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Pharm Test #1 Flashcards

1
Q

what is the study of biological effects of chemicals

A

pharmacology

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2
Q

what are chemicals that are introduced into the body to cause some sort of change

A

drugs

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3
Q

what kind of pharmacology do nurses deal with

A

pharmacotherapeutics or clinical pharmacology

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4
Q

who focuses on how chemicals act on living organisms

A

healthcare providers

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5
Q

what is the nurse’s responsibility

A

administering drug
assessing drug effects
intervening to make drug regimen more tolerable
providing patient teachings about drugs and the drug regimen
monitoring overall pt care plan to prevent medication errors

***know

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6
Q

what does a nurse always do after giving a pt medications

A

reassess the pt

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7
Q

what category of drugs is risk to fetus in the first trimester, but no evidence of risk in later trimesters

A

category A

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8
Q

chemicals produced by companies involved solely in manufacturing of drugs

A

generic drugs
**know

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9
Q

bioavailabilty of drug may be different than brand name

A

generic drug

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10
Q

these are dispensed as written

A

generic drugs

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11
Q

taking these drugs w/ prescription medicatons could result in drug interactions and interfere w/ drug therapy

A

OTC

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12
Q

these products are available without prescriptons

A

OTC

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13
Q

these are high abuse protentional, no accepted medical use

what types of drugs are included in this

A

Level I drug on DEA schedule of controlled substance

heroin, marijuana, lsd

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14
Q

control over coding of drugs and the enforcement of these codes

A

FDA and the DEA

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15
Q

this agency deals with the prescription, distribution, storage and use of drugs

A

FDA

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16
Q

study of the interactions btwn the chemical components of living systems and foreign chemicals that enter those systems

A

pharmacodynamics

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17
Q

this is how the drug acts on the body

A

pharmacodynamics

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18
Q

drugs act in what four ways

A
  1. replace or act as a substitute for missing chemicals
  2. increase or stimulate certain cellular activities
  3. depress or slow cellular activities
  4. interfere with the functioning of foreign cells
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19
Q

these react to certain chemicals to cause an effect within the cell

A

receptor sites

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20
Q

this produces an effect

A

agonists

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21
Q

these block the receptor sites

A

competitive antagonists
noncompetitive antagonists

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22
Q

these distrupt cell function

A

drug enzyme interactions

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23
Q

this targets only foreign cells

A

selective toxicity

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24
Q

the study of absorption, distribution, metabolism, and excretion of drugs

A

pharmacokinetics

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25
Q

distribution means

A

moving into another body system

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26
Q

excretion means

A

how the drug leaves the body

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27
Q

this means how the body detoxifies chemicals to make them friendly throughout body

A

metabolism

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28
Q

this means when the drug has effects - not always instant unless its via IV

A

onset of drug action

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29
Q

time it takes drug to peak

A

drug half life

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30
Q

time for max effect of drug

A

timing of the peak effect

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31
Q

how long the drug stays in the system

A

duration of drug effects

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32
Q

the reaction before excretion of drgu

A

metabolism/biotransformation of drug

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33
Q

another word for metabolism

A

biotransformation

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34
Q

where the drug is eliminated from body

A

site of excretion

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35
Q

amount of drug that is needed to cause a theraputic effect

A

critical concentraion

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36
Q

a higher dose than usually used for treatment

A

loading dose

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37
Q

what is the action of a drug

A

to depress or slow cellular activities

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38
Q

most common route of taking drugs

A

via oral

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39
Q

this is what happens to a drug from time it is introduced to the body until it reaches circulating fluids and tissues

A

absorption

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40
Q

movement of a drug to the body’s tissues affected by lipid solubility, ionization, perfusion of reactive tissue

A

distribution

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41
Q

3 types of distribution

A

protein binding
blood brain barrier
placenta and breast milk

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42
Q

factors affecting absorption intravenously

A

none

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43
Q

factors affecting absorption via intramuscular

A
  1. perfusion or blood flow to muscle
  2. fat content of muscle
  3. temp of muscle
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44
Q

factors affecting absorption subcutaneous

A
  1. perfusion or blood flow to tissue
  2. fat content of tissue
  3. temp of tissue
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45
Q

factors affecting absorption PO (oral)

