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Pharmacology: Test 1 > Week 1: Intro to Pharm > Flashcards

Week 1: Intro to Pharm Flashcards

1
Q

Characteristics of an Ideal Drug

A
  1. Effective
  2. Selective
  3. Reversible
  4. Predictable
  5. No harmful side effects
  6. No drug/food interactions
  7. Inexpensive
  8. Easy to administer
  9. Chemically stable
  10. simple name

*There currently are NO ideal drugs

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2
Q

Objective of drug treatment

A

Maximum Benefit with minimum harm

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3
Q

Education to Patient and family about Medications

A
  1. Medication name
  2. expected respone; possible side effects
  3. dosage and administration schedule
  4. route of administration
  5. duration of drug use
  6. drug storage
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4
Q

Pharmacokinestics:

define/the 4 steps

A
  • How drugs can move through the body
    1) Absorption
    2) Distribution
    3) Metabolism
    4) Excretion
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5
Q

Pharmacotherapeutics:

The use of drugs to….

A

1) Diagnose
2) Prevent disease
3) Treat disease
4) Prevent pregnancy

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6
Q

5 Rights to give medication

A

1) Right drug
2) Right dose
3) Right time
4) Right patient
5) Right route

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7
Q

Pharmacokinetics:

Absorption

A
  • from site of administration into bloodstream.
  • rate determines how soon effects occur
  • amount determines intensity of effects
  • effecting: ph, had food or not, pain, stress, rate of gastric empyting
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8
Q

Lipid soluable drugs tend to be _______ and hang around _________ than water soluable drugs

A

stored in fat, longer

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9
Q

Passive absorption

A

diffusion…higher to lower concentration..no energy needed

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10
Q

Active Absorption

A

needs carrier or enzyme to move across membrane

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11
Q

Pinocytosis

A

cell engulfs particles of drug

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12
Q

disintegration

and

dissolution

A

disintegration- brode down into small particles

dissolution- dissolving into smaller particles

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13
Q

Factors affecting drug absorption

A

1) Rate of dissolution
2) Surface area
3) blood flow
4) lipid solubility
5) Food or fluids taken along with drugs (some meds will be slowed down with food and drink while some need it)

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14
Q

Routes of Administration

A

1) Enteral– gut,mouth, peg tube, gtube, rectal (Absorbed through oral or gastric mucosa, small intestine or rectum)
2) Topical
3) Parenteral –IV, IM, SQ

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15
Q

Distribution

Define/distribution effected by:

A

-How it moves/gets through the body..movement of drug throughout the body through the circulatory system

effected by:
-bloodflow to tissues

  • ability of drug to exit the vascular system
  • ability of drug to enter cells

_*determined by how well med can enter the cells*_

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16
Q

Drug diffuses out of blood to ___________

A

the site of action

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17
Q

blood brain barrier

A
  • tight junction between cells of capillary walls in the CNS
  • only drugs that are lipid soluable or have a transport system can cross through the capillary walls to the CNS
  • Benefits: very specific on what crosses, can protect the brain from drugs and harmful substances
  • Disadvantage: obsticale treating seizures, cancers in brain or parkinsons
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18
Q

Protein Binding

A
  • Type of drug storage system
  • Drugs form reversible bonds with protein
  • drugs NOT bound to protein are a FREE state and are still active
  • drugs bound to protein are NOT active
  • As free drug acts on cells, there is a decrease in plasma drug levels
  • need to know pts albumin level
  • two highly bound protein bound drugs will compete and one will become toxic
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19
Q

highly protein bound

moderately protein bound

low protein bound

A
  • 80-90%
  • 50%
  • 10-20%
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20
Q

Metabolism

A
  • “Biotransformation”
  • converting a drug to a form more easily removed from the body
  • Almost all occurs in liver
  • Hepatic microsomal enzyme or P450
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21
Q

Conjugates

A

make drugs more water soluble and more easily excreted by the kidneys

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22
Q

P450

A
  • a way that a drug is metabolized
  • enzyme from the liver which aid in metabolism of many drugs
  • Initiate drugs, accelerate excretion
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23
Q

