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Pharm Review Midtrm
Pharm midter
| Question | Answer |
|---|---|
| What are Vasodilators? | Drugs used to relax the muscles controlling blood vessels, which will increase blood flow |
| What conditions can vasodilators be used for? | Renal failure, CHF, HTN |
| What are the different types of vasodilators? | Beta Blockers, Angiotensin Converting Enzyme (ACE) Inhibitors, Angiotensin Receptor Blockers, Calcium channel Blockers (VND), |
| Effect of vasodilators on the blood | Increase blood flow, decrease HR, decrease force of contraction of heart |
| Effect of vasodilators on oxygen consumption | Decrease O2 consumption |
| Vasodilators can be used alone or with other drugs for the treatment | HTN and CHF |
| Renal blood flow | Volume of blood delivered to the kidneys per unit time, about 25% of CO goes to the kidney |
| Different structures where blood goes in the kidney | Renal arteries, 5 segmental arteries. Lobular arteries, interlobular arteries, afferent arterioles, Glomerulus, Efferent arterioles, peritubular capillary network, venus channel, Inferior vena cava |
| Aldosterone cause what? | Retention of sodium (water) from the kidney |
| Renin cause what? | Convert angiotensinogen to angiotensin I and create vasoconstriction |
| What stimulate the release of renin? | Reduced blood flow to the kidney |
| Angiotensin cause what? | Vasoconstriction and release of aldosterone |
| The role of the renal tubule | Reabsorbtion of ions and nutrients, especially Sodium, Secretion of H, K, |
| The role of glomerulus | Filtration of substances from the blood to the nephron |
| Causes of renal failure | Diabetes, A sudden, serious drop in blood flow to the kidneys, Damage from some medicines, poisons, or infections, A sudden blockage that stops urine from flowing out of the kidneys, HTN, CHF, |
| What are the 4 elements removed by kidney | Water, Sodium, Potassium, and Hydrogen |
| Mechanism of Diuretics | Promote water loss in the urine by: -Blocking the production of H+ and bicarbonate (HCO3-) ions; -Blocking the exchange of H+ for Na+; -Blocking the exchange of K+ for Na+; -Creating an osmotic gradient through a concentration of non-absorbable molecules |
| Different classes of Diuretics, how many | 5 classes Osmotic diuretics; Organic acids Thiazide and thiazide-like Potassium-sparing Carbonic anhydrase inhibitors |
| Reduce the production of hydrogen ions to exchange for sodium ions so water stays with sodium ions, refractory | Carbonic Anhydrase Inhibitors |
| Enter the tubules but cannot be reabsorbed so water stays with the concentration of diuretic molecules, non-refractory | Osmotic Diuretics |
| Inhibit sodium and chloride ion exchange in the tubule loop of Henle, non-refractory, Most common and strongest form of diuretic | Organic Acids (Loop diuretics) |
| Inhibit sodium ion reabsorption by multiple mechanisms along the renal tubules, nonrefractory | Thiazide and Thiazide-like Diuretics |
| Inhibit K+ exchange for Na+ in the distal renal tubules | Potassium-Sparing Diuretics |
| Which Diuretics are the strongest? Why? | Organic/Loop diuretic. It’s non refractory, inhibit sodium and chloride ion exchange, result in a high amount of sodium and water loss. |
| Which Diuretics are mild and have lesser effect on electrolyte balance? | Osmotic. The drug had large molecules that cannot be reabsorb my blood, so it has to follow urine secretion, and the drug attract water, no effect on any electrolyte balance. |
| Which Diuretics are more potent and run the risk of serious electrolyte imbalance? | Organic/Loop diuretics |
| Side effects of different types of Diuretics | Nausea; Diarrhea; Constipation; Headache; Anorexia; Hypotension (from water loss); Dizzy, lightheaded, faint; Hypokalemia (from ion exchange); Hyperuricemia, Neurotoxicity (Loop) |
| Diuretics effects on water, sodium | Most of diuretic increase loss of sodium and water |
| Which Diuretics causes greater loss of K+ and which will spare K+ | Loop for loss and Potassium sparing diuretic spare K |
| Conditions Diuretics are used for | HTN, renal diseases, CHF, Edema. Glaucoma |
| What do local anesthetics do? | Prevent or interrupt painful stimulation, or adjunct to another medication |
