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Lab > Midterm > Flashcards

Midterm Flashcards

1
Q

Clinical kinetics

A

Application of PK principles for safe and effective therapeutic drug management in individual pts

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2
Q

Therapeutic drug monitoring

A

Use of assay procedures to determine drug concentrations in plasma for developing safe and effective drug regimens

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2
Q

Goals of clinical kinetics

A

Enhance efficacy
Decrease toxicity

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3
Q

Interpatient variability causes

A

Variations in drug:
Absorption
Distribution
Metabolism
Disease states
Drug interactions

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4
Q

When is therapeutic monitoring valuable?

A

Good correlation between pharmacologic response and plasma concentration

Wide intersubject variation

Narrow TI

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5
Q

Drug concentration formula

A

(Amount of drug in body) / (volume in which drug is distributed)

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5
Q

Process of therapeutic drug monitoring

A

Diagnosis
Drug selection
Dosage regimen
Administration
Concentration measurement
Model application
Dose adjustment

(Don’t Do Drugs At College. Might Die)

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6
Q

Volume of distribution

A

Measure of drug distribution throughout the body

Large volume = wide distribution

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7
Q

When does the peak drug level occur?

A

30 min - 1 hr after admin

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8
Q

When does the drug level trough occur?

A

Immediately prior to next dose

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8
Q

SBAR communication framework

A

Situation
Background
Assessment
Recommendation

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9
Q

Pharmacist role in clinical PK

A

Designing pt specific dosage regimens

Monitoring & adjusting doses

Evaluating unusual pt responses

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10
Q

Standards of effective communication

A

Clear
Complete
Brief
Timely

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11
Q

Common barriers to interprofessional communication

A

Generational differences
Culture
Language differences
Personal values
Hiearchy

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12
Q

Drug level collection timing considerations

A
  • Steady state status
  • Peak/trough/random level needed
  • Drug-lab interactions
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12
Q

General rules for team communication

A

Keep it concise
Include relevant info
Stick to facts
Avoid arrogance & judgement

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13
Q

Medication Administration Record (MAR)

A

Tool used to document and track med admin in healthcare settings

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14
Q

Options when drug level is not collected properly

A

Delay dose
Retime level
Order random level (rare)

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15
Q

Sources for clinical kinetic info

A

Lexi-comp
Micromedex
Other pharm resources

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16
Q

Number of marketed OTC meds

A

Over 300,000 in different therapeutic classes

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16
Q

Self-care

A

Preventing, diagnosing, and treating one’s own illnesses without professional advice

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17
Q

OTC medication market value

A

$102B annually in US healthcare system

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18
Q

OTC medicine categories

A
  • Respiratory
  • GI
  • Ophthalmic
  • Otic
  • Dermatologic/reproductive/
    genital disorders
  • Pain & fever

(Really GOOD Party)

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19
Q

OTC product sales increase

A

From $2B in 1965 to $17B in 2012

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20
Q

Average pharmacist OTC recommendations per week

A

29

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21
Q

Percentage of consumers who purchase pharmacist recommended OTC products

A

81%

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22
Q

Primary reason patients choose OTC meds

A

Convenience

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23
Q

Annual savings from increased OTC med use

A

$5.2B for consumers and taxpayers

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24
Q

What is QUEST/SCHOLAR? (Not what does it stand for)

A

Structured approach for pharmacists to counsel pts on self care

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25
Q

Low health literacy

A

Pt barrier to effective communication and self care

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26
Q

Lack of training

A

Clinician barrier to effective communication and self care

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27
Q

Lack of privacy

A

A healthcare setting barrier to effective communication and self care

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28
Q

Tamper evident packaging

A

Safety feature to protect consumers against criminal tampering

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29
Q

OTC drug facts label regulation publication date

A

March 1999

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30
Q

Number of OTC drug products affected by labeling rule

A

More than 100,000

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31
Q

Dietary supplements labeling

A

Regulated as food products with supplement facts panel

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32
Q

Ibuprofen overdose case

A

3 year old given incorrect dose due to babysitter’s measuring device

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33
Q

PSE misuse case

A

23 year old woman took four 240mg tabs in 8 hours instead of one per 24 hours

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33
Q

What percentage of OTC drugs are purchased by older Americans?

