Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anatomy And Physiology > Pharmcotherapeutics > Flashcards

Pharmcotherapeutics Flashcards

1
Q

Define pharmacology.

A

the study of biological effects of chemicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are drugs?

A

chemicals introduced to the body to cause some type of change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Health care providers focus on what type of pharmacology?

A

the way chemicals effect living organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

As nurses we study pharmacotherapeutics aka…

A

clinical pharmacology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

As nurses we study clinical pharmacology aka…

A

pharmacotherapeutics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 6 responsibilities of the nurse in regards to pharmacotherapeutics?

A
  1. administer medication
  2. assess adverse effects
  3. intervening to make drug regime more tolerable
  4. patient teaching about drug and regime
  5. monitor for prevention of errors
  6. follow the 8 CNO rights for medication administration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are 4 drug sources?

A
  • plant
  • animal
  • inorganic compounds (elements)
  • synthetic sources (genetically engineered bacteria to make chemicals or developed groups of drugs derived from original prototype)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are generic drugs?

A
  • generic drugs are cheaper then the original name brand (the one to first discover and patent)
  • generic drugs come out after patent runs out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who regulates drugs in Canada?

A

Heath Protection Branch (HBP) of Health Canada

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What isHeath Protection Branch (HBP) of Health Canada responsible for?

A
  • regulates sale and use of foods, drugs, cosmetics, and medical devices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the controlled substance act?

A

prohibits activities such as possession, possession for the purpose of trafficking, trafficking, importing and exporting, and cultivating narcotics or controlled and restricted drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who enforces the controlled drugs and substance act?

A

royal canadian mounted police

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In regards to controlled substances what are nurses responsible for?

A
  • storing controlled substances in locked containers
  • administering to those prescribed
  • recording each dose given on agency narcotic sheets and on the patients medication administration record
    Maintaining an accurate inventory
  • reporting discrepancies to proper authority
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where do you need to record info on narcotic administration?

A
  • agency narcotic sheet

- clients administration record

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When are narcotics given?

A

only when prescribed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are narcotics stored?

A

in locked containers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a DIN number?

A

Drug Identification Number which is assigned by health canada

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What information can be obtained from a DIN?

A

identifies all drug products sold in a dosage form in Canada and is located on the label of prescription and over the counter drug products that have been evaluated and authorized for sale in Canada

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What characteristics does a DIN identify?

A
  • manufacturer
  • product name
  • active ingredients
  • strengths of active ingredients
  • pharmaceutical form
  • route of administration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name 5 drug laws and standards.

A
  • controlled drugs and substances act
  • food and drug regulations
  • the narcotic and control regulations
  • benzodiazepine and other targeted substances regulations
  • marijuana medical access regulations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In regards to drug regulation, nursing documentation is both _____ and _______.

A

strict and comprehensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Who approves OTC drugs?

A

Health Protection branch of Health Canada

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some pro’s of OTC drugs?

A
  • recommended doses are lower for safety

- shifts primary responsibility to the patient and off the health care team

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define orphan drugs.

A

drugs that have been discovered, but are not financially viable and therefore have not been adopted by a drug company

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where can you find drug information?

A
  • label
  • insert packaging
  • reference book
  • journals
  • internet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What should nurses consider in regards to OTC drugs?

A
  • can mask symptoms
  • can cause drug interaction
  • watch for over dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is ISMP?

A
  • an independent non profit organization committed to the advancement of medication safety in the health care system
  • work collaboratively to promote safe practices
  • analyze medication incidents, making recommendations for the prevention of harmful medications incidents, and facilitating quality improvement initiatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Who helps to promote safe policy and prevention of medications errors?

A

ISMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Define pharmacodynamics.

A

the science of dealing with interactions between living organisms and foreign chemicals
(drug action on targeted cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a drug action?

A
  • REPLACE or act as a substitute for missing chemicals (insulin)
  • to increase or STIMULATE certain cellular activity (antibiotics)
  • to DEPRESS or slow cellular activities
  • to INTERFERE with the function of FOREIGN cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are receptor cells?

