Pharmacology exam #3 - study guide Flashcards
Dermatological medications/conditions., Cardiac drugs, Antimicrobial medications, Autonomic Nervous System
Acne Vulgaris
formation of papules, nodules and cysts on the facce, neck, shoulders, and back that results not from dirt but from keratin plugs at the base of the pilosebaceous oil glands near the hair follicles
Contact dermatitis
common form of eczema that results when skin is exposed to irritants or allergens
Keratitis
infection and inflammation of the cornea
Keratolysis
horny cell cohesion due to bacterial growth
Macules
flat with varying colors <1 cm
Papules
raised solid not fluid <1cm
Plaques
hard, rough, raised and flat on top
Psoriasis
Multisystem disease with predominant skin and joint disorders
Vesicles
raised, filled with serous fluid, <1cm
what are the different classes of anti-acne drugs for acne vulgaris
Keratolytic (keratin dissolvers)/ Vitamin A derivatives/ Topical antibiotics/ Oral antibiotics/ Oral contraceptives/ Oral Vitamin A derivatives
what are some nonpharmacological approaches for acne vulgaris
prescribed or OTC cleansing agent, avoid vigorous scrubbing, well balanced diet, decrease stress
what is the purpose of benzoyl peroxide
what does salicylic acid do for the skin
exfoliates skin and dissolves skin buildup that promotes inflammatory and non inflammatory acne
keeps the pores clear
examples of keratolytics (keratin dissolvers)
Benzoyl Peroxide, salicylic acid, azelaic acid
how long does it take to see results from benzoyl peroxide
4-6 weeks for the full effect for the resolution of acne
what types of classes of drugs are used for mild to moderate acne
Keratolytics
what is given to treat pharmacologically severe acne
Oral antibiotics
+doxycycline
+minocycline
+tetracycline
{think -cycline antibiotics for severe acne}
Topical glucocortoids
systemic approach isotretinoin
what are the side effects of isotretinoin
Pruritis, nosebleeds, inflammation of eye/lips, teratogenic effects
ADVERSE EFFECTS
Exacerbation of depression. suicidal behaviors
preventable measures
monitoring of bloodwork
what is part of isotretinoin
IPLEDGE program to promise you will not become pregnant on the medication and your birth control will have 2 types of contraceptives.
what are some characteristics of psoriasis
chronic autoimmune skin disorder/ erythematous papules and plaques covered with silvery scales/ appears on scalp, elbows, palms of hands, knees, and soles of feet/ epidermal cell growth and turnover are accelerated @5x the normal rate/ periods of remission and exacerbation
what are some non pharmacological approaches for psoriasis
Ultraviolet light
UVA & UVB
what are some pharmacological approaches for psoriasis mild to moderate
Keratolytic, topicl glucocortoids, other topicals (anthralin, calcpotriene, tarzotene, coal tar), phototherapy,
what are some pharmacological approaches for severe psoriasis
Systemic biologic response modifers
(methotrexate, cyclosproine, tumor necrosis factor inhibitors, alefacept, inflixamab, adalimumab,
ustekinumab)
monoclonal antibodies -mab
pharmacological approach for verruca vulgaris
salicyclic acids, podophyllum resin
give an examples of different medications that can cause drug-induced dermatitis
Penicillin hypersensitivity, mood stabilizer/ anticonvulsant therapy/ phenytoin, Lamotrigine
what are the characteristics of drug-induced dermatitis
Rash, urticaria, papules and vesicles
what are life thereatening drug-induced dermatitis
erythema multiforme/ steven-johnson syndrome/ toxic epidermal necrolysis
what is contact dermatitis
skin rash with itching, swelling, blistering, oozing, or scaling at the affected skin sites causes can be chemical (cosmetics, perfume, soap, dyes) or from plants (poison ivy, oak and sumac)
non pharmacological measures for contact dermatitis
Avoid direct contact, protective clothing, oatmeal baths, oil stripping soaps
Pharmacological approach for contact dermatitis
alumium acetate/ calamine lotion/ glucocortiod oitments, creams or gels such as dexamethasone
different sunscreens
Chemical (absorbs UV radiation)/ Physical (scatter UV radiation)
Sunscreen after applied 30 minutes before going outside the sunscreen gives protection for 2 hours
what the different degree of burns
First, seconf, third
what are first degree burns
Superficial epidermal (erythema, painful)
what are second degree burns
Deep thickness (blistering, very painful)
what are thrid degree burns
full thickness (pearly white skin, charred, may have no pain)
topical drugs for burns
Mafenide/ silver sulfadiazine
Mafenide
used for treatment of burns
SE/ AE:
burning sensation, blistering, superinfection, metabolic acidosis
why would you be taking an antihyperlipidemic?
If the patients serum lipid values HDL >60, LDL <100, Cholesterol 150-200, and triglycerides 40-150.
The patients genetics
Some of the modifiable factors of the patient is Diet (reduce saturated fat adn total cholesterol), Smoking, exercise
Nursing contraindications of antihyperlipidemic
If the patient has a liver disorder or Pregnant clients
Antihyperlipidemic
-statins
inhibits cholesterol synthesis in the liver and decreases the concentration of cholesterol, decreases LDL, and slightly increases HDL cholesterol.
Reduction of cholesterol can be seen as early as 2 weeks after initiating therapy.
what should the nurse monitor for in statins?
Serum lab values (fasting / Q3-6 months), liver function, diet modification, sudden onset of weakness (Rhabdomyolysis)
why would you have a patient on Diuretics?
Heart failure from hypertension from fluid overload/ to promote sodium and chloride reabsorption=decrease in volume/ Edema (fluid overload
Some renal and liver disorders
what are the different classes of diuretics
Loop, Thiazide (thiazide-like), Potassium-sparing, Osmotic, Carbonic anhydrase inhibitors
what is the ending for loop diuretics
-semide
what is the ending or suffix for thiazide diuretics
thiazide
what can loop diuretics affect in the patient
affect blood glucose levels, increase uric acid production so be cautious with patients who have gout, can cause depletion of water and electrolytes so watch for electrolyte imbalance
what are the different classes of antihypertensives
Beta-blockers, Calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II- receptor blockers, Alpha-adrenergic blockers, Vasodilators, Diuretics
what is the ending for beta-blockers? and what is important to teach and assess on a patient prescribed a beta-blocker?
-olol
Teaching: do not abruptly discontinue medication can cause rebound hypertension, Never use in patients with heart blocks, Avoid OTC drugs while taking beta blockers
Assessment: check Labratory values BUN, Serum creatinine, AST, LDH, obtain the patients drug history OTC and herbal, vital signs this medication can decrease blood pressure and also in rare occassions cause bronchial constriction leading to Respiratory distress
What is the first line antidote for beta-blockers considered
When symptomatic bradycardia and hypotension are present a high-dose of glucagon is the first line antidote
What are the side effects and adverse effects of Beta-blockers
SE: decreased pulse rate, markedly decreased blood pressure
(from abrupt discontinuation of medication can cause palpitations, arrhythmias and angina with the hypertension)
AE: Respiratory distress
What is the ending and suffix for Calcium channel blockers? what patients do you not give calcium channel blockers to and what do you watch for when you administer the medication?
-tiazem,-ipine
Patients with an AV block
prevent vasospasm
Watch the heart rate
what are the side effects of the medication and what would you teach a patient about calcium channel blockers?
SE: flushing, headache, and dizziness
AE: ankle edema, bradycardia, and AV block
Teaching: rise slowly when sitting to standing it can cause a dramatic drop in blood pressure upon standing, when you take any cold medicines read the label to check if the OTC medication has pseudoephedrine and phenylephrine as this can decrease the effects of medication lowering your blood pressure
what is a common calcium channel blocker by mouth
Amlodipine
what is the ending for Angiotensin-Converting Enzyme Inhibitors? what are the side effects and adverse effects of the medication?
what would you teach the patient about this medication?
explain this medication
-pril
SE: dizziness, headache, blurred vision, and weakness
AE: Angioedema, Dry nagging cough,
Teaching: if you start to experience a nagging dry cough contact us immediately so we can put you on an alternative medication, if you are to become pregnant call your provider for an alternative medication to regulate your blood pressure, If the dizziness persists past the second week call your provider immediately.
these cause little change in heart rate/ these are the first line of antihypertensive therapy
this medication should not be taken with potassium sparing diuretics due to increased risk of hyperkalemia
what are some important lab value ranges to know for cardiac medications?
BUN
Potassium K
what cardiac medication lower the heart rate?
Beta blockers, calcium channel blockers, Angiotensin II- Receptor blockers.
what cardiac medication can possibly increase the heart rate
Alpha-adrenergic blockers