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Nursing 232 > MODUL 1 PART 3: PHARMACOLOGY > Flashcards

MODUL 1 PART 3: PHARMACOLOGY Flashcards

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1
Q

Acetaminophen
(Tylenol)

Class
Mechanism of Action
Assessments

A

T: Antipyretics (anti-fever), non-opiod analgesics

Treatment of mild pain, fever
Inhibits synthesis of prostaglandins, primarily in CNS.

Assessments: allergy, pain, fever

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2
Q

Acetylsalicylic Acid AKA?

Class
Mechanism of Action
Assessments

A

Aspirin

T: Antipyretics, nonopioid analgesic
P: salicylates

Inhibits prostaglandins production, producing analgesia and reduces inflammation/fever

Allergy, pain, fever, BP

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3
Q

Codeine

Class
Mechanism of Action
Assessments

A

T: antitussives, opioid analgesics
Allergy, cold and cough remedies;
P: opioid agonists

  • Manages mild to moderate pain
  • Binds to opiate receptors in the CNS = generalized CNS depression. Dec cough reflex. Dec GI motility

BP, RR, LOC
Bowel function (LBM)
Pain level

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4
Q

Diltiazem

A

T: antianginals, antiarrhythmics, antihypertensives
P: Calcium channel blockers

Inhibits transport of calcium into myocardial and vascular smooth muscle cells, causing inhibition of contraction

  • BP + pulse
  • Intake/output, daily weight,
  • Signs of HF (edema, rales, dyspnea, etc.)
  • Angina, arrhythmias
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5
Q

Enalapril

A

T: antihypertensives
P: ACE (angiotensin-converting enzyme) inhibitors

Block conversion of angiotensin I to the vasoconstritor angiotensin II. Also prevent the degredation of bradyknin and other vasodilatory prostaglandins. Also inc plasma renin levels + dec aldosterone levels.

(less fluid + less vasoconstriction)

  • BP + pulse
  • Signs of angioedema (dyspnea + facial swelling)
  • HF: weight + fluid overload (peripheral edema, rales, dyspnea, weight gain, jugular venous distension)
  • Kidney fx
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6
Q

Fentanyl

A

T: opioid analgesics
P: opioid agonists

Binds to opioid receptors in the CNS

  • Pain (before and 1 hr after)
  • BP, pulse + resps (if
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7
Q

Furosemide

A

T: diuretics
P: loop diuretics

Inhibits reabsorption of Na + Cl from loop of Henle and distal renal tubule. Inc excretion of water + electrolytes.

  • Weight, intake/output, edema, lung sounds
  • BP + pulse
  • Electrolytes
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8
Q

Hydromorphone

A

T: opioid analgesics
allergy, cold, and cough remedies (antitussives),
P: Opioid agonists

Binds to opiate receptors in CNS, Suppresses cough reflex.

  • BP, pulse + RR
  • LOC
  • Bowel function
  • Pain
  • Overdose:naloxone
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9
Q 
Insulin 
Humanlog (mixture) Lantus (long acting)
A

T: antidiabetics, hormones
P: pancreatics

Lower blood glucose by: stimulating glucose update in skeletal muscle + fat, inhibiting hepatic glucose production. Inhibition of lipolysis and proteolysis, enhanced protein synthesis

  • Signs of hypoglycemia (anxiety, mood changes, tingling, chills, confusion, cool, pale skin, LOC)
  • Body weight
  • Blood glucose Q6h
  • Overdose: severe hypoglycemia treated with IV glucose, glucagon, or epinephrine
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10
Q

Morphine

A

T: opioid analgesics
P: opioid agonist

Binds opiate receptors in CNS, generalized CNS depression

  • Pain (prior, 1hr after or 20mins for IV)
  • BP, pulse, RR (level of sedation), LOC
  • Bowel function
  • Overdose: naloxone
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11
Q

Morphine CR

A

T: opioid analgesics
P: opioid agonist

Used for pts who require round the clock pain relief and who have become tolerant to other opioids.

