Test 1 Flashcards
(119 cards)
1
Q
How can you reduce medication errors?
A
Write legibly
Provide complete information
Use Zeros before decimals
Only use approved abbreviations
2
Q
B1 selective adrenergic antagonists are? (-olol)
A
- Atenolol
- Betaxolol
- Esmolol (approved for thyroid storms)
- Metoprolol
- Nebivolol (may have nitric oxide vasodilating effect)
3
Q
At what dose does dopamine stimulate A1 receptors?
A
High dose >10mcg/kg/min
4
Q
Mixed A1 and non-specific B blockers are? (vowel-lol)
A
- Carvedilol (HTN and CHF)
- Labetalol - PO/IV (severe HTN, PO preferred for Pregnancy) (useful for elderly and black HTN Pts that cannot tolerate increases in PVR)
5
Q
Anyphylactic shock, Bronchospasms, Cardiac arrest, and anesthetic adjunct are the clinical uses of what?
A
Epinephrine
6
Q
- Drug that may or may not compete with agonist.
- Permanently antagonizes agonist and reduces the efficacy of the agonist.
A
Irreversible antagonist
7
Q
Drugs that reduce or prevent the effects of normal physiologic cell regulators or agonists.
A
Antagonists
8
Q
Immunologic hypersensitivity occuring as the result of unusual sensitivity to a medicine.
A
Allergic reaction
9
Q
Neuromuscular Blocking agents are clinically useful for what specifically? (3)
A
- Intubation
- Paralyze Vent Pts
- Relax muscles during surgery
10
Q
The study of substances that interact with living systems through chemical processes, especially by binding to regulatory molecules and activating or inhibiting normal body processes.
A
pharmacology
11
Q
gtt or gtts means?
A
drop or drops
12
Q
When a drug favors one receptor. The higher this is, the fewer adverse reactions it will cause.
A
Selectivity
13
Q
What receptor is not well understood, but thought to play a role in fat breakdown?
A
B3
14
Q
Receptor that is involved in stimulation of the bladder, exocrine glands and smooth muscle is?
A
M3
15
Q
Alpha specific Direct acting Adrenergics that Increase BP are?
A
Phenylephrine (Sudafed PE, Neosynephrine)
Midodrine (prodrug)
16
Q
What direct acting catecholamine is a prodrug used to decrease Intraocular pressure (gloucoma)?
A
Dipivefrin
17
Q
qs means?
A
add quantity sufficient to make
18
Q
What anticholinergics are used for their action in the CNS in an attempt to restore the balance of ACh and dopamine?
A
- Benztropine (helps control extrapyramidal disorders)
- Trihexyphenidyl
19
Q
The conversion of Tyrosine to Epinephrine involves three other molecules. What are they in order?
A
Tyrosine >> DOPA >> Dopamine >> Norepinephrine >> Epinephrine
20
Q
What direct acting non-catecholamine is used for overactive bladder?
A
Mirabegron (Only B3 drug covered)
21
Q
Direct acting non-catecholamine used for severe hypertension that is 6x more potent than dopamine for producing renal vasodilation is?
A
Fenoldopam (D1)
22
Q
Exocrine glands secrete their products (e.g., digestive enzymes) where?
A
into a duct that leads to the environment.
23
Q
This type of drug will block acetylcholine’s interaction with either a muscarinic or nicotinic receptor.
A
Anticholinergic
24
Q
Epinephrine is commonly associated with treatment of arrythmias, however there is no mortality difference between Epinephrine and what?
A
Norepinephrine
25
au means?
both ears
26
What direct acting catecholamine is used in Critical Care for cardiac and septic shock?
Dopamine
27
Nicotine in low doses can depolarize autonomic ganglia and cause euphoria, but in large doses it can decrease BP and cause respiratory paralysis. Nicotine is a?
Ganglionic stimulant
28
Drugs that compete by interacting witih opposing regulatory pathways.
Physiologic antagonist
29
Non-specific Alpha and Beta receptor Adrenergic antagonists are?
