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Pharm Review Midtrm

Pharm midter

QuestionAnswer
What are Vasodilators? Drugs used to relax the muscles controlling blood vessels, which will increase blood flow
What conditions can vasodilators be used for? Renal failure, CHF, HTN
What are the different types of vasodilators? Beta Blockers, Angiotensin Converting Enzyme (ACE) Inhibitors, Angiotensin Receptor Blockers, Calcium channel Blockers (VND),
Effect of vasodilators on the blood Increase blood flow, decrease HR, decrease force of contraction of heart
Effect of vasodilators on oxygen consumption Decrease O2 consumption
Vasodilators can be used alone or with other drugs for the treatment HTN and CHF
Renal blood flow Volume of blood delivered to the kidneys per unit time, about 25% of CO goes to the kidney
Different structures where blood goes in the kidney Renal arteries, 5 segmental arteries. Lobular arteries, interlobular arteries, afferent arterioles, Glomerulus, Efferent arterioles, peritubular capillary network, venus channel, Inferior vena cava
Aldosterone cause what? Retention of sodium (water) from the kidney
Renin cause what? Convert angiotensinogen to angiotensin I and create vasoconstriction
What stimulate the release of renin? Reduced blood flow to the kidney
Angiotensin cause what? Vasoconstriction and release of aldosterone
The role of the renal tubule Reabsorbtion of ions and nutrients, especially Sodium, Secretion of H, K,
The role of glomerulus Filtration of substances from the blood to the nephron
Causes of renal failure Diabetes, A sudden, serious drop in blood flow to the kidneys, Damage from some medicines, poisons, or infections, A sudden blockage that stops urine from flowing out of the kidneys, HTN, CHF,
What are the 4 elements removed by kidney Water, Sodium, Potassium, and Hydrogen
Mechanism of Diuretics Promote water loss in the urine by: -Blocking the production of H+ and bicarbonate (HCO3-) ions; -Blocking the exchange of H+ for Na+; -Blocking the exchange of K+ for Na+; -Creating an osmotic gradient through a concentration of non-absorbable molecules
Different classes of Diuretics, how many 5 classes Osmotic diuretics; Organic acids Thiazide and thiazide-like Potassium-sparing Carbonic anhydrase inhibitors
Reduce the production of hydrogen ions to exchange for sodium ions so water stays with sodium ions, refractory Carbonic Anhydrase Inhibitors
Enter the tubules but cannot be reabsorbed so water stays with the concentration of diuretic molecules, non-refractory Osmotic Diuretics
Inhibit sodium and chloride ion exchange in the tubule loop of Henle, non-refractory, Most common and strongest form of diuretic Organic Acids (Loop diuretics)
Inhibit sodium ion reabsorption by multiple mechanisms along the renal tubules, nonrefractory Thiazide and Thiazide-like Diuretics
Inhibit K+ exchange for Na+ in the distal renal tubules Potassium-Sparing Diuretics
Which Diuretics are the strongest? Why? Organic/Loop diuretic. It’s non refractory, inhibit sodium and chloride ion exchange, result in a high amount of sodium and water loss.
Which Diuretics are mild and have lesser effect on electrolyte balance? Osmotic. The drug had large molecules that cannot be reabsorb my blood, so it has to follow urine secretion, and the drug attract water, no effect on any electrolyte balance.
Which Diuretics are more potent and run the risk of serious electrolyte imbalance? Organic/Loop diuretics
Side effects of different types of Diuretics Nausea; Diarrhea; Constipation; Headache; Anorexia; Hypotension (from water loss); Dizzy, lightheaded, faint; Hypokalemia (from ion exchange); Hyperuricemia, Neurotoxicity (Loop)
Diuretics effects on water, sodium Most of diuretic increase loss of sodium and water
Which Diuretics causes greater loss of K+ and which will spare K+ Loop for loss and Potassium sparing diuretic spare K
Conditions Diuretics are used for HTN, renal diseases, CHF, Edema. Glaucoma
What do local anesthetics do? Prevent or interrupt painful stimulation, or adjunct to another medication
Local Anesthetic/ side effects and toxic doses SAMS, Slurred speech, Altered CNS (drowsiness, dizziness, nervousness, confusion), Muscles Twitching (tremors), Seizures (convulsions, Resp depression)
Types of local Anesthetic that cause arrhythmias Amides. They are long lasting and go in all the circulatory system.
