Pharm Exam 1 Review Powerpoint

Front 1

The study of biological effects of chemicals

Back 1

Pharmacology

Front 2

A committee established to review and approve research involving human subjects

Back 2

institutional Review Board (IRB)

Front 3

Phase of clinical trials that involve healthy volunteers that do not have the medical condition

Back 3

Stage 1

Front 4

What legal regulatory body identifies the standards for drugs related to safety, purity, packaging

Back 4

United States Pharmacopeia

Front 5

What legal regulatory body regulates the development and sale of drugs

Back 5

Food and Drug Administration (FDA)

Front 6

What legal regulatory body defines the nurse scope of practice, and is specific to each state

Back 6

Nurse Practice Act

Front 7

A medication is shown to have no effects on animals and has not been tested on humans

Back 7

Pregnancy Category B

Front 8

A substance that has high potential for abuse, the risk for severe dependence, and accepted medical use

Back 8

Schedule II

Front 9

The ability of a drug to only attack those systems in foreign cells

Back 9

Selective toxicity

Good- antibiotics

Poor-chemo

Front 10

This estimates the margin of safety of a medication

Back 10

Therapeutic index-

Wide- safer- wider range of it being therapeutic

Narrow- schedule, monitor with lab values to make sure they don't enter toxicity mode

Front 11

A high dose of a drug given rapidly to achieve effective connection is

Back 11

Loading dose- large dose given to jumpstart to get you therapeutic

Maintenance dose- given regularly to continue therapeutic state

Front 12

What is the study of the absorption, distribution, metabolism, and excretion of a drug

Back 12

Pharmacokinetics

Absorption-distribution-metabolism (liver)- excretion (kidneys)

Front 13

Routes of administration such as: intravenous, intramuscular, subcutaneous, Sublingual, rectal, topical, inhalation

Back 13

Parenteral (outside of GI tract)- altered by blood flow to the area, tissue type

Enteral meds (through GI tract)- thru mouth or any GI tube

Altered by GI motility, food in stomach, pH of stomach, amount of bowel surface area

Front 14

Occurs when the body forms antibodies to a particular drug causing an immune response when the person is re-exposed to the drug

Back 14

Drug Allergy

Four main classifications

1) anaphylactic- airway- administer epinephrine

2) cytotoxic

3) serum sickness

4) delayed

Front 15

What is a decision making, problem solving process to provide efficient and effective care

Back 15

Nursing Process

Five steps: assessment, nursing diagnosis, planning, implementation, evaluation

Front 16

What is the rest and digest piece of the ANS

Back 16

Parasympathetic nervous system/ Cholinergic

Front 17

What are the three neurotransmitters in the sympathetic system

Back 17

Dopamine, epinephrine, norepinephrine

Epinephrine= cardiac dysrhythmia

Front 18

What is the main neurotransmitter of the parasympathetic nervous system

Back 18

Acetylcholine

Front 19

The parasympathetic nervous system has what effect on the bladder

Back 19

Bladder emptying

Front 20

Beta 2 medications are going to have an effect primarily on the

Back 20

Lungs

Front 21

Dopamine is used for more than one condition. How will you know what you are giving it for

Back 21

It is dose dependent

Low dose- increase renal blood flow; protect the kidneys

High dose- to control BP, works like epinephrine

Front 22

What medication can be used as a pre-op medication, an antispasmodic, and for bradycardia

Back 22

Atropine

Front 23

Epinephrine can be very potent. What are two side effects you can assess for

Back 23

Cardiac dysrhythmias and decreased urine output

Alpha 1-blood vessels- increase blood pressure

Beta 1-heart-increase heart rate

Beta 2-bronchus- relax bronchioles

Front 24

What medication is available OTC that is similar to ephedrine

Back 24

Pseudoephedrine/ Sudafed

Front 25

What can you teach your patient to so about some of the unpleasant side effects from anticholinergic agents

Back 25

Dry mouth- hard candy, artificial saliva

Constipation- fluid, fiber, stool softener

Front 26

When administering a beta blocker, prior to administration of this medication, what VS should you monitor

Back 26

HR and BP

Front 27

Nonselective adrenergic blocking agents, such as carvedilol (coreg), will have an effect on both

Back 27

Beta 1 and Beta 2

Front 28

Clonidine, an alpha specific adrenergic agonist, can be used for the treatment of

Back 28

HTN, chronic pain, opiate withdrawal

Front 29

Sympathetic nervous system ___ heart rate

Back 29

Increases

Parasympathetic nervous system decreases heart rate

Front 30

Chemicals that may have therapeutic value are tested on laboratory animals

Back 30

Preclinical Trials

Purpose:

To determine whether they have the effect on living tissue

To evaluate adverse effects

Chemicals discarded:

Chemical does not have therapeutic activity

Chemical is too toxic

Chemical is highly teratogenic

Safety margins are small

Front 31

Given to healthy volunteers: healthy young men- used to assess safety of the drug, determine the dose range and study the pharmacokinetics

Back 31

Phase I

Dropped because:

Not therapeutic in humans

Cause unacceptable adverse effects

Highly teratogenic

Too toxic

Front 32

Clinical trials performed at various places (hospitals, clinics, doctor offices) on individuals who have the disease

