final review for pharm Flashcards
4 processes of pharmacokinetics and description
absorption- to bloodstream / oral/ topical
distribution- the movement of medication
metabolism - how the body breaks it down
excretion - how it leaves
Factors that influence drug absorption
weight age sex pathological factors interactions mediations psychological factors
How Dietary supplements are regulated?
DSHEA- diet act of 1994
requires all supplement to be labeled as “dietary supplements”
not labeled to say that it diagnosis, treat or cure disease
what is Half-life
length of the time that it takes plasma for medication to decrease in 1/2
what are the advantages and disadvantages of over-the-counter drugs?
Con:
lack of education
underdiagnosed
undertreated
Pro:
acute care can treat at home
what is a narrow therapeutic rate?
the high point of absorption to excretion that the drug is working properly in the body
the narrow range where anything outside of it can cause harmful effects
Calcitriol
*Vitamin D * bone reabsorption build bones Vitamin D elevates calcium levels Don't take if hypercalcemia
Adverse Effects:
dry mouth and metallic taste
Calcitonin
Does not prevent osteoporosis
PROTOTYPE: Calcitonin Salmon
Approves to treat postmenopausal osteoporosis
Allergies to mediation and fish protein and salmon are contraindicated
common adverse effect: Flushing of face, rash (most common)
don’t take if lactation, it is contraindicated
Calcium Carbonate
calcium supplement (prevent osteoporosis)
Don’t take if you have cardiac dysrhythmias,
Adverse effects: kidney stones
Drug and food interactions:
- calcium decreases absorption of thyroid hormone and some antibiotics
- Zinc risk food decrease absorption
Bisphonates
PROTOtype: alendronate
Need to remain upright for 30 min after taking and avoid eating or drinking anything other than water, take on an empty stomach
For osteoporosis, decreases bone absorption
don’t take this meditation: hypocalcemic
adverse effect: bone pain and esophageal erosion, esophagitis (inflammation of the esophagus )
DMARDS 1
(Major nonbiologic)
Prototypes: methotrexate and hydroxychloroquine
they are antimetabolite drugs-
they are used for immunosuppression
Category X
Therapeutic effects: RA, SLE, malaria, cancer
Adverse effects: liver damages, Bone marrow suppression, Gi ulcers, pulmonary fibrosis
weekly folic acid supplements and get routine eye checks
DON’t take with antiacids (prevent absorption)
hepatotoxic drugs and alcohol
when your client is on methotrexate what should they be educated on?
weekly folic acid supplements and get routine eye checks.
What is the goal of PD meds?
to decrease symptoms and increase the ability for a client to perform normal ADLS
What is the cause of PD
An imbalance of acetylcholine and dopamine
loss of dopamine-producing neutrons
What are the drugs used for PD?
Dopmanergic agents :levodopa and carbadopa
anticholinergic: benztropine
What can help with the involuntary movement like tremors and twitches
amantadine
What are the Dopaminergic agents:
also, why are they taken?
Taken for Parkinsons : levodopa/carbidopa
crosses BBB
takes 2-3 weeks to start working effectively, effects will diminish
orthostatic hypertension
anticholinergic: why is it taken and how does it work?
lower ACH levels for Parkinsons
Prototype: benztropine
GI: ** paralytic ileus ** most serious so check for hypoactive bowel sounds
works quickly at 2-3 days
NSAIDS/ Slalicylate: Asprin
- mild to moderate pain and inflammation, fever, decrease thrombotic events
- bleeding risks
- salicylism is the toxicity of aspirin and is shown with tinnitus (ringing in the ears)
-**Reyes syndrome **
ASA is irreversible to COX 1 after taking
Acetaminophen
Treat mild to moderate pain, fever education
Inhibits COX in CNS
Acute poisoning: Acetylcysteine
Adverse effects
-Hepatotoxicity
-Caffeine enhances analgesic effects
what are Opiod agonists
Morphine for moderate and severe pain, check for CNS depression with apnea.
- Urinary retention
- Pruritis (Itch)
- Pupil constriction
overdose treatment NALOXONE
what medications are considered bronchodilators?
- Xanthines
- inhaled anticholinergics
- beta2 adrenergic adjonists
what mediations are considered antiinflammatory?
