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Pharm > Modules 7,8,9,10 > Flashcards

Modules 7,8,9,10 Flashcards

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1
Q

Respiration

A

Process by which gases are exchanged

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2
Q

Ventilation

A

Process of moving air into and out of the Lungs

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3
Q

Upper Respiratory

A 
Tongue
Trachea
Epiglottis
Larynx
Uvula
Nasopharynx
Tonsils
Pharynx
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4
Q

Upper Respiratory Infections

A

Infectious Process of any component of the upper airway

Examples: Sinus Infection
Laryngitis
Rhinitis

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5
Q

Acute Rhinitis

A

Caused by rhinovirus

Main symptom is rhinorrhea

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6
Q

Allergic Rhinitis

A

Caused by foreign pathogens

Main symptom is rhinorrhea

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7
Q

Treatment for common cold?

A

Treat symptoms, comfort care essentially.

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8
Q

Expectorants

A

Used to thin bronchial secretions so they can more easily be eliminated by coughing

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9
Q

Guaifenesin

A
  • Expectorant category

- Most common side effect is drowsiness

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10
Q

Antitussives

A

Used to suppress the cough reflex ( usually dry or non-productive cough.)

Opioid and non opioids

risk of dependency with opiates

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11
Q

dextromethorphan

A
  • Antitussive
  • Non Opioid
  • Suppresses cough reflex by inhibiting the cough centre of the brain
  • Available over the counter at low doses, prescription for high doses
  • etc. Buckleys
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12
Q

Psychosis

A

Term used to describe loss of contact with reality

Not considered a disease but rather a symptom of a mental illness

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13
Q

Delusions

A

Firm ideas and beliefs that are false and not formed based on reality.
etc. being a king or a god.

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14
Q

Hallucinations

A

Involve: seeing, hearing, or feeling something that is not really there
hearing voices or seeing people that aren’t really there.

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15
Q

Cardiac Output

A

Volume of blood pumped by the heart in 1 minute

Stroke Volume x Heart rate = Cardiac Output

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16
Q

What is Blood Pressure

A

Pressure used to circulate blood through the body.

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17
Q

What does the body do to compensate for Low BP

A
  1. Sympathetic Response
    • Increase heart rate
    • Vasoconstriction
    • Increase heart contractility
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18
Q

What does the body do to compensate during High BP

A
  1. Activate parasympathetic
    • HR will decrease
    • Blood vessels will Dilate
    • Decrease in cardiac contractility
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19
Q

Renine

A

Enzym released by the kidneys in response to low bp

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20
Q

Angiotensin converting enzyme ( ACE )

A

Controls blood pressure by regulating the volume of fluids in the body
converts angiotensin 1 hormone into the angiotensin 2 hormone which is a vasoconstrictor.

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21
Q

Angiotensin

A

Peptide hormone that causes vasoconstriction and increase in blood pressure.

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22
Q

ADH

A

Anti-Diuretic Hormone that comes from the posterior pituitary

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23
Q

HDL(good cholesterol )

A

High density lipoprotein that contains the most apoprotein 50%

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24
Q

LDL(bad cholesterol)

A

Low density lipoprotein that contains the highest amount of cholesterol.

