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NUR256 Bex > Week 13 > Flashcards

Week 13 Flashcards

1
Q

An example of a drug allergy is:

a. Dry mouth occurring with use of an antihistamine
b. Increased urination occurring with use of a thiazide diuretic
c. Breathing difficulty after an injection of penicillin
d. Skin rash associated with procainamide use.

A

c. Breathing difficulty after an injection of penicillin

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2
Q

A person is experiencing a reaction to the penicillin injection that was administered approximately 30 minutes ago. The healthcare provider is concerned that it might be an anaphylactic reaction. What signs and symptoms would validate her suspicion?

a. Rapid heart rate
b. Diaphoresis
c. Constricted pupils
d. Hypotension
e. Rash
f. The person reporting a panic feeling

A

a. Rapid heart rate
b. Diaphoresis
e. Rash
f. The person reporting a panic feeling

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3
Q

A woman has repeated bouts of bronchitis throughout the autumn and has been taking antibiotics. She calls the clinic with complaints of vaginal pain and itching. When she is seen, it is discovered that she has developed a yeast infection. You would explain to her that:

a. Her bronchitis has moved to the vaginal area
b. She has developed a superinfection because the antibiotics kill bacteria that normally provide protection
c. She probably has developed a sexually transmitted disease related to her lifestyle
d. She will need to take even more antibiotics to treat this new infection

A

b. She has developed a superinfection because the antibiotics kill bacteria that normally provide protection

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4
Q

A drug reaction that does not occur unless the client has been previously exposed to the agent is a:

a. Idiosyncratic reaction
b. Teratogenic reaction
c. Allergic reaction
d. Liberation reaction

A

c. Allergic reaction

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5
Q

When the pharmacological effects of one medication are potentiated or diminished by another medication, this is termed a:

a. Adverse drug reaction
b. Medication incompatibility
c. Medication interaction
d. Placebo effect

A

c. Medication interaction

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6
Q

A nurse or midwife is about to administer digoxin to a person whose apical pulse is 48 beats/min. She should

a. Give the drug and notify the prescriber that the heart rate is low
b. Retake the pulse in 15 minutes and give the drug if the pulse has not changed
c. Retake the pulse in 1 hour and withhold the drug if the pulse is still less than 60 beats/min.
d. Withhold the drug and notify the prescriber that the heart rate is below 60 beats/min

A

c. Retake the pulse in 1 hour and withhold the drug if the pulse is still less than 60 beats/min.

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7
Q

Antiarrhythmic drugs alter the action potential of the cardiac cells. Because they alter the action potential, antiarrhythmic drugs often:

a. Cause heart failure
b. Alter blood flow to the kidney
c. Cause new arrhythmias
d. Cause electrolyte disturbances

A

c. Cause new arrhythmias

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8
Q

A person who is receiving an antiarrhythmic drug needs:

a. Constant cardiac monitoring until stabilised
b. Frequent blood tests, including drug levels
c. An antidepressant to deal with the psychological depression
d. Dietary changes to prevent irritation of the heart muscle

A

a. Constant cardiac monitoring until stabilised

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9
Q

Medications that increase the force of myocardial contractions have what type of effect?

a. Positive inotropic
b. Negative inotropic
c. Positive chronotropic
d. Negative chronotropic

A

a. Positive inotropic

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10
Q

Digoxin is classified as a:

a. Hypokalaemic
b. Cardiac glycoside
c. Coronary artery vasodilator
d. Positive chronotropic

A

b. Cardiac glycoside

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11
Q

Atropine and hyoscine work by blocking

a. Nicotinic receptors only
b. Muscarinic and nicotinic receptors
c. Muscarinic receptors only
d. Adrenergic receptors to allow cholinergic receptors to dominate

A

c. Muscarinic receptors only

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12
Q

A nurse or midwife would expect atropine to be used for which of the following?

a. To depress salivation
b. To dry up bronchial secretions
c. To increase the heart rate
d. To promote uterine contractions
e. To treat myasthenia gravis
f. To treat alzheimer’s disease

A

a. To depress salivation
b. To dry up bronchial secretions
c. To increase the heart rate

