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SurfaceTest2Pharm1
| Question | Answer |
|---|---|
| What is assay? | Chemical or biological technique by which the strength and purity of a drug are measured |
| OTC drug study in 1983 | Approximately 1/3 of these drugs were safe and effective for labeled use |
| Generic drugs | Nearly every state has a drug substitution law that permits/mandates this substitution by the pharmacist. |
| Controlled Substances | Physicians were unable to write narcotic Rx for an addicted individual even if it was part of the cure |
| Black box warning | Most serious type of warning label by FDA |
| When does product liability exist? | Product is defective/not fit for uses Defect arose before product left control of manufacturer **Defect caused someone harm** |
| What are observable physical defects of drugs and what do you do about it? | Unusual discoloration, precipitates, inconsistencies, foreign body in fluids. Withhold med and contact pharmacy or other authoritative source. |
| What do we look for in preclinical testing? | Toxicity(acute,subacute,chronic) Therapeutic index Modes of absorption, distribution, metabolism, and excretion |
| Goals of clinical testing | determine clinical effectiveness and drug safety, establish tolerated dose/range |
| Clinical testing phase I | determines pharmacokinetics on a small group of healthy people |
| Clinical testing phase II | Selected individuals with the targeted disease (100-300 people) that are monitored closely for side effects/effectiveness |
| Clinical testing phase III | Extended clinical evaluation done in various centers in U.S. on around 1000-3000 people |
| Clinical testing phase IV | Postmarketing surveillance dependent on volunatry reporting of people in medical field. Kept confidential |
| Nonmalfeasance | Do no harm |
| Nurse's ethics | Guidance for nurse's actions |
| Nurse's responsibilities to the client | Promote health, prevent illness, restore health, alleviate suffering, respect client wishes and views |
| Basic guidelines for litigation-free, professional nursing practice | Know limits as a nurse, know limits in skills/experiences, inform involved personell and document all happenings, maintain professional caring and collaborative relationship with client and family |
| Can you relieve a nurse from responsibility for their actions? | No |
| Legal requirements before medication administration | Med order must be valid, prescriber and nurse must be licensed, nurse must know all about the drug being given |
| Why do we check with patient first about beliefs and practices? | They vary from individual to individual |
| Justice | Fair and equal treatment for all |
| What can the nurse function within to prevent harm from clients, themselves, professional reputation, and job? | Accepted boundaries of practice, stretch for new knowledge, act accountably for benefit of client |
| Beneficence | Do good |
| Possible cultural practices | Folk medicines, home remedies, amulets, balances in good/evil |
| Integrity | Stay true to your word |
| Fidelity | faithful to obligations |
| State nurse practice acts | Protect public from unskilled, undereducated, or unlicensed nurses. Delineate clearly scope of nursing as a healthcare profession. Protect nurses by clearly defining responsibilites/freedoms Some states have almost no barriers while others do. |
| Nursing practice is regulated by ______ | Drug standards, legislation, individual state nurse practice acts, joint policy statements, insitutional/agency policy |
| Nuremberg Code | Rights of human participants are protected during medical research |
| Drug suppliers, hospitals, physicians, pharmacists, and nurses are individually and collectively responisble for accounting for what? | Inventory and flow/distribution of controlled substances. (nurse/computer counts ALL controlled substances) |
| Limitations of drug testing | # of volunteers, time allotment, pregnant women, multiple diseases/meds, children, women, older adults |
| Double blind study | Subject receives either drug or placebo. Subject and researcher do no know which is drug/placebo. |
| What are antibacterial topical opthalmic drugs often used for and why? | treat most gram + |
| What is assay? | Chemical or biological technique by which the strength and purity of a drug are measured |
| OTC drug study in 1983 | Approximately 1/3 of these drugs were safe and effective for labeled use |
| Generic drugs | Nearly every state has a drug substitution law that permits/mandates this substitution by the pharmacist. |
| Controlled Substances | Physicians were unable to write narcotic Rx for an addicted individual even if it was part of the cure |
| Black box warning | Most serious type of warning label by FDA |
| When does product liability exist? | Product is defective/not fit for uses Defect arose before product left control of manufacturer **Defect caused someone harm** |