A
  • receptor site reacts to certain chemicals
  • the better the fit the more pronounced the reactions
  • agonists work on receptor and antagonists block the receptor
  • enzyme are needed to break down chemicals to open up the receptor site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What to agonists do to a receptor site?

A

work on the receptor site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What do antagonists do the the receptor site?

A

block the receptor site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Define pharmacokinetics.

A
  • the onset of drug action (how long it takes to work)
  • half life
  • timing of peak effect
  • duration of drug effect
  • metabolism or biotransformation of the drug
  • site of excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Define critical concentration.

A

the amount of a drug that is needed to cause a therapeutic effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Define loading dose.

A

a higher dose than that usually used for treatment (usually to bypass the liver since it metabolizes the drug)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Define dynamic equilibrium.

A

the actual concentration that a drug reaches in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is dynamic equilibrium effected by?

A

absorption

  • distribution
  • biotransformation (metabolism)
  • excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is absorption effected by?

A
  • the route

- oral medications are effected by the presence of food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the first pass effect?

A

medications are extensively metabolized in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is distribution effected by?

A
  • PROTEIN BINDING (how well the drug binds to protein to be distributed in the blood)
  • BLOOD BRAIN BARRIER (lipid soluble meds are more likely
  • PLACENTA AND BREAST MILK (can the drug effect the infant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which medications have the fasted onset

a. tightly bound to protein
b. loosely bound

A

b. loosely bound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the most important site for biotransformation?

A

the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What does the process of biotransformation do to drugs?

A
  • metabolizes (breaks down meds)

- helps prevent medications from causing adverse effects in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which organ plays an important role in excretion?

A

kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What should urine be checked for?

A
  • colour
  • odour
  • volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is half life?

A

the its it takes for the amount of drug in the body to decrease to one-half the peak level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What affects the half life?

A
  • absorption
  • distribution
  • metabolism
  • excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What factors influence the drugs effect?

A
  • weight (more tissue to perfuse)
  • age (function decrease in elderly)
  • gender (body composition or pregnancy
  • physiological factor
  • pathological factors
  • genetic factors
  • immunologic factor (allergy)
  • psychological factors (placebo)
  • environmental factors
  • drug tolerance
  • cumulative effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

When can drug interactions occur?

A
  • any time 2 or more drugs are taken
  • includes OTC & herbal
  • more common in drugs with small margin of safety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What does ‘small margin of safety’ mean?

A

can quickly become dangerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What kinds of food might drugs interact with?

A
  • grapefruit
  • milk
  • most often recommended to take meds on an empty stomach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What can effect your lab test?

A

drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Is off-label use of drugs accepted?

A

Yes

- it is legal, common, necessary and generally accepted medical practice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What should be considered when using drugs for off label use?

A
  • risk
  • benefit
  • monitor closely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Medication error occur due to what?

A
  • ineligible writing
  • similar sounding drugs
  • pharmacist filling prescription
  • nurses with inadequate knowledge or not following rights of medication
  • OTC or polypharmacy
  • distraction of interruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What does a medication order include?

A
  • clients full name
  • generic and/or trade name of drug
  • dose
  • route
  • frequency
  • time and date
  • signature of prescriber
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Drug calculations require what 3 things?

A
  • basic math skills
  • knowledge of units of measure
  • methods of using data in performing calculations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Convert 1 ml to cc (cubic centimeters)

A

1 cc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Convert 1 tsp to ml.

A

5 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Convert 1tbsp to tsp and ml

A

3tsp or 15ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Convert 1 oz to ml.

A

30 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Convert 1 cup to ml

A

250 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Convert 1 L to ml

A

1000 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Convert 1000 mcg to mg

A

1 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Convert 1000g to g

A

1g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Convert 1000 g to kg

A

1 kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

gm is also referred to as…

A

g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

D/H×V= X

What do the letters stand for?

A 
D= desired dose
H= dose on hand
V= volume/supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

MD order: 975 mg po every 6 hours prn for an earache. Acetaminophen is supplied in 325 mg tablets. How many tablets are administered?

