Test 1 Flashcards
Clinical pharmacology
drugs used to treat, prevent, or diagnose disease
Phase I drug study
Healthy human volunteers who are often paid for their participation
The generic name of a drug is
the name assigned to the drug by the pharmaceutical company developing it
An orphan drug is
has been tested but is not considered to be financially viable
The FDA pregnancy categories
indicate a drug’s potential or actual teratogenicity effects
The strong, prescribing, and distribution of controlled substances-drugs-are monitored by
the DEA
Health young women are not usually involved in phase I studies of drugs because
females are more apt to suffer problems with ova, which are formed only before birth
A pt. has been taking fluoxetine (prozac), the tables start to look different, the nurse should tell the pt.
the law requires that prescriptions be filled with generic form if available to cut down the cost of medications
When teaching a pt about OTC drugs
- Some of these drugs were once prescription drugs, but now thought to be safe to use as directed
- Read the label of drugs to know active ingredient
- Important to read the label and the recommended dose
- Important to report use to provider
Generic drug
a drug sold by the name of the ingredient, not by the brand name
generic drugs are not available until the patent expires on the drug
generic drugs are usually cheaper
physician may want you to have the brand name and will have DAW
Chemotherapeutic agents are drugs that
interfere with foreign cell functioning, such as, invading microorganisms or neoplasms
Receptor sites
are protein areas on cell membranes that react with specific chemicals
Selective toxicity is
the ability of a drug to attack only those systems found in foreign or abnormal cells
When trying to determine why the desired therapeutic effect is not being seen with an oral drug, the nurse should consider
food altering the makeup of gastric juices
Much of the biotransformation that occurs when a drug is taken occurs as part of
the first pass effect through the liver
The half life of a drug
is determined by a balance of all pharmocokinetic processes
When reviewing a drug to be given, the nurse notes that the drug is excreted in the urine. What points should be included in the nurse’s assessment of the pt?
The pt. renal function tests
The pt. fluid intake
Other drugs being taken that could affect the kidney
When considering pharmacokinetics of a drug, what points would the nurse need to consider?
How the drug will be absorbed
How the drug will be excreted
How the drug will be metabolized
The half life of the drug
Drug-drug interactions are important considerations in clinical practice. When evaluating a pt for potential drug-drug interactions, what would the nurse expect to address?
The need to adjust drug dose or timing of administration
Increased adverse effects
The use of herbal or alternative therapies
An example of a drug allergy
breathing difficulty after an injection of penicillin
A pt. taking glyburide (antidiebetic drug) has his morning dose and then does not have a chance to eat for several hours. An adverse effect that might be expected from this would be
hypoglycemia
Pt. with severe infection is given gentamicin. Few hrs later the pt. becomes restless and develops edema. Blood test reveal abnormal electrolytes and elevated blood urea nitrogen. This reaction was most likely caused by
renal toxicity associated with gentamicin
Pt. receiving antineoplastic drugs that disrupt cell function often have adverse effects involving cells that turn over rapidly in the body. These cells include
bone marrow cells
A woman has had repeated bouts of bronchitis. She is taking an antibiotic. She develops a yeast infection. How does the nurse explain this to her?
she has developed a superinfection because the antibiotics kills bacteria that normally provide protection.
Knowing that a pt is taking a loop diuretic and is at risk for developing hypokalemia, the nurse would assess the pt. for
weak pulse, low bp, and muscle cramping
Pt. taking a drug that is known to be toxic to the liver. What teaching points are related to liver toxicity?
Fever, changes in color of urine
Changes in the color of the stool, malaise
Yellowing of the skin or the whites in the eyes
Pregnant women should be advised of the potential risk to the fetus. What fetal problems can be related to drug exposure in utero?
Fetal death Nervous system disruption Skeletal and limb abnormalities Cardiac defects Low set ears Deafness
A client is experiencing a reaction to the penicillin injection that the nurse administered approx. 1/2 hour ago. The nurse is concerned that it might be an anaphylactic reaction. What signs/symptoms would validate her suspicion?
Rapid heart rate
Diaphoresis
Rash
Client reports a panic feeling
A client is experiencing a serum sickness reaction. Which interventions would be appropriate?
Cool environment
Position of comfort
Ice joints
administer anti inflammatory agents
When describing the functions of the autonomic nervous system, which would the instructor include?
