Chapter 13: Pharmacology Flashcards by Jayden McKee

Catecholamines and sympathomimetic medications should be administered with caution because they:

Can increase cardiac workload and myocardial oxygen demand

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What is the primary physiologic effect of dobutamine

Increase inotropy (contractility)

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What are the 10 patient rights

Right patient
Right medication
Right dose
Right route
Right time
Right documentation
Right assessment
Right to refuse
Right evaluation
Right patient education

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Chronotropic effect

Increased HR

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Inotropic effect

Increased myocardial contractility

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Dromotropic effect

Increased myocardial conduction

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Paradoxical bradycardia may occur if atropine is given:

In doses less than 0.1 - 0.2 mg

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What type of medication is used to eliminate certain toxins from the body?

Diuretic

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In general, alpha-adrenergic receptor antagonists:

Lower blood pressure

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Examples of schedule I substances

Heroin
marijuana
LSD

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Examples of schedule II substances

fentanyl
methylphenidate
cocaine

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Agonist effect for alpha 1 receptors

Vasoconstriction of arteries and veins

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Agonist effects for alpha 2 receptors

Insulin restriction
Glucagon secretion
Inhibition of norepinephrine

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Agonist effects for beta 1 receptors

Increased HR (chronotropic)
Increased myocardial contractility (inotropic)
Increased myocardial conduction (dromotropic)
Renin secretion for urinary retention

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Agonist effects for beta 2 receptors

Bronchus and bronchiole relaxation
Insulin secretion
Uterine relaxation
Arterial dilation in certain key organs

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Pinocytosis

The process that the cells of large medication molecules use to ingest intracellular fluids and their contents

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What situation would you most likely administer a drug rectally

Seizure termination

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What medications dissolve clots

Fibrinolytics (activase)

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Patients with _________ are at significant risk for toxic effects of medications or metabolic waste products in the body.

Renal failure

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What receptors does epinephrine stimulate

Alpha, beta 1, and beta 2 receptors

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What receptors does norepinephrine stimulate

Alpha receptors

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Cross-tolerance to a medication occurs when:

Repeated exposure to a medication within a particular class causes tolerance to other medications in the same class

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Patients who are genetically predisposed to an immune-mediated medication response:

Had an initial exposure and sensitization to a particular antigen

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When might massive doses of atropine be required

When acetylcholine increases dramatically due to acetylcholinesterase inhibition

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The vagus nerve releases ________, which acts on ________ receptors.

acetylcholine, muscarinic-2

Why should beta-blockers be used with extreme caution in patients with a reactive airway

Beta-2 receptors can potentially be antagonized, resulting in bronchospasm

What classification of medication is ketorolac (Toradol)

NSAID

Physiologic drug antagonism occurs when:

Two medications, each producing opposite effects, are present simultaneously, resulting in minimal or no clinical changes

The percentage of an unchanged medication that reaches the systemic circulation is referred to as

Bioavailability

Metoprolol has the brand name ______, which may be a subtle reference to lowering the blood pressure.

Lopressor

Lipid-soluble medications require higher weight-based doses in elderly patients because

Elderly patients have a higher body fat percentage and fat distribution

At 5-10 mcg/kg/min, dopamine:

Activates beta-1 receptor sites, causing an increased heart rate and increased cardiac contractility

Assuming no ongoing blood loss, one unit of packed red blood cells will increase the hematocrit by

The rectal route is preferred over the oral route for certain emergency medications because

Rectal medications are usually not subject to first-pass metabolism

Where does a medication undergo first-pass metabolism

Liver

What class of medication is typically used to control the heart rate in patients with atrial fibrillation or atrial flutter?

Calcium channel blocker

What are the 5 phases of cardiac cell activity

Phase 4: Cardiac cells at rest Phase 0: Cells receives an impulse; sodium ion rapidly enter the cell Phase 1: Sodium channels close while potassium exits the cell Phase 2: Sodium and calcium slowly enter the cell; potassium continues to leave Phase 3: Calcium channels slowly close and calcium leaves; potassium channels open, rapid movement of potassium out of the cell

Compared to succinylcholine, rocuronium

Has a rapid onset of action, a longer (15 to 60 minutes) duration of action, and fewer adverse effects

Fresh frozen plasma is used to

Replace critical clotting factors

Common medications administered intranasally

fentanyl midazolam naloxone

The therapeutic index of a medication is defined as the

Difference between the median effective dose and the median toxic dose

IV calcium is routinely used to treat:

Magnesium sulfate toxicity

A drug that possesses the same desired clinical effect in several smaller doses as it does in a larger single dose has demonstrated

A cumulative action

Fentanyl (Sublimaze) is the preferred opioid analgesic for patients in critical or unstable condition because:

It is not as prone to causing hypotension as morphine

Define tachyphylaxis

A condition in which repeated doses of medication within a short period rapidly cause tolerance, making the medication virtually ineffective

What is the MOA of anticoagulant medications

To prevent new clot formation and the growth of existing clots

What is the preferred IV fluid for Y-site tubing administration during a blood product transfusion

Normal saline

Acetylcholinesterase is an enzyme that:

Breaks down acetylcholine

What type of medication is used to decrease gastric acid secretion

Histamine-2 receptor antagonist

Tranexamic acid (TXA) has been shown to significantly decrease patient mortality when administered

within 3 hours of a traumatic injury

Unlike a nondepolarizing paralytic, a competitive depolarizing paralytic:

Causes muscle fasciculations

A patient recently began taking an antipsychotic medication and is experiencing a dystonic reaction. What drug is indicated?

Diphenhydramine

What is Stevens-Johnson syndrome

Severe, possibly fatal reaction that mimics a burn

The physical, emotional, or behavioral need for a medication in order to maintain a certain level of “normal” function is called:

Dependance

When is aspirin indicated for the treatment of a stroke

Only after an intracranial hemorrhage has been ruled out

Dopamine is commonly used in the prehospital setting as the primary medication for:

Nonhypovolemic hypotension

A medication that has a negative chronotropic effect will

Cause a decrease in the heart rate

A patient who overdosed on acetaminophen is at greatest risk for:

Liver failure

A malnourished patient with a history of long-tern alcohol abuse would most likely recieve:

Thiamine

Why might hypotension occur following the initiation of dobutamine infusion

It reduces cardiac afterload

How does ACE inhibitor medications lower blood pressure

They block the conversion of angiotension I to angiotension II

Newer medications are designed to target only specific receptor sites on certain cells in an attempt to:

Minimize the adverse effects

What is an abnormal susceptibility to a medication that is peculiar to an individual patient called

Idiosyncratic reaction

What is the physiologic effects of nitroglycerin when given to patients with cardiac related chest pain

Decrease preload and coronary vasodilation

How does the renin-angiotensin system function under normal conditions

Promote vasoconstriction and fluid retention in response to hypotension or hypoperfusion

At 15 mcg/kg/min, dopamine:

Causes vigorous vasoconstriction

First pass metabolism of a medication occurs when:

The bioavailability of a medication is reduced before it reaches the systemic circulation

Patients who take alpha-blocking medications at home are frequently prone to:

Postural hypotension

Chapter 13: Pharmacology Flashcards

(68 cards)