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25
Cholesterol
Steroid that can cause atherosclerosis. | the body only needs small amounts of this steroid.
26
Non-pharmacologic ways to lower cholesterol
- Limit Alcohol use to 2 standard drinks a day - Reduce saturated fats in diet - exercise plan - eliminate tobacco use.
27
Antilipemic drugs
Drugs that lower the levels of certain lipids in the blood Statins Bile acid resins
28
HMG-CoA reductase inhibitors ( statins)
First line drugs in the treatment of lipid disorders Reduce blood LDL(bad ) lipid levels, increase HDL (good) causes the liver to make less cholesterol. Usually administered at night when cholesterol biosynthesis is higher. atorvastatin, rosuvastatin
29
Left Sided Heart Failure Symptoms
Shortness of Breath Cough Fluid in Lungs Weakness
30
Right sided heart failure symptoms
Edema in lower extremities
31
ACE Inhibitor
Class of medication used for treating high BP and HF relaxes blood vessels and decreases blood volume. this causes a decrease o2 demand from the heart and lower BP
32
Diuretic
class of medication used to increase urinary output reducing blood volume and cardiac workload
33
What assessments should a nurse do prior to giving antitussive
History of respiratory distress, shortness of breath. Does the client know what antitussives do ?
34
For pneumonia do I want to give an expectorant or an Antitussive ?
Expectorant: this class of drug helps easily eliminate secretions.
35
Nasal Congestion
Happens when vessels in the nose dilate in response to infection or allergen
36
Decongestants
these cause a sympathetic response causing vasoconstriction.
37
Opiod antitussives
Used to increase the cough threshold in the CNS etc: codeine
38
Teaching for clients with antitussives
Avoid driving because of drowsiness avoid the use of alcohol can increase CNS depression report if you cough up green or yellow secretions, difficulty breathing store opioid antitussives away from children
39
Decongestant adverse effect
``` Hypertension Tachycardia Difficulty voiding jittery Hyperglycemia ```
40
Rebound Nasal congestion
constant congestion due to overuse of nasal sprays/drops/gels/ that contain decongestant medications.
41
Decongestant Examples
Ephedrine and pseudoephedrine
42
What is Histamine
inflammatory response compound involved in the immune system. causes runny nose watery eyes vasodilation caucusing swelling
43
Antihistamine
Block histamine H1 receptors cause vasoconstriction decreasing swelling.
44
Diphenhydramine
1st gen antihistamine
45
Side effects of 1st generation antihistamines
drowsiness GI upset Dry mouth and eyes weakness
46
Fexogenadrine and Loratadine
2nd Generation antihistamines
47
Before administering 1st gen antihistamine the nurse should..
vital signs | ECG in clients with history of heart disease because they cause vasodilation.
48
Before administering 2nd generation antihistamines the nurse should ...
assess history of allergies, conjunctivitis. baseline vital signs breathing pattern LOC
49
What do i teach a patient using diphenhydramine
don't drive as this causes drowsiness report any don't drink alcohol
50
Asthma
acute bronchospasm | acute inflammatory response causing secretions
51
Signs and symptoms of someone in respiratory distress
``` Shortness of breath anxiety Low O2 stats nasal flaring tachycardia increased respiratory rate fatigue use of accessory muscles ```
52
Reliever
Short acting
53
Controllers
``` Daily medications controlling persistent symptoms Long acting anti-inflammatory effect LABA ( Long Acting Beta2 agonist.) LAAC(long acting anticholinergics) LAMA (Long Acting Muscarinic antagonist) ICS ( Inhaled coricosteroid) ```
54
PATIENT teaching for controllers
Needs to be taken daily even if symptoms are absent | not to be used for emergency asthma attacks
55
LABA Long acting beta2 adrenergic agonists
Relax smooth muscles in bronchi increase bronchodilation ETC : sameterol
56
LAAC long acting anticholinergics
relax smooth muscle in airway COPD used in combination with short acting for asthma etc: tioropium bromide
57
ICS Inhaled Corticosteroids
Reduce inflammation | long term treatment and prevention of asthma attacks
58
Combination Medication
Combine long acting and short acting to decrease inflammation and dilate bronchioles
59
Relievers
Work to relax smooth muscles only to be taken in acute respiratory distress 2-5 min between medication delivary
60
SABA short acting beta2 adrenergic agonist
relaxs bronchiole smooth muscle careful to administer to individuals with dysrhythmias
61
Systemic Glucocorticoids
Given oral or IV systemic action rather then localized greater adverse effects
62
Adverse effects of systemic glucocorticoids
Hyperglycemia insomnia growth suppression in children
63
Adverse/ side effects of inhaled steroids
Mouth Irritation thrush upper respiratory tract infection
64
Side effects of bronchodilators
Constipation, dry mouth, headache
65
Adverse effects of bronchodilators
Tachycardia hypertension tremors difficulty uirinating
66
Patient teachings for inhalers
Rinse mouth
67
Beta 2
Receptors on Lungs
68
Beta 1
Receptors on heart
69
Agonist
Working FOR causes action
70
Antagonist
Working AGAINST blocks action
71
Adrenergic
Stimulate the sympathetic nervous system
72
Anticholinergic
inhibit parasympathetic nerve impulses by blocking acetylcholine causing sympathetic response
73
Cholinergic
mimic or enhance acetylcholine neurotransmitters causing a parasympathetic response
74
Signs and symptoms of someone in respiratory distress
Nasal flaring shortness of breath increase respiratory rate use of accessory muscles
75
Asthma is controlled by which meds
Corticoid steroids | Bronchodilators ( Beta 2 Agonist and Anticholinergics)
76
COPD is controlled by which medications
``` Corticoidsteroids Bronchodilators ( Beta 2 Agonist and Anticholinergics) Antibiotics Expectorants diuretics Oxygen ```
77
Reliever Medications
SAAC ( Short acting anticholinergics) SABA ( short acting beta 2 agonist) or combination of SAAC and SABA
78
SAAC
Short acting anticholinergic
79
SABA
Short acting beta 2 agonist
80
Controller Medications
LABA (Long acting beta 2 agonist) LAAC( Long acting anticholinergic) LAMA ( Long acting muscarinic antagonist ) ICS ( inhaled corticoid steroid )
81
LABA
Long Acting Beta 2 agonist
82
LAAC
Long Acting anticholinergic
83
LAMA
Long Acting Muscarinic Antagonist
84
ICS
Inhaled Corticoidsteroid
85
What are Controllers used for What are the medication catagories
Daily meds used to control persistent symptoms in lower respiratory disorders ( asthma and COPD) long term controller anti-inflammatory effect LABA LAAC ICS Combinations
86
Why should clients take controllers even without symptoms?
To prevent symptoms from reoccuring
87
Patient teaching for Controllers
1. Continue to take even after symptoms have gone 2. Overtime this will reduce inflammation and airway sensitivity to allergen 3. Not to be used in acute asthma or COPD attacks
88
Relievers work by
Relaxing smooth muscle and decreasing acute airway inflammation Only be taken in acute respiratory distress wait 2-5 minutes between meds
89
Hyperlipidemia is controlled by which class of drugs?
Statins
90
Hyperlipidemia
To man fats or lipids in the blood stream.
91
Side Effects of statins?
``` Myopthy Rhabdomyolysis Nausea heartburn abdominal cramping ```
92
Nursing considerations for statins
Monitor liver function Assess for muscle pain, weakness and tenderness Should not be used in women who are or who are planning on getting pregnant. Monitor clients alcohol intake
93
Patient teachings on statins
Maintaining a diet low in saturated fats Avoid or limit alcohol Report any symptoms of leg or muscle pain.
94
Bile acid resins or sequestrants
Bind bile acids that contain cholesterol and accelerate the excretion can reduce LDL levels but due to the side effects are not drug of choice.
95
Dyslipidemia
Abnormal amount of lipids in the blood
96
Side effects of Bile acid resins
Abdominal pain | Bloating
97
Non-pharmacological management of angina
Limiting alcohol treating high BP early Not using tobacco Eliminating foods high in cholesterol
98
Pharmacological goal for clients with Angina
- Slow heart rate down - Dilating veins so heart receives less blood - Causing the heart to contract with less force.
99
3 classes of drugs used for Angina
Organic Nitrates Beta-andrenergic blockers Calcium channel blockers
100
Organic Nitrate
Have the ability to relax both arterial and venous smooth muscles. Two Types Slow acting and long acting.
101
Short acting organic nitrate
Nitroglycerin
102
side effects of organic nitrates
hypotension Flush face headache
103
Beta-adrenergic Blockers
First line drug for chronic angina | work by decreasing the oxygen demands on the heart
104
Negative chronotropic
Slowing heart rate down
105
Negative inotropic
reducing conrtacitlity
106
Patient teachings for Beta-andergenic blockers
- Don't abruptly stop medication as it could cause increase cardiac workload and worsen angina symptoms - If diabetic the medication can mimic hypoglycaemic symptoms so monitor blood glucose levels - change positions slowly report dizziness
107
Side effects of Beta-andergenic blockers
fatigue depression lethargy Can cause shortness of breath and respiratory distress in larger doses
108
Nursing considerations for beta-andergenic blockers
Assess Vital signs Monitor for shortness of breath Monitor heart rate no less then 50 bpm at rest or 100bpm during exercise
109
Calcium Channel Blockers
Relax arterial smooth muscle lowering BP Decrease HR and cardiac workload by slowing the conduction velocity Dilate coronary arteries increase O2 to the myocardium
110
Nursing considerations for CA+ bLOCKERS
Assess BP ECG if client has conduction issues avoid grapefruit juice
111
Adverse Effects of CA+ blockers
Bradycardia hypotension Heart Failure
112
Adverse effects of Nitrates
Tachycardiaand hypotension
113
Adverse effects of beta blockers
Bradycardia hypotension heartfailure bronchoconstriction
114
Patient teachings for calcium channel blockers
take BP before taking medication, don't take if BP is too low Keep a record of angina attacks change positions slowly.
115
Beta Blockers decrease cardiac contractility by...
Blocking the effects of epinephrine and norepinephrine
116
Calcium channel blocker decreases cardiac contractility by..
Blocking the influx of calcium
117
Nitrates decrease cardiac contractility by ?
causing vasodilatation which decreases preload.
118
Thrombolytics
Dissolve clots obstructing coronary arteries and restore circulation to the myocardium.
119
Thrombolytics work best when administered within what amount off time
20min - 12 hours after onset of MI
120
Primary Risk of Thrombolytics
Excessive bleeding from interference with the normal clotting process
121
Nursing Considerations for Thrombolytics
- Monitor vital Signs - Hemoglobin and HCT labs should be assessed - Monitor for Dysarithmias
122
Patient teachings with Thombolytics
Keep movement of IV sites to a min to prevent bleeding decrease physical activity during infusion to a minimum report right away any bleeding from gums, rectum or vagina during and for 4 days after infusion.
123
Antiplatelets
suppress platelet aggregation | antiplatelet agents that Block adenosine diphosphate
124
Heparin
Anticoagulant that is given after an MI has occurred to prevent future thrombi from forming.
125
What do you monitor for with Calcium Channel Blockers
SOB Frothy sputum profound fatigue swelling.
126
Nursing considerations with ACE
Chronic dry cough | severe episodes of dry cough could indicate swell and angioedema
127
What is tardive Dyskinesia sign or symptom?
Characterized by tongue thrusting and involuntary movements
128
Extroprymidal EPS is characterized by movement disorders such as?
Pseudo parkinsonism Dystonia Akathisia
129
Pseudo Parkinsonism
resembles symptoms of parkinson's disease
130
Dystonia
a state of abnormal tonicity or muscle spasm
131
Akathisia
inability to sit still intense motor restlessness
132
3 patient assessments to preform prior to administering an anticoagulant drug
PT, PTT, INR Labs Antidotes Assessment for bleeding
133
3 teachings points to give to patient going home with fragmen ( heparin )
Avoid contact sports report if gums bleed injection sites must be sub Q
134
Short acting Beta 2 agonist teachings on how to use inhlaler
Hold breath for 10 seconds after inhalation and wait 2 full min before second inhalation
135
Patient teachings
``` Limit caffeine report any sob heart palpitations vision changes ```
136
Meds to manage Parkinson Disease
Restore dopamine functions(Dopamine agonist) | Black the effect of ACh (Anticholinergics)
137
Dopaminergics | Levodopa
Increase are replace dopamine lost in Parkinsons disease
138
Levodopa
Dopaminergic used for Parkinsons disease Most effect medication for Parkinsons disease. combined with carbidopa increases the effects of levodopa
139
Side effects of Levodopa
Neusea
140
Nursing considerations for Dopaminergics
Muscle twitching dark urine several months for full therapeutic effect
141
Selective Serotonin Reuptake Inhibitor ( SSRI )
1st choice in anti depressants works on serotonin and increases its levels decreases the reabsorption process allowing serotonin to stay longer and increase the transmitter prozac and citcalopram
142
MAOI
3rd choice Antidepressant work by inhibiting monoamine oxidase ( the enzyme that breaks down neurotransmitters increases all 3 neurotransmitters
143
Why can't MAOIs not be taken with Tyromine?
tyrosine regulates BP | Risk of high BPand hypertensive crisis
144
Adverse effects of antidepressants
``` Sedation hypotension palpitations insomnia confusion ```
145
What is a life saving assessment for patients taking antidepressants ?
Do you want to kill or harm yourself?

Pharm (5 decks)

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