NPN 139 Pharmacology 2 final at BGTC 5/7/13
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| Drug Therapy for pediatric patients, Medicines effect peds differently, how? | absorption slower gastric emptying
distribution 75% body is water, require higher dose of water soluble drug
metabolism develop at different stages
excretion kidneys are not completely mature till 1 yr
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| Determining pediactric dosage | Body Surface Area (physicians use) and weight/kg
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| Where do you give an IM injection to a kid under 3? | vastus laterus
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| Where do you give an IM injection to a kid over 3? | dorso gluteal
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| How do you administer ear drops to a child? | down and back/out
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| If child ingests a poisionous medication what can you give them? | syrup of ipecac
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| If child ingests a poision, who do you call? | poision control
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| Polypharmacy | taking numerous medications on daily basis
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| Drug therapy in the Elderly; medications effect elderly differently how? | blood flow decreases to the GI tract, decrease in GI secretions-absorption decreases, fatty tissues increase-decreases activity or prolonged activity in many drugs, decreased binding sites, decreases blood flow to liver leading to toxicity
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| IM injection preferred site for the elderly? | ventrogluteal
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| Asepsis | free of pathogenic microorganisms
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| medical aspesis | "clean technique" inhibits growth
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| surgical aspesis | "sterile technique" destroys/abscent from microorganisms
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| Principles of sterile technique | sterile objects remain sterile when touched only by sterile, only sterile can be place on sterile field, sterile objects our of sight/held below waist become contaminated, if field becomes wet contaminated, edges (1 in) contaminated
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| Sympathetic (Adrenergic) System | Fight or Flight, increases processes when faced with stress, supresses those body functions not vital during stressful situation
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| Examples of body reactions for Sympathetic | pupils dilate, heart rate increase, blood vessels dilate
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| Receptors in the Sympathetic System | alpha 1
beta 1
beta 2
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| Alpha1 | found in smooth muscles of the peripheral blood vessels, GI GU tracts, when stimulated cause constriction, BP increases, used commonly in hypotension meds
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| Beta1 | primarily found in the heart, when stimulated increases heart rate, force, and contractions
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| Beta2 | primarily found in bronchial smooth muscles (lungs) when stimulated bronchodilation meaning OPENS UP airways
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| Parasympathetic (Cholinergic) | opposite of sympathetic, directed in conversing energy; increased acid secretions, salvation, decrease heart rate and BP, pupil constriction, promotes sweating, increased elimination
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| 4 classes/agentsof drugs that effect the Autonomic Nervous System | 1.Sympathetic or Adrenergic Agents
2.Sypatholytics or Adrenegic Blockers
3.Parasympathominetics or Cholinergics
4.Parasympatholytic or Anticholinergic
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| Adrenergic Agents | mimic the sympathetic nervous system
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| Adrenergic Blockers | stop/block adrenergic system, decreases/constrict
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| Cholinergics | mimics parasympathetic, increases secretions conserves energy increases SLUD
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| Anticholinergic | antiSLUD, decreases or stops SLUD
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| SLUD stands for | S-SALIVATION
L-LACRIMATION
U-URINATION
D-DEFICATION
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| What is the main function of the Respiratory System? | Gas Exchange
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| Medications Effecting Respiratory System | Antihistamines
Decongestants
Antitussives
Mucolytics
Expectorants
Topical Nasal Steroids
Bronchodilators
Corticosteroids
Xanthine Bronchodilators
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| Antihistamines Benadryl, Phenergan, Zyrtec, Allegra | block action of histamines, limits vasodilation, edema, produces anti-cholinergic effect, also has sedative effect.
