Pharm Test 2 - Study Guide (37-44)

Front 1

Triptans are what:

when are they given?

Back 1

Selective Serotonin agonists

migraine and cluster headaches

Front 2

Triptans
-what kind of headaches do they work on?
-how do they work to help a headache?

Back 2

These drugs work on dilatory headaches

enhance receptor action (the serotonin system in the brain)

Front 3

Triptans

how can they affect cerebral and coronary vascular struuctures?

Back 3

Can cause vasoconstriction of the cerebral/cardio vascular system and produce an anti-inflammatory effect

Front 4

Triptans
-before administration, what must the patient be evaluated for?

Back 4

for any coronary or cerebral risk factors by their primary health care provider (coronary and stroke risk factors like hypertesion, obesity, post menopausal women, men over 40, smokers, diabetes, family history of CAD)

Front 5

Triptans

what is the risk:

pregnancy category

Back 5

can cause MI and stroke

c

Front 6

tension headache- caused by:

Back 6

constriction of muscles in the neck

Front 7

triptan

adverse effect

Back 7

Coronary vasospasm --> angina --> hypertension

Front 8

Osteoporosis
-name pharmaceutical prevention

Back 8

lifestyle changes; stop smoking, healthy diet, weight bearing exercises (30-40 minutes a day) like walking and weight training

Front 9

Osteoporosis

OTC products that can be used as prevention:

Back 9

calcium (caltrate) and Vitamin D

Front 10

Osteoporosis

What perscription med can be used

Back 10

Alendronate (Fosamax)

Front 11

Osteoporosis

Patient education and Fosamax

Back 11

Fosamax- they can’t lay down 30 minutes after taking it. they have to sit up.

When u lay down the gastric contents will flex back up towards you’re your esophagus. The medication causes the acid to be more acidic and it reflexes up and can erode the sphincter between the esophagus and stomach

Front 12

Osteoporosis

Fosamax
-side effects if you lay down?

Back 12

headache
GI upset
esophageal burns

Front 13

How can a women help bone production naturally?

Back 13

Weight bearing and vit d and calcium supplements

Front 14

BPH (Benign Prostatic Hyperplasis)

2 causes:

Back 14

overgrowth of epithelial cells causes mechanical obstruction of urethra

over growth of smooth muscle causes dynamic obstruction

(both cause problems starting and stopping stream)

Front 15

BPH (Benign Prostatic Hyperplasis)

Herbal treatment

Back 15

Saw Palmetto 320 mg qd

(it will take 4-6 months for it to get in there and help. It will work by reducing inflammation )

Front 16

BPH (Benign Prostatic Hyperplasis)

alpha blockers
-what do you use if you have a large prostrate?

-what do you use if you have a small prostrate?

Back 16

5-alpha reductase inhibitors (use if you have a lg prost.)


Alpha 1 – adrenergic antagonist (use if u have a sm prostrate)

Front 17

BPH (Benign Prostatic Hyperplasis)

Look for ______ to tell you your dealing with 5 alpha that is used specifically for prostrate problems

Back 17

“asteride”

Front 18

BPH (Benign Prostatic Hyperplasis)

5-alphas reductase inhibitors
(what are the names of the two used for treatment?)

Back 18

Proscar (Finasteride)
Avodart (Dutasteride)

Front 19

BPH (Benign Prostatic Hyperplasis)

how do the 5-alphas reductaste inhibitors (finasteride and dutasteride) help a patient with BPH?


how long will it take to see effect?

two side affects?

Back 19

-Promote regression of epithelial cell tissue growth(inhibit cell growth)

Can take 6-12 mths for effectiveness to be seen


decreased libido, gynecomastia

Front 20

BPH (Benign Prostatic Hyperplasis)

Proscar (Finasteride)
Avodart (Dutasteride)
-what type of BPH are these used for?

