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110 Cards in this Set
- Front
- Back
Define pharmacotherapeutics |
*DESIRED* therapeutic effect of a drug |
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Define pharmacodynamics |
the *effects* of the drug in the body |
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Define pharamacokinetics |
changes that occur TO THE DRUG while inside the body |
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Define anaphylaxis |
Most serious allergic response. Symptoms are swelling, itching, and DIFFICULTY BREATHING |
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Define allergic reaction |
symptoms like itching and rash, but NO DIFFICULTY breathing |
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What are adverse effects? |
unintended & undesired effects that may occur from a drug but NOT NECESSARILY an allergy |
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What is half life? |
the amount of time required to remove half of the blood concentration of the blood. The time it takes to excrete HALF the drug. |
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What is an idiosyncratic response? |
unusual response |
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What is the difference between a paradoxical and idiosyncratic response? |
Paradoxical responses are when the opposite happens of what we think should happen. Idiosyncratic is when an unusual response happens. |
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What is spasticity? |
condition where certain muscles are CONTINUOUSLY contracted |
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The adrenergic and cholinergic nervous system make up... what? |
autonomic nervous system (ANS) |
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________&______ are receptor sites for the sympathetic nervous system. |
Alpha 1 & 2 and Beta 1 & 2 |
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Preganglionic is always..... |
acetylcholine |
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Parasympathetic is the only one that... |
acetylcholine on pre and post ganglionic.. |
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adrenergic nervous system is the... |
sympathetic nervous system |
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cholinergic nervous system is the ... |
parasympathetic nervous system |
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What are the steps of viral replication? |
1. Absorption 2. Penetration 3. Uncoating 4. Replication 5. Transcription |
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What happens in the first stage of viral replication? |
ABSORPTION virus adheres to the cell surface |
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What happens in the second stage of viral replication? |
PENETRATION by pinocytosis the virus pushes into the cell membrane and the cell membrane pinches off, the virus suspends inside the cell) |
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What happens in the third stage of viral replication? |
UNCOATING shedding protein covering the virus to allow genetic material (RNA)out to be replicated |
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What happens in the fourth stage of viral replication? |
REPLICATION making copies of RNA |
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What happens in the fifth stage of viral replication? |
TRANSCRIPTION changing RNA to DNA |
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What does the optimal immune response include? |
Defense Homeostasis Surveillance |
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What lab tests are done for HIV? |
CD4 (t helper cell) count viral load count resistance assays |
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How to manage HIV replication and treatment |
cocktail of drugs are used to disrupt replication @ multiple stages. Compliance with drug treatment is ESSENTIAL. |
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What is HAART? |
highly active anti retroviral therapy |
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What is altered immunity? |
the response is either exaggerated or suppressed |
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What is primary immunodefficiency? |
both b and t cell deficiency GENETIC Improperly developed cells or absence of cells required to produce immune response |
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What is secondary immunodefiency? |
loss of immune functioning as a result of illness or treatment (intentional: chemo) |
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What is the nursing diagnosis? (part of nursing process) |
reflects current, actual problem OR risk for development a problem related to drug therapy. Highly individualized & may reflect effects of drugs. |
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What are the 6 stages of the nursing process? |
1. Assessment 2. Nursing Diagnosis 3. Nursing Outcomes 4. Planning Stage 5. Intervention 6. Evaluation |
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What happens during Assessment in the nursing diagnosis? |
core drug knowledge & patient core variables |
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What happens during nursing outcomes in the nursing diagnosis? |
determine desired results, these are based on data collected, and they are specific to the pt's drug regimen |
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What happens during the planning stage in the nursing diagnosis? |
Identify interventions necessary to reach desired outcomes. Use strategies to maximize therapeutic effects and minimize adverse effects. Defines what needs to be done to achieve desired effects. |
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What happens during the intervention stage in the nursing diagnosis? |
perform plan and carry out interventions. Educate the patient and family about the drug |
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What happens during the evaluation stage in the nursing diagnosis? |
measure patient progress, did drug reach the desired effect? Why were the goals not achieved? HAVE to know the reason behind the treatment failure |
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What are the 5 rights of drug administration? |
right patient right drug right time right dose right route |
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Placental membrane barrier |
drugs have to be lipophilic, not ionized, and not protein bound to pass through. |
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Does insulin pass through the placenta? |
NO |
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What is the teratogenic effect? |
can cause physical defects in a fetus and women should be advised against them (use of illegal drugs= unborn baby @ risk) |
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What does asking open ended questions do? |
gives us the most information |
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What should you do if patient has a history of drug interaction? |
Monitor them for signs and symptoms of adverse (unwanted) drug effects |
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What is medication adherence? |
refers to whether patients take their meds as prescribed for example: pill organizers help with this, especially in the elderly |
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What are therapeutic drug effects? |
desired effects of a drug |
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What are spasms? |
sudden, violent involuntary contraction of a muscle or group of muscles. |
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What are spasms related to? |
Related to localized muscle injury or an imbalance of electrolytes |
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What is tonic spasm? |
unusually prolonged & strong muscular contraction |
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What is spasticity? |
where certain muscles are continuously contracted. Causes stiffness or tightness of muscles. |
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What is spasticity associated with? |
spinal cord injury CEREBRAL PALSY |
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What are the three types of cerebral palsy? |
spastic dyskinetic ataxic |
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What is spastic cerebral palsy? |
most common, hypertonic so very stiff muscle movements |
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What is dyskinetic cerebral palsy? |
athetoid, slow worklike movements of extremities, trunk, face, tongue, drooling, speech problems, and sometimes lead to jerky involuntary movements |
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What is ataxic cerebral palsy? |
rapid repetetive movements, wide gait, unable to hold onto objects, problems with coordination |
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what are some possible cerebral palsy motor signs? |
poor head control after 3 months of age stiff or rigid limbs floppy tone arching back/pushing away can't sit w/o support at 8 months age clenched fists after 3 months |
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What disorder is cyclobenzaprine used for? |
Cerebral Palsy |
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What is the trade name for cyclobenzaprine? |
Flexeril |
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What is cyclobenzaprine used for? |
muscle spasms associated with acute musculoskeletal disorders |
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Where is cyclobenzaprine metabolized? Excreted? |
liver urine & bile |
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What are the side effects of cyclobenzaprine? |
drowsiness, dizziness, hypotensive BP, arrhythmias, seizures |
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Cyclobenzaprine pt teaching? |
maybe don't drink maybe careful driving |
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Cyclobenzaprine life span? |
pregnancy elderly caution (CNS Probs) effects can build up in the elderly |
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Cyclobenzaprine monitored labs? |
kidney & liver |
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Is P450 an issue with cyclobenzaprine? |
No |
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What pregnancy category is cyclobenzaprine? |
B, it can effect the baby |
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What kind of depressant is cyclobenzaprine? |
CNS depressant |
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What drug class is cyclobenzaprine? |
central acting muscle relaxant |
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What is baclofen used to treat? |
Cerebral Palsy |
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What drug class is baclofen? |
spasmolytic (relives spasm of smooth muscle) |
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What does baclofen do? |
relieves some component of spinal spasticity, used to treat spasticity, spinal cord injuries |
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Does baclofen cross blood brain barrier? |
no |
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Does baclofen cross the placenta? |
yes & passes into breast milk as well |
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What are the pharmacodynamics of baclofen? |
inhibits transmission of impulses to cause hyperpolarization (allows muscle to relax by reducing reflex activity) |
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What are side effects of baclofen? |
drowsiness, weakness, hypotension |
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Interactions with baclofen? |
CNS depressants |
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patient teaching with baclofen? |
could take up to 1 month to get full effect, avoid alcohol and avoid driving |
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What age group shouldn't take baclofen? |
children under 12 |
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labs to monitor while taking baclofen? |
liver & kidney |
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1/2 life of baclofen |
2-4 hours |
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where is baclofen metabolized? |
liver |
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is P450 a consideration for baclofen? |
no |
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Pregnancy category for baclofen? |
C |
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Where is baclofen excreted? |
kidneys |
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What is neurotoxicity? |
central nervous system |
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What are effects of neurotoxicity? |
drowsiness diziness seizures auditory and visual disturbances |
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What is hepatotoxicity? |
liver |
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What are effects of hepatotoxicity? |
hepatitis jaundice elevated liver enzyme levels fatty infiltration of liver |
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what is nephrotoxicity? |
kidneys |
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What are effects of nephrotoxicity? |
decreased urine output elevated BUN & creatitine levels electrolyte imbalance |
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what is ototoxicity? |
8th CN |
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what are effects of ototoxicity? |
ringing in ear hearing loss balance issues vertigo spinning nausea vomiting |
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What is cardiotoxicity? |
heart |
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what are effects of cardiotoxicity? |
irregular heart rhythms heart failure damage to myocardium |
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What is immunotoxicity? |
immune system |
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what are effects of immunotoxicity? |
immunosuppression more susceptible to infections (bact, viral, fungal) |
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What medications are used to treat CP? |
flexeril (cyclobenzaprine) baclofen |
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Medications are used for PD? |
carbidopa/levodopa benztropine |
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What is the enteral raoute? |
GI tract used for ingestion & absorption (most common) |
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What is the parenteral route? |
avoids GI tract. all forms of injections like IM, SQ, and IV |
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What is the topical route? |
applied to skin or mucous membranes
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What is oseltamivire used to treat? |
flu |
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What drug class is oseltamivire? |
neurominidase inhibitor (blocks the neurominidase protein in the virus so it can't replicate) |
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How quick should oseltamivire be administered? |
within the first 48 hours |
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Where is oseltamivire excreted and metabolized? |
excreted kidneys metabolized liver |
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How is oseltamivire administered? |
PO, absorbed in GI tract |
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What problems can oseltamivire cause? |
problems in pts with athsma or chronic airflow limitations, can cause problems in pts w/ renal issues too |
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Adverse effects of oseltamivire? |
nausea, vomiting bronchitis insomnia vertigo |
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How do we deal with drug dosage in children? |
almost all ped. drugs are based on weight of the child in kilograms (if the dose isn't specific it can be determined from adult dose based on the body surface area of the child |
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What does protein binding effect? |
Will effect the distribution of the drug because of competitive protein binding sites |
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What are P450 enzymes? |
enzymes that catalyze for protein binding drugs. They allow metabolism to occur |
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What is important to know about medication and P450 enzymes? |
The medication HAS to have protein in order for P450 to be a consideration |