Drug to drug interations involving P450

A
  • inhinitor works against enzyme
  • inducer makes more enzymes available
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24
Q

Factors Influencing rate of metabolism

A
  • age
  • nutritional status
  • liver disease
  • induction of drug-metabolizing enzymes
  • first pass effect
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25
Q

First Pass effect:

A

**Changes how much of the drug is available for the body to use

*A strong first pass = increase in dose given to body

  1. drug absorbed
  2. drugs enter hepatic portal circulation–go to liver
  3. hepatic microsomal enzymes metabolize drug to inactive form
  4. drug conjugates–leaving liver
  5. drug distributed to general circulation
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26
Q

Excretion

A
  • elimination of drugs from the body
  • eliminate non protein bound drugs…had to be eliminated by protein first to be eliminated
  • primarily through kidneys

-rate of excretion determines the meds concentration in the bloodstream and tissue...concentration determines the duration of action

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27
Q

Excretion:

Glomerular Filtration

A

filtration moves drugs from blood to urine…protein bound drugs are not filtered

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28
Q

Excretion:

Passive Reabsorption

A

lipid soluble drugs move back into the blood (polar and ionized drugs remain in the urine)

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29
Q

Excretion:

Active Transport

A

Tubular “pumps” for organic acids and bases move drugs from blood to urine

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30
Q

Drug Half Life

A
  • time for amount of drug to decrease 50%
  • amount of time it takes fro half the drug concentration to be eliminated
  • most drugs eliminated over 4 half lives
  • the greater the half life, the longer it takes the medicine to be excreted
    ex. …asprin 650 mg/ half life 3 hrs…pt takes it at 7:00. 3 hrs later, half the drug has been excreted. Leaving 325mg in system….3 hrs later, half of 325mg will be left.
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31
Q

Drug Actions

A
  • Cellular processes involved in drug and cell interactions
  • Onset, peak, duration
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32
Q

Onset

A

time it takes for drug to elicit therapeutic response

(ex. IV vs. PO)

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33
Q

Peak

A

time it takes for drug to reach maximum therapeutic response

high concentration of drug

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34
Q

Duration

A

time that drug concentration is sufficient to elicit therapeutic response….lowest concentration of drug

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35
Q

Pharmacodynamics

A

-what drugs do to the body and how they do it

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36
Q

Drug Mechanisms of Action

A
  • 3 basic ways that drugs can act to produce therpeutic effects
    1) receptor interaction
    2) enzyme interaction- deactivate or activate drugs
    3) Nonspecific interactions
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37
Q

Receptor Interaction:

Agonist

A

mimics actions of endogenous regulatory molecules

(ex. Insulin)

Sympathetic agonist = increase HR

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38
Q

Receptor Interaction:

Antagonist

A

prevents or inhibits action of agonist

(ex. beta blockers)

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39
Q

Receptor Interaction:

Agonist-Antagonist

A

exerts some agonist and some antagonist action

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40
Q

Enzyme Interaction

A
  • drugs can inhibit action of a specific enzyme
  • enzyme binds to drug instead of normal target cell
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41
Q

Non specific Interactions

A

Sites of action include cell membrances and metabolism

ex. penicillin breaks down bacteria cell wall…no lock and key enzyme

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42
Q

Receptor Interaction

A

A. Tissue receptor

B. Poor receptor fit, no response likely

C. Some drug-receptor fit, some response likely

D. Excellent receptor fit…good response likely

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43
Q

Drug Process and Resources

A
  • Food and Drug Administration
  • Controlled substances
  • Drug Names (All have two…)

Generic: Ibuprofen
Brand: Advil

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44
Q

Cultural Considerations

A
  • heritage
  • communication
  • family organization
  • nutrition
  • spiritual
  • herbs
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45
Q

Herbal Therapies

A

Herbs: a botanical without any woody tissu such as stems or bark

common herbs used:
aloe vera, chamomile, Dong quai, echinacea, garlic, ginkgo, st. johns wort

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46
Q

Autonomic Nervous System:

What is the central Nervous system?

