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Pharm Midterm

Pharm midterm

opioid analgesics prevent constipation by providing fluid and fiber, prevent respiratory depression, provide instruction for clients about drug admin and position changes.
analgesic agents salicylates(ASA), Acetaminophen, combination narcotic and non narcotic analgesics
anti-inflammatory analgesic agents (NSAIDs) Nonsteroidal anti inflammatory drugs
ASA (aspirin) adverse effects gastrointestinal bleeding and irritation, increases bleeding time, tinnitus, Reye's syndrome in children
acetaminophen adverse effects acute overdose causes hepatic necrosis, long term ingestion can result in nephropathy
treatment for acute overdose of acetaminophen acetylcysteine- oral form, iv form now approved, prevents the formation of hepatotoxic metabolites
uses for NSAIDs analgesic, antigout, anti-inflammatory, antipyretic, relief of vascular headaches, platelet inhibition
common NSAIDs ibuprofen, ketoprofen, ketorolac, naproxen
1st gen, NSAIDs GI adverse effects dyspepsia, heartburn, epigastric distress, nausea, GI bleeding, mucosal leasions
2nd gen, NSAIDs Cardio adverse effects Cardiac arrhythmias, heart attack, stroke, (Celebrex)
Don't take NSAIDs had stomach ulcers or bleeding, asthma, allergic response to aspirin, severe kidney problems, severe liver problems, or pregnant.
NSAIDs renal adverse effects creatinine clearance reduced, renal failure, acute tubular necrosis
Before beginning therapy with NSAIDs assessment for GI lesions or peptic ulcer disease, bleeding disorders, heart disorders, perform lab studies to include cbc, platelet count, cardiac, renal, and liver.
NSAIDs serious drug interactions alcohol, heparin and warfarin, phenytoin, steroids, sulfonamides
Salicylates do not give to children under 12, give with food and milk
gout a metabolic disease associated with the development of high uric acid in the blood.
uric acid is formed from the breakdown of proteins, the accumulation of this causes a problem in the joints and kidneys, kidney stones, kidney failure, gouty arthritis, hyperuricemia
acute attacks of gout are treated with NSAIDs, Corticosteroids, colchicine/probenecid
Colchicine/Probenecid drink plenty of fluids and take with food if stomach upset occurs, can cause N,V,D, loss of appetite, dizziness, alopecia, headaches, frequent urination,
Allopurinol most commonly used agent for gout, prevents formation of uric acid, adverse effects; hepatoxicity and skin rash
most commonly used for gouty arthritis NSAIDs; indomethacin, naproxen, sulindac
Uricosuric agents Probenecid-AE;headaches,dizziness, Sulfinpyrazone-AE; N&V, Diarrhea
Secretory functions of the stomach lining parietal cells secrete hydrochloric acid, chief cells secrete pepsinogen, mucoid cells secrete mucus
stomach hyperchlorhydria produced from eating high fat meals, increased alcohol intake, emotional turmoil
goal of antacid therapy neutralize the acid, inhibit pepsin activity, increased resistance of the stomach lining, increase tone of the lower esophageal sphincter
antacids three forms; aluminum, magnesium, calcium.
systemic antacids useful in short term therapy, rapid onset, prolonged use causes an overload on the kidneys, ex sodium bicarbonate
nonsystemic antacids remain in gi tract, useful in longterm therapy, will not alter acid base system, ex calcium carbonate(Tums, Rolaids)
magnesium adverse diarrhea
aluminum and calcium adverse constipation
antacids interactions binding of other drugs causes reduced availability of the other drugs to the client, chemical inactivation, increases stomach and urine ph which will decrease the absorption and excretion of certain drugs
histamine receptor antagonists cimetidine(Tagamet), Famotidine(Pepcid), Nizatidine(Axid), Ranitidine(Zantac)
Proton pump inhibitors Omeprazole(Prilosec)-blocks the final step of acid production in the stomach.
