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Pharm exam 2 terms
| Question | Answer |
|---|---|
| Anti microbial resistance | Microbial resistance to drugs once successfully used to destroy microorganisms |
| Crystalluria | Presence of crystals in the urine, indicating renal irritation |
| Tetracycline prototype and use | Tetracycline hydrochloride Used to treat mycoplasma clamydia, and rickettsia, to of chronic bronchitis, gonorrhea, and syphilis in pts with penicillin Penetrates microbial cells by passive diffusion an an active transport system |
| Other drugs in the tetracycline class | Demeclocycline, Doxycycline, Eravacycline, minocyline hydrochloride, sarecycline, omadacycline, tigecycline |
| Sulfonamides prototype and use | Trimethoprim-sulfamethoxazole To of P. Jurovecii pneumonitis, severe UTIs, shigella enteritis, and enterobacteriaceae Act os antimetabolites of para-aminobenzoic acid (PABA), which microorganisms require to produce folic acid Also called TMP-SMZ |
| Other drugs in sulfonamides class | Mafenide, sulfadiazine, silver sulfadiazine, sulfasalazine |
| Adjuvant medications used to treat urinary tract infections: urinary antiseptics | Nitrofurantoin, phenazopyridine, trimethoprim |
| Nitrofurantoin | An anti-infective agent that is administered for the treatment and prophylaxis of UTIs. Contraindications include renal insufficiency as well as pregnancy in the first trimester |
| Phenazopyridine hydrochloride | Urinary analgesic that is administered to provide pain relief related to burning, urgency, frequency, and irritation of the lower urinary tract mucosa. May turn urine orange. BBW: if pts skin turns yellow report to health care provider. |
| Trimethoprim | Folate antagonist that is a urinary tract anti-infective. Administered in combination with the sulfamethoxazole or as an adjuvant agent with sulfonamides or by itself. Can treat pneumonia. Inhibits folic acid reduction interfering with bacterial cell grow |
| Chronotropic effect | Causing a change in heart rate |
| Dromotropic effect | Causing a change in speed of electrical conduction in the heart |
| Inotropic effect | Causing a change in myocardial contraction |
| Normotensive | Having normal blood pressure |
| Pressor | Effect that increasing blood pressure |
| Hypovolemic shock | The most common type of shock. Caused by insufficient circulating volume from blood loss or relative loss from fluid shifts in body. May result from hemorrhage, trauma, burns, and medical conditions such as DKA or DI. Vomiting and diarrhea are causes for |
| Cardiogenic shock | Occurs when the myocardium has lost its ability to contract efficiently and maintain an adequate cardiac output. Seen with myocardial infarction, atrial and ventricular arrhythmias and valve or ventricle septal rupture. |
| Obstructive shock | May result when any kind of mass or fluid accumulation and or blood clot outside of the heart interferes with the heart’s ability to adequately pump a sufficient quantity of blood. Causes: PE, pulmonary hypertension, tension pneumothorax, constrictive per |
| Distributive or vasogenic shock | Develops from impaired utilization of oxygen and production of energy by the cell. Characterized by massive vasodilation, which results in a relative hypovolemia. Divided into three subtypes: anaphylactic, neurogenic, and septic shock |
| Anaphylactic shock | Due to massive vasodilation caused by release of histamine in response to a severe allergic reaction |
| Neurogenic shock | Result of massive vasodilation of the peripheral blood vessels from high level spinal cord injures |
| Septic shock | Due to massive vasodilation caused by release of mediators of the inflammatory process in response to overwhelming infection |
| Treatment of hypotension and shock | Initial treatment is placing pt in recumbent position, give blood transfusions, fluids, and electrolytes, and treat infections |
| Adrenergic drug prototype and ise | Norepinephrine Treats severe hypotension and shock that persist after adequate fluid volume replacement. First choice vasopressor for management of sepsis and septic shock |
