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pharmacology 1 Flashcards

1
Q
  1. What is the generic name of a drug?
A

The chemical name of a drug (ex. acetaminophen)

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2
Q
  1. What is the trade name of a drug?
A

Brands that make the drug (EX Advil)

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3
Q
  1. What is a drug?
A

any chemical that can affect living processes

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4
Q
  1. What is the drug action?
A

How the drug molecules change processes in the body

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5
Q
  1. What is the therapeutic use of a drug?
A

Prevention, treatment, or management of a disease of system

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6
Q
  1. What are drug classes?
A

Classified according to physiologic function or primary disease treated

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7
Q
  1. What are preferred agents?
A

The “go-to” drugs in a healthcare system

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8
Q
  1. What is pharmacokinetics?
A

the study of what the body does to the drug

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9
Q
  1. What is the time of onset?
A

Time required for a drug to elicit a therapeutic effect

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10
Q
  1. What is peak effect?
A

time required for a drug to reach its maximum therapeutic response

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11
Q
  1. What is. peak level?
A

highest level of a drug in the body

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12
Q
  1. What is the duration of action?
A

the length of time the drug has a pharmacologic effect

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13
Q
  1. What are the pharmacokinetic actions?
A

Absorption, Distribution, Metabolism, Excretion

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14
Q
  1. What is absorption?
A

Movement of the drug from the admin site into the blood stream

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15
Q
  1. What. is distribution?
A

transport of a drug by the bloodstream to its site of action

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16
Q
  1. What is a drug-drug interaction?
A

occurs when two drugs are metabolized by the same enzyme and affect each other’s metabolism

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17
Q
  1. What is metabolism?
A

Happens in the liver, skeletal muscle, kidneys, lungs, plasma, or intestinal mucosa

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18
Q
  1. What is the first pass effect?
A

The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream.

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19
Q
  1. What is excretion?
A

removal of drugs from the body

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20
Q
  1. What is the half-life of a drug?
A

amount of time it takes for the blood level of a drug to be reduced by 50%.

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21
Q
  1. What is pharmacodynamics?
A

How the drug affects the body

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22
Q
  1. What is the mechanism of action?
A

Changes that result from interactions

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23
Q
  1. What is the therapeutic index?
A

ratio of toxic dose to therapeutic dose

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24
Q
  1. What are the 3 chemical classes of opioids?
A

Morphine-Like, Meperidine-like, Methadone-Like

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25
Q
  1. What are some adverse effects of opioids?
A

respiratory depression, constipation, urinary retention, dizziness, hypersensitivity

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26
Q
  1. What are some contraindications of opioids?
A

Severe asthma, renal failure, increased intracranial pressure, known allergy

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27
Q
  1. Which opioid is a “non-ceiling” drug?
A

Morphine

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28
Q
  1. Which opioid is most effective given orally?
A

Codeine

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29
Q
  1. What is codeine metabolized to?
A

morphine

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30
Q
  1. Which opioids are schedule II?
A

Morphine, hydrocodone, meperidine,

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31
Q
  1. Which two opioids can be used an antitussives?
A

Codeine, Hydrocodone

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32
Q
  1. Which two drugs are oxycodone often combined with?
A

Acetaminophen (Percocet) or aspirin (Percodan)

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33
Q
  1. How quickly can opioid withdrawal occur?
A

2 weeks after use

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34
Q
  1. How do agonist-antagonist opioids work?
A

Binds to a pain receptor but causes a weaker pain response than a full agonist

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35
Q
  1. Which pain receptors are most important?
A

Mu receptors

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36
Q
  1. What are some adverse effects of agonists-antagonists?
A

Respiratory depression, dizziness, lightheadedness, abstinence syndrome

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37
Q
  1. Which patients cannot receive agonists-antagonists?
A

Patient with MI or cardiac insufficiency

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38
Q
  1. How are agonist-antagonists administered?
A

IM, IV, or intrsnasally

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39
Q
  1. How is Pentazocine (Talwin) administered?
A

Orally

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40
Q
  1. What do opioid antagonists do?
A

reverses symptoms of addiction, toxicity, and overdose

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41
Q
  1. How do opioid antagonists work?
A

Block opioid receptors

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42
Q
  1. What is the antagonist prototype?
A

Narcan (Naloxone)

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43
Q
  1. What are adverse effects of narcan?
A

