wwall RX Review Ch 1,2,10&11 6/08
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| Anticholenergic action | show 🗑
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| show | mg=mL x % x 10
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| powder aerosols | show 🗑
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| Checking MDI contents | show 🗑
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| MDI technique | show 🗑
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| sympathomimetic bronchodilators method of action | show 🗑
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| Adrenergic agonist method of action | show 🗑
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| show | aka anticholinergic, aka antimuscarinic, blocks ACH receptor sites, causes bronchodilation by blocking ACH, competitive antagonist for M receptor
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| Cholinergic | show 🗑
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| ACH regulation | show 🗑
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| NE regulation at synapse | show 🗑
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| show | cells regulate NE by increasing cAMP or blocking phosphodiesterase (enzyme that breaks up cAMP)
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| Un-ionized | show 🗑
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| show | receptor site of ACH, parasympathetic, class of drugs that stimulate ACH, action is decreased HR, bronchoconstriction and vasodilation
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| Potentiation | show 🗑
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| show | norepinephrine, neurotransmitter of sympathetic nervous system, receptors sites are a, B1 and B2
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| a action | show 🗑
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| B1 action | show 🗑
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| show | smooth muscle relax, bronchodilation
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| show | liver * alphabetically e and k come first in alphabet fallowed by l and m, so excretion = kidney and liver=metabolism
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| Excretion | show 🗑
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| show | acetylcholinesterase aka ACHE, enzyme that metabolizes excess ACH
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| Drug absorption | show 🗑
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| ACH | show 🗑
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| show | more physiological effect with smaller dose, more potent-more toxic, lower the effective dose-more potent
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| Parenteral | show 🗑
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| show | GI tract, pills caplets, suppository, elixir, suspension (most common)
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| show | transdermal, cream patch ointment, inhaled, MDI, DPI, SVN, USN, atomized, vaporized
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| show | receptor site of Sympathetic NS aka adrenomimetic, receptors sites are a, B1 and B2
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| Pharmacokinetics | show 🗑
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| tid | show 🗑
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| show | every 4 hours
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| show | 4 times daily
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| bid | show 🗑
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| show | plasma protein binding, tissue affinity and blood flow
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| drug transport | show 🗑
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| prototype | show 🗑
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| pharmacodynamics | show 🗑
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| sympathetic nervous system | show 🗑
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| show | median lethal dose
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| show | Therapeutic Index, ratio of LD50 to ED50 indicates drugs safety, lower TI is the more toxic the drug, higher the TI, the safer the drug.
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| Antimuscarinic | show 🗑
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| Competitive antagonist | show 🗑
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| show | effects of two drugs cancel each other out
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| show | effective dose
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| Idiosyncrasy | show 🗑
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| Tachyphylaxis | show 🗑
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| Anticholinesterase | show 🗑
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| show | enzymes that metabolize excess Ne, can be injected or inhaled
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| show | study of drugs and their origin plants animals and minerals
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| show | not a neurotransmitter, released by adrenal gland in response to sympathetic activation
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| Ceiling effect | show 🗑
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| Phosphodiesterase | show 🗑
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| Choline esters action | show 🗑
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| SLUD | show 🗑
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| show | competitive (affinity but no effect), functional (effects of 2 cancel each other), chemical (physically chemically binds in blood stream)
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| show | two drugs act on receptors to have a combined effect that is the sum of the two drugs effect 1+1-2
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| show | USP, NF, PDR
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| drug class that includes Albuterol that cause bronchodilation | show 🗑
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| show | aka synergism when two drugs are combined and the effect is greater than the sum, 1+1-3
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| show | aka cholinergic, rest and digest, neurotransmitter is ACH, receptor sites are Muscarinic and nicotinic, blocker is atropine, does not function as a unit
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| show | medial to pt on circuit, actuate at end expiration adjust dosage as needed, minimum 8 puffs may go to 20, 15 seconds between puffs
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| show | effective ceiling is 15 mg, heart neb for continuous, hazard is hypovolemia, decreased k+, increased glucose
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| Aerosol advantages | show 🗑
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| show | exact dose is unknown, only 10-20% is deposited, breathing pattern effects airway deposit, 2/3 exhaled, much swallowed, wrong neb or flow effects delivery
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| Nebulizer flow rates | show 🗑
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| show | inspiratory hold (3-5 seconds) is most important for distribution and retention of meds-slow deep breath, 6 L/min flow for 1-5 micron particles, 2.5-4 ml’s solution, inspiration only
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| show | convenient, inexpensive, no prep, new MDI’s are patent actuated and assures proper aspiratory flow and pattern
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| MDI disadvantages | show 🗑
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| show | meds tend to stick to tube or baffle, 1.5 to 3% make it to airway, SVN should be distal to pt in circuit (close to flow source) often requires double dose
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| Spacer | show 🗑
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| Bronchodilator side effects | show 🗑
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| SVN particle size | show 🗑
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| show | giving meds directly down ET tube or trach, 3-5 ml normal dose, no guarantee of dose, most often used for mucus plugging. Disadvantage, violent cough and systemic side effects
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| show | Epi-cardiac arrest, NS-sputum sample, B2, mucomyst, surfactant in premies.
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| show | ventolen + atrovent combination sympathomimetic and anticholinergic, best with copd’er
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| Finding active ingrediance | show 🗑
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| Bronchodilator categories | show 🗑
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| show | aka theophylline, caffeine, thrombromine & theophylline, Phosphodiesterase inhibiter, used in treating neonate apnea and bradycardia, long term COPD. Bad side effects.
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| show | desired dose/dose on hand=amount/X example morphine in 10 mg/5mL vial, need 4 mg.....10/5=4/X.....10X/10=20/10.....X=2 vials
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| Anticholinergic bronchodilators | show 🗑
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| Swelling & edema treatment | show 🗑
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| what is Bronchoconstriction | show 🗑
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| the anticholinergic bronchodilators drugs are | show 🗑
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| show | albuterol + ipratropium (Ventolen + Atrovent), B2 agonist plus anticholinergic
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| show | .5% mL or 2.5 mg (.5mL+2.5mL NS), MDI 2 puffs 3-4 hrs, rapid onset=5 mins, effective 4-6 hrs aka Provental or Ventolen,
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| Xopenex dosage | show 🗑
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| what are catecholamines and what are their actions? | show 🗑
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| show | modified catecholamines, resistant to MAO and COMT, terbuterline (stops contractions) and metaproterenol (not used now because of B1 side effects, hard on heart)
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| show | albuterol, levalbuterol, (Xopenex) and salmeterol (Serevent)
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| strong a, B1, B2 drugs | show 🗑
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| show | levalbuterol (Xopenex) is the only single isomer B2 agonist drug, all others have some B1 effects
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| show | Isoproterenol (Isuprel)
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| strong B2, mild B1 agonist are | show 🗑
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