| What are observable physical defects of drugs and what do you do about it? | Unusual discoloration, precipitates, inconsistencies, foreign body in fluids. Withhold med and contact pharmacy or other authoritative source. |
| What do we look for in preclinical testing? | Toxicity(acute,subacute,chronic) Therapeutic index Modes of absorption, distribution, metabolism, and excretion |
| Goals of clinical testing | determine clinical effectiveness and drug safety, establish tolerated dose/range |
| Clinical testing phase I | determines pharmacokinetics on a small group of healthy people |
| Clinical testing phase II | Selected individuals with the targeted disease (100-300 people) that are monitored closely for side effects/effectiveness |
| Clinical testing phase III | Extended clinical evaluation done in various centers in U.S. on around 1000-3000 people |
| Clinical testing phase IV | Postmarketing surveillance dependent on volunatry reporting of people in medical field. Kept confidential |
| Nonmalfeasance | Do no harm |
| Nurse's ethics | Guidance for nurse's actions |
| Nurse's responsibilities to the client | Promote health, prevent illness, restore health, alleviate suffering, respect client wishes and views |
| Basic guidelines for litigation-free, professional nursing practice | Know limits as a nurse, know limits in skills/experiences, inform involved personell and document all happenings, maintain professional caring and collaborative relationship with client and family |
| Can you relieve a nurse from responsibility for their actions? | No |
| Legal requirements before medication administration | Med order must be valid, prescriber and nurse must be licensed, nurse must know all about the drug being given |
| Why do we check with patient first about beliefs and practices? | They vary from individual to individual |
| Justice | Fair and equal treatment for all |
| What can the nurse function within to prevent harm from clients, themselves, professional reputation, and job? | Accepted boundaries of practice, stretch for new knowledge, act accountably for benefit of client |
| Beneficence | Do good |
| Possible cultural practices | Folk medicines, home remedies, amulets, balances in good/evil |
| Integrity | Stay true to your word |
| Fidelity | faithful to obligations |
| State nurse practice acts | Protect public from unskilled, undereducated, or unlicensed nurses. Delineate clearly scope of nursing as a healthcare profession. Protect nurses by clearly defining responsibilites/freedoms Some states have almost no barriers while others do. |
| Nursing practice is regulated by ______ | Drug standards, legislation, individual state nurse practice acts, joint policy statements, insitutional/agency policy |
| Nuremberg Code | Rights of human participants are protected during medical research |
| Drug suppliers, hospitals, physicians, pharmacists, and nurses are individually and collectively responisble for accounting for what? | Inventory and flow/distribution of controlled substances. (nurse/computer counts ALL controlled substances) |
| Limitations of drug testing | # of volunteers, time allotment, pregnant women, multiple diseases/meds, children, women, older adults |
| Double blind study | Subject receives either drug or placebo. Subject and researcher do no know which is drug/placebo. |
| What are antibacterial topical opthalmic drugs often used for and why? | treat most gram +/- organisms decreased risk of systemic side effects/toxicity may have local irritation *contraindicated in epithelial herpes simplex kertitis, vaccinia, varicella, and hypersensitivity |
| Why do eye infections require prompt treatment? | Prevents spread and drainage to eye |
| Anti-infective drugs | Administered systemically/locally, antibiotics, antifungals, and antivirals |
| Rose bengal | rose color, stains dead epithelial cells, used for routine exams, used when superficial cornea/conjunctival tissue change is expected |
| Florescein sodium | nontoxic, watersoluble dye can be applied to cornea stains scratches and leaves ring of bright green around foreign bodies Areas with loss of conjunctiva stained yellow appears in nasal drainage impregnated on dry filter paper |
| Paternal | the nurse or doctor decides what is best for patient without their consent |
| Anti-inflammatory drugs (NSAIDS and corticosteroids) | Indicated in certain nonpyogenic inflammatory conditions of the eye to control inflammation and ultimately reduce amount of permanent scarring or visual loss |
| Use of corticosteroids | Most commonly used in acute ocular disorders cause by hypersensitivity |
| What do we monitor with steriods? | signs of infections because they decrease defense mechanisms |
| What do steroids topically increase? | Short term use only, delays wound healing, incidence of glaucoma/cataracts, has potential for fungal infections |
