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pharm FINAL to know1
| Question | Answer |
|---|---|
| Pregnancy safety category | a. no risk to human fetus b. no risk to animal fetus c. adverse effects in animal d. possible fetal risk in humans X. fetal abnormalities, should not be used in pregnant women |
| Pediatric – Pharmacokinetics | body Wt, BSA, maturation of organs A- ↓ acid, emptying, 1st pass elimination lvl of enzymes); ↑ absorption of topical/IM D- more body H20- ↓ fat content; ↓lvl of protein binding; ↑drugs get to brain M- infants require ↓ doses,↓metabolism E- ↓perfu |
| Pediatric – Pharmacokinetics con't | Tetracycline – discoloration Corticosteroid – suppress growth (if given systemically);Fluoroquinolone =damage cartilage (gait deformities) |
| Elderly Pharmacokinetics Start low & go slow | A-↓ GI motility ↓muscle tone ↓ acid; ↓ blood flow to GI 40- 50% ↓ perfusion; ↓ absorptive D- ↓ drugs to tissues;↓ CO; ↑H20 soluble drugs levels; ↓ serum albumin ↑ circulation of free drugs; ↑ body fat ↑ duration of drug |
| Elderly Pharmacokinetics con't | M- Aging liver=fewer microsomal enzymes, (cytochrome P-450); prolong ½ life/drug accum. E- ↓ GFR/ # of intact nephrons |
| Scheduled 1 | greatest likelihood for tolerance & abuse (heroin); No accepted medical use in U.S.; Lack of accepted safety for use under medical supervision |
| Scheduled 2 | High potential for abuse (meperidine, methadone, Percodan, methylphenidate); Accepted medical use in U.S.; Abuse potential |
| Scheduled 3 | High potential for abuse, but < I & II (codeine, Lortab, Fiorinal); Accepted medical use in U.S. |
| Schedule 4 | Low potential for abuse, but < I & II (phenobarbital, diazepam) |
| Schedule 5 | least likelihood to be abused (cough syrup, Lomotil) |
| Chinese, Asian American & Pacific Islanders | values are considered more highly than the use of medicine. Religiously grounded Herbalist, acupuncturist, fortune teller, shaman yin and yang Use of heat/ cold Cold (female – - energies of darkness and cold) Heat (male – +. energies of light/warmth |
| Native Americans | Believe in preserving harmony with nature or keeping a balance b/n body/mind and the environment to maintain health; Shaman – medicine man. Treatment varies from massage, application of heat to acts of purification |
| African American | When ill, they treat with proper diet and rest Use herbal teas, laxatives, & protective bracelets, folk medicines, prayers and the “laying on of hands” Home remedies are important to health practice |
| Hispanics | health= good luck, living right Illness = bad luck, committing a bad deed They restore the body (for balance) through the use of cold remedies for “hot” illnesses (fever) and hot remedies for “cold” illnesses (resp. infection) |
| Gene therapy- | the transplantation of normal genes into cells in place of missing or defective ones in order to correct genetic disorders. |
| Triptan drugs for migraines | rovatriptan, naratriptan, rizatriptan, and sumatriptan |
| COMT inhibitor + advantages- | anti-parkinson drugs- indirect acting dopaminergic Therapeutic effects of COMT inhibitors may be noticed within a few days; it may take weeks with other drugs |
| SSRI (fluvoxamine) | Pt teaching- don’t skip doses; 2-3 wks to notice change; notify dr- suicide, agitation, insomnia, anxiety, aggression; avoid alcohol; hives, HA, N, anorexia, anxiety, insomnia NI- monitor mood changes, I/O, assess for serotonin syndrome & toxicity/OD |
| DOC for anaphylaxis reaction | epinephrine |
