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Test 1 Flashcards

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1
Q

What is the concentration for NS?

A

0.9%

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2
Q

What do most drugs comes from?

A

Laboratory synthesis

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3
Q

What does MAB stand for?

A

Monoclonal antibodies

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4
Q

What does Premarin come from?

A

Urine of pregnant mares

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5
Q

What is another name for opioids?

A

Narcotics

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6
Q

What plant does opioids come from?

A

Poppy’s

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7
Q

What plant does digoxin comes from?

A

Foxglove

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8
Q

What does UFH stand for? Where does it come from?

A

Unfractionated fractionated heparin

Pig intestine

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9
Q

Where does MAB come from?

A

Laboratory synthesis

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10
Q

What is pharmacodynamics?

A

Study of what drugs do to the body

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11
Q

What can prolonged exposure of antagonist do to receptors? How does that effect the tolerance?

A

Up regulates receptors

Decreases tolerance

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12
Q

What can prolonged exposure of an agonist do to receptors? How does that effect the tolerance?

A

Down regulated receptors

Increases tolerance

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13
Q

What does potency measure?

A

How much action a drug caused

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14
Q

What does affinity measure?

A

How well a drug binds to a receptor

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15
Q

Do agonists and antagonist bind or stay bound to receptors?

A

They stay bound to receptors until an enzyme cleaves then off

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16
Q

What does LD50 stand for?

A

Lethal dose to kill 50% of the population

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17
Q

What does ED50 mean?

A

Effective dose to help 50% of the population

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18
Q

How is therapeutic index measured?

A

LD50/ED50=therapeutic index

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19
Q

What is a teratogen?

A

Something that causes a birth defect

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20
Q

What is a carcinoma?

A

Something that causes cancer

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21
Q

What is the most common drug allergy?

A

Penicillin

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22
Q

What does OTC stand for?

A

Over the counter

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23
Q

What is the most abused drug classified in the drug schedule? Least abused drug schedule?

A

Schedule 1

Schedule 5

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24
Q

What does PO mean? What type of route is it?

