Pharm Exam 1 Flashcards

1
Q

Covert the different types of medication concentrations.

A

Kilogram→ gram→ milligram→ microgram & %= (%# x 10) / 100mL

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2
Q

how many micrograms are in a milligram, or how many micrograms are in a gram?

A

1000mcgs=1mg

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3
Q

a 4% medication, what does that mean to you?
How many milligrams per mL would that contain?

A

=4Gs/100mLs
=4Gs—>4000mgs

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4
Q

What is the three-step process that I have instilled into your brains when solving a med math problem?

A

What are we solving for? Weight based? All units the same?

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5
Q

administer a medication via an intramuscular injection.

A

90 degree angle; deltoid(up to 2mLs), Dorsal gluteal(butt (5 mLs or more) upper lateral side, vastus lateralus (5mLs or more), Rectus femoris (up to 5mL)

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6
Q

Solve a med math problem to administer a medication bolus via either the IO route

A

find epiphysis/ growth plate of bone, 90 degree angle push needle till 1 line showing, then drill, aspirate at least with a 10mL (20mL preferred), (3-way-cockstop push & push method for kids), admin 2% lidocaine for pain

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7
Q

Solve a med math problem that deals with administering a bolus of IV fluid over time.

A

TAV
Time, Admin Set , Volume

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8
Q

Solve a med math problem that deals with administering a medicated IV/IO infusion.

A

CAD
Concentration , Admin Set , Dosage

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9
Q

the “8 Rights” of medication administration.

A

PT, Dose, Doc, med, time, response, reason, route

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10
Q

What is the difference between antiseptic and a disinfectant? When would we use one versus another?

A

Antiseptic = person
Disinfectant = tools

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11
Q

what is medical asepsis

A

providing a medical environment that is free of pathogens

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12
Q

What technique should be used if you ever must recap a needle?

A

Pick up cap on a surface alone with needle

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13
Q

what are the 4 different general routes of medication administration:

A

Enteral, Parental, Pulmonary, Percutaneous

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14
Q

Enteral med admin/=

A

GI; PO, NG/OG Tubes, SL, PR, Buccal

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15
Q

Parenteral med admin/=

A

“needles”; IV, IO, ET, IM, Umbilical, Subcutaneous, Topical, IN

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16
Q

Percutaneous med admin/=

A

per skin ;Sublingual, buccal, ocular, aural (ear),

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17
Q

Pulmonary med admin/=

A

Inhaled (albuterol): musclnaric receptors on smooth M. of bronchioles

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18
Q

What is the “first past effect” and during what type of medication administration would that apply?

A

Liver filtering the med/ & applies only to Enteral med/s

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19
Q

what are the different types of oral medication forms:

A

tablets, capsules, enteric coated/time release, syrups (dissolved in sugary based), suspensions (water based), elixirs (meds mixed w/ alcohol based), lozenges (melt w/ heat)

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20
Q

When would you use an OG tube versus an NG tube?

A

PT is unconscious

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21
Q

How would you measure for the correct insertion depth of the different types of gastric tubes?

A

“?” measuring technique Confirm placement with air while listening to epigastric

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22
Q

How would you administer medications to a patient utilizing their gastric tube?

A

Crush meds into 30mLs of warm water then admin w/ 50-100mLs warm flush after

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23
Q

the different ways that we carry parenteral medications

A

glass ampules, single and multi-dose vials & pre-filled/loaded syringes

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24
Q

What are the three different parts of a syringe?

A

Flashback chamber, Hub (base before needle), stylet =needle

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25
Q

Hypodermic needle is what/used for?

What are the different parts of a hypodermic needle?

A

hypodermic needle=hollow metal tube used w/ the syringe to admin/ med/s. It’s sharp enough to puncture tissues, blood vessels, or IV medication poorts
Parts: hilt & shaft. Hilt is a threaded plastic tube that screws securely onto the syringe’s distal adapter. shaft is a thin metal tube through which med/s can flow from the syringe into the site. A bevel at the shaft’s distal end accounts for its sharpness

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26
Q

intradermal medication administration:
what sites can you use:
What degree of insertion would you use?
How much fluid can you administer using this route?

