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322 Final
322 Old Important
| Term | Definition |
|---|---|
| absoprtion | taken into the body, moved to the bloodstream |
| disintegration | breakdown to smaller particles |
| dissolution | combining small particles with liquid to be absorbed from GI into blood stream |
| distribution | drug is delivered to tissues; based on blood flow, capillary permeability, protein binding and solubility |
| high distribution | small, lipid soluble, unbound |
| low distribution | large, water soluble, bound |
| metabolism | liver converts drug into a form that can be excreted; patients with hepatitis or cirrhosis can develop toxicity |
| excretion | kidney removes drugs from the body; if kidney injury leads to drug accumulation |
| shorter half life | dies out quickly, need more doses |
| first pass effect | drugs are inactivated on their first pass through the liver, need a higher or loading dose |
| bioavailability | percent of drug ready for use; IV is always 100, oral depends on GI secretion and motor function |
| PO drug fastest | liquid since it's already broken down |
| protein binding | reversible; bound molecules cannot reach their site of action |
| patient with lower albumin | drug toxicity |
| safety in administration | right patient, drug, dose, time, route, assessment |
| phase 1 | evaluate safe dosage and side effects; small group, no comorbidities |
| phase 2 | tested in patients with the disease, determine therapeutic effects, safety and effectiveness |
| phase 3 | clinical market, prescribers observe closely |
| phase 4 | unexpected effect identified here, post marketing surveillance |
| anticholinergic bronchodilators | allow air passages to remain open; chosen if patient expericnes side effects from regular bronchodilator |
| short acting inhaler | albuterol, relieves and stops asthma attack in its track |
| long acting inhlaer | salmeterol, prophylactically used for prevention, taken around the clock |
| steroid and bronchodilator | long term to prevent attack; decrease inflammation and keep airways open |
| side effects of bronchodilators | nervousness, restlessness, BP and HR increase |
| rebound congestion | happens if nasal decongestant is used longer than 3 days |
| 1st generation antihistamine | diphenhydramine causes sleepiness and hangover, dry mouth common |
| 2nd generation antihistamine | less able to pass BBB and cause sedation, loratidine |
| opioid antitussive | guaf, must be taken with water |
| expectorant | loosens bronchial secretions and reduces surface tension; less sticky |
| osmotic laxative | hyper osmolar salts pull water into colon and increase water in feces to increase bulk; used in bowel preps; lactulose |
| stimulant laxative | increases peristalsis by irritating nerve endings; dulcolax; most abused; senna |
| bulk forming laxatives | natural fibrous substance, increases bulk and peristalsis, need to increase water and fiber intake |
| emollient laxative | stool softener, docusate, used for cardiac patients, give with water |
| antiemetic | serotonin antagonist; ondansetron for chemo, nausea; no drowsiness side effect; headache, dizziness |
| PUD | use endoscopy tissue sample for H pylori, breath test; double antibiotic therapy and PPI |
| H2 blockers | reduce acid secretion, work quicker than a PPI |
| PPI | suppress secretion of hydrochloric acid and does not allow the body to produce HCl |
| metronidazole | gut antibiotic, metallic taste |
| digoxin toxicity | anorexia, malaise, vomiting, halos around objects, confusion and delirium, bradycardia, low potassium increases risk |
| antidote digoxin | digoxin immune fab, digibind; excretes through the urine |
| nitroglycerin | promotes rapid vasodilation, dilates veins leads to less blood flow to heart, dilates arteries less resistance; used for angina, MI |
| side effect nitroglycerin | hypotension, syncope |
| administration nitroglycerin | sublingual, onset 1 to 3 minutes, feel zing; 1 dose under tongue every 5 minutes, 3 doses max; has high first pass |
| beta blocker - olol | diminish SNS response which lowers BP and HR |
| calcium channel blocker - diltiazem | relax coronary artery spasm, relax arterioles; peripheral edema, flushing, headache, slows and controls heart rate |
| ace inhibitors - pril | vasodilates, causes dry nonproductive cough, hyperkalemia |
| thiazide | do not use in renal patients, if potassium is too low, do not administer |
| loop | potent, choose for renal patients |
| osmotic | increased intracranial pressure, glaucoma |
| potassium sparing | monitor potassium levels |
| warfarin | inhibits synthesis of vitamin K, monitor PT and INR |
| warfarin antidote | vitamin K |
| heparin | accelerates anticoagulation cascade and prolong clotting time; monitor PTT |
| heparin antidote | protamine sulfate |
| anticoagulant teaching | examine for signs of bleeding, inform dentist when on anticoagulants, use soft toothbrush, electric razor and avoid leafy greens |
| adverse reaction of statins | rhabdomyolysis - breakdown of skeletal muscle that releases damaging protein, causes renal failure |
| statin monitor | avoid grapefruit juice, monitor BUN, Cr, liver functions test, have annual eye exams |
| priority seizure assessment | neuro and safety - side rails padded, lowest position, know timing of seizure, recovery position - side lying |
| hydantoins | 10 - 20, causes gingival hyperplasia, nystagmus, purple glove syndrome |
| iminostilbene | 4 - 12, hematologic toxicity, GI distress, interaction with grapefruit juice |
| succinimides | 40 - 100; blood dycrasias, SJS, lupus, suicidal ideation |
| valproic acid | 50 - 100; liver toxicity is deadly, GI upset, insomnia, thrombocytonpenia |
| parkinson's | lack of dopamine affects the extrapyramidal tract - controls posture, balance, locomotion |
| parkinson care | improve ability to perform ADL's, safety |
| dopaminergic | increases mobility, carvidopa added to levodopa so it can reach the brain; can cause EPS and orthostatic hypotension |
| myasthenia gravis | decreased ACh prevents normal muscle contraction; concerned about respiratory muscles and airway |
| myasthenia crisis | underdosing acetylcholinesterase inhibitors causes generalized muscle weakness and intercostal muscle failure |
| myasthenia crisis treatment | neostigmine - fast acting AChE inhibitor |
| cholinergic crisis | overdosing acetylcholinesterase inhibitors, causes respiratory paralysis and arrest within 30 minutes |
| cholinergic crisis antidote | atropine |
Created by:
ahommel
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