Pharmacology - FINAL EXAM General Info Flashcards
1
Q
Qualities of a Perfect drug
A
- Effective
- Safe
- Selective (not a lot of side effects)
2
Q
Drug Safety
A
ALL drugs can cause harm
ALL drugs cause side effects
3
Q
Controlled Substance Abuse Act
A
Regulates manufacture & distribution of narcotics, stimulants, depressants, hallucinogens, and anabolic steroids
4
Q
Three ways drugs cross cell membranes
A
Passage (through channels or pores)
Transport system
Direct penetration of the membrane (lipophillic/lipid soluble)
5
Q
Bioavailability
A
Amount of drug absorbed into the blood stream
6
Q
Enzyme induction
A
with chronic administration, some drugs activiate hepatic enzymes, increasing drug metabolizing enzymes produced. Need to increase dose to produce therapeutic effect.
Med increases enzyme, more enzyme requires and increase in med.
7
Q
Enzyme inhibition
A
concurrent administration of 2 or more drugs compete for metabolizing enzyme.
- smaller doses required
- grapefruit effect
8
Q
First Pass Effect
A
oral drugs are extensively metabolized in the liver with only part of the drug dose reaction systemic circulation for distribution to sites of action.
9
Q
“Empty Stomach”
A
1hr before or 2hr after meal
10
Q
Idiosyncrasy
A
Uncommon drug response resulting from a genetic predisposition
11
Q
Effective Dose (ED50)
A
the dose require to produce a defined therapeutic response in 50% of the population
12
Q
Lethal Dose (LD50)
A
the dose that is lethal to 50% of animals tested
13
Q
Therapeutic index
A
Measure of drug’s safety
ratio of a drugs LD50 to its ED50
Large TI = safe
small TI = not safe
14
Q
Schedule I
A
Drugs not approved for medical use and have high abuse potentials.
- Heroin
- LSD
- Peyote
- Marijuana
- mescaline
15
Q
Schedule II
A
Drugs that are used medically and have high abuse potentials
- Opioid analgesics: codeine, hydromorphone, methadone, morphine, oxycodone
- CNS Stimulants: cocaine, methamphetamine,methylphenidate
- Barbituate sedative-hypnotics
16
Q
Schedule III
A
Drusgs with less potential for abuse than those in Schedule I & II, but abuse may lead to psychological/physiological dependence.
-anabolic steroids
17
Q
Schedule IV
A
Drugs with some potential for abuse:
- benzodiazapines
- sedative-hypnotics
18
Q
Schedule V
A
Products containing moderate amounts of controlled substances.
-antidiarrheal drugs: Lomotil
19
Q
Absorption
A
drug moves from site of entry to bloodstream
20
Q
Distribution
A
movement of drugs throughout the body
Transport of drug to target tissue
21
Q
Pharmacogenetics
A
Study of the influence of genes on individual response to drugs
22
Q
Pharmacodynamics
A
what drugs do to the body & how they do it
23
Q
Agonist
A
Stimulate cell function
24
Q
Antagonists
A
Inhibit cell function by occupying the receptor site
25
Up-Regulation
When prolonged inhibition with antagoinist is suddenly stopped or reduced cells become excessively responsive to agonist
26
Down-Regulation
if prolonged stimulus with agonist less responsive/or fewer receptor sites
*Desensitization or refractory
27
Phamacokinetics
```
Absorption
Distribution
Metabolism
Excretion
P-Glycoproteins
```
28
Trade Name
Brand Name (1st letter capitalized)
29
Generic
Nonproprietary (not owned/made/sold by one holding a trademark or patent)
Name is assigned by the US Names Council
Each drug only has ONE generic name
30
Metabolism
- Method by which drugs are inactivated or biotransformed by the body
- Enzymatic alteration of drug structure
31
Excretion
Removal of drugs from the body
- Kidneys
- Bowels
- Lungs
- Skin
- Breastmilik
32
Half-Life
Time required for the serum concentration of a drug to decrease by 50%.
-Impacts frequency of administration
33
What factors affect a client’s response to meds?
.
34
Severe/dangerous AE of Opioids
#1 = RESPIRATORY DEPRESSION
- N/V
- Hypotension
- Excessive Sedation
- Constipation
- Urinary retention
- Increased IOP
35
Reyes Syndrome
Occurs with aspirin use in children
36
AE of ADHD Medications in children
.
