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NU 308 Pharmacology > Pharm Exam 1 revised > Flashcards

Pharm Exam 1 revised Flashcards

New and improved

1
Q

What is pharmacotherapy?

A

the use of drugs to prevent s/s and diseasees

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2
Q

Where do drugs historically come from?

A

plants,animals,minerals

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3
Q

Where do most drugs come from now?

A

laboratories

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4
Q

How are drugs classified?

A

Based on their effects on particular body systems, therapeutic uses, and chemical characteristics

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5
Q

What is a prototype drug?

A

an individual drug that represents a group of drugs (penicillin represents antibacterial drugs)

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6
Q

What does the FDA do?

A

approves drugs for use

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7
Q

What is a schedule I controlled substance?

A

No current accepted medical use in the U.S.

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8
Q

What are examples of schedule I drugs?

A

heroin, LSD, marijuana

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9
Q

What are examples of schedule II drugs?

A

Oxycodone
fentanyl
percocet
codeine

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10
Q

What are schedule II drugs?

A

high potential for abuse

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11
Q

What are schedule III drugs?

A

ptoential for abuse less than I or II

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12
Q

What are examples of schedule III drugs?

A

tylenol with codeine
anabolic steroids
testosterone

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13
Q

What are schedule IV drugs?

A

low potential for abuse compared to schedule III

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14
Q

What are examples of schedule IV drugs?

A

xanax
klonopin
ativan

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15
Q

What are schedule V drugs?

A

Low potential for abuse relative to schedule IV

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16
Q

What are examples of schedule V drugs?

A

cough perparations with no more than 200 mg of codeine per 100ml or per 100g
robutussin AC

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17
Q

What does the DEA do?

A

enforce drug laws

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18
Q

What is absorption?

A

When the drug goes from the administration site to the bloodstream

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19
Q

What are slower absorptions sites?

A

intradermal/topical
oral
subcut

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20
Q

What are fast aborption sites?

A

sublingual/buccal
rectal/vaginal
inhalation

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21
Q

What is bioavailability?

A

the amount of drug reaching circulation

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22
Q

What is distribution?

A

The medication is transported by bodily fluids

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23
Q

What is metabolism?

A

How drugs are usually made less active by enzymes

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24
Q

What is a prodrug?

A

drugs metabolized into an active form

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25
Q

Where doe excretion occur?

A

through the kidneys

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26
Q

What is serum drug level?

A

amount of drug in the blood

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27
Q

What does half-life mean?

A

time it takes for drug concentration to drop by 50%

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28
Q

Whats an example of a short half life

A

4 to 8 hr

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29
Q

Whats an example of a long half-life?

A

over more than 24 hr

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30
Q

What is pharmacodynamics?

A

what the drug does to the body

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31
Q

What is pharmacokinetics?

A

what the body does to the drug.

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32
Q

What is an agonist?

A

produces desired effect
binds to receptor

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33
Q

What is an antagonist?

A

block receptors
prevents effect
competes with other molecules

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34
Q

What is a partial agonist

A

both an agonist and antagonist
limited affinity to recepors

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35
Q

What is drug tolerance?

A

body gets used to a drug
needs larger does for effects

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36
Q

What is cross tolerance?

A

tolerance to pharmacologically related drugs

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37
Q

What is onset?

A

When the drug first begins to take effect

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38
Q

What is peak?

A

when the max concentration of a drug is in the body

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39
Q

What is duration?

A

the length of time the drug produces its effect

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40
Q

What is potency?

A

the amount of drug required to produce the effect

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41
Q

What is efficacy?

A

max response that the med can achieve

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42
Q

What is a side effect?

A

effect o ther than the desired effect

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43
Q

What is an advers effect?

A

unanticipated effects that are dangerous

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44
Q

What is a black box warning?

A

strongest FDA warning

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45
Q

What is the safe pregnancy category?

A

A

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46
Q

What is the most dangerous pregnancy category?

A

X

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47
Q

What is a drug overdose?

A

excessive amounts of drug may damage body tissues

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48
Q

How is toxicity treated?

A

support vital functions
CPR may be needed
endotracheal intubation
seizure treatment
IV line
activated charcoal (not for unconscious patient) (only for orally ingested drugs)

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49
Q

What is the therapeutic range/window?

A

does where the safed and most effective treatment occurs

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50
Q

What is titration?

A

helps maintain therapeutic effects and avoid toxicity

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51
Q

What is peak?

A

highest plasma level

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52
Q

What is trough?

A

lowest level in blood

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53
Q

What is plateau?

A

drugs concentration in plasma during series of doses

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54
Q

What is therapeutic index?

A

measurement of relative safety of a drug

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55
Q

What is beta-lactamase?

