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pharmacology

Exam 2/Chapter 5-7

TermDefinition
This drug category inhibits aggregation or clumping to prevent clot formation antiplatelet agents
Certain antihypertensive medications can effectively treat heart failure because they lower blood volume
A medication that increases the stretch of myocardial fibers in order to increase the force of contractions is demonstrating the Frank-Starling Law
All of these tend to increase blood pressure EXCEPT increasing diuresis
Which of the following drug classes is indicated for immediate treatment of patients admitted with symptoms of blood clot (such as myocardial infarction, stroke or pulmonary embolism)? thrombolytics (such as streptokinase)
Indicated to prevent future clots in patients with a history of clotting abnormalities, such as patients with previous myocardial infarction anticoagulants (such as heparin and warfarin)
These medications are considered the drugs of choice (i.e., first-line treatment option) for treatment of moderate to severe hypertension because they have relatively few side effects: calcium channel blockers (such as nifedipine, amlodipine, diltiazem and verapamil)
Low molecular weight heparin (LMWH) exhibits higher bioavailability and longer-lasting effects than standard heparin. T/F True
Which of the following are most directly involved in the coagulation process? the liver and Vitamin K
Which of the following treats heart failure by reducing hert rate and increasing the force of myocardial contractions (i.e., exerts both a negative chronotropic effect and a positive inotropic effect)? cardiac glycosides (such as digoxin)
Describe the role of Vitamin K and the liver in coagulation disorders The liver uses Vitamin K to produce several clotting factors as a result hepatic disease, hepatic injury, or Vitamin K deficiency can also cause coagulation disorders
Name the two types of heparin and state the advantages of LMWH regarding bioavailability -standard which is animal extract derived from pork -lovenox is a LMWH has a higher bioavailability over standard
Name the two types of heparin and state the advantages of LMWH regarding duration of effect -LMWH has a shortened molecule and it has a longer lasting effect
Define, and describe the role they play in hypertension: a. stroke volume is the volume of blood ejected from ventricles with each beat (stroke) of the heart -increase in SV is and increase in BP -volume of blood pumped per minute
Define, and describe the role they play in hypertension: b. peripheral resistance is the friction in arteries as blood flows through the vessels -the pressure exerted -increase in PR will have an increase in BP
Define, and describe the role they play in hypertension: c. blood volume is the total amount of blood in vascular system -increase BV will have an increase in BP
Chronotropic effect in heart failure -anything that causes a change in HR -a positive chronotropic effect increases the HR -a negative chronotropic effect decreases the HR Ex: atropine, dopamine, epi, theophylline
Inotropic effect in heart failure -anything that causes a change in strength or contractility of the a heart -a positive inotropic effect increases contractility -a negative inotropic effect decreases contractility Ex:digoxin, calcium, Eicosanoids
Preload in heart failure the degree of stretch of cardiac muscle fibers just before they contract
afterload in heart failure the pressure in the aorta that must be overcome for blood to be ejected from the left side of the heart
Frank-Starling Law in heart failure -the principle that states that the greater the degree of stretch of the myocardial fibers, the greater the forces of contract -same principle behind shooting a rubber band
Name the class of drugs that reduces heart failure by reducing heart rate and increasing the force of myocardial contractions (i.e., exerts a negative chronotropic effect and a positive inotropic effect) cardiac glycosides ex: digoxin and digitoxin
Discuss non-pharmaceutical methods to control blood pressure and treat heart failure. -regular aerobic exercise -weight management -limit sodium intake -reduce stress -avoid tobacco products
Explain why certain antihypertensives can effectively treat heart failure. it decreases cardiac workload, preload, and afterload. -ex: ACE inhibitors, directacting vasodilators, and certain diuretics
State the benefit and potential adverse reaction of natriuretic peptides. benefit is they increase cardiac efficiency in moving fluids by increasing excretion and vasodilation adverse is they can cause life threatening hypotension
How does adrenergic blockers lower bp block or inhibit the sympathetic nervous system
How does calcium channel blockers lower bp contraction of muscle is regulated by the amount of calcium ion inside the muscle cell
How does ACE inhibitors lower bp prevent angiotensin converting enzyme from producing angiotensin II and stimulates aldosterone production
How does angiotension-receptor blockers lower bp block an action of angiotensin II after it is formed causing vasodilation, reduces restriction, and reduces BV
