Pharmacology Test 2

Front 1

water and the body

Back 1

body is 60% water. 20% is outside cells in blood and stuff and 40 % is water in cells.

Front 2

lab values

Back 2

na 135-145
k+ 3.5-5.5
ca+ 9-11
cl- 96-106
phosphate 2.8-4.5

Front 3

crystalloids

Back 3

fluid replacement for fluid and electrolyte maintence or replacement. they're clear. TPN is example.

Front 4

colloids

Back 4

fluid replacement that has proteins in it. blood, albumin, and plasma are all examples.

Front 5

isotonic solutions

Back 5

ns; LR; D5 1/4 NS, D5W

Front 6

hypertonic

Back 6

3% NaCl; D5NS; D51/2NS. flud moves from cells into vascular circulation, so it can cause pulmonary hyertension (check lung sounds), high Na+ levels, and high BP.

Front 7

kayexalate (sodium polystyrene sulfonate)

Back 7

reduces elevated K+ levels
exchanges Na+ for K+ in GI
good for acidosis
given PO, rectal

Front 8

magnesium sulfate (vicon forte, eldertonic)

Back 8

excreted by kidneys. prevents and controls convulsions with pregnancy, epilepsy, nephritis. can cause diarrhea, and high doses = flushing, sweating, and hypermagnesemia (low bp, depressed dtr, heart block, rr paralysis.

Front 9

thiamin

Back 9

oral im iv
give to trauma pt if they're alcohoic or if difficient.

Front 10

pyridoxine (B6)

Back 10

for alcoholism and given because of TB drugs that cause deficit.

Front 11

cobalmin (b12)

Back 11

po im
deficiency, elderly, or ppl who don't have intrinsic factor

Front 12

folic acid, b6, b 12

Back 12

used to decrease homocysteine leves = cardiac benefits

Front 13

vitamin e and selenium

Back 13

may prevent prostate cancer. no cardiac benefit from vit e, as was previously thought.

Front 14

vitamin k

Back 14

promotes blood clotting. give it to newborns or people with a hemmoragic disorder because they don't make vitamin k.

Front 15

ferrous sulfate

Back 15

300 mg tid. oral can cause reversible tooth staining and dark stools. constipation too. sometimes diarrhea. better absorbed in acidic environment.

Front 16

adverse reactions of iron supplements

Back 16

toxic to children. iv iron can cause anapylaxis.

Front 17

sodium bicarb and sodium citrate (shohls solution)

Back 17

alkalinizing agent. used for people with chronic renal failure, and for someone with metabolic acidosis. remember, these can change pH, so they may ionize other drugs.

Front 18

sodium chloride and potassium chloride and ammonium choride

Back 18

acidifying agents. treat metabolic alkalosis. replace cl- so kidneys can excrete bicarb. monitor for hypertension, pulmonary edema and acidosis because they are hypertonic solutions.

Front 19

open angle glaucoma (chronic)

Back 19

gradual onset. progressive damage to optic nerve causes vision loss. no s/s. meds work to lower intraoccular pressure.

Front 20

open angle glaucoma (acute)

Back 20

sudden onset. pain. sx required.

Front 21

drugs for glaucoma

Back 21

timolol maleate (timoptic)
latanoprost (xalatan)
atropine (isopto atropine) and cyclopentolate (cyclogyl)
brimonine (aphagan)
phenylephrine

Front 22

beta blockers for glaucoma

Back 22

timolol maleate (timoptic). first line agent. decreases production of aqueous humor. topical. can cause stinging, conjunctivitis, photophonia, dry eyes, blurred vision

Front 23

alpha two agonists for glaucoma

Back 23

brimonidine (aphagam). first line agent. different than beta blocker because it decreases production of a.h. and also makes it easier for fluid to move out. delays degredation of optic nerve. can cause blood shot eyes, burning and stinging and dry mouth.

Front 24

prostaglandin analog for glaucoma

Back 24

latanoprost (xalatan). relaxes ciliary muscle and helps a.h. move out. can increase brown pigment in iris.

Front 25

cycloplegics and mydriatics (anticholinergics) for glaucoma.

Back 25

they're antichoinergics that dilate the eye and then paralyze it. used for dx and sx. can cause blurred vision, closed angle glaucoma and systemic effects. atropine (isopto atropine) and cyclopentolate (cyclogyl)

Front 26

adrenergic agonist for glaucoma

Back 26

phenylephrine. used for dx and sx. causes mydriasis. also can cause closed angle glaucoma, floaters and pain.

Front 27

autonomic tone

Back 27

when both pns and sns innervte an organ so body has full control of that organ.

