Week 6: Pharmacology Flashcards
The study of the biological effects of chemicals
Pharmacology
___ deals with drugs effects on the body and the body’s response to drugs
Brach of pharmacology that uses drugs to prevent, treat, and diagnose disease.
Clinical pharmacology (pharmacotherapeutics)
Nurses monitor for _____ (what drug is susposed to do) and ___ (what the drug shouldn’t do)
Therapeutic effects
Adverse effects
Drug evaluation
Preclinical trails
Animals
Drug evaluation
Phase 1
Healthy humans
Drug evaluation
Phase 2
Target patients
Drug evaluation
Phase 3
Clinical setting
Drug evaluation
Phase 4
Continual evaluation
Drug names
N-(4-Hydroxyphenyl) acetamide
Acetaminophen
Tylenol
Chemical Name
Generic Name
Trade Name
U.S. Food and Drug Administration
Assigns drugs to a category of
Nonprescription
Prescription
Prescription can be divided into 2 more catagories
Controlled / Uncontrolled
How many schedules are there for controlled drugs
Which has no medical use in the US
5
Schedule 1 has no medical use in the US
_____ therapy is used with conventional/ tradicional medicine
Complementary therapy (integrative medicine)
______ is used instead of traditional/ conventional medicine
Alternative
_____ are substances that cause abnormal development of the fetus
Teratogens
When are fetuses most susceptible to teratogenic effects
1st trimester
How the drug affects the body
Replace / substitute for missing chemicals
Increase or Decrease cellular activity
Interfer with the functioning of foreign cells
Pharmacodynamics
How the body acts on drugs
Main processes involved are
Absorption
Distribution
Metabolism
Excretion
Pharmacokinetics
Pharmacodynamics (how drugs affect the body)
Ability to only attack foreign cells
(Penicillin)
Selective Toxicity
Pharmacodynamics (how drugs affect the body)
Interfer with enzyme systems that act as a catalyst for chemical reactions
(Lisinopril)
Drug-enzyme interactions
Pharmacodynamics (how drugs affect the body)
Receptor sites
Agonists (Morphine or Naloxone)
Antagonist (Morphine or Naloxone)
Agonist = Morphine
Antagonist = Naloxone
Pharmacokinetics (what the body does to the drugs)
_____ is the amount of drug needed to cause a therapeutic effect
Critical concentration
Drug dissolves in GI tract to be absorbed
Tabs and capsules will dissolve in the stomach and esophagus
______ do not dissolve until they reach the Alkaline small intestine
This process describes the _____ Phase
Enteric coated
Pharmaceutic Phase
Pharmacokinetics (what the body does to the drugs)
___ is moving a drug into the body for circulation
Absorption
Pharmacokinetics (what the body does to the drugs)
____ involves the movement of a drug to the body’s tissues
Factors that affect are
Circulation
Cell membrane
Plasma protein binding
Distribution
To cross the blood brain barrier a drug must be _____ soluble
Lipid
Aka biotransformation
Process by which th3 body changes a drug to a less active form that can be excreted
Metabolism
EC, ER, SR, XL are all long lasting drugs and examples of ____ coated
Enteric
Liver uses _____ enzyme to alter drugs and start metabolism
P-450
Nicotine, Alcohol, and Gluticosteroids all (Induce / Inhibit) P-450 enzyme
Speeds up the metabolism
Patient will not receive full effect of medication
Induce
Aminodarone
Ketoconazole
Both (Induce/ Inhibit) cytochrome P-450 metabolism
This can allow the drug to build up to toxic levels
Inhibit
First-pass effect refers to
The ability of the liver to make drugs less powerful
Drugs are metabolized by _____
Excreted by ____
Liver
Kidneys
The amount of time it takes the level of a drug in your system to be cut in half.
