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Pharm Exam 2 > Pharm 103 Exam 1 > Flashcards

Pharm 103 Exam 1 Flashcards

1
Q

What is the difference between a DVT and a PE?

A

A DVT is a blood clot forming in the veins, a PE is a clot that has moved into the lungs

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2
Q

What situations require heparin for rapid anticoagulation?

A

Afib, PE, DVT, stroke

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3
Q

What foods should be avoided when taking allopurinol?

A

Foods high in purin content (organ meats, salmon, sardines, gravy, legumes)

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4
Q

What is the MOA of heparin?

A

Binds with antithrombin III, accelerating the anticoagulation cascade and inhibiting the action of thrombin, which prevents the conversion of fibrinogen to fibrin and stops a clot from forming

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5
Q

What is the MOA of parenteral anticoagulants?

A

Binds with and inhibits free-flowing thrombin

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6
Q

What is the MOA of oral anticoagulants?

A

Inhibit hepatic synthesis of vitamin K, affecting clotting factors II, VII, IX, and X

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7
Q

What lab tests need monitored when a patient is receiving heparin?

A

PTT and aPTT (can also decrease platelets)

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8
Q

What is the antidote to heparin or LMWH overdose?

A

Protamine sulfate (IV)

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9
Q

How are LMWH different to heparin?

A

LMWHs have a lower risk of bleeding and produce more stable responses at recommended doses, don’t need frequent lab monitoring of aPTT, and have a half life that is 2-4 times longer than that of heparin

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10
Q

Why is oral warfarin started before ending heparin?

A

Prevents other clots from forming (rebound?)

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11
Q

All anticoagulants are contraindicated in which patients?

A

Patients with head trauma, bleeding in the brain, history of brain bleeds, or active bleeding

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12
Q

What medications are discouraged when taking anticoagulants?

A

Antiplatelet drugs (like aspirin)

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13
Q

How do oral anticoagulants, such as warfarin, work to prevent clotting?

A

Inhibit hepatic synthesis of vitamin K, thus affecting clotting factors II, VII, IX, and X

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14
Q

What lab tests is used to monitor anticoagulation with warfarin and when is it drawn?

A

PT and INR; drawn right before next drug dose

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15
Q

How is INR different than a PT?

A

INR accounts for variability in reported PTs from different labs

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16
Q

What is a normal PT and INR?

A

Pt: 11-12.5 seconds
INR- 1.3-2 seconds

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17
Q

What is the ideal INR of a patient on warfarin?

A

2-3

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18
Q

What is the antidote to warfarin overdose?

A

Vitamin K (takes 24-48 hours to be effective)

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19
Q

Why is heparin safer than wafarin in pregnancy?

A

Heparin does not cross the placental barrier, unlike warfarin; warfarin use is not recommended during pregnancy

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20
Q

How do antiplatelets work to prevent thrombosis in the arteries?

A

Antiplatelts suppress platelet aggregation

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21
Q

How soon prior to surgery should aspirin be discontinued?

A

At least 7 days before surgery

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22
Q

How soon should a thrombolytic be administered after an AMI?

A

Within 3-4 hours (ideally within 30 minutes)

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23
Q

Should anticoagulants and antiplatelets he given at the same time at alteplase?

A

No- there is an increased risk for bleeding

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24
Q

What is the antidote for alteplase?

A

Aminocaproic acid

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25
Q

Inherent resistance

A

Occurs without previous exposure to the drug; occurs naturally

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26
Q

Acquired resistance

A

Caused by prior exposure to the antibacterial

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27
Q

Additive effects

A

Equal to the sum of the effects of two antibiotics

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28
Q

Potentiative effects

A

Occurs when one antibiotic potentiates the effect of the second, increasing its effectiveness

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29
Q

Antagonistic effect

A

When a bactericidal drug and and bacteriostatic drug are used together, which can greatly reduce the desired effect

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30
Q

What are the three general adverse effects to antibacterials?

