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Final Exam Flashcards

1
Q

Pharmacokinetics

A

effect of the body on the drug

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2
Q

Pharmacodynamics

A

effect of the drug on the body

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3
Q

Half-life

A

the time taken for blood concentration to decrease 50%

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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
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5
Q

Pharmacokinetics - distribution

A
  • protein binding
  • blood flow
  • chemical properties
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6
Q

Pharmacokinetics - metabolism

A

occurs in the liver via enzymes

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7
Q

Pharmacokinetics - excretion

A

primarily through the kidneys

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8
Q

Difference between allergy and adverse drug reaction

A

allergy - immune reaction to medication

adverse drug reaction - unintended, at normal dose

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9
Q

Schedule I

A

high abuse potential, no medical use, not safe, illegal, heroin

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10
Q

Schedule II

A

high abuse potential, accepted medical use, Rx, no refills, oxycodone

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11
Q

Schedule III

A

low-moderate abuse potential, accepted medical use, Rx, 5 refills, ketamine

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12
Q

Schedule IV

A

low abuse potential, accepted medical use, Rx, 5 refills, Valium

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13
Q

Schedule V

A

low abuse potential, accepted medical use, Rx, 5 refills, codeine

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14
Q

What doe HIPAA stand for?

A

Health Insurance Portability and Accountability Act

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15
Q

What does HIPAA mean in terms of practical application?

A

protected health information

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16
Q

BID

A

twice a day

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17
Q

QHS

A

every night at bedtime

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18
Q

NPO

A

nothing by mouth

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19
Q

PO

A

by mouth

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20
Q

PR

A

through the rectum

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21
Q

PRN

A

as needed

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22
Q

q

A

every

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23
Q

q2h

A

every 2 hours

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24
Q

QID

A

four times a day

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25
Q

TID

A

three times a day

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26
Q

IM

A

intramuscular

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27
Q

IV

A

intravenous

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28
Q

Generic name

A

approved name or nonproprietary name

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29
Q

Brand or trade name

A

specific to manufacturer, protected by trademark

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30
Q

Chemical name

A

chemical makeup of the drug

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31
Q

Seven rights of drug administration

A
  • right patient
  • right dose
  • right route
  • right drug
  • right time
  • right technique
  • right documentation
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32
Q

Lbs to kg

A

2.2 lbs = 1 kg

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33
Q

Medication reconciliation

A

process of obtaining the most accurate list of medications a patient is taking and comparing that list to the patient’s medication orders

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34
Q

Water-soluble vitamins

A

B and C

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35
Q

Fat-soluble vitamins

A

A, D, E, K

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36
Q

Deficiency in Folate (B9)

A

megaloblastic anemia

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37
Q

Deficiency in cyanocobalamin (B12)

A

megaloblastic anemia

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38
Q

Deficiency in vitamin C

A

scurvy

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39
Q

Deficiency in vitamin A

A

night blindness, glare blindness

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40
Q

Deficiency in vitamin D

A

Rickets (brittle bones)

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41
Q

Deficiency in vitamin E

A

hemolytic anemia

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42
Q

Deficiency in vitamin K

A

rare

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43
Q

Dietary sources of vitamin K

A

green leafy vegetables, liver

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44
Q

Acetaminophen overdose adverse effects

A

early stages nausea and vomiting

liver failure/death after 2-3 days

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45
Q

Acetaminophen antidote

A

acetylcysteine (acetadote)

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46
Q

Benzodiazepine overdose adverse effects

A

CNS depression, coma, respiratory depression

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47
Q

Benzodiazepine antidote

A

flumazenil

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48
Q

Opioid overdose adverse effects

A

euphoria, drowsiness, constricted pupils, hypotension, respiratory arrest, coma

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49
Q

Opioid antidote

A

nalozone

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50
Q

Digoxin overdose adverse effects

A

nausea, vomiting, visual changes, seizures, arrhythmias

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51
Q

Digoxin antidote

A

digibind

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52
Q

Warfarin overdose adverse effects

A

bleeding

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53
Q

Warfarin antidote

A

vitamin K

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54
Q

Difference between abuse and dependence

A

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

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55
Q

What medications for smoking cessation?

