REVIEW Flashcards
What is the DOD Prescription Form?
D 1289
What is the Poly-Prescription form?
NAVMED 6710/6
What do you NOT want to do while filling out a prescription?
Do not use shorthand
If a DD 1289 is not required, what must you fill out for proper documentation?
A proper SOAP note
What is the study of drug absorption, distribution, metabolism, and excretion? (Activities of the drug after it enters the body)
Pharmacokinetics
What is:
A carrier molecule such as a protein or enzyme ACTIVELY moves the drug across the membrane? (ATP)
Active absorption
What is:
Diffusion of a drug across a membrane from higher concentration to lower concentration?
Passive absorption
what is:
Drug’s ACTIONS and effects within the body?
Pharmacodynamics
What is:
A compulsive need to use a substance to obtain a pleasurable experience?
Psychological Dependence
What is:
A compulsive need to use a substance repeatedly to avoid mild to severe withdrawal symptoms?
Physical Dependence
What is:
A drug that binds with a receptor to produce the therapeutic effect?
Agonist
What is:
A drug that binds to a receptor stronger than the agonist?
Antagonist (Narcan)
What is:
A reaction that occurs when the combined effect of two drugs is equal to the sum of each drug given alone?
Additive drug reaction
What is:
A drug interaction that occurs when drugs produce an effect greater than the sum of their separate actions?
Synergism
What sex require smaller doses due to less fat and water ratios?
Women
What are the 3 oral routes?
- Nasogastric (NG)
- Sublingual
- Buccal
What drug administration means:
Giving a drug into the body but NOT through the G.I. tract?
Parenteral
What Parenteral route:
Is placed into the tissues between the skin and muscle?
Subcutaneous
What Parenteral route:
Is placed directly into the muscle?
Intramuscular
What Parenteral route:
Is placed directly into the blood via needle?
Intravenous
What Parenteral route:
Is typically used to administer sensitivity tests, such as TB test?
Intradermal
What drug route:
Are rapidly absorbed from the skin and have systemic effects?
Transdermal
What medication class:
Depress the sensory cortex, decrease motor activity, alter cerebellar function, and produce drowsiness, sedation, and hypnosis?
Barbiturates
Phenobarbital is what class?
Barbiturate
What are the 2 subclasses of Antianxiety drugs?
- Benzodiazepines
2. Non- Benzodiazepines
What subclass:
Bind to receptors in the GABA receptor complex, which enhances the binding of this inhibitory neurotransmitter?
Benzodiazepines (Benzos)
What subclass:
Act on brain’s dopamine and serotonin receptors?
Non-Benzodiazepines
What subclass causes a higher risk of dependency when used long term?
Benzos
- Alprazolam
- Diazepam
- Lorazepam
Benzos
- Buspirone Hydrochloride (Bu Spar)
- Hydroxyzine
- Sertraline (SSRI)
Non-Benzo
What is the GO-TO medication class for antidepressants?
SSRI (Selective Serotonin Reuptake Inhibitors)
What Antidepressant class:
Increase serotonin by inhibiting neuronal uptake to the Central Nervous System (CNS)?
SSRI
Do not take TCA’s and MAOI’s within how many days from each other?
Within 14 days
What Antidepressant class has MANY MEDICATION INTERACTIONS?
MAOI’s
Antidepressants may take up to how many weeks for desired effect?
4-6 weeks
- Venlafaxine
2. Duloxetine
SNRI’s
- Fluoxetine
- Sertraline
- Paroxetine
SSRI’s
What class:
Block dopamine receptors in the brain; also alter dopamine release and turnover?
Antipsychotics
How are Antipsychotics classified?
- Typical (1st gen)
2. Atypical (2nd gen)
- Haloperidol
Antipsychotic drug
What class:
A reduction of excitability of the neurons in the brain?
anticonvulsant
Using Benzos and Non-Benzos for this class? (reduce excitability)
Anticonvulsants
- Prochlorperazine (Phenothiazine)
- Ondansetron
- Promethazine
Antiemetics
- Meclizine
- Diphenhydramine
- Benzodiazepines
Antivertigo
What class:
Produce a local anesthesia by inhibiting transport of ions across neuronal membranes?
Local Anesthetics
What medication causes neuro-inhibition and anesthesia, where the patient is dissociated from their surrounding?
Ketamine
How much Ketamine should be given for pain control?
20-40 mg IM
- Lidocaine
2. Bupivacaine
Local Anesthetics
- propofol
General anesthetic
What are:
The 4 classes of Non-Narcotic Analgesics?
