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Pharm Test 1 Hodges
TCC Pharm #1 Hodges
| Question | Answer |
|---|---|
| FFP | Fresh Frozen Plasma / unconcentrated/ NOT for SVE/ |
| HCP Pain Management | Understand pain, listen to Pt., treat appropriately, stay in front of the pain curve. |
| Post-surgical pain managment | PCA, opioids,agonists help, antagonists block receptors, check for resp. depression, ortho. hypotsn, ICP, urinary retention. |
| Morphine Sulfate (PTD) Use for | narcotic, mod-severe pain, no upper dose limit. |
| Morphine Sulfate MOA | Occupies receptors, alters perception of pain |
| Morphine Sulfate Adverse Effects | Respiratory depression, pruritis,increased ICP |
| MS - Contras/ Precautions | Not for preg, or premies/ Caution with elderly, hep or renal impairment, CNS depression, head injury, increased ICP, COPD |
| Overdose of Morphine Sulfate | Naxalone |
| MS Nursing Implications | Assess for pain, allergies, VS. / Monitor VS, esp. with elderly / Monitor I/O, constipation and O.H. (orthostatic hypotension) |
| Tramadol (PTD) | Prototype of NSAIDS that act on the CNS. Also acts as an SRRI. |
| Gate Control | Well-supported theory that you can flood the receptors with stimuli and this will shut the gate in the dorsal horn to further pain transmission. |
| Pain Perception | impacted by many factors. Pain is transmitted through nociceptors. NSAIDS work at the peripheral level, opiates work on the CNS. |
| Sumatriptan (PTD) | Migraine management. Cranial vessel constriction. Reduces transmission in tregiminal pain pathways. |
| Sumatriptan: Contra/ Precautions | Any cardiac issue, HTN, cholesterol or renal/hep impairment |
| Sumatriptan: Drug Interactions | Do NOT use within 2 weeks of MAOIs or SRRIs. |
| Sumatriptan: Nursing Implications | Administer at first symptom/ Labs for liver functions/ Chest and Jaw monitoring for pain. |
| Serum osmolality | Number of particles in 1kG/L of water. In body fluids, talking about sodium, glucose, urea. |
| Normal range for serum osmolality | 275-295 mml/kg |
| Fluid resuscitation | Keeping fluid levels balanced. Replace fluids. Lost H20? Use hypotonic. Loss of blood? Use blood products. Salt? Hypertonic. |
| What causes thirst? | Osmoreceptors in hypothalamus sens ECF is hypertonic. Pit. releases ADH to retain water via distal kidneys. |
| Hypertonic IV | Fluids being introduced are compared to body fluids. More solvent in IV, it is hyper to body. Less in IV, it is hypo to body. |
| T2Diab. Mellitus | Majority of all diabetics. Capable of producing insulin, target cells are unresponsive. Life style impacts greatly. Obesity raises resistance to insulin. |
| Tx of T2 Dm | Most do NOT require insulin. 3 classes of oral antidiabetics (1. Sulfyonureas - secretagogues 2. Biaguinides - stop liver from prod. glucose 3. Thiaz - increase uptake on cell. |
| Diagnosis of T2DM | Primarily use FPG (fasting plasma glucose) now >100. OGTT (oral glucose tolerance test) saved for pregnancies. |
| Insulin drugs | Rapid - Aspart, Lispro, Glulisine/ Short - Regular/ Interm - Isophane NPH/ Long - Demeter, Glargine |
| DKA | Fatty acid metabolism ~ normally T1. Acidic ketones. 3 Ps. Hyerglycemia. Kussmauls Resp (deep and labored) |
| Glyburide (PTD) | PTD of sulfonylurea (stim. secretion of insulin from pancreatic beta cells). Increases sensitivity of surrounding tissues. |
| Glyburide contras | Allergies to sulfa or thiazide diuretics. |
| Beta B1 Adrenergic Antagonist | HTN, more specific, fewer non-cardiac effects (safer for COPD and asthma),(less effect on glucose). Dec. HR, MC contraction, cardiac cond. Inh. sec. of renin and form. of AT2. |
| Verapamil with amlodipine | Verapamil is a calcium channel blocker. So is amlodipine. Cumulative effect. |
| Verapamil with digoxin | Vera. decreases dist/excret of digoxin. Risk of toxicity. Digoxin used for heart failure. Together can cause bradycardia as both affect AV node. |
