tara's pharm part 2 final review
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| show | investigate for ototoxicity
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| vancomycin-iv only (PK) ABSORPTION AND EXCRETION | show 🗑
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| VANCO (PD) | show 🗑
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| S/E VANCO | show 🗑
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| show | SHOULD BE SLOWER INFUSION RATE
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| show | THERAPEUTIC WINDOW-SO CHECK CP EX;PEAKS AND TROUGHS(BE ACCURATE WITH TIME)
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| show | PREVENT PROTEIN SYNTHESIS, COVERS GRAM - ONLY,EXCEPT WHEN ADDED TO TO BETA-LACTAMS OR VANCO B/C RIBOSOME IS INSIDE CELL AND THOSE BETA-LACTAMS AND VANCO CAN BREAK CELL WALL-COMBO=SYNERGY(1+1=3)
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| RIBOSOMALS (PK) | show 🗑
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| S/E RIBOSOMALS | show 🗑
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| MACROLIDES-ERYTHROMYCIN EX;CLARITHROMYCIN, AZITHROMYCIN(Z-PACK) (PD) | show 🗑
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| show | ALL ARE POTENT (METABOLIC ENZYME INHIBITORS) SO AVOID OTHER DRUGS W/ THERAPEUTIC WINDOW B/C IT WILL INCREASE OTHER DRUGS AFTER TIME (TOXICITY)
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| AZITHROMYCIN (PK) | show 🗑
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| show | TELL THEM IT STAYS IN THEIR BODY LONGER THEN MOST ABX
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| CLARITHROMYCIN S/E | show 🗑
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| show | COVERS GRAM - ONLY-NEAR TOXIC DOSES MAY COVER COMMUNITY ACQUIRED MRSA
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| SULFONAMIDES (PK) | show 🗑
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| show | PHOTOSENSITIVITY FOR ALL-IF SHADOW IS SHORTER IN SUN, STAY OUT, CRYSTALURIA-STAY WELL HYDRATED-NOALCOHOL, W/ GERIATRICS-RISK OF HYPERKALEMIA
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| QUINOLONES-"FLOXACIN" | show 🗑
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| show | CAN INHIBIT CAFFEINE AND THEOPHYLLINE METABOLISM
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| QUINOLONES S/E | show 🗑
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| show | DIVIDES SLOW-NEED LONG TERM TREATMENT > 6 MONTHS TO YEARS, FAR SPREAD- NEED MULTIPLE MEDS-ALL TB REGIMENS SHOULD BE 3 DRUGS OR MORE
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| PORBLEMS WITH TB TX | show 🗑
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| SPECIFIC REGIMENS FOR TB ALL SHOULD CONTAIN | show 🗑
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| TB COMMON 3RD DRUG | show 🗑
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| show | ACT LIKE BETA-LACTAMS ON FUNGAL YEAST CELL WALLS AND MEMBRANES
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| show | ALL ARE POTENT ENZYME INHIBITORS, CAN ALL AFFECT HOW OTHER DRUGS ARE METABOLIZED
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| ANTIFUNGAL WEAKEST TO STRONGEST | show 🗑
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| show | SWITCH TO DIFLUCAN
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| ANTIVIRALS(HERPETICS) "CLOVIR" ACYLOVIR/ZOVIRAX AND GANCICLOVIR/CYTOVENT (PD) | show 🗑
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| show | take as directed otherwise toxic s/s-risk for bone marrow suppression, which leads to decreased rbc,wbc, and platelets, gi ulcerations which can lead to n/v, hair loss
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| ganciclovir | show 🗑
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| show | UNINHIBITED CAN MEK 5 BILLION COPIES IN 24 HOURS- 80%NORM/NULL 19% FATAL MUTATION <1% BENEFICIAL TO VIRUS MUTATION -SO TAKE DRUGS ON TIME TO PREVENT 1% MUTATION EX 3X/DAY= Q8HOURS(IMPORTANT)