A

nicotine replacement therapy, Chantix, Bupropion

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56
Q

Structure of bacterial cell walls

A

gram positive - thick layer of peptidoglycan

gram negative - thin layer of peptidoglycan

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57
Q

Structure of fungal cell walls

A

contain ergosterol

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58
Q

Penicillin common ending

A

end in -cillin

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59
Q

Penicillin mechanism

A

interfere with the synthesis of peptidoglycan

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60
Q

Penicillin adverse effects

A

hypersensitivity, diarrhea, rash

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61
Q

Cephalosporins common beginning

A

cef beginning of name

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62
Q

Cephalosprorins mechanism

A

inhibits peptidoglycan

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63
Q

Cephalosprorins adverse effects

A

hypersensitivity, diarrhea, rashes

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64
Q

Sulfonamides common beginning

A

sulf at beginning of name

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65
Q

Sulfonamides mechanism

A

inhibit bacterial folic acid synthesis

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66
Q

Sulfonamides adverse effects

A

diarrhea, sun sensitivity, kidney stones

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67
Q

Aminoglycosides common ending

A

-mycin or -micin

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68
Q

Aminoglycosides mechanism

A

disrupts bacterial protein synthesis

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69
Q

Aminoglycosides adverse effects

A

ototoxicity, nephrotoxicity, Red man’s syndrome (vancomycin only)

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70
Q

Macrolides common ending

A

-thromycin

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71
Q

Macrolides mechanism

A

inhibit bacterial protein synthesis

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72
Q

Macrolides adverse effects

A

diarrhea

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73
Q

Fluoroquinolones common ending

A

-floxacin

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74
Q

Fluoroquinolones mechanism

A

interferes with bacterial DNA synthesis

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75
Q

Fluoroquinolones adverse effects

A

rash, photosensitivity, cartilage damage in children

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76
Q

Tetracyclines common ending

A

-cycline

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77
Q

Tetracyclines mechanism

A

prevents bacterial protein synthesis

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78
Q

Tetracyclines adverse effects

A

diarrhea, photosensitivity, dark pigmented teeth in children

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79
Q

Azole antifungals common

A

azole in name

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80
Q

Azole antifungals mechanism

A

block synthesis of ergosterol

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81
Q

Azole antifungals adverse effects

A

diarrhea, itching hepatitis

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82
Q

Antivirals common name

A

vir in name

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83
Q

Cell-mediated immunity

A

immunity obtained when cells attack the antigens directly rather than producing antibodies

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84
Q

Humoral immunity

A

immunity based on the antigen-antibody response

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85
Q

What immunization should adults receive? and how often?

A

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

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86
Q

What reference do you use to look up vaccine schedules?

A

Pinkbook

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87
Q

Aspirin properties

A

anti-inflammatory

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88
Q

Acetaminophen properties

A

analgesic and antipyretic

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89
Q

Opioids properties

A

analgesic

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90
Q

How is celecoxib different from other NSAIDs

A

only inhibits COX-2

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91
Q

Mechanism of action of alkylating agents

A

replace hydrogen in DNA with an alkyl

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92
Q

Mechanism of action of antimetabolites

A

replace nucleotides to alter DNA structure

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93
Q

Mechanism of action of mitotic inhibitors

A

inhibit DNA and RNA synthesis

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94
Q

Mechanism of action of antitumor antibiotics

A

inhibit DNA and RNA synthesis

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95
Q

What phase of the cell cycle do alkylating agents work?

A

G0

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96
Q

What phase of the cell cycle do antimetabolites work?

A

S-phase

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97
Q

What phase of the cell cycle do mitotic inhibitors work?