Back 32

Phase II

Dropped because:

Less effective than anticipated

Too toxic

Produces unacceptable adverse effects

Low benefit to risk ratio

Not more effective than another drug

Front 33

Trial where drug is used over a large clinical market and monitored closely by prescribers

Back 33

Phase III

After phase is completed:

Application is submitted to the FDA for approval

Drug is given brand (trade) name

Front 34

Phase of continual evaluation after a drug is approved and is available to all

Back 34

Phase IV

FDA continues to monitor and evaluate any unexpected adverse effects

Front 35

Pregnancy category where no controlled studies have been conducted in humans but animal studies show no risk to the fetus

Back 35

Category B

Front 36

Pregnancy category where no controlled studies have been conducted in humans or animals

Back 36

Category C

Front 37

Pregnancy category where controlled studies in humans show no risk to the fetus

Back 37

Category A

Front 38

Pregnancy category where controlled studies in both animals and humans demonstrate fetal abnormalities and the risk in pregnant women outweighs any possible benefit

Back 38

Category X

Front 39

Pregnancy category where evidence of human risk to the fetus exists, however benefits may outweigh risks in certain situations

Back 39

Category D

Front 40

Controlled substance that has a low potential for abuse relative to substances in C-III

Back 40

C-IV

Front 41

Controlled substance in which substances have a high potential for abuse, which may lead to severe psychological or physical dependence, and have a currently accepted medical use (with severe restrictions)

Back 41

C-II

Front 42

Controlled substance that have a low potential for abuse relative to substances listed in C-IV and consist primarily of preparations containing limited quantities of certain narcotics

Back 42

C-V

Front 43

Controlled substances that have a high potential for abuse, have no currently accepted medical use in treatment in the US and have a lack of accepted safety for use under medical supervision

Back 43

C-I

Front 44

Controlled substance that have less potential for abuse than substances in C-I or C-II and abuse may lead to moderate or low physical dependence or high psychological dependence

Back 44

C-III

Front 45

Treatment of heart failure

Back 45

Dobutamine (sympathomimetic)

Front 46

Treatment of shock

Back 46

Dopamine (sympathomimetic)

Given in emergent situations when perfusion is decreased

Dose dependent: low=increase renal blood flow (kidneys)

High=control blood pressure (acts like epinephrine)

Front 47

Treatment of hypotension

Back 47

Ephedrine (sympathomimetic)

Used in hypotension and mild forms of asthma

Constricts blood vessels and is also used as cold/allergy meds

Front 48

Treatment of shock, bronchospasms, to prolong effects of local anaesthetics

Back 48

Epinephrine

Anaphylaxis, cardiac arrest, bronchospasms, shock

High doses can lead to cardiac dysrhythmia

Expected side effect: pallor (all blood shunted to vital organs)

Front 49

Treatment of shock, used during cardiac arrest

Back 49

Norepinephrine

Front 50

Treatment of HTN, chronic pain, ease opiate withdrawal

Back 50

Clonidine

Stimulates Alpha 2 to vasodilate

Alpha specific adrenergic agonist

Front 51

Treatment of orthostatic hypotension

Back 51

Midodrine

Stimulates Alpha 1

Alpha specific adrenergic agonist

Front 52

Treatment of shock like states, tachycardia, glaucoma, cold and allergies, rhinitis, otitis media

Back 52

Phenylephrine

Stimulates Alpha 1 to vasoconstrict

Alpha specific adrenergic agonist

Front 53

Treatment and prevention of bronchospasm (PO or inhalation)

Back 53

Albuterol (Proventil)

Beta specific adrenergic agonist

Selective for beta 2 receptors

Front 54

Treatment and prevention of bronchial asthma and reversible bronchospasms (nebulizer)

Back 54

Levalbuterol (Xoponex)

Beta specific adrenergic agonist

Specific for beta 2 receptors

Front 55

Treatment of life threatening ventricular arrhythmias

Back 55

Amiodarone

Nonselective adrenergic blocking agent

Front 56

Treatment of HTN and HF

Back 56

Carvedilol (Coreg)

Nonselective adrenergic blocking agent

Front 57

Treatment of HTN, clonidine withdrawl

Back 57

Labetalol

Nonselective adrenergic blocking agent

Front 58

Alpha 1 selective adrenergic blocking agents

Back 58

Doxazoain (Cardura) and Tamsulosin (Flomax)

Stimulates vasodilation to decrease BP, decrease prostate and bladder contractions

Used to treat HTN and BPH

Side effects: cardiac dysrhythmia, flushing, hypotension, reflex tachycardia

Front 59

Nonselective beta adrenergic blocking agent

Back 59

Propranolol (Inderal)

Used to treat HTN, heart rhythm, and stage fright

Front 60

Beta 1 selective adrenergic blocking agent

Back 60

Atenolol (Tenormin) and Metoprolol (Lopressor)

Used to treat HTN, heart rhythm, heart rate, and chronic angina

Also good to use with patients who have a history of an airway diagnosis- they do not block the beta 2 receptor site therefore they do not block the sympathetic bronchodilation