pharm exam 3 Flashcards by katie marrero

disease that affects person’s brain behavior and leads to inability to control legal and illegal drugs

substance use disorder

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what are the 4 qualifiers of D5M5?

mental disorders
1. deviance
2. dysfunction
3. distress
4.danger

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taking meds that aren’t prescribed, wrong dose, someone else’s Rx, or just to feel the affects

misuse

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physical vs phycological withdraw from addiction

physical: increased HR & n/v
phycological: emotional or angry or mood swings

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patients reduced reaction to a drug following its repeated use

tolerance

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unpleasant sensory & emotional experience caused by stimuli

pain

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what is pain stimulation based on?

opioid receptors in the nervous system & stimulation from chemical mediators

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minimum point at which something causes your pain

threshold

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maximum amount of pain that you can handle

tolerance

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class of drugs designed to relieve pain without causing loss of consciousness

analgesia

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abnormal sensation

dysesthesia

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pain from a normally non-painful stimuli

allodynia

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describe the drug schedules

1 = most potential for abuse
4 = least potential for abuse

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what are the medicine steps of pain management? (mild to severe)

1- mild pain
(non opioid meds)
2- moderate pain
(weak opioid med, non opioid meds, adjuvant analgesia)
3- severe pain
(strong opioid med, non opioid meds, adjuvant analgesia)

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what meds are non opioids?

NSAIDS & Acetaminophen(tylenol)

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what meds are NSAIDS?

1st generation:
ASA(aspirin)
mortin(ibuprofen)
advil
toradol
naproxen

2nd generation:
celebrex

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what are NSAIDS used for?

mild to moderate pain:
decrease pain, inflammation, and platelet aggregation (by inhibiting COX enzymes)

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NSAID side effects

GI upset, GI bleeding, ulcers, tinnitus

*second generation (Celebrex) doesn’t affect GI tract and platelet function

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NSAID nursing considerations

dont give to active bleeding pts
dont give to kidney disease pts (monitor BUN & creatinine increases)

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what is acetaminophen(tylenol) used for?

mild to moderate pain
h/a
fever (antipyretic)

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acetaminophen(tylenol) side effects

generally no SE but possible rash, n/v, and anorexia

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acetaminophen(tylenol) nursing considerations

can cause liver damage (check AST & ALT)(jaundice)
can cause cyanosis (blue) if take a toxic dose

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morphine
meperide (demerol)
hydromorphine (dilaudad)
codeine
Lortab
oxycontin
Percocet
methadone

opioids

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opioid side effects

n/v
constipation
hypotension (& orthostatic)
decrease RR
urine retention
itching

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what are opioids used for?

to block painful stimuli in nervous system, suppress respirations, & cough

what are opioids made from?

opium poppy plant

opioid nursing considerations

dont give to pts with low BP (hypotension) monitor BP & RR

what is the opioid reversal agent?

naloxone (narcan)

what are the 4 signs of inflammation?

heat, redness, swelling, pain

what are the 2 inflammatory mediators?

prostaglandins & COX enzyme

what are the 4 anti-inflammatory meds?

NSAIDS Steroids DMARDS (disease modifying anti-rheumatic drugs) Antigout drugs

what do steroids do?

suppress inflammation & adrenal function

what are steroid meds?

"-sone" hydrocortisone (cortef) methylprednisolone (Solu-medrol) prednisone dexamethasone (decadron)

steroid side effects

- increase BG, BP, HR, appetite, risk for infection - Na & water retention - decrease K - osteoporosis - mood changes - irritability - insomnia - moon face - HTN

steroid teaching

short term must be tapered to quit decrease salt intake take w meals watch for hypokalemia

steroid nursing considerations

- dont give a live vaccine to someone on steroids - monitor BG, BP, WBCs - observe for hyperglycemia - dont crush prednisone - to decrease or prevent GI upset: take w food; may need to take with H2-receptor antagonist [cimetidine or ranitidine]

used to alleviate pain and cause loss of consciousness by depression of CNS through decreasing firing of neurons and other mechanisms

anesthetics

what 4 anesthetic states come from general anesthesia?

1. unconscious - not aware of self or environment 2. sedation - dont move 3. analgesia - dont feel pain 4. amnesia - dont remember

general anesthesia side effects

cardiac and respiratory depression hypotension n/v dysrhythmias hyperthermia

general anesthesia nursing considerations

monitor ABC's, BP, HR

nitrous oxide midazolam (versed) fentanyl (innovar, sublimaze) propofol (diprivan)

general anesthetics

anesthetics that are IV & inhaled

general anesthesia

anesthetics that are topical route

local anesthesia

what do local anesthetics do?

only block pain in a specific part DONT affect consciousness

lidocain (Xylocaine)

local anesthetic

bupivacaine (Marcaine)

regional anesthetic

local and regional anesthetic side effects

h/a hypotension rash

severe vomiting can lead to what

electrolyte imbalance and dehydration

promethazine (phenergan)

antiemetic GI med for n/v

ondansetron (zofran)

antiemetic GI med for n/v

inflammatory erosion of stomach or duodenum lining

peptic ulcer disease

decreased muscular tone of esophageal sphincter that causes regurgitation of stomach contents that irritate the esophagus

GERD

ulcer that causes pain right after eating

gastric ulcer

ulcer that causes pain between meals

duodenal ulcer

diphenoxylate (Lomotil)

antidiarrheal med

loperamide (immoddium)

antidiarrheal med

hyperosmolar laxative that pulls water from the gut to move feces

osmotic laxative

laxative that irritates the lining of the intestines

stimulant laxative

laxative that gives fiber to the patient

bulk forming laxative

laxative that brings water to the stool to soften it

emollient laxative

name the 4 types of laxatives

osmotic stimulant bulk forming emollient

antacid that slows the GI tract

calcium carbonate (tums)

antacid that speeds up the GI tract

magnesium hydroxide

when do patients need to take magnesium hydroxide?

1-3 hours after a meal or at bedtime

sucralfate (carafate)

pepsin inhibitor

why do you have to wait to take other drugs when taking carafate?

this medicine creates a protective lining and other medicines wont be able to absorb accurately

examples of H2 blockers

"-idine" cimetidine (tagamet) famotidine (pepcid) nizatidine (axid) ranitidine (zantac)

what do H2 blockers do?

block histamine to decrease acid production

H2 blocker nursing considerations

watch with patients with renal and liver disease take during the day or at bedtime

what do PPIs do?

block acid production in parietal cells

examples of PPIs

"-zole" esmeprazole (nexium) lansoprazole (prevacid) omeprazole (prilosec) pantoprazole (protonix)

PPI nursing considerations

proton pump inhibitors take before meals longterm use can cause osteoporosis (bc it disturbs Ca absorption)

cystitis or urethritis

lower UTI

upper pyelonephritis

upper UTI

what are the common bacteria from UTIs

e. coli proteus staph candida

nitrofuration (macrobid) fosfomycin (monurol)

anti-infectives that suppress bacteria growth in urinary tract

what does the urine anti-infective methenamine do

acidify the urine

trimethoprim- sulfamethoxazole (batrium)(sulfonamides)

antibiotic that kills both gram + and gram - bacteria

ciprofloxacin (cipro) (fluoroquinolones)

urinary antibiotic

phenazopyridine (pyridium/azo)

urinary analgesic that decreases pain thats associated with UTI

what produces hormones that regulate body functions

endocrine gland

name the 7 endocrine glands

1. hypothalamus 2. pituitary 3. thyroid 4. parathyroid 5. adrenals 6.pancreas 7. ovaries and testies

what gland coordinates ANS & activity of the pituitary gland

hypothalamus

what gland is the "master gland" and helps other glands secrete hormones

pituitary

what gland regulates T3 & T4

thyroid gland

2 glands in the neck on the thyroid that regulate calcium

parathyroid gland

what gland secretes steroids needed for homeostasis (fluid and electrolyte regulation)

adrenal gland

what gland secretes insulin and glucagon

pancreas

what steroid produced by adrenal gland promotes sodium retention and potassium secretion

corticosteroids

thyroid dysfunction can cause what

hypothyroidism & hyperthyroidism

myxedema

hypothyroidism

levothyroxine sodium (Synthroid)

medication for hypothyroidism

exopthamos

bulging of eyes

graves disease is from what

hyperthyroidism

methiamozole (tapazole) propylthiouracil (PTU) potassium iodine

medication for hyperthyroidism

what is crushing's syndrome from

hyper-secretion of corticosteroid

addison's disease is from what?

hypo-secretion of corticosteroid

uncontrolled DM can lead to what

- kidney failure - blindness - peripheral arterial disease (PAD) - HTN

what is the normal BS level

60-100

what are the symptoms of diabetes

polyuria - urine polydipsia - thirst polyphasia - hungry

insulin is used to help what

type 1 DM and hyperglycemia

what is Amylin analogue (Symlin)

- anti-diabetic med used with insulin to help control BS in type 1 & 2 DM - given SQ before meals - never given in the arm

how do you treat hypoglycemia?

eat 10-15g of a simple carbohydrate

what should you educate your hypoglycemic patients on?

to have a snack with them in case their BS drops too low

oral anti-diabetic agents are used for what?

type 2 DM

what are the 3 drug classes of oral anti-diabetic agents

- sulfonylureas - biguanides - sodium-glucose CO transporter 2

medication that stimulates beta cells to produce more insulin

sulfonylureas

medication that decreases hepatic production of glucose from stored glycogen

biguanides

what medication do you educate to hold for 48 hours before and after IV contrast dye

biguanides

what anti-diabetic medication works with the kidneys to excrete glucose in the urine

sodium-glucose CO transporter 2

invokana

sodium-glucose CO transporter 2

metformin (glucophage)

Biguanide

glipizide (glucotrol) glycuride (DiaBeta) glimepride (amaryl)

"gl...ide" sulfonylureas

exenatide (byetta, bydureon)

glucagon-like peptide-1 agonists (GLP-1)/ (incretin mimetics)

trulicty

once a week injection to help with type 2 DM

what are glucagon-like peptide-1 agonists (GLP-1)/ (incretin mimetics)

pre-filled injection pens used BID for managing type 2 DM