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Pharm II Exam 1 > Pharm II Exam 1 > Flashcards

Pharm II Exam 1 Flashcards

1
Q

How should doses be given to children?

A

Smaller doses are given b/c they have immature organse

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2
Q

What do immature kidneys mean?

A

Immature excretion

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3
Q

How are all meds for infants measured?

A

By their body weight in kg

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4
Q

What can alter absorption and metabolism in a pediatric patient?

A

Genetics

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5
Q

If an infant has down syndrome, what happens to their absorption?

A

It is slowed down

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6
Q

What affects absorption in a pediatric patient?

A

Depends on age, gastric emptying, intestinal motility, route of administration, and skin permeability

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7
Q

What would a fever do the absorption?

A

Speed it up

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8
Q

If there are GI problems, like babies who are colic can it cause the absorption to change?

A

Make absorption different and it may be difficult for them to absorb anything PO

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9
Q

Should meds be given to infants IM?

A

No, there muscles are under developed altering the absorption as well as causing a lot pain

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10
Q

What does distribution mean?

A

How does the drug get to its targeted cell

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11
Q

What does distribution depend on in an infant?

A

Amount of body water (80%) they have, liver function, protein binding, and development of the blood brain barrier

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12
Q

What happens to their plasma protein levels during the distribution of meds?

A

They decrease

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13
Q

What happens to the metabolism in pediatric patients?

A

Pediatric patients have immature organs so they cannot break down meds as well as someone who is fully developed.

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14
Q

What should be done until liver matures?

A

Calculate drug doses carefully and monitor them closely; liver matures around the end of 2nd year

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15
Q

How should meds be given to an infant?

A

PO using a dropper or syringe placed in the inner cheek

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16
Q

If IM meds need to be given what size needle needs to be used?

A

Smallest needle possible and given in vastus lateralis (do not give to infant)

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17
Q

Are suppositories allowed to be given to infants?

A

YES, they can make administration easier

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18
Q

What site should an IV be given to an infant?

A

Scalp veins, foot veins, or hand veins, but more commonly is the scalp

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19
Q

Where does the excretion of drugs happen?

A

Kidneys (increased levels of drugs eliminated by the kidneys)

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20
Q

Where are drugs eliminated?

A

Urine

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21
Q

Having immature kidneys causes?

A

Decreased glomeruluar filtration rate and slowed renal clearance

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22
Q

What is important to do before infant gets discharged?

A

Provide parent teaching

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23
Q

What is important to remember when administering meds to toddlers and preschoolers?

A

Try and incorporate them as much as possible-they are very hands on at this stage

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24
Q

How should explanations be to toddlers and preschoolers?

A

Short and simple

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25
Q

Who controls the administration of meds to toddlers and preschoolers?

A

The parents, so education is important to provide to them

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26
Q

If a med is given PO to a toddler or preschooler, what should you do?

A

Mix med with syrups, applesauce, popsicle, juices

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27
Q

Where should the location be for an IM med given to a toddler or preschooler?

A

Ventrogluteal area

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28
Q

Are suppositories recommended for toddlers and preschoolers?

A

NO, they generally have a strong and quick reaction to them

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29
Q

What site should an IV be given to a toddler?

A

Scalp

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30
Q

What site should an IV be given to a preschooler?

A

Feet, hands, or antecubital

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31
Q

What is important to remember before administering meds to school-aged and adolescent patients?

A

They should participate in the administration; take independently but need supervision

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32
Q

What kind of PO meds work well with school-aged patients?

A

Chewables

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33
Q

What should be done if a med is given IM to school-aged and adolescent patients?

A

Give them praise and encouragement

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34
Q

What is the site used for IM injections for school-aged and adolescent patients?

A

Deltoid

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35
Q

Why is education so important to adolescents?

A

They start to experiment with things

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36
Q

What is likely to occur in adult and geriatric patients?

A

Polypharamacy

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37
Q

How should education be given to adult and geriatric patients?

