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pharmacology 1 Flashcards

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1
Q
  1. What is the generic name of a drug?
A

The chemical name of a drug (ex. acetaminophen)

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2
Q
  1. What is the trade name of a drug?
A

Brands that make the drug (EX Advil)

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3
Q
  1. What is a drug?
A

any chemical that can affect living processes

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4
Q
  1. What is the drug action?
A

How the drug molecules change processes in the body

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5
Q
  1. What is the therapeutic use of a drug?
A

Prevention, treatment, or management of a disease of system

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6
Q
  1. What are drug classes?
A

Classified according to physiologic function or primary disease treated

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7
Q
  1. What are preferred agents?
A

The “go-to” drugs in a healthcare system

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8
Q
  1. What is pharmacokinetics?
A

the study of what the body does to the drug

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9
Q
  1. What is the time of onset?
A

Time required for a drug to elicit a therapeutic effect

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10
Q
  1. What is peak effect?
A

time required for a drug to reach its maximum therapeutic response

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11
Q
  1. What is. peak level?
A

highest level of a drug in the body

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12
Q
  1. What is the duration of action?
A

the length of time the drug has a pharmacologic effect

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13
Q
  1. What are the pharmacokinetic actions?
A

Absorption, Distribution, Metabolism, Excretion

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14
Q
  1. What is absorption?
A

Movement of the drug from the admin site into the blood stream

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15
Q
  1. What. is distribution?
A

transport of a drug by the bloodstream to its site of action

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16
Q
  1. What is a drug-drug interaction?
A

occurs when two drugs are metabolized by the same enzyme and affect each other’s metabolism

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17
Q
  1. What is metabolism?
A

Happens in the liver, skeletal muscle, kidneys, lungs, plasma, or intestinal mucosa

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18
Q
  1. What is the first pass effect?
A

The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream.

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19
Q
  1. What is excretion?
A

removal of drugs from the body

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20
Q
  1. What is the half-life of a drug?
A

amount of time it takes for the blood level of a drug to be reduced by 50%.

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21
Q
  1. What is pharmacodynamics?
A

How the drug affects the body

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22
Q
  1. What is the mechanism of action?
A

Changes that result from interactions

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23
Q
  1. What is the therapeutic index?
A

ratio of toxic dose to therapeutic dose

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24
Q
  1. What are the 3 chemical classes of opioids?
A

Morphine-Like, Meperidine-like, Methadone-Like

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25
25. What are some adverse effects of opioids?
respiratory depression, constipation, urinary retention, dizziness, hypersensitivity
26
26. What are some contraindications of opioids?
Severe asthma, renal failure, increased intracranial pressure, known allergy
27
27. Which opioid is a "non-ceiling" drug?
Morphine
28
28. Which opioid is most effective given orally?
Codeine
29
29. What is codeine metabolized to?
morphine
30
30. Which opioids are schedule II?
Morphine, hydrocodone, meperidine,
31
31. Which two opioids can be used an antitussives?
Codeine, Hydrocodone
32
32. Which two drugs are oxycodone often combined with?
Acetaminophen (Percocet) or aspirin (Percodan)
33
33. How quickly can opioid withdrawal occur?
2 weeks after use
34
34. How do agonist-antagonist opioids work?
Binds to a pain receptor but causes a weaker pain response than a full agonist
35
35. Which pain receptors are most important?
Mu receptors
36
36. What are some adverse effects of agonists-antagonists?
Respiratory depression, dizziness, lightheadedness, abstinence syndrome
37
37. Which patients cannot receive agonists-antagonists?
Patient with MI or cardiac insufficiency
38
38. How are agonist-antagonists administered?
IM, IV, or intrsnasally
39
39. How is Pentazocine (Talwin) administered?
Orally
40
40. What do opioid antagonists do?
reverses symptoms of addiction, toxicity, and overdose
41
41. How do opioid antagonists work?
Block opioid receptors
42
42. What is the antagonist prototype?
Narcan (Naloxone)
43
43. What are adverse effects of narcan?
Increased RR, HR, and BP as well as withdrawal
44
44. How often should you monitor vitals after administration of Narcan?
- Every 5-15 minutes for several hours
45
45. What are some interactions between opioids and substances (I.e. alcohol)
Respiratory depression
46
46. What are some interactions of opioids and mono amine oxidase inhibitors?
Respiratory depression, seizures, hypotension
47
47. What can show up on lab tests after administering opioid antagonists?-
Abnormal serum levels of amylase, bilirubin, lipase, and more Abnormal decrease in urinary 17-ketosteroid levels Increase in urinary alkaloid & glucose concentrations
48
48. What is the dosage for Narcan?
.1-2 mg every 2-3 minutes
49
49. What are the types of non-opioid analgesics?
1st Gen NSAIDS (COX-1 & COX-2) 2nd Gen NSAIDS (COX-2) Acetaminophen Centrally-acting non-opioids
50
50. What are NSAIDS used for?
Inflammation, Pain, Fever reduction
51
51. What are the NSAID prototypes?
Aspirin, Ibuprofen, Naproxen, Indomethacin, Ketorolac
52
52. What are the expected pharmacologic actions of NSAIDS?
Inhibit COX
53
53. What are some adverse effects of NSAIDS?
GI bleeding, acute renal failure, Reye's Syndrome (in kids), Salicylism
54
54. What kidney levels should be monitored with NSAIDS?
BUN and Creatinine
55
55. What are some contraindications of NSAIDS?
Known allergy, risk for bleeding, severe renal or hepatic disease, chronic alcohol abusers, pregnancy, children with viral infections
56
56. What are some interactions with NSAIDS?
Anticoagulants, ibuprofen, ACE inhibitors, angiotensin receptor blockers, lithium carbonate and methotrexate
57
57. Characteristics of Aspirin
Blocks pain centrally & peripherally Decrease responsiveness to pyrogens Anti-platelet activity Toxicity above 300 mcg/ml Low to moderate pain Gastric upset
58
58. What is the first sign of aspirin toxicity?
Tinnitus
59
59. Characteristics of Ibuprofen?
Plasma protein bound Used for pain and fever Max of 2400 mg/day
60
60. Symptoms of nonsalicylate NSAIDS toxicity
Drowsiness, lethargy, mental confusion, parenthesis, numbness, aggressive behavior, disorientation, seizures, and GI toxicity
61
61. What are COX-2 inhibitors used for?
Mild to mod pain, anti-inflammation, fever reduction, menstural pain
62
62. What is the COX-2 inhibitor prototype?
