Review Part 1 Flashcards
Get through this shit
What form do you use to prescribe Controlled Substances?
DD 1289
What 3 methods can you use to write prescriptions?
Ink
Indelible pencil
typewritten
If you need to prescribe multiple medications what form can you use?
NAVMED 6710/6 Poly-prescription
Poly is a prefix meaning more than one
What must be written on the DD 1289?
8 items
1) Name
2) DOD ID
3) Date of prescription
4) Date of birth/Age
5) Drug-name/form/dosage/quantity dispensed
6) directions
7) signature
8) Refill authorization
In regards to drug/medication,
what must be included on DD 1289?
Full GENERIC name
Form of drug (tabs/capsule)
Dosage (written in metric)
Quantity to be dispensed
Directions on how to take meds
Refill Authorization
What are the 4 principles of pharmacology?
factors
Factors that affect actions of drugs
Factors that affect drug reactions
Various types of drug interactions
Factors influencing drug response interactions
Define Active absorption
Factor that affects an action of drug
Carrier molecule such as a protein or enzyme actively moves the drug across the membrane.
*The bouncer letting you in and preventing the ugly people in.
Define pinocytosis
Factor that affects an action of drug
Cell engulfs the drug particle across the cell membrane.
*It’s like when a Cheeto falls on my stomach and the rolls engulf it.
What is Bioavailability?
The percentage of the administered drug does that reaches the systemic circulation.
*It’s like the people that make it through IDC school.
6 Factors that alter Bioavailability?
Changes in liver metabolism cause by dysfunction
Route of administration
The drug forms
GI mucosa and motility
Food and drugs
Solubility -Drugs that are fat soluble are absorbed faster than water-soluble drugs.
*People love fat instead of water
What disease would require a lower dose of a medication or different medication?
A patient with liver disease may require a lower dose or a different medication that is not metabolized by the liver
The following are what type of pharmaceutical factors:
Adverse reaction
Allergic reaction
Drug idiosyncrasy
Tolerance
Factors that affect drug reactions
Name four Factors that affect drug reactions
Cumulative Drug effect
Toxic
Pharmacogenetics reactions
Pharmaceutic phase
What is an additive (+) drug reaction?
Various type of drug interactions
A reaction that occurs when the combined effect of two drugs is equal to the sum of each drug given alone.
What is synergism?
Various types of drug interactions
A drug interaction that occurs when drugs produce an effect that is greater than the sum of their separate actions.
What is an antagonist drug reaction?
Various types of drug interactions
When one drug interferes with the
action of another, causing neutralization or a decrease in the effect of one drug.
What are the 5 factors that influence a drug response?
Age-metabolism is poor when young/old
Weight
Gender- women require smaller doses
Disease- damn liver again
Route of administration- IV is fast as f*** boy!
What is a teratogen?
a substance that may produce physical or functional defects in a human embryo
why not say causes birth defects…
What is pregnancy categories
A
B
C
D
X
A- human studies SHOW NO risk
B-No EVIDENCE of risk
C-Risk CANNOT be ruled out
D-Positive evidence of risk
X- Contraindicated
Which method is absorbed more slowly than IM injections?
Subcutaneous (SC)
What type of parenteral administration is the Tuberculin test?
Intradermal (ID)
Which drug administration is a method that maintains a relatively blood concentration and reduces the possibility of toxicity?
Transdermal
Which method of drug administration may have a local effect on the lungs?
Inhalation
Drug droplets, vapors, and gas are administered through the mucus membranes of the respiratory tract.
What must you educate your patient when prescribing a Barbiturate (psychotherapeutic)?
Do not take it with alcohol because it will intensify the effect.
What are the 4 patient managements for a Barbiturate?
(a) Check vital signs and record
(b) Assess patient after giving medication for effect
(c) Patient Education: Abuse potential
(d) Natural Remedies: Melatonin
What are the 6 classes of antidepressants?
TCAs
MAOI
SSRI
SNRI
Serotonin Reuptake inhibitor/Antagonist
Dopamine/Norepinephrine-Reuptake Inhibitor
What does TCA stand for?
Antidepressant
Tricyclic antidepressants (TCAs)
What does MAOI stand for?
Antidepressant
Monoamine Oxidase Inhibitors (MAOI)
What does SSRI stand for?
Antidepressant
Selective Serotonin Reuptake Inhibitor
What does SNRI stand for?
