pharm test 2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Alternative Medicine | non-traditional medicine such as acupuncture, mind-body interventions, biologically based therapies, manipulative body-based methods, herbals
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| Traditional Medicine | type of healthcare traditionally taught for NCLEX-RN and seen in acute care settings
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| Complimentary Medicine | combination of alternative and traditional therapies mixed together with the complete knowledge of all parties involved
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| Herbals | a form of alternative therapy, not controlled or tested by the FDA, contain an element of placebo effect, considered to be dietary supplements, can produce unexpected effects and toxic reactions
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| Do Not Give-any combo of herbal supplement and | anticoagulant/Coumadin
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| Probiotic | organisms that are used medicinally, including bacteria, thought to be healthy for the host organism
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| Activa | a probiotic, Bifidus Regularis works to help regulate digestive system
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| Acidophilus | bacteria for prevention/tx of uncomplicated diarrhea, prevention of yeast inf, do NOT give w/ anticoagulants
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| Aloe Vera | salve for burns, wounds, orally for chronic constipation, NOT w/ deep wounds or diuretics
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| Glucosamine and Chondroitin | GLS is naturally occurring aminosugar-used to make joint fluid, tendons, nails, and cartilage, for osteoarthritis, NOT w/ anticoagulants
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| Echinacea | stimulates immune system, may be toxic to liver
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| Ginger | prevention of N/V, NOT w/ anticoagulants
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| Ginkgo | improves memory and concentration, NOT w/ anticoagulants or antidepressants, tyramine-containing foods, MAOIs, and many other drugs
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| Ginseng | aphrodisiac, mood elevator, improves concentration, Not w/ caffeine or antidepressants, tyramine-containing foods, MAOIs, and many other drugs
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| Saw Palmetto | tx of benign prostatic hyperplasia(BPH), diuretic, Not w/ finasteride/Proscar
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| St. John’s Wort | tx of depression, NOT w/ other antidepressants, tyramine-containing foods, MAOIs, and many other drugs
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| Renal Injury | the glomerulus in the kidney has a very small capillary network that filters blood into renal tubules-some drug molecules are just the right size to get plugged into capillary network, causing cute inflammation and severe renal probs
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| gentamicin/Garamycin | aminoglycoside antibiotic, effective against gram-negative bacteria(E. coli), usually for most drug resistant bacteria, causes renal problems, ototoxicity, need peak & trough
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| Vancomycin | miscellaneous anti-infective, effective against most drug resistant gram-positive bacteria(MRSA), causes renal problems, ototoxicity, red man syndrome, need peak & trough
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| Complete/Basic Metabolic Panel | sodium, potassium, chloride, random glucose, carbon dioxide, BUN, creatinine, calcium
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| Serum peak and trough | for aminoglycoside or vancomycin serum level
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| Peak level | obtained 30 minutes after completion of 30-60min IV infusion
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| Trough level | obtained 30min PRIOR to next dose
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| Hepatic System | oral drugs are absorbed and passed directly into liver in the first-pass effect
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| Hepatic Testing | Liver enzymes; AST/ALT
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| Causes of Hepatic Damage | acetaminophen-more than 4g(4,000mg) in 24hrs, chronic alcoholism->cirrhosis-hepatic encephalopathy
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| Ototoxicity | damage to 8th cranial nerve-vestibulochlear; gentamycin/Garamycin, vancomycin, furosemide/Lasix
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| Classification | a systematic method of assigning medications into various groups dependent upon their function on body systems
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| Having the knowledge of a drugs specific classification helps in understanding mechanism of action | Pharmacodynamics
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| Chemotherapy is drug therapy | used to help destroy bacteria, viruses, parasites, protozoa, fungi, neoplasms, and/or cancers
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| Antiinfectives-General Guidelines-HCW | right drug-right bug, prophylactic-no s/sx, ETE-(a)improvement in condition (b)decrease in WBC count (c)improvement in VS, C&S prior to 1st dose, nourishment, hydration
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| Antiinfectives-General Guidelines-Pt | take all the prescription, don’t share, maintain nutrition, oral hygiene, report SE, common SE-malaise, lack of appetite, N/V, diarrhea
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| Chain of Infection-Infectious agent | rapid accurate identification of organisms
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| Chain of Infection-Reservoirs | employee health, environmental sanitation, disinfection/sterilization
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| Chain of Infection-Portal of Exit | hand hygiene, control of excretions/secretions, trash and waste disposal