Celecoxib (Celebrex)
63
63. Why were COX 2 inhibitors developed?
To produce relief from pain and inflammation without the side effects of gastric irritation, bleeding and ulcers or the effects on blood coagulation
64
64. What do COX-2 inhibitors do effectively?
Suppress pain and inflammation
65
65. What are the side effects of COX-2?
GI Upset Renal dysfunction Cardio and cerebrovascular events (MI, stroke)
66
66. What are the COX-2 interactions?
Lasix decrease Fluconazole increases celecoxib levels Anticoagulant effects of warfarin increase Glucocorticoids. increase bleeding risk Antihypertensive effects of ACE inhibitors decrease Risk of lithium carbonate toxicity increases
67
67. Is acetaminophen an NSAID?
No, it does not have anti-inflammatory effects
68
68. What is the mechanism of action of acetaminophen?
Inhibits prostaglandin synthesis in CNS
69
69. Does acetaminophen interfere with coagulation?
No
70
70. What is the centrally acting nonopioid?
Tramadol
71
71. What are the indications of uricosurics?
Treat hyperuricemia which causes gout Treat secondary hyperuricemia caused by chemo and anemias
72
72. What are the Uricosurics?
Allopurinol (Zyloprim) febuxostat (Uloric) probenecid (Benemid)
73
73. How do allopurinol and febuxostat work?
Inhibit xanthine oxidase from converting hypoxanthine and xanthine to uric acid
74
74. How does probenecid work?
Inhibits reabsorption of uric acid in kidneys Promotes excretion of uric acid
75
75. What are the indications of glucocorticoids?
symptomatic relief of pain and inflammation management of skin disorders
76
76. What are the glucocroticoids?
Prednisone (Deltasone) hydrocortisone sodium succinate (Solu-Cortef) methylprednisone (Solu-Medrol)
77
77. What are the 2 types of Corticosteroids (glucocorticoids)?
Glucocorticoids (cortisol)
78
78. What are some adverse effects of glucocorticoids?
Moon face, trunk heavy, buffalo hump Myopathy Bone loss cataracts
79
79. What is a sedative?
Reduces nervousness, excitability, irritability DOES NOT CAUSE SLEEP
80
80. What is a hypnotic?
Causes sleep, drowsiness
81
81. What is a sedative-hypnotic?
Has properties of both a sedative and hypnotic (dose dependent)
82
82. What are the early signs of CNS depression
Lack of coordination, lightheaded, slowed/slurred speech, cognitive impairments
83
83. What are the late signs of CNS depression?
Poor judgement, slowed breathing, slowed HR, confusion, lethargy
84
84. What drugs are in the benzo family?
Diazepam (Valium) Alprazolam (Xanax) Lorazepam (Ativan) Temazepam (Restoril)
85
85. What is the most popular benzo?
Diazepam (Valium)
86
86. Which are the most prescribed benzos?
Lorazepam (Ativan) Alprazolam (Xanax)
87
87. What are the pharmacologic effects of Benzos?
CNS "stimulates GABA receptors Cardio" "depends on route given Respiratory" weak resp. depressants
88
88. What are the therapeutic uses of benzos?
Anxiety, insomnia, seizure disorders, muscle spasm, alcohol withdrawal
89
89. What are the adverse effects are benzos?
CNS depression Resp. Depression Abuse Paradoxical effects
90
90. What is the antidote for a benzo overdose?
Flumazenil (Romazicon)
91
91. What is the dosage for Romazicon?
Initial "0.2 mg IV 30 secs later give 0.3 mg IV then 0.5 mg every minute MAX DOSE" 3 mg/hour
92
92. What are the contraindications of barbiturates?
Causes tolerance and Dependence High abuse potential Multiple drug interactions Powerful respiratory depressants CNS depression Cardio effects
93
93. Signs of Acute Barbiturate Toxicity Syndrome?
Resp. Depression Coma Pinpoint pupils
94
94. What. are some benzo-like medications?
Zolpidem (Ambien) Zolpidem tartrate (Ambien CR) Buspirone (Buspar)
95
95. Characteristics of Zolpidem (Ambien) and Zolpidem tartrate (Ambien CR)?
Sedative-hypnotic Most widely used hypnotic Short-term management of insomnia Administer before bedtime
96
96. What are side effects of above medications?
Daytime drowsiness & dizziness
97