A
  1. acidity of stomach
  2. length of time in stomach
  3. blood flow to gi tract
  4. presence of interacting foods or drugs
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46
Q

factors affecting absorption PR (rectal)

A

perfusion or blood flow to rectum
lesions in rectum
length of time retained for absorption

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47
Q

factors affecting absorption muscuos membranes (sublingual buccal)

A

perfusion or blood flow to area
integrity of mucous membranes
presence of food or smoking
length of time retained in area

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48
Q

factors affecting absorption topical (skin)

A

perfusion or blood flow to area
integrity of skin

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49
Q

factors affecting absorption inhalation

A

perfusion or blood to low to area
integrity of lung lining
ability to administer drug properly

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50
Q

what is the single most important site for biotransformation (metabolism)

A

liver

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51
Q

this is the first pass effect
hepatic enzyme system

A

metabolism (biofransformation)

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52
Q

if this doesn’t work it will cause toxicity within body

A

liver

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53
Q

this is the removal of drugs from body

A

excretion

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54
Q

what is the most important role in excretion of medication

A

kidneys

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55
Q

nephrotoxicity is where

A

kidneys

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56
Q

normal BUN numbers

A

8-20

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57
Q

factors influencing drug effect

A
  1. weight
  2. age
  3. gender
  4. physiological & pathological factors
  5. genetic factors
  6. immunological & psychological factors
  7. environmental factors
  8. tolerance, accumulation, interactions
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58
Q

what is accumulation in regards to influencing drug effect

A

time drug takes to get into body and take too much it turns toxic

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59
Q

what is the half life of drug

A

time it takes for amount of drug in body to decrease to one half the peak level

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60
Q

half life is affected by what four things

A

absorption, distribution, metabolism, excretion

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61
Q

what impacts absorption and is important that may interact with drugs

A

food

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62
Q

this can occur any time two or more drugs are taken together

A

drug to drug interaction

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63
Q

what is tydrating

A

slowly coming down from medication

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64
Q

excessive response to primary or secondary effect of drug

A

hypersensitivity

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65
Q

body forms antibodies to a drug, causing immune response when reexposed

A

drug allergy

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66
Q

a reason adverse effect of drug occurs

A

pt is sensitive to drug being given
pt is taking too much or too little of drug

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67
Q

what is the inflammation of mucous membranes

A

stomatitis

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68
Q

what types of infections are hardest to treat

A

fungal

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69
Q

destruction of the bodys normal flora

A

superinfections

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70
Q

bone marrow suppression caused by drug effects

A

blood dyscrasia

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71
Q

toxicity =

A

poison

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72
Q

what interventions would you do for liver injury toxicity

A

small frequ meals, good skin care, vital signs, let pt rest since they’ll be fatigue

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73
Q

what interventions would you do for renal injury toxicity

A

renal diet, fluid restriction, discontinue meds, treat electrolyte balance

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74
Q

what intervention would you do for hypoglycemia

A

get blood sugar level up — use juice or dextrose IV

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75
Q

what intervention would you do for hyperglycemia

A

admin insulin, reassess

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76
Q

what intervention would you do for hypokalemia

A

EKG to check cardiac rhythm and function

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77
Q

what intervention would you do for hyperkalemia

A
  1. kayexalate - orally or enema
  2. do cleansing enema
  3. give insulin bc binds with potassium and give dextrose
78
Q

what assessment would take place for ocular damage

A

visual changes (blurred vision, corneal changes, blindness)

79
Q

what assessment would take place for auditory damage

A

dizziness, ringing in ears, loss of balance, loss of hearing

80
Q

what is the assessment for atropine-like effects (anticholinergic)

A

dry mouth, urinary retention, constipation, blurred vision, nasal congestion, skin dryness

81
Q

what are the interventions for atropine-like effects

A

sugarless lozenges to keep mouth moist
prevent dehydration
have pt void before admin of medication

82
Q

in regards to neurological effects - waht is the most important to know for the CNS

A

know pts base line

83
Q

any drug causes harm to developing fetus or embryo

A

teratogenicity

84
Q

when teaching to prevent teratogenicity - waht is the most important thing

A

advise pregnant woman any medication may have possible effects on baby

85
Q

this is a progressive chronic neurological disorder; may develop in ppl of any age