How Anesthetic are administered/applied topical, Intradermal, spinal, epidural, caudal, infiltration
The deposition of a solution directly into tissue Infiltration
Epinephrine with anesthetics, what changes in action and duration occur? Epinephrine is added to amide local anesthetics to constrict blood vessels and keep the drug at the site of action longer
Conduction blockade sequence 1.Small unmyelinated-sensory, autonomic; 2.Intermediate myelinated-preganglionic; 3.Large myelinated-motor, visceral sensory
Stages/phases of Anesthesia Onset, Excitement, Surgical anesthesia and danger.
OTC Anesthetics procaine, tetracaine, lidocaine, bupivacaine, prilocaine
Bacteriostatic vs Bacteriocidal drugs Cidal kill microorganism, statics inhibit the growth.
Spherical in shape and usually arranged in pairs (diplo), chains (strepto), or clusters (staphylo) Cocci
Rod-like in shape Bacilli
Curved and rod-like in shape Spirilla
Bacteria that take up the blue stain Gram positive, Gm(+)
Bacteria that take up the red stain Gram negative, Gm(-)
Which bacteria produce beta-lactamases, and what effect will this have on the body and the effectiveness of the drug? Gram Negative bacteria. They alter the outcome of ABT. They inactivate Penicillin and Cephalosporin
Cephalosporins Bacteriocidal, Not if allergic to penicillin,
Tetracycline, shouldn’t be taken with what? Dairy or antacid products, Bacteriostatic, contra if pregnant, nursing or children <8
Aminoglycosides Bacteriocidal, broad spectrum, Peak and through, Oto and Nephro toxicity
Penicillins Bacteriocidal
Bacteriocidal ABT Peniccilin, Cephalosporin, Aminoglycosides, Fluroquinolones
Bacteriostatic ABT Tetracyclines, Sulfonamides, Macrolide
Difference between antiseptics and disinfectants Antiseptics for living tissues, disinfectant on non-living surfaces.
Antiseptics: types, uses, side effects Static and cidal, Reduce the growth and contamination of wounds (burns, skin ulcers), Eliminate microorganism from entering punctures encountered in procedures such as spinal, regional anesthesia, blood draws for clinical laboratory analysis
Topical adverse effects of Antiseptics Dry skin, rash, hypersensitivity
Internal adverse effects of Antiseptics Anorexia, Vomiting, Internal cramping, Convulsions, Death
Disinfectants: types, uses, side effects Reduce the need for antibiotics by eliminating potential pathogenic infectious organic material on nonliving surfaces
Different types of sterilization Dry heat sterilization; Moist heat sterilization; Chemical sterilization; Radiation sterilization; Filtration
Pertaining to a procedure or substance that prevents, alleviates, or corrects an abnormal cardiac rhythm Antiarrhythmic
Inhibit the formation of angiotensin which is a potent vasoconstrictor, Inhibit the conversion of angiotensin I to angiotensin II Angiotensin-converting Enzyme inhibitors
An area in the heart that initiates abnormal beats Ectopic Focus
Preferred drug treatment for CHF cardiac glycoside, Digoxin.
What is CHF? What happens? Weakening of the contractile function of the heart, blood and fluid accumulate in the heart, lungs, abdomen, and lower extremities, decreased cardiac output and blood pressure are unable to meet body requirements
How are cardiac glycosides able to improve symptoms of CHF? Increase the force of contraction of myocardium and decrease the heart rate.
What to check before giving a cardiac glycoside? Pulse below 60, serum blood level at 0.5-2mg/mL Potassium not too high and not too low.