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13
Q

Adverse drug reactions are classified into 6 categories, however there might be some
over-lap between categories. Describe the characteristics of each category in the table

Type A

A 
Type A
Augmented	
•	Common
•	Related to pharmacological action
•	Predictable
•	Low mortality
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14
Q

Adverse drug reactions are classified into 6 categories, however there might be some
over-lap between categories. Describe the characteristics of each category in the table

Type B

A 
Type B
Bizarre	
•	Uncommon
•	Not related to pharmacological action
•	Unpredictable
•	High mortality
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15
Q

Adverse drug reactions are classified into 6 categories, however there might be some
over-lap between categories. Describe the characteristics of each category in the table

Type C

A

Type C
Chronic
• Uncommon
• Related to cumulative dose

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16
Q

Adverse drug reactions are classified into 6 categories, however there might be some
over-lap between categories. Describe the characteristics of each category in the table

Type D

A 
Type D
Delayed	
•	Uncommon
•	Usually dose related
•	Occurs or becomes apparent sometime after the use of the drug
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17
Q

Adverse drug reactions are classified into 6 categories, however there might be some
over-lap between categories. Describe the characteristics of each category in the table

Type E

A

Type E
End of Use
• Uncommon
• Occurs soon after withdrawal of the drug

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18
Q

Adverse drug reactions are classified into 6 categories, however there might be some
over-lap between categories. Describe the characteristics of each category in the table

Type F

A 
Type F
Failure	
•	Common
•	Usually dose related
•	Often caused by drug interactions
19
Q

List factors that may increase the risk of an adverse drug reaction, these risk factors are generally specific to the individual person

A 
Factors relating to the person  
•	Age, 
•	Gender, 
•	concurrent disease, 
•	genetic factors, 
•	history of prior drug reaction
20
Q

List factors that may increase the risk of an adverse drug reaction, these risk factors are generally specific to the drug.

A 
Factors relating to the drug 
•	Route
•	Duration
•	Frequency
•	Chemical characteristics
•	Dose
21
Q

The ability of the heart to contract and propel blood into circulations relies on the regularity of the events occurring within the cardiac cycle. Describe the cardiac conduction system, including heart structures.

A

Each cycle consists of a period of relaxation (diastole) followed by a period of contraction (systole).

The rhythm and rate of the cardiac cycle are regulated by a contraction system which is made up of the SA node, intermodal pathways, the AV node, the bundle of his, left and right bundle branch and purkinje fibros.

The rhythm and rate of the cardiac cycle are regulated by the conduction system, specialised cardiac cells that have the ability to initiate and transmit the electrical impulses needed to stimulate the contraction of the cardiac muscle.

22
Q

Define Automaticity

A

Is the ability of cardiac cells to depolarize spontaneously, without external electrical stimulation from the nervous system.

  • They are found in specialised conductive tissues such as the SA and AV nodes end the His-Purkinje system
23
Q

Define conductivity

A

Conductivity
Refers to the ability of a cell to transmit an action potential along its plasma membrane. They are found in specialised conductive tissues such as the SA and AV nodes end the His-Purkinje system

24
Q

Define refractoriness

A

Refractoriness

The non-responsiveness of cardiac tissue for stimulation during the initial phase of systole (contraction).

25
Q

Define and give example of drugs for

Positive inotropic effect –

A

Increases force of myocardial contraction ADRENALINE, DOBUTAMINE

26
Q

Define and give example of drugs for

Negative inotropic effect –

A

decreases the force of myocardial contraction PROPRANOLOL

27
Q

Define and give example of drugs for

Positive chronotropic effect –

A

accelerates heart rate - increase rate of impulse formation in the SA node ADRENALINE

28
Q

Define and give example of drugs for

Negative chronotropic effect –

A

slows heart rate down by slowing the impulses in the SA node DIGOXIN

29
Q

Define and give example of drugs for

Positive dromotropic effect –

A

Increases conduction velocity through specialised conducting tissues PHENYTONIN

30
Q

Define and give example of drugs for

Negative dromotropic effect –

A

delays conduction velocity though specialised tissues VERAPAMIL

31
Q

Explain why digoxin can produce cardiac arrhythmias and why it is important to monitor the plasma concentrations of digoxin closely;

A

Digoxin toxicity can cause cardiac arrhythmias, it is important to monitor the plasma concentrations to ensure the drug is kept at a therapeutic range. It is also important to monitor electrolyte balance as this can contribute to toxicity reactions of digoxin.

