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Lpn > Exam 1 Pharm Chpt 3 4 5 Bertha Chpt 43 > Flashcards

Exam 1 Pharm Chpt 3 4 5 Bertha Chpt 43 Flashcards

(56 cards)

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1
Q

Pharmacodynamics

A

Effect of the drug on the body

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2
Q

Pharmacodynamics

A

Effect of the drug on the body

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3
Q

Pharmacotherapeutics

A

How the drug is used to treat disease

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4
Q

Generic name

A

Same in all countries
Original name
Lowercase
Stays on after trade name expires

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5
Q

Trade name aka Brand name

A

Capitalized followed by ‘r’ symbol

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6
Q

Drug attachment

A

Drugs lock onto outside of cells-Receptor cells

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7
Q

Agonist

A

Attaches and activates receptor
Action mimics chemicals of body

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8
Q

Partial agonist

A

Drug partially attaches at receptor site
Only slight action results

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9
Q

Antagonist

A

Drug attaches at receptor site
No response is produced
Blocks activation of the receptor

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10
Q

Drug process- absorption

A

How fast a drug is dissolved and absorbed- form affects solubility How the drug gets into the body, bloodstream, target cells
Requires no energy-higher concentration to lower concentration- diffusion, filtration, osmosis
Requires energy- lower concentration to higher concentration-active transport

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11
Q

Drug process- distribution

A

Movement from the blood and lymph (after absorption)
Circulation (distributes) takes it to the target
Distribution is usually uneven depending on type of drug, type of tissue
Brain and placenta have barriers
May bind to proteins
May be attracted to fats(build ups)
Affects duration of action

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12
Q

Absorption and distribution

A

Route of administration influences absorption
ENTERAL- into GI tract PO by mouth, NG nasogastric, PEG, G tube
PARENTERAL-directly into tissue, mucous membranes, spinal fluid, or bloodstream
Intravenously, intramuscularly, subcutaneously (SQ), sublingual, buccal, intranasal, inhaled, epidural,PR,vaginally, eye drops
PERCUTANEOUS- topical ointments, patches, creams

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13
Q

Drug process- Metabolism

A

How body breaks down and gets rid of drugs
Once drug is absorbed and distributed the body alters (breaks down, metabolizes) the drug into active/inactive chemicals
This bio transformation happens in various sites mainly in the liver
Oral drugs- first pass ( GI tract to liver)
SL and IV avoid first pass (more potent)

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14
Q

Drug process-excretion

A

Elimination of metabolites(leftovers)
Usually feces or urine
Sometimes via lungs, skin, tears, saliva, breast milk
KIDNEY OR LIVER DISEASE???????

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15
Q

Variability

A

First time use of particular drug

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16
Q

Drug half life

A

Time it takes for 50% of drug to be 3xcreted
Long half life- dosed once daily
Short half life- dosed more frequently

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17
Q

Preparations

A

Never crush, chew, or open long acting or extended release forms

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18
Q

Desired action

A

Therapeutic goal
What you want the drug to do

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19
Q

Side effect

A

Expected mild and annoying result of the drug

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20
Q

Adverse reactions

A

NURSES MUST BE PREPARED TO REACT TO THESE
More severe symptoms that develop from drug
some require hospitalization/can be life threatening
Examples; Steven’s-Johnson syndrome (skin Condition) and anaphylactic shock
Severe adverse effects such as damage to kidney or liver, or bleeding develop the drug must be stopped

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21
Q

Hypersensitivity (unexpected reaction)/Allergic reaction

A

Increased reaction to a drug
Antibody response to drug
When an individual has taken a drug and the body has developed antibodies to it when the patient takes the drug again the antigen antibody reaction produces hives, rash, itching, or swelling of the skin. This type of allergic reaction is very common so you must ask the patient about whether they have ever had a drug reaction . 

