Pharm 2
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102 terms
Terms | Definitions |
|---|---|
 fast route | sublingual, IV, rectum, because it goes straight into peripheral system |
| slow route | by mouth - must go through stomach, HCL, liver, ect before getting into system |
| When do you need high concentration of drugs? | by mouth |
| what to do if give pt wrong dose | 1. antidote 2. lithium or stomach lavage if within 60 min 3. if after 60 min, monitor pt, tell boss (for consoling not punishment), contact dr (may just tell you its fine) |
| Litium antidote | charcoal |
| aspirin antidote | sodium bicarb |
| antagonist | inhibit/block certain chemicals from receptors or target sites, Sometimes given to enhance certain effects or slow down certain disease processes |
| agonist | mimic/stimulate certain target sites and actions, May enhance or inhibit hormone release |
| Benzodiazepines | DOC for anxiety, insomnia, and now seizures Valium also is muscle relaxant. |
| what is a TCA | antidepressant |
| TCA drug of choice | elavil - dont use with heart attack pt |
| what do MAOIs treat? | depression |
| What is mechanism for MAOIs treating depression? | prevents enzymatic breakdown of norepinephrine at target site |
| What type of food should ppl taking MAOIs avoid | food with tyramine |
| what types of food contain tyramine? | asparagus, avocados, alcohol - wine, processed meat, beans, chocolate |
| Side effects for MAOIs, TCAs, benzodiazepines, SSRIs | orthostatic hypotension, sexual dysfunction, and weight gain |
| what do SSRIs treat? | first line of drugs to treat depression |
| SSRI DOC | lexapro |
| Barbituates | suppress CNS, used to use for seizures, gone away from using because benzodiazepines have less side effects, and are highly addictive, have suicidal tendencies. |
| Drugs to treat Seizure | barbituates, benzodiazepine |
| DOC for Bipolar | Lithium, keeps manic and depressive state in balance |
| old DOC for Schizophrenia | Haldol |
| new DOC for schizophrenia | Chlorozil (treats pos and neg effects) |
| Drugs to treat Anxiety and Insomnia | benzodiazepine |
| Drugs to treat depression | SSRI, MAOI, TCA |
| Drug to treat Parkinson's | Anticholinergic Drug, increase dopamine. |
| DOC for Parkinson's | Levodopa |
| What drug can take 6 months to kick in? | Levodopa |
| What is a sure sign of parkinson's | pill rolling |
| What do ADHD meds do? | CNS stimulant |
| ADHD DOC | Ritalin |
| How does Ritalin Work? | makes them focus |
| when should you give ritalin | In the morning |
| At what time should you stop giving ritalin | 4 o clock, once they hit evening they will be very hungry |
| Dif in gender for ADHD | Boys tend to have overt behavior, girls have social withdraw, |
| What other drugs may be needed in adjuct with Ritalin | may need other enhancement drugs to fall asleep. |
| Type of drug for Alzheimer's | Acetocholineesterase inhibitor |
| DOC for alzhiemers | aricept (breaks down acetylcholine, want levels outside of cells circulating through cerebellum) |
| What happens if you take too much antipsychotic drugs? | may have NMS (neuroleptic malignant syndrome) |
| what is NMS? | look for altered level on conscious, increased temp, first thing to go down is increase BP, difficult breathing |
| How should we end antipsycotic/alzheimers/parkinsons etc meds? | slowly - Don't want to get off drugs abruptly, if we do tend to have a 60-80