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185 Cards in this Set

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acetaminophen (Tylenol)
liver toxic
acyclovir (Zovirax)
treating the symptoms of herpes (genital, simplex, zoster); also used to treat chickenpox
adenosine (Adenocard)
management of rapid HR (supraventricular tachycardia)
albumin 25% (Albuminar)
used to treat hypoalbuminemia, third spacing, etc. by increasing the colloid oncotic pressure
albuterol (Ventolin)
hold for increased HR or BP
amikacin (Amikin)
nephrotoxicity; monitor BUN and creatinine levels
amiodarone (cordarone)
indicated for ventricular arrhythmias (PVCs, V-tach, V-fib)
amoxicillin with clavulanic acid (Augmentin)
defeat beta-lactamase producing organisms
amphotericin B (Fungizone)
pre-medicate with antipyretics, corticosteroids, antihistamines, meperidine, and antiemetics
ampicillin (Omnipen)
cross-sensitive with cephalosporins
penICILLIN doesn't like cephalosporins
anastrozole (Arimidex)
blocks estrogen receptors
Arimidestrogen blocker
aropiprazole (Abilify)
extrapyramidal reactions (tardive dyskinesias)
atropine sulfate (generic)
treatment of symptomatic bradycardia and heart blocks (increases
heart rate); treatment of pesticide and nerve agent poisonings; contraindicated in glaucoma
beclomethasone (Vanceril)
asthma prophylaxis; rinse mouth out with water (will cause fungal infections)
benztropine (Cogentin)
contraindicated in glaucoma
blood products
whole blood and packed red blood cells can transmit oxygen; fresh frozen
plasma contains clotting factors
bosentan (Tracleer)
indicated for pulmonary arterial hypertension
ceftriaxone (Rocephin)
cross blood/brain barrier; effective against CNS infections (meningitis)
RoCNSin infections
cephradine (Velosef)
broad spectrum; cross-sensitive with penicillins
CEPHalosporins don't mix with penicillins
ciprofloxacin (Cipro)
broad spectrum
corticosteroid drugs
contraindicated in active infections; adverse effects include adrenal
suppression (Cushing’s syndrome), elevated blood sugar, and osteoporosis; do not stop abruptly
cortisone (Cortisone)
dexamethasone (Decadron)
corticosteroid; reduce cerebral edema in meningitis
methylprednisilone (Solu-Medrol)
prednisone (Deltasone)
cyclosporine (Sandimmune)
decrease immune response by inhibiting T-cell activity; adverse effects may include opportunistic infections
demeclocycline (Demclomycin)
tetracycline; pregnancy D
pregnancy Demeclocycline
desmopressin (DDAVP)
treatment of diabetes insipidus
dextrose 50% in water (D50W)
indicated for hypoglycemia
diazoxide (Hyperstat)
indicated for emergency treatment of hypertension
Hyper = hypertension; stat = emergency
digoxin (Lanoxin)
increases force of cardiac contractions (+ inotropic), slows HR (- chronotropic); contraindicated in HR < 60 bpm
digoxin serum
0.5 - 2 ng/ml
maintenance dose
0.125 - 0.25 mg
PO qd
digoxin monitoring
monitor serum levels of
potassium and heart rate
frequently; give daily
potassium supplement
signs and symptoms of
digoxin toxicity
fatigue; nausea and vomiting;
bradycardia; halo vision;
heart blocks; cardiac arrest
digoxin immune Fab (Digibind)
digoxin antidote; adverse effects include increased pulmonary edema
diltiazem (Cardizem)
calcium channel blocker; indicated for hypertension and supraventricular tachycardia (SVT)
calcium channel blockers
decrease HR and BP
dopamine (Intropin)
treatment of shock along with adequate fluid replacement
doxycycline (Doxy Caps)
tetracycline; treatment of anthrax; pregnancy D
counters immunosuppressant drugs; blocks drugs for TB, cancers, and HIV
enalapril (Vasotec)
adverse effects include hypotension, dry cough, and tachycardia
enfuvirtide (Fuzeon)
prevents seroconversion
enoxaparin (Lovenox)
same as heparin, but safer because it blocks only one clotting factor; so safe patients may give themselves injections at home