A

parkinsons disease

86
Q

what are signs of progression of parkinsons disease

A
  1. lack of coordination
  2. rhythmic tremors
  3. bradykinsea
  4. problems with urinary retention, mostly men
  5. mask like expressions
  6. rigidity/weakness
87
Q

mgmnt of care for pt’s with parkinson’s disease

A
  1. encourage pt’s to: be active, perform exercises, maintain independent ADL, follow drug protocol
  2. caregivers should: monitor adverse effects; provide support
88
Q

what two drugs for parkinson’s disease

A

levodopa (generic)
carbidopa-levodopa (sinemet)

**these must be taken with food

89
Q

parkinson’s disease meds are what type

A

dopaminergics

90
Q

what are the pharmacokinetics for dopaminergics (4)

A
  1. well absorbed from GI tract and widely distributed in body
  2. metabolized in liver and peripheral cells
  3. excreted in urine
  4. crosses placenta
91
Q

what actions do dopaminergics do

A
  1. increase levels of dopamine in substantia nigra
  2. directly simulating dopamine receptors in area
  3. helping to restore balance btwn inhibitory and stimulating neurons
92
Q

contraindiction of dopaminergics

A

angle closure glaucoma

93
Q

what cautions for dopa minergics

A

cv disease
bronchial asthma
h/o petic ulcer
**these can aggravate condition

94
Q

adverse effects of dopaminergics

A

anxiety
headache/blurred vision
arrhythmia
neutropenia
bowel movement probs

95
Q

what drug to drug interactions occur with dopaminergics

A

vitamin b6
st johns wart

**decrease theraputic effect of med

96
Q

what are the RN interventions for parkinson’s disease

A

baseline vitals and neurologic assessment
check for dyskinesia, rigidity, tremors, gait disturbances
assess ability to swallow
do not crush extended release pills
drugs are admin by transdermal patch. – use fatty or muscle areas

97
Q

this is the mainstay treatment of parkinsons
precursor of dopamine that crosses blood/brain barrier
almost always given in combo with carbidopa

98
Q

what is another name for sinemet

A

levodopa carbidopa

99
Q

what are the anticholinergic contraindictions

A
  1. allergy, glaucoma, prostatic hypertrophy, tachycardia, hepatic dysfunction
100
Q

adverse effects of anticholinergic agents

A

cns effects & peripheral anticholinergic effects

101
Q

drug to drug interactions of anticholinergics

A

other anticholinergics, antipsychotics

102
Q

this is used with drug to enhance effects of drug

A

adjunctive agents

103
Q

this is used to restimulate the carbidopa levodopa after pts show signs of deteriorating response to treatment

A

selegiline

104
Q

this is used with carbidopa levodopa to increase the plasma concentration and duration of action of levodopa

A

entacapone

105
Q

what are the 8 rights for nurse’s role

A
  1. right pt
  2. right drug
  3. right storage
  4. right route
  5. right dose
  6. right preparation
  7. right time
  8. right recording
106
Q

during assessment what do we need to know

A

history: chronic conditions; drug use; allergies, level of educ; social supports; finl supports; pattern of healthcare
phy exam: weight, age, physical parameters related to disease

107
Q

what are the steps to the nursing process

A

assessment
planning
implementation
evaluation

108
Q

nursing interventions are aimed at what

A

achieving outcome goals determined in planning phase

109
Q

all medication issues are reported to who

A

national level and institutional level

110
Q

this is part of the continuing process of pt care
leads to changes in assessment, diagnosis & intervention

A

evaluation & re evaluation

111
Q

**may not need to take pt off med… may just need to

A

reduce the medication dosage

112
Q

what are signs of depression

A

low energy level
sleep disturbances
overwhelming saddness, hopelessness

113
Q

what is an example of a tricyclic antidepressant

A

amitriptyline ***know

114
Q

how choose the right tricyclic antidepressants

A

choice depends on individual response to drug and tolerance of adverse effects

115
Q

what are indications of tricyclic depressants are working

A

relief of symptoms of depression

116
Q

what cautions are associated with tricylic antidepressants

A

cardiovascular disease. dont put pt on if cv history - can cause reinfarction, palpitations

117
Q

what are adverse effects of tricyclic antidepressants

A

fatigue, dry mouth, sleep disturbances,

can’t go cold turkey or will cause withdrawal symptoms
-must check liver functions due to concentration of drug in liver

