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Pharm > Modules 7,8,9,10 > Flashcards

Modules 7,8,9,10 Flashcards

1
Q

Respiration

A

Process by which gases are exchanged

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2
Q

Ventilation

A

Process of moving air into and out of the Lungs

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3
Q

Upper Respiratory

A 
Tongue
Trachea
Epiglottis
Larynx
Uvula
Nasopharynx
Tonsils
Pharynx
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4
Q

Upper Respiratory Infections

A

Infectious Process of any component of the upper airway

Examples: Sinus Infection
Laryngitis
Rhinitis

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5
Q

Acute Rhinitis

A

Caused by rhinovirus

Main symptom is rhinorrhea

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6
Q

Allergic Rhinitis

A

Caused by foreign pathogens

Main symptom is rhinorrhea

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7
Q

Treatment for common cold?

A

Treat symptoms, comfort care essentially.

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8
Q

Expectorants

A

Used to thin bronchial secretions so they can more easily be eliminated by coughing

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9
Q

Guaifenesin

A
  • Expectorant category

- Most common side effect is drowsiness

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10
Q

Antitussives

A

Used to suppress the cough reflex ( usually dry or non-productive cough.)

Opioid and non opioids

risk of dependency with opiates

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11
Q

dextromethorphan

A
  • Antitussive
  • Non Opioid
  • Suppresses cough reflex by inhibiting the cough centre of the brain
  • Available over the counter at low doses, prescription for high doses
  • etc. Buckleys
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12
Q

Psychosis

A

Term used to describe loss of contact with reality

Not considered a disease but rather a symptom of a mental illness

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13
Q

Delusions

A

Firm ideas and beliefs that are false and not formed based on reality.
etc. being a king or a god.

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14
Q

Hallucinations

A

Involve: seeing, hearing, or feeling something that is not really there
hearing voices or seeing people that aren’t really there.

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15
Q

Cardiac Output

A

Volume of blood pumped by the heart in 1 minute

Stroke Volume x Heart rate = Cardiac Output

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16
Q

What is Blood Pressure

A

Pressure used to circulate blood through the body.

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17
Q

What does the body do to compensate for Low BP

A
  1. Sympathetic Response
    • Increase heart rate
    • Vasoconstriction
    • Increase heart contractility
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18
Q

What does the body do to compensate during High BP

A
  1. Activate parasympathetic
    • HR will decrease
    • Blood vessels will Dilate
    • Decrease in cardiac contractility
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19
Q

Renine

A

Enzym released by the kidneys in response to low bp

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20
Q

Angiotensin converting enzyme ( ACE )

A

Controls blood pressure by regulating the volume of fluids in the body
converts angiotensin 1 hormone into the angiotensin 2 hormone which is a vasoconstrictor.

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21
Q

Angiotensin

A

Peptide hormone that causes vasoconstriction and increase in blood pressure.

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22
Q

ADH

A

Anti-Diuretic Hormone that comes from the posterior pituitary

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23
Q

HDL(good cholesterol )

A

High density lipoprotein that contains the most apoprotein 50%

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24
Q

LDL(bad cholesterol)

A

Low density lipoprotein that contains the highest amount of cholesterol.

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25
Q

Cholesterol

A

Steroid that can cause atherosclerosis.

the body only needs small amounts of this steroid.

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26
Q

Non-pharmacologic ways to lower cholesterol

A
  • Limit Alcohol use to 2 standard drinks a day
  • Reduce saturated fats in diet
  • exercise plan
  • eliminate tobacco use.
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27
Q

Antilipemic drugs

A

Drugs that lower the levels of certain lipids in the blood

Statins
Bile acid resins

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28
Q

HMG-CoA reductase inhibitors ( statins)

A

First line drugs in the treatment of lipid disorders

Reduce blood LDL(bad ) lipid levels, increase HDL (good)

causes the liver to make less cholesterol.

Usually administered at night when cholesterol biosynthesis is higher.

atorvastatin, rosuvastatin

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29
Q

Left Sided Heart Failure Symptoms

A

Shortness of Breath
Cough
Fluid in Lungs
Weakness

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30
Q

Right sided heart failure symptoms

A

Edema in lower extremities

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31
Q

ACE Inhibitor

A

Class of medication used for treating high BP and HF
relaxes blood vessels and decreases blood volume.

this causes a decrease o2 demand from the heart and lower BP

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32
Q

Diuretic

A

class of medication used to increase urinary output reducing blood volume and cardiac workload

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33
Q

What assessments should a nurse do prior to giving antitussive

A

History of respiratory distress, shortness of breath. Does the client know what antitussives do ?

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34
Q

For pneumonia do I want to give an expectorant or an Antitussive ?

A

Expectorant: this class of drug helps easily eliminate secretions.

