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ABSN Cohort 19 > Pharm Exam1 > Flashcards

Pharm Exam1 Flashcards

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1
Q

S/S of Stress (↑3 ↓2)

A

↑ HR, BP, Pupil dilation, ↓ secretions, GI mobility

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2
Q

How does stress cause cell damage (4)

A

free radicals, hypoxia, ATP depletion, !intracellular calcium homeostasis

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3
Q

Stress phase 1: Alarm (2, 4 released)

A

SNS and HPA on, fight v flight initiated

Cortisol, adrenaline, noadrenaline released

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4
Q

Stress phase 2: Resistance (4)

A

Selective defenses.
Homeostasis restores balance for period of recovery. Hormones normalize.
If condition persists body adapts to continued effort.

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5
Q

Stress phase 3: Exhaustion (4, 4 AKA)

A

Stress levels stay high, very hazardous for health
Resources depleted, results in systemic damage
AKA: Overload/burnout/adrenal fatigue/
maladaption/dysfx

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6
Q

Increase of cell numbers?

A

Hyperplasia

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7
Q

Adaptations to Stress (10)

A 
Physiologic/Anatomic reserve
Time
Genetic Endowment
Age
Gender
Health Status
Nutrition
Sleep-wake cycles
Hardiness
Coping
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8
Q

Increased capacity to adapt to stress

A

Coping

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9
Q

Types of Stress (3)

A

Acute (time limited), Chronic (intermittent), PTSD (sustained)

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10
Q

Which type of stress if fight v. flight?

A

Acute

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11
Q

Which system manifested first w/ stress response?

A

Autonomic Nervous System

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12
Q

Wheezing/SOB w/ acute bronchial asthma is caused by? (2)

A

Inflammatory response and swelling

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13
Q

States of PTSD (1 description, 3 phases)

A

PTSD is chronic activation of stress related to an event (SNS is activated, cortisol levels ↓)
Intrusion
Avoidance (numbing)
Hyperarousal (irritability, startle reflex)

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14
Q

Definition of “Intrusion State”

A

“Flashbacks” and nightmares of event in detail

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15
Q

Sections of CNS? (2)

A

Brain and spinal cord

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16
Q

Where do SNS impulses come from? (3)

A

Hypothalamus, adrenal medulla, spinal cord

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17
Q

S/S of Fight v. Flight (6)

A

↑ RR, diaphoresis, dilated pupils, ↓ secretions, GI motility, constriction of sphincters

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18
Q

How does heat cause cell injury?

A

Coagulation of blood vessels and tissue proteins

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19
Q

How does cold cause cell injury?

A

Viscosity induces vasoconstriction through SNS reflex.
↓ blood results in hypoxia -> tissue injury
also… frost bite.

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20
Q

Types of Adrenergic Receptor sites (4)

A

A1 - bladder/vasoconstriction, iris dilation
A2 - ↑ insulin release from pancreas
B1 - cardiac and contractility
B2 - bronchi,vasodilation, relaxation of uterus

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21
Q

Which site when stimulated results in myocardial activity and an increased HR?

A

Beta 1

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22
Q

What does PNS do?

A

Opposite of SNS. Begins energy storage and conservation

“Rest of Digest”

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23
Q

Adrenergic blockers fx? (↑1 ↓3)

Treatment similar to?

A

↓ BP, pulse, renin levels ↑ renal perfusion

Treatment for HTN

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24
Q

When receiving adrenergic blockades. Priority assessment?

