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Pharmocology
Pharm
| Question | Answer |
|---|---|
| Alzehiemers can be cured | No, the progression can be slowed |
| Primary neurotransmitters involved in dementia | Acetylcholine And. Glutamate |
| What are neurotransmitters? | Neurotransmitters are the messengers that carry signals across the synapse |
| Dementia | Chronic degenerative memory loss |
| Pharmacology is | The study of biological effects of chemicals |
| Pharmacotherapeutics | Application of drugs for the purpose of disease prevention |
| ACE suffix | Pril Prototype: Lisinopril |
| BETA suffix | Olol Atenolol, Metoprolol, and Bisoprolol- cardio selective betablockers Labetalol and carvedilol block beta- and alpha-adrenergic receptors work on heart and peripheral |
| Heart Failure drugs | |
| Decongestants | |
| Levadopa | Parkinson’s drugs |
| Cardopa | Parkinson’s drug |
| Adrenergic respoptors respond to | Catecholamine |
| What are catecholamines | Norepinephrines and epinephrine |
| What drugs suppress the cough | What are antitussives |
| What do anticholinergics do | Dry you out and symptoms are dry mouth, urinary retention, |
| Main drug classes for osteoporosis | Calcium, calcitonin, biophosphonates, selective estrogen receptor modulators(SERMs) |
| What drug causes ginival hyperplasia | Dilantin |
| 1st line drugs for MS | Interferon Beta 1a /1b. & Glatiramer |
| Drugs used to manage symptoms of MS | Anti anxiety, antidepresssants, analgesics |
| What is the characteristics of a perfect drug? | RESPONSE TIME • ADVERSE EFFECTS • CONVENIENCE • EFFECTIVENESS • FREQUENCY • EXPENSE • ELIMINATION • DRUG/FOOD INTERACTION 4 |
| when was the FDA established | 1906 |
| What Is a teratogen | DRUGS THAT CAUSE BIRTH DEFECTS alcohol,german mealses, mercury |
| What is a generic drug | • BIOEQUIVALENT TO BRAND NAME DRUGS • EQUALLY SAFE • MORE COST-EFFECTIVE • HAVE IDENTICAL THERAPEUTIC USES |
| Orphan Drugs are | Drugs that have been discovered, but are not financially viable and therefore have not been “adopted” by any drug company |
| TWO BASIC CLASSIFICATION SYSTEMS | THERAPEUTIC CLASSIFICATION: DESCRIBES WHAT IS BEING TREATED BY THE DRUG • PHARMACOLOGIC CLASSIFICATION: DESCRIBES HOW THE DRUG ACTS |
| define prototype | • A PROTOTYPE DRUG IS THE AGENT TO WHICH ALL OTHER MEDICATION IN A CLASS ARE COMPARED |
| Define pharmacodynamics | THE STUDY OF THE INTERACTIONS BETWEEN THE CHEMICAL COMPONENTS OF LIVING SYSTEMS AND THE FOREIGN CHEMICALS, INCLUDING DRUGS, THAT ENTER THOSE SYSTEMS • PHARMACO = MEDICINES • DYNAMICS = CHANGE 20 |
| what is a agonist | A drug that activates a receptor and produces the same type or greater response the natural chemicals would cause at that site |
| What is a Antagonist | A drug that binds to a receptor and prevents the endogenous chemical from binding to produce its action 22 |
| What is a therapeutic index | A RATIO OF THE BLOOD CONCENTRATION AT WHICH A DRUG BECOMES TOXIC TO THE CONCENTRATION AT WHICH IT IS EFFECTIVE |
| Define Pharacokinetics | PHARMACOKINETICS FOCUSES ON HOW THE BODY ACTS ON THE DRUG AFTER ADMINISTRATION. |
| 4 PROCESSES OF PHARMACOKINETICS | • ABSORPTION • DISTRIBUTION • METABOLISM (BIOTRANSFORMATION) • EXCRETION |
| absorption is | THE PROCESS OF MOVING A DRUG FROM THE SITE OF ADMINISTRATION TO THE BLOODSTREAM • ABSORPTION IS THE PRIMARY FACTOR TO DETERMINE THE ONSET OF DRUG ACTION AND THE INTENSITY OF THE DRUG ACTION continued on next slide |
| what is the routes of administration | • ENTERAL • ORAL, NASOGASTRIC TUBE, OR GASTROSTOMY TUBE • FIRST-PASS EFFECT • TOPICAL • APPLIED TO THE SKIN OR MUCOUS MEMBRANES • PARENTERAL • IV, IM, SQ |
| drug allergies require a exposure to drug | True |
| what are the 2 types of histimine receptors | H1- activation produces typical symptoms of allergy • H2- increase gastric acid secretion |
| name the generations of histamines | 1st generation: diphenhydramine • 2nd generation: cetirizine • 3rd generation: fexofenadine |
| adverse effects of antihistamines | CNS: drowsiness and dizziness (more common with 1st generation) • Young children may experience CNS stimulation instead of CNS depression • GI: N/V • Anticholinergic effects (more common with 1st generation |
