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Spring Pharm > Semester 1 Review > Flashcards

Semester 1 Review Flashcards

1
Q

Categories of drug actions

A
  • stimulation or depression
  • replacement
  • inhibition or killing of organisms
  • irritants (given for pneumothorax & to advance NG tube for placement)
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2
Q

Geriatric Pharm

A
  • polypharmacy
  • Beers criteria
  • individualize education/schedule
  • have decreased metabolism & hold onto meds longer due to increased body fat & decreased muscle mass
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3
Q

Pediatric pharm

A
  • high risk population
  • variations: kinetics/dynamics; increased drug metabolism
  • family centered teaching/education
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4
Q

Drug interaction categories

A 
Category A --> no interaction
Category B --> no action needed
Category C --> monitor therapy
Category D --> consider therapy modification
Category E --> avoid combination

Symptoms: N/V, headache, diarrhea, possible CNS depression

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5
Q

Hypersensitivity reactions

A

Type 1: allergic reaction to anaphylaxis (decreased BP, increase HR & RR, airway constriction, decreased O2)
-allergic reaction: give benadryl, ritidine
-anaphylaxis: give epinephrine, fluids, steroids
Stevens Johnson syndrome –> delayed reaction; rash on hands/feet & anything with epithelial cells
-treatment: fluid replacement, burn treatment
Blood transfusion reaction: decreased BP, flank pain, increase HR, hives
-treatment: similar to type 1 allergic reaction

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6
Q

Adrenergic agonists

A

-epinephrine
-norepinephrine
-dopamnine
Effect:

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7
Q

Adrenergic antagonist

A

-metoprolol
-carvedilol
Effect:

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8
Q

Anticholinergic drugs

A

Atropine:
-indications:
-effects:
Scopolamine:
-indication: prevention of N/V associated with motion sickness & post-anesthesia
Anticholinesterase: enzyme that breaks down acetylcholine

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9
Q

Barbituates

A

GABA receptor agonists

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10
Q

Zolpidem

A

GABA
minimal anxiolytic
Nursing implications

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11
Q

Benzodiazepine

A

Examples:
Indications:
Adverse effects:
VS:

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12
Q

Anticonvulsants

A

MOA: potentiate GABA, suppress the activation of Na+ channels, inhibit select types of Ca2+ channels

  • Phenytoin: teaching
  • Levetiracetam: SJS
  • Phenobarbital: type?
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13
Q

Anticonvulsants adverse effects

A
  • CNS suppression
  • Dermatologic effects: SJS, urticaria (hives), need sun protection
  • gingival hyperplasia
  • hematologic effects: pancytopenia
  • GI effects
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14
Q

Gabapentin

A

-primarily used for neuropathy

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15
Q

NSAIDs

A

Aspirin: used in unstable angina, blocks thromboxane A2 to prevent platelet aggregation
-onset: 3-5 minutes if chewed
-causes Reye’s syndrome in peds
Ibuprofen:
-concerned about kidney toxicity
Toradol: IV form of ibuprofen
-Indications: migranes, post op pain, chronic back pain, kidney stones

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16
Q

Acetaminophen

A

MOA: inhibits prostaglandin synthesis
Indications: pain, fever
-concerned about liver toxicity

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17
Q

Antihystamines

A

H1 Antagonists:
-1st generation: Diphenhydramine; effects are quicker, but have more side effects
-2nd generation: Cetirizine; decreased side effects
Side effects:
-sedative
-anticholinergic effects: constipation, dry eyes, xerostoma, urinary retention
-concerns: worsens BPH

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18
Q

Narcotic Assessment

A
  • VS: RR, O2 sat, BP, altered mental status

- pain scale with 7 dimensions of pain

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19
Q

Opioid

A

Morphine

  • routes:
  • uses: moderate to severe pain
  • adverse effects:
  • max dose:
  • reversal agent: naloxone
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20
Q

Hypothyroidism

A

Symptoms: intolerance to cold, fatigue, anorexia, constipation
Late clinical manifestations: subnormal temp, bradycardia, weight gain, decreased LOC, thickened skin, cardiac complications