A

an enzyme that attacks the beta-lactam ring
renders some drugs ineffective

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56
Q

What is cross allergenicity?

A

allergy to a drug of another class with similiar structure

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57
Q

What is superinfection?

A

infection after a previous infection
caused my microorganisms resistant to previous antibiotics

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58
Q

What is a bactericidal?

A

agent that kills bacteria

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59
Q

What is a bacteriostatic?

A

agent that inhibits bacterial growth

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60
Q

What is broad spectrum?

A

effective against a wide range of bacteria

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61
Q

What are important notes for self-administration teaching of antibiotics?

A

take them at evenly spaced intervals
determening if they can be taken with food
Take with a full glass of water

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62
Q

T or F, antibiotics affecting the cell wall are bactericidal?

A

T

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63
Q

What are indications for penicillin?

A

gram positive (pneumonia, strep throat)
gram neg (meningitis)
kill spirochetes (syphillis)
broad spectrum- gram neg focused
prophylaxis against bacterial endocarditis

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64
Q

What are important teachings for penicillin?

A

use additional contraceptive methods (penicillin decreased hormonal birth control effectiveness)
complete entire course of therapy
take 1 hr before or 2 hrs after meals

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65
Q

What are adverse effects of penicillin?

A

allergies
anaphylaxis

66
Q

What are contraindacations/precautions for penicillin?

A

hx of severe allergic reaction to penicillin or cephalosporins

67
Q

What nursing actions should you take for a patient on penicillin?

A

observe for allergic reaction for 30 min

68
Q

What can penicllin be used for?

A

gonorrhea
UTI
peritonitis
pneumonia
septicemia
meningitis

69
Q

What averse effects can occur with penicillin?

A

GI distress
oral/vaginal candidasis
generalized rash
anaphylaxis

70
Q

What are adverse effects of cephalosporins?

A

allergy
hypersensitivity
anaphylaxis
cross-sensitivity to penicillin

71
Q

What are contraindications/precautions for cephalosporin?

A

Do not give to client with severe allergic reaction to this drug or penicillin
caution in clients with renal impairement/bleeding tendencies

72
Q

What nursing actions are relevant for cephalosporins?

A

if allergy appears, stop med, notify provider
acceptable for mild PCN allergies
avoid w/ bleeding disorders
avoid w/ anticoagulants
observe for bleeding
monitor PT and bleeding times
Give lower dose to prevent toxic levels

73
Q

How would you adminsiter cephalosporins?

A

IM- deep into large musce (ventroglute)
Intermittent infusion or slowly 3-5 min for bolus

74
Q

What are indications for carbapenems?

A

pneumonia, peritonitis, UTIs (serious infections)

75
Q

What are adverse effects of carbapenems?

A

allergy
hypersensitivity
GI upset
suprainfection

76
Q

What are indications for monobactam?

A

UTI
skin infection
lower respiratory tract
intra-abdominal
gynecologic infection
septicemia

77
Q

What are indications for vancomyin?

A

MRSA
staph epidermis
strep infections
treat C-diff (not preferred treatment)

78
Q

What are adverse effects of vancomycin?

A

ototoxicity
infusion reaction
renal toxicity

79
Q

How do you administer vancomycin?

A

slowly over 60 min
monitor trough levels
PO
IV
rectal

80
Q

What nursing actions should be taken for vancomycin?

A

assess for hearing loss
monitor trough levels
rotate injection sites
monitor infusion site
monitor I&O
monitor kidney function

81
Q

What are indications for tetracycline?

A

Rocky Mountain spotted fever
urethre/cervix infection due to chlamydia
pneumounia
lyme disease
anthrax

82
Q

What are adverse reactions to tetracycline?

A

GI discomfort
yellow/brown tooth discoloration
hypoplasia of tooth enamel
hepatotoxicity (jaundice, lethargy)
photosensitivty
suprainfection
diarrhea
yeast infections of mouth, pharynx, vagina, bowels

83
Q

What are some administration considerations for tetracycline?

A

If given for STD, abstain from intercourse until finished
Will decrease the effectiveness of hormonal birth control

84
Q

What are some contraindications/precautions for tetracycline?

A

Pregnancy Risk D
avoid in children younger than 8
Taking after 4th month of pregnancy can stain baby teeth
Stain permanent teeth of kids between 4 months and 8 years

85
Q

What would you teach a patient taking tetracycline?

A

To lower GI discomfort, take doxycycline and minocycline with meals
Wear protective clothing and sunscreen SPF of 30 or greater in sunlight
complete entire course of therapy

86
Q

What are indications for Macrolides?