A

Brain and spinal cord

-it revieves signals and sends them back out

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47
Q

The peripheral nervous system

A
  • The Autonomic nervous system
  • The somatic nervous system
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48
Q

The Automatic nervous system is _________

A

Involuntary – smooth muscle and glands

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49
Q

The Somatic Nervous system is ________

A

Voluntary – skeletal muscle

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50
Q

THE NERVOUS SYSTEM CHART

A
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51
Q

The sypathetic and parasympathetic cause opposite effects to provide ________

A

Homeostasis

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52
Q

The sympathetic effects from the spinal cord

A

Eyes: dilate pupils

lung: dilate bronchioles
heart: increase HR

blood vessels: constrict them

gastro: relaxes
bladder: relaxes it
uterus: relaxes

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53
Q

Alpha 1 receptor

Blood vessels, eyes, bladder, prostate

A

Blood vessels: causes vasoconstriction. increased BP, and increased contractibility of the heart

eyes: pupil dilation
bladder: contraction
prostate: contraction

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54
Q

Alpha 2 receptor

blood vessels and smooth muscle (GI tract)

A

blood vessels: decreased BP ( reduced norepinepherine)

smooth muscle (GI): decreased GI tone and motility

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55
Q

Beta 1 receptor

Heart*, kidneys

A

heart: increased HR, and increased heart contraction
kidneys: increased renin secretion, increased angiotensin, increased BP

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56
Q

Beta 2 receptors

smooth mucle (GI), lungs, uterus, liver

A

smooth musle (GI): decreased GI tone and motility

lungs: bronchodilation
uterus: relaxation of uterine smooth muscle
liver: activation of glycogenolysis, increased blood sugar

57
Q

Parasympathetic Nervous system

recepotors and neurotransmitters

what do Acetylcholine and acetylcholinesterase do?

A
  • Cholinergic receptors are NICOTINIC and MUSCARINIC
  • Neurotransmitter is: ACETYLCHOLINE: which stimulates receptors to produce a response
  • The enzyme ACETYLCHOLINESTERASE can inactivate acetylcholine before it reaches receptors
58
Q

Drugs that mimic these systems will produce response __________________________.

A

Opposite to each other in the same organ

59
Q

sympathomimetic

A

mimic neurotransmitter norepinephrine

adrenergics

60
Q

Parasympathomimetic

A

Mimic nerurotransmitter acetylcholine

cholingergics

61
Q

The Parasympathetic nervous system from the spinal cord effects:

A

Eyes: constrict pupils

Lungs: cpmstroct bronchioles amd increase secretions

heart: decreased HR

blood vessels: dilate

GI: increase peristalsis and secretions

bladder: contracts

salivary glands: incraesed salivation

62
Q

The sympathetic Nervous system:

A

-ADRENERGIC

Neurotransmitter is NOREPINEPHRINE: which is released from terminal nerve endings to stimulate cell receptors to produce response

63
Q

The Adrenergic receptors are

A

Alpha 1, Alpha 2, Beta 1, beta 2

Beta-1: one heart

Beta 2- two lungs

Alpha 1: blood vessels

64
Q

Both Pediatrics and Geriatric Patients are:

A
  • more sensitive to drugs
  • greater individual variation
  • increased risk for adverse drug reactions
65
Q

Pediatrics

Pharmacokinetic differences

A
  • everything moves faster for kids
  • absoprtion, distribution, metabolism, excretion
66
Q

Pediatric Adverse drug reactions

A

Peds pts are subject to unique adverse reactions to certain meds:

examples include:

  • growth suppression
  • discoloration of teeth
67
Q

Med administration:

to an Infant

A
  • give PO in cheek and make sure it has all gone down
  • droppers in ears, eyes, nose, mouth
  • suppositories have to hold butt cheeks together for 5-10 mints

-they lack developed muscle mass so use smaller needles for IM or IV
(swap legs for giving injections)

