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sophomore year slump > pharm 1 > Flashcards

pharm 1 Flashcards

1
Q

vancomycin indications for use

A

staph infections, drug resistant staph aureus and cardiac prophylaxis

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2
Q

vancomycin side effects

A

NVD
rash
chills
dizziness
fever
too rapid of an infusion–> red mans syndrome

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3
Q

tetracycline indications for use

A

uncommon gram + and gram - organisms
respiratory and skin infections
chlamydia
gonorrhea
syphilis

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4
Q

tetracycline patient education

A

caution with alcohol
don’t give to children under eight because they stain teeth

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5
Q

tetracycline side effects

A

NVD
rash
flatulence
abdominal discomfort
headache
photosensitivity
pruritus
heartburn
color vision changes

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6
Q

cefazolin

A

10% chance of cross sensitivity to penicillin do not give

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7
Q

ceclor

A

avoid alcohol for 72 hours after last dose

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8
Q

Penicillin and gentamicin: recommendations for IVPB

A

separate it by two hours

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9
Q

gentamicin: baseline labs, toxicity

A

need baseline renal function
ototoxicity (with loop diuretics)
nephrotoxicity (with furosemide and vancomycin)

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10
Q

cipro

A

tendon rupture
photosensitivity
nephritis
rash
fever
GI upset
palpitation
eosinophilia
headache
restlessness

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11
Q

TB (treatment, lab values

A

INH is used with pyrazinamide and rifampin
Monitor liver function- prophylactic therapy is contraindicated in liver disease because INH may cause liver damage
Assessment- past history of chest x-ray, eye exam, hepatic disease, baseline BUN, Cr, hearing changes
Planning- sputum culture first thing in morning x3 days

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12
Q

TB treatment education

A

INH 1 hour before meal or 2 hours after meals never with meal, avoid alcohol adhere to med schedule avoid pregnancy

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13
Q

TB adverse effects

A

Hepatotoxicity and chemical hepatitis
Peripheral neuropathies
Discolored body fluids
Optic neuritis
Pregnant people can take it (benefits outweigh the risks)

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14
Q

antivirals for herpes

A

Acyclovir
Cold sores, genital herpes, CMV, varicella

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15
Q

anyclovir side effects

A

NVD
rash
headache
tremors
lethargy
pruritus (itchy skin)

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16
Q

acyclovir cautions

A

Nursing mothers
Young children
Those with severe renal or hepatic disease

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17
Q

NPH

A

Intermediate-acting (contains protamine → prolongs action)
Onset 1-2 hours
Peak 4-12 hours (most at risk for hypoglycemia) plate at peak
Duration 14-24 hours

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18
Q

hypoglycemia

A

blood glucose <60
Headache, lightheaded
Nervous
Tremor
Slurred speech, memory lapse, confusion, seizures
Tachycardia
Diaphoresis (sweating, cold/clammy skin)

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19
Q

Glipizide

A

Oral antidiabetic (hypoglycemic) drug → sulfonylureas
Second-generation (more effective in lower doses than first generation): increase
tissue response to insulin and decrease glucose production by liver
Don’t use with liver or kidney disease

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20
Q

IV infiltration

A

Signs/Symptoms
Swelling, coolness, pallor, discomfort at site, slowed infusion rate, absence of blood return
Action
Discontinue IV and restart in another location
Apply warm soaks to decrease swelling
Prevention
Select a site that is over long bones that act as splints
Avoid sites over joints
Consider using manufactured stabilization devices

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21
Q

medicine

A

A drug used for therapeutic purposes to prevent, diagnose, treat, or cure disease