A

3 tabs every 6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

The client is to receive Phenergan (promethazine) 25 mg IV q 6h prn. The medication is supplied as 12.5 mg/mL. How many mL does the nurse need to draw up in the syringe? What size syringe will the nurse use? 1 cc, 3 cc, 5 cc, 10 cc

A

Give 2 ml

cc = mL so use the 3 cc syringe since dose will fit and there is more accuracy in smaller syringes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Nurse knows that drug half life is the amount of time required for 50% of drug to do which of the following?

  • be absorbed by body
  • reach therapeutic level
  • exert response
  • be eliminated from body
A

be eliminated from body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Which physiological factor is most responsible for the differences in the pharmacokinetic and pharmacodynamics behaviour of drugs in neonates and adults?

  • infant’s stature
  • infant’s smaller weight
  • immaturity of neonatal organs
  • adult’s longer exposure to toxins
A
  • immaturity of neonatal organs

o liver metabolizes and kidney eliminates, possibly longer exposure for child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Nurse applies knowledge of the physiological differences between men and women to recognize which of the following drug effects

A
  • women have more fat cells so drugs depositing in fat will have prolonged effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Why do children require different doses then older adults?

A
  • Children have immature body systems and may metabolize drugs slower than adults
  • Children are also smaller and an adult dose would be a higher ratio concentration to their body than in an adult (higher chance of toxicity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What are the 7 points in the CNA code of ethics?

A
  1. Providing sage compassionate competent and ethical care
  2. Promote health and wellbeing
  3. promote respect and informed decision making
  4. preserving dignity
  5. maintaining privacy and confidentiality
  6. promoting justice
  7. being accountable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What does the CNO standard on clinical practice provide us with?

A

The 8 rights of medication

78
Q

What are the CNO 8 rights of medication?

A
  • right client
  • right medication
  • right frequency
  • right time
  • right dose
  • right route
  • right reason
  • right site
79
Q

What is done in the nursing process?

A
  • assessment
  • nursing diagnosis
  • implementation
  • evaluation
80
Q

What is off-label use of drugs?

A

therapeutic uses of a drug that differ from the approved indications outlined by the drug manufacturer and Health Canada in the official product monograph

81
Q

Define a

A

before

82
Q

Define ac

A

before meals

83
Q

Define bid

A

twice a day

84
Q

Define c

A

with

85
Q

Define h

A

hour

86
Q

Define IM

A

intramuscular

87
Q

Define IV

A

intravenous

88
Q

Define npo

A

nothing by mouth

89
Q

Define p

A

after or post

90
Q

Define pc

A

after meals

91
Q

Define po

A

by mouth

92
Q

Define q

A

every

93
Q

Define q2h

A

every 2 hours

94
Q

Define qd

A

every day

95
Q

Define qh

A

every hours

96
Q

Define qid

A

4x a day

97
Q

Define s

A

without

98
Q

Define sc

A

subcutaneous

99
Q

Define stat

A

immediately

100
Q

Define tid

A

three times daily

101
Q

What are some advantages of taking medication po?

A
  • non-invasive
  • less expensive
  • safest way
  • patients can easily continue regiment at home
  • convenient
102
Q

What are disadvantages of po?

A
  • meds must go through many barriers that aim to destroy ingested foreign chemicals (acidity may increase of decrease effects)
  • can cause GI tract irritation
  • drugs that come in delayed release/time-release formulas can cause faster delivery than intended
103
Q

Define Parenteral

A

administered or occurring elsewhere in the body than the mouth and alimentary canal

104
Q

What are the advantages of IV?

A
  • full absorption, direct entry to blood stream
105
Q

What are disadvantages to IV?

A
  • can become toxic quickly

- have to be trained to administer

106
Q

What are some advantages of IM?

A
  • faster peak level for men due to more muscle
107
Q

What are the disadvantages to IM?

A
  • slower for woman
  • speed depends on fat content
  • discomfort
  • have to be trained to administer
  • toxicity or OD quickly
108
Q

What are the advantages to topical medication?

