Pharm Exam 2

Front 1

Status Asthmaticus

Back 1

Prolonged asthma attack that does not respond to drug therapy.

Medical emergency

Front 2

Status Asthmaticus

Back 2

May last several minutes to hours

Front 3

Histamine 1

Back 3

Diphenhydramine (Benadryl)

Loratidine (claritin)

Front 4

Histamine 2

Back 4

Famotidine (Pepcid)

Typically used to treat GI Conditions

Front 5

Antihistamine Properties

Back 5

Antihistamines

Anticholinergic

Sedative

Front 6

Antihistamine Mechanism of Action

Back 6

Binding of H1 blockers to histamine receptors prevents adverse consequences of histamine stimulation

Vasodilation, Increased GI and Respiratory Secretions, Increased Capillary Permeability`

Front 7

Histamines Effects

Back 7

Dilation of BV and Increased capillary permeability-congestion

Stimulate salivary, gastric and lacrimal and bronchial secretions

Mast cells release histamine and other substances, resulting in allergic reaction

Front 8

Antihistamine Effects

Back 8

Reduced dilation of BV and decreased capillary permeability. Reduced salivary, gastric, lacrimal and bronchial secretions. Binds to histamine receptors form causing a response

Front 9

Anticholinergic Effect

Back 9

Drying effect that reduces nasal, salivary and lacrimal gland secretions (runny nose, tearing, itching eyes)

Front 10

Sedative Effect of Antihistamines

Back 10

Some antihistamines cause drowsiness

Diphenhydramine (benadryl)

Front 11

Indications of Antihistamines

Back 11

Nasal Allergies, Seasonal/perennial allergic rhinitis (hay fever), allergic reactions, motion sickness, parkinsons, sleep disorders, relief of cold symptoms

Front 12

Anticholinergics

Back 12

Drying Effects: Most Common

Dry mouth, difficulty urinating, constipation, changes in vision, no excess fluid

Front 13

Antihistamines Adverse Effect-Drowsiness

Back 13

Mild sleepiness to deep sleep

Front 14

Antihistamines adverse effects on elderly

Back 14

Be much more significant in elderly person

Front 15

Traditional (sedating) Antihistamine

Back 15

Diphenhydramine (Bendadryl)

Front 16

Nonsedating Antihistamine

Back 16

Loradidine (Claratin)

Developed because of sedative effects of newer classes

Front 17

Antihistamine Assessment

Back 17

Condition that requires treatment of drug allergies.

Front 18

Contraindications of Antihistamines

Back 18

Acute Asthma Exacerbation

Pneumonia

Front 19

Adverse effects of Antihistamines on Integumentary System

Back 19

Reduce capillary permeability, wheal and flare formation, itching

Front 20

Antihistamine Precautions`

Back 20

Increased intraoccular Pressure

Cardiac, renal disease, HTN

Asthma, COPD, PUD, BPH

Pregnancy (Anticholinergic Affect)

Front 21

Antihistamine Teachings

Back 21

Report Excessive Sedation, Confusion, Hypotension, Avoid driving or operating heavy machinery, Do not take with ETOH or other CNS depressants, Do not take these meds with other prescriptions/OTC med until checked with provider

Front 22

Antihistamine Administration

Back 22

Best Tolerated with meals-Reduces GI Upset

If dry mouth occurs, teach patient to perform frequent mouth care, chew gum, suck on hard candy. Use non-alcoholic Mouthwash

Front 23

Nasal congestion

Back 23

Excessive Nasal secretions, inflamed swollen nasal mucosa

Front 24

Causes of Nasal congestion

Back 24

Allergies. Upper respiratory Infections (common cold)

Front 25

Decongestants

Back 25

Adrenergics, Anticholinergics, Corticosteroids

Front 26

Adrenergics

Back 26

Largest group of decongestants

Sypathomimetics

Front 27

Anticholinergics for Nasal congestion

Back 27

Less commonly used

Parasympatholytics-minimize PNS

Front 28

Corticosteroids for Nasal Congestions

Back 28

Topicals and Intranasal steroids

Front 29

Oral Decongestants

Back 29

Prolonged onset, less potent than topical, no rebound congestion, systemic effects, long period of no relief

Pseudoephedrine (sudafed)

Front 30

Inhaled Decongestant

Back 30

Prompt onset, potent, limited systemic effects, rebound congestion

Front 31

Topical Nasal Deoncgestants

Back 31

Adrenergices, Steroids (intranasal), Anticholinergic (intranasal)

Front 32

Pupose of not treating a Productive Cough

Back 32

Has a purpose of expelling bad stuff within the lungs

Front 33

Nonproductive Cough

Back 33

Dry cough

Can treat

Front 34

Cough Reflex

Back 34

Induces coughing and expecrotation

Initiated by irritation of sensory receptors in respiratory tract

Front 35

Intranasal Steroids

Back 35

Budesonide (Rhinocort)

Fluticasone (flonase)

Triamcinolone (nasacort)

Front 36

Productive Cough

Back 36

Congested, removes excessive secretions. May be clear, white or green.

