Pharm Exam 2 (B) Flashcards
Facts about Beta2 Agonists
- The help relax the muscles making the air way bigger.
🔶 SABAs
- Albuterol and Levalbuterol
- they start working in 5 mins and lasts a few hours)
- its rescue medications
🔶 LABAs
- They have a slow onset of actions but last for 12 hours.
High yield concepts of Digoxin
- Narrow therapeutic index
- GI disturbances
- Visual disturbance ( yellow & blurred vision)
- Dysrhythmias
- Digoxin immune fab
Facts about Nitroglycerin?
- Available as :-
* Sublingual tablets.
* Translingual sprays
* Oral capsules (sustained release)
* Transdermal Patches
* Topical Ointment
* IV injection
Signs and symptoms of Angina
- Pain beneath the sternum.
- Pain radiating from the left arm to the jaw.
- Sharp pain
High yield concepts of Montelukast
- Usually well tolarated.
- Causes mood changes
- Causes suicidal ideation.
Sign and symptoms of Pulmonary Embolism (PE)?
- Tachycardia
- Chest pain
- Dyspnea
- Coughing up blood (hemoptysis)
Signs and symptoms of Heart failure?
- Left-sided failure (lungs & crackles)
- Right-sided failure (fluid buildup, edema)
- ## Cardiogenic shock (lack or O2 in the brain)
Amiodraone Toxicity
- Lung problems (Pulmonary fibrosis)
- Liver issue (hepatotoxicity)
- Thyroid problems (hypothyroidism/Hyperthyroidism)
- Eye problems (optic neuropathy & corneal deposits)
Asthma worsens at __________?
Night
High yield concepts of Beta 2 Agonist?
- Acute attacks
- Order of administration
- Increased Sympathetic stimulation
- LABA monotherapy warning
High Cholesterol and high blood pressure can lead to?
- The build-up of fatty streaks in arteriers
( Atherosclerosis)
What are the three major medication options for Allergic Rhinitis?
- Antihistamines
- Nasal glucocorticoids
- Decongestants
Facts about Decongestants?
- They relieve Nasal congestions.
High yield concepts of Adenosine/
- Has very short half life (less than 10 secs)
- Must be infused very quickly via IV line (push rapidly 1-2 secs).
- Can cause the heart to temporarily stop and resets its rhythm.
- Dyspnea.
- Reports of impending sense of doom.
Facts about Digoxin?
- It has a Narrow therapeutic index
- Vagal Nerve Stimulation - (slows down the heart)
- Sodium, Potassium-ATPase inhibition (If K+ is high, Digoxin is low and vise visa)
High yield concepts of Levothyroxine?
- Insomnia
- Drug interactions
- Drug toxicity
- Lifelong therapy
- Dose adjustment
- Changing brands
Variant Angina/ Prinzmetal’s Angina
- The Pt have Coronary Arteries that Spasms.
- It happens while the Pt is Resting or Sleeping.
Allergic Rhinitis is also called ________?
Hay fever
High yield concepts for Nitroglycerin?
- Orthostatic Hypotension
- Headache
- Teaching for Sublingual Nitroglycerin
- Proper storage
- Nitrate free intervals
- Incompatibility with Erectile dysfunction drugs
Alpha 1 Receptors
- They are found in the Arteries.
- When activated they cause Vasoconstriction, which causes an increased blood pressure.
Signs of Heparin crisis?
- Low Platelets (no platelets)
- Alot of Blood clots
Examples of Angina Medications?
- Nitrates
- Beta-Blockers 1
- Calcium channel blockers
Facts about Adrenergic Agonists?
- Epinephrine - Treats severe allergic reactions and cardiac arrest.
- Dopamine - Used to treat hypotension, and also helps increase blood flow in the kidneys.
- Dobutamine - Its used short term (48 hrs) to treat heart failure.
- Norepinephrine - Used to treat sever hypotension or shock.
Inhaled glucocorticoid medications
(They end with “Sone”)
- Budesonide
- Fluticasone
- Mometasone
Medication options of Cholesterol?
- HMG-CoA reductase inhibitors (statins)
- Cholesterol absorption inhibitors
- Fibrates
- Bile-acid sequestrants
- Monoclonal antibodies
- Vitamin B3 (niacin)
Angina occurs when?
- The heart muscles need more oxygen.
Examples of Decongestants?