- inhaled steroids
- leukotriene receptors antagonists
- mast cell stabilizer
Know which meds are for quick relief asmtha attack
beta 2 selective adrenergic agonists, short acting agents (SABA) “beta agonists”
beta TWO because two lungs
the second choice for quick relief asmtha attack is inhaled anticholinergic = Ipratropium (short acting)
a client is perscribed a beta 2 aganoist and an inhaled glucocorticoid what one should they take first ?
beta 2 aganoist. so the airway will open up
what are the main adverse effects of Beta2 agonists?
tachycardia, palpitations and nervousness
Prototype for beta 2 agonists?
Albuterol (SABA)
Blocking of the parasympathetic NS will cause
vasodilation
What is the inhaled anticholinergics prototype?
Ipratropium (short acting)
When do we use Xanthines?
for long term management of persistent asthma/COPD that is unresponsive to beta-agonists or inhaled corticosteroids
narrow therapeutic index
What is Xanthines prototype?
theophyline
When someone is having theophylline toxicity what are the levels and what will we commonly see?
anything about 20 is toxic and we would commonly see restlessness and insomnia.
What are some contraindications of someone taking Xanthines? (theophylline)
Anyone with seizures, HF or cardiac dysrhythmias
Don’t take with many antibiotics and antianxiety drugs
Caffeine will boost the effect and st. john wort will decrease the effects
True/ False
Corticosteroids should be used for acute asthma attacks
FALSE
corticosteroids are used for the prevention of attacks in long term management of chronic asthma
what are the adverse effects of a person using corticosteroids (beclomethasone)
short: hoarseness sore throat, dry mouth, and oral candidates (thrush) so rinse mouth *** on test
Long term: risk of osteoporosis, decreased growth in children
Beclomethasone is the prototype for what class of meditation
Corticosteroid
what is the prototype for Leukotriene receptor antagonists?
Zafirlukast
delayed onset and work by blocking leukotriene synthesis and suppressing inflammation
used in COPD, persistent chronic asthma, long term rhinitis
What are some special directions when taking Leukotriene receptor antagonists (Zafirlukast)
- do not take if liver is damaged
- BBW for neuropsychiatric symptoms and suicidal ideations especially in children
- take on an empty stomach
what are mast cell stabilizers prototype and how do they work?
the prototype is: Cromolyn
used for long term treatment of prophylaxis of asthma and seasonal allergies
Common adverse effects: dry mouth, bitter taste, tingling / burning in throat after inhalation
they prevent the degranulation of mast cells , prevent histamine relief and inflammatory mediatiors
vascular tissue is controlled by the Upper respiratory tract sympathetic NS
Constricts the arteries in the nose which reduces the thickness of the mucosal layer.
what are the 2 categories of allergic rhinitis?
Preventers: used for prophylaxis
- include antihistamines, intranasal corticosteroids and mast cell stabilizer
Relleivers: immediate, temporary relief
- Oral and intranasal decongestants
What are 1st generations antihistamines?
they are allergic Rhinitis that block H1 and alleviating allergy symptoms.
Generations one has sedating effects.
theses are older and have greater anticholinergic effects. Cause drowsiness
What is the 2st generation antihistamine prototype?
Diphenhydramine (benadryl) used for allergic rhinitis
What drugs can be used for asmatha and Allergic rhinitis ?
mast cell stabilizer (cromolyn)
anticholinergics (ipratropium nasal spray)
leukotriene receptor blocker (montelukast?)
Diphenhydramine (benadryl)
What are sympathomimetics used from and what is their prototype?
They are decongestants
Phenylephrine: (intanasal)
Pseudoephedrine: (oral)
what are antitussives and what is their prototype
it is a medication for dry NON productive cough, works by raising the cough threshold in CNS.
Come in opioid and non opioid forms.
The prototype is Dextromethorphan (OTC)
When do we use expectorants and what is the prototype?
we use them for the common cold.
-Increases the productivity of cough to clear airwways
- thins mucus
better at treating dry cough
Prototype: Guaifenesin
What is Vareniclin and its adverse effects?
helps with smoking cessation, given 12-24 weeks starting with a low dose and moving up.
most common adverse effects: vivid dreams and constipation
Angioedema, serious skin effects like stevens johnson MI
- used to have a black box warning for suicidal ideations
- don’t take with nicotine replacement
Physical dependence
Occurs when the body adapts to repeated use of the substance by altering the normal physiology
- withdrawal syndrome occurs if the substance is discontinured
- not the same as addiction
When is Disulfiram given?
for alc abuse if you drink while on this drug….. H/A, palpitations, chest pain, dyspnea
- severe respitory depressions
- ALL akc products need to be avoided
how does Disulfiram work?
irreversibility inhibits enzyme dehydrogenase causing toxic acetaldehyde to build up in the blood
