT for pregnancy, bone marrow suppression
241
Common bugs that infect our skin
staphylococcus aureus
streptococcus
canidida albicans
242
Primary treatment for peptic ulcers and GERD
proton-pump inhibitors, histamine-2 receptor antagonists, antacids, prostaglandins
243
Antacid
calcium carbonate (Tums), magnesium hydroxide (Milk of magnesia), mylanta
244
Two common antidiarrheal medications
loperamide (lmodium) diphenoxylate/atropine (lomotil)
245
Class antidiarrheal medications belong to
opioids
246
Adverse effects of opioids
constipation and drowsiness
247
Contraindications of opioids
intestinal obstruction, loss of efficacy in chronic diarrhea, hepatic failure
248
Common stool softeners
docusate (Colace)
249
Common bulk-forming laxatives
Metamucil, FiberCon
250
Common osmotic laxatives
lactulose, magnesium hydroxide
251
Common stimulant laxatives
bisacodly (Dulcolax) senna (senokot)
252
Common antiemetics
promethazine (Phenergan), ondansetron (Zofran), metoclopramide, meclizine, scopolamine
253
Common short-acting beta agonist
albuterol or levalbuterol
254
Situations that must be considered with prescribing medications for elderly
physiologic and financial considerations
255
Polypharmacy
prescribing multiple medications for one patient
256
Problems associated with polypharmacy
increase cost, increase likelihood of adverse effects, increase likelihood of drug interactions
257
How do elderly patients have altered pharmacokinetics?
slower rate of absorption, drugs take longer to work, increased body fat, decrease body water
258
Creatinine clearance used for
used for an indicator of kidney function
259
What does Beers criteria do?
list of inappropriate medications for elderly
260
Category A
well controlled studies demonstrated no fetal risk
261
Category B
animal studies have demonstrated no fetal risk
262
Category C
studies not available or animal studied reveal harm
263
Category D
well-controlled human studies demonstrated fetal risk
264
Category X
well-controlled studies demonstrated fetal risk