A

Almost 30%

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34
Q

What are the components of a drug facts label

A

Active ingredients
Purpose
Uses
Warnings
Dosage instructions
Inactive ingredients

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35
Q

OTC product info sources

A

Product labels
Lexicomp

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36
Q

What are the 5 vital signs

A

Temperature
HR
Respiratory rate
Oxygen saturation
BP

(THROB)

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37
Q

BP measurement preparation

A

Pt seated and rested for 5 min

No caffeine/nicotine/alcohol for 30 min prior

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38
Q

Proper cuff fit for BP

A

Index line between range lines

Bladder encircles 80% of arm

Width at least 1/2 arm circumference

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39
Q

Korotkoff sounds

A

Used to obtain systolic and diastolic BP measurements

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40
Q

Tachycardia

A

HR > 100 bpm

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41
Q

Normal oral temp range

A

95.9 - 99.5

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41
Q

Normal respiratory rate

A

8-16 breaths/min

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41
Q

Bradycardia

A

HR < 60 bpm

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41
Q

Tachypnea

A

Respiratory rate > 16 breaths/min

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42
Q

Bradypnea

A

Respiratory rate < 8 breaths/min

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43
Q

Fever threshold for oral temp

A

> 100*F

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44
Q

Fever threshold for rectal temp

A

> 101.8*F

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44
Q

Normal rectal temp range

A

97.9-100.4

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45
Q

What are the advantages of taking temperature rectally?

A

Closest to core temp
Preferred if < 6 months

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46
Q

Normal axillary temp range

A

94.5-99

47
Q

Tympanic temp accuracy

A

More accurate in adults than oral or axillary

48
Q

Normal tympanic temp range

A

96.4 - 100.4

48
Q

Temporal temp sensitivity

A

More sensitive than tympanic for detecting fever

49
Q

Sensitivity in lab tests

A

Probability of a positive result if the pt truly has the disease

50
Q

Specificity in lab tests

A

Probability of a negative result if the pt does NOT have the disease

50
Q

Positive predictive value

A

Probability that a pt w/ a positive test result actually has the disease

51
Q

Negative predictive value

A

Probability that a pt w/ a negative test result does NOT have the disease

51
Q

Biopsychosocial model

A

Concept that a pt’s health is influenced by multiple interacting factors within dynamic systems

52
Q

Clinical reasoning

A

Process of integrating clinical info, preferences, medical knowledge, and contextual factors to make pt care decisions

52
Q

Components of a medication list

A

Frequency
Purpose
Dose
Special notes
Name
Route

(Filling People’s Drugs? Sorry, No Refills)

52
Q

What is the purpose of a personal medication record?

A

Decrease med related adverse events

Core component of med therapy management

53
Q

Collect (PPCP)

A
  • Gather pt info
  • List diagnoses
  • Relevant data for each condition
53
Q

Assess (PPCP)

A

Evaluation collected information to ID drug therapy problems and prioritize issues

53
Q

Pharmacist Patient Care Process

A

Orderly process with steps:
Collect
Assess
Plan
Implement
Follow-up

53
Q

Implement (PPCP)

A

Execute chosen strategies, including med orders & pt education

53
Q

Plan (PPCP)

A

Create SMART goals and generate strategies for each prioritized problem

54
Q

Follow-up (PPCP)

A

Develop monitoring plan and evaluate outcomes for each problem

55
Q

Drug therapy problems

A

Seven categories including unnecessary therapy, need for additional therapy, an ineffective drug

55
Q

SMART goals

A

Pt centered objectives that are:

Specific
Measurable
Achievable
Relevant
Time-bound

56
Q

Diagnostic reasoning

A

Process of determining the cause or nature of a problem/solution

57
Q

Therapeutic reasoning

A

Process involved in pt management and treatment decisions

58
Q

Medication efficacy

A

Evaluation of how well a drug achieves its intended purposes

58
Q

Medication safety

A

Assessment of potential risks and adverse effects associated w/ drug therapy

58
Q

Good clinical reasoning

A

Provides adequate and true explanations w/ logically strong, complete, and informative hypotheses

59
Q

Adherence

A

Pt’s consistency in following prescribed treatment regimens

59
Q

Drug therapy problem: unnecessary drug therapy

A

Pt taking medication without valid indication

60
Q

Preventative care

A

Measures taken to prevent illness or disease before they occur

61
Q

Drug therapy problem: needs additional therapy

A

Pt requires additional medication

62
Q

Drug therapy problem: ineffective drug

A

Medication is not producing the desired therapeutic effect

63
Q

Drug therapy problem: dosage too low

A

Dose insufficient to achieve therapeutic goals

63
Q

Drug therapy problem: adverse drug reaction

A

Unwanted/harmful effects from med use

64
Q

Drug therapy problem: Dosage too high

A

Dose exceeds safe/effective levels

65
Q

Drug therapy problem: Inappropriate adherence

A

Pt not following regimen as prescribed

66
Q

Pt centered issues in treatment selection

A

Cost
Safety
Efficacy
Evidence
Adherence ability

(Can’t SEE Anything)

67
Q

Monitoring parameters

A

Specific indicators used to evaluate treatment effectiveness and safety over time

68
Q

Clinical reasoning in pharmacy practice

A

Application of critical thinking to investigate, understand, and resolve drug therapy problems

69
Q

How should capsules be stored?

