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ABSN Cohort 19 > Pharm2 Exam1 > Flashcards

Pharm2 Exam1 Flashcards

1
Q

Reproductive Drugs (5)

A 
Doxazosin
Premarin
Testoterone
Tamoxifen
Herceptin
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2
Q

Doxazosin CUSA (Class, Use, s/fx, and admin considerations)

A

Non-selective Alpha 1 (relaxes smooth muscle of bladder/prostate)

Benign Prostatic Hyperplasia and HTN

HypoTN and Ø ejaculation

Monitor BP and (care w/ nitro)

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3
Q

Premarin CUSA

A

Estrogen

Postmenopausal S/S

↑% embolytic event (MI, PE, DVT, CVA, CHF)
↑% endometrial/breast cancer

Ø Nicotine and monitor embolism

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4
Q

Testosterone CUSA

A

Androgen

Hypogonadism, delayed puberty, testicular failure
*anemia if Ørx to traditional therapy

Jaundice, ↑Cholesterol, ↑% prostate cancer

Monitor AST/ALT, BG levels, and PT/INR if on anti-coagulants

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5
Q

Tamoxifen CUSA

A

Hormone Regulator - Estrogen Receptor Blocker (for est. dependent cancers)

Advanced breast cancer/early (precocious) puberty

Menopausal S/S, N/V, ↑Ca, Vaginal Bleeding/Discharge

↑ Comfort against Menopausal S/S, report Chest pain or SOB

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6
Q

Herceptin CUSA

A

Immune Suppresant - Monoclonal Antibody (targets cancerous tissue)

Metastatic Breast Cancer

Toxicity, Tachycardia, HF, N/V

ECG/Monitor, SOB/Chest pain, Dyspnea, edema

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7
Q

Inflammation, Immune, Transplantation, and Rheumatoid Drugs (4)

A

Celebrex
Cyclosporoin
Aspirin/Ibuprofen
Acetaminophen

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8
Q

Celebrex CUSA

A

Anti-Rheumatic, NSAID

Osteoarthritis, rheumatoid arthritis, chest pain

MI, bleeding, stroke, thrombosis, edema

Notify if S/S toxicity (blackstool, rash, ↑ wieght, stroke, thrombosis, edema)

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9
Q

Cyclosporin CUSA

A

Anti-Rheumatic (DiseaseModifying ARD), immunosuppresant

Prevent transplant rejection (w/ corticosteroids) and rheumatoid arthritis

S/S infx
Hepato/Nephrotoxicity
HTN
Bone marrow suppression
**Hirsutism (abnormal hair growth)**

Monitor BUN, creatinine, I&Os, AST/ALT, CBC

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10
Q

Aspirin/Ibuprofen CUSA

A

Antipyretic, non-opiod Analgesic

Fever, pain, inflammation

♥ burn, bleeding, ↓ urine output (↑ BUN/creatinine), Salicylism
Reye Syndrome (rare swelling of liver/brain)

Take w/ food, milk to ↓ gastric d/comfort

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11
Q

Acetaminophen CUSA

A

Antipyretic, non-opiod Analgesic

Fever, pain

Hepatic failure, sweating, ↓K

Ø↑ 4g/day, if overdose counter w/ Mucomyst

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12
Q

The ONLY Chemotherapy Agent

Methotraxate CUSA

A

Antineoplastics (anti-tumor), anti-rheumatic, immunosuppresant

Leukemia, psoriasis, malignant cancer of placenta (choriocarcinomas)

Chills, fever, fatigue

Monitor CBC q3-6mo
↑ birth control

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13
Q

Anticoagulant & Thrombolytic Drugs (3)

A

Warfarin
Heparin/Lovenox
Streptokinase

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14
Q

Warfarin CUSA

A

Anticoagulant

Thrombosis, ♥ dz

Hemorrage, toxicity

Monitor for bleeding and CBC
If overdose counter w/ VitK

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15
Q

Heparin/Lovenox CUSA

A

Anticoagulant

embolisms, thrombosis, prophylaxis post-op venous thrombosis (like hip surgery)

Anticoagulant regulars (HypoTN, tachycardia, bruising, CBC)
Overdose counter w/ protamine
AVOID NSAIDS, aspirin, salicylates
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16
Q

Streptokinase CUSA

A

Thrombolytic (dissolves clots)

Acute MI, transient ischemia attack, restore catheter patency

GI, GU, cerebral, and superficial bleeding

Limit INJ, monitor LoC, Monitor PT, PTT, HH

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17
Q

Neurological Drugs (3)

