All Pharm Final Review

Front 1

Which type of receptor binding results in an increased heart rate, force of contraction, and conduction velocity?

Back 1

Beta1

Front 2

Which of the following explains the principle of elimination?

Back 2

Excretion by the liver into bile

Front 3

Why is a person with hepatitis more likely to suffer from drug toxicity?

Back 3

Detoxification of drugs occurs in the liver.

Front 4

__________ are used to mimic the actions of the sympathetic nervous system.

Back 4

Catecholamines

Front 5

Before administering nitroglycerin you note your chest pain patient to be hypotensive, tachycardic, and weak. These signs and symptoms are examples of

Back 5

contraindications

Front 6

Norepinephrine is the primary neurotransmitter for which of the following?

Back 6

Sympathetic nervous system, post-ganglionic neurons

Front 7

The purpose of a neurotransmitter is

Back 7

to allow transmission of an impulse across the synapse.

Front 8

After administering nitroglycerin to a patient with chest pain, you should be most concerned by which of the following developments?

Back 8

Hypotension

Front 9

Overstimulation of the vagus nerve will mimic the effects of which class of medications?

Back 9

Parasympathomimetics

Front 10

Which of the following would be an example of a contraindication of an antihypertensive agent?

Back 10

Hypotension

Front 11

__________ is how drugs are delivered to and removed from affected organs, including how drugs are processed in the body through absorption, distribution, metabolism and excretion.

Back 11

Pharmacokinetics

Front 12

Overstimulation of the vagus nerve will mimic the effects of which class of medications?

Back 12

Parasympathomimetics

Front 13

A patient on an ACE Inhibitor and Beta-Blocker likely has

Back 13

hypertension

Front 14

Which of the following classes of medications prevents thrombi by interrupting the clotting cascade?

Back 14

Anticoagulants

Front 15

Your 63 year old patient has a history of cardiac arrhythmia and hypertension. She is dizzy and is seeing "yellow halos." She takes digoxin (an antiarrhythmic) and metoprolol (a Beta-Blocker) and was recently diagnosed with renal failure. Her vital signs are: HR 48 with second degree, type 2 AV block; BP 108/64; and R 18. What is the likely cause of her symptoms?

Back 15

The patient's renal failure makes her susceptible to "dig toxicity" due to decreased renal filtration.

Front 16

Organophosphate Poisoning causes the inhibition of acetylcholinesterase (AChE), an accumulation of acetylcholine (ACh), and profound parasympathetic effects. What class of drugs would be used to reverse these effects?

Back 16

Anticholinergics

Front 17

Norepinephrine is the primary neurotransmitter for which of the following?

Back 17

Sympathetic nervous system, post-ganglionic neurons

Front 18

Which type of receptor binding results in increased heart rate, force of contraction and conduction velocity?

Back 18

Beta1

Front 19

The purpose of a neurotransmitter is

Back 19

to allow transmission of an impulse across the synapse.

Front 20

You respond to a call for a "person down." Upon arrival, you find your patient sitting on the floor. He is weak and confused, and is suffering from altered mental status. His vital signs are: HR 36, BP 80/56, and R 20. You should administer medication from which class of drug?

Back 20

Parasympatholytics

Front 21

Which of the following procedures is an acceptable method for sterilization of medical equipment?

Back 21

Apply pressurized steam

Front 22

In accordance with your local protocols, you should frequently inspect your ambulance's medication supply. When performing this task, you should

Back 22

make sure the appropriate supplies are available to prepare and administer every medication in the formulary.

Front 23

What four drugs are currently approved for endotracheal administration within the ICEMA region?

Back 23

None

Front 24

In regard to medication administration, what is a contraindication?

Back 24

A contraindication is a reason a drug should not be administered.

Front 25

Why is it important to dispose of needles in a sharps container?

Back 25

Sharps containers are specially designed with rigid sides to keep needles from piercing the container.

Front 26

What is the difference between an IV/IO bolus and an IV/IO infusion?

Back 26

A bolus is a concentrated dose given relatively quickly, while an infusion is a slow, continuous administration over a longer time frame.

Front 27

Which of the following items used in medication administration is NOT likely to have an expiration date?

Back 27

Syringes

Front 28

_________ drugs need to be accounted for at the beginning and end of your shift, and should be kept secure throughout your shift.

Back 28

Narcotic

Front 29

What is the FIRST step you should take before administering a medication via an IV bolus?