Back 20

mechanical obstruction- Over growth of epithelial cells cause mechanical obstruction of urethra

USED FOR LARGE PROSTRATE OVERGROWTH

Front 21

BPH (Benign Prostatic Hyperplasis)

Prazosin
Terazosin
-how do these meds help with BPH?

Back 21

competitive antagonist at alpha 1 receptors (benign prostrate growth)

Front 22

erectile dysfunction

Look for _____ to tell it’s a phosphodiesterase inhibitor

Back 22

fil

Think corpus filling to help remember this drug. It going to fill the corpus in the penis and allow it to engorge (vasodilate) with blood to get an erection

Front 23

erectile dysfunction

Phosphodiesterase 5 (PDE5) inhibitors
-what are the 3 drugs?

Back 23

Silenadfil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)

Front 24

erectile dysfunction
-common causes:

Back 24

damage to nerves, arteries, smooth muscle most often as a result of a disease

diabetes is one of the most common causes

kidney diseaes, chronic alcoholism, MS)

Front 25

Phosphodiesterase 5 (PDE5)
-Silenadfil (Viagra)
-Vardenafil (Levitra)
-Tadalafil (Cialis)

how do these drugs work?


what do we inhibit?

Back 25

Work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.

Front 26

Phosphodiesterase 5 (PDE5)
-Silenadfil (Viagra)
-Vardenafil (Levitra)
-Tadalafil (Cialis)

what do these meds cause (constriction or dilation)
-what kidn of meds can make this worse?


do these drugs cause cardiac arrest?

Back 26

-these drugs are dilators (if they dilate in the penis they are dilating throughout the entire body -- Hypotension is what kills the patient)


increased HR meds cause Hypotension that can be deadly

These drugs do not cause cardiac arrest, the act of intercourse itself is the causative agent

Front 27

Phosphodiesterase 5 (PDE5)
-Silenadfil (Viagra)
-Vardenafil (Levitra)
-Tadalafil (Cialis)

what are the other drug interactions?

Back 27

Interact with nitroglycerin products

Patients on heart rate control meds or antidysrthymic meds could have problems with these drugs

Caution with other meds that inhibit CYP3A4.
(Fungal agents, erythromycin, HIV protease inhibitors, Tagament these can increase the risk for hypotension to occur)

Front 28

Desmopressin DDAVP

3 things it's used to treat?

Back 28

Maintenance tx for diabetes insipidus

nocturnal enuresis (bed wetting) decreases urine production


von Willebrand’s disease (is Hemophilia A problem. It is a stress mediated problem. --clotting disorder.
-Stimulates release of clotting factor VIII

Front 29

Desmopressin DDAVP

diabetes insipidus
-what effect does it have?

Back 29

causes reabsorption of water

Front 30

Cholinergic Antagonists

Atropine
-what does it do?
-what are the side effects?

Back 30

---antagonizes the effects of excess acetylcholine due to organophosphorous poisioning.

Atropine has side effects, one of the main ones is Tachycardia. It will also slow down the bowel. It will block acetylcholine, so anywhere Ach is activate, it will block that.

Front 31

Cholinergic Antagonists

Atropine
-what do you have to monitor?

Back 31

-Cardiac monitoring
-fluid therapy
- activated charcoal for ingestions
-dehydration happens fast

Front 32

Cholinergic Inhibitors

- Cholinesterase is a enzyme responsible

Back 32

for the breakdown of Acetylcholine

Front 33

Cholinergic Inhibitors

We need to inhibit cholinesterase to keep:

Back 33

Ach from breaking down:

Front 34

Cholinergic Inhibitors

what medical problem are these typically used to treat?
-how are these drugs used to help treat this medical problem?

Back 34

myasthenia gravis


prolongs muscle contraction

Front 35

Cholinergic Inhibitors

how are these drugs dangerous to people?
-what is it used for?