| Other drugs in the adrenergic class | Epinephrine, dopamine, dobutamine, phenylephrine. Epinephrine is the drug of choice for relief of anaphylactic shock |
| Angioedema | Sudden deep swelling or welts under skin particularly around the eyes and lips |
| Antiadrenergic | Decrease or block the effects of sympathetic nerve stimulation |
| Autoregulation | Ability of body tissues to regulate their own blood flow |
| Bradykinin | Peptide that causes vasodilation and lowers blood pressure |
| Essential hypertension | High blood pressure for which no cause can be found |
| First dose phenomenon | Orthostatic hypotension with palpitations, dizziness, and syncope 1 to 3 hours after the first dose of the drug or an increased dose |
| Secondary hypertension | High blood pressure from an identified cause such as kidney disease, endocrine or central nervous system disorders |
| Angiotensin converting enzyme inhibitors (ACE inhibitors) prototype and use | Captopril. Blocks the enzymes that normally converts angiotensin 1 to potent vasoconstrictor angiotensin 2 Prevents or reverses the remodeling of heart muscle and blood vessel walls that impairs cardiovascular function and exacerbates cardiovascular disea |
| Angiotensin 2 receptor blockers prototype and use | Losartan. Blocks vasoconstricting and aldosterone secreting effects of angiotensin 2 To of hypertension and Is effective in people with type 2 diabetes who have diabetic neuropathy |
| Calcium channel blocker prototype and use | Ampodipine. Dilate peripheral arteries and decrease peripheral vascular resistance by relaxing vascular smooth muscle. Tx of hypertensive emergencies or urgent hypertensive events and other cardiovascular disorders like CAD |
| Adjuvant medications used treat hypertension Direct renin inhibitors | Aliskiren is the only direct renin inhibitor, deceased plasma renin activity and inhibits the conversion on angiotensin to angiotensin 1. Treatment of hypertension and should never be used in combination with ACE inhibitors or an ARB. |
| Acute coronary syndromes | Umbrella term used to describe conditions brought on by sudden reduced blood flow to the heart in situations where myocardial ischemia is suspected. Includes unstable angina l, non-ST- segment elevation myocardial infarction l, and ST segment elevation my |
| After load | Amount of vascular resistance that must be overcome to open the aortic valve on the left side of the heart or pulmonic valve on the right and eject the blood with systole |
| Cardioselectivity | Ability of beta-adrenergic blocker to selectively block beta 1 receptors |
| Coronary artery vasospasm | Smooth muscle constriction of a coronary artery |
| Coronary heart disease | Stable angina pectoris and acute coronary syndromes which results from coronary artery disease or spasm |
| Intima | Inner layer of an artery |
| Media | Middle layer of vessel |
| Negative chronotropy | Causing slowing of the heart rate |
| Preload | Passive stretch of the ventricles just prior to systole |
| Organic nitrates prototype and use | Nitroglycerin relaxes smooth muscles in blood vessel walls Relief of sudden onset angina |
| Beta adrenergic blockers prototype and use | Atenolol treats of angina and hypertension as well as for the prophylaxis and treatment of MI |
| Calcium channel blockers prototype and use | Nifedipine inhibits the influx of calcium entering through slow channels producing vasodilation of the peripheral blood vessels and coronary arteries. Treatment for stable, variant, and unstable angina, mild to severe hypertension and Raynaud’s phenomeno |
| Adjuvant medications for coronary heart disease | Ranolazine is the first line treatment for chronic angina |
| Central adiposity | Accumulation of abdominal fat resulting in an increased waist circumference |
| Cholesterol | Component of cell membrane that is produced and processed in the liver; a fat essential for the formation of steroid hormones that is produced in cells and taken in by dietary sources |
| Dyslipidemia | Abnormal lipid levels in the blood associated with atherosclerosis and its many pathophysiologic effects (myocardial ischemia and infarction, stroke, peripheral arterial occlusive disease) |