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| Decongestants Ephedrine, Epinephrine, Afrin/Oxymetazoline Sudafed/pseudoephrine | action effects all alpha receptors, vasoconstriction, reducing blood flow, fluid movement, and mucousal edema, shrinks it tightens up. Used for allergies, Upper Resp Inf, Reactions nasal stinging, dryness, rebound congestion. Do not use more than 3-5 days
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| Antitussives Codeine, Hydrocodone, Benzonatate/Tessalon Perles | act centrally on the cough center in the brain, numbs receptors in the respiratory tract; used for overactive,nonproductive cough. Narcotic/nonnarcotic. Reactions: constipations, drowsiness, dry mouth, othostatic hypotension. Can cause addiction
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| Mucolytics Mucomyst/Acetylcysteine | reduce the thickness of secretions, used for chronic respiratory conditions. Reactions:NVF broncho spasms, irritation to throat/trachea/bronchis. Drink plenty of fluids
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| Expectorants Robituusin/Guaifenesin | (expell) agents decrease thickness of secretions by increasing fluids in respiratory tract. Used for productive coughs, chronic respiratory diseases, Reaction: GI upset, Used for short term ONLY, not for persistant coughs, drink fluids, humidifier
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| Topical Intranasal Steroids Beconase, Rhinocort, Nasalide, Flonase | anti-inflammatory effect, decrease local congestion
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| Bronchodilators Albuterol/Proventil, Epinephrine, Salemeterol/Serevent, Metaproterenol, Levabuterol, Foradil | open up the bronchi, allows air to pass through, Gets O2 in and CO2 out, 2 types: Sympathomimetic and Xanthine,
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| Xanthine Bronchodilators Aminophylline, Theophylline | related to caffeine, relax smooth muscles in bronchi & blood vessels in lungs, reduces swelling
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| Leukotriene Receptor Inhibitors Montelukast/Singulair, Accolate, Zyflo | newer category for asthma, not a bronchodilator, block leukotrienes which are potent bronchoconstrictors
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| Mast Cell Stabilizers Cromolyn/Intal, Nedocromil/Tilade | inhibit the release of substance histamine, use forprophylaxis in asthma, food allergies, allergic rhinitis, Reactions: dizzy HA, N
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| Corticosteroids Inhaled: Vanceril, Pulmicort, AeroBid, Flovent, Azmacort Systemic: Methylprednisolone, Predisolone, Prednisone | relaxes muscles/open up. long term use for Asthma
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| Quick Acting for Asthma | Beta2 Agonists, Anticholinergics
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| Long Term acting for Asthma | Leukotriene Receptor Inhibitors, Xanthine Bronchodilator, Anticholingerics, corticosteroids
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| Hormones | chmeical made in an organ or gland carried in blood stream to another part of the body
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| Steroid | specific group of hormones that have a powerful effect on cell sensitivity healing & development
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| Insulin | help glucose move into target tissues for energy. lovers blood glucose levels
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| S/S of Hypoglycemia | nervousness, hungry, malaise, cold-clammy hands, change in LOC, lethargy, pallor, shallow resp
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| onset | when insulin first begins
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| peak | when insulin is exerting its maximum action highest point
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| duration | length of time insulin remains in effect
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| When mixing insulins, which do you draw up first? | CLEAR TO CLOUDY, never shake, roll, given subq open vials can only keep for 1 month
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| which insulin can be given IV? | Regular
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| Sliding scale Insulin Administration | the nurse admin supplemental insulin based on blood glucose readings and amount and type prescribed by healthcare provider
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| Androgens | male sex hormones develop secondary male sex characteristics
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| Abortifacients | abort fetus
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| Oxytocic Agents Pitocin, Oxytocin | cause uterus to contract help labor, act on smooth muscles of uterus & stimulate milk flow
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| Uterine Relaxins | relax uterus
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| Tocolytics | stop preterm labor
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| Androgen Hormone Inhibitor Proscar/finasteride | inhibits conversion of testosterone into DHT which the prostate gland is dependent on.can treat male pattern bladness, treats S/S of benign prostate hyperplasia