* Phenoxybenzamine (NonCompetitive blocker for pheochromocytoma management)
* Phentolamine (Competitive blocker for diagnosis of pheochromocytoma)
30
What direct acting A1 and A2 agonist used for ocular and nasal vasoconstriction is also associated with rebound congestion.
Oxymetazoline (eye drops/ nasal spray)
31
The amount of drug necessary to elicit a response is called?
Potency
32
Drugs that may act as either agonist or antagonist.
Partial agonist
33
IVPB means
intravenous piggyback
34
The competitive indirect cholinergics are?
* Edrophonium (M.G. and Nerve agents)
* Neostigmine (M.G. and Nerve agents)
* Physostigmine (M.G. and Nerve agents)
* Pyridostigmine (M.G./ Nerve agents/ N.A. prophylaxis)
35
Drugs that inhibit the release of acetylcholine from nerve fibers at neuromuscular junctions are?
* Onabotulinumtoxin A (horse botulism antitoxin used as antidote)
* Incobotulinum toxin A
36
Drugs that bind to the same receptor site as the agonists, and prevent binding that leads to reduction of agonist potency.
Competitive Antagonist
37
Neuromuscular blocking agent that you should never give as a continuous infusion is?
Succinylcholine
38
Short acting beta 2 agonists are?
* Albuterol (Drug of choice for respiratory relief)
* Levalbuterol (isomer of albuterol)
* Metaproterenol
* Terbutaline (rarely bronchodilator. **Primarily premie preventor**)
39
A drugs ability to produce a desired or intended result is called?
Efficacy
40
Drugs that bind to a different site on the receptor, and indirectly block the agonist. Cannot be overcome by increasing dose.
Non-competitive antagonists
41
What factors effect a drugs effect on its target site?
* Route of administration
* Extent and rate of absorption
* Distribution of drugs in body compartments
* Effects of protein binding and tissue binding
* Rate of metabolism
* Rate of elimination (clearence) from the system
42
Malignant hyperthermia is a genetic disorder that accelerates the metabolism of skeletal muscle. What is the antidote?
Dantrolene
43
1 tsp = ?mls
5
44
The parasympathetic and sympathetic systems are both parts of what?
Autonomic nervous system
45
The use of a drug for an indication that has not been approved by the FDA is called?
unlabeled use
46
Direct acting synthetic catecholamines are?
Dobutamine (selective B1)
Isoproterenol (non-selective B1 = B2)
47
Receptor that is responsible for increasing BP as a result of vasoconstriction is?
A1
48
What is the rationale for writing prescriptions?
1. Make specific diagnosis
2. Consider the pathophysiology of the diagnosis
3. Select the therapeutic objectives
4. Select a drug of choice
5. Determine the appropriate dosing regimen
6. Devise a plan for monitoring the drugs action and determine an endpoint
7. Plan a program of patient education
49
When writing a prescription what information goes in the prescription body?
Superscription (Rx)
Inscription (Name and strength)
Subscription (quantity prescribed)
Signature/Sig/Directions
Refill information
50
Who determines if a drug will be Legend or OTC?
Food and Drug Administration (FDA)
51
What anticholinergics are used in the eye?
* Atropine (14 day recovery)
* Cyclopentolate
* Tropicamide (preferred- shorter recovery time)
52
Drugs that produce a response by activating a receptor.
Agonists
53
1 tbsp = ?mls
15mls
54
This drug dilates the eyes, increases HR, decreases GI spasms, and is sometimes paired with an indirect acting cholinergic to treat Nerve agent exposure.
Atropine
55
What drugs block ACh at parasympathetic sites in smooth muscle, secretory glands and the CNS, decreasing GI spasms?
* Dicyclomine
* Belladonna alkaloids (combo anticholinergic)
56
Monoamine oxidase and Catechol-o-methyltransferase are involved in the termination of what?
Norepinephrine
57
What the drug does to the body is?
Pharmacodynamics
58
Non-specific beta adrenergic antagonists are?
* Prepanolol (Crosses BBB, DOC for Thyroid storms)
* Nadolol (Migrain prophylaxis)
* Timolol (opthalmic/PO rarely used)
59
A1a specific Adrenergic antagonists are?
