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86 Cards in this Set

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Where do drug/medication come from?
Plants, Laboratories
State the purpose of the FDA
(Food & Drug Administration)

Determines safety, controls what manufacturer states the drug does, looks @ all new things created
Explain the difference b/w generic & name brand
Generic Name = Official name

Brand Name = Name given by the company, have different dyes/fillers
How are drugs classified?
1st = by therapeutic classification (disease state drugs are used to treat)

2nd = Pharmacologic classification (drugs mechanism of action)
What is a prototype drug?
1st drug created in its classification
What does the term pregnancy category refer to?
Safety of drugs to fetus
What does the term schedule refer to?
Referred to control substances 1-5

1 = Highly addictive
2 = morphine
3 = Cough syrup w/ codeine
Compare the terms therapeutic & unlabeled use
Therapeutic use = What drugs are created for

Unlabeled use = using meds for other reasons/use
How do drugs work?
Majority drugs work by hitting receptor site, blocks responses
Define the term pharmacodynamics
pharmacodynamics = how the drug works, the study of the action of drugs
Explain why drugs cause side effects/adverse effects
Drug hits other receptor sites
Define the term pharmacokinetics
pharmocokinetics = refers to the way the body processes a medication
-Absorption
-Distribution
-Metabolism (all oral meds go through liver first)
-Excretion
Describe each component involved in the pharmacokinetic process
Absorbed -> Live -> Enzymes system -> Metabolism -> Inactive metabolite
Identify three factors that affect absorption
1. Presence of food
2. Age
3. Formulation of the drug (pill/liquid)
Discuss how liver disease affects metabolism of drugs
-If liver is sick, metabolism of drugs decrease
-Doses should be lower
-Slows down metabolism, rick of overdose
Cite the main method of drug elimination
Kidneys
Identify four legal responsibilities of the nurse when administering medications
-Check allergies
-Documentation
-Meds ordered by physician
-Know what drug is being used for
-Know dosage patient is taking & drug/drug interactions
-Know specific responsibilities related to the drug (BP)
Liver disease
Liver is sick & can't metabolize

