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Drugs that readily pass through the blood-brain barrier are...
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Decreased response to a drug with prolonged use is...
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Pharm Comprehensive
Comprehensive Cards
| Question | Answer |
|---|---|
| Drugs that readily pass through the blood-brain barrier are... | lipid soluble |
| Decreased response to a drug with prolonged use is... | tolerance |
| Six rights of drug administrations are... | patient, drug, dosage, time, route, documentation |
| Water solubility, reduced blood flow, ionized, small surface area, and bowel hyperactivity are... | factors that reduce drug movement (pharmacokinetics) |
| An example of physical barrier to the distribution of drugs is... | blood brain, blood-eye, or fetal placental |
| Impact of protein binding on drug distribution is... | decreased distribution (intrinsic activity) |
| This organ must be mature and healthy in order to effectively metabolize drugs | liver |
| Size of doses needed for drugs with a high first pass effect: | increase in amount needed |
| Effect of competition for drug metabolizing enzymes on drug levels: | decrease in amount needed |
| Ratio between lethal dose of a drug and effective dose is called... | therapeutic index |
| This organ must be mature and healthy in order to effectively excrete drugs: | kidneys |
| Routes which avoid first pass effect are: | IV, IM, SubQ |
| Non-protein bound, water soluble, ionized: | |
| Safety level of drugs with a narrow therapeutic range: | decreased |
| Amount of time required for the 50% of a dose to be eliminated | half-life |
| Type of drug that mimics the actions of the body's own regulatory molecules: | agonist |
| Type of drug that prevents receptor activation by endogenous regulatory molecules and have no effect of their own: | antagonist |
| Effect of food on rate of drug absorption: | decreases absorption |
| Effect of grapefruit on the levels of many drugs: | increases drug levels (can create toxic effect) |
| Disease produced by drugs: | iatrogenic |
| Tests used to monitor for hepatoxicity: | LFT (tests AST and ALT levels) |
| Tests used to monitor for nephrotoxicity: | BUN, creatinine |
| Test used to monitor for bone marrow suppression: | CBC |
| Proven risk of fetal harm: | Category X |
| Step to minimize entry of medications into breast milk: | Administer just after breastfeeding, use drugs that are water-soluble with a short half-life |
| About 10% of individuals are allergic to this class of antimicrobials: | penicillins |
| 5-10% of individuals who are allergic to penicillins are allergic to this class of antimicrobials: | cephalosporins |
| DOC for treatment of an anaphylactic response: | epinephrine |
| DOC for treatment of methicillin-resistant Staph aureus (MRSA): | vancomycin |
| Antimicrobial that discolors teeth and can cause enamal loss--withhold pregnancy and less than 8 yr.: | tetracycline |
| Antimicrobial alternative for individuals allergic to penicillin: | erythromycin |
| Major toxic effects of this class of antimicrobials are ototoxicity and nephrotoxicity: | aminoglycosides |
| This antimicrobial has a higher risk for photosensitivity: | tetracycline |
| This antimicrobial can produce a hypersensitivity reaction known as Stevens-Johnson syndrome (25% mortality): | sulfonamides (sulfamethexazole) |
| DOC for antibiotic associated colitis: | metronidazole |
| This antimicrobial can produce a disulfiram-like reaction if comined with alcohol: | Flagyl |
| Adverse effects of this antimicrobial include infusion reactions, nephrotoxicity, hypokalemia, phlebitis, hypotension, and bone marrow depression: | Amphotericin B |
| This antimicrobial is used to treat herpes simplex virus (HSV): | acyclovir |
| Contraindicated for persons with hypersensitivity to eggs: | vaccinations |
| Enfavirtide (Fuzeon), zidovudine (Retrovir), efavirenz (Sustiva), Lopinavir (Kaletra), and nelfinavir (Viracept): | anti-retroviral drugs |
| Reduction in viral load: | treatment is working |
| Levodopa, Levodopa with Carbidopa (Sinemet), Amantadine (Symmetrel), and Benztoprine (Cogentin) are... | drugs to treat Parkinson's disease |
| Length of time to wait betwen administration of last dose of Levodopa and first dose of Sinemet: | eight hours |
| To avoid abrupt cessation of this prototype drug's effects--spread out protein intake throughout the day: | Levodopa |
| Dyskinesias, postural hypotension, psychosis, n/v--are adverse effects of this prototype drug used to treat Parkinson's: | Levodopa |
| Tacrine (Cognex) and Memantine (Namenda) are drugs to treat... | Alzheimer's disease |
| Phenytoin (Dilantin) carbamazepine (tegretol), valproic acid (depakote), diazepam (valium), and phenobarbital (barbiturate) are... | anti-epileptic drugs |