A

Allergy or hypersensitivity, superinfection, and organ toxicity

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31
Q

Which superinfections are common after antibiotic therapy?

A

MRSA and C. Diff

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32
Q

How do penicillins affect oral contraceptives?

A

Decreases effectiveness of oral contraceptive

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33
Q

How do penicillins effect potassium?

A

Increases serum potassium levels

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34
Q

How do penicillins affect aminoglycosides?

A

Actions of both drugs are inactivated

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35
Q

How are cephalosporin generations different?

A

The higher the generation, the more resistant to beta-lactamases, the larger the spectrum, and the more increased the ability to reach cerebrospinal fluid

36
Q

How can patients prevent superinfection?

A

Take medication for full course, eat yogurt, buttermilk, or an acidophilus supplement

37
Q

How do penicillins or cephalosporins affect bleeding risk?

A

Increase risk for bleeding by inhibiting platelet function

38
Q

What route can macrolides not be given in and why?

A

IM- too painful. Give orally OR IV slowly instead to prevent phlebitis

39
Q

How does C. Diff result from macrolide use?

A

Extended use of macrolides can kill the normal flora in the gut, allowing an overgrowth of c. Diff

40
Q

Which antibiotic is typically prescribed to treat c-diff?

A

Fidaxomicin

41
Q

Why should patients report loose stools when on azithromycin?

A

CDAD needs to be ruled out

42
Q

What are the two types of toxicity caused by vancomycin?

A

Nephrotoxicity and ototoxicity

43
Q

What infection is vancomycin widely used for?

A

Staphylococcal infections

44
Q

Is a vancomycin infusion reaction an allergic reaction?

A

No- it’s a toxic effect

45
Q

How can a nurse prevent vancomycin infusion reaction?

A

Infuse slowly

46
Q

Which drugs increase the risk of ototoxicity and nephrotoxicity when given with vancomycin?

A

Furosemide, aminoglycosides, ammphotericin B, colistin, cisplatin, and cyclosporine

47
Q

When should tetracyclines be taken in relation to food? Which ones are not included in this?

A

On an empty stomach 1 hour before or 2 hours after meals; doxycycline and minocycline are outliers to this rule and do better with food, specifically milk

48
Q

What are the most common side effects of tetracyclines?

A

Nausea, vomiting, diarrhea, and photosensitivity

49
Q

How are digoxin and warfarin affected by concurrent use with tetracyclines?

A

Increased effects of digoxin and warfarin

50
Q

Which patients are most affected by tooth discoloration from tetracyclines?

A

Children under 8 and pregnant women in the last trimester

51
Q

How do fluoroquinolones affect oral hypoglycemics and blood glucose?

A

Increases effects of oral hypoglycemics; increases risk for hypoglycemia

52
Q

What types of infections are sulfonamides primarily used to treat?

A

UTIs, E.Coli, meningococcal meningitis, chlamydia, toxoplasma gondii, coccal infections

53
Q

Why should the nurse monitor for bruising or bleeding when a patient is taking a sulfonamide?

A

Blood disorders such as hemolytic anemia, aplastic anemia, and low WBC and platelet counts can result from prolonged use and high dosages

54
Q

When should a patient take a sulfonamide in relation to food?

A

1 hor before or 2 hours after meals with a full glass of water

55
Q

Why should patients increase fluid intake when taking a sulfonamide?

A

To prevent crystalluria

56
Q

Why are multi-drug combinations important in HIV treatment?

A

Taking single ARVs can increase the risk of drug resistance to all ARVs

57
Q

What are the common side effects of NRTIs?

A

Nausea, diarrhea, abdominal pain, rash

58
Q

What are the common side effects of NNRTIs?

A

Dizziness, sedation, nightmares, euphoria, loss of concentration, rashes

59
Q

What are the common side effects of PIs?

A

N/V, diarrhea, rash

60
Q

Which health screenings are important to encourage for a patient with HIV?