Half-life
Drugs with a (short / long) half-life need to be administrated more frequently
Drugs with a (short/long) half-life need to be administrated less frequently
Short = more frequently
Long = less frequently
A (large / small) therapeutic index is safer
Large
Levels important when discussing therapeutic index
_____ highest concentration in blood
______ lowest concentration of drug in blood
Peak
Trough
Expected and predictable effects that result at therapeutic dosage
Benadryl makes you sleepy
Opiods cause constipation
Antibiotics cause nausea
Side effects
Undesirable, inadvertent, unexpected and sometimes sever response to medications
Lasix causes hearing loss
Antibiotics allow for a Cdiff infection
Adverse effects
Conditions clients have that make it unsafe to recieve medications
Contraindications
Adverse effects can be divided into primary and secondary effects not related to the therapeutic effect
_____ blood thinner causes excessive GI bleeding.
_____ dermatological reaction because drug can deposit in skin
Primary
Secondary
Toxic reactions are likely to occur due to this organ not functioning properly
Kidney
Angioedema is…
Swelling of eyes, lips, tongue
Rapid onset
Dyspnea
Tingling
Itching
Low BP
Tachycardia
Are symptoms of
Anaphylaxis
Nurse implications for administration of drugs includes
Monitor for therapeutic ___
Response
Beta blockers
Suffix
Used for
Before giving check….
Side Effects
Suffix - olol
Used for HTN, HF, Irregular heart rhythm
SE:
Lightheadedness
Bradycardia
Hypotension
Fatigue
Suffix - olol
Used for HTN, HF, Irregular heart rhythm
SE:
Lightheadedness
Bradycardia
Hypotension
Fatigue
Beta blockers
Prevents conversion of angiotensin 1 to angiotensin 2.
Which causes vasodilation
Suffix - pril
Ace inhibitor
Ace Inhibitor
Suffix -
Use
Suffix - pril
Use: prevention of conversion of angiotensin 1 to angiotensin 2 (which causes vasodilation)
Angiotensin II
Receptor
Blockers (ARB)
SUFFIX -
Treats
TEACH
Suffix: SARTAN (irbesartan, valsartan, losartan and candesartan)
Treats: to treat high blood pressure and heart failure.
Teach: slow posistion changes
Notify provider if angioedema
Calcium channel blockers
Suffix - Plus 2 exceptions
Therapeutic effect
Side Effects
Suffix - Dipine
Plus, verapamil & diltiazem
Therapeutic effect: Lowe’s contractility & conductivity of the heart.
Lowers demand for oxygen
Side effects:
Lower BP
Bradycardia
Precipitate AV block
Headache
Peripheral Edema
Suffix - Dipine
Plus, verapamil & diltiazem
Therapeutic effect: Lowe’s contractility & conductivity of the heart.
Lowers demand for oxygen
Side effects:
Lower BP
Bradycardia
Precipitate AV block
Headache
Peripheral Edema
Calcium Channel blockers
High Loop Diuretics
Suffix - ide
Before giving check
Clinical uses:
Side effects:
Suffix -ide
Check BP / K+ before giving
Clinical uses:
Heart Failure
Hypertension
Edema
Side effects:
Hyponatremia
Hypokalemia
Hypomagnesium
Ototoxicity (hearing or balance problem due to medication)
Suffix -ide
Check BP / K+ before giving
Clinical uses:
Heart Failure
Hypertension
Edema
Side effects:
Hyponatremia
Hypokalemia
Hypomagnesium
Ototoxicity (hearing or balance problem due to medication)
High loop diuretics
Loop diuretics include
ET is Fabulous
Erthacrynic acid
Torasemide
Furosemide
Azosemide
Bumetanide
Potassium Sparring Diuretics
Names: PASTE
Potassium sparring diuretics
Amilorde
Spironolactone
Triamterene
Epleronome
Potassium Sparring Diuretics
Used to treat:
Check ___ before giving
What is their function
Treat: Edema CHF
Check K & BP
Function: gets rid of sodium and water. Blocks Aldosterone in the kidney
Ace inhibitor Adverse Effects (2)
Hyperkalemia/ Angioedema
ACE & ARBS are similar except by this side effect
ACE has a dry cough
Adverse effect for ACE INHIBITOR
Hyperkalemia/ angioedema
Name Calcium channel blockers
(Are Very Nice Drugs)
Amlodipine
Verapamil
Nifedepine
Diltiazem
Loop diuretics will affect this electrolyte the most
K+ Potassium
Potassium Sparring Diuretics can lead to (hypo / Hyperkalemia)
Hyperkalemia
Thiazide diuretics used most commonly for…
HTN
Thiazide Diuretics only keep this electrolyte and get rid of the rest
Rid: Potassium, Sodium, Magnesium
Keep: Calcium
Ie.