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35
Q

Nasal Congestion

A

Happens when vessels in the nose dilate in response to infection or allergen

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36
Q

Decongestants

A

these cause a sympathetic response causing vasoconstriction.

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37
Q

Opiod antitussives

A

Used to increase the cough threshold in the CNS

etc: codeine

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38
Q

Teaching for clients with antitussives

A

Avoid driving because of drowsiness
avoid the use of alcohol can increase CNS depression
report if you cough up green or yellow secretions, difficulty breathing
store opioid antitussives away from children

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39
Q

Decongestant adverse effect

A 
Hypertension 
Tachycardia
Difficulty voiding
jittery
Hyperglycemia
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40
Q

Rebound Nasal congestion

A

constant congestion due to overuse of nasal sprays/drops/gels/ that contain decongestant medications.

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41
Q

Decongestant Examples

A

Ephedrine and pseudoephedrine

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42
Q

What is Histamine

A

inflammatory response compound involved in the immune system.
causes runny nose
watery eyes
vasodilation caucusing swelling

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43
Q

Antihistamine

A

Block histamine H1 receptors cause vasoconstriction decreasing swelling.

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44
Q

Diphenhydramine

A

1st gen antihistamine

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45
Q

Side effects of 1st generation antihistamines

A

drowsiness
GI upset
Dry mouth and eyes
weakness

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46
Q

Fexogenadrine and Loratadine

A

2nd Generation antihistamines

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47
Q

Before administering 1st gen antihistamine the nurse should..

A

vital signs

ECG in clients with history of heart disease because they cause vasodilation.

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48
Q

Before administering 2nd generation antihistamines the nurse should …

A

assess history of allergies, conjunctivitis.
baseline vital signs
breathing pattern
LOC

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49
Q

What do i teach a patient using diphenhydramine

A

don’t drive as this causes drowsiness
report any
don’t drink alcohol

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50
Q

Asthma

A

acute bronchospasm

acute inflammatory response causing secretions

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51
Q

Signs and symptoms of someone in respiratory distress

A 
Shortness of breath
anxiety
Low O2 stats
nasal flaring
tachycardia
increased respiratory rate
fatigue
use of accessory muscles
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52
Q

Reliever

A

Short acting

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53
Q

Controllers

A 
Daily medications controlling persistent symptoms
Long acting
anti-inflammatory effect
LABA ( Long Acting Beta2 agonist.)
LAAC(long acting anticholinergics)
LAMA (Long Acting Muscarinic antagonist)
ICS ( Inhaled coricosteroid)
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54
Q

PATIENT teaching for controllers

A

Needs to be taken daily even if symptoms are absent

not to be used for emergency asthma attacks

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55
Q

LABA Long acting beta2 adrenergic agonists

A

Relax smooth muscles in bronchi
increase bronchodilation

ETC : sameterol

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56
Q

LAAC long acting anticholinergics

A

relax smooth muscle in airway
COPD
used in combination with short acting for asthma

etc: tioropium bromide

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57
Q

ICS Inhaled Corticosteroids

A

Reduce inflammation

long term treatment and prevention of asthma attacks

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58
Q

Combination Medication

A

Combine long acting and short acting to decrease inflammation and dilate bronchioles

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59
Q

Relievers

A

Work to relax smooth muscles
only to be taken in acute respiratory distress
2-5 min between medication delivary

60
Q

SABA short acting beta2 adrenergic agonist

A

relaxs bronchiole smooth muscle

careful to administer to individuals with dysrhythmias

61
Q

Systemic Glucocorticoids

A

Given oral or IV
systemic action rather then localized
greater adverse effects

62
Q

Adverse effects of systemic glucocorticoids

A

Hyperglycemia
insomnia
growth suppression in children

63
Q

Adverse/ side effects of inhaled steroids

A

Mouth Irritation
thrush
upper respiratory tract infection

64
Q

Side effects of bronchodilators

A

Constipation, dry mouth, headache

65
Q

Adverse effects of bronchodilators

A

Tachycardia
hypertension
tremors
difficulty uirinating

66
Q

Patient teachings for inhalers

A

Rinse mouth

67
Q

Beta 2

A

Receptors on Lungs

68
Q

Beta 1

A

Receptors on heart

69
Q

Agonist

A

Working FOR causes action

70
Q

Antagonist

A

Working AGAINST blocks action

71
Q

Adrenergic

A

Stimulate the sympathetic nervous system

72
Q

Anticholinergic

A

inhibit parasympathetic nerve impulses by blocking acetylcholine causing sympathetic response

73
Q

Cholinergic

A

mimic or enhance acetylcholine neurotransmitters causing a parasympathetic response