How does diuretics lower bp Decreases fluid volume by increasing urinary excretion of water and electrolytes, block reabsorption of Na and Cl
Identify the drug category that is currently the drug category of choice for treatment of heart failure, and explain the reason. ACE inhibitors because it reduces cardiac workload by lowering BV, increasing CO and causing venous dilation with minimal adverse effects
Identify the drug category that is considered a first-line option for treatment of moderate-to-severe hypertension, and explain the reason Calcium channel blockers because it blocks calcium from entering the cells. It decreases vessel tone, HR, and force of contractions
Name the common dosing measurement for heparin administered in units- a measurement of the amount required to keep blood suspended in a liquid solution)
Explain the difference between using heparin for treatment of coagulation disorders and administering it to keep an IV line open treatment is administered in units while IV line is a heparin push which is a large dose pushed intravenously to keep IV site open
Anticoagulants MECHANISM OF ACTION: prevent clot formation by inhibiting specific clotting factors INDICATIONS: atrial fibrillation, coronary artery disease EX: heparin and warfarin
Antiplatelets MECHANISM OF ACTION: prevent clotting by inhibiting platelet aggregation INDICATIONS: arterial thrombosis, MI stroke EX: aspirin, adenosine diphosphate (ADP)
Thrombolytics MECHANISM OF ACTION: dissolve existing clots INDICATIONS: pulmonary embolism, deep vein thrombosis EX: streptokinase
Antifibrinolytics (hemostatics) MECHANISM OF ACTION: promote clotting time by inhibiting fibrin destruction, slow blood flow INDICATIONS: excessive bleeding from surgical sites EX: aminocaproic acid
adrenergic blockers INDICATIONS: due to multiple adverse effects and only used for patients who have not responded to other antihypertensives EX: metopranolol and propranolol
cardiac glycosides INDICATIONS: chronic cardiac insufficiency, arrhythmia absoluta EX: digitoxin
Select the four conditions for which calcium channel blockers are indicated hypertension dysrhythmias angina pectoris myocardial infarction
Which of the following is a vasoconstrictor? epinephrine
This category of medications converts to nitric oxide in the body, resulting in vasodilation of coronary arteries. They are often administered sublingually organic nitrates, such as nitroglycerin
Caduet, Vytorin and Advicor are ... combination drugs for treatment of hyperlipidemia
High levels of low-densipity lipoproteins (LDLs) are desirable. T/F False
HMG-CoA Reductase inhibitors (statins) reduce lipid levels by: slowing production of cholesterol by the liver
Which of the following is appropriate immediate treatment for hemorrhagic cerebrovascular accident (i.e., hemorrhagic stroke or hemorrhagic brain attack)? hemostatics
Auto-injectors (such as Epi-Pen) are used to administer epinephrine to treat for anaphylaxis
The main difference between the Class 1-A, 1-B and 1-C antidysrhythmics is length of onset and duration of effects
The reason for administering vasoconstrictors when treating for shock is to: prevent hypotension by increasing vessel tone
Describe the main differences between Class IA, IB and IC Sodium channel blockers in the treatment of dysrhythmias. Class IA- drugs work quickly and are eliminated quickly, slow conduction velocity in the atria Class IB- are short acting and reserved for ventricular dysrhyth. Class IC- stay in the body for a longer period of time, reserved for life threatening
State the general mechanism of action of each of the following in the treatment of dysrhythmias: a. Class I / sodium channel blockers these medications slow impulse conduction by blocking the sodium ion channels
State the general mechanism of action of each of the following in the treatment of dysrhythmias: b. Class II / beta blockers slow heart rate, decrease conduction velocity and decrease ventricular function
State the general mechanism of action of each of the following in the treatment of dysrhythmias: c. Class III / potassium channel blockers block the potassium channels, reducing the ability of the heart to respond to rapid tachycardias
State the general mechanism of action of each of the following in the treatment of dysrhythmias: d. Class IV / calcium channel blockers drugs depress conduction velocity in dysrhythmias that must travel through the atriventricular node, calcium dependent
Identify the classes of meds appropriately used for the treatment of : myocardial infarction organic nitrates beta blockers calcium channel blockers antidysrhythmics aspirin analgesics anxiolytics
Identify the classes of meds appropriately used for the treatment of: angina pectoris Organic nitrates- SL or transdermal Beta blockers- that have negative chronotropic(reduce HR) + inotropic effects(reduce force of contractions) Calcium channel blockers-lower HR + force of contractions -also dec vascular tone and inc vasodilation
State the general mechanism of action for each of the following in the treatment of angina pectoris and/or myocardial infarction: a. organic nitrates it converts to nitric oxide in the body, which causes vasodilation of the coronary arteries, dec the preload, afterload, and demand for O2 by myocardial cells
State the general mechanism of action for each of the following in the treatment of angina pectoris and/or myocardial infarction: b. beta blockers drugs that reduce HR and reduces force of contractions and decrease the heart's demand for oxygen
State the general mechanism of action for each of the following in the treatment of angina pectoris and/or myocardial infarction: c. calcium channel blockers lowers HR and force of contractions, decreases vascular tone and increase vasodilation, which reduces myocardial demand for O2
When treating for shock, explain the purpose of administering: a. fluids b. vasoconstrictors c. positive inotropic medications a. fluids-IV, electrolytes, blood products to rehydrate the body b. vasoconstrictors-like epi to stabilize BP + prevent hypotension c. positive inotropic medications-dopamine/digoxin to increase the force of myocardial contractions
When treating for ischemic stroke, explain the purpose of administering: a. thrombolytics b. tissue plasminogen activator c. anticoagulants a. thrombolytics- to dissolve existing clots b. tissue plasminogen activator-to open occluded arteries/plasmin-enzyme that degrades plasma proteins c. anticoagulants-to prevent future clot formation
When treating for hemorrhagic stroke, explain the purpose of administering: a. hemostatics b. hyperosmotics a. hemostatics-to stop bleeding by increasing clotting activity b. hyperosmotics- to help decrease swelling of brain tissue
Name the categories of drugs that would appropriately be administered to counter each of the following when treating patients for either ischemic or hemorrhagic stroke: a. anxiety anxiolytics
Name the categories of drugs that would appropriately be administered to counter each of the following when treating patients for either ischemic or hemorrhagic stroke: b. hypertension antihypertensive agents
Name the categories of drugs that would appropriately be administered to counter each of the following when treating patients for either ischemic or hemorrhagic stroke: c. pain analgesics
When treating for anaphylaxis, explain the purpose of administering: a. vasoconstrictors like epi to increase BP and reverse vasodilation
When treating for anaphylaxis, explain the purpose of administering: b. antihistamines to stop the histamine release
When treating for anaphylaxis, explain the purpose of administering: c. bronchodilators to combat bronchoconstriction- constriction of the airways in the lungs due to the tightening of surrounding smooth muscle
When treating for anaphylaxis, explain the purpose of administering: d. corticosteroids to decrease the inflammatory response
When treating for anaphylaxis, explain the purpose of administering: e. oxygen to help with breathing
When treating for anaphylaxis, explain the purpose of administering: f. fluids, electrolytes, blood products to help increase BP to increase Mass arterial pressure
Explain why low levels of LDL are desirable while high levels of HDL are desirable HDL are good cholesterol, which return cholesterol to the liver, where it can be synthesized and removed and LDL are bad cholesterol which carries cholesterol to the arteries
Describe the advantage of each of these combination medications in the treatment of hyperlipidemia: a. Caduet it contains an antihyperlipidemic (atorvastatin) with an antihypertensive agent (amlodipine)
Describe the advantage of each of these combination medications in the treatment of hyperlipidemia: b. Vytorin it contains ezetimibe (inhibits cholesterol absorption) and simbastin (slows production of cholesterol in the liver)
Describe the advantage of each of these combination medications in the treatment of hyperlipidemia: c. Advicor it contains lovastatin (slows production of cholesterol in the liver) and niacin (decreases liver triglycerol synthesis)
Identify the drug category that is considered the drug of choice for treating hyperlipidemia, and describe its mechanism of action. combination therapy in which 2 antihyperlipidemics with different mechanisms of action are combined is to attack the cholesterol from 2 different angles, inhibiting cholesterol and slowing production of cholesterol
antidysrhythmics INDICATIONS: tachycardia, serious ventricular fibrillation
antihyperlipidemics INDICATIONS: high cholesterol or high LDL EXAMPLES: atorvastatin
sodium channel blockers (Class I antidysrhythmics) INDICATIONS: atrial fibrillation, superventricular and ventricular tachyarrhythmias EXAMPLES: quinidine, lidocaine
beta blockers (Class II antidysrhythmics) INDICATIONS: angina pectoris, atrial fibrillation, cardiac arrhythmia, and congestive heart failure EXAMPLES: propranolol
potassium channel blockers (Class III antidysrhythmics) INDICATIONS: atrial fibrillation, life threatening ventricular tachycardia EXAMPLES: amiodarone
calcium channel blockers (Class IV antidysrhythmics) INDICATIONS: high BP, CAD, angina EXAMPLES: diltiazem, verapamil
epinephrine / auto-injectors INDICATIONS: acute hypersensitivity, acute asthmatic attacks EXAMPLES: EpiPen
organic nitrates INDICATIONS: acute angina pectoris, chronic angina pectoris, pain associated with anal fissures EXAMPLES: nitroglycerin
nitroglycerin DRUG CLASS: Nitrates
Caduet, Vytorin, Advicor DRUG CLASS: antihyperlipidemics
epinephrine DRUG CLASS: Vasoconstrictors
Some antibacterials inhibit protein synthesis, which in turn inhibits bacterial reproduction. This represents: a bacteriostatic agent
Cephalosporins are grouped into subcategories called "generations" with each higher generation representing a broader spectrum of effectiveness
These drugs act by blocking the replication cycle of human immunodeficiency virus (HIV): antiretrovirals
Which of the following are common adverse effects of aminoglycosides and some other antibacterials? ototoxicity and nephrotoxicity
MRSA ("Mersa") is a resistant strain of bacteria
Which drug category would be indicated for a gram-positive infection in patients who are allergic to penicillin? macrolides
Which of the following contributes to acquired resistance of bacteria to antibacterials? - not completing all of the medication as prescribed -mutations -hospital-acquired infections
Broad spectrum refers to antibacterial agents which are effective against a wide variety of gram-positive and gram-negative bacteria
Appropriate medication category for a patient diagnosed with pinworms (a species of roundworm) is antihelminthics
Patients being treated for tuberculosis must take antibacterials for a very long time. Which of the following will most likely prevent resistance? Administer several different antibacterials concurrently
Differentiate between a bacteriocidal agent and a bacteriostatic agent bacteriocidal agent- that is capable of killing bacteria bacteriostatic agent- is one that inhibits (stops) the bacteria’s ability to reproduce (-static means to limit increase)
Explain the role of the beta-lactam ring and B-L ring enzyme (beta-lactamase) in antibiotic choice and bacterial resistance beta-lactam ring- ring coat around penicillin cell B-L ring enzyme (beta-lactamase)-which can break down the beta-lactam ring, rendering the penicillin ineffective
Explain how culture and sensitivity studies should be used in determining appropriate antibiotic therapy culture-Specimen is collected, Specimen is grown in culture medium, and if growth indicates infection, sensitivity is determined sensitivity-Gram staining and other tests are conducted to determine which antibiotics will likely kill the organism
Describe four factors that contribute to the development of acquired resistance to antibacterial agents 1-mutations-allowing bacteria to be resistant to antibiotic 2-Nosocomial infections-HAI 3-Inappropriate antibiotic usage- stop of antibiotic before time 4-over prescribing-antibiotics completely ineffective
Explain why tuberculosis requires a concurrent multi-antibacterial regimen tubercles make it difficult for antibiotics to reach the organisms and allow the organisms an extended time in which to develop resistance
Explain why antibiotics (antibacterials) are ineffective against viruses have no cell wall that can be breached, do not reproduce in the same way that bacteria do, and they are not dependent on folic acid
Identify the most serious side effect(s) associated with each of the following: penicillins (headache; gastrointestinal upset, rash) or very serious adverse effects such as anaphylactic reactions
Identify the most serious side effect(s) associated with each of the following: cephalosporins kidney damage, (headache; gastrointestinal upset, rash) or very serious adverse effects such as anaphylactic reactions
Identify the most serious side effect(s) associated with each of the following: levofloxacin (a fluoroquinolone) seizures, hallucinations, nightmares, depression, confusion, GI infections, and peripheral neuropathy
Describe, in general, the difference between cephalosporin generations 1st gen- beta lactam ring/many are resistant to them 2nd gen- broader spectrum w/ beta lactamase 3rd gen-even more resistant to beta-lactamase 4th gen-very effective against many gram-positive and gram-negative organisms
Describe the effect that repeated or prolonged tetracycline use can have on the teeth stains teeth
For aminoglycosides: describe their primary use and their commonly-associated adverse effects -primary use for serious gram neg. infections in hospitalized patients -common adverse effects ototoxicity and nephrotoxicity
bacterial resistance or antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth
broad spectrum antibacterial agents (antibiotics) are agents that are effective against a wide variety of grampositive and gram-negative bacteria
chemoprophylaxis is the administration of antibiotics to prevent an infection
extended spectrum antibacterial agents these combine an antibiotic with a drug that inhibits bacterial production of beta-lactamase
MRSA (also known as “Mersa”) Methicillin-resistant Staphylococcus aureus bacterial mutations occur which create genes resistant to the antibiotic. The resultant genes are then passed on to subsequent generations of bacteria
narrow spectrum antibacterial agents are effective against very specific types of bacteria
nephrotoxicity capable of causing kidney damage
nosocomial infection nosocomial means “hospital acquired” but the term applies to infections acquired in any type of health care facility, such as hospitals, long term care facilities, clinics and doctors’ offices
ototoxicity capable of causing hearing loss
pathogenicity is the ability of a pathogenic agent to produce a disease in any given species. In other words, it refers to the ability of the bacteria to harm the host
superinfection – Infections occurring postanti-infective therapy – May or may not be caused by resistant strains – Etiology: disruption of normal host flora – Can result in uncontrolled growth of microorganisms that are not affected by the antibacterial in use
virulence pertains to the power of any given strain to produce disease. Higher virulence means the pathogen can produce disease when present in very small numbers
Identify the advantage of combination antibacterials such as Augmentin and Timentin Combination drugs that combine an antibacterial with a drug that inhibits the bacterium’s ability to produce penicillinase
Explain why Vancomycin should be reserved for only the most severe bacterial infections It is an extremely potent antibiotic and adverse effects are very serious
Name the side effects associated with Vancomycin, and explain the precautions that should be taken in patients receiving this drug nephrotoxicity, ototoxicity and anaphylaxis -patients taking the drug must undergo blood and urine tests two to three times daily to monitor for signs of adverse reactions
bacteriocidal antibacterials (such as penicillin) MECHANISM OF ACTION;they kill bacteria by breaking up the cell wall. Fluids then enter the breached bacterial cell, causing it to swell and disintegrate INDICATIONS: bacterial infections
bacteriostatic antibacterials (such as macrolides, tetracyclines) MECHANISM OF ACTION; Interfere w/ protein synthesis (bacteriostatic) + are resistant to penicillins Tetracyclines IND:rocky mountain spotted fever, chlamydia, lyme disease, anthrax, cholera Macrolides IND:Legionnaire's disease, STDs, UTI, Pertussis
antifungals MECHANISM OF ACTION; bind to fungal membranes, cause change in cell permeability, causes destruction INDICATIONS: superficial mycoses and candidiasis
antiretrovirals MECHANISM OF ACTION;block replication cycle of the virus INDICATIONS: HIV
antivirals MECHANISM OF ACTION; block or prevent the virus from attaching to human cells, interfere w/ viral activity, impair viral synthesis INDICATIONS: herpes, influenza
antituberculars INDICATIONS; latent TB infection
cephalosporins INDICATIONS; bacterial infections, Resp tract infections, skin infections, UTI
aminoglycosides INDICATIONS;to deadly gram-negative nosocomial infections such as Klebsiella and Pseudomonas
fluoroquinolones INDICATIONS; anthrax exposure or for prophylactic (preventive) treatment when possible exposure has occurred. It is also one of the drugs that is often prescribed for treatment of tuberculosis
Vancomycin INDICATIONS;against many gram-positive bacterial infections, including Staphylococcal and Streptococcal infections
sulfonamides INDICATIONS; treatment of susceptible urinary tract infections
antihelminthics INDICATIONS; used to treat infections with parasitic worms
antimalarials INDICATIONS; prevent or treatment of malaria, lupus
antiprotozoans INDICATIONS;infections of the GI tract
amebicides INDICATIONS; acute and chronic intestinal amebiasis, hepatic coma
Functions of the liver -uses vit K to make the clotting factors -plasminogen is produced -secrete bile -detoxification -breakdown of erythrocytes and hemoglobin
What can cause coagulation disorders? -conditions in which the patient's blood clots when it shouldn't -conditions in which the clotting mechanism is impaired, resulting in chronic blood loss or hemorrhage
What are the three main factors contributing to hypertension medications allergic reactions illnesses
What are the MOA of drugs to treat hypertension? -decrease fluid volume -block absorption of calcium into the cells -lower blood volume/receptor blockers block the action of angiotensin II, block aldosterone production -block sympathetic NS
What are the five main categories of drugs to treat hypertension? -diuretics -ace inhibitors -adrenergic blockers -Ca channel blockers -angiotension receptor blockers
There are two forms of stroke – name each and describe treatment ischemic stroke due to thrombus -thrombolytics /TPA /antihypertensive /Anticoagulent /analgesics /anxiolytics Hemorrhagic stroke is a ruptured blood vessel in the brain -Hemostatics /Hyperosmotic/ antihypertensives/analgesics/ Anxiolytics
Lipids are insoluble compounds stored in muscles and organ cells, name the types Triglycerides Steroids (one of which is cholesterol) Phospholipids
How do viruses respond to antibiotics and what is the treatment for viruses -ineffective because have no cell that can be breached, don't reproduce like bacteria, and not dependent on folic acid -treatment must block the replication cycle or prevent attachment to host cells or impair viral protein synthesis
Created by: vtlove116
 

 



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