| adverse effects of a steroid decongestants and name the protype | Adverse Effects • Uncommon when use appropriately (because they aren't absorbed systemically) • Local burning, irritation, stinging, dryness of the mucosa, and headache (common) • Prototype: fluticasone |
| preferred drugs for asthma | Controllers Low-dose inhaled corticosteroids Relievers o Low-dose inhaled corticosteroids with formoterol Or o Inhaled short-acting beta2 agonist (SABA) |
| BETA2-ADRENERGIC AGONISTS are | Prototype: Albuterol (SABA |
| inhaled anticholinergics | Ipratropium (short-acting)- prototype • Aclidinium (long-acting) • Tiotropium (long-acting) • Umeclidinium (long-acting) • Glycopyrrolate and revefenacin |
| adverse effects of anticholergics | Hoarseness, dry mouth, and a bitter taste • Increased intraocular pressure (worsens glaucoma) (rare) • Anticholinergic adverse effects (not common |
| XANTHINES (AKA METHYLXANTHINES | modest bronchodilators • Chemically related to caffeine • Include • Theophylline (prototype) and caffeine 30 |
| what herbal medicine should not be taken with theophylline | St. John’s Wort |
| CORTICOSTEROIDS inhaled | Beclomethasone is prototype • Meds Include: beclomethasone, budesonide, fluticasone, ciclesonide, and triamcinolone |
| INHALED STEROIDS side effects | Hoarseness, sore throat, coughing, dry mouth, and oral fungal infection, headache • Long term therapy has the potential to affect bone physiology in children and adults • Decrease in growth in children • Risk of osteoporosis in adults |
| LEUKOTRIENE RECEPTOR ANTAGONISTS | Montelukast is prototype • Zafirlukast, montelukast, & zileuton |
| IMMUNE MODULATORS | Benralizumab • Dupilumab • Mepolizumab • Omalizumab (prototype Reslizumab |
| what are the side effects of calcitrol | GI effects (N/V, dry mouth, constipation, metallic taste) • hypercalcemia |
| CALCITONIN | Contraindications: • Allergy to med and to fish protein and salmon • Adverse Effects • Flushing of face and hands, N/V, rash (most common) • Hypocalcemia • Nasal dryness (with intranasal) or injection site reactions • Hypersensitivity reactions/a |
| What are BISPHOSPHONATES | Prototype: alendronate drug for osteoporosis |
| Side effects of alendronate | Hypocalcemia • GI Effects: N/V, abdominal pain, constipation/diarrhea, esophagitis, and esophageal ulceration • Osteonecrosis of the jaw |
| SELECTIVE ESTROGEN RECEPTOR MODIFIERS (SERMs) | Drug for osteoporosis • Prototype: raloxifene |
| what is the warning on all antidepressants | All antidepressants come with a Box warning because they are associated with an increased risk of suicidal behavior in children through young adults 5 |
| 3 main classifications/mechanism of action | Inhibit monoamine oxidase (MAO) 2. Block reuptake of neurotransmitter(s) 3. Regulate receptor sites and the breakdown of neurotransmitters |
| SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs drugs | oPrototype: fluoxetine (Prozac) o1st SSRI oMost widely prescribed SSRI in the United States oCitalopram (Celexa) oEscitalopram (Lexapro) oSertraline (Zoloft) oParoxetine (Paxil) oFluvoxamine (Luvox) |
| side effects of SSRI | GI: N/V (most common but decreases as therapy progresses), diarrhea, dry mouth (common) CNS: GU: Painful menstruation and sexual dysfunction Weight gain Bruxism |
| MOA of SSRI-- | blocks reuptake of serotonin |
| What is serotonin syndrome | Occurs when there is too much serotonin in the body |
| symptoms of serotonin symdrome | confusion (altered mental status), agitation, hallucinations, seizures, tachycardia, sweating, ataxia, tremors, fever, hyperreflexia, coma, death |
| SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIs drugs | Venlafaxine (Effexor) Duloxetine (Cymbalta) Desvenlafaxine (Pristiq) Levomilnacipran (Fetzima) Milnacipran (Savella) *for fibromyalgia only |
| MOA of SNRI | Decreases the neuronal reuptake of serotonin and norepinephrine Some are also very weak dopamine reuptake inhibitors |
| Side effects of SNRI | GI: Nausea (most common), vomiting, constipation CNS stimulation: GU: Sexual dysfunction (common) CV: HTN, tachycardia, palpitations |
| Other Antidepressants | bupropion (Wellbutrin) mirtazapine (Remeron) nefazodone trazodone |
| MOA of Bupropion | Weekly blocks reuptake of norepinephrine and dopamine |
| TRICYCLIC ANTIDEPRESSANTS (TCAS) | |
