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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
Q

Potentiation drug interaction

A

2 drugs combined but only one is enhanced

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26
Q

antagonistic drug interaction

A

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

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27
Q

Pregnancy category C-1

A

severe risk
Heroin
LSD

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28
Q

Pregnancy category C-2

A

Very high risk
Morphine
Hydromorphone
Adderall

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29
Q

Pregnancy category C-3

A

Moderate risk
Sedatives (valium)

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30
Q

Pregnancy category C-4

A

Limited risk
lorazepam

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31
Q

Pregnancy C-5

A

Lowered risk
Antidiarrheics
codeine

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32
Q

Nurses must record

A

Date and time of administration
Patient name, prescriber name, nurses name
Drug, amount, route administered

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33
Q

Nurses must ensure that (narcotics)

A

An accurate count of narcotics occurs each shift
Narcotics are stored in double locked cabinets

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34
Q

Herbal products labeling

A

Name of supplement
Amount of the supplement
Nutrition labeling
Ingredient list
Name, place of manufacturer, packer, or distributor

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35
Q

Brand vs generic name

A

generic: nonproprietary name, assigned by the FDA (if unsure, look up in drug reference books
brand: proprietary name, trademarked

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36
Q

Phases of research, preclinical testing

A

1-5 years, average 2.6
“in vitro”
short term, in vivo animal studies
long term and multigenerational animal stuudies

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37
Q

Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 1

A

pharmacokinetics/ usually healthy volunteers

38
Q

Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 2

A

efficacy, dose range/ small select group of patients

39
Q

Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 3

A

safety and efficacy/ larger select group of patients
FDA approval

40
Q

Phases of research: clinical testing (2-10 years, average 5.6 years) Phase 4

A

Post marketing surveillance (by drug company)

41
Q

Exceptions to clinical testing: compassionate use

A

since 1988, meds can be used with FDA permission in life-threatening situations before they are approved and without enrolling in a trial

42
Q

Exceptions to clinical testing: Expedited process

A

meds targeted to public health threats may be used while still in phase 2 or 3 trials

43
Q

Exceptions to clinical testing: orphan drugs

A

since 1983, companies are given tax and other incentives to develop and produce drugs for rare diseases

44
Q

Z track administration

A

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
Q

Heparin administration

A

SQ in the abdomen

46
Q

Insulin administration preparation

A

Regular insulin can also be given IV
Inject air into NPH
Inject air into Regular
Draw up Regular
Draw up NPH

47
Q

Intradermal administration

A

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
Q

MDI administration

A

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
Q

Patch administration

A

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
Q

Lotion application

A

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
Q

Eye drops

A

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
Q

Ear Drops

A

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
Q

Drug considerations for the elderly

A

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
Q

Elderly considerations polypharmacy

A

Taking more than 5 medications
Increased risk of drug toxicity
Struggle to take meds
Isolation
Financial limitations
Physical limitations
No motivation

55
Q

Elderly Absorptions

A

GI changes: Decreased swallowing
Decreased smooth muscle intestine surface area
Gastric emptying
decreased hephatic flow
decreased kidney functions

56
Q

Pharmacodynamics in geriatric

A

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
Q

Pregnancy category A

A

Most ideal med
Little risk to fetus
Studies have demonstrated little risk in first trimester and continuously in later trimesters

58
Q

Pregnancy category B

A

Done on animals (not humans) failed to show risk to fetus but no human info

59
Q

Pregnancy Category C

A

Animal studied show adverse effects no studies in human
If benefits outweigh the risk, still go ahead

60
Q

Pregnancy Category D

A

Risk to human fetus in human studies
Given if benefits outweigh risk

61
Q

Pregnancy Category X

A

Risks clearly outway benefits
Not recommended

62
Q

Pharmacokinetics first pass

A

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
Q

Nurse scope of practice and role in safety

A

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
Q

Rights of medication

A

Right patient
Right medication
Right amount
Right route
Right time
Documentation
Assessment
Education
Evaluation
Refusal

65
Q

adverse reactions

A

harmful undesirable effects that are unexpected

66
Q

side effects

A

Known that there are a possibly
tiredness and drowsiness

67
Q

medication error remadiation

A

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
Q

Dose response relationship Potency

A

Amount of drug that elicits a response

69
Q

Dose response relationship Maximal efficacy

A

The point where the drugs dose will no longer increase the desired response

70
Q

Dose relationship theraupeutic index

A

relationship between theraputic dose and toxic dose
if there is a close relationship, there should be more monitoring

71
Q

Drug relationship Drug toxicity

A

drug levels exceed therapeutic range
Increase adverse effects

72
Q

Drug relationship tolerance

A

decreased responsiveness to a drug
need a higher dose for same desired effect

73
Q

short half life

A

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
Q

Nurses role in research

A

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
Q

Steps of pharmacodynamics

A

Absorption
Disruption
Metabolism
Excretion

76
Q

Pharmacotherapeutics

A

Therapy through pharmaceutical drugs

77
Q

Synthroid levothyroxine general

A

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
Q

Synthroid levothyroxine drug effects

A

Increase the effects of anticoagulants, tricyclic antidepressants, and vasopressors
Decrease oral antidiabetic or insulin affects

79
Q

Sinthroid Levothyroxine side effects

A

Headache
NVD
Cramps
Tremors
Nervousness
insomnia
weight loss

80
Q

Sinthroid Levothyroxine adverse effects

A

tachycardia
hypertension
palpitations

81
Q

Sinthroid levothyroxide life threatening effects

A

Thyroid crisis or storm, cardiac dysrhythmias, angina

82
Q

sinthroid levothyroxide contraindication

A

history f MI with severe cardiac damage (ejection factor)
renal disease

83
Q

Sinthroid levothyroxide causious

A

Have cardiovascular disease (hypertension angina

84
Q

Prednisone uses

A

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
Q

Prednisone education

A

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
Q

Prednisone side effects

A

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
Q

Prednisone drug food lab

A

Hyperglycemia
False positive for PPD
With estrogen it increases prednisone
GI toxicity with aspirin and NSAIDS
Cardiac glycosides can lead to cardiac dysrhythmias

88
Q

Prednisone adverse reactions

A

tachycardia
osteoporosis
muscle wasting

89
Q

Prednisone life threating reactions

A

GI hemorrhage
pancreatitis
circulatory collapse decreases permeability of the blood vessels and the integrity of the blood vessels decrease)

90
Q

Prednisone Contraindications

A

Very cautious with diabetes–> change insulin doses to compensate
Psychosis (don’t need more mood swings)

91
Q

Indications of someone getting steroid IV clinical manifestations

A

Glaucoma
Cataracts
DM
electrolyte imbalances
muscle spasms
hair growth
hormone imbalances

92
Q

Hypoglycemia managed in the hospital for those who don’t get insulin at home

A

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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