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22
Q

Drugs more likely to produce allergic reactions

A

Aspirin, Sulfa, and Penicillin

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23
Q

Idiosyncratic reactions (not expected)

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A

Rare, strange, peculiar- may be caused by genetic or hormonal variation in that individual
Paradoxical effect is an idiosyncratic response- reaction is opposite of what would be expected (rare)

24
Q

Drug interactions

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A

One drug changes the other drug
ADDITIVE EFFECT-increases effect.
Probenecid added to pcn for added effectiveness
ANTAGONISTIC EFFECT- interferes with the expected effect (such as oral contraceptives and antibiotics), antidotes
SYNERGISTIC EFFECT- effect of both are increased

25
Food alcohol and drug interactions
Most medications interact with at least one other med MOIs (antidepressant drugs) noted for food drug interactions Foods: grapefruit, fatty meals, milk products Pregnancy Caffeine, nicotine Alcohol and other drugs
26
Factors influencing drug therapy
Hydration, low BP, shock, heart failure, reduced blood flow, use of ETOH,and drugs, Liver or kidney problems Age, size, body fat composition (body water) Genetics (enzymes)
27
Drug therapy in older adults
Drugs are absorbed, metabolized, and excreted more slowly Decreased body water volume ( more fat less water) Decreased liver mass, slowed kidney function Low albumin Vision, arthritis, finances
28
Drug card should contain the following info
Generic and trade name, dosage range Desired action, expected side effects, adverse effects Administration and usual routes Important info/nursing considerations
29
Parts and sizes of needles
30
Needles
Gauge=diameter Larger #=smaller needle 17G is larger than 25G Viscosity of liquid, amount of liquid Smaller gauge for smaller amounts Smaller
31
SQ( subcutaneous) sites
Skin between dermis and muscle Less blood in this area- slow but long duration 45 degree angle, rotate injection sites Do not aspirate to prevent bruising apply slight pressure after injection Thigh=vastus laterus
32
I M injection Z track method
Pull tissue laterally Insert needle straight down into muscle Release tissue as needle is withdrawn, this allows skin to slide e over injection track and seal drug inside
33
I M sites
Upper arm=deltoid for vaccinations in adolescents and adults Ventrogluteal= hips. children over 7 and adults Vatus lateralis=thigh
34
Nitroglycerin paste
35
Buccal, sublingual, ear and eye drugs
36
Buccal, sublingual, ear, and eye drops
37
Chapter 5 p71-72 planning and intervention ANTIBIOTICS
Immediately all provider for rash, itching, SOB, lump in throat, or drop inB/P Diarrhea is a common side effect not an allergic reaction If bloody, watery, fever or cramps could be c diff Yeast can be vaginal or oral Consistent timing- tid=q8h, qid=q4h, q6h etc Timing side effects interactions Must finish course unless instructed otherwise
38
Penecillins.Amoxicillin (pink liquid). Mouth throat skin ears heart lungs Fewer side effects
Bactericidal Sometimes mixed with other ingredients to increase duration(last longer) or decrease resistance (prevent it from being destroyed) 5 generations (1929) Used prophylaxis (prevent endocarditis) before surgery or dental procedure Broad spectrum Most common side effect is simple diarrhea (kills some normal flora), also N/Vand GI distress If diarrhea is severe notify HCP ADVERSE EFFECT-Rash;redness or inflammation, Urticaria; hives, Angiodema; swelling of the skin and mucous membranes, Laryngeal edema; swelling of the larynx Anaphylaxis;shock Reduces effectiveness of oral contraceptives Antacids decrease absorption
39
Cephalosporins. Lower respiratory tract, CNS, genitourinary, sepsis, skin, soft tissue, skeletal
Bactericidal, broadspectrum spectrum, similar to PCN, 5 generations Expected side effects/V/D Adverse reactions-allergy/ acute hypersensitivity from mild to anaphylaxis CAUTION- cross sensitivity pts. W/PCN allergy NEPHROTOXICITY in older adults and kidney diagnosis Usual response is REDMANS SYNDROME; deep red rash on upper body response (slow infusion) Avoid alcohol mimics Antabuse (vomitting HA, SOB, low B/P,