118
Q

MAOIs stand for waht

A

monoamine oxidase inhibitors

119
Q

what is the indications for MAOIs

A

treatment of pts with depression who are unresponsive to or unable to take other antidepression agents ***** know

120
Q

what are the pharmacokinetics of MAOIs

A

*metabolize in liver, excreted in urine — watch liver functions
*cross placenta and enter breast milk
*can’t have food w/ tyramine — beer, cheese, soy, smoked meats, etc

121
Q

what drug can you not put pt on if on MAOIs

A

SSRI - causes serotinin syndrome

122
Q

what drugs do MAOIs have interactions with

A

*other anti depressants - hypertensive crisis, coma
*methyldopa - sympathomimetic effects increase
*insulin - additive hypoglycemia

123
Q

what food does MAOIs interact negatively with

A

tyramine - increases blood pressure

124
Q

can you take MAOIs if you have liver or kidney issues

125
Q

Can MAOIs cause suicidal ideations

126
Q

what does SSRI stand for

A

selective serotonin reuptake inhibitors

127
Q

waht do SSRIs do

A

block reuptake of 5Ht, with little to no known effects on NE

128
Q

how many adverse effects do SSRIs have associated with TCAs and MAOIs

A

not many. safest meds. fewest side effects

129
Q

What are 3 examples of SSRIs

A

*citalopram (celexa)
*escitalopram (lexapro)
*sertraline (zoloft)

130
Q

waht SSRI doesn’t cross placental barrier

131
Q

what are the pharmacokinetics of SSRIs

A

absorbed in GI tract
metabolized in liver
associated with congenital abnormalities

132
Q

what contraindications do SSRIs have

A

known allergy, pregnancy, lactation, impaired renal function, hepatic function

133
Q

can you crush or chew your SSRIs

134
Q

what herb decreases concentration of meds

A

st johns wort

135
Q

how many days does a pt need to be off medications before switching to a different class of antidepressant

136
Q

what is adverse effect of SSRI

A

headache, drowsiness, dizziness, hypertension

137
Q

how do you know if SSRI is working

A

improving pts depression

138
Q

waht drug interactions do SSRI have

139
Q

What does SNRI stand for

A

serotonin norepinephrine inhibitors

140
Q

what actions do SNRI take

A

decrease neuronal reuptake of both serotonin and norepinephrine and more weakly inhibit dopamine ** know

141
Q

when do you take you SSRI

A

in the AM for max effect

142
Q

what are the pharmacokinetics of SNRI

A

absorbed from GI tract
metabolize din liver
excreted in urine

143
Q

waht are the contraindications of SNRI

A

allergy, MAOI use ***** know

144
Q

what two drugs are SNRI taht you’ll see in hospital

A

duloxetine (cymbalta)
venlafaxine (effexor)

145
Q

what are some mental disorders for psychotherapeutic agents

A

schizophrenia
bipolar
narcolepsy
ADD

146
Q

what are psychotherapeutic agents for

A

used to treat psychoses – preceptual and behavioral disorders

147
Q

do psychotherapeutic drugs cure the disorders

A

no. they help pts function with ADL. helps with symptoms

148
Q

3 psychotherapeutic drugs that cause paramedial effects

A

*chlorpromazine (thorazine)
*haloperidol (haldol)
*risperidone (risperdal)

149
Q

this person has hallucinations, paranoia, delusions

A

schizophrenia

150
Q

what are the causes of schizophrenia

A

strong genetic association
may reflect fundamental biochem abnormality

151
Q

antipsychotic neuroleptic drugs are used for what disorder

A

schizophrenia

152
Q

this is extreme depression followed by hyperactivity and excitement

153
Q

this is daytime sleepiness and sudden periods of loss of wakefulness

A

narcolepsy

154
Q

this is the inability to concentrate on one activity longer than a few mins.