(They end with “rine”)
- Phenylephrine
- Pseudoephedrine (ingredient of Crystal Meth)
Major classes of Dysrhythmias medications
- Class 1a, 1b, 1c - N+channel blockers (Lidocaine)
- Class II - Beta blockers (Propranolol)
- Class III - K+ channel blockers (Amiodarone)
- Class IV - Ca2+ channel blockers (Verapamil)
DVT is a blood clot that starts from the ________?
Leg
Facts about Amiodarone?
- Prescribed for many Dysrhythmias including Atrial Fibrillation.
- It blocks the Na+ channels, beta receptors, Calcium channels.
- Its a very lipid soluble.
- Has a very long half life (about 100 days)
Which two Anticoagulants should we monitor with labs?
- Warfarin - INR
- Heprarine - PT
- Enoxaparin - anti-Xa (0.6
Facts about Antithrombins
- They are Old Anticoagulants
- They start working immediately
- Prevents and treats various thromboembolic disorders (DVT, PE, Atrial fibrillation)
What are the signs of Digoxin toxicity?
- GI disturbance
- Vomiting
- Nausea
- Anorexia
- Bradydysrhythmias (most feared)
- dizziness
- Fatigue
- Fainting
Facts about Nitrates?
- Prescribed Angina Pectoris.
- Prescribed for Acute heart attacks (MI)
Facts about Theophylline?
- Its an old respiratory drug
- Prescribed for Asthma and COPD
- Its a Narrow therapeutic index drug.
- It belongs to a small group of drugs called Methylxanthines.
- Causes brochodilation.
Why do we need cholesterol?
- It makes hormones
High yield concepts of Warfarin?
- Warfarin monitoring - (INR between 2 and 3)
- Dietary Vitamin K (Antidote)
- Bleeding - (Use soft toothbrush & Electric razor)
Examples of Heart failure medications?
- Digoxin
- Adrenergic agonists
- ACE Inhibitors
- Diuretics
- ARBs
- Beta-blockers
Dopamine Receptors
- They are found in the Kidneys.
- When activated they help increase blood flow.
Sign and symptoms of DVT?
- Pain
- Swelling
- Redness
Unstable Angina
- Happens when one of the plaques in the Coronary artery raptures and causes a clot that partially blocks the vessels.
- It happens at anytime. its considered a Medical Emergency.
Facts about Inhaled anticholinergics?
- These is used in Emergency situations.
- They cause bronchodilation.
Signs and symptoms of Allergic Rhinitis?
- Runny nose
- Sneezing
- Itchy eyes
- Nasal Congestion
Facts about Nasal Glucocorticoids?
- These are steroids that are sprayed into the nose.
- They treat Allergic Rhinitis.
High yield concepts of Ezetimide?
- It well tolerated, when combined with a statin.
- Myopathy.
- Hepatotoxicity.
Facts about Statins?
- They help prevent heart attacks and strokes.
- They cause a decrease in LDL and VLDL cholesterol.
What are the Risk factor for DVT?
- Smoking
- Immobility
- Surgeries
- Trauma
- Cancers
- Oral contraceptives
High yield concepts of Theophilline?
- Narrow therapeutic index
- Toxicity
- Food interactions (Avoid caffeine)
High yield concepts of Nasal Glucocorticoids?
- Illegal Use (Pseudoephedrine).
- Increased Sympathetic Stimulation - (Pt with the history of Hypertension and Cardiac disease should avoid these meds).
High yield concepts of Novel oral Anticoagulation?
- Bleeding
- GI Bleeds
- Dabigatran storage - (Keep dry & away from moisture)
Stable Angina
- Happens when there is a partial blockage of the Coronary Artery.
- When the Pt is resting there is no pain,but when the Pt is doing any physical activity there is pain.
What is the Antidote of Digoxin?
Digoxin Immune Fab
High yield concepts of Antithrombins?
- Bleeding
- Enoxaparin administration (Love handles SubQ)
- Lab monitoring of Enoxaparin
- Lab monitoring of Heparin Check PTT btw 60 & 80 secs.
- Antidote - “Protamine sulfate”
- Heparin-induced Thrombocytopenia (HIT) - Heparin crisis
Examples of Antihistamines?
- First Generations (Old Antihistamines)
* Diphenhydramine (Benadryl)
* Hydroxyzine
* Promethazine - Second Generations (Newer Antihistamines)
* Loratadine
* Cetirizine
* Fexofenadine
Nitrates medications?
