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XIO > Pharm quiz 1 study guide > Flashcards

Pharm quiz 1 study guide Flashcards

1
Q

9 rights(reason)

A

1 - right drug
2 - right dose
3 - right time
4 - right route and form
5 - right patient
6 - right documentation
7 - right reason or indications
8 - right response
9 - right to refuse

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2
Q

fastest to slowest absorption

A

fasteste to slowest:
epidural
IV
IM
SC
PO

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3
Q

allergic

A

an immunologic hypersensitivity reaction resulting from unusual sensitivity of a patient to a particular medication; a type of adverse drug event

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4
Q

idosynchratic reaction (ritalin is idosychratic)

A

an abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient

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5
Q

cultural assessment

A

languages spoken, written and understood. need for an interpreter.
health beliefs and practices
past uses of medicine
use of herbal treatments, folk remedies, home remedies, or supplements
use of otc drugs
usual responses to illness
religious practices and beliefs (christian scientists don’t take any meds at all)
support from the patient’s cultural community that may provide resources or assistance as needed, such as religious connections, leaders, family members, or friends
dietary habits

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6
Q

how to identify a patient before giving a med

A

2 unique identifiers - (full name, dob, name band)

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7
Q

therapeutic index - lethal dose etc

A

To establish Toxicity & Effectiveness:
-“LD50” dose lethal to 50% animals tested
- Median effective dose-
-Therapeutic dose for 50% of animals tested
To determine Therapeutic Index
- LD50/ Median effective dose

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8
Q

med error (the patient and the provider are errors)

A

preventable adverse drug event involving inappropriate medicaiton use by patient or health care provider, may or may not cause harm

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9
Q

nursing process (ANPIE is the process, the framework)

A

organizational framework for the practice of nursing. all steps taken by nurse in caring for patietn. AI (human needs) PIE

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10
Q

outcomes (the specific outcome is measurable) - this is the planning phase of ANPIE

A

specific patient behaviors or responses that meet or achieve patient human needs. specific and measurable

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11
Q

additive effects

A

similiar or equivalent to the sum of the individual effects 1 + 1 = 2

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12
Q

adverse drug event (the event is the admin’s fault)

A

undesirable occurance related to administering or failing to administer meds

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13
Q

adverse drug reaction (the reaction is therapeutic)

A

unexpected, unintended, undesired response given at theraupetic doses (unlike an overdose)

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14
Q

adverse effects

A

undesirable effects that are a direct response to one or more drugs

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15
Q

agonist

A

drug that stimulates the activity of one or more receptors

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16
Q

antagonist effect

A

1 + 1 = less than 2. a substance that stops the action or effect of another substance. also called inhibitors

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17
Q

bioavailability (available to absorb)

A

a measure of the extent of drug absorption for a given drug and route (from 0 - 100%)

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18
Q

biotransformation

A

one or more biochemical reactions involving a parent drug. occurs mainly in the liver and produces a metabolite that is either active or inactive. also called metabolism.

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19
Q

cytochrome P-450

A

general name for a larger class of enzymes that plays significant role in drug metabolism and interactions

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20
Q

dependence (your dependence is compulsive)

A

compulsive or chronic need for a drug

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21
Q

dissolution (before entering where?)

A

solid form disentigartes in gi tract and becomes soluble before entering circulation

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22
Q

drug

A

a chemical that affects the phsyiology of a living thing

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23
Q

drug effect

A

The physiologic reaction of the body to the drug
can be good or bad

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24
Q

teratogenic

A

Structural defects to Fetus

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25
Q

duration

A

The time a drug concentration is sufficient to elicit a
therapeutic response

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26
Q

first pass

A

initial metabolism in liver before reaching ciriculation

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27
Q

high first pass rate

A

a large amount of drug is absorbed by liver and less will reach target sites

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28
Q

glucose-6-phosphate dehydrogenase

A

hereditary - RBC break down when body is exposed to certain drugs

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29
Q

incompatability

A

2 parental drugs when mixed together result in deteroration of one drug

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30
Q

medication use process

A

prescribing, despensing, admin of meds and their effects

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31
Q

metabolite

A

chemical form of a drug that is the product of one ore more biochemical reactions involving parent drug. active metabolites have activity of their own, even if parent drug is inactive. inactive are drug waste products.

