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110 Cards in this Set

  • Front
  • Back

Define pharmacotherapeutics

*DESIRED* therapeutic effect of a drug

Define pharmacodynamics

the *effects* of the drug in the body

Define pharamacokinetics

changes that occur TO THE DRUG while inside the body

Define anaphylaxis

Most serious allergic response. Symptoms are swelling, itching, and DIFFICULTY BREATHING

Define allergic reaction

symptoms like itching and rash, but NO DIFFICULTY breathing

What are adverse effects?

unintended & undesired effects that may occur from a drug but NOT NECESSARILY an allergy

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.

What is an idiosyncratic response?

unusual response

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.

What is spasticity?

condition where certain muscles are CONTINUOUSLY contracted

The adrenergic and cholinergic nervous system make up... what?

autonomic nervous system (ANS)

________&______ are receptor sites for the sympathetic nervous system.

Alpha 1 & 2 and Beta 1 & 2

Preganglionic is always.....

acetylcholine

Parasympathetic is the only one that...

acetylcholine on pre and post ganglionic..

adrenergic nervous system is the...

sympathetic nervous system

cholinergic nervous system is the ...

parasympathetic nervous system

What are the steps of viral replication?

1. Absorption


2. Penetration


3. Uncoating


4. Replication


5. Transcription

What happens in the first stage of viral replication?

ABSORPTION


virus adheres to the cell surface



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)

What happens in the third stage of viral replication?

UNCOATING


shedding protein covering the virus to allow genetic material (RNA)out to be replicated

What happens in the fourth stage of viral replication?

REPLICATION


making copies of RNA

What happens in the fifth stage of viral replication?

TRANSCRIPTION


changing RNA to DNA

What does the optimal immune response include?

Defense


Homeostasis


Surveillance

What lab tests are done for HIV?

CD4 (t helper cell) count


viral load count


resistance assays

How to manage HIV replication and treatment

cocktail of drugs are used to disrupt replication @ multiple stages. Compliance with drug treatment is ESSENTIAL.

What is HAART?

highly active anti retroviral therapy

What is altered immunity?

the response is either exaggerated or suppressed

What is primary immunodefficiency?

both b and t cell deficiency


GENETIC


Improperly developed cells or absence of cells required to produce immune response

What is secondary immunodefiency?

loss of immune functioning as a result of illness or treatment (intentional: chemo)

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.

What are the 6 stages of the nursing process?

1. Assessment


2. Nursing Diagnosis


3. Nursing Outcomes


4. Planning Stage


5. Intervention


6. Evaluation

What happens during Assessment in the nursing diagnosis?

core drug knowledge & patient core variables

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

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.

What happens during the intervention stage in the nursing diagnosis?

perform plan and carry out interventions. Educate the patient and family about the drug

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

What are the 5 rights of drug administration?

right patient


right drug


right time


right dose


right route

Placental membrane barrier

drugs have to be lipophilic, not ionized, and not protein bound to pass through.

Does insulin pass through the placenta?

NO

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)

What does asking open ended questions do?

gives us the most information

What should you do if patient has a history of drug interaction?

Monitor them for signs and symptoms of adverse (unwanted) drug effects

What is medication adherence?

refers to whether patients take their meds as prescribed


for example: pill organizers help with this, especially in the elderly

What are therapeutic drug effects?

desired effects of a drug

What are spasms?

sudden, violent involuntary contraction of a muscle or group of muscles.

What are spasms related to?

Related to localized muscle injury or an imbalance of electrolytes

What is tonic spasm?

unusually prolonged & strong muscular contraction

What is spasticity?

where certain muscles are continuously contracted. Causes stiffness or tightness of muscles.

What is spasticity associated with?

spinal cord injury


CEREBRAL PALSY

What are the three types of cerebral palsy?

spastic


dyskinetic


ataxic

What is spastic cerebral palsy?

most common, hypertonic so very stiff muscle movements

What is dyskinetic cerebral palsy?

athetoid, slow worklike movements of extremities, trunk, face, tongue, drooling, speech problems, and sometimes lead to jerky involuntary movements

What is ataxic cerebral palsy?

rapid repetetive movements, wide gait, unable to hold onto objects, problems with coordination

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

What disorder is cyclobenzaprine used for?

