Review Flashcards
what do you use to prescribe single meds
dd1289
what is the poly script
navmed 6710/6
should you use RX short hand
no
what is pharmacokinetic
movement of the drug after it enters the body
what does active absorption mean
using atp to move drug accross the membrane
what is pharmacodymanics?
interactions of the effects within the body
what is physical dependence
compulsion to use due to withdrawal
agonist
drug that binds to a receptor to make a therapeutic response
antagonist
binds to a receptor stronger than the agonist blocking it (naloxone)
additive drug reaction
multiple drugs combining producing an effect equal to the sum
synergistic reaction
greater than the sum (potassium and PCN)
does gender have an effect on drug effect
yes
1 cc is equal to ?
1 ml
how many mcg are in a mg
1000
oral routes of meds
oral
bucal
sublingual
ng
what is parenteral
drug entering the body not through the GI tract
fastest way to give meds
IV
what class does sedatives and hypnotics have
barbiturates’
whats an example of a barbiturate
phenobarbital
anti anx meds are
Nonbenzos
benzos
examples of benzos
diazepam
lorazepam
how do benzos work
bind to specific benzo receptors in GABA receptor complex enhancing binding of inhibitory neurotransmiter
how do nonbenzos work?
Act on dopamine and serotonin receptors
what is the go to for anti depresso meds
SSRI
SNRI
how do SSRI and SNRIs work?
Increase serotonin by inhibiting neuronal uptake to CNS
how long does it take for SSRIs to take effect
4-6 weeks
SNRI examples
Venlafaxine, Duloxetine
SSRI examples
1) Citalopram: Celexa
2) Fluoxetine: Prozac
3) Sertraline: Zoloft
4) Paroxetine: Paxil
how do anti psychotics work?
Block dopamine receptors in the brain
example of 1st gen antipsyco
Haloperidol
how to anticonvulsants work?
Reduction of excitability of the neurons of the brain
examples of anti convulsant
Diazepam, Phenytoin, Midazolam
examples of antiemetics
Ondansetron, Promethazine, Phenothiazines
Antivertigo meds
Benzodiazepines:
Diphenhydramine:
Meclizine
local anesthesia works by
inhibiting transport of ions across neuronal membranes
What effect does ketamine have on pain
dissociated from the surroundings and pain
do not use consious sedation and analgesia on people who have
Known or suspected
schizophrenia
If giving Ketamine IM for pain control
give 20-40 mg IM
ex of local anesthesia
Lidocaine:
bupivacaine
classes of analgesics
(a) Salicylate
(b) Non-salicylate
(c) Nonsteroidal Anti-inflammatory Drugs (NSAIDS)
(d) Urinary Analgesics
ex of salicylate
asprin
why wouldnt you give aspin to children
ray syndrome
use of nonsalicylate
(a) Relieve mild to moderate pain
(b) Reduce body temperature (antipyretic)
(c) Arthritis
Nsaids
COX-1 & COX-2 are resp for
prostaglandin
synthesis
ex of nsaids
ketorolac
ibuprophen
Naproxen:
Celecoxib
Meloxicam
Indomethacin:
ex of urinary anegesic
phenzopyridine
Pyridium is known to turn the patient’s urine
a reddish-orange color that can
stain undergarments
The result of opioids is to
alteration to
the perception of and response to pain
contraindication to opioids
Head injury or increased ICP
Hypoxia
Hepatic impairment
Hypersensitive to opioids or naloxone
Examples of opioid agonists
Hydromorphone:
Methadone:
Morphine sulfate
Oxycodone:
Hydrocodone:
Codeine:
the Narcotic Antagonist is what
naloxone
Highest of histamines are amount found in
basophils
(WBC) and mast cells
H¹ - antihistamines where
in mast cells
smooth muscle, and endothelium in the body as well as in the in the brain
2nd Generation Antihistamines
1) Cetirizine HCL: Zyrtec
2) Fexofenadine: Allegra
3) Loratadine: Claritin
1st Generation Antihistamines
1) Diphenhydramine:
2) Hydroxyzine:
3) Promethazine:
examples of decongestants
Oxymetazoline HCL
Pseudoephedrine
Phenylephrine
Oxymetazoline HCL: Notorious for causing rebound congestion when used for more than______
3 days consecutively
ex. Beta² Agonists
Albuterol sulfate
Levalbuterol HCL
Beta² Agonists is it gonna be less affective if the pt is taking what?
beta blocker
contraindication for albuterol
Cardiac arrhythmias,
ex of muscarinic
Ipratropium:
Tiotropium:
Mast Cell Stabilizer what do?
