Exam 1 Pharm

Front 1

Adverse effect

Back 1

A general term for any undesirable effects that are a direct response of one or more drugs

Front 2

Allergic reaction

Back 2

An immunologic hypersensitivity of a patient to a particular medication, a type of adverse drug effect

Front 3

Bioavailability

Back 3

A measure of the extent of drug absorption for a given drug and route from 0 to 100%

Front 4

Contraindication

Back 4

Any condition, especially one related to a disease state or patient characteristic, including current or recent drug therapy, which renders a particular form of treatment improper or undesirable

Front 5

Drug accumulation

Back 5

Occurs when the dosage in the body surpasses the amount that the body can get rid of through metabolism and excretion

Front 6

Drug interactions

Back 6

Alteration in the pharmacologic or pharmacokinetic activity of a given drug caused by the presence of one or more additional drugs; it is usually related to the effects on the enzymes required for metabolism of the involved drugs

Front 7

Efficacy

Back 7

How well a drug produces its effect

Front 8

Half life

Back 8

In pharmacokinetics, the time required for half of an administered dose of a drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%

Front 9

Idiosyncratic response

Back 9

An abnormal or unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient

Front 10

Pharmacokinetics

Back 10

The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body pharmacokinetics include the drug absorption, distribution, metabolism, and excretion

Front 11

Potency

Back 11

The amount of drug that must be given to produce a response

Front 12

Precautions

Back 12

Situation is one of the drug is given, it has to be used with very careful

Front 13

Steady state

Back 13

The physiologic state in which the amount of drugs removed via elimination is equal to the amount of drug absorbed with each dose

Front 14

Tolerance

Back 14

Reduced response to a drug after prolong do use

Front 15

Acetylcholine

Back 15

The neurotransmitter responsible for the transmission of nerve impulses to effector cells in the parasympathetic nervous system

Front 16

Adrenergic agonist

Back 16

Drugs that stimulate and mimic the actions of sympathetic nervous system neurotransmitters norepinephrine, epinephrine, and dopamine. Also called sympathomimetics.

Front 17

Alpha adrenergic receptor

Back 17

A class of adrenergic receptors that are further subdivided into alpha-1 and alpha-2 adrenergic receptors

Front 18

Agonist

Back 18

Drugs with a specific receptor affinity that mimic the body’s natural chemicals, like hormones and neurotransmitters

Front 19

Antagonist

Back 19

Drugs that bind to specific receptors and inhibit or block the response of the receptors

Front 20

Autonomic

Back 20

Involuntary or unconscious; autonomic nervous system does things like breathing or controlling heart rate without you having to thank

Front 21

Beta adrenergic receptor

Back 21

Receptors located on postsynaptic cells that are stimulated by specific autonomic nerve fibers. Beta-1 adrenergic receptors are located primarily in the heart where is beta-2 adrenergic receptors are located in the smooth muscle fibers of the bronchioles, arterioles, and visceral organs

Front 22

Cholinergic agonist

Back 22

Drugs that mimic the effects of acetylcholine and can stimulate cholinergic receptors, either directly or indirectly. Also called parasympathomimetic.

Front 23

Cholinergic antagonist

Back 23

Drugs that block the action of acetylcholine and substances similar to acetylcholine at receptor sites in the synapse

Front 24

Chronotropic effect

Back 24

Modifies the heart rate. Positive effect increases heart rate while negative effect decreases heart rate

Front 25

Dromotropic effect

Back 25

Affects the speed of conduction of cardiac electrical nerve impulses through the atrioventricular node. Positive effect increases speed while negative effect decreases speed

Front 26

Inotropic effect

Back 26

Modifies the force or speed of contraction of muscles. Positive effect increases force/speed while negative effect decreases

Front 27

Muscarinic receptors

Back 27

Cholinergic receptors located postsynaptically in the effector organs such as smooth muscle, cardiac muscles, and glands supplied by the parasympathetic nerve fibers

Front 28

Nicotinic receptors

Back 28

Cholinergic receptors located in the ganglia of both parasympathetic nervous system and the sympathetic nervous system

Front 29

Parasympatholytic

Back 29

Drugs that reduce the activity of the parasympathetic nervous system; also called anti-cholinergics

Front 30

Sympathomimetic

Back 30

Drugs that mimic the sympathetic nervous system, also referred to as adrenergic agonist drugs

Front 31

Vasoconstrict

Back 31

The narrowing or constriction of blood vessels by small muscles in their walls; increases blood pressure

Front 32

Vasodilate

Back 32

The widening of blood vessels usually near the surface of the skin, which leads to increased blood flow and decreased blood pressure

Front 33

What are the five parts of the nursing process?

Back 33

Assessment

human needs statement

planning with outcome identification

implementation including patient education

evaluation

Front 34

What are the nine rights of medication administration?

Back 34

Right drug

Right dose

Right time

Right route and form

Right patient

Right documentation

Right reason or Indication

Right response

Right to refuse

Front 35

What are the three types of drug names?

Back 35

Chemical, generic, and trade

Front 36

What lab values assess drug impact on the liver, kidney, and hematologic?

Back 36

Liver - AST, ALT

Kidney - Creatinine, creatinine clearance, BUN

Hematologic - Hematocrit, hemoglobin, WBC’s, and platelets (CBC)

Front 37

What are the four steps of pharmacokinetics?

Back 37

Absorption

Distribution

Metabolism

Excretion

Front 38

What can affect absorption rate?

Back 38

Route of administration, solubility and concentration of the drug, circulation to the area, surface conditions, contact time, PH at the absorption site, cell membrane transport mechanisms

Front 39

What does the distribution rate depend on?

Back 39

Blood flow (more blood flow = faster distribution), affinity to the body tissue, and protein binding affect

Front 40

What is protein binding?

Back 40

When a drug enters the circulatory system and is distributed all over the body, organs start to metabolize in excrete the drug through the liver and kidneys. Most of the drug is bound to a protein, like albumin, making it pharmacologically inactive, while a limited portion of the drug stays unbound and pharmacologically active. This is because when the drug is bound to a protein, it is usually too large to fit through the walls of blood capillaries in into the surrounding tissues. When a drug is unbound, it is small enough to fit through the walls of blood capillaries and go to the extra vascular tissue to get to the site of action

Front 41

Someone with low ______ _______ is at greater risk for toxicity from a highly protein bound drug

Back 41

Serum albumin

Front 42

What is the principle site of drug metabolism?

Back 42

The liver

Front 43

What is the primary route for excretion?

Back 43

The kidneys

Front 44

What is the first pass effect?

Back 44

Since the liver is the principal site of drug metabolism, any drug that gets absorbed by the intestine must first pass through the liver to get into blood circulation and become bioavailable. The liver chemically changes drugs into inactive metabolites. The more inactive metabolites that are formed, the less of the actual drug will become bioavailable.

Front 45

What is the cytochrome P-450 system?

Back 45

During hepatic metabolism, a large class of enzymes called the cytochrome P-450 enzymes are used to control several reactions that help with the metabolism of drugs. These enzymes specifically target lipid soluble drugs that are generally hard to eliminate from the body and are responsible for the metabolism of most drugs. And each specific P-450 enzyme has a corresponding drug substrate, making at one of the most important systems affecting drug-drug interactions. If two drugs are both metabolized by the same enzyme and are administered together, they may compete for the enzyme, which can cause the drugs to become more or less bioavailable than intended

Front 46

What do rising levels of creatinine indicate?

Back 46

Decreased kidney function

Front 47

What does BUN indicate?

Back 47

Hydration status

Front 48

What is the minimum amount of urine a patient should produce?

Back 48

At least 30 mL per hour

Front 49

How many half-lives does it take to reach a steady state?

Back 49

4 to 5

Front 50

What is a loading dose?

Back 50

A larger dose than usual to get the drug into the system

Front 51

What is the difference between additive, synergistic, potentiated, and antagonistic effects?