A

Monitor HR

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25
Areas of Pharmacology (5)
Pharmaco... Dynamics - org to chemi Kinetics - drug action, HL, peak, duration, metabolism Therapeutics - therapeutic fx of drugs + admin Economics - value of therapy vs another Genomics - drug fx vs. individual genetics
26
Area of pharmacology involved in exploring unique differences in drug responses due to genetic makeup?
Pharmacogenomics
27
Phases of Pharmacokinetics (4)
Absorption, Distribution, Metabolism/Biotransformation, Excretion
28
Labs to administer if giving nephrotoxic antibiotics
Creatinine and BUN
29
FDA Category where fetal abnormalities > beneficial fx of drugs
Category X substances.
30
Concerns when administering to older pts? (3)
↑ susceptible to AdFx Monitor hydration, nutrition, hepatic renal fx Ensure compliance (alarms/reminders)
31
More effective method of antibiotic therapy? | Broad vs Selective
Selective targets infections (IV is quickest) Broad used when C&S not available or pt is too sick to wait for results
32
Preventing drug resistance (4)
Only use if C&S identifies ↓ dis/misuse Complete full round !save for self-medication in future
33
How do penicillins fight bactera?
Interfere w/ cell wall building
34
What antibiotic is used to prophylactically treat family members living w/ a pt with tb?
Isoniazid
35
When does antibiotic therapy stop?
When full round is complete
36
How do organisms develop resistance?
alter cell walls/enzymes to become resistant to unfavorable conditions/situations
37
How to prevent accumulation of anti-infective in kidneys?
Hydration throughout drug therapy
38
Lab values to monitor when administering aminoglycosides?
BUN and creatinine monitor renal system
39
When is Flagyl (metronidazole) used prophylactically
For pts undergoing vaginal, abdominal, or colorectal surgery (pre/post op)
40
Flagyl | Type of antiinfective?
Antiprotozoal
41
Ketoconazole (Nizoral) and Lotrimin | Type of antiinfectives?
Antifungals?
42
How are Nizoral/Lotrimin applied?
Topically. Nizoral also can be taken orally
43
Nizoral/Lotrimin Contraindications? (6)
``` Hepatic dysfx Renal dysfx Endocrine/Fertility probs Pregnant/Lactating Known allergy/hypersensitivity reaction Open lesions ```
44
Where can Candidiasis infx occur? (2)
mouth and vagina (vaginitis)
45
What is oral Candidiasis called?
Thrush
46
Sidefx to warn pt when giving antifungals (5)
Systemic - bruising/bleeding, yellowing eyes/skin (hepatic toxicity) Topical - serious irritation, burining, pain STOP IF ANY OCCUR
47
What should nurse monitor if administering antifungals? (!, 4)
They're very toxic! | Monitor renal, hepatic fx, CBC (%blood, platlet b/c excessive bruising)
48
Pressure generated through semipermeable membrane?
Osmotic
49
Diffusion?
Movement of un/charged particles from [High] to [Low]
50
What is tonicity if ECF > ICF
Hypertonic. Stronger forces draw H2O.
51
Causes of interstitial edema (4)
↑ capillary filtration pressure, permeability ↓ capillary colloidal osmotic pressure, lymphatic flow
52
Most effective method to measure body fluid volume (do this every day)
Urine output
53
What condition can occur w/ rapid infusion of hypertonic solution
Edema
54
How do electrolyes fx a cell
Electrolyes form ions. | Ions help determine osmotic pressure of body fluids
55
Normal values of electrolyes (5)
``` Na 135-145 K 3.5-5 Mg 1.2-2 Ca 9-10.5 P 3-4,5 ```
56
Hyponatremia fx on cell?
Cell swells
57
What electrolytes is inversely related to calcium?
Phosphorus
58
Isotonic fluid body deficit results in? (what travels w/ h2o?)
Hyponatremia
59
Causes of hyponatremia (4) | Manifestations (4)
↓ renal fx, sweating, GI losses, SIADH | Edema, cramps, weakness, fatigue
60
What to administer to counter hypermagnesemia
IV Ca
61
What to monitor when administering NSS? (5)
Hypervolemia, edema, crackles, HR, BP
62
PSNS neurotransmitter and fx (3)
