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Pharmacology Final

Pharm notes

Objective of drug therapy? Provide maximum benefit with minimum harm.
Drug Safety? cannot produce harmful effects.
Side Effect? a nearly unavoidable secondary drug effect produced at therapeutic doses.
Maximum Efficacy? The largest effect drug can produce.
Pharmacodynamics? what the drugs do in the body and how.
Relative Potency? the dosage needed to produce effect.
ED50? the safe dose to produce the therapeutic effect in 50% of the population.
Adverse Drug Reaction? unintended and undesired effect that occurs at normal drug doses. Can occur in all patients, more common in elderly and infants.
Ways to decrease ADR?(5) 1.Educate patients about s/s. 2.anticipate ADRs. 3.Monitor organs of known toxicity of certain drugs. 4.Individualize Therapy. 5.Monitor Chronic Disorders pts.
General Properties of Drugs?(3) 1.They modify existing functions. 2.Exert multiple actions rather than a single effect. 3.They act by combining with a molecule or alter cell membrane activity.
Drugs Action on Receptors? (3) 1.Agonist: mimic body's action 2.Antagonists: prevent receptor activation 3.Partial Agonist: intrinsic activity that produce a effect lower than agonist.
Pharmacokinetic Phase? Movement of drugs through the body. Absorption, Distribution, Metabolism, and Excretion.
Pediatric Elimination? Renal function is lower in infants. So prolonged elimination. immature kidneys is the most important consideration sin all drug, fluid and electrolyte therapy for children and the ability to concentrate urine and the ability to excrete.
Most accurate Method of Calculating Pediatric Dosage? Body Surface Area
Alternative to IV routes in Pediatrics? Intraosseous Route.
Nomogram? chart used to relate the child's body weight to surface area.
Trade Names? Proprietary or brand names, name under which a drug is marketed.
Generic Names? Nonproprietary names that are assigned by the US Adop0ted Names Council.
Legal Requirements Before Med Administration?(3) order is valid. 2.physician and nurse is licensed. 3.nurse must know the purpose, actions, effects and major adverse effects and teaching required.
Difference between Prescription and OTC drugs? Prescription must be ordered by a licensed physician.
Telephone Orders? order must be correct, complete, legible and clearly understandable, if not clarification with the prescriber must be sought.
Drug Development Trials?(4) 1.Preclinical Testing: on animals 2.Investigational New Drug Status: evidence of drug safety. 3.Clinical Testing: on humans(Phase 1 on volunteers=pharmacokinetics, Phase 2 on target disease=effectiveness, Phase 3 open to market=safety,effectiveness,dose
Drug Enforcement Administration enforces? drug suppliers and hospitals have all doses of controlled substances should be kept in double-locked cabinets or other secure areas. they also must have actual counts by 2 nurses at the end of each shift or computerized system.
Florescein Sodium? nontoxic water-soluble dye that's applied to the cornea. Bright Green(scratches), Green Ring(foreign bodies), Yellow(loss of conjunctiva)
Chronic Glaucoma? The treatment's purpose? Types?(3) Open Angle:slow degeneration of anterior chamber that impairs uptake of aqueous humor. TX: is to improve humor uptake. Types:Beta-Blockers, Epinephrine and Miotics.
Beta-Blockers? Epinephrine? Miotics? BB: decrease humor production. Initial TX. Epi: stimulate adrenergic(decrease humor) to dilate pupils. Mio: constrict pupils and inhibit accommodation(so poor vision in dim light).
Acute Glaucoma? The treatment's purpose? Types?(4) Closed: bulging of iris that shuts off aqueous humor(emergency). TX: prepares pt for surgery. Types: Cholinomimetic, Carbonic Anhydrase Inhibitor, Epinephrine and Osmotic Diuretic
Cholinomimetics? Carbonic Anhydrase Inhibitors? Osmotic Diuretic? Epinephrine? Cho: mimic action to produce Miosis(constrict pupils) to allow more area for uptake of humor. Carbonic: decrease formation of humor. Osmotic: short-term tx to lower IOP before surgery. Epi: stimulate adrenergic(decrease humor) to dilate pupils.
Local Anesthetics? SE?(4) Prolonged use can cause?(2) Local: inhibits pain sensation. SE: stinging, burning, conjunctiva redness and photophobia. Prolong: permanent corneal opacification(no light coming through) and scarring.
Mydriatic Eye Drops? Type?(2) Drops: to dilate the pupils for eye exam. Types: Adrenergic(cause mydrasis without cytoplegia) and Anticholinergic(cause mydrasis and cytoplegia-blurred vision).
Classification of Opioid Drugs?(3) 1. Agonist(mimic/produce maximum effect). 2. Antagonist(block/reverse). 3. Agonist-Antagonist(mixing effects that act differently on each receptor).
Morphine? Indication?(5) Side Effects?(2) Adverse Effects?(5) Its a prototype of Agonist Opioids. Use: severe pain, depress cough, pulmonary edema, MI and antidiarrheal effects. SE: vertigo and pruitius. ADR: Resp. Depression, seizures, Tachycardia, confusion and hepatic toxicity.
Meperidine? Indicated?(3) least potent with short duration so will need large doses. Use: acute asthma, biliary colic and pancreatitis.
Naloxone Hydrochloride(Narcan)? Therapeutic Uses?(3) Routes? Narcan: can reverse effects of opioid agonist. Use: Opioid Overdose, Opioid Effects(SE/ADR) and Resp. Depression. Routes: IV, IM, and SubQ. no PO.
NSAIDS? Prototype? Indications?(4) Contraindication? Adverse Effects?(4) NSAIDS: inhibit both Cox1&2. Prototype: Aspirin. Use: Suppression Inflammation, relieve pain, reduce fever and antiplatelet. Contra: Bleeding Disorders. ADR: GI, Bleeding, Renal, Salicylism(tinnitus/HA)
Cyclooxygenase Forms? Inhibiting causes? Cox-1:(good) found in all tissues. Inhibit cause bleeding tendencies and acute renal failure. Cox-2:(bad)found in injured to produce inflammation and perception of pain. Inhibit cause suppression of inflammation, alleviate pain and reduce fever.
Phenytonin(Dilantin)? Administration?(4) Therapeutic Range? Traditional AED. Admin: PO(with food), IM(not recommended), IV(not >50mg), SubQ(never). Range: 10-20mcg
Barbiturates(Phenobarbital)? Administration?(2) Therapeutic Range? Traditional AED. Admin: PO, IV(no >60mg). Range: 15-45mcg.
Overall AED Teaching?(6) 1.Take med as ordered. 2.Keep seizure chart. 3.avoid driving/hazardous activities. 4.never discontinue w/o permission. 5.Carry extra med. ETOH or CNS depressants.
Prophylactic ATB? Indications?(6) given to prevent an infection rather than to treat a infection. Use: surgery, bacterial endocarditis, Neutropenia, recurrent UTI, rheumatic carditis and STDs.
Alternatives to PCN Allergy?(2) Their contraindications? Macrolides., Contra:taking Fluroquinolones. and Clindamycin, Contra: severe liver disease.
Peak/Trough purpose? Procedure? Peak: highest concentration of a drug in bloodstream. Trough: lowest concentration in bloodstream, the specimen is collected prior to admin of the drug. its to determine the drug levels in the blood.
Selective Toxicity? selective to injure only the target cell or target organism without injuring others.
Nosocomial Infections? infections gained in the hospital
Suprainfection? new infection that occurs during the course of tx for a primary one.
Vancomycin? Action?(2) Use?(3) Administration?(1) Contraindicated?(3) Van: serious infections. Action: Bactericidal/static. Use: MRSA, MRSE, C-Diff(tx by taking PO). Admin: admin IV slowly to prevent Red-Man Syndrome. Contra:<8yo, pregnant, lactation.
Aminoglycosides? Action? Use?(2) Route?(1) Adverse Effects?(2) Contraindicated?(1) Drug-Drug Interaction?(1) Act: bactericidal. Use: Systemic infections, TB(in combo fluroquinolones). Route:Parenteral Only. ADR: Otoxicity and Nephrotoxicity. Contra:Renal impairment. Drug-Drug: inactivated with PCN.
Tetracyclines? Use?(5) Action?(1) Adverse Effects?(2) Drug-Drug Interaction?(4) Contraindications?(3) Education?(1) Tet: tx uncommon infections. Use:Rocky Mt., Lyme, Mycoplasma, Acne, Malaria. Act: Bactericidal. ADR:Yellow/Brown Teeth, Photosensitivity. Drug:MG, CA, FE, AL. Contra:Renal Failure, <8yo, and liver damage. Edu:empty stomach/food prolongs absorption.
Amphotericin B? Use?(1) Toxic?(1) Adverse Reactions?(2) Amph:important but dangerous. Use: fatal systemic infections. Toxic: Renal Damage. ADR: Shake and Bake, nephrotoxicity
Amatadine? Use?(2) Side Effects?(3) First Gen influenza vaccine. Use: prophylaxis and tx of Influenza A. SE:CNS(insomnia, dizziness, confusion), CV(ortho hypotension, CHF), and Teratogenic(disrupted growth/development of the embryo).
Acyclovir? Use?(4) Administration?(3) Acy: #1 choice for Herpes Virus. Use:genital, lips, shingles and chickenpox. Admin: Topical(initial), Oral(recurrent), IV(severe)
Flucytosin? Administration?(1) Adverse Effects?(2) Flu: for systemic fungal infections. Admin: in combo with Ambhotericin B. ADR: Hematologic(bone marrow depression) and Hepatoxicity.
Interferon Alfa? Use?(2) Side Effects?(2) Caution?(1) Use: Hepatitis B and C. SE: flu-like symptoms and depression. Caution: giving to those dx with depression because suicide may occur.
Administering liquid medicines to infants? Hold your baby at a 45-degree angle, with his hands down and head supported. Use a plastic syringe, drip the medicine onto the back of his tongue near the sides, Not into his cheek pouches. Avoid squirting the medicine down into your baby's throat.
Administering ear-drops to children? Ask your child to lie down or sit with the affect ear facing up. For Children under Age 3:Gently pull the outer flap of the affected ear DOWNWARD and backward. For Children over Age 3:Gently pull the outer flap of the affected ear UPWARD and backward.
Appropriate IM site for Pediatrics?. Younger than 3: Anterior lateral thigh muscle Older than 3: Deltoid muscle (upper arm)
Contraindicated drugs for pediatrics?(4) Tetracyclines, Aspirin, Varicella/Influenza, and Fluoroquinolones,
Ophthalmic drugs administration? Avoid touching dropper with tip, tilt head back and pull lower eye lid down, while looking up squeeze bottle so a single drop lands in the eye. close eye for 2-3minutes and tilt head down.
Current ability to fight infections?(2) immunity and vaccinations.
Contraindications to antibiotics?(6) age, pregnancy, existing medical conditions, patient's history, existing medications, allergies.
Created by: aneshia



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