- Salicylate
- Non-Salicylate
- NSAIDS
- Urinary analgesic
What non-narcotic analgesic class MAY cause Reye Syndrome in children with chickenpox or flu?
Salicylates
- Aspirin
Salicylate
- Relieve mild to moderate pain
- Reduce body temperature
- Arthritis
Non-Salicylate
- Acetaminophen
2. Benzocaine-Menthol
Non-Salicylates
What non-narcotic analgesic class:
Inhibit COX-1 and COX-2 which is responsible for prostaglandin synthesis?
NSAIDS
- Anti-Inflammatory
- Analgesic
- Antipyretic
NSAIDS
- Ibuprofen
- Ketorolac
- Naproxen
- Meloxicam
- Mobic
NSAIDS
- Phenazopyridine
Urinary Analgesic
What medication may turn urine a reddish orange color?
Phenazopyridine (Urinary Analgesic)
What class:
Alters the perception of and response to pain?
Narcotic Analgesics
DO NOT give this drug class to a patient with a head injury or increased ICP?
Narcotic Analgesics
- Codeine
- Fentanyl
- Hydromorphone
- Morphine Sulfate
- Oxycodone
- Hydrocodone
Narcotics
What medication is a competitive antagonist that bind to opioid receptors?
Naloxone
What is a chemical created in the body? Highest amounts are found in basophils and mast cells.
Histamines
How do H-1 Antihistamines work?
Bind to H1 receptors in mast cells, smooth muscle, and endothelium in the body as well as in the brain to prevent release of histamine.
How do H-2 Antihistamines work?
bind to H-2 histamine receptors in the Upper G.I. tract, primarily in the stomach.
- Diphenhydramine
- Hydroxyzine
- Promethazine
1st gen Antihistamines
- Cetirizine HCL
- Fexofenadine
- Loratadine
2nd gen Antihistamine
- Oxymetazoline HCL
- Pseudoephedrine
- Phenylephrine
Decongestants
What drug class:
contraindicated for patients with cardiac arrhythmia or taking a beta blocker?
Beta 2 Agonist
- Albuterol sulfate
2. Levalbuterol HCL
Beta 2 Agonist
- Ipratropium
2. Tiotropium
Muscarinic Antagonist
What class inhibit the release of substances that cause bronchoconstriction and inflammation from the mast cells in the respiratory tract?
Mast Cell Stabilizer
What Class:
Decrease inflammatory process in the airway through inhibiting multiple different inflammatory cytokines?
Inhaled Corticosteroids
- Budesonide
2. Fluticasone
Inhaled Corticosteroids
What Class:
Depress the cough center (central acting)?
Antitussives
- Codeine sulfate
- Benzonatate
- Dextromethorphan
- Diphenhydramine
Antitussives
What class:
Loosen and mobilize thick mucus from respiratory system?
Mucolytic
What Class:
Raise thick mucus from respiratory system?
Expectorant
- Acetylcysteine
Mucolytic
- Guaifenesin
Expectorant
Abnormal electric current in the heart?
Cardiac Arrhythmias
Antiarrhythmic class:
Raise the potential threshold? (Lidocaine HCL)
Class 1
Antiarrhythmic class:
Block Beta receptor stimuli (Metoprolol)
Class 2
Antiarrhythmic Class:
Blockade of Na or K channels? (Amiodarone)
Class 3
Antiarrhythmic Class:
Block calcium channels? (Diltiazem)
Class 4
What Class:
Direct relaxing effect on smooth muscle of blood vessels
Nitrates
What must you do BEFORE and AFTER giving Nitrates?
Blood Pressure
What class:
Do not give if patient is taking erectile dysfunction medications?
Nitrates
4 Classes of Antihypertension medications?
- Ace Inhibitors
- Diuretics
- Calcium channel blockers
- Beta blockers
What antihypertension class:
Prevents the conversion of Angiotensin 1 to Angiotensin 2? (lungs)
Ace Inhibitors
What antihypertension class:
May cause a dry hacking cough?
Ace Inhibitors
- Lisinopril
2. Captopril
Ace Inhibitors
- Nifedipine
- Felodipine
- Nicardipine
Calcium channel blockers
What receptor is located chiefly in the heart?
Beta 1 adrenergic receptor
What receptor is found in the Lungs and smooth muscle (MSK)?
Beta 2 adrenergic receptors
- Metoprolol
- Propranolol
- Atenolol
Beta Blockers
What are the 2 main classes of Diuretics?
