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Flashcards in Pharm Exam 1: Final Deck (122):
1

Detrol

  • overactive bladder

2

Cholinergic effects mimic which nervous system

parasympathetic (rest & digest)

3

The nurse is reviewing a patient's list of medications with the patient. The nurse understands that the older adul's slower absorption of oral meds is primarily because of...

increased pH of gastric secretions

4

Decreased albumin level is expected in

  • Elderly
  • Newborns
  • Liver Disease
  • Manourished.

5

Acebutolol HCl (Sectral), a beta blocker, has negative chronotropic effects, what are they?

could cause symptomatic bradycardia and/or heart block

6

Which physiologic change that normally occurs in the older adult has implications for the nurse assessing drug response?

Drug half life is lengthened (shorter half life is better)

7

Drug movement from the blood to the interstitial space of tissues and from there into the cells.

Distribution

8

Which drug can be taken orally, noncat or cat?

Noncatecholamine

9

An example of this category drug would be accutane.

Category X

10

Psychological benefit of a drug despite no chemical drug effect

Placebo Effect

11

How is cardiac output measured?

  • heart rate,
  • blood pressure
  • urine output

12

has an antagonistic effect with warfarin and will inhibit its effects.

Vitamin K

13

pre-op med to decrease salivary secretions and maintain heart rate. Will Increase the heart reate.

Atropine

14

The nurse assesses a patient receiving an adrenergic (sympathomimetic) agent. Which finding will be of greatest concern to the nurse?

Weak peripheral pulses and decreased heart rate

15

Adverse reactions of Atropine

  • asal congestion
  • tachycardia
  • hypotension
  • pupillary dilation
  • abdominal distention
  • palpitations.

16

Scopolamine

decreased Gi Motility, Motion sickness

17

Cholinergic/Parasympathetic Actions

  • Salivation
  • Broncho Constriction
  • GI peristalsis
  • Pupil Constriction
  • Vasodilation

18

Cholinergic Neurotransmitter

Acetycholine

19

Schedule III Drug

moderate or low physical dependence.

20

Drug that creates a response

Agonist

21

If a drug becomes ionized what will happen?

it will not pass a lipid soluble

22

Atropine Toxicity

MAd as a hatter (confusion), dry as the street, hot as the summer, red as a beet.

23

If a patient has diabetes, what would the best beta blocker be for that patient?

Lopressor, Tenormin

24

The nurse takes all precautions in order to ensure that the pediatric patient will receive a drug dosage that is accurate based on body surface area. To which step of the nursing process does this action most closely correspond?

planning

25

The nurse is caring for a patient who is prescribed propranolol (Inderal). Which assessment finding will reveal if the medication is having a therapeutic effect?

The patient’s blood pressure is 130/75 mm Hg

26

Which symptom presenting in an older adult would cause the nurse to suspect drug toxicity?

Confusion

27

Hypertension Treatment ABCD

  • Ace inhibitor
  • Beta Blockers
  • Calcium channel Blockers
  • Diuretics

28

Movement of the drug and their metabolites out of the body.

Excretion

29

What are the reasons for the lack of research done for Pediatric Pharmacology?

  • difficult to get large enough study sample
  • Diseases occur in small numbers

30

Pharmacokinetics Includes These 4 Things

  1. Distribution
  2. Excretion
  3. Metabolism
  4. Absorption

31

BBB

  • Blood Brain Barrier
    • semipermeable in the CNS
    • protects brain from foreign substances
    • highly lipid drugs cross
    • water soluble drugs do not make it across

32

The nurse is administering medication to an older adult. The nurse anticipates that this patient’s renal system will have which effect on the medication?

the medication will be excreted slower

33

If an acid is exposed to an alkaline environment what happens

it becomes ionized

34

A decrease in the responsiveness of the drug over the course of therapy.

Tolerance

35

An estimate of the margin of safety of a drug.

Therapeutic Range

36

A nurse is monitoring a patient receiving atropine. Which finding requires nursing action?

Blood pressure of 90/40 mm Hg

37

Absorption of Medications:

  • Lipid soluble medications absorb easily through the GI membrane because the GI membrane is composed mostly of lipids.
  • Nonionized substances pass easily through the GI membrane.
  • Water soluble medications require a carrier to pass through the GI membrane (active absorption).

38

A 2 year old patient is to receive a topical medication. The nurse considers which factro when administering this medication?

thinner skin in children allows for rapid absorption.

39

an antispasmodic cholinergic blocker used to decrease GI motility in patients with functional GI disorders such as irritable bowel syndrome.

Dicyclomine (Bentyl)

40

Atrovent

used for asthma COPD, and rhinitis

41

A disease characterized by spasm of the arteries in the extremities, especially the fingers. It is typically brought on by constant cold or vibration, and leads to pallor, pain, numbness, and in severe cases, gangrene.