68
Q

Med Administration:

to a Toddler

A
  • IM injections given into the vastus lateralis
  • IVS in scalp or feet
  • After child has walked for about a yr. can use the VENTROGLUTEAL site for IM b/c less pain
  • NO more scalp for IV access
69
Q

Med Administration:

Preschool range

A
  • same as toddler group
  • can give oral meds better now
70
Q

Med administration:

School aged

A
  • rapid physical, metal, and social developement occurs
  • chew tablets okay now
  • VENTROGLUTEAL site best for IM injections and muscles
71
Q

Geriatrics:

Complicated drug therapy

A
  • Altered pharmacokinetics
  • multiple and severe illnesses
  • increased risk for drug interaction b/c of POLYPHARMACY
  • poor compliance
72
Q

Geriatric:

Polyoharmacy

A

taking of multiple drugs conccurently, most seen with patients who visit multiple physicians

73
Q

Possible causes of ineffective management of health care regimen

A
  • extended therapy for chronic illness causes pt to become discouraged
  • troublesome adverse reactions
  • lack of understanding of the purpose for the drug
  • forgetfulness
  • misunderstanding of oral or written instructions on how to take the drug
  • A weak pt-nurse relationship
  • lack of funds to obtain drug
  • mobility problems
  • lack of family support
  • confnitive deficits
  • visual or hearing defects
  • lack of motivation
74
Q

Geriatric Adverse drug reactions:

Factors predisposing the elderly

A
  • some from polypharmacy
  • some predictable b/c aging
  • degeneration og organ systems
  • multiple/severe illnesses
  • unreliable compliance
75
Q

Measures for reduction of geriatric Adverse drug reactions

A
  • thorough drug history (inclusing OTC and herbal)
  • initiate therapy with low doses
  • monitor pt responses and plasma drug levels closely
  • simple regimen
  • encourage pt to dispose of old meds
  • promote compliance
76
Q

Geriatric Adults:

Absoprtions

A

-slower in older adults due to diminished gastric motility and decreased bloodflow to digestive organs

77
Q

Geriatric:

distribution

A
  • increase body fat in geriatric pts provide larger storage compartment for lipid-soluble drugs
  • decreased plasma levels
  • decreased body water
78
Q

geriatric:

metabolism

A
  • decreased in the enzyme production in the liver
  • visceral blood flow diminished
  • increased half life in drugs
79
Q

Geriatrics:

excretion

A

reduced renal blood flow, glomerular filtration rate, active tubular secretion and nephron function

80
Q

drugs given in high doses are absorped _____ and have a more rapid _____

A

faster, onset of action

81
Q

high fat meals affect absorption how?

A

SLOW STOMACH MOTILITY AND DELAY ABSORPTION

82
Q

acids and bases

absorption

A

acids are absorped in acides

and bases are absorped in bases

83
Q

Hormone functions:

Estrogen and Progesterone

A
  • regulate development and maintenance of female reproductive system and secondary sex characteristics
  • also affect metabolism
  • estrogens produce effects on tissues with estrogen receptors: female genitalia, breasts, pituitary, hypothalamus
  • regular menstrual cycle
  • control fertility (prevent pregnancy)
84
Q

Estrogen

A

the maturation of the female reproductive organs and appearance of secondary sex organs

-Replacement:
(Menopause signs and symptomes, bone loss, cardiac protection)
Often used to treat disorders caused by estrogen deficiency

  • Prevent actions of hormones (prevent pregnancy) with oral contraceptives, parenteral, transdermal contraception
  • Assist actions of hormones (fertility treatments) from ovarian failure
  • other uses: dysmenorrhea, atrophic vaginitis
85
Q

Progesterone

A
  • Increases basal body temp, changes vaginal epithelium, relaxes uterine smooth muscle, stimulates breast tissue growth, produces withdrawal bleeding in presence of estrogen
  • Affects pituitary, uterus, vaginal mucosa, and mammary glands
  • Uses: uterine bleeding: amenorrhea, dysmenorrhea, contraception, endometriosis, infertility, and to prevent miscarriage
86
Q