Front 28

preganglionic neurotransmitter

Back 28

always Ach

Front 29

post ganglionic neurotransmitter

Back 29

in parasympathetic nervous system it's ach and in sympathetic nervous system it's NE and E.

Front 30

muscarinic agonists

Back 30

can cause brady cardia and hypotension, salivation cramping and diarrhea, bladder rupture if used with UT obstruction, bronchoconstriction.

Front 31

muscarinic agonists

Back 31

bethanechol chloride, pilocarpine, acetylcholine

Front 32

treatment drug for muscarinic poision

Back 32

ATROPINE

Front 33

symptoms of muscarinic poisoning

Back 33

profuse salivation, tearing, visual distrubances, bronchospasm, diarrhea, bradycardia, huypotension

Front 34

atropine sulfate (sal-tropine, atroAPen)

Back 34

muscarinic antagonist (anticholinergic, parasympatholytic). 0.4-.6 preop. 0.4-1 for bradycardia (max 2 g). 2-6 as antidote for poisoning.

Front 35

atropine sulfate: uses

Back 35

preanesthetic, reduce reflex bradycardia/incr hr, mydriasis and cycloplegia, blocks hypermobility of gi, antidote.

Front 36

side effects of atropine or anticholinergics

Back 36

xerostomia (dry mouth), no sweat (anhidrosis), urinary retention, thickened mucus, constipation, visual distrubances, increased intraoccular pressure, tachycardia.

Front 37

treatment for antimuscarinic intoxication

Back 37

thizostigmine.

Front 38

oxybutynin (ditropan) and tolterodine (detrol)

Back 38

anticholinergics/ antimuscariics. patch form of oxybutynin causes less dry mouth. tolterodine (detrol) used for overactive bladder.

Front 39

neostigmine (prostigmin)

Back 39

cholinesterase inhibitor. stimulates pns. gives better neurocontrol for mysthenia gravis, and is also the reversal agent for neuromuscular blockers.

Front 40

adverse effects of cholinesterase inhibitors like neostigmine

Back 40

incr secretions, pupil constriction, airway constriction,decr hr and bp and incr stomach motility.

Front 41

muscarinic agonists

Back 41

bethanechol chloride, pilocarpine, acetylcholine

Front 42

treatment drug for muscarinic poision

Back 42

ATROPINE

Front 43

symptoms of muscarinic poisoning

Back 43

profuse salivation, tearing, visual distrubances, bronchospasm, diarrhea, bradycardia, huypotension

Front 44

atropine sulfate (sal-tropine, atroAPen)

Back 44

muscarinic antagonist (anticholinergic, parasympatholytic). 0.4-.6 preop. 0.4-1 for bradycardia (max 2 g). 2-6 as antidote for poisoning.

Front 45

atropine sulfate: uses

Back 45

preanesthetic, reduce reflex bradycardia/incr hr, mydriasis and cycloplegia, blocks hypermobility of gi, antidote.

Front 46

side effects of atropine or anticholinergics

Back 46

xerostomia (dry mouth), no sweat (anhidrosis), urinary retention, thickened mucus, constipation, visual distrubances, increased intraoccular pressure, tachycardia.

Front 47

treatment for antimuscarinic intoxication

Back 47

thizostigmine.

Front 48

oxybutynin (ditropan) and tolterodine (detrol)

Back 48

anticholinergics/ antimuscariics. patch form of oxybutynin causes less dry mouth. tolterodine (detrol) used for overactive bladder.

Front 49

neostigmine (prostigmin)

Back 49

cholinesterase inhibitor. stimulates pns. gives better neurocontrol for mysthenia gravis, and is also the reversal agent for neuromuscular blockers.

Front 50

adverse effects of cholinesterase inhibitors like neostigmine

Back 50

incr secretions, pupil constriction, airway constriction,decr hr and bp and incr stomach motility.

Front 51

alpha 1 receptor drugs (agonist)

Back 51

cause vasoconstriction and mydriasis. when given, effect hemostasis (blood clotting), nasal decongestion, adjunct local anesthesia, incr bp, and pupil dilation.

Front 52

alpha 2 receptor drugs (agonist)

Back 52

decr NE release, cause bradycardia, decr cardiac output, and decr BP.

Front 53

Beta 1 receptor drugs (agonist)

Back 53

affect the heart. stimulate heart contractions, heart squeezes harder (inotropic effects), increases cardiac output, and enhances impulse conduction.

Front 54

beta 2 receptor drugs (agonist)

Back 54

lungs and uterus. cause bronchodilation and delay preterm labor.

