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RT210 > Lesson 9: Pharmacology > Flashcards

Lesson 9: Pharmacology Flashcards

1
Q

List the 3 uses for drugs:

A

Drugs are used for treatment, diagnosis, and prevention.

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2
Q

What is the chemical name of a drug?

A

The chemical name of a drug is the scientific name based on the compound’s chemical structure.

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3
Q

What is a generic name of a drug?

A

The generic name describes the active ingredient of the drug.

Ex: Tylenol is a trade (brand) name but Acetaminophen is the generic name of the drug.

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4
Q

What is the trade name of a drug?

A

A trade name is a brand name of a drug that is sold by a drug company under a specific name or trademark.

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5
Q

Describe what the side effect, half life, and tolerance of a drug is.

A

A side effect is anything other than the desired effect.

The half-life of a drug is the time taken for the plasma concentration of a drug to reduce to half its original value in the body.

Drug tolerance is a condition where the body gets used to the drug so either more is needed or something different is needed. This describes how low or high of a dose someone may need.

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6
Q

Describe what the additive effects, potentiation, and synergism of a drug is.

A

Additive effects describes the combining of two drugs to get the desired effect. The sum of the effect equals the two individual chemical effects combined.

Potentiation is the action of two drugs when the total affects are greater than one.

Synergism describes the interaction of two or more drugs when their combined effect is greater than the sum of the effects that are seen when the drug is given alone.

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7
Q

List the 6 things that must be checked before administering a drug to a patient.

A

The chart, name band, med label, dosage, response to previous Rx, exp. date(or opening).

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8
Q

List the 7 normal routes of administration from fastest to slowest.

A

IV, Inhale, IM, Sub Q, , sublingual or rectal absorption, oral, and topical.

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9
Q

What is the ratio of grams to solute and what does it mean? How many mg is in 1ml of 1% of solution?

A

1:200 means 1g of solute to 200 grams of solvent; 10mg.

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10
Q

What does cAMP cause?

A

Bronchial relaxation

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11
Q

List the prescription requirements.

A

Pt name, drug name, dose, frequency, route of administration and physician signature.

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12
Q

What are the 3 adrenergic receptors and what do they affect?

A

B1 affects the heart, B2 affects the lungs, and alpha is a vasoconstrictor so it affects the blood vessels.

SN: Remember that you have ONE heart (B1) and TWO lungs (B2).

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13
Q

What does stimulation of alpha and beta receptors cause?

A

Alpha is a vasoconstrictor and causes BP to increase.

B1 increases the HR and causes myocardial contractility.

B2 relaxes bronchial smooth muscle, stimulates mucociliary activity, and has some inhibitory action on inflammatory mediator release.

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14
Q

List the effects of adrenergics.

A

Palpitations, anxiety, tachycardia, tremor, hypertension, weakness, restlessness, dizziness, palor, and fear.

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15
Q

A _____ exerts a biological effect.

A

Drug

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16
Q

What are the drugs that are usually given during a code (ACLS Drugs)?
Hint: ALIENV

A 
Atropine
Lidocaine
Isuprel
Epinephrine
Narcan
Versed/Valium

Remember the acronym ALIENV for ACLS drugs!

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17
Q

List the trade name, generic name, concentration, receptor effects, duration, and dosage of Isoproterenol HCL.

A 
Trade: Isuprel.
 Generic: Isoproterenol HCL
 Alpha: 0
 B1: 4+,
B2: 4+ 
duration: short, 
dosage: .25 - .5ml q4h.
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18
Q

List the trade name, generic name, concentration, receptor effects, duration, and dosage of Isoetharine.

A 
Trade: Bronkosol 
Generic: Isoetharine
Concentration: 1% solution
Alpha: 0
B1: 1
B2: 3
Duration: medium
Dosage: .5cc, max: 1.0
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19
Q

List the trade name, generic name, concentration, receptor effects, duration, and dosage of Metaproterenol Sulfate.

A 
Trade:
a. Alupent   b. Metaprel
Generic: Metaproterenol sulfate
Concentration: n/a
Alpha: 0
B1: 2+
B2: 2+
Duration: up to 6h
Dosage: .25 - .3ml Max: .3ml
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20
Q

List the trade name, generic name, concentration, receptor effects, duration, and dosage of Racemic Epinenephrine.

A 
Trade:
a. Vaponephrine b. micronephrine.  c. asthaneprhine
Generic: Racemic Epinenephrine
Concentration: n/a
Alpha: 2+
B1: 3+
B2: 2+
Duration: 1 - 1 1/2h 
Dosage: .25 - .75ml Max: 1ml
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21
Q

List the trade name, generic name, concentration, receptor effects, duration, and dosage of Epinephrine HCL.

A 
Trade: Adrenaline
Generic: Epinephrine HCL
Concentration: n/a
Alpha: 3+
B1: 4+
B2: 3+
Duration: short
Dosage: .25cc Max: 5cc
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22
Q

List the trade name, generic name, concentration, receptor effects, duration, and dosage of Albuterol.

