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Applied Pharmacology > FINAL EXAM Review > Flashcards

FINAL EXAM Review Flashcards

1
Q

Define obtunded

A

Mentally dull.
Obtundation is a state similar to lethargy in which the patient has a lessened interest in the environment, slowed responses to stimulation, and tends to sleep more than normal with drowsiness in between sleep states.

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2
Q

What is a gastroscopy?

A

Gastroscopy (or endoscopy) is an examination of the oesophagus (gullet or food pipe), stomach and duodenum (upper part of the small bowel) using a flexible telescope called a gastroscope.

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3
Q

What is a Cycloplegic eye drop

A

Cause paralysis of the ciliary muscle, resulting in loss of accommodation for 2 to 48 hours depending on the strength. Doctors use this to allow them to measure a patient’s vision problem

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4
Q

Miotic eyedrops are do what & used for what condition ?

A

Constrict the pupil. Used to treat glaucoma

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5
Q

Mydriatic eye drops have what effect and are used for?

A

Dilates the pupil. Used for certain Eye exams and treatment of eye inflammation

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6
Q

What is the antidote for magnesium sulfate?

A

Calcium gluconate

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7
Q

What is the antidote for heparin/low molecular weight heparin?

A

Protamine sulfate

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8
Q

What is the antidote for warfarin?

A

Vitamin K

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9
Q

What is the antidote for acetaminophen?

A

Acetylcysteine (mucomyst)

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10
Q

What is the antidote for opiates?

A

Naloxone (narcan)

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11
Q

What is the antidote for benzodiazepines?

A

Flumazenil

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12
Q

Antidote for digoxin?

A

Digibind

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13
Q

Antidote for iron?

A

Deferoxamine

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14
Q

<p>What are schedule 1 medications?</p>

A

<p>Requires a prescription and provided by pharmacist. Include the following:all prescription drugs, drugs with potential for abuse, controlled drugs, narcotic drugsexample: Morphine</p>

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15
Q

What are schedule 2 medications?

A

Behind the counter – consultation required from pharmacist example - Ephedrine

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16
Q

What are scheduled 3 medications?

A

Behind the counter - no consultation or invention required from pharmacist

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17
Q

What are unscheduled drugs?

A

Can be sold in any store without professional supervision

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18
Q

What is pharmacotherapy?

A

Application of drugs to prevent disease and ease suffering

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19
Q

What is therapeutic range (duration of action)?

A

Concentration of the drug that is needed to produce a therapeutic response; Describes when the therapeutic response begins, peaks, and remains therapeutic

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20
Q

What is a loading dose?

A

A high dosage of the medication administered to a client in order to achieve a quick therapeutic response

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21
Q

what is Pharmacokinetics

A

How a drug moves through the body (how it is absorbed, distributed, metabolized and excreted)
Repeat four processes: A. D. M. E.

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22
Q

what is Pharmacodynamics

A

How a drug affects the body (how it works)

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23
Q

Pharmacotherapeutics is

A

The use of a drug to prevent and treat disease

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24
Q

what is half-life

A

The time it takes for half of a drug to achieve 50% of the original plasma concentration

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25
Q

Agonist

A

Drugs that produce the same response as the endogenous substance

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26
Q

antagonist

A

Drugs that block the endogenous chemical from acting

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27
Q

maintenance drugs are for

A

chronic conditions

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28
Q

Therapeutic class is

A
  • relates to therapeutic usefulness for treatment

- drugs with similar chemical properties

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29
Q

Pharmacologic class is

A

“the way a drug works at the molecular, tissue, and body system level”

the effect the drug aims to have on the body

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30
Q

what is drug misuse

A

Inappropriate use of prescription drugs in a way not intended to be used

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31
Q

what is drug abuse

A

A pattern of using any drug in such a way that it negatively affects a persons psychological and physiological well-being

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32
Q

what is drug dependence

A

When someone require a drug to maintain a state of psychological or physical well being.

