Final Study Guide Flashcards
(125 cards)
1
Q
Understand ionization and how it pertains to the movement of a drug
A
Ionized (or charged) drugs are not absorbed as efficiently as un-ionized drugs are. Practically speaking, this means that if taken orally, a drug that is a weak acid will be absorbed primarily in the acidic environment; whereas, a drug that is a weak base will be absorbed in the alkaline environment small intestines.
2
Q
Potency
A
the amount of drug necessary to produce a pharmacological effect
3
Q
efficacy
A
how effective a drug is at producing a pharmacological effect
4
Q
Schedule 1 drug
A
- all drugs start here
- will remain here if no therapeutic effect
5
Q
Schedules 2-4
A
- ordered with prescription
- records kept for two years
- DEA sets quotas for amount manufactured/distributed
6
Q
Schedule 5
A
-no prescription needed
records kept for 2 years
7
Q
Schedule 2 drug
A
o High potential for abuse
o Prescription cannot be refilled
• Maximum 30 day supply
• Prescription must be rewritten on security paper
o Prescriptions can be refilled by phone, but a written prescription must follow 72 hours after
8
Q
o SCHEDULE III
o Moderate to low physical dependence
o High psychological dependence
o Prescription must be renewed after 6 months of 5 refills
A
Schedule 3
9
Q
Schedule 4
A
o Limited dependence
o Same prescription writing issues as Schedule III
10
Q
Security paper
A
tamper resistant security prescription forms required for schedules 2-4
11
Q
Chemical name
A
exact chemical composition of drug
12
Q
official name
A
used in USP
13
Q
Generic name
A
usually name given during testing
14
Q
trade/brand name
A
copyrighted name whose use is restricted to single company
15
Q
USP
A
o Full time director, voluntary team of pharmacologists, physicians, pharmacists, nurses, consumer activists
o Older drugs deleted in favor of newer more affective agents
o Gives average dose, toxicity, methods of administration
o How to prepare. Drugs, standards for tablet disintegration
16
Q
National formulary
A
o Single drugs and formulas for drug mixtures
o Often include drugs deleted by USP
17
Q
What are the two official drug reference books?
A
NF and USP
18
Q
Ama drug evaluations
A
o Prepared by appointed experts
o Drugs grouped according to use
o Favorable and unfavorable judgements expressed
19
Q
PDR
A
o Manufacturers buy space
o Similar to drug inserts
o Cross-referenced generic and chemical names
o Useful for drug identification and dosage forms
20
Q
Drug facts and comparisons
A
o Grouped according to use
o Compares various drug forms
o Color photo section
o Includes over the counter medication
21
Q
Local drug administration
A
o Skin:
• Antiseptic, cleansing, emollient
o Nasal mucosa
• Sprays, nose drops, decongestants, hemostatics
o If too much is applied, systemic absorption may happen
o Inhalation
• Antibiotics
• Detergents and enzymes for breaking up secretions
o Genitourinary
• Oral (swallow to stomach and intestine)
• Sublingual and buccal
• Rectal
22
Q
Systemic drug administration
A
o Nasal mucosa: vasopressin, cocaine, heroin
o Inhalation: anesthetics, CO2, O2, NO
o Oral
• Simplest route into bloodstream
o Sublingual/ buccal
• For drugs destroyed by liver or digestive enzymes
• Do not chew, swallow or take with water
o Rectal
• Bypass liver and digestive enzymes
• Irritating to stomach
• Antiemetic
• Used for retention enemas or suppositories
23
Q
Sympathetic
A
o Preganglionic neurons are located in thoracic and lumbar regions
o Fight or flight
o Decreased GI, pupil dilation, increased HR/BP
o During stressful conditions
24
Q
Parasympathetic
A
o Rest and digest
o Increased GI, constricted pupils, lower HR/BP
o During relaxing conditions
25
How does the voluntary nervous system differ in terms of # of neurons
o Only controls skeletal muscle
| o One long neuron instead of 2
26
Adrenergic receptors...Where are they located, what NT stimulates them?
o Adrenergic receptors normally respond to norepinephrine neurotransmitter release in the body.
o Location: vasculature, heart, smooth muscle wrapping around brochiole.
27
Alpha adrenergic receptors...what they do where they are
contracts smooth muscle. Found in Peripheral blood vessels, vasculature.
28
Beta adrenergic (B1) what do they do, where are they located?
stimulates heart rate, strength. Heart is major place found.