| NSAIDS | Decrease prosteglandin concentrations in the eye. May decrease inflammation/itching |
| Properties of NSAIDS | analgesic, antipyretic, anti-inflammatory |
| Contraindications with NSAIDS | Hypersensitivity, fungal/viral infection, acute infection, TB, ocular herpes simplex |
| Adverse effects of NSAIDS | increase IOP, glaucoma, impaired healing, masked s/s of infection, irritation of eye |
| When do systemic side effects occur with NSAIDS? | Prolonged use |
| Local anesthetics | inhibit pain sensation so eye can be examined, foreign bodies removed, or superficial surgery performed |
| When does anesthesia start working? | Produces anesthesia in 13-36 seconds and lasts 15-20 minutes |
| Side effects of local anesthetics | Can delay wound healing |
| Prolonged use of local anesthetics | permanent corneal opacification, scarring, systemic absorption can cause CNS disturbances |
| Contraindications with local anesthetics | Hypersensitivity Cautiously give to patients with heart disease or hyperthyroidism |
| Lubricants | May be needed by healthy people to replace tears or moisten contacts/superficial eyes Ill people need it during unconsciousness Protects eye during procedures/surgery |
| What do lubricants contain/ | Balanced amount of salts to maintain ocular tonicity |
| Excessive use of lubricants | can dry on eyes or leave sandlike granules. Need to wash out with sterile eye-irrigating solution |
| Petrolatum-based lubricants | applied to hard contacts to lubricate before insertion. Added to other eye products to prolong contact time |
| Andrenergic drugs | Causes vasoconstriction while dilating the eyes. 1-2 drops given every 3-4 hours prn |
| Andrenergic drugs may temporarily relieve ______ | itching, minor irritaion caused by chemical/mechanical irritants, immediate type allergic reactions |
| Mydriasis | dilated pupils |
| Cytoplegia | blurred vision |
| Anticholinergic drugs | block muscarinic receptors of spincter muscles and paralyze cilary muscles. removed through systemic circulation used for exams/treatment of inflammation |
| Anticholinergic drug of choice and why? | Atropine. It is potent, long acting, refraction measurement, relaxes eye muscles, treats inflammation |
| Glaucoma | 3rd leading cause of visual impairment and blindness in U.S. Blindness results from damage to optic nerve cause by increased IOP |
| Cause of inc | |
| Why do eye infections require prompt treatment? | Prevents spread and drainage to eye |
| Anti-infective drugs | Administered systemically/locally, antibiotics, antifungals, and antivirals |
| Rose bengal | rose color, stains dead epithelial cells, used for routine exams, used when superficial cornea/conjunctival tissue change is expected |
| Florescein sodium | nontoxic, watersoluble dye can be applied to cornea stains scratches and leaves ring of bright green around foreign bodies Areas with loss of conjunctiva stained yellow appears in nasal drainage impregnated on dry filter paper |
| Paternal | the nurse or doctor decides what is best for patient without their consent |
| Anti-inflammatory drugs (NSAIDS and corticosteroids) | Indicated in certain nonpyogenic inflammatory conditions of the eye to control inflammation and ultimately reduce amount of permanent scarring or visual loss |
| Use of corticosteroids | Most commonly used in acute ocular disorders cause by hypersensitivity |
| What do we monitor with steriods? | signs of infections because they decrease defense mechanisms |
| What do steroids topically increase? | Short term use only, delays wound healing, incidence of glaucoma/cataracts, has potential for fungal infections |
| NSAIDS | Decrease prosteglandin concentrations in the eye. May decrease inflammation/itching |
| Properties of NSAIDS | analgesic, antipyretic, anti-inflammatory |
| Contraindications with NSAIDS | Hypersensitivity, fungal/viral infection, acute infection, TB, ocular herpes simplex |
| Adverse effects of NSAIDS | increase IOP, glaucoma, impaired healing, masked s/s of infection, irritation of eye |
| When do systemic side effects occur with NSAIDS? | Prolonged use |
| Local anesthetics | inhibit pain sensation so eye can be examined, foreign bodies removed, or superficial surgery performed |
| When does anesthesia start working? | Produces anesthesia in 13-36 seconds and lasts 15-20 minutes |
| Side effects of local anesthetics | Can delay wound healing |
| Prolonged use of local anesthetics | permanent corneal opacification, scarring, systemic absorption can cause CNS disturbances |
| Contraindications with local anesthetics | Hypersensitivity Cautiously give to patients with heart disease or hyperthyroidism |
| Lubricants | May be needed by healthy people to replace tears or moisten contacts/superficial eyes Ill people need it during unconsciousness Protects eye during procedures/surgery |
| What do lubricants contain/ | Balanced amount of salts to maintain ocular tonicity |
