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Adv Pharmacodynamics > Test #1 > Flashcards

Test #1 Flashcards

1
Q

The Role of the NP in Prescribing (gen)

A

The NP role requires basic knowledge of a drug and combining it with advanced knowledge about a medical diagnosis you make and the pathophysiology of the disease or illness.

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2
Q

The Role of the NP in Prescribing (List)

A

Includes knowledge of bioequivalence
Cost of the drug
Generic versus Brand
Enzyme systems in metabolism that can lead to drug interactions
Pharmacokinetics of the drug/class/genetics
Legal authority of NP to write the drug
Constraints to write the drug. Health plan or no health plan.

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3
Q

What period is most teratogenic in fetal development

A

3-9 weeks (embryonic period)

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4
Q

4 Pharmokinetic Actions

A

Absorption
Metabolism
Elimination
Distribution

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5
Q

Most important aspect of NP when she is prescribing for a woman who is pregnant:

A

LActmed website use, and educate the pt on the use.

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6
Q

Pharmacodynamics

A

Processes through which drugs affect the body

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7
Q

What vaccines should pregnant woman receive

A

Hepatitis A - risk vs. benefit.
Hepatitis B - Some circumstances.

Influenza (Inactivated) - Recommended.

Meningococcal (ACWY) - May be used if otherwise indicated.

Meningococcal (B) - risk vs. benefit.

PCV13 - No recommendation.

PPSV23 I- No recommendation.

Polio - May be used if needed.

Td Should be used if otherwise indicated (Tdap preferred).
Tdap - Recommended.

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8
Q

When is Tdap given

A

3rd Trimester

27 and 36 weeks

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9
Q

SOAPP

A

Screener and Opioid Assessment for Patients with Pain

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10
Q

What is SOAPP

A

Questionnaire designed to help providers evaluate the patients’ relative risk for developing problems when placed on long-term opioid therapy.

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11
Q

Contract’s for opioid use

A

Between NP and the patient, provides a systematic approach to opioid administration

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12
Q

Narrow therapeutic index drugs

A 
Anticonvulsants (phenytoin)
Oral hypoglycemic medicines (glibenclamide (Diabeta))
Oral anticoagulants (acenocumarol, warfarin) 
Antifungals (amphotericin B)
Antidysthrymic medicines (quinidine)
Aminoglycosides (gentamicin)
Anticancer medicines (5 fluorouracil)
Digitalis glycosides (digoxin)
Lithium carbonate (lithium)
Immunosuppressive medicines (cyclosporine)
Antiretrovirals (zidovudine)
Theophylline
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13
Q

Pharmokinetic Absorption:

A

First, the drug is absorbed from the site of administration and permits entry of the therapeutic agent (either indirectly or directly) into the plasma.

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14
Q

Pharmokinetic Distribution:

A

Second, the drug may then reversibly leave the bloodstream and distribute into the interstitial and intracellular tissues.

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15
Q

Pharmokinetic Metabolism:

A

Third, the drug may be biotransformed by metabolism by the liver (prodrug), or by other tissues.

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16
Q

Pharmokinetic Elimination:

A

Final step, the drug and its metabolites are eliminated from the body.

17
Q

First-Pass Effect

A

The phenomenon by which a drug first passes through the liver for degradation before distributed to the tissues.

18
Q

Schedule 3-5 Restrictions

A

Schedule III drug prescriptions can be refilled up to five times within 6 months.

Examples of Schedule III drugs include many narcotics containing codeine (Tylenol #3) and nonbarbiturate sedatives. Also can include hormones (Testosterone)

19
Q

Schedule 4

A

Can be refilled up to five times within 6 months.

Examples of Schedule IV drugs include nonnarcotic analgesics and antianxiety agents such as lorazepam (Ativan), alprazolam (Xanax)

20
Q

Schedule 2 Restrictions

A

No refills permitted
Written prescriptions only (no telephone orders)
Prescription expires in 72 h if not filled.

Narcotics (morphine, codeine, meperidine, opium, hydromorphone, oxycodone, oxymorphone, methadone)
Stimulants (cocaine, amphetamine, methylphenidate)
Depressants (pentobarbital, secobarbital)

21
Q

DEA Drug Schedule

A

The Drug Enforcement Agency (DEA), established in 1973, is a branch of the U.S. Department of Justice. The DEA evaluates substances along with the FDA to see if they meet the criteria to be a scheduled drug. If so, they then classify these drugs into five schedules according to their abuse potential

22
Q

Controlled Substances Act

A

Comprehensive Drug Abuse Prevention and Control Act was made law in 1970.
Title II is the legal foundation of narcotics enforcement in the United States. The Controlled Substances Act regulates the manufacture, possession, movement, and distribution of certain drugs

23
Q

Does an NP needs co-signer on prescription script?

A

Not in NY

24
Q

Who gives prescriptive authority

A

Individual states

25
Q

Most important aspect of NP when she is prescribing for a woman who is pregnant

A

LActmed website use, and educate the pt on the use.

26
Q

Best practices in drug prescribing

A

Follow up in short amount of time

27
Q

Cytochrome P450 (CYP450) - 6 Familys

A

CYP1A2

CYP2C9

CYP2C19

CYP2D6
(approx 25% many antidepressant drugs)

CYP2E1

CYP3A4
(approx 35-40%)

28
Q

CYP2D6

A

CYP2D6 is a highly variable gene with 77 different alleles and is a major determinant of the interindividual variability among patients in plasma concentrations of Tricyclic antidepressants (e.g., Amitriptyline) and Selective Serotonin Reuptake Inhibitors (SSRI’s) (e.g., Prozac).

29
Q

Vaccine Information Statement VIS

A

before the vaccination, comes in 30 languages

30
Q

How to manage the person diagnosed with HTN

A

lifestyle,
meds, generic meds when possible
education
cheaper drugs

31
Q

How to manage someone pregnant with UTI or might be pregnant

A

urine culture

32
Q

Pregnant woman if injured should receive in the first or second trimester

A

Hepatitis B immune globulin (HBIG)

33
Q

Vaccine Recommendation Not Safe In Pregnancy

A

Human Papillomavirus (HPV) -Not recommended.

Influenza (LAIV) - Contraindicated.

MMR - Contraindicated.

Varicella - Contraindicated.

Zoster - Contraindicated.

34
Q

CYP1A2

A

Sub - acetome, Estradiol, Caffeine

Inducer - Tabacco, Grill Meats, Insulin

inhibitor - Cimetidine, Amiodarone, Ticlopidine

35
Q

CYP2C19

A

Sub - Daizepam, Omeprazole, progesterone

Inducer - Prednione, Riframpin

inhibitor - Cimetidine, Ketokonazole, Omeprazole

36
Q

CPY2D6

A

Sub - Debrisoquine, Ondansatron , amphetamine

Inducer - Dex?, Riframpin

inhibitor - Cimetidine, Fluoxetine, Methadone

37
Q

CYP3A4-5-6

A

Sub - Cyclosporin, Clarithomicin , hydrocortisone, Vincristine

Inducer - Barbituates, Glucocotocsteriods St Johns Wort ?, Riframpin

inhibitor - Cimetidine, Clarithomicin Ketokonazole, Grapefruit

Adv Pharmacodynamics (3 decks)

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