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32
Q

onsest

A

time to reach therapeutic response

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33
Q

p-gylcoprotein (p for pusher)

A

transporter protein that moves drugs out of cells into gut, urine or bile

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34
Q

pharmaceutics (ceut the dose)

A

the study of how various dosage forms influence the way in which the drug affects the body

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35
Q

pharmacodynamics

A

drug-receptor relationship.
the mechanism of drug actions in living tissues

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36
Q

pharmacogenomics

A

study of genetic factors

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37
Q

pharamcognosy

A

from natural plants or animals

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38
Q

pharmacokinetics (what does coke-netics do to the body from start to finish)

A

body does to the drug.
- Absorption
- Distribution
- Metabolism
-Excretion

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39
Q

receptor

A

reactive site on cell surface or inside cell

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40
Q

substrates

A

substances on which an enzyme acts

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41
Q

toxic

A

quality of being poisonous

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42
Q

trough

A

lowest concentration of a drug after peak.

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43
Q

neonate

A

younger than 1 month

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44
Q

pediatric

A

12 or younger

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45
Q

polypharmacy

A

use of multiple meds by older ppl

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46
Q

bias (bias against this measurement)

A

systematic error in measurement process

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47
Q

drug polymorphism

A

variation in response to a drug because of a patient’s age, gender, size and body composition

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48
Q

HIPAA

A

protects health insurance coverage for workers when they change jobs. protects patient info.

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49
Q

investigational new drug

A

not yet approved by FDA but safe

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50
Q

malpractice

A

type of negligence or failure by person with SPECIALIZED education to act in a reasonable or prudent way

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51
Q

negligence

A

failure to act in prudent or reasonable way

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52
Q

orphan drugs

A

treat rare diseases

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53
Q

adverse drug event - just basic description but also includes what?

A

adverse drug reaction and medication errors

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54
Q

adverse drug reaction (the reaction is therapeutic)

A

unexepected or unitended or excessive response to meds given at therapeutic dose

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55
Q

med reconciilation

A

maintain up to date list of meds for all patients and all phases of health care

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56
Q

affective domain (you affect my feelings)

A

expression of feelings

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57
Q

Iiatrogenic effects (analis is liatrogenic)

A

unitentional adverse effects caused by actions of a prescriber or health care person.

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58
Q

integrative medicine

A

use of western and nontraditional meds at the same time

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59
Q

phytochemicals

A

active ingredients in herbal remedies

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60
Q

adjuvant analgesic drugs

A

drugs added for combined therapy

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61
Q

agonist

A

drug binds to the receptor; there is a response

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62
Q

agonist-antagonist

A

bind to receptor and cause partial response not as strong as agonist

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63
Q

antagonist

A

drug binds to the receptor: there is no response. drug prevents biding of agonists.

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64
Q

central pain

A

pain caused by CNS damage

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65
Q

chronic pain

A

longer than 3 - 6 months

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66
Q

nociception (the process is nociception)

A

processing pain signals in brain that give rise to feelings of pain

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67
Q

partial agonist

A

drug binds to the receptor; the response is diminished compared to agonist

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68
Q

somatic pain

A

skeltal muscles, ligaments, or joints

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69
Q

superficial pain

A

skin or mucosa

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70
Q

general anesthesia

A

a drug induced state in which the CNS nerve impulses are altered to reduce pain and other sensations throughout the entire body. total loss of consciousness and respiratory drive.