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| TX OF SHOCK-DECREASED BP=DECREASED PERFUSION | show 🗑
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| ALPHA EX;TETRAHYDRALOZINE | show 🗑
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| show | ^HR AND ^ STRENGTH
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| show | BRONCHODILATOR (LUNGS)
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| EPINEPHRINE | show 🗑
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| show | ALPHA AND BETA 1 AGONISTS
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| show | SNS AGONIST ^BP TITRATEABLE=DIFFERENT DOSES DO DIFFERENT THINGS
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| show | LOW DOSE-AGONIST AT DOPAMINE RECEPTOR IN THE SPLANCHIC BEDS.. RENAL DOSE(VASODILATOR)..... MED DOSE-BETA 1 AGONIST=^HR,^STRENGTH (CARDIAC)... HIGH DOSE=BETA 1 AND ALPHA AGONIST
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| DOBUTAMINE ^BP | show 🗑
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| ^ STRENGTH OF HEART | show 🗑
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| DECREASE STRENGTH OF HEART | show 🗑
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| show | POSITIVE CHRONOTROPIC
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| show | NEGATIVE CHRONOTROPIC
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| show | VESSELS-CONSTRICT FAST.. .KIDNEYS- RETAIN FLUID (SLOW)
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| show | (PK) SNS ANTAGONIST, BETA 1 AND BETA 2, WILL HAVE NEGATIVE CHRONOTROPIC AND INOTROPIC EFFECTS
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| show | FLAT AFFECT, NIGHTMARES
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| show | ASTHMA (IF IT ENDS IN -OLOL IT BLOCKS DILATION) AND TREATED DIABETES (MASKS THE S/S OF HYPOGLYCEMIA
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| show | (PD) NEG CHRONO/INOTROPIC- MAKES CA LESS AVAILABLE FOR MYOCARDIAL CONTRACTIONS AND SLOWS IMPULSE CONDUCTION-IF SOMEONE IS DX W/ DIABETES 2, YOU CAN SWITCHED THE PERSON TO THIS DRUG
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| show | (PO) CONSTIPATION
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| COMPENSATORY FOR VASODILATORS (DECREASE BP) | show 🗑
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| ALPHA BLOCKERS (-ZOSIN) EX TERAZOSIN/HYTRIN | show 🗑
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| ALPHA BLOCKERS S/E | show 🗑
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| NEW CA CHANNEL BLOCKERS (-DIPINE) EX; DIFEDIPINE/PROCARDIA | show 🗑
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| NEW CA CHANNEL BLOCKERS S/E | show 🗑
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| ACE INHIBITORS "PRIL" EX CAPTOPRIL/CAPOTEN S/E | show 🗑
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| show | ORTHOSTATIC HYPOTENSIION MILD EDEMA ANGIO-EDEMA POTASSIUM RETENTION MORE IN ELDERLY
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| DIURETICS "SALT LOSS AGENTS" BY SALT MEANING ANY ELECTROLYTE | show 🗑
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| show | STRONGEST-LOOP DIURETICS; FURESIMIDE/LASIX (LAST 6 HOURS)-LOSE ALOT OF ELECTROLYTES AVAIL PO/IV....THIAZIDES;CHLORTHALIDONE/HYGROTON DO RETAIN CALCIUM...K+ SPARING;SPIROMALACTONE/ALDACTONE-LOSE NA RETAIN K+-RETENTION WILL INCREASE WITH AGE
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| show | LASIX IV
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| show | ARE SULFA RELATED
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| show | ELECTROLYTE PANELS-LOOP/THIAZIDE= GREATEST RISK FOR ELECTROLYTE IMBALANCE
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| show | ^HR ^STRENGTH AND VASOCONSTRICTION
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| show | MISMATCH OF O2 SUPPLY TO DEMAND IN THE MYOCARDIUM TX;PREVENTION-LONG ACTING MEDICATIONS WHICH TEND TO HAVE LONG ONSETS SO WON'T TX ACUTE
