Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm II > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Why would epinephrine cause stinging at the injection site?

A

Because it causes vasoconstriction which irritates the vessels in the surrounding tissue as they constrict

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What makes hyperkalemia a medical emergency? What causes hyperkalemia? Why? What are s/s?

A

causes cardiac arrhythmias leading to cardiac arrest

any cellular damage: burns, crush injuries, DKA, rhabdomyolysis, renal failures, meds

most of K+ is intracellular so damage to cells causes the release of K+

peaked T wave, muscle and abdominal cramps, weakness, paralysis, oliguria, low BP dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are s/s of hypokalemia?

A

arrhythmias (tachy, brady, irregular rhythm), shallow respirations, dyspnea, irritability, lethargy, thready pulse, N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are normal potassium levels?

A

3.5-5 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are normal sodium levels?

A

135-145 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are s/s of hypernatremia?

A

flushed skin, irritability, restless, high BP, high pulse, edema, fever (low grade), low cardiac contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are s/s of hyponatremia?

A

mental status change, lethargic, confusion, HA, loss of consciousness, seizure, death, bounding pulse, low BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are normal calcium levels?

A

9-10.5 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are s/s of hypercalcemia?

A

Muscle weakness, high fatigue, diminished deep tendon reflexes (hyporeflexia), mental status changes, headache, kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are s/s of hypocalcemia?

A

“CATS” Convulsions, Arrhythmias, Tetany; spasms & stridor, positive Chvostek’s sign, Trousseau’s sign, increased deep tendon reflexes, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is the heart controlled by the ANS? What neurotransmitters are involver? What is the result?

A

Parasympathetic control through the Vagus Nerve, using Acetylcholine as the neurotransmitter, causing Bradycardia.

Sympathetic control through the Sympathetic ganglion chain using Epinephrine or Norepinephrine causing Tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are 2 other names for adrenergic agonists?

A

Sympathomimetic,
Catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are 2 other names for adrenergic antagonists?

A

Sympatholytics,
\Adrenergic blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are 2 other names for cholinergic agonists?

A

Parasympathomimetics,
Muscarinic agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 3 other names for anticholinergic drugs?

A

Parasympatholytics,
Muscarinic antagonists,
Cholinergic blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What neurotransmitters are involved with “fight or flight” (sympathetic)? Where do they come from? What are their effects?

A

epinephrine and norepinephrine

adrenal gland

Pupillary dilation,
accelerated heart rate and increased contractility, bronchodilation of lungs,
stimulates release of glucose from liver,
inhibits salivation,
inhibits digestion,
inhibits contractions of bladder muscle,
inhibits sex organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the function of adrenergic drugs?

A

stimulate the sympathetic nervous system by stimulating the adrenergic alpha or beta receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 3 neurotransmitters (catecholamines) of the sympathetic nervous system?

A

dopamine
norepinephrine
epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What breaks down catecholamines?

A

COMT (catechol methyltransferase)
MAO (monamine oxidase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are influenced by alpha 1 receptors? What is the response?

A

all sympathetic organs besides the heart

constriction of blood vessels
dilation of pupils
relaxes bladder sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is influenced by the alpha 2 receptor? What is the response?

A

brain stem adrenergic terminals

inhibition of norepinephrine release
causes vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is the location of beta 1 receptors? What is the response?

A

heart and kidneys

increased heart rate and force of contraction
release of renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where is the location of beta 2 receptors? Response?

A

all sympathetic organs except heart

inhibition of smooth muscle contraction
bronchodilation
uterine relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is used if norepinephrine is extravasated into tissue?