Back 29

Ask the patient about known allergies.

Front 30

When obtaining IV access, what step should you perform IMMEDIATELY before removing the stylette from the entry site?

Back 30

Occlude the vein proximal to the catheter.

Front 31

What is a receptor?

Back 31

Specialized protein that combines with a drug, resulting in a biochemical effect

Front 32

What does affinity mean?

Back 32

force of attraction between a drug and a receptor

Front 33

What is efficacy?

Back 33

A drugs ability to cause the expected response

Front 34

Mechanism of action

Back 34

How a drug works

Front 35

Proteins present on cell membrane to which a drug must bind in order to elicit a desired response

Back 35

Drug receptor

Front 36

Classifications of receptors:

Back 36

˗ Agonist: shows affinity, enhances functionality of a receptor
˗ Antagonist: can compete for a receptor site, keeps a response from occurring
o Competitive
o Noncompetitive (inhibits response reguardless)

Front 37

The power a drug has to produce a therapeutic effect; process of change that occurs as a result of the drug binding to the receptor

Back 37

Efficacy

Front 38

• Agonist

Back 38

affinity and efficacy

Front 40

Relative amount of drug required to produce the desired response

Back 40

Drug Potency

Front 41

How receptors bind:

Back 41

• Ionic bonds (chemical where ions are transferred from one to another)
• Hydrogen bonds (share a common hydrogen ion between molecules)
• Hydrophobic bonds (nonpolar bonds)
• Van de Waals forces (transient weak electrical action one atom for another that allows molecule to change its shape)
• Covalent bonds (chemical bonds by sharing pairs of electrons)

Front 42

Several drugs may bind to the same receptor site creating different responses
2 main functions:
˗ Ligand binding: bond part of a larger molecule
˗ Message propagation: process by which chemical or electrical impulses spread from one part of the body to the other

Back 42

Several drugs may bind to the same receptor site creating different responses
2 main functions:
˗ Ligand binding: bond part of a larger molecule
˗ Message propagation: process by which chemical or electrical impulses spread from one part of the body to the other

Front 43

each drug contributes to the response of the cell and the result is cumulative

Back 43

Additive

Front 44

overall effect if greater than the sum of the individual drugs effects

Back 44

Synergistic

Front 45

Response that cancel each other out and no response is greater than the other resulting in cell inhibition rather than cell activation

Back 45

Inhibitory

Front 46

specialized chemicals that conduct impulses between nerve cells or between a nerve cell and an organ

Back 46

Neurotransmitters

Front 47

˗ Adrenergic receptors:

Back 47

o Alpha 1: peripheral vasoconstriction, increase contractile force, positive inotropic effect, decrease heart rate (negative chronotropic effect)
o Alpha 2: peripheral vasoconstriction, limits the release of norepinepherine
o Beta 1: increased heart rate, positive chronotropic effect, increased contractile force (positive inotropic effect), increase automaticity (dromotropic)
o Beta 2: peripheral vasodilation, bronchodilation, smooth uterine relaxant, GI muscle relaxant

Front 48

˗ Dopaminergic receptors

Back 48

o Renal and vasal dilation
o Mesenteric vasodilation

Front 49

Beta blockers: -olol

Antihyperlipidemics: -statin

ACE inhibitors: -pril

Calcium channel blocker: -ipines

Opiods: -ine, -one

Back 49

Beta blockers: -olol

Antihyperlipidemics: -statin

ACE inhibitors: -pril

Calcium channel blocker: -ipines

Opiods: -ine, -one

Front 50

The study of drugs

Back 50

Pharmacology

Front 51

Explores how drugs are delivered to, and removed from, affected organs. Includes how drugs are processed in the body through absorption, distribution, metabolism, and excretion.

Back 51

Pharmacokinetics

Front 52

The most important considerations in the pharmacokinetic process are the..

Back 52

Molecular size and shape, Solubility, ability to bind to tissue proteins, and how much a drug is ionized.

Front 53

Describes how readily or easily the drug is able to combine with substances such as water or oil.

Back 53

Solubility

Front 54

Describes how much of a drug has been altered through the gain or loss of electrically charged particles

Back 54

Ionization

Front 55

Ionizing a drug changes it into a

Back 55

Metabolite

Front 56

Studies how drugs interact with the living tissues in the body

Back 56

Pharmacodynamics

Front 57

A term used to describe a substance added to a drug preparation to provide for or enhance delivery of the drug to the body tissues.