| DOC for treatment of status epilepticus: | Benzodiazepines (Diazepam/Lorazepam) and Phenytoin |
| This anti-seizure drug should not be administered at a rate faster than 50 mg/min: | Dilantin |
| This anti-seizure drug should not be administered at a rate faster than 2 mg/min: | Benzodiazepines (Diazepam/Lorazepam) |
| These prototype drugs are strong opiods: | Morphine/Fentanyl |
| Prototype opioid antagonist: | Pentazocine/Narcan |
| To avoid this adverse effect, morphine must be administered slowly over 5 minutes: | respiratory depression |
| Morphine should be held if a client's baseline respiratory rate is less than ______/min | twelve |
| Constipation, respiratory depression, urinary retention, emesis, increased ICP, and sedation are adverse effects of this class of analgesics: | opioids |
| A maximum of 4 gm of this prototype drug should be taken in one day in order to avoid hepatoxicity: | acetaminophen |
| Sumatriptan (Imitrex) and ergotamine are... | drugs to treat migraines |
| Anti-inflammatory, analgesic and antipyretic effects are the result of inhibition of: | Cox 2 (aspirin) |
| Tinnitus, sweating, headache, and dizziness are symptoms of what type of drug toxicity? | Salicylism |
| Use of this analgesic is contraindicated for children who may have influenza or chickenpox: | aspirin |
| Neurotransmitter at nicotinic and muscaranic receptors: | acetylcholine |
| Location of alpha 1 sympathetic system receptors: | eyes, arterioles, veins, bladder |
| Location of beta 1 sympathetic system receptors: | heart, kidneys |
| Location of beta 2 sympathetic system receptors: | lungs |
| Response to activation of alpha 1 receptors: | pupil dilation |
| Response to activation of beta 1 receptors: | increased heart rate, renin release |
| Response to activation of beta 2 receptors: | bronchodilation |
| Response to blockade of alpha 1 receptors: | pupil constriction |
| Response to blockade of beta 1 receptors: | decreased heart rate, no release of renin |
| Response to blockade of beta 2 receptors: | bronchoconstriction |
| Response to activation of muscarinic receptors on the bladder: | increased urine output |
| Response to activation of muscarinic receptors on the eye: | pupil constriction |
| Response to blockade of muscarinic receptors in the lungs: | bronchodilation |
| Effect of blockade of muscarinic receptors on quantity of secretions: | decrease in output |
| Response to blockade of muscarinic receptors on the heart: | increase in heart rate |
| Prototype drug used to treat hypertension by blockade of alpha 1 receptors: | Prazosin |
| Prototype drug used to treat hypertension, decrease 02 demand, and/or to decrease HR for rapid dysrhythmias through blockade of beta 1 receptors: | Propanolol/Atenolol/Metaprolol |
| Prototype cholinergic (muscarinic) agonist used to treat urinary retention: | Bethanecol |
| Prototype cholinesterase inhibitor used to treat myasthenia gravis: | Neostygmine |
| Antidote for too much cholinesterase inhibitor or too much cholinergic agonist: | atropine |
| Prototype cholinergic (muscarinic) antagonist: | epinephrine |
| Effect of anticholinergics on pupil diameter: | pupil dilation |
| Drugs which increase contractility are: | positive inatropics |
| Class of drugs which prevent the conversion of angiotensin 1 to angiotension 2: | ACE inhibitors |
| Effect of blockade of aldosterone secretion in the RAA: | water and sodium excretion (lowers blood pressure) |
| Effect of blockade of the converstion of angiotension 1 to angiotension 2 on vascular smooth muscle: | vasodilation (decreased afterload) |
| Strategies for "first dose" hypotension: | take at bedtime; rise slowly |
| Antihypertensives should be held if the systolic pressure falls below _____ mm Hg | 100 |
| Beta blockers CCB and Dig should be held for baseline pulse rates below _____ bpm | 60 |
| Potential adverse effect of all antihypertensives | hypotension |
| Rate at which furosemide (Lasix) is given IV in order to avoid hypotension: | 20 mg/min |
| Normal (therapeutic) digoxin level: | 0.5-0.9 ng |
| Effect of dopamine and dobutamine on cardiac contractility (output): | increases contractility |
| Cardiosuppressant effects on heart rate, contractility (CO) and AV conduction: | decreases |
| Adverse effect of all vasodilators: | reflex tachycardia, decreases BP |
| Periodic liver function tests are indicated for users of this cholesterol lowering agent: | statins |
| This cholesterol-lowering agent has to be separated from other medications because of its binding effects. It also has constipation and decrease absorption of fat soluble vitamins adverse effects: | Questran (cholestyramine) |
| Used for hypertensive crises. Adverse effects include hypertension, cyanide poisoning, and thiocyanate toxicity: | Nipride |