A

Oral

Enteral route

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25
What does SL mean? What route is it?
Sublingual Enteral route
26
Where is a buccal taken and what route is it?
Taken in the mucous membranes Enteral route
27
What are the two different route that rectal medications can be taken?
Enteral or topical route
28
What does IM mean? What route is it considered?
Intramuscular Parenteral route
29
What does SC mean? What route is it considered?
Subcutaneous Parenteral route
30
What does ID mean? What route is it considered?
Intradermal Parenteral route
31
What does IA mean? What route is it considered?
Intraaterial Parenteral route
32
What does IT mean? Where is it inserted? What route is it considered?
Intrathecal-spinal cord Parenteral route
33
Where is intraarticular injected?
In joints
34
What does parenteral route?
Medication is injected
35
What type of route is Nasal spray (NS)?
Topical route
36
What type of route is a meter dose inhaler (MDI)?
Topical route
37
What does anhydrous mean?
Containing alcohol
38
What does tincture/elixir/spirits mean?
Containing alcohol
39
What is the length of the pre ganglionic neuron for the sympathetic system? Parasympathetic system?
Sympathetic: short Parasympathetic: long
40
What is the length of the post ganglionic neuron of the sympathetic system? Parasympathetic system?
Sympathetic: long Parasympathetic: short
41
What receptors are on the post ganglion of sympathetic and parasympathetic system?
N2 receptors
42
What receptors are on sympathetic effort organs?
Adrenergic (Alpha or beta) receptors
43
What receptors are found on parasympathetic effectors organs?
Muscarinic receptors
44
What type of Neuron is a post ganglion neuron? What does it release?
Adrenergic neuron Norepinephrine
45
What type of receptors are on skeletal muscles of cholinergic neurons?
N1 receptors
46
What system innervates generalized and localized sweating? What types of neurons are pre and post ganglion for localized sweating and generalized sweating?
Sympathetic system Generalized sweating: cholinergic and cholinergic ganglion Localized sweating: cholinergic and adrenergic ganglion
47
What neurotransmitters are released from adrenergic or cholinergic receptors?
Adrenergic: NE Cholinergic: ACh
48
What receptors are on generalized sweat glands?
Muscarinic receptors
49
What system are blood vessel only innervated by?
Sympathetic system
50
What receptors are found on localized sweat glands?
Alpha-1 receptors
51
What organs and systems are only innervated by the sympathetic system?
Blood vessels Generalized sweat glands Localized sweat glands
52
What type of effect happens with odd numbered receptors? What effect happens with even numbered receptors?
Odd # receptors: excitatory | Even # receptors: inhibitory
53
True of false: nicotinic receptors cause only excitatory responses?
True
54
True of false cholinergic receptors only give excitatory responses?
False
55
What receptors are on ciliary processes to produce aqueous humor?
Beta 1
56
What receptors are on ciliary muscles that cause suspenseful ligaments to relax?
Beta 2 receptors
57
What happens to ligaments and lens when ciliary muscle contracts? Relaxes?
Contracts: slack on ligaments and lens becomes round (near sight) Relaxes: tension on ligaments and lens flattens (fat sight)
58
What muscle causes a pupil to dilate and what muscle cause a pupil to constrict?
Pupil Dilate: dilator pupillae Pupil Constrict: sphincter pupillae
59
What is another name for pupil dilation? Pupil constriction?
Pupil dilate: mydriasis | Pupil constrict: miosis
60
What receptors are found on dilator pupillae? Sphincter pupillae?
Dilator pupillae: alpha 1 receptors Sphincter pupillae: muscarinic receptors
61
What is Brimonidine(Alphagan P)? What is it’s MOA? What is it used for?
Alpha 2 agonist Alpha 2 receptor blocks release of NE Used to Tx glaucoma by decreasing aqueous humor production
62
What class of drug is an alpha 1 agonist called?
Alpha adrenergics
63
What is the prototype for alpha 1 adrenergics?
NE
64
What are the effects on BP, GI system and pupils with alpha adrenergics?
BP: increases due to vasoconstriction GI: constipation due to decrease gut motility Pupil: mydriasis
65
What is dobutamine(Dobutrex)? What receptors does it interact with most? What does it cause and what is it indicated for?
sympathomimetic Interacts mostly with B1 receptors Increases CO and vasodilator Indication: cardiogenic shock and HF(heart failure)
66
What is dopamine(intropin)? What receptors does it react with at a low dose? What does it do and what is it’s indicator?