| Lipoproteins | Specific proteins in plasma that transport blood lipids, contains cholesterol, phospholipid, and triglyceride bound protein. They vary in density and amounts of lipid and protein |
| Metabolic syndrome | Cluster of several cardiovascular risk factors liked with obesity, increase waist circumference, elevated triglycerides, reduced high density lipoprotein cholesterol, elevated BP, and elevated fasting glucose |
| HMG-COA reductase inhibitors prototype and use | Atorvastatin. Inhibits an enzyme required for hepatic synthesis of cholesterol Treatment of hypercholesterolemia and reducing cardiovascular events in people with multiple risk factors |
| Bile acid sequestrants prototype and use | Cholestyramine. Binds bile acids in the intestinal lumen causing bile acids to be excreted in feces preventing recirculation in the liver. Reduced LDL cholesterol levels (15-30%) and produces minimal elevation in HDL cholesterol (3-5%) |
| Fibrates prototype and use | Fenofibrate. Increases oxidation of fatty acids in liver and muscle tissue. Reduces serum triglycerides values and main indication is for high serum triglycerides greater than 500 |
| Cholesterol absorption inhibitor prototype and use | Ezetimibe. Blocks biliary and dietary cholesterol absorption at the brush border of the intestine without affecting absorption of fat soluble vitamins and triglycerides Treatment of primary dyslipidemia |
| PCSK9 inhibitor prototype and use | Alirocumab. Promotes modulation of the receptors that clears cholesterol, prolonging the receptors activity and promoting the clearance of cholesterol. Indicated in adults with ASCVD or familial hypercholesterolemia who require additional lowering of LDL |
| Catecholamines | Active amines ( epinephrine, norepinephrine, dopamine) that have an effect on the cardiovascular system |
| Chronotropic | Related to impacting myocardial rate or heart rate/ pulse |
| Decompensation | The inability of the heart to adequately circulate oxygenated blood to the body’s vital organs |
| Digitalis toxicity | An accumulation of digoxin in the body that leads to nausea, vomiting, visual disturbances, atrial or ventricular tachydysrhythmias, vfib, sinoatrial block, and atrioventricular block |
| Digitalization | The administration of a loading dose of digoxin to achieve a therapeutic blood level of the medication more rapidly |
| Ejection fraction | The percentage of the total amount of blood in the left ventricle that is ejected with each heartbeat |
| Endothelin | A peptide that raises blood pressure, constricts blood vessels, and contributes to the onset of heart failure |
| Maintenance dose | A dose administered on a routine basis to produce a therapeutic effect and control symptoms |
| Phosphene | Intermittent enhanced brightness in a limited area of the visual field; appearance of halos or multiple images |
| Renin | An enzyme produced by the kidney that divides angiotensinogen to form angiotensin 1 which then changes to angiotensin 2 to produce vasoconstriction |
| Therapeutic index | The margin between effectiveness and toxicity in the blood level of a drug |
| Ventricular remodeling | Dilation and hypertrophy of the ventricles in the initial phase of heart failure causing the ventricle to assume a spherical shape |
| Cardiac glycosides prototype and use | Digoxin. Produces a cardiotonic effect that improves the contractility and pumping ability of the heart. Management of mild to moderate HF in adults when children |
| Phosphodiesterase inhibitors (cardiotonic-inotropic agents) prototype and use | Milrinone. Increases the force of contraction of the ventricles providing positive inotropic effect and Improving ejection fraction. Intermediate and long term as a bridge therapy in HF |
| Angiotensin neprilysin inhibitors prototype and use | Sacubitril/valsartan. Sacubitril is a neprilysin inhibitor and valsartan is an ARB. management of chronic HF with a reduced ejection fraction |
| Sinoatrial node modulators prototype and use | Ivabradine. Produces selective inhibition of the pacemaker of the sinoatrial node with resultant disruption of the current flow. Reduces the risk of hospitalization for worsening HF in pts with stable, symptomatic chronic HF with left ventricular ejectio |