29
Beta adrenergic receptors (B2) what do they do.... where are they found
Beta2 (B2) adrenergic receptors- relaxes smooth muscle, increases metabolic rate. (bronchiole tree)
30
2 types of nicotinic receptors and where are they found and what NT is used with them
o The 2 types of cholinergic receptors are muscarinic cholinergic receptors & nicotinic cholinergic receptors.
o found especially in smooth muscle of hollow organs
o neurotransmitter: acetycholine
31
Alpha agonist indications
```
Causes vasoconstriction
• Relieves nasal congestion
• Increases BP
Topical to the eye
• Dilates pupil for eye exam
• Relieves redness/congestion
Used to treat severe allergic reactions
```
32
Beta1 agonist indications
```
Increase cardiac output
Treat severe allergic reactions
Heart failure
Atrioventricular block
Shock
```
33
Beta2 agonist indications
```
Relaxation of bronchiolar smooth muscle
• Asthma
• COPD
Relaxes uterine muscle
• Pre-term labor contractions
```
34
Muscarinic Cholinergic agonist indications
```
Increase smooth muscle tone and contraction of GI tract
Stimulate muscle of urinary tract
Stimulate most exocrine glands
Contract sphincter muscle of the eye
Contraction of ciliary muscle
```
35
Nicotinic cholinergic indications
Activate Ach receptors in ganglia
Nicotine is only drug used therapeutically
Used as nicotine replacement
36
Muscarinic Cholinergic antagonist indications
```
Supresses GI secretions and motility
• Peptic ulcers
• cramps/diarrhea associated with IBS
• Acute pancreatitis
Relaxes bladder
Pupil dilation
Bradycardia
Dilates bronchi
• COPD/asthma
Parkinsons disease
Andidotes for poisoning with muscarinic agonist
Preanesthetic medication
```
37
Nicotinic Cholinergic Angonist indications
Facilitate surgery
Facilitate electroconvulsive therapy
Facilitate endotracheal intubation
Treat tetanus
38
Alpha1 antagonist indications
Vasodilation to prevent local necrosis
Shock- vasodilation can pull fluid back into circulation
Pheochromocytoma (adrenal tumor)
Hypertension
39
Beta1 antagonist indications
```
Cardiac arrhythmias
Angina
Hypertension
Migraine prophylaxis
Controls signs of thyrotoxins
Counteracts symptoms of hyperthyroidism
```
40
Contraindications for beta1 agonist
Hypertension
Hyperthyroidism
• Increased metabolism
• Heart palpitations
41
contraindications for alpha antagonist
Hypotension (unless with arrhthmisa requiring treatment)
Congestive heart failure, heart block
caution: Diabetes
42
contraindications for alpha agonist
angina, hypertension
43
contraindications for beta2 antagonist
asthma, hypotension, CHF, heartblock
44
contraindications for nicotinic antagonist
glaucoma, gastric or urinary retention
45
contraindications for nicotinic and muscarinic agonists
extreme stimulation
46
• What is postural hypotension? What drugs cause it?
o Postural hypotension is when blood pressure drops upon standing after sitting or lying down
o Drugs used to treat high blood pressure, such as diuretics, beta-blockers, calcium-channel blockers, and angiotensin-converting enzyme (ACE) inhibitors.
47
What is a pressor?
o A pressor produces an increase in BP by constricting blood vessels
48
ace inhibitor..what it is, side effects
block the formation of angiotension II, decreasing BP through vasoconstriction and blocking aldosterone from being secreted.
• Enhance effects of thiazide diuretics
• Side effects:
Persistant cough and orthostatic hypotension
Hyperkalemia
Angioedema
49
Beta blocker...MOA, who is it best for, side effects, what it does
```
decrease HR and force of contraction
Inhibit release of renin and angiotension II
Best for patients under 40
Side effects
• Fatigue, activity intolerance,
```
50
calcium channel blockers... what they do, when not to use, side effects
Block calcium channels in cardiac and arteriolar muscle, limiting degree of muscle contraction
Do not use with HF and AV block
Side effects
• Reflex tachycardia, peripheral edema, dizziness, fatigue and flushing
• Constipation, nausea, diarrhea
51
diuretics....what they do, side effects, contraindications
```
Reduce blood volume through urinary excretion of water and electrolytes
Side effects
• Potassium depletion
• dehydration
• hyperglycemia in diabetic patients
Contraindications
• Diabetes
• Renal or liver disease
• Cardiac arrhythmias
```
52
What is angina? How is it treated?
o Insufficient blood supply to cardiac muscle causing pain (steady and intense)
o Treated by beta-adrenergic blockers and calcium channel blockers
Beta-adrenergic
• Selectively blocks beta 1 receptors. Slow HR and reduces contractility
Calcium channel blockers
• Relax arteriolar smooth muscle, reducing BP
• Slow cardiac conduction which decreases HR and work
• Dilate coronary arteries bringing more O2 to myocardium
53
What are arrhythmias? How are they treated?