A
  • less systemic side effects
109
Q

What are the disadvantages of topical medication?

A
  • risk of skin irritation

- dosage can be difficult to control

110
Q

Where do you report adverse reactions of drugs?

A

Canada Vigilance Program (national post-market surveillance program)

111
Q

What types of med errors are there?

A
  • errors of omission
  • errors of commission (during administration process)
  • near miss (mistake that does NOT get to client)
112
Q

Which med errors are reported?

a. errors of omission
b. errors of commission
c. near miss

A

all of them

113
Q

Why is there a no fault learning process?

A
  • otherwise no one reports mistakes and will continue covering up to avoid blame; risk of more mistakes
  • helps us track errors, examine system and reflection helps us learn from them
114
Q

When do thou need to communicated and validate clients medication?

A 
o admission (meds taken before)
o transfer points
o discharge
115
Q

Define adverse drug reactions.

A

undesired effects that may be unpleasant or dangerous, caused by:

116
Q

What causes adverse drug reactions?

A
  • drug may have other effects on body besides therapeutic
  • patient may be sensitive to drug
  • drug’s action on body may cause other undesirable responses
  • patient may be taking too much/too little of drug → adverse effects
  • types: primary action, secondary action, or hypersensitivity reaction
117
Q

Define primary action of the drug.

A

overdose; extensions of the desired effect

118
Q

Define secondary action of drug.

A

undesired effects produced along with and unrelated to therapeutic effect

119
Q

Define hypersensitivity or intolerance.

A

excessive response to primary or secondary effect of drug

120
Q

Define drug allergy.

A

occurs when body forms antibodies to particular drug, causing immune response when person is re-exposed to drug (cannot be allergic if there is no prior exposure)

121
Q

Name 4 types of drug reactions.

A
  • anaphylactic
  • cytotoxic (antibodies circulate blood and attach antigens (the drug) on the cell site)
  • serum thickness reaction
  • delayed allergic reaction
122
Q

Define an anaphylactic reaction?

A

o antibody reacts with specific sites in body to cause release of chemicals like histamine, which produce immediate reactions (mucus membrane swells, bronchi constricted) leading to respiratory distress or even respiratory arrest
o see hives, rash, difficulty breathing, increased BP, panic, increased HR

123
Q

Define a cytotoxic reaction

A
  • allergy involving antibodies circulate blood and attack antigens (drug) on cell sites, causing death to that cell death
  • seen over a few days
  • damage to blood forming cells and decreased hematocrit, liver enzymes elevated, decreased renal function
124
Q

Define a serum sickness reaction.

A
  • antibodies circulate in the blood causing damage to various tissues by depositing in the blood vessel
  • occurs 1 wk or more after exposure
125
Q

Define delayed allergic reaction.

A
  • involve antibodies that are bound to specific white blood cells
  • rash hives and swollen joints occurs several hours after exposure
126
Q

What is a super infection

A
  • Infections caused by destruction of normal flora bacteria by certain drugs, allowing other bacteria to enter body and cause second infection.
  • Fever, diarrhea, vaginal discharge (no itching), black/hairy/swollen tongue
127
Q

Define the dermatological reaction stomatitis.

A
  • Inflamed mucus membranes (gums, tongue)

- use frequent mouth care

128
Q

Define blood dyscrasia.

A
  • Bone marrow suppression from drug effects (from drugs that can cause cell death)
  • Fever, chills, weakness, sore throat, low WBC
  • Monitor blood counts, protective isolation (to avoid infection, injury, bleeding out)
129
Q

What are 3 things that can occur from toxicity?

A
  • liver injury
  • kidney injury
  • poisoning
130
Q

Why does liver injury occur from toxicity?

A
  • Oral drugs first absorbed will directly pass the liver, so hepatocytes get the full impact of potentially toxic drugs
131
Q

What are signs of liver injury?

A
  • fever, nausea, jaundice, changes in urine/stool colour, elevated liver enzymes
132
Q

Why does kidney injury occur?