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| Erectile Dysfunction Viagra, Cialis, Levitra | inability to obtain/maintain an erection suffiecent for sexual intercourse
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| Thyroid | gland in neck, produces hormones, comes from anterior pituitary gland, helps maintain metabolism actice of tyroid
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| Hypothyroidism | underactive thyroid
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| Hyperthyroidism | overactive thyroid
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| Antithyroid Iodine Products, Methimazole/Tapazole | stops new production of thyroid hormones, used for hyperthyroidism
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| Drugs for BPH Proscar, Flomaz, Hytrin | BPH: Benign Prostatic Hyperplasia, non-cancerous, overgrowth of prostate gland can become a problem with voiding, adverse reaction: orthostatic hypotension
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| Drugs fors Urinary Tract Analgesia Phenazopyridine/Pyridium | Treat UTI/pain relief, makes urine orange/red, S/S: urengency
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| Urinary Anti-Infectives Nalidixic Acid/Neg Gram, Furandantin | antiseptic action, short term, treats acute, chronic, reoccuring UTI's, increase cranberry juice & fluids
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| Diurectics | drugs used to remove sodium & water from body, treat hypertension
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| Thiazide Diurectics Chlorothiazide, Hydrochlorothiazide, Metalazone | inhibit sodium & chloride reabsorption, does not spare postassium goes with sodium
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| Loop Diurectic Furosemide/Lasix, Bumetanide/Bumex, Torsemide/Demadex | promote sodium & fluid secretions, cannot save potassium, can cause hypokalemia
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| Potassium Sparing Diurectic Spironolactone/Aldactone, Triamterene/Dyrenium | inhibit potassium excretion while allowing fluid excretion
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| Osmotic Diurectic Mannitol/Osmitrol | used in treatment for increased intracranial pressure
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| Carbonic Anhydrase Inhibitors Acetazolamide/Diamox | promote water and sodium scretions. Used in intracranial pressure associated with gloucomma, form eye drops
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| Electrolytes | ions required yby cells to regulate electrical change and flow of water molecules across cell membranes
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| Bicarbonate NaHCO3 | mineral, viable to acid base balance, vital electrolyte to acid base 22-24mEq/L
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| Calcium Phoslo, Caltrate, Tums EX, Citracal | mineral, necessary for function of nerves, muscles, blood clotting, building teeth & bones, 4-5 mEq/L
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| Magnesium Magnesium Sulfate, Slow Mag, MgSO4 | transmission of nerve impulses, activity to enzyme action, 1.5-2.5mEq/L
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| Potassium Potassium Chloride | necessary for nerve impulses, muscle contraction, 3.5-5.5 mEq/L
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| Sodium Sodium Chloride,Normal Saline | normal heart action & regulation of osmotic pressure in the cells
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| Combined Electrolyte Solutions | Pedialtye, D51/2NS, D5NS, LR
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| Vitamins | chemical compund that is found naturally in the human body
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| Vitamin A | fat soluble
helps eyes adjust from light to dark, helps fight infection
dairy products, eggs, organ meats, oranges, yellow/green fruit, veggies
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| Thiamine Vitamin B | Water Soluble, functions as a co-enzyme, found in pork, whole grains, enriched breads, cerals, legumes
treats deficiencies in alcholism, gastric lesions, hyperemphesis in pregnancy
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| Riboflavin Vitamin B2 | water soluble, metabolism of proteins, fats, and carbohydrates, milk, eggs, liver, green leafy veggies, enriched breads and cereals
Decreased by oral contracetives
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| Niacin Nicotinic Acid Vitamin B | water soluble essential part of co-enzyme that function in release and amino acid metabolism, treat disorders associated with limited dietary intake, side effect: hot flashes, flushing, found in lean meats, peanuts, yeast, cereal
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| Vitamin B6 | watersoluble, co-enzyme in metabolism protein carbohydrates and fats. Treat congentital defects, yeast wheat corn egg yolk, liver, kidney/muscle meat
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| Folic Acid | necessary for RBC formation. Treat anemias, acholism, pregnancy (neural tube defects) Leafy green veggies, organ meat, cerals
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