A

For clients w/ penicillin allergy to treat against rheumatic fever and bacterial endocarditis
Legionnares’ disease
pertussis
whooping cough
acute diptheria
treat chlamydial infections
pneumonia due to mycoplasma
pneumoniae
streptococcal infections

87
Q

What are adverse effects of macrolides?

A

GI discomfort
Prolonged QT intervals
ototoxicity with high dose therapy

88
Q

What are some administration considerations for macrolides?

A

if given to treat an STD, should abstain from intercourse until finishing meds
Hormonal contraceptive effectiveness decreases

89
Q

What are some contraindications/precautions for macrolides?

A

erythromycin and azithromycin are pregnancy risk B
Liver disease and QT prolongation are contraindications

90
Q

What are indications for gentamicin?

A

Aerobic gram-negative bacilli (E.coli, proteus mirabilis)
Paromomycin treats intestinal amebiasis and tapeworm infections

91
Q

What are adverse effects of gentamicin?

A

hearing loss
loss of balance
nephrotoxicity

92
Q

What are some administration considerations for gentamicin?

A

ONCE-A-DAY DOSING: only necessary to obtain blood for measuring trough levels
DIVIDED DOSES peak: 30 min after admin of aminoglycoside im or 30 min after completion of an IV infusion
trough: right before next dose

93
Q

What are some contraindications/precautions for gentamicin?

A

Caution w/ kidney impairment (need lower doses of aminoglycosides)
hearing loss
myasthenia gravis

94
Q

What should you teach the patient on gentamicin?

A

notify provider if tinnitus, hearing loss, or headaches occur

95
Q

What nursing actions are taken for patients on gentamicin?

A

monitor for tinnitus, headache, hearing loss, nausea, dizziness, vertigo
do baseline hearing tests

96
Q

What are indications for sulfonamides?

A

UTIs
otitis media
chancroid
pertussis
shigellosis

97
Q

What are adverse effects of sulfonamides?

A

hypersensitivity
Steven Johnsons syndrome
blood dyscrasis
hyperkalemia
hemolytic anemia
agranulocytosis

98
Q

What are some administration considerations for sulfonamides?

A

hormonal contraceptive effectiveness reduced

99
Q

What are some contraindication/precautions for sulfonamides?

A

Pregnancy risk cat D
caution in clients w/impaired kidney function
neonate can develop kernicterus
caution in adults over 65 taking ACE inhibitors

100
Q

What are some nursing actions for sulfonamides?

A

obtain baseline and periodic CBC
monitor urine output
monitor potassium levels

101
Q

NWhat are some indications for nitrofurantoin?

A

acute UTIs
prophylaxis for recurrent lower UTIs

102
Q

What are some adverse effects of nitrofurntoin?

A

Hypersensitivity
Blood dyscrasias
peripheral neuropathy
headache
drowsiness
dizziness
GI discomfort

103
Q

What are some administration considerations for nitrofurantoin?

A

hormonal contraceptive effectivenesss reduced
turns urine rust yellow to brown
can stain teeth
take with food
avoid crushing etc
avoid while pregnant

104
Q

What are some contraindication/precautions for nitrofurantoin?

A

do not admin. during third trimester
not for infants under 1 month
not for older adults with renal impairment

105
Q

What are some nursing actions for nitrofurantoin?

A

admin. with milk or meals
do not admin. to clients with chronic kidney disease

106
Q

What are important things to know for penicillin class drugs?

A

Cross-sensitivity to cephalosporins
Use additional contraceptives when taking

107
Q

What are important considerations cephalosporin class?

A

Cross sensitivity with penicillin

108
Q

Where must you administer meds (vancomycin) for C-diff?

A

MUST be oral

109
Q

What are important considerations about tetracyclines?

A

Yellow/brown color of teeth (avoid during pregnancy and children less than 8)
Photosensitivity to sun
Used on Lyme disease and Rocky Mountain
Stop intercourse during treatment for STD
Can decrease effectiveness of oral contraceptives

110
Q

What are some important things for macrolides? (Azithromycin)

A

Given to all newborns in ophthalmic ointment form for chlamydial conjunctivitis
Advoid grapefruit and antacids
Monitor liver enzymes

111
Q

What are important considerations for aminoglycosides? (Gentamycin)

A

Can cause hearing loss

112
Q

What adverse effect can fluoroquinolones cause?

A

Achilles tendon rupture

113
Q

What common medication is in the fluoroquinolones class?

A

Levofloxacin

114
Q

What is the black box warning for clindamycin?

A

Colitis/diarrhea may lead to c-diff

115
Q

What is the first line treatment for C-diff?

A

Metronidazole

116
Q

What are some considerations for nitroimidaoles (metronidazole)?

A

Avoid alcohol-can cause to become very ill with GI complications

117
Q

What side effect can isoniazid cause?