Tamsulosin (only BPH) *Priapism/IFIS*
Silodosin (only BPH) *Not for Renal Pts*
60
OU means?
both eyes
61
The direct acting Cholinergics are?
* Acetylcholine (eye procedures)
* Pilocarpine (gloucoma and xerostomia)
* Bethanecol (Urinary retention)
62
Long acting B2 agonists are?
Arformoterol (COPD only)
Formoterol
Salmeterol
Indacterol (COPD only)
63
How is a graded response measured?
by continuous variables like BP, enzyme activity and change in muscle tension.
64
What patient information is included on a prescription?
Name
Address
Phone number
Social Security Number
65
Endocrine glands secrete hormones where?
directly into the bloodstream
66
"Reversible" pertains to which type of cholinergics?
Competitive indirect acting
67
Anti-Muscarinics can be used for what?
| (PMSDOCBRB)
* Parkinson's
* Motion Sickness
* Sedation
* Diarrhea
* Overactive bladder (OAB)
* Cholinergic Intoxication
* Bronchospasm (COPD)
* Reduce Secretions
* Bradycardia
68
The degree to which something is successful in producing a desired result is?
Effectiveness
69
Receptor that is involved in secretions from salivary glands and stomach is?
M1
70
Alkalizing urine will have what effect on the elimination of an acidic drug?
Increase elimination
71
Pharmacotherapeutic class and Target physiologic system are used for what?
Systems for Classifying Drugs
72
How is a quantal response measured?
The number of subjects showing an "all or nothing" response. Such as pain relief, death, and number anesthetized.
73
Mixed direct acting Adrenergic agonists displace Norepinephrine. List them.
* Ephedra (Workout stimulant banned Apr2004)
* Ephedrine (Use: bronchospasms, nasal congestion, hypotension)
* Pseudophedrine (Direct acting A/B agonist)
74
Pharmacokinetic parameters are measurements that help determine the dosage regimen. What are they?
* Bioavailability
* Volume of Distribution
* Drug Accumulation
* Clearance
* Elimination
75
Synthesis of Norepinephrine involves Tyrosine being converted to what?
L-DOPA
76
Direct acting endogenous catecholamines are?
* Epinephrine
* Norepinephrine
* Dopamine
77
Alpha 2 specific Direct acting adrenergics are?
* Clonidine (decreases BP) (DC slowly to prevent HTN crisis)
* Brimonidine (eye drops/ gloucoma)
78
Cholinergics can be used to treat what?
| (AMGUACXC)
* Alzheimers
* Myasthenia Gravis
* Gloucoma
* Urinary Retention
* Anti-Cholinergic OD
* Curare Poisoning
* Xerostomia (dry mouth)
* Constipation
79
Non-specific Nicotinic neural receptor blockers that are no longer used therepeutically are?
Ganglionic Blockers
80
What information is included in the prescribers signature area of a prescription?
Name printed and signed
Branch of service
DEA number or social
81
What things should be considered when writing a prescription?
* Type of medication (Legend Rx or OTC)
* Use (labeled or unlabeled)
* Chance for abuse
* Brand or Generic
* Quantity of medication
* Directions for use
* Refills
* Reducing medication errors
82
Neuromuscular blocking agents that work in sync with acetylcholine esterase to prevent depolarization are?
Atracurium (**seizure risk**) (intermediate)
Cisatracurium (intermediate)
Rocuronium (intermediate)
Vercuronium (intermediate)
Pancuronium (**Long acting**)
83
Receptor that is responsible for presynaptic negative feedback of multiple neurotransmitter outflow is?
A2
84
Any unexpected, unintended, undesired, or excessive response to medicine.
Adverse drug reaction
85
Indirect-acting adrenergic agonists are?
* Dextroamphetamine (schedule II)
* Methamphetamine (schedule II)
* Cocaine (topical anesthesia) (schedule II)
* Tyramine (not a drug, Found in fermented foods) (Can interact with MAOI and cause HTN crisis)
86
as, ad mean?
left ear, right ear
87
At what dose does dopamine favor B1?