Digoxin induced arrhythmias are caused by depression of the SA and AV nodes of the heart

Digoxin can also cause increased myocardial automaticity, producing extra systoles or tachycardia.

It must be monitored closely because glycosides have a narrow therapeutic index.

32
Q

Describe below the affects that atropine has on the following systems
Eyes –

A

The pupil is dilated and the cillary muscle relaxes causing failure of accommodation or near vision. It may reuse outflow of fluid causing a rise in intraocular pressure.

33
Q

Describe below the affects that atropine has on the following systems
Skin and Mucous Membranes –

A

inhibits secretion from lacrimal, bronchia, salivary and sweat glands; produces drying of the mucus membranes of the mouth, nose, pharynx and bronchi. It causes the skin to become hot and dry.

34
Q

Describe below the affects that atropine has on the following systems
Respiratory System –

A

relaxes the smooth muscle of the bronchial tract but less effective than adrenaline.

35
Q

Describe below the affects that atropine has on the following systems
Cardiovascular System –

A

low doses temporarily slow the heart, high doses increase the rate of the heart.

36
Q

Describe below the affects that atropine has on the following systems
GI Tract –

A

in large doses atropine inhibits GI motility. Gastric acid is reduced slightly

37
Q

Describe below the affects that atropine has on the following systems
Urinary Tract –

A

slightly relaxes smooth muscle of the urinary tract and decreases the tone of the bladder. It also causes constriction of the internal sphincter causing urinary retention, especially in elderly men with enlarged prostate

38
Q

Describe below the affects that atropine has on the following systems
Central Nervous System –

A

large doses cause excitement, agitation, irritability, hallucinations, delirium, stupor and coma. A rise in temperature is sometimes seen especially in children and infants

39
Q

Both alpha and betas adrenoceptors are further broken down into subtypes. List the subtypes below and where they are found in the body. Finally list the responses that each type of adrenoceptor is responsible for in the body.

α ₁

A

α ₁ - located on post synaptic membrane

α ₁ - vaso constriction of peripheral blood vessels, dilation of pupil, increased contractibility of the heart

40
Q

Both alpha and betas adrenoceptors are further broken down into subtypes. List the subtypes below and where they are found in the body. Finally list the responses that each type of adrenoceptor is responsible for in the body.

α ₂

A

α ₂ - located on presynaptic nerve terminals, postsynaptically on vascular and smooth muscle and sites remote from nerve terminals such as platelets and leucocytes.
α ₂ - inhibition of transmitter release, aggregation of platelets, contraction of smooth muscle

41
Q

Both alpha and betas adrenoceptors are further broken down into subtypes. List the subtypes below and where they are found in the body. Finally list the responses that each type of adrenoceptor is responsible for in the body.

β₁

A

β₁ - located on the heart.

β₁- increased heart rate, increased contractibility of the heart

42
Q

Both alpha and betas adrenoceptors are further broken down into subtypes. List the subtypes below and where they are found in the body. Finally list the responses that each type of adrenoceptor is responsible for in the body.

β₂

A

β₂- located on the bronchials, arterial smooth muscle and skeletal muscle.
β₂ - relaxation of the uterus, gycogenolysis, dilation of bronchial smooth muscle.

43
Q

Both alpha and betas adrenoceptors are further broken down into subtypes. List the subtypes below and where they are found in the body. Finally list the responses that each type of adrenoceptor is responsible for in the body.

β₃-

A

β₃- located on the plasma membrane of adipocytes.

β₃- mediate lipolysis

44
Q

Discuss the pharmacological effects of noradrenaline in the treatment of acute hypotensive episodes.

A

Noradrenaline functions as a peripheral
vasoconstrictor
inotropic stimulator of the heart
dilator of coronary arteries

These actions result in an increase in systemic blood pressure and coronary artery blood flow.

Noradrenaline infusion helps raise the blood pressure to an optimal level and establish a more adequate circulation.

NUR256 Bex (7 decks)

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