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88 Cards in this Set
- Front
- Back
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What is the role of the Therapeutic Goods Administration?
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Evaluate, assess and monitor therapeutic goods in Australia meets its standards for manufacturing quality, safety and effectiveness in treating a particular illness, it will approve it for sale in Australia
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4 stages that medications are approved
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1. Biochemical and animal experiments to see if medication can be used safely on humans.
2. Test safety and work out the dose. About 20 -80 healthy volunteers. 3. Test how well the medication works, and how safe it is 100 - 150 volunteers with target illness 4. Give more information about how well the medicine works and how safe it is. About 1000-3000 Volunteers with the target illness |
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Pharmaceutical Benefits Advisory Committee (PBAC) role?
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decides the medicine works as decides whether medication works well or better than other medicines can subsidised on the PBS.
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3 stages of how medications are approved?
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1.Medicines are approved for sale in Australia by the TGA if phase 3 trial results meet efficacy and safety standards
2. Medicines are approved for subsidy on the PBS by the Australian Government if the medicine is as good as, or better than other medicines with the same effect, at an acceptable price 3. Comparisons with other treatments for the same illness, and use in wider settings than earlier trials Ongoing safety monitoring |
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What are the 9 schedules
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1. not in use
2. pharmacy meds 3. pharmacy only meds 4. Prescription meds 5. caution 6.poison 7. dangerous poison 8. controlled drug 9. prohibited |
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what do you need to see on a prescription for it to be valid?
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Identify the prescriber
Identify the patient (including address or MRN) Date Drug Dose, route and frequency Must be Legible |
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With enteric coated tablets where does discintegration take place?
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the intestines
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capsules hard and soft, what is the difference?
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solid medication (can be opened up and liquid meds
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what is sustained release?
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slowly released throughout GI tract
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What is controlled release?
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NB the semi-permeable membrane remains intact as it travels through the GI Tract. It may then appear as a ‘tablet ghost’ in the faeces
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what is topical treatment
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applied directly onto the body for treatment
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does Sublingual or Buccal Administration go through first pass effect?
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NO!
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What is Transdermal Administration?
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applied onto the skin
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what is another name for rectal administration
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suppositories
enemas |
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what is another name for vaginal administration
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pessaries
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What medications are defined as Parental Drug Administrations
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Any method of administration that avoids the GI Tract is termed Parental Administration.
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What are the SIX rights?
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Right Patient
Right Drug Right Dose Right Route Right Time Right to Refuse |
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The sympathetic NS comprises of of adrenergic or cholinergic receptors
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adrenergic
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The parasympathetic NS comprises of of adrenergic or cholinergic receptors
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cholinergic
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adrenergic receptor respond to what neurotransmitter?
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adrenaline and noradrenalin
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cholinergic receptors respond to what type of neurotransmitters
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AcH
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What are the adrenergic receptors
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A1 A2 and B1 B2
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What are the cholinergic receptors?
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Muscarinic
M1 - M5 and Nicotinic |
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Where are the
M1 M2 M3 receptors located in the body |
M1 = cns
M2= heart M3 =smooth muscle |
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Where are A1 receptors located?
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Blood vessels
GIT Iris Liver cells Smooth muscles of reproductive organs |
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Where are A2 receptors located?
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Blood vessels
Adrenergic nerve terminals GIT |
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Where are the B1 receptors located?
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Renal arterioles
Myocardium GIT |
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Where are the B2 receptors located?
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Bronchioles
Uterine muscle Some skeletal muscle |
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What are the functions of all 4 histamines
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H1 = vascularity and capillary permeability
H2 = Stomach - acid secretion CNS relaxation heart, contractile force H3 = CNS H4 = white cells and immunity and inflammation |
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Function of prostaglandins
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1. contract myometrium
2. relax other smooth muscles 3. causes vasodilation 3. causes bronchoconstriction |
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what are examples of prostaglandin drugs?
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NSAIDS, indocid
Dinoprostone gel Corticosteroids |
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What is serotonin and what are examples of drugs ?
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Chemical mediator, drugs are Fluoxetine (prozac) for depression its a SSRI
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Example of some anti histamine drugs?
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Chloropheniramine (Dezmazin)
Pseudoephedrine (Sudafed) Promethazine (Phenergan) |
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Nitric oxide causes ? and
Example of a drug? |
vasodilation
Glycerine trinitrate (Angenine) = acts as a nitric oxide ;) |
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Endothelins cause? and
Example of a drug? |
Vasoconstriction
Bosentan = used to treat pulminary arterial hypertension |
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Drug Advertising is a NO in aust.
what are the exeptions? |
inhaled corticosteroids, vaginal anti infective agents and nicotine to treat smoking dependence.
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Pharmacopoeia
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a book! listing standard drugs in a particular country
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Pharmacoeconomics
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The application of health economics to the selection and supply of drugs
and investigating cost effectiveness |
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Polypharmacy
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use of many drugs with no appreciation espec. OTC drugs
duplicating meds |
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what is pharmacology?
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Clinical pharmacology is pharmacology applied to the treatment of patients
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What is the first pass effect?
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First pass effect does not remove the entire drug, but does reduce its bioavailability.
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why are Half Life of Drugs important?