A

Levodopa
Dantrolene
Phenytoin

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18
Q

Levodopa CUSA

A

Anti-Parkinson

Parkinsons DZ

Dyskinesias (bobbing, tics, grimacing)
Orthostatic HypoHTN
d/colored sweat/urine

Ø High protein, MAOI, HypoTN S/S

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19
Q

Dantrolene CUSA

A

Skeletal Muscle Relaxant

Spinal injur, CVA, cerebral palsy, malignant hyperthermia

drowsiness, fatigue, ↑ urinatipon

Avoid other CNS depressants and driving

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20
Q

Phenytoin CUSA

A

Anti-Epileptic/Arrhythmic

clonic/psychomotor siezures

↓ CNS (dpliopia, slurred speech, dizziness)

Ø Alcohol
ONLY mix with NSS
Ø↑ 50g/min

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21
Q

Testicular CA R/F and Pharm Intervention

A

Cryptorchidism, FamHx

Anti-neoplastics

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22
Q

Prostate CA R/F and Pharm Intervention

A

Race (Black > White > Asian), Diet, and FamHx
HEAVY METAL, STDs and Vasectomy

Anti-androgens

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23
Q

Androgen Fx and Indication

A

↑ electrolyte retention, protein, RBC

Delayed puberty and to delay ovulation for endometriosis (uterine skin painful overgrowth)

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24
Q

Androgen ↑ levels of…?

A

Warfarin, Glucocorticoids, and Oral Hypoglycemis

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25
Q

Androgen Monitor for…?

A

Bleeding, ↓Glycemia, S/S infx

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26
Q

Names of Androgens and what for..?

SOUNDS TRADE NAMES?

A

Testosterone and Fluoxymesterone - Hypgonad/boob cancer
Testolactone - boob cancer
Danazol - blocks FSH/LH release in ♀

SOUNDS - Tes/Testo/Testin and Danocrine

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27
Q

Anabolic Steroids Fx and Indications

A

↑ tissues, RBC, and HH

Anemia, cancer, ↑ protein

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28
Q

Names of Anabolic Steroids and what for…?

SOUNDS TRADE NAMES?

A

Oxandrolone - ↑ weight, prtoein, ↓ cancer
Oxymetholone - anemia
Stanozol - Hx angioedema

Oxa and Drol/Strol

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29
Q

Adfx Androgens/Anabolic Steroids and things to monitor

A

Gender trait switches
↓ LDL ↑ HDL

Monitor liver, ♥, LDL/HDL

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30
Q

Prostate-Specific Antigen (PSA) Testing

Class, 2 tests, ↑ levels =?

A

Single-Chain Glycoprotein test with finger up butthole and Blood labs for antigen

↑ levels indicate prostate CA

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31
Q

Herceptin

A

Binds to HER2 tumor cells and MARKS FOR DESTRUCTTIION

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32
Q

BRCA genetic markers and CA

A

BRCA1 and 2 help repair mutated DNA.

If they are mutated… ↑% CA

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33
Q

Pros and Cons of HRT of Menopausal S/S

A

Pros
↓ S/S, ↓% CV dz, dementia, and osteoporosis

Cons
↑% breast/cervical CA, ↑ %CVdz, clots, and gallstones

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34
Q

Organ Preservation

A

Date/time of death with consent form.
Infuse organ w/ preservation solution
Package in preservative, triple bagged on ice

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35
Q

Histocompatibility

A

Ability of cells and tissue to live w/out interference from the immune system (MHC I and II are key)
More likely with family members/twins

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36
Q

Immunosuppresant Drug therapy

A

Immunosuppresants + Corticosteroids blcok inflam/immune fx to ↓ dmg to transplant

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37
Q

Macrolide Antibiotics

A 
Tacrolimus FK506 (Prograf)
From soil fungus, ↓ T lymphs

Sfx ↑ BP/BG levels
Monitor BP/BG

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38
Q

Antimeabolites

A

Azathioprine or AZA (Imuran)
Cytotoxic Agents
USED to be drug of choice for Øgraft rejection but is TOXIC

↓ DNA/RNA synthesis, Targets T lymphs and some B lymphs
Replaced by Mycophenolate Mofetil (MMF)

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39
Q

Take MMF after or before meals?