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| Chain of Infection-Means of Transmission | isolation, food handling, airflow control, standard precautions, sterilization, hand hygiene
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| Chain of Infection-Portal of Entry | wound care, catheter care, aseptic technique
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| Chain of Infection-Susceptible Host | recognition of high-risk patients, treatment of underlying diseases
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| SE-GI Toxicity | direct toxic effects on cells lining GI tract-N/V, stomach upset, diarrhea
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| SE-Renal Toxicity | aminoglycosides & vancomycin-hydrate pt as much as possible
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| Therapeutic serum levels for | phenytoin/Dilantin, theophylline, digoxin/lanoxin
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| Antineoplastic Agents SE | alopecia, GI complaints(N/V), weight loss/loss of appetite/anorexia, fatigue/malaise, mouth sores, susceptibility to infection, ^risk of bleeding, fear of diagnosis, referrals to specialists
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| Culture and Sensitivity Testing | performed before an anti-infective agent is prescribed
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| Synergy | combination of antibiotics resulting in greater effect than if given individually
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| Different Antibiotics | NEVER run on the same tubing
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| cefazolin/Ancef/Keflex | 1st generation cephalosporin antibiotic, use prophylactically for gram+ infections
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| ceftriaxone/Rocephin | 3rd generation cephalosporin antibiotic, effective for gram- infections(UTI, respiratory, E Coli)
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| ciprofloxacin/Cipro | fluoroquinolone, broad-spectrum antibiotic, effective for gram+ and selective gram- (Anthrax), given PO or IV
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| sulfamethoxazole trimethoprim(SMZ-TMP)/Septra, Septra DS/Bactrim, Bactrim DS | sulfonamide antibiotic, effective for UTI, Sinusitis, respiratory and PCP if HIV+
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| isoniazid(INH)/Nydrazid, rifampin/Rifadin | antimycobacterial antibiotic, SE; neuritis/parasthesia, hepatitis(w/ alcohol)-inflammation of liver, orange-tinged body fluids, use for mycobacterium tuberculosis, must receive full course of therapy
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| fluconazole/Diflucan | systemic antifungal, for Candida infections, local and systemic fungal infections
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| metronidazole/Flagyl | antiprotozoal, before or after GI surgery, NO alcohol
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| acyclovir | herpes virus agent, antiviral for any kind of herpes virus, HCW may need personal protective equipment
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| zidovudine(AZT)/Retrovir | antiviral for HIV+, does not cross to baby during breastfeeding
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| estradiol/Estrace/Premarin | estrogen for discomforts of menopause, osteoporosis, palliative for cancers, NO smoking->blood clots
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| raloxifene/Evista | estrogen receptor modulator for menopause, NO smoking->blood clots
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| sildenafil/Viagra | tx of penile erectile dysfunction by relaxing blood vessels, NO nitrates or Alpha blockers, risk for HTN
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| cyclosporine/Sandimmune | T-and B-Cell suppressor for rejection of transplant, ^risk for infection->reduce exposure to infectious organisms, do not stop taking
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| Pharmacodynamics/Mechanism of Action | process by which a drug works on the body
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| Drugs may work by-Replacing a Missing Body Chemical | insulin for diabetics, levodopa->dopamine for Parkinson’s, synthroid for thyroid
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| Drugs may work by-Stimulating Cellular Activity | clonidine/Catapres-stimulating alpha2 which decreases BP
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| Drugs may work by-Depressing Cellular Activity | amlodipine/Norvasc-CCBs prevent movement of calcium which causes vasodilation/reduced BP, expect decreased BP, check BP before giving
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| Drugs may work by-Interfering with Functioning of Foreign Cells | ciprofloxacin/Cipro-effective against broad-spectrum of gram+ and gram- organisms
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| Drugs are THOUGHT to work by-Reacting w/ Specific Receptor Sites | receptor sites react w/ certain chemicals to cause effect w/in cell, naloxone/Narcan-blocks opioid receptors and reverses effect of the opioid given
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| Chemical messengers are known as | neurotransmitters
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| Acetylcholine | triggers muscle contractions and involved in memory, anger, and aggression, Alzheimer’s is lack of acetylcholine, Cholinesterase inhibitors
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| Dopamine | helps control movement, modulates mood, motivation and reward, transmission low in Parkinson’s, Levodopa
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| GABA | involved in movement and regulation of anxiety, moderates neuron firing, low levels of GABA lead to floods of brain signals-seizures, Tx for epilepsy & anxiety ^GABA transmission
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| Norepinephrine | plays part in stress responses, influences alertness, arousal, and reward, implicated in anxiety and mood conditions including depression and bipolar, SSRIs and other antidepressants enhance transmission of norepinephrine
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| Serotonin | helps regulate mood, body temp, sleep and appetite, depression, impulsive behavior and aggression are linked to serotonin, SSRIs improve serotonin transmission
