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chronic > final review for pharm > Flashcards

final review for pharm Flashcards

1
Q

4 processes of pharmacokinetics and description

A

absorption- to bloodstream / oral/ topical
distribution- the movement of medication
metabolism - how the body breaks it down
excretion - how it leaves

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2
Q

Factors that influence drug absorption

A 
weight
age 
sex
pathological factors 
interactions mediations 
psychological factors
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3
Q

How Dietary supplements are regulated?

A

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

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4
Q

what is Half-life

A

length of the time that it takes plasma for medication to decrease in 1/2

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5
Q

what are the advantages and disadvantages of over-the-counter drugs?

A

Con:
lack of education
underdiagnosed
undertreated

Pro:
acute care can treat at home

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6
Q

what is a narrow therapeutic rate?

A

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

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7
Q

Calcitriol

A 
*Vitamin D *
bone reabsorption 
build bones 
Vitamin D elevates calcium levels 
Don't take if hypercalcemia

Adverse Effects:
dry mouth and metallic taste

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8
Q

Calcitonin

A

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

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9
Q

Calcium Carbonate

A

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
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10
Q

Bisphonates

A

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 )

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11
Q

DMARDS 1

A

(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

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12
Q

when your client is on methotrexate what should they be educated on?

A

weekly folic acid supplements and get routine eye checks.

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13
Q

What is the goal of PD meds?

A

to decrease symptoms and increase the ability for a client to perform normal ADLS

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14
Q

What is the cause of PD

A

An imbalance of acetylcholine and dopamine

loss of dopamine-producing neutrons

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15
Q

What are the drugs used for PD?

A

Dopmanergic agents :levodopa and carbadopa

anticholinergic: benztropine

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16
Q

What can help with the involuntary movement like tremors and twitches

A

amantadine

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17
Q

What are the Dopaminergic agents:

also, why are they taken?

A

Taken for Parkinsons : levodopa/carbidopa
crosses BBB
takes 2-3 weeks to start working effectively, effects will diminish

orthostatic hypertension

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18
Q

anticholinergic: why is it taken and how does it work?

A

lower ACH levels for Parkinsons
Prototype: benztropine

GI: ** paralytic ileus ** most serious so check for hypoactive bowel sounds

works quickly at 2-3 days

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19
Q

NSAIDS/ Slalicylate: Asprin

A
  • 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

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20
Q

Acetaminophen

A

Treat mild to moderate pain, fever education

Inhibits COX in CNS

Acute poisoning: Acetylcysteine

Adverse effects
-Hepatotoxicity

-Caffeine enhances analgesic effects

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21
Q

what are Opiod agonists

A

Morphine for moderate and severe pain, check for CNS depression with apnea.

  • Urinary retention
  • Pruritis (Itch)
  • Pupil constriction

overdose treatment NALOXONE

22
Q

what medications are considered bronchodilators?

A
  • Xanthines
  • inhaled anticholinergics
  • beta2 adrenergic adjonists
23
Q

what mediations are considered antiinflammatory?

A
  • inhaled steroids
  • leukotriene receptors antagonists
  • mast cell stabilizer
24
Q

Know which meds are for quick relief asmtha attack

A

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)

25
Q

a client is perscribed a beta 2 aganoist and an inhaled glucocorticoid what one should they take first ?

A

beta 2 aganoist. so the airway will open up

26
Q

what are the main adverse effects of Beta2 agonists?

A

tachycardia, palpitations and nervousness

27
Q

Prototype for beta 2 agonists?

A

Albuterol (SABA)

28
Q

Blocking of the parasympathetic NS will cause

A

vasodilation

29
Q

What is the inhaled anticholinergics prototype?

A

Ipratropium (short acting)

30
Q

When do we use Xanthines?

A

for long term management of persistent asthma/COPD that is unresponsive to beta-agonists or inhaled corticosteroids

narrow therapeutic index

31
Q

What is Xanthines prototype?

A

theophyline

32
Q

When someone is having theophylline toxicity what are the levels and what will we commonly see?

A

anything about 20 is toxic and we would commonly see restlessness and insomnia.

33
Q

What are some contraindications of someone taking Xanthines? (theophylline)

A

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

34
Q

True/ False

Corticosteroids should be used for acute asthma attacks

A

FALSE

corticosteroids are used for the prevention of attacks in long term management of chronic asthma

35
Q

what are the adverse effects of a person using corticosteroids (beclomethasone)

A

short: hoarseness sore throat, dry mouth, and oral candidates (thrush) so rinse mouth *** on test

Long term: risk of osteoporosis, decreased growth in children

36
Q

Beclomethasone is the prototype for what class of meditation

A

Corticosteroid

37
Q

what is the prototype for Leukotriene receptor antagonists?

A

Zafirlukast

delayed onset and work by blocking leukotriene synthesis and suppressing inflammation

used in COPD, persistent chronic asthma, long term rhinitis

38
Q

What are some special directions when taking Leukotriene receptor antagonists (Zafirlukast)

A
  • do not take if liver is damaged
  • BBW for neuropsychiatric symptoms and suicidal ideations especially in children
  • take on an empty stomach
39
Q

what are mast cell stabilizers prototype and how do they work?

A

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

40
Q

vascular tissue is controlled by the Upper respiratory tract sympathetic NS

A

Constricts the arteries in the nose which reduces the thickness of the mucosal layer.

41
Q

what are the 2 categories of allergic rhinitis?

A

Preventers: used for prophylaxis
- include antihistamines, intranasal corticosteroids and mast cell stabilizer

Relleivers: immediate, temporary relief
- Oral and intranasal decongestants

42
Q

What are 1st generations antihistamines?

A

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

43
Q

What is the 2st generation antihistamine prototype?

A

Diphenhydramine (benadryl) used for allergic rhinitis

44
Q

What drugs can be used for asmatha and Allergic rhinitis ?

A

mast cell stabilizer (cromolyn)
anticholinergics (ipratropium nasal spray)
leukotriene receptor blocker (montelukast?)
Diphenhydramine (benadryl)

45
Q

What are sympathomimetics used from and what is their prototype?

A

They are decongestants

Phenylephrine: (intanasal)
Pseudoephedrine: (oral)

46
Q

what are antitussives and what is their prototype

A

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)

47
Q

When do we use expectorants and what is the prototype?

A

we use them for the common cold.

-Increases the productivity of cough to clear airwways

  • thins mucus
    better at treating dry cough

Prototype: Guaifenesin

48
Q

What is Vareniclin and its adverse effects?

A

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
49
Q

Physical dependence

A

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
50
Q

When is Disulfiram given?

A

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
51
Q

how does Disulfiram work?

A

irreversibility inhibits enzyme dehydrogenase causing toxic acetaldehyde to build up in the blood

chronic (7 decks)

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