A

After

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40
Q

Antibodies r/t Acute Organ Rjx

A

OKT# (Monoclonal)

Atgam (Polyclonal)

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41
Q

HyperAcute Rjx

A

Immediately via Antibodies (min - hrs)

Adhere to blood vessels and clot, r/in necrosis/inflammation of organ

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42
Q

Acute Rjx

A

1 - 3 weeks
Includes 2 fx:
HyperAcute+ Cellular Response

Can be tx with medication

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43
Q

Cellular Response

A

T and NK penetrate organ and r/in inflammatory resp. and lysis of organ

TYPE4 T lymphs and macrophages attack and destroy

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44
Q

Chronic Rjx

A

Humoral, antibodies slowly attack graft over years

Similar to HyperAcute but at lower lvl

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45
Q

Blood Labs and what they monitor (5)

A

CBC - most common, RBC, HH, platelets, WBCs
Chemistry/Metabolis - Glucose, electrolytes, and Kidney fx
Enzyme - ♥ troponin, creatine kinase
Lipoprotein - Cholestrol, L/HDL, Triglyercides
Blood Clotting - PT, PTT, INR

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46
Q

4 Types of Immunity

A

Primary - macrophage consumes antigen, r/in TH cells which activate B cells
Secondary - B cells respond to antigens and ↑ plasma antibody levels
Vaccination - simulates primary
Booster Shot - simulates secondary

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47
Q

Vascular vs. Cellular Stage of Acute Inflammation

A 
Vasc -
prostaglandin/leukotrienes ↑permeability r/in warmth and WBC access
Cellular - WBC↑
Granuloytes
Monocytes
Leukocytes
and Liver fx together to destroy
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48
Q 
Granulocyte FX
Neutro
Eosino
Baso
Mast
A

arrive w/in 90 min
↑ blood
release histamine/mediators
release histamine but in CT

49
Q

Monocyte and Leukocyte FX

A

Mono - macrophage stuff

Leuko - adhesive proteins clot and mediate ↑ response

50
Q

Liver Fx in immune resp.

A

↑ fibrinogen and CRP

51
Q

Chronic Inflammation vs Acute

A

Macrophages and Lymphocytes replace NEUTOPHILS which r/in Granulomatous Inflammation
Fibroblasts replace EXUDATES

52
Q

Granulomatous Inflammation

A
  • distinctive s/s to chronic inflammation where macrophages and CT surround foreign bodies (like in TB)
53
Q

4 Types of Hypersensitivity

A

1 - allergic rx and anaphylactic
IgE r/in degranulation which dominos inflammation response
2 - Cytotoxic, IgG and IgM’s attack antigens of surfaces (RBC transfusion) which domino
3 - IgM’s clump around vessel walls and r/in tissue dmg
4 - TH improperly attack wrong antigens

54
Q 
IgA
IgD
IgE
IgG
IgM
A 
in mucous, blocks entrance
in B cells, rx to antigens
in mast cells, c/ inflammation
in fluids, attacks antigens
in fluids, clumps antigens
55
Q

Antibodies and complement proteins

A

Antibodies couple and Compliment proteins rx to antigen and DESTROY cell

56
Q

NK cells (Natural Killers)

A

Don’t need MHC or antibodies to kill

57
Q

CD4 (T-Helpers)

A

Attach to MHC 2 proteins and c/ immune response

58
Q

CD8 (T Cytotoxic)

A

Attach to MHC 1 and KILL

59
Q

B Lymphocites (CD4 followup)

A

Only attacks cells w/ T-helpers on… then r/in…
Memory B - remain and fight against
Plasma - produce antibodies against

60
Q 
Exudate Types
serous
Sanguinous/Hemorrhagic
Fibrinous
Membranous
Purulent
A 
water plasma
RBC's ind. vessel dmg
thick
whitish r/t necrotic cell collection
pus, malodorous, ind. infx ↑ swelling and pain
61
Q

Anti-Inflammation Drugs (5)

A 
Corticosteroids
Antihistamines
Salicylates
NSAIDS
Anti-Arthritics
62
Q

Salicylates like aspirin!

A

Block prostaglandins and thromboxane A.
Ø w/ NSAIDS and tatazine

Salicylism is when ↑ levels r/in ear issues, confusion, and diarrhea

63
Q

NSAIDS like Tylenol!

A

5 Types
Block prostaglandins and COX1-2
Ø w/ salicylates, sulfonamindes, and GI issues

64
Q

5 Types of NSAIDS

A 
Proprionic Acids
Acetic Acids
Fenamates
Oxicam Derivatives
COX-2 Inhibitors
65
Q

Anti-Arthritics (GOOOLD!!!)