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for calculating when the next dose is necessary
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What are drugs called for the use of hypercholesterolemia?
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Statins
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Nursing considerations for Statins?
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Monitor liver function
increased myopathy risk |
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what are the 3 categories of hypertension
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Essential - Minimal symptoms
seconday - as a result of something else ie. renal disease Malignant - can trigger cerebral odemas and eclampsia |
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To remember the various treatments for hypertension what must we remember?
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A :angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists
B : ß Blockers C : calcium channel antagonists D : diuretics E : endothelin receptor antagonists |
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Two types of pain?
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can be considered either
chronic or acute or somatic and visceral |
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What do prostaglandins do in regards to pain ?
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assist in the transmission to the brain
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Paracrine
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A local hormone released from a tissue and enters the circulation
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Autocrine
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Released from the tissue and confined to tissue
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How do NSAIDS work?
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Inhibit the cox enzyme necessary to make prostaglandin, without this the transmission is inhibited from getting to the brain!
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What is a narcotic analgesia?
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derived from opiods
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what is the difference between NSAIDs and Narcotics?
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Unlike NSAIDS, narcotic analgesics have an action only on the CNS.
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What are the 3 types of laxitives
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Osmotic
Stimulant Faecal softeners |
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How do antacids work?
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Antacids are all weak bases that combine with hydrochloric acid and neutralise it
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streptococci
diplococci staphylococci |
chains
pairs clusters |
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What is special about viruses as opposed to bacteria ?
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Viruses are not ‘living’ organisms like bacteria, so they can’t be ‘killed’
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When can Fungis become serious
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If they go systemic
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what are anti-mycotics used for?
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anti fungal agents
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what is the chain of infection
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1.infectious agent
2. resevouir 3.portal of exit 4. Mode of transmission 5. Portal of entry 6. Suseptible host |
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4 key mechanisms of action employed by antibacterial drugs
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inhibition of DNA synthesis
cell wall Protein Folate |
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four unwanted effects of AB
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Superinfection (Candida albicans, MRSA)
Antibiotic-associated colitis Hypersensitivity reactions (allergies) Antimicrobial resistance |
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what is MRSA
AND treatment! |
Methicillin Resistant Staphylococcus Aureus
Vancomysin |
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What is ESBL
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Extended-spectrum Beta Lactamase
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What is VRE?
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Vancomycin Resistant Enterococcus
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What are the 2 types of asthma
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Extrinsic - due to allergen
Intrinsic - due to alteration in the ANS |
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The brain transmitter AcH is responsible for which mental behaviour and therefore what drug treats what disease?
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Arousal sleep mood and appetite
Dementia |
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The brain transmitter Dopamine is responsible for which mental behaviour and therefore treats what disease?
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Behaviour and emesis
Aberrent behaviour |
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The brain transmitter Seretonin is responsible for which mental behaviour and therefore treats what disease?
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Arousal sleep mood and appetite
Eating disorders, depression and insomnia |
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The brain transmitter Glutamine is responsible for which mental behaviour and therefore treats what disease?
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Learning and memory
Epilepsy, neurogenative disease |
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The brain transmitter GABA is responsible for which mental behaviour and therefore treats what disease?
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Memory and consciousness
Insomnia and anxiety |
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What are the seven endocrine glands?
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Hypothalamus
Pituitary (Anterior/Posterior) Thyroid Parathyroid Adrenal Pancreas Ovaries/Testicles |
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High blood (cortisol) causes what?
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cushings syndrome
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What is the issue with diabetes insipitus
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Associated with a deficiency of production or secretion of ADH or a decreased renal response to ADH
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Hyperthyroidism
treatment |
overactive thyroid
radioactive iodine operation antithyroid drugs |
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Hypothyroidism
treatment |
underactive thyroid
L- thyroxine close monitor thyroid hormones |
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what is Goitre and Exophthalmos
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goitre - enlarged thyroid
Exophathalmos - protruding eye balls |
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what is addisons disease?
treatment? |
Causes hypofunction of the Adrenal Cortex
replacement cortisol |
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Diabetes Mellitus
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related to abnormal insulin production, impaired insulin utilisation or both
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what is Hypo/hyperglycaemia
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Too little/too much insulin in blood
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to be hypoglycaemic one must have a BGL of what?
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Hypo – BGL < 4mmol
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Hyperglycaemia can turn into
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Diabetic Ketoacidosis (DKA)
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DKA treatment
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Fluid Replacement
IV insulin regime Monitor potassium levels as insulin will drive K into cells monitor BGL |
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Paracetamol dose
half life antidote considerations |
.5 to 1 g 3-4hrly
1-3 hrs activated charcol lots of brands! often combined with other medications |
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Movicol indication
dose onset contra. considerations |
constipation
13 sachets daily 1 hour renal failure ensure hydrated consider rebound constipation nausea electolyte imbalanace |
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Protophane
Indication Dose Peak/duration |
Insulin
.5 to 1 UI/kg/day Steady, 24hrs |
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Atorvastatin
Indication Dose considerations |
Hypercholesterolemia
10 -80mg daily may increase plasma conc. of digoxin monitor liver function, risk of myopathy avoid grape juice |
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Oxycodone indication
dose |
Narcotic analgesia
5-10mg PO after food |