Hypo: kalemia, natremia, magnesia
Hypercalcemia
Antihyperlipidemics
Purpose:
Suffix
Purpose: lower cholesterol & CV events
Suffix: Statin
(Statins) Antihyperlipidemics
Lower cholesterol & CV events
SE:
Myopathies (muscle aches)
Weakness
Increased liver enzymes
Rhabdomyosis
Insulin given with meals is called
Prandial
Insulin
SE
Hypoglycemia
Weight gain
Peripheral Edema
Opiods
SE
M
O
R
P
H
I
N
E
Myosis (Pinhead eyes)
Out of it
Respitory depression
Pneumonia
Hypotension
Infrequency
Nausea
Emesis
Corticosteroids (Anti-inflammatory)
Given for:
Asthma
COPD (Respitory)
Autoimmune
Suffix
Suffix- one
(Hydro)cortisone
(Methyl)Prednisone
Dexamethasone
Betamethasone
Corticosteroids (Anti-inflammatory)
Given for which conditions _______
Suffix- one
(Hydro)Cortison, (Methyl)prednisone
SE
Given for: Asthma, COPD, Autoimmune
SE: weight gain, mood swings, insomnia, fluid retention, High BP
Antiplatelets (anti-clotting)
Suffix -
Examples
Reduces risk of ______
Suffix- Grel
clopidogrel, prasugrel and ticagrelor.
Reduces risk of Artherosclerotic events
Antiplatelets (anti-clotting)
Suffix - grel
clopidogrel, prasugrel and ticagrelor.
Reduces risk of artherosclerotic events
Check these levels
Avoid these medications
Teaching
Check these levels: thrombocytopenia & CBC
AVOID MEDICATIONS: NSAIDS / PPI
Teaching: Monitor for cuts and increased bruises
Benzodiazepine:
Suffix:
Side effects: drowsy, lightheaded, falls, adictive
Azolam
Azepam
Proton Pump Inhibitor (PPI)
Suffix
Use _____
Suffix - prazole
Use: Heartburn / inhibit gastric secretions
Give before meals
Omeprazole, Pantoprazole, Iansoprazole
Type of medication
Suffix / names
Use
Proton Pump Inhibitor
-prazole
Omeprazole, Pantoprazole, Iansoprazole
Use: heartburn / decrease gastric juices
Can RN’s take telephone/ verbal orders
Can student nurses
RN = Yes
Student = No
Types of Orders
Coutinous until otherwise noted
Everyday Sametime
Routine
Pain or Nausea medication may be ordered to be given when the patient needs it
PRN
Bolus is the administration of a discrete amount of drug within 1–30 minutes, to raise its concentration in blood to an effective level.
Example of this type of order
One time order
Parts of Med order
Patients Name
___________
Name of drug
___________
Route of administration
__________
Signature of Prescriber
Date / time
Dosage of drug
Frequency of Administration
Parts of a medication order
_______
Date / time
________
Dosage of drug
___________
Frequency of Administration
___________
Patients Name
Date / time
Name of drug
Dosage of drug
Route of administration
Frequency of Administration
Signature of provider
Which type of orders need to have a reason
PRN
When to do the 3 medication checks
- Reaching for the unit dose in the pyxis
- Compare lable with the MAR after retrieving from the drawer
- Replacing the container to the drawer / Before dose is given to patient
No medication maybe given to a patient without…
Medication Order
- Reaching for container or unit dose
- Compare lable with MAR after retrieval from drawer / before pouring from multidose container
- Before giving to patient/ when replacing
Describes
3 checks
Before giving medication preform the (3) checks
- Reaching for container or unit dose
- Compare lable with MAR after retrieval from drawer / before pouring from multidose container
- Before giving to patient/ when replacing
And these Rights
5 rights of medical administration
- Medication
- Patient
- Dosage
- Route
- Time
Has patient recieved this med before
Does it make sense
Why is THIS patient taking this med
Is Right
Right medication
Verify right patient by
Looking at wrist band
Ask patients Name and birthday
Vitals
Labs
Medication administration instructions/ parameters
Physical assessment findings
Deal with this Right
Right Assessment
Assess lab values as appropriate
Side effects / Adverse effects
Effective?