```
o Bradycardia (50-60 BPM)- cardiac stimulants
o Tachycardia (100-200 BPM)- sodium channel blocker/ calcium channel blockers, quinidine
o Flutter (200-300 impulses/ minute)- beta-blockers
o Filbrillation (<300/ minute) cant measure due to non-effective contraction- quinidine
```
54
Anticoagulants. uses and side effects?
o Venous thrombosis, prevention of coronary thrombosis, Afib or valve disease
o Side effects
Hemorrhage
GI Bleed, gum bleed, nose bleed, uterine bleed
55
Antianemics. what are they? common uses and dangers
```
o Replace missing factor (iron, Vitamin B12, folic acid, RBC, WBC, erythropoietin)
o Side effects
Mostly with iron
Headaches, GI symptoms
Death in children is possible
```
56
Neurotransmitter involved with Epilepsy
Gaba
57
Neurotransmitter involved with parkinsons
decreased dopamine..imbalance between dopamine and ACH
58
Neurotransmitter involved with depression
decreased serotonin, norepinephrine, and dopamine
59
Neurotransmitter involved with anxiety
Low GABA
60
Neurotransmitter involved with schizophrenia
high dopamine
61
Neurotransmitter involved with manic depression
high serotonin/ NE
62
uses of CNS stimulants
- ADHD
- narcolepsy
- weight contro
- usually schedule 2 drugs
63
Anesthetics...what do they do? How fast do they work?
o They give amnesia, analgesia, muscle relaxation
| o Inhalation anesthetics work in seconds
64
Antitussive...uses and side effects
```
o They prevent coughing (only when coughing is nonproductive)
o Narcotic side effects
Abuse
Constipation, depress respiration,
o Non-narcotic side effects
Dry mouth, nausea, vomiting
```
65
H1 antagonist
- antagonize therapeutic reactions, prevent symptoms from reacting
- motion sickess
66
H2 antagonist
decrease gastric secertion
| -treat heartburn
67
acute asthma treatment
- sympathomimetics
| - xanthines
68
chronic asthma treatment
- anticholinergic
| - asthma prophylactic
69
side effects of corticosteroid
o Hoarsness, dry mouth, local infections in mouth and pharynx
o Poor wound healing, salt/water retention, insomnia
70
Bacteriostatic
stop microbial growth, limits spread of infection, relies on host immune system
71
tetracycline
bacteriostatic..broad
72
chloramphenical
broad, bacteriostatic
73
bacteriocidal
kill bacteria, decrease # of viable pathogens, preferred for patients with compromised immunity, good for life threatening infections
74
penicillin
broad, bacteriostatic
75
cepholosporins
bacteriostatic
76
carbapenems
broad, bacteriostatic
77
monobactems
bacteriostatic
78
glycopeptides
bacteriostatic
79
aminoglycosides
bacteriostatic
80
fluoroquinolone
broad, bacteriostatic
81
macrolides
bacteriostatic
82
sulfonamides
broad bacteriostatic
83
erthyromycin
broad bacteriostatic
84
cell wall synthesis inhibitors
kill bacteria by preventing synthesis or repair of cell wall
85
penicillins (MOA)
inhibit last step of cell wall synthesis
86
Cepholosporins (MOA)
cell wall synthesis inhibitor
87
Monobactams
Cell wall synthesis inhibitor
88
Aminoglycosides
bind directly and irreversibly to 30s ribosomal subunit
89
tetracycline
bind reversibly to the 30s subunit go the bacterial ribsome and inhibit protein synthesis
90
Trentoin side effects
- temporary worsening of skin
- more susceptible to sunburn
- might accelerate carcinogenic effect of UV light
91
tetracyline side effects
Gastric upset, vaginitis, skin and fungal infections
Decreases effectiveness of oral contraception
Contraindicated in pregnancy
92
erythromycin side effects
Gastric upset, vaginitis, skin and fungal infections
93
cisrentic acid side effects
Severe birth defects
| Dry cracked skin, alopecia, hypertriglyceridemia, hepatitis, acute pancreatitis, pseudotumor, joint/muscle pain
94
oral zinc side effects
GI bleeding
95
Topical corticosteroids
can make acne worse if it is the inflammatory kind
96
open angle glaucoma..what causes it?
draining canals become clogged overtime causing an increase in IOP
97
narrow angle glaucoma..what causes it?
the iris is pushed or pulled forward blocking the drainage angle of the eye
98
when are steroids used for eye conditions?
