Pharmacology in acute settings

Question 1

Which enzyme does aspirin inhibit?

Answer 1

cycloxygenase 1 and 2

Question 2

Why does aspirin increases chance of getting gastric ulcers?

Answer 2

Cox 2 helps promote blood flow and increase mucus secretions in the gut to prevent damge from gastric acid

aspirin inhibits cox which then in turn inhibits this pathway. Result in lest protection of the gut lining

Question 3

Which cox enzyme does aspirin preferentially work on?

Answer 3

Cox 1

Question 4

What is dyspepsia?

Answer 4

pain or discomfort in the abdominal area - in other words indigestion

Question 5

What are the main adverse effects of anti platelet drugs?

Answer 5

aggravation of bronchospasm - mayb contraindicated in asthmatics

increased bleeding

Question 6

Which antiplatelet should be avoided on use of patients with active pathological bleeding or a history of troke /tia? Why?

Answer 6

Prasugrel - increased risk of intercranial presssure.

Question 7

What are the 3 nursing responsibilities when dealing ith a patient on anti-platelet medication?

Answer 7

Monior risk of bleeding

Monitor bp

Assess risk of drug interactions

Question 8

Briefly decribe action of anti-platelet drugs

Answer 8

reduced clotting by inhibiting certain clotting factors (which activate platelet receptors) thus preventing activation of platelet receptor reducng stickiness of platelets

Question 9

Which organ produces clotting factors/proteins and coagulation proteins?

Answer 9

liver

Question 10

Briefly describe action of anti-coagulaent.

Answer 10

Inhibits certain proteins in thrombus cascade (which aims to convert fibrinogen to fibrin) thus reducing the ability to for blood clot - unlike anti-platelets does not have a direct effect on platelet proteins

Question 11

What is antithrombin?

Answer 11

an anticoagulant protein found in the body which inhibits the conversion of fibrinogen into fibrin

Question 12

What type of drug is heparin?

Answer 12

Anti-coagulant

Question 13

briefly decribe mechanism of heparin

Answer 13

no active anticoagulent properties of its own.

catalyses and enhances binding properties of antithrombin in body preventing fibrin mesh being formed

Question 14

When administering heparin via IV, what is the type of heparin use?

Answer 14

un fractionated heparin

Question 15

What is unfractionated heparin?

Answer 15

larger molecules of heparin used

Question 16

What problems ar associated with un-fractionated heparin?

Answer 16

non-specific binding to different cells means great individual variability

effect on thrombin requires monitoring of blood clotting levels

Question 17

What’s the benfit of fractionated (low molecular weight heparin) over unfractionated heparin?

Answer 17

smaller molecule less variable effects

administrated via sub cut

dose based on body weight

no need to adjust dosing based on lab results

Question 18

Briefly describe action of heparin

Answer 18

inhibits enzyme vit k epoxide reductase which recycle used vit k

Question 19

Why is vit k important in clotting?

Answer 19

used to produce important clotting factor proteins such as fibrinogen.

Question 20

Why are cascade mechanisms important in our body?

Answer 20

the mechanism can enhance certain effects in the body

Question 21

What are the 3 main actions of antibacterials on pathogenic bacteria?

Answer 21

Affects cell wall

Affects protein prodcution

Afects DNA reproduction

Question 22

Which type of bacteria is more harmful and why?

Answer 22

gram negative, has polysaccharides on it’sout layer which are also endotoxins