Cardiac glycoside treat CHF and Atria arrhythmias and atria fibulation
What impact can K+ levels have on therapeutic action of a cardiac glycoside? Low Potassium will increase drug toxicity can lead to cardiac arrhythmias; High Potassium will decrease the action of the cardiac glycosides (the drug will not work)
Adverse effects of Cardiac glycosides HA, dizziness, nausea, vomiting
Mild overdose symptoms of cardiac glycosides Visual disturbances “halo effect” around lights
Major overdose symptoms of cardiac glycosides Bradycardia, ectopic beats, and a variety of other cardiac arrhythmias
Coagulation Process of making a clot
Infarction Complete blockage of something
Thromboembolism Clot that block something, form a plug, can block a blood vessel
Conditions used for Anticoagulant Prevention or treatment of venous thrombosis, pulmonary embolism, and atrial fibrillation with embolism
Potential complications/Adverse reaction of anticoagulant drugs Hematuria, Bleeding gums, Nausea, Diarrhea, Urticaria, Alopecia, Hemorrhage
Aggregation and how it is related to clot formation Process of platelet sticking together, it’s a big part of formation of a clot
Thrombolytic enzymes Dissolve clot already formed
Anticoagulants classes, routes Heparin (ardeparin, dalteprin)=IV, Coumarins/Warfarin=Oral
Antidote for Heparin Protamine sulfate
Antidote for Coumarin Vitamin K, takes 72 hours to work
The formation, presence, or development of a thrombus (clot) Thrombosis
High risk area for thrombosis Legs
Allergic reactions Snizzing, coughing, itching, HA, nasal congestion
What do calcium Channel Blockers drugs do? Vasodialator, Block the influx of calcium into the heart and arterial blood vessels
What do ACE-Angiotensin-Converting Enzyme-inhibitors do? Vasodialator, Inhibit the formation of angiotensin which is a potent vasoconstrictor; Decrease the release of aldosterone which retains sodium and water.
Used to block the physiological effects of histamine after exposure to allergen Antihistamines
Used to inhibit the physiological effects of histamine before exposure to allergen Antiallergics
How many different types of antihistamines Chlorpheniramine (Chlor-Trimeton), Diphenhydramine (Benadryl),
Antihistamine Adverse Effects Drowsiness, Mental confusion, Sedation, Dry mouth, Anorexia, Epigastric distress, Hypotension, Tachycardia, Urinary retention, Dysrhythmias
What types of clients are safe to take antihistamines? Not if hx of HTN, Cardiovascular disease, Urinary retention, Stenosing peptic ulcer, CNS depression, nursing mothers, dehydrated children.
Foods rich in potassium fruits
Foods rich in B12 Clams, Oysters, and Mussels, Liver, Caviar (Fish Eggs), Octopus, Fish, Crab and Lobster, Beef, Lamb (Mutton), Cheese
Ester local anesthetic Esters-benzocaine, procaine, tetracaine; Amides-lidocaine, bupivacaine, prilocaine
Heparin Anticoagulant, IV, Inhibit cloating factor, Adv effects, Bleeding,
H1 receptor antagonist Acts on blood vessels and gastrointestinal and respiratory systems by competing with histamine for H1 receptor sites; decreases allergic response by blocking histamine
Cromolyn sodium Antiallergic, anti-inflammatory, Asthma
Dimenhydrinate Antihistamine, Histamine-1 Receptor Antagonist; motion sickness, nausea, vomiting
Promethazine Antihistamine
Desloratidine Antihistamine, Histamine-1 Receptor Antagonist
Chlorpheniramine Antihistamine, Histamine-1 Receptor Antagonist
Cyproheptadine Antihistamine
Hydroxyzine Antihistamine
Hydralazine Antihypertensive, Arteriolar vasodilator,HTN, Heart failure, Pre-eclampsia, Pulmonary hypertension, Malignant hypertension
Verapamil Calcium Channel Blocker, HTN, Angina, Heart attack, Supraventricular tachycardia, Prinzmetal's angina
Azatadine Antihistamine
Certirizine Antihistamine, Histamine-1 Receptor Antagonist
Fexofenadine Antihistamine, Histamine-1 Receptor Antagonist
Loratidine Antihistamine, Histamine-1 Receptor Antagonist
Digoxin Cardiac glycoside, Heart failure, Atrial fibrillation, Atrial flutter, Check BP, increase HR
Digitoxin Cardiac glycoside, Heart failure, Atrial fibrillation, Atrial flutter
Albuterol Beta Blocker, Asthma
Theophylline Methylxanthine, Asthma, Emphysema, Slow heartbeat, Acute bronchitis,Stopped breathing, Bronchospasm
Erythromycin Macrolide Antibiotic, Acne, Chlamydia bacteria infection, Pertussis,
Azithromycin Macrolide Antibiotic, Chlamydia bacteria infection, Gonorrhea
Created by: fausfez