Antidepressant
Serotonin Non-Epinephrine Reuptake Inhibitor
Which drugs inhibit the reuptake of Norepinephrine and serotonin.
Antidepressants
What are CNS stimulants used for? (2)
Narcolepsy -
*(decreased ability to regulate sleep wake cycles)
ADHD
*Speed!
What are the adverse effects of CNS stimulants?
Headache, dizziness, and apprehension
Over stimulation of the CNS
INSOMNIA, tachycardia, and blurred vision
Speed!
What are anticonvulsants used for?
Decrease the incidence and severity of seizures.
What is a psychomotor seizure?
May experience an AURA with perceptual alterations, and HALLUCINATION.
What is a tonic-clonic seizure?
Alternate contraction and RELAXATION of muscles.
What is a myoclonic seizure?
SUDDEN FORCEFUL contraction involving the musculature of the trunk, neck, and extremities.
I had a barbershop lady with his condition in Oki or maybe she was old.
What is an absence seizure?
(Petit mal) brief loss of consciousness during which physical activity ceases.
Usually seen in children only
*(Absence of physical activity)
Nystagmus is an adverse effect of?
Not on TG but told to add.
Anticonvulsants
What is an example of an anticonvulsant?
1) Diazepam: (IV) Valium
2) Lorazepam: (0.1mg/kg IV) Ativan
3) Midazolam: (IM) Versed
4) Clonazepam: (IV) Klonopin
What three drugs diminish motion sickness?
Meclizine
Scopolamine
Dimenhydrinate
This drug inhibits the transport of ions across neuronal membranes,
thereby preventing initiation and conduction of normal nerve impulses
Local anesthetics
Which drug causes neuro-inhibition and anesthesia,
where the patient is dissociated from the surrounding?
Ketamine,
an anesthetic.
What are some examples of anesthetics?
Bupivacaine: Marcaine (local)
Lidocaine: Xylocaine (Local)
Ketamine: Ketalar (Induction of general)
Propofol (IV)
Etomidate (general)
The intravenous (IV) induction drug of choice for most non-trauma patients because of its rapid onset and recovery is which anesthetic?
Propofol
What is epilepsy?
Permanent, and recurrent seizure disorder
Hepatotoxicity is usually associated with which drug?
excessive Acetaminophen intake and often involves more than one product that contains acetaminophen.
What is the Contraindication/warning/cautions for Celecoxib (COX-2Selective)?
allergy to sulfonamides
Peptic ulcer,
GI bleed,
and hypertension
are Contraindication/Warning/Caution for?
Ibuprofen (Non-Selective)
What is the action for NSAIDs?
Inhibit the action of the enzyme cyclooxygenase (COX-1 & COX-2 (Nonselective) or Cox 2 -Selective) which is responsible for prostaglandin synthesis.
Prostaglandin is responsible for inflammation…
What are 2 examples of NSAIDs?
Celecoxib
(selective COX 2 inhibitor): Celebrex
Meloxicam
(selective COX 2 inhibitor): Mobic
What is the first line treatment for Gout?
Indomethacin
Which class of drugs is a short-term management of moderate to severe pain?
Narcotic Analgesics
Fentanyl
Morphine Sulfate
Codeine
What are some examples of Narcotic analgesics?
Agonist:
Fentanyl: Sublimaze
Morphine sulfate: MS Contin
Codeine: Codeine
Hydromorphone: Dilaudid
Methadone: Dolophine
Hydrocodone: Norco/Lortab/Vicodin
Oxycodone: OxyContin
Which class of drug effectively blocks the receptor, preventing the body from responding to opiates and endorphins
Narcotic Antagonist
The drug is:
Naloxone
What is an example of a Narcotic Antagonist?
Naloxone
Naw fam, no overdose for you
What is the most common/example of an antihistamine?
Diphenhydramine:
Ask if Benadryl is cheap for you.
Which drug is notorious for causing a rebound congestion when used for more than 3 days consecutively?
Oxymetazoline HCL:
This drug is a decongestant
Tachyphylaxis is a rebound effect (adverse effect) for?
The drug is:
Oxymetazoline
which the drug is a Decongestants
which drug releases stimulants and reuptake inhibitors that increase the levels of endogenous catecholamines. Beta 2 receptors are in bronchial smooth muscle and when stimulated cause relaxation (dilation) of bronchioles?
