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Nclex flashcards > pharmacology > Flashcards

pharmacology Flashcards

1
Q

what is absorption

A

how well a drug can pass into the body

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2
Q

what is distribution

A

how the drug is carried throughout the body to sites of action

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3
Q

what is metabolism, where does this occur

A

how the drug is prepared for elimination, this happens in the liver

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4
Q

what is excretion, where does this occur

A

how the drug is eliminated by the body, occurs in the kidneys

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5
Q

what is an agonist

A

any drug that binds to a receptor and activates the receptor

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6
Q

what is lethal dose 50 or LD50

A

the lethal dose in 50% of the tested population

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7
Q

what is an antagonist

A

any drug that binds to the receptor and prevents the receptor from activating

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8
Q

what is ED50

A

the effective dose in 50% of the tested population

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9
Q

what is the therapeutic index, what in the equation, what does a high therapeutic index mean

A

the margin of safety of the drug, LD50 ÷ ED50, higher index indicates a safer drug

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10
Q

what are the three drugs with narrow therapeutic indexes

A

digoxin
lithium
warfarin

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11
Q

why can’t grapefruit be mixed with some medications?

A

grapefruit juice inhibits P450 which is an enzyme that metabolizes many drugs, therefore digesting grapefruit juice will cause the drug levels to increase

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12
Q

which drugs require avoiding grapefruit

A

nifedipine
verapamil
statins
midazolam
fluoxetine
sertraline

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13
Q

which cardiovascular drugs prolong QT interval

A

amiodarone, nicardipine, sotalol

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14
Q

which antibiotics prolong qt interval

A

azithromycin, erythromycin, levofloxacin

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15
Q

which antifungals prolong qt interval

A

fluconazole, voriconazole

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16
Q

which antidepressants prolong qt interval

A

amitriptyline, escitalopram, fluoxetine, protriptyline, citalopram, sertraline

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17
Q

which antipsychotics prolong qt interval

A

haloperidol, quetiapine, risperidone

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18
Q

which “misc” drugs prolong qt interval

A

ondansetron, phenylephrine, pseudoprimes, lithium, tacrolimus, terbutaline

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19
Q

which statins are hepatotoxic

A

atorvastatin, lovastatin, rosuvastatin

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20
Q

which antiseizure meds are hepatotoxic

A

carbamazepine, phenytoin, vaporic acid

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21
Q

which antifungals are hepatoxic

A

fluconazole, ketonazole, itraconazole

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22
Q

which antidepressants/antipsychotics are hepatoxic

A

bupropion, TCAs, trazodone

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23
Q

which antimicrobials are hepatoxic

A

amoxicillin, erythromycin, penicillin

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24
Q

which “other” drugs are hepatoxic

A

amiodarone, labetalol, lisinopril, losartan, omeprazole, acetaminophen (with alcohol or in excess)

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25
Q

what is the antidote for acetaminophen

A

acetylcysteine

26
Q

what is the antidote for benzos

A

flumazenil

27
Q

what is the antidote for cyanide poisoning

A

methylene blue

28
Q

what is the antidote for digitalis

A

digoxin immune FAB

29
Q

what is the antidote for ethylene poisoning

A

fomepizole

30
Q

what is the antidote for heparin and enoxaparin

A

protamine sulfate

31
Q

what is the antidote for iron

A

deferoxamine

32
Q

what is the antidote for lead

A

succimer

33
Q

what is the antidote for magnesium sulfate

A

calcium gluconate

34
Q

what is the antidote for narcotics

A

naloxone

35
Q

what is the antidote for warfarin

A

vitamin K (phytonadion)

36
Q

what drugs would you want to avoid with ACE inhibitors and why

A

potassium sparing meds
increased risk of hyperkalemia

37
Q

what drugs would you avoid with nitoglycerine and why

A

erectile dysfunction meds
increase risk of profound hypertension

38
Q

what drugs would you want to avoid with metformin and why

A

contrast dye
risk for nephrotoxicity

39
Q

what drugs would you want to avoid with MAOIs and st. johns wort, why

A

other antidepressants
increases risk for serotonin syndrome

40
Q

what drugs would require you to avoid tyramine rich foods, what are tyramine containing foods, what would happen when mixing medication with the food

A

monoamine oxidase inhibitors (MAOIs) should avoid red wine, cheese, salami and chocolate because it can lead to a hypertensive crisis

41
Q

what drug would require you avoid excessive amounts of vitamin K, what could occur as a result of mixing the medication with vitamin K

A

warfarin, could lead to increased clotting

42
Q

if a client has asthma they should not take which type of medication, why

A

beta blockers because they cause bronchospasms

43
Q

if a client has congestive heart failure, which drugs should they avoid, why

A

calcium channel blocker and NSAIDs can cause sodium retention and increase the risk of a cardiac event
steroids (prednisone) can cause sodium and water retention