A

Done simply; using repeat education-reinforcement; getting the patient’s family involved is also helpful

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38
Q

What happens to absorption, metabolism, and excretion in adult and geriatric patients?

A

Slows down making it easier for toxic effect; they have a decreased number of receptor sites as well

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39
Q

What happens if there are not enough receptor sites?

A

The drug will stay in the blood stream causing toxic effects

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40
Q

To prevent adverse effects, it is important to do what?

A

Assess drug-drug interactions, drug-herb interactions, drug-diet interactions, assess patients therapeutic drug level, assess creatinine and BUN levels

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41
Q

What is the lowest level that Librium, digoxin can go to?

A

0.25

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42
Q

What does BUN stand for?

A

Blood Urine Nitrogen

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43
Q

What is creatinine?

A

Waste product excreted by the kidneys

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44
Q

How are older adults more likely to comply with their daily medication regimen?

A

If it is going to make their daily lives better

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45
Q

What are reasons older adults are more likely to be noncompliant?

A

Cost, ability to assess the meds, economics

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46
Q

What is the key thing to remember when giving older adults meds?

A

START SLOW AND LOW

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47
Q

What happens to the absorption in adult and geriatric patients?

A

Decreased gastric ability causing an increase in gastric pH; decreased absorption of med causing a decrease in pH, decrease in blood flow and surface area; decreased circulation; decreased muscle mass; changes in peak serum levels

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48
Q

What happens to the distribution in adult and geriatric patients?

A

Slow cardiac output, increase body fat, decrease in body mass and body fluid-risk for toxicity, and decrease in serum albumin

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49
Q

What happens to the metabolism in adult and geriatric patients?

A

Decrease in liver size and mass, decrease in hepatic circulation, decrease in hepatic enzymes of liver, and decreased ability to remove metabolic by products

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50
Q

What race metabolizes and excretes quicker?

A

Asian Americans can much quicker than Caucasians and African Americans

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51
Q

What happens to the elimination process in adult and geriatric patients?

A

Decrease in renal blood flow, number of functioning nephrons, glomerular filtration rate, and tubular secretion; decrease in creatinine and muscle mass;

52
Q

What happens to the glomerular filtration rate in females?

A

It decreases b/c they have less muscle mass

53
Q

What happens to the glomerular filtration rate in African Americans?

A

It increases b/c they have more muscle mass

54
Q

Is it safe for women who are pregnant or lactating to take meds?

A

NO

55
Q

What happens to the blood volume in pregnant women?

A

Increases

56
Q

Does metabolism increase or decrease in pregnant women?

A

Increase

57
Q

What do pregnant women retain?

A

Water

58
Q

The increase in metabolism can cause what?

A

It can affect drugs causing the drug to be broken down faster, which increases the risk for toxicity

59
Q

Everything in the mom goes directly to whom?

A

THE BABY

60
Q

What is the drug pregnancy category?

A

Ranks drugs from A-X describing how dangerous they are

61
Q

A in the pregnancy category means?

A

The safest

62
Q

X is the pregnancy category means?

A

The most dangerous

63
Q

What are some drugs used for infertility?

A

Clomiphene Citrate, Follitropins, Human Chorionic Gonadotropin, Leuprolide, and Menotropin

64
Q

Clomiphene Citrate

A

Increases FSH; take basal temp. 5-10 days following admin-presence of increased temp means ovulation;

65
Q

What are some side effects of Clomiphene Citrate?

A

Hot flashes, breast pain/tenderness, uterine bleeding

66
Q

Follitropins

A

Increased follicle development; admin subq; recieve hCG afterwards

67
Q

What are the side effects of follitropins?

A

Same as Clomiphene Citrate

68
Q

Human Chorionic Gonadotropin

A

Replacement for LH

69
Q

What are the side effects of human chorionic gonadotropin?

