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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
Prednisone
Side effects: Caution: Education: Other uses:
26
Somatropin
Adverse effects: hyperglycemia (need to check daily)
27
DDAVP (antidiuretic)
Indication: ADH deficiency MOA: conservation of water in the collecting ducts of the nephron Adverse effects: Nursing implications:
28
Lispro
Rapid acting insulin Onset: 5-15 minutes Peak: 0.5-1 hour Duration: 3-4 hours
29
Humulin R
Short acting insulin Onset: 30-60 minutes Peak: 2.5-5 hours Duration: 4-8 hours
30
Humulin N
Intermediate acting insulin Onset: 1-2 hours Peak: 4-12 hours Duration: 18-24 hours
31
Glargine
long acting insulin Onset: 2-4 hours NO PEAK Duration: 24 hours
32
Biguanide
Insulin sensitizer Side effects: Contraindication: acute illness (risk for lactic acidosis)
33
Glipizide
Class: MOA: promote insulin release Risks:
34
Glipizide
Class: MOA: promote insulin release Risks:
35
Furosemide
Loop diuretic Adverse effects: Labs: K+, creatinine
36
Hydrochlorothiazide
Thiazide diuretic | Indication: HTN
37
Spironolactone
Potassium-Sparing diuretic | Adverse effects: hyperkalemia
38
Mannitol
Osmotic diuretic Indication: increased ICP Concerned about patients with CHF & renal failure due to profound fluid shift
39
Antihypertensive meds
``` Renin-Angiotensin-Aldosterone medications -ACE inhibitors -Angiotensin II receptor blockers -Renin inhibitors -Aldosterone antagonists Calcium channel blockers Direct vasodilators Diuretics ```
40
Lisinopril
``` ACE Inhibitors MOA: blocks the conversion of angiotensin I to angiotensin II Labs: VS: Side effects: ```
41
Calcium channel blockers
Nifedipine: -indication: BP Cardizem (diltiazem): -Indications: BP, but used more for atrial dysrhythmias
42
Beta blockers
-olol MOA: Adverse effects: Nursing implications:
43
Dysrhythmic meds
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
Antidysrhythmic med adverse effects
- EKG changes - AV blocks - Hypotension - QT prolongation - CNS effects (Lidocaine/Digoxin) - Pulmonary toxicity (Amiodarone)
45
Symptoms of Heart Failure
Left-sided: | Right sided:
46
Digoxin
MOA: Nursing implications: -take 1 min apical pulse prior to admin Labs:
47
Nitroglycerine
``` MOA: Indications: Nursing implications: -for IV nitro, need HR & BP prior to admin Admin: Education: -drug holiday -education on orthostatic hypotension ```
48
Antihyperlipidemics
- HMG-CoA Reductase inhibitors: Rosuvastatin - Bile Acid sequestrates: Cholestyramine - Fibric acid derivatives: Gemfibrozil - Nicotinic Acid: Niacin
49
Antihyperlipidemics
- HMG-CoA Reductase inhibitors: Rosuvastatin - Bile Acid sequestrates: Cholestyramine - Fibric acid derivatives: Gemfibrozil - Nicotinic Acid: Niacin
50
HMG-CoA Reductase Inhibitors
Rosuvastatin Adverse effects: -Rhabdomyolysis (muscle weakness or fatigue, arthralgia, myalgia that can lead to renal failure) -Labs: creatinine kinase
51
Bile-acid sequestrants
Cholestyramine | MOA: binds with bile salts in the intestines & is excreted in the feces
52
Fibric acid derivatives
Gemfibrozil MOA: inhibits breakdown of stored fats Adverse effects: GI symptoms
53
Nicotinic Acid
Niacin MOA: inhibits release of free fatty acids Side effects: facial flushing (to prevent, take aspirin 30-45 minutes prior to admin)
54
Anticoagulants
``` Heparin -lab: PTT, platelets Warfarin: -lab: PT/INR Enoxaparin: -lab: Platelets ```
55
Antiplatelets
Aspirin Clopidogrel Eptifibatide (Integrilin): IV
56
Thrombolytic
Aletpase (tPa) Indications: embolic CVA Adverse effects:
57
Respiratory agents
``` Anti-inflammatory agents Leukotriene modifiers Beta 2 agonists Anticholinergic agents Expectorant ```
58
GI agents
H2 Receptor antagonists: Ranitidine Proton pump inhibitors: Esomeprazole, pantoprazole Anti-ulcer agents: sucralfate, antacids Anti-diarrheal agents: Atropine/Diphnoxylate, Bismut subsalicylate
59
Laxatives
Bulk forming: methylcellulose Surfactant laxatives: decussate sodium Stimulant laxatives: bisacodyl Osmotic laxatives: polyethylene glycol
60
Atropine/Diphenoxylate
MOA: inhibits peristalsis
61
Bismuth Subsalicylate
MOA: antisecretory & antimicrobial effects
62
Bismuth Subsalicylate
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
Ranitidine
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
Esomeprazole
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
Sucralfate
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
Aluminum Hydroxide
Antacid Indication: PUD, minimize aspiration pneumonitis, GERD Contraindications: kidney failure, CHF

Spring Pharm (8 decks)

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