Medium dose 5-10mcg/kg/min
88
What drugs are used for bronchodilation and respiratory secretion decrease in the treatment of COPD?
Ipratropium (short acting)
Tiotropium (long acting)
89
Synthesis of Norepinephrine involves the conversion of L-DOPA to what?
Dopamine
90
Inactivates the agonist of interest by modifying or sequestering it.
Chemical antagonist (Neutralizing Antagonist)
91
What statement is included in prescriptions for controlled substances written by non-physicians?
May be filled at any MHS pharmacy where this provider is privileged
92
A1 specific Adrenergic antagonists are? (-zosin) (4)
Prazosin (PTSD) (Not for BPH)
Doxazosin (HTN, XL dose only for BPH)
Terazosin (BPH and HTN)
Alfuzosin (Only for BPH, but not A1a specific)
93
This class within cholinergic drugs is effective because of its similarity to Acetylcholine.
Direct acting cholinergics
94
Abnormal susceptibility to a medication that is peculiar to the individual.
Idiosyncratic reaction
95
Beta blockers with intrinsic sympathomimetic activity (ISA) aka partial agonists were designed to weakly stimulate B1 and B2 receptors. They are? (-olol)
* Acebutolol (B1 specific blocker)
* Pindolol (non-specific B blocker)
* Penbutolol (non-specific B blocker, not as much ISA prop.)
96
Prescriptions for children under 12 includes what?
age and weight
97
Drugs that are considered to have abuse potential are monitored by who?
The Drug Enforcement Agency (DEA)
98
What the body does to the drug is called?
Pharmacokinetics
99
The primary catecholamine is what?
Norepinephrine
100
When a drug has one effect and only one effect on all biological systems.
Specificity
101
PV means?
Vaginally
102
Any preventable event that may cause or lead to inappropriate med use, or patient harm while the medication is in the control of the provider, patient, or consumer.
Medication error
103
od, os mean
od- right eye, os- left eye
104
Name the drugs that decrease bladder constriction, and constrict the sphincter.
* Oxybutynin (patch)
* Darifenacin (M3)
* Solifenacin (M2)
* Tolterodine
* Fesoterodine
* Trospium (Less CNS S.E.)
105
Receptor that is involved in bladder stimulation, smooth muscles, and Cardiac cells is?
M2
106
Anticholinergic used for motion sickness, and a prophylactic for nausea post op.
Scopolamine (patch)
107
Receptor involved in stimulating the lungs, skeletal muscle blood vessels, glucose production, and accomodation of the eye is?
B2
108
The Somatic and Autonomic systems are both divisions of what?
Peripheral nervous system
109
When writing the amount to be dispensed, why would you spell and number the quantity?
For Controlled substances
110
Increase in the number of receptors on target cells.
Up-regulation
111
What receptor plays a role in renin release, but is primarily Cardiac?
B1
112
Acidification of the urine will have what effect on the elimination of a basic drug?
Increase elimination
113
A patient that presents with Hypotension and low HR can be effectively treated without risk of reflex tachycardia by what direct acting catecholamine?
High dose Dopamine (\>10mcg/kg/min)
Stimulates A1 and B1
114
Noncompetitive indirect acting cholinergics aren't used regularly anymore, but because ISIS and Kim Jong Un are real, name them.
* Serin (warfare nerve agent)
* Parathion (insecticide)
* Ecothiopate (gloucoma eye drops)
115
What Cholinergic type acts by inhibiting Acetylcholinesterase in the PNS?
Indirect acting
116
What drug is only effective if given in enough time?
Nerve agent antidote
Pralidoxime
117
Cholinergics that are preferential to the CNS are?
* Tacrine (alzheimer's - QID)
* Donepezil (alzheimer's)
* Galantamine (alzheimer's - BID/QD)
* Rivastigmine (alzheimer's - patch)
118
Any substance that brings about a change in biologic function through its chemical action.
Drug
119
What are the types of adverse drug events?
Medication Error
Allergic Reaction
Idiosyncratic Reaction
