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Pharmocology Test #2

pharm test 2

QuestionAnswer
Alternative Medicine non-traditional medicine such as acupuncture, mind-body interventions, biologically based therapies, manipulative body-based methods, herbals
Traditional Medicine type of healthcare traditionally taught for NCLEX-RN and seen in acute care settings
Complimentary Medicine combination of alternative and traditional therapies mixed together with the complete knowledge of all parties involved
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
Do Not Give-any combo of herbal supplement and anticoagulant/Coumadin
Probiotic organisms that are used medicinally, including bacteria, thought to be healthy for the host organism
Activa a probiotic, Bifidus Regularis works to help regulate digestive system
Acidophilus bacteria for prevention/tx of uncomplicated diarrhea, prevention of yeast inf, do NOT give w/ anticoagulants
Aloe Vera salve for burns, wounds, orally for chronic constipation, NOT w/ deep wounds or diuretics
Glucosamine and Chondroitin GLS is naturally occurring aminosugar-used to make joint fluid, tendons, nails, and cartilage, for osteoarthritis, NOT w/ anticoagulants
Echinacea stimulates immune system, may be toxic to liver
Ginger prevention of N/V, NOT w/ anticoagulants
Ginkgo improves memory and concentration, NOT w/ anticoagulants or antidepressants, tyramine-containing foods, MAOIs, and many other drugs
Ginseng aphrodisiac, mood elevator, improves concentration, Not w/ caffeine or antidepressants, tyramine-containing foods, MAOIs, and many other drugs
Saw Palmetto tx of benign prostatic hyperplasia(BPH), diuretic, Not w/ finasteride/Proscar
St. John’s Wort tx of depression, NOT w/ other antidepressants, tyramine-containing foods, MAOIs, and many other drugs
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
gentamicin/Garamycin aminoglycoside antibiotic, effective against gram-negative bacteria(E. coli), usually for most drug resistant bacteria, causes renal problems, ototoxicity, need peak & trough
Vancomycin miscellaneous anti-infective, effective against most drug resistant gram-positive bacteria(MRSA), causes renal problems, ototoxicity, red man syndrome, need peak & trough
Complete/Basic Metabolic Panel sodium, potassium, chloride, random glucose, carbon dioxide, BUN, creatinine, calcium
Serum peak and trough for aminoglycoside or vancomycin serum level
Peak level obtained 30 minutes after completion of 30-60min IV infusion
Trough level obtained 30min PRIOR to next dose
Hepatic System oral drugs are absorbed and passed directly into liver in the first-pass effect
Hepatic Testing Liver enzymes; AST/ALT
Causes of Hepatic Damage acetaminophen-more than 4g(4,000mg) in 24hrs, chronic alcoholism->cirrhosis-hepatic encephalopathy
Ototoxicity damage to 8th cranial nerve-vestibulochlear; gentamycin/Garamycin, vancomycin, furosemide/Lasix
Classification a systematic method of assigning medications into various groups dependent upon their function on body systems
Having the knowledge of a drugs specific classification helps in understanding mechanism of action Pharmacodynamics
Chemotherapy is drug therapy used to help destroy bacteria, viruses, parasites, protozoa, fungi, neoplasms, and/or cancers
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
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
Chain of Infection-Infectious agent rapid accurate identification of organisms
Chain of Infection-Reservoirs employee health, environmental sanitation, disinfection/sterilization
Chain of Infection-Portal of Exit hand hygiene, control of excretions/secretions, trash and waste disposal
Chain of Infection-Means of Transmission isolation, food handling, airflow control, standard precautions, sterilization, hand hygiene
Chain of Infection-Portal of Entry wound care, catheter care, aseptic technique
Chain of Infection-Susceptible Host recognition of high-risk patients, treatment of underlying diseases
SE-GI Toxicity direct toxic effects on cells lining GI tract-N/V, stomach upset, diarrhea
SE-Renal Toxicity aminoglycosides & vancomycin-hydrate pt as much as possible
Therapeutic serum levels for phenytoin/Dilantin, theophylline, digoxin/lanoxin
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
Culture and Sensitivity Testing performed before an anti-infective agent is prescribed
Synergy combination of antibiotics resulting in greater effect than if given individually
Different Antibiotics NEVER run on the same tubing
cefazolin/Ancef/Keflex 1st generation cephalosporin antibiotic, use prophylactically for gram+ infections
ceftriaxone/Rocephin 3rd generation cephalosporin antibiotic, effective for gram- infections(UTI, respiratory, E Coli)
ciprofloxacin/Cipro fluoroquinolone, broad-spectrum antibiotic, effective for gram+ and selective gram- (Anthrax), given PO or IV
sulfamethoxazole trimethoprim(SMZ-TMP)/Septra, Septra DS/Bactrim, Bactrim DS sulfonamide antibiotic, effective for UTI, Sinusitis, respiratory and PCP if HIV+