A

Glomerulus’s small capillary network is the right size to be plugged by drug molecules, causing acute inflammation and renal problems.
(Some drugs are also excreted unchanged by the entire absorption process, and have potential to do damage on kidneys.)

133
Q

What are signs of kidney injury?

A
  • changes in urinary pattern, elevated BUN (blood urea nitrogen) and creatine
134
Q

When does poisoning occur?

A

Occurs when overdose of drug causes damage to multiple body systems. This can lead to fatal reaction.

135
Q

Define hypokalemia.

A

Decreased serum potassium levels, weakness, numb, orthostatic hypotension
- Occurs when drugs alter renal exchange

136
Q

Define hyperkalemia.

A

Increased serum potassium level, weakness, muscle cramps, numbness
- Occurs when drugs effecting kidneys lead to potassium retention

137
Q

Define ocular toxicity

A

Visual blur, colour vision change, corneal damage, blindness due to damage from drugs

138
Q

Define auditory damage

A
  • damage to the 8th cranial nerve

- results in dizzy, ringing in ears, loss of balance, loss of hearing

139
Q

Define general CNS effects.

A
  • some drugs can affect the brain directly or alter electrolyte/glucose levels
  • causing altered level of consciousness, hallucinations, insomnia, bizarre dreams, delirium, numbness
140
Q

Define Atropine-like (anticholinergic) effects.

A
  • Drugs may block effect of parasympathetic nervous system by blocking cholinergic receptors (direct/indirect)
  • Dry mouth, urinary retention, blurred vision, mental confusion
  • uses sugarless lozenges to keep throat moist
141
Q

Define parkinsons-like syndrome (due to neurological effects of drugs)

A
  • Drugs affecting dopamine can cause this

- Muscle tremors, changes in gait, drooling, restlessness, spasms

142
Q

Define Neuroleptic malignant syndrome.

A
  • General anesthetics and others directly affecting CNS can cause NMS, a generalized syndrome
  • Extrapyramidal symptoms (slow reflex, rigid, involuntary moves), high fever, quick HR
143
Q

Define teratogenicity.

A

Any drug that causes harm to the developing fetus/embryo,

144
Q

What are 3 types of drug actions?

A
  • primary action
  • secondary action
  • hypersensitivity
145
Q

What are the 4 types of allergic reaction

A

o anaphylactic
o cytotoxic
o serum sickness
o delayed

146
Q

What kinds of tissue damage can occur from medication?

A

o dermatological
o stomatitis
o super infection
o blood dyscrasia

147
Q

what types of toxicity can occur from medication?

A

o liver injury
o renal injury
o poisoning

148
Q

What are the terms for altered glucose?

A

o hypoglycemia

o hyperglycemia

149
Q

What are the terms for electrolyte imbalance?

A

o hypokalemia

o hyperkalemia

150
Q

What types of sensory effects can occur from medication?

A

o ocular toxicity

o auditory damage

151
Q

What neurological effects can occur from medication?

A

o general CNS system effects
o atropine-like effects
o Parkinson-like syndrome
o neuroleptic malignant syndrome

152
Q

What are some bronchoconstrictive disorders?

A

asthma, CF, COPD, and respiratory distress syndrome

153
Q

What are the main pathophysiological characteristics of asthma

A
  • Characterized by reversible bronchospasm, inflammation, and hyperactive airway
  • Triggered by allergens, non-allergens, emotions, and/or exercise causing an immediate release of histamines causing bronchospasm in 10 min
  • Later response is cytokine-mediated inflammation, mucus production, and edema contributing to obstruction (3-5 hours)
  • Asthmaticus is the severe form of asthma with prolonged reaction
154
Q

What are bronchodilators?

A

(aka antiasthmatics) medication used to facilitate dilating the airway; helpful in symptomatic relief or prevention of bronchial asthma and bronchospasm associated with chronic obstructive pulmonary disease.

155
Q

What are adrenergics (Sympathomimetics)?

A

drugs that mimic the effect of the sympathetic nervous system. The desired effect when used as a bronchodilator is dilation of the bronchi, with increased rate and depth of inspiration.

