Pharmacy Flashcards
Deals with biological, biochemical, and economic features of natural meds?
Pharmacognosy
Preparation, dispensing, and proper use of meds?
Pharmacy
Study of dosages and the criteria that influence it?
Posology
Study of the action or the effects of medications on living organisms?
Pharmacodynamics
Uses of meds in the treatment of disease?
Pharmacotherapeutics
Study of poisons?
Toxicology
Science of treating disease by any method that will relieve pain, treat, or cure infections?
Therapeutics
Therapeutics may use what treatment method other than medications?
Radiological treatment, diathermy, hydrotherapy
What text sets the standards for the quality, purity, strength and provides standards for medication?
United States Pharmacopeia & National Formulary (USP-NF)
What designates the USP-NF as the official reference for medications marketed in the US?
The U.S. Federal Food, Medication, and Cosmetics Act
How is the reference Drug Facts and Comparisons organized?
Therapeutic medications class
What reference contains quick and concise medication info?
Drug Information Handbook
What is known as the “blue bible” of pharmacology for its wide use in American pharmacies?
Remington: The Science and Practice of Pharmacy
The term “dosage range” is applied what?
The minimum and maximum amount to produce the desired effect
What term describes the least amount of medication required to produce therapeutic effect?
Minimum dose
What term describes the largest amount of medication that can be given without reaching the toxic effect?
Maximum dose
What is the least amount of medication that will produce symptoms of poisoning?
Toxic dose
What term is used to describe the normal adult dose?
Therapeutic dose
What is a minimum lethal dose?
Least amount of med that can produce death
What are the two primary factors affecting dosage?
Age (most common), weight
How is Young’s Rule expressed?
Age in years over age in years plus 12 multiplied by normal adult
What has more direct bearing on the dose than any other factor?
Weight
How is Clark’s Rule expressed?
Pt weight in lbs over 150 times adult dose
Injections may require ________ doses than oral meds?
smaller
What two methods of administration are closely associated with oral administration?
Sublingual, Buccal
What are pyrogens?
Products of the growth of microorganisms
Parenteral meds are examined at least what 3 times?
Reception of solution, periodically, immediately before use
Unless stated on the label, parenteral solutions must be free of what?
Turbidity or undissolved material
Inhalation is divided into what three major types?
Vaporization, Gas Inhalation, Nebulization (med converted to fine spray via compressed gas)
Topically applied meds serve what two purposes?
Local effect, systemic effect
What are the 6 “rights” of patient medication administration?
Patient, Medication, Dose, Route, Time, Documentation
What is a MAR?
Medication administration record
Medications normally have what 3 names?
Chemical, Generic, Brand/Trade
Astringents cause ______ of the skin?
Shrinkage
Aluminum Acetate solution (Burrow’s Solution, Domeboro) is used as what?
Wet to dry dressing for the relief of inflammatory conditions of the skin
What is used as a topical astringent and protectant to blistered, raw, or oozing areas of the skin?
Calamine lotion
Bland or fatty substances applied to skin to make it more pliable and soft?
Emollients
What is the generic name for cocoa butter?
Theobroma oil
Zinc Oxide is a white petrolatum emollient containing what percentage of zinc oxide powder?
Approximately 20%
Expectorants are more accurately known as what?
Bronchomucotropic agents
Guaifenesin and codeine phosphate (Robitussin AC) relieve symptoms of what?
Common cold (may cause dependency)
What is used to relieve Eustachian tube congestion?
Nasal decongestants
What is HCL?
Pseudophedrine Hydrochloride
Actifed is the trade name for HCL and Triprolidine Hydrochloride which reduces congestion and?
Swelling of mucous membranes
What is the generic name for Mucinex D?
Pseudophedrine and Guaifenesin
This drug is used for motion sickness, nighttime sleep aid, urticaria, and allergic rhinitis?
Diphenhydramine HCL (Benadryl)
Chlor-Trimeton is used for what?
Symptomatic treatment of urticaria
Dimenhydrinate (Dramamine) may control nausea/vomiting in connection with?
Radiation sickness
What medication is used to treat GERD?
Ranitidine (Zantac)
Histamine H2 Receptor Antagonists are effective in preventing complications of?
Peptic ulcer disease
A low PH may cause the intestinal tract to become?