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| CNS | pain, nausea, blood pressure
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| Sympathetic Nervous System(SNS) | alpha1, alpha2, beta1, beta2
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| Parasympathetic Nervous System(PSNS) | muscarinic
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| Atenolol | B1 antagonist sympatholytic blocker
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| GI System | H2-prevent gastric release
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| Sinuses | H1
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| Transmission of action potentials reaches axon terminal | causes release of chemicals called neurotransmitters which cross synaptic cleft to stimulate effector cell, another nerve, muscle, or gland
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| Neurotransmitter | must be produced by a nerve, must be released into synapse when nerve is stimulated, must react w/ specific receptor site to cause reaction, must be immediately broken down or removed from synapse so cell can be ready to be stimulated again
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| Much of drug therapy in nervous system | involves receptor sites and release or reuptake and breakdown of neurotransmitters
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| SNS Stimulation | ^BP, ^pulse, ^heart contractions, ^respirations, bronchodilation, pupil dilation, sweating, bladder sphincter contraction/decreased voiding, decreased GI activity and secretions
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| PSNS Stimulation | decreased BP, decreased P, decreased heart contractions, decreased R, bronchial constriction, pupil constriction, sweating, ^tone motility and relaxed sphincter/easier to void, ^ GI activity and secretions
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| SNS-Sympathetic-Adrenergic | ergon-work, relating to nerve fibers that release norepinephrine or epinephrine at synapses
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| SNS-Sympathomimetic | Mimic the effects of the SNS-adrenergic agonist
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| SNS-Sympatholytic | Blocks the effects of the SNS-adrenergic antagonist
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| SNS A1 Sympatholytics | antagonistic effect on blood vessels-prazosin/Minipress-reduction in BP, tamsulosin/Flomax-^in voiding
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| SNS A2 Sympathomimetic | agonist on brainstem-clonidine/Catapres, activates inhibitory neuron in brainstem->decrease in BP
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| SNS B1 Symphatholytics | antagonist on cardiac tissue-atenolol/Tenormin, metoprolol/Lopressor-reduction in BP, reduction in heart rate, reduction in angina, no reinfarction after MI
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| SNS B2 Sympathomimetic | agonist on bronchi-albuterol/Poventil/Ventolin->results in bronchodilation
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| PSNS-Cholinergic | ergon-work, drugs/chemicals that act at same site as the neurotransmitter acetylcholine(Ach)
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| PSNS-Parasympathomimetic | Stimulate the PSNS by Mimicking ACh-Cholinergic agonist
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| PSNS-Parasympatholytic | Blocks the effects of the PSNS-Cholinergic antagonist
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| Muscarinic-Direct Acting | stimulate muscarinic receptor sites by binding them to stimulate same reaction as Ach-agonist, pilocarpine/Pilocar-treats acute angle glaucoma by constricting pupil to allow for drainage
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| Indirect-Acting Cholinergic Agonist | some cholinergic agents work by ^levels of Ach in brain by preventing breakdown by acetylcholinesterase an enzyme-donepezil/Aricept, pyridostigmine/Regonol
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| donepezil/Aricept | results in reduced dementia of Alzheimer’s disease, ^short-term memory
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| pyridostigmine/Regonol/Mestinon | for Myasthenia Gravis-an autoimmune disease->muscle weakness-pitosis, chewing/swallowing difficulties, prevents breakdown of Ach->improved muscular functioning
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| atropine | slows down GI secretions in peptic ulcer disease or uncontrolled diarrhea, given preoperatively to dry oral/respiratory secretions, tx of sinus bradycardia/heart block, dilates the pupil-mydriasis
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| Anxiolytic | Benzodiazipines-diazepam/Valium, Lorazepam/Ativan
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| Benzodiazepines | reduce over activity of CNS, make GABA more effective, OD treated w/ antagonist flumazenil/Romazicon
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| diazepam/Valium, Lorazepam/Ativan | for anxiety, off label use IV bolus for tx of status epilepticus
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| Antidepressant-SSRIs | fluoxetine/Prozac
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| fluoxetine/Prozac | for depression, effect may take up to 4wks, ^risk of suicide, serotonin syndrome if taken w/ St John’s wort
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| Antipsychotic/Neuroleptic | chlorpromazine/Thorazine-blocks dopamine
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| Antipsychotic drugs-SE | sedation, drowsiness, anticholinergic effects, and EPS->if EPS-STOP Med
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| Anticholinergic effects | dry mouth, blurred vision, retention of urine, constipation
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| Mu Receptor-CNS-Narcotic Agonist | morphine
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| morphine | produces analgesia, sedation,& sense of well-being, Indications-severe/chronic pain,SE-respir depression, apnea, cardiac arrest, light-headedness, constipation, IV admin calls for dilut of ordered amt in AT Least 5mL sterile water or 0.9%NaCl over 4-5min
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