156
Q

What are some examples of adrenergics?

A

albuterol (Proventil), arformoteral (Brovana), bitolterol (Tornalate), ephedrine (generic), epinephrine (EpiPen), formoterol (Foradil), isoproterenol (Isuprel), etc.

157
Q

What are the uses of adrenergics?

A
  • Beta2 selective adrenergic agonists as a bronchodilator
  • Prevention of bronchospasm
  • Used in acute asthma attaches
  • Prevention of exercise or environmental` induced asthma
  • (available in many forms; inhaled, IV, IM, oral, subcutaneous)
158
Q

What are the effects of adrenergics?

A
  • Bronchodilator, ^BP, ^HR, decreased renal and GI blood flow, vasoconstriction
  • (all are actions of the sympathetic nervous system)
  • Adverse effects: CNS stimulation, GI upset, cardiac arythmias, diabetes, and hyperhyperthyroidism
159
Q

What are Anti-cholinergic?

A
  • drugs that block action of acetocholine in bronchial smooth muscle
  • bronchodilator
  • acts synergistically with adrenergic bronchodilators and may be used together
160
Q

When is an anti-cholinergic used for?

A
  • When patients cannot tolerate the SNS stimulation they may respond better to anticholinergic although not as effective as sympatheomimetics
  • Used as a bronchodilator
  • Maintenance and treatment of bronchospasm for adults with COPD (can be long term)
  • Nasal Spray for rhinorrhea associated with seasonal and perennial rhinitis or the common cold
161
Q

What are the effects of anticholinergics?

A
  • Blocks, or antagonize the action of acetocholine at the vagal mediated receptor site which is typically responsible for smooth muscle contraction (causing bronchial smooth muscle relaxation, thus vasodilation
  • Typically an inhaled bronchodilator
162
Q

What are the adverse effects of anticholinergics?

A

(Adverse effects: dizziness, headache, fatigue, nervousness, dymouth, sore throat, palpatations, and urinary retention)

163
Q

What are relievers?

A
  • (SABA) Short acting beta agonists that provide quick relief for asthma symptoms
  • sympathominetic response
164
Q

What are controllers?

A
  • (LABA) long acting beta agonists
  • used for maintenance
  • ICS (inhaled corticosteriods)
165
Q

What is the Asthma Management continuum used for?

A

guides treatment adjustments

166
Q

What are beta adrenergic agonist

A
  • SABA or sympathominetic
  • most effective in relieving acute bronchospasm
  • relaxes bronchial smooth muscle
  • works rapidly
167
Q

What are Inhaled Corticosteroids (ICS)

A
  • Effective treatment for bronchospasm
  • Used to decrease inflammation in the airway, thus increasing airflow in persons with inflamed airways
  • Inhaling reduces systemic effects associated with steroid use
168
Q

What are the effects of ICS?

A

o decrease swelling
o promote beta-adrenergic receptor activity which promotes smooth muscle relaxation and inhibits bronchoconstriction
o Pharmokinetics: takes 2-3 weeks to be effective levels
o Adverse effects: Sore throat, horseness, coughing, dry mouth, and pharyngeal and laryngeal fungal infection, systemic effects if administered improperly and sores develop

169
Q

What are leukotriene receptor agonists?

A
  • reduces inflammation component of asthma
  • primarily used for asthma prophylaxis (action to prevent decease)
  • slow acting
    Examples: zafirlukast (Accolate), montelukast (Singulair), and zileuton (Zyflo)
170
Q

What are the uses of leukotriene receptor agonists(LTRA)?

A
  • Selectively and completely or antagonize receptor for the production of leukotrienes D4 and E4 which are components of SRSA (slow reacting substance of anaphylaxis)
  • Used for treatment of chronic bronchial asthma and prophylaxis
171
Q

What are the effects of leukotriene receptor agonists(LTRA)?