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| NEW CA+ CHANNEL BLOCKERS AND ACE INHIBITORS | show 🗑
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| BETA BLOCKERS AND OLD CA+ CHANNEL BLOCKERS | show 🗑
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| show | TX;NITROGLYCERIN SL OR BUCCAL SPRAY-DECREASES DIASTOLIC UP TO 40 MMHG
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| NTG (PD) | show 🗑
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| NTG TEACHING | show 🗑
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| NTG SL | show 🗑
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| show | LONG ONSET-PREVENTION (PD) SAME AS PO-AVOID HEAT AND ALCOHOL CONSUMPTION, TRIM HAIR W/ SCISSORS-NEED A NITRATE FREE INTERVAL OF ABOUT 8 HOURS TO DECREASE TOLERANCE TO NTG
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| CHF | show 🗑
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| show | ACE INHIBITORS/ANGIOTENSION RECEPTOR BLOCKERS -PRIL/-SARTANS AND THEN EVENTUALLY ADD DIURETICS...LATE ADD DIGOXIN/LANOXIN (^QUALITY, NOT QUANTITY)-MAKES YOU FEEL BETTER, BUT NOT LIVE LONGER
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| DIGOXIN/LANOXIN (TABLET) (PD) | show 🗑
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| show | NARROW THERAPEUTIC INDEX-EASY TO OVERDOSE ON, ALSO TELL "DON'T DOUBLE UP, BUT IF W/IN 8 HOURS THEY CAN STILL TAKE IT" "SAME TIME EACH DAY" "KEEP ALL LAB APPTS" "TRY TO GET LOCALLY"
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| show | (A)-PO TABLET...NO (D)..NO (M)..(E)-GOES STRAIGHT TO RENAL EXCRETION SO B4 START NEED TO KNOW RENAL FUNCTION (BUN/CREAT)
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| show | ^BUN/CREAT=LONGER HALF LIFE, HALF LIFE TAKES ABOUT 24 HOURS W/ NORMAL RENAL FUNCTION, WHEN STARTING IT TAKES A LIL TIME TO BUILD UP TO THERAPEUTIC (2-3 DAYS) B/C THERAPEUTIC WINDOW
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| show | NEED DAILY SELF ASSESSMENTS "TAKE PREDOSE HR IF <60-HOLD AND CALL MD" "TAKE PULSE FOR ONE FULL MINUTE"(AS NURSES TAKE AT APICAL) CAN TELL PT TO TAKE FROM CAROTID"ONE SIDE" "DON'T RUB OR MASSAGE OR RUB CAROTID"-IF SUSTAINED RACING HR OR WGHT^>2LBS CALL MD
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| show | NEED TO KEEP TRACK OF SODDIUM INTAKE
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| DIGOXIN S/S OF TOXICITY (FOR NURSE) | show 🗑
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| DIGOXIN S/S TOXICITY (PT) | show 🗑
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| DIGOXIN | show 🗑
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| show | FAB=FRAGMENTED ANTIBODY-OVINE ORIGIN (SHEEP)- THERE IS A SIGNIFICANT RISK OF ANAPHYLAXIS (SHEEP)
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| show | CLASS 1=SODIUM CHANNEL BLOCKERS.. .CLASS 2= BETA BLOCKERS... CLASS 3= AMIODARONE/CORDARONE (BEST ONE)
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| PT A-FIB ON B-BLOCKER W/ NEW DIABETES DX | show 🗑
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| ANTIARRHYTHMICS (PK) | show 🗑
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| show | IF THEY DON'T KNOW WHY-THATS A PROBLEM
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| show | NEGATIVE CHRONOTROPIC NEGATIVE INOTROPIC
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| AMIODARONE/CORDARONE (PK) | show 🗑
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| AMIODARONE/CORDARONE S/E | show 🗑
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| show | PULMONARY FIBROSIS
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| show | NEED DRUG LEVEL AND THYRIOD PANEL
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| show | IF IN ARTERIAL=PLATELTS W/ FIBRIN, VENOUS=FIBRIN W/ PLATELTS EX HEPARIN PREVENTS CLOT FORMATION AND OR EXISTING CLOT GROWTH
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| PLATELET MODIFIERS | show 🗑
