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Test 1 Flashcards

1
Q

What is the concentration for NS?

A

0.9%

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2
Q

What do most drugs comes from?

A

Laboratory synthesis

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3
Q

What does MAB stand for?

A

Monoclonal antibodies

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4
Q

What does Premarin come from?

A

Urine of pregnant mares

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5
Q

What is another name for opioids?

A

Narcotics

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6
Q

What plant does opioids come from?

A

Poppy’s

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7
Q

What plant does digoxin comes from?

A

Foxglove

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8
Q

What does UFH stand for? Where does it come from?

A

Unfractionated fractionated heparin

Pig intestine

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9
Q

Where does MAB come from?

A

Laboratory synthesis

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10
Q

What is pharmacodynamics?

A

Study of what drugs do to the body

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11
Q

What can prolonged exposure of antagonist do to receptors? How does that effect the tolerance?

A

Up regulates receptors

Decreases tolerance

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12
Q

What can prolonged exposure of an agonist do to receptors? How does that effect the tolerance?

A

Down regulated receptors

Increases tolerance

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13
Q

What does potency measure?

A

How much action a drug caused

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14
Q

What does affinity measure?

A

How well a drug binds to a receptor

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15
Q

Do agonists and antagonist bind or stay bound to receptors?

A

They stay bound to receptors until an enzyme cleaves then off

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16
Q

What does LD50 stand for?

A

Lethal dose to kill 50% of the population

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17
Q

What does ED50 mean?

A

Effective dose to help 50% of the population

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18
Q

How is therapeutic index measured?

A

LD50/ED50=therapeutic index

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19
Q

What is a teratogen?

A

Something that causes a birth defect

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20
Q

What is a carcinoma?

A

Something that causes cancer

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21
Q

What is the most common drug allergy?

A

Penicillin

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22
Q

What does OTC stand for?

A

Over the counter

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23
Q

What is the most abused drug classified in the drug schedule? Least abused drug schedule?

A

Schedule 1

Schedule 5

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24
Q

What does PO mean? What type of route is it?

A

Oral

Enteral route

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25
Q

What does SL mean? What route is it?

A

Sublingual

Enteral route

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26
Q

Where is a buccal taken and what route is it?

A

Taken in the mucous membranes

Enteral route

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27
Q

What are the two different route that rectal medications can be taken?

A

Enteral or topical route

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28
Q

What does IM mean? What route is it considered?

A

Intramuscular

Parenteral route

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29
Q

What does SC mean? What route is it considered?

A

Subcutaneous

Parenteral route

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30
Q

What does ID mean? What route is it considered?

A

Intradermal

Parenteral route

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31
Q

What does IA mean? What route is it considered?

A

Intraaterial

Parenteral route

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32
Q

What does IT mean? Where is it inserted? What route is it considered?

A

Intrathecal-spinal cord

Parenteral route

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33
Q

Where is intraarticular injected?

A

In joints

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34
Q

What does parenteral route?

A

Medication is injected

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35
Q

What type of route is Nasal spray (NS)?

A

Topical route

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36
Q

What type of route is a meter dose inhaler (MDI)?

A

Topical route

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37
Q

What does anhydrous mean?

A

Containing alcohol

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38
Q

What does tincture/elixir/spirits mean?

A

Containing alcohol

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39
Q

What is the length of the pre ganglionic neuron for the sympathetic system? Parasympathetic system?

A

Sympathetic: short

Parasympathetic: long

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40
Q

What is the length of the post ganglionic neuron of the sympathetic system? Parasympathetic system?

A

Sympathetic: long

Parasympathetic: short

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41
Q

What receptors are on the post ganglion of sympathetic and parasympathetic system?

A

N2 receptors

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42
Q

What receptors are on sympathetic effort organs?

A

Adrenergic (Alpha or beta) receptors

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43
Q

What receptors are found on parasympathetic effectors organs?

A

Muscarinic receptors

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44
Q

What type of Neuron is a post ganglion neuron? What does it release?

A

Adrenergic neuron

Norepinephrine

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45
Q

What type of receptors are on skeletal muscles of cholinergic neurons?

A

N1 receptors

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46
Q

What system innervates generalized and localized sweating? What types of neurons are pre and post ganglion for localized sweating and generalized sweating?

A

Sympathetic system

Generalized sweating: cholinergic and cholinergic ganglion

Localized sweating: cholinergic and adrenergic ganglion

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47
Q

What neurotransmitters are released from adrenergic or cholinergic receptors?

A

Adrenergic: NE

Cholinergic: ACh

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48
Q

What receptors are on generalized sweat glands?