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
fluconazole/Diflucan systemic antifungal, for Candida infections, local and systemic fungal infections
metronidazole/Flagyl antiprotozoal, before or after GI surgery, NO alcohol
acyclovir herpes virus agent, antiviral for any kind of herpes virus, HCW may need personal protective equipment
zidovudine(AZT)/Retrovir antiviral for HIV+, does not cross to baby during breastfeeding
estradiol/Estrace/Premarin estrogen for discomforts of menopause, osteoporosis, palliative for cancers, NO smoking->blood clots
raloxifene/Evista estrogen receptor modulator for menopause, NO smoking->blood clots
sildenafil/Viagra tx of penile erectile dysfunction by relaxing blood vessels, NO nitrates or Alpha blockers, risk for HTN
cyclosporine/Sandimmune T-and B-Cell suppressor for rejection of transplant, ^risk for infection->reduce exposure to infectious organisms, do not stop taking
Pharmacodynamics/Mechanism of Action process by which a drug works on the body
Drugs may work by-Replacing a Missing Body Chemical insulin for diabetics, levodopa->dopamine for Parkinson’s, synthroid for thyroid
Drugs may work by-Stimulating Cellular Activity clonidine/Catapres-stimulating alpha2 which decreases BP
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
Drugs may work by-Interfering with Functioning of Foreign Cells ciprofloxacin/Cipro-effective against broad-spectrum of gram+ and gram- organisms
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
Chemical messengers are known as neurotransmitters
Acetylcholine triggers muscle contractions and involved in memory, anger, and aggression, Alzheimer’s is lack of acetylcholine, Cholinesterase inhibitors
Dopamine helps control movement, modulates mood, motivation and reward, transmission low in Parkinson’s, Levodopa
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
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
Serotonin helps regulate mood, body temp, sleep and appetite, depression, impulsive behavior and aggression are linked to serotonin, SSRIs improve serotonin transmission
CNS pain, nausea, blood pressure
Sympathetic Nervous System(SNS) alpha1, alpha2, beta1, beta2
Parasympathetic Nervous System(PSNS) muscarinic
Atenolol B1 antagonist sympatholytic blocker
GI System H2-prevent gastric release
Sinuses H1
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
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
Much of drug therapy in nervous system involves receptor sites and release or reuptake and breakdown of neurotransmitters
SNS Stimulation ^BP, ^pulse, ^heart contractions, ^respirations, bronchodilation, pupil dilation, sweating, bladder sphincter contraction/decreased voiding, decreased GI activity and secretions
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
SNS-Sympathetic-Adrenergic ergon-work, relating to nerve fibers that release norepinephrine or epinephrine at synapses
SNS-Sympathomimetic Mimic the effects of the SNS-adrenergic agonist
SNS-Sympatholytic Blocks the effects of the SNS-adrenergic antagonist
SNS A1 Sympatholytics antagonistic effect on blood vessels-prazosin/Minipress-reduction in BP, tamsulosin/Flomax-^in voiding
SNS A2 Sympathomimetic agonist on brainstem-clonidine/Catapres, activates inhibitory neuron in brainstem->decrease in BP
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
SNS B2 Sympathomimetic agonist on bronchi-albuterol/Poventil/Ventolin->results in bronchodilation
PSNS-Cholinergic ergon-work, drugs/chemicals that act at same site as the neurotransmitter acetylcholine(Ach)
PSNS-Parasympathomimetic Stimulate the PSNS by Mimicking ACh-Cholinergic agonist
PSNS-Parasympatholytic Blocks the effects of the PSNS-Cholinergic antagonist
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
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
donepezil/Aricept results in reduced dementia of Alzheimer’s disease, ^short-term memory
pyridostigmine/Regonol/Mestinon for Myasthenia Gravis-an autoimmune disease->muscle weakness-pitosis, chewing/swallowing difficulties, prevents breakdown of Ach->improved muscular functioning
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
Anxiolytic Benzodiazipines-diazepam/Valium, Lorazepam/Ativan
Benzodiazepines reduce over activity of CNS, make GABA more effective, OD treated w/ antagonist flumazenil/Romazicon
diazepam/Valium, Lorazepam/Ativan for anxiety, off label use IV bolus for tx of status epilepticus
Antidepressant-SSRIs fluoxetine/Prozac
fluoxetine/Prozac for depression, effect may take up to 4wks, ^risk of suicide, serotonin syndrome if taken w/ St John’s wort
Antipsychotic/Neuroleptic chlorpromazine/Thorazine-blocks dopamine
Antipsychotic drugs-SE sedation, drowsiness, anticholinergic effects, and EPS->if EPS-STOP Med
Anticholinergic effects dry mouth, blurred vision, retention of urine, constipation
Mu Receptor-CNS-Narcotic Agonist morphine
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
Created by: neffielewis
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