A

In tight containers w/ constant, adequate humidity

69
Q

Capsule shell materials

A

Gelatin
Starch
Cellulose polymers

70
Q

What is the largest capsule size for humans?

A

00

71
Q

How do you decide what size capsules to use

A

Based on weight of powder to be filled

Use capsule capacity table to determine

72
Q

When compounding capsules, how much extra powder do you make?

A

10% to account for loss

73
Q

Minimal weighable qty (MWQ)

A

Minimum amount that can be accurately weighed on a balance

74
Q

When do you prepare an aliquot?

A

When drug amount is below the MWQ of the balance

75
Q

How do you determine how much diluent you need in capsules?

A

Compare total powder amount to capsule capacity

76
Q

Steps to create an aliquot

A
  1. Weigh allowable amount of drug
  2. Add diluent
  3. Mix homogeneously
  4. Measure desired amount
77
Q

Capsule filling methods

A

Hand punch
Capsule machine

78
Q

What is the advantage of a capsule machine?

A

Quicker for large batches

79
Q

Hand punching capsules process

A

Create powder bed
Punch capsules
Fill
Cap

79
Q

What is the disadvantage of a capsule machine?

A

May waste more powder

80
Q

Quality control for capsules

A

Weigh to ensure within 5% of desired weight

81
Q

BUD if using a manufactured product for the AI

A

25% of remaining time until exp or 6 months (whichever is earlier)

82
Q

BUD if using USP or NF substance (bulk powder)

A

6 months

83
Q

Compounding record essential components

A

Name
Qty
Therapeutic use
Dosage form
Route
BUD
Ingredients
Strength

(Never Quit Taking Down RBI Stats)

84
Q

Geometric dilution

A

Technique for mixing powders to ensure uniform distribution

85
Q

Auxiliary label for phenobarbital containing capsules

A

Do not use heavy machinery

86
Q

Quality control data in compounding

A

Weight of empty and filled capsules

87
Q

Infestation

A

Parasitic disease caused by animals such as arthropods and worms

88
Q

Infection

A

Condition caused by protozoa, fungi, bacteria, or viruses

89
Q

Head lice transmission

A

Direct contact w/ infested head or shared items like combs and hats

90
Q

Nits

A

Eggs laid by female lice
Hatch in 7-8 days

91
Q

Pruritus in head lice

A

Most common symptom
Allergic reaction to live saliva

92
Q

First line therapy for head lice

A

Permethrin

93
Q

Non-pharmacologic head lice management

A

Change clothing daily
Treat infested items
Wash hair tools

94
Q

Mosquito bite effects

A
  • Welt
  • Itching
  • Potential urticaria reactions and systemic symptoms

(WIP)

95
Q

Flea bite characteristics

A

Multiple, grouped, often on legs and ankles

96
Q

Insect bite prevention

A

Use of insect repellent

97
Q

Bed bug hiding places

A

Crevices in walls, floors, bedding, suitcases

98
Q

Scabies causative agent

A

Sarcoptes scabiei mite

99
Q

Scabies transmission

A

Physical contact

100
Q

FDA approved scabicides

A

Lindane
Crotamiton
Permethrin
Spinosad

(Let Cassie Pass Stats)

101
Q

Tick removal method

A

CLEAN tweezers
Make sure the head is still attached to the tick
Must be done within 36 hours of attachment

102
Q

Lyme disease vector

A

Deer tick

103
Q

Rocky mountain spotted fever vector

A

Lone star tick

104
Q

Chigger myth

A

They burrow into the skin and stay there

105
Q

Life-threatening spider envenomations

A

Recluse and widow spiders

106
Q

Recluse spider bite initial management

A

Rest
Ice
Compression
Elevation

(RICE)

107
Q

Widow spider bite symptoms

A

Painful cramps
Abdominal muscle rigidity
Excruciating pain

108
Q

Pinworm transmission

A

Fecal-oral through ingestion of eggs

109
Q

OTC medication for pinworm infection

A

Pyrantel pamoate

110
Q

Pyrantel pamoate mechanism

A

Depolarizing neuromuscular agent that paralyzes adult worms

111
Q

Lyme disease symptoms

A

Bullseye rash
Acute headache
Tender urticarial lesions

(BAT)

112
Q

Rocky mountain spotted fever symptoms

A

Rash
Fever
Nausea/vomiting
Muscle pain
Headache

(Really Fucking Need Mental Help)

Lab (4 decks)

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