is usually diagnosed in school age kids

A

ADD - attention deficit disorder

155
Q

who’s involvement is needed to fill out APPIE for ADD pts

156
Q

what are these interventions for

  1. ID factors that aggravate/alleviate pt’s performance
  2. provide distraction free environment
  3. use simple language, talk slowly
  4. state expectations of tasks
A

nursing interventions for ADHD

157
Q

waht is the most important nursing intervention for ADHD pts

A

provide positive feedback for completion of each step of task

158
Q

WHAT kind of medications are used to treat ADHD

A

stimulants

159
Q

what are contraindications of antipsychotic and neuroleptic drug

A

parkinsons disease
coronary disease
prolonged QT interval - cardiac rhythm

160
Q

what are drug to drug interactions for antipsychotic/neruoleptic drugd

A

alcohol
anticholinergics
ziprasidone

161
Q

these have the signs and symptoms of anticholinergics

A

antipsychotic / neuroleptic drugs

162
Q

these are muscle tremors, cogwheel rigidity, drooling, shuffling gait

extrapyramidal effect

A

pseudoparkinsonism

163
Q

extrapyramidal effect

spasms of tongue, neck, back, legs which can cause unnatural posturing

164
Q

extrapyramidal effect

continuous restlessness, inability to sit still (foot tapping, hand movements)

165
Q

extrapyramidal effect

abnormal muscle movements, lip smacking, tongue rolling, chewing, leg/arm movements

** know this

A

tardive dyskinesia

166
Q

what drug is used for bipolar

***know this

A

lithium (lithobid)

167
Q

-this alters sodium transport in nerve and muscle cells
-inhibits release of norepinephrine and dopamine from stimulated neurons

168
Q

what does lithium cross that’s associated with creating congenital abnormalities

A

placenta barrier

169
Q

what are the adverse effects of lithium

A

lithium toxicity

170
Q

what #s are the therapeutic lithium level

A

0.5-1.0 mEq/L

*must know

171
Q

this lithium level creates lethargy, slurred speech, muscle weakness,, nausea **** know this

172
Q

what is a lithium drug

A

haloperidol

173
Q

what is important for nursing considerations for antimanic drugs

A

any known allergies to lithium
sodium depletion
use of diuretics

urinary output, liver and renal function tests

174
Q

this is most prevalent of neurological disorders

175
Q

this disorder is frightening to pts

176
Q

two types of generalized seizures

A

absence and status epilepticus

177
Q

this seizure lasts 3-5 secs, can lose consciousness, mostly in children, disappears once hit puberty

178
Q

this seizure is a medical emergency, most dangerous bc no recovery in btwn seizures

A

status epilepticus

179
Q

2 categories of seizures

A
  1. grand mal
  2. petit mal (absence)

*** these are now called generalized or partial seizures

180
Q

what do generalized seizure drugs treat

A

they stabilize nerve membranes by blocking channels in cell membrane or altering receptor sites.

work generally on central nervous system

181
Q

what hydantoins drug is used for seizures

A

phenytoin ** know

182
Q

why is phenytoin used

A

*generally less sedating
*may be drug of choice for pts unable to tolerate sedation and drowsiness

183
Q

waht is the pharmacokinetics of hydantoins

A

therapeutic serum phenytoin levels 10-20 mcg/mL

184
Q

can you give hydantoins with dextrose

A

no. only normal saline. give IV or orally

185
Q

waht are adverse effects of hydantoins

A

***** know

depression, confusion, severe liver toxicity, bone marrow suppression, decrease appetite

186
Q

*** know these

what are the nursing considerations for hydantoins …. phenytoin (7)

A
  1. thorough neuro assessment
  2. gingival hyperplasia (overgrowth of gum tissue)
  3. PO or IV (vesicant – harmful to vein)
  4. take 2-3 hours before or after antiacid
  5. no grapefruit
  6. therapeutic drug levels drawn as prescribed
  7. photosensitivity
187
Q

what benzodiazepines are used for anti seizure

A

diazepam (valium) **

188
Q

what are the RN considerations for benzodiazepines for antiseziures

A

-addictive drugs
-CNS assessment to know level or orientation

189
Q

what are adverse effects of benzodiazepines

A

depression, confusion, drowsiness, cardiac arrhythmias, urinary retention, phys dependence, withdrawal

190
Q

adverse effects for treating absence seizures

A

liver toxicity and CNS suppression

191
Q

RN considerations for treating absence seizures

A

N/V, anorexia, drowsiness/dizziness, photosensitivity, bleeding

Nursing 111 & Pharmacology (12 decks)

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