A

Muscarinic receptors

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49
Q

What system are blood vessel only innervated by?

A

Sympathetic system

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50
Q

What receptors are found on localized sweat glands?

A

Alpha-1 receptors

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51
Q

What organs and systems are only innervated by the sympathetic system?

A

Blood vessels
Generalized sweat glands
Localized sweat glands

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52
Q

What type of effect happens with odd numbered receptors? What effect happens with even numbered receptors?

A

Odd # receptors: excitatory

Even # receptors: inhibitory

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53
Q

True of false: nicotinic receptors cause only excitatory responses?

A

True

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54
Q

True of false cholinergic receptors only give excitatory responses?

A

False

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55
Q

What receptors are on ciliary processes to produce aqueous humor?

A

Beta 1

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56
Q

What receptors are on ciliary muscles that cause suspenseful ligaments to relax?

A

Beta 2 receptors

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57
Q

What happens to ligaments and lens when ciliary muscle contracts? Relaxes?

A

Contracts: slack on ligaments and lens becomes round (near sight)

Relaxes: tension on ligaments and lens flattens (fat sight)

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58
Q

What muscle causes a pupil to dilate and what muscle cause a pupil to constrict?

A

Pupil Dilate: dilator pupillae

Pupil Constrict: sphincter pupillae

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59
Q

What is another name for pupil dilation? Pupil constriction?

A

Pupil dilate: mydriasis

Pupil constrict: miosis

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60
Q

What receptors are found on dilator pupillae? Sphincter pupillae?

A

Dilator pupillae: alpha 1 receptors

Sphincter pupillae: muscarinic receptors

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61
Q

What is Brimonidine(Alphagan P)? What is it’s MOA? What is it used for?

A

Alpha 2 agonist

Alpha 2 receptor blocks release of NE

Used to Tx glaucoma by decreasing aqueous humor production

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62
Q

What class of drug is an alpha 1 agonist called?

A

Alpha adrenergics

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63
Q

What is the prototype for alpha 1 adrenergics?

A

NE

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64
Q

What are the effects on BP, GI system and pupils with alpha adrenergics?

A

BP: increases due to vasoconstriction

GI: constipation due to decrease gut motility

Pupil: mydriasis

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65
Q

What is dobutamine(Dobutrex)? What receptors does it interact with most? What does it cause and what is it indicated for?

A

sympathomimetic

Interacts mostly with B1 receptors

Increases CO and vasodilator

Indication: cardiogenic shock and HF(heart failure)

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66
Q

What is dopamine(intropin)? What receptors does it react with at a low dose? What does it do and what is it’s indicator?

A

sympathomimetic

Dopaminergic receptors

Vasodilator

Indication: septic or cardiogenic shock

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67
Q

What is dopamine(intropin)? What receptors does it react with at a moderate dose? What does it do and what is it’s indicator?

A

Sympathomimetic

Beta1 receptors

Increases CO (inotropic)

Indicators: septic and cardiogenic shock

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68
Q

What is dopamine(intropin)? What receptors does it react with at a high dose? What does it do and what is it’s indicator?

A

Sympathomimetic

Alpha1 receptor

Vasoconstrictor

Indication: septic or cardiogenic shock

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69
Q

What is epinephrine(Adrenalin)? What receptor does it work with at a low dose? What does it do? What is it used for?

A

Sympathomimetic

Beta1 receptors

Increases HR, inotropic, bronchodilation

Anaphylactic shock, cardiac arrest, acute asthma

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70
Q

What is epinephrine(Adrenalin)? What receptor does it work with at a high dose? What does it do? What is it used for?

A

Sympathomimetic

Alpha 1 receptor

Increase HR, inotropic, bronchodilator

Indication: Acute asthma, cardiac arrest, anaphylactic shock

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71
Q

What is norepinephrine(Levophed) indicated for?

A

Hypotension/circulatory shock

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72
Q

What is a risk of using norepinephrine(Levophed)? How can it be corrected?

A

Risk of extravasation that can lead to NE causing necrosis and gangrene to tissue?

Corrected by giving NS flush and phentolamine(alpha 1 blocker)

73
Q

What is extravasation? How is it avoided?

A

When a needle goes thru both side of vein while giving a shot

Usually avoid by giving it thru central line

74
Q

what is an alpha adrenergic medication?

A

Alpha1 agonist?

75
Q

What type of medication is tetrahydrozoline(Visine)? How is it given? What does it do?

A

Alpha adrenergics

Given as eye drops

Vasoconstriction vessels to decrease mucus production

76
Q

What type of medication is phenylephrine(Neo-synephrine)? How is it given? What does it do?