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22
Q

agonist drug interaction

A

activate receptors and have a desired response

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23
Q

additive drug interaction

A

two or more drugs that have a combined effect

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24
Q

Synergistic drug interaction

A

2 or more unlike drugs combined

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25
Potentiation drug interaction
2 drugs combined but only one is enhanced
26
antagonistic drug interaction
one drug diminishes or cancels the effect of the other, prevent receptor activation EX: give narcan for a drug overdose because it has an antagonistic effect
27
Pregnancy category C-1
severe risk Heroin LSD
28
Pregnancy category C-2
Very high risk Morphine Hydromorphone Adderall
29
Pregnancy category C-3
Moderate risk Sedatives (valium)
30
Pregnancy category C-4
Limited risk lorazepam
31
Pregnancy C-5
Lowered risk Antidiarrheics codeine
32
Nurses must record
Date and time of administration Patient name, prescriber name, nurses name Drug, amount, route administered
33
Nurses must ensure that (narcotics)
An accurate count of narcotics occurs each shift Narcotics are stored in double locked cabinets
34
Herbal products labeling
Name of supplement Amount of the supplement Nutrition labeling Ingredient list Name, place of manufacturer, packer, or distributor
35
Brand vs generic name
generic: nonproprietary name, assigned by the FDA (if unsure, look up in drug reference books brand: proprietary name, trademarked
36
Phases of research, preclinical testing
1-5 years, average 2.6 "in vitro" short term, in vivo animal studies long term and multigenerational animal stuudies
37
Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 1
pharmacokinetics/ usually healthy volunteers
38
Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 2
efficacy, dose range/ small select group of patients
39
Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 3
safety and efficacy/ larger select group of patients FDA approval
40
Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 4
Post marketing surveillance (by drug company)
41
Exceptions to clinical testing: compassionate use
since 1988, meds can be used with FDA permission in life-threatening situations before they are approved and without enrolling in a trial
42
Exceptions to clinical testing: Expedited process
meds targeted to public health threats may be used while still in phase 2 or 3 trials
43
Exceptions to clinical testing: orphan drugs
since 1983, companies are given tax and other incentives to develop and produce drugs for rare diseases
44
Z track administration
Used to minimize local skin irritation by sealing the medication into muscle tissue Displace skin and subcutaneous tissue 1-1.5 in, laterally, prior to injection and releasing needle immediately after injection, then release skin Colored medications
45
Heparin administration
SQ in the abdomen
46
Insulin administration preparation
*Regular insulin can also be given IV* Inject air into NPH Inject air into Regular Draw up Regular Draw up NPH
47
Intradermal administration
Local effect Site: lightly pigmented, free of lesions, hairless areas (ventral mid forearm, clavicular area, or scapular area) 10-15 degrees Allergy tests, TB tests
48
MDI administration
Insert medication canister into the holder (If used) insert the MDI into end of the spacer Shake the inhaler vigorously & remove cap Have the patient take a breath and exhale & exhale through mouth Close mouth around MDI or spacer (or position device 1-2 inches from mouth) Hold inhaler with the thumb at the mouthpiece & index & middle finger at the top Take a slow deep breakthrough the mouth and push the top of the canister once during inhalation Hold breath for 10 seconds & exhale slowly through pursed lips Wait 1-2 minutes for second dose When used first time or time has passed, spray into air to ensure function Wait five min between glucocorticoid and bronchodilator Check pulse Always have a spare inhaler Rinse mouth after use, especially if using a steroid Avoid smoking Daily cleaning of equipment with warm water and dry thoroughly
49
Patch administration
Clean site before administration Wash hands and wear gloves Do not cut patch Write date and time of administration on the patch Apply to clean, dry, preferably hairless, site Secure the patch with tape, not gauze to keep the patch visible and easy to find
50
Lotion application
Skin should be clean with soap and water Wash hands and wear gloves Do not contaminate the drugs in the container Use applicator or gloved hand to remove medication Apply thin coating of lotion Applied to the skin and may be covered with a dressing
51
Eye drops
Wash hands and wear gloves Gently pull down the skin below the eye to expose conjunctival sac Apply drops to the missile third of the sac Apply gentle pressure over lacrimal duct Avoid touching the vial tip to the eye or other surfaces
52
Ear Drops
Wash hands and wear gloves Ensure medications are room temperature Have patient sit up with head tilted to affected side Inspect the ear canal fir discharge before administering Instill at the side of the ear canal Do not contaminate the dropper <3 years, pull auricle down & back >3 years, pull auricle up & out
53
Drug considerations for the elderly
Drug dosages adjusted to weight, lab results - liver and renal, comorbidities due to slow tired organs Drug toxicity Problems with drug administration include lack of coordinated care recent Weight loss and decreased kidney function, reduction in water, diminished hepatic clearance, diuretics (volume depletion), bleeding from anticoags, GI irritation (often given a decreased dose of a drug)
54
Elderly considerations polypharmacy
Taking more than 5 medications Increased risk of drug toxicity Struggle to take meds Isolation Financial limitations Physical limitations No motivation
55
Elderly Absorptions
GI changes: Decreased swallowing Decreased smooth muscle intestine surface area Gastric emptying decreased hephatic flow decreased kidney functions