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71
Q

monitored anesthesia care (MAC)

A

planned procedure where patient undergoes local anesthesia with sedation and analgesia

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72
Q

overton-meyer theory (over a ton lipid)

A

theory describing the relationship between lipid solubility of anesthetic drugs and their potentency

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73
Q

barbituates (barb will put you to sleep)

A

induce sedation

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74
Q

benzos (benzo for my anxiety)

A

anxiolytic (anxiety) drugs

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75
Q

GABA - gamma-aminobutyric acid (gaba all of em)

A

inhibitory neurotransmitter found in brain. key compound affected by sedative, benzos, psychotropic and muscle relaxers

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76
Q

hypontics (hypnotized but not sleepy)

A

calm or soothe cns without inducing sleep unless at high doses

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77
Q

non REM

A

4 stages before REM

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78
Q

REM interference

A

drug induced reduction of REM sleep time

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79
Q

REM rebound

A

excessive REM following discontinuation of drug

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80
Q

sedatives (sedate me, but don’t sleep)

A

inhibitory effect on CNS that reduce nervousnes, irritabilty without causing sleep

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81
Q

amphetamines

A

stimulants

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82
Q

analeptics (ana loves stimulants)

A

CNS stimulates that produce increase in responsiveness to external stimuli and stimulate respiration

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83
Q

anorexiants

A

drugs used to control or suppress appetite

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84
Q

catplexy

A

abprut attacks of muscle weakness triggers by joy, laughter, anger, fear, suprise

85
Q

ergot alkaloids

A

drugs that constrict blood vessels in brain - for migraines

86
Q

seratonin receptor agonists

A

CNS stimulants used to treat migraines

87
Q

sympathomimetic drugs (mimic the sympthatic)

A

CNS stimulants such as nonadrenengic drugs who mimic those of the sympathetic nervous system

88
Q

Schedule I

A

Schedule I: No accepted medical use w/high potential for Abuse.
Example: Heroin, Ecstasy, LSD, & Marijuana

89
Q

Schedule II (Schedule II is MAD, FC V)

A

Schedule II: accepted severe restrictions use w/ high potential for Abuse.
Example: Cocaine, Morphine, Vicodin, Demerol, Fentanyl, & Adderall

90
Q

Schedule III (schedule III is SKTCH)

A

Schedule III: accepted medical use w/moderate to low potential for Abuse.
Example: Ketamine, Anabolic Steroids, Codeine, Hydrocodone, Tylenol/ASA

91
Q

Schedule IV (schedule 4 is VAAXK)

A

Schedule IV: accepted medical use w/ low potential for Abuse.
Example: Valium, Ambien, Xanax, Klonopin, Ativan

92
Q

Schedule V

A

Schedule V: accepted medical use w/ low potential for Abuse.
Example: Robitussin AC

93
Q

PQRST

A

P = provoking factors - what factors precipitate pain - What were you doing when the pain started? What caused it? What makes it better or worse? What seems to trigger it? Stress? Position? Certain activities? -
Q=Quality - description of pain - What does it feel like? Use words to describe the pain such as sharp, dull, stabbing, burning, crushing, throbbing, nauseating, shooting, twisting or stretching
R=region or radiation
S=severity on a pain scale
T = how long has it been present? what makes it better or worse? - When/at what time did the pain start? How long did it last? How often does it occur: hourly? daily? weekly? monthly?

94
Q

WHO pain management scale/ladder (WHO is the adjuvant?)

A

1) (bottom) nonopiod +/- adjuvant
2) pain persisitng or increasing
3) opioid for mild or moderate pain
+/- opioid
+/_ adjuvant
4) pain persiting or increasing
5) (top) opioid for moderate to severe pain
+/- opioid
+/_ adjuvant

95
Q

pinpoint pupils is called…

A

myosis, miosis. possible overdose opiates

96
Q

post op is what type of therapy and what to do?

A

maintain integrity of body functions, provide fluids and electrolytes to prevent dehydration if they are vomiting, or blood products to patient who has lost blood during surgery. manage pain.