epoetin alfa (Procrit)
stimulates RBC production in the bone marrow
famotidine (Pepcid)
interferes with drug/food absorption
filgrastim (Neupogen)
increases WBCs
furosemide (Lasix)
diuretic; inhibits reabsoprtion of lytes and water in the loop of Henle; cross-sensitive with sulfonamide antibiotics
ginko biloba
increases coagulation times when taken with warfarin
glipizide (Glucotrol)
stimulates pancreatic cells to produce insulin
glucogon (GlucaGen)
contraindication in starvation (no hepatic stores of glucose)
haloperidol (Haldol)
used acutely as “chemical handcuffs;” extrapyramidal reactions (tardive dyskinesia)
heparin (porcine heparin)
prevents new clots from forming
heparin nursing
monitor for bleeding; monitor
APTT (1.5x normal); avoid
aspirin and NSAIDs; teach
client: soft toothbrush, electric razor, etc.; if sign of overdose discontinue heparin, notify MD, have IV protamine sulfate ready
hydromorphone (Dilaudid)
adverse effects may include respiratory depression or arrest
ibuprofen (Advil)
inhibits prostaglandin synthesis; contraindicated in GI bleeding
inamrinone (Inocor)
short-term management of CHF not responding to digoxin or after digibind
contraindicated in hypoglycemia
sliding scale insulin
if BS < 50, call MD
BS 51 - 150 = 0 units
BS 151 - 200 = 2 units
BS 201 - 250 = 4 units
BS 251 - 300 = 6 units
BS 301 - 350 = 8 units
BS 351 - 400 = 10 units
if BS > 400, call MD
DNA insulin analog (Lispro R)
give with first bite of food
rDNA insulin glargin (Lantus)
24-hour insulin; give one dose daily at bedtime; SQ only, never IV
interferon alfa-2b (Intron-A)
adjunct with other drugs to treat leukemias, MS, chronic hepatitis (A, B, C), and AIDS
isoniazid (INH)
prophylaxis for TB exposure
isosorbide (Isordil)
long-acting nitrate; concurrent use with Viagra can result in profound hypotension
Lactated Ringer’s solution
replaces water and electrolytes; balanced salt solution
leucovorin (Wellcovorin)
protects healthy cells from antimetabolites
levonorgestrel (Norplant)
used to treat men with prostate cancer
lidocaine (Xylocaine)
ventricular arrhythmias (PVCs, V-tach, V-fib); do not use with epinephrine for a digital block
lithium carbonate (Carbolith)
contraindicated in CV diseases
CARbolith = no CARdiovascular diseases
loperamide (Imodium)
used for diarrhea, esp. r/t tube feeding and antibiotic use; contraindicated in diarrhea caused by toxins (salmonella, shigella, etc.) because it will prevent the organisms from being moved out of the bowel and can cause toxic megacolon
mannitol (Osmitrol)
osmotic diuretic; inhibits reabsorption of lytes and water (potent kaluretic); adverse effects include transient volume expansion, hypokalemia, and phlebitis at the IV site (hypertonic)
methotrexate (Folex)
causes bone marrow depression, but it can be reduced with leucovorin rescue
metoclopramide (Reglan)
accelerates gastric emptying
metronidazole (Flagyl)
indicated in amebic dysentery and PCP
morphine sulfate
can cause respiratory depression or arrest
nevirapine (Viramune)
prevents seroconversion; adverse effects include severe fatigue, anemia, and bone marrow suppression
oseltamivir (Tamiflu)
indicated for avian flu (H5N1 virus)
propranolol (Inderal)
lowers BP and HR; contraindicated in asthma and COPD
protamine sulfate (generic)
heparin antidote
reteplase (Retavase)
lyses thrombi; specific only to newly formed clots
rofecoxib (Vioxx)
increases prothrombin which causes increased clotting
somatropin (Humatrope)
long bone X-rays are essential prior to administering to children to be sure that their epiphyses (growth plates) have not closed
spironolactone (Aldactone)
must teach patient not to eat foods rich in potassium
Alda(no K+)e
sublingual nitroglycerine tablets (Nitro Bid)
contraindicated in hypotension and concurrent
use with Viagra (profound hypotension)
tadalafil (Cialis)
contraindicated in men using nitrates for angina (profound hypotension)
technetium (99mTc, a radioactive isotope)
must do serum pregnancy test
trimethoprim/sulfamethoxazole (Septra)
cross-sensitive with furosemide (Lasix)
vancomycin (Vancocin)
used for MRSA; monitor IV sites frequently; do frequent peak and trough levels of BUN and creatinine to monitor for renal function
warfarin sodium (Coumadin)
interferes with vitamin K clotting factors
warfarin nursing
PO only; monitor bleeding;
monitor PT (1.5x normal);
client teaching: avoid foods
containing vitamin K; avoid
aspirin and NSAIDs; take as
ordered, don't miss a dose,
never "double up;" antidote is vitamin K SQ
zidovudine (AZT)
prevents seroconversion
α-tocopherol (vitamin E)
best antioxidant; donates electron and becomes a free radical; vitamin C donates an electron to it to turn it back into vitamin E
influences living systems, a
group of molecules that
affects patient molecules
study of drugs
use of drugs to prevent,
diagnose, or treat diseases
(empirical-tradition vs.
what your body does to the drug
what a drug does to your body
study of how an individual will respond to a drug,
use DNA screening
study of drugs derived from plants or animals
harm a drug does to a fetus
study of poisons and toxins
FDA phase 1 of new drug approval
pre-clinical trials - animal studies
FDA phase 2 of new drug approval
healthy humans
FDA phase 3 of new drug approval
small population of persons with the disease/condition
FDA phase 4 of new drug approval
large sample of persons with the disease/condition
FDA phase 5 of new drug approval
continual evaluation (ongoing monitoring)
DEA controlled drug schedule
high abuse potential, no accepted medical use, illegal (heroin, LSD)
DEA controlled drug schedule
high abuse potential, severe dependency liability (pain meds, narcotics, amphetamines)
DEA controlled drug schedule
less abuse potential, moderate dependency liability (sedatives, stimulants, some narcotics)
DEA controlled drug schedule
less abuse potential and less dependency liability than schedule III (anti-anxiety agents, non-narcotic analgesics)
DEA controlled drug schedule
limited abuse potential, primarily small amounts of narcotics (codeine used in cough meds, etc), some can be purchased without a prescription
Pregnancy category A
little maternal or fetal risk (Tylenol)
Pregnancy category B
little maternal risk, some fetal risk in 1st trimester, little risk in 2nd and 3rd trimesters (antibiotics)
Pregnancy category C
some maternal and fetal risks, but drug may be acceptable in some cases despite the risks
Pregnancy category D
fetal risks have been demonstrated, but drug may be used in life-threatening maternal conditions
Pregnancy category X
absolute maternal/fetal risk – do not administer, will abort or severely damage fetus (chemotherapy)
study of genetic differences associated with individual variability in drug responses
one double-stranded (helix) of DNA
single segment of DNA
sub-unit of DNA strand
all of the genetic information contained in an organism
Human Genome Project
has determined exact sequence of > 3 billion nucleotides within the human genome
a person’s specific DNA composition
mutations in an individual’s DNA that makes him/her different from others (all humans are 99.9% alike)
Single-nucleotide polymorphism (SNP)
a snip profile is a way to scrutinize the genetic bases for diseases and a way to predict a patient’s response to a drug
Single-gene disorders
cystic fibrosis, sickle cell anemia
Multiple-gene or more complex disorders
diabetes, hypertension, asthma
Cytochrome P-450 Enzyme
System (CYP)
hepatic enzyme that metabolizes all drugs
subset of the CYP system that metabolizes ~25% of all drugs

many people have genetic variations in the CYP2DC subset
If enhanced CYP2DC
ultra rapid metabolism (drugs are ineffective due to rapid excretion)
If deficient CYP2DC
poor metabolism (drug may become toxic even at normal doses)
4 processes of pharmacokinetics



administered and absorbed into systemic circulation (blood)
to various body compartments
chemically broken down by enzymes in the liver
eliminated from body, mostly via the renal system
Absorption: enteral route
PO and per rectum (PR) must undergo the first-pass effect in the liver, all substances absorbed via the gut enter the portal circulation, pass through the liver where hepatic enzymes metabolize or biotransform them
Absorption: parenteral route
injectable drugs (SQ, ID, IM, IV, and sublingual) have no first pass effect, IV & SL routes have the fastest onset of action, then IM, then SQ
Absorption varies with
skin thickness, temperature, perfusion
Only drugs that can directly penetrate cell membranes
Distribution of drugs
all drugs bind to albumin in the blood to some degree

protein bound drugs are not bioavailable

as drugs slowly become unbound they become bioavailable
Unbound drugs
affect the body quickly
Time-release drugs
must be very bound
Drug-drug interactions
some drugs bind to each other which reduces bioavailability

some drugs cancel each other out

some drugs can increase the potency of other drugs which causes adverse effects
condition of decreased serum albumin (liver diseases, etc.) which results in more free drug than desired, dosages must be reduced in patients with decreased albumin
Metabolism: liver
cytochrome P-450 enzyme system (CYP) metabolizes drugs and detoxifies various substances
P-450 enzyme
decreased in children because of their immature system, the elderly because of decreased function, and patients with liver diseases; must reduce their dosages
most drugs are excreted in the urine

some drugs excreted in sweat, feces, and by exhalation

drug excretion is decreased in children, the elderly, and patients with renal diseases
Pharmacokinetic curve: duration
onset of drug until it drops below the therapeutic range
Pharmacokinetic curve: terminal phase half-life
5 half-lives

drug is completely excreted from the body

used for dosing schedules
4 ways that drugs work
replacing missing chemicals/enzymes (insulin)

increasing or stimulating cell activities

depressing or slowing cell activities

interfering with (killing) foreign cells – microorganisms or neoplasms
Agonist drugs
stimulate cell receptors to function
Antagonist drugs
block sites by either competing with enzymes/hormones or by blocking action
Non-specific drugs
alter or disrupt cellular membrane or DNA (antibiotics and anticancer drugs)
Body fluids
75% of total body weight
Extracellular fluid
intravascular fluid

interstitial fluid
Intravascular fluid
water in blood vessels
Interstitial fluid
water surrounding cells
IV solutions containing small molecules in water; usually clear (NaCl, KCl)
IV solutions containing large molecules in water; usually cloudy (albumin)
Hydrostatic pressure
pressure exerted by blood pressure (left ventricle); pushes water out of blood vessels into interstitial space and cells

water is forced through a semi-permeable membrane to an area of lower pressure (high to low)
Colloid oncotic pressure
osmotic pressure exerted by colloids (proteins) in blood; pulls water from interstitial spaces and cells into blood vessels

water will go from an area of low concentration to an area of high concentration (low to high)
coLLoid = puLLing pressure
excessive water loss; cell shrinkage (burns)
fluid accumulation; overload, cells swell
watery, straw-colored fluid component of the blood in which blood cells are suspended, plasma contains electrolytes and proteins (albumin)
concentration of solids in a solution
IV fluid with the same concentration of solids as human plasma
IV fluid with greater concentration of solids than human plasma
IV fluid with less concentration of solids than human plasma
substances in a solution that conduct an electrical current such as sodium, chloride, potassium, also called ions
Fluid balance
balance between hydrostatic and oncotic pressures

extracellular fluid (interstitial and plasma)

intracellular fluid

extracellular fluid (interstitial and plasma)
Serum osmolality
measurement of the amount of dissolved electrolytes in the serum or plasma
Normal range of serum osmolality
280 – 294 mOsm/kg
High range of serum osmolality
> 300 mOsm/kg – concentrated, dehydrated
Low range of serum osmolality
< 280 mOsm/kg – diluted, too much water
Serum osmolality equation
mOsm/kg = 2(Na) + BUN/2.8 + Glucose/18
Active immunization
exposure to attenuated (neutralized) antigen forces body to produce antibodies; long term, lasting defense
Passive immunization
by-passing the body’s immune system by giving agents containing antibodies (immune globulins); short-acting protection
Booster injection
a vaccine or toxoid given in small amounts periodically to maintain immune response
Immunoglobulins (IgG)
prepared from human serum, antibodies vs. many diseases (hepatitis B, H-BIG)
exotoxins produced by bacteria that are detoxified (attenuated), cause production of antibodies
live or attenuated microorganisms that promote active immunity against the particular organism