56
Pharmacodynamics in geriatric
Effects seen most frequently in CV and CNS Reduction in dopaminergic and cholinergic receptors and adrenergic receptors Reduced blood flow to brain more permeable blood brain barrier
57
Pregnancy category A
Most ideal med Little risk to fetus Studies have demonstrated little risk in first trimester and continuously in later trimesters
58
Pregnancy category B
Done on animals (not humans) failed to show risk to fetus but no human info
59
Pregnancy Category C
Animal studied show adverse effects no studies in human If benefits outweigh the risk, still go ahead
60
Pregnancy Category D
Risk to human fetus in human studies Given if benefits outweigh risk
61
Pregnancy Category X
Risks clearly outway benefits Not recommended
62
Pharmacokinetics first pass
Concerned about absorption with alcohol abuse Oral meds will travel from GI tract to liver via the portal vein. The liver will metabolize some drugs and result in an active form ex) lidocaine would metabolize almost 100% if taken orally In instances of liver disease, dose may need to be lowered because the patient will not metabolize as much Can also occur in the lungs, vasculature, GI tract, and other metabolically active tissues in the body
63
Nurse scope of practice and role in safety
Nurses shall not exceed their role, nurses must adhere to established drug control laws and protocols Cannot prescribe Cannot suggest drugs without proper training Educate, administer and assess reactions Responsible for drug security 6 rights of medication
64
Rights of medication
Right patient Right medication Right amount Right route Right time Documentation Assessment Education Evaluation Refusal
65
adverse reactions
harmful undesirable effects that are unexpected
66
side effects
Known that there are a possibly tiredness and drowsiness
67
medication error remadiation
Assess patients for adverse effects first notify prescriber ASAP Obtain appropriate orders to stabilize patient Notify nurse manager or supervisor Document steps taken in chart Complete incident report ASAP, usually within 24 hours
68
Dose response relationship Potency
Amount of drug that elicits a response
69
Dose response relationship Maximal efficacy
The point where the drugs dose will no longer increase the desired response
70
Dose relationship theraupeutic index
relationship between theraputic dose and toxic dose if there is a close relationship, there should be more monitoring
71
Drug relationship Drug toxicity
drug levels exceed therapeutic range Increase adverse effects
72
Drug relationship tolerance
decreased responsiveness to a drug need a higher dose for same desired effect
73
short half life
time it takes for a drug to be reduced in half Dependent on Amount prescribed Amount in the body from previous doses Metabolism Elimination
74
Nurses role in research
needing informed consent for research know whats being tested and what for Giving them the opportunity to not participate and leave at any time
75
Steps of pharmacodynamics
Absorption Disruption Metabolism Excretion
76
Pharmacotherapeutics
Therapy through pharmaceutical drugs
77
Synthroid levothyroxine general
Empty stomach preferably before breakfast Pregnancy category A Same time every day Lab value low T3 and T4 (T4 specifically) Monitor T3 and T4 very important Life long medication and never stop
78
Synthroid levothyroxine drug effects
Increase the effects of anticoagulants, tricyclic antidepressants, and vasopressors Decrease oral antidiabetic or insulin affects
79
Sinthroid Levothyroxine side effects
Headache NVD Cramps Tremors Nervousness insomnia weight loss
80
Sinthroid Levothyroxine adverse effects
tachycardia hypertension palpitations
81
Sinthroid levothyroxide life threatening effects
Thyroid crisis or storm, cardiac dysrhythmias, angina
82
sinthroid levothyroxide contraindication
history f MI with severe cardiac damage (ejection factor) renal disease
83
Sinthroid levothyroxide causious
Have cardiovascular disease (hypertension angina
84
Prednisone uses
Severe allergic reaction systemic anti inflammatory severe ulcerative colitis immunosuppression (transplant) secondary pain relief due to lower inflammatory response anti allergy dermatological disorders blood vessel permeability
85
Prednisone education
Taper it down from starting dose with acute condition, can not stop abruptly Lead to adrenal insufficiency and lack of epinephrine, glucocorticoids renal crisis
86
Prednisone side effects
Peptic ulcers eroding the line of the stomach Patients will have a moon face and trunk Thin skin easy ecchymotic Nausea diarrhea Increased appetite Headache Mood changes (depression and manifest in other ways) Flush, temperature changes Thin skin High susceptibility to bruising and skin tears Skin can come off with IV
87
Prednisone drug food lab
Hyperglycemia False positive for PPD With estrogen it increases prednisone GI toxicity with aspirin and NSAIDS Cardiac glycosides can lead to cardiac dysrhythmias
88
Prednisone adverse reactions
tachycardia osteoporosis muscle wasting
89
Prednisone life threating reactions
GI hemorrhage pancreatitis circulatory collapse decreases permeability of the blood vessels and the integrity of the blood vessels decrease)
90
Prednisone Contraindications
Very cautious with diabetes--> change insulin doses to compensate Psychosis (don't need more mood swings)
91
Indications of someone getting steroid IV clinical manifestations
Glaucoma Cataracts DM electrolyte imbalances muscle spasms hair growth hormone imbalances
92
Hypoglycemia managed in the hospital for those who don't get insulin at home
When under physiological stress they could need insulin in the hospital to monitor their blood sugar and may not go home on insulin, manage their hypoglycemics orally at home but get higher and their in the hospital to control it in normal limits as much as possible because hypoglycemia puts at risk for infection and other complications

sophomore year slump (3 decks)

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