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NUR 334: Pharmacology > Exam 1 Study Guide > Flashcards

Exam 1 Study Guide Flashcards

1
Q

what are the 5 rights of medication administration?

A

right dose
right time
right patient
right route
right medication
right documentation?

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2
Q

what is missing from this prescription?

Metoprolol 25mg BID for 30 days

A

does not include route

must say PO

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3
Q

True or False:

medications are dosed specifically for the route they are given:
PO vs IV

A

True

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4
Q

what do these abbreviations mean:

PR
SC
IO
SL
ODT
Buccal
IN

A

PR = per rectal

SC = subcutaneous (into the fat)

IO = intraosseous (into the bone - everything that is given IV can be given IO, they are identical routes, IO cath must be removed w/in 24 hours)

SL = sublingual (under the tongue. i.e. nitro for chest pain)

ODT = orally disintegrating tablet (dissolves on tongue in less than a minute i.e. Zofran)

Buccal = cheek (absorbed into MM)

IN = intranasal (i.e. versed and narcan)

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5
Q

what is the difference between therapeutics and pharmacotherapeutics?

A

therapeutics:
- what we do to make you feel better
i.e. use ice, exercise more, massage

pharmacotherapeutics:
- medication involved to treat things

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6
Q

what is pharmacology?

A

the study of medicine

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7
Q

naturally occurring vs. synthetic substances

A

naturally occurring:
- something that is naturally in the body
i.e. morphine - body can release morphine

synthetic:
- made in a lab
i.e. fentanyl similar to morphine but made in a lab

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8
Q

what is CAMs?

A

complementary and alternative medications (CAM)
- any substance people take for therapeutic effect that has not been proven to have that effect
i.e. st. johns wort, garlic, omega 3, cranberry juice for UTI prevention
- advertised as FDA cleared (not approved): they say it probably won’t cause harm but distinguished from medications because they have been found through clinical trials to have the intended effect

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9
Q

story or because thats the way we’ve always done it

i.e. crushed something and gave it to gma, it worked, now give it to everyone else

A

anecdotal

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10
Q

proven, proper clinical trial that found most people benefit from something

A

EBP
evidence based practice

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11
Q

4 ways medicine is a called?

A

generic name
trade/brand name
chemical name
pharmaceuticals

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12
Q

what are factors that affect absorption?

A

formulation:
dose
route
molecular size
lipid
surface area drug acting upon
blood flow
GI

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13
Q

filters blood coming into the brain

A

blood brain barrier (BBB)

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14
Q

filters blood coming to the fetus from the rest of the body

A

fetal placental barrier (FPB)

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15
Q

how the drug changes in the body, change in the formulation of the drug

A

biotransformation (metabolism)

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16
Q

medication that only works after it is changed in the body

A

prodrug

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17
Q

through the GI tract
PO mainly

A

enteral

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18
Q

round the GI tract
IV, IM, SC, IO
always quicker than enteral

A

parenteral

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19
Q

what routes have the quickest speed on onset?

A

IV > IO > IM > SC

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20
Q

what may help a patient that gets nauseous after taking their medication

A

take medications with food

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21
Q

what drug reverses an opioid overdose?

A

narcan/naloxone/evzio

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22
Q

blocks the enzyme to allow ACH levels to increase

A

inhibitors

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23
Q

way to manipulate things/levels without being able to directly impact them

A

enzyme induction

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24
Q

how the body gets rid of a drug

kidney or liver disease will impact drug doses
mainly through kidney or liver

A

excretion

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25
Q

when the concentration of X gets up to Y in the blood then drug starts to work

A

minimum effective concentration

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26
Q

level in the blood that will now cause damage

A

toxic concentration

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27
Q

range between toxi concentration and minimum effective concentration

A

therapeutic range

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28
Q

dose at which more than 50% of all patients will have the desired effect

A

median effective dose

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29
Q

dose at which more than 50% of all patients will die

A

median lethal dose

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30
Q

difference between median effective dose and median lethal dose

A

therapeutic index

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31
Q

amount of a drug you can increase and continue to get an increased response

A

graded dose response

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32
Q

plugs into receptor and lights it up - increases effect

A

agonist

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33
Q

binds to receptor and causes the high

A

heroine opioid agonists

34
Q

blocks the receptor and prevents anything binding or any effect

A

antagonist

35
Q

blocks the opioid receptor and prevents anything from binding

A

narcan opioid antagonists

36
Q

drug inidcated for one thing but can be effective for another, just hasnt been clinically proven yet/FDA approved for

A

off-label drug

37
Q

off label:

can be used to treat ED

A

nitroglycerine - chest pain

38
Q

off label:

SSRI used for sleeping/insomnia

A

seroquel

39
Q

off label:

seizure med used for weight loss

A

topomax

40
Q

what tablets cannot be chewed, crushed, or broken?

