Applied Bioscience 263

Front 1

Identify sources of drug information for nurses/midwives in clinical practice.

Back 1

Pharmacology books
Health professionals
Pharmacists

Front 2

Identify Commonwealth and State legislation underpinning nursing/midwifery and the administration of drugs.

Back 2

Therapeutic Drugs Act 1964
Poisons Act 1965

Front 3

Define the terms pharmacology, pharmacodynamics and pharmacokinetics

Back 3

Pharmacology: study of drugs
Pharmacodynamics: what the drug does to the body
Pharmacokinetics: what the body does to the drug

Front 4

Differentiate between a drugs generic and trade name.

Back 4

Generic: name chosen by drug company to identify drug shown with lower case letter
Trade: different variations of that type decided by the company, upper case letter

Front 5

Identify the three most common classifications of drugs.

Back 5

Generic name
Route
Pharmacokinetics

Front 6

Outline the different routes of drug administration.

Back 6

Topical, parental, inhalation, anal, oral, injection, intravenous, intramuscular

Front 7

Outline the factors that influence drug absorption, distribution, metabolism and drug excretion.

Back 7

Absorption: nature of absorbing membrane, blood flow, solubility of drug, degree of ionisation, formulation characteristis
Distribution: blood flow, solubility of drug, degree of protein binding
Metabolism: disease, age, gender, enviro
Excretion: kidney function,

Front 8

Discuss what is meant by drug bioavailability.

Back 8

Proportion of administered dose that reaches the systemic circulation intact

Front 9

Discuss the relationship between plasma levels, biological half life and a drugs therapeutic range

Back 9

Time taken for plasma concentration/activity to half, affects the therapeutic range

Front 10

Distinguish between an agonist and antagonist.

Back 10

Agonist: binds to a receptor and activates it, same as endogenous ligand
Antagonist: binds to a receptor and blocks access of the endogenous ligand, diminishing response

Front 11

Outline what is meant by a loading dose.

Back 11

Initial dose is higher than proceeding doses to kick start drug action

Front 12

Discuss the range of factors influencing drug therapy across the lifespan. i.e. lactation to the elderly.

Back 12

maturation of drug-metabolising enzymes, plasma and tissue binding, physiological maturation of organ systems, increased risk of drug reactions, changes in pharmacokinetics/dynamics

Front 13

Discuss the factors that determine the passage of drugs across the blood – brain membrane, placenta and
breast milk.

Back 13

Brain: through the selective membrane, smaller ones get through
Placenta: physiochemical properties, protein binding and lipid solubility
Breast: higher degree of ionisation, low molecular weight, fat solubility and concentration

Front 14

Outline the basic information nurses and midwives must know about each drug they administer and why.

Back 14

Route, group, effects, side effects, interactions

Front 15

Differentiate between a “drug reaction” and “drug allergy” from a pathophysiological perspective

Back 15

Reaction: noxious, unintended occurs at normal doses used for prophylaxis, diagnosis or disease therapy
Allergy: severe life threatening, occurs after 2nd exposure,

Front 16

Compare the distinguishing features oftype 1 and type 2 diabetesmellitus

Back 16

Type 1: insulin deficiency, juvenille
Type 2: insulin resistance, lifestyle

Front 17

Discussthe aetiology of type 1 and type 2 diabetes.

Back 17

Type 1: body can't produce insulin
Type 2: body produces insulin, effects don't happen

Front 18

State clinicalmanifestationsfortype 1 and type 2 diabetes and explain the pathophysiology

Back 18

Type 1: weight loss

Type 2: weight gain

Front 19

State criteria fortype 1 and type 2 diabetes

Back 19

Type 1: insulin deficiency, juvenille
Type 2: insulin resistance, lifestyle

Front 20

Explain the pathophysiology of gestational diabetes.

Back 20

Hormones out of whack, double the insulin needed, body can't cope

Front 21

Discussthe pharmacological(antidiabetic agents and insulin)management oftype 2
diabetesincludingmechanismof action, dosage,side effects

Back 21

Antidiabetic:
action:
dose:
effects:

Insulin:
action: giving the body insulin
dose:
effects: hyperglyceamia

Front 22

Explain the non pharmacologicalmanagement of a patient presenting with type 2 diabetes.

Back 22

Lifestyle changes, exercise plan, healthy eating, blood sugar testing

Front 23

Describe the role of blood glucosemonitoring in themanagement of diabetes and the
normal valuesfor blood sugarlevels.

Back 23

Complications: increased risk for other diseases, slower healing,

Prevention: exercise plan, healthy eating,

Front 24

Outline the complications of diabetes and prevention strategiesthat are implemented.

Back 24

Educator: explain disorder, show how to manage and treat, discuss complications

Australia: funding to lower costs, support groups

Front 25

Define pain

Back 25

An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.

Front 26

Describe the difference between acute and chronic pain

Back 26

Acute: lasts for less than 3 months
Chronic: lasts for more than 3 months

Front 27

Define the three categories of pain (nociceptive,neuropathic/psychogenic) in terms of the
aetiology,duration and treatment

Back 27

Nociceptive:
External: few seconds –days, simple interventions to assist the healing process, NSAID’s
Internal: severe trauma & disease, few days-weeks, removing cause of damage, opiods
Neuropathic: injury/nervous system disease, few months-years, pain relief depends on patient
Psychogenic: no seeming cause i.e. headaches, back pain

Front 28

Outline the physiology of pain and identify the order of neurons.

Back 28

Nociceptive:
External: few seconds –days, simple interventions to assist the healing process, NSAID’s
Internal: severe trauma & disease, few days-weeks, removing cause of damage, opiods
Neuropathic: injury/nervous system disease, few months-years, pain relief depends on patient
Psychogenic: no seeming cause i.e. headaches, back pain

Front 29

Describe the three cortical regions responsible for the perception of pain

Back 29

Lateral pain pathway: terminates in parietal and insular lobes
Responsible for the sensory-discriminative aspect (position, intensity and modality of tissue damage)
Medial pathway: terminates in the frontal lobe
Responsible for the affective-motivational aspect (changes in mental state and behavior)

Front 30

Outline the clinical manifestations , assessment and management of pain.

Back 30

Clinical manifestations: pain tolerance and threshold, subjective symptom, activation of nervous systems depending on the type of pain
Assessment: listen and believe what the patient is saying, relate location, type, duration and previous medical history; pain assessment scales
Management of pain: non-pharmacological then pharmacological, for pharmacological consider which therapy, the route can use WHO analgesic ladder

Front 31

Discuss clinical features and likely pathophysiology of complex regional pain syndromes and
diabetic neuropathy.

Back 31

Peripheral nerve damaged by traumatic injury; nerve compression or transection causing severe, burning pain with hyperalgesia and allodynia.
Diabetic neuropathy: numbness and burning pain in the distal extremities causing the formation of ulcers, degeneration of unmyelinated axons and ischaemia to the blood vessels

Front 32

State he most common behavioural responses observed in infants with pain

Back 32

Crying, facial expressions, high blood pressure, increased heart rate

Front 33

Describe 4 non pharmacological methods of pain relief.

Back 33

Massage, nursing care, hot and cold therapy, distraction

Front 34

Identify one example of analgesia for each step of the WHO analgesia ladder

Back 34

Mild pain: paracetamol; weak inhibitor of the synthesis of prost, 2 tablets (1000 mg), dyspnea, fatigue
Moderate pain: codeine; selective for the mu receptor, 80 mg, slow heart rate, fainting, dizziness
Severe pain: morphine; interacts with u-opioid receptor, 30mg, cold skin, shallow breathing

Front 35

Discuss the function of the immune system

Back 35

To protect the body from foreign substances, a number of levels work together to provide immune responses.

Front 36

Describe the different mechanisms of immune system dysfunction (hypersensitivity,
autoimmunity and immunodeficiency

Back 36

Hypersensitivity: overexaggerated response that causes disease to the individual
Autoimmunity: immune system attacks itself because of failure to recongise
Immunodeficiency: immune system failing to function normally, increases susceptibility

Front 37

Contrast and compare the general properties of innate and adaptive immunity.