A
  • Block signs and symptoms of asthma (symptoms are inflammation, edema and mucous secretion)
  • PO so rapidly absorbed in GI tract metabolized in the liver
  • Caution: Cross placenta and enter breast milk, hepatic and renal impairment can effect metabolism and excretion of the drug, not used for acute attacks because it is not a rapid enough effect
172
Q

What are the adverse effects of leukotriene receptor agonists (LTRA)?

A

• Adverse effects: headache, nausea, dizziness, diarrhea, abdominal pain, elevated liver enzymes, vomiting, generalized pain, fever and myalgia (muscle pain), increased toxicity can occur

173
Q

Define prophylaxis.

A

taking drug as a preventative

174
Q

What are mast cell stabilizers?

A
  • prevent the release of inflammatory and bronchoconstriction substances when the mast cells are stimulated to release these substances (due to irritation from an antigen)
  • OTC drug because it is no longer part of treatment standard because of the availability of safer more effective drugs- Examples: cromolyn (NasalCrom)
175
Q

What are the reasons for using inhaled drugs?

A
  • Inhaled drugs have less effect on the systemic, thus having less potential for systemic side effects
  • If treatment is directed at the lungs it is going right to the effected site
  • Rich blood supply allows for quick absorption and onset of action
  • Rapid and effective
176
Q

What are rescue medications.

A

also called QUICK-RELIEF or fast-acting medications, work immediately to relieve asthma symptoms when they occur.

177
Q

What are quick relief medications?

A
  • directed at lungs
  • don’t have long term effects
  • relieves symptoms quickly
  • most common of these are beta 2 agonists
178
Q

What are controller medications?

A
  • also called preventive or maintenance medications, work over a period of time to reduce airway inflammation and help prevent asthma symptoms from occurring
  • they may be inhaled or swallowed as a pill or liquid
  • takes days to weeks to start working
  • variety but ICS are most common
179
Q

What are nursing interventions for asthma management?

A
  • educated on use (positioning, a shaking, etc), storage, spacers (if needed), etc of INHALERS
  • educate on NEBULIZERS
  • educate on ENVIRONMENT (be aware of triggers)
180
Q

What are nebulizers?

A
  • A nebulizer uses compressed air to change a liquid drug into a fine mist for inhaling
181
Q

What needs to be considered with asthmatic children?

A
  • leukotriene receptor agonists found effective for LONG TERM prophylaxis
  • SHORT TERM best treated with a beta-agonist and then a long acting inhaled steroid or a mast cell stabilizer
  • more sucepptible to ADVERSE EFFECT
  • OTC and herbals should be avoided
182
Q

What needs to be considered with asthmatic older adults?

A
  • more sucepptible to ADVERSE EFFECT
  • more likely to have RENAL or HEPATIC impairment
  • lower doses required
  • inform risk of OTC interactions and consult pharmacist
  • polypharmacy
183
Q

What does the Canadian Thoracic Society discuss about guidelines for the diagnosis and management of asthma in preschoolers, children and adults.

A
  • assessment of sputum eosinophils, in addition to standard measures of asthma control
  • a guide adjustment of controller therapy in adults with moderate to serve asthma
  • appraisal of the evidence regarding which adjunct controller therapy to add to ICS
  • what ICS dose to start children and adults at with poor asthma control
184
Q

What are the Canadian Thoracic Society guidelines?

A
  • self management education (environment, inhale technique, adherence, written action plan)
  • reliever therapy as needed
  • daily controller dose
  • regular assessment
185
Q

What drugs are used to treat the upper respiratory tract?

A
  • antitussives
  • decongestants
  • antihistamines
  • expectorants
  • mucolytics
186
Q

What do antitussives do?

A
  • block cough reflex (works on medullary cough center)
187
Q

What do decongestants do?

A

decrease blood flow to the upper respiratory tract to decrease secretions

188
Q

What do antihistamines do?

A

block the release or action of histamines that increase secretions and narrow airways

189
Q

What do expectorants do?

A

increase production of cough to clear air way

190
Q

What do mucolytics do?

A

increase or liquify respiratory secretions to aid in clearing airways

Anatomy And Physiology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions