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pharm final
| Question | Answer |
|---|---|
| distribution | extent that a drug spreads into three specific compartments blood stream/blood volume interstitial space intracellular space |
| distribution | determined by size and chemical nature |
| Elimination | Inactivation/removal of a drug from the body |
| bioavailability | amount of drug that makes it to the blood |
| percutaneous route | applied and absorbed thru the skin |
| enteral route | through GI tract, most commonly used route for drug administration, given by oral route |
| parenteral route | injected into the body |
| pharmacodynamics | how a drug works to change body function |
| pharmacokinetics | How the body changes the drug |
| intended action | desired effect of a drug on a specific body cell or tissue |
| adverse effect | harmful side effect that is more severe than expected and has potential to damage tissue or cause serious health problems. |
| absorption | the movement of drug dose that actually reaches the blood |
| bioavailibilty | the amount of a drug dose that actually reaches the blood |
| transdermal | the drug is applied to skin, passes through skin, and enters the bloodstream to affect an internal organ. ex.Nitroglycerin paste |
| rectal route | patients who are unable to swallow or have severe nausea and vomiting may need to have drugs given by this route (suppository or enema) |
| rectal route | left sims position is best for which route |
| intradermal route | administered by an injection between the layers of the skin, most common site is inner forearm. |
| primary uses for Intradermal route | allergy testing local anesthetics tb testing |
| Intradermal | (0.01-0.1 mL) needle is short and small (3/8 inch, 25 gauge) 10 -15 degree angle |
| subcutaneous route | injected into tissues between skin and muscle |
| subcutaneous route | insert needle at 45 degree angle obese pt. 90 thin pt. less than 45 |
| Corticosteroids | reduces WBCs , so pt. is at greater risk for infections |
| corticosteroids teaching | -check older pts blood glucose level (increases levels) hyperglycemia -don't stop taking drug suddenly (reduce amount) adrenal insuff. -avoid large crowds (risk of infections) -take w/ food (prevents stomach ulcers) |
| NSAIDS | inhibits prostaglandin action, taken for pain and inflammation. |
| Antihistamines | avoid alcohol and driving because it can induce sedation. report vision probs and enlarged prostate. |
| Aspirin | avoid giving to children causes Reyes syndrome (liver disease that can cause coma, brain damage, and death.) |
| NSAID (COX 1) | reduce platelet clumping and blood clotting. (blood thinner) (increases risk for bleeding) |
| Leukotriene inhibitors | work in several ways to prevent asthma, prevents asthma episode. Intended responses—reduced swelling of oral, nasal, eye, respiratory mucous membranes; reduced secretions; narrowed airways open |
| Leukotriene inhibitors | check for liver probs. (causes liver impairment) |
| Antihistamines | reduces inflammation , by preventing the inflammatory mediator histamine from binding to its receptor. |
| NSAIDS | don't take with Warfarin, causes risk for stroke and excessive bleeding. |
| Antihistamines | Intended responses: Blood vessels do not dilate; reduced swelling; mucus, other nasal, eye, respiratory secretions are reduced; narrowed airways widen; hives decrease in size, itchiness |
| opioid blocker | Narcan, Meloxican |
| Acetaminophen | max dose is 3g every 24 hours, and toxic to the liver at high doses |
| Acetaminophen | for overdose you have to take Acetylcysteine, (IV) ASAP to prevent liver damage. (will not work over 24 hrs.) |
| Acetaminophen | avoid alcohol (liver probs), be careful of OTC meds that contain this same med (overdose) |
| Opioids | before and after giving check vitals ( resp. rate, BP, HR) (causes respiratory depression) |
| addiction | need or craving for a high, when pain is not present |
| Opioids | causes risk for respiratory depression. <8 bpm (hypoxia) |
| tetracyclines | -can cause photosensitivity -teeth discoloration in kids(yellowish- grayish) -drink w full glass of water |
| Vancomycin | nephrototoxic, ototoxic |
| Pseudomembranous colitis | a complication of antibacterial therapy that causes severe inflammation in areas of the colon (large intestine). diarrhea |
| Vancomycin and Amoxicillin | these meds causes Pseudomembranous colitis |
| antieffectives | side effects: increased bowel movements yo severe diarrhea loss of normal flora in mouth and vagina causing yeast infections and thrush |
| Vancomycin | has a Red Man Syndome complication, give aspirin to slow rate down. |
| Vancomycin | only given through IV, over 60 minutes slowly to reduce Red man syndrome |
| Antibiotics | can cause overgrowth of fungus causing thrush and yeast infections |
| antivirals | virustatic drug that prevents viruses from either reproducing or releasing genetic material |
| Antibiotics | before giving an antibiotic get and culture and sensitivity or blood test before 1st dose |
| steven Johnson syndrome | results from a variety of rashes and skin blistering. pt is dehydrated and may need skin graft |
| Acyclovir and Valacyclovir | Take w/ full glass of water (3L) daily see if pt is taking Dilantin phenytoin may needed to be adjusted (decrease effectiveness) Admin slowly over 60 mins to avoid kidney prob. |
| Zanamavir | must be taken within 12 -36 hrs of 1st symptom |
| Oltamnavir | must be taken within 12 -48 hrs of 1st symptom |
| Antiretroviral | suppress the replication of of retroviruses |
| HAART | Highly Active Antiretroviral Therapy , combination of 2 or more drugs to reduce the number a person has to take. |
| antiretroviral | interact w/ so many other drugs, can cause serious adverse effects and change activity of drugs |
| HAART doses | do not skip or reduce doses |
| TB - first line drugs | diarrhea, headache, nausea, vomiting, difficulty sleeping |
| Rifampin | causes anema, orange urine, tears, skin stains, abdominal pain ad urinary retention not permenant , drink lots of water |
| TB meds | Liver toxic, check LFTs. avoid alcohol , can lead to liver damage or failure. |
| tb med pt. teaching | no longer contagious after 2-3 wks of treatment 6 months of med therapy no alcohol or acetaminophen |
| Antifungal adverse effects | anemia, liver toxicity, hyperkalemia, severe rashes, abnormal heart rhythms, and reduced kidney function |
| Antifungals | check liver function, jaundice, BUN, creatinine |
| fungicidal | kill fungal infections with systemic drugs |
| Insulin | the hormone secreted by the beta cells of the pancreas to orevent glucose levels from becoming too high. |
| Insulin | given when hyperglycemia occurs to restore normal blood glucose levels |
| fast acting insulin | give within 15 mins of meal or close to meal |
| type 1 DM | results when beta cells of pancreas no longer secrete any insulin. begins in chldren |
| type 2 DM | genetic causes, make some insulin of their own. common in obesity |
| insulin angle and needle size | 28 - 30 gauge/ 1/2-5/16inch 90 degree 45 thin pts |
| Hypoglycemia S/S | loss of consciousness, anxiety,confusion headache cool, clammy skin hunger increased sweating rapid, pounding heart rate shaking, tremors |
| Metformin | can cause lactic acidosis, check see if pt. has surgery or scan involving dye. if so hold this med |
| Hypothoroidism | condition of low function, causing low blood levels of thyroid levels and slows metabolism |
| Hyperthoroidism | increase in thyroid gland activity causing high blood level i thyroid hormones. |
| Thyroid hormone agonist drugs | taking warfarin increase the risk for bleeding and bruising take 2-3 hours before meal or after taking fiber supplement (can absorb w/ food) |
| untreated hypothyroidism can lead to | Myxedema |
| untreated hyperthroidism can lead to | thyroid crisis or thyroid storm |
| diuretics | drugs that rid the body of excess water and sodium by i ncreasing a persons urine output *(can lead to dehydration) |
| diuretics | work directly on kidneys or may increase blood flow to the kidney. |
| before giving a diuretics | monitor weight, bp,hr. monitor electrolytes (esp. potassium & sodium) give in the a.m. ( for sleep at night) take as prescribed |
| potassium sparing meds | slow the sodium pumps so more sodium and water are excreted as urine, (do not increase the loss of K+) |
| potassium sparing meds | avoid supplements avoid high K+ diet limit salt substitues |
| potassium sparing meds | hypotension hyponatremia vomiting, diarrhea hyperkalemia |
| hypertension | when blood pressure remains abnormally high |
| hypertension | check BP teach how to monitor for orthostatic hypotension |
| Ace inhibitors | block production of substances that constrict (narrow) blood vessels. the decrease the buildup of water and salt |
| Ace inhibitors | persistent dry cough, hypo-tension, protein in urine, taste disturbances ,hyperkalemia, headache |
| Ace inhibitors adverse effects | Risk for angioedema |
| Ace inhibitors | given to patients with heart problems ,kidney disease, and diabetes. are often prescribed w/ diuretics to control hypertension |
| Ace inhibitors | report cough to HCP so another type of med can be given |
| ARBs | block the effects of Angiotensin II by directly binding the angiotension II to angiotension II type 1 receptors |
| ARBs adverse effects | Kidney failure Severe Angioedema Liver Toxicity Drug induced Hepatitis |
| ARBs | controls high blood pressure |
| drugs for heart failure | Ace inhibitors, Beta Blockers Vaodilators( Nitroglycerin) Cardiac Glycosides Diuretics Human B type natriuretic peptides Positive Inotropes |
| vasodilators (Nitroglycerin) | Keep in dark place every 5 mins up to 3x BP over 100 |
| Vasodilators | act on peripheral arteries to cause them to dilate and lower BP |
| Nitroglycerin types | Sublingual Oral Patch Ointment Buccal IV |
| Nitroglycerin adverse effects | hypotension |
| Nitroglycerin teaching for ointment | Wear gloves , take old patch of first, clean and rotate site give acetaminophen for headache. |
| Hydralazine | causes tachycardia , headache and salt retention |
| Statins | inhibit HMG CoA reductase, an enzyme that controls cholesterol production in the body. Lower LDL cholesterol |
| Bile Sequestrants | helps the body lose cholesterol. |
| Rhabdomyosis | Muscle weakness and breakdown |
| Normal Cholesterol Level | <200 mg/dL |
| Salicylates | decrease platelet aggregation. prevent clot formation |
| Bronchodilators | when giving two or more meds for asthma, give _______ first then wait at least 5 mins before giving second drug. |
| Short Acting beta adrenergic agonist SABAs | rescue drugs, bcuz they provide a rapid but short term relief. most useful when asthma attacks begins |
| Long Acting adrenergic agonist LABAs | used to prevent asthma attack but effects last longer. must be taken daily |
| What to do prior to giving bronchodilators | asses lungs |
| beta blocker eye drops can cause | systemic effects like worsening asthma and heart failure |
| ED side effects | Difficulty keeping and maintain erection decreased sexual desire |
| BPH meds side effects | decreased libido floppy iris syndrome ED slowing growing of hair low BP stuffy nose back pain |
| Contraceptive teaching | take with food have a scheduele risk for developing blood clots, (stop smoking) check for jaundice doesnt prevent HIV rt, any other drugs taken |
| hormone therapy teaching | urge to quit smoking check for jaundice report chest pain, diff. breathing, swelling in on leg, or stoke symptoms |
| before giving anti dysrhytmic meds | assess apical pulse, HR and rhythm, hold if below 60 |
| Intravenous (IV) | Emergency Drugs IV Fluids Antibiotics TPN, PPN |
| Intravenous (IV) | Very fast Absorption Directly into vein |
| Intramuscular (IM) | Vaccinations Immunizations Antibiotics Pain Meds |
| Intramuscular (IM) | Faster than Sub Q, slower than IV Deltoid Vastus Lateralis Ventrogluteal |
| Intramuscular (IM) | 20-22 gauge 90 degree angle, Z track method |
| Subcutaneous | Slower than IM 45 degree angle (thin) 90 degree angle (obese) |
| Subcutaneous | Insulin Heparin Lovenox |
| Subcutaneous | Abdomen Upper back Back of Arms |
| Subcutaneous | 3/8 inch -(25-27 gauge) |
| Subcutaneos | 0.5 - 1 mL |
| Intramuscular (IM) | 1-3 mL over 3 doses divide |
| Intradermal | Slower than Sub Q |
| Intradermal | Lower forearm Between Layers of skin |
| Intradermal | 3/8 inch - 25 gauge 10-15 degree angle |
| Intradermal | 0.01 -0.1 mL |
| bile acid sequestrants | They bind with cholesterol in the intestine, preventing the fats from being absorbed into the blood. This action then eliminates the cholesterol from the body through the stool. |