40
POWERFUL vancomycin and Carbapenems treat MRSA and other superbugs
Usually IV, PO to treat MRSA, cell wall inhibitor ADVERSE REACTIONS NEPHROTOXICITY and OTOTOXICITY Kidneys and ears are biologically related Vanco: Low B/P, RED MANS SYNDROME (histamines) Carbapenems: confusion SEIZURES AVOID PROENICID
41
TETRACYCLINE doxycycline minocycline(usually for acne) UTI Lyme dx anthrax
Take on empty stomach** SIDE EFFECTS V/N/D (dose related), PHOTOSENSITIVITY**, yeast infection ADVERSE EFFECTS use contraindicated in pregnant women/breast feeding and children under 8 yrs causes inadequate bone and tooth formation cause permanent yellow brown tooth discoloration Permanent damage to fetus skeletal retardation Can cause LIVER TOXICITY and High doses can decrease kidney function
42
Macrolides erythromycin azithromycin Mouth throat skin ears
Alternative for PNC if allergic effective against same Action similar to tetracycline Take on empty stomachs SIDE EFFECTS PHOTOSENSITIVITY GI upset ADVERSE REACTION. LIVER DAMAGE** phlebitis w/ IV Has numerous drug interactions that can be LIFE THREATENING CHECK DRUG BOOK**
43
Gentamicin streptomycin. Amika in. To serious gram negative bacteria E. coli proteus pseudomonas
Weight based Weakens bacteria SIDE EFFECTS IRRITATES VEINS N/V, Fever, rash, lethargy SERIOUS ADVERSE EFFECTS. NEPHROTOXICITY OTOTOXICITY persistent HA dizziness Narrow therapeutic range (based on pt. Weight) Monitor peak(after dosing) and trough (just before next dose) check BUN and CREATINE VNCO INCREASES RISK OF NEPHROTOXICITY *** OTOTOXICITY increased w/ aspirin and diuretics ** Poorly absorbed from GI tract Monitor labs. Frequent urine/ hearing screenings***
44
Sulfonamides Bactria, Sentra spectrum pre and post bowel surgery. UTI bladder infection (cystitis), Renal infection (pyelitis
Take with lots of water and or food increase to 1.5 L water daily to prevent crystals Photosensitivity Expected side effects HA. Fatigue,dizziness. Insomnia tinnitus ADVERSE EFFECTS CAN CRYSTALLIZE IN KIDNEY RASH THAT BEGINS WITH FEVER PHOTOSENSITIVITY DRUG INTERACTIONS. Interacts with/blood, then a Coumadin and seizure medication CAN INCREASE EFFECT OF DIABETIC DRUGS 
45
Cipro, levo,are fluor. Treats anthrax STI Respitory bone and skin
Side effects N/V/D and Abd pain incontinence can irritate skin** urine crystals ADVERSE REACTION not for children under **18 causes tendon rupture TINGLING BURNING AND NUMBNESS IN FEET AND HANDS INTERACTONS No dairy no vitamins minerals antacids take w food keep older pts. Well hydrated
46
Macrolides
ACE Macrolides= azithromycim,clarithromycin, erithromycin
47
Super toxic- vancomycin, gentamicin, neomycin
Report signs of vertigo, tinnitus=OTOTOXICITY Report immediately=creatine over 1.3=bad kidney Bun over 20, urine output less than 30mL= kidney distress
48
Pregnancy
Childcare=clillins, cyclins Penicillin, amoxicillin Doxycycline, tetracycline
49
No sun- Avoid fun the sun
F-fluoroquinolones T-tetracycline- S-sulfa
50
Psoriasis
Inflammatory! autoimmune Rapidly replicating skin cells and keratin Flare ups and remissions Tx- photo chemotherapy, methotrexate (immunosuppressant) and biological agents ending in imab
51
Acne vulgaris
Inflammation of sebaceous glands; pustules Tx - Isotretinoin (accutane) dangerous for fetus Tropical antibiotics and hormones Side effects photo sensitivity, dry cracked skin (mouth area)
52
Scabies aka Pediculosis
Caused by human itch mite, burrows under the skin and lays eggs especially on hands and arms, Brown wavy lines CONTAGIOUS Tx all comities and patient
53
Malignant tumors of the skin. BASIL CELLL
Basil cell carcinoma. Metastasis is rare. Good out come*** Small, translucent meaty
54
Papules- pop
Larger than 1 cm small solid Ex.plantar warts, elevated moles, lichen plants
55
Malignant melanoma- Melanocytes
Exposure to sunlight increase risk Invade layers of the skin Deadliest skin cancer Warning signs are ABCDE asymmetrical border, diameter, and evolving
56
Atopic dermatitis
Caused by allergies and dry skin

Lpn (18 decks)

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