Pharm Test 2 - Study Guide (21-25)

Front 1

Cox-1
(3)

Back 1

-Protect gastric mucosa
-Promotes platelet aggregation (test) (so you don’t hemorrhage)
-Assists renal function


All about body function
Cox 1- helping with secretions that u need to make in gut to protect stomach
-in blood it helps so u don’t hemorrhage

-helps renal tubules do job properly


-Cox 1 is normal body functions

Front 2

Cox-2
(3)

Back 2

-Mediates inflammation (prostaglandin production)
-Mediates pain
-Mediates fever in brain


All about response

Cox 2 is response. When cox 2 is stimulated, u get inflammation (prostaglandin production)

-Cox 2 “I don’t want them. they give symptoms. Stimulates when something happens (injury, disease process, fever)

Front 3

Aspirin ASA/acetylsalicylic acid

What is this drug used for?

-drug of choice for?

Back 3

-Suppression of inflammation
-Fever
-Vascular: anti-platelet effects
(-Effects of aspirin on platelets can last 7-8 days
-Used as part of the primary prevention of MI & stroke)
-Pain management
-May help in the prevention of colon CA
-May help in the prevention of Alzheimer’s disease

-drug of choice for rheumatoid arthritis

Front 4

Aspirin ASA/acetylsalicylic acid

How does this drug affect cox 1 and cox 2?

Back 4

-Non-selective it blocks cox 1 and 2
-Irreversible once u give it, u can’t take it away. U can’t give another drug to stop its effects
-These are blocking agents, they block whats going on (if u block cox 1 with these, you can develop a stomach ulcer. If you block platelet aggregation you have the potential to bleed) –block cox 2 (you block pain, fever, inflammation)

Front 5

Aspirin ASA/acetylsalicylic acid

why is this drug given to cardiac patients?

Back 5

decreases platelet aggregation so it prevents MI and strokes

Front 6

Aspirin ASA/acetylsalicylic acid

adverse effects of this drug?
Gi:
Renal:
Neuro:
Systemic:
Allergy:
pregnancy category?

Back 6

-GI: upset, nausea, GI bleed, ulceration
-Renal: can cause dysfunction, insufficiency, failure this is the OD’er
-Neuro: Dizziness, Tinnitus, H/A (salicylism)
-Systemic: increased bleeding tendencies
-Hypersensitivity: allergy type symptoms

Pregnancy category D

Front 7

Aspirin ASA/acetylsalicylic acid

what does Ibuprofen do to this drug?

Back 7

Ibuprofen: reduces the antiplatelet effect of ASA
(increases it's ability to clot)

Front 8

Ibuprofen vs Aspirin - what is safer?

Back 8

ibuprofen because it has less platelet aggregation and it can be given with other anticoagulants

Front 9

Ibuprofen inhibits:

Naproxen inhibits:

Back 9

-Ibuprofen: Inhibits prostaglandins, analgesic, antiinflammatory & antipyretic = to reduce fever or block fever

-Naproxen: Inhibits prostaglandins, analgesic & antiinflammatory no fever fighting ability, helps with pain

Front 10

Which war did the cutter surveyor battle the British frigate Narcissi's?

Back 10

War of 1812
EPME study guide p. 282

Front 11

Ibuprofen & Naproxen

what results in overuse of these drugs?

Back 11

gastric ulcers

Front 12

Ibuprofen & Naproxen

adverse effects:

Back 12

gastric ulcers
bleeding
renal impairment
MI and Stroke but produce fewer GI renal and hemorrhaigc effects than aspirin beacuse of anticoagulant

Front 13

Ibuprofen & Naproxen

patient education

Back 13

take with food or milk

no alcohol
no diuretics

Front 14

what is the drug of choice for peds?

Back 14

Ibuprofen

Front 15

What is pediatric Ibuprofen dosage amounts based on?

Back 15

weight based

Front 16

Ibuprofen and PEDS

Dosage

Back 16

6-12 years of age 5mg/kg with a Temperature less than 102.5 -- q4-6 hrs

6-12 years of age 10mg/kg with a temperature above 102.5 --q4-6 hrs

Front 17

Ibuprofen and PEDS

what is the maximum dose?

----------------------------------------------------------------------------------

Ibuprofen and Naproxen what are the uses

Back 17

Max dose is 40 mg/kg maximum 1 dose

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Rheumatoid Arthritis
Osteoarthritis
Dysmenorrhea
Fever (Ibuprofen only)
General pain-only work on the analgesic response

Front 18

Ibuprofen and PEDS

-how do you convert lbs to kg?

if you have a 7 year old who weight 8kg and has a fever of 103 how much ibuprofen do you give them?

Back 18

-Person weights 220 lb , divide pounds by 2.2kg and that will give u kg…answer: 100kg


8kg x 10 = 80kg / 1 dose

Front 19

Naproxen and PEDS

-tell me about them

-what form does Naproxen come in

Back 19

Naproxen is not given to Ped pt’s their bodies can’t metabolize them because of their livers (except for those PEDS that have JRA)
-given to 16 years or older

-There is no liquid format for naproxen (only ibuprofen)

Front 20

Celebrex (celecoxib)

-what is this classified as?
what is the mechanism of action?

Back 20

-2nd generation NSAID

-Selective for Cox-2 inhibition/blockage
-No cardiovascular benefit (no platelet aggregation)

Front 21

Celebrex (celecoxib)

any allergy concerns with this med?

Back 21

sulfa allergy

Front 22

Celebrex (celecoxib)

does thist med have any cardio effect?

Back 22

no because it has no effect on platelet aggregation

Front 23

Celebrex (celecoxib)

uses (4)

Back 23

-Rheumatoid arthritis
-Osteoarthritis
-Pain
-Dysmenorrhea

Front 24

Acetaminophen (Tylenol)

what is the mechanism of action?