Excessively acidic
Oral medications normally should not be taken within ______ hours of taking an antacid?
Two
Is used to reduce phosphate absorption in patients with chronic renal failure?
Magnesium Hydroxide (Milk of Magnesia)
Magnesium Hydroxide (Milk of Magnesia) should be taken on an empty stomach with lots of fluid, and therefore should not be given in the presence of what?
Abdominal pain, nausea, vomiting
Magnesium Hydroxide (Milk of Magnesia) may have a laxative effect and prolonged use may cause?
Kidney stones
Although it may cause constipation, the major advantage to Aluminum Hydroxide Gel (Amphojel) is what?
No systemic alkalosis is produced
Alumina (Maalox) coats the stomach lining and is better than Amphojel for what reason?
Less constipating
Antiseptics _______ growth of microorganisms?
Suppress
Germicides ______ susceptible organisms?
Kill
Disinfectants are primarily _______ in their action?
Germicidal
What is the standard by which all other antiseptic agents are measured for effectiveness?
Phenol (carbolic acid)
High concentration of Phenol can cause what?
Tissue destruction
Phenol is inactivated by what?
Alcohol
What does Betadine release into the skin?
Free iodine
Isopropyl Alcohol is used in what percentage as a skin antiseptic?
70% solution
Hexachlorophene (pHisoHex) is a neurotoxin agent effective against gram-positive organisms. What decreases its effectiveness?
Presence of pus or serum
pHisoHex should not be used on what?
Premature infants, denuded skin, burns, or mucous membranes
Residual amounts of pHisoHex can be removed with what?
Alcohol
Glutaraldehyde (Cidex) is used to sterilize materials that are not resistant to heat and is effective against what kind of gram positive/negative bacteria?
Vegatative
Hydrogen Peroxide is normally available in ____ % solution and is effective against what dental condition known as trench mouth?
3%, NUG
In a solid form, this is most commonly used to cauterize mucous membranes and to treat aphthous ulcers?
Silver Nitrate
What is the most common side effect of Silver Nitrate?
Causes the skin to turn black
Silver Nitrate in liquid form is used to prevent what in newborns?
Gonorrheal ophthalmia
What happens if a wet dressing of Silver Nitrate dries out?
Turns the skin slate grey, a condition known as argyria
Prior to penicillin, what was the first effective chemotherapeutic agent available in safe dosage ranges?
Sulfonamides
What year were penicillins introduced?
1941
Sulfisoxazole (Gantrisin) is a ______ sulfonamide used to treat UTIs?
Bacteriostatic
Trimethoprim and Sufamethoxazole (Bactrim, Septra) is an ______ sulfonamide used to treat UTIs?
anti-infective
Sulfacetamide Sodium (Sodium Sulamyd, Bleph-10 _______ bacteriostatic used to treat conjunvtivitis?
Ophthalmic
Silver Sulfadiazine (Silvadene Creme) is topical antimicrobial agent used to treat what?
Second and third degree burns
Penicillins are derived from what?
Molds on bread and fruit
What is Penicillin’s mechanism of action?
Inhibit cell wall synthesis during the reproductive phase of bacterial growth
Penicillin G, Aqueous is administered how?
Parenteral IV only
Penicillin G, Benazathine (Bicillin LA) is injected into a large muscle to treat syphilis and upper respiratory infections caused by what group of bacteria?
Streptococcal Group-A
What has a longer duration of action than most other penicillins?
Penicillin G Procaine, Aqueous (Wycillin)
What is usually the drug of choice for uncomplicated group-A beta-hemolytic streptococcal infections?
Penicillin V Potassium (tablets of powder)
Dicloxacillin Sodium (Dynapen) is used to treat what?
Penicillin-G resistant staphylococci
What is used to treat shigella, salmonella, e-coli, gonorrhea?
Ampicillin (Polycillin)
Amoxicillin (Amoxil) is preferred over Ampicillin due to its effectiveness against what?
Shiggella (has more complete absorption)
Amoxicillin and Clavulante potassium (Augmentin) is used to treat many different infections caused by?
Bacteria
Cephalosporin C is an antimicrobial agent of what origin?
Fungal
What percentage of patients allergic to penicillin may also be allergic to cephalosporin?
5-16%
Cephalosporin antibiotics are generally divided into how many generations?