| Adjuvant medications to treat HF ACE inhibitors and beta adrenergic blocking agents | ACE inhibitor: Enalapril maleate blocks the conversion of angiotensin 1 and angiotensin 2 which promotes vasodilation and decreases aldosterone secretion. Used to treat hypertension, acute and chronic HF and asymptomatic left ventricular dysfunction. |
| Beta adrenergic blocking agents prototype and use | Metoprolol succinate is administered in patients following MI and HF because of their effectiveness in improving symptoms, reducing hospitalization, and improving survival |
| Loop diuretics prototype for HF | Furosemide is administered to patients with moderate to severe HF to reduce edema |
| Thiazide diuretics prototype for HF | Hydrochlorothiazide inhibits the reabsorption of sodium and chloride in the distal renal tubule increasing excretion of sound water by the kidneys. Beneficial for treating edema in HF |
| Aldosterone antagonists diuretic prototype for HF | Spironolactone reduces aldosterone induced retention of sodium and water and impaired vascular function by antagonizing the action of aldosterone at mineralocorticoid receptors. |
| Antidysrhythmic | Medication used for prevention and treatment of cardiac dysrhythmia |
| Automaticity | Ability of the heart to generate an electrical impulse |
| Bradydysrhythmia | Dysrhythmia of less than 60 beats/minute |
| Conductivity | Ability of the cardiac tissue to transmit electrical impulses |
| Dysrhythmia | Abnormality in formation or conduction or both of electrical impulse in the heart affecting heart rate and or rhythm |
| Ectopic | When an electrical impulse arises from an abnormal focus anywhere other than the sinoatrial node. |
| Excitability | Ability of a cardiac muscle cell to respond to an electrical stimulus |
| Paroxysmal supraventricular tachycardia | Episodic burst of a rapid heart rate that originates in a part of the heart above the ventricles |
| Prodysrhythmic effect | Tendency of antidysrhythmic drugs to cause the development of new dysrhythmias |
| Sinus rhythm | Electrical activity of the heart initiated by the SA node |
| Tachydysrhythmia | Dysrhythmia of greater than 100 beats/min |
| Class 1 sodium channel blockers Class 1A prototype | Quinidine reduces automaticity and slows conduction throughout cardiac system through direct and indirect anticholinergic effect on cardiac tissue reducing myocardial contractility. Treatment of atrial dysrhythmias and paroxysmal supraventricular tachyca |
| Class 1B prototype and use | Lidocaine is used to treat serious ventricular dysrhythmias associated with acute myocardial infarction, cardiac catheter, cardiac surgery. It decreases myocardial irritability in the ventricles by increasing the electrical stimulation threshold of ventri |
| Class 2 beta adrenergic blockers prototype and use | Propranolol given for chronic therapy to prevent ventricular dysrhythmias precipitated by exercise. Blocks beta adrenergic receptors in the heart and juxtaglomerular apparatus. |
| Class 3 potassium channel blockers prototype and use | Amiodarone prolongs duration of the action potential, slow repolarization, and prolong the refractory period in both atria and ventricles. Used for various types of life threatening tachydsyrhymias both ventricular and atrial dysrhythmias. |
| Class 4 calcium channel blockers prototype and use | Diltiazem obstructs the movement of calcium into conductive and contractile myocardial cells by inhibiting the influx of calcium through its channels causing slower conduction through the SA and AV nodes. Is only effective on supraventricular tachycardia |
| Anticoagulants | Drugs that prevent formation of new clots and extension of clots already present; do not dissolve formed clots |
| Antiplatelet drugs | Drugs that prevent one or more steps in the prothombotic activity of platelets |
| Embolus | Object that migrates through the circulation until it lodges in a blood vessel causing occlusion. May be thrombus, fat, air, amniotic fluid, a bit of tissue l, or bacterial debris |
| Essential thrombocytopenia | Chronic blood disorder characterized by the overproduction of platelets by megakaryocytes in the absence of another cause |