Back 24

-Limited to blocking and inhibiting prostaglandins in the CNS (brain and in the brain only) if you have a headache, it will help. (if you twisted your ankle, Tylenol will not go out to the cellular level in your ankle it won’t go out and inhibit prostaglandins)
-Good relief of pain and fever inhibition within the CNS
-Main drug we give for fever
-Minimal prostaglandin inhibition peripherally

Front 25

Acetaminophen (Tylenol)

uses:

Back 25

relief of pain and fever inhibitition within the CNS

Front 26

Acetaminophen (Tylenol)

tell me abotu the metabolism and toxicity

how do we know if the person has a problem with tylenol?

Back 26

Metabolized by liver when the liver metabolizes this, it puts out a byproduct which it toxic (its poison to the liver) and the chemical will cause the liver to become inflamed and it will alter liver function.



-LFT will be elevated if the person has a problem with Tylenol

Front 27

Acetaminophen (Tylenol)

how many grams are we allowed in 24 hours?

if your greater than 12 years of age...whats ur dosage

Back 27

We are allowed 4grams in 24 hours of acetaminophen (2 Tylenol q4 -you’re already there)

325-650 mg q4-q6

Front 28

Acetaminophen (Tylenol)

PO
-if they are greater than 12 years old, what is their dosage

-if they are less than 12 years old, what is the dosage?

Back 28

PO >12 yrs 325-650 mg q4-6

<12 yrs of age 10-15 mg/kg q4 hrs test

Front 29

Toxicity and Acetaminophen

-when will it happen?
-what will it result in?

-when can we see damage?

Back 29

can occur if Acetaminophen dose exceeds 4gm/day


liver damage (Hepatoxocitiy)

Liver effects not totally known for 48-72 hrs after ingestion if they come in, in 6 hours we will draw CBC, LFT, Tylenol level, etc.

Front 30

Acetaminophen (Tylenol)

what is the antidote for tylenol OD?

-what does it do?

Back 30

Mucomyst (acetylcysteine)

--Converts toxins into non-toxic product that can be excreted through the kidney and in the stool

Front 31

Tylenol and Mucomyst (Acetylcysteine)

needs to be given:
how is it given?
what's the dose?

Back 31

-Needs to be given as soon as possible after the ingestion
-Given PO or via NG tube, IV
-Smells and tastes really bad!
-Can mix with chocolate milk or white soda

2-2.5 oz dose -weight based

Front 32

Antihistamines:

Activation of the H1 receptor will produce what physiologic effect

Back 32

-vasodilation
-increased permeability (edema)
-bronchial constriction
-itching and pain at nerve endings

Front 33

Antihistamines


Activation of the H2 receptor will produce what physiologic effect

Back 33

gastric acid secretion

Front 34

Antihistamines

What histamine receptor is blocked by antihistamines during an allergic reaction

Back 34

H1

Front 35

What is the main difference between the 1st generation and 2nd generation antihistamines

Back 35

2nd generation do not cross the blood brain barrier because they don’t have chemical properties. Because of that they are not suppose to cause sedation.

2nd gen- ITS ALL PO OR IN THE NOSE (no iv or im)

Front 36

Antihistamine 1 or 2

Dissolvable tablets

Back 36

2

Front 37

Antihistamine 1 or 2

Rectal supp: Phenergan

Back 37

1

Front 38

Antihistamine 1 or 2

PO IV IM

Back 38

1

Front 39

Antihistamine 1 or 2

Nasal spray

Back 39

2

Front 40

Antihistamine 1 or 2

crosses the BBB and gets into the brain

Back 40

1

Front 41

Antihistamine 1 or 2

Given for people with seasonal allergies

Back 41

2

Front 42

Antihistamine 1 or 2

Take with food

Back 42

1

Front 43

Antihistamine 1 or 2

Monitor for urinary retention

Back 43

1

Front 44

Antihistamine 1 or 2

Tachycardia

Back 44

1

Front 45

Antihistamine 1 or 2

Hard candy for dry mouth
(anticholinergic effects)

Back 45

1

Front 46

Antihistamine 1 or 2



Promethazine

Back 46

(Phenergan)

1

Front 47

Antihistamine 1 or 2

Diphenhydramine

Back 47

1
Benadryl OTC

Front 48

Antihistamine 1 or 2

Cetirizine

Back 48

Zyrtec OTC
2

Front 49

Antihistamine 1 or 2

Loratadine

Back 49

Claritin OTC
2

Front 50

Antihistamine 1 or 2

Chlorpheniramine

Back 50

Chlor-Trimetron OTC
1

Front 51

Antihistamine 1 or 2

Fexofenadine

Back 51

Allegra
2

Front 52

Antihistamine

When it comes to mast cell and basal cell which carry histamine, there are no receptors on those cells, so when u give Benadryl or any other antihistamine, it wont stop the release of histamine off the cells.
-what does it do?

Back 52

It just stops the receptor activation that the histamine will cause.

Cannot block release of histamine from mast & basophil cells all u can stop is the receptor response from it

Front 53

Antihistamine 1 or 2


Causes CNS depression

Back 53

1

because of the histamine in the brain – it’s a neurotransmitter. when u block the receptor in brain by giving antihistamine u r blocking the receptors ability to be actived by histamine in my brain that says wake up!

When you block, you get drowsiness, sedation

Front 54

Tell me about Pediatric pt’s and Antihistamines

Back 54

very sensitive to these drugs (anti-histamine products)
Too much can cause seizures

Front 55

Antihistamine 1 or 2

Anticholinergic effects which means: (dry mouth)

Back 55

1

Benadryl and Phenergan have a significant effect