sympathomimetic Dopaminergic receptors Vasodilator Indication: septic or cardiogenic shock
67
What is dopamine(intropin)? What receptors does it react with at a moderate dose? What does it do and what is it’s indicator?
Sympathomimetic Beta1 receptors Increases CO (inotropic) Indicators: septic and cardiogenic shock
68
What is dopamine(intropin)? What receptors does it react with at a high dose? What does it do and what is it’s indicator?
Sympathomimetic Alpha1 receptor Vasoconstrictor Indication: septic or cardiogenic shock
69
What is epinephrine(Adrenalin)? What receptor does it work with at a low dose? What does it do? What is it used for?
Sympathomimetic Beta1 receptors Increases HR, inotropic, bronchodilation Anaphylactic shock, cardiac arrest, acute asthma
70
What is epinephrine(Adrenalin)? What receptor does it work with at a high dose? What does it do? What is it used for?
Sympathomimetic Alpha 1 receptor Increase HR, inotropic, bronchodilator Indication: Acute asthma, cardiac arrest, anaphylactic shock
71
What is norepinephrine(Levophed) indicated for?
Hypotension/circulatory shock
72
What is a risk of using norepinephrine(Levophed)? How can it be corrected?
Risk of extravasation that can lead to NE causing necrosis and gangrene to tissue? Corrected by giving NS flush and phentolamine(alpha 1 blocker)
73
What is extravasation? How is it avoided?
When a needle goes thru both side of vein while giving a shot Usually avoid by giving it thru central line
74
what is an alpha adrenergic medication?
Alpha1 agonist?
75
What type of medication is tetrahydrozoline(Visine)? How is it given? What does it do?
Alpha adrenergics Given as eye drops Vasoconstriction vessels to decrease mucus production
76
What type of medication is phenylephrine(Neo-synephrine)? How is it given? What does it do?
Alpha adrenergic Nasal spray Vasoconstricts vessels to decrease mucus production
77
What are side effects of alpha adrenergics?
Excessive dryness (mydriasis) Rebound congestion (rhinitis medicamentosa)
78
What is rhinitis medicamentosa?
Rebound congestion
79
Why is a alpha adrenergic bad to give to pt with heart disease/HTN, DM, or BPH?
Heart disease/HTN- b/c vasoconstrictor raises BP DM- increases sympathetic system, increases BGL BPH- vasoconstrictor makes it more difficult to pee
80
What does BPH stand for?
Benign prostate hyperplasia
81
What type of drug is phenylephrine HCl (AK-Dilate)? What does it do?
Alpha 1 agonist Mydriasis and vasoconstriction
82
What is the drug of choice for anaphylaxis? What receptors does it stimulate?
Epinephrine (EpiPen) Alpha and bets receptors
83
What type of drug class is epinephrine(EpiPen)?
Beta-adrenergics (non-selective)
84
What effect does epinephrine have on the heart, lungs and vessels?
Heart: increase HR and inotropic Lungs: bronchodilator Vessels: vasoconstriction
85
What type of drug is albuterol(Proventil)? How is it delivered?
Beta-2 (selective) MDI
86
What type of drug is terbutaline(Brethine)? What is it used for? What route is is it given?
Beta-2 (selective) Decrease uterine contractions SC, IM, PO
87
What is the r/f of terbutaline(Brethine) for the fetus?
Can have effect on beta-1 receptors and lead to tachycardia
88
What type of drug is mirabegron(Murbetriq)? What is it’s indication? What does it do?
Beta-3 selective drug Indication: overactive bladder Relaxes Detrusor muscle to be able to pee
89
What is the detrusor muscle?
Muscle that helps generate force to pee
90
What is droxidopa(Northera)? What is it used for? What does it do?
Precursor NE Indication: neurogenic orthostatic hypotension Coverts into NE and vasoconstricts vessels
91
What is doxazosin(Cardura)? What does it do?
Alpha-blocker Relaxes smooth muscles
92
What is tamsulosin(Flomax)? What does it do?
Alpha blocker Relaxes smooth muscles
93
What are indications for alpha-blockers?
BPH/HTN Ryanair’s disease Pheochromocytoma
94
What is pheochromocytoma?
Tumor in adrenal medulla that is releasing increases NE and Epi
95
What does ADR mean?
Adverse drug Rx
96
What is the ADR for alpha blockers? Eyes, nose and circulation
Miosis, nasal congestion, orthostatic hypotension
97
``` Why are beta blockers given for these conditions? HTN CHF arrhythmia Angina Post MI Glaucoma ```
HTN-lower HR CHF- lower HR Arrhythmia-usually cause tachycardia does lower HR Angina-decrease workload on heart by lowering HR Post MI-decrease workload on heart by lowering HR Glaucoma-decrease ciliary processes making aqueous humor
98
How are migraines usually caused? Why does a beta blocker help?
Migraines happen with vasodilation A beta 2 blocker can cause vasoconstriction
99