Cerebral Palsy

What is the trade name for cyclobenzaprine?

Flexeril

What is cyclobenzaprine used for?

muscle spasms associated with acute musculoskeletal disorders

Where is cyclobenzaprine metabolized? Excreted?

liver


urine & bile

What are the side effects of cyclobenzaprine?

drowsiness, dizziness, hypotensive BP, arrhythmias, seizures

Cyclobenzaprine pt teaching?

maybe don't drink


maybe careful driving

Cyclobenzaprine life span?

pregnancy


elderly caution (CNS Probs)


effects can build up in the elderly

Cyclobenzaprine monitored labs?

kidney & liver

Is P450 an issue with cyclobenzaprine?

No

What pregnancy category is cyclobenzaprine?

B, it can effect the baby

What kind of depressant is cyclobenzaprine?

CNS depressant

What drug class is cyclobenzaprine?

central acting muscle relaxant

What is baclofen used to treat?

Cerebral Palsy

What drug class is baclofen?

spasmolytic (relives spasm of smooth muscle)

What does baclofen do?

relieves some component of spinal spasticity, used to treat spasticity, spinal cord injuries

Does baclofen cross blood brain barrier?

no

Does baclofen cross the placenta?

yes & passes into breast milk as well

What are the pharmacodynamics of baclofen?

inhibits transmission of impulses to cause hyperpolarization (allows muscle to relax by reducing reflex activity)

What are side effects of baclofen?

drowsiness, weakness, hypotension

Interactions with baclofen?

CNS depressants

patient teaching with baclofen?

could take up to 1 month to get full effect,


avoid alcohol and avoid driving

What age group shouldn't take baclofen?

children under 12

labs to monitor while taking baclofen?

liver & kidney

1/2 life of baclofen

2-4 hours

where is baclofen metabolized?

liver

is P450 a consideration for baclofen?

no

Pregnancy category for baclofen?

C

Where is baclofen excreted?

kidneys

What is neurotoxicity?

central nervous system

What are effects of neurotoxicity?

drowsiness


diziness


seizures


auditory and visual disturbances

What is hepatotoxicity?

liver

What are effects of hepatotoxicity?

hepatitis


jaundice


elevated liver enzyme levels


fatty infiltration of liver

what is nephrotoxicity?

kidneys

What are effects of nephrotoxicity?

decreased urine output


elevated BUN & creatitine levels


electrolyte imbalance

what is ototoxicity?

8th CN

what are effects of ototoxicity?

ringing in ear


hearing loss


balance issues


vertigo


spinning


nausea


vomiting

What is cardiotoxicity?

heart

what are effects of cardiotoxicity?

irregular heart rhythms


heart failure


damage to myocardium

What is immunotoxicity?

immune system

what are effects of immunotoxicity?

immunosuppression


more susceptible to infections (bact, viral, fungal)

What medications are used to treat CP?

flexeril (cyclobenzaprine)


baclofen

Medications are used for PD?

carbidopa/levodopa


benztropine

What is the enteral raoute?

GI tract used for ingestion & absorption (most common)

What is the parenteral route?

avoids GI tract. all forms of injections like IM, SQ, and IV

What is the topical route?

applied to skin or mucous membranes

What is oseltamivire used to treat?

flu

What drug class is oseltamivire?

neurominidase inhibitor (blocks the neurominidase protein in the virus so it can't replicate)



How quick should oseltamivire be administered?

within the first 48 hours

Where is oseltamivire excreted and metabolized?

excreted kidneys


metabolized liver

How is oseltamivire administered?

PO, absorbed in GI tract

What problems can oseltamivire cause?

problems in pts with athsma or chronic airflow limitations, can cause problems in pts w/ renal issues too

Adverse effects of oseltamivire?

nausea, vomiting


bronchitis


insomnia


vertigo



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

What does protein binding effect?

Will effect the distribution of the drug because of competitive protein binding sites

What are P450 enzymes?

enzymes that catalyze for protein binding drugs. They allow metabolism to occur

What is important to know about medication and P450 enzymes?

The medication HAS to have protein in order for P450 to be a consideration