Pharmacology Final

Front 1

What are the 5 drug schedules?
Their significance?
What law created them?

Back 1

CSA 1970
How often drugs can be prescribed
Scheduled I-IV (II highest in USA)

Front 2

What is the difference bw agonist and antagonist?

Back 2

Agonist= binds and creates action

Antagonist= binds and inhibits action

Front 3

Name and define the 4 stages of new drug development

Back 3

1) Preclinical = animals and test tubes

2) Clinical = humans

3) IND review = FDA, marketed

4) Postmarketing = studies by anyone

**black box warning**

Front 4

What are the enteral routes and what the parenteral routes?
The "other" routes?

Back 4

Enteral = oral, sublingual, OG/NG tube, buccal

Parenteral = interdermal/ muscular, subQ, intravenous

Other = opthalmic/ otic, rectal, vaginal, transdermal, inhilation, intranasal

Front 5

What factors affect the rate of drug absorption in the body?

Back 5

body weight, half-life, age, disease, food in GI, pH in GI, sleep pattern

Front 6

What are the 7 rights of medication administration?

Back 6

right:
1- pt

2- drug

3- dose

4- route

5- time

6- technique

7- documentation

Front 7

What is the purpose of the prescription drug marketing act?

Back 7

to prevent reimportation

Front 8

The angles and procedures involved in giving an ID, subQ, IM and IV injection.

Back 8

ID= 10-15*, creates a wheal (bubble)

SubQ= 45*, pinch skin

IM= 90*, z track method, pull skin down

IV= puncture vein, around 15-30*

Front 9

What is the difference between an allergic rxn and anaphylactic shock?

Back 9

allergy = itchy, red

anaphylactic shock = itching, red, low BP, resp distress

Front 10

What are the tips/ tricks to aiding in drug excretion that you might give to a pt?

AKA routes of drug excretion

Back 10

sweat, tears, urine, feces, saliva, mucous, breast milk, breath

exercise, drink water, chew gum, pump bm, exercise

Front 11

What is the purpose of the Omnibus Budget Reconciliation Act?

Back 11

government was low on $

many health care advances now unfunded mandate on states

Front 12

What are the 4 subcategories in the Health Insurance Privacy Accountability Act?

Back 12

confidentiality

electronic security

unique ID

system of accountability

Front 13

Explain the difference between pharmacokinetics and pharmacodynamics?

Back 13

kinetics = elimination of drug

dynamics = how drug affects body, MOA

Front 14

The sources of drug dervation

Back 14

plants = digitalis

synthetic = fentanyl

mineral = silver nitrate

animals = old insulin

engineered = insulin, tPA

Front 15

What are the 4 parts of Medicare?

Back 15

A = inpatient care

B = outpatient care

C = HMO

D = prescription drugs

Front 16

What unit is insulin measured in?

Back 16

International Units (IU)

Front 17

Describe the primary difference between gram + and gram - bacteria?

Back 17

the cell wall

Front 18

Describe the 4 steps of Gram staining?

Back 18

1= crystal violet

2= gram's iodine

3= alcohol

4= safranin

Front 19

List the common side effects of antibiotic therapy

Back 19

nausea

nephrotoxicity

hypersensitivity - allergy

Front 20

Suffixes of:

sulfonamides

penicillins

fluoroquinolones

cephalosporins

macrolides/ aminoglycosides

Back 20

"sulfa"

"___cillin"

"____oxacin"

"cef/ ceph"

"___mycin"

Front 21

Name 2 common drug categories which will have altered effectiveness when coadministered w/ antibiotics?

Back 21

anticoagulants = increase

contraceptives = decrease

Front 22

List MOA's that make an agent bacteriostatic and several mechanisms that make an agent bactericidal

Back 22

static = prevents replication by destroying DNA

cidal = kills cell by preventing the cell wall from forming

Front 23

Define opportunistic infection, and what types of agents can cause it?

Back 23

takes advantage of reduced immune system or bacteria/ fungi/ viral imbalance

Front 24

Why can't TB be gram stained?

How long is the tx regimen?

What is used to treat it?

Back 24

outer membrane is mycolic acid
Tx is 6 months
Rifampin and INH

Front 25

Describe the relationship bw a T cell and a B cell in the immune response

Back 25

T = alert immune system, attack

B = alert immune system, make antibodies

Front 26

Define antigen and antibody.
Define toxoid.