A

=Deposit med into the dermal layer of the skin
=Anywhere
= 10-15 degrees
= less than 1 mL

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27
Q

Subcutaneous medication admin/:
What sites can we use:

What degree of insertion would you use?
How much fluid can you administer using this route?

A

=Tissue Comp/: Loose connective tissue between skin and muscle.
= skin on the upper arms, thighs, abdomen (avoid tattoos & superficial important vessels & ligaments/tissues)
= 15 degrees
=No more than 1mL to avoid irritation/ possible abscess.

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28
Q

Intramuscular medication admin/:
What sites can you use?

What degree of insertion would you use?
How much fluid can you administer into the four ?

A

= deposit into muscle through muscle
= deltoid, Dorsal gluteal(butt) upper lateral side), vastus lateralis (back of thigh), Rectus femoris, PEDIS & stabilize
= straight on 90 degrees
;delt=2mL, butt & Vas Lat/ = 5 or more mLs, , Butt= up to 5mLs

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29
Q

what are the different types of percutaneous medication administration routes:

A

Sublingual, buccal, ocular, nasal, aural (ear), pulmonary, trans/subdermal

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30
Q

What medications could (but probably shouldn’t be) administered down an ET tube?

A

=(NAVEL) Narcan, Atropine, Vasopressin, Epi, Lidocaine
Vaso-irratators (really any med that isn’t nutritional replacement)

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31
Q

Water is contained in what 3 compartments in the human body? What are the percentages?

A

60% of body weight is water 45%=intracellular & 15% extracellular (outside cell)
Interstitial 10.5%
Intravascular 4.5%

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32
Q

What is osmosis?
What is simple diffusion?
What is Facilitated Diffusion?
What is Active transport?

A

= water moving to high solute concentration from low
= molecules moving high to low
= Molecules moving with a helper EX metformin or insulin
= Molecules moving low to high concentration with use of ATP

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33
Q

different types of IV fluid:

A

Hypo/Iso/Hyper tonic, fluids, blood, crystalloids, & colloids,

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34
Q

What are the two most common types of isotonic crystalloid solutions that are used in the prehospital environment?

A

Lactate Ringer’s & 0.9% sodium Chloride

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35
Q

If you were administering isotonic crystalloid solutions, how much would move out of the intravascular compartment within 1 hour?

A

2/3s would move out

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36
Q

What would occur to the cells in the body if admin/ a isotonic solution?
What’d occur to the cells in the body if admin/ a hypertonic solution?
What’d occur to the cells in the body if admin/ hypotonic solution?

A

= cells stay same
=cells shrink & can shrink to crenation
= Cells would swell up & can blow up

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37
Q

What is hydrostatic pressure in the vascular system & what creates it?

What is oncotic pressure in the vascular system and what creates it?

A

=Pressure from heart in blood vessels & forces water to cross the capillary membrane into the interstitial space.
=Pulling water back into the blood vessels by the presence of large proteins in the blood (pulling back in)

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38
Q

What IV sites are considered “peripheral IV” sites?

A

Arms, Feet, hands, Legs, External Jugular

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39
Q

What are central venous sites?

A

(IJ) intra jugular, subclavian, femoral, peripherally inserted central cath (PICC) line, Port-a-cath

40
Q

What type of needle must be utilized to access a Port-a-Cath?

A

Huber needle –> slanted needle with hole laterally also

41
Q

What is a Micro IV administer set & How many drops equals 1 mL?

A

60ggts

42
Q

What are the different Macro IV administer sets?

A

20,15,12,10 gtts/min

43
Q

What are the different types of needles used of intravenous therapy?

A

Butterfly, Teflon, Hallow, Huber, hyperdermic

44
Q

When performing an IV stick, what degree of insertion would you use?

A

15-30 degrees

45
Q

What size of IV catheter would you use to access an EJ?

A

16-18 gauge

46
Q

What does the acronym “TKO” mean?
What does the acronym “KVO” mean?

A

(to keep open) = 20-25mLs/Hr
( keep vein open)= 20-25mLs/Hr

47
Q

the different complications that can come from intravenous therapy.