Menopause

A

the permanen end of menstration cause by a decrease in ovarian function

  • no periods for 1 year
  • trigger unknown
  • age range of 45-55 and can also happen after surgical removal of the ovaries
  • signs and symptoms are caused by a decrease in estrogen:

Irregular bleeding, vaginal dryness, hot flashes, night sweats, sleep problems, mood changes, weight gain, thinning of hair, loss of breast fullness

87
Q

Hormone replacement:

Conjugated estrogens

(ex. Premarin, and Prempro)

A
  • promote growth and developement of female sex organs and the maintenence of secondary sex characteristics
  • resoration of hormonal balance in treatment of hormone sensitive tumors.
  • Side effects: headache, edema, HTN, nause, weight changes, increased appetite, jaundice, vomitting

onset-repid

peak-unknown

duration- 24 hr

88
Q

Hormone replacement:

Estradial

(ex. Estrace, Estraderm)

A
  • promote growth and development of female sex organs
  • metabolic effects include reduced blood cholesterol, protein synthesis and sodium/water retention
  • restoration of hormonal balance in menopause

-side effects:
headache, edema, HTN, nausea, amenorrhea, hypergylcemia

  • onset/peak/duration unkown
  • po, im, SQ. vaginal, topical, implants
89
Q

Contraception:

Estrogen companents

A

decrease release of FSH, so no ovum released

preventing ovulation b/c ovarian follicle cant mature, no release

most common

90
Q

Contraception:

Progesterone Components

A

decrease release of LH, prevent implantation

prevent fertilization by inhibiting ovulation

91
Q

Benefits of contraception

A

imprves regularity of menstrual cycle and decreases blood loss

92
Q

Contraception definition

A

prevent ovulation by inhibiting release of gonadotropins and increasing uterine mucous viscosity resulting in decreased sperm movement and fertilization of ovum and possible inhibition of fertilized egg implantation

93
Q

Contraception:

Combination

Monophasic

A

fixed level of E & P throughout cycle

94
Q

Contraception:

Combination

Biphasic

A

E constant/ P varied, low in 1st half, high in 2nd half

increase @ end to nourish the uterine lining

95
Q

Contraception:

Combination

Triphasic

A

E & P levels vary to mimic normal cycle

96
Q

Nuva ring

A

vaginal ring containing estrogen and progesterone

inserted for 3 weeks then removed

97
Q

Progesterone ONLY contraception

mini pills, depo-vera, implanon

A

mini-pills:
less risk than with combination pills, does not suppress ovulation, increased risk for break through bleeding (menstrual irrregularities), may have less contraceptive effectiveness, stay on schedule!!!!

Depo-vera
(Medroxyprogesterone)
Im injection: every 3 months

Implanon: new progestin implant…effective for 3 years

98
Q

Depo-provera
Medroxyprogesterone

class, how it works, uses, onset/peak/duration, side effects

A

Class: progestin

-fixed dosage of estrogen/progestin. Ovulation inhibited by supression of FSH and LH
(prevents penetration of sperm/implantation of egg)

  • Uses: prevent pregnany, regulate pd, emergency contraceptive, acne
  • side effects: depression, cerebral hemmorhage, thrombosis, pulmonary embolism, edema, HTN, abdominal cramps, bloating

onset- 1 month

peak- 1 month

duration- 1 month

99
Q

other uses for oral contraception

A

dysmenorrhea
(produce cyclic withdrawal bleeding for pts with dysmenorrhea and irregular pds.

treat endometriosis

ortho tri-cyclen can be used to treat acne

100
Q

Emergency Contraception

Yupze regimen, Plan B, Copper IUD

A

1)Yupze reguman:
(large dose of estrogen taken as soon after intercourse as possible and another 12 hrs later) aka: morning after pill, important to follow up with HCP to rule out pregnancy