Increased RR, HR, and BP as well as withdrawal

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44
Q
  1. How often should you monitor vitals after administration of Narcan?
A
  • Every 5-15 minutes for several hours
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45
Q
  1. What are some interactions between opioids and substances (I.e. alcohol)
A

Respiratory depression

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46
Q
  1. What are some interactions of opioids and mono amine oxidase inhibitors?
A

Respiratory depression, seizures, hypotension

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47
Q
  1. What can show up on lab tests after administering opioid antagonists?-
A

Abnormal serum levels of amylase, bilirubin, lipase, and more
Abnormal decrease in urinary 17-ketosteroid levels
Increase in urinary alkaloid & glucose concentrations

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48
Q
  1. What is the dosage for Narcan?
A

.1-2 mg every 2-3 minutes

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49
Q
  1. What are the types of non-opioid analgesics?
A

1st Gen NSAIDS (COX-1 & COX-2)
2nd Gen NSAIDS (COX-2)
Acetaminophen Centrally-acting non-opioids

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50
Q
  1. What are NSAIDS used for?
A

Inflammation, Pain, Fever reduction

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51
Q
  1. What are the NSAID prototypes?
A

Aspirin, Ibuprofen, Naproxen, Indomethacin, Ketorolac

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52
Q
  1. What are the expected pharmacologic actions of NSAIDS?
A

Inhibit COX

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53
Q
  1. What are some adverse effects of NSAIDS?
A

GI bleeding, acute renal failure, Reye’s Syndrome (in kids), Salicylism

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54
Q
  1. What kidney levels should be monitored with NSAIDS?
A

BUN and Creatinine

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55
Q
  1. What are some contraindications of NSAIDS?
A

Known allergy, risk for bleeding, severe renal or hepatic disease, chronic alcohol abusers, pregnancy, children with viral infections

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56
Q
  1. What are some interactions with NSAIDS?
A

Anticoagulants, ibuprofen, ACE inhibitors, angiotensin receptor blockers, lithium carbonate and methotrexate

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57
Q
  1. Characteristics of Aspirin
A

Blocks pain centrally & peripherally Decrease responsiveness to pyrogens
Anti-platelet activity
Toxicity above 300 mcg/ml
Low to moderate pain
Gastric upset

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58
Q
  1. What is the first sign of aspirin toxicity?
A

Tinnitus

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59
Q
  1. Characteristics of Ibuprofen?
A

Plasma protein bound Used for pain and fever
Max of 2400 mg/day

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60
Q
  1. Symptoms of nonsalicylate NSAIDS toxicity
A

Drowsiness, lethargy, mental confusion, parenthesis, numbness, aggressive behavior, disorientation, seizures,
and GI toxicity

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61
Q
  1. What are COX-2 inhibitors used for?
A

Mild to mod pain, anti-inflammation, fever reduction, menstural pain

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62
Q
  1. What is the COX-2 inhibitor prototype?
A

Celecoxib (Celebrex)

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63
Q
  1. Why were COX 2 inhibitors developed?
A

To produce relief from pain and inflammation without the side effects of gastric irritation, bleeding and ulcers or the
effects on blood coagulation

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64
Q
  1. What do COX-2 inhibitors do effectively?
A

Suppress pain and inflammation

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65
Q
  1. What are the side effects of COX-2?
A

GI Upset Renal dysfunction
Cardio and cerebrovascular events (MI, stroke)

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66
Q
  1. What are the COX-2 interactions?
A

Lasix decrease Fluconazole increases celecoxib levels
Anticoagulant effects of warfarin increase
Glucocorticoids. increase bleeding risk Antihypertensive effects of ACE inhibitors decrease
Risk of lithium carbonate toxicity increases

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67
Q
  1. Is acetaminophen an NSAID?
A

No, it does not have anti-inflammatory effects

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68
Q
  1. What is the mechanism of action of acetaminophen?
A

Inhibits prostaglandin synthesis in CNS

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69
Q
  1. Does acetaminophen interfere with coagulation?
70
Q
  1. What is the centrally acting nonopioid?
71
Q
  1. What are the indications of uricosurics?
A

Treat hyperuricemia which causes gout Treat secondary hyperuricemia caused by chemo and anemias

72
Q
  1. What are the Uricosurics?
A

Allopurinol (Zyloprim) febuxostat (Uloric)
probenecid (Benemid)