Regulation of integrated internal body functions
The ANS differs from the other systems in the CNS in that is
affects the organs and muscles via a two neuron system
If you suspect that a person is very stressed and is experiencing a sympathetic stress reaction, you would expect to find
dilated pupils and elevated systolic blood pressure
One a postganglionic receptor site has been stimulated, the neurotransmitter must be broken down immediately. The sympathetic system breaks down postganglionic neurotransmitters by using
MAO and COMT
The parasympathetic nervous system in most situations, opposes the actions of the SNS, allowing the ANS to
maintain fine control over internal homeostasis
Cholinergic neurons, those using acetylcholine as their neurotransmitter, would be least likely found in
the adrenal medulla
Stimulation of the parasympathetic nervous system would case
slower heart rate and increased gastrointestinal secretions
The SNS
is called the thoracolumbar system
is called the fight or flight system
is active during a stress reaction
The sympathetic system uses catecholamines at the postganglionic receptors. Which are catecholamines?
dopamine
norepinephrine
epinephrine
serotonin
Adrenergic drugs
sympathomimetric agents
The adrenergic agent of choice for treating the signs and symptoms of allergic rhinitis
phenylephrine
Phenylephrine
Shock, hypotension, tachycardia, nasal congestion, dilate pupils, decongestant to relieve eye irritation
An adrenergic agent being used to treat shock infiltrates into the tissue with IV administration. Which administration should the nurse take?
Remove the IV and prepare phentolamine for administration to the area.
Phenylephrine, an alpha specific agonist, is found in many cold and allergy preparations, the nurse instructs the pt. to be alert for which adverse effects?
Cardiac arrhythmias and difficulty urinating
Adverse effects associated with adrenergic agonists are related to the generalized stimulation of the sympathetic nervous system and could include
hypertension
Pt. has elected to take and OCM cold preparation that contains phenylephrine. The nurse would advise the pt not to take that drug if the pt has
thyroid or cardiovascular disease
Isoproterenol is a nonspecific beta agonist. The nurse might expect to administer this drug for which of the following conditions?
Bronchospasm
Cardiac standstill
Shock
Heart block in transplanted hearts
A nurse would question the order for an adrenergic agonist for a pt. who is also receiving the following
halogenated hydrocarbon anesthetics
beta blockers
monoamine oxidase inhibitors
tricyclic antidepressants
Adrenergic blocking drugs, because of their clinical effects, are also known as
sympatholytics
The nurse would anticipate administering drugs that generally block all adrenergic receptor sites to treat
cardiac related conditions
Phentolamine (Regitine), an alpha adrenergic blocker, is most frequently used to
prevent cell death after extravasation of intravenous dopamine or norepinephrine
A pt. with which of the following would most likely be prescribed an alpha 1 selective adrenergic blocking agent?
Hypertension and BPH
The beta blocker of choice for a pt. who is hypertensive and has angina is
nadolol
A nurse would question an order for beta 1 selective adrenergic blocker for a pt. with
cardiogenic shock
A smoker who is being treated for hypertension with a beta blocker is most likely receiving
a beta 1 specific blocker
You would caution a pt. who is taking an adrenergic blocker
to never stop the drug abruptly
A nurse would question an order for a beta adrenergic blocker if the pt. was also receiving what other drugs?
Clonidine
Ergot alkaloids
Non-steroidal anti inflammatory drugs
Epinephrine
The beta adrenergic blocker propranolol is approved for a wide variety of uses. Which of the following are approved indications?
Migraines
Stage fright
Re-infarction after a MI
Hypertension
Alpha 1 receptors
Blood vessels-vasoconstriction/increased peripheral resistance/raise bp
Iris: cause pupil dilation
Urinary bladder: increased closure of the internal sphincter
Alpha 2 receptors
Nerve membranes: modulators of norepinephrine release
Beta cells in pancreas: moderate insulin release stimulated by SNS activation
Beta 1 receptors
Cardiac tissue: increased force of myocardial contraction and activity/ increased heart rate/ increased lipolysis in peripheral tissues
Beta 2 receptors
Smooth muscle in blood vessels: vasodilation
Bronchi: dilation of bronchi
Periphery: increased breakdown of glycogen in the muscle and liver/increased release of glucagon
Uterine muscle: relaxes uterina smooth muscle
Propranolol
Treats hypertension. angina, syncope, cardiac arrhythmia’s, stage fright, tremors. It is a nonselective beta adrenergic blocking agent, works to prevent certain stimulating activities that normally occur in the body in response to stress, excitement, stabilizes nerves. Take BP and do not stop suddenly.
Epinephrine
Adrenalin
SusPhrine
Treats shock, glaucoma, prolongs effects of anesthetics
Norepinephrine
Levophed
Treats shock, used in cardiac arrest-stimulates sympathetic activity
Dopamine
Itropin
Treats shock
Dobutamine
Dobutrex
Treats congestive heart failure
Ephedrine
Pretz-D
Treats seasonal rhinitis, hypotensive episodes, causes bronchodilation
Ritodrine
Yutopar
Management of preterm labor