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33
Q

Adrenergics/Sympathomimetics/Adrenergic agonists produce

A

fight or flight response

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34
Q

Adrenergic antagonists/antiadrenergics produce

A

action opposite to adrenergics

rest and digest

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35
Q

Cholinergic/Parasympathomimetics/Muscarinic agonists produce

A

Rest and digest response

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36
Q

Anticholinergics/muscarinic blockers produce

A

action opposite of cholinergics

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37
Q

Adrenergic Agonist: What do alpha 1 treat? Action?

A

treatment of nasal congestion or hypotension, induces mydriasis for eye surgery ex. dopamine (Intropin)
- constricts blood vessels in bronchi

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38
Q

Adrenergic Agonist: What do alpha 2 treat? How is it different from alpha 1?

A

treatment of hypertension (centrally-acting by inhibiting release of norepinephrine), example: clonidine (Catapres)
Different from Alpha1 as it Acts on the CNS rather than the PNS, and decreases sympathetic activity

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39
Q

Adrenergic Agonist: What do Beta 1 treat?

A

Cardiac arrest, heart failure, shock. ex. dobutamine (Dobutrex)
- Increases heart rate, force of contraction, velocity of impulse conduction across myocardium

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40
Q

Adrenergic Agonist: What do Beta 2 treat? Non selective?

A

Asthma and premature labour contractions, example: salbutamol (Ventolin) Bronchodilation
(Nonselective, example: epinephrine stimulates all adrenergic receptors; used for cardiac arrest and asthma.)

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41
Q

what is prazosin (minipress)

A

Alpha 1 blockers
a medication primarily used to treat high blood pressure, symptoms of an enlarged prostate, and posttraumatic stress disorder (PTSD)

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42
Q

What is the pharmacologic class of metoprolol (lopresssor)

A

beta-blocker that affects the heart and circulation (blood flow through arteries and veins
- used to treat angina (chest pain) and hypertension (high blood pressure)

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43
Q

what are the direct-acting and indirect-acting actions of Cholinergic Agonist

A

Direct-acting (muscarinic agonists): Directly bind and activate nicotinic and muscarinic receptors eventually increase smooth muscle tone.
Indirect-acting: inhibitanticholinesterasethe enzyme which destroysacetylcholine

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44
Q

what is the action of Anticholinergics

A

Occupies acetylcholine receptors, therefore blocking the action of acetylcholine.
Inhibit parasympathetic impulses; induces fight or flight response.

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45
Q

Vitamin A is essential for

A

Epithelial tissues, skin, eyes, hair, bone growth

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46
Q

Vitamin D is essential for?

A

Regulates Calcium and Phosphorous

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47
Q

Vitamin E is essential for?

A

Protects cellular components & RBCs

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48
Q

Vitamin K is essential for?

A

Required for synthesis of prothrombin & clotting factors

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49
Q

Vitamin B12 is essential for?

A

RBC formation, CNS maintenance, DNA synthesis

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50
Q

Vitamin B Complex is essential for?

A

New cell formation, antioxidant, beauty, skin and nails

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51
Q

Vitamin C is essential for?

A

Helps with iron absorption, normal growth and development

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52
Q

Folic acid is essential for?

A

DNA synthesis, CNS development of fetus

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53
Q

what are the fat solubles vitamins

A

Vitamin A, D, E, K

54
Q

How are water soluble vitamins different from fat soluble? What are the water soluble vitamins?

A

stored in the body, readily excreted in urine vs. fat soluble which are stored in fatty tissue, liver, and muscle.
- Vitamin B12, B complex, C, Folic acid

55
Q

Sodium is important for

A

Nerve conduction, neuromuscular function

56
Q

Potassium is important for

A

Conducts nerve impulses to the myocardium, skeletal and smooth muscles

57
Q

Calcium is important for

A

Nerve and muscle activity, contraction of the heart muscle, blood clotting, bones and teeth. Should be administered with food

58
Q

Magnesium is important for

A

Transmission of neuro muscular activity, myocardium contraction

59
Q

Iron is important for

A

Vital for Hgb (hemoglobin) regeneration. Can cause constipation and black/dark green stool.