A

phentolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Why are bronchodilators used before other inhalers when treating asthma?
albuterol/salbutamol cause immediate bronchodilation which allows other inhaled medications to be deposited further into the bronchiole tree , thus increasing their effectiveness.
26
What is the nature of 1st dose phenomenon? When is a good time to take med to deal with 1st dose effect?
Sudden & Severe decrease in blood pressure Syncope or loss of consciousness Give the dose at bedtime to prevent falls & subsequent injury
27
What are the cardiac rules?
Change positions slowly BP <90/60 hold the medication, call the HCP HR <60 hold the medication, call the HCP Never abruptly stop a cardiac medication Daily weights: Weight gain or loss of more than Two pounds a day or 5 pounds a week call your HCP
28
What does the parasympathetic division manage?
"rest and digest" Activated under less stressful conditions, promotes relaxation & body maintenance
29
What are parasympathetic responses?
Constricts pupil, simulates salivation, slows heart, constricts breathing, stimulates digestion, stimulates gallbladder, contracts bladder, stimulates sex organs
30
Where are muscarinic receptors? Response?
Locations: Parasympathetic target organs (other than the heart???), heart Selected Response: Stimulation of smooth muscle and exocrine gland secretions. Decreased heart rate and force of contraction
31
Where are nicotinic receptors located? Response?
Locations: Postganglionic neurons and neuromuscular junctions of skeletal muscle  Selected Response: Stimulation of smooth muscle and gland secretions 
32
What do niconic recptors most importantly influence?
the somatic system or neuromuscular junction
33
What do muscarinic receptors most importantly influence?
Stimulation of smooth muscle and gland secretions 
34
What is myasthenia gravis? What are s/s?
Loss of functioning Ach in the neuromuscular junction. Ach receptor antibodies decrease  Ach receptor sites by up to 80% S/S:  Generalized muscle weakness & fatigue. First Signs: Eyelid muscle weakness, ptosis of eyelids & fatigue
35
What are neuro muscular blocker agent? What are their timeframe of paralysis?
Nondepolarizing : Skeletal muscle paralytic, intubation, ventilation, seizure control, lengthy procedures  Action: blocks ACh at the neuromuscular junction Nursing Consideration?  Pancuronium (Pavulon) long acting 60-90 minutes Rocuronium (Zemuron) short acting 15 minutes Vecuronium (Norcuron) medium acting 30-45 minutes
36
What receptors are in the SNS?
adrenergic
37
What receptors are in the parasympathetic NS?
cholernergic
38
What drugs turn on the sympathetic nervous system?
Adrenergic agonists
39
What drugs turn off the sympathetic nervous system?
Adrenergic antagonists, mimics parasympathetic response
40
What drugs turn on the parasympathetic nervous system?
Cholinergic agonists
41
What drugs turn off the parasympathetic nervous system?
Cholinergic antagonists or anticholinergics
42
What are agonists?
Drugs that occupy receptors and activate them
43
What are antagonists?
Drugs that occupy the receptors but do not activate them. Antagonist also block activation by agonists
44
What are ANS drugs called? What do they affect?
Neuropharmacology. Drugs that help the systems that work without conscious input E.g. smooth muscle control, cardiac contraction, salivary, blood glucose, gastric, bronchial, respirator rate, etc.
45
What are some s/s of the effects of the sympathetic nervous system? how may it present?
Dilated pupils = blurry vision Inhibited saliva = dry mouth Inhibit GI = shuts off peristalsis, constipation, ileus of the bowel (from stopping of bowel movements) Increased heart rate = tachycardia, high blood pressure, vasoconstriction Relaxing of airways = bronchioles will dilate Relaxation of bladder = urinary retention from sphincter closing ** Increased blood sugar levels = for more available energy
46
Who do you worry about in fight or flight mode? Why?
Diabetic. Increase of glucose levels
47
What will adrenergic antagonists do?
Decrease blood pressure, constrict airflow, etc.
48
What are the adrenoreceptors?
A1, A2, B1, B2
49
What are the agonist (turn on) effects of A1? Where are the receptors found? What would be the effect? What does the antogonis do?
Vasoconstriction Increased peripheral resistance Increased blood pressure Mydriasis Increased closure of bladder spincter Vascular system and bladder sphincter Increase blood pressure, help with hypotension (antagonist) Vasodilation, help with HTN (antagonist) BPH, open up the sphincter wider and circumvent the pressure from the prostate blockage
50
What should you remember for alpha 1?
VASCULAR
51
What are the agonist effects on A2? Where are the receptors found? What would be the effect? What does the antagonist do?
Does the opposite of what you would expect Inhibits release of norepinephrine (used to cause vasoconstriction) Will see vasodilation Inhibits acetylcholine release Inhibits insulin release Located in the adrenal glands There are no A2 drugs
52
What are the agonist effects on B1? Where are the receptors found? What would be the effect? What does the antagonist do?
Tachycardia, increased HR, contractility, increased blood pressure Increased lipolysis Increased release of renin All over the heart, kidneys (antagonist) beta blockers = lowered HR, decreased contractility, decreased BP “lol” drugs Used for HTN, dysrhythmias, heart failure
53
What do you need to remember with B1?
1 HEART
54
What are the agonist effects on B2? Where are the receptors found? What would be the effect? What does the antagonist do?
Vasodilation Decreased peripherial resistance Bronchodilation Increased muscle and liver glycogenolysis Increased release of glucagon Receptors are in the lungs Used to open up airways Can lower the blood pressure by causing vasodilation No B2 antagonist drugs