2) Plan B: taking a levonorgesterel in 2 hrs, 12 hrs apart.
(Progestin only) large 1 dose or 2 time dose, 95% effective if done within 24 hours
-will NOT terminate a preg if implantation had already occured

3)Copper IUD within 5 days of intercourse

101
Q

Adverse effects: Estrogen

A
  • N/V most common
  • fluid retention, weight gain, breast enlargement
  • abnormal vaginal bleeding
  • HTN

-Thrombophlebitis/Thrombotic Conditions
(increased risk for smokers over 35)

  • Myocardial infarction, CVA
  • elevated serum calcium
  • hyperglycemia
102
Q

Precautions: Estrogen

A
  • Caution with smokers and woman over 35
  • Contraindicated with breast CA, pregnancy, thromboembolic disorder, undx vaginal bleeding
  • use with caution in pts with history of migraines or asthma. family hx of breast cancer
  • unopposed estrogen therapy associated with increased risk of endometrial hyperplasia
103
Q

Adverse effects: Progesterone

A
  • N/V (not as bad as with estrogen)
  • elevated blood pressure
  • weight gain
  • visual changes
  • migranes
  • thrombophlebitis/thrombolic events
  • liver dusfunction
104
Q

Pt teaching: Estrogen and Progesterone

A
  • Take PO with food or milk to minimize GI upset
  • BSE, routine pap smears
  • report any weight gain greater than 5 ib per week
  • sun precautions
  • DO NOT SMOKE
105
Q

amenorrhea

A

absence of menstration

106
Q

endometriosis

A

abnormal location of endometrial tissue

107
Q

oligomenorrhea

A

infrequent menstration

108
Q

Pt teaching for birth control pills

A
  • other drugs can decrease effectiveness
  • use other forms of contracetion when using antibiotics, rifampin, phenytoin/phenobarbita, steriods
  • take pills as directed
  • make up missed pills ASAP
  • report any pain/headaches/depression/dizziness/blurred vision/resp distress
109
Q

Endometriosis

A

-Abnoral location of endometrial tissu outside the uterus
(implants on ovaries, uterus, uterosacral, broad ligaments and bowel. Displaced tissue still responds to hormonal control so bleeds during menstration

-Causes: inflammation, scar tissue, adhesions, infertility, pain, bleeding

-most pt asymptommatic
(severe lower back pain, pelvic pain worse during period.

-give Danazol (Danocrine)

110
Q

Danazol (Danocrine)

class, how it works, what it does, side effects

A

Class: androgens

  • suppresses and atrophies uterine tissue, supresses FSH production, which shuts down extopic and normal edometrial activity
  • given PO
  • treats endometriosis
  • Side effects: hot flashes, weight gain
111
Q

Osteoporosis

Alendronate (Fosamax)

class, how it works, what it does, side effects, onset/peak.duration

A
  • Class: biphosphonate, bone reabsorption inhibitor
  • lowers serum alkaline phosphatase
  • used for prevention/treatment of osteoporosis in post menopausal women
  • Take in AM with glass of water, do not lay flat for 30-1 hr.
  • Side effects: N/D, constipation, hypocalcemia, hypophos., patho fractures if taken more than 3 months
    onset: 3-6 weeks
    peak: 3-6 months
    duration: 12 weeks or more
112
Q

Osteoporosis:

Ibandronate Sodium (Boniva)

class, what it does, how it works, side effects, onset/peak/duration

A
  • Class: biphosphonates
  • inhibits resorption of bones by inhibiting osteoclast activity
  • for reversal/prevention of osteoporosis
  • side effects: diarrhea, dysppsie, gastric ulcers
  • Take AM with water, do not lay flat for 30 mints-1 hr
    onset: unknow
    peak: 0.5-2 hrs
    duration: up to 1 month
113
Q

Fertility Medications:

Clomiphene Citrate (Clomid)

A
  • Class: Estrogen antagonist
  • stimulates hypothalamus and thus ovaries to develop ovarian follicle which will stimulate ovulation
  • can also treat menstrual abnormalities
  • Side effects: ovarian hyperstimulation-cysts, multiple pregnancies, hot flashes, abdominal discomfort, GI distress, depression, weight gain, hair loss, dizziness, blurred vision, birth defects
114
Q