Back 57

Vehicle

Front 58

How can drugs enter the body

Back 58

Ingestion, injection, absorption, and inhalation

Front 59

This route introduces drugs to the body by swallowing or eating, so the drug enters the bloodstream by absorption from the gastrointestinal (GI) tract.

Back 59

Ingestion

Front 60

Drugs sometimes receive a special coating to ensure absorption from a specific location within the GI tract.

Back 60

True

Front 61

A special coating around a drug to ensure it does not break down in the stomach

Back 61

Enteric Coating

Front 62

This route involves placing a medication through the skin into an underlying structure such as the vascular system, muscle, bone, organ, joint, or other tissue or structure.

Back 62

Injection

Front 63

The process of handling medications that require the maintaining of sterility

Back 63

Asepsis

Front 64

This route occurs when a medication moves through the skin or mucous membrane into the body cells, tissues, organs, and structures underneath.

Back 64

Absorption

Front 65

This route occurs when a drug is inhaled into and absorbed from the lung.

Back 65

Inhalation

Front 66

Medication routes can be classified into one of two categories

Back 66

Enteral or Parenteral

Front 67

Brings a drug into the body via the gastrointestinal tract. Any drug introduced via the mouth, rectum, or anywhere in-between.

Back 67

Enteral Route

Front 68

Drugs through Enteral Routes usually pass through the _____ and _____ prior to reaching their target tissue.

Back 68

Liver; Lungs

Front 69

oral, buccal (cheek), sublingual (under the tongue), direct introduction of a drug into any portion of the GI tract (nasogastric or orogastrict, or rectal.

Back 69

Enteral Routes

Front 70

Drugs introduced into any other part of the body are following the ______ _____ and include intravenous, intraosseous (into the bone), intrathecal (into the spinal cord canal), intramuscular, intradermal (into the skin), subcutaneous (under the skin, above the muscle), or absorbed topically through the skin, vagina, nose, eye, ear, or respiratory system.

Back 70

Parenteral Route

Front 71

Describes the rate at which a drug leaves the site of administration and how readily this process occurs.

Back 71

Absorption

Front 72

Fastest Routes of Absorption

Back 72

Intravenous, Intraosseous, and Intra-arterial

Front 73

Very Rapid Routes of Absorption

Back 73

Nebulized, Intrathecal (spine), Intramuscular, and Sublingual

Front 74

Rapid Routes of Absorption

Back 74

Subcutaneous, Intradermal, intraocular, Intraocular, Intranasal, rectal

Front 75

Slower Routes of Absorption

Back 75

Buccal, Nasogastric, Orogastric, Intraotic, Topical, Oral

Front 76

Drugs the prevent, treat, or suppress irregular heart rhythms

Back 76

Antidysrhythmic

Front 77

Drugs that stimulate the sympathetic nervous system, directly affecting the cardiovascular and respiratory systems

Back 77

Catecholamine/Sympathomimetic

Front 78

Drugs that cause constriction of the vascular system

Back 78

Inotrope

Front 79

Drugs that affect the cardiac and vascular systems by blocking the calcium ion

Back 79

Calcium Channel Blocker

Front 80

Drugs that block the parasympathetic nervous system, particularly the vagus nerve, which results in an effect similar to sympathetic stimulation

Back 80

Parasympatholytic

Front 81

Drugs that provide needed ions and minerals or, by their presence, block other ions or minerals

Back 81

Mineral/Electrolytes

Front 82

Drugs that promote positive endocrine and metabolic functions

Back 82

Endocrine/Metabolic Enhancing Agent

Front 83

Drugs that control pain and or suppress the nervous system

Back 83

Analgesics

Front 84

Drugs that stop or prevent allergic reactions, including anaphylactic shock

Back 84

Anaphylaxis

Front 85

Drugs that decrease uncomfortable sensations by inhibiting nerve function

Back 85

Anesthetics

Front 86

Drugs that stop anginal discomfort and pain by improving oxygenation of affected tissues

Back 86

Antianginal Agent

Front 87

Drugs that interfere with the clotting mechanisms at various points in the pathway

Back 87

Anticoagulant

Front 88

Drugs that stop or prevent seizure activity

Back 88

Anticonvulsants

Front 89

Drugs that stop or suppress vomitting

Back 89

Antiemetic

Front 90

Drugs that maintain blood pressure at near normal values through a variety of actions