| MOA of TCAs | Inhibits presynaptic reuptake of Norepinephrine (NE) Serotonin |
| MONOAMINE OXIDASE INHIBITORS (MAOIs) | phenelzine (prototype) isocarboxazid tranylcypromine selegiline |
| MAOI side effects | GI Effects: dry mouth, liver toxicity GU : CV : orthostatic hypotension (common), Hypertensive crisis |
| MAOIs food interactions | Food containing tyramine St. John’s wort & antidepressants(serotonin syndrome) Other herbal therapies |
| foods that contain tyramine | aged cheese, blue cheese,aged fermented meats, fish, fava beans, red wines,smoked or pickled meats, soy sauce, Avocados, chocolate, yogurt, Liquors |
| manfestations of hypertensive crisis | Occipital headache • Palpitations • Neck stiffness • N/V • Sweating • Dilated pupils • Photophobia • Tachycardia • Chest pain |
| Most common types of bipolar disorders | Bipolar I: 1 or more manic episodes usually accompanied by major depressive episodes Bipolar II: 1 or more major depressive episodes accompanied by at least 1 hypomanic episode |
| THERAPY FOR BIPOLAR DISORDER | Mood stabilizers_Lithum Antipsychotics Antidepressants |
| Anxiolytic- Hypnotics | Benzodiazepines (short term treatment) 2. Nonbenzodiazepine antianxiety drugs 3. Barbiturates 4. Antidepressants |
| BENZODIAZEPINES AS ANXIOLYTIC-HYPNOTICS drugs | For Anxiety: -pam alprazolam chlordiazepoxide clonazepam clorazepate diazepam (prototype) lorazepam midazolam oxazepam |
| MOA of Benzos | Act in the limbic and RAS system to make GABA more effectiv |
| Antidote for Benzos | flumazenil |
| Side effects of Benzos | CNS depression: sedation GI: dry mouth, constipation CV: hypotension GU: urinary retention, loss of libido, changes in sexual functioning |
| NONBENZODIAZEPINE ANXIOLYTICS: | BUSPIRONE |
| MOA of NONBENZODIAZEPINE ANXIOLYTICS: | Unclear but it binds to serotonin and dopamine receptors |
| BARBITURATES USED AS ANXIOLYTIC-HYPNOTICS drug | Prototype: phenobarbital |
| MOA of Barbiturates | Inhibit neuronal impulse conduction in the ascending RAS, depress the cerebral cortex, alter cerebellar function, and depress motor output |
| BENZODIAZEPINES FOR SLEEP DISORDERS drugs | temazepam (prototype) estazolam flurazepam midazolam quazepam triazolam diazepam |
| NONBENZODIAZEPINE FOR SLEEP DISORDERS Drugs | ZOLPIDEM |
| MOA of Zolpidem | Enhances the action of GABA |
| Drugs used for Narcolepsy and ADHD | 1. Amphetamines 2. Methylphenidate 3. Non-amphetamines 1 non-stimulate drug approved for ADHD 1. SNRI: Atomoxetine (Strattera) |
| amphetamines Drugs and MOA | Prototype: dextroamphetamine sulfate |
| MOA of Amphetamines | Increase release of norepinephrine and dopamine in the brain and peripheral nervous system Increases alertness and energy Improves mood Inhibits the appetite center in the brain Increased focus and length of attention span |
| Methylphenidate MOA | Increase release of norepinephrine and dopamine in the brain and peripheral nervous system Increases alertness and energy Improves mood Inhibits the appetite center in the brain Increased focus and length of attention span |
| NON-AMPHETAMINES | modafinil |
| MOA of ModAFINIL | Unclear May be related to the ability to block reuptake of norepinephrine |
| Mechanism of Action of NSAIDS | They all act by inhibiting the synthesis of prostaglandins by inhibiting the enzyme cyclooxygenase (COX) |
| 1st Generation NSAID | Salicylates: Aspirin (ASA |
| 2nd Generation NSAID | Celecoxib (prototype |
| What are Adjuvant Analgesics | A diverse group of drugs that are used to enhance analgesia for specific indications Pain that is refractory to opioids (ex intractable cancer pain) Neuropathic pain |
| opiod Categories | Opioid agonists: react with both mu and kappa receptors 2. Mixed opioid agonist-antagonist: stimulate certain opioid receptors but block others 3. Opioid antagonists: Bind to both mu and kappa receptors but do not activate them |
| What are antianginal medications | Nitrates • Beta-adregergic blockers • Calcium channel blockers • Piperazine acetamides |
| Nitrates MOA | Relaxes and dilated veins, arteries and capillaries decreased systemic blood pressure and increased blood flow decreased preload, decreased afterload, increased O2 supply |
| Nitrates drugs | Isosorbide dinitrate (Isordil)- long acting Isosorbide mononitrate (Imdur)- long acing |