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21
Q

Hypothyroidism

A

Symptoms: intolerance to cold, fatigue, anorexia, constipation
Late clinical manifestations: subnormal temp, bradycardia, weight gain, decreased LOC, thickened skin, cardiac complications
Treatment: Levothyroxine (converts to T3)
Extreme form: myxedema; severe thyroid deficiency that can lead to coma & death

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22
Q

Hyperthyroidism

A

Symptoms: intolerance to heat, tachycardia, diarrhea, amenorrhea, increased systolic BP, facial flushing
Treatment: Methimazole, surgery
Extreme: Graves/thyroid storm, exophthalmos

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23
Q

Cushing’s syndrome

A

Symptoms: hyperglycemia, moon face, susceptibility to infection, gynecomastia, purple striae, fat deposits on face & back of shoulders
Treatment: treat underlying cause; possibly argument with Spironolactone

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24
Q

Addison’s disease

A

Symptoms: hypoglycemia, postural hypotension, changes in distribution of body hair, weight loss, bronze pigmentation of skin
Adrenal crisis: profound fatigue, dehydration, vascular collapse (decrease BP), renal out down, decreased serum NA & increased serum K
Treatment: prednisone

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25
Q

Prednisone

A

Side effects:
Caution:
Education:
Other uses:

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26
Q

Somatropin

A

Adverse effects: hyperglycemia (need to check daily)

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27
Q

DDAVP (antidiuretic)

A

Indication: ADH deficiency
MOA: conservation of water in the collecting ducts of the nephron
Adverse effects:
Nursing implications:

28
Q

Lispro

A

Rapid acting insulin
Onset: 5-15 minutes
Peak: 0.5-1 hour
Duration: 3-4 hours

29
Q

Humulin R

A

Short acting insulin
Onset: 30-60 minutes
Peak: 2.5-5 hours
Duration: 4-8 hours

30
Q

Humulin N

A

Intermediate acting insulin
Onset: 1-2 hours
Peak: 4-12 hours
Duration: 18-24 hours

31
Q

Glargine

A

long acting insulin
Onset: 2-4 hours
NO PEAK
Duration: 24 hours

32
Q

Biguanide

A

Insulin sensitizer
Side effects:
Contraindication: acute illness (risk for lactic acidosis)

33
Q

Glipizide

A

Class:
MOA: promote insulin release
Risks:

34
Q

Glipizide

A

Class:
MOA: promote insulin release
Risks:

35
Q

Furosemide

A

Loop diuretic
Adverse effects:
Labs: K+, creatinine

36
Q

Hydrochlorothiazide

A

Thiazide diuretic

Indication: HTN

37
Q

Spironolactone

A

Potassium-Sparing diuretic

Adverse effects: hyperkalemia

38
Q

Mannitol

A

Osmotic diuretic
Indication: increased ICP
Concerned about patients with CHF & renal failure due to profound fluid shift

39
Q

Antihypertensive meds

A 
Renin-Angiotensin-Aldosterone medications
-ACE inhibitors
-Angiotensin II receptor blockers
-Renin inhibitors
-Aldosterone antagonists
Calcium channel blockers
Direct vasodilators
Diuretics
40
Q

Lisinopril

A 
ACE Inhibitors
MOA: blocks the conversion of angiotensin I to angiotensin II
Labs:
VS:
Side effects:
41
Q

Calcium channel blockers

A

Nifedipine:
-indication: BP
Cardizem (diltiazem):
-Indications: BP, but used more for atrial dysrhythmias

42
Q

Beta blockers

A

-olol
MOA:
Adverse effects:
Nursing implications:

43
Q

Dysrhythmic meds

A

Class I: Lidocaine
-MOA: slows impulse conduction in the atrial, ventricles & His-Purkinje system
Class II: Beta blockers
Class III: Amiodarone
-Half life:
Toxic effects:
Class IV: calcium channel blockers (diltiazem)

44
Q

Antidysrhythmic med adverse effects

A
  • EKG changes
  • AV blocks
  • Hypotension
  • QT prolongation
  • CNS effects (Lidocaine/Digoxin)
  • Pulmonary toxicity (Amiodarone)
45
Q

Symptoms of Heart Failure

A

Left-sided:

Right sided:

46
Q

Digoxin

A

MOA:
Nursing implications:
-take 1 min apical pulse prior to admin
Labs:

47
Q

Nitroglycerine

A 
MOA:
Indications:
Nursing implications:
-for IV nitro, need HR & BP prior to admin
Admin:
Education:
-drug holiday
-education on orthostatic hypotension
48
Q

Antihyperlipidemics

A
  • HMG-CoA Reductase inhibitors: Rosuvastatin
  • Bile Acid sequestrates: Cholestyramine
  • Fibric acid derivatives: Gemfibrozil
  • Nicotinic Acid: Niacin
49
Q

Antihyperlipidemics

A
  • HMG-CoA Reductase inhibitors: Rosuvastatin
  • Bile Acid sequestrates: Cholestyramine
  • Fibric acid derivatives: Gemfibrozil
  • Nicotinic Acid: Niacin
50
Q

HMG-CoA Reductase Inhibitors

A

Rosuvastatin
Adverse effects:
-Rhabdomyolysis (muscle weakness or fatigue, arthralgia, myalgia that can lead to renal failure)
-Labs: creatinine kinase

51
Q

Bile-acid sequestrants

A

Cholestyramine

MOA: binds with bile salts in the intestines & is excreted in the feces

52
Q

Fibric acid derivatives

A

Gemfibrozil
MOA: inhibits breakdown of stored fats
Adverse effects: GI symptoms

53
Q

Nicotinic Acid

A

Niacin
MOA: inhibits release of free fatty acids
Side effects: facial flushing (to prevent, take aspirin 30-45 minutes prior to admin)

54
Q

Anticoagulants

A 
Heparin
-lab: PTT, platelets
Warfarin:
-lab: PT/INR
Enoxaparin:
-lab: Platelets
55
Q

Antiplatelets

A

Aspirin
Clopidogrel
Eptifibatide (Integrilin): IV

56
Q

Thrombolytic

A

Aletpase (tPa)
Indications: embolic CVA
Adverse effects:

57
Q

Respiratory agents

A 
Anti-inflammatory agents
Leukotriene modifiers
Beta 2 agonists
Anticholinergic agents
Expectorant
58
Q

GI agents

A

H2 Receptor antagonists: Ranitidine
Proton pump inhibitors: Esomeprazole, pantoprazole
Anti-ulcer agents: sucralfate, antacids
Anti-diarrheal agents: Atropine/Diphnoxylate, Bismut subsalicylate

59
Q

Laxatives

A

Bulk forming: methylcellulose
Surfactant laxatives: decussate sodium
Stimulant laxatives: bisacodyl
Osmotic laxatives: polyethylene glycol

60
Q

Atropine/Diphenoxylate

A

MOA: inhibits peristalsis

61
Q

Bismuth Subsalicylate

A

MOA: antisecretory & antimicrobial effects

62
Q

Bismuth Subsalicylate

A

MOA: disrupts the cell wall of H.pylori & therefore it’s adherence (antisecretory & antimicrobial effects)
Side effects: harmless discoloration of tongue & still (black)
Contraindications: children < 2 years (can cause Reye’s syndrome) or children with flu infection

63
Q

Ranitidine

A

H2 receptor antagonist
MOA: competitive inhibition of H2 receptors of the gastric parietal cells resulting in reduced gastric acid secretion, gastric volume & H+ concentration
Indications: duodenal & gastric ulcer, GERD, aspiration pneumonitis, multi-drug therapy for H. pylori
Adverse effects: pneumonia, antiadronergic effects, CNS depression, suppression of leukocytes & T lymphocytes

64
Q

Esomeprazole

A

Proton pump inhibitor
MOA: irreversibly binds to ATPase enzyme to inhibit the parietal cell H+/K+ ATP pump and suppress basal & gastric acid secretion
Indications: gastric & duodenal ulcers, erosive esophagitis, GERD, stress ulcer prophylaxis
Admin: PO/IV, do NOT crush, AM dosing

65
Q

Sucralfate

A

MOA: mucosal protectant
Indications: acute & maintenance therapy for gastric & duodenal ulcers
-relieves symptoms of PUD (protective lining so acid can’t cause problems)
Adverse effects: (minimal) constipation, lower GI cramping

66
Q

Aluminum Hydroxide

A

Antacid
Indication: PUD, minimize aspiration pneumonitis, GERD
Contraindications: kidney failure, CHF

Spring Pharm (8 decks)

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