Midterm 2 Flashcards
(120 cards)
1
Q
what is the sandwich eliza test
A
diagnostic test for virual infections, uses 2 different antibodies
2
Q
what is a PCR test
A
polymerase chain reaction
test that uses DNA/RNA to replicate virus to identify the virus
3
Q
how do most antiviral drugs work
A
by inhibiting replication of virus inside host cel
4
Q
suffix for antiviral drugs
A
-vir
-ovir
5
Q
what are the forms varicella can take
A
chicken pox - children
shingles - adults
6
Q
how can antivirals be administered
A
systemic or topical
7
Q
acyclovir mechanism of action
A
inhibits DNA polymerase and incorporates into viral DNA
8
Q
acyclovir indication
A
herpes viruses - herpes simplex (HSV) or varicella zoster virus (ZSV)
9
Q
acyclovir contraindications
A
hypersensitivity, caution with renal impairment, immunocompromised host, pregnancy, lactation
10
Q
acyclovir adverse effects
A
IV therapy - phlebitis, reversible nephrotoxicity, neurotoxicity
oral - GI and vertigo
topical - stinging sensation
11
Q
ganciclovir & valganciclovir mechanism of action
A
inhibit viral DNA replication by competing with viral substrates to form shorter, noneffective DNA chains
12
Q
ganciclovir and valganciclovir indications
A
severe systemic CMV infections in immunocompromised pts, CMV retinitis
13
Q
ganciclovir and valganciclovir contraindications
A
allergy, caution with renal impairment, pregnancy and lactation, children
avoid in female partner of male pt incase of pregnancy
14
Q
ganciclovir and valganciclovir adverse effects
A
headache, depression, neuropathy, granulocytopenia, thrombocytopenia, anemia, renal dysfunction, fetal toxicity (retardation, birth defects)
most to do with bone marrow suppression
15
Q
direct-acting antivirals mechanism of action
A
block ability of hep C virus to replicate
16
Q
direct-acting antivirals indications
A
hep c
17
Q
direct-acting antivirals contraindications
A
not recommended during pregnancy
18
Q
direct-acting antivirals adverse effects
A
fatigue, GI symptoms, anemia, headache
19
Q
ribavirin mechanism of action
A
inhibit DNA/RNA synthesis and subsequent replication
20
Q
ribavirin indications
A
chronic hep C, must be used with direct-acting antiviral
21
Q
ribavirin contraindications
A
<18 years old, pregnancy, nursing, pre-conception and conception
22
Q
ribavirin adverse effects
A
hemolytic anemia (low RBC count), flu-like symptoms (achy, fatigue, headache), severe depression, significant birth defects if taken by male or female partner (mutagenic and teratogenic birth defects)
23
Q
neruaminidase inhibitors mechanism of action
A
prevent release of virus from host cell
24
Q
neuraminidase inhibitors indication
A
influenza A and B, COVID-19 viruses
25
neuraminidase inhibitors contraindications
not recommended during pregnancy or while nursing, caution with renal impairment
26
neuraminidase inhibitors adverse effects
nausea, vomiting diarrhea, usually well tolerated
27
when do neuraminidase inhibitors function best
within 2 days of showing symptoms
28
adamantanes suffix
-antadine
29
adamantanes mechanism of action
prevents virus from entering susceptible cells
30
adamantanes indication
treatment/prophylaxis of influenza A in the elderly and pts with cardiopulmonary dysfunction
31
adamantanes adverse effects
nausea, dizziness, insomnia, hallucinations
32
polyenes mechanism of action
bind to sterols in fungi cell membranes and make holes in the membrane, inhibited growth or death of fungal cells
33
azoles mechanism of action
inhibits cytochrome P-450 enzymes, inhibits step in synthesis of plasma membrane sterols which damages the cell wall, inhibits growth or kills fungal cells
34
amphotericin B target
broad spectrum antifungal, polyene
35
amphotericin B mechanism of action
fungistatic and funicidal, polyene
36
amphotericin B indications
systemic fungal infections
37
amphotericin B contraindications