97
Q

sleep cycles - 1 (small to start)

A

non-REM - dozing, can be easily awakened 2-5% of sleep time

98
Q

sleep cycle - 2 (2 is at the top)

A

sleep deepening, high arousal required to be woken up . 50% of sleep

99
Q

sleep cycle 3 (3 is 3) and what about breathing? (second smallest)

A

deep sleep, difficult to wake, respiration, etc decreases 5% of sleep

100
Q

sleep cycle 4 (a little sleep before REM)

A

very difficult to wake. 10-15% of sleep time

101
Q

REM (REM is my favorite number)

A

vivid dreams, irregular breathing 25-33% of sleep

102
Q

Dantrolene (Dan trolled the hyperthermia)

A

used to treat malignant hyperthermia

103
Q

malignant hyperthermia

A

uncommon, genetic metabolic reaction to general anesthesia. associated with inhaled anesthesias. at risk - children, adolescents, and ppl with skeletal abnormalities

104
Q

pregnancy - B

A

Animal reproductive studies failed to
determine Risk to Fetus & there are no adequate & well controlled studies in pregnant women

105
Q

pregnancy category - C (c, there is an adverse effect on animals)

A

Animal reproductive studies shown an
adverse effect on Fetus & there are no adequate & well controlled studies in humans, but potential Benefits may warrant drug use in pregnant women despite potential Risks.

106
Q

pregnancy category - D (delightfully not animals this time)

A

Positive evidence of human fetal Risk based
on adverse reaction data from investigational, marketing experience or studies in humans, but potential benefits may warrant use of drug in pregnant women despite Risks

107
Q

9 rights

A
  1. RIGHT Patient X
  2. RIGHT Drug X
  3. RIGHT Dose X
  4. RIGHT Route X
  5. RIGHT Time X
  6. RIGHT Documentation X
  7. RIGHT to Refuse X
  8. RIGHT response X
  9. RIGHT Reason X
108
Q

ex of human needs statement

A

altered safety needs (human response), risk for injury related to medication

109
Q

implementation

A

nurse intervenes on behalf of patient, ie physical therapy

110
Q

QSEN (patient is the center, then the team, then the evidence, then quality brings safety and info)

A

patient-centered care, teamwork, evidence-based practice, quality improvement, safety, and informatics.

111
Q

rectal drugs are given for what reason?

A

for systemic effects - reduce fever, anything system–wide

112
Q

do sublingual and buccal bypass the liver?

A

YES, ie nitroglycerin

113
Q

fastest to slowest routes for absorption

A

parenteral (IV), enteral, topical

114
Q

do topical meds bypass the liver?

A

Yes, ALL but rectal

115
Q

nurse practic act defines the..

A

scope

116
Q

affective domain learning

A

expression of feelings

117
Q

Pharmaceutical - (does the drug suit the dissolution)

A

Dosage form determines the rate drug dissolution (dissolving of solid dosage forms and their absorption from the GI tract). goes from solid and breaks down in gut
🞑 Enteric-coated tablets
🞑 Extended-release form

118
Q

Pharmacokinetic (what does coke-netics do to the body from start to finish)

A

The study of what the body does to the drug
- Absorption
- Distribution
- Metabolism
-Excretion

also onset, peak, duration and UNTIL the parent drug and metabolites have left the body.

119
Q

Absorption (absorb the bupe into your bloodstream to your sore muscles)

A

the movement from administration into the bloodstream for distribution to the tissues

120
Q

Pharmacodynamics involves..(the dynamic between the drug and receptor)

A

drug-receptor relationship.
the mechanism of drug actions in living tissues

121
Q

examples of enteral routes (enteral BROS)

A
  • Oral
  • Sublingual
    -Buccal
    -Rectal (can also be topical)
122
Q

lungs are what route?

A

topical

123
Q

ANA - Provision 1 (it takes one for compassion)

A

Provision 1 The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

124
Q

Provision 2 - ANA (it takes 2 to commit)

A

The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.

125
Q

Provision 3 - ANA (advocate for the number 3)

A

Provision 3 The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.

126
Q

Provision 4 ANA (accountable for 4 chambers in the heart)

A

The nurse has authority, accountability and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.

127
Q

Provision 5 - ANA (five fingers make up the self)

A

The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

128
Q

Provision 6 ANA (666 is not safe)

A

The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.

129
Q

Provision 7 (educated at 7/11)

A

The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.

130
Q

Provision 8 ANA (I ate your human rights with other professionals)

A

The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.

131
Q

Provision 9 ANA (nine social justices)

A

The profession of nursing, collectively through its professional
organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

132
Q

kidney stone is what type of pain?