- Nitroglycerin
- Isosorbide
T4 is converted into _________?
T3 hormone
Beta 1 Receptors
- They are found in the Heart.
- When activated they cause the heart to beat faster and stronger.
High yield concepts of Clopidogrel?
- Bleeding
- Drug interactions (its often combined with Aspirin to increase effectiveness, but also increases the risk of bleeding
Signs and symptoms of Hyperthyroidsm?
- Sweeting
- Anxiety
- Irritability
- Weight loss
- Bulging eyes
- Tachycardia
- Heat intolerance
- Goiter
- Fatigue
- Muscle weakness
-Hyperactivity - Insomnia
High yield concepts of Adrenergic Agonists
- Cardiac Complications.
- Necrosis.
Signs and symptoms of Hypothyroidsm?
- Fatigue
- Weight gain
- Depression
- Constipation
- Cold intolerance
- Cretinism
Beta 2 Agonist Medications?
(They end with “Terol”)
- Albuterol
- Levalbuterol
- Formoterol
- Salmeterol
Facts about Clopidogrel
- Its prescribed to Pt with a history of Heart attacks, Ischemic stroke & peripheral arterial disease.
What should a nurse do first before giving Digoxin to a Pt?
- Draw blood to check on the digoxin levels in the blood before giving.
Signs and symptoms of Asthma?
- Dyspnea
- Chest tightness
- Coughing
- Wheezing
Facts about Asthma?
- Causes difficulty moving air through their airway.
- Triggered by environmental pollutantsC
Facts about COPD ?
- Chronic Bronchitis & Emphysema
- Causes severe damage to the lung tissue
- Causes difficulty getting Air out of their airways
Examples of Novel oral Anticoagulation?
- Apixaban
- Dabigatran
- Rivaroxaban
What the Digoxin’s safe levels?
Between 1.0 and 2.0
High yield concepts of Inhaled anticholinergics?
- Dry mouth
- Hoarseness
Facts of Methimazole?
- Treats hyperthyroidism.
- Prevents hyperthyroidism caused by thyroid surgery.
Facts about Novel oral Anticoagulation?
- They are Newer Anticoagulants.
- They prevent clots and cause fewer brain bleeds.
- Prevents and treats various thromboembolic disorders (DVT, PE, and Atrial fibrillation)
Dyslipidemia (unhealthy cholesterol) is diagnosed via?
Blood tests.
Montelukast its normally takes at ______?
Night
(Because Asthma worsens at night)
High yield concepts of Nasal Glucocorticoids?
- Time frame (It takes a WEEK before its effective)
- Nose bleeds (They dry the nasal mucosa)
- Administrations (Shake & prime if its not been used for long)
Facts about Ezetimibe?
- Prescribed to lower cholesterol, Especially LDL.
- Its combined with other Statins.
Angine Pectoris is __________________?
Severe Chest pain
Facts of Levothyroxine?
- Its the second most commonly prescribed to treat hypothyroidism.
- Its converts T4 to T3.
- Its a Narrow therapeutic index
- Normal range for TSH 0.5 to 5mU/L
High yield concepts of Inhaled glucocorticoid
- Oral Candidiasis (Pt should rinse their mouth)
- Oral Glucocorticoids (they don’t absorb into the body)
High yield concepts of Antihistamines?
- CNS Depressions (Pt should avoid alcohol)
- Anticholinergic Effects
(Both happened when taking 1st Generations Antihistamines)
What are the causes of Heart failure?
- Hypertension
- Heart attacks (MI)
- Faulty heart valves
- Dysrhythmias
- Stiff ventricles - (Restrictive cardiomyopathy)
- Abnormally thin & enlarged ventricles (Dilated cardiomyopathy)
High yield concepts of Amiodarone?
- Amiodarone toxicities (Not good for long term use)
- Dysrhythmias
Signs and symptoms of COPD?
- Cyanosis (blue bloaters)
- Dyspnea
- Chronic cough
- Wheezing
- Crackles
- Hypoxemia
- Lots of sputum production
- Barrel chest (emphysema)
- Pursed lips (pink puffers)
High yield concepts of Statins?
- Hepatotoxicity
- Myopathy & Rhabdomyolysis
- Time of Dose
- Food Interactions
- Contraindications
Facts about Warfarin
- Its an Old Anticoagulant.
- Most common blood thinner
- INR lab monitoring when taking this meds
- Prevents blot formation in the heart valves.
- Prevents and treats various thromboembolic disorders (DVT, PE, Atrial fibrillation, heart attacks)
- They take 5 days to reach the therapeutic level.
Whats the normal Theophilline blood range
Between 10 and 20 mcg/mL
Importance of the T3 hormone?
- Increases metabolism.
- Stimulates growth & development.
- Stimulates the heart.
- Gives the body more energy.
- Makes the body warm.
Facts about Antihistamines?
🔶 First Generations (Old Antihistamines)
* Prescribed for :-
1) Allergic reactions
2) Nausea
3) Cough
4) Insomnia
5) Itching (Pruritis)
* Prescribed for Extrapyramidal effects (Benadryl) * Can easily cross the Blood Brain Barrier
🔶 Second Generations (Newer Antihistamines)
* It has a long half-life
* Do not cross the Blood Brain Barrier
* Good choice for Allergic Rhinitis
Inhaled anticholinergics Medications?
(They end with “tropium”)
- Ipratropium
- Tiotropium
Facts about Inhaled glucocorticoid?
- Used for Asthma & COPD
Atrial Fibrillation
-It’s an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart.
- Increases the risk of stroke, heart failure and other heart-related complications.
- This happens when the SA node is not in control of initiating the heartbeat.
- Causes an unclear P wave on their EKG causing the rhythm to look irregular.
Examples of Statins Medication?
(They end with “Vastatin”)
- Atorvastatin
- Lovastatin
- Pravastatin
- Rosuvastatin
- Simvastatin
High yield concepts of Methimazole?
- Overmedication - (monitor Pt for signs of hypothyroidism)
- Agranulocytosis - (Pt may report infection e.g sore throat and fever)
Other Dysrhythmia medications
- Blood thinners
- Digoxin
- Adenosine (Not a treatment for Atrial Fibrillation)
Hypothyroidism
- Cause by the low secretion of the Thyroid hormone.
- Hashimoto’s disease
Examples of Fibrates Medication?
- Fenofibrate
- Gemfibrozil
Beta 2 Receptors
- They are found in the Lungs.
- When activated they cause Bronchodilation, which causes the airway to open up.
Facts about Montelukast?
- Prescribed for Asthma.
- Prescribed for seasonal Allergic Rhinitis.
- Its meant for maintenance therapy.
High yield concepts of Fibrates?
- Myopathy
- Hepatotoxicity
- Diarrhea (Fibrates)
- Risk for Gallstones (Cholelithiasis)
Types of Cholesterol?
- Very low-density Lipoprotein (VLDL)
- Low-density protein (LDL) - Bad Cholesterol
- High-density protein (HDL) - Good Cholesterol
Medications that treat Blood clots?
- Warfarin
- Antithrombins
- Novel oral anticoagulants
- Antiplatelet medications
Examples of Antithrombins?
(They end with “parin)
- Enoxaparin (Lovenox)
- Heparin
DVT clots get stuck in the _____?
Lungs
Hyperthyroidism?
- Cause by too much secretion of the Thyroid hormone.
- Grave’s disease
Facts about Fibrates?
- Prescribed for patients with high triglyceride (VLDL) and LDL levels.
Examples of Adrenergic Agonist medications?
- Epinephrine
- Dopamine
- Dobutamine
- Norepinephrine
Signs and Symptoms of Atrial Fibrillation?
- Heart palpitations (Pounding heartbeat)
- Chest pains
- Lightheadedness
- Dizziness
- Dyspnea
- Weakness
Facts about Adenosine?
- Its administered for Superventricular tachycardia (SVT)
- It converts SVT into the SA and AV nodes.
- It doesn’t treat Atrial Fibrillation.
Digoxin is commonly prescribed for?
- Heart failure
- Cardiac dysthymia (Atrial Fibrillation
When should a Nurse hold on to Heparin or stop it?
- When the Platelet levels drop.
P wave
- Is one of the waves that starts every heartbeat.
- Its the small bump at the beginning that represents and (SA) node electrical event.
Asthma and COPD medication options?
- Beta2 agonists (long and short acting)
- Inhaled anticholinergics (long and short acting)
- Inhaled glucocorticoid
- Methylxanthines
Examples of Nasal Glucocorticoids?
(They end with “Sone”)
- Fluticasone
- Mometasone