74
Q

Signs and symptoms of someone in respiratory distress

A

Nasal flaring
shortness of breath
increase respiratory rate
use of accessory muscles

75
Q

Asthma is controlled by which meds

A

Corticoid steroids

Bronchodilators ( Beta 2 Agonist and Anticholinergics)

76
Q

COPD is controlled by which medications

A 
Corticoidsteroids
Bronchodilators ( Beta 2 Agonist and Anticholinergics)
Antibiotics
Expectorants
diuretics
Oxygen
77
Q

Reliever Medications

A

SAAC ( Short acting anticholinergics)
SABA ( short acting beta 2 agonist)
or combination of SAAC and SABA

78
Q

SAAC

A

Short acting anticholinergic

79
Q

SABA

A

Short acting beta 2 agonist

80
Q

Controller Medications

A

LABA (Long acting beta 2 agonist)
LAAC( Long acting anticholinergic)
LAMA ( Long acting muscarinic antagonist )
ICS ( inhaled corticoid steroid )

81
Q

LABA

A

Long Acting Beta 2 agonist

82
Q

LAAC

A

Long Acting anticholinergic

83
Q

LAMA

A

Long Acting Muscarinic Antagonist

84
Q

ICS

A

Inhaled Corticoidsteroid

85
Q

What are Controllers used for What are the medication catagories

A

Daily meds used to control persistent symptoms in lower respiratory disorders ( asthma and COPD)

long term controller
anti-inflammatory effect

LABA
LAAC
ICS
Combinations

86
Q

Why should clients take controllers even without symptoms?

A

To prevent symptoms from reoccuring

87
Q

Patient teaching for Controllers

A
  1. Continue to take even after symptoms have gone
  2. Overtime this will reduce inflammation and airway sensitivity to allergen
  3. Not to be used in acute asthma or COPD attacks
88
Q

Relievers work by

A

Relaxing smooth muscle and decreasing acute airway inflammation

Only be taken in acute respiratory distress

wait 2-5 minutes between meds

89
Q

Hyperlipidemia is controlled by which class of drugs?

A

Statins

90
Q

Hyperlipidemia

A

To man fats or lipids in the blood stream.

91
Q

Side Effects of statins?

A 
Myopthy 
Rhabdomyolysis
Nausea
heartburn
abdominal cramping
92
Q

Nursing considerations for statins

A

Monitor liver function
Assess for muscle pain, weakness and tenderness
Should not be used in women who are or who are planning on getting pregnant.
Monitor clients alcohol intake

93
Q

Patient teachings on statins

A

Maintaining a diet low in saturated fats
Avoid or limit alcohol
Report any symptoms of leg or muscle pain.

94
Q

Bile acid resins or sequestrants

A

Bind bile acids that contain cholesterol and accelerate the excretion
can reduce LDL levels but due to the side effects are not drug of choice.

95
Q

Dyslipidemia

A

Abnormal amount of lipids in the blood

96
Q

Side effects of Bile acid resins

A

Abdominal pain

Bloating

97
Q

Non-pharmacological management of angina

A

Limiting alcohol
treating high BP early
Not using tobacco
Eliminating foods high in cholesterol

98
Q

Pharmacological goal for clients with Angina

A
  • Slow heart rate down
  • Dilating veins so heart receives less blood
  • Causing the heart to contract with less force.
99
Q

3 classes of drugs used for Angina

A

Organic Nitrates
Beta-andrenergic blockers
Calcium channel blockers

100
Q

Organic Nitrate

A

Have the ability to relax both arterial and venous smooth muscles.
Two Types Slow acting and long acting.

101
Q

Short acting organic nitrate

A

Nitroglycerin

102
Q

side effects of organic nitrates

A

hypotension
Flush face
headache

103
Q

Beta-adrenergic Blockers

A

First line drug for chronic angina

work by decreasing the oxygen demands on the heart

104
Q

Negative chronotropic

A

Slowing heart rate down

105
Q

Negative inotropic

A

reducing conrtacitlity

106
Q

Patient teachings for Beta-andergenic blockers

A
  • Don’t abruptly stop medication as it could cause increase cardiac workload and worsen angina symptoms
  • If diabetic the medication can mimic hypoglycaemic symptoms so monitor blood glucose levels
  • change positions slowly report dizziness
107
Q

Side effects of Beta-andergenic blockers

A

fatigue
depression
lethargy

Can cause shortness of breath and respiratory distress in larger doses

108
Q

Nursing considerations for beta-andergenic blockers

A

Assess Vital signs
Monitor for shortness of breath
Monitor heart rate no less then 50 bpm at rest or 100bpm during exercise

109
Q

Calcium Channel Blockers

A

Relax arterial smooth muscle lowering BP
Decrease HR and cardiac workload by slowing the conduction velocity
Dilate coronary arteries increase O2 to the myocardium

110
Q

Nursing considerations for CA+ bLOCKERS

A

Assess BP
ECG if client has conduction issues
avoid grapefruit juice

111
Q

Adverse Effects of CA+ blockers

A

Bradycardia
hypotension
Heart Failure

112
Q

Adverse effects of Nitrates

A

Tachycardiaand hypotension

113
Q

Adverse effects of beta blockers

A

Bradycardia
hypotension
heartfailure
bronchoconstriction

114
Q

Patient teachings for calcium channel blockers

A

take BP before taking medication, don’t take if BP is too low
Keep a record of angina attacks
change positions slowly.

