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1
Q

Define Obtunded

A

Refers to less than full alertness (altered level of consciousness), typically as a result of a medical condition or trauma. It can appear in hypercalcaemic crisis.

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2
Q

Define Gastroscopy

A

Is an examination of the esophagus, stomach and duodenum (upper part of the small bowel) using a flexible telescope called a gastroscope.

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3
Q

Define Postpartum

A

Following childbirth

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4
Q

What is Cycloplegic?

A

An eye drop that causes paralysis of the ciliary muscle, resulting in loss of accommodation for 2-48hrs, depending on the strength. Doctors use this to allow them to measure the patient’s vision problem.

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5
Q

What is Miotic?

A

Eye drop that constricts the pupil. Used to treat glaucoma.

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6
Q

What is Mydriatic?

A

Eye drop that dilates the pupil. Used for certain eye exams and treatment of eye inflammations.

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7
Q

What is donepezil (Aricept)

A

Donepezil is used to treat confusion (dementia) related to Alzheimer’s disease.

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8
Q

What is erythropoietin (Eprex)

A

used to increase the production of red blood cells and decrease the need for transfusions of red blood cells.

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9
Q

What is fluoxetine (Prozac)

A

Fluoxetine is used to treat depression, panic attacks, obsessive compulsive disorder, a certain eating disorder (bulimia), and a severe form of premenstrual syndrome (premenstrual dysphoric disorder).

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10
Q

What is the antidote for Magnesium sulfate?

A

Calcium Gluconate

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11
Q

What is the antidote for Heparin/Low Molecular weight heparin?

A

Protamine Sulfate

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12
Q

What is the antidote for Warfarin?

A

Vitamin K

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13
Q

What is the antidote for Acetaminophen (Tylenol)?

A

Acetylcysteine (Mucomyst)

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14
Q

What is the antidote for Opiates?

A

Naloxone (Narcan)

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15
Q

What is the antidote for Benzodiazepines?

A

Flumazenil

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16
Q

What is the antidote for Digoxin?

A

Digibind

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17
Q

What is the antidote for Iron?

A

Deferoxamine

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18
Q

What can decrease absorption of medication?

A

Area of absorptive surface, Blood flow, Pain, Stress, Disease, Diet, Route, Drug formulation & Other drugs.

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19
Q

Drinking water with medication can increase absorption of medication. Increasing absorption may do what to the onset of the medication?

A

txtbook

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20
Q

How can constipation increase absorption of medications?

A

txtbook

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21
Q

What are some factors, other than the aging process, that may affect distribution of medications?

A

Blood flow, Solubility & Protein binding

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22
Q

What are idiosyncratic effects?

A

non documented drug effect, likely due to individual genetics (unpredictable/unexplained)

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23
Q

Review metabolism and excretion of medications.

A

Refers to the chemical alteration of a drug by the body
process in which the drug is changed to a water soluble form so it can be excreted.
When a drug is metabolized in can become one of three…
1. Inactive metabolite (no longer able to work in the body)
2. Active metabolite (metabolized but still able to work in the body)
3. Pro drug (a drug that doesn’t become active until it is metabolized)

Factors affecting metabolism are:
 Liver failure 
 Genetics
 Environment and other drugs
 Age
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24
Q

What are Antagonistic effects?

A

when two drugs compete for absorption or protein binding sites resulting in a less then desired therapeutic effect for one or both drugs

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25
What are Synergistic effects?
different drugs given together to increase the action of one of the drugs
26
How do adrenergic agonists work?
Produce fight or flight response; Mimics sympathetic neurotransmitters (epinephrine and norepinephrine);
27
What are some common side/adverse effects of adrenergic agonist medications?
Tachycardia; Hypertension; Palpations; Dry Mouth
28
How do adrenergic blockers work?
Block alpha and beta receptor sites; Indirectly inhibit the release of norepinephrine and epinephrine;
29
What are some side effects of adrenergic blockers?
orthostatic hypotension, dizziness, drowsiness
30
How do cholinergic agonists work?
mimic the parasympathetic neurotransmitter acetylcholine.
31
What is the difference between fat soluble and water soluble vitamins?
Fat Soluble: Metabolized slowly, stored in fatty tissue of liver and muscles, excreted in urine slowly, includes A D E K. Water Soluble: Not stored in body, readily excreted in urine. Includes Vitamin B12, B complex, Vitamin C, & Folic Acid
32
Why is vitamin K essential for?
Required for synthesis of prothrombin & clotting factors
33
What is vitamin B12 essential for?
Helps in the formation of red blood cells Maintenance of the CNS- keeps nerves working properly Essential for DNA synthesis
34
What is pernicious anemia?
Vitamin B12 Deficiency
35
What are some possible adverse effects of K+ supplementation?
Changes in cardiac rhythm, skeletal muscle irritability, damage to veins (IV)
36
What are some possible side effects of iron supplementation?
Constipation
37
What vitamin is given with calcium to enhance absorption?
Vitamin D
38
What are some side effects of magnesium? What GI issue may it be used to treat?
Used as a laxative for constipation. Side effects may include diarrhea.
39
What is warfarin used to treat? What does it do? What is the antidote? Health teaching?
Warfarin is an anti-coagulant ( blood thinner); Antidote is Vitamin K; INR Bloodwork should be done
40
What is heparin used to treat? What does it do? What is the antidote?
Heparin is an Anticoagulant used to Prevent clot formation in veins; do not dissolve existing clots. Antidote is Protamine Sulfate.
41
What is the difference between thrombolytic drugs, anti-platelets, and anti-coagulants?
Anticoagulants prevent clot formation Antiplatelet suppress platelet aggregation Thrombolytic are clot busters
42
What are antilipidemics used to treat?
Cholesterol
43
What are adverse effects of statins?
textbook
44
What are the actions of bile acid sequestrants?
Bind bile acids, which contain a high concentration of cholesterol. Because of their large size, resins are not absorbed from the small intestine and the bound bile acids and cholesterol are eliminated in the feces.
45
What is furosemide used to treat? What is the effect of this medication on BP?
Heart Failure & Kidney Disease; Loop Diuretic; Potassium-Wasting; Lower BP
46
Name the indication for erythropoietin [epoietin (Eprex)] and nursing considerations when administering this medication.
textbook
47
What classifications of rescue inhalers given to patients with acute asthma? Examples? Health teaching?
textbook
48
What classifications of maintenance inhalers administered to patients with asthma and COPD? Examples? Health teaching?
textbook
49
What are antitussives used to treat, and what are some common side effects?
Used to suppress cough reflex. Drowsiness, dizziness, headache, blurred vision, upset stomach, nausea, constipation, or dry mouth/nose/throat may occur.
50
What is Neuroleptic Maligant Syndrome?
Neuroleptic malignant syndrome (NMS) is a rare, but life-threatening, idiosyncratic reaction to neuroleptic medications that is characterized by fever, muscular rigidity, altered mental status, and autonomic dysfunction. NMS often occurs shortly after the initiation of neuroleptic treatment, or after dose increases.
51
What are some common side effects of Anticholinergic drugs?
``` Dry mouth. Blurred vision. Dry eyes. Constipation. Urinary retention. Dizziness due to drop in blood pressure on standing up (postural hypotension) Cognitive problems (confusion) Heart rhythm disturbance. ```
52
What is a common GI side effect of many narcotics?
Constipation; Assess Respiratory Rate and report if less than 10 per minute
53
What do opioid agonists do?
textbook
54
What is the indication of lithium carbonate? Nursing Considerations?
Effective for mania, bipolar and conduct disorders. Last resort for treatment. Monitor serum sodium levels closely.
55
What vital signs are important to take before administering a narcotic?
Respiration
56
Why is epinephrine included in anesthetics? Sodium Bicarbonate?
Epi is mixed with to create vasoconstriction leading to prolong effect.
57
What assessment before and after patient receives anesthetics?
textbook
58
What is tardive dyskinesia?
neurological disorder characterized by involuntary movements of the face and jaw.
59
What are some signs of parkonsonism? What neurotransmitter is mainly involved with Parkinson’s disease (PD)?
tremor, slow movement, impaired speech or muscle stiffness; Dopamine
60
What drugs used to treat PD and side effects of these drugs?
Dopamine Agonists/Dopaminergics - restore dopamine function to regulate movement and emotions. Anticholinergics to block the effect of ACh which is the exitatory neurotransmitor that regulates movement
61
What are anticonvulsants used to treat? Main categories of these drugs? Main side effects of these drugs? Nursing considerations?
