Pharm Exam 1 revised Flashcards
New and improved (161 cards)
1
Q
What is pharmacotherapy?
A
the use of drugs to prevent s/s and diseasees
2
Q
Where do drugs historically come from?
A
plants,animals,minerals
3
Q
Where do most drugs come from now?
A
laboratories
4
Q
How are drugs classified?
A
Based on their effects on particular body systems, therapeutic uses, and chemical characteristics
5
Q
What is a prototype drug?
A
an individual drug that represents a group of drugs (penicillin represents antibacterial drugs)
6
Q
What does the FDA do?
A
approves drugs for use
7
Q
What is a schedule I controlled substance?
A
No current accepted medical use in the U.S.
8
Q
What are examples of schedule I drugs?
A
heroin, LSD, marijuana
9
Q
What are examples of schedule II drugs?
A
Oxycodone
fentanyl
percocet
codeine
10
Q
What are schedule II drugs?
A
high potential for abuse
11
Q
What are schedule III drugs?
A
ptoential for abuse less than I or II
12
Q
What are examples of schedule III drugs?
A
tylenol with codeine
anabolic steroids
testosterone
13
Q
What are schedule IV drugs?
A
low potential for abuse compared to schedule III
14
Q
What are examples of schedule IV drugs?
A
xanax
klonopin
ativan
15
Q
What are schedule V drugs?
A
Low potential for abuse relative to schedule IV
16
Q
What are examples of schedule V drugs?
A
cough perparations with no more than 200 mg of codeine per 100ml or per 100g
robutussin AC
17
Q
What does the DEA do?
A
enforce drug laws
18
Q
What is absorption?
A
When the drug goes from the administration site to the bloodstream
19
Q
What are slower absorptions sites?
A
intradermal/topical
oral
subcut
20
Q
What are fast aborption sites?
A
sublingual/buccal
rectal/vaginal
inhalation
21
Q
What is bioavailability?
A
the amount of drug reaching circulation
22
Q
What is distribution?
A
The medication is transported by bodily fluids
23
Q
What is metabolism?
A
How drugs are usually made less active by enzymes
24
Q
What is a prodrug?
A
drugs metabolized into an active form
25
Where doe excretion occur?
through the kidneys
26
What is serum drug level?
amount of drug in the blood
27
What does half-life mean?
time it takes for drug concentration to drop by 50%
28
Whats an example of a short half life
4 to 8 hr
29
Whats an example of a long half-life?
over more than 24 hr
30
What is pharmacodynamics?
what the drug does to the body
31
What is pharmacokinetics?
what the body does to the drug.
32
What is an agonist?
produces desired effect
binds to receptor
33
What is an antagonist?
block receptors
prevents effect
competes with other molecules
34
What is a partial agonist
both an agonist and antagonist
limited affinity to recepors
35
What is drug tolerance?
body gets used to a drug
needs larger does for effects
36
What is cross tolerance?
tolerance to pharmacologically related drugs
37
What is onset?
When the drug first begins to take effect
38
What is peak?
when the max concentration of a drug is in the body
39
What is duration?
the length of time the drug produces its effect
40
What is potency?
the amount of drug required to produce the effect
41
What is efficacy?
max response that the med can achieve
42
What is a side effect?
effect o ther than the desired effect
43
What is an advers effect?
unanticipated effects that are dangerous
44
What is a black box warning?
strongest FDA warning
45
What is the safe pregnancy category?
A
46
What is the most dangerous pregnancy category?
X
47
What is a drug overdose?
excessive amounts of drug may damage body tissues
48
How is toxicity treated?
support vital functions
CPR may be needed
endotracheal intubation
seizure treatment
IV line
activated charcoal (not for unconscious patient) (only for orally ingested drugs)
49
What is the therapeutic range/window?
does where the safed and most effective treatment occurs
50
What is titration?
helps maintain therapeutic effects and avoid toxicity
51
What is peak?
highest plasma level
52
What is trough?
lowest level in blood
53
What is plateau?
drugs concentration in plasma during series of doses
54
What is therapeutic index?
measurement of relative safety of a drug
55
What is beta-lactamase?
an enzyme that attacks the beta-lactam ring
renders some drugs ineffective
56
What is cross allergenicity?
allergy to a drug of another class with similiar structure
57
What is superinfection?
infection after a previous infection
caused my microorganisms resistant to previous antibiotics
58
What is a bactericidal?
agent that kills bacteria
59
What is a bacteriostatic?
agent that inhibits bacterial growth
60
What is broad spectrum?
effective against a wide range of bacteria
61
What are important notes for self-administration teaching of antibiotics?
take them at evenly spaced intervals
determening if they can be taken with food
Take with a full glass of water
62
T or F, antibiotics affecting the cell wall are bactericidal?