A

gold salt tx where gold is consumed by macrophages and blocks phagocytosis. Used if traditional therapy Øfx

CAN BE VERY TOXIC.
Ø w/ DM1-2 and CV r/t issues (♥, vessels, blood)

66
Q

Salicylates prototype and -suffixes

A

Aspirin

-ide, -ine, -late

67
Q

NSAIDS prototype and -suffixes

A

Ibuprofen

-profen, -rozin

68
Q

Acedtic Acid -suffixes

A

-ac, -cin, -ton, -tin

69
Q

Fenamates buzzwords

A

Long Meclo/Mef names

70
Q

OxiCAM derivative -suffixes

A

-cam

71
Q

COX2 Inhibitor -suffix

A

-coxib

72
Q

Benign vs. Malignant Neoplasms/Tumors

A

Benign - non-cancerous (moles, uterine fibroids, lipomas)

Malignant - metastasizes and SPREADS!!! (aka CA)

73
Q

Secondary Neoplasm

A
  • metastatic offshoot of primary tumor or an unr/t tumor that ↑ in freq w/ chemo and radiotherapy
74
Q

Herceptin in Biological Therapy

A

tx with drugs that stop cancer cells from communicating to divide.

It’s called Trastuuzumab and is used against early breast cancer. Also ↓% of cancer coming back post-op

75
Q

Methotrexate Class and Use

A

Prototype Antimetabolite Agent

Interferes w/ cells that reproduce quickly. Counters CA, bone marrow, and skin cells.
Good against ALL CA, psoriasis, and rheumatoid arthritis

76
Q

Acute Coronoary Syndrome/Acute Myocardial Infarction

A

Atherosclerosis of coronary arteries c/b plaque growth

77
Q

Two types of plaque growth and fx

A

Stable - rich lipid core inflames b/c it attracts platelets/thrombus formation
Unstable - r/in unstable angina’s and MI’s

78
Q

ACS/AMI Key S/S

A

ACS
Chest pain >20 min @ rest (sitting on chest)
More severe per episode
Radiates to LUE and jaw

AMI
Many are ASYMPTOMATIC

79
Q

2 Types of MI classifications

A

Transmural - full thickness of vent. wall

Sub-endocardial - 1/3 vent wall.

80
Q

Anticoagulant Fx

A

Ø clotting/thrombin formation
r/in bleeding, GI upset, etc.
Overdose counter w/ VitK or Coumadin (Warfarin)

81
Q

Heparin rx (drug 2 drug) with…? (5)

Overdose counter?

A 
Oral anti-coags, 
salicylates, 
PCN, 
cephalosporins, 
and nitroglycerin

Protamine Sulfate

82
Q

Warfarin rx (drug 2 drug) with…?

A

Basically everything…

83
Q

Warfarin (Coumadin)

A

Maintains state of anti-coagulation if pt is in danger of clot formation

84
Q

Heparin (Generic)

A

Ø prothrombin to thrombin

85
Q

Argatroban (Acova)

A

Tx thrombosis r/t Heparin induced thrombocytopenia

86
Q

Bivalirudin (AngioMax)

A

w/ aspirin prevents ischemic events

87
Q

Antiplatelets Use and adfx

A

↓ platelet aggregation by blocking receptor site of platelet membrane (with Anagrelide)
Ø use with recurrent ♥ issues

Bleeding

88
Q

Thrombolytic Drugs Fx, route, adfx

A

Activates plasminogen to plasmin, which breaks fibrin threats in clots

INJ, metabolized by liver

Bleeding, HypoTN

89
Q

Drug r/t PT/INR, PTT, and Platelet therapy?

A

PT/INR = Warfarin (Coumadin)
PTT = Heparin
Platelet - Antiplatelet Drugs

90
Q

Myoglobin
Troponin I & T
Creatine Kinase and MB

Onset of Myocardial Dmg and Markers

A

1 hour / 4 - 8 hours
3 hours / 7 - 10 days
4 - 8 hrs/ 2 - 3 days

91
Q

Preload
Afterload
Cardiac Tamponade

A

Degree of stretch @ end of diastole
Resistance on ventricles c/b resistance via vessels
Pressure on ♥ c/b fluid between myocardium (♥ muscle) and outer covering (pericardium)

92
Q

Zones of Myocardial Dmg

A

Ischemic - recovers if flow is re-established (Time is Myocardium)
Injury - some can be salvaged, some die
Necrotic - dead and will never come back

Outside
V
Inside

93
Q

Digoxin Positive and Negative Fx?

Contraindications? and OD counter?