A

Infiltration, pyrogenic reaction, air emboli, catheter shear, vein blowing, necrosis, thrombophlebitis, artery puncture, circulatory overload

48
Q

Can you use a scalp vein for IV access, and if you can, what must you remember?

A

Yes you can, and remember can easily blow

49
Q

When is it okay to perform an IO? (i.e. what type of patient/conditions)

A

Cardiac arrest, cant get IV, Critical PTs

50
Q

What are the different parts of a bone? (ends, middle, etc..)

A

Epi/ Meta/ Dia/physis, medullary canal, red & yellow bone marrow

51
Q

Where is red bone marrow found?

A

Epiphysis

52
Q

Where is Yellow bone marrow found?

A

Diaphysis -> medullary canal

53
Q

What is a more technical name for the growth plate of a bone?

A

Metaphysis

54
Q

What sites can you use for the placement of an IO? (adult versus pediatric)

A

Proximal Tibia (~2 inches for stability)
Proximal Humorous (in peoples way)
Distal Tibia (easier for manual IO),
Sternal aka manubrium (for adults)
Distal femur (for kids)

55
Q

What are some potential complications with IO access?
What are the contraindications for the placement of an IO?

A

=PE, Fat emboli, Infiltration, breaking bone
= Infection, previous attempt @ same site, Brittle bones, broken bones

56
Q

What are the 3 most common types of central venous catheters that you will see in the prehospital environment?

A

PICC line, tunneled, med/ port

57
Q

Accessing a central venous catheter, what’s min/ syringe size that should be used?

A

10mL
use 20mL preferably

58
Q

If a patient has their tunneled venous access device utilized for dialysis therapy, can we access it?

A

NO, b/c line have been used already

59
Q

What are some techniques that you could use if you encounter difficulties while trying to aspirate fluid from a PICC line or tunneled venous line?

A

Roll & Shrug shoulders, Turn head side to side

60
Q

What are the two main branches of the nervous system?

A

Central & Peripheral

61
Q

The central nervous system (CNS) is made up of what structures?

A

Brain & Spinal Cord

62
Q

What are the two subdivisions of the peripheral nervous system (PNS)?

A

Somatic & Autonomic

63
Q

What are the 2 subdivisions of the autonomic NS (ANS)?

A

Sympathetic & Parasympathetic

64
Q

What effects would you see if the sympathetic nervous system (SNS) was to take over?

A

“Fight or Flight”
increase HR & electricity, GI constriction, ect

65
Q

What type of receptors are used by the sympathetic nervous system?

A

A1, B1, B2

66
Q

What is the main pre and post ganglionic neurotransmitter for the SNS?

A

Epinephrine

67
Q

What part of the spinal cord does the SNS originate from?

A

Lumbar & Thoracic Spine

68
Q

How do the nerves of the SNS differ from the PSNS?

A

shorter Pre & longer Post ganglions

69
Q

What would you call a med/ that caused a direct increase in the SNS?

A

Sympathomimetic

70
Q

What would you call a medication that directly blocked the SNS?

A

Sympatholytic

71
Q

What effects would you see if the parasympathetic nervous system (PSNS) was to take over?

A

“Rest & Digest”
“calms down” bodies’ organs

72
Q

What type of receptors are used by the parasympathetic nervous system?

A

Nm (nicotinic muscle), Nn (nicotinic neuronal),
& Muscarinic = found in heart

73
Q

What is the main pre and post ganglionic neurotransmitter for the PSNS?

A

Acetylcholine

74
Q

hat part of the spinal cord does the PSNS originate from?

A

Cervical & Sacral Spine

75
Q

How do the nerves of the PSNS differ from the SNS?

A

longer Pre & shorter Post Ganglion

76
Q

What would you call a med/ that caused a direct increase in the PSNS?

A

Parasympathomimetic

77
Q

What would you call a medication that directly blocked the PSNS?

A

Parasympatolytic

78
Q

What is the difference between an agonist and an antagonist?

A

Agonist= Stimulates Antagonist= Inhibits

79
Q

The very small area between two nerve cells is known as a?

A

Synapse

80
Q

What is the difference between a positive and negative feedback loop?

A

Neg/= maintains/ brings back to homeostasis Pos/= Continues effects

81
Q

Autoclave means?

A

clean/sanitize w/ heat

82
Q

ET tube meds you can give:

A

(NAVEL) Narcan, Atropine, Vasopressin, Epi, Lidocaine

83
Q

Chemical med name:
Generic med name:
Official med name:
Brand med name:

A

least common EX 7-chlor-1-3dihydro….
manufactured EX diazepam, (usually capitalized) EX Ibuprofen
name registered listed with USP EX Diazepam, USP
name by company followed by trademark/propriety EX Motrin Advil

84
Q

Where meds come from:

A

plants, animals, minerals, synthetic (lab-made),

85
Q

Harrison-Narcotic act (1914):

A

aimed a controlling the importation, manufacture, & sale of opium & coca plant & its derivatives

86
Q

FDA & Cosmetic act (1938)

A

truth-in-labeling cause→ state whether prep has habit-forming drugs and its%

87
Q

Durham-Humphrey amendments (1951)=

A

requires pharmacists to have either a prescription for certain meds

88
Q

Kufauver-Harris amendment (1962)=

A

amendment to FDCA, → mandates pharmaceutical manufacturers to list complications

89
Q

Drug abuse (1970)=

A

classifies the drugs used in medicine into 5 different schedules

90
Q

Schedule 1 med:
Schedule 2 med:
Schedule 3 med:
Schedule 4 med:
schedule 5 med:

A

=never give, highest abuse potential
=high abuse ~dependence accepted med indi/s (codeine, morphine)
=less abuse potential low dependence (acetaminophen)
=low abuse potential = benzos (diazepam, lorazepam)
=lowest abuse potential w/ lil bits of opioids often for cough/diarrhea

91
Q

Phase 1 med studies:
Phase 2 med studies:
Phase 3 med studies:
Phase 4 med studies:

A

=meds/ pharmacokinetics, toxicity, safe dose (therapeutic dose)
=test on limited population
= refined therapeutic dose; collects data on side effects
= post-marketing analysis during conditional approval

92
Q

FDA pregnancy category A:
FDA pregnancy category B:

FDA pregnancy category C:

FDA pregnancy category D:
FDA pregnancy category X:

A

=studied a lot and had not showed harmful effects to fetus/mom
=animals studies hadn’t showed harm effects to animals but not humans
=animals studies pos/ prob/ w/ no studies on pregnant mother no good studies on animals/pregnant
= fetal risks have been demonstrated benefits could outweigh risks
=fetal risk demonstrated risk outweighs possible benefits to mother

93
Q

Med Bioavailability:
Med Biotransformation:
Med Prodrug:

A

=how much the body breaks down the dose
=METABOLISM→ liver #1 ⅔ filter → means of body filtering med
=body has to break drug down for med to work as intended EX aspirin

94
Q

Idiocrasy effect:
Cross tolerance effect:
Tachyphylaxis effect:
Cumulative effect:

Med antagonist effect:
Summation effect:
Synergism effect:
Potentiation effect:
Interference effect:

A

=individual reaction is unusually dif/ from what is commonly seen
= body builds up tolerance to 1 med thus, tolerance to another med
=rapid occurring tolerance to med
= when med admin/ in many doses thus increased effect, due to quantitative buildup of the drug in the blood
=effects of one med blocks the response to another drug
=2 meds that enhance each other
= 2 meds admin/ together that produces a greater response (“1+1=5”)
=when med enhances effects of another (promethazine + morphine)
=med directly effects the pharm/ of another “football” EX: non-selective beta blocker w/ albuterol so asthma worsts

95
Q

Bioequivalence:
Assay:
Bioassay:
Efficacy:
Teratogenic med:

A

=relative therapeutic effectiveness of chemically equivalent med/s
= test done to determine the amount of purity of a given chemical
=test to ascertain a med/s in a biological model
= ability of med/ to cause a expected response
=medication that can kill/deform the fetus in the mother