Deals with this Right
Right Response
Why is the patient receiving?
What is the purpose
Expalin Expected effects / side effects
Explain Direction to take
Associated with these patients Rights
Right education
Right
Reason
Assessment
Documentos
Response
Education
________
Six more “ Rights”
Refuse
What to know before admission of meds
N
C
A
U
U
S
I
N I
P T
A
Name
Class
Action
Use
Usual route / dose
Side effects/ adverse effects
Interaction
Nursing Implications
Patient teaching
Antidote
Error or commission or omission that could harm a patient but do not
Near misses
1.0 mg of gabapenton PO q6h
Correct?
No
Never use Trailing zeros
1mg gabapenton PO q6h
0.25 mg gabapenton q6h
Correct?
Correct
.25 mg could be read as 25 mg
Always use leading zeros
How many patients rights are there
11
Amilorde
Spironolactone
Triamterene
Epleronome
Potassium sparring diuretics
Suffix - Dipine
Plus, verapamil & diltiazem
Examples of
Calcium channel blockers
Amlodipine
Verapamil
Nifedepine
Diltiazem
Are these class of drugs
Calcium blockers
Difference between Pharmacology Vs Pharmacotherapeutics
Pharmacology: Biological effects of chemicals
Clinical Pharmacology/ pharmacotherapeutics
Branch of Pharmacology that uses drugs to treat, prevent, diagnose diseases
National Drug Code (NDC) ….
Number used to identify specific drug
The more the drug is bound to ______, the more difficult it is to cross cell membranes
Protein
(Plasma binding protein)
Urea nitrogen (BUN) is a normal waste product that comes from….
Breakdown of protein in foods
Creatinine is a waste product in the blood that comes from…
Muscle activity
Factors influence drug effects
Electrolyte imbalance, hydration, acid base balance are examples of
(Physiological/ Pathological) factors
Physiological
Factors that influence drug effects
Hepatic, renal, GI dysfunction, vascular disorders
(Physiological/ Pathological)
Pathological
Metoprol
Type
Used for
Check
Side effects
Beta blockers
Used for: HTN, HF, irregular heart rhythm
Check HR & BP prior
SE: light headedness, bradycardia, hypotension, fatigue
Labetalol
Type
Used for
Check
SE
Beta blockers
Used for: HTN, HF, irregular heart rhythm
Check HR & BP prior
SE: light headedness, bradycardia, hypotension, fatigue
Atenolol
Type
Use
Check
SE
Beta blockers
Used for: HTN, HF, irregular heart rhythm
Check HR & BP prior
SE: light headedness, bradycardia, hypotension, fatigue
Benazepril
Type
Use
Check
SE
ACE inhibitor
Use: HTN, Heart failure,
Check: BP, HR, respiratory
SE: Dry cough
Adverse effects: Angioedema/ Hyperkalemia / Dry Cough
Captopril
Type
Use
Check
SE
ACE inhibitor
Use: HTN, Heart failure,
Check: BP, HR, respiratory
SE: Dry cough
Adverse effects: Angioedema/ Hyperkalemia / Dry Cough
Enalapril
Type