| Local Anesthetic/ side effects and toxic doses | SAMS, Slurred speech, Altered CNS (drowsiness, dizziness, nervousness, confusion), Muscles Twitching (tremors), Seizures (convulsions, Resp depression) |
| Types of local Anesthetic that cause arrhythmias | Amides. They are long lasting and go in all the circulatory system. |
| How Anesthetic are administered/applied | topical, Intradermal, spinal, epidural, caudal, infiltration |
| The deposition of a solution directly into tissue | Infiltration |
| Epinephrine with anesthetics, what changes in action and duration occur? | Epinephrine is added to amide local anesthetics to constrict blood vessels and keep the drug at the site of action longer |
| Conduction blockade sequence | 1.Small unmyelinated-sensory, autonomic; 2.Intermediate myelinated-preganglionic; 3.Large myelinated-motor, visceral sensory |
| Stages/phases of Anesthesia | Onset, Excitement, Surgical anesthesia and danger. |
| OTC Anesthetics | procaine, tetracaine, lidocaine, bupivacaine, prilocaine |
| Bacteriostatic vs Bacteriocidal drugs | Cidal kill microorganism, statics inhibit the growth. |
| Spherical in shape and usually arranged in pairs (diplo), chains (strepto), or clusters (staphylo) | Cocci |
| Rod-like in shape | Bacilli |
| Curved and rod-like in shape | Spirilla |
| Bacteria that take up the blue stain | Gram positive, Gm(+) |
| Bacteria that take up the red stain | Gram negative, Gm(-) |
| Which bacteria produce beta-lactamases, and what effect will this have on the body and the effectiveness of the drug? | Gram Negative bacteria. They alter the outcome of ABT. They inactivate Penicillin and Cephalosporin |
| Cephalosporins | Bacteriocidal, Not if allergic to penicillin, |
| Tetracycline, shouldn’t be taken with what? | Dairy or antacid products, Bacteriostatic, contra if pregnant, nursing or children <8 |
| Aminoglycosides | Bacteriocidal, broad spectrum, Peak and through, Oto and Nephro toxicity |
| Penicillins | Bacteriocidal |
| Bacteriocidal ABT | Peniccilin, Cephalosporin, Aminoglycosides, Fluroquinolones |
| Bacteriostatic ABT | Tetracyclines, Sulfonamides, Macrolide |
| Difference between antiseptics and disinfectants | Antiseptics for living tissues, disinfectant on non-living surfaces. |
| Antiseptics: types, uses, side effects | Static and cidal, Reduce the growth and contamination of wounds (burns, skin ulcers), Eliminate microorganism from entering punctures encountered in procedures such as spinal, regional anesthesia, blood draws for clinical laboratory analysis |
| Topical adverse effects of Antiseptics | Dry skin, rash, hypersensitivity |
| Internal adverse effects of Antiseptics | Anorexia, Vomiting, Internal cramping, Convulsions, Death |
| Disinfectants: types, uses, side effects | Reduce the need for antibiotics by eliminating potential pathogenic infectious organic material on nonliving surfaces |
| Different types of sterilization | Dry heat sterilization; Moist heat sterilization; Chemical sterilization; Radiation sterilization; Filtration |
| Pertaining to a procedure or substance that prevents, alleviates, or corrects an abnormal cardiac rhythm | Antiarrhythmic |
| Inhibit the formation of angiotensin which is a potent vasoconstrictor, Inhibit the conversion of angiotensin I to angiotensin II | Angiotensin-converting Enzyme inhibitors |
| An area in the heart that initiates abnormal beats | Ectopic Focus |
| Preferred drug treatment for CHF | cardiac glycoside, Digoxin. |
| What is CHF? What happens? | Weakening of the contractile function of the heart, blood and fluid accumulate in the heart, lungs, abdomen, and lower extremities, decreased cardiac output and blood pressure are unable to meet body requirements |
| How are cardiac glycosides able to improve symptoms of CHF? | Increase the force of contraction of myocardium and decrease the heart rate. |
| What to check before giving a cardiac glycoside? | Pulse below 60, serum blood level at 0.5-2mg/mL Potassium not too high and not too low. |
| Cardiac glycoside treat CHF and | Atria arrhythmias and atria fibulation |
| What impact can K+ levels have on therapeutic action of a cardiac glycoside? | Low Potassium will increase drug toxicity can lead to cardiac arrhythmias; High Potassium will decrease the action of the cardiac glycosides (the drug will not work) |
| Adverse effects of Cardiac glycosides | HA, dizziness, nausea, vomiting |
