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Pharmacology- Keiser > Misc. Pharm > Flashcards

Misc. Pharm Flashcards

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1
Q

What does DAW stand for?

A

Dispense as Written

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2
Q

What are S&S of Antimalarias?

A

Related to destruction of RBCs & liver toxicity

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3
Q

What is the aimed treatment of Antimalarias?

A

Aims to attack parasite at any stage of development in & out of the human body.

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4
Q

What drug is the best drug to treat Malaria?

A

Quinine

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5
Q

What are Antimalarias?

A

Combo drugs/cocktails designed to attack plasmodium @ various state of its cycle.

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6
Q

What are the 2 most common Helminths?

A

Nematodes/Roundworms

Platyhelminths/Flatworms

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7
Q

What is the definition of a tumor?

A

Neoplasm

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8
Q

How do malignant tumors develop?

A

From one cell w/ somatic mutations occurring during division as tumor grows.

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9
Q

What feeds a tumor?

A

Glucose

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10
Q

What are somatic cells?

A

Any cells that are not sex cells

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11
Q

What are Gamma cells?

A

Sex cells

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12
Q

The nurse is caring for a patient with a fungal infection. Which of the following would be considered an adverse effect of an antifungal medication?

A

Burning or irritation in the sexual partner

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13
Q

What is primary action?

A

Side effects that are extensions of desired effects

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14
Q

What is secondary actions?

A

Effects IN ADDITION to desired effects

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15
Q

What is hypersensitivity?

A

Excessive response to primary/secondary effects

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16
Q

What are the 4 main classifications of drug allergy?

A

Anaphylactic
Cytotoxic
Serum sickness
Delayed

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17
Q

What are the signs of anaphylaxis?

A

Hives/rash
Difficulty breathing
Increased BP
Dilated pupils
Diaphoresis
Panic feeling
Increased HR
Increased RR

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18
Q

What are the interventions for anaphylaxis?

A

Epinephrine
Prevention

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19
Q

What is the symptoms of cytotoxic reaction?

A

CBC: decreased hematocrit, WBCs, platelets
Liver function test: elevated enzymes
Renal function test: decreased renal function

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20
Q

What are cytotoxic reaction interventions?

A

Notify & discontinue
Support to prevent infection
Conserve pt energy until response complete

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21
Q

What are symptoms of serum sickness?

A

Itchy rash
High fever
Swollen lymph nodes
Swollen/painful joints
Edema of face/limbs

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22
Q

What are the interventions for serum sickness?

A

Notify & discontinue
Provide comfort measures to S&S

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23
Q

What are the symptoms of delayed allergic reaction?

A

Rash
Hives
Swollen joints- similar to poison ivy

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24
Q

What are the interventions of delayed allergic reaction?