Back 35

-very toxic
-highly lipid soluble
-used in pesticides and bioterrism

Front 36

Cholinergic Inhibitors

Symptoms:

Back 36

-Laryngospasm -airway difficulty problems
-Bronchoconstriction -wheezing can occur. (Tripod’ing because they can’t breath properly)
-Increased salivation like crazy
-Uncontrollable voiding or defecation diarrhea
-Seizure

Front 37

General Anesthesia:
-what is it?

Back 37

-State of CNS depression
-M/S relaxation
-alteration in reflexes

Front 38

Conscious sedation:
-what is intact?

Back 38

-Reflexes intact,
-pt aware but doesn't care;
-Analgesic, sedative,
-benzodiazepine

Front 39

Succinylcholine: Anectine

non-depolarizing/depolarizing?

long or short acting?

-main drug used for:

Back 39

depolarizing

main drug used for paralization

ulta short acting wears off within 20 minutes

Front 40

Succinylcholine: Anectine

Depolarizes:

Blocks:

What is the effect directly linked to?

Back 40

-Depolarizes and blocks receptors , the muscle loses its ability to contract
-Blocks cholinergic receptors at the motor end plate
-Effect is directly linked to blood concentrations of drug

Front 41

Whenever you see ‘curonium’ think ________

Back 41

general anesthesia.

Front 42

Pancuronium and Rocuronium

non-depolarizing/depolarizing?

-what are they approved for?

Back 42

non depolarizing

muscle relaxation

Front 43

Isoflurane
Enflurane
Halothane

are all examples of

Back 43

Inhaled anesthesia

Front 44

Inhaled anesthesia
-Isoflurane
-Enflurane
-Halothane

They cause depression of:

-they start off as:

Back 44

-Depression of cerebral and spinal cord function
-Start as liquids and are aerosolized into a vapor and inhaled.

Front 45

Inhaled anesthesia
-Isoflurane
-Enflurane
-Halothane

-are they metabolized?

Back 45

Not metabolized by the liver, they are inhaled in an active form for cellular absorption

Front 46

Inhaled anesthesia
-Isoflurane
-Enflurane
-Halothane

How is it excreted?

Back 46

Excreted through exhalation phase of respirations if any pt has any lung impairment (COPD asthma, cystic/pulmonary fibrosis, if they are missing a long, TB, cancer, anything that impairs pulmonary function has the potential to cause the medication not to be excreted properly)

Front 47

Look for “flurane” – it will tell you its:

Back 47

inhaled anesthesia product

Front 48

Inhaled anesthesia is a way people are kept in a __________

-what does it keep depressed?
-what does it suppress? (2)

Back 48

general anesthetic state.

It keeps the cerebral tissues depressed and suppresses spinal cord function.

Pain stimuli from periphery is also suppressed.

Front 49

nursing care during anesthesia:

Back 49

A – Airway, laryngospasm
B – Breathing, rate, depth, quality, SAO2
C – Circulation, IV, pulse quality, B/P, cap refill, Urine output
D – Disability, neurologic status

Front 50

Local anesthetics:
give...

Back 50

GIVE SUPERFICIALLY in 1 specific area to numb 1 area
They all mean that nothing is going into cerebral system – only on periphery

Front 51

Local anesthetics:
where is it applied

how does it work?

Back 51

to the skin or injected near the incision site

numbs the area by blocking the generation and conduction of the impulse through nerve fibers and blocks the movement of certain ions

Front 52

Local anesthetics:
-what are the ions that it blocks?

-what is the main one?

Back 52

Potassium, Calcium, Sodium

The blockage of Na is the main mechanism that produces the anesthesia affect

Front 53

Local anesthetics:
-what happens when sodium is blocked?

Back 53

Membrane becomes less permeable to the ions and they cannot move around to illicit the impulse

Front 54

Local anesthetics:
what are the uses:

Back 54

Used for surgical procedures, dental procedures, & diagnostic procedures

Front 55

local anesthetics are drugs that suppress the _______ by doing what

Back 55

pain

blocking impulse conduction along axons

Front 56

local anesthetics

-pain can be suppressed without causing generalized depression of the

Back 56

entire nervous system