97. What is the mechanism of action of Buspar?
Binds w/ serotonin and dopamine receptors
98
98. What does BuSpar treat?
anxiety
99
99. What medical emergencies can BuSpar cause?
Serotonin Syndrome, Hypertensive crisis
100
100. What are the traditional antiepiletics
Phenytoin (Dilantin) Carbamazepine (Tegretol) Valproic Acid (Depakote)
101
101. What are the newer antiepiletics?
Lamotrigine (Lamictal) Oxcarbazepine (Trileptal) Topiramate (Topamax) Gabapentin (Neurontin)
102
102. How do antiepileptic drugs work?
Slows movement of electrolytes (sodium, calcium) Decreases speed of nerve impulses Increases seizure threshold Limits the spread of a seizure
103
103. What are the goals with AED therapy?
Control or prevent seizures Maintain a reasonable quality of life
104
104. What is the most important level for a nurse to monitor on a pt taking AEDs?
Serum drug level
105
105. What vitamin also needs to be given to a pt taking phenytoin (Dilantin)?-
Vitamin D
106
106. What are some adverse effects of Dilantin?
sedation, blurred vision, gingival hyperplasia, acne, Dilantin facies, osteoporosis
107
107. What is the therapeutic range of Dilantin>?
10.0-20.0mcg/ml
108
108. How is Dilantin given?
VERY SLOWLY by IV
109
109. Which antiepileptic may need to be increased after 2 months due to autoinduction?
Carbmazepine
110
110. What are some adverse effects of carbamazepine?
Vertigo, fluid overload, blood cell issues
111
111. What should be avoided while taking carbamazepine?
Grapefruit
112
112. Adverse effects of all newer AEDs?
CNS effects, suicidal ideation, skin disorders
113
113. Which Newer AED can lead to Steven-Johnson Syndrome?
Lamotrigine (Lamictal)
114
114. What is Topamax used for?
Adjunct therapy for partial and secondarily generalized seizures
115
115. Which neuro med is used to treat. migraines?
Triptans (serotonin receptor agonists)
116
116. Adverse effects of Triptans?
Sun sensitivity, cardiac effects, CNS effects
117
117. What are the antidepressants?
TCAs, SSRIs, SNRIs, MAOIs
118
118. What are the clinical features of depression?
Loss of pleasure or interest, Insomnia Anorexia Feelings of guilt Thoughts of death SYMPTOMS MUST BE PRESENT MOST OF THE DAY, NEARLY EVERY DAY FOR AT LEAST 2 WEEKS
119
119. What are anxiolytics?
Benzos, SSRIs, SNRIs, TCAs, MAOIs, Atypical Anxiolytics
120
120. What are the SSRIs
Paroxetine, sertraline, fluoxetine, others
121
121. What are the SNRIs
Venlafaxine, duloxetine
122
122. What are the TCAs
Amitriptyline, imipramine, clomipramine
123
123. What is an MAOI
Phenelzine
124
124. What is the. mechanism of action of the SSRIs
inhibit serotonin reuptake
125
125. What is the medical emergency caused by SSRIs
Serotonin Syndrome
126
126. Adverse effects of SSRIs
Nausea, diaphoresis, tremor, nervousness, suicidal ideation Sexual dysfunction, weight fluctuation, Serotonin syndrome, GI bleed, hyponatremia, bruxism, orthostatic hypotension
127
127. Mechanism of action of Atypical Antidepressants
Inhibits dopamine uptake
128
128. Cautions of atypical antidepressants
history of suicide attempt, renal or hepatic, impairment
129
129. Contraindications of. atypical antidepressants
Seizures or ED MAOI w/in 14 days
130
130. Adverse effects of Bupropion (Wellbutrin)
dry mouth, constipation, decreased appetite, weight loss, lower seizure threshold, suicidal ideation, insomnia, restlesness
131
131. Adverse effects of Mirtazapine (Remeron)
sleepiness, weight gain, elevated cholesterol
132
132. Adverse effects of Trazadone (desyrel)
sleepiness, priapism
133
133. Mechanism of action of SNRIs
Inhibits norepinephrine and serotonin reputake
134
134. What are the SSRI meds?
Mirtazapine (Remeron) Duloxetine (Cymbalta) Venlafaxine (Effexor)
135
135. Cautions of SNRIs
Hx of bipolar disorder, mania, seizure disorder, recent MI, interstitial lung disease
136
136. Contraindications of SNRIs
MAOIs w/in 14 days Renal OR hepatic impairment
137
137. Adverse. effects of SNRIs