Seizures; Barbiturates, Benzodiazepines, Hydantoins/Phenytoin. S/E: Drowsniness and bradypnea. Nursing Considerations: Risk for fall, moniote LOC & RR
62
Types of sedative drugs, and what they are used to treat?
Pentobarbital
63
What does Akathsia mean?
Inability to sit still/intense most restlessness
64
What is a MAOI?
Monoamine Oxidase Inhibitorl works by inhibiting the enzyme that breaks down neurotransmitters. Requires strict diet because dangerous/deadly interactiosn with foods such as cheese, pickles and wine.
65
What is the effect of sedative/hypnotics on the body?
Depression of the CNS
66
At what stage of antidepressant treatment are clients most at risk of suicide?
3-4 weeks after treatment
67
What are some adverse effects of antidepressants?
Drowsiness/Sedation, Orthostatic hypotension, Palpitations, Insomnia, Confusion
68
What is Tyramine?
An amino acid that regulates BP- people taking antidepressants cant breakdown Tyramine and as a result it'll go into bloodstream and raise BP
69
What does thyroid replacement therapy do?
Mimic the effect of thyroid hormones; Thyroid Agent; Levothyroxine Sodium (Synthyroid)
70
What are some symptoms of a thyroid storm?
high fever, palpitations, vomiting, diarrhea, agitation
71
What medications are used to treat hyperthyroidism?
Methimazole (Tapazole) inhibit T4 and T3
72
What are glucocorticoids used to treat? What are some major adverse reactions and side effects of glucocorticoids? Why should patients be tapered off these drugs slowly?
Glucocorticoids suppress acute inflammatory response by preventing cell mediated immune reaction. tapering the drug gives the adrenal glands time to return to their normal patterns of secretion. Withdrawal symptoms and signs (weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea, abdominal pain) can mimic many other medical problems.
73
Name the classifications of insulin, and give one example of brand name for each.
Rapid-Acting -Humalong Short Acting/Regular-Humulin R Intermediate Acting-Humulin N Long-Acting-Lantus
74
What is the difference between Type I and Type II diabetes? What medication is typically given for each type of diabetes and why?
Type 1: Insulin Dependent; Ideal Body Weight; Insulin | Type 2: May require Insulin; 85% overweight; Oral Antidiabetic Agens
75
Ideally, when should food be ingested prior to administering regular insulin?
30 minutes before
76
What is the primary disease resulting from too much glucocorticoid?
Cushings Syndrome
77
What is Zantac (Ranitidine) used to treat? Health teaching?
Heartburn; Can lead to Vitamin B12 Deficiency
78
What do proton pump inhibitors do?
Block the enzyme responsible for HCi secretion and reduce acid secretion; must monitor liver function
79
What antiemetic is given before chemotherapy? Why?
To prevent vomitting; Chemo can cause serotonin to be released into the gut and brain.
80
Why might an opiate be used to treat diarrhea?
Because they cause constipation. They cause muscles in the GI tract to become tense inhibiting normal peristalsis.
81
What are some important teachings for pts on antidiarrheal agents?
Stay hydrated; avoid foods that can further cause diarrhea; life threatening in children and elderly
82
Name the classifications of laxatives and their indications.
Osmotic Laxatives; Pull water into feces from surrounding tissue Bulk-Forming; Absorb liquid in the intestines and swell to form soft bulky stool (psyllium, metamucil); fibre base Emollients; Help liquids into stool acting as lubricant to prevent hard dry stool Stimulant; Trigger contractions to promote peristalsis and increase water in stool
83
What are absorbents often used to prevent?
Diarrhea; work by coating wall of GI tract and absorb/inhibit bacteria; Pepto-Bismol
84
What are absorbents often used to prevent?
Diarrhea; work by coating wall of GI tract and absorb/inhibit bacteria; Pepto-Bismol
85
What is a bacterial culture test? Should it be done before or after antibiotics are administered?
Before
86
Why should a client complete taking all of their antibiotics ordered?
Finish dose of medication to inhibit resistance if serum levels drop off micro can become smart (evolve) and mutate to live in body with medication by changing its cell wall its gets thicker
87
Describe antibiotic treatment regimen for tuberculosis.
Combo of antibiotics and Anti-tubercolosis Treatment while Chemoprophylaxis are prescribed for family of TB patient
88
A client may take erythromycin if they are allergic to penicillin. What are some other names for penicillin or penicillin derivatives they need to avoid?
Amoxicillin; Cloxacillin; Piperacillin
89
What antiviral vaccine are healthcare workers often required to take each year?
Influenza
90
What assessments are appropriate for a patient who is prescribed an antibiotic?
Allergies; C&S collected prior to first dose; History of liver/kidney disease; VS; Oral Contraceptives
91
What assessments are appropriate for a patient who is prescribed an antibiotic?
Allergies; C&S collected prior to first dose; History of liver/kidney disease; VS; Oral Contraceptives
92
Name side effects and contraindications of oral contraceptives.
Breast cancer, thromboembolic diseases and smokers should avoid; S/E: weight gain, hypertension, acne, migraines, elevated glucose
93
Review eye drops that are used to treat glaucoma.
Cholinergic Agonists/Miotics cause constriction of pupil | Prostaglandins decrease aqueous humor formation
94
What are common ear conditions? Briefly state pharmacologic management
``` Otitis Externa (inflammation of external ear) Otitis Media (inflammation of middle ear) ```

Pharmacology (4 decks)

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