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Pharmacology Unit3&4

Pharm notes

Federal Food and Drug Act of 1906? first law passed to protect public from adulterated and mislabeled drugs
Harris-Kefauver Amendment of 1962? requires safety and efficacy of drugs, required informed consent and established new drug testing.
Food and Drug Administration Modernization Act of 1997? fast track for aids and cancer drugs, made drugs give 6months notice before declining a drug
Black Box Warning? warning put in the labeling of prescription drugs when there is reasonable evidence of an association of a serious hazard with the drug.
Assay? measures the strength and purity of a drug.
Chemical Assay? determine the types and amounts of ingredients present
Bioassay? test to measure the amount of preparation required to produce an effect on tested animal
Harrison Narcotic Act of 1914? established narcotics and rules on how to manufacture or sale them. Physicians were unable to give a narcotic prescription to a person addicted under no circumstance.
Controlled Substance Act of 1970? provide more research on substance abuse and provide treatment/rehabilitation to those effected
The DEA requires drug supplier and hospitals to?(2) keep all controlled substances in double lock cabinets and have two nurses count them or use a computerized system.
Manufacturer's Liability? manufactures are liable for injuries caused by defect of products, drugs or devices.
Product Liability?(3) liable for 1.product is defective. 2.defect arouse before the product left manufactures' control. 3.caused harm.
What are some Observable Physical Defects in drugs?(4) Unusual discolorations, precipitates, inconsistencies, or foreign bodies.
The nurse is responsible for? every medication they administer
Preclinical Testing? takes 6-12 years to test on at least two mammal sources to ascertain toxicity, therapeutic index and pharmacokinetics.
Investigational New Drug Status?(3) application must have, 1.evidence of drug safety. 2.proof of investigator's qualifications. 3.drugs' proven quality and strength.
Clinical Testing on Humans?(3) three phases. 1.small number of healthy volunteers to determine pharmacokinetics. with targeted disease to determine side effects and effectiveness 3.tested on various centers to determine effectiveness, safety and dosage size and range.
Double Blind Study? neither the researcher or volunteers knows which group has the placebo effect or the actual drug. usually conducted between phase 1 and 2 of clinical testing on humans.
New Drug Application? drug passes all phases of Clinical Testing on Humans and is approved for market
Limitations of Drug Testing? Number of volunteers, pregnant women, women, children, older adults, volunteers with multiple diseases, volunteers on multiple medications, and research time allotment.
MedWatch? voluntary adverse reaction reporting program to report any adverse effect of a drug.
Phase 4 of New Drug Application? post-marketing surveillance used by greater number of clients for a longer period of time. helps to determine any additional effects of the drugs.
Nurses involved in drug research? knowledgeable about informed consent and protect client against errors.
Nuremberg Code? right of human participants have rights to be aware of any experimental testing. even drug studies on children must be approved by child and parents of child.
Nursing Practice is regulated by? drug standards, legislation and state nurse practice acts.
State Nurse Practice Acts? conditions under which nurses may be licensed to practice professionally. Protects the nurse my clearly defining their responsibilities and freedoms.
Legal Requirements before Med admin?(3) order must be valid. 2.perscriber and nurse must be licensed. 3.nurse must know purpose, actions, effects and major adverse effects and teaching required.
Valid Orders? leave no room for doubt about dosage, route, interval and prescriber's name
If you believe that a med order is incorrect what do you do?(3) validate with pharmacist, report conflicting facts wit prescriber, and if the prescriber decides to admin anyway report to supervisor.
Malpractice? patient believes that a behavior or procedure that was done was not expected of someone with a nurse's professional education and experience.
ANA'S Code of Ethics? guides to standards of conduct, relationships, and practice
Nurses' responsibilities to clients? promote health, prevent illness, restore health, and alleviate suffering
Nurse's Ethics? guidance for nurses actions
Fidelity? Faithfulness to one's obligations
Paternalism? nurse decides best for client without the approval of patient
Cultural Factors? important to holistic nursing because they affect the patient's health, health belief, and health care practices
Cultural Practices?(4) folk medicine, home remedies, amulets, balances of good/evil etc
Drug Polymorphism? patients' age, gender, size, body composition, and ethnicity effects how the patient absorbs or metabolizes specific drugs.
What are the Diagnostic aids?(3) Florescein Sodium, fluorexon, rose bengal
Florescein Sodium? nontoxic water-soluble dye that's applied to the cornea. Bright Green-scratches. Green ring-foreign bodies. Yellow-loss of conjunctiva
Fluorexon? used to fit soft contact lenses
Rose Bengal? used for routine ocular exams to highlight dead or degenerated epithelial cells
Anti-infection drugs forms?(5) drops, ointment, packs, corneal baths and injections
Types of Anti-infection drugs?(3) Antibacterials, Anti-fungal, Anti-Viral
What route is preferred for ophthalmic drugs? Topical
Types of Anti-inflammatory Drugs? NSAIDS and Adrenal Corticosteroids
Anti-inflammatory Drugs? control inflammation and ultimately reduce the amount of permanent scarring and visual loss.
Corticosteroids? commonly used for allergic reactions/hypersensitivities
NSAIDS? decrease prostaglandin concentrations in the eye
Why should we monitor eyes closely for signs of infection? steroids decrease defense mechanisms and reduce resistance to pathogens
Local Anesthetics? inhibit pain sensation
Local Anesthetics may have temporary_(5) stinging, burning, tearing, conjunctival redness and photophobia
Prolonged use of Local Anesthetics can cause?(2) permanent corneal opacification and scarring.
Lubricants? replace tears to moisten contact lenses or artificial eyes
Decongestants? drugs used to cause constriction of the conjunctival blood vessels.
Decongestants help with? reliving itching and minor irritation caused by irritants or allergic reaction.
Anticholinergic Drug? help with eye examinations to dilate pupils so sphincter muscles doesn't contract and the cilliary muscles are paralyzed so no accommodation
Mydriasis? dilated pupils
Cytoplegia? blurred vision
Atropine(in eye exams) in children and adults? Children: recommended,potent and long acting, for measuring refraction. Adult:relaxes eye muscles during surgery or trea
What is the antidote for Mydriasis and Cytoplegia in eye exams? Atropine and Adrenergic Drugs
What is Anticholinergic Drugs used for? used for exam and treatment of inflammation
Adrenergic drugs such as Phenylephrine? are used when cytoplegia is not required and reduce mydriasis.
Glaucoma? increased IOP caused by overflow of the aqueous humor. the humor is normally reabsorbed by the anterior chamber. the pressure can damage the optic nerve causing blindness.
Types of Glaucoma? Chronic (open-angle) Glaucoma. Acute (closed-angle) Glaucoma.
Chronic Glaucoma? common, slow degeneration of the anterior chamber that impairs uptake of aqueous humor
What is the purpose of the drugs to treat Chronic Glaucoma? improve the uptake of aqueous humor
What are the most common drugs for Chronic Glaucoma?(3) Beta-Blockers. Epinephrine. Miotics.
Acute Glaucoma? bulging of the iris that shuts off the aqueous humor to the anterior chamber. its an emergency because the increased IOP can damage the optic nerve.
What is the treatment for Acute Glaucoma?(4) Cholinomimetic. Carboic Anhydrase Inhibitor. Epinephrine. Osmotic Diuretic. These drugs prepares the patient for immediate surgery
Beta-Blockers? decrease Aqueous Humor by stopping production
What is the initial treatment for Chronic Glaucoma? Beta-Blockers
Can Beta-Blockers cause Mydriasis or Cytoplegia? no
Betoptic (Beta-Blocker)? selective, preferred for those with pulmonary problems
Timoptic (Beta-Blocker)? treats Glaucoma by lowering IOP
Adrenergic Drugs Decrease aqueous humor by stopping production. can be found in Epinephrine
Epinephrine? stimulates the alpha adrenergic receptors to dilate pupils, treat glaucomaby stopping the production of aqueous humor, reduce hemorrhaging and conjunctival congestion
Repeated use of Epinephrine can cause?(3) reactive to redness, allergic conjunctivitis, dermatits
Dipivefrin (Epinephrine) converted to epinephrine by esterases in the cornea and anterior chamber.
Cholinomimetics? mimic the action of neurotransmitter acetylcholine. produces the process of Miosis. This allows the anterior chamber to contract allowing more area for uptake of aqueous humor.
Miosis? process when the sphincter muscles contract to constrict the pupils
Types of Cholinomimetics? Pilocarpine and Carbachol
Types of Cholinomimetics drug forms? drops, gel or drug delivery system
Pilocarpine (Cholinomimetics)? Used in Acute Glaucoma before and after surgery and is more tolerated.
Charbachol (Cholinomimetics)? more potent and longer acting, replacement drug in patient is tolerant to Pilocarpine, and induce Miosis
Pilocarpine and Charbachol (Cholinomimetics) both can? counteract with anticholinergic effects of atropine. so they produce opposite effect that the drug does for mydriasis.
Anticholinesterase Miotics? turns off the parasympathetic system. cause miosis to improve uptake of aqueous humor. For patients with Chronic Glaucoma
Miotics? inhibit accomodation
Carbonic Anhydrase Inhibitors? decrease formation of aqueous humor by blocking ocular carbonic anhydrase. this drug is seen in patients with Acute Glaucoma and is usually adjunct with other drugs.
Prostaglandin Analog? increase the outflow of aqueous humor with few gradual changes in eye color. fewer side effects than beta blockers
Osmotic Agents? short-term treatment to lower IOP before surgery of Acute Glacoma and is highly irritating on injection so must be given IV
Created by: aneshia



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