Back 51

Additive - 2 similar drugs given together to create the sum of drugs effect (1+1=2)

Synergistic - two unlike drugs given together to create an effect greater than either alone (1+1=3)

Potentiated - two unlike drugs given together, but the effect of only one drug is enhanced (1+1/2=2)

Antagonistic - two unlike drugs given together, but one drug blocks the effect of the other (1+1=0)

Front 52

What are the antidotes for the following drugs: acetaminophen, organophosphates, tricylic antidepressants, benzodiazepines, beta blockers, opiates, and calcium channel blockers

Back 52

Acetaminophen - acetylcysteine

Organophosphates - atropine

Tricyclic antidepressants - sodium bicarbonate

Benzodiazepines - flumazenil

Beta blockers - glucagon

Opiates - naloxone

Calcium channel blockers - calcium IV

Front 53

What is beers criteria?

Back 53

Helps prevent an adverse drug event in older adult patients. It provides a list of medications to either avoid or consider and use with extreme caution.

Front 54

What are the three pregnancy risk categories?

Back 54

Drug properties

Fetal gestational age

Maternal factors

Front 55

How are drugs categorized in relation to pregnancy?

Back 55

A through D and X with A showing no increased risk of fetal abnormalities and X showing positive evidence of fetal abnormalities

Front 56

How are controlled substances categorized?

Back 56

C-1 through C-5

C-1 are hard drugs, C-2 and 3 are narcotics, C-5 are anti-diarrheals

Front 57

Type of needle and syringe used for insulin, transdermal, subcutaneous, and intramuscular injections

Back 57

Insulin- insulin syringe with fixed needle

Transdermal- 3/8” 26-31 gauge needle

Subcutaneous- 3/8” to 1/2” to 5/8” 25-31 gauge needle

Intramuscular- 1” to 3” 18-25 gauge needle

Front 58

Signs and symptoms of anaphylaxis

Back 58

Difficulty breathing, low blood pressure, increased heart rate, dilated pupils, diaphoresis, panic, respiratory arrest

Front 59

What are the differences between alpha-1 and alpha-2 receptors?

Back 59

Alpha-1: located on postsynaptic effector cells (tissue, muscle, or organ the nerve stimulates) and causes excitement/vasoconstriction

Alpha-2: located on presynaptic nerve terminals and cause relaxation/inhibit SNS stimulation

Front 60

What are the differences between beta-1 and beta-2 receptors?

Back 60

Both located on postsynaptic effector cells

Beta-1: located primarily in the heart and affect heart rate and contractility

Beta-2: located in the smooth muscle fibers of bronchioles, arterioles, and visceral organs. Causes broncho/vasodilation

Front 61

What are the three functions of the autonomic nervous system?

Back 61

Regulate the heart

Regulate secretory glands

Regulate smooth muscle

Front 62

What are the three functions of the sympathetic nervous system and how does it maintain these functions?

Back 62

Regulates cardiovascular system

•maintains blood flow to brain

•redistributes blood with exercise

•compensates for blood loss

Regulates body temperature

•dilates and constricts vessels

•sweating

•goosebumps

Fight or flight reaction

•increase HR and BP

•dilates bronchi and pupils

•mobilizes stored energy/regulates glucose

•shunts blood from viscera to skeletal muscles

Front 63

What are the seven functions of the parasympathetic nervous system?

Back 63

Slows heart rate

Increases gastric secretions

Emptying of bladder and bowel

Focus eye for near vision

Constricts pupil

Contracts bronchial smooth muscle

Front 64

What are the differences in how the SNS and PSNS effect the body?