| side effects of Nitrates | headache, dizziness, weakness, N/V, hypotension, reflex tachycardia, syncope, flushing, pallor, increased perspiration, contact dermatitis, tolerance |
| MOA of Beta Blockers | Block beta-adrenergic receptors prevents catecholamines from binding Slows the heart rate, reduces contractility, and decreased blood pressure reduces workload on the heart Improved CO |
| side effects of Beta Blockers (Angina Prophylaxis) | Bradycardia Hypotension Masks Hypoglycemia Bronchospasm |
| C A L C I U M C H A N N E L B L O C K E R S MOA | Inhibits influx of calcium ->vasodilation of peripheral and coronary arterie |
| uses of Calcium Channel blockers | Angina – stable, unstable, variant • Hypertension – moderate to severe • Raynaud phenomenon |
| Side Effects of Calcium Channel Blockers | Hypotension • Flushing • Headache • Dizziness • Lower limb edema • Reflex tachycardia |
| Calcium channel Blocker Drugs | Amlodipine, diltiazem, nicardipine, nifedipine, verapamil |
| Prototype of Calcium channel Blockers | Diltiazem |
| Side Effects of ACE Inhibitors | Dry cough- most common side effect Hypotension Hyperkalemia Angioedema- Rare but severe |
| Angiotensin receptor blockers(ARBs) MOA | Block angiotensin II at the receptor site causes vasodilation decreases afterload improved CO Reduces secretion of aldosterone prevents sodium and water retention reduces preload improved CO |
| ARBs prototype | Losartan |
| Side effects of ARBs | Headache/Dizziness Acute renal failure Weakness/Syncope Angioedema- Rare but severe |
| P I P E R A Z I N E A C E T A M I D E A G E N T MOA | Not completely understood Decreases myocardial workload decreases demand |
| Lipid-lowering/ Antihyperlipidemic Agents | HMG-CoA Reductase Inhibitors Bile Acid Sequestrants Cholesterol Absorption Inhibitor PCSK9 Inhibitors Other Lipid-Lowering Agents Niacin Omega 3 Fatty Acids Fibric Acid Drugs (Fibrates) |
| HMG-CoA reductase inhibitors: Statins | 7 statins available (all end in –statin) Prototype: atorvastatin |
| DRUG CLASSES FOR HTN | Thiazide diuretics Angiotensin-converting enzyme (ACE) inhibitors Angiotensin receptor blockers (ARBs) Calcium channel blockers (CCB |
| Explain the meaning of half-life of a drug and calculate the half-life of given drugs | an estimation of the time it takes for the drug's initial concentration in the body to decrease by half |
| Explain the role of inflammation and bronchospasm in the pathogenesis of asthma | In asthma, chronic airway inflammation and acute bronchospasm (muscle constriction) are key players in the disease's pathogenesis, leading to airflow obstruction and symptoms like wheezing and shortness of breath. |
| Rapid-acting Insulin | Lispro, Aspart, Glulisine |
| Short-acting Insulin | Regular |
| Intermediate-acting Insulin | NPH |
| Long-acting insulin | Lantus |
| Outline the nursing considerations, including important teaching points, for patients receiving an antidiabetic or glucose-elevating agent | thorough assessment, medication management, monitoring for adverse effects, and patient education on self-management, including recognizing signs of hypo/hyperglycemia and proper medication administration |
| Compare and contrast the prototype drugs with other antidiabetic agents in their class | Antidiabetic agents are categorized by their mechanism of action, with prototype drugs serving as benchmarks. |
| Biguanides MOA | Decreases hepatic glucose production Increases the uptake of glucose Improves insulin sensitivity of peripheral cells (Metformin |
| Sulfonylureas MOA | Stimulate release of insulin from pancreatic islet cells and increase sensitivity and amount of insulin receptors on target cells (Glipizide) |
| Glucose Elevating Agents | Dasiglucagon (SC) Diazoxide (PO) Glucagon (Intranasal, SC, IM, IV) Glucose (PO (tablet or gel) or IV) |
| Beta2 Andrenergic Agonist | albuterol (Proventil, Ventolin) |
| 6 classes of nutrients | supply energy: carbs, proteins, lipids regulate body processes: vitamins, minerals, water |
| Aims of Nursing | 1. To promote health 2. To prevent illness 3. To restore health 4. To facilitate coping with disability or death |
Created by:
Anmag002
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