Inhibit the release of substances that cause
bronchoconstriction and inflammation from the mast cells in the respiratory tract
what is the action for Inhaled Corticosteroids
Decrease inflammatory process in the airway through inhibiting multiple
different inflammatory cytokines
ex of Inhaled Corticosteroids
Fluticasone
Budesonide
Antitussives
Central acting vs Peripheral acting
Central: Depresses cough center. medulla
Peripheral: Anesthetize stretch receptors
Examples anti tussive
Codeine sulfate
Benzonatate:
Dextromethorphan:
Diphenhydramine:
Mucolytic and Expectorants what do
Loosens and mobilize thick mucus from respiratory system
ex of Mucolytic:
Acetylcysteine:
ex of Expectorant:
Guaifenesin:
Cardiac arrhythmias what is
Abnormal electric current in the heart
Class 1 anti arrhythmic
Lidocaine…
-raises the threshold in the
ventricular myocardium
-Depresses myocardial excitability to electrical stimuli thus
decreasing the pulse rate
Class 2:
beta blockers
block stimulation of the beta receptors
Class 3:
Amiodarone
Blockade of Na or K channels
Class 4:
Verapamil
blocks calcium channels used in production of muscle contraction and electrical conduction
?how do nitrates work
relaxes smooth muscle of blood vessels
ACE inhibitors do what and how
Lower blood pressure by dilating or increasing the size of the arterial blood
vessels.
inhibits the conversation of angiotensin I to angiotensin II.
Ace inhibiters examples
Lisinopril
Captopril
Enalapril
Ramipril
CCB examples
Diltiazem:
Verapamil:
Beta² -
adrenergic receptors are found mainly in
bronchial and vascular smooth muscle
and the uterus
Beta¹ -
adrenergic receptor sites are located chiefly in the
heart where stimulation
results in increased heart rate, contractility, and AV conduction
contraindication for beta blockers
Sinus bradycardia
beta blockers example
Metoprolol
Propanolol:
Atenolol
Diuretics classes to pay attention to
Loop Diuretics
Thiazide
Loop Diuretics example
Furosemide
Thiazide diuretics example
Hydrochlorothiazide
Hyperlipidemia
HMG-CoA reductase inhibitors do what?
Inhibit an enzyme involved in
cholesterol synthesis
HMG CoA Reductase Inhibitors example
(statins)
Atorvastatin
Simvastatin
Antacids work how
NEUTRILIZE or reduce the acidity of the stomach and duodenal contents by
combining with hydrochloric acid and producing salt and water
contraindication for antacids
Severe abdominal pain of unknown cause.
Histamine H² Antagonist does what
Inhibit the actions of histamine at histamine H² receptor cells of the stomach, which REDUCE the secretion of gastric acid.
ex. Histamine H² Antagonist
Famotidine:
Cimetidine
Proton Pump Inhibitors work by
SUPRESS gastric acid secretion
……..by blocking the final step in the production of gastric acid be the gastric mucosa
Proton Pump Inhibitors
Examples:
Esomeprazole
Omeprazole
Pantoprazole
Rabeprazole
Lansoprazole
Antidiarrheal works how?
Decrease intestinal peristalsis, which is usually increased in a patient with
diarrhea
When can you not give an antidiarrheal
Diarrhea associated with organisms
Abdominal pain of unknown origin
Antidiarrheal
example
loperamide
Anti-flatulents
how work?
Simethicone has a defoaming action that disperses and prevents the formation of mucus-surrounded gas pockets in the intestine
Laxatives action
Bulk-producing
Not digested by the body, adds bulk. The added bulk in the intestines stimulates
peristalsis.
Laxatives action
Emollient
Lubricate the intestinal walls and soften the stool
Laxatives Action:
Hyperosmolar
Dehydrate local tissue causes irritation and increases peristalsis.
Laxatives Action:
Irritant or stimulant
Increase peristalsis by direct action on the intestine
Laxatives Action:
Saline
Attract or pull water into the intestine
Emollient:
example
Mineral oil
Bulk-forming
example
Psyllium Metamucil
Methylcellulose
Polycarbophil
Wheat dextrin
Hyperosmolar\
example
Glycerin
Polyethylene glycol (PEG)
Lactulose
Sorbitol
Irritant or stimulant
example
Bisacodyl
Senna:
Saline:
example
Magnesium citrate
Milk of magnesia
Excessive or prolonged use of Hemorrhoid agents may lead to…..
atrophy of the affected tissues
Excessive or prolonged use of Hemorrhoid agents may lead to…..
atrophy of the affected tissues
Oral Antidiabetics
Sulfonylureas action
lower blood glucose by stimulating beta cells of pancreas to make more insulin.
Oral Antidiabetics
Biguanides action
reduces hepatic glucose production and increases insulin sensitivity in muscle and fat cell
Sulfonylureas
Examples:
Glyburide
Examples:
Biguanides
Metformin
Contraindication
Oral Antidiabetics
-severe Infection
-Sulfonylureas are not recommended in patients who have allergy to sulfonamides
-can cause or exacerbate congestive heart failure (CHF) in some patients.