| Fibrinolysin | Enzyme that breaks down the fibrin meshwork that stabilizes blood clots axle referred to as plasmin |
| Hemostasis | Prevention or stoppage of blood loss form an injured blood vessel and is the process that maintains the integrity of the vascular compartment |
| Heparin induced thrombocytopenia (HIT) | Immune mediated adverse effect that leads to thrombogenesis resulting in a decrease in platelet count associated with heparin administration in patients with detectable HIT antibodies |
| Plasmin | Enzyme that breaks down the fibrin meshwork that stabilizes blood clots also referred to as fibrinolysin |
| Plasminogen | Inactive protein found in many body tissues and fluids |
| Thrombogenesis | Formation of blood clot |
| Thrombolysis | Breakdown or dissolution of blood clots |
| Thrombolytics | Drugs that dissolve blood clots |
| Thrombosis | Formation of a blood clot |
| Thrombus | Blood clot |
| Anticoagulant drug prototype and use | Heparin inhibits the conversion of prothrombin to thrombin and prevent thrombus formation. Prevents DVY and pulmonary embolism |
| Vitamin K antagonists prototype and use | Warfarin acts in the liver to prevent synthesis of vitamin k dependent clotting factors. Long term prevention or management of venous thromboembolic disorders including DVT, PE, and embolization associated with atrial fibrillation and prosthetic heart va |
| Direct renin inhibitors prototype and use | Dabigatran etexilate inhibits both free and fibrin bound thrombin. Used to prevent strokes and systemic embolization in individuals with nonvalvular Afib |
| Direct factor Xa inhibitors prototype and use | Rivaroxaban inhibits platelet activation and formation of Fibrin clotting by inhibition of factor Xa in both intrinsic and extrinsic coagulation pathways Treatment and secondary prevention of venous thromboembolism and in stroke prevention in patients wi |
| Adenosine do diphosphate receptor antagonists prototype and use | Clopidogrel irreversibly blocks the ADP receptor on platelet cell surface. Reduction of myocardial infarction, stroke, and vascular death in patients with atherosclerosis and in those after placement of coronary stents |
| Thrombolytic drug prototype and use | Alteplase lyses unwanted fibrin blood clots by catalyzing the conversion of plasminogen to plasmin. Lysis of acute coronary artery thromboembolism associated with evolving transmural myocardial infarction or acute pulmonary thromboembolism. |
| Biologic response modifiers | Intrinsic and extrinsic substances in the body that enhance the body’s response to infection |
| Cytokines | Small proteins released by cells that specifically affect cell to cell communication these include colony stimulating factors, interleukins, and interferons |
| Erthropoiesis | Production of red blood cells |
| Erythropoietin | Hormone secreted by the kidneys that stimulates bone marrow production of red blood cells |
| Hematopoiesis | Formation of blood cells |
| Immunocompetence | Normal immune system function |
| Immunodeficiency | Inadequate or impaired immune function |
| Immunostimulants | Drugs that stimulate immune function to flight infection and disease |
| Neutropenia | Low neutrophil count |
| Pegylation | Process of modifying a protein drug by treatment with polyethylene glycol. |
| Erythropoiesis stimulating agents prototype and use | Epoetin Alfa induces erythropoiesis by stimulating erythroid progenitor cells. Treatment for cancer patients with chemotherapy associated anemia who have hemoglobin level that decreased below 10 |
| Granulocyte colonystimulating factors prototype and use | Filgrastim stimulates the production, maturation, and activation of neutrophils within bone marrow. Preventing infection in patients with neutropenia induced by cancer chemotherapy or bone marrow transplantation or mobilizing stem cells from bone marrow |
| Interferons prototype and use | Interferon Alfa 2b binds to specific membrane receptors on the cell surface enhancing immune response. In adults 18 or older include hairy cell leukemia, chronic hepatitis B and C, AIDS, warts, malignant melanoma, lymphoma and condylomata |
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