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| ANTICOAGULANTS INPATIENT | show 🗑
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| show | WARFARIN/COUMADIN DAGIBACTRAN/PRADAXA
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| HEPARIN | show 🗑
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| show | HETEROGENOUS MIXTURE- ABSORPTION VARIES FROM BATCH TO BATCH D/T SIZE AND ACTIVITY USE PTT AS A CHECK
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| show | LMWH-LOW MOLECULAR WGHT HEPARIN- CUT TO UNIFORM SIZE,SHAPE AND ACTIVITY (EMZYMATICALLY)... SQ-ABSORPTION UNIFORMED RATE- MUCH MORE PREDICTABLE DOSE TO RESPONSE RELATIONSHIP- PTT IS UNRELIABLE AT BEST
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| show | LOVENOX
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| INPATIENT HEPARIN AND LOVENOX S/E | show 🗑
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| show | DEFECTIVE FORM OF VIT K, LEADS TO FORMATION OF DEFECTIVE VIT-K DEPENDENT CLOTTING FACTORS- LESS CONTROLLABLE THEN HEPARIN
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| ON DAY 4 OF COUMADIN 2.8 INR WHAT WOULD IT BE BY DAY 8 | show 🗑
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| show | YOU MUST OVER COME THE VIT-K RESERVOIR (AVG OVER MONTHS)- KEEP INTAKE THE SAME, TELL MD ABOUT DIETARY CHANGES NOW!!
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| show | SPINACH BROCCOLI CAULIFLOWER CABBAGE BRUSSEL SPROUTS KALE... ASPARAGUS(MOST VIT-K) AVOID EXCESS CONSUPMTION
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| show | THE SAME
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| show | RULE- ASSUME ALL DRUGS INTERACT W/ WARFARIN THEREFORE NEED OF ALL DRUGS LIST AND CHANGE OF DOSES TO BE REPORTED TO MD
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| show | BISMUTH SUBSALICYLATE/PEPTO BISMAL METHYL SALICYLATE. OIL OF WINTERGREEN AND ASPERCREAM.. .ALL NEED TO BE AVOIDED WHEN ON WARFARIN B/C IT WILL ^ BLEEDING
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| PLATELET MODIFIERS | show 🗑
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| show | PREVENTS PROSTOGLANDINS SYNTHESIS.. IS TITRATABLE
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| show | WORKS INSIDE PLATELET
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| show | OUTSIDE THE PLATELET, PLAVIX WORKS MORE ON INSIDE- SO CAN BE ON BOTH
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| show | LOW DOSE INHIBITS TX SYNTHESIS ONLY.. HIGH DOSE INHIBITS BOTH PROSTOGLANDINS AND IS USED FOR ANTI-INFLAMMATORY
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| HOW DOES ASA WORK...IS IT TITRATABLE...PRIMARY PREVENTION IS WHICH DOSE | show 🗑
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| PLAVIX "DOGREL" (PD) WORKS INSIDE PLATELETS | show 🗑
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| PLAVIX | show 🗑
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| TX OF HIGH CHOLESTEROL | show 🗑
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| show | (PD) INHIBIT HEPATIC CHOLESTEROL SYNTHESIS.. CHOLESTEROL BINDING RESINS- SHOULD TAKE W/ MEALS, TAKE OTHER MEDS -+2 HOURS
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| SSTATINS EX SIMVASTATIN/ZOCOR AND ATORVASTATIN/LIPITOR | show 🗑
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| STATINS S/E | show 🗑
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| ASTHMA; PAROXYSMAL BRONCHIAL CONSTRICTION AND INFLAMMATION | show 🗑
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| show | ALBUTEROL ACUTE...STEROID PREVENTATIVE
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| show | B2 AGONIST (THERAPEUTIC) AND B1 AGONISTS (^HR ^BP)..SNS AGONISTS
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| show | BLACK BOX WARNING
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| show | ^HR AND ^BP
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| STEROID INHALERS BECLOMETHASONE LONG ONSET LONG DURATION S/E | show 🗑