A

Notify & discontinue
Provide skin comfort measures

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25
What is a superinfection?
Infection caused by destrution of normal flora
26
What are the early symptoms of hypoglycemia?
Sweating Blurry vision Dizzy Anxiety Hungry Irritable Shaky Headache Weakness/ fatigue
27
What are symptoms of hyperglycemia?
Fatigue Polyuria (frequent urination) Polydipsia (frequent thirst) Deep RR Restlessness Polyphagia (increased hunger) Nausea Hot/ flushed skin Fruity breath
28
What are S&S of hyperkalemia?
Serum K+ = 5+ mEq/L Weakness Muscle cramps Diarrhea Numbness/tingling Bradycardia Low BP Decreased urine output Difficulty breathing
29
What is an agonist?
Drugs that interacts directly w/ receptor sites Example: INSULIN
30
What is an antagonist?
Drugs block receptor site activity
31
What does First-Pass effect do?
Destroys large portion of portion of oral drug potency
32
What is a prototype?
Original drug in its class
33
What are pre-clinical trials?
Testing in lab w/ animals.
34
What is Phase 1 studies?
Studies introducing human volunteers
35
What are Phase ll studies?
Studies allowing patients w/ disease
36
What are scheduled l drugs?
Street drugs, highly abusive Example: Meth
37
What are schedule ll drugs?
Pharmaceuticals w/ high abuse potential Example: amphetamines
38
What are scheduled lll drugs?
Moderately dependent
39
What are schedule lV drugs?
Less abusive potential, limited dependence
40
What are scheduled V drugs?
Limited abuse, 18+ to get
41
What are orphan drugs?
Drugs discovered but not financially viable; unadapted by drug company
42
What are sources of drug info?
Drug labels Package inserts Reference books Journals Internet info
43
What are the comments of the heart?
Heart Arteries Veins Venoules Arterials
44
What is the cardiovascular systems function?
Deliver O2 & nutrients to all cells Removes waste
45
What is the flow of deoxygenated blood?
Right atrium, through tricuspid valve, to right ventricle, though pulmonary valve to lungs
46
What is the flow of oxygenated blood?
Through pulmonary veins, To left atrium Through mitral valve To left ventricle Through aortic valve To aorta
47
What is automaticity?
Generates action potential (electrical impulses) w/out external stimulant
48
What is conductivity?
Special cells conducting rapid impulse to stimulant at the same time Example: lub, dub, dub, lub
49
What are the components of the conduction system?
SA node= pace maker Atrial bundles AV node Bundle of His= Bachmann’s bundle Bundle branches Purkinje fibers
50
What is the Starling’s Law of the Heart?
= stroke volume of left ventricle; increases LV volume
51
What is the Diastole of the BP?
Rest period Blood returned to heart by veins
52
What is the Systole of BP?
Contraction period Blood is pumped from the heart
53
What does Starling’s law of the heart address? A. Automatic properties of the heart B. Conductive properties of the heart C. Contractile properties of the heart D. Pressure properties of the heart
D.
54
What are the type of arrhythmias(no rhythm)?
Sinus arrhythmias= caused by normal breathing Supraventricular arrhythmias= Afib, atrial flutter, PAT, PACs Atrioventricular block Ventricular arrhythmias= originates BELOW AV node, PVCs, Vfib
55
Where does the pulmonary circulation take place?
Right side if the heart, sending blood to lungs CO2/wastes are removed O2 is picked up by RBCs
56
Where does systemic circulation?
Left side of the heart sends oxygenated blood out
57
What are the forces determining O2 consumption?
HR= harder the work, the more O2 needed Preload= amount of blood return After load= resistance against heartbeat Ventricle stretch
58
Wha this paroxysmal mean?
Sudden reoccurrence/attack; sudden worsening symptoms
59
What happens when you get a high diastolic?
Venous pressure increases Can result in backup if congestion
60
What happens in heart failure?
Blood back ups Results in edema
61
What is BP determined by?
HR Stroke volume Total peripheral resistance Baroreceptors= relays BP info w/in ANS Renin-angiotensin-aldosterone system
62
What is the Risks for CAD related to hypertension?
Thickening of heart muscle Increased pressure by muscle contraction Increased cardiac workload
63
What are conditions related to HTN?
CAD Stroke Renal failure Loss of vision
64
What are known factors that increase BP?
High levels of psychological stress Exposure high-frequency noise High salt diet Lack of rest Genetic predisposition
65
What happens in hypotension?
BP too low Heart muscle is damaged, unable to pump effectively Severe blood/fluid loss drops, dramatically NE is depleted is severe stress; body is unable to respond to stimuli
66