A

Peripheral neuropathy

118
Q

What vitamin can prevent peripheral neuropathy in isoniazid?

A

Vitamin B6

119
Q

What is fluconazole?

A

Oral med for vaginal yeast

120
Q

What is ketoconazole for?

A

Liver toxicity

121
Q

What is the black box warning for griseofulvin?

A

Hepatic toxicity

122
Q

What are some important things to know about permethrin (pedicullicide class)?

A

Treats lice and scabies
Fro scabies apply cream from head to toe
Repeat if needed
Treat bedding

123
Q

What are important things to know for meds in the anthelmintic class?

A

Crush or chew pills and mix with food
Check stool 3 week after completing meds
Check for ova and parasites

124
Q

What are important things to know for meds (hydroxychloroquine) in the anti-malarial class?

A

Patient neeeds to take 1 week before and during travel, and 4 weeks after
Need regular eye exams for retina issues

125
Q

What are important things to know about antivirals for herpes?

A

Treats HSV 1 and 2
Start treatment as soon as lesions appear

126
Q

What are important things to know for antiviral for influenza?

A

For flu A and B
Given 48 hrs before s/s onset
Can be prescribed prophylactically

127
Q

What suffix do antivirals end in?

A

-ciclovir

128
Q

What is the adverse effect for nitrofurantoins?

A

peripheral neuropathy

129
Q

What is an advers effect of sulfonamides?

A

steven johnsons syndrome

130
Q

What is the adverse effect for cephalosporin? (IV)

A

thrombophlebitis

131
Q

What is a adverse effect of PCN, and sulfonamides?

A

hyperkalemia

132
Q

What is an adverse effect of tetracycline?

A

esophageal uleraction

133
Q

What is an adverse effect of vancomycin?

A

red man syndrome

134
Q

What is an adverse effect of vancomycin and amingoclycosides?

A

Requires trough and nephrotoxic

135
Q

What is an adverse effect of sulfa, fuoroquinolones, and tetracyclines

A

photosensitivty

136
Q

what is an adverse effect of PCN, cephalosporin?

A

renal impairment

137
Q

What is an adverse effect for tetracycline?

A

hepatotoxic

138
Q

What is the one difference between COX1 and COX2 inhibitors?

A

COX2 does affect platelet aggregation

139
Q

What are common adverse effects of NSAIDS?

A

GI discomfort
Take with food
Bone marrow suppression (aspirin like)
Increased risk of CI events (naproxen)
Reye’s syndrome
Aspirin toxicity
Salicylism

140
Q

What organ do NSAIDS effect the most?

A

Kidneys

141
Q

What organ does acitomenaphen effect the most?

A

Liver

142
Q

What are some important teaching points for NSAIDS?

A

Avoid alcohol
Take w// water or milk
Tell about any OTC meds
Observe for bone marrow suppression

143
Q

What occurs during salicylism?

A

Tinnitus
Sweating headaches
Dizziness
Respiratory alkalosis

144
Q

What can be done for aspirin toxicity?

A

Activated charcoal to decrease absorption
Cool client
Correct dehydration

145
Q

What are s/s of Reye’s syndrome?

A

Blood sugar drops
Ammonia and acidity rise
Liver swells and develops fatty deposits
Swelling in the brain
Seizures
Convulsions
Loss of consciousness

146
Q

T/F, aspirin in children for a virus is okay?

A

False

147
Q

What does acetaminophen do?

A

Reduce fever and relieve pain
No anti-inflammatory effects

148
Q

What is the antidote for acetaminophen?

A

Acetylcystein (mucomyst)

149
Q

How can we administer acetaminophen?

A

PO, rectal, or IV

150
Q

What pregnancy risk if acetaminophen?

A

B (it is safe)

151
Q

How do you know an opioid is working?

A

Pain is decreased

152
Q

What is an indicataion for morphine?

A

Moderate to severe pain

153
Q

What are adverse effects of opioids?

A

Respiratory depression
Constipation
Orthostatic hypotension
Urinary retention
Cough suppression
Sedation
Nausea/vomiting
Opioid toxicity triad

154
Q

What is the antidote for opioids?

A

Narcan (naloxone)

155
Q

What is butorphanol used for?

A

Opioid dependence
Relieve moderate to severe pain

156
Q

Is naloxone an antagonist or agonist?

A

Antagonist

157
Q

What can fix a cluster migraine?

A

Sumatriptan and oxygen

158
Q

How do you treat a tension migraine?

A
159
Q

What is abortive treatment for migraines

A

Treats migraine ASAP

160
Q

What are some meds for abortive therapy?

A

NSAIDS
Analgesics
Ergo alkaloids
Tristan’s
Estrogen

161
Q
A

NU 308 Pharmacology (23 decks)

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