Front 37

Steroid Adverse Effects

Back 37

Local mucosal dryness and irritaiton. Rince with water and discard to avoid overgrowth of normal flora or thrush

Front 38

Phenylephrine (neo-synephrine)

Back 38

Adrenergic

Front 39

Ipratiopium (atrovert)

Back 39

Intranasal Anticholinergic

Front 40

Adrenergic Mech of Action

Back 40

Constrict Small blood vessels causing tissue to shrink, relieving congestion

Front 41

Benefits of Coughing

Back 41

Removes excessive secretions, Removes potentially harmful foreign substances

Front 42

Nasal Steroids Mech of action

Back 42

Antiinflammatory effects decrease inflammation and decrease congestion

Front 43

Adrenergic Adverse effects

Back 43

Nervousness, insomnia, palpitations, tremors, systemic effects by stimulation of SNS

Albuterol

Front 44

Nasal Decongestant indications

Back 44

Acute/chronic Rhinitis

Common Cold

Sinusitis

Hay fever, may also be used to reduce swelling for intranasal surgery or diagnostic procedures

Front 45

Nasal Decongestants Mech. of Action

Back 45

Drug effects allow for shrinkage of nasal mucosa, relieving congestion

Front 46

Con of coughin

Back 46

hiatal repair surgery

Front 47

Antitussives

Back 47

Drugs used to stop/reduce coughing. Opioids/ nonopioids, used only for nonproductive cough

Front 48

Opioids

Back 48

Suppress cough reflex by direct action on cough center in medulla

Front 49

Opioid Examples

Back 49

Codeine (robitussin A-C, Dimetane DC)

Hydrocodone

Front 50

Non-opioids

Back 50

Suppress cough reflex by numbing the stretch receptors in the respiratory tract and preventing the cough reflex from being stimulated.

Benzonatate (tessalon Perles)

Dextromethorphan (Vicks formula 44, robitussin DM)

Front 51

Antitussive Indications

Back 51

Used to stop the cough reflex when cough is nonproductive and or harmful

Front 52

Opioid Adverse Effects

Back 52

Sedation, N/V, lightheadedness, constipation, crosses blood-brain barrier; need med for BM

Front 53

Expectorant

Back 53

Drugs that aid in removal of mucus, Reduce viscosity of secretions, disintegrate and thin secretions.

Guaifensine (mucinex)

Front 54

Reflex Stimulation

Back 54

Drug causes irritation of GI tract, lossening and thinning of respiratory tract secretions occurs in response to this irritaiton

Front 55

Direct Stimulation

Back 55

Secretory glands are stimulated directly to increase their production of respiratory tract fluids

Front 56

Expectorant Indications

Back 56

Common cold, bronchitis, laryngitis, pharyngitis, coughs caused by chronic paranasal sinusitis, pertussis, influenza and measels

Front 57

Herbal Products: Echinacea

Back 57

Reduces symptoms of common cold and recovery time

Front 58

Echinacea adverse effects

Back 58

Dermatitis, GI Disturbances, Dizziness, Headache

Front 59

Disease of Lower Respiratory System

Back 59

COPD, Asthma, Emphysema, Chronic Bronchitis

Front 60

Bronchial Asthma

Back 60

Recurrent and Reversible SOB, Occurs when airways of lungs become narrowed as a result of bonchospasm, inflammation of bronchial mucosa, edema or bronchial mucosa, production of viscous mucus

Front 61

Bronchial Asthma

Back 61

Alveolar Ducts/ alveoli remain open, but air flow to the is obstructed

Front 62

Symptoms of Bronchial Asthma

Back 62

Wheezing, Difficulty Breathing`

Front 63

4 Stages of Asthma

Back 63

Intrinsic

Extrinsic

Exercise Induce

Drug Induced

Front 64

Emphysema

Back 64

Air spaces enlarge as a result of alveolar walls. Caused by the effect of proteolytic enzymes released from leukocytes to alveolar inflammation, Surface area where gas exchange takes place is reduced. Effective respiration is impaired