Infertility causes

A

1) pelvic infections
2) obstruction of uterine tubes
3) lack of ovulation
(preg. can not occur unless ovarian follicles recieve hormonal signal to mature each month

115
Q

Nursing Considerations for fertility meds

A
  • pt much have normal liver function and estrogen levels
  • inform pt of optimal time for intercourse
  • strict treatment regimen (take same time everyday)
  • take basal temp 4-10 days after treatment to determine if ovulation occured
  • monitor for abdominal pain that could indicate ovarian cyst or rupture of cyst
  • report visual symptomes such as blurring
  • multiple births common
116
Q

Obstetric Medications

A
  • Prenatal Meds: multivitamins, iron, folic acids
  • Meds for pregnancy discomfort: N/V, heartburn, constipation, pain
117
Q

Pregnancy

A
  • normal pregnancy is 40 weeks
  • any birth less than 27=premature
  • a loss prior to 20 weeks gestation is considered miscarriage
118
Q

Pregnancy or labor complications

A

diabetes, HTM, preeclampsia, labor not pregressing, fetal intolerance, post partum hemorrhage

119
Q

Reasons to induce:

A

fetal or maternal well being, diabetes, preeclampsia, infection, reptured membrances

120
Q

Terbutaline (Brethine)

class, how it works, side effects, onset/peak/duration

A
  • prevent pretern labor after 20 weeks gestation
  • delay preterm delivery so that seroids can be given
  • inhibits the release of mediators
  • Side effects: tachycardia, tremors, nervousness, headache, GI distress, anxiety, arrhythmis, hyperglycemia, hypokalemia, pulmoney edema
  • given SQ, PO, or pump
    onset: 60-120 mint.
    peak: 2-3 hrs
    duration: 4-8 hrs
121
Q

Magnesium sulfate

class, what it does, how it works, side effects, onset/peak/duration

A
  • Class: Calcium antagonist, CNS depressant
  • for preeclampsie and eclampsia, prenatal, intrapartal and post partum
  • Side effects: flushing, diaphoresis, dizziness, nausea, HA, hypotension, lethary, decreased fetal HR, lethary in neonate
  • Monitor serum mag levels, deep tendon relfexes, uterine reponse and urine output
    onset: 60 mint
    peak: unknown
    duration: 3-4 hr
122
Q

Nifedipine
(Procardia)

Class, what it does, side effects, onset/peak/duration

A
  • Class: Calcium channel blockers
  • most often used for long term control of preterm labor
  • inhibits calcium transport into myocardial and vascular smooth muscle cells leading to inhibition of excitation contraction
  • Side effects: headache, anxiety, flushing, constipation, diarrhea, weight gain, steven johnson syndrome
    onset: 20 min

Peak: uknown

duration: 6-8 hrs

123
Q

Oxytocin

and Synthetic Pitocin

what it does, side effects, onset/peak/duration

A
  • secreted by the post. pituitary gland, stimulates smooth muscle of uterus and mammary gland
  • stimulates uterine contraction to promote induction of labor
  • stimulate by breastfeeding or nipple stim
  • has a short half life and able to stom immediately
    onset: immediate
    peak: unknown
    duration: 1 hr

Sythetic: Pitocin used for labor induction, stimulate increased contractions during labor, prevent and control postpartum bleeding, and partial birth abortions after 20 week gestation

124
Q

Prostagladins

A
  • used to induce labor
  • local hormone that act directly at the site where they are secreted
  • In uterus…cause smooth mucsle contraction
  • In carboprost used to control post pardum hemmorage
125
Q

Labor Induction:

Dinoprostone (Prostin E2, prepidil)

class, what they do, onset/peak/duration, side effects

A
  • Prostaglandin to induce softening of cervix prior to inducing labor or for incomplete aborstions
  • produce contractions by stimulating the myometrium
  • Class: oxytocic, prostagladins