44
Q

if a client has epilepsy which drugs should they avoid, why

A

TCAs, antimalarials and antipsychotics because they decrease seizure threshold

45
Q

if a client has hypertension which drugs should they avoid, why

A

NSAIDS because they can increase blood pressure due to sodium retention

46
Q

if a client has Parkinson’s disease what drugs should they avoid, why

A

COX-2 inhibitors because they can cause a worsening of Parkinson’s disease symptoms

47
Q

if a client has renal failure what drugs should they avoid, why

A

NSAIDs because it can lead to nephrotoxicity

48
Q

if a client has resp failure what drugs should they avoid, why

A

neuroleptics because is can cause further resp depression

49
Q

what a drugs a local anesthetics, what is the action of local anesthetics and what is the indication

A

the “caines” dibucaine, lidocaine, benzocaine, cocaine, tetracaine
indication: painful procedure, localized pain
action: stops axonal conduction by blocking sodium channels in the axonal membrane, no conduction = no sensation

50
Q

what are some nursing considerations regarding local anesthetics

A

systemic absorption can lead to heart palpitations, tachycardia and hyper tension, can sometimes be used with a vasoconstrictor to limit the absorption of the drug into surrounding tissue

51
Q

which drugs are opioid agonists, what is the action and indications

A

the “ines” and “ones” + fentanyl
morphine, codeine, meperidine, fentanyl oxycodone, hydrocodone, hydromorphone, oxymorphone
indication: pain
action: binds to opioids receptors in the CNS and alters the perception of pain while producing general depression of the CNS

52
Q

what are some nursing considerations regarding opioid agonists

A

antidote is naloxone, symptoms of overdose are decreased resps, decreased heart rate
always monitor resps when giving opioid agonists

53
Q

how is methadone different from other opioid agonists

A

it binds to opiate receptors in the CNS and alters the perception of pain but it does not have a euphoric effect therefore is indicated for pain and in opioid withdrawal

54
Q

what are nursing considerations of methadone

A

it has a long half-life so it takes a long time to be out of the body, when weaning a client off of opioids it needs to be titrate down very slowly

55
Q

what are opioid agonist-antagonists, indications and action

A

buprenorphine, butorphanol, nalbuphine, suboxone
indication: mild to moderate pain, opioid addictions
action: opioid receptor agonist-antagonist so does not cause a euphoric feeling and is less powerful

56
Q

what are opioid antagonists, indications and action

A

naloxone, naltrexone and methylnaltrexone
indication: treatment of opioid overdose, relief off opioid-induced constipation, reversal of post operative effects
action: blocks the effects of opioid agonists, reversing analgesics, sedation, euphoria and resp depression

57
Q

what are non-opioid analgesics, indication and action

A

they are cyclooxygenase inhibitors “COX-2” there are two categories, NSAIDS and not NSAIDs
NSAIDs: naproxen, ketoprofen, indomethacin, ibuprofen, ketorolac, ASA (aspirin), celecoxib
not NSAIDs: acetaminophen

indicated for inflammation, mild-moderate pain and fever
action: block prostaglandin which causes pain fever and inflammation

58
Q

what does COX-1 and 2 act do for the body, if someone takes a too much of COX inhibitors how will it then effect them

A

COX provides gastric protection, if taking COX inhibitor it can cause gastric ulceration
aides in platelet aggregation, if taking COX inhibitor can cause excess bleeding
promotes vasodilation, if taking inhibitors can cause vasoconstriction
assists with maintenance or renal function, if taking inhibitor can cause renal impairment
cause inflammation, pain and fever, if taking inhibitor can relieve inflammation, fever and pain

59
Q

how is acetylsalicylic acid (ASA, aspirin) different from other COX inhibitors?

A

it also decreases platelet aggregation so can be used to protect against thrombolytic disorders (MI, stroke)

60
Q

what are some nursing considerations for aspirin

A

client is at higher risk of bleeding, must discontinue 5-7 days prior to surgery, do not give with any other anticoagulants, must use caution in peds clients because it can cause Reye’s syndrome it is usually only used with peds if they have Kawasaki’s disease

61
Q

what are symptoms of asa toxicity

A

tinnitus, sweating (diaphoresis), headache, dizziness, metabolic acidosis

62
Q

what are the indications of acetaminophen, action, and nursing considerations

A

indication: pain and fever, it does not have any anti-inflammatory properties
action: inhibits the synthesis of prostaglandin
nursing considerations: an overdose on acetaminophen or when taking with alcohol can cause a toxic metabolite build up leading to severe damage to the liver, the max daily dose is 4g except in long term use, which would be 3g/day

Nclex flashcards (12 decks)

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