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| show | MORE COMMONLY USED W/ COPD BUT STILL FOR ASTHMA EX IPOTROPIUM/STROVENT TIOTROPIUM/SPIREVA
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| show | MAKE B2 AGONIST WORK BETTER
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| show | TELL TO HOLD BREATH FOR AS LONG AS COMFORTABLE WHEN INHALING S/E-DRY MOUTH
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| show | STILL MAKE INSULIN "NON RESPONDERS TO INSULIN"
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| show | SULFAMYLUREAS; GLIPIZIDE/GLUCOTROL= ^INSULIN RELEASE... "GLINIDE" "GLITIZONE" = NEWER CLASS
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| NEW SCHOOL DIABTETIC MEDS | show 🗑
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| show | W/ TYPE 2 DIABETES HAVE TO TREAT INSULIN AND GLUCAGON-SULFANYLUREAS ADDRESS INSULIN
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| GREATER RISK OF HYPOGLYCEMIA | show 🗑
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| METFORMIN/GLUCOPHAGE-EU- GLYCEMIC AGENT | show 🗑
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| show | DECREASE GLUCONEOGENISIS- DECREASE GLYCOGENOLYSIS- INCREASE GLUCOSE UPTAKE BY MUSCLES... WORK ON THE LIVER-CAN'T PREVENT OTHER DRUGS FROM CAUSING HYPOGLYCEMIA
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| METFORMIN + GLIPIZIDE=METOGLIP | show 🗑
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| show | METFORMIN
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| MUST D/C METFORMIN | show 🗑
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| show | MICROSCOPIC DEFECT-DISPLAYS AUTOMATICITY, PAROXYSMAL, RECRUITS OTHER PORTIONS OF THE BRAIN
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| EPILEPSY | show 🗑
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| show | PHENTOIN/PHT/DILANTIN... CARBAMAZEPINE/CBZ/TEGRETOL... PHENOBARBITAL/LUMINOL.. VALPORIC ACID/DEPOKOTE..ADD ON(ADJUNCT)- GABAPENTIN/NEURONTIN (S/E SEDATION)
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| WHICH MED FOR EPILEPSY NEEDS TO BE COMBINED W/ OTHER MED | show 🗑
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| EPILEPSY MED ON BLOOD | show 🗑
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| IF CLIENT EXPLAINS OF MORE SEIZURES | show 🗑
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| S/E EPILEPSY MEDS | show 🗑
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| EPILEPSY MEDS ON ORGAN-LIVER/HEART | show 🗑
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| (PK) DILANTIN, PHENOBARB, CARBAMEZEPINE | show 🗑
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| (PK) VALPORIC ACID | show 🗑
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| show | ALL MEDS CAN CAUSE PHOTOSENSITIVITY "WEAR SUNSCREEN" ALL CAN CAUSE RASHES, IT IS COMMON FOR THEM TO CAUSE A SELF-LIMITING RASH (DOESN'T LAST LONG)... RARE-STEVEN JOHNSONS SYNDROME- USUALLY OCCURS 1ST 6 MONTHS OF STARTING-PROGRESSING- CALL MD
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| PHENYTOIN/DILANTIN SPECIFIC | show 🗑
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| PHENYTOIN/DILANTIN S/E | show 🗑
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| OPIATES S/E | show 🗑
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| show | PHYSICAL- LONG TERM WILL NEED HIGHER DOSES TAPER DOSES WHEN STOPING), PSYCHOLOGICAL- ATC DOSING(DON'T WAIT TILL PAIN)
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| PHYSICAL AND PSYCHOLOGICAL DEPENDENCE | show 🗑
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| ACETAMINOPHEN NARROW THERAPEUTIC EFFECT | show 🗑
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| ANTIDOTE TO ACETAMINOPHEN | show 🗑
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| NON TOXIC IN GENERAL FOR TYLENOL | show 🗑
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| NSAIDS (PD) | show 🗑