Inset:
onset: rapid

peak: 30-40 mints
duration: 12 hrs
- side effects: uterine abnormalities, fever, uterine rupture, back pain, Hypotension/hyper., UTI

126
Q

Labor Induction:

Misoprostol (Cytotec)

class, what it does, side effects, onset/peak/duration

A
  • Class: Prostaglandins
  • soften cervix and labor induction

-given PO
Onset: 30 mint

Peak: unknown

duration: 3-6 hrs
- Side effects: N/V/D, uterine rupture, abdominal pain, uterine bleeding

127
Q

Labore Induction:

Methylergonovine Maleate (Methergine)

class, what it does, side effects, onset/peak/duration

A
  • Class: ergot alkaloids
  • given PO or IM, IV if emergent
  • stimulate uterine and vascular smooth muscle uterine contraction

Onset: 5-15 mints

Peak: unknown

duration: 3 hours
- Side effects: hypotension, cramps, N/V, allergic reactions

128
Q

Labor Induction:

Carboprost (hemabate)

A

-caution with asthma pts

-side effects:
N/V/D, uterine cramping, headache, chills

129
Q

Testosterone

A
  • constant secretion by testes in men..increased in pubirty and decreased in adulthood
  • feedback: testosterone levels get to high in blood, feedback to pituitary that shuts off secretion of LH and FSH
130
Q

Androgens

A

male sex hormones that mediate normal growth and developement and maintenance of primary and secondary male sex characteristics

131
Q

Pharmacothery with
Testosterone

A

-promotes synthesis of erythropoietin…and increases crit compared to women

-Adverse effects:
enhanced secondary sex characteristics, continuous erection, prolonged use can produce gynecomastia and halt spermatogenesis, N/V, insomnia, GI disturbances, libido changes

  • IM better absorbed
    onset: unknown
    peak: unknown
    duration: 1 to 3 days
132
Q

Benign prostate hyperplasia

A

enlargement of the prostate gland that decreases outflow of urine by obstructing the urethra

133
Q

Prostatic Hypertrophy treatment

A
  • minimize urinary obstruction
  • prevent complication
  • treat symptoms
  • give Finasteride (Proscar)
134
Q

Finasteride (Proscar)

A
  • Class: 5 alpha reductase inhibitor
  • Inhibits 5-alpha reductase

-treatment of behign prostatic hyperplasia (BPH)
and reduces prostate size and improves urine flow

  • pregnant women should not handle tablets
  • Side effects: loss of libido, loss of erection, ejaculatroy dysfunction, myopathy…stimulates hair growth…so some people use this for male pattern baldness

Onset: 3-6 months

Peak: 1-2 hours

duration: 5-7 hrs

135
Q

Prostatic Hypertrophy:

Doxazosin (Cardura)

A
  • Class: peripherally acting antiadrenergics
  • Alpha-adrenergic antagonist
  • Treatment of BPH as well as HTN
  • reduces contraction of smooth muscles in bladder, neck and prostate gland
  • watch for orthostatic hypotension, dizziness, reflex tachcardia
    onset: 1-2 hrs
    peak: 2-6 hrs
    duration: 24 hrs
136
Q

Erectile dysfunction

A
  • consistant inability to either obtain an erection or to sustain erection long
    treatment: Viagra

could be R/T:

  • arthrosclerosis
  • diabetes
  • kidney disease
  • stoke
  • HTN
  • Smoking
137
Q

Erectile dusfunction:

Sildenafil citrat (Viagra)

A
  • Class: phosphodiesterase
  • enhances flow of blood into corpus cavernosum by relaxing the smooth mucsle
  • last about 4 hours
  • Does not caus automatic erection, responds to stimulationg: NO EFFECT IN ABSENCE OF SEXUAL STIMULATION
    onset: 20-60 min
    peak: 30-130 min
    duration: 24 hr
138
Q

Precaution with Viagra and Cialis

A

Pharmacology: Test 1 (4 decks)

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