| Mild overdose symptoms of cardiac glycosides | Visual disturbances “halo effect” around lights |
| Major overdose symptoms of cardiac glycosides | Bradycardia, ectopic beats, and a variety of other cardiac arrhythmias |
| Coagulation | Process of making a clot |
| Infarction | Complete blockage of something |
| Thromboembolism | Clot that block something, form a plug, can block a blood vessel |
| Conditions used for Anticoagulant | Prevention or treatment of venous thrombosis, pulmonary embolism, and atrial fibrillation with embolism |
| Potential complications/Adverse reaction of anticoagulant drugs | Hematuria, Bleeding gums, Nausea, Diarrhea, Urticaria, Alopecia, Hemorrhage |
| Aggregation and how it is related to clot formation | Process of platelet sticking together, it’s a big part of formation of a clot |
| Thrombolytic enzymes | Dissolve clot already formed |
| Anticoagulants classes, routes | Heparin (ardeparin, dalteprin)=IV, Coumarins/Warfarin=Oral |
| Antidote for Heparin | Protamine sulfate |
| Antidote for Coumarin | Vitamin K, takes 72 hours to work |
| The formation, presence, or development of a thrombus (clot) | Thrombosis |
| High risk area for thrombosis | Legs |
| Allergic reactions | Snizzing, coughing, itching, HA, nasal congestion |
| What do calcium Channel Blockers drugs do? | Vasodialator, Block the influx of calcium into the heart and arterial blood vessels |
| What do ACE-Angiotensin-Converting Enzyme-inhibitors do? | Vasodialator, Inhibit the formation of angiotensin which is a potent vasoconstrictor; Decrease the release of aldosterone which retains sodium and water. |
| Used to block the physiological effects of histamine after exposure to allergen | Antihistamines |
| Used to inhibit the physiological effects of histamine before exposure to allergen | Antiallergics |
| How many different types of antihistamines | Chlorpheniramine (Chlor-Trimeton), Diphenhydramine (Benadryl), |
| Antihistamine Adverse Effects | Drowsiness, Mental confusion, Sedation, Dry mouth, Anorexia, Epigastric distress, Hypotension, Tachycardia, Urinary retention, Dysrhythmias |
| What types of clients are safe to take antihistamines? | Not if hx of HTN, Cardiovascular disease, Urinary retention, Stenosing peptic ulcer, CNS depression, nursing mothers, dehydrated children. |
| Foods rich in potassium | fruits |
| Foods rich in B12 | Clams, Oysters, and Mussels, Liver, Caviar (Fish Eggs), Octopus, Fish, Crab and Lobster, Beef, Lamb (Mutton), Cheese |
| Ester local anesthetic | Esters-benzocaine, procaine, tetracaine; Amides-lidocaine, bupivacaine, prilocaine |
| Heparin | Anticoagulant, IV, Inhibit cloating factor, Adv effects, Bleeding, |
| H1 receptor antagonist | Acts on blood vessels and gastrointestinal and respiratory systems by competing with histamine for H1 receptor sites; decreases allergic response by blocking histamine |
| Cromolyn sodium | Antiallergic, anti-inflammatory, Asthma |
| Dimenhydrinate | Antihistamine, Histamine-1 Receptor Antagonist; motion sickness, nausea, vomiting |
| Promethazine | Antihistamine |
| Desloratidine | Antihistamine, Histamine-1 Receptor Antagonist |
| Chlorpheniramine | Antihistamine, Histamine-1 Receptor Antagonist |
| Cyproheptadine | Antihistamine |
| Hydroxyzine | Antihistamine |
| Hydralazine | Antihypertensive, Arteriolar vasodilator,HTN, Heart failure, Pre-eclampsia, Pulmonary hypertension, Malignant hypertension |
| Verapamil | Calcium Channel Blocker, HTN, Angina, Heart attack, Supraventricular tachycardia, Prinzmetal's angina |
| Azatadine | Antihistamine |
| Certirizine | Antihistamine, Histamine-1 Receptor Antagonist |
| Fexofenadine | Antihistamine, Histamine-1 Receptor Antagonist |
| Loratidine | Antihistamine, Histamine-1 Receptor Antagonist |
| Digoxin | Cardiac glycoside, Heart failure, Atrial fibrillation, Atrial flutter, Check BP, increase HR |
| Digitoxin | Cardiac glycoside, Heart failure, Atrial fibrillation, Atrial flutter |
| Albuterol | Beta Blocker, Asthma |
| Theophylline | Methylxanthine, Asthma, Emphysema, Slow heartbeat, Acute bronchitis,Stopped breathing, Bronchospasm |
| Erythromycin | Macrolide Antibiotic, Acne, Chlamydia bacteria infection, Pertussis, |
| Azithromycin | Macrolide Antibiotic, Chlamydia bacteria infection, Gonorrhea |
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