A

Alpha adrenergic

Nasal spray

Vasoconstricts vessels to decrease mucus production

77
Q

What are side effects of alpha adrenergics?

A

Excessive dryness (mydriasis)

Rebound congestion (rhinitis medicamentosa)

78
Q

What is rhinitis medicamentosa?

A

Rebound congestion

79
Q

Why is a alpha adrenergic bad to give to pt with heart disease/HTN, DM, or BPH?

A

Heart disease/HTN- b/c vasoconstrictor raises BP

DM- increases sympathetic system, increases BGL

BPH- vasoconstrictor makes it more difficult to pee

80
Q

What does BPH stand for?

A

Benign prostate hyperplasia

81
Q

What type of drug is phenylephrine HCl (AK-Dilate)? What does it do?

A

Alpha 1 agonist

Mydriasis and vasoconstriction

82
Q

What is the drug of choice for anaphylaxis? What receptors does it stimulate?

A

Epinephrine (EpiPen)

Alpha and bets receptors

83
Q

What type of drug class is epinephrine(EpiPen)?

A

Beta-adrenergics (non-selective)

84
Q

What effect does epinephrine have on the heart, lungs and vessels?

A

Heart: increase HR and inotropic

Lungs: bronchodilator

Vessels: vasoconstriction

85
Q

What type of drug is albuterol(Proventil)? How is it delivered?

A

Beta-2 (selective)

MDI

86
Q

What type of drug is terbutaline(Brethine)? What is it used for? What route is is it given?

A

Beta-2 (selective)

Decrease uterine contractions

SC, IM, PO

87
Q

What is the r/f of terbutaline(Brethine) for the fetus?

A

Can have effect on beta-1 receptors and lead to tachycardia

88
Q

What type of drug is mirabegron(Murbetriq)? What is it’s indication? What does it do?

A

Beta-3 selective drug

Indication: overactive bladder

Relaxes Detrusor muscle to be able to pee

89
Q

What is the detrusor muscle?

A

Muscle that helps generate force to pee

90
Q

What is droxidopa(Northera)? What is it used for? What does it do?

A

Precursor NE

Indication: neurogenic orthostatic hypotension

Coverts into NE and vasoconstricts vessels

91
Q

What is doxazosin(Cardura)? What does it do?

A

Alpha-blocker

Relaxes smooth muscles

92
Q

What is tamsulosin(Flomax)? What does it do?

A

Alpha blocker

Relaxes smooth muscles

93
Q

What are indications for alpha-blockers?

A

BPH/HTN
Ryanair’s disease
Pheochromocytoma

94
Q

What is pheochromocytoma?

A

Tumor in adrenal medulla that is releasing increases NE and Epi

95
Q

What does ADR mean?

A

Adverse drug Rx

96
Q

What is the ADR for alpha blockers? Eyes, nose and circulation

A

Miosis, nasal congestion, orthostatic hypotension

97
Q 
Why are beta blockers given for these conditions?
HTN
CHF
arrhythmia
Angina
Post MI
Glaucoma
A

HTN-lower HR
CHF- lower HR
Arrhythmia-usually cause tachycardia does lower HR
Angina-decrease workload on heart by lowering HR
Post MI-decrease workload on heart by lowering HR
Glaucoma-decrease ciliary processes making aqueous humor

98
Q

How are migraines usually caused? Why does a beta blocker help?

A

Migraines happen with vasodilation

A beta 2 blocker can cause vasoconstriction

99
Q

What is timolol(Timoptic)? What is it used for?

A

Non-selective beta blocker

Decreases secretion for glaucoma

100
Q

What is metoprolol(Lopressor)?

A

Beta 1 selective blocker

101
Q

What is atenolol(Tenormin)?

A

Beta 1 selective blocker

102
Q

What is propanolol(Inderal)? Why shouldn’t it be used on asthmatic pt?

A

Non selective beta blocker

Beta blocker can constrict bronchioles

103
Q

What would be the DOC for anaphylaxis?

A

Epinephrine

104
Q

What would be the class DOC for BPH?

A

Alpha blocker (tamulosin or doxizosin)

105
Q

What is alpha 2 receptors found? What is their function?

A

Post ganglionic neurons

Regulate NE

106
Q

What do cholinergic drugs do?

A

Drugs that increase parasympathetic system

107
Q

What effect does a muscarinic(direct) drug do?

A

Muscarinic agonist

108
Q

What does a anticholinesterase(indirect) do? What is another name for these drugs?