Use
Check
SE
ACE inhibitor
Use: HTN, Heart failure,
Check: BP, HR, respiratory
SE: Dry cough
Adverse effects: Angioedema/ Hyperkalemia
Fosinopril
Type
Use
Check
SE
ACE inhibitor
Use: HTN, Heart failure,
Check: BP, HR, respiratory
SE: Dry cough
Adverse effects: Angioedema/ Hyperkalemia
Losartan
Type
Use
Check
SE
Angiotensin II
Receptor
Blocker (ARB)
Use: HTN, HF
Check: BP b4 giving
SE: Hypotension/ Hypokalemia
Lightheaded, fatigue
Angioedema
Valsartan
Type
Use
Check
SE
Angiotensin II
Receptor
Blocker (ARB)
Use: HTN, HF
Check: BP b4 giving
SE: Hypotension/ Hypokalemia
Lightheaded, fatigue
Angioedema
Olmesartan
Type
Use
Check
SE
Angiotensin II
Receptor
Blocker (ARB)
Use: HTN, HF
Check: BP b4 giving
SE: Hypotension/ Hypokalemia
Lightheaded, fatigue
Angioedema
Amlodipine
Type
Use
Check
SE
Calcium channel blockers
Use: Lowers contractions, conduction, demand for oxygen
HTN, Angina (chest pain), Heart rhythm disorders
Check BP & HR
SE:
Lower BP
Bradycardia
Peripheral edema
Nifedepine
Type
Use
Check
SE
Calcium channel blockers
Use: Lowers contractions, conduction, demand for oxygen
HTN, Angina (chest pain), Heart rhythm disorders
Check BP & HR
SE:
Lower BP
Bradycardia
Peripheral edema
Verapamil
Type
Use
Check
SE
Calcium channel blockers
Use: Lowers contractions, conduction, demand for oxygen
HTN, Angina (chest pain), Heart rhythm disorders
Check BP & HR
SE:
Lower BP
Bradycardia
Peripheral edema
Diltiazem
Type
Use
Check
SE
Calcium channel blockers
Use: Lowers contractions, conduction, demand for oxygen
HTN, Angina (chest pain), Heart rhythm disorders
Check BP & HR
SE:
Lower BP
Bradycardia
Peripheral edema
Blackbox warning
Dangerous Adverse effects associated with drug
Prescribed because Benefits outweigh the Risks
Are generic drug names capitalized?
Are trade names capitalized
No
Exp. acetaminophen
Yes
Exp. Tylenol
Drug which brand name version of drug is usually Preferred over the generic
Synthoid
Do uncontrolled drugs require a prescription/ monitoring by a provider
Yes, they are prescription drugs
No risk for abuse
Complementary Vs Alterernative medicines
Comp used with Standard treatment
Alt used instead of
Selective Toxicity
Drug enzyme Interaction
Receptor Site
(Pharmacodynamics/ Pharmacokinetics)
Pharmacodynamics
Lisinopril is an example of which type of Pharmacodynamics action
Drug- enzyme interactions
Angiotensin
Converting
Enzyme
Inhibitor (ACE INHIBITOR)
Some drugs will be given a _____ dose which is a higher concentration of medication then is normally given in a Maintenance dose
Loading
Maintaining Critical Concentration requires ________ a process of absorption, distribution, metabolism, excretion
Dynamic equilibrium
A rash is an alergic reaction or a side effect from a drug?
