TEST 1 Flashcards
What is the cytochrome P450 system?
group of enzymes that control the concentrations of many endogenous substances and drugs. These enzymes are mainly found in the liver (hepatic microsomal enzymes) and gut.
Seizure med Gabapentin (Neurontin) used for neuropathic pain is an example of?
Adjuvants
What neurotransmitter drives the PNS?
Hint: Bind to cholinergic receptors
Ach
What are the cholinergic receptors of the PNS?
nicotinic and muscarinic
What are the key neurotransmitters for the adrenergic receptors?
epi and norepi
Where are Beta adrenergic receptors located?
Beta 1- the ht and kidneys
Beta 2- lungs
What are catecholamines?
Epi and NE
What neurotransmitters does the post ganglionic neuron of the SNS release?
Catecholamines
Where are alpha adrenergic receptors located?
Target organ cell of the SNS
What neurotransmitter does the pre-ganglionic neuron of the PNS and SNS release?
Ach
Where are muscarinic receptors located?
Parasympathetic organs
Where are nicotinic receptors located?
Post ganglionic neuron of the SNS and PNS; skeletal msl of somatic nervous system
alpha receptors are mostly associated with what?
Smooth vascular msl
Drug classes for antihypertensives?
beta blockers, ACE inhibitors, ARBs, and thiazides
Which class of antihypertensive drugs should be used when a pt is bradycardic?
ARBs and ACE inhibitors because they do not affect the HR
What is afterload?
the resistance the L ventricle must overcome to squeeze the blood out of the heart
Selective dilation of arterioles will affect pre load or after load?
After load
What is the prototype for vasodilation of the arterioles?
Hydralazine
Selective dilation of the veins affects pre load or after load?
Pre load
Which drugs will affect both pre load and after load?
prazosin and sodium nitroprusside
Which drug vasodilates veins?
Nitro
If a pt has a HA after taking nitro what should you do?
Give them Tylenol or HA medication
How does nitro relieve pain of stable angina?
decreases cardiac oxygen demands
How does nitro relive pain of variant angina?
increasing cardiac oxygen supply
What is variant angina?
coronary artery vasospasms
MOA of nitro?
converts to nitric oxide (vasodilator)
patient education for nitro?
check drug expiration; don’t put it in pocket; take nitro holiday (min 8H); take sublingual, topical, sustained release, or translingual spray,
What is the contraindication for Nitro?
Erectile dysfunction drugs (PDE5 inhibitors)
What are the 4 classes of antidysrhythmic drugs?
- Na+ channel blockers
- Beta blockers
- K+ channel blockers
- Ca2+ channel blockers
Which class of antidysrhythmic drugs have the risk of HF and 3rd degree AV block?
Ca2+ channel and beta blockers
Someone with impaired liver function should limit Acetaminophen dose to?
2g/day
A healthy person can take max of how much acetaminophen?
4g/day
Which anticoagulant can be given during pregnancy?
Heparin
Routes for iron meds?
IM, IV, PO
Routes for vitamin B12?
PO, subQ, IM, and intranasal
Routes for folic acid?
PO, SubQ, IV, and IM
Adverse effects of iron meds?
GI upset; allergic rxn from IV administration
When giving IV iron what should we consider?
Giving a slow infusion
When should PO iron be given to allow effective absorption?
Between meals
Why should you use a straw when taking liquid iron?
it can stain teeth
What meds should you avoid taking at the same time as iron?
Antacids or tetracyclines
How do we know iron is working?
Reticulocytes should increase in 4-7 days, H/H should increase in a week
Precautions when giving children iron meds?
Iron poisoning can be fatal and requires rapid tx
High risk patients taking iron?
UC and PUD
What is a pro drug?
It is inactive until it gets metabolized by the liver