Define attenuated.

Back 26

Antigen = protein expressed on the outside of immune cells

Antibody = protein substance that alerts immune system

Toxoid = attenuated antigen that won't get you sick

Attenuated = live bac / virus in immunization

Front 27

Define active and passive immunization and give an example of each.
What route is common for each type?

Back 27

Active = get illness or immunization (dead / attenuated)

Passive = breast milk, mom to fetus, injection of antibodies

Front 28

What age for MMR immunization?

Back 28

12 months

Front 29

How often for Tetanus booster?

Back 29

10 years

Front 30

Commonly prescribed antifungal cream in the elderly population?

Back 30

ketaconazole cream

Front 31

Signs and symptoms of malaria and how it's transmitted?

Back 31

fever, diarrhea, severe dehydration

transmitted by mosquitos

Front 32

Contraindications to opioid antagonist use

Back 32

allergy, pregnancy, <1 month old

Front 33

Opioids CSA schedule?
Mix w/ NSAID's makes it what schedule?

Back 33

II

mixed makes them II or V

Front 34

Name examples of NSAID's and Opioids

Back 34

NSAIDS = ibuprofin, ketorolac, indomethacin

Opioids = morphine, fentanyl, heroin, buprenophine

Acetaminophin = safe for pregnancy

Asprin

Front 35

Indications, Contraindications and Side Effects of Opioids

Back 35

Ind = pain (acute or after surgery)
Contra = allergy, increased ICP, alcohol use, low BP

S.E. = allergy, resp depression, lethargy, nausea, miosis

Front 36

Describe the signal gating theory of pain stimulation

Back 36

triggering somatosensory blocks pain from nociceptors

rubbing a jammed finger

Front 37

Side effects of NSAID administration include:

Back 37

stomach pain, ulcers, increased bleeding, headache, dizziness, allergic rxn

Front 38

Painkiller used in pregnancy

Back 38

acetaminophin

Front 39

Four substances in the body that facilitate pain transmission

Back 39

histamine

prostaglandins

serotonin

bradykinins

Front 40

Two substances in the body which naturally stimulate opioid receptors

Back 40

endophins

enkephalins

Front 41

What are the physiological changes that occur when the SNS is activated?

Back 41

pallor, ^ HR, ^ BP< clammy, tremors, repro and GI get reduced blood flow

Front 42

Physiological changes that occur when PNS is activated?

Back 42

color returns, decreased HR, decreased BP, returned blood flow, lowered anxiety and tremors, SLUDGE symptoms

Front 43

Neurotransmitters and their effects

Back 43

ach = attention

dopamine = mood / behavior

serotonin = mood

norepi = mood / attn

glutamate = stimulates signals

GABA = inhibits signals

Front 44

two things remain intact to remain conscious?

Back 44

RAS

1 cerebral hemisphere

Front 45

gray matter is made of what?

Back 45

nerve cell bodies

Front 46

functions controlled by autonomic nervous system

Back 46

HR, RR

Front 47

pathophysiology of parkinson's

Back 47

breakdown of basal ganglia

decreased dopamine and increase ach

carb/ lev to supplement dopamine

benadryl to inhibit ach

Front 48

effects of b1, b2, a1, and a2

Back 48

b1- increase hr

b2- bronchiole dilation

a1- vasoconstrict

a2- vasodilate

Front 49

effects of b1, b2, a1, and a1 antagonists

Back 49

b1= decreased hr

b2= nothing

a1= vasodilate

a2= nothing

Front 50

if a pt is on MAOIs what precation should they take?

Back 50

avoid aged foods (tyramine) or it could lead to a hypertensive crisis

Front 51

MOA of SSRA/SSNRA, Tricyclics nad MAOI's used to treat depression

Back 51

SSRI/ SSNRI = safest

they all keep serotonin and norepi in the synapse longer

Front 52

MOA of cardiac glycosides

Back 52

make heart beat stronger

Front 53

the shared MOA between all antiarrhythmics:

Back 53

slow HR

Front 54

MOA for class I-IV and antiarrythmics

Back 54

I = NA channel blockers (caine)

II = B blockers (lol's)

III = K channel blockers

IV = Ca channel blockers

Front 55

Drugs such as nifedipine slow HR, what kind of drug is it?