•Pain 
•BP, pulse, RR (level of sedation), 
LOC
•Bowel function
•Overdose: naloxone
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12
Q

Naloxone

A

T: antidotes (for opioids)
P: opioid antagonists

Competitively blocks the effects of opioids, including CNS and respiratory depression, w/o producing any agonist (opioid-like) effects

  • Resps
  • Pulse, BP, ECG
  • LOC for 3-4hr after the expected peak
  • Repeat doses may be necessary
  • Pain – will reverse analgesia
  • Signs of opioid withdrawal
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13
Q

Propanolol

A

T: antianginals, antiarrhythmics, antihypertensives, vascular headache suppressants
P: beta blockers

Blocks stimulation of beta (myocardial) and beta (pulmonary, vascular + uterine)-adrenergic receptor sites

•BP, pulse
- Signs of hypoglycemia in children
•ECG
•Signs of orthostatic hypotension when assisting to supine position
•Intake/output ratio
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14
Q

Warfarin

A

T: anticoagulants
P: coumarins

Interferes with hepatic synthesis of vitamin-K dependent clotting factors

•Bleeding/ hemorrhage (tarry black stools, hematuria, fall in Hct
•Stool + urine for occult blood
- CBC (platelets, possible HCt fall with bleeding)
•Lab: PT, INR, clotting factors (therapeutic ranges 1.3-1.5X greater)
•Hepatic function: ALT, AST, Bilirubin, Albumin

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15
Q

Sufix “olol” typically what class of drug?

A

Beta blocker

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16
Q

Suffix “pril” typically what kind of drug?

A

ACE inhibitor

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17
Q

Pharmacokinetics =

A

the study of absorption, distribution, biotransformation, and excretion of drugs
= what does the body does to the drug

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18
Q

Pharmacodynamics =

A

the mechanism of drugs action and relationships between drug concentration and the body’s response
= what the drug does to the body

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19
Q

Absorption =

A

Process by which drug passes into bloodstream

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20
Q

First Pass Effect =

A

Oral drug first passes through liver before entering systemic circulation ==> is partially metabolized, requires higher oral dosage for desired effect

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21
Q

Distribution =

A

transportation of drug from site of absorption to site of action

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22
Q

When a drug enters the blood, is carried to what organs predominantly?

A

Carried to most vascular organs (liver, kidneys + brain), skin + muscles

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23
Q

Metabolism of drug AKA x2?

What is metabolism?

A

1)Detoxification
2)Biotransformation
= process by which drug converted to less active form

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24
Q

Where does most drug metabolism occur?

A

Liver

may also occur in lungs, kidneys, blood, intestines

25
Q

Products of drug metabolism = ?

Are they active or inactive?

A

Metabolites

Can be active or inactive

26
Q

Excretion =

From where?

A

process by which metabolites + drugs eliminated from body

Most from kidneys, some in feces, breath, perspiration, saliva, breast milk

27
Q

4 elements of pharmacokinetics?

A

Absorption
Distribution
Metabolism
Excretion

28
Q

4 Liver fx tests?

A

ALT
AST
Bilirubin
Albumin

29
Q

ALT Test?

A

Alanine aminotransferase
Typically to detect liver injury, helps to detect liver disease + track progression of treatments
(Usually ordered in conjuction with AST)

30
Q

AST Test?

A
  • Usually ordered with ALT

- For detection of liver injury + disease

31
Q

Bilirubin

What is it?

Why is this measured?

Abnormal levels d/t?

A
  • Measured to diagnose and/or monitor liver disease
  • Bilirubin usually mostly secreted into bile by liver (from RBC breakdown)…small amounts remain circulating in blood
  • Low levels d/t liver damage or interference with the excretion into bile ducts
  • Typically ordered in conjuction with other liver fx tests
32
Q

Albumin

What is it?

When will you see high/low levels?

A

Plasma protein produced by liver - is one of most abundant proteins in blood plasma.

If your liver and/or kidneys are not working well, serum albumins won’t be at their normal levels

  • low levels d/t liver inactivity or malnutrition
33
Q

Frequency Distribution Curve

A

A frequency distribution curve is a type of descriptive statistics depicted as a graph that demonstrates the frequency of a given variable’s occurrence, where x represents some measure of the variable’s occurrence and y represents the number of cases at each frequency. With very large populations, a frequency distribution curve is said to resemble the statistical ideal of a bell curve and assumes the properties of a normal distribution

34
Q

Median effective dose

A

a dose that produces the desired effect in 50 per cent of a population.