mouth -> stomach -> intestine -> liver
What does the liver do to the drug?
1. Nothing = Drug leaves liver, enters blood stream, hits receptor sites
2. Part of drug metabolized into inactive metabolites -> enters blood stream -> does nothing -> remainder of drug -> hits receptor sites
3. Makes some active metabolites, remainder of drug hits receptor sites
Define: Antipyretic, analgesia, pain, & inflammation
-Antipyretic = Reduces fever
-Analgesia = deadening of sense of pain w/o loss of consciousness
-Pain = acute physical pain
-Inflammation = Swelling, red, warm, pain
Discuss the role of prostaglandins in the etiology of pain, fever, and inflammation
-Prostaglandins cause pain, inflammation, & fever
-Potent hormone like substances produced in various mammalian tissues
-Prostaglandins have a wide range of physiological functions; control of blood pressure, contraction of smooth muscle, modulation of inflammation
Aspirin (ASA, Acetylsalicylic Acid)
-Produce analgesia & reduce inflammation & fever, inhibits production of prostaglandins
-Anti-inflammatory histamine
-Vasodiltion = blood vessels open wider
-Anti-pyretic = reduces fever
-Anti-platelet = prevents clumping
-SE = GI bleeding, Hearing loss, kidney failure
Ibuprofen (Motrin)
(amalgesis)
-Inhibits production of prostaglandins
-Anti-inflammatory
-Anti-pyretic (fever reduction)
-Anti-platlet (prevents clumping)
-SE = Kidney damage, GI bleeding
Acetaminophen (Tylenol)
-Inhibits production of prostaglandins
-Not an anti-inflammatory
-Anti-pyretic (reduce fever)
-Not an anti-platelet
-SE = Damages liver
-Don't take more than 5 grams
(500 mg = 1 gram)
Opioid agonists
-Prototype – morphine
-Cause of response
-Helps relax people
-Comes in a lot of different routes
(1)Oral, intravenously (most common way given IV)
Opioid antagonists
-Prototype = naloxone (Narcan)
-Blocks a response
-Knocks opioid off receptor site
Compare and contrast acute and chronic pain.
-Acute pain = specific area
-Chronic pain = body adjusted to pain for more than 6 months
Describe the endogenous analgesia system.
-Endogenous Analgesia = (inside) creates endorphins
-Exercise, massage, crying, etc.
Identify key questions to ask when doing a pain assessment.
-Ask “Are you in discomfort?”
-Do pain check & count respirations
Name the prototype drug for narcotic analgesics.
Prototype - Morphine sulfate opioid
State the mechanism of action of opioids.
-Alters our perception of pain & response to pain
-Describe specific assessment prior to and during administration of opioids.
-Do pain assessment
-Count patient respirations
-Rate = 10 or above
-<10/min = dose needs to be decreased by 25-50%
Morphine
-Opioid agonists
-Decrease in severity of pain
-Binds to opiate receptors in the CNS
-Alters perception of response to pain
-Use with cautions w/ MAO inhibitors
-SE = constipation, confusion, sedation, dizziness, hallucinations, nausea, itching, physical and psychological dependence
Meperidene (Demerol)
-Opioid agonists
-Binds to opiate receptors in the CNS
-Decrease in severity of pain
-SE = constipation, confusions, sedation, hallucinations, headache, nausea, physical and psychological dependence
Fentanyl (Duragesic)
-Opioid agonists
-Molecular like Demerol & morphine
-Pain relief like morphine
- SE = constipation, over sedating (patch), respiratory depression(dispose patches in sharp container)
Oxycontin
-Opioid agonists
-Oxycodone in long acting form
-Crush or dissolve = get a rush
-Very effecting pain med
-Great for chronic pain issues
-Not as sedating as fentanyl
-SE = constipation, some sedating and constipation
Codeine
-Opioid agonists
-Used for mild/moderate pain, w/ Tylenol
-Ceiling to amount given b/c opioid is in combination w/ something
-SE = constipation, vomiting, GI distress
Outline patient teaching to include – signs of overdose, bowel care, position changes, mentation changes and safety issues.
-Overdoes – increasing drowsiness, confusion.
-Peristalsis slows down -> creates constipation -> decrease in blood pressure -> changes in mentation -> changes way a person thinks
Identify two potential problems associated with frequent use of the combination drugs Hydrocodone bitartrate (Vicodin) and oxycodone hydrochloride (Percodan, Percocet).
-Vicodin = Tylenol & Hydocodone
-SE = Liver damage

-Percocet = Oxycodone & Tylenol
-SE = Liver damage

-Percodan = Oxy & Aspirin
-SE = GI distress
Define physical and psychological dependence, tolerance, and cross tolerance.
-Physical dependence = Body is getting use to it (Wing patients off slowly or side effects-Withdrawals, tremors, vomiting, diarrhea)
-Psychological dependence = Anxiety, irritability, no physical withdrawal signs, have higher doses b/c take it all the time (high tolerance), (Smoking, coffee, alcohol)
-Cross tolerance = Build up a tolerance in opioid you build up a tolerance in all opioid drugs
Identify one opioid antagonist; describe its mechanism of action, side effects and adverse effects.
-Antagonists = blocks responses, displaces
-Narcon = given intravenously
-SE = Withdrawals, nausea, vomiting
Penicillin

-Prototype
-Adverse Effects
-Histamine
-Epinephrine
-Benadryl
-Prototype = Penicillin G
-Adverse Effects = Seizures & Anaphylaxis=life threatening allergic response
-Histamine = causes inflammation, high capillary permeability, redness, heat & swelling, vasodilatation
-Epinephrine = bronchi dilation, to open up the bronchi
-Benadryl = anti-histamine
Cephalosporin

-Prototype
-Prototype – cefazolin (Ancef)
-Identical to penicillin
-Close to molecular structure of penicillin
Aminoglycosides