What is timolol(Timoptic)? What is it used for?
Non-selective beta blocker Decreases secretion for glaucoma
100
What is metoprolol(Lopressor)?
Beta 1 selective blocker
101
What is atenolol(Tenormin)?
Beta 1 selective blocker
102
What is propanolol(Inderal)? Why shouldn’t it be used on asthmatic pt?
Non selective beta blocker Beta blocker can constrict bronchioles
103
What would be the DOC for anaphylaxis?
Epinephrine
104
What would be the class DOC for BPH?
Alpha blocker (tamulosin or doxizosin)
105
What is alpha 2 receptors found? What is their function?
Post ganglionic neurons Regulate NE
106
What do cholinergic drugs do?
Drugs that increase parasympathetic system
107
What effect does a muscarinic(direct) drug do?
Muscarinic agonist
108
What does a anticholinesterase(indirect) do? What is another name for these drugs?
Blocks AChase enzyme to increase ACh in synapse Also called acetylcholinesterase inhibitor
109
What is an anticholinergic drug? What is the prototype?
Muscarinic antagonist Atropine
110
What are the ADR for cholinergics? What is the acronym?
SLUDGE ``` SALIVATION LACRIMATION URINATION DEFECATION GI cramps EMESIS ```
111
What is absorption in pharmacokinetics?
Movement of drugs from GI tract...to portal circulation....to liver....to systemic circulation
112
How does lipid solubility effect absorption?
Hydrophobic drugs get absorbed faster
113
How does ionization effect absorption?
Unionized drugs (drugs without a charge) are absorbed faster
114
How does drug formulation effect absorption?
The small the drug or more surface area of the drug the fast it absorbes
115
What is distribution in pharmacokinetics?
Drug moving to various organs and tissues of the body
116
How does plasma protein binding effect distribution of drugs?
Drug can bind to protein (albumin) and get delivered faster thru the body
117
How does blood flow effect distribution of drugs?
Blood mainly moves to three specific organs - liver - kidneys - brain
118
How does the BBB effect distribution of drugs?
Only drugs that are hydrophobic can cross the BBB
119
Why do schedule 1 drugs usually stay in the brain?
Because they are extremely hydrophobic
120
What makes the BBB?
Foot processes of astrocytes
121
What is an influx transporter?
Transporter that allows a drug into the cell
122
What is an effluent transporter?
A drug that removes a drug out of the cell
123
What often makes a compound hydrophobic?
Hydrocarbons
124
What organ is most important for metabolism?
Liver
125
What is metabolism in pharmacokinetics?
Break down of drugs
126
What is the most important organ for excretion?
Kidney
127
What does enzyme induction mean?
Increase in enzyme activity or numbers
128
What does enzyme inhibition mean?
Decrease in enzyme activity or numbers
129
What things are more excretable? What things are more absorbable? Hydrophobic drugs or hydrophilic drugs?
Excreted often: hydrophilic Absorbed often: hydrophobic
130
What is P450? Where is it found and in what organ?
Enzyme that breaks down drugs Found inside SER of hepatocytes
131
What is the formula for bioavailability?
F= Fg* Fh Fg=percent absorbed into blood from gut Fh=percent of drugs that escapes liver and goes into circulation
132
How are drugs removed from saliva or breast milk?
Drugs can leave through lactation and lacrimation
133
Where does metabolism of drugs most often happen?
Liver
134
What are the FDA pregnancy categories? Which categories are safe for pregnant women?
A category to show which drugs are safe to take while pregnant Drugs closer to A are safe to take during pregnancy X category drugs you should not take during pregnancy
135
What increases tolerance of a drug? (Hint: enzymes and receptors)
Enzyme induction-increasing enzymes to decrease how long drug stays Down regulation-decreasing receptors for the drug
136
How is dependence of a drug increased?
Psychological (addiction) Physical (withdrawal)
137
What are the 6 rights?
``` Right patient Right dose Right drug Right route Right time Right documentation ``` Patients Do Drugs Round The Day
138
What is pharmacotherapeutics?
The principles of drug actions
139
What is palliative therapy? When is it usually used?
Therapy that provides relief from pain and stress Usually used during end stage of illnesses
140
What is prophylactic therapy? When is it usually used?
Therapy that provides preventative care Usually used when a pt is about to go into surgery to prevent post infections
141
What is empiric therapy?
Therapy used for non-definitive conditions. Like using broad spectrum antibiotics
142
What is an Nn receptor?
N2 receptor
143
What is an Nm receptor?