A

+Inotropic - ↑ force of conraction
-Chronotropic - ↓ HR

Ø if HR

94
Q

Thrombolytic vs. Anticoagulant

A

Thromos - plasminogen -> plasmin which break clots

Anticoags - interfere with clotting process

95
Q

Multiple Sclerosis

A

Immune-mediated destruction of myelin
Stage 1 - inflammatory lesions
Stage 2 - r/in demylenation and ↓ conduction

96
Q

Myasthenia Gravis

A

Bacteria in nerves r/in ptosis/diplopia.
↓Neurological fx apply

Myasthenia Crisis = respirations compromised
Acetylcholine Øfx

97
Q

Tx for MG

A

Anticholinesterase
Corticosteroids
Cyclosportine
Antibiotics

Pyrido/Neostigmine for long term tx

98
Q

Parkinsons, Alzheimers, and Siezures

A

Rigid
Forget
Involuntary

99
Q

Provoked vs. Unprovoked Siezures

A

Provoked are caused by fever, ↓BG, CNS infx, etc.

Unprovoked cause unknown

100
Q 
Absence
Atonic
Myoclonic
Tonic-Clonic
Generalized Siezures
A

↓ consciousness
↓ muscle tone
muscle contraction/stiffening
muscle contraction + LoC
^ starts Tonic Phase - rigid/LoC then Clonic - rhythmic jerking
Siezures w/out recovery (involves both hemispheres of brain)

101
Q

Complex

vs Simple Focal/Local Siezures

A

Syncope for 1-3 min f/b amnesia (temporal)

Conscious but exp. smell or pain

102
Q

Cluster
Tension
Migraine Headaches

A

Episodic, 1-8 a day b/c vasorx and hypothalamus,
Pain in forhead, temporal, and eyes.

Caused by stress or oromandiublar d/fx
Pain in neck and shoulders

R/t arterial inflammatory process
Common - 85% no aura, throbbing, visual disturbance
Classic - aura -> pain with S/S similar to Common (5 - 20 minutes before pain)

103
Q

Cluster
Tension
Migrane Headaches S/S

A

Sharp, steady pain
Dull band around head
Severe throbbing

104
Q

Ergot Derivatives and Triptans

A

Block alpha-adrenergic/serotonin receptors and reduce headaches
Rx w/ betablockers
Binds to serotonin sites and tx acute migrane (not prevent)
Rx w/ ergots and MAOIS ↑ fx

105
Q

Preventative Migrane Therapy (5)

A 
Anti-inflammatory
NSAIDS
Smooth Muscle Relaxants
Beta-Blockers
CaChnl blockers
106
Q

Tx for Alzheimers Dz (5)

A 
Donepezil (Aricept) = prototype
Galantamine (Razadyne)
Rivastigmine (Exelon)
Tacrine (Cognex)
Memantine (Namendia) = newest
107
Q

Tx Multiple Sclerosis with…?

A

Dantrolene

108
Q

Huntington’s Dz r/in…?

A

Loss of nerves in brain and brain cells

109
Q

Tx Parkinsons w/…? (2)

A

Anticholinergics and Dopaminergics

110
Q

Anticholinergic Fx

A

Block ACh in CNS to normalize dopamine imbalance
Tx Parkinsons

Ø w/ GI/GU obs

111
Q

Dopaminergic Tx (Levodopa) Fx

A

MAINSTAY TX Parkinsonism
Always given with Carbidopa (Sinemet) which counters levels

Rx with MAOS and VitB

112
Q

Seizure Drugs (5)

A 
Hydantoins
Barbiturates
Gabapentin
Succinimides
Benzos
113
Q

Hydantoins (Dilantin and Fosphenytoin)

A

Tx tonic-clonic seizures
Ø use with absence seizures (will ↑% frequency)
Ø mix with NSS or give >50mg/min

Controls short term seizures

114
Q

Barbituates (3)

A

Phenobarbital - emergency control
Primdone - partial control
Mephobaribital - absence seizures

Ø give is RR

115
Q

Gabapentin Tx

A

Partial seizures

Ø give w/in 2 hrs of antacids

116
Q

Succinimides (2)

A

Valporic Acid - absence seizures

Ethosuximide - DRUG OF CHOICE for absence seizures

117
Q

Benzodiazepines (2)

A

Diazepam - prototype, relieves anxiety/spasms

Clonazepam - absence and myoclonic seizures

118
Q

R/F for Seizure activity (6)

A 
Fever
Electroimbas
↓BG
CNS infx/dmg
Alcohol withdrawal 
Stroke
119
Q

OD Counters for Benzos and Opiods

A

Benzo counter w/ Romazicon (Flumazenil)

Opiods counter w/ Naloxone (Ø PO)

ABSN Cohort 19 (28 decks)

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