-Prototype
-SE
-Prototype – Gentamicin Sulfate (Garamycin)
-Cause damage to the ear & kidneys
-Nephrotoxcity = kidney damage
-Ototoxicity = ear damage
Quinolone

-Prototype
-AE
-Prototype = Ciprofloxacin Hydrochloride (Cipro)
-Cipro = very affective antibiotic
-Crystals form in kidneys, must take w/ water
-AE = Photosensitivity, sunburns, seizures (use w/ caution on people w/ history of seizures)
Macrolide

-Prototype
-SE
-Prototype = Erythromycin
-Used for variety for infections = Respiratory infection
-A lot of drug/drug interaction
-SE = GI distress, yeast infection, Ototoxicity (ear damage)
Tetracycline

-Prototype
-SE
-Prototype = Doxycycline (Vibramycin)
-Taken w/ food, not w/ dairy products, Will combine w/ dairy products
-Don't give to pregnant women=birth defects
-Discoloration of teeth
-SE = colitis (inflammation of the Colan), GI distress
Sulfonamides

-Prototype
-SE
-Prototype = Trimethoprim & Sulfamethoxazole (Bactrim)
-Bractrim = Used for urinary tract infections
-SE = Crystal formation in urine, allergic reaction, (many people allergic to sulfur)
State a therapeutic indication for Vancomycin Hydrochloride.
-Vanomycin = Use when all else fails
-Use if allergic to penicillan
-Binds to bacterial cell wall, resulting in cell death
Anti–HIV therapy
-Protease inhibitors
-Prototype = Zidovudine (AZT)
-Slowing replication of the virus
-SE =Blood disorders, GI distress
Anti–Herpes therapy
-Prototype = acyclovir (Zovirax)
-SE = GI distress, dizziness, headaches, hallucinations
-AE = Seizures
-Herpes virus can stay forever
-Herpes Simplex I & II = Not deadly, dangerous to get in cornea
-valcerations
-Blindness, high pain, sensitive to light & tearing, clear damage
-Herpes I

-Herpes II & Active
-Herpes I = Corners of mouth

-Herpes II & Active = Birthing mom must have C-Section, fatal to newborns, don’t have strong immune systems
-Herpes Zoster (Shingles)
-Herpes Zoster (Shingles) = Varicella virus (chicken pox) reactivates
-Pain right on nerve
-Past neveptic neuralgia = Nerve Pain, contagious to people who haven’t had chicken pox or if own immune response drops
Anti–Influenza therapy
-Prototype = Amantadine (Summetrel)
-Prevents penetration of influenza
-SE = constipation
-AE = slows virus replication
HIV
-Immune deficiency
-Tlymphocyte Count (WBC) lower than 200
-Blood count helps fight, viruses, mutant cells, precancerous
AIDS
-Acquired
-Collection of symptoms
-Opportunistic diseases = caners, preumocytis pneumonia, fungal infection(yeast), herpes,CMV = Retina (cyto meglo virus)
-State the cause of Acquired Immunodeficiency Syndrome (AIDS).
HIV (virus)
-AZT = slows virus replication
Identify four opportunistic diseases associated w/ AIDS.
1. Cancers
2. Preumocytis pneumonia
3. Fungal infection-yeast
4. Herpes
5. CMV = Retina (Cyto meglo virus)
Identify one common side effect and one adverse effect associated with AZT.
-Blood disorders
-GI distress
State a common side effect related to amantadine and acyclovir.
-Amantadine = SE= Constipation, AE= Overdose, problems w/ motor coordination/function