T
63
What are indications for penicillin?
gram positive (pneumonia, strep throat)
gram neg (meningitis)
kill spirochetes (syphillis)
broad spectrum- gram neg focused
prophylaxis against bacterial endocarditis
64
What are important teachings for penicillin?
use additional contraceptive methods (penicillin decreased hormonal birth control effectiveness)
complete entire course of therapy
take 1 hr before or 2 hrs after meals
65
What are adverse effects of penicillin?
allergies
anaphylaxis
66
What are contraindacations/precautions for penicillin?
hx of severe allergic reaction to penicillin or cephalosporins
67
What nursing actions should you take for a patient on penicillin?
observe for allergic reaction for 30 min
68
What can penicllin be used for?
gonorrhea
UTI
peritonitis
pneumonia
septicemia
meningitis
69
What averse effects can occur with penicillin?
GI distress
oral/vaginal candidasis
generalized rash
anaphylaxis
70
What are adverse effects of cephalosporins?
allergy
hypersensitivity
anaphylaxis
cross-sensitivity to penicillin
71
What are contraindications/precautions for cephalosporin?
Do not give to client with severe allergic reaction to this drug or penicillin
caution in clients with renal impairement/bleeding tendencies
72
What nursing actions are relevant for cephalosporins?
if allergy appears, stop med, notify provider
acceptable for mild PCN allergies
avoid w/ bleeding disorders
avoid w/ anticoagulants
observe for bleeding
monitor PT and bleeding times
Give lower dose to prevent toxic levels
73
How would you adminsiter cephalosporins?
IM- deep into large musce (ventroglute)
Intermittent infusion or slowly 3-5 min for bolus
74
What are indications for carbapenems?
pneumonia, peritonitis, UTIs (serious infections)
75
What are adverse effects of carbapenems?
allergy
hypersensitivity
GI upset
suprainfection
76
What are indications for monobactam?
UTI
skin infection
lower respiratory tract
intra-abdominal
gynecologic infection
septicemia
77
What are indications for vancomyin?
MRSA
staph epidermis
strep infections
treat C-diff (not preferred treatment)
78
What are adverse effects of vancomycin?
ototoxicity
infusion reaction
renal toxicity
79
How do you administer vancomycin?
slowly over 60 min
monitor trough levels
PO
IV
rectal
80
What nursing actions should be taken for vancomycin?
assess for hearing loss
monitor trough levels
rotate injection sites
monitor infusion site
monitor I&O
monitor kidney function
81
What are indications for tetracycline?
Rocky Mountain spotted fever
urethre/cervix infection due to chlamydia
pneumounia
lyme disease
anthrax
82
What are adverse reactions to tetracycline?
GI discomfort
yellow/brown tooth discoloration
hypoplasia of tooth enamel
hepatotoxicity (jaundice, lethargy)
photosensitivty
suprainfection
diarrhea
yeast infections of mouth, pharynx, vagina, bowels
83
What are some administration considerations for tetracycline?
If given for STD, abstain from intercourse until finished
Will decrease the effectiveness of hormonal birth control
84
What are some contraindications/precautions for tetracycline?
Pregnancy Risk D
avoid in children younger than 8
Taking after 4th month of pregnancy can stain baby teeth
Stain permanent teeth of kids between 4 months and 8 years
85
What would you teach a patient taking tetracycline?
To lower GI discomfort, take doxycycline and minocycline with meals
Wear protective clothing and sunscreen SPF of 30 or greater in sunlight
complete entire course of therapy
86
What are indications for Macrolides?