What is the care management steps of HTN?
1. Lifestyle modification 2. Drug therapy 3. Drug dose/class, or combo drug therapy 4. 2nd/3rd agent/diuretic is added
67
What are the antihypertensive agents?
ACE inhibitors Angiotensin ll receptor blockers Renin inhibitors Calcium channel blockers Vasodilators Diuretics Sympathetic nervous system blockers
68
What is the common drug ending for ACE inhibitors?
-pril
69
What is the action of ACE inhibitors?
Blocks ACE from conversion into angiotensin ll Decreases BP Decreases aldosterone production Slightly increases serum K+ levels Slightly increases NA+/fluid loss
70
What is the indication for use of an ACE inhibitor?
HTN CHF Diabetic nephropathy Left ventricular dysfunction- following MI
71
What is the contraindications for ACE inhibitors?
Allergies Impaired renal function Pregnancy/lactation CAUTION: CHF
72
What are the adverse effects of ACE inhibitors?
Related to vasodilation effects & blood flow alterations GI irritation Renal insufficiency Cough
73
What is a drug that interacts with ACE inhibitors?
Allopurinol
74
What are nursing considerations for ACE inhibitors?
HX & physical Allergy Impaired kidney function Pregnancy/lactation Salt/volume depletion & HF Baseline status before therapy starts VS, LS, BS, weight, skin, ECG, CBC w/ diff & electrolytes
75
What is the prototype for ACE inhibitors?
Captopril
76
What is the action of captopril?
Blocks angiotensin l from converting angiotensin ll, leads to decreased BP, aldosterone production, & small increase of serum K+ & Na+/fluid loss
77
What is the onset for captopril? What is the half life?
15 minutes & 2 hrs.
78
What is the adverse effects of captopril?
Tachy MI Rash Pruritus Gastric irritation Aphthous ulcers Peptic ulcers Dysgeusia Proteinuria Bone marrow suppression Cough
79
What is the common drug ending for angiotensin ll receptor blockers?
-Sartan
80
What is the action of angiotensin ll receptor blockers?
Blocks vasoconstriction & aldosterone release by selectively binding to angiotensin ll receptors in vascular smooth muscle/adrenal cortex
81
T/F: angiotensin ll receptor blockers doesn’t use the P450 system in the liver.
False.
82
What are the contraindications for angiotensin ll receptor blockers?
Allergy, pregnancy, lactation CAUTION: hepatic/renal dysfunction & hypovolemia
83
What are the adverse effects of angiotensin ll receptor blockers?
Headache Dizzy Syncope Weakness GI complaints Skin rash/dry skin
84
What drug interacts w/ angiotensin ll receptor blockers?
Phenobarbital
85
What are the nursing considerations for angiotensin ll receptor blockers?
Assess: Hx/physical Allergy Impaired renal/hepatic function Pregnancy/lactation Hypovolemia Baseline: VS, LS, ECG, renal/function tests
86
What is the prototype for angiotensin ll receptor blockers?
Losartan
87
What is the indication for use of losartan?
HTN Diabetic neuropathy Elevated serum creatine Elevated proteinuria w/ type ll diabetes/HTN
88
What is the action of losartan?
Blocks vasoconstriction & release aldosterone associated w/ RAAS
89
What is the onset, peak, and duration for losartan? What is the half life?
Varies, 1-3 hrs, 24 hrs 2 hrs
90
What is the adverse effects of losartan?
Dizziness Headache Diarrhea Abdominal pain Upper respiratory tract infection symptoms Cough Back pain Fever Muscle weakness Hypotension
91
What does calcium channel blockers do?
Decrease BP Decrease cardiac workload Decrease myocardial O2 consumption
92
What is the action of calcium channel blockers?
Stops calcium ion movement across cardiac/arterial membrane, leading to slowed conduction, decreased myocardial contractility, arterioles. Lowering BP & myocardial O2 consumption.
93
What are the contraindications for calcium channel blockers?
Allergy Heart block Sick sinus syndrome Renal/hepatic dysfunction Pregnancy/lactation
94
What are the adverse effects for calcium channel blockers?
Effects related to cardiac output Gi symptoms Cardiovascular symptoms
95
What is the drug that interacts with calcium channel blockers?
Cyclosporine
96
What is the food interactions for calcium channel blockers?
Grapefruit juice
97
What should the nurse consider for calcium channel blocker?
Hx/physical Allergy
98
What is the main use for calcium channel blockers?
Angina
99
What is the prototype for calcium channel blockers?
Diltiazem
100
What is the onset, peak, and duration of diltiazem? What is the half life?
30-60 min 6-11 hrs 12 hrs 5-7hrs= T1/2
101
What is the most powerful natural vasoconstrictor in the human body?
Angiotensin ll
102
What does aldosterone play a big part of?
Regulating BP
103
What are the adverse effects of diltiazem?
