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Pharmacology > Test #3 Insulins, Heparin, PCN, etc. > Flashcards

Test #3 Insulins, Heparin, PCN, etc. Flashcards

1
Q

Synthetic Human Insulin is produced either by..

A

Recombinant DNA synthesis of human insulin, conversion of pig to human insulin

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2
Q

Metformin does not play a role in which type of diabetes?

A

Type 1 Diabetes

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3
Q

What is the broad classification for heparin?

A

agents used to treat cardiovascular disorders

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4
Q

What is the specific classification for heparin?

A

agents affecting blood clotting

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5
Q

What type of syringe do you use to administer heparin?

A

TB syringe

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6
Q

A heparin injection may not exceed ___

A

1 mL

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7
Q

When giving SQ, do not round, leave in the __ place.

A

hundredths

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8
Q

How many strengths does heparin come in?

A

variety of strengths

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9
Q

Older versions of insulin originate from?

A

Cow/Pig

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10
Q

Type 1 Diabetes means?

A

Insulin dependent or juvenile onset (IDDM)

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11
Q

Type 2 Diabetes means?

A

Non-insulin dependent (NIDDM)

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12
Q

TX for Type 1 Diabetes…

A

with insulin subq. injection the entire life, failure to make insulin by pancreas.

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13
Q

TX for Type 2 Diabetes…

A

with oral hypoglycemic agents & insulin injections (ex. metformin & insulin inj)

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14
Q

What does lipodystrophy mean?

A

tissue damage

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15
Q

Drugs that affect the blood sugar?

A

steroids, beta blockers, aspirin, alcohol, asthma medications

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16
Q

What is hypoglycemia?

A

Blood glucose is too low <60 mg/dL

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17
Q

Hypoglycemia is produced from…

A
  • skipped/irregularly scheduled meals
  • excessive exercise ( ^ rate of insulin absorbed)
  • Insulin administration errors
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18
Q

If a patient is having signs of hypoglycemia, what do you do first? why?

A

Give glucose (FOOD) first, because you can always bring blood sugar back down

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19
Q

What are the S/S of hypoglycemia?

A
  • sweating
  • confusion
  • tachycardia
  • HA
  • excessive hunger
  • weakness
  • poor muscle control
  • emotional instability
  • coma & death
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20
Q

TX for hypoglycemia?

A

Glucose by mouth, but if you can’t & need something faster, you may give Glucagon (IM, IV, SQ), IV dextrose 50% aka D50W

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21
Q

What is glucagon?

A

this is what you give when glucose is gone (severe)

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22
Q

What are the side effects of insulin?

A

allergic reactions
lipodystrophy
insulin resistance

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23
Q

What has to be going on in the body in order to give oral hypoglycemics?

A

has to be producing some insulin

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24
Q

Oral hypoglycemics are used to treat ___ & requires ___ production.

A

Type 2 diabetes; endogenous insulin resistance

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25
Q

What factors reduce renal function with oral hypoglycemics?

A
  • increase risk of toxic accumulation & lactic acidosis

- monitor creatinine & other renal labs

26
Q

Anything that reduces renal function can cause an accumulation of ___ in the ___ & can cause ___

A

metformin; liver; lactic acidosis

27
Q

Heparin is a blood thinner, so it treats? What is it?

A

Thromboemboli - little fats in blood vessels

28
Q

What does heparin inhibit? What does it do to existing clots & new clots?

A

Inhibits clotting process (formation)

-it does not reverse existing clots, it just keeps from getting more clots

29
Q

What is heparin’s mechanism of action?

A

Interferes with clotting mechanism and blocks clotting cascade

30
Q

How is heparin destroyed?

A

PO

31
Q

What routes can you give heparin in?

A

SQ, IV infusion (No IM injections)

32
Q

What patients do you not give heparin to?

A

Coagulation disorders

33
Q

When giving heparin, you should monitor ___

A

PTT & other labs

34
Q

What does PTT stand for? What is it?

A

Partial thromboplastin time; it is a lab used to evaluate heparin therapy, it shows how long it takes a patient’s blood to clot in order to know how much heparin to give.

35
Q

PTT is measured in?

A

Seconds

36
Q

Normal range of PTT for adults?

A

25-35 seconds

37
Q

The normal PTT target to heparin therapy are usually…?

A

1.5 to 2.0 times the control values

38
Q

Client should be closely monitored with what drug?

A

Coumadin (warfarin)

39
Q

What does coumadin inhibit & how?

A

blood clotting by interfering w/ the synthesis of Vit K dependent clotting factors

40
Q

Dosage for Coumadin is ____

A

individualized

41
Q

How long does it take for Coumadin to be effective?

A

2-3 days lag time

42
Q

What is a PT/international normalized ratio (used w/ coumadin)?

A

PT (prothamin) a lab used to evaluate a patient’s therapy to coumadin, measured in seconds, it is the time it takes for prothamin (clotting factor) to work

43
Q

What is the normal range for PT in adults?

A

11 - 12.5 seconds

44
Q

What is the target for a patient on coumadin?

A

1.5 to 2.0 times higher than normal values

45
Q

How does the immune system work?

A

it responds to foreign agents (antigen), it forms antibodies, it recognizes & destroys antigen, reasons for an allergic reaction is an overaggressive antibody reaction)

46
Q

What are the two types of immunity?

A

Active immunity & Passive immunity

47
Q

What is active immunity?

A

administration of an antigen, a weakened/killed vaccine, stimulates (revs up) your immune system to form antibodies against disease, lasts for many years. (ex. HepB Vaccine)

48
Q

What is passive immunity?

A

administration of preformed antibodies, provides instant protection, short duration

49
Q

Where is zofran stored?

A

in the GI tract, mostly on dopamine & serontonin receptors

50
Q

Zofran helps with ___ but does not keep you from ___

A

Nausea ; vomiting

51
Q

How does zofran help with nausea?

A

it blocks the receptor in the CNS

52
Q

What are some factors that can lead to infection?

A
  • Age (young/elderly)
  • ^ exposure to pathogenic organisms
  • disruption of normal barriers
  • inadequate immunological defenses
  • impaired circulation
  • poor nutritional status
53
Q

Sources of infection?

A
  • bacteria
  • fungal
  • viruses
54
Q

What are the 3 organisms resistant to antibiotics?

A
  • MRSA/VRSA
  • VRE
  • ORSA
  • C-diff
55
Q

What does MRSA/VRSA, VRE, ORSA stand for?

A
  • Methicillin or Vancomycin resistant staph aureus
  • Vancomycin resistant enterococcus
  • Oxacillin resistant staph aureus
56
Q

Antimicrobial agents are classified based on the following factors…

A
  • Bactericidal or bacteriostatic
  • Site of action
  • Narrow or Broad spectrum
  • Adverse effects
57
Q

What are the different antimicrobial classes?

A
  • Sulfonamides
  • PCN
  • Cephalosporins
  • Tetracyclines
  • Macrolides
  • Aminoglycosides
  • Fluoroquinolones
  • Carbapenem
  • Ketolides
58
Q

What is PCN derived from?

A

Fungus & Mold

59
Q

Together with Cephalosporins, PCN is considered a large group called ____

A

Beta-Lactam Antibotics

60
Q

What is the action of PCN?

A

Inhibits synthesis of bacterial cell wall

  • most effective on newly forming or actively growing cell walls
  • some are rapidly destroyed in stomach
61
Q

What routes is PCN given in?

A

PO, IM, IV

Pharmacology (8 decks)

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