Back 90

Antihypertensives

Front 91

Drugs that treat low blood sugar levels

Back 91

Antihypoglycemics

Front 92

Drugs that interfere with the platelet portion of the blood clotting mechanism

Back 92

Antiplatelet Agents

Front 93

Drugs to treat or counteract poisonings and other toxicologic emergencies

Back 93

Antitoxicologics

Front 94

Drugs that block beta receptors of the sympathetic nervous system

Back 94

BETA Blockers

Front 95

Drugs that promote diuresis (urine) production and/or excretion

Back 95

Diuretics

Front 96

Drugs used to stop blood clots from forming or enlarging or that aid in destroying clots that have been formed

Back 96

Fibrinolytics

Front 97

Drugs used to bind or eliminate toxic substances that are ingested

Back 97

Gastric Decontaminants

Front 98

Drugs used to promote a comatose or unconscious state for the purposes of performing medical procedures or controlling pain and discomfort

Back 98

Induction Agents

Front 99

Drugs that compete for narcotic or benzodiazepine receptors in order to antagonize (block) their effects

Back 99

Narcotic and Benzodiazepine Antagonists

Front 100

Drugs used to dry up mucous membranes to improve breathing

Back 100

Nasal Decongestants

Front 101

Drugs used to relax the patient or place them in an altered state of consciousness

Back 101

Neuroleptics

Front 102

Drugs that block ACH receptors, resulting in temporary paralysis of muscles to facilitate the performance of medical procedures like orotracheal intubation

Back 102

Paralytics

Front 103

Drugs given following the delivery of a baby to assist the mother in recovery

Back 103

Postpartum Agents

Front 104

Drugs used to treat respiratory emergencies. In the prehospital setting, this often means medications used to stop a problem (rescue) via bronchodilation versus preventing a problem from starting

Back 104

Respiratory Agents

Front 105

Drugs used to treat inflammation through inhibition of immune system responses. Drugs used to suppress immune system responses in the case of allergies.

Back 105

Steroids

Front 106

Drugs used to suppress premature labor

Back 106

Tocolytics

Front 107

Drugs used to control hypotension by causing vasoconstriction

Back 107

Vasopressors

Front 108

Drugs used as supplemental therapy of naturally occurring vitamins or minerals to enhance or regulate metabolism or other functions

Back 108

Vitamins and Electrolytes

Front 109

H's

Back 109

Hypovolemia
Hypoxia
Hydrogen ions (Acidosis)
Hyperkalemia or Hypokalemia
Hypothermia
Hypoglycemia or Hyperglycemia

Front 110

T's

Back 110

Toxins
Cardiac Tamponade
Tension pneumothorax
Thrombosis (Myocardial infarction)
Thromboembolism (Pulmonary embolism)
Trauma

Front 111

Six rights (More) of Drug administration

Back 111

- Right person
- Right drug
- Right dose
- Right time
- Right route
- Right Documentation
- Right Technique
- Right Circumstances
- Right Indication
- No Allergies

Front 112

DICCE

Back 112

Drug
Integrity
Clarity/Concentration
Expiration Date

Front 113

Absorbed through the skin at a slow rate

Back 113

Transdermal

Front 114

Kinds of Parenteral Drug Containers

Back 114

Glass ampoules
Single and Multidose vials
Nonconstituted syringes
Prefilled syringes
Intravenous medication fluids

Front 115

Information of Drug Labels

Back 115

Name of Med
Exp date
Total dose and concentration

Front 116

Subcutaneous Injection

Back 116

45 Degree
1cc Max Fluid

Areas:
Deltoids
Upper Abdominis Rectus
Thigh

Gauge:
22 and above

Front 117

Intramuscular

Back 117

90 Degree Angle

Max: 5cc in on IM

Area:
Delotid
Dorsal gluteal
Vastus lateralis
Rectus Femoris

Gauge:
20 gauge or below, 18; meds and size of patient; inch to inch and a half

Front 118

Central Venous Access

Back 118

Veins located deep in the body
Internal jugular, subclavian, femoral

Front 119

I/O

Back 119

Distal Femur
Medial Malleoulus
Tibial Tuberosity
Humerus

Pediatric First Line I/O

Complication
Fracture
Infiltration
Growth plate damage
Complete insertion
PE
Infections
Thrombophlebitis
Air Embolism
Circulatory overload
Allergic reaction


Contrainidcitaion
Fractures to tibia or femur on side of access
Ostegogenses imperfect
Congenial bone diseas resuling in fragile bones