Front 55

epinephrine (adrenalin, primatene)

Back 55

nonselective. works at both 1 +2 alpha and beta. used for bronchial asthma, tx anaphylaxis, adjunct for anesthesia because controls bleeding and treats cardiac arrest. causes mydrasis. *topical, SQ, inhalation.

Front 56

adverse effects of epinephrine

Back 56

htn, dysrhythmias, angina, necrosis with extravasation, hyperglycemia.

Front 57

drugs that interact with adrenergic agonists

Back 57

maoi (prolong and intensify E), TCAs (prolong and intensify E), GA (heart is sensitive to catacholamines), adrenergic blockers (prevent from working)

Front 58

isoproterenol hydrochloride (Isuprel)

Back 58

beta agonist. used for heart block, cardiac arrest, shock, asthma, and increases cardiac output. stimulates beta 1 and 2, but can cause dysrhythmias, angina, and hyperglycemia.

Front 59

phenytephrine hydrochloride (neo-synephrine)

Back 59

selective alpha agonist. treats acute hypotension, sinusitis, rhinitis, hay fever. causes vasoconstriction. given sc, im iv opthalmic, nasal spray.

Front 60

adverse effects of phenytephrine hydrochloride (neo- synephrine

Back 60

reflex bradycardia, ha, excitability, rebound congenstion

Front 61

prazosin (minipress)/ terazosin (hytrin) **used to treat BPH **causes HA/ doxazosin (cardura)

Back 61

adrenergic blockers. block alpha 1 and cause dilation of arterioles and veins. lower BP. adverse effects are ORIN (orthostat. htn, reflex tachycard, inhibition of ejaculation, and nasal congestion.

Front 62

meds that are used for allergi rhinitis

Back 62

antihistamines (2nd generation: astelin, zyrtec, xyzal, allegra claritin, clarinex) (or first generation: chlor-trimeton, tavist, benadryl, phenergan, vistaril); glucocorticoids (beconase, rhinocort, flonase, nasonex, nasocort); decongestants (neo-synephrine, afrin, sudafed)

Front 63

second generation antihistamines

Back 63

zaxacc
zyrtec
astelin
xyzal
allegra
claritin
clarinex

Front 64

first generation antihistamines

Back 64

c bp tv
chlor-trimenton
benadryl
phenegran
tavist
vistaril

Front 65

what do antihistamines do?

Back 65

block H1 receptors, so they inhibit vasodilation, itching, pain, mucus production, and vascular permiability. good for mild allergies, acute hives, and allergic conjunctivitis. NOT GOOD FOR SEVER ALLERGIES. also insomnia, treating common cold, reducing runny nose and motion sickness (dramamine and phenergan)

Front 66

things to remember for pts taking antihistamines

Back 66

alcohol will intensify CNS depression
take in evening
don't drive
lozenges for dry mouth
contraindicated: 3rd trimester, nursing mothers, asthma pts, elderly pts. OD tx = charcoal, ice packs, IV dilantin for seizures.

Front 67

glucocortacoids for seasonal rhinitis

Back 67

beconase, nasonex, nasocort rhinocort, flonase

bnnrf *have few side effects

Front 68

nasal decongestants used for congestion, allergic rhinitis, sinusitis, and colds

Back 68

neo-synephrine, and pseudoephedrine (afrin, drixoral, sudafed)

they're sympathomimetic, so they will cause vasoconstriction of membranges and thus decrease nasal drainage.

Front 69

adverse effects of decongestants

Back 69

going to be alpha 1 adrenergic effects

(incr BP, HR, arrhythmias, palpitations, hemorrhagic stroke in women with pheylpropanolamine. more commonly will cause restlessness, irritability, anxiety, insomnia, HA. sometimes N/V urinary retention

Front 70

pseudoephedrine (sudafed, afrin, drixoral) contraindications (or at least caution with these pts)

Back 70

CAD, HTN, DM, hyperthyroidism, narrow angle glaucoma, bladder neck obstruction

Front 71

administration for drops and sprays

Back 71

drops: head back, one nostril, remain in position 5 min, then other nostril

spray: head errect, sniff while squeezing container, wait 3-5 min then blow nose.

Front 72

antitussives (centrally and peripherally acting ones)

Back 72

centrally acting: codeine, hydrocodone (opioid), dextromethorphan ('tussin) and benylin or diphenhydramine.
peripherally acting: tessalon perles or benzonatate

Front 73

codeine

Back 73

most effective cough suppressant for chronic, nonproductive cough. not good for productive cough or cold related cough.