Raynaud's Disease

42

Hypertension Nursing Care

  • Daily Weight
  • Intake & Output
  • Urine Output
  • Response of BP
  • Electrolytes
  • TAke pulses
  • Ischemic Episodes
  • Compications (4C's)

43

"protein binding" refers to...?

  • "free" drug (drug not bound to protein) that will be able to create a pharmacologic response
  • When two drugs are given together that are both "highly protein-bound" drugs, the pateint is at greater risk of drug accumulation (drug toxicity).
  • Ibuprofen is a 98% protein bound drug.  This means that 98% of the drug is bound to protein (albumin), and only 2% of the drug is "free".

44

What organ metabolizes the lipid soluble drug to trasnform it to a water soluble drug for renal excretion

Liver

45

Alpha 1 Agonist Used for...

  • Bradycardia
  • Low BP
  • GI

46

Which is a priority nursing diagnosis for a patient receiving an anticholinergic (parasympatholytic) medication?

Impaired gas exchange related to thickened respiratory secretions

47

If a patient has renal disease what happens to drug excretion

slowed or impaired. Drug accumulation

48

Hypertension Treatment

ABCD

  • Ace inhibitors/ARBs
  • Beta Blockers
  • Calcium channel blockers
  • Diuretics

49

Knowing that the albumin in neonates and infants has a lower binding capacity for medications, the nurse anticipates that the health care provider will order which adjustment to minimize the risk of toxicity?

A decrease in the dosage of drug given

50

During this phase a drug in solid form must be disintegrated to dissolve and be absorbed

pharmacoceutic

51

Cholinergic Agonist Effects

Sludge BAM

  • Salivation/Sweating/Secretions
  • Lacrimation
  • Urination
  • Defecation
  • GI Upset
  • Emesis
  • Bradycardia
  • Ab Cramps
  • Miosis

52

A patient with poor renal function (low glomerular filtration) will have what type of creatinine?

  • elevated blood creatinine levels
  • low urine creatinine levels.
  • drug dosages typically need to be decreased. 

53

Adverse drug reaction from excessive dosing of the drug

Toxic Effect

54

Adrenergic Neurotransmitter

norepinephrine, epinephrine

55

Abrupt withdrawal of a beta blocker can cause

rebound hypertension

56

The term used for a drug that is approved for one thing but used for something completely different?

Off Label

57

Predictable secondary effect of the drug.  Can be desirable or undesirable

Side effect

58

beta blockers are used to treat:

  1. Angina pectoris
  2. Congestive heart failure (CHF)
  3. Hypertension

59

The process in which a drug passes first through the liver after absorption.

First Pass Effect

60

Schedule I Drug

high abuse, no current medical use

61

why would a protein supplement be prescribed for an older adult?

increases circulation of free drug

62

A patient taking an alpha 1 blocker. What side effect should the patient be cautioned about

 

reflexive bradycardia

63

Which crosses the blood brain barrier, noncatecholamine or Catecholamine?

NonCatecholamine

64

Drugs that blocks a response

Antagonist

65

What type of food decreases the absorption rate of enteric coated medications?

high fat

66

This is the percentage of the administered drug dosage that reaches the blood stream (systemic circulation).

bioavailability

67

The older adult patient has questions about oral drug metabolism. What is the most important information to include in this patients teaching plan?

first pass effect

68

If excretion is impaired what risks are there for medication?

toxicity

69

Category B Risk for the pregnant woman

May have some risk on animals but none to humans

70

A patient is admitted to the emergency department with an expected cholinesterase inhibitor overdose. What is the nurse’s primary action?

Administer ordered anticholinergic medication

71

Mneumonic

 

You have 1 heart and 2 lungs

  • Beta 1: Heart
  • Beta 2: Lungs

72

The nurse uses an appropriate drug reference to obtain drug parameters prior to administration of a medication. To which step of the nursing process does this action most closely correspond?

Nursing Intervention

73


Propranolol (Inderal) is nonselective—it blocks
 

both beta1 and beta2 receptors at therapeutic dose

74

Movement of a drug from the site of administration to body fluids

Absorption

75

This organ cannot excrete lipid soluble drugs

Kidneys

76

This is an anticholinergic agent that blocks the effects of the parasympathetic nervous system, producing sympathetic nervous system effects

Atropine

77

This can directly penetrate membranes. The drug will dissolve into the membrane and cross to the other side.

Lipid Soluble

78

the study of what the body does to the drug

Pharmacokinetics

79

The protein bound drug gets released into the blood stream

free drug

80

"lol" =

beta blockers

81

This is the drug that creates the action desired

Free Drug

82

Adrenergic agents stimulate the

  • sympathetic nervous system

83

atenolol selectively blocks which beta blocker?