A

visceral

133
Q

adjuvant

A

second drug when first isn’t enough

134
Q

somatic pain

A

skeletal muscles, ligaments or joints

135
Q

neuorpathic pain

A

damage to peripheral nerve

136
Q

central pain

A

tumors, trauma or inflammation of the brain (anything CNS related)

137
Q

meripidine (D for demerol)

A

(D for demerol and D for die 7x stronger than morphine) - can cause seizures - toxic

138
Q

antidote for benzos (benzo has the flu, what’s the antidote?)

A

flumazenil

139
Q

neuropathic tissue is unhealthy tissue - like

A

neuropathy

140
Q

analgesic

A

analgesic - more relief from pain without losing consciousness

141
Q

morphine - agonist or antagonist?

A

opioid agonist analgesic - mimics endogenous opiate

142
Q

opiate contraindications (Ana nicole is BAB)

A

benzos, alcohol, and barbiturates

143
Q

what to give for alcohol withdrawals?

A

benzos

144
Q

do sublingual and buccal bypass the liver?

A

yes, nitrogylcerin

145
Q

do topical meds bypass the liver?

A

yes, all but rectal

146
Q

recovering from an illness is what type of therapy?

A

supportive

147
Q

Examples of drugs with a narrow therapeutic index (Amine in the corner)

A
  1. Aminoglycosides (Gentamicin®)
  2. Digoxin (Lanoxin®)
  3. Lithium (Lithobid®)
  4. Phenytoin (Dilantin®)
  5. Valproic Acid (Depakote®)
  6. Warfarin (Coumadin®)
148
Q

Potentiation (potent for the other drug)

A

when one drug does not elicit a response on its own but enhances the response to another drug.

149
Q

gate theory

A

injured tissue releases bradykinin, histamine, potassium, prostaglandins, seratonin. This release causes an action potential in sensory nerve fibers through pain receptors called nonciceptors. These impulses activate pain receptors in spinal cord (dorsal horn). The gates are here.
If impulses are stopped at the gate, no pain is felt. Doesn’t reach the brain.
If the gate allows many action potentials through, they reach the brain and pain is felt. This is known as nonciception.

150
Q

Nurses Practice Act

A

The Nursing Practice Act (NPA) is the body of California law that mandates the Board to set out the scope of practice and responsibilities for RNs.

151
Q

major adverse effect with opioids - what about cough?

A

it’s a cough suppressant and patients can’t cough and clear their throat. They are at risk for post-op pneumonia.

152
Q

don’t combine morphine, demerol (or any opiates) with

A

MAO inhibitors (depression meds) excessive activation of
serotonin receptors causing excitation, delirium,
hyperthermia, seizures, coma & death

153
Q

demerol pregnancy category (demerol is surprisingly low)

A

B

154
Q

naloxone pregnancy category

A

C

155
Q

vicodin pregnancy category

A

C

156
Q

methadone pregnancy category

A

C

157
Q

xanax pregnancy category (xanax is Damn bad)

A

D

158
Q

diazapam pregnancy category (think benzo)

A

D

159
Q

demerol w/ antihistamine?

A

increases effect of demerol which is good…you can use less of it, less toxic

160
Q

vicodin inhibitors and inducers

A

Inhibitors: Amiodarone (cardiovascular drug)
🞑 Inducers: barbiturates, tegretol

161
Q

methadone inhibitors and inducers

A

Inhibitors: sertraline, rifampin
🞑 Inducers: tegretol, phenobarb, phenytoin, barbiturate anesthetics

162
Q

 Interactions: NSAIDS

A

njury to gastric mucosa Tylenol® =
liver damage with only 2-4 drinks per day (limit should not
exceed 2 grams per day)

163
Q

Chlor-DI-ze-POX-ide (chlora is a libra)

A

librium
 Action:
🞑 Potentiates the actions of GABA, especially in the limbic
system, reticular formation
 Uses:
🞑 Short-term management of anxiety, acute alcohol
withdrawal, preoperatively for relaxation

164
Q

during non-REM

A

bp falls
pulse rate slows
metabolic rate decreases
gastro slows
urine formation slow
O2 consumption and CO2 production is reduced
temp decreases slightly
respiration slower and more shallow
body movement is minimal

165
Q

ativan (my Ortho takes Ativan)

A

 Adverse Effects
🞑 Dizziness, drowsiness, Orthostatic hypotension, ECG
changes, tachycardia, hypotension; apnea, cardiac
arrest (IV, rapid)

166
Q

benzos have what in the name?