Back 64

SNS (adrenergic, anti-cholinergic, sympathetic agonist) - dilates pupils/dry eyes, increased HR/contractility, decreased GI motility/secretions, dilates trachea/bronchi, constricts blood vessels, decreases salivation

PSNS (Cholinergic agonist, anti-adrenergic) - constricts pupils/tears flow, decreased HR/contractility, increased GI motility/secretions, constrict trachea/bronchi, dilates blood vessels, increased salivation

Front 65

SLUDGE(S) reaction

Back 65

The effects of Cholinergic poisoning

S - salivation

L - lacrimation

U - urination

D - diarrhea

G - GI cramps

E - emesis

S - slows HR

Front 66

SNS synonyms

Back 66

Fight or flight

Adrenergic/adrenergic agonist

Sympathomimetic

Front 67

What blocks the SNS

Back 67

Adrenergic antagonists

Sympatholytic

Front 68

PSNS synonyms

Back 68

Rest and digest

Cholinergic/Cholinergic agonist

Front 69

What blocks the PSNS

Back 69

Anti Cholinergic

Cholinergic antagonist

Parasympatholytic

Front 70

Epinephrine drug class, mechanism of action, indications, contraindications/precautions, and adverse effects

Back 70

Drug class - non selective adrenergic agonist

MOA - stimulates alpha and beta receptors (positive ino/Chronotropic effects, increase BP)

Indications - anaphylaxis, asthma, cardiac arrest (emergency drug for resuscitation)

Contraindication/precautions - if a pt has chest pain/active MI, tachycardia, hypertension, glaucoma

Adverse effects - HR and BP too high (sweating, dizziness, palpitations, nausea, vomiting)

Front 71

What do you need to check/monitor when giving epinephrine?

Back 71

Monitor HR and BP

Front 72

Norepinephrine and phenylephrine drug class, mechanism of action, and indications

Back 72

Drug class - alpha adrenergic agonists

MOA - stimulate alpha receptors

Indications - used for hypotension and shock to cause vasoconstriction (raises BP and HR)

Front 73

Tamulosin and phentolamine drug class, mechanism of action, and indications

Back 73

Drug class - alpha adrenergic receptor antagonists

MOA - blocks alpha 1 receptors (blocks vasoconstriction/reduces peripheral vascular resistance)

Indications - men with enlarged prostate (allows them to pee) (tamulosin)

IV extravasion of a vasoconstricting drug (phentolamine)

Front 74

Metaprolol drug class, mechanism of action, indications, and contraindications

Back 74

Drug class - selective beta blocker

MOA - mostly blocks beta-1 but can block beta-2 in high doses

Indications - patients who have had a heart attack (lowers BP/HR)

Contraindications - do not stop abruptly, do not give if pt has low HR (below 60 bpm)

Front 75

What do you never want to do when giving Metaprolol or propranolol?

Back 75

Never stop abruptly

Front 76

What should you assess when giving Metaprolol or propranolol?

Back 76

HR (no less than 60) and BP (no less than 100)

Front 77

Propranolol drug class, mechanism of action, indications, and contraindications

Back 77

Drug class - non selective beta blocker

MOA - decreases HR/contractility, bronchoconstriction

Indications - angina, dysrhythmias, hypertension, post-MI, migraines

Contraindications - asthma

Front 78

Bethanchol drug class, indications, pharmacokinetics, and mechanism of action

Back 78

Drug class - Cholinergic agonist

Indications - urinary retention not caused by an obstruction

Pharmacokinetics - mainly oral

MOA - increases muscle tone in bladder (contraction) and relaxes sphincters in bladder (helps to urinate)

Front 79

Pyridostigmine drug class, indications, pharmacokinetics, and adverse effects

Back 79

Drug class - indirect acting Cholinergic agonist

Indications - myasthenia gravis to gain muscle strength

Pharmacokinetics - mainly oral, can be IV

Adverse effects - too much SLUGES effect

Front 80

What should you monitor when giving pyridostigmine and what is the antidote?

Back 80

Monitor first dose

Atropine is the antidote

Front 81

Atropine drug class, indications, mechanism of action, contraindications, adverse effects, and what to consider

Back 81

Drug class - Cholinergic antagonist

Indications - cardiac bradycardia (emergency drug)

MOA - increases HR

Contraindications - myasthenia gravis and glaucoma

Adverse effects - dry mouth, blurred vision

What to consider - oral hygiene, be careful when pt is sweating a lot