Bronchodilators
The drug is:
Beta 2 Agonists
Which drug causes relaxation (dilation) of bronchioles?
Bronchodilators
The Drug is:
Beta 2 Agonists
What are the 5 uses of Bronchodilators or Beta² Agonists?
Bronchitis,
Exercise-induced bronchospasm,
Emphysema
Reversible Airway Obstruction (caused by bronchospasm due to bronchial asthma)
(COPD) Obstructive pulmonary disease.
What is an example of Inhale Corticosteroids or
Bronchodilators?
FLUTicasone: Flovent
BUDeSonide: Pulmicort
What are 4 examples of Antitussives?
Codeine sulfate
Benzonatate: Tessalon Perles
Dextromethorphan: Robitussin
Diphenhydramine: Benadryl
what are the actions of Mucolytic and Expectorants?
Mucolytic: Loosens and mobilize thick mucus from respiratory system.
Expectorant: Loosen and mobilize thick mucus from respiratory system. -this one helps you cough it up
What is an example of Mucolytic?
ACETYLcysteine
What is an example of expectorants?
Guaifenesin
What are the 4 actions of antiarrhythmics?
Raise the potential threshold
Block Beta receptor stimuli
Blockade of Na or K
Block calcium channels
Which Class of Antiarrhythmic
Depresses myocardial excitability to electrical stimuli thus decreasing the pulse rate.
Class 1
The first thing is to tell the heart to calm the fuck down.
Which Class of Antiarrhythmic
Beta blockers block stimulation of the beta receptors of the heart. Adrenergic neurohormones stimulate the beta receptors and increase the heart rate.
Class 2
*Beta blockers/ Block Beta receptors start with B which is 2nd after the letter A
Which Class of Antiarrhythmic causes
Amiodarone to Block Potassium channels in the heart. This is used for ventricular dysrhythmias and atrial fibrillation.
Class 3
Which drug is involved with the direct relaxing effect on smooth muscle of blood vessels (both arterials and veins)?
Nitrates
(Class of drug)
Antianginal
Which drug is used for the treatment of angina pectoris?
Nitrates
Or antianginal
What is an example of Nitrates or Antianginal?
Nitroglycerin
What is the systolic pressure for
Stage 1 and stage 2 hypertension?
Systolic 130-139 /diastolic 80-89 mm Hg
Systolic 140 /diastolic 90 mm Hg
Angiotensin-converting Enzyme (ACE): Converts angiotensin I to angiotensin II, is the action of which drug?
Class: ACE inhibitors, ARBs
Hypertensives
An adverse effect of which medication causes a dry, hacking cough in 5 to 20 percent of patients?
ACE inhibitor
A dry cough from ACE inhibitors usually begins within 1 to 2 weeks of instituting therapy but it can be delayed up to?
6 months
What is an example of ACE inhibitors?
*They end with -pril
LISINOPRIL
Ramipril
Enalapril
Captopril
This drug competes with adrenergic (sympathetic) neurotransmitters (epinephrine and norepinephrine) for adrenergic receptor sites.
Class: Beta blockers
Antihypertensives
What are the 3 Adverse effects of Beta Blockers? Antihypertensive
Bronchospasm (lung tubes spasm)
Orthostatic hypotension (low BP)
Bradycardia (slow heart rate)
What are the 4 contraindication/Warning/Caution of Beta Blockers?
Antihypertensive
Sinus bradycardia (slow heart rate)
Heart Block
Hypotension (low blood pressure)
Bronchial asthma
( Non-Selective Beta blocker (for example : Propranolol)
What is the action of diuretics?
Inhibit the action of carbonic anhydrase which leads to the excretion of sodium, potassium, bicarbonate and water
Antihyperlipidemic do what?
promote the REDUCTION of lipid levels
Which is the most commonly prescribed antihyperlipidemic?
Statins
Constipation Abdominal pain/cramps Nausea Liver dysfunction and RHABDOMYOLYSIS is adverse effect of?
Class: Anti-Hyperlipidemia (Statins)
Antihyperlipidemic
What is the first step before prescribing Anti-Hyperlipidemic?
Obtain initial labs (LFTs, Lipid panel, Chemistry
Which drugs neutralize or reduce the ACIDITY of the stomach and duodenal contents by combining with hydrochloric acid and producing salt and water?
Antacids