A

Edema, depression, breast enlargement, ovarian cysts, and ovarian hypersensitivity

70
Q

Leuprolide

A

Gonadotropin-releasing hormone; admin subq

71
Q

What are the side effects of leuprolide?

A

Hot flashes, insomnia, vaginal dryness, decrease breast size, painful intercourse, and bone loss (much like menopausal symptoms)

72
Q

Menotropin

A

Increase in FH and LH; admin subq in alternative sides of abdomen or IM; followed with hCG

73
Q

What are the side effects of menotropin?

A

Same as Clomiphene Citrate

74
Q

Why do some baby’s have respiratory problems?

A

They have not yet produced surfactant so baby may be intubated

75
Q

Some premature babies might have respiratory problems. What can be given to treat the baby before she even delivers?

A

Corticosteroids

76
Q

What are some pregnancy associated symptoms?

A

Anemia, constipation, GERD, gestational diabetes mellitus, N/V, pregnancy-induced HTN.

77
Q

What can be done if a mom has anemia?

A

Giving food instead of drugs

78
Q

What is the most common deficiency in pregnant women?

A

Iron deficiency and folic acid deficiency

79
Q

What can supplements do to a pregnant women?

A

May lead to excessive levels of hemoglobin, iron overload, HTN in mother and premature birth or low birth weight

80
Q

What can be done if a mom is constipated?

A

Increase exercise and intake of fluids and eating more high-fiber foods (happens due to a decrease in peristalsis)

81
Q

What should be avoided if a mom is constipated?

A

Mineral oil, castor oil, all strong laxatives and excessive amounts of any laxative-this can cause uterine contractions and initiate labor

82
Q

What can be done if a mom is experiencing GERD?

A

Eat small meals, do not eat 2-3 hours before bedtime, avoid caffeine, gas-producing foods, and constipation, sit in upright position

83
Q

What causes GERD in pregnant women?

A

Hormonal changes relax lower esophageal sphincter, growing fetus increases abdominal pressure; may trigger asthma attacks in patients with asthma

84
Q

What happens if a pregnant women has gestational diabetes mellitus?

A

Likelihood of structural defects in fetus, congenital deformities

85
Q

How can respiratory depression result from gestational diabetes?

A

Decrease in the production of surfactant-fetal lung maturity-lack can result in respiratory distress

86
Q

What is the drug of choice for gestational diabetes mellitus?

A

Insulin

87
Q

What can decrease your risk for developing gestational diabetes mellitus?

A

Following a good diet and exercising more frequently

88
Q

Why does N/V result from being pregnant?

A

An increase level of hCG and estrogen, decreased blood sugar, and magnesium deficiency

89
Q

What med can be taken to decrease N/V?

A

Antiemetic drugs-Zofran is the drug of choice; total parenteral nutrition may be needed if therapy is unsuccessful

90
Q

What is included in pregnancy-induced hypertension?

A

Preeclampsia and ecamplsia

91
Q

What is preeclampsia?

A

Manifested by HTN and proteinuria-diastolic BP above 90 mmHg and proteinuria greater than 300 mg in 24 hrs or urine dipstick of 2+

92
Q

What is eclampsia?

A

Potentially fatal seizures during pregnancy or after birth

93
Q

Patients with pregnancy-induced HTN should….?

A

Avoid salty foods, sit with feet up, lower stress, bed rest

94
Q

What do Tocolytics do?

A

Stop preterm labor

95
Q

What are some Tocolytics?

A

Magnesium Sulfate, Nidefipine, Terbutaline Sulfate, Indomethacin

96
Q

Magnesium Sulfate

A

Stops nerves that cause uterine contractions (neuromuscular blocking activity)

97
Q

Nifedipine

A

Decreases uterine contractions and lowers BP (calcium channel blocker)

98
Q

Terbutaliune Sulfate

A

Inhibits uterine contractions by reducing intracellular calcium levels (beta-adrenergic agent)

99
Q

Indomethacin

A

Inhibits uterine prostaglandins that initiate uterine contractions of normal labor (NSAIDs) (Aleve)-given if nothing else works

100
Q

What drugs are used for the induction of labor?