115
Q

Beta Blockers decrease cardiac contractility by…

A

Blocking the effects of epinephrine and norepinephrine

116
Q

Calcium channel blocker decreases cardiac contractility by..

A

Blocking the influx of calcium

117
Q

Nitrates decrease cardiac contractility by ?

A

causing vasodilatation which decreases preload.

118
Q

Thrombolytics

A

Dissolve clots obstructing coronary arteries and restore circulation to the myocardium.

119
Q

Thrombolytics work best when administered within what amount off time

A

20min - 12 hours after onset of MI

120
Q

Primary Risk of Thrombolytics

A

Excessive bleeding from interference with the normal clotting process

121
Q

Nursing Considerations for Thrombolytics

A
  • Monitor vital Signs
  • Hemoglobin and HCT labs should be assessed
  • Monitor for Dysarithmias
122
Q

Patient teachings with Thombolytics

A

Keep movement of IV sites to a min to prevent bleeding

decrease physical activity during infusion to a minimum

report right away any bleeding from gums, rectum or vagina during and for 4 days after infusion.

123
Q

Antiplatelets

A

suppress platelet aggregation

antiplatelet agents that Block adenosine diphosphate

124
Q

Heparin

A

Anticoagulant that is given after an MI has occurred to prevent future thrombi from forming.

125
Q

What do you monitor for with Calcium Channel Blockers

A

SOB
Frothy sputum
profound fatigue
swelling.

126
Q

Nursing considerations with ACE

A

Chronic dry cough

severe episodes of dry cough could indicate swell and angioedema

127
Q

What is tardive Dyskinesia sign or symptom?

A

Characterized by tongue thrusting and involuntary movements

128
Q

Extroprymidal EPS is characterized by movement disorders such as?

A

Pseudo parkinsonism
Dystonia
Akathisia

129
Q

Pseudo Parkinsonism

A

resembles symptoms of parkinson’s disease

130
Q

Dystonia

A

a state of abnormal tonicity or muscle spasm

131
Q

Akathisia

A

inability to sit still intense motor restlessness

132
Q

3 patient assessments to preform prior to administering an anticoagulant drug

A

PT, PTT, INR Labs

Antidotes

Assessment for bleeding

133
Q

3 teachings points to give to patient going home with fragmen ( heparin )

A

Avoid contact sports

report if gums bleed

injection sites must be sub Q

134
Q

Short acting Beta 2 agonist teachings on how to use inhlaler

A

Hold breath for 10 seconds after inhalation

and wait 2 full min before second inhalation

135
Q

Patient teachings

A 
Limit caffeine
report any 
sob
heart palpitations
vision changes
136
Q

Meds to manage Parkinson Disease

A

Restore dopamine functions(Dopamine agonist)

Black the effect of ACh (Anticholinergics)

137
Q

Dopaminergics

Levodopa

A

Increase are replace dopamine lost in Parkinsons disease

138
Q

Levodopa

A

Dopaminergic used for Parkinsons disease

Most effect medication for Parkinsons disease.

combined with carbidopa increases the effects of levodopa

139
Q

Side effects of Levodopa

A

Neusea

140
Q

Nursing considerations for Dopaminergics

A

Muscle twitching
dark urine
several months for full therapeutic effect

141
Q

Selective Serotonin Reuptake Inhibitor ( SSRI )

A

1st choice in anti depressants

works on serotonin and increases its levels

decreases the reabsorption process allowing serotonin to stay longer and increase the transmitter

prozac and citcalopram

142
Q

MAOI

A

3rd choice Antidepressant

work by inhibiting monoamine oxidase ( the enzyme that breaks down neurotransmitters

increases all 3 neurotransmitters

143
Q

Why can’t MAOIs not be taken with Tyromine?

A

tyrosine regulates BP

Risk of high BPand hypertensive crisis

144
Q

Adverse effects of antidepressants

A 
Sedation
hypotension
palpitations 
insomnia
confusion
145
Q

What is a life saving assessment for patients taking antidepressants ?

A

Do you want to kill or harm yourself?

Pharm (5 decks)

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