A

S and M phase

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98
Q

Adverse effects of chemotherapy

A

hair loss, bone marrow suppression, mucositis, nausea/vomiting

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99
Q

Effects of stimulants

A

increase alertness, wakefulness, endurance, productivity, motivation, self-confidence, euphoria

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100
Q

Adverse effects of stimulants

A

raise blood pressure/heart rate, abuse potentials, withdrawal after prolonged use

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101
Q

Effects of benzodiazepine overdose

A

respiratory depression, coma

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102
Q

Causes of Parkinson’s disease

A

lack of dopamine in substantia nigra and imbalance of neurotransmitters acetylcholine and dopamine

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103
Q

What do Parkinson’s medications do?

A

restore neurotransmitter balance

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104
Q

What medication classes treat Parkinson’s disease?

A

dopaminergics and anticholinergics

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105
Q

Adverse effects of anticholinergic

A

anxiety, agitation, drowsiness, dry mouth, urine retention, constipation

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106
Q

How does carbidopa-levodopa work?

A

precursors of dopamine or dopamine agonists

107
Q

What is carbidopa-levodopa brand name?

108
Q

Adverse effects of carbidopa-levodopa

A

confusion, hallucinations, dyskinesia, loss of effectiveness

109
Q

What drugs treat schizophrenia?

A

antipsychotics

110
Q

Difference between atypical and typical antipsychotics

A

atypical - newer with better side effects

typical - older ones with more side effects

111
Q

What class of drugs is first line for depression?

112
Q

Difference between sympathetic nervous system and parasympathetic nervous system

A

sympathetic - fight or flight

parasympathetic - rest and digest

113
Q

What drugs bind adrenergic receptors?

A

norepinephrine, dopamine, epinephrine

114
Q

Alpha 1 and alpha 2

A

alpha 1 - agonists cause vasoconstriction

alpha 2 - agonists cause vasodilation

115
Q

Beta 1 and beta 2

A

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
Q

Cholinergic effects

A

SLUDGE

  • salivation
  • lacrimation
  • urination
  • defecation
  • gastrointestinal upset
  • emesis
117
Q

Anticholinergic effects

A

low heart rate, motion sickness, urinary incontinence, bladder spasms

118
Q

Three components that affect blood pressure

A

cardiac output, peripheral resistance, blood volume

119
Q

How do antihypertensives work?

A

aimed at decreasing cardiac output, peripheral resistance, or blood volume

120
Q

How do diuretics work to lower blood pressure?

A

decrease blood volume

121
Q

How do beta blockers work to lower blood pressure?

A

reduce heart rate and dilate vessels

122
Q

How do ACEIs work to lower blood pressure?

A

dilate blood vessels

123
Q

How do ARBs work to lower blood pressure?

A

dilate blood vessels

124
Q

How do calcium channel blockers work to lower blood pressure?

A

slow heart rate, dilate vessels

125
Q

How do alpha blockers work to lower blood pressure?

A

dilate vessels

126
Q

How do vasodilators work to lower blood pressure?

A

dilate vessels

127
Q

Diuretics common ending

A

end in -ide

128
Q

Beta blockers common ending

A

end in -olol

129
Q

ACEIs common ending

A

end in -pril

130
Q

ARBs common ending

A

end in sartan

131
Q

Calcium channel blockers common ending

A

end in -ipine

132
Q

Adverse effects of diuretics

A

increase urination, electrolyte imbalances, hypotension

133
Q

Adverse effects of beta-blockers

A

hypotension, bradycardia, depression

134
Q

Adverse effects of ACEIs

A

hypotension, cough, hyperkalemia, renal impairment

135
Q

Adverse effects of calcium channel blockers

A

constipation, hypotension or bradycardia, edema of legs

136
Q

Adverse effects of vasodilators

A

hypotension, tachycardia, headache, dizziness

137
Q

Difference between ACEIs and ARBs

A

ACEIs cause coughing while ARBs do not

138
Q

Difference between dihydropyridine and non-dihydropyridine

A

dihydropyridine - decrease blood pressure

non-dihydropyridine - decrease heart rate

139
Q

What class of medication treats hyperlipidemia?