| Adrenergic alphas | Alpha 1: Vasoconstriction of blood vessels, ↓GI motility; constrict bladder sphincter, contract uterus, male ejaculation, ↓IO pressure, dilate pupils Alpha 2: Mediator of negative feedback. Prevents further release of norepinephrine; ↓BP |
| Adrenergic betas | Beta 1: ↑ heart rate, ↑force of contrax, ↑conduction through AV node Beta 2: Relaxation of smooth muscle in bronchi, uterus, peripheral arterial blood vessels; ↓GI motility; ↑renin secretion |
| Dopamine: | ↑ cerebral, renal, cardiac and mesenteric perfusion ↑ PNS, SNS sexual responses Anxiety, fear response, High blood pressure, Tachycardia, Dry mouth, Dilated pupils endogenous- epinephrine, norepinephrine synthetic- dobutamine, phenylephrine |
| Beta Blockers 1 | b1 receptors: Located primarily on the heart; b-blockers selective for these receptors= cardioselective b-blockers; ↓SNS stim of heart, ↓hr, prolong SA recovery, slow conduction, ↓workload & O2 demand |
| Beta Blockers 2 | b2 receptors- Located primarily on smooth muscles of bronchioles and blood vessels; constrict bronchioles= SOB; vasoconstriction |
| Cholinergic | Nicotinic receptors - stimulated by the alkaloid nicotine- PSNS & SNS (High doses) Muscarinic receptors - stimulated by the alkaloid muscarine- PSNS, smooth muscle, cardiac muscle, glands |
| Cholinergic con't | SLUDGE- Salivation, Lacrimation, Urinary incontinence, Diarrhea, Gastrointestinal cramps, Emesis ↓hr, vasodilation, narrow airways atropine is antidote take 30 mins prior to meal |
| Anticholinergic | block ACh & PSNS physostigmine- antidote to anticholinergics small doses- ↓hr, muscle rigidity& tremors, large doses- ↑hr; drowsiness, disorientation, hallucinations dilate pupils, ↓ accommodation |
| Heart Failure + treatment | The heart is unable to pump blood in sufficient amounts from the ventricles to meet the body’s metabolic needs ACE inhibitors (DOC)- Inhibits aldosterone secretion which prevents Na & H2O reabsorption ARBS- angiotensin II receptor blocker; ↓ SVR |
| Heart Failure Tx | Beta Blockers- Prevent catecholamine-mediated actions (↓ SNS stimulation) Loop diuretics- ↓ fluid overload B-type natriuretic Peptide- ↓ PVR (afterload) → ↑ CO → ↑ perfusion organs/muscles; ↓ preload ↓ pulmonary congestion |
| Calcium Channel Blockers – Pt. education | Inhibits movement of calcium ions across cell membrane → smooth muscle relaxation antidysrhythmic/anti-HTN take as directed; no grapefruit; monitor pulse; change pos slowly; good dental hygiene; avoid alcohol & OTC; wear protective clothing/sunscreen |
| Chest pain – what you do? | monitor VS & *hypotension |
| Ace inhibitors | DOC for HF; -PRIL’s; Inhibits aldosterone secretion which prevents Na & H2O reabsorption |
| Various types of diuretics (loop, osmotic, thiazide, etc) | CAI- MIDE’s- block the action of carbonic anhydrase, thus preventing the exchange of H+ ions with sodium & water distally to glomerulus loop- Act directly on the ascending limb of the loop of Henle to inhibit Cl- & Na+ reabsorption; fast acting- 2 hrs |
| Osmotic & K Sparing diuretics | osmotic-Work mostly in the proximal tubule & descending loop (entire nephron) potassium-sparing- Work in collecting ducts and distal convoluted tubules |
| Interfere with sodium-potassium exchange | thiazide-Inhibit tubular resorption of Na, Ch and K ions; Action primarily in the distal convoluted tubule Dizziness, HA, tinnitus, blurred vision, N/V/D, Agranulocytosis, neutropenia, thrombocytopenia, hypokalemia, hyperglycemia, hyperuricemia |
Created by:
ethompso08
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