60
Q

What do HMG-CoA reductase inhibitors (-statins) do?

Theyre the first line drugs for tx of what disorder?

A

Inhibit the enzyme HMG-CoA reductase, which results in less cholesterol biosynthesis by liver. Check LFT prior administration.
- Lipid disorders

61
Q

Bile acid resins or Bile sequestrants

How do they work? How are they eliminated?

A

Bind bile acids, which contain a high concentration of cholesterol. Because of their large size, resins are not absorbed from the small intestine and the bound bile acids and cholesterol are eliminated in the feces.
Patients need supplements of fat soluble vitamins (A,D,E,K)

62
Q

What are antilipidemics used to treat?

A

Cholesterol

63
Q

What are the actions of bile acid sequestrants?

A

adjunctive therapy to diet and exercise for the reduction of LDL cholesterol in patients with hypercholesterolemia. Binds bile acids in the GI tract which increases clearance of cholesterol.

64
Q

how do antianginals work? what are the three types?

A 
They work by either increasing the blood flow to the myocardium or decreasing the O2 demand of the myocardium.
Three types:
	1) Nitrates
	2) Beta blockers
	3) Calcium channel blockers
65
Q

What is the primary therapeutic action of
anti-anginals: Organic Nitrates?
What are the two types?

A

Can relax both arterial and venous smooth muscles, as well as coronary arteries

  • Short Acting: Nitroglycerin SL
  • Long-acting: Isosorbide dinitrate
66
Q

what are Anti-anginals: Beta blockers (-olol) used for? what is the effect?

A

Used for chronic stable angina.
Negative chronotropic (rate) and negative inotropic effect
(force of contraction)

67
Q

what are the cardiovascular actions of Calcium channel blockers?

A
  • Relax arteriolar smooth muscle, thus lowering BP and afterload
  • Slow conduction velocity, thus decrease HR and cardiac workload
  • Dilate the coronary arteries, thus more O2 to the myocardium
68
Q

calcium-channel blockers are the drug of choice for what?

A

Drug of choice for variant angina, and may be used monotherapy for pts unable to tolerate beta blockers

69
Q

What is the drug of choice for chronic stable angina?

A

beta blockers

70
Q

drug of choice for acute angina?

A

nitrates

71
Q

What are some nursing considerations for antianginals?

A
  • Monitor VS
  • Do not crush ER tablets
  • Patients on antianginal should avoid taking Sildenafil (Viagra).
  • Do not beta-blockers stop abruptly
72
Q

Differences between thrombolytic drugs, anti-platelets, and anti-coagulants.

A
  • Anticoagulants: Prevent clot formation. Given in DVT to prevent new clot formation. (Ex. Heparin, warfarin)
  • Thrombolytic: *dissolve clots. Destroys thrombus, administered in acute MI. Ex. (Reteplase)
  • Anti-platelets: Stops platelet aggregation. Contraindicated for patients with bleeding disorders. Ex. Clopidogril
73
Q

Nursing considerations: what should you monitor for Anticoagulants?

A

Monitor PTT (partial thromboplastin time) for Heparin and INR (international normalized ratio) for Warfarin

74
Q

Patients with thromboembolic disorders should avoid

A

oral contraceptives

75
Q

Diuretics act by increasing the volume of urine production. They are widely used in the treatment of

A

Hypertension and Heart failure

Diuretics, in general, reduce total blood volume and circulatory congestion.

76
Q

What are the potassium-sparing and potassium-wasting diuretics?

A
  • Potassium-sparing, ex: spironolactone (Aldactone)
  • Potassium-wasting
    1) Thiazide and thiazide-like diuretics, ex: hydrochlorothiazide (HCTZ)
    2) Loop, ex: furosemide (Lasix)
77
Q

how do Calcium Channel Blockers work in lowering BP?

A

Cause the smooth muscles in the arterioles to relax, lowering PR

78
Q

What are selective and non-selective Calcium Channel Blockers for Hypertension for?

A

Selective = blood vessels
(-dipine): nifedipine (Adalat), amlodipine (Norvasc)

non-selective = Blood vessels and heart:
verapamil (Isoptin), diltiazem (Cardizem)

79
Q

Beta adrenergic antagonists (beta blockers) block

A

the effects of epinephrine and norepinephrine on the vascular system thus causing vasodilation Ex: metoprolol (Lopresor), timolol (Apo-Timolol)

80
Q

Drugs that affect the renin-angiotensin-aldosterone pathway decrease blood pressure and increase urine volume. They are widely used in the treatment of HTN, HF, and MI. What are the drugs?

A
  • Angiotensin Converting Enzyme (ACE) inhibitors - (-pril). Ex: Enalapril
  • Angiotensin II receptor blockers (ARB) (-sartan). Ex: Losartan
81
Q

what are Nursing Interventions for antihypertensives?

A

Monitor VS
Monitor I/O for Diuretics
Instruct to change position slowly to prevent orthostatic hypotension
Administer diuretics in morning

82
Q

What is the action of Loop Diuretics?

A

Block the reabsorption of Na+ and Cl- in the loop of Henle. Ex: furosemide

83
Q

Action of Thiazide and Thiazide-like diuretics

A

Act on the distal tubule to block Na+ reabsorption and increase K+ and H2O excretion. Ex. Chlorothiazid

84
Q

Action of Potassium Sparing Diuretics

A

Block exchange of Na+ and K+ in the distal tubule, causing Na+ to stay in the tubule and leave through the urine, and more K+ to be retained in the body. Ex. spironolactone

85
Q

Nursing Considerations for Diuretics

A 
Monitor I/O and V/S
Monitor weight (baseline weight)
Electrolytes (Na+ &amp; K+) 
Administer in morning
Monitor ototoxicity for loop diuretics
Monitor lung sounds if patient is getting diuretics for pulmonary edema
86
Q

Antiarrhythmic: Potassium channel blockers do what?

A

Delay repolarization of the myocardial cells and lengthen the refractory period. Ex. Amiodarone

87
Q

Antiarrhythmic: Calcium channel blockers do what?

A

Work by stopping calcium influx across cardiac and smooth muscle. Ex. Diltiazem

88
Q

Natural hormones that promote some aspect of blood formation are called? What are examples for hematopoietic disorders?
Nursing considerations?

A 
hematopoietic growth factors.
Ex. Epoietin alfa, Erythropoietin 
Nursing Consideration:
Monitor RBC and Hb
Can be administered safely for Jehovah’s witness
Diet rich in iron may help
89
Q

what do Expectorants do?

A

Used to thin bronchial secretions so they can more easily be eliminated by coughing Ex. Guaifenesin

90
Q

what do Antitussives do?

A

Used to suppress the cough reflex (usually dry or non-productive cough) Ex. Dextromethorphan

91
Q

what do decongestants do?

A

Decongestants produce a vasoconstriction effect Ex. Ephedrine

92
Q

what do antihistamines do?

A

Block effects of histamine, given for rhinitis and allergic reactions Ex. Diphenhydramine

93
Q

What are the 4 Reliever meds for the lower respiratory tact? what are their actions?

A
  1. Short-acting β2 agonists (SABA). Sympathomimetics, Relaxes smooth muscle in airways Ex: salbutamol (Ventolin)
  2. Short-acting anticholinergics (SAAC). Work by antagonizing the actions of acetylcholine. Ex: ipratropium (Atrovent)
  3. Combination of SABA + SAAC Ex: salbutamol + ipratropium (Combivent)
  4. Systemic Glucocorticoids Ex. Dexamethasone
94
Q

What are the 4 Controller meds for the lower respiratory tact? what are their actions?

A
  1. Long-acting β2 agonists (LABA). Relax the smooth muscle in the bronchi and increasing bronchodilation Ex: salmeterol (Serevent)
  2. Long-acting anticholinergics (LAAC). Work by antagonizing the actions of acetylcholine. Ex: tiotropium (Spiriva)
  3. Inhaled corticosteroids (ICS). Reduce inflammation Ex: budesonide (Pulmicort)
  4. Combination: Work by combining both a long acting Beta 2 adrenergic agonist with a steroid Ex. Fluticasone and salmeterol (Advair)
95
Q

Nursing considerations for Medications for Lower Respiratory Tract

A
  • Respiratory assessment
  • V/S including RR, O2 sats, BP and HR
  • Corticosteroids can increase BP and SABA (Ventolin) can increase HR.
  • Administer bronchodilator prior administering inhaled corticosteroids
96
Q

What chemical depletes in parkinsons?

A

Dopamine

97
Q

What 3 types of meds are given for Parkinsons?

A

Dopamine Agonists/ Dopaminergics, Anticholinergics, and Acetylcholinesterase (AChE) Inhibitors

98
Q

Dopamine Agonists/ Dopaminergics, Anticholinergics, and ACHe inhibitors are given to help manage Parkinsons disease. What are their actions? examples of meds?

A
  • Dopamine Agonists/ Dopaminergics - Restore dopamine function (regulate movement and emotions)
    Ex. Levodopa and Carbidopa
  • Anticholinergics - Block the effect of ACh (Excitatory neurotransmitor, regulates movement)
    Ex. Benztropine
  • Acetylcholinesterase (AChE) Inhibitors – Increases AcH eventually Increase cognitive function
    Ex. tacrine
99
Q

GABA is the main _______ neurotransmitter. What does it do?

A

Inhibitory.
works by decreasing brain activity. Although different classes of CNS depressants work in unique ways, ultimately it is their ability to increase GABA activity that produces a drowsy or calming effect.

100
Q

Serotonin is a ____ neurotransmitter and maintains what?

A

inhibitory, maintains mood balance

101
Q

Dopamine is a _____ and ______ neurotransmitter and regulates ?

A

Inhibitory and excitatory which regulates movement and emotional response. Also helps to regulate reward and pleasure centers in the brain

102
Q

Norepinephrine is what time of neurotransmitter and what is its action?

A

Excitatory action related to mood, motor activity, arousal and reward

103
Q

Acetylcholine is what time of neurotransmitter and what is its action?

A

Excitatory action which regulates movement and memory

104
Q

Anticholinergics have what action?

A

Decrease the activity of acetylcholine.

Not as effective as other agents, therefore mostly used in early onset PD
Mainly used to control tremor and ease dystonia
Example: benztropine (Cogentin)

105
Q

MS is caused by

A

CNS demyelination

106
Q

Centrally acting muscle relaxants are prescribed for MS. What do they cause? Example of drug?

A

Cause CNS depression
Example: baclofen (Lioresal)- used to relieve painful muscle spasms common in multiple sclerosis, spinal cord lesions or trauma

107
Q

3 drugs for seizures

A

Barbiturates, Benzodiazepines, Hydantoins and Phenytoin Like Drugs

108
Q

Action of Barbiturates. examples

A

Enhances the inhibitory neurotransmitter GABA, thereby depressing CNS. Ex. Phenobarbital, Gabapentin

109
Q

Action of Benzodiazepines. examples

A

Enhances the inhibitory neurotransmitter GABA, thereby depressing CNS. Used for short period of time. Ex. Diazepam, Clonazepam

110
Q

Action of Hydantoins and Phenytoin Like Drugs:

A

Suppress Na+ influx by desensitizing Na+ channels. Ex. Phenytoin, carbamazepine

111
Q

Nursing considerations for Seizure drugs

A

Nursing diagnosis: Risk for fall
Monitor LOC and RR. Benzodiazepines can cause drowsiness and bradypnea
Phenytoin needs periodic lab works
Antidote for Benzodiazepines is Flumazenil
Phenytoin may change urine color

112
Q

Antipsychotics all work to decrease

A

amount of dopamine.
Ex. Resperidone, haloperidol.
Patients with active symptoms and in need of antipsychotics

113
Q

What are the 3 antidepresants (typical) used and their function

A
  • Selective Serotonin Reuptake Inhibitors (SSRI): slow the reuptake of serotonin (maintain mood) into the presynaptic neuron. It takes up to one month for SSRI to effect and reduce symptoms
  • Tricyclic Antidepressants (TCA): Inhibit the reuptake of norepinephrine and serotonin
  • Monoamine Oxidase Inhibitors (MAOI): Work by inhibiting monoamine oxidase, the enzyme that breaks down neurotransmitter
114
Q

Lithium is effective for? what should you monitor?