A

HMG-CoA Reductase Inhibitors (statins)

140
Q

Adverse effects of statins

A

muscle pain, muscle breakdown

141
Q

Contraindications of statins

A

pregnancy and myopathy

142
Q

Medications that are used for stable angina

A

nitrates, beta-blockers, verapamil

143
Q

Identify a nitrate

A

has nitr in the name

144
Q

What do inotropes do?

A

increase muscular contractions of heart to increase cardiac output

145
Q

List all three inotropes

A

cardiac glycosides, beta-agonists, phosphodiesterase inhibitors

146
Q

Difference between the antiarrhythmic classes in terms of mechanism

A 
class 1 - sodium channel blockers
class 2 - beta blockers
class 3 - potassium channel blockers
class 4 - calcium channel blockers - nondihydrophyridine
147
Q

Most commonly used antiarrhythmic agents

A

amiodarone, sotalol, dofetilide

148
Q

Sotalol

A

class 2 and 3

149
Q

Common adverse effects of antiarrhythmic

A

interstitial lung disease, hypo/hyperthyroidism, visual changes, liver dysfunction, blue-grey skin discoloration

150
Q

How does heparin work?

A

inhibits clots from forming or growing larger

151
Q

How does warfarin work?

A

inhibits the synthesis of vitamin-K dependent factors

152
Q

Brand name of warfarin

153
Q

How does low-molecular weight heparin work?

A

inhibits clots from forming or growing larger

154
Q

How does enoxaparin work?

A

inhibit factor Xa to decrease clotting

155
Q

Brand name of enoxaparin

156
Q

What class of medication breaks up existing clots?

A

thrombolytics

157
Q

Adverse effects of heparin

A

bleeding and low platelets

158
Q

Adverse effects of enoxaparin

159
Q

Interactions of warfarin

A

alcohol, drug and food

160
Q

Adverse effects of warfarin

A

bleeding and skin necrosis

161
Q

Difference between anticoagulants and antiplatelets

A

anticoagulants - inhibits clots

antiplatelets - bind receptors on platelets to inhibit platelet aggregation and prevent clot formation in arteries

162
Q

Common antiplatelets

A

aspirin, Plavix, effient, brilinta

163
Q

Adverse effects of antiplatelets

164
Q

How do thrombolytics work?

A

dissolve blood clots

165
Q

Common thrombolytics

A

alteplase (tPA, Activase)

166
Q

Adverse effects of thrombolytics

167
Q

Contraindications of thrombolytics

A

bleeding, recent surgeries/trauma, uncontrolled hypotension, current/recent anticoagulant use

168
Q

Hyperthyroidism

A

high thyroid hormones

169
Q

Hypothyroidism

A

low thyroid hormones

170
Q

Symptoms of hyperthyroidism

A

nervousness, thin skin/hair, weight loss, heat intolerance

171
Q

Symptoms of hypothyroidism

A

fatigue, poor memory, weight gain, cold intolerance

172
Q

What medications treat hyperthyroidism?

A

methimazole and propylthiouracil

173
Q

Mechanism of hyperthyroidism medication

A

inhibit synthesis of thyroid hormones

174
Q

Adverse effects of hyperthyroidism medication

A

fever, rash, agranulocytosis, hypothyroidism

175
Q

What medications treat hypothyroidism?

A

levothyrozine, liothyroine

176
Q

Mechanism of hypothyroidism medication

A

provide thyroid hormones (T3/T4)

177
Q

Adverse effects of hypothyroidism medication

A

hyperthyroidism, osteoporosis, coronary artery disease

178
Q

What hormones are secreted by the pancreas?

A

insulin and glucagon

179
Q

How do insulin and glucagon affect the body?

A

increase or decrease glucose in blood

180
Q

Difference between type 1 and 2 diabetes

A

type 1 - autoimmune disorder destroys beta cells

type 2 - insulin resistance

181
Q

How does metformin work?