Prilosec indication clients with Gastroesophageal reflux disease(GERD), Gastric hypersecretory condition
Prilosec interactions causes warfarin(an anticoagulant) action to be increased
helicobacter pylori an organism associated with the development of peptic ulcer disease
TX for H.pylori metronidazole (Flagyl), an antimicrobial agent along with bismuth subsalicylate(Pepto) and tetracycline for 4 weeks to eradicate
metoclopramide(Reglan) a drug that stimulates the motility of the upper gi tract without stimulatin the production of gastric, biliary, or pancreatic solutions. Action, increases peristalsis in the duodenum and jejunum and decreses gastroesophageal reflux
metoclopramide(Reglan) adverse effects produces extrapyramidal(Parkinson like symptoms)effects, CNS depression, GI upset
Emetics agents that induce vomiting, used in overdoses, ex ipecac syrup, inappropriate for use in bulimics
Antiemetics anticholinergics, antihistamines, neuroleptic agents, prokinetic agents, serotonin blockers
anticholinergics bind to and block acetylcholine receptors to prevent nausea stimuli from being transmitted
antihistamines block h2 receptors to prevent cholinergic stimulation.
neuroleptic and prokinetic agents bind to dopamine receptors and block action, block dopamine and stimulate acetylcholine to increase gastric emptying
Anticholinergics Scopolamine(Trans Scop)
Antihistamines Promethazine(Phenergen), Meclizine(Antivert)
Antiemetics and Emetics Neuroleptic agents-Chlorpromazine(Thorazine), Prokinetic agents-Metoclopramide(Reglan), Serotonin blockers-Ondansetron(Zofran)
antiemetics, and emetics adverse effects dizziness, drowsiness, dry mouth, headache
Stimulant laxatives increase motility of the gi tract, increase secretion of water into the large and small intestine, ex bisacodyl
Saline laxatives increase osmotic pressure within the intestinal tract, cause more water to enter the intestines, result in bowel distention, increased peristalsis, and evacuation, ex fleet enema
saline laxatives adverse contain salt, unpleasant taste, systemically absorbed result in poor client compliance, risk for dehydration, risk for congestive heart failure.
bulk forming laxatives absorbs water to increase bulk, distends bowel to initiate reflex bowel activity, high fiber, natural or semisynthetic, ex Metamucil, Fibercon, Citrucel, must be followed with a large amount of fluid, if chewed or taken in dry powder for, can cause esopha
lubricant laxatives oils lubricate fecal material and intestinal walls, therby promoting fecal passage, prevent fat soluble vitamins from being absorbed, ex mineral oil
stool softeners detergent like drugs, permit mixing of fats and fluids with fecal mass, stool becomes softer and is passed much easier, takes several days to work, ex docusate salts (Colace and Surfak)
Suppositories usually in a wax base, administered rectally, absorbed systemically, available containing stimulant drugs, ex glycerin-absorbs water from tissues creating more mass, bisacodyl- induces peristaltic contraction by direct stimulation of sensory nerves.
lactulose laxatives two monosaccharides that are not digested or absorbed, digested in the colon by bacteria to form acid substances, acid substances cause water to be drawn into the colon
enemas hyperosmotics, solution contains salt, administered rectally and cause a laxative effect by osmotically drawing fluid into the colon to initiate defecation
long term use of laxatives often results in decreased bowel tone and may lead to dependency, encourage a healty high fiber diet and increased fluid intake.
adsorbents claylike materials administered in a tablet or liquid suspension form after each loose bowel movement, bind to the causitive bacteria or toxin and are eliminated through the stool, ex kaopectate
antidiarrheals reduce gi motility, opium is a narcotic, decreases transit time through the bowel, more time for water and electrolytes to be absorbed. Paragoric is an opium tincture, may cause physical dependence.
common antidiarrheals loperarmide (imodium) made from chemicals related to meperidine, a narcotic, diphenoxylate hcl and atropine sulfate (lomotil) narcotic and anticholinergic drug, reduces gi motility
anticholinergics decrease intestinal muscle tone and peristalsis of gi tract. result is slows the movement of fecal matter through the gi tract ex belladonna alkaloids (donnatal)
anemia decreased number of circulating red blood cells, decreased hemoglobin, decreased oxygen capacity, many causes
iron deficiency anemia nutritional deficit is common cause, clients with bleeding disorders, menses, pregnant, infants, blood donors.
iron deficient therapies ferrous sulfate, ferrous fumarate, ferrous gluconate, IV or IM
side effects of iron therapies Gi upset, constipation
Epogen or Procrit synthetic products, generic name-epoetin alfa recombinant, erythropoietin is synthesized by the liver and stimulates red blood cells.