A

coated capsules or tablets

41
Q

cure the disease and fix the problem

A

antibiotics

42
Q

a side effect that requires intervention versus one that is expected/minor

A

priority side effects

43
Q

what may help a patient that gets nauseous after taking their medication?

A

take medication with food

44
Q

a drug that is teratogenic cannot be used in what patients?

A

pregnant patients

45
Q

drug that damages or kills a fetus

cannot be given to women of childbearing age that are not on birth control

must have negative pregnancy test and a form of birth control

A

teratogen/teratogenic

46
Q

what medication is always safe in pregnancy?

A

none, must contact the provider

47
Q

should a patient stop their medications if they become pregnant?

A

no, notify the provider

many medications required titration

48
Q

what are important points about giving medication to infants?

A

use a syringe - put in cheek
give a small amount at a time and make sure they dont spit it out

49
Q

important points about give medication to toddlers?

A

giving education to parents
do not tell them it is candy to get them to take it
do not crush into healthy snacks

50
Q

important points when treating teenagers?

A

questions about pregnancy, contraception, or STI
may abuse medications

51
Q

what age group is most likely to have polypharmacy (multiple drugs)?

A

geriatric

52
Q

what is neuropathic pain?

A

nerve pain

53
Q

five examples of non-pharmacological pain management interventions

A

hot/cold application
accupuncture
guied imagery
distraction
movement
conversation/talking
massage
hypnosis
exercise

54
Q

important points about opioid use and addiction?

A

you are not likely to get addicted from an appropriate short term opioid use

will not avoid prescribing opioids to someone who needs them based solely on risk of addiction

55
Q

five examples of opioids

A

fentanyl
hydromorphone
morphine
tramadol
codeine
vicodin

56
Q

GI bleeds are a priority side effect with what medication?

A

NSAIDs

57
Q

what are s/s of GI bleeding?

A

blood in stool
fatigue
weakness
hypotension

58
Q

name two conditions that opioids are used to treat besides pain?

A

cough: codeine
diarrhea: loperamide/imodium

59
Q

what is the highest priority effect of opioids?

A

Respiratory depression
low RR <12

60
Q

what is the most common side effect of opioids?

A

constipation

61
Q

what are considered the weaker opioids?

A

codeine and tramadol/ultram

less likely to cause addiction and less effective against pain

62
Q

which opioids are considered stronger opioids?

A

fentanyl
hydromorphone/dilaudid
meperoline/demerol
morphine

morphine is natural
fentanyl is synthetic

63
Q

what are combination drugs and their benefits?

A

combination of an opioid and non-opioid

goal is to give less opioid to control pain

vicodin: acetaminophen and hyrocodone
percocet: acetaminophen and oxycodone

64
Q

what is the opioid mechanism of action?

A

bind to opioid receptor sites to elicit response

65
Q

what is PCA?

A

patient controlled analgesia

PCA pump - usually in hospice or cancer patient who is discharged

66
Q

what is the advantage to using a mixed agonist antagonist?

A

lower change for addiction and easier to discontinue use

methadone - used in narcotic rehab: prevents physical withdrawal without high

67
Q

name four classes of non-opioid analgesics

A

aspirin
traditional NSAID: COX-1/COX-2 inhibitor
COX-2 inhibitors
centrally acting non-opioid analgesics

68
Q

what are the 3 uses of aspirin/ASA?

A

antipieuretics: fever reducer
analgesic: pain
antiplatelet aggregator: prevents blood clots/blood thinner

69
Q

not considered an anti-inflammatory

A

aspirin/ASA

70
Q

what is first line treatment for migraines?

A

Triptans

MOA: vasoconstriction of cranial arteries
indication: first line migraines
side effect: drowsiness
Sumatriptan

71
Q

what are other drug classes used for migraines?

A

ergot: alkaloids
antiepileptics, beta blockers, calcium channel blockers, and tricyclic antidepressants

72
Q

what is the key inflammation chemical mediator?

A

histamine: causes swelling

73
Q

what are two overall classes of drugs that treat inflammation?

A

steroids and NSAIDs

74
Q

what is NSAID?

A

nonsteroidal anti-inflammatory drugs

75
Q

what is MOA

A

inhibiting/antagonists for COX/cyclooxygenase receptors (COX-1 and COX-2)

76
Q

what is indication

A

anti-inflammatory

gout, RA, headaches, everyday pain

77
Q

what is BB warning

A

GI bleeds/peptic ulcers (blood in stool, fatigue, weakness, hypotension)

78
Q

Naproxen
Ibuprofen

A

OTC

79
Q

Ketorolac
Meloxicam
Indomethacin
Celecoxib

A

Rx

80
Q

what are NSAIDs used for?

A

anti-inflammatory:

gout/RA
pain
headaches
everyday pain

81
Q

what would be an appropriate escalation plan for the treatment of pain?

A

nonpharmacological
pharmacological
nonopioid analgesics
opioid analgesics

NUR 334: Pharmacology (13 decks)

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