A

promote glucose uptake by cells
decrease glucose production by liver
slow glucose absorption

182
Q

Adverse effects of metformin

A

weight loss, GI upset, diarrhea, lactic acidosis in renal failure

183
Q

Contraindications of metformin

A

type 1 diabetes and renal failure

184
Q

Common rapid-acting insulins

A

lispro (Humalog) or aspart (Novolog)

185
Q

Common long-acting insulins

A

glargine (Lantus)

186
Q

What hormones are secreted by adrenal glands?

A

corticosteroids

187
Q

What do corticosteroids do?

A

anti-inflammatory, increase glucose, increase blood pressure

188
Q

Adverse effects of corticosteroids

A

insomnia, hypertension, behavioral changes, stomach ulcers, increased appetite, diabetes, osteoporosis, infection, edema

189
Q

Contraindications of corticosteroids

A

ulcers, severe infections, psychoses, diabetes

190
Q

How do you treat diabetes?

A

insulin and blood glucose monitoring

191
Q

How do you treat adrenal insufficiency?

A

corticosteroids

192
Q

How do you treat hypogonadism?

A

testosterone replacement

193
Q

Adverse effects of estrogen

A

changes in libido, edema, breast enlargement, cardiovascular disease, stroke, clots, dementia

194
Q

Contraindications of estrogen

A

breast cancer, clots, pregnancy, breastfeeding

195
Q

Adverse effects of progestins

A

weight gain, clotting, breakthrough bleeding, cycle irregularity

196
Q

Contraindications of progestins

A

pregnancy, breast feeding, active clots

197
Q

Effects of oxytocin

A

increases uterine smooth muscle contraction and promote milk ejection from mammary glands

198
Q

What medication classes treat osteoporosis?

A

bisphosphonates and hormonal agents

199
Q

Band name of bisphosphates

A

Fosamax and Actonel and Boniva

200
Q

Generic name of bisphosphates

A

have -dronate

201
Q

How do hormonal therapies work for osteoporosis?

A

inhibit bone resorption

202
Q

What medication classes are used for rheumatoid arthritis?

A

analgesics, anti-inflammatory, and DMARDs

203
Q

How does hydroxychlororquine work?

A

inhibits movement of white blood cells

204
Q

Adverse effects of hydroxychloroquine

A

agranulocytosis/thrombocytopenia, weakness/myopathy, visual loss

205
Q

Contraindications of hydroxychloroquine

A

visual changes while on therapy and hepatic dysfunction

206
Q

How does sulfasalazine work?

A

unknown anti-inflammatory

207
Q

Adverse effects of sulfasalazine

A

headache, nausea, dyspepsia, rash, fatal rashes, oligospermia, agranulocytosis, infections

208
Q

Contraindications of sulfasalazine

A

sulfa allergies, hepatic failure

209
Q

How does methotrexate work?

A

unknown for RA

210
Q

Adverse effects of methotrexate

A

bone marrow suppression, GI upset/stomatitis, renal and hepatic toxicity

211
Q

Contraindications of methotrexate

A

immunosuppressed patient, liver failure, renal failure, pregnancy

212
Q

What medications are used to treat gout?

A

diet, NSAIDs, colchicine

213
Q

What medications are used to prevent gout?

A

colchicine, allopurinol, uricosuric agents

214
Q

What 3 classes of medications treat glaucoma?

A

prostaglandin agonists, beta-blockers, and carbonic anhydrase inhibitors

215
Q

Prostaglandin agonists common ending

216
Q

Carbonic anhydrase inhibitors common ending

217
Q

Adverse effects of Prostaglandin agonists

A

blurred vision/vision changes, redness, lacrimation, eyelash growth, change in iris pigmentation

218
Q

Adverse effects of beta-blockers

A

burning/stinging

219
Q

Adverse effects of carbonic anhydrase inhibitors

A

burning, blurred vision, rashes

220
Q

Contraindications of beta-blockers

A

angle-closure glaucoma

221
Q

Contraindications of carbonic anhydrase inhibitors

A

closed-angle glaucoma

222
Q

Three intentions of general anesthesia

A

amnesia, analgesia, skeletal muscle relaxation

223
Q

Amnesia

A

lack of memory

224
Q

Analgesia

A

lack of pain

225
Q

Skeletal muscle relaxation

A

lack of movement

226
Q

What medications at inhaled anesthetics?