55
What should you remember about B2?
2 LUNGS
56
What helps relax the uterus to stop labor?
Terbutaline
57
What are 3 adrenergic agonists? What is another name for an adrenergic agonist?
Epinephrine, norepinephrine, dopamine Sympathomimetics (mimics the sympathetic)
58
Epinephrine can be used for which indications? Why?
Cardiac arrest, severe bronchoconstriction, decongestion, anaphylaxis Because it can turn on all adrenergic receptors (A1, A2, B1, B2)
59
Why is there stinging at the injection site with epinephrine?
Because it causes vasoconstriction
60
What is a contraindication for adrenergic agonists? Why?
Glaucoma. Increasing pressure can happen in the eyes too
61
What is important about storing epi pens? .
They do not need to be refrigerated. They need to be on your person. Store in a cool, dark place.
62
How is epinephrine administered?
IV, IM and inhalation
63
What med is contraindicated for a person with Raynaud’s disease? Why? What is Raynaud’s disease?
Phenylephrine It’s an alpha 1 agonist. It turns on vasoconstriction. It will increase their symptoms Vasoconstriction of the peripheral arteries. white, cold, painful. Affects the heart as well
64
What is an indication of norepinephrine? Why? How is it administered
Hypotension, sepsis, cardiac failure It vasoconstricts and elevates the BP because it works on an alpha 1 receptor IV only, slow drip, short half-life, titrate
65
What are similar drugs to phenylephrine? What is an important patient teaching?
Oxymetazoline (Afrin), pseudoephedrine (Sudafed) Limit use for 3-5 days because of rebound congestion
66
What are the side effects of clonidine? Why?
Orthostatic hypotension, increased risk for bleeding (because of vasodilation) It’s an A2 agonist and reduces sympathetic outflow
67
What is the one alpha 2 agonist drug?
Clonidine
68
What receptors does isoproterenol affect?
B1 an B2
69
What are LABA (long acting beta agonists)? What are they not used for?
Formoterol, olodaterol, salmterol Emergency situations because they are longer acting
70
What lowers potassium in the bloodstream because it pulls the K+ into the cells with it?
Albuterol
71
Is albuterol short acting? Does it last long? What is it followed up with?
Yes, No, it does not last long. steroid
72
What are adverse effects of abuterol?
Palpitations, HA, throat irritations, tremors, nervousness, tachycardia, insomnia, dry mouth, hypokalemia
73
What is a critically high blood pressure? What is the lowest normal BP?
180/120 90/60
74
What is a first dose phenomenon?
it more reactive with the first dose. Extremely low BP and can be at an unsafe level fainting, orthostatic hypotension, syncope, LOC
75
What is similar to clonidine? What is the difference in the indications? Recepors?
prazosin BPH alpha 2 agonist = clonadine alpha 1 blocker = prazosin
76
what is the nature of reflex tachycardia?
regular BP but high HR, pulse
77
What does a nonselective beta blocker do? How does it manifest? what is a drug?
acts on all beta receptors in the body constricts the bronchioles as well as the heart propranolol
78
What can beta blockers mask?
hypoglycemia or septic shock
79
What is the most common beta blocker? why?
Metoprolol safest because it is selective and only affects the heart
80
What is angina?
chest pain caused by ischemia to the heart tissue, low blood flow to the heart tissue
81
What is miosis?
pupils constricting pinpoint pupils
82
what is mydriasis?
dilated pupils
83
What is the neurotransmitter of the parasympathetic?
Acetycholine
84
What is a cholernergic agonsit? what is it used for? Do we give it wit meals?
bethanechol urinary retention no, it affects its effectiveness
85
What is myasthenia gravis? Features? What is it treated with?
neuromuscular junction disease. Destroys Ach receptors drooping eyelids weak arms and legs drooling change of voice pyridostigmine
86
How can a myasthenia gravis mimic? How is it distinguished?
cholernergic crisis edrophonium, if there is improvement then it is myasthenia gravis
87
What do you do before giving pyridostigmine?
give small drink of water to test their swallowing
88
What can cause a cholinergic overload?
organophosphate poisening from pesticides
89
What are s/s of a cholernergic overdoes? SLUDGEM
S salic L lacrimation U urination D dirrhea G GI effects, cramping E emesis M miosis, muscle twitching
90
What is given for a cholnergic overdoes?
atropine cholernergic antagonist, muscarinic antagonist, anticholnergic
91
what are the TD patch similar to atropine? What is an important nursing consideration. Is it an adrenergic drug?
scopolamine wear gloves no. it blocks the parasympathetic receptors which mimics the sympathetic but that does not make it a sympathetic drug
92
What is the order of using a paralytic?
sedatation, intubation, paralytics
93
What paralytic is the shortest?
succinycholine
94
What is malignant hyperthemia? What is the antidote?
HTN, muscle rigidity, tachycardia dantrolene
95
What is hyperkalemia contraindicated with succinylcholine?
it keeps the cells depolarized by stooping the potassium from entering the cell. Can exasperate hyperkalemia
96
What is a long-acting paralytic? What is the reversal agent? What is a contraindiction?
pancuronium neostigmine sensitivity to bromide ion
97
What is chronotropic inotropic dromotropic
c: lower rate, decrease in resistance i: less force,, decrease in workload d: less beats, decrease in cardiac output
98
What are the 4 main dangers of beta blockers (4 Bs)?
bradtcardia, hold with low BP breathing problems, from vasoconstriction bad for HF, worsening crackles blood sugar masking

Pharm II (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions