Nurs 369 Pharmacology Test 2 Flashcards Preview

Nursing N369 Pharmacology II > Nurs 369 Pharmacology Test 2 > Flashcards

Flashcards in Nurs 369 Pharmacology Test 2 Deck (78):
1

penicillins

beta-lactam antibioticbactericidal: cell wall inhibitor

2

Ampicillin/Amoxicillin

(aminopenicillin) extended spectrum of action GP: enterococcus feacium GN: Neisseria meningitolis

S/E: hypersensitivity, pseudomembranous colitis

3

Nafcillin

pencillinase resistant antibiotic for GP: streptococcus anerobes: peptostreptococcus

doesn't require renal adjustment

4

Piperacillin (Zosyn)

antipseudomonal PCNs broad spectrumrequires renal adjustment

5

cephalosporins

cell wall inhibitor-preferred for surgical prophylaxis

6

1st generation cephalosporins

cefadrixul (duricef)cefazolin cephalexin (keflex)-GP: streptococcus-GN: E. coli

7

2nd generation cephalosporins

cefaclor (ceclor)CefotetanCefoxitin(Mefoxin)Cefuroxime (Ceftin)-GP: streptococcus-GN:flu, E. coli,-anerobes: covers most

8

3rd generation cephalosporins

cefdinir (omnicef)cefriaxone (rocephin)-GP: streptococcus, Niesseria-GN: extensive broad gram- coverage except pseudomonas

9

4th generation cephalosporins

Cefepine (maxipime) often used for broad empiric coverage

10

Carbapenems

Ertapenem (invanz)

11

Tetracyclines

Tetracycline (acromycin) /doxycycline (virbamycin)-->Inhibits bacterial protein synthesis

12

Macrolides

Accumulate in liver & Inhibit protein synthesis

13

Clarithromycin (biaxin)

Used to treat h. Pylori infections

14

Clindamycin

Inhibits bacterial protein synthesis

15

Aminoglycoside

Inhibits bacterial protein synthesis

16

See effects of aminoglycoside therapy

Ototoxicity (irreversible)

17

Fluroquinolones

Inhibits bacterial replication & dna repair Broad spectrum bacteriocidal

18

fluroquinolone side effects

GI disturbances, CNS problems, phototoxicity, connective tissue problems, QTc prolongation-contraindicated in pregnancy**Don't take w/ milk products, iron supplements, magnesium-containing laxatives

19

Bactrim

kill bacteria by inhibiting bacterial metabolism of folic acid

S/E: skin rash, nausea, vomiting, hyperkalemia,

20

Metronidazole (flagyl)

Amebicide-inhibits replication of DNA repairSpectrum: c.diff, anaerobic gram + & gram -, entamoeba histolytica

S/E: nausea, vomiting, metalic taste, numbness

21

RX treatment for MRSA

vancomycin (vancocin)-cell wall inhibitor covers ONLY gram+-watch for red mans syndrome (nephrotoxicity)

22

RX treatment for MRSA & VRE

Linezolid (zyvox)- inhibits bacterial protein synthesis, gram+Daplomycin (cubicin)-destabalizes cell membrane & metabolic functions w/in cell-can't be used for pneumonia-can cause elevations in CPK levels

23

Amphotericin B

Antifungal (IV only)fungal cell membrane inhibitorprimary use: candidias (all forms), histoplasmosis, invasive aspergillosis

24

Amphotericin B side effects

renal toxicityinfusion-related reactionselectrolyte imbalances

25

Azoles antifungals 

inhibit cyp450 (metabolic)--> inhibits cell wall synthesis-Ketoconazole (Nizoral)/Itraconazole (sporanox)/ Fluconazole (diflucan)

26

Ketonconazole (Nizoral)

spectrum: candida, histoplasma, no aspergillus coverage-requires stomach acid for dissolution in the stomach