- allergic reactions of the eye
- severe injury
- non-pus producing inflammations
99
Emollient..what is it..when is it used
fatty or oily substances that may be used to soften or soothe irritated skin and mucous membrane
100
Keratolytic..what is it..when is it used
keratin dissolvers: soften scale and loosen the outer horny layer of the skin
101
Secretion in kidneys
certain molecules are secreted from blood to urine
102
filtration in kidneys
water and solutes are filtered from the plasma in the glomerulus
103
reabsorption in kidneys
things are reabsorbed from the nephron back into circulation
104
How to correct alkalosis
* Decreases respiratory rate, retaining CO2. Carbonic acid dissociates into H+ (neutralizes excess OH-)
* Kidneys: eliminates excess HCO3- by absorbing less bicarb and more chloride
* Retain needed H+ by secreting less H+ and more K+
105
How to correct acidosis
* Increase RR, removing CO2 and carbonic acid
* Kidney: reabsorbs more bicarb instead of chloride in the proximal tubule
* Secretes more H+ than K+ in distal tubule
106
What is a diuretic? What is the MOA of most diuretics
o Diuretics hold water to increase urine volume
o Most of them inhibit inhibition of Na+, Cl-, and HCO3-
o All result in decreased Na+ reabsorption
107
Uses for diuretics that act on the proximal tubule, ascending loop of henle, distal tubule
```
o Proximal tubule
Inhibits reabsorption of HCO3-
o Ascending loop of henle
Inhibits Cl- reabsorption
o Distal tubule
Potassium sparing diuretics
Mimics effect of aldosterone antagonist
```
108
Uses for furosemide
o Loop diuretics
o Retains effect of blood vessels (vasodilation)
o Powerful inhibitor of Cl- reabsorption from ascending limb of loop of henle
o Can cause up to 4 liters of urine to be formed within the first few hours
109
Uses for osmotic diuretics
o Withdraw water from overhydrated cells
o Maintain high volume of urine
o Prevent renal failure following hemolytic reaction, shock, hemorrhage, surgery
o Helps eliminate drug overdose such as barbiturates or salicylates
110
causes and symptoms of hyperkalemia
```
Causes
• Decreased aldosterone
• Renal failure
• Cellular damage
• Metabolic acidosis
Symptoms
• Decreased neuromuscular function
• AV block, cardiac arrest
```
111
causes and symptoms of hypokalemia
```
• Decreased K+
• Increased GI loss
• Metabolic alkalosis
• Increased aldosterone secretion
Symptoms
• Decreased neuromuscular function
• Increased HR, impaired conduction
```
112
Causes and symptoms of hypercalcemia
```
Causes
• Hyperparathyroidism
• Vitamin D intoxication
• Excessive mineral intake
• Acidosis
• Bone cancer
```
```
Symptoms
• Nerve membranes less excitable
• Increased HR
• Stones and calcium deposits
• polyuria
```
113
Causes and symptoms of hypocalcemia
```
• Hypoparathyroidism
• Too little vitamin D
• Chronic renal insufficiency
• Bed rest and inactivity
• Alkalosis
• Stored blood
Symptoms
• Nerve membranes more excitable (irritability, tetany, convulsions)
• Heart weak
```
114
causes and symptoms of hypermagnesemia
```
Causes
• Renal insufficiency
• Acidosis may make worse
Symptoms
• Sedation and depression
• Muscle weakness
```
115
causes and symptoms of hypomagnesemia
```
• Starvation
• Diarrhea
• Overtake of Ca++
Symptoms
• Increased irritability
• Convulsions
• Cardiac arrhythmia
```
116
acquired immunity
* Vaccine: suspension of either attenuated or killed microorganisms
* Toxoid: toxin modified so that it is nontoxic by stikk antigenic
117
passive immunity
* Mother to fetus or nursing infant
* Antivenins
* Rhogam
118
uses for adrenocorticosteroid
- anti-inflammatory
| - pallative care
119
uses for glucocorticosteroid
* Addisons disease
* Suppress ACTH
* Suppress inflammatory response
* Bronchodilation
* Some types of cancer
120
mineralocorticoid treatment
adrenal insufficiency
121
side effects of glucocorticoid treatment
```
Atrophy of adrenal gland
Delayed healing
Reduces resistance to infections
Peptice ulcers
Amenorrhea
Mimic’s cushings syndrome
```
122
side effects of insulin deficiency
Hyperglycemia
Polyuria, thirst, dehydration
Ketoacidosis (fruity breath, hunger)
Vascular damage (eye, extremities, heart)
123
indications for oral hypoglycemic agents
Stimulates insulin release
Alter receptor sensitivity
Change livers response to insulin
124
side effects of hormone therapy
```
Memory problems
Tiredness
Digestive issues
Weight gain
Muscle and bone changes
Headaches
```
125
uses for biphophonates
```
Prevention and treatment of osteoporosis
Pagets disease
Myeloma
Primary hyperparathyroidism
Osteogenesis imperfecta
Bone fragility
```