history of anaphylactic rxn to amphotericin B
38
amphotericin B adverse effects
highly toxic, infusion rxns, nephrotoxicity, hypokalemia, bone marrow suppression
39
nystatin mechanism of action
fungistatic and fungicidal, polyene
40
nystatin indications
yeast and yeast-like cutaneous/mucocutaneous and GI mycotic infections
41
nystatin contraindications
allergy, caution during pregnancy
42
nystatin adverse effects
mouth irritation, diarrhea, nausea, vomiting, stomach upset, may damage latex contraceptives
43
azoles indications
systemic or topical mycoses, candidiassi, athlete's foot, ringworm
44
azoles contraindications
teratogenic to developing fetus, pregnancy, hepatic disease, allergy
45
Azoles adverse effects
GI effects, hepatotoxicity (jaundice, uncontrolled blood sugar, changing enzyme levels, etc), cardio suppression (decreased EF from ventricles), can inhibit drug metabolizing enzymes
46
what are the main pharmacologic classes used for asthma and COPD
anti-inflammatory agents and bronchodilators
47
anti-inflammatory drugs use
long-term control of airway inflammation, take daily on fixed schedule as preventative measure
48
glucocorticoids mechanism of action
decrease synthesis/release of inflammatory mediators, infiltration and activity of inflammatory cells, edema of airway mucosa, and inflammation/mucus production
49
glucocorticoids indication
prophylaxis of chronic asthma and COPD, dose on fixed schedule, not used as emergency med
treat bronchospastic disorders not controlled by conventional bronchodilators
50
glucocorticoids oral use and adverse effects
for pts with moderate to severe persistent asthma or management of acute exacerbations of asthma/COPD
safe for short-term therapy (<10 days)
long-term can cause adrenal suppression, osteoporosis, hyperglycemia, immunosuppression, fluid retention, hypokalemia, peptic ulcer disease, growth suppression in young pts
51
why do glucocorticoids be discontinued slowly
prevent adrenal crisis
adrenal glands stop producing enough cortisol so stopping slowly leaves body with inadequate amounts
need to trick body into being stressed to maintain hormone levels then taper of exogenous source gradually
52
glucocorticoids inhaled use and adverse effects
1st line therapy for management of inflammatory component of asthma
adrenal suppression (long term suppression), oropharyngeal candidiasis, dysphonia (hoarseness, difficulty speaking), slow growth in youth, promotion of bone loss, increased risk of cataracts and glaucoma
53
leukotriene receptor antagonist mechanism of action
suppress effects of leukotrienes by preventing production or blocking receptors
54
leukotriene receptor antagonists indications
reduction of inflammation
55
leukotriene receptro antagonists adverse effects
depression, suicidal thinking, hallucination, other psychiatric effects
fewer adverse effects with montelukast
56
beta-adrenergic agonist mechanism of action
stimulate specific beta2-adrenergic receptors in smooth muscle of lungs
57
beta-adrenergic agonist indication
treatment of acute bronchospasm and prevention of exercise-induced bronchospasm
can be short or long-acting
58
beta-adrenergic agonist contraindication
allergy, use with caution in pts wiht uncontrolled cardiac dysrhythmias and high risk of strokes, diabetes
59
beta-adrenergic agonist adverse effects
tachycardia, restlessness, insomnia, hyperglycemias
60
ABCDE nursing considerations of pain management
A - ask/assess regularly
B - believe pt and family in their reports of pain and what relieves it
C - choose appropriate pain control options
D - deliver intervention in timely, logical, coordinated fashion
E - empower pts and their families
61
function of analgesic
selectively blocks sensation of pain without blocking other symptoms or loss of consciousness
62
function of anesthetics
local anesthetic blocks nerve conduction and all local sensations