A

end in -flurane

227
Q

Common names of general anesthetics

A

local and amide anesthetics

228
Q

Mechanism of action of general anesthetics

A

block sodium channels to prevent neurotransmitter conduction

229
Q

Typical treatment of dermatitis

A

topical or oral corticosteroids

230
Q

How do corticosteroids work?

A

prevent white blood cells from migration to inflammation site

231
Q

Adverse work of corticosteroids

A

irritation, skin burning, atrophy, thinning skin

232
Q

Common name ending of corticosteroids

A

end in -sone

233
Q

What is psoriasis?

A

chronic immune system related disease where there is rapid growth of skin with scaly, red or white itchy plaques or patches

234
Q

Common treatments for psoriasis

A

topical medication, UV light, oral medications

235
Q

Use of corticosteroids for psoriasis vs. dermatitis

A

psoriasis - skin thinning

dermatitis - anti-inflammatory

236
Q

Common side effects of methotrexate

A

renal/hepatic failure, bone marrow suppression, GI toxicity, infertility, NOT used in pregnancy

237
Q

Cause of acne

A

plugged sebaceous glands

238
Q

Topical side effects

A

itching, burning, stinging, redness, excessive drying

239
Q

Tetracyclines side effects

A

photosensitivity, pediatric tooth discoloration, GI discomfort

240
Q

Isotretionoin (Accutane)

A

suicidal ideation, NOT for pregnancy, bone marrow suppression

241
Q

Common bugs that infect our skin

A

staphylococcus aureus
streptococcus
canidida albicans

242
Q

Primary treatment for peptic ulcers and GERD

A

proton-pump inhibitors, histamine-2 receptor antagonists, antacids, prostaglandins

243
Q

Antacid

A

calcium carbonate (Tums), magnesium hydroxide (Milk of magnesia), mylanta

244
Q

Two common antidiarrheal medications

A

loperamide (lmodium) diphenoxylate/atropine (lomotil)

245
Q

Class antidiarrheal medications belong to

246
Q

Adverse effects of opioids

A

constipation and drowsiness

247
Q

Contraindications of opioids

A

intestinal obstruction, loss of efficacy in chronic diarrhea, hepatic failure

248
Q

Common stool softeners

A

docusate (Colace)

249
Q

Common bulk-forming laxatives

A

Metamucil, FiberCon

250
Q

Common osmotic laxatives

A

lactulose, magnesium hydroxide

251
Q

Common stimulant laxatives

A

bisacodly (Dulcolax) senna (senokot)

252
Q

Common antiemetics

A

promethazine (Phenergan), ondansetron (Zofran), metoclopramide, meclizine, scopolamine

253
Q

Common short-acting beta agonist

A

albuterol or levalbuterol

254
Q

Situations that must be considered with prescribing medications for elderly

A

physiologic and financial considerations

255
Q

Polypharmacy

A

prescribing multiple medications for one patient

256
Q

Problems associated with polypharmacy

A

increase cost, increase likelihood of adverse effects, increase likelihood of drug interactions

257
Q

How do elderly patients have altered pharmacokinetics?

A

slower rate of absorption, drugs take longer to work, increased body fat, decrease body water

258
Q

Creatinine clearance used for

A

used for an indicator of kidney function

259
Q

What does Beers criteria do?

A

list of inappropriate medications for elderly

260
Q

Category A

A

well controlled studies demonstrated no fetal risk

261
Q

Category B

A

animal studies have demonstrated no fetal risk

262
Q

Category C

A

studies not available or animal studied reveal harm

263
Q

Category D

A

well-controlled human studies demonstrated fetal risk

264
Q

Category X

A

well-controlled studies demonstrated fetal risk

Pharmacology (13 decks)

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