73
Q
  1. How do allopurinol and febuxostat work?
A

Inhibit xanthine oxidase from converting hypoxanthine and xanthine to uric acid

74
Q
  1. How does probenecid work?
A

Inhibits reabsorption of uric acid in kidneys Promotes excretion of uric acid

75
Q
  1. What are the indications of glucocorticoids?
A

symptomatic relief of pain and inflammation
management of skin disorders

76
Q
  1. What are the glucocroticoids?
A

Prednisone (Deltasone) hydrocortisone sodium succinate (Solu-Cortef) methylprednisone (Solu-Medrol)

77
Q
  1. What are the 2 types of Corticosteroids (glucocorticoids)?
A

Glucocorticoids (cortisol)

78
Q
  1. What are some adverse effects of glucocorticoids?
A

Moon face, trunk heavy, buffalo hump
Myopathy
Bone loss
cataracts

79
Q
  1. What is a sedative?
A

Reduces nervousness, excitability, irritability DOES NOT CAUSE SLEEP

80
Q
  1. What is a hypnotic?
A

Causes sleep, drowsiness

81
Q
  1. What is a sedative-hypnotic?
A

Has properties of both a sedative and hypnotic (dose dependent)

82
Q
  1. What are the early signs of CNS depression
A

Lack of coordination, lightheaded, slowed/slurred speech, cognitive impairments

83
Q
  1. What are the late signs of CNS depression?
A

Poor judgement, slowed breathing, slowed HR, confusion, lethargy

84
Q
  1. What drugs are in the benzo family?
A

Diazepam (Valium) Alprazolam (Xanax)
Lorazepam (Ativan)
Temazepam (Restoril)

85
Q
  1. What is the most popular benzo?
A

Diazepam (Valium)

86
Q
  1. Which are the most prescribed benzos?
A

Lorazepam (Ativan) Alprazolam (Xanax)

87
Q
  1. What are the pharmacologic effects of Benzos?
A

CNS “stimulates GABA receptors
Cardio” “depends on route given
Respiratory” weak resp. depressants

88
Q
  1. What are the therapeutic uses of benzos?
A

Anxiety, insomnia, seizure disorders, muscle spasm, alcohol withdrawal

89
Q
  1. What are the adverse effects are benzos?
A

CNS depression Resp. Depression
Abuse
Paradoxical effects

90
Q
  1. What is the antidote for a benzo overdose?
A

Flumazenil (Romazicon)

91
Q
  1. What is the dosage for Romazicon?
A

Initial “0.2 mg IV 30 secs later give 0.3 mg IV
then 0.5 mg every minute
MAX DOSE” 3 mg/hour

92
Q
  1. What are the contraindications of barbiturates?
A

Causes tolerance and Dependence
High abuse potential
Multiple drug interactions
Powerful respiratory depressants
CNS depression
Cardio effects

93
Q
  1. Signs of Acute Barbiturate Toxicity Syndrome?
A

Resp. Depression Coma
Pinpoint pupils

94
Q
  1. What. are some benzo-like medications?
A

Zolpidem (Ambien) Zolpidem tartrate (Ambien CR)
Buspirone (Buspar)

95
Q
  1. Characteristics of Zolpidem (Ambien) and Zolpidem tartrate (Ambien CR)?
A

Sedative-hypnotic
Most widely used hypnotic
Short-term management of insomnia
Administer before bedtime

96
Q
  1. What are side effects of above medications?
A

Daytime drowsiness & dizziness

97
Q
  1. What is the mechanism of action of Buspar?
A

Binds w/ serotonin and dopamine receptors

98
Q
  1. What does BuSpar treat?
99
Q
  1. What medical emergencies can BuSpar cause?
A

Serotonin Syndrome, Hypertensive crisis

100
Q
  1. What are the traditional antiepiletics
A

Phenytoin (Dilantin) Carbamazepine (Tegretol)
Valproic Acid (Depakote)

101
Q
  1. What are the newer antiepiletics?
A

Lamotrigine (Lamictal) Oxcarbazepine (Trileptal)
Topiramate (Topamax)
Gabapentin (Neurontin)

102
Q
  1. How do antiepileptic drugs work?
A

Slows movement of electrolytes (sodium, calcium) Decreases speed of nerve impulses
Increases seizure threshold
Limits the spread of a seizure