For clients w/ penicillin allergy to treat against rheumatic fever and bacterial endocarditis
Legionnares' disease
pertussis
whooping cough
acute diptheria
treat chlamydial infections
pneumonia due to mycoplasma
pneumoniae
streptococcal infections
87
What are adverse effects of macrolides?
GI discomfort
Prolonged QT intervals
ototoxicity with high dose therapy
88
What are some administration considerations for macrolides?
if given to treat an STD, should abstain from intercourse until finishing meds
Hormonal contraceptive effectiveness decreases
89
What are some contraindications/precautions for macrolides?
erythromycin and azithromycin are pregnancy risk B
Liver disease and QT prolongation are contraindications
90
What are indications for gentamicin?
Aerobic gram-negative bacilli (E.coli, proteus mirabilis)
Paromomycin treats intestinal amebiasis and tapeworm infections
91
What are adverse effects of gentamicin?
hearing loss
loss of balance
nephrotoxicity
92
What are some administration considerations for gentamicin?
ONCE-A-DAY DOSING: only necessary to obtain blood for measuring trough levels
DIVIDED DOSES peak: 30 min after admin of aminoglycoside im or 30 min after completion of an IV infusion
trough: right before next dose
93
What are some contraindications/precautions for gentamicin?
Caution w/ kidney impairment (need lower doses of aminoglycosides)
hearing loss
myasthenia gravis
94
What should you teach the patient on gentamicin?
notify provider if tinnitus, hearing loss, or headaches occur
95
What nursing actions are taken for patients on gentamicin?
monitor for tinnitus, headache, hearing loss, nausea, dizziness, vertigo
do baseline hearing tests
96
What are indications for sulfonamides?
UTIs
otitis media
chancroid
pertussis
shigellosis
97
What are adverse effects of sulfonamides?
hypersensitivity
Steven Johnsons syndrome
blood dyscrasis
hyperkalemia
hemolytic anemia
agranulocytosis
98
What are some administration considerations for sulfonamides?
hormonal contraceptive effectiveness reduced
99
What are some contraindication/precautions for sulfonamides?
Pregnancy risk cat D
caution in clients w/impaired kidney function
neonate can develop kernicterus
caution in adults over 65 taking ACE inhibitors
100
What are some nursing actions for sulfonamides?
obtain baseline and periodic CBC
monitor urine output
monitor potassium levels
101
NWhat are some indications for nitrofurantoin?
acute UTIs
prophylaxis for recurrent lower UTIs
102
What are some adverse effects of nitrofurntoin?
Hypersensitivity
Blood dyscrasias
peripheral neuropathy
headache
drowsiness
dizziness
GI discomfort
103
What are some administration considerations for nitrofurantoin?
hormonal contraceptive effectivenesss reduced
turns urine rust yellow to brown
can stain teeth
take with food
avoid crushing etc
avoid while pregnant
104
What are some contraindication/precautions for nitrofurantoin?
do not admin. during third trimester
not for infants under 1 month
not for older adults with renal impairment
105
What are some nursing actions for nitrofurantoin?
admin. with milk or meals
do not admin. to clients with chronic kidney disease
106
What are important things to know for penicillin class drugs?
Cross-sensitivity to cephalosporins
Use additional contraceptives when taking
107
What are important considerations cephalosporin class?
Cross sensitivity with penicillin
108
Where must you administer meds (vancomycin) for C-diff?
MUST be oral
109
What are important considerations about tetracyclines?
Yellow/brown color of teeth (avoid during pregnancy and children less than 8)
Photosensitivity to sun
Used on Lyme disease and Rocky Mountain
Stop intercourse during treatment for STD
Can decrease effectiveness of oral contraceptives
110
What are some important things for macrolides? (Azithromycin)
Given to all newborns in ophthalmic ointment form for chlamydial conjunctivitis
Advoid grapefruit and antacids
Monitor liver enzymes
111
What are important considerations for aminoglycosides? (Gentamycin)
Can cause hearing loss
112
What adverse effect can fluoroquinolones cause?
Achilles tendon rupture
113
What common medication is in the fluoroquinolones class?
Levofloxacin
114
What is the black box warning for clindamycin?
Colitis/diarrhea may lead to c-diff
115
What is the first line treatment for C-diff?
Metronidazole
116
What are some considerations for nitroimidaoles (metronidazole)?