Fatigue/drowsiness, paradoxical effects, decreased appetite or. weight loss, nausea, sexual dysfunction, hyponatremia, respiratory issues
138
138. Life Threatening SNRI adverse effects?
Serotonin syndrome, seizures, hepatotoxicity, suicidal ideation
139
139. Mechanism of action of TCAs
blocks reuptake of norepinephrine and serotonin
140
140. Cautions of TCAs
Pairing w/ other serotonin agents active suicidal ideation/attempt history of CAD, diabetes, liver/kidney issues, respiratory disorders, urinary retention, obstruction, angle-closure glaucoma, benign prostatic hyperplasia, hyperthyroidism
141
141. Contraindications of TCAs
Use of MAOI Seizures Recent MI
142
142. Adverse effects of TCAs
anticholinergic cardiac issues
143
143. Mech. of Action of. MAOIs
Inhibits. MAO. enzymes
144
144. Cautions of MAOIs
Large amounts of caffeine, cough/cold meds, diet pills, Tyramine, diabetes. & seizures disorders
145
145. What foods contain tyramine?
non aged cheese, bananas, red wine, fava beans
146
146. MAOI adverse effects
-CNS stimulation -ortho hypotension -hypertensive crisis from tyramine
147
147. What is general anesthesia
reversible state of unconsciousness
148
148. What are the general anesthesia meds?
Brevital, Versed, Duragesic
149
149. How does. GA work?
Enhances transmission at inhibitory synapses depresses transmission at excitatory synapses
150
150. Advantages v disadvantages of GA
Advantages no absolute contraindication, quick to establish, never fails Disadvantages
151
151. How does local anesthesia work?
sodium channel blocker
152
152. What are examples of local anesthesia
Lidocaine, chloroprocaine, procaine
153
153. Advantages v disadvantages of local anesthetic
Advantages "effective alternative to GA, avoids polypharm, pt can remain awake Disadvantages" "limites scope, higher failure rate, time constraints, anticoagulants, risk of neural injury"
154
154. How does regional anesthesia work?
injected into a central nerve
155
155. What are the major types of regional anesthesia?
Peripheral Nerve Block Epidural & spinal anesthesia
156
156. Adverse effects of regional anesthesia?
Damage to nerve, systemic toxicity, spinal headache w/ spinal administration
157
157. What is Lidocaine?
Topical anesthetic, local/regional
158
158. Adverse effects of lidocaine?
hypotension, can disrupt intestinal and urinary tracts
159
159. Midazolam (Versed)?
Short acting, no analgesic properties, provides anxiety. relief
160
160. Onset time of Versed?
IV 0.5 to 1 min IM "15 mins PO/rectal" <10 mins
161
161. What are ways to prevent a med error?
Checks and Balances Correct, legible orders Resources (pharmacist or physician) Triple Check Six Rights
162
162. How does a nurse respond to a med error?
Report and Document Always tell your Charge Complete all paperwork Notify the patient
163
163. What drug categories are not advised for use during pregnancy?
Category C, D, X
164
164. What are some neonatal and peds considerations for dosages?
Immature Organs Skin is thinner Sensitivity of receptor sites Stomach acid is less acidic Weaker lungs Rapidly developing tissues
165
165. What are some pregnancy considerations for drugs?
Diffusion Fetus is exposed to what the mother is exposed to
166
166. Which trimester is the fetus most susceptible to effects of outside agents?
1st trimester
167
167. What are some causes for concern with drugs while breastfeeding?
- Cross from mother's circulation to the breastmilk
168
168. What are some concerns in the older generations when it comes to pharmacology?
Polypharmacy Organ system functionality Decreased body weight Malnutrition MONITOR LIVER & KIDNEY FUNCTION
169
169. What are some important factors for patient education?
Illiteracy Poor health literacy Individual learning needs Making sure they know when their next appointment is Making sure they understand medication instructions
170
170. What is the strongest indicator of a person's health?
Poor Health literacy

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