Front 74

hydrocodone

Back 74

more potent. higher abuse potential. makes ppl sleepy.

Front 75

robitussin or dextromethorphan

Back 75

non-opioid, no euphoria, in lg doses can cause mild inebriation, and mind-body dissociation. no RR suppression.

Front 76

diphenhydramine or benylin

Back 76

antihistamine with antitussive properties with higher doses. these high doses cause sedation.

Front 77

benzonatate or tessalon perles

Back 77

is the peripherally acting one. decr sensitivity of resp tract receptors. don't chew. helpful for lingering cough.

Front 78

antitussives are contraindicated for...

Back 78

CHILDREN, ESPECIALLY INFANTS.

Front 79

guaifenesin or mucinex/robitussin

Back 79

expectorant (only fda approved one). incr ammount of secretions and facilitates their removal.

Front 80

acetylcysteine or mucomyst

Back 80

mucolytic. liquefies secretions and enhances ciliary action. oral or inhaled water. can be given intratracheally or orally for abnormally thick secretions with pulmonary dz or cystic fibrosis. also antidote for acetaminophen.

Front 81

corticosteroids for ashtma

Back 81

inhaled (beclomethasone, pulmicort, ciclesonide, flunisolide, fluticasone, mometasone, triamcinolone)

Front 82

side effects with inhaled corticosteroids

Back 82

oral candidiasis (thrush); dysphonia (hoarseness); reflex cough with bronchspasm (alleviated by spacer).

Front 83

3 classes of bronchodilators

Back 83

beta 2 adrenergic agonists (LA and SA)
methylxanthines
anticholinergics

Front 84

albuterol or ventolin, proventil

Back 84

SABA
exercise induces asthma, causes bronchial smooth muscles to relax

Front 85

side effects of beta agonists

Back 85

adrenergic things:
tachycardia, QT prolongation
tremor, HA, hypokalemia, hyperglycemia, paradoxical bronchospasm (may be from propellant) **with LABA and corticosteroid combo the bronchoprotective effect can be lost

Front 86

formoterol/ foradil and
salmeterol/ serevent

Back 86

LABA. not for rescue, but for long term. not mono-tx.

Front 87

combo products with steroids and LABA

Back 87

advair and symbicort

Front 88

theophylline and aminophylline (IV form of theo)

Back 88

methylxanthine. causes bronchodilation, incr CO, HR, accelerates mucous exit, improves diaphram contractility. has narrow drug levels, lots of drug interactions.

Front 89

mild and serious reactions of methylxanthines (phyllines)

Back 89

mild = N/V nervousness, HA, insomnia

serious= low K+, high BS, tachycardia, arrhythmias, tremors, neuromusc irritability seizures and death

Front 90

drugs that would increase/decrease levels of theophylline in blood (due to drug interactions)

Back 90

increase = cimetidine and fluroquinolone antibiotics

decrease = phenobarbital, phenytoin, rifampin

Front 91

blood levels of methylxanthines (phyllines)

Back 91

5-15 mcg/mL (anything above 15 want to take action)
20-30 mcg/mL is mild toxicity and above 30 is serious

Front 92

atrovent or ipratropium

Back 92

SHORT acting anticholinergic for asthma

MDI

Front 93

tiotropium or spiriva

Back 93

LONG acting anticholinergic for ashtma

DPI

Front 94

ipratropium

Back 94

anticholinergic that's used off label as rescue inhaler for ppl with genetic variations that make them unresponsive to beta agonists

Front 95

atrovent HFA

Back 95

anticholinergic drug that's cross reactive with peanut allergic people because it has soy in it.

Front 96

singulair, accolate, zyflo

Back 96

all oral leukotriene modifiers. inhi bit edema, mucous production, decr bronchoconstriction. alternative for corticosteroids. MONITOR ALT AND ALS WITH THESE

Front 97

cromolyn sodium or intal

Back 97

mast cell stabilizers. inhibits release of mediators after allergen exposure. good in pediatric pts and for people who know what the specific thing they're allergic to is. no systemic effects and rare side effects.

Front 98

long term asthma meds

Back 98

corticosteroids are 1st choice: "one" or "ide"
cromolyn sodiumnedocromil (mast cell)
LABA formoterol, salmeterol
methylxanthines (phylline)
leukotriene mod (singulair, accolate, zyflo)

Front 99

agents used to treat peptic ulcers

Back 99

pepto
clarithromycin
amoxicillin
tetracycline
metronidazole

Front 100

tagamet/ cimetadine
ranitidine/ zantac
famotidine/ pepcid
nizatidine/ axid

Back 100

H2 receptor antagonist --->lowers gastric acid by reducing volume. PO (empty stomach!) , IM, IVPB (give slowly).

