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NPN 139 Pharmacology 2 final at BGTC 5/7/13

Drug Therapy for pediatric patients, Medicines effect peds differently, how? absorption slower gastric emptying distribution 75% body is water, require higher dose of water soluble drug metabolism develop at different stages excretion kidneys are not completely mature till 1 yr
Determining pediactric dosage Body Surface Area (physicians use) and weight/kg
Where do you give an IM injection to a kid under 3? vastus laterus
Where do you give an IM injection to a kid over 3? dorso gluteal
How do you administer ear drops to a child? down and back/out
If child ingests a poisionous medication what can you give them? syrup of ipecac
If child ingests a poision, who do you call? poision control
Polypharmacy taking numerous medications on daily basis
Drug therapy in the Elderly; medications effect elderly differently how? blood flow decreases to the GI tract, decrease in GI secretions-absorption decreases, fatty tissues increase-decreases activity or prolonged activity in many drugs, decreased binding sites, decreases blood flow to liver leading to toxicity
IM injection preferred site for the elderly? ventrogluteal
Asepsis free of pathogenic microorganisms
medical aspesis "clean technique" inhibits growth
surgical aspesis "sterile technique" destroys/abscent from microorganisms
Principles of sterile technique sterile objects remain sterile when touched only by sterile, only sterile can be place on sterile field, sterile objects our of sight/held below waist become contaminated, if field becomes wet contaminated, edges (1 in) contaminated
Sympathetic (Adrenergic) System Fight or Flight, increases processes when faced with stress, supresses those body functions not vital during stressful situation
Examples of body reactions for Sympathetic pupils dilate, heart rate increase, blood vessels dilate
Receptors in the Sympathetic System alpha 1 beta 1 beta 2
Alpha1 found in smooth muscles of the peripheral blood vessels, GI GU tracts, when stimulated cause constriction, BP increases, used commonly in hypotension meds
Beta1 primarily found in the heart, when stimulated increases heart rate, force, and contractions
Beta2 primarily found in bronchial smooth muscles (lungs) when stimulated bronchodilation meaning OPENS UP airways
Parasympathetic (Cholinergic) opposite of sympathetic, directed in conversing energy; increased acid secretions, salvation, decrease heart rate and BP, pupil constriction, promotes sweating, increased elimination
4 classes/agentsof drugs that effect the Autonomic Nervous System 1.Sympathetic or Adrenergic Agents 2.Sypatholytics or Adrenegic Blockers 3.Parasympathominetics or Cholinergics 4.Parasympatholytic or Anticholinergic
Adrenergic Agents mimic the sympathetic nervous system
Adrenergic Blockers stop/block adrenergic system, decreases/constrict
Cholinergics mimics parasympathetic, increases secretions conserves energy increases SLUD
Anticholinergic antiSLUD, decreases or stops SLUD
What is the main function of the Respiratory System? Gas Exchange
Medications Effecting Respiratory System Antihistamines Decongestants Antitussives Mucolytics Expectorants Topical Nasal Steroids Bronchodilators Corticosteroids Xanthine Bronchodilators
Antihistamines Benadryl, Phenergan, Zyrtec, Allegra block action of histamines, limits vasodilation, edema, produces anti-cholinergic effect, also has sedative effect.
Decongestants Ephedrine, Epinephrine, Afrin/Oxymetazoline Sudafed/pseudoephrine action effects all alpha receptors, vasoconstriction, reducing blood flow, fluid movement, and mucousal edema, shrinks it tightens up. Used for allergies, Upper Resp Inf, Reactions nasal stinging, dryness, rebound congestion. Do not use more than 3-5 days
Antitussives Codeine, Hydrocodone, Benzonatate/Tessalon Perles act centrally on the cough center in the brain, numbs receptors in the respiratory tract; used for overactive,nonproductive cough. Narcotic/nonnarcotic. Reactions: constipations, drowsiness, dry mouth, othostatic hypotension. Can cause addiction
Mucolytics Mucomyst/Acetylcysteine reduce the thickness of secretions, used for chronic respiratory conditions. Reactions:NVF broncho spasms, irritation to throat/trachea/bronchis. Drink plenty of fluids
Expectorants Robituusin/Guaifenesin (expell) agents decrease thickness of secretions by increasing fluids in respiratory tract. Used for productive coughs, chronic respiratory diseases, Reaction: GI upset, Used for short term ONLY, not for persistant coughs, drink fluids, humidifier
Topical Intranasal Steroids Beconase, Rhinocort, Nasalide, Flonase anti-inflammatory effect, decrease local congestion
Bronchodilators Albuterol/Proventil, Epinephrine, Salemeterol/Serevent, Metaproterenol, Levabuterol, Foradil open up the bronchi, allows air to pass through, Gets O2 in and CO2 out, 2 types: Sympathomimetic and Xanthine,
Xanthine Bronchodilators Aminophylline, Theophylline related to caffeine, relax smooth muscles in bronchi & blood vessels in lungs, reduces swelling
Leukotriene Receptor Inhibitors Montelukast/Singulair, Accolate, Zyflo newer category for asthma, not a bronchodilator, block leukotrienes which are potent bronchoconstrictors
Mast Cell Stabilizers Cromolyn/Intal, Nedocromil/Tilade inhibit the release of substance histamine, use forprophylaxis in asthma, food allergies, allergic rhinitis, Reactions: dizzy HA, N
