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NNP Board Review Questions > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is Absorption?

A

Movement of the drug from the site of administration to the blood stream

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2
Q

What is Distribution?

A

Movement of absorbed drug from tissues to various body compartments

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3
Q

How does being protein bound affect the drug?

A

The more protein bound the less available the drug is to the body for the desired affect.

DRUGS WANT TO BE FREE NOT BOUND!

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4
Q

What is the primary drug binding protein?

Preemies and sick babies have decreased albumin levels, how does this effect them?

A

Albumin

Creates more unbound drug circulating and creates more effect at lower doses.

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5
Q

What competes with albumin binding sites

A

Bilirubin competes with albumin binding sites. Drugs can displace bilirubin from binding sites and create more free drug.

Increases bill levels and risk for kernicterus

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6
Q

What type of PH balance can effect albumin binding?

A

Acidosis

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7
Q

What is Metabolism?

A

Metabolism (Biotransformation) of drug into another form; active or inactive form

Phase 1, Phase 2, and First Pass Effect

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8
Q

What is First Pass Effect?

A

Drugs are metabolized in the GI tract and alter availability before reaching systemic circulation.

PO drugs= largely metabolized and effect reduced
IV meds= bypass liver and effect increased

This explains why PO doses are often much larger than IV in order to have the same effect.

For Test ** Pick higher PO dose**

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9
Q

What is Excretion?

A

Final drug elimination from the body

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10
Q

What effects PO dosing?

A

Stomach has a nuetral PH for 2-3 months and First pass metabolism

Normal PO metabolism= absorption in small intestine, then thru liver (which removes part of drug), then to circulation.

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11
Q

Terbuteline and Mag are Tocolytics. How do they work differently to stop contractions?

A

Terbuteline: B2 agonist; decreases Ca

Mag Sulfate: Stops influx of calcium

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12
Q

How does Terbutaline effect the fetus/neonate

A

Tachycardia in fetus

Tachy, hypoglycemia and hypocalcemia in neonates

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13
Q

How does Mag Sulfate effect the neonate?

A

(Muscle Relaxant effect)

Respiratory depression, lethargy, hypotonia, apnea, decreased peristalsis.

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14
Q

How do maternal sedatives and analgesics affect infant?

A

Both are rapidly transferred to fetus and cause resp depression

Analgesics: also cause decreased oxygenation

Sedatives: also cause decreased peristalsis

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15
Q

Does an epidural effect the fetus?

A

Very little is passed to fetus.

Can cause maternal hypotension which can cause fetal hypo perfusion and/or bradycardia

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16
Q

Do Muscle relaxants and Paralytics pass to the fetus?

A

No. Do NOT affect the fetus and rarely cross placenta.

17
Q

When is General Anesthesia used in delivery room?

A

Emergent situations that don’t allow regional anesthesia.

When spinals fail

Maternal defect of spinal or airway

18
Q

What is used in general anesthesia for delivery?

A

Induce+muscle relaxant+ inhaled anesthetic+ O2

Muscle relaxants don’t cross to baby

Inhaled anesthetics rapidly get to baby

19
Q

What are common medication teratogens during pregnancy

A

DES= multiple deformtities

Phenytoin= cleft lip/palate; cardiac, nail hypoplasia

Lithium= Ebstein’s anomaly, seizure, goiter

Valproic acid= Cardiac and NTDs

20
Q

Cocaine

A

Induces vasoconstriction in placenta

Midline defects common

Fetal stroke, IUGR, SGA

21
Q

How does infant present with cocaine exposure?

A

Angry

Don’t usually have respiratory issues d/t increased cortisol levels in utero and high stress

22
Q

When does cocaine withdrawal present?

A

48 hours

23
Q

Do infant’s exposed to Methamphetamines show withdrawal signs?

A

No, but will see nuerobehavioral symptoms.

24
Q

How does Methadone affect mom and baby?

A

Blocks effects of heroin and decreases cravings.

Heroin addicted mothers are encouraged to take methadone.

Withdrawal on methadone is seen up to 2 weeks and presents in 96 hours of birth, symptoms are worse and last longer than heroin

25
Q

Does marijauna have withdrawal symptoms? How does it affect infant?

A

No withdrawal but may have sleep issues and be sensitive to touch.

26
Q

Urine Toxicology of drugs and how long they can show a positive?

A

Marijauna: 7-10 days

Cocaine: up to 4 days

Heroin: up to 2 days

Methadone: up to 10 days

27
Q

What are the most common early onset infections?

A

GBS, E. Coli, Listeria

28
Q

What antibiotics do you start with EARLY onset infections?

A

Ampicillin + Gentamicin

29
Q

What antibiotics do you start with LATE onset?

A

Amp+ Gent +Vancomycin

30
Q

What treats Gram + infections?

A

Ampicillin

31
Q

What treats Gram - infections?

A

Aminoglycosides

Gentamicin and Tobramycin

NNP Board Review Questions (10 decks)

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