Front 65

Chronic Bronchitis

Back 65

Continuous inflammation and low grade infection of bronchi, excessive secretion of mucus and certain pathologic changes in bronchial structure, often occurs as a result of prolonged exposure to bronchial irritants

Front 66

Bronchodilators

Back 66

These drugs relax bronchial smooth muscle, which causes dilation of bronchi and bronchioles that are narrowed as a result of the disease process

Front 67

Three classes of bronchodilators

Back 67

Beda-adrenergic Agonists

Anticholinergics

Xantine Derivatives

Front 68

B1 Affects

Back 68

Heart

Front 69

B2 Affects

Back 69

Lungs

Front 70

Short Acting Beta Agonist

Back 70

SABA Inhaler

Albuterol (ventolin)

Levalbuterol (Zopenex)

Front 71

Long Acting Beta Agonist

Back 71

LABA Inhaler

Arformoterol (brovana)

Salmeterol (Severent)

Front 72

Beta Adrenergic Agonists

Back 72

Used in treatment and prevention of acute Attacks

Front 73

Emphysema Patients

Back 73

Albuterol, if used too frequently loses its beta 2 specific action at larger doses

Front 74

Anticholinergics of Bronchodialators

Back 74

Ipratopium Bromide (Adrovert)

Slow and prolonged action

Used to prevent bronchoconstriction

Not sued for acute asthma exacerbation

Front 75

Xanthine Derivaties of Bronchodilators

Back 75

Theophylline-only used as a bronchodilator

Front 76

Xanthine

Back 76

Cigarette smoking enhances its metabolism

Front 77

Leukotriene Receptor Antagonist

Back 77

Montelukast (Singulair)

Front 78

LTRA

Back 78

Prophylaxis and long term treatment and prevention of asthma in adults and children 12 years of age and older. Not meant for management of acute asthmatic attacks, montelukast is also approved for the treatment of allergic rhinitis.

Front 79

Corticosteroids of Nonbronchodilating drugs

Back 79

May take several weeks before full effects are seen

Front 80

Spympathomimetics

Back 80

Meaning they mimic the SNS

Getting ready for flight-need enough 02 and heart must be able to beat

Front 81

3 types of beta adrenergic Agonists

Back 81

Nonselective Adrenergics, nonselective Beta adrenergics, selective beta 2 drugs

Front 82

Nonselective Adrenergics

Back 82

Stimulate alpha, beta 1 (cardiac) and beta 2 (respiratory) receptors

Epinephrine

Front 83

Nonselective beta adrenergics

Back 83

Stimulate both beta 1 and beta 2 receptors

Methaproterenol (alupent)

Front 84

Selective Beta 2 drugs

Back 84

Stimulate only beta 2 receptors

Albuterol

Front 85

Antiseptics

Back 85

Alcohol and Benadine

inhibit the growth of microorganisms

Front 86

Disinfectants

Back 86

Kill microorganisms

Front 87

Antibiotics

Back 87

Meds used to treat bacterial infections

Front 88

Superinfection

Back 88

Cdiff

Front 89

Pseudomembranous Colitis

Back 89

Over production of normal flora

Front 90

Bactericidal

Back 90

Kills bacteria

Front 91

Bacteristatic

Back 91

inhibit the growth of bacteria

Front 92

Empiric Therapy

Back 92

Treatment of an infection before specific culture information has been reported or obtained

Front 93

Definitive Therapy

Back 93

Antibiotic therapy tailored to treat organism identified with cultures

Front 94

Prophylactic Therapy

Back 94

Treatment with antibiotics to prevent an infection as in intraabdominal surgery or trauma

Front 95

Therapeutic Response

Back 95

Decrease in specific sings and symptoms of infection are noted (fever, elevated WBC, redness, inflammation, drainage, pain)

Front 96

Subtherapeutic Response

Back 96

Signs and symptoms of infection do not improve

increase dosage or prescribe a new drug

Front 97

Sulfonamide

Back 97

One of the first group of antibiotics often combined with another antibiotic. Bacteriostatic, prevents synthesis of folic acid which is needed for DNA, does nto affect human cells, only bacterial cells

Front 98

Sulfonamide indications

Back 98

Effective against both gram positive and gram negative bacteria. Treatment of UTIs caused by susceptible strains of e.coli, staph aureus