Three
What is unique about third generation cephalosporin agents?
They have a much broader gram-negative spectrum than earlier generations
What is used preoperatively to reduce the chance of certain infections following surgical procedures?
Cefazolin Sodium (Ancef, Kefzol)
What cephalosporin is used to treat infection of the respiratory tract, otitis media, skin and genitourinary system?
Cephalexin (Keflex)
What are mixed infections?
Infections that include both aerobic and anaerobic pathogenic organisms
What was the first truly broad spectrum antibiotics?
Tetracyclines (introduced in 1948)
What is the tetracycline’s most important mechanism of action?
Blocking the formation of polypeptides used in protein synthesis
What is the most common side effect of tetracyclines?
Mild gastrointestinal disturbances (not indicated for children or pregnant women)
Why should children and pregnant women not take tetracyclines?
Discolors teeth and depresses bone marrow growth
Why should tetracyclines not be administered with milk products, antacids and iron preparations?
They combine with metal ions to form non-absorbable compounds
Tetracycline HCL (Achromycin, Sumycin) is indicated for what?
Rocky Mountain spotted fever, typhus fever, and severe acne
When should Tetracycline HCL be given?
1 hr before and 2 hrs after meals
Doxycycline Hyclate (Vibramycin) has a low affinity for binding with calcium, is used for malaria prophylaxis and what else?
Uncomplicated chlamydial and gonococcal infections
What drug class can cause varying degrees of ototoxicity and nephrotoxicity?
Aminoglycoside (more prevalent toxicity when used with diuretics)
What is the aminoglycoside’s method of action?
Inhibiting protein synthesis
Gentamicin sulfate (Garamycin) is used to treat what?
Serious systemic infections of susceptible gram-negative organisms. Topically for burns, infected wounds and eyes
What is used to treat serious infections such as septicemia, meningitis, and infections of the eye?
Tobramycin sulfate (Nebcin)
Neomycin sulfate (Mycifradin) is used in what two ways?
Topical: skin infections, burn wounds, ulcers, dermatoses. ORALLY: Reduce intestinal flora prior to bowel/anus surgery
Used in patients sensative to penicillin, this drug class is effective against gram-positive cocci, Neisseria, Hemophilus, and microbacteria.
Macrolides
What is the drug of choice when penicillin is contraindicated?
Erythromycin (Ilotycin)
What drug can make the skin more sensitive to sunlight and sunburn may result?
Erythromycin (Ilotycin)
The use of what drug is often associated with colitis and profuse diarrhea?
Clindamycin HCL (Cleocin)
When is Vancomycin HCL indicated?
Potential life threatening infections not treatable with less toxic antimicrobials
Given in a one dose treatment, this drug is used for the treatment of community-acquired pneumonia and chancroid?
Azithromycin (Zithromax)
If the human cell can resist a chemical’s action, what can be assumed about most fungi?
Completely resistant to the same chemical
Systemic antifungals should be limited to what conditions?
Systemic or potentially fatal
Drug is most often used to treat candidiasis and can be used with tetracycline for overgrowth in the bowel?
Nystatin (Mycostatin)
Generally reserved for chronic infections, this fungistatic is given orally to treat what?
Fungal infections of the nails, hair, and skin.
Monistat, a synthetic antifungal which inhibits the growth of dermatophytes has what generic name?
Miconazole nitrate
What is the treatment for Vincent’s angina?
Hydrogen Peroxide
Undecyclenic acid (Desenex) is generally used to treat what?
Tinea pedis
What broad spectrum antifungal inhibits various fungal growth including Candida albicans?
Clortrimazole (Lotrimin, Mycelex)
What accounts for the largest number of chronic disabling diseases known?
Parasitic infections or infestations
Although it has potential for poisoning, it is indicated for scabies and ectoparasites?
Permethrin (Elimite/Nix)
What are the proper names for head lice and crab lice?
Pediculosis capitis and phthirus pubis
What anti-parasitic is effective in treating amebiasis and should not be combined with alcohol?
Metronidazole (Flagyl)
What is the drug of choice for pinworm and roundworm infestations?
Mebendazole (Vermox)
Effective in treating infestations of hook/round/pin/whip worm?
Pyrantel pamoate
A vermicide not indicated as a prophylactic agent and can destroy threadworms?
Thiabendazole (Mintezol)
What does Chloroquine phosphate treat?
Acute malarial attacks
Primaquine phosphate is the drug of choice for the prevention or relapse of malaria caused by what?
P.vivax and P.ovale (Contraindicated in G-6-PD deficient pts)
Primaquine phosphate is the drug of choice for the prevention or relapse of malaria caused by what?
P.vivax and P.ovale (Contraindicated in G-6-PD deficient pts)
What drug group is used to clean catharsis?
Laxatives
What laxative is normally taken at bedtime, stimulates the colon on contact and produces soft stools in 6-12 hours?
Bisacodyl (Dulcolax)
What laxative is preferred by the x-ray department and inhibits water absorption?
Magnesium citrate (Citrate of magnesia)
What laxative produces the desired effect in 12-72 hours?
Psyllium hydrophillic (Metamucil)
Ducosate calcium (Surfak) promotes what?
Water retention in the fecal mass
What should be monitored and replenished when using diuretics?
Lost sodium and potassium
What diuretic is used for edema associated with congestive heart failure?
Hydrochlrothiazide (Esidrix, Oretic)
What diuretic is used to treat edema associated with congestive hear failure as well as cirrhosis of the liver and renal disease?
Furosemide (Lasix)
What diuretic is used to treat glaucoma, congestive heart failure and acute mountain sickness?
Acetazolamide (Diamox)
What diuretic is known as potassium-sparing and potassium-depleting?
Triamterene and hydrochlorothiazide
Used to treat conditions such as rheumatoid arthritis and bursitis and is the most economical drug in its class?
Aspirin (ASA, Ecotrin)
What analgesic/antipyretic is used to relieve pain and fever accompanying diseases and for pts allergic to aspirin?
Acetaminophen (Tylenol)
When is Ibuprofen (Motrin) not recommended?
Gastrointestinal bleeding, renal impairment, third trimester of pregnancy
What anti-inflammatory is reserved for cases of chronic rheumatoid arthritis, osteoarthritis, and acute gout?
Indomethacin (Indocin)
What analgesic is not indicated for pts with a hx of gastrointestinal disease, especially peptic ulcer disease?
Naproxen (Naprosyn, Anaprox)
When is the anti-inflammatory Meloxicam (Mobic) contraindicated?
3rd trimester of pregnancy
Used to relieve symptoms of arthritis?
Piroxicam (Feldene)
What chapter of the MANMED sets forth the control, custody and accountability for controlled substances?
Chapter 21
What CNS stimulant is indicated for use in hyperkinetic children and narcolepsy in adults?
Methylphenidate HCL (Ritalin)
What CNS stimulant is occasionally used as an adjunct to diet therapy for obesity?
Dextroamphetamine sulfate (Dexadrine)
What CNS depressant is the drug of choice for petit mal epilepsy?
Phenobarbital (Luminal)
What CNS depressant is indicated for short-term treatment of insomnia?
Pentobarbital (Nembutal)
What CNS depressant is preferred to Phenobarbital in treating seizure disorders because it possesses no hypnotic disorders?
Phenytoin sodium
The major medical use for opium has been for what?
Antiperistaltic activity
Morphine Sulfate (Roxanol, MS Cotin) is an opium alkaloid indicated for what?
Relief of sever pain
What synthetic analgesic is not as effective as morphine in its analgesic properties?
Meperidine HCL (Demerol)
Psychotherapeutic agents are classified as what three types?
Major tranquilizers, minor tranquilizers and mood modifiers.
Considered to be a good all around tranquilizer?
Thioridazine (Mellaril)
What psychotherapeutic agent is most often used for symptomatic treatment of nausea and vomiting?
Prochlorperizine (Compazine)
What drug is indicated for schizophrenia?
Haloperidol (Haldol)
What is Amitriptyline HCL (Elavil)?
Anti-depressive mood elevator. Long term treatment.
What drug is a rapid-acting antianxiety and antiemetic with antispasmodic effects?
Hydroxyzine pamoate (Vistaril, Atarax)
Diazepam (Valium) is useful in treating what?
Moderate depression, spastic muscle conditions. Drug of choice for status epilepticus.
In the U.S. Military, Diazepam is also known as what?
CANA - Convulsive Antidote, Nerve Agent
Fluoxetine HCL (Prozac) is an oral antidepressant that may be useful in treating what?
Bulimia nervosa and obsessive compulsive disorders.
Zolpidem (Ambien) is indicated for what?
Short term treatment of insomnia
What skeletal muscle relaxant is indicated as an adjunct to physical therapy?
Cyclobenzaprine (Flexeril)
What drug is indicated for congestive heart failure and increases force of contractions.
Digoxin (Lanoxin)
Quinidine Sulfate is indicated for premature atrial and ventricular contractions and should not be confused with what drug?
Quinine sulfate (antimalarial)
What cardiovascular agent is used to treat angina and for the prevention of erection following circumcision?
Amyl Nitrite
What drug is indicated for acute and chronic angina pectoris?
Nitroglycerin (Nitrostat, Nitro-Bid)
Isosorbide dinitrate (Isordil, Sorbitrate) is similar to what drug?
Nitroglycerin
What drug is used in the prevention of postoperative thromboembolic complications of cardiac valve replacement and is similar to warfarin sodium?
Dipyridamole (Persantine)
Indicated for premature ventricular contractions?
Procainamide hydrochloride (Pronstyl, Procan SR)
Manages essential hypertension?
Verapamil (Isoptin) and Diltiazem (Cardizem)
What vasoconstrictor is an ophthalmic preparation for symptomatic relief of irritated eyes?
Tetahydrozaline
What vasoconstrictor shrinks mucous membranes of the nose to relieve local congestion?
Phenyephrine HCL (Neo-Synephrine)
What topical vasoconstrictor is used to relieve nasal congestion?
Oxymetazonline
What should be done before an anticoagulant agent is prescribed and dosage determined?
Lab testing for blood clotting capabilities
What anticoagulant is used in prophylaxis and treatment of venous thrombosis and pulmonary embolism?
Heparin sodium
What anticoagulant is used extensively to treat embolism in the prevention of occlusions?
Warfarin sodium (Coumadin)
What is the benefit of vitamin A (Retinol)?
Visual adaptation to darkness
What vitamin is necessary for carbohydrate metabolism?
Bitamin B1 (Thiamine HCL)
Beriberi is caused by a deficiency of what vitamin?
Bitamin B1 (Thiamine HCL)
What vitamin functions as a coenzyme necessary in tissue respiratory processes?
Vitamin B2 (Riboflavin)
A deficiency in what vitamin is associated with cheilosis, glossitis, visual disturbances/fatigue?
Vitamin B2 (Riboflavin)
What vitamin is used in the treatment of pellagra?
Vitamin B3 (Niacin)
What vitamin is used during isoniazid (INH) therapy to prevent the development of peripheral neuritis?
Vitamin B6 (Pyridoxine hydrochloride)
What vitamin is necessary for the prevention of scurvy?
Vitamin C (Ascorbic acid)
What vitamin regulates calcium and phosphorous metabolism?
Vitamin D
What does a deficiency in n vitamin D lead to?
Rickets in children and asteomalacia in adults
How does vitamin-E prevent the destruction of red blood cells?
Prevents fatty acids in the red blood cells from taking on too much oxygen
Which fat soluble vitamin has many synthetic forms that are water soluble?
Vitamin K
Commonly called laughing gas, this anesthetic is commonly used in dentistry or as a preinduction agent to other general anesthesia?
Nitrous oxide
High concentrations of nitrous oxide may cause what?
Cyanosis or asphyxia
What inhalation anesthesia is used in most operative procedures with patients of all ages?
Halothane (Fluothane)
What anesthetic is used for procedures that do not require skelatal muscle relaxation, may cuase psychological manifestations and is contraindicated for patients with hypertensive disease.
Ketamine HCL (Ketalar)
What injectable drug may be used for spinal anesthesia?
Procaine hydrochloride (Novocain)
What drug is the standard to which all other anesthetics are compared?
Lidocaine hydrochloride (Xylocaine).
{CAUTION}
.05g max per 24hr when used with epinephrine
What topical local anesthetic is used on mucous membranes?
Dibucaine (Nupercainal)
What topical anesthetic is used for almost every ophthalmic procedure?
Proparacaine (Ophthectic, Ophthaine)
What oxytocic treats postpartum and post-abortal hemmorage?
Ergonovine maleate (Ergotrate, Maleate)
What oxytocic improves uterine contractions?