| Stains should be avoided in | Pregnant Women |
| NSAIDS side effects | Bleeding probs. GI ulcersand Pain Fluid Retention HTN |
| NSAIDS | These drugs are discontinued before planned procedures , Dental work or surgies |
| Celecoxib (celebrex) | A pt who is allergic to sulfa is likely to be allergic to this drug |
| COX 1 | Helps make many different types of prostaglandins |
| COX 2 | Help make all mediators of the inflammatory response |
| NSAIDS | CAN RETAIN SODIUM AND FLUID causing hypertension. |
| antihistamine side effects | Sleepiness dry mouth blurred vision tachycardia urinary retention |
| Antihistamines | do not give to a pt who is having an acute asthma attack, causes drowsiness. |
| Antihistamines | Dont give with opioids, sedatives, barbiturates, and muscle relaxants., increases drowsiness. |
| Antihistamine job is to? | Stop Histamine from causing inflammation |
| Antihistamines | do not give in a patient with glaucoma, urinary retention and hypertension |
| Monteleukast (singular) | report any thoughts of suicide while taking this drug (assess for mood changes) |
| Leukotriene side effects | headache and abdominal pain |
| corticosteroids | causes sodium and water retention which can lead to hypertension and weight gain. |
| ends is -one | Corticosteriods |
| corticosteroids adverse effects | adrenal gland suppression reduced immune function delayed wound healing |
| corticosteroids after 1 week of therapy | acne Na+ and H20 retention elevated BP Nervousness Diff. sleeping crying easily |
| corticosteroids after 1 month of therapy | fragile skin weight gain fat redistribution thin scalp hair stretch marks loss of muscle mass and strength gi ulcers and bleeding |
| tolerance | adjustment of body to long tern opioid use, drugs is eliminated fast |
| dependence | long term opioid use that is not needed for pain control |
| withdrawal | symptoms occur after long term opioid use is stopped suddenly |
| schedule 1 drugs | high potential for abuse; heroin, LSD, weed |
| schedule 2 drugs | high potential for drug abuse, but accepted as treatment. cocaine, morphine, oxycodone, dilaudid |
| schedule 3 drugs | potential for abuse , may lead to dependence Tylenol 3 or 4,acetaminophen, aspirin |
| schedule 4 drugs | low potential for abuse; benzodiapenes, Valium, Xanax |
| schedule 5 drugs | least for abuse; cough meds. |
| opioids | can cause constipation. |
| opioids | can cause nausea take with food |
| Pseudomembraneous colitis | severe diarrhea low grade fever abdominal pain constant feeling of having to shit |
| cell wall synthesis inhibitors | a class of antibacterial drugs that kill susceptible bacteria from preventing them from forming strong, protective walls |
| Tetracycline | is a protein synthesis inhibitor prescribed to ppl allergic to penicillin |
| Tetracycline side effects | nausea/vomiting sore tongue rash |
| potassium channel blockers | used to treat VT, VF amidarone dofetilide ibutilide sotaolol |
| potassium channel blockers | class III |
| beta blockers | used to treat SVT block the effects of epinephrine on the heart |
| beta blockers | class II acebutolol emolol propanolol sotaolol |
| Calcium channel blockers | class IV slow the conduction of the av nodes and sa nodes , decreasing the heart rate |
| Calcium channel blockers | Treats SVT dilitiazem (cardizem) verapamil (calan) |
| Magnesium | Treats torsades de pointes |
| Adenosine | Treats SVT slows eletctrical impulse conduction to av node to return normal sinus rhythm |
| Sodium Channel Blockers class Ia | Treats PVCs, SVT, VT,prevent VF stops sodium movement thru cell membranes quinindine procainamide disopyramide |
| Miscellaneous | class 1 treats life threatening ventricular dysrhythmias |
| sodium channel blockers class Ib | treats PVCs, VT, prevent VF lidocaine phenytoin tocainide mexiletine |
| sodium channel blockers Ic | treats life threatening VT or VF and SVT unresponsive to other drugs flecainide propaferone |
| SABAs | albuterol levalbuterol pirbuterol |
| LABAs | salmeterol arformoterol formoterol |
Created by:
Krissydior
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