103
Q
  1. What are the goals with AED therapy?
A

Control or prevent seizures Maintain a reasonable quality of life

104
Q
  1. What is the most important level for a nurse to monitor on a pt taking AEDs?
A

Serum drug level

105
Q
  1. What vitamin also needs to be given to a pt taking phenytoin (Dilantin)?-
106
Q
  1. What are some adverse effects of Dilantin?
A

sedation, blurred vision, gingival hyperplasia, acne, Dilantin facies, osteoporosis

107
Q
  1. What is the therapeutic range of Dilantin>?
A

10.0-20.0mcg/ml

108
Q
  1. How is Dilantin given?
A

VERY SLOWLY by IV

109
Q
  1. Which antiepileptic may need to be increased after 2 months due to autoinduction?
A

Carbmazepine

110
Q
  1. What are some adverse effects of carbamazepine?
A

Vertigo, fluid overload, blood cell issues

111
Q
  1. What should be avoided while taking carbamazepine?
A

Grapefruit

112
Q
  1. Adverse effects of all newer AEDs?
A

CNS effects, suicidal ideation, skin disorders

113
Q
  1. Which Newer AED can lead to Steven-Johnson Syndrome?
A

Lamotrigine (Lamictal)

114
Q
  1. What is Topamax used for?
A

Adjunct therapy for partial and secondarily generalized seizures

115
Q
  1. Which neuro med is used to treat. migraines?
A

Triptans (serotonin receptor agonists)

116
Q
  1. Adverse effects of Triptans?
A

Sun sensitivity, cardiac effects, CNS effects

117
Q
  1. What are the antidepressants?
A

TCAs, SSRIs, SNRIs, MAOIs

118
Q
  1. What are the clinical features of depression?
A

Loss of pleasure or interest, Insomnia
Anorexia
Feelings of guilt
Thoughts of death
SYMPTOMS MUST BE PRESENT MOST OF THE DAY, NEARLY EVERY DAY
FOR AT LEAST 2 WEEKS

119
Q
  1. What are anxiolytics?
A

Benzos, SSRIs, SNRIs, TCAs, MAOIs, Atypical Anxiolytics

120
Q
  1. What are the SSRIs
A

Paroxetine, sertraline, fluoxetine, others

121
Q
  1. What are the SNRIs
A

Venlafaxine, duloxetine

122
Q
  1. What are the TCAs
A

Amitriptyline, imipramine, clomipramine

123
Q
  1. What is an MAOI
A

Phenelzine

124
Q
  1. What is the. mechanism of action of the SSRIs
A

inhibit serotonin reuptake

125
Q
  1. What is the medical emergency caused by SSRIs
A

Serotonin Syndrome

126
Q
  1. Adverse effects of SSRIs
A

Nausea, diaphoresis, tremor, nervousness, suicidal ideation Sexual dysfunction, weight fluctuation, Serotonin syndrome, GI bleed, hyponatremia, bruxism, orthostatic hypotension

127
Q
  1. Mechanism of action of Atypical Antidepressants
A

Inhibits dopamine uptake

128
Q
  1. Cautions of atypical antidepressants
A

history of suicide attempt, renal or hepatic, impairment

129
Q
  1. Contraindications of. atypical antidepressants
A

Seizures or ED MAOI w/in 14 days

130
Q
  1. Adverse effects of Bupropion (Wellbutrin)
A

dry mouth, constipation, decreased appetite, weight loss, lower seizure threshold, suicidal ideation, insomnia, restlesness

131
Q
  1. Adverse effects of Mirtazapine (Remeron)
A

sleepiness, weight gain, elevated cholesterol

132
Q
  1. Adverse effects of Trazadone (desyrel)
A

sleepiness, priapism

133
Q
  1. Mechanism of action of SNRIs
A

Inhibits norepinephrine and serotonin reputake

134
Q
  1. What are the SSRI meds?
A

Mirtazapine (Remeron) Duloxetine (Cymbalta)
Venlafaxine (Effexor)

135
Q
  1. Cautions of SNRIs
A

Hx of bipolar disorder, mania, seizure disorder, recent MI, interstitial lung disease

136
Q
  1. Contraindications of SNRIs
A

MAOIs w/in 14 days Renal OR hepatic impairment

137
Q
  1. Adverse. effects of SNRIs
A

Fatigue/drowsiness, paradoxical effects, decreased appetite or. weight loss, nausea, sexual dysfunction, hyponatremia, respiratory issues

138
Q
  1. Life Threatening SNRI adverse effects?
A

Serotonin syndrome, seizures, hepatotoxicity, suicidal ideation

139
Q
  1. Mechanism of action of TCAs
A

blocks reuptake of norepinephrine and serotonin

140
Q
  1. Cautions of TCAs
A

Pairing w/ other serotonin agents active suicidal ideation/attempt
history of CAD, diabetes, liver/kidney issues, respiratory disorders, urinary retention, obstruction, angle-closure glaucoma, benign prostatic hyperplasia, hyperthyroidism

141
Q
  1. Contraindications of TCAs
A

Use of MAOI Seizures
Recent MI

142
Q
  1. Adverse effects of TCAs
A

anticholinergic cardiac issues

143
Q
  1. Mech. of Action of. MAOIs
A

Inhibits. MAO. enzymes

144
Q
  1. Cautions of MAOIs
A

Large amounts of caffeine, cough/cold meds, diet pills, Tyramine, diabetes. & seizures disorders

145
Q
  1. What foods contain tyramine?
A

non aged cheese, bananas, red wine, fava beans

146
Q
  1. MAOI adverse effects
A

-CNS stimulation -ortho hypotension
-hypertensive crisis from tyramine

147
Q
  1. What is general anesthesia
A

reversible state of unconsciousness

148
Q
  1. What are the general anesthesia meds?
A

Brevital, Versed, Duragesic

149
Q
  1. How does. GA work?
A

Enhances transmission at inhibitory synapses depresses transmission at excitatory synapses

150
Q
  1. Advantages v disadvantages of GA
A

Advantages no absolute contraindication, quick to establish, never fails Disadvantages

151
Q
  1. How does local anesthesia work?
A

sodium channel blocker

152
Q
  1. What are examples of local anesthesia
A

Lidocaine, chloroprocaine, procaine

153
Q
  1. Advantages v disadvantages of local anesthetic
A

Advantages “effective alternative to GA, avoids polypharm, pt can remain awake
Disadvantages” “limites scope, higher failure rate, time constraints, anticoagulants,
risk of neural injury”

154
Q
  1. How does regional anesthesia work?
A

injected into a central nerve

155
Q
  1. What are the major types of regional anesthesia?
A

Peripheral Nerve Block Epidural & spinal anesthesia

156
Q
  1. Adverse effects of regional anesthesia?
A

Damage to nerve, systemic toxicity, spinal headache w/ spinal administration

157
Q
  1. What is Lidocaine?
A

Topical anesthetic, local/regional

158
Q
  1. Adverse effects of lidocaine?
A

hypotension, can disrupt intestinal and urinary tracts

159
Q
  1. Midazolam (Versed)?
A

Short acting, no analgesic properties, provides anxiety. relief

160
Q
  1. Onset time of Versed?
A

IV 0.5 to 1 min IM “15 mins
PO/rectal” <10 mins

161
Q
  1. What are ways to prevent a med error?
A

Checks and Balances Correct, legible orders
Resources (pharmacist or physician)
Triple Check
Six Rights

162
Q
  1. How does a nurse respond to a med error?
A

Report and Document Always tell your Charge
Complete all paperwork
Notify the patient

163
Q
  1. What drug categories are not advised for use during pregnancy?
A

Category C, D, X

164
Q
  1. What are some neonatal and peds considerations for dosages?
A

Immature Organs Skin is thinner
Sensitivity of receptor sites
Stomach acid is less acidic
Weaker lungs
Rapidly developing tissues

165
Q
  1. What are some pregnancy considerations for drugs?
A

Diffusion Fetus is exposed to what the mother is exposed to

166
Q
  1. Which trimester is the fetus most susceptible to effects of outside agents?
A

1st trimester

167
Q
  1. What are some causes for concern with drugs while breastfeeding?
A
  • Cross from mother’s circulation to the breastmilk
168
Q
  1. What are some concerns in the older generations when it comes to pharmacology?
A

Polypharmacy
Organ system functionality
Decreased body weight
Malnutrition
MONITOR LIVER & KIDNEY FUNCTION

169
Q
  1. What are some important factors for patient education?
A

Illiteracy Poor health literacy
Individual learning needs
Making sure they know when their next appointment is
Making sure they understand medication instructions

170
Q
  1. What is the strongest indicator of a person’s health?
A

Poor Health literacy

Pharm (14 decks)

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