S/E:GI disturbances, decreased libido, known teratogen, severe drug interactions

27

Fluconazole

oral tx for mucosal and superficial fungal infections-no aspergillus coverage

S/E:GI disturbances, no endocrine side effects

28

Echinocandin antifungals

caspofungin (cancidas)/micafungin(mycamine)spectrum: candida & aspergillus infections only

S/E: nausea, vomiting, headache, very non-toxic compunds

29

negative feedback

last hormone in pathway provides feedback, increasing level of hormone leads to decreased levels of releasing/stimulating hormone--> decreases hormone levels

30

hypothalamus

activates hormones--> secretes releasing hormones

31

posterior pituitary

releases hormones in response to nerve signals from hypothalamus-stores 2 hormones (ADH & oxytocin)

32

leuprolide (lupron)

inhibits premature leutinizing hormone surge in women undergoing fertility treatment

33

Corticotrophin-releasing hormone (CRH)

used in diagnosis of cushings syndrome

34

Diabetes insipidus

antidiuretic hormone (ADH)-conserves water in body-deficiency in ADH, kidneys are unable to conserve H2O

35

Desmopressin (tx for DI)

long duration of action=half life 20hrsforms: nasal sprays, oral, intravenous, subq

36

thyroid gland

secrets thyroxine (T 4) & triodothyronine (T 3)-controls basal metabolic rate parafollicular cells:secrete calcitoninfollicular cells: secrete thyroid hormone

37

symptoms of hypothyroidism (myxedema)

weakness, muscle cramps & dry skin-slurred speech, bradycardia, weight gain, decreased sense of taste & smell, intolerance to cold

38

symptoms of hyperthyroidism 

increased body metabolism, tachycardia, wt. loss, elevated body temp, anxiety

39

hypothyroidism (myxedema)

common cause=chronic autoimmune thyroiditis (hashimotos disease)-elevated TSH, decreased T3 & T4-tx synthetic thyroid hormone (give 2 weeks to work)

40

hyperthyroidism

common cause=graves diseasetx. administer thioamides, which decrease activity of thyroid gland. radioactive iodine, methimazole

41

Prophylthiouraciln (ptu)

Thioamides-treatment for hyperthyroidism

42

Methimazole (tapazole)

Inhibits synthesis of thyroid hormones

43

Adrenal cortex

Secretes glucocorticoids-mobilize body, influence carbs. Lipids and protein metabolism in cells

44

Addisons disease

primary adrenocortical insufficiencysymptoms: nausea, vomiting, lethargy, confusion, coma.-low plasma cortisol levels accompanied by high plasma ACTH levels

45

Cushings syndrome

due to prolonged high levels of glucocorticoids s/s: adrenal atrophy, HTN, delayed wound healing, acne, peptic ulcers, redistribution of fat

46

short acting selected glucocorticoids

Cortisone

S/E: Na+/fluid retention, nausea, anxiety, weight gain, increased appetite, mood swings

47

intermediate acting selected glucocorticoids

prednisoline/prednisone/methylprednisolone

S/E: impaired wound healing, adrenal atrophy, hypokalemia, peptic ulcers, osteoporosis, muscle wasting, CHF, edema

48

antiadrenal drugs

Metyraponc-dx of cushingskryoconazole(nizoral)-antifungalMifepristone(Mifepprex)-steriod

49

Progestins

secreted by corpus luteum-->prepare endometrium for implantation-high progesterone & estrogen levels

50

Hormone replacement therapy

estrogen-progestin combination used during & after menopause-commonly used to treat s/s of menapause

51

dysfunctional uterine bleeding 

hemorrhaging that occurs in abnormal amounts-estrogen causes proliferation of endometrium-progesterone limits and stabilizes endometrial growth-progestins are drugs of choice for treating uterine abnormalities

52

oxytocics 

natural hormones secreted by posterior pituitarystimulate uterine contractions induce labor

53

tocolytics

Magnesium sulfate/verapmil(Calan SR)slow uterine contractions, cause muscle relaxationbeta-agonists, CCBs, prostaglandin synthetase inhibitors

54

clomiphene (clomid,serophene)

rx for female infertility, stimulates release of LH, results in malnutrition and rise in LH