  • only the beta1 receptors in the heart,
  • not the beta2 receptors located in the lungs

84

What organ is responsible for the majority of drug excretion

kidneys

85

A neonate with lower than normal albumin levels. The nurse is ordered to administer medication that is highly protein bound.  The nurse know that what must occur in response to these factors?

Dose should be decreased because of increased unbound active medication

86

a test to determine renal function by comparing the level of creatinine in the blood with the level of creatinine in the urine

 

Creatinine Clearance

87

This can be used as an antidote to the toxicity caused by cholinesterase inhibitors and organophosphate ingestion

anticholinergic

88

Secondary effect of the drug.  Always undesirable.

Adverse Effect

89

Bentyl

used for irritable bowel syndrome

90

he nurse realizes that a drug administered by which route will require the most immediate evaluation of therapeutic effect?

intravenous

91

What effect may the older adult’s cardiac system have on drug administration in this patient?

Delayed transportation of drugs to the body tissues

92

The nurse recognizes that the administration of a drug influences cell physiology. What is the term for this concept?

Pharmacodynamics

93

This category drug may be used for a pregnant woman experiencing life threatening conditions. When benefit for risk must be determined

Category D Drug

94

Risk for pregnant woman with a category A Medication

No risk to the Fetus

95

A 3-year-old child has been started on a new medication. What is the most important information to convey to the parents?

“Observe the child for potential adverse effects of the medication.”

96

The nurse is caring for a patient who is taking a cholinergic (parasympathomimetic) drug. Which assessment will indicate that the medication is having a desired effect?

Increased gastrointestinal (GI) motility

97

Antimuscarinic/Anticholinergic Side Effects

The ABCD'S of Anticholinergic Side Effects

  • Anorexia
  • Blurry Vision
  • Constipation/Confusion
  • Dry Mouth
  • Stasis of Urine

98

The nurse understands the differences between drug excretion in children and that in adults. With this knowledge, what does the nurse consider when administering medications to children?

evaulate for drug accumulation, because the excretion of drugs in children is slower

99

This type of drug solubility cannot dissolve into the lipid membrane of the cells. They need a carrier.

Water Soluble

100

Schedule II Drug

potential for abuse both physiological and psychological. Ritalin

101

Effects for a beta blocker used for a COPD patient or Diabetic

  • Broncho Dilator
  • Effects Blood Sugar
  • Increase Heart rate

102

Occurs when the drug reaches its highest blood or plasma concentration

peaked

103

Adrenergic/Sympathetic Actions

  • Incease HR
  • Increase BP
  • Pupil Dilation
  • Broncho dilation

104

Drugs for Bradycardia and Low Blood Pressure (IDEA)

  • Isoprotonel
  • Dopamine
  • Epinephrine
  • Atropine Sulfate

105

This is not a singular entity but rather a group responsible for drug metabolism

Cytochrome P450

106

Which factors will influence the absorption of oral medications?

  1. presence of food in the stomach
  2. pH of the stomach
  3. form of drug preparation
  4. pain

107

For a schedule V drug is the potential for abuse small or large?

small

108

What are influencing factors for pharmacokinetics in children related to absorption?

  • weight
  • age
  • health status
  • disease
  • hydration

109

What are influencing factors for pharmocokinetics in children related to route of admin?

  • pH more ALKALINE
  • gastric emptying
  • breast feeding?
  • GI surface areas INCREASED

110

Absorption problems IM/SubQ with Children

  • peripheral perfusion
  • decreased muscle, subq fat
  • circulation effects

111

What is a child < 2years first pass effect?

decreased hepatic enzymes

112

Factors influencing pharmacodynamics in older adults

  • altered therapeutic range
  • increase sensitivity
  • change in organ function
  • compensatory response to phys changes

113

Absorbtion factors in older adults

  • decreased GI blood flow & motility
  • increased Alkaline secretions

114

Distribution facors for older adults

  • decreased albumin levels
  • decreased mobility (IM)
  •  

115

Adrenergic Receptors

  • Alpha 1
  • Alpha 2
  • Beta 1
  • Beta 2

116

Alpha 2 Characteristics

  • Reduced Norepi (dec BP)
  • decrease GI Tone and motility
  • smooth muscle

postaganglionic, decrease vasoconstriction

117

Alpha 2

  • Blood Vessel
  • Eye
  • Bladder
  • Prostate

blood vessels, causes vasoconstriction

118

Anatomy involved in Beta 1 Receptor

  • Heart
  • Kidney

119

Anatomy Involved in Beta 2 Receptor

  • Smooth Muscle
  • Lungs
  • Uterus
  • Liver

120

Beta 1 causes

the release of renin into the blood

121

Beta 2 & muscles

  • relaxes uterine smooth muscles
  • dilates arterioles in heart, lungs, skeletal muscles

122

Nonselective Beta Blockers characteristics

  • use beta 1 and beta 2
  • not good for diabetics