Avoid alcohol-can cause to become very ill with GI complications
117
What side effect can isoniazid cause?
Peripheral neuropathy
118
What vitamin can prevent peripheral neuropathy in isoniazid?
Vitamin B6
119
What is fluconazole?
Oral med for vaginal yeast
120
What is ketoconazole for?
Liver toxicity
121
What is the black box warning for griseofulvin?
Hepatic toxicity
122
What are some important things to know about permethrin (pedicullicide class)?
Treats lice and scabies
Fro scabies apply cream from head to toe
Repeat if needed
Treat bedding
123
What are important things to know for meds in the anthelmintic class?
Crush or chew pills and mix with food
Check stool 3 week after completing meds
Check for ova and parasites
124
What are important things to know for meds (hydroxychloroquine) in the anti-malarial class?
Patient neeeds to take 1 week before and during travel, and 4 weeks after
Need regular eye exams for retina issues
125
What are important things to know about antivirals for herpes?
Treats HSV 1 and 2
Start treatment as soon as lesions appear
126
What are important things to know for antiviral for influenza?
For flu A and B
Given 48 hrs before s/s onset
Can be prescribed prophylactically
127
What suffix do antivirals end in?
-ciclovir
128
What is the adverse effect for nitrofurantoins?
peripheral neuropathy
129
What is an advers effect of sulfonamides?
steven johnsons syndrome
130
What is the adverse effect for cephalosporin? (IV)
thrombophlebitis
131
What is a adverse effect of PCN, and sulfonamides?
hyperkalemia
132
What is an adverse effect of tetracycline?
esophageal uleraction
133
What is an adverse effect of vancomycin?
red man syndrome
134
What is an adverse effect of vancomycin and amingoclycosides?
Requires trough and nephrotoxic
135
What is an adverse effect of sulfa, fuoroquinolones, and tetracyclines
photosensitivty
136
what is an adverse effect of PCN, cephalosporin?
renal impairment
137
What is an adverse effect for tetracycline?
hepatotoxic
138
What is the one difference between COX1 and COX2 inhibitors?
COX2 does affect platelet aggregation
139
What are common adverse effects of NSAIDS?
GI discomfort
Take with food
Bone marrow suppression (aspirin like)
Increased risk of CI events (naproxen)
Reye’s syndrome
Aspirin toxicity
Salicylism
140
What organ do NSAIDS effect the most?
Kidneys
141
What organ does acitomenaphen effect the most?
Liver
142
What are some important teaching points for NSAIDS?
Avoid alcohol
Take w// water or milk
Tell about any OTC meds
Observe for bone marrow suppression
143
What occurs during salicylism?
Tinnitus
Sweating headaches
Dizziness
Respiratory alkalosis
144
What can be done for aspirin toxicity?
Activated charcoal to decrease absorption
Cool client
Correct dehydration
145
What are s/s of Reye’s syndrome?
Blood sugar drops
Ammonia and acidity rise
Liver swells and develops fatty deposits
Swelling in the brain
Seizures
Convulsions
Loss of consciousness
146
T/F, aspirin in children for a virus is okay?
False
147
What does acetaminophen do?
Reduce fever and relieve pain
No anti-inflammatory effects
148
What is the antidote for acetaminophen?
Acetylcystein (mucomyst)
149
How can we administer acetaminophen?
PO, rectal, or IV
150
What pregnancy risk if acetaminophen?
B (it is safe)
151
How do you know an opioid is working?
Pain is decreased
152
What is an indicataion for morphine?
Moderate to severe pain
153
What are adverse effects of opioids?
Respiratory depression
Constipation
Orthostatic hypotension
Urinary retention
Cough suppression
Sedation
Nausea/vomiting
Opioid toxicity triad
154
What is the antidote for opioids?
Narcan (naloxone)
155
What is butorphanol used for?
Opioid dependence
Relieve moderate to severe pain
156
Is naloxone an antagonist or agonist?
Antagonist
157
What can fix a cluster migraine?
Sumatriptan and oxygen
158
How do you treat a tension migraine?
159
What is abortive treatment for migraines
Treats migraine ASAP
160
What are some meds for abortive therapy?
NSAIDS
Analgesics
Ergo alkaloids
Tristan’s
Estrogen
161