A

Prostaglandins (Dinoprostone) and Oxytocics (Pitocin)

101
Q

What drugs are given to help pain?

A

Analgesics and anesthetics

102
Q

What are primary skin disorders?

A

Originate in the skin or mucous membranes (eczema)

103
Q

What are secondary skin disorders?

A

Result from a systemic condition, such as measles or adverse drug reactions

104
Q

What is dermatitis (eczema)?

A

Inflammatory response of the skin to either allergens or irritants or trauma; S/S: erythema, pruritus, lesions (acute or chronic)

105
Q

What is atopic dermatitis?

A

Characterized by dry skin, pruritus, and lesions depending on inflammation, stage of healing and scratching

106
Q

What is contact dermatitis?

A

Direct contact with irritants or allergens stimulate inflammation

107
Q

What is seborrheic dermatitis?

A

Disease of the sebaceous glands with excessive sebum (dandruff)

108
Q

What is drug induced dermatitis?

A

Virtually caused by any drug

109
Q

What are some common inflammatory disorders?

A

Dermatitis, psoriasis, urticaria, and rosacea

110
Q

What is psoriasis?

A

Chronic inflammatory disorder; activates T lymphocytes-produces cytokines which stimulate abnormal growth of affected skin cells and blood vessels

111
Q

What are some S/S of psoriasis?

A

Erythematous, dry and scaling; found anywhere but mostly on bony areas; exacerbating factors: infections, winter, some drugs, stress, obesity, and alcoholism

112
Q

What is urticaria?

A

Hives; wheal raised edematous area with pale center and red border, very itchy; Histamine is the most common mediator

113
Q

What is Rosacea?

A

Chronic disease characterized by erythema, telangiectases (fine, red, superficial blood vessels), acne-like lesions of facial skin

114
Q

What are the most common skin disorders in nursing homes?

A

Pressure ulcers and venous stasis ulcer, also anal recetal disorders

115
Q

What is the most common route to treat skin disorders?

A

Topical ointment; used when we don’t want it to become systemic

116
Q

What is the purpose of using topical ointments?

A

Helps with the barrier function, soften harden calluses, bunions, helps increase blood flow to that area-helps skin heal faster

117
Q

What is a good antifungal topical ointment>

A

Nistatin

118
Q

What are some drugs to treat skin disorders?

A

Antimicrobials, antiseptics, corticosteroid creams, immunosuppressants, emollients or moisturizers, topical enzymes, Ketatolyctics, Retinoids, and sunscreens

119
Q

Action of Retinoids

A

Suppress sebum production, inhibits comedone formation and inhibition of inflammation; decreases size of sebaceous glands and makes sebum less viscous and less likely to plug follicles

120
Q

Indications of Retinoids

A

Acne that is unresponsive to other treatments, high-risk neuroblastoma in children and adolescents, psoriasis, aging and wrinkling of skin from sun, and skin cancers

121
Q

Contraindications of Retinoids

A

Hypersensitivity, pregnant women, hx of mental illness, asthma, liver disease, diabetes, heart disease, osteoporosis, anorexia nervosa

122
Q

Nursing Interventions for Retinoids

A

Assess for decrease in total cyst count, observe for blurred vision, headache, conjunctivitis, and monitor lab tests

123
Q

Patient education for Retinoids

A

Take w/ or shortly after meals, report depression, avoid medicated soaps, sun exposure, washing does not improve acnes

124
Q

SE of Retinoids

A

Dryness and swelling of lips, arthralgia, back pain, hyperlipidemia, psychosis, decreased night vision, bone marrow suppression

125
Q

What are some examples of Retinoids?

A

Isotretinoin, Acitretin, and Adapalene

Pharm II Exam 1 (1 decks)

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