An N1 receptor
144
What is bladder atony?
Bladder isnt contracting to help you pee due to detrusor muscle not contracting
145
What is postoperative ileus?
Little to no peristalsis after surgery due to general anesthesia
146
What is urinary retention?
Can’t pee
147
What are the two types of cholinergic drugs? (Direct and indirect)
Direct= muscarinic agonists Indirect=anticholinesterase (acetylcholinesterase inhibitors)
148
What are anticholinergics?
Muscarinic antagonists/blockers
149
What do ganglionic stimulants or blockers effect?
N2 receptors
150
What do neuromuscular blockers or muscle relaxants effect?
N1 receptors
151
What is the acronym to know what cholinergics causes or effects?
SLUDGE Salivation, Lacrimation, Urination, Defecation, GI cramps, Emesis DUMBELS Defecation, urination, Miosis, bronchospasm, emesis, lacrimation, salivation
152
What helps drain aqueous humor fluid better, pupil dilation or contraction?
Pupil contraction/miosis
153
What is pilocarpine(Pilocar)? What is it used for?
Muscarinic agonist Used for glaucoma -because it helps cause miosis to drain aqueous humor
154
Why is cholinergics used for urinary retention and postoperative ileus?
Because cholinergics increase peristalsis and increase flow of urine
155
What receptor is found on ciliary muscle s to cause them to contract?
Muscarinic receptors
156
If a lens is flat an object is close or far away?
Object is far away
157
What is edrophonium(Tensilon)? What is it indicated for? Why is it used? What route is it given?
Anticholinesterase (decreases amount of AChase) Indicated for Myasthenia Gravis Used to Dx MG Route: IV
158
What is Pyridostigmine(Mestinon)? What is it indicated for? What does it do for the indication? What can an overdose cause!
Anticholinesterase Indicated for Myasthenia Gravis Tx for MG Overdose can cause spastic paralysis
159
What neurotransmitter is in charge of Memory and learning in the brain?
ACh
160
What is Donepezil(Aricept)? What is it’s indication? What are common side effects?
Central acting Anticholinesterase drugs Indication for Alzheimer’s disease N/V and diarrhea
161
Why can Central acting anticholinesterase drugs cause - nausea - vomiting - diarrhea
N/V occur when too much ACh is in the brain Diarrhea is caused because anticholinesterase increase parasympathetic system
162
What is Malathion or Parathion? Why are they deadly?
They are poisons because they are irreversible AChase inhibitors
163
Why is bronchoconstriction a Sx of ADE of cholinergics?
Because cholinergics increase parasympathetic system
164
Why is muscle tremors a Sx of ADE of cholinergics?
Because cholinergics increase the amount of ACh in the NMJ
165
Why is bradycardia and hypotension a Sx of ADE of cholinergics?
Because of the parasympathetic decreasing HR and strength of contraction
166
Why are GI cramps a effect of cholinergic overdose?
Because of increased peristaltic movements
167
What is a belladonna plant(deadly nightshade)?
Anticholinergic drug that causes severe pupil dilation
168
What do anticholinergic drugs usually end in?
-ine
169
What are anticholinergics? What do they do?
Decrease parasympathetic
170
What is ipratropium(Atrovent)? What is its indication? MOA? How is it given?
Anticholinergic Indication for COPD or asthma MOA: bronchodilator and decreases saliva Given thru MDI
171
What is oxybutinin(Ditropan)? What is it indicated for? MOA?
Anticholinergic Indicated for overactive bladder and incontinence MOA: decreases excretion
172
What is solifenacin(Vesicare)? What receptor does it react with? What is it indicated for? MOA?
Anticholinergic M-3 antagonist Indicated for overactive bladder and incontinence MOA: decreases bladder tone and contractions
173
How does stimulation of receptor M3 effect the bladder?
Causes contractions and increases bladder tone
174
What is glycopyrrolate(Robinul)? What is it indicated for? MOA?
Anticholinergic Indicated for IBS-D Decreases peristalsis
175
How do anticholinergics decrease N/V?
Anticholinergics decrease levels of ACh
176
How can anticholinergics effect a cardiac arrest pt?
They can increase HR
177
What is Scopolamine(transderm scoop)? What is it indicated for?
Anticholinergic Indicated for motion sickness
178
Why should you never use anticholinergics with a glaucoma pt?
Because the decrease in parasympathetic system can increase the sympathetic system...causing mydriasis and increasing IOP
179
What is the rhyme used to know if someone is overdosing on anticholinergics?
Can’t see Can’t pee Can’t spit Can’t sh*t(defecate)

Pharmacology (27 decks)

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