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| S/E APAP | show 🗑
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| show | ON MORE THEN ONE DRUG THEN IS NEEDS-LASIX FROM ONE MD AND FURESOMIDE FROM OTHER MD
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| IBUPROFEN | show 🗑
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| MAPROXEN | show 🗑
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| 200MG IBUPROFEN PO QMORNING AND 275MG NAPROXEN PO Q12H | show 🗑
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| show | SEDATIVE GOAL IS CALM...HYPNOTIC GOAL IS SLEEP-CAN BE USED FOR 2 THINGS (SLEEP/CALM)
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| show | LORAZEPAM/ATIVAN.. OXAZEPAM/SERAX.. TEMAZEPAM/RESTORIL.. TRIAZOLAM/HALCION.. ALPRAZOLAM/XANEX- ALL HAVE SHORT ONSET(<1H) AND SHORT DURATION(<8H)
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| ATIVAN,SERAX, RESTORIL | show 🗑
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| HALCION, XANEX | show 🗑
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| 4 CLIENTS-IF NOT LOTTA, SHORT ONSET, LONG DURATION | show 🗑
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| show | SUPRESS NEURONAL FIRING-WIDE THERAPEUTIC INDEX TILL YOU ADD ETOH B/C ETOH CAN AMPLIFY 2X-200X THE EFFECT S/E SOME HAVE MILD ANTICHOLINERGIC EFFECTS, OTHERS ANTEROGRADE AMNESIA (CAN'T REMEMBER WHATS HAPPENS WHILE ON DRUG) DON'T TEACH PT WHILE USING THESE
🗑
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| show | TYPICALS- HALOPERIDOL/HALDOL.. .ATYPICALS- OLANZAPINE/ZYPREXA
🗑
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| show | CLASS CALLED TRI-CYCLIC ANTIDEPRESSANTS AMITRYPTILINE/ELAVIL
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| show | ANTICHOLINERGIC (DRY MOUTH) ALPHA BLOCKING (VASODILATORS/ ORTHOSTATIC HYPOTENSION) SEDATING
🗑
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| show | DRY EYES DRY MOUTH WOBBLY WHEN GETTING UP
🗑
|
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| show | CNS ANTIHISTAMINE- DECREASE SATIETY- WGHT GAIN- NEED TO ASSESS FOR TYPE 2 DIABETES & SODIUM CHANNEL BLOCKERS LEAD TO CARDIAC ARRHYTHMIAS (MOST SERIOUS S/E)
🗑
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| HOW LONG DOES IT TAKE FOR ANTIPSYCHOTIC/ANTIDEPRESSANTS TO WORK | show 🗑
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| THERAPEUTIC WINDOW | show 🗑
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| THERAPEUTIC INDEX | show 🗑
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| B-BLOCKERS W/ DIABETES | show 🗑
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| show | PATCH PO IV SL ETC
🗑
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| ASTHMA ATTACK IN FRONT OF YOU | show 🗑
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| show | KIDNEYS-DIURETICS ACE INHIBITORS... HEART-B-BLOCKERS,OLD CA CHANNEL BLOCKERS.. VESSLES-ALPHA BLOCKERS,NEW CA CHANNEL BLOCKERS, ACE INHIBITORS
🗑
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| show | ^HR AND STRENGTH (FAST) AND CONSTRICTION OF VESSLES(FAST)
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| show | VESSLES CONSTRICT(FAST) KIDNEYS RETAIN FLUID(SLOW)
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| HTN TX VESSELS COMPENTASORY:ALPHA BLOCKERS,NEW CA CHANNEL BLOCKERS,ACE INHIBITORS,ARB's | show 🗑
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| show | -PRIL. CAPTOPRIL/CAPOTEN
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| ARB's | show 🗑
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| show | -OLOL,ALOL... METOPROLOL/LOPRESSOR
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| OLD CA CHANNEL BLOCKERS | show 🗑
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| show | -ZOSIN..TERAZOSIN/HYTRIN
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| show | -DIPINE..DIFEDIPINE/PROCARDIA
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| show |
🗑
|
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