Front 99

Adverse effects of sulfonamides on blood

Back 99

Hemolytic, aplastic anemia, agranulocytosis, thrombocytopenia

Front 100

Sulfonamides nursing implications

Back 100

Take with 2000-3000 ml of fluid/24hr-prevent crystal formation in urine

Assess RBCs prior to beginning therapy

Take oral doses with food

Front 101

Beta-lactam Antibiotics

Back 101

Penicillins

Cephalosporins

Carbapenems

Monobactams

Front 102

Natural Penicillins

Back 102

Penicillin G and V

Front 103

Penicillinase-resistant Penicillins

Back 103

nafacillin

cloxacillin

oxacillin

dicloxacillin

Front 104

Aminocillins

Back 104

amoxicillin

amphicillin

Front 105

Extended spectrum penicillins

Back 105

carbenicillin

pipercillin

ticarcillin

Front 106

Penicillin Adverse Affects

Back 106

Only those patients with history of throat swelling or hives from penicillin should not receive cepthalosporins

Front 107

Penicillin Interactions

Back 107

NSAIDS, Oral contraceptives, Warfarin

Front 108

Cephalosporin Adverse Effects

Back 108

Potential cross sensitivity with penicillins if allergies exist

Front 109

Macrolides

Back 109

Prevent protein synthesis within bacterial cells

bacteriostatic

in high enough concentration may be bactericidal

Front 110

Tetracyclines

Back 110

Should not be used in children under the age of 8 or in pregnant/lactating women because tooth discoloration will occur if the drug binds to the calcium in the teeth

Front 111

Tetracyclines Adverse Affects

Back 111

Discoloration of permanent teeth and tooth, enamel in fetuses and children or nursing infants if taken by mother. May retard fetal skeletal development if taken during pregnancy

Front 112

Aminoglycosides Adverse Effects

Back 112

Causes serious toxicities. Nephrotoxicity, ototoxicity. must monitor drug levels to prevent toxicities. Minimum inhibitory concentration

Front 113

Quinolones

Back 113

End in foxacin

Front 114

Ciprofloxacin

Back 114

Cipro

Front 115

Norfloxacin

Back 115

Noroxin

Front 116

Levofloxacin

Back 116

Levaquin

Front 117

Monifloxacin

Back 117

Avelox

Front 118

Black box warning of Quinolones

Back 118

Increased risk of tendonitis and tendon rupture

Front 119

Vacomyacin treatment

Back 119

Treatment of choice for MRSA and other gram positive infections

Front 120

Oral Vancomycin

Back 120

Is indicated for the treatment of antibiotic incuded colitis CDIFF and for treatment of staphylococcal entercolitis

Front 121

Red Man Syndrome

Back 121

Flushing/itching of head, neck, face, upper trunk. Antihistamines may be ordered to reduce these effects

Front 122

Vacomyacin Infusion Rate

Back 122

Over 60 minutes

Front 123

Zanamivir (Relenza)

Back 123

Causes diarrhea, nausea, sinusitis

Front 124

Influenza Symptoms

Back 124

Treatment should begin within 2 days at the onset of symptoms

Front 125

Isoniazid (INH)

Back 125

drug of choice for TB. Resistant strains of Mycobacterium emerging. Metabolized in liver through acetylation. Used alone or in combination with other drugs. Contraindications with liver disease.

Front 126

Adverse Effects of Isoniazid (INH)

Back 126

Peripheral neuropathy hepatotoxicity

Front 127

Ethambutol Adverse effects

Back 127

Retrobulbar neuritis, blindness

Front 128

Adverse Effects of Rivampin

Back 128

Hepatitis, Discoloration of urine, stools, sweat and tears

Red/orange color

Front 129

Adverse Effects of antitubercular therapy

Back 129

Instruct patients on the adverse effects that should be reported to the prescriber immediately. These include fatigue, N/V, numbness and tingling of the extremities, fever, loss of appetite, depression, jaundice.

Front 130

Antifungal Drug Indicators

Back 130

Systemic and topical fungal infections.

Front 131

Amphotericin B

Back 131

Drug of choice for the treatment of many severe systemic fungal infections

Front 132

Amphotericin B Adverse Effects

Back 132

Cardiac Dysrhythmias, Neurtoxicity, tinnitus, visual disturbances, hand for feet numbness, tingling, or pain, confusion. Renal toxicity, potassium loss, hypomagnesemia, Pulmonary infiltrates

Front 133

Expected Adverse effects of Amphotericin B

Back 133

Fever, chills, headache, nausea, occasional hypotension, gastrointestinal upset, anemia

Front 134

Antifungal Drug Contraindications

Back 134

Liver failure, Renal failure, Porphyria (griseofulfin), drug allergy

Front 135

Porphyria

Back 135

Problem in the production of heme