A

zepam or zolam

167
Q

Hypnotics are used to

A

Hypnotics are used to induce sleep with greater
CNS depression than sedatives.

at low or moderate doses, calms CNS. At high doses, induces sleep

168
Q

drug classifications (BC M at the clinic)

A

1) Clinical indication
2) Mechanism of Action
3) Body system

169
Q

1) Clinical indication

A

(Bronchodilator)

170
Q

2) Mechanism of Action (just what a drug does)

A

(biochemical process through which a drugproduces its effect)

171
Q

Body system

A

Body system - ( CNS)

172
Q

WHO pain scale (goes in 3s)

A

 Pain Description
 “Mild pain” - 1 to 3
 “Moderate pain” - 4 to 6
 “Severe pain” 7 to 10

173
Q

Chlordiazepoxide (chlora loves librium)

A

librium - for alcohol withdrawals, benzo

174
Q

Lorazepam (Lorazepam in LA)

A

Ativan® (for anxiety) sedative

175
Q

alprazolam (al loves xanax)

A

xanax - sedative

176
Q

diazapam

A

valium (pam, so it’s a benzo). anxiety, insomnia

177
Q

nonceceptors respond to what kind of pain? (TMC)

A

🞑 “thermal” (heat or cold),
🞑 “mechanical”(crushing, tearing, etc.) and
🞑 “chemical”(iodine in a cut, chili powder in the eyes).

178
Q

tylenol antidote

A

N-acetylcysteine

179
Q

6 rights - use these for the exam

A

rights patient, dose, route, time, med, right reason

180
Q

digoxin antidote (binding to digoxin)

A

Digibind or Digifab

181
Q

cholenergic toxic antidote (cholera airplane)

A

atropine

182
Q

To name a few, aged cheese and wine
interact with

A

MAO inhibitors

183
Q

Tachyphylaxis (law of diminishing returns is tacky)

A

rapidly diminishing response to successive doses of a drug, rendering it less effective

184
Q

steady state

A

elimination is equal to absorption

185
Q

nociceptors

A

sensory nerves that transmit pain signals to the CNS

186
Q

analeptics (ana loves stimulants)

A

CNS stimulants that produce an increased reaction to external stimulus

187
Q

a medication error is what type of event?

A

adverse drug event

188
Q

if you want to sleep, use..

A

then hypnotics - barbs not recommended for sleep anymore

189
Q

only use barbs for

A

convultions

190
Q

for benzos muscle relaxers, what to check?

A

check sleep patterns, full phsycial, and depression and drug use

191
Q

for zolidepem,

A

(ambien) head to toe, allergies, and drug use

192
Q

Nociceptive pain is caused by

A

Nociceptive pain is caused by stimulation of
peripheral nerve fibers (cold, crushing, burning)

193
Q

methadone nursing consideration

A

chest pain

194
Q

2 types of adverse drug reactions (my allergy is reacting to my idiosynchocy)

A

allergic and idiosynchratic

195
Q

OD (OD once a day)

A

once daily

196
Q

per OS

A

by mouth, orally

197
Q

qn (n for nightly)

A

nightly

198
Q

qod (od = other day)

A

every other day

199
Q

ss

A

sliding scale

200
Q

SSI or SSRI

A

sliding scale insulin

201
Q

TIW

A

3 times a week

202
Q

human needs statements usually say (I’m altering your human needs)

A

altered

203
Q

threshold is the level of

A

stimulus

204
Q

adverse effect to opioids

A

itching, CNS depression

205
Q

local anethetics work on what nerves?

A

peripheral

206
Q

succincoyline

A

depolarizing NMBD

207
Q

barbs stimulate

A

enzymes

208
Q

leafy green vegetables interact with

A

warfarin

XIO (372 decks)

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