| Verapamil with simvastatin | Simvastatin is an inactive prodrug until changed to an active metabolite via the liver. Lowers cholesterol. RISK of myopathy increases greatly. |
| Calcium Channel Blockers (CCBs) | CCBs. C.Channels facilitate card. contractions. Blocking it impacts smooth heart muscle. Some affect arteriolar smooth muscle. None affect serum level. Don't affect veins. Reduce force of myocardial contractions. 2 big classes - dihydropyridies and non. |
| RAAS | Renin Angiotensin Aldosterone system. |
| ACE | Angiotensin converting enzyme I to II (instantly).Also breaks down kinase (sometimes called kinase II) |
| ACE inhibitors | Lower BP. Can cause increase in bradykinins due to blocking the breakdown. Increase in BK can cause angioedema and cough. |
| ARBS | Angiotensin II receptor blockers. After AII created, stop it from activating target receptors. |
| ARBS MOA | Cause vasodilation, drops BP. Work like ACE inhib. but no cough, angioedema, no accum of bradyk.MOre $, but prevent cardiac remodeling. |
| Cardiac remodeling | hypertrophy of myocardial cells from AII. Collagen deposits in cardiac matrix like scar tissue. Increased morbidity/mortality. |
| Lisinoprol (PTD)(active, not a prodrug) | PTD for ACE inhibitor. Heart Failure, Acute MI, HTN. 2-3 to achieve max. ther. benefit. Watch for hyperkalemia. Orthostatic hyper.NO ETOH, NSAIDS, drink 6-8 H2O daily. |
| HCTZ | Most common thiazide type diuretic. Lowers reab. of NaCl, BVD, BP falls. |
| HCTZ adverse effects | May precipitate gout attacks. Elect. imbal. Low chlor, mag, pot, sodium. |
| HCTZ drug interactions | Increased risk of toxicity from NSAIDS and digoxin. Lowered excretion of lithium and Ca. |
| HCTZ Nursing Responsibilities | Baseline/periodic serum electrolytes. CBC. BUN. Uric Acid. |
| HCTZ Pt teaching | Eat K+ rich food. (green, leafy, vegetables - kale, collards, spinach, and turnip greens are the highest), Avoid direct sun 10-14 days. |
| Classification of microorganisms | Stain, Shape, Oxygen preference. |
| 2 Classification of Anti-Infectives | Chemical Class - fundamental chem structure of a group/ Pharm Class refers to MOA. Predicts similar action, similar adverse effects. |
| Prophy ABx | Stab wounds, HIV, heart valves, some surgeries, antimalarials, anti TB, antiretrovirals for infected HCP. |
| 1 generation Cephalosporins | Beta lactam ring like Penicillins. Good for Staph and strep. Don't cross BBB. |
| Cephalosporin Allergy | most common adverse effect. 5-10 % of those allergic to pen. also allergic. Contra in pt. with anaphylaxis to peni. |
| Carbapenems | largest group of cell wall inhibitin, bacteriocidal. Broadest spectrum. Resistant to beta lactamese. Parenteral. Low adverse effects. |
| Tetracyclines - | Antibiotics that inhibit protein SYNTHESIS of the bacteria. Cycle around and ruin RNA/DNA. EMPTY stomach. Watch for pseudomembranous colitis.Hpylori and acne. Superinfections. Empty stomach and water. |
| Tetracycline - PTD | Sumycin |
| Macrolide | ABx Safe alternative to penicillin for many gram + infections. Whooping cough, diptheria, legionnaires. Inhibits synthesis of ribosomes. |
| Erythromycin - PTD macrolide. | Destroys ribosomes, gram pos. |
| Aminoglycosides - effective against | gram negative. . Mostly saved now for TB due to safer alternatives. Destroys ribosomes PTD - Gentamicin |
| Gentacimin - PTD | Aminoglycosides. Gram neg. Ototoxic and nephrotoxic. Avoid anything else that interferes with 8th CN. |
| Minocycline | 1-2 day dosing, w/or w/out food. Watch lab values for hepatoxicity. |
| Ciprofloxacin - PTD fluoroquinolones | inhibits DNA replica. Anthrax. Tendonitis and tendon rupture. |
| Metronidazole - PTD | antiprotozoan. Rosacea, trichomoniasis, parasites in colon. |
Created by:
TCC2013
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