| Excessive use of lubricants | can dry on eyes or leave sandlike granules. Need to wash out with sterile eye-irrigating solution |
| Petrolatum-based lubricants | applied to hard contacts to lubricate before insertion. Added to other eye products to prolong contact time |
| Andrenergic drugs | Causes vasoconstriction while dilating the eyes. 1-2 drops given every 3-4 hours prn |
| Andrenergic drugs may temporarily relieve ______ | itching, minor irritaion caused by chemical/mechanical irritants, immediate type allergic reactions |
| Mydriasis | dilated pupils |
| Cytoplegia | blurred vision |
| Anticholinergic drugs | block muscarinic receptors of spincter muscles and paralyze cilary muscles. removed through systemic circulation used for exams/treatment of inflammation |
| Anticholinergic drug of choice and why? | Atropine. It is potent, long acting, refraction measurement, relaxes eye muscles, treats inflammation |
| Glaucoma | 3rd leading cause of visual impairment and blindness in U.S. Blindness results from damage to optic nerve cause by increased IOP |
| Cause of increased IOP | accumulation of aqueous humor in space between lens and cornea |
| Aqueous humor | protein poor fluid formed by ciliary body. Reabsorbed through trabecular spaces then to Schlemm's canal then into anterior chamber of cornea |
| Chronic (open angle) Glaucoma | more common form, very gradual in onset, slow degeneration of anterior chamber, drug therapy used to improve uptake |
| beta-blockers | decreases production of aqueous humor, applied directly to eye, onset 30-60 minutes, drug of choice for initial treatment of chronic glaucoma |
| beta-blockers can cause __________ | ocular pain, dizziness, headache, redness, blurred vision, different pupil size, discoloration of eye color, double vision |
| beta-blockers are not used for __________ | severe CVD, COPD, asthma *Can mask s/s of hypoglycemia/hyperthyroidism |
| beta-blocker drugs | Betaxolol (betoptic)- selective for patients with pulmonary problem Timolol (timoptic)- treats glaucoma r/t specific cause generally better tolerated |
| epinepherine | stimulates alpha and beta adrenergic receptors decreases production of aqueous humor dilates pupil treats chronic glaucoma |
| systemic effects with epinepherine | care is given to those with a history of hypertension, arrythmias, hyperthyroidism, or recent MI |
| Propine | prodrug converted to epinepherine by esterases in cornea. more lipid soluble than epinepherine. concentrates in eye more rapidly. less burning/irritation. fewer allergic reactions |
| pilocarpine and carbachol | direct acting cholinomimetic drugs. mimic action of neurotransmitter acetylcholine. constrics pupil through miosis. therapeutic effects are from spread of trabecular space. the larger area allows uptake of aqueous humor |
| carbachol | more potent and slightly longer acting than pilocarpine |
| use of pilocarpine | used in emergency acute angle glaucoma before and after surgery. counteracts effects of sycloplegics and mydriatics after eye exam |
| uses of carbachol | replacement drug when eyes become resistent to pilocarpine. induces miosis during ocular surgery |
| most common side effects of pilocarpine | stinging and local irritation |
| carbachol and pilocarpine counteract __________ | anticholinergic effects of atropine and other anticholinergics |
| anticholinesterase miotics | inhibit degradation of acetylcholine causes miosis spread of trabecular spaces improved uptake of aqueous humor |
| What are potent miotics generally used for? | only for patients with chronic glaucoma that is not well controlled by other agents |
| what do miotics inhibit? | accomodation; poor vision in dim light |
| side effects of miotics | browaches, ocular pain, ciliary/conjunctival congestions, tearing, eyebrow twitching |
| contraindications of miotics | pregnant, retinal detachment, uveitis |
| acetazolamide | blocks ocular carbonic anhydrase causing decreased formation of aqueous humor by 50-60% Only patient with glaucoma have fall in IOP Not for long term use/pregnancy Increases urine pH May precipitate acute pulmonary failure in COPD/ flare up gout |
| Carbonic anhydrase inhibitors | acetazolamide, brinzolamide, dorolamide (do not give to patients with hx of kidney stones), methazolamide |
| Xalatan | analog of prostaglandin F2 increases outflow of aqueous humor changes eye color as effective as beta-blocker with less side effects |
| effects of Xalatan | stinging, blurred vision, redness, feeling of foreign body in eye |
| Osmotic agents | short term treatment only. lowers IOP of glaucoma before surgery. emergency treatment of acute glaucoma |
| Mannitol | Given IV to lower IOP in 30-60 minutes. Lasts 6-8 hours. Has pronounced diuresis, headache, nasuea, vomiting, and dehydration |
Created by:
cbelcher
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