- Loop
2. Thiazide
- Furosemide
Loop Diuretic
- Hydrochlorothiazide
Thiazide Diuretic
What inhibit an enzyme involved in cholesterol synthesis?
HMG-COA reductase inhibitors
- Atorvastatin
2. Simvastatin
HMG-COA Reductase Inhibitors
What gastrointestinal drug class:
NEUTRALIZE the acidity of the stomach?
Antacids
What is the main contraindication for taking Antacids?
Severe abdominal pain from unknown cause.
- Aluminum hydroxide gel
- Magnesium hydroxide
- Calcium carbonate
Antacids
What gastrointestinal drug class:
REDUCES the secretion of gastric acid?
Histamine H2 Antagonist
- Cimetidine
- Famotidine
- Ranitidine
Histamine H2 Antagonist
What gastrointestinal drug class:
SUPPRESS gastric acid secretion by blocking the final step in the production of gastric acid be the gastric mucosa?
Proton Pump Inhibitors
- Omeprazole
- Pantoprazole
- Rabeprazole
- Lansoprazole
Proton Pump Inhibitors
what drug class:
Decrease intestinal peristalsis?
Antidiarrheal
What drug class:
Contraindicated with diarrhea associated with organisms that can harm the intestinal mucosa?
Antidiarrheal
- Loperamide
Antidiarrheal
What drug class:
Has a defoaming action that disperses and prevents the information of mucus-surrounded gas pockets in the intestine?
Anti-Flatulents
- Simethicone
Anti-Flatulent
What Laxative drug class:
Adds bulk and water to the contents of the intestines?
Bulk-Producing
What laxative drug class:
Lubricate the intestinal walls and soften the stool, enhancing passage of fecal material?
Emollient
What laxative drug class:
Promote water retention in the fecal mass and soften the stool?
Fecal Softener
What laxative drug class:
Dehydrate local tissue causes irritation and increases peristalsis?
Hyperosmolar
What laxative drug class:
increase peristalsis by direct action on the intestine?
Irritant of stimulant
What laxative drug class:
Attract of pull water into the intestine, thereby increasing pressure in the intestine followed by an increase in peristalsis?
Saline
- Methylcellulose
Bulk-Forming
- Mineral Oil
Emollient
- Polyethylene Glycol
Hyperosmolar
- Bisacodyl
Irritant or Stimulant
- Magnesium Citrate
Saline
What drug Class:
Is used for inflamed hemorrhoids?
Hemorrhoid Agents
- Hydrocortisone
2. Pramoxine
Hemorrhoid Agents
What drug class:
Is used to control Type 1 Diabetes and SOMETIMES type 2 diabetes for severe cases?
Insulin
What are the 2 Oral Antidiabetic drug subclasses?
- Sulfonylureas
2. Biguanides
What subclass:
Lower blood glucose by stimulating beta cells of the pancreas to make more insulin?
Sulfonylureas
What subclass:
Reduces hepatic glucose production and increases insulin sensitivity in muscle and fat cells?
Biguanides
What Antidiabetic drug class:
Is used to treat patients with type 2 diabetes only?
Oral antidiabetics
What antidiabetic class:
Can cause severe infection and CHF?
Oral antidiabetics
- Metformin
Biguanides
- Levothyroxine
Thyroid hormones
What are the 2 types of contraceptives?
- Estrogen
2. Progestin
What type of contraceptive:
Inhibits ovulation?
Estrogens
What type of contraceptive:
Prevents the maturation of the ovarian follicle and ovulation?
Progestin
- Norethindrone
2. Levonorgestrel (Emergency)
Progestin (Progestin only pills) “POPS”
What Contraceptive:
Contraindicated a risk of thromboembolic disease is increased in females 35 years or older that use tobacco?
Oral contraceptives
The term for drugs that kill bacteria?
Bactericidal
The term for drugs that slow or retard the multiplication of bacteria?
Bacteriostatic
What antibacterial drug:
Is “Bacteriostatic” and often is used to control urinary tract infections caused by E-Coli and Staph?
Sulfonamides
- Silver Sulfadiazine
2. Sulfamethoxazole
Sulfonamides
- Amoxicillin
2. Amoxicillin/Clavulanate
Penicillin
- Cefazolin
- Cephalexin
- Ceftriaxone
Cephalosporines
- Doxycycline
- Tetracycline
- Minocycline
Tetracyclines
- Azithromycin
- Erythromycin
- Clarithromycin
- Teithromycin
Macrolides
What antibacterial drug:
Is “bactericidal” and is used to treat pneumonia and UTI’s?