A

Blocks AChase enzyme to increase ACh in synapse

Also called acetylcholinesterase inhibitor

109
Q

What is an anticholinergic drug? What is the prototype?

A

Muscarinic antagonist

Atropine

110
Q

What are the ADR for cholinergics? What is the acronym?

A

SLUDGE

SALIVATION
LACRIMATION
URINATION
DEFECATION
GI cramps
EMESIS
111
Q

What is absorption in pharmacokinetics?

A

Movement of drugs from GI tract…to portal circulation….to liver….to systemic circulation

112
Q

How does lipid solubility effect absorption?

A

Hydrophobic drugs get absorbed faster

113
Q

How does ionization effect absorption?

A

Unionized drugs (drugs without a charge) are absorbed faster

114
Q

How does drug formulation effect absorption?

A

The small the drug or more surface area of the drug the fast it absorbes

115
Q

What is distribution in pharmacokinetics?

A

Drug moving to various organs and tissues of the body

116
Q

How does plasma protein binding effect distribution of drugs?

A

Drug can bind to protein (albumin) and get delivered faster thru the body

117
Q

How does blood flow effect distribution of drugs?

A

Blood mainly moves to three specific organs

  • liver
  • kidneys
  • brain
118
Q

How does the BBB effect distribution of drugs?

A

Only drugs that are hydrophobic can cross the BBB

119
Q

Why do schedule 1 drugs usually stay in the brain?

A

Because they are extremely hydrophobic

120
Q

What makes the BBB?

A

Foot processes of astrocytes

121
Q

What is an influx transporter?

A

Transporter that allows a drug into the cell

122
Q

What is an effluent transporter?

A

A drug that removes a drug out of the cell

123
Q

What often makes a compound hydrophobic?

A

Hydrocarbons

124
Q

What organ is most important for metabolism?

125
Q

What is metabolism in pharmacokinetics?

A

Break down of drugs

126
Q

What is the most important organ for excretion?

127
Q

What does enzyme induction mean?

A

Increase in enzyme activity or numbers

128
Q

What does enzyme inhibition mean?

A

Decrease in enzyme activity or numbers

129
Q

What things are more excretable? What things are more absorbable? Hydrophobic drugs or hydrophilic drugs?

A

Excreted often: hydrophilic

Absorbed often: hydrophobic

130
Q

What is P450? Where is it found and in what organ?

A

Enzyme that breaks down drugs

Found inside SER of hepatocytes

131
Q

What is the formula for bioavailability?

A

F= Fg* Fh

Fg=percent absorbed into blood from gut

Fh=percent of drugs that escapes liver and goes into circulation

132
Q

How are drugs removed from saliva or breast milk?

A

Drugs can leave through lactation and lacrimation

133
Q

Where does metabolism of drugs most often happen?

134
Q

What are the FDA pregnancy categories? Which categories are safe for pregnant women?

A

A category to show which drugs are safe to take while pregnant

Drugs closer to A are safe to take during pregnancy

X category drugs you should not take during pregnancy

135
Q

What increases tolerance of a drug? (Hint: enzymes and receptors)

A

Enzyme induction-increasing enzymes to decrease how long drug stays

Down regulation-decreasing receptors for the drug

136
Q

How is dependence of a drug increased?

A

Psychological (addiction)

Physical (withdrawal)

137
Q

What are the 6 rights?

A 
Right patient
Right dose
Right drug
Right route
Right time
Right documentation

Patients Do Drugs Round The Day

138
Q

What is pharmacotherapeutics?

A

The principles of drug actions

139
Q

What is palliative therapy? When is it usually used?

A

Therapy that provides relief from pain and stress

Usually used during end stage of illnesses

140
Q

What is prophylactic therapy? When is it usually used?

A

Therapy that provides preventative care

Usually used when a pt is about to go into surgery to prevent post infections

141
Q

What is empiric therapy?

A

Therapy used for non-definitive conditions. Like using broad spectrum antibiotics

142
Q

What is an Nn receptor?

A

N2 receptor

143
Q

What is an Nm receptor?

A

An N1 receptor

144
Q

What is bladder atony?

A

Bladder isnt contracting to help you pee due to detrusor muscle not contracting

145
Q

What is postoperative ileus?

A

Little to no peristalsis after surgery due to general anesthesia

146
Q

What is urinary retention?

A

Can’t pee

147
Q

What are the two types of cholinergic drugs? (Direct and indirect)

A

Direct= muscarinic agonists

Indirect=anticholinesterase (acetylcholinesterase inhibitors)

148
Q

What are anticholinergics?