35
Q

Median lethal dose

A

the quantity of an agent that will kill 50 per cent of the test subjects

36
Q

Therapeutic index

A

The ratio between the toxic dose and the therapeutic dose of a drug, used as a measure of the relative safety of the drug for a particular treatment

37
Q

Median toxicity dose:

A

the dosage expected to cause a toxic effect in half of the patients to whom it is given.

38
Q

Graded dose-response:

A

A response to a drug such that as the dose of drug increases the intensity of the response increases. A graded dose-response relationship can be measured on a continuous scale.

39
Q

Potency

A

Strength of a drug, Amount of drug required to produce an effect

40
Q

Efficacy

A

producing a desired effect

is the maximum response achievable from a drug

41
Q

Agonist

A

Molecules that activate receptors (neurotransmitters, hormones)

When drugs act as agonists they bind to the receptor and mimic the action of the body’s own regulatory molecules

42
Q

Antagonist

A

Produce their effects by preventing the activation of receptors by agonists

Can produce beneficial pharmacological effects by blocking:
Actions of endogenous molecules at receptor site
Actions of drugs at receptor sites

43
Q

Resistance

A

the reduction in effectiveness of a drug such as an antimicrobial, anthelmintic or an antineoplastic in curing a disease or condition. When the drug is not intended to kill or inhibit a pathogen, then the term is equivalent to dosage failure or drug tolerance.

44
Q

Considerations for drugs in infants =

A

small doses (body size + immaturity of liver + kidneys), different gastric acidity + liver enzymes required for drug metabolism = different drugs + doses given

45
Q

Considerations for pharmacodynamics/

pharmacokinetics for the elderly?

A
  • decreased liver + kidney function
  • consideration of drug interactions
  • dec gastric mobility + acidity = impaired drug absorption
  • inc adipose tissue + dec bodily fluid proportionate to body mass = inc risk of toxicity; fat soluble drugs move more readily into brain, often = dizziness + confusion (particularly with B blockers)
46
Q

Therapeutic classification =

A

How the drug is used in treating a particular disease

47
Q

Pharmacological Classification

A

how the drug works at the molecular, tissue, and body system level

48
Q

3 mains routes of drug admin?

A

1) Topical (skin, eyes, ears, nose, vaginal, lungs (inhalers))
2) Enteral (oral, sublingual, rectal)
3) Parenteral: IM, ID, IF, intrathecal, subQ

49
Q

Factors affecting pharmacokinetics + dynamics?

A
  • cardiovascular function
  • gastric (stomach lining)
  • renal, hepatic fx
  • dieases
  • drug interactions
  • diet
  • Age
  • Genetics
  • Gender (hormones)
50
Q

Antidote for acetaminophen?

A

acetylcysteine

51
Q

Onset of drug =

A

The time it takes for the drug to create a response

52
Q

Loading dose =

A

A higher amount of the drug given normally once or twice to “prime” the blood stream with a level sufficient to induce a therapeutic response.

53
Q

Maintenance Dose

A

Before plasma levels can drop back towards zero intermittent maintenance doses are given to keep the plasma drug levels in the therapeutic range.

54
Q

Peak (of a drug)

A

The time it takes for the drug to reach its maximum response

55
Q

Duration (of a drug)

A

The length of time that the drug concentration is sufficient to create a response.

56
Q

Pharmacogenetics =

A

the study of how the actions of and reactions to drugs vary with genes

57
Q

Therapeutic Drug Monitoring =

A

A process of measuring peak and trough levels of a drug in a person’s blood with the goal of adjusting the dosage to maximize the therapeutic effect (and minimize toxicity)

58
Q

7 Rights of Drug Admin

A 
Right client
Right medication
Right dose
Right route 
Right time 
Right documentation
Right reason
59
Q

Drugs that affect homeostasis?

A

= Those affecting inflammatory process, Immune response, or infection

Nursing 232 (12 decks)

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