Corticosteroids Inhaled: Vanceril, Pulmicort, AeroBid, Flovent, Azmacort Systemic: Methylprednisolone, Predisolone, Prednisone relaxes muscles/open up. long term use for Asthma
Quick Acting for Asthma Beta2 Agonists, Anticholinergics
Long Term acting for Asthma Leukotriene Receptor Inhibitors, Xanthine Bronchodilator, Anticholingerics, corticosteroids
Hormones chmeical made in an organ or gland carried in blood stream to another part of the body
Steroid specific group of hormones that have a powerful effect on cell sensitivity healing & development
Insulin help glucose move into target tissues for energy. lovers blood glucose levels
S/S of Hypoglycemia nervousness, hungry, malaise, cold-clammy hands, change in LOC, lethargy, pallor, shallow resp
onset when insulin first begins
peak when insulin is exerting its maximum action highest point
duration length of time insulin remains in effect
When mixing insulins, which do you draw up first? CLEAR TO CLOUDY, never shake, roll, given subq open vials can only keep for 1 month
which insulin can be given IV? Regular
Sliding scale Insulin Administration the nurse admin supplemental insulin based on blood glucose readings and amount and type prescribed by healthcare provider
Androgens male sex hormones develop secondary male sex characteristics
Abortifacients abort fetus
Oxytocic Agents Pitocin, Oxytocin cause uterus to contract help labor, act on smooth muscles of uterus & stimulate milk flow
Uterine Relaxins relax uterus
Tocolytics stop preterm labor
Androgen Hormone Inhibitor Proscar/finasteride inhibits conversion of testosterone into DHT which the prostate gland is dependent on.can treat male pattern bladness, treats S/S of benign prostate hyperplasia
Erectile Dysfunction Viagra, Cialis, Levitra inability to obtain/maintain an erection suffiecent for sexual intercourse
Thyroid gland in neck, produces hormones, comes from anterior pituitary gland, helps maintain metabolism actice of tyroid
Hypothyroidism underactive thyroid
Hyperthyroidism overactive thyroid
Antithyroid Iodine Products, Methimazole/Tapazole stops new production of thyroid hormones, used for hyperthyroidism
Drugs for BPH Proscar, Flomaz, Hytrin BPH: Benign Prostatic Hyperplasia, non-cancerous, overgrowth of prostate gland can become a problem with voiding, adverse reaction: orthostatic hypotension
Drugs fors Urinary Tract Analgesia Phenazopyridine/Pyridium Treat UTI/pain relief, makes urine orange/red, S/S: urengency
Urinary Anti-Infectives Nalidixic Acid/Neg Gram, Furandantin antiseptic action, short term, treats acute, chronic, reoccuring UTI's, increase cranberry juice & fluids
Diurectics drugs used to remove sodium & water from body, treat hypertension
Thiazide Diurectics Chlorothiazide, Hydrochlorothiazide, Metalazone inhibit sodium & chloride reabsorption, does not spare postassium goes with sodium
Loop Diurectic Furosemide/Lasix, Bumetanide/Bumex, Torsemide/Demadex promote sodium & fluid secretions, cannot save potassium, can cause hypokalemia
Potassium Sparing Diurectic Spironolactone/Aldactone, Triamterene/Dyrenium inhibit potassium excretion while allowing fluid excretion
Osmotic Diurectic Mannitol/Osmitrol used in treatment for increased intracranial pressure
Carbonic Anhydrase Inhibitors Acetazolamide/Diamox promote water and sodium scretions. Used in intracranial pressure associated with gloucomma, form eye drops
Electrolytes ions required yby cells to regulate electrical change and flow of water molecules across cell membranes
Bicarbonate NaHCO3 mineral, viable to acid base balance, vital electrolyte to acid base 22-24mEq/L
Calcium Phoslo, Caltrate, Tums EX, Citracal mineral, necessary for function of nerves, muscles, blood clotting, building teeth & bones, 4-5 mEq/L
Magnesium Magnesium Sulfate, Slow Mag, MgSO4 transmission of nerve impulses, activity to enzyme action, 1.5-2.5mEq/L
Potassium Potassium Chloride necessary for nerve impulses, muscle contraction, 3.5-5.5 mEq/L
Sodium Sodium Chloride,Normal Saline normal heart action & regulation of osmotic pressure in the cells
Combined Electrolyte Solutions Pedialtye, D51/2NS, D5NS, LR
Vitamins chemical compund that is found naturally in the human body
Vitamin A fat soluble helps eyes adjust from light to dark, helps fight infection dairy products, eggs, organ meats, oranges, yellow/green fruit, veggies
Thiamine Vitamin B Water Soluble, functions as a co-enzyme, found in pork, whole grains, enriched breads, cerals, legumes treats deficiencies in alcholism, gastric lesions, hyperemphesis in pregnancy
Riboflavin Vitamin B2 water soluble, metabolism of proteins, fats, and carbohydrates, milk, eggs, liver, green leafy veggies, enriched breads and cereals Decreased by oral contracetives
Niacin Nicotinic Acid Vitamin B water soluble essential part of co-enzyme that function in release and amino acid metabolism, treat disorders associated with limited dietary intake, side effect: hot flashes, flushing, found in lean meats, peanuts, yeast, cereal
Vitamin B6 watersoluble, co-enzyme in metabolism protein carbohydrates and fats. Treat congentital defects, yeast wheat corn egg yolk, liver, kidney/muscle meat
Folic Acid necessary for RBC formation. Treat anemias, acholism, pregnancy (neural tube defects) Leafy green veggies, organ meat, cerals
Created by: nbuchanan0006
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