A

Pap tests, ophthalmologic and dental examinations, and agr or risk-related colonoscopies

61
Q

Which laboratory tests are important to monitor while a patient is taking antiretrovirals for HIV?

A

Viral load and CD4+ counts

62
Q

Describe adjuvant therapy

A

Cancer that is treated with surgery and ending with chemotherapy

63
Q

Why is chemotherapy usually administered in cycles?

A

Improves the likelihood thematic cancer cells will be destroyed and normal cells can recover

64
Q

Why is chemotherapy usually administered as combination therapy?

A

Combination therapy increases the likelihood of affecting cancer cells in all phases of the cell cycle

65
Q

When do patients typically reach nadir?

A

7-10 days after treatment

66
Q

What would the nurse do if extravasation began in an IV line?

A

Stop the infusion immediately

67
Q

What are the signs of neurotoxicity specific to a patient taking vincristine?

A

Sensory loss, paresthesias, difficulty walking, hyporeflexia, and muscle wasting

68
Q

What effect do monoclonal antibodies have on the immune system?

A

Improves the immune system to find and attack cancer cells

69
Q

Why are diphenhydramine and acetaminophen used as premedications for mAb infusions?

A

They help to prevent nausea, blood pressure changes, hyperglycemia, and hypoxia

70
Q

How do BRMs enhance the immune system?

A

-enhance immune systems ability to kill abnormal cells (immunomodulation)
-change cancer cells to make them behave more like healthy cells
-inhibit normal cells from changing into cancer cells
-enhance the body’s ability to repair or replace damaged cells caused by other cancer treatments
-prevent cancer cells from metastasizing

71
Q

When should a patient stop taking erythropoietin?

A

When the hemoglobin concentration is higher than 11 g/dL

72
Q

What are the 3 ways antiseizure drugs work?

A

-suppressing sodium influx through the drug binding to the sodium channel when it is inactivated, which prolongs the channel inactivated and thereby prevents neuron firing
-suppressing the calcium influx, which prevents the electric current generated by the calcium ions to the T-type calcium channel
-increasing the action of GABA, which inhibits neurotransmitters throughout the brain

73
Q

Why do children need a higher dose of phenytoin?

A

They have a higher metabolism, which decreases drug availability

74
Q

Which IV solution can phenytoin not mix with?

A

Dextrose solutions (D5W, D10)

75
Q

Why route should phenytoin not be administered through? Why?

A

IM- erratic absorption rate and tissue irritation/damage

76
Q

How does phenytoin affect blood glucose?

A

Increases blood sugar by inhibiting the production of insulin

77
Q

How does phenytoin affect oral health?

A

May cause gingiva hyperplasia (overgrowth of gums or reddened gums that bleed easily)

78
Q

How does phenytoin interact with aspirin and anticoagulants?

A

Increases their drug activity and availability

79
Q

Which long-acting barbiturate is prescribed to treat seizures and status elipticus?

A

Phenobarbital

80
Q

Which benzodiazepine is administered IV for status elipticus? Followed by which drugs?

A

Diazepam is administered first, followed by phenytoin or phenobarbital (other antiseizure drugs)

81
Q

What patients should not take anticholinergics?

A

Patients with dementia or memory loss

82
Q

What medications treat drug-induced parkinsonism?

A

Anticholinergics

83
Q

When is levodopa inhalation used?

A

As needed in between treatments of carbidopa levodopa

84
Q

What does carbidopa-levidopa do?

A

Decreases symptoms of PD; the carbidopa allows for less levodopa to be used because it is a decarboxylase inhibitor

85
Q

What happens to urine when on carbidopa-levidopa?

A

It becomes discolored and can darken when exposed to oxygen- this is normal

86
Q

What foods should be avoided when taking selegiline?

A

Foods high in tyramine (to avoid hypertensive crisis)

Pharm Exam 2 (3 decks)

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