general anesthetics cause loss of sensation and unconsciousness
63
3 classes of analgesics
opioids (natural, synthetic or semi-synthetic), non-opioids, NSAIDs
64
3 classes of opioid receptors and their impact
mu receptors - analgesia, resp depression, euphoria, sedation, physical dependence, decreased GI motility
kappa receptors - weak effect from opioids, analgesia, sedation and decreased GI motility, may be responsible for psychotomimetic (dysphoria, hallucination) effects
delta receptors - no activation by opioids, respond to body's own opioid peptides
65
what is a prototype drug
the blueprint, rest of drugs are derivatives, same drug change other ingredients/administration factors to change potency/half life/onset time, etc
66
opioid analgesic indications
alleviate mild to moderate to severe pain, codeine for cough suppression (if very necessary
67
opioid analgesic mechanism of action
primarily mu opioid receptors
68
opioid analgesic adverse effects
sedation, euphoria, resp depression, nausea, vomiting, miosis (pinpoint pupils, constipation, postural hypotension, dilation of cutaneous blood vessels (warm skin), urinary retention
69
morphine adverse effects
neurotoxicity - delirium, agitation, myoclonus, hyperalgesia
tolerance - increased doses needed to obtain same response, cross-tolerance to other opioid agonists
resp depression, CNS depression, nausea, vomiting, constipation, hypotension, itchiness/rash, urinary retention, diaphoresis and flushing, miosis
70
risk factors for morphine adverse effects
renal impairment, pre-existing cognitive impairment, prolonged high-dose opioid use
71
how to manage morphine adverse effects
hydration (help kidney with excretion), dose reduction (get analgesic effect but reduce neurotoxicity)
72
morphine contraindication
allergy, severe asthma/resp insufficiency, stomach/bowel obstruction, use of MAO inhibitor in part 14 days (causes issue with metabolism)
caution with liver/kidney disease, pregnancy, head injury, brain tumor, urination problems, alcohol/drug use and addiction
73
fentanyl routes of administration
parenteral (rapid and short-lasting effects), transdermal (72hrs), transmucosal
74
naloxone uses
opioid overdose, reversal of postop opioid effects, reversal of neonatal resp depression
75
treatments for opioid substance use disorder
individual/group/family therapy, methadone, suboxone
76
acetaminophen indications
analgesic for mild to moderate pain, antipyretic, no anti-inflammatory action
77
acetaminophen mechanism of action
blocks prostaglandin synthesis in CNS (weak inhibitor)
78
acetaminophen adverse effects
nausea, vomiting, liver failure
79
acetaminophen contraindications
allergy, severe hepatic impairment or active hepatic disease
80
acetaminophen overdose effects
hepatotoxicity, hepatic necrosis, coma, death
81
NSAIDs indication
relief of mild to moderate pain, fever, inflammation
82
NSAID mechanism of action
prevent prostaglandin synthesis, inhibits cyclooxygenase (COX, which converts arachidonic acid into prostanoids)
83
effects of COX inhibitors
COX-1 (good COX) - protection against MI and stroke
COX-2 (bad COX) - suppression of inflammation, alleviation of pain and fever, protection against colorectal cancer
84
first generation NSAID mechanism of action
inhibit COX 1and 2
85
1st generation NSAID use
treat inflammatory disorders, alleviate mild to moderate pain, suppress fever, relieve dysmenorrhea
86
1st generation NSAID adverse effects
NSAID induced ulcers
87
acetylsalicylic acid mechanism of action
nonselective inhibitor of COX
88
ASA indications
analgesic, antipyretic, anti-inflammatory, suppression of platelet aggregation
89
ASA adverse effects
GI effects, bleeding, renal impairment, Reye's syndrome, tinnitus (sign of toxicity)
90
ASA contraindications
salicylate or NSAID hypersensitivity, astham (can cause bronchoconstriction and bronchospasm), rhinitis, nasal polyps, bleeding disorder, recent history of stomach or intestinal bleedings, breastfeeding
91
ASA overdose signs
resp depression, hyperthermia, dehydration, acidosis
92
ASA drug interactions
anticoagulants, glucocorticoids, alcohol, non-ASA NSAIDs, ACE inhibitors, ARBs, vaccines
93
how are non-ASA NSAIDs different from ASA
fewer GI/renal/hemorrhagic effects, COX inhibition is reversible, don't protect against MI and stroke (after 5-7 days increases risk), greater impact on kidneys
94
ibuprofen drug class
1st generation NSAID
95
ibuprofen mechanism of effects
COX inhibition, anti-inflammatory, analgesic and antipyretic actions
96
ibuprofen indications
fever, mild to moderate pain, arthritic, primary dysmenorrhea
97
ibuprofen adverse effects
generally well tolerate, rare stevens-johnson allergy rxn, all 1st gen NSAIDs associated with increased risk of GI bleeding
98
2nd generation COX-2 inhibitors
only work on COX-2, only celecoxib approved is celecoxib, fewer GI effects than other NSAIDs, not for long-term use
99
celecoxib indication
osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, acute pain, dysmenorrhea
100
celecoxib adverse effects
dyspepsia (indigestion), abdominal pain, renal impairment, increase risk of MI and stroke in those history of heart disease
101
celecoxib contraindications
sulfonamide allergy, pregnancy
102
local anesthetic indication
minor surgical procedures, spinal anaesthesia, dental or diagnostic pruposes
103
types of local anesthetic
topical, IV, epidural/spinal injection, nerve block
104
local anesthetic mechanism of action
renders specific portion of body insensitive to pain by interfering with nerve transmission or blocking nerve conduction at site of administration
105
local anesthetics suffix
-ine
-aine
-caine
106
local anesthetic adverse effects
limited unless absorbed into circulation or injected intravenously
CNS excitation then depression
spinal headache common from spinal anaesthetic
CVS - hypotension, bradycardia, heart block, cardiac arrest
if containing epinephrine - palpitations, tachycardia, nervousness, HTN
107
why do some local anesthetics contain epinephrine
vasoconstriction limits blood flow to the area which can decrease blood loss and prolong anesthetic effects because of slower distribution and metabolism
108
lidocaine use and adverse effects
most common local anesthetic, topical or injectable, also given for cardiac dysrhythmias
can cause hypotension, spinal headaches, fecal incontinence, and urinary incontinence or retention
109
groups of hemostatis modifiers
anticoagulants, anti-platelet drugs, thrombolytic drugs
110
anticoagulant indications
used prophylactically to prevent clot formation and clot dislodgement
111
anticoagulant mechanism of action
work on different points of clotting cascade
112
anticoagulant contraindications
known allergy, acute bleeding process, thrombocytopenia
113
anticoagulant adverse effects
bleeding, unusual bruising, tarry stool, anemia
114
heparin drug class
anticoagulant
115
heparin indications
preferred anticoagulant during pregnancy or when rapid anticoagulation needed, pulmonary embolism, massive DVT, open heart surgery, renal dialysis, low-dose therapy post-op, disseminated intravascular coagulation, MI
116
heparin mechanism of action
enhances antithrombin which inactivates clotting factors thrombin and factor Xa
117
heparin special considerations
derived from cattle and pigs - need to consider pt religion, dietary preferences and allergies
ordered in units with strength ranging from 100 units/mL to 5 thousand units/mL
118
heparin adverse effects
bleeding, heparin-induced thrombocytopenia (HIT), hypersensitivity rxns (chills, fever, urticaria)
119
heparin contraindications
thrombocytopenia, uncontrollable bleeding, avoid immediately after surgery of eye/brain/spinal cord or lumbar puncture
120
heparin interactions
anti-platelet agents