Back 37

Innate: natural, present at birth, protects with a natural barrier
Adaptive: acquired, develops upon exposure to foreign substances, more precise but slower

Front 38

Discuss the four different types of hypersensitivity reactions identifying mechanisms and clinical manifestations.

Back 38

Type 1: immunoglobulin E-mediated, allergic reactions, mediated by antigen-specific immunoglobulins and tissue mast cells.
M = histamine, causes bronchial constriction, odema and increased blood flow
CM = biological effects of histamine; diarrhea, abdominal pain, urticaria
Type 2: tissue specific; reactions against specific cells, antibodies that bind to the antigen of the tissues
M = drugs bind to plasma and function as targets
CM = depend on the affected tissue
Type 3: immune complex-mediated; antigen-antibody complexes formed in circulation and deposited in vessel walls and other tissues
M = activation of the complement system, generation of chemotactic factors for neutrophilis
CM = cause lupus, not organ-specific, symptoms have little to do
Type 4: cell-mediated; killing of cytotoxic T cells them or release of soluble factors by macrophages
M/CM = graft rejection, substance-contact allergic reactions, autoimmune diseases

Front 39

Define hypersensitivity, allergy and anaphylaxis.

Back 39

Allergy: hypersensitivity to environment antigens
Anaphylaxis: rapid and severe hypersensitivity caused by re-exposure to antigen, severe reactions

Front 40

Compare passive and active immunity

Back 40

Passive: injection of antibodies OR pregnancy, that injection fights disease rather than your cells
Active: exposed to pathogen OR vaccine, immunity due to primary response

Front 41

Explain the transfer of passive immunity from mother to fetus and from mother to
infant during breast-feeding

Back 41

Fetus: passed through placenta
Infant: passed through colostrum and milk

Front 42

Describe changes in the immune response that occur with aging.

Back 42

Diminished T-cell function: thymic hormone production drops as does organ’s ability to mediate T cell differentiation. Decreased delayed hypersensitivity reactions, decreased T cell-mediated responses to infections and activity

Front 43

Describe the process of inflammatory response.

Back 43

tissues are injured, damaged cells release chemicals histamine, bradykinin, and prostaglandins. These chemicals cause blood vessels to leak fluid into the tissues, causing swelling. This helps isolate the foreign substance from further contact with body tissues.

The chemicals also attract phagocytosis. Phagocytes eventually die. Pus is formed

Front 44

Name the main groups of non-steroidal anti-inflammatory drugs. NSAIDS and one drug
(generic/trade) from each group. Discuss the mode of action, side effects effects and
contraindications for NSAIDS

Back 44

Acetic acids, coxibs, oxicams, propionic acids; inhibiting prostaglandin synthesis

Front 45

Identify different groups of microorganisms that cause infection

Back 45

Bacteria, mycoplasma, spirochaetes, fungi and viruses

Front 46

Explain what a vaccine is and the purpose.

Back 46

A biological agent that confers immunity to a disease, the vaccination stimulates antibody production but does not cause infection and so the individual develops immunity against the disease

Front 47

• Describe the detection and non pharmacological and pharmacological treatment of microorganisms.

Back 47

Pharmacological: antibiotic selection based on prescriber’s clinical impression
Non-pharmacological: culture and sensitivity results, gram stain,

Front 48

Discuss antibiotic resistance and factors leading to it.

Back 48

Emergence of antibiotic resistant organisms, prescribing of antimicrobial drugs, resistance is prevalent in countries where antibiotic use is high

Front 49

Define the role of the complement system in immunity and inflammation.

Back 49

Activated components can destroy pathogens directly and activate or collaborate with every other component of the inflammatory response

Front 50

Discuss methods of infection and clinical manifestations.

Back 50

Infection: viral pathogens bypass many defense mechanisms by developing intracellularly, antigenic variation changing their appearance by altering surface antigens.
Clinical manifestations: fatigue, malaise, weakness, loss of concentration, aching, anorexia