55

ethinyl estradiol w/norethindrone

inhibits release of FSH & LH, preventing ovulation-use for contraceptive, improve menstrul cycle regularity

S/E: edema, nausea, abdominal cramps, dysmenorrhea, fatigue

56

Conjugated estrogens (premain)

replacement for female sex hormones/treat abnormal uterine bleeding

57

Medroxyprogesterone (provera)

inhibits effect of estrogen on uterus, tx uterine bleeding-restores normal hormonal balance

58

type I diabetes mellitus

absolute lack of insulin secretion-->autoimmune destruction of pancreatic islet cellstx:dietary restriction, exercise, insulin therapy

59

type II diabetes mellitus

lack of sensitivity of insulin receptors at target cells/deficiency in insulin secretion

60

Rapid acting insulin

insulin aspart(NovoLog)/ insulin lisipro (Humalog)/ insulin glulisine (Apirdra)onset:5-30 minutesPeak: 1-3 hoursDuration: 3-5 hours

61

Short acting insulin

Insulin regularonset:30-60 minPeak: 1-5 hoursDuration: 6-10 hours

62

Intermediate acting insulin

Isophane susp (NPH, humulin N)onset: 1-2hoursPeak: 6-14 hoursDuration: 16-24 hours

63

Long acting insulin

Insulin detemir(levemir)/ insulin glargine (lantus)onset: gradualpeak: 6-8 hours or no peakduration: to 24 hours

64

oral hypoglycemics

glipizide-stimulate pancreas to secrete more insulin-also increase sensitivity of insulin receptors at target tissues

65

sulfonylureas

stimulate release of insulin from pancreatic cell, increase sensitivity of insulin receptors on target cells

S/E: hypoglycemia

66

Biguanides

Metformin (glucophage)decrease hepatic production of glucose & reduces insulin resistance

S/E: gI related

67

Alpha-glucosiadase inhibitors

block enzymes in small intestine responsible for breaking down complex carbs.-digestion of glucose is delayed

68

H2-receptor blockers

Ranitidine (Zantac)block H2-receptors in stomach and decreases acid productiontx for peptic ulcer disease

S/E: loss of libido in men, decrease RBC and WBC

69

Proton pump inhibitors

Omeprazole (Prilosec)reduces acid secretion by binding irreversibly to enzyme H+ K+ATPase tx for short term PUd & GERD

S/E: headache, nausea, diarrhea

70

(Alkaline) antacids

Aluminum hydroxideneutralize stomach acid by raising PH of stomachtemporary relief of

S/E:constipation

71

Laxatives and Cathartics

prokinetic agents: metoclopromaide (reglan) improve peristalsisStimulants/herbal: sennosides (senokot) stimulate peristalsis reflexMineral oil/stool softeners: docusate(colace) lubricates fecal massBulk-forming agents: psyllium (metamucil) add more bulk/water

72

Inflammatory bowel disease treatment RX

mild-moderate: 5-aminosalicylic acid, glucocorticoidsSevere: immunosuppressant, monoclonal antibodies, tumor necrosis factor inhibitors

73

treatment for IBS

relaxation therapy, dietary changesconstipation: bulk laxative use, serotonin agonist stimulate peristaltic reflexdiarrhea: anticholinergic

74

tegaserod (Zelnorm)

IBS txserotonin receptor agonist that causes an increase stool formation-use for constipation

S/E: diarrhea

75

Prochloperazine (compazine)

Antiemetic: phenothiazineblocks dopamine receptorsused to treat nausea

S/E: dry mouth, sedation, hypotension, tachcardia

76

Acute pancreatitis management

bed rest, NPO for few days, H2 receptor blockers for gastric secretion, IV fluids and TPN

77

Chronic pancreatitis management

IV fluids, insulin, oral pancreatic enzyme supplements

78

cephalosporins

cell wall inhibitor-preferred for surgical prophylaxis

divided into subgroups, each one being more broad spectrum then the