Estrogens
inhibitions of ovulation
Progestin
maturation of the ovarian
follicle and ovulation.
Emergency Contraceptive is what
Levonorgestrel
oral BC
Risks of thromboembolic disease is increased in females __ years or older that use ____
35, tobacco
SULFONAMIDES used to control
urinary tract infections caused by E coli, Staphylococcus aureus
SULFONAMIDES:
examples
Silver Sulfadiazine
Trimethoprim/sulfamethoxazole
PENICILLINS
bactericidal or bacteriostatic
examples:
bactericidal
(a) PEN VK
(b) Amoxicillin: Amoxil
(c) Amoxicillin/Clavulanate:
CEPHALOSPORINES
bactericidal or bacteriostatic
examples:
bactericidal
CEF drugs…
TETRACYCLINES
bactericidal or bacteriostatic
examples:
bacteriostatic
(a) Doxycycline
(b) Tetracycline
(c) Minocycline
TETRACYCLINES
Adverse Reactions
Gastrointestinal upset, photosensitivity.
MACROLIDES
bactericidal or bacteriostatic
examples:
bacteriostatic
(a) Azithromycin: Zithromax
(b) Erythromycin (Alternate therapy and off label use for acne).
(c) Clarithromycin
(d) Teithromycin
Fluoroquinolones
bactericidal or bacteriostatic
examples:
bactericidal
(a) Ciprofloxacin: Cipro
(b) Levofloxacin: Levaquin
Fluoroquinolones serious adverse reactions that have occurred together including
,
tendinitis and tendon rupture
Aminoglycosides
bactericidal or bacteriostatic
examples:
bactericidal
(a) Gentamicin
(b) Neomycin
Aminoglycosides
Adverse Reactions:
(a) Nephrotoxicity
(b) Ototoxicity
(c) Neurotoxicity
Carbapenems
bactericidal or bacteriostatic
examples:
bacteriostatic
(a) Imipenem: Primaxin
(b) Meropenem: Merrem
(c) Ertapenem: Invanz
use what class of antibotic for
Severe infections with drug resistant organisms, hospital acquired pneumonia, meningitis, intra-abdominal infections, prosthetic joint infection, necrotizing soft
tissue infections, and pyelonephritis
Carbapenems
Lincosamide
bactericidal or bacteriostatic
examples
Both
a) Clindamycin
b) Lincomycin
Lincosamide uses
Bacterial vaginosis
Toxic shock syndrome
Bite wound, prophylaxis or treatment, animal or human bite
Antivirals action
Most agents inhibit viral replication
Antivirals
Examples:
(a) Acyclovir: Zovirax
(b) Vancyclovir: Valtrex
(c) Penciclovir (topical): Denavir
(d) Oseltamivir: Tamiflu
Adverse Reaction
Corticosteroid
big bad
Cushing’s syndrome
adrenal insufficiency If abrupt cessation of medication occurs
Corticosteroids
examples
(a) Hydrocortisone: Solu-Cortef
(b) Prednisone
(c) Triamcinolone: Kenalog
(d) Methylprednisolone: Solu-Medrol
(e) Dexamethasone: Decadron
Antimigraine action
Acts on intracranial blood vessels and sensory nerves of the trigeminal system
Antimigraine
Examples:
(a) Rizatriptan: Maxalt
(b) Sumatriptan: Imitrex
Keratolytic used for?
warts
Keratolytic
examples
(a) Podofilox 0.5% topical solution and gel: Condylox
(b) Salicylic acid gel 17%: Compound-W
eye antiviral preparation Ganciclovir is used for?
Prevention of cytomegalovirus
is a lozenge an oral tab?
NO its a lozenge…..
Partial Nicotine Agonist?
Varenicline
overall resp for CSIB prog
CO
minimum of ___ safes are required for security of controlled substances
two
Prescriptions for controlled substances SHALL NOT be issued by an IDC while in their homeport, unless ____
an emergency situation exists and treatment will be delayed.
A person receiving a controlled substance will not normally be returned to duty for a period of?
of 8 hours
The board will perform inventories how often?
every 90 days
within 30 days of any transaction
NAVMED 6710/22
coversheet
NAVMED 6710/23
audit
NAVMED 6710/5
perpetual inventory
form utilized during all destructions
DD 200
DEA form 106,
Report of Theft of Controlled Substances
Creatine Over use associated with ____
stroke
how do Barbiturates work
depress the sensory cortex, decrease motor activity, alter cerebellar function, and produce drowsiness, sedation, and hypnosis
In high doses, Barbiturates exhibit what?
anticonvulsant activity