| Toxicity that is characterized by bradycardia, GI symptoms, and CNS effects like visual disturbances. Toxicity is potentiated by hypokalemia: | Digoxin |
| This class of drugs have generic names that end in "sartan": | ARB's (angiotensin receptor blockers) |
| This class of drugs have generic names that end in "pril": | ACE inhibitors |
| This class of drugs have generic names that end in "olol": | Beta blockers |
| Clients taking this antihypertensive agent must be monitored for hyperkalemia: | ACE inhibitors and ARB's |
| Clients taking this antihypertensive agent must be monitored for hypokalemia: | Lasix |
| An adverse effect of this drug is a persistent dry irritating nonproductive cough due to bradykinin accumulation: | ACE inhibitors |
| Digoxin, Dopamine, Dobutamine are referred to as: | positive inatropics |
| DOC for iron deficiency anemia: | 1st choice: Ferrous sulfate; 2nd choice: Iron dextran |
| DOC for Vitamin B12 deficiency: | cyanocobalamin |
| Doc for folic acid deficiency: | folic acid |
| Erythropoietin growth factor: | Epogen |
| Leukopoietic growth factor: | Neupogen |
| Thrombopoietic growth factor: | Neumega |
| DOC for prevention of arterial thromboses: | Ticlid, Plavix, Persantine, aspirin |
| Thrombolytic: | Streptokinase/Altepase |
| DOC for prevention of venous thromboses: | Heparin |
| Antidote for heparin: | Protamine sulfate |
| Antidote for warfarin (Coumadin): | Vitamin K |
| Expected change in stool appearance with iron administration: | dark green, black tarry stools |
| Rationale for test dose prior to IV administration of iron: | analphylactic reaction (IV/IM) |
| Reason that cyanacobalamin is usually not given orally: | |
| Adverse effect associated with filgastrin (Neupogen) administration: | bone pain |
| Adverse effect associated with oprelvekin (Neumega) administration: | fluid retention, cardiac dysrhythmias |
| Lab test to monitor effectiveness of ferrous sulfate: | CBC, iron level |
| Lab test to monitor effectiveness of epoeitin alfa (Epogen): | HGB, CBC diff, BUN, uric acid, creatine, P, K, iron |
| Lab test to monitor effectiveness of filgrastim (Neupogen): | CBC, platelets |
| Lab test to monitor effectiveness of oprelvekin (Neumega): | CBC, platelets |
| Lab test to monitor effectivenes of warfarin: | INR-PT |
| Lab test to monitor effectiveness of heparin: | aPTT |
| Target aPTT range for heparin anticoagulation: | 1.5-2x aPTT(nl 40 sec; target 60-80sec) |
| Target PT range for warfarin anticoagulation: | 1.5-2X normal (nl PT 12 sec) |
| Target INR range for warfarin anticoagulation: | 3-4.5 |
| Interpretation of a WBC of 1800: | low (normal=5,000-10,000) |
| Interpretation of a platelet count of 35,000: | low (normal=150,000-400,000) |
| Potential adverse effect of heparin therapy: | hemorrhage and Heparin-Induced Thrombocytopenia |
| Anticoagulant of choice during pregnancy: | Heparin |
| Expected onset of Warfarin effects: | 8-12 hours after admin. Peak several days |
| Timeframe in which thrombolytics must be administred following symptom onset: | 4-6 hours |
| Most serious adverse effect associated with use of thrombolytics: | bleeding, hypotension |
| Urticaria, itching, flushing, and headache are signs of an allergic reaction to which thrombolytic: | Streptokinase |
| Interpretation of a peak flow meter reading in the yellow zone: | some symptoms present, insufficient control, some intervention (SA beta 2 agonist inhaler) |
| Inhaled beta 2 agonist used for quick relief during an asthma attack: | albuterol |
| Tachycardia, angina, and tremor can be adverse effects of this bronchodilator if taken in excess: | Beta 2 agonists-Albuterol |
| Pseudoephedrine (Sudafed) and phenylphrine (Neosynephrine): | Sympathomimetics (tx of allergic rhinitus) |
| Diphenhydramine (Benadryl), Loratadine (Claritin), and Azelastine (Astelin): | oral/nasal antihistamines |
| Expected action of guafenesin (Mucinex): | stimulate flow of respiratory tracts secretions |
| Expected action of acetylcysteine (Mucomyst): | reacts directly with mucus which results in increased water content of secretions |
| Hypokalemia, immunosupression, fluid retention, ulcerogenic, hyperglycemia: | Glucocorticoids |
| Adverse effect of use of nasal decongestant sprays for more than 3-5 days: | rebound congestion |
| Adverse effect of first generation antihistamines: | drowsiness |
| A leukotriene modifier: | Singulair |
| A mast cell stabilizer: | Cromolyn (Intal) |
| Oropharyngeal candidiasis and dysphonia are possible adverse effects of this inhaled prototype drug: | Glucocorticoids |
| With this prototype drug use to prophylactically treat asthma the nurse must monitor for toxicity. Therapeutic range is 10-20 mcg/ml. | Theophylline (Theolair-SR) |
Created by:
fambrough
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