Both
Which type of drugs can reduced the effectiveness of other types of drugs
PPI
Omeprazole
Heart burn
Ethancrynic Acid
Type
Use
Check
SE
High loop diuretics
Use: Heart Failure, Hypertension Edema
Check: BP & K+
SE: Hypo: natremia, kalemia, magnesemia & ototoxicity
Torasemide
Type
Use
Check
SE
High loop diuretics
Use: Heart Failure, Hypertension Edema
Check: BP & K+
SE: Hypo: natremia, kalemia, magnesemia & ototoxicity
Amilorde
Potassium Sparring Diuretics
Get rid of other electrolytes
Spironolactone
Potassium Sparring Diuretics
Get rid of other electrolytes
Triamterene
Potassium Sparring Diuretics
Get rid of other electrolytes
Epleronome
Potassium Sparring Diuretics
Get rid of other electrolytes
Simvastatin
Type
Use
Check
SE
Antihyperlipidemics
Reduce cholesterol and CV events
Lipid panel
SE: Mild muscle pain
Notify provider if sever muscle pain, tenderness, or fever occurs
Atorvastatin
Type
Use
Check
SE
Antihyperlipidemics
Reduce cholesterol and CV events
Lipid panel
SE: Mild muscle pain
Notify provider if sever muscle pain, tenderness, or fever occurs
Rosuvastatin
Type
Use
Check
SE
Antihyperlipidemics
Reduce cholesterol and CV events
Lipid panel
SE: Mild muscle pain
Notify provider if sever muscle pain, tenderness, or fever occurs
Hydroclorothiazide
Type
Use
Check
SE
Thiazide Diuretics
Diuretics Keeps CALCIUM, gets rid of potassium, Sodium, Magnesium
Check: K+ before giving
SE:
Hypotension
Hypokalemia
Hyponatremia
Hypomagnesemia
Hypercalcemia
Heparin SQ & IV
Type
Use
Check
SE
Teach
Anticoagulant
Blocks certain clotting factors
Check: Hgb/Hct, Plt, PT/ INR, OCCULT BLOOD, aptt , Vitamin K
SE: bleeding precaución Avoid NSAIDS, ASA, IM injection
Enoxaparin SQ
TYPE
USE
CHECK
Teaching
Anticoagulant
Blocks certain clotting factors
Check: Hgb/Hct, Plt, PT/ INR, OCCULT BLOOD, aptt , Vitamin K
Teaching: bleeding precaución Avoid NSAIDS, ASA, IM injection
Warfin PO
TYPE
USE
CHECK
SE
Anticoagulant
Blocks certain clotting factors
Check: Hgb/Hct, Plt, PT/ INR, OCCULT BLOOD, aptt , Vitamin K
SE: bleeding precaución Avoid NSAIDS, ASA, IM injection
Suffix (-rin) & (-aban/ -atran)
Type of drug
Anticoagulant
Rivaroxaban
Type
Use
Check
SE
Anticoagulant
Blocks certain clotting factors
Check: Hgb/Hct, Plt, PT/ INR, OCCULT BLOOD, aptt , Vitamin K
SE: bleeding precaución Avoid NSAIDS, ASA, IM injection
Dabigatran
Type
Use
Check
SE
Anticoagulant
Blocks certain clotting factors
Check: Hgb/Hct, Plt, PT/ INR, OCCULT BLOOD, aptt , Vitamin K
SE: bleeding precaución Avoid NSAIDS, ASA, IM injection
Apixaban
Type
Use
Check
SE
Anticoagulant
Blocks certain clotting factors
Check: Hgb/Hct, Plt, PT/ INR, OCCULT BLOOD, aptt , Vitamin K
SE: bleeding precaución Avoid NSAIDS, ASA, IM injection
Prednisone
Type
Use
Teachings
SE
Corticosteroids
Anti-inflammatory: Asthma, COPD, Autoimmune disease
Must wean off - don’t just stop
SE: Long term osteoporosis, aseptic joint necrosis, adrenal insufficiency
Cortisone
Type
Use
Teach
SE
Corticosteroids
Anti-inflammatory: Asthma, COPD, Autoimmune disease
Must wean off - don’t just stop
SE: Long term osteoporosis, aseptic joint necrosis, adrenal insufficiency
Hydrocortisone
Type
Use
Teaching
SE
Corticosteroids
Anti-inflammatory: Asthma, COPD, Autoimmune disease
Must wean off - don’t just stop
SE: Long term osteoporosis, aseptic joint necrosis, adrenal insufficiency
Clopidogrel
What is the trade name
Type
Teaching
SE
Plavix
Inhibit platelet aggregation
Teaching: take at same time, don’t double up, ask physicians b4 taking otc supplements
SE: GI Bleed, neutropenia, thrombocytopenia
Omeprazole
Type
Trade name
Use
PPI Proton Pump Inhibitor
Prilosec
Reduce heart burn
ARBs stand for
Used for
Angiotensin receptor blockers
Used: High blood pressure / heart failure
Nancy’s Cat Ate Umbrellas Under Sunny Indigo Nights. It Purred Through All.
Mnemonic is used for what?
Before administración of meds
Name
Class
Action
Use
Usual route / dose
Side effects/ adverse effects
Interaction
Nursing Implications
Patient teaching
Antidote