A

Muscarinic antagonists/blockers

149
Q

What do ganglionic stimulants or blockers effect?

A

N2 receptors

150
Q

What do neuromuscular blockers or muscle relaxants effect?

A

N1 receptors

151
Q

What is the acronym to know what cholinergics causes or effects?

A

SLUDGE
Salivation, Lacrimation, Urination, Defecation, GI cramps, Emesis

DUMBELS
Defecation, urination, Miosis, bronchospasm, emesis, lacrimation, salivation

152
Q

What helps drain aqueous humor fluid better, pupil dilation or contraction?

A

Pupil contraction/miosis

153
Q

What is pilocarpine(Pilocar)? What is it used for?

A

Muscarinic agonist

Used for glaucoma
-because it helps cause miosis to drain aqueous humor

154
Q

Why is cholinergics used for urinary retention and postoperative ileus?

A

Because cholinergics increase peristalsis and increase flow of urine

155
Q

What receptor is found on ciliary muscle s to cause them to contract?

A

Muscarinic receptors

156
Q

If a lens is flat an object is close or far away?

A

Object is far away

157
Q

What is edrophonium(Tensilon)? What is it indicated for? Why is it used? What route is it given?

A

Anticholinesterase (decreases amount of AChase)

Indicated for Myasthenia Gravis

Used to Dx MG

Route: IV

158
Q

What is Pyridostigmine(Mestinon)? What is it indicated for? What does it do for the indication? What can an overdose cause!

A

Anticholinesterase

Indicated for Myasthenia Gravis

Tx for MG

Overdose can cause spastic paralysis

159
Q

What neurotransmitter is in charge of Memory and learning in the brain?

160
Q

What is Donepezil(Aricept)? What is it’s indication? What are common side effects?

A

Central acting Anticholinesterase drugs

Indication for Alzheimer’s disease

N/V and diarrhea

161
Q

Why can Central acting anticholinesterase drugs cause

  • nausea
  • vomiting
  • diarrhea
A

N/V occur when too much ACh is in the brain

Diarrhea is caused because anticholinesterase increase parasympathetic system

162
Q

What is Malathion or Parathion? Why are they deadly?

A

They are poisons because they are irreversible AChase inhibitors

163
Q

Why is bronchoconstriction a Sx of ADE of cholinergics?

A

Because cholinergics increase parasympathetic system

164
Q

Why is muscle tremors a Sx of ADE of cholinergics?

A

Because cholinergics increase the amount of ACh in the NMJ

165
Q

Why is bradycardia and hypotension a Sx of ADE of cholinergics?

A

Because of the parasympathetic decreasing HR and strength of contraction

166
Q

Why are GI cramps a effect of cholinergic overdose?

A

Because of increased peristaltic movements

167
Q

What is a belladonna plant(deadly nightshade)?

A

Anticholinergic drug that causes severe pupil dilation

168
Q

What do anticholinergic drugs usually end in?

169
Q

What are anticholinergics? What do they do?

A

Decrease parasympathetic

170
Q

What is ipratropium(Atrovent)? What is its indication? MOA? How is it given?

A

Anticholinergic

Indication for COPD or asthma

MOA: bronchodilator and decreases saliva

Given thru MDI

171
Q

What is oxybutinin(Ditropan)? What is it indicated for? MOA?

A

Anticholinergic

Indicated for overactive bladder and incontinence

MOA: decreases excretion

172
Q

What is solifenacin(Vesicare)? What receptor does it react with? What is it indicated for? MOA?

A

Anticholinergic

M-3 antagonist

Indicated for overactive bladder and incontinence

MOA: decreases bladder tone and contractions

173
Q

How does stimulation of receptor M3 effect the bladder?

A

Causes contractions and increases bladder tone

174
Q

What is glycopyrrolate(Robinul)? What is it indicated for? MOA?

A

Anticholinergic

Indicated for IBS-D

Decreases peristalsis

175
Q

How do anticholinergics decrease N/V?

A

Anticholinergics decrease levels of ACh

176
Q

How can anticholinergics effect a cardiac arrest pt?

A

They can increase HR

177
Q

What is Scopolamine(transderm scoop)? What is it indicated for?

A

Anticholinergic

Indicated for motion sickness

178
Q

Why should you never use anticholinergics with a glaucoma pt?

A

Because the decrease in parasympathetic system can increase the sympathetic system…causing mydriasis and increasing IOP

179
Q

What is the rhyme used to know if someone is overdosing on anticholinergics?

A

Can’t see
Can’t pee
Can’t spit
Can’t sh*t(defecate)

Pharmacology (27 decks)

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