Dizzy Light headed Headache Peripheral edema Bradycardia Atrioventricular block Flushing Nausea
104
What does diuretics do?
Increase NA+/water excretion from kidneys to lower BP
105
What is the common drug ending for diuretics?
Thiazide
106
What is the common drug ending for beta blockers? (Sympathetic nervous system blockers)
Olol
107
The nurse is caring for a 27-year-old woman who was just prescribed an ACE inhibitor for management of her hypertension. What should be advised related to contraception? A. The use of spermicidal jellies is recommended. B. The mini pill is the contraception method of choice. C. Use barrier contraceptives to prevent pregnancy while taking these drugs. D. No special precautions need to be taken.
C.
108
What is the CYP-450 system?
System of enzymes needed to metabolize in the liver.
109
What does the sympathetic nervous do? What does the parasympathetic do?
Sympathetic= Fight/flight Parasympathetic= body calmer
110
What is the most important ventricle in the heart?
Left ventricle
111
What does the aortic do?
Take un-oxygenated blood through heart
112
What does the mitral valve do?
Send blood to be pumped though body
113
What is the action potential?
Electrical conduction of heart; biogenetic theory depression
114
What are the causes of cardiac arrhythmias?
Electrolyte disturbance Decrease O2 delivery Structural damage Acidosis (waste accumulation) Drugs
115
What tends to be blocked? What tends to be clogged?
Arteries= blocked Veins= clot
116
What are the types of cardiac arrhythmias?
Tachycardia= fast Bradycardia= slow PACs (premature atrial contractions)= PVCs (premature ventricular contractions)= Atrial flutter= A-fib= V-fib= Alterations in conduction through the muscle (heart blocks & bundle branch blocks)
117
What are the classifications of antiarrhythmics?
Class l= blocks NA+ channels in cell membrane Class ll= blocks beta-receptors; causes phase 4 depression Class lll= blocks K+ channels; prolongs phase 3 Class lV= blocks CA+ (calcium) channels in cell membrane
118
What are class l anti-arrhythmias?
Ia= Disopyramide (Norpace), Procainamide (generic), quinidine (generic) Ib= Lidocaine (Xylocaine), mexiletine (generic) Ic= flecainide (generic), propafenone
119
What is the action of class l anti-arrhythmias?
Decreases polarization & automaticity of ventricular cells Increases ventricular fib threshold
120
What is the indication for class l anti-arrhythmias?
Management of acute ventricular arrhythmias during cardiac surgery Or MI
121
What is class l anti-arrhythmias mostly absorbed through?
GI tract
122
What are contraindications for class l antiarrhythmics?
Allergy Bradycardia Heart block CHF Hypotension Shock Electrolyte disturbance
123
When should you use caution when giving a class 1 anti-arrhythmic?
Renal/hepatic dysfunction Pregnancy
124
What are the adverse affects of class 1 anti-arrhythmias?
CNS= dizzy, fatigue, slurred speech GI= nausea/vomiting CV= arrhythmias Respiratory depression Misc= rash, hair loss, potential bone marrow suppression
125
What drugs interact with class 1 anti-arrhythmias?
Quinidine Oral anticoagulants Digoxin Beta blockers
126
What does class ll antiarrhythmics?
Blocks beta-receptors, causing a depression of phase 4 action potential
127
What are class ll antiarrhythmics?
Acebutolol (Sectral) Esmolol (Brevibloc) Propranolol (Inderal)
128
What is the actions of class ll antiarrhythmics?
Competitively blocks beta receptor sites in heart/kidneys Decrease HR, cardiac excitability, cardiac output Clot AV node conduction
129
What are the indications for use for class ll antiarrhythmics?
Supraventricular tachycardia & PVCs treatment
130
What are the pharmacokinetics of class ll antiarrhythmics?
Absorbs in GI Liver metabolized Urine excreted
131
What are the adverse effects of antiarrhythmics?
CNS= dizzy, insomnia, dreams, fatigue CV= hypotension, bradycardia, AV block, arrhythmias Respiratory- bronchospasm, Dyspnea GI= nausea, vomiting, anorexia Misc= libido loss, decreased exercise tolerance, alterations in blood sugar
132
What does class 2 antiarrhythmics interact w/ drug wise?
Verapamil Insulin
133
What are the class IV antiarrhythmics drugs?
Diltiazem (generic) Verapamil (generic)
134
What are the indications for use for class IV antiarrhythmics?
Supraventricular tachycardia Controls ventricular response to rapid atrial rates
135
What are the pharmacokinetics of class IV antiarrhythmics?
Well absorbed Protein bound Liver metabolized Urine excreted
136
What are the contraindications for use in class IV antiarrhythmics?
Allergy Sick sinus syndrome Heart block Pregnancy Lactation CHF hypotension
137
When you should you use caution when using class lV antiarrhythmics?
Idiopathic hypertrophic subaortic Stenosis
138
What are the adverse effects of class IV antiarrhythmics?
Dizzy Weak Fatigue Depression GI upset Hypotension CHF Shock
139
How does the blood flow through the heart?
Enters at top right atrium Blood flows downward through tricuspid into right ventricle Right ventricle pushes blood up to the pulmonary valve of the heart Blood goes into lungs and re-enters through top left ventricle Blood flows down through mitral and into left ventricle Left ventricle pushes blood up through aortic into body
140
What are the definitions of coronary artery disease?
Atheromas- fatty tumor in intima of heart vessels Artherosclerosis- narrowing heart vessels Angina pectoris- chest suffocation MI- myocardial cells die
141
Angina is specific to what part of the heart
Coronary artery
142
What is the inner most part of the artery?
Tunica intima
143
What is the second layer of an artery?
Tunica media
144
What is the outer layer of an artery?
Tunica exsterna Or Tunica Adventia
145
What are the types of angina?
Stable angina- no damage to muscle; reflexes restore blood flow Unstable angina- episodes of ischemia; happens even at rest Prinzmetal’s angina- caused by blood vessel spams; not just narrowing
146
What is an acute myocardial infarction?
Completely occluded & unable to deliver blood to heart muscle resulting in extreme pain, nausea, and severe sympathetic stress reaction (tachy, dilated pupils, increase RR/BP).
147
What is the action of antianginal?
Improve blood delivery by dilation of blood vessels to heart Increases o2 supply Decreases cardiac workload Decreases o2 demand
148
What are the factors affecting MI o2 demand & antianginal effects?
Increased: HR Preload (blood volume) Afterload (BP) Left ventricular muscle size Muscle contractility
149
What are the types of antianginal drugs?
Nitrates Beta-adrenergic blockers Calcium channel blockers
150
What does Nitrates do?
Helps restore supply & demand ratios in O2 delivery to heart muscle when resting isn’t enough
151
What are the nitrate drugs?
Amyl nitrate (generic) Isosorbide dinitrate (Isordil) Isosorbide mononitrate (Moneket) Nitroglycerin
152
What are the contraindications for Nitrates?
Allergy Sever anemia Head trauma/ cerebral hemorrhage Pregnancy/lactation
153
When should you use caution when using Nitrates?
Hepatic/renal disease Hypotension Hypovolemia Conditions limiting cardiac output
154
What are the adverse effects of nitrates?
Related to vasodilation & decreased blood flow CNS= headache, dizzy, weakness GI= nausea, vomiting CV= hypotension Misc= flushing, pallor, increased sweating
155
What drugs interact w/ nitrates?
HEPARIN Ergot derivatives
156
What are the nursing considerations for nitrates?
Assess: Hx/physical exam Allergy Early MI Head trauma Cerebral hemorrhage Hypotension Hypovolemia Anemia Low-cardiac output Pregnancy/ lactation Skin Pain- onset, duration, intensity, location, relief measures RR LS Cardiac status BP Baseline ECG Lab values
157
What is the definition of CHF /HF?
Heart fails to effectively pump blood throughout body
158
What is the primary treatment?
Allowing more efficient contraction of the heart to bring back balance
159
What are the types of CHF?
CAD (coronary artery disease) Cardiomyopathy HTN Valvular heart disease
160
What are the S&S of right sided CHF?
Elevated jugular venous pressure Splenomegaly Hepatomegaly Decreased renal perfusion when upright Increased renal perfusion when supine (nocturia) Pitting edema Weakness/fatigue
161
What are the S&S of left sided CHF?
Anxiety Tachycardia Dyspnea Orthopnea Hemoptysis Rales Cardiomegaly S3 Increased HR GI upset Nausea Abdominal pain Decreased peripheral pulses Hypoxia
162
What are the underlying problems in HF involving muscle function?
Muscle damage: atherosclerosis, cardiomyopathy Increased workload to maintain efficient output: HTN, valvular disease Structural abnormality: congenital cardiac defects
163
What are the CHF drug treatments?
Cardiotonic (inotropic) drugs: Cardiac Glycosides Phosphodiesterase inhibitors HCN blocker
164
What does cardiac glycosides do?
Increases force of heart muscle contraction/ renal perfusion and output, decreases blood volume to slow HR, conduction velocity through AV
165
What does a phosphodiesterase inhibitors do?
Short term management of HF in pts receiving digoxin/diuretics
166
What does HCN stand for in HCN blockers?
Hyperpolarization-activated cyclic nucleotide- gated channel blockers
167
What does HCN blockers do?
Slows hearts pacemaker (SA node) in re-polarization (diastole phase) phase of action potential

Pharmacology- Keiser (5 decks)

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