-Acyclovir = SE= GI distress, headaches, dissiness, hallucinations, AE= seizers
Polyene
-Antifungal Agent
-Amphotericin B (Fungizone)
-Med used intravenously on those that have a fungal infection in the blood only.
-Lots of adverse effects, not used routinely
Azole
-Anitfungal Agent
-Fluconazole (Diflucan)
-Oral
-Is used for AIDS
-Works extremely well
-SE = Liver damage (Hepatotoxicity), lost of taste (Permanent or not)
-Most physicians won’t order this drug b/c of extreme liver damage
Anti Anxiety Drugs (Anxiolytics)
-Classifications
1.Benzodiazephines
Prototype – Diazepam (Valium)
2.Azapirone (Nonbenzodiazepine)
Prototype – Buspirone Hydrochloride (BuSpar)
Antidepressant Drug Classifications
1.Tricyclic Antidepressants
2.Monoamine Oxidase Inhibitors (MAO)
3.Selective Serotonin Reuptake Inhibitors (SSRI’s)
Tricyclic Antidepressants
-Antidepressant Drug Classifications
-Prototype = Imipramine Hydrochloride (Tofranil & Elavil)
-Allowing accumulation of norepinephrine in brain (prevents the re-uptake b/w two nerve cells)
-Lessen serotonin
-4 weeks for effects
-SE = Constipation,urinary tension, dry mouth, blurred vision
-AE = Diserhythmias - saves up pills & take at one time
Monoamine Oxidase Inhibitors (MAO)
-Antidepressant Drug Classifications
-Examples – Phenelzine (Nardil) & Tranylcypromine (Parnate)
-ase – enzyme
-Monoamine Oxidase = One enzyme
-Preventing enzymes in liver from breaking down accumulating norepinephrine & slows metabolism
-Rarely used b/c of drug/drug interactions
-Norepinephrine = vassal constricter = high BP
-AE = high blood pressure = stroke
-4 weeks for effects
Selective Serotonin Re-uptake Inhibitors (SSRI’s)
-Antidepressant Drug Classifications
-Prototype = Fluoxetine Hydrochloride (Prozac)
-Examples – Sertaline (Zoloft) & Paroxetine (Paxil)
-Most commonly used
-Selective serotonin re-uptake inhibitor = target serotonin more = accumulation
-SE = Weight gain, Headache
-AE = Weight gain = cardiac disease, Sexual dysfunction = Male becomes emphatint, Withdrawals = Go off slowly
-1 – 2 weeks for effects
Antimanic Drug Classifications
-Drug of Choice – lithium carbonate
-Other drugs used, Anti-convulsants
Tramine foods
(Bland foods Ex. Rabbit Food)-> Noropinephrine -> Increase blood pressure
#1 Depression
-anti-depressant = life long
-Genetically chemical imbalance of neuron transmitters
#2 Depression
-anti-depressant = short term
-1 time event related to situational trauma, result of a major trauma (stress alters the brain)
Theraphy for Depression
-Electro Convalsive Theraphy (ECT)
-Increase nerve transmitter levels
-Patient given IV sedative, electos put on brain
-Enough elctro put stimalis to make feet twitch.
-Done 2/3 times a week for 4/6 weeks
-Immediate side effect = Short term memory loss
What do you ask someone that approaches you about they're depression?
1st-Are you considering suicide
2nd-Do you have a plan?

-Suicide success increase when energy level increases
Patient kidney's are damage
-Overdose b/c kidneys won't excrete meds properly
Prototype of Opioids
-Morphine
What is unlabeled use?
-An unitended use of medicine
what medicine was taken off the market?
-Vioxx = heart problems
Medicine that should not be given to children
-aspirin = Reyes syndrome (deterioration of liver)
-till 18 yrs old do not give aspirin

-syndrome = collection of symptoms
What happens to a patient taking more than the prescribed dose of vicodin?
-damage to liver (Tylenol)
-Jondis = skin becomes yellow (sign of liver disease
-4 grams (8 tablets) Tylenol OK
Side effect for all Opioids
-Constipation
How long can a patch be on?
-72 hrs
Penicillin G Adverse Effects
-Anaphylaxis = allergic response (rash, itching)
-Lows blood pressure so much
-Histamine released -> dilation -> permeability
Epinephrine
-Opens up the bronchi
-Increase person's ability to breathe
Aminoglycosides
-Nephrotoxcity = kidney damage
-Ototoxcity = ear damage
Upper respiratory problem
-Is a viral infection, not a bacteria infection
Tetracycline Adverse Effect
-AE = Colitis (inflammation of the colon)