A

Effective for mania, bipolar and conduct disorders. Last resort for treatment.
Monitor serum sodium levels closely.
(mechanism of action is unknown)

115
Q

3 meds for insomnia

A

Antihistamines Ex: diphenhydramine (Benadryl)
Benzodiazepines- Class of hypnotic medication Ex: lorazepam (Ativan)
Non-benzodiazepines- Class of hypnotic medication Ex: zopiclone (Imovane)

116
Q

non opioid analgesics vs opioid analgesics - where they act

A
  • Non Opioid Analgesics: act at the peripheral level

- Opioid Analgesics: act in the CNS

117
Q

what are the 4 classes of drugs for Peptic Ulcers and GERD

A
  • H2- receptor antagonists (Histamine2-blockers)
  • Proton pump inhibitors (PPIs)
  • OTC antacids
  • Antibiotics
118
Q

H2- receptor antagonists (Histamine2-blockers) - Inhibit histamine at H2-receptor sites in parietal cells, which decreases gastric acid secretions. Long-term use may lead to

A

Vitamin B12 deficiency.

Ex. Ranitidine (Zantac)

119
Q

Proton pump inhibitors (PPIs): Blocks the enzyme responsible for HCl secretion. When should it be taken ?

A

Taken 30 minutes before meals.

Ex. pantoprazole

120
Q

What are OTC antacids?

A

Alkaline substances that neutralize gastric acid.

Ex. Calcium Carbonate (Tums)

121
Q

Medications for Nausea and Vomiting

A

Anticholinergics and Antihistamines: Work by inhibiting vestibular stimulation in the middle ear. Effective for nausea and vomiting, and motion sickness. Ex. dimenhydrinate (Gravol)
Dopamine Antagonists: Block dopamine II receptor sites in the brain, increase peristalsis. Ex. metoclopramide (Maxeran)
Serotonin (5-HT3) Receptor Antagonists: Suppress nausea and vomiting by blocking serotonin receptors. Preferred drug for serious N/V by antineoplastic therapy, radiation therapy, or surgical procedures. Ex. ondansetron (Zofran)

122
Q

Culture and Sensitivity test is conducted prior or after administering antibiotics?

A

Prior

123
Q

What history needs to be taken before giving antibiotics?

A

Take history of liver or kidney diseases

124
Q

Classification of Antibiotics: Cephalosporin is used for

A

patients allergic to Penicillin

125
Q

Classification of Antibiotics: Tetracyclines are not to be taken with

A

milk, iron, magnesium-containing laxatives or antacids.

126
Q

Classification of Antibiotics: Macrolides may decrease what? and can cause?

A

May decrease warfarin metabolism and excretion. Can cause hepatotoxicity

127
Q

Classification of Antibiotics: Fluoroquinolones should not be taken with

A

with vitamin, mineral supplements or warfarin

128
Q

Classification of Antibiotics: Sulfonamides may cause

A

crystals in urine, increase fluid intake

129
Q

Classification of Antibiotics: Aminoglycoside May cause? Check for what?

A

nephrotoxicity. Check for BUN and Cr.

130
Q

Antifungal and Antiviral meds work by

A

Antifungal Medications: Work by causing the fungal cell wall to become porous and leaky. Ex. Nystatin, fluconazole

Antiviral Medications: Works by inhibiting viral nucleic acid synthesis in the cell. Ex. Tamiflu

Applied Pharmacology (16 decks)

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