A 
Trade: a. Ventolin   b. Proventil
Generic: Albuterol
Concentration: n/a
Alpha: 0
B1: 1+
B2: 4+
Duration: long
Dosage:
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23
Q

List the trade name, generic name, concentration, receptor effects, duration, and dosage of Terbutaline sulfate.

A 
Trade: a. Bricanyl    b. brethine
Generic: Terbutaline SulfatE
Concentration: n/a
Alpha: 0
B1: 1+
B2: 3+
Duration: long
Dosage: 1ml or 1cc Max: 2 1/2 ml
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24
Q

/When do you stop treatment

A

When the HR goes up by 20 during treatment, of pt complains of dizziness, lightheadedness or if the pt asks for it to be stopped.

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25
Q

What medication is used to treat stridor?

A

Racemic epinephrine

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26
Q

What are xanthines and what do they do? List two.

A

Xanthines are drugs that are used to treat bronchospasm caused by lung conditions like COPD, asthma, etc.

They also inhibit phosphodiesterase thus increasing cAMP which promotes bronchial relaxation.

Rx: Theophylline - po ; Aminopyliline - IV

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27
Q

What are the most commonly used devices to administer orally or nasally inhaled aerosols?

A

MDI, DPI, SVN, and a soft mist inhaler(Resimat)

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28
Q

What is the pharmacokinetic phase?

A

Describes the time course and disposition of a drug in the body based on its absorption, distribution, metabolism, and elimination.

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29
Q

What is the pharmacodynamic phase?

A

Describes the mechanisms of drug action by which a drug molecule causes its effect on in the body.

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30
Q

There are ___________(adrenergic) and __________(cholinergic) receptors in the lung.

A

Sympathetic; parasympathetic

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31
Q

What is the usual neurotransmitter in the sympathetic system?

A

Norepinephrine

32
Q

What is the usual neurotransmitter in the parasympathetic system?

A

Acetylcholine

33
Q

What is the difference between agonists and antagonists?

A

Agonists are stimulating agents whereas antagonist are blocking agents.

34
Q

What is an adrenergic and antiadrenergic drug?

A

Adrenergic drugs are drugs that stimulate a receptor responding to norepinephrine or epinephrine.

A anti adrenergic drug is a drug that blocks a receptor for norepinephrine and epinephrine.

35
Q

What is a cholinergic and anticholinergic drug?

A

A cholinergic drug is a drug that stimulates a receptor for acetylcholine.

A anticholinergic drug is a drug that blocks a receptor for acetylcholine

36
Q

Which group of drugs represent the largest group of drugs among the aerosolized agents that are used for oral inhalation?

A

Adrenergic bronchodilators

37
Q

What are the indications for adrenergic bronchodilators? What disease are they used in?

A

Presence of reversible airflow obstruction. The most common use of these agents is to improve flow rates in asthma, acute and chronic bronchitis, emphysema, bronchiectasis, cystic fibrosis, and other obstructive airways states.

38
Q

Short-acting B2 agonists are indicated for relief of acute reversible airflow obstruction in obstructive airways disease like asthma.

Name some Short-acting B2 agonists (adrenergic bronchodilators)

A

Albuterol(proventil, ventolin); levalbuterol(xopenex)

39
Q

Indications for long acting adrenergic bronchodilator agents?

A

Indicated for maintenance bronchodilation, control of bronchospasm, and the treatment of nocturnal symptoms in asthma or other obstructive diseases such as COPD.

40
Q

List some long acting adrenergic bronchodilator agents?

A

Salmeterol(serevent diskus), formoterol(peeforomist)

41
Q

When is racemic epinephrine(Asthmanefrin) often used and what is the route of admin used?

A

Often used by inhaled aerosols or direct lung instillation for its strong vasoconstricting effect

42
Q

What disease is racemic epinephrine used on?

A

It is used to reduce airway swelling after exit at ion or during epiglottis or croup or to control airways bleeding during endoscopy.

43
Q

List the three receptor sites and what they cause.

A

Beta-1: increases HR, and myocardial contractility

Beta-2: relaxes bronchial smooth muscle, stimulates mucocilliary activity, and has some inhibitory action on inflammatory mediator release.

Alpha: is a vasoconstrictor and it increases BP

44
Q

The duration of action of salmeterol is ___.

A

12h

45
Q

True or false?

Salmeterol is used for acute respiratory airflow obstruction or bronchospams and is best used alone.

A

False

Explanation: Since it’s onset is longer than 20mins w/ a peak effect occurring by 3-5h it’s better used as a maintenance.

LABA are not to be used alone in treating asthma and are best used in combination with inhaled corticosteroids.

46
Q

Potential adverse effects with the use of adrenergic bronchodilators include:

A

Dizziness, hypokalemia, loss of bronchoprotection, nausea, tolerance(tachyphylaxis), worsening ventilation/perfusion (V/Q) ratio,l

47
Q

True or false?

A cholinergic blocking agent is effective only if bronchoconstriction exists due to cholinergic activity.

A

True

48
Q

True or false?

Anticholinergic agents have been found to be as effective as B agonists in airflow improvement in asthma but less so in COPD.

A

False.

It is more effective in COPD than asthma

49
Q

List a anticholinergic bronchodilator agent

A

Ipratropium bromide(atrovent)

50
Q

Indications for anticholinergic bronchodilators:

A

These agents are indicated as bronchodilators for maintenance treatment in COPD, including chronic bronchitis and emphysema.

51
Q

List some adrenergic+anticholinergic combinations and their uses.

A

Ipratropium bromide + albuterol = DuoNeb, combivent, respimat) and is used for patients with COPD receiving regular treatment who require additional bronchodilation for relief of airflow obstruction.

52
Q

The two agents approved in the U.S. for oral inhalation with an effect on mucus are _____ and ____.

A

N-acetylcysteine(10%: Mucomyst, 20%: Pulmozyme) and Dornase Alfa(pulmozyme).

53
Q

How is NAC (N-acetyl) usually given?

A

By either nebulization or direct tracheal instillation

54
Q

Dornase Alfa (pulmozyme) is used for what type of patients?

A

CF patients

55
Q

True or false?

N-acetylcysteine is a mucolytic that breaks down mucus and is effective for treating airway disease.

A

False! It is a mucolytic that breaks down mucus BUT efficacy has not been demonstrated for any lung disease.

56
Q

Why is NAC less used in patients with hypersecretory states?

A

Because the drug is irritating to the airway and can produce bronchospasm especially in those with asthma or hyper reactive airways.

57
Q

Since NAC may cause bronchospams to reduce the occurrence which solution of NAC could be used?

A

To reduce the occurrence of bronchospasm, use of 10% solution (mucomyst) can be used rather than the 20%(pulmozyme) since it is less hypertonic.

58
Q

What are some side effects of Dornase Alfa (pulmozyme).

A

Pharyngitis, voice alteration, laryngitis, rash, chest pain, and conjunctivitis.

59
Q

EXTRA KNOWLEDGE!

FLIP! FLIP! FLIP!

A

Bland aerosols of water, including distilled water and isotonic,hypertonic, and hypotonic saline have traditionally been nebulized to improve the mobilization of secretions in respiratory disease states.

60
Q

Corticosteroids are hormones produced in the adrenal cortex that regulate basic metabolic functions in the body and exert an __________ effect.

A

Anti inflammatory

61
Q

What is the primary use of orally inhaled corticosteroids?

A

Anti inflammatory maintenance therapy of persistent asthma and severe COPD.

62
Q

True or false?

After a patient received inhaled corticosteroids, they should always rinse their mouth with water and spit at the conclusion of the therapy to prevent local effects of oral candidiasis and dysphonia.

A

True

63
Q

What is the indication for use with nonsteroidal antiasthma drugs?

A

The general indication for the clinical use of nonsteroidal antiasthma agents is prophylactic management (control) of persistent asthma.

64
Q

List some prophylactics:

A

Advair, Tilade, and Intal

65
Q

_____________ also known as NebuPent is an anti protozoan agent that has been used in the treatment of opportunistic pneumonia caused by pneumocystic jirovecii which causes PJP that is seen in immuno compromised patients such as those with AIDS.

A

Pentamidine isethionate

66
Q

List some inhaled anti infective agents:

A

Pentamidine isethionate (NebuPent), Ribavirin(Virazole) , Tobramycin(TOBI)

67
Q

Orally inhaled aerosol drug classes include:

A

B-agonist bronchodilators, anticholinergic bronchodilators, mucolytics, corticosteroids, nonsteroidal antiasthma drugs, antiinfective agents, and anti-pulmonary hypertension agents.

68
Q

B-agonist and antocholinergic bronchodilators are used to reverse or improve ______ ______.

A

Airway obstruction

69
Q

True or false?

Mucolytics are used to reduce viscosity and improve mucociliary clearance.

A

True

70
Q

What are corticosteroids and nonsteroidal antiasthma agents used for?

A

They are used to reduce or prevent airway inflammation in asthma

71
Q

The anti infective agent __________(NebuPent) is used to treat PJP, especially in patients with ___________ syndrome.

A

Pentamidine; acquired immunodeficiency

72
Q

Agents that are used in asthma that provide quick relief include which short acting B agonists and what else?

A

Albuterol and levalbuterol and cholinergic bronchodilators

73
Q

What is Ribavirin?

A

Ribavirin is an antiviral agent that treats RSV(respiratory syncytial virus) in infants

74
Q

List the equipment that is used for administering inhaled medication:

A

Small volume nebs: SVN, HHN, HFN
Metered dose inhalers(MDI)
Dry powder inhalers (DPI)
Spacers(chambers)

75
Q

List all the wetting agents and their function.

A

Distilled water, isotonic saline, hypertonic saline, and hypotonic saline are all diluents that are nebulized to improve the mobilization of secretions in respiratory disease states.

76
Q

What is Tachyphylaxis?

A

Rapidly developing tolerance

77
Q

What are the 3 channels?

A

Front door: adrenergic
Back door: anticholenergic
Side door: xanthines

RT210 (4 decks)

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