megaloblastic anemias large red blood cells, neutrophil and platelet changes, treated with vitamin B12 by IM.
folic acid deficiency needed for proper neural development, products enriched include grain
protein essential for synthesis, maintenance, and repair of body tissue for energy production, made of amino acids
fat a very concentrated dietary source of energy and a carrier of fat soluble vitamins, made of fatty acids
carbohydrates made up of glucose molecules and is a rapidly produced energy source
vitamins chemical substances that regulate and participate in chemical reactions within the body
water soluable vitamins B complex and C, need daily replacement, excreated in the urine
fat soluable vitamins A,D,E,and K stored in the liver and fatty tissues, excreted in the feces.
vitamin A (Retinol) found in foods of animal origin, such as liver, milk fat, and egg yolk, excessive use is a problem
hypervitaminosis A irritability, vomiting, loss of appetite, and loss of body hair, Children-delirium and coma
vitamin D fish oil is a rich source, works in conjunction with parathyroid hormone and calcitonin to absorb and utilize calcium and phosphorous
vitamin D used to treat rickets in children and osteomalacia in adults
hypervitaminosis D weakness, lethargy, nausea and Vomiting, and behavioral changes
vitamin E found in vegetable oils and green leafy veges, known as the tocopherols, prevention and treatment of MD, cancer, infertility, toxic effects of oxygen therapy in premature infants
vitamin K stored in the liver, small amount synthesized by intestinal flora, essential for blood coagulation, used for the treatment of hypoprothrombinemia in newborns.
vitamin B1 (thiamine) required for CHO metabolism, contained in whole grain and enriched breads, cereals, pork, and organ meat, deficiency results in beriberi-polyneuropathy of peripheral nerves and brain lesions
vitamin B2 (riboflavin) essential for CHO, fat, and protein metabolism and tissue respiration, found in organ meats, dairy products, yeasts, eggs, and green leafy veges.
vitamin B2 deficiency results in ocular changes, skin disorders, and inflammation of the mouth, treat migraine headaches and burning feet syndrome.
vitamin B3 (niacin/nicotinic acid) found in liver, lean meats, fish, poultry, and enriched flour and cereals, essential for synthesis of fat and tissue respiration, peripheral vasodialator, lowers cholesterol
vitamin B3 deficiency produces pellagra, psychotic changes, neural changes, erythema, oral, and vaginal lesions, and diarrhea
vitamin B6 (Pyridoxine) found in whole grain cereals, beef, liver, and pork. Metabolizes protein
vitamin B6 deficiency results in neurological disorders, dermatological disorders.
vitamin B12 (Cyanocobalamin) contains cobalt, required to form red blood cells, found in meat, fish and dairy products
vitamin B12 deficiency pernicious anemia, megaloblastic anemia, irreversible neurological damage.
vitamin C (ascorbic acid) found in citrus fruits, green leafy vegetables, tomatoes, and other foods, assists in the formation and maintenance of collagen, assists in forming teeth, bone, and hormones.
vitamin C deficiency scurvy, gingivitis, loss of teeth, anemia, bone lesions and delayed healing
sodium major positively charged ion in the extracellular fluid
potassium major positively charged ion in the intracellular fluid
sodium and potassium control electrical potential across cell membranes, assist in fluid regulation
hyponatremia low sodium, below 135 mEq/L, causes confusion, agitation, weakness, muscle cramping, and/ or convulsions
hypernatremia high sodium, above 145 mEq/L, causes elevated body temp, flushed skin, and dry mucous membranes
hypokalemia low potassium, below 3.5 mEq/L, causes serious cardiac arrhythmias
hyperkalemia high potassium, above 5.0 mEq/L, causes muscular weakness, cardiac arrhythmias, and/or paresthesia, leading to paralysis
Calcium required for blood coagulation, muscle contraction, nerve excitation, found in dairy and vegetables
calcium deficiencies produce tetany, osteoporosis, and rickets. Excess leads to kidney stones
allopurinol is a drug used primarily to treat hyperuricemia (excess uric acid in blood plasma) and its complications, including chronic gout.[1] It is a xanthine oxidase inhibitor which is administered orally.
Created by: sleepytime



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