Oxytocin (Pitocin)
What instruction should be referred to for immunizations?
BUMEDINST 6230.15
What bacteria causes anthrax?
Bacillus anthracis
Hep-A vaccination is to prevent acute infection of what?
The liver [acquired through food/water]
How is Hep-B acquired?
Exposure to blood and body fluid
What causes acute febrile respiratory viral infections that can cause epidemics within military populations?
Influenza A/B
How is MMR spread?
Respiratory or person-to-person contact
The World Health Organization (WHO) declared the global eradication of what?
Naturally occuring smallpox.
Tetanus is an acute illness caused by an exotoxin called?
Clostridium tetani
Diptheria is an acute disease caused by a cytotoxin of the bacteria called?
Corynebacterium diptheriae
Pertussis is an acute illness caused by the bacteria called?
Bordetella pertussis
Tdap is preferred to Td so that people sustain immunity to what?
Pertussis
Called the arithmetic of pharmacy, study and science of weights and measures
Metrology
Official system of weights and measures?
Metric system
RELATIONSHIP of one quality to another of like value
RATIO
EXPRESSION of equality of two ratios?
Proportion
a:b = c:d
a:b :: c:d
a/b = c/d
Aromatic, sweetened hydroalcoholic solutions containing meds?
Elixirs
Course dispersions comprised of finely divided insoluble material suspended in a liquid medium?
Suspensions
Semisolid, fatty, or oily preparations of medicinal substances?
Ointments
Two types of balances?
Torsion
Electronic
All dispensing pharmacies are required to have at least how many Class-A balances on hand at all times
one
The inside surface of what utensil tapers at 60 degrees and is used in the filtering process?
Ribbed funnel
Glass container with metric measurements inscribed on it, used for mixing and measuring?
Erlenmeyer flask
Used to reduce substances to fine powders?
Mortar and Pestle
Knife-like utensil with a rounded, flexible, smoothly ground blade, used to transfer quantities?
Spatula
Used to measure liquids volumetrically?
Graduates
Occurs when agents antagonistic to one another are prescribed together?
Therapeutic incompatibilities
Failure of medications to combine properly?
Physical incompatibilities
Prescribed agents react chemically upon combination to alter the composition of one or more ingredients?
Chemical incompatibilities
Immiscibility
incapable of being mixed of two or more liquids
Precipitation due to change in solution that results in decreased solubility?
Salting out
Liquification of solids mixed in a dry state?
eutexia
Metric system is also called?
International System of Units
Prefixes for
10
100
1,000
Deka
Hecto
Kilo
Prefixes for
1
01
001
deci 1/10
centi 1/100
milli 1/1,000
Symbol for liter may be expressed how?
Capitalized or not
What should not follow metric symbols?
period
Use 3 mg/ml
NOT 3 mg/milliliter (spelled out)
Basic units in Apothecaries’ system?
WEIGH: grain “gr”
Volume: minim “m”
Basic units in AVOIRDUPOIS system?
dram (27.344 grains)
ounce (16 drams)
pound (16 ounces)
Metric to household measurements
5ml = 1 TEASPOONFUL
15ml = 1 TABLESPOONFUL (1/2 fl oz)
Most important tool used by the pharmacy?
Prescription
Two standardized forms used for prescriptions?
DoD prescription, DD Form 1289 (one medication order)
Polyprescription, NAVMED 6710/6 (up to four prescriptions)
Controlled meds should be written on what form?
DD 1289
Center of the DD 1289 contains how many parts?
4
Superscription?
“Take thou”
Inscription?
Quantity of medication
Subscription
directions to the compounder
Signa
directions for the patient
Verify label on meds ___ times when filling a prescirption
3
Schedule II
Narcotics
proceeded by the letter “N”
Schedule III, IV, V
Controlled meds
proceeded by the letter “C”
All prescriptions not filed separately are maintained in?
General files
Prescriptions are required to be kept on file for how long?
At least 2 yrs
Controlled substances have how many categories?
five
Sheduled drugs abuse potential
I - high (no accepted use) II - high (fill w/in 7 days) III - Moderate (fill w/in 30 days) IV - Limited V Limited
(IV & V: up to 5 refills in 6 months)
Inventory of controlled substances should occur how often?
Quarterly
The CO appoints how many members of the CSIB?
3