Fluoroquinolones
What antibacterial drug class:
May cause tendinitis and tendon rupture?
Fluoroquinolones
- Ciprofloxacin
2. Levofloxacin
Fluoroquinolones
What antibacterial drug class:
Is “bactericidal” and may cause Ototoxicity?
Aminoglycosides
- Gentamicin
2. Neomycin
Aminoglycosides
What antibacterial drug class:
Is used to treat severe infections with drug resistant organisms and hospital acquired pneumonia?
Carbapenems
- Imipenem
- Meropenem
- Ertapenem
Carbapenems
What are the 2 types of antiprotozoal therapies?
- Amebiasis
2. Giardiasis
What antibacterial drug class:
Is used to treat toxic shock syndrome, bacterial vaginosis, and bite wounds?
Lincosamide
- Clindamycin
2. Lincomycin
Lincosamide
- Acyclovir
- Vancyclovir
- Penciclovir
- Oseltamivir
Antivirals
- Ketoconazole
2. Fluconazole
Antifungals
- Cyclobenzaprine
2. Diazepam
Muscle Relaxers
What drug class:
May have an adverse reaction if abrupt cessation of medication occurs a potentially life-threatening adrenal insufficiency can occur?
Corticosteroids
- Hydrocortisone
- Prednisone
- Triamcinolone
- Methylprednisolone
- Dexamethasone
Corticosteroids
What drug class:
Act on intracranial blood vessels and sensory nerves of the trigeminal system; causes vasoconstriction?
Antimigraine
- Rizatriptan
2. Sumatriptan
Antimigraine
What drug class:
Causes paralysis and death of a pest?
Scabicide
- Permethrin
Scabicide
What drug class:
Is used to remove warts, calluses, corns?
Keratolytic
- Podofilox 0.5% topical solution gel
2. Salicylic acid gel 17%
Keratolytic
What subclass of Ophthalmic Preparations: Are used for the prevention of cytomegalovirus?
Antiviral preparations
- Gum
- Nasal Spray
- Lozenge
Nicotine Replacement Therapy
- Bupropion
Antidepressant
- Varenicline
Partial nicotine agonist
Who is responsible for the oversight of the CSIB program?
CO
Who will maintain custody of all controlled substances authorized for shipboard use?
SMDR
The working stock custodian shall maintain a minimum of how many units of issue in the safe at all times?
Minimum of 1 unit of issue
All CSIB records must be maintained how long?
3 years
The bulk stock custodian must be what personnel?
A commissioned Officer
What 3 occasions will a safe combination be changed?
- Immediately upon turnover
- Suspicion
- Every 6 months
What is the ONLY justification to give a controlled substance while in homeport?
Only in an emergency situation where treatment will be delayed
When can a patient return to work after taking a controlled substance?
8 hours after taking the medication
What letter will be used as a prefix for controlled substance prescriptions?
“C”
What is the minimum amount of CSIB members for a ship of 100 personnel or more and what are their ranks?
- Minimum of 3 members
- 2 must be a commissioned officers
- 1 MAY BE an E-7 or above
What is the minimum amount of CSIB members for a ship of less than 100 personnel and what are their ranks?
- Minimum of 2 members
- 1 Commissioned Officer
- 1 Chief petty officer
All CSIB members must score a minimum of what % on the CSIB test?
90% or above
What 5 occasions will the CSIB members perform inventories?
- At least quarterly
- Within 1 month of any transaction
- At the time of the relief of the CO, or SMDR
- At the request of the CO
- Upon direction from higher authority
What is the NAVMED 6710/22?
Coversheet
What is the NAVMED 6710/23?
Audit
What is the DEA Form 106?
Theft of significant loss of any controlled substance
How many CSIB members must be present for destruction of medications?
minimum of 3 members
SENIOR MEMBER MUST BE PRESENT
What dietary supplement can be associated with a stroke if over used?
Creatine
What drug class:
Can lead to Parkinson like symptoms, Akathisia, and dystonia?
Antipsychotics
What antiemetic medication block the effects of serotonin in the HT3 receptor sites?
Ondansetron
What medication if used more than 3 days consecutively can cause rebound congestion?
Oxymetazoline
What is a broncho constrictive substance released by the body during inflammation?
Leukotriene
The effectiveness of antibiotics depend on what 3 factors?
- Location of infection
- Ability to reach the infection
- Ability of bacteria to resist or inactivate the antibiotic