37
Nitroglycerin common AE
Headache
Dizziness
Hypotension
Tachycardia
38
AE of excessive immunosuppression
Infection
39
Anticholinergic side effects
photophobia, dry mouth, constipation
40
Early sign of digitalis toxicity
ANOREXIA #1
| N/V
41
Withhold digoxin if:
pt has pulse less than 60bpm
42
Outcome associated with admin of digoxin
is increased urinary output
43
Common AE of erythromycin
NVD much more than most!!!!
44
Salicylism (Salicylate toxicity) S/S
tinnitus and decreased hearing
Headache
dizziness
sweating
Severe toxicity/Acute Poisoning: Metablolic acidosis & seizures
45
Hypoalbuminemia can result in...
excess free drug and an exaggerated effect
46
Highly protein bound drugs
Coumadin , benzos, barbituates
47
Major SE for NSAIDs
```
GI irritation #1
nephrotoxicity
HTN
hypersensitivity
dyspnea
bronchospasm
rashes
CV risk
```
48
Actions of aspirin:
inhibit aggregation, inhibit prostgl. Synth. and blocks pain impulse transmission
49
Signs of Opioid Toxicity
Severe respiratory depression
Pinpoint pupils
Coma
50
Sign of Opioid withdrawal
irritability
anorexia
tremor
gooseflesh
51
Ergotism
Ischemia of the extremities: coolness, numbness, tingling & or gangrene of the extremities
52
Cholinergic Receptors
Bind to Acetylcholine
Parasymathetic
-Nicotinic N, Nicotinic M, muscarinic
53
Adrenergic
Bind to Epinephrine (adrenaline) & norepinephrine
Sympathetic
Alpha 1, Alpha 2, Beta1, Beta 2
54
Alpha 1 Adrenergic
Vasoconstriction-skin, mucous membranes, viscera
Contraction of urinary sphincter
Mydriasis pupil dilation
55
Alpha 2 Adrenergic
Inhibit transmitter release
56
Beta 1 Adrenergic
HEART ("one heart")
| kidney renin release
57
Beta 2 Adrenergic
"two lungs"
Bronchodilation
Relaxation of uterus
Vasodilation- heart, lung, skeletal muscle
58
Dopamine
Renal dilation
| used in treatment of shock b/c increases renal perfusion.
59
Inotropic action
Increase force of contraction
Increase CO
Decreases systemic venous pressure
60
Chronotropic effect
"Speed"
Negative Chronotropic =decreases HR
Positive Chronotropic = increases HR
61
Prodysrhythmic action
Meds used to Tx dysrhythmias can cause dysrhythmias
62
Nitroglycerin Contraindication
Viagra, Cialis, Levitra,
| MAY BE FATAL - ABSOLUTE CONTRAINDICATION
63
Statins
Most effective drugs to lower cholesterol
64
Anti-infectives that work by INHIBITING bacterial cell wall SYNTHESIS
Penicillins
| Cephalosporins
65
Anti-infectives that work by INHIBITING protein SYNTHESIS
Aminoglycosides
Tetracyclines
Erythromycin
Clindamycin
66
Anti-infectives that work by interfering with SYNTHESIS of bacterial DNA
Flouroqinolones (Cipro)
| Metronidazole (Flagyl)
67
Anti-infectives that work by INHIBITING cell metabolism of FOLIC ACID
Sulfonamides
68
Major AE of Aminoglycosides
Otoxocity (irreversible)
| Nephrotoxicity (reversible)
69
Suprainfection
new infection that appears during treatment of a primary infection
70
AE of Opioids
```
Hypotension #1
constipation
excessive sedation
respiratory depression
ICP
urinary retention
nausea
```
71
Contraindications for live Vaccine
.
72
What is the only IM NSAID
Toradol
73
Pyridium (phenazopyridine)
Urinary analgesic used during UTI Tx
| Causes Redish-orange color urine
74
SE of Sulfonylureas
Hypoglycemia
| Promotes insulin secretion by pancreas therefore decrease sugar in blood.
75
MIC
Minimum inhibitory concentration- lowest concentration fo antibiotic that produces complete inhibition of bacterial growth (not death)
76
MBC
Minimal bactericidal concentration -lowest concentration of drug that produces a 99.9% decline in the # of bacterial colonies.
77
tinea pedis
Athletes foot
78
tinea corporis
fungal body rash
79
tinea cruris
"Jock itch"
80
tinea capitis
fungal infection of the scalp
81
Hypertension
AP = CO X PR
82
Renal Processes
Filtration
Secretion
Reabsorption
(Cleanses & maintains ECF)
83
Hyperkalemia
K+ >5 mEq/L
84
Hirsutism
growth of hair in unwanted areas
85
AE of Penicillins
Allergy
86
Don't use Cephalosporins if pt has an allergy to....
Penicillins
| B/C both have beta lactam ring
87
AE of Cephalosporins
- Pseudomembranous colitis
- Allergic reaction
- thrombophlebitis
- bleeding
88
What should be monitored with Aminoglycosides?
- Monitor peak & trough levels
- Trough PRIOR to dose and peak 30-60 min after dose
- Monitor BUN & Creatinine
89
What antibiotic is used to Tx cholera, rocky mtn fever, chlamydia & acne?
Tetracycline
90
Tetracycline is contraindicated in?
Renal disease
Pregnancy
Pts younger than 8 years old
91
Pts taking Flagyl (Metronidazole) should avoid
Alcohol because of Antabuse effect
92
What is used to tx topical and oral Candida infections
Nystatin
93
Pts taking Tylenol should avoid
- Alcohol due to Hepatoxicity
| - Coumadin (Warfarin) bc increased risk of bleeding
94
Prostaglandin inhibitor that ONLY effects the CNS
Tylenol
95
Used to prevent blockage of coronary artery stents & reduce thrombic events
Clopidogrel (Plavix)
96
Taken to prevent MI & Stroke
Aspirin
97
Used to Tx Acute MI, DVT, Massive PE
Thrombolytics = Streptokinase (Streptase)
98
Which Cardiac Medication causes cough when dose is too high?
ACE inhibitors
99
S/S of Addison's Disease
hypotension, hypoglycemic
GI disturbances, dehydration
weight loss, weakness, fatigue
Bronze pigmentation of skin
100
S/S of Cushing's Disease
Moon Face, fat deposits on back
thin extremities, thin skin, purple striae
hyperglycemia, bruises & petechiae
Na+ and fluid retention
101
What disease is related to too little cortisol
Addison's Disease
102
What disease is related to too much cortisol
Cushing's Disease
103
What is used to Tx Acromegaly
Somatotropin
| -inhibits GH release
104
Used to Tx GH deficiency
Somatropin
- before epiphyses of long bones close in children
- pediatric non GH deficiency must be 2.25 SD below mean height for age group.
105
Diabetes Insipidus is a result of
ADH (antidiuretic hormone) deficiency
106
ADH replacement therapy meds
Vasopressin & desmopressin
107
Aldosterone is a
Minderalcorticoid
108
AE of Corticosteroids
PUD
Cataracts & Glaucoma
Hyperglycemia
109
Major D-D interaction of Corticosteroids
Interactions related to potassium loss
- Digoxin & Diuretics
- NSAIDS
110
Why does adrenocorticoid, predisone, have to be tapered?
to allow gradual reactivation of the HPA axis
111
Long term use of corticosteriods require
An increased dose during times of additional stress such as illness, trauma or surgery
112
Nursing Dx related to corticosteroid use
Fluid Volume Excess
Delayed wound healing (from long term use)
Risk for infection (long term use)
113
Action of Thyroid hormone (TSH)
Increase BMR, HR, Contraction force
Increased O2 consumption & heat production
Increased O2 & CO2 demand
114
Iodine deficiency
Goiter
115
Excess release of TSH & TRH
Grave's Disease
116
Action of Propylthiouracil (PTU)
Used to tx Graves disease by
- blocks thyroid hormone synthesis
- suppress conversion of t4 to t3
117
Cretinism
Severe Hypothyroidsim in children
| low hairline, puffy eyelids, edematous face
118
Myxedema
Severe Hypothyroidsim in adults.
119
Rickets
Vit D deficiency
120
Paget's disease
Inflammatory skeletal disease
121
Osteoporosis Prevention
Regular weight-bearing exercise
Sufficient intake of Ca & Vit D
Avoid excess alcohol
Avoid smoking
122
Administration of Aldenronate (Fosamax) a Biphosphonate
Take on empty stomach
NO food, OJ or coffee within 30 min
Take with full-glass of water
Remain upright & avoid chewing/sucking tablet (to prevent esophagitis)
123
Action of Androgens
stimulate erythropooiesis
124
AE of Anabolic Steroids
Testicular atrophy
125
Insulin Glargine (Lantus) is given
Once at bedtime 24hr duration