Front 101

side effects of tagamet

Back 101

confusion and hallucinations
gynocomastia, impotence, decr libido, incr risk of pneumonia. if given IV risk of hypotension and dysrhythmias. interacts with warfarin, phenytoin, theophylline, lidocaine. DON'T TAKE WITH ANTACIDS.

Front 102

omeprazole/ prilosec
lansoprazole/ prevacid (prevpac)
rabeprazol/ achiphex
pantoprazole/ protonix (IV)

Back 102

PPI. most effective at suppression secretion of gastric acid. take before meals; 4-8 wks; CAN TAKE ANTACID; don't crush.

Front 103

sucralfate/ carafate
misoprostol/ cytotec

Back 103

cytoprotective: protects lining of stomach with barrier to acid.


M/C: NSAID prevention

Front 104

sucralfate/carafate

Back 104

few adverse effects. topical on stomach. little systemic absorption. give on empty stomach. large tablet, so liquid is easier sometimes. cytoprotective agent.

Front 105

misoprostol/ cytotec

Back 105

used to prevent NSAID induced ulcers. Prostaglandin analog, so protects from PG inhibitors. DO NOT GIVE WITH ANTACIDS. diarrhea, abd pain in women can cause spotting. pregnancy category x (stimulates contractions)

Front 106

amphogel (Al), milk of mg (Mg), tums (Ca), riopan (Na+)

Back 106

antacids. all raise pH. long term use = renal impairment and effects from ca, mg od. will have drug interactions because it changes ph, so allow one h between drugs.

Front 107

the one thing an RN should remember with liquid antacids

Back 107

if pt has an NG tube, flush before and after with NS/sterile H20 because it will clog tube.

Front 108

metoclopramide/ reglan

Back 108

bvlocks CTZ and increases upper GI motility so it can be used as an anti nausea, stimulate gastroparesis, and for GE reflux. causes diarrhea and sedation, EPS in kids and Tardive Dyskinesia in elderly.

Front 109

pancrelipase or cotazym

Back 109

lipase, amylase, protease. given with meals. can cause nausea, abd cramps or diarrhea.

Front 110

odansetron/ zofran
granisetron/ kytril
dolasetron/ anzemet

Back 110

antiemetic. serotonin receptor agonist. prevents CINV. PO or IV.

SE: HA, diarrhea, dizziness. NO EPS.

Front 111

methylprednisolone/ solumedrol
dexamethasone/ decadron

Back 111

IV or in combo to suppress CINV

Front 112

aprepitant/ Emend

Back 112

PREVENTS cinv
blocks neurokinin receptors
used in combo with glucocort and serotonin ag.. well tolerated. interfere with metabolising enzymes so high drug interactions.

Front 113

chlorpromazine/thorazine, prochlorperazine/ compazine
promethazine/ phenergan

Back 113

antipsychotics with antiemetic properties.
lots of sedation. most commonly Ach Effects, but also has EPS effects and hypotension.

Front 114

scopolamine

Back 114

muscarinic antagonist. used for motion sickness. PO, SC, TD patch behind ear. Ach side effects.

Front 115

dimenhydrinate/ dramamine
meclizine/antivert
cyclizine/marezine

Back 115

antihistamines which are also antinausea

Front 116

methylcellulose/citrucel
psyllium/ metamucil

Back 116

bulk forming. absorbs water by enlarging stool and softening it. wont work immediately.

Front 117

docusate sodium/ colace

Back 117

surfactant stool softener. facilitates penetration of water and electrolytes. good for post op or post childbirth. no immediate effects.

Front 118

bisacodyl/ correctol, dulcolax
castor oil
senna/sennakot

Back 118

stimulate lax that stimulates peristalsis and increases water and electrolytes. will get cramping but will relieve acute constipation

Front 119

phillips MOM
mg citrate
sodium phosphate/ fleet
polyethylene glycol/ golytely

Back 119

osmotic action retains water. stool will be liquid.

Front 120

lactulose

Back 120

osmotic. used in liver failure pts to excrete ammonia.

Front 121

diphenoxylate hydrochloride and atropine/ lomotil

loperamide hydrochloride/ immodium AD

Back 121

acute self limitiing diarrhea. opioid antidiarrhea. imodium AD is meperidine analog, but not opioid.

Front 122

alosetron/ lotronex

Back 122

used for IBS. only in women who have severe diarrhea IBS. serotonin type 3 receptor blocker. big complication is ischemic colitis, which can be fatal. drs have to be specially certified to give this.