Acetylcholine. | Fx pre/postganglionic neurons to ↑ digestion, nutrient absorption, and protein building to conserve energy
63
What are Cholinergic Agents? (Parasympathomimetics) and !?
Imitate AChs to make PSNS fx | !? cannot be limited to specific site, often cause fx on whole body and cause undesirable adfx
64
What is Duvoid (bethanchol)
Cholinergic agonist, used for non-obstructive post/operative/partum UTR, also reflux esophagitis
65
What are cholinergic agonists used to treat? (4+1)
↑ bladder tone, excretions, GI secretions, mouth secretions for dry mouth (Sjogren) relieve intraocular pressure
66
Fx of anti-cholinergics?
Depresses PSNS and lets SNS dominate | Fight v Flight S/S
67
Most common anti-cholinergic and fx on vitals?
Atropine. ↑ HR. Found in natural produces (belladona) and in herbal therapy which can cause toxciity
68
Anti-cholinergic Adfx? (7)
dry mouth, constipation, UTR, ↑ HR. ↓ sweating, blurred vision, dilated pupils
69
Conditions worsened w/ anti-cholinergics? (8)
Narrow angle laucoma, GI/GU obstruction, prostatic hypertrophy, HTN, tachycardia, renal/liver dysfx
70
ARF vs CRF
Acute Renal Failure - seriously ill. rapid decline in fx due to poor balance/excretion Chronic - permanent loss of nephrons.
71
Fx lost in CRF
fx kidney nephrons and GFS. Remainders have to work harder
72
Common indicator of ACF?
Azotemia, accumulation of nitrogenous wastes
73
What does kidney activate to maintain Ca levels in body?
Vit K b/c it promotes Ca absorption | !P, it cannot excrete P
74
Signs of recovery from ARF? (↑,↓, possibility?)
↑ urine output, ↓ creatinine | Possible BUN, Creatinine, K, and P levels remain elevated but eventually will normalize
75
Pre/Intrinsic/Post Renal? (3,3,2)
Pre - ↓ blood flow b/c hemorrhage, CHF, dehydration Intrin - injury to kidney, ischemia, obstruction, etc. Post - urine outflow obstruction (prostatic hyperplasia)
76
Renal failure caused by acute dehydration? | Urinary obstruction?
dehy - pre | obs - post
77
Prototype Diuretics. (5)
Thiazide (Hydrochlorotiazide), blocks Cl pump results in ↓Na, K, Cl Loop (Furosemia), fx loop of Henle, results in ↓h2o, Na, K Carbonic Anhydrase inhibitors (Acetazolamid), inhibits carbonic anhydrase, resulting in basic urine (treats glaucoma) Potassium sparing (Spironolactone), sparts K in exchange of ↓Na and H2o Osmotic (Mannitol), ↑ osmalrity of GFR, ↓h2o, Na, Cl
78
Lab to monitor when giving Furosemide? (4)
HypoK, HypopH, HypoCa, hyperGlycemia
79
Diuretic for glaucoma?
Acetazolamid (Diamox)
80
Class of diuretics most commonly used for out/inpt conditions?
Loops
81
What does Chlorothiazide do? (treats what caused by 4)
treat edema caused by HF, liver dz, and renal dz. | Also HTN
82
What imbalance if pt has leg cramps, fatigue when taking thiazide?
Hypokalemia
83
Which tubules are fx'd by thiazide? (and 2 electros)
Distal, Cl and Na
84
MOST important instruction when giving pt diuretic therapy
Maintain fluid intake to avoid rebound
85
Diamox is a...?
Carbonic Anhydrase Inhibitor
86
Drug interactions to watch w/ Diamox? (2)
Lithium and Salicylate levels
87
Nephritis v. Nephrosis
Nephritic - inflammatory response w/ ↓ GFR, results in retention and accumulation Nephrotic - ↑ GFR, proteins in urine yo
88
What causes edema in pt with nephritic syndrome and glomerulonephritis?
nephritis causes Na and H2o retention, glomerulo - ↓ plasma pressure (↓ GFR) and protein loss
89
Bladder/UT dz (3)
Lower UTObs/Stasis - kidney ok but retained (can cause kidney dmg) Spastic - failure to store b/c spasms/neural dmg Flaccid - failture to empty b/c muscle/neuropathy
90
Types of incontinence (3)
Stress - involuntary loss b/c coughing Overactive - urgency b/c hyperdetrusor muscle Overflow - loss b/c increase pressure w/out muscle activity
91
Which incontinence includes dysfx detrusor?
Overflow
92
Most common Bacteria w/ uncomplicated UTIs?
Ecoli

ABSN Cohort 19 (28 decks)

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