Back 55

antiarrythmics

Front 56

Nitrates MOA and Contraindication?

Back 56

MOA- make vessels bigger

Contra - trauma, low BP

Front 57

MOA of ACE inhibitors and Contraindications?

Back 57

MOA= lower BP, lower HR, vasodilation
Contra= already ^^

Front 58

common side effect of ACE inhibitors

Back 58

dry annoying cough

Front 59

when are B blockers contraindicated?

Back 59

lowered HR, lowered BP

Front 60

Difference between antibleeding drugs

Back 60

AntiCoagulants = inhibits coagulation cascade

AntiPlatelets = inhibits platelets from sticking

ThromboLytics = break the clot

Warfarin, "aban", ASA, Clopidogrex (plavix)

Front 61

What does keeping calcium in the cell longer do to the heart?

Back 61

increase the strength

Front 62

Describe the MOA of statin drugs and complications

Back 62

MOA = reduce liver production of cholestrol

Complications = rhabdomyolysis (musc pain, dark pee)

Front 63

why would a b blocker make pulmonary edema worse?

Back 63

cause more fluid to back up, making them worse

Front 64

When are diuretics indicated?
When are they contraindicated?

Back 64

ind = high bp, heart failure

contra = low bp, renal failure, severe dehydration

Front 65

a potential complication w/ the adminstration of a ______ diuretic is hypoalemia

Back 65

loop

Front 66

Common loop dieuretics

Back 66

lasix, bumex

Front 67

common thiazide

Back 67

HCTZ

Front 68

common beta blocker

Back 68

end in "lol"

Front 69

common cardiac glycoside

Back 69

digatalis

Front 70

what med prevents damage to the thyroid from radioactive iodine exposure?

Back 70

potassium iodine

Front 71

MOA of insulin and contraindications?

Back 71

MOA - lower bgl by facilitating glucose entering the cell

Contraindicatin - hypoglycemia, unknown BGL

Front 72

types of insulin by naming schemes

Back 72

humulin = rapid

humulin R = regular

humulin N/L = long

humulin U = ultra long

Front 73

MOA of glucagon

Back 73

increased BGL

Front 74

type 2 diabetes

Back 74

insulin resistance

high glucose absorption

Front 75

type 2 diabetes tx and contraindications

Back 75

reduce resistance (^ insulin receptors, change receptors, increase insulin affinity)
reducing glucose absorb (reduces BGL)

contra= low BGL

Front 76

uses for glucocorticoid include:

Back 76

decreased pain, allergic rxn, asthma, decreased swelling

Front 77

"triple therapy" is used in the the tx of ______ and medications are:

Back 77

peptic ulcers

amoxyl, flagyl, omeprazole

Front 78

Combination drugs to treat asthma that include two meds

Back 78

advair (b2 w/ cortico)

symbicort (b2 w/ cortico)

duoneb (b2 w/ drying agent)

Front 79

best tx for vomiting / diarrhea

Back 79

let it go

Front 80

serotonin inhibitor for GI irritation

Back 80

zofram

Front 81

dopamin inhibitor for GI irritation

Back 81

haldol

Front 82

Biggest concern w/ over the counter decongestants

Back 82

increased BP, expecially w/ history of hypertension

Front 83

Compazine is contraindicated w/??

Back 83

pregnancy

Front 84

3 reversible items in the pathophysiology of an asthma pt

Back 84

smooth mus constriction (b2, xanthine derivatives reverses)

inflammation (corticosteroids, leukotriene, mast ell stabilizers reverse)

mucous production (antitissives)

Front 85

adsorbents such as pepto bismol reduce diarrhea by

Back 85

preventing water absorption

Front 86

three types of diabetes

Back 86

I= pancreas doesn't produce insulin

II= insulin resistance

Gestational= insulin resistance due to hormonal changes

Front 87

difference bw adsorption and absorption

Back 87

ab = fluid is dissolved within

ad = atoms from substance adhere to surface of the adsorbent

Front 88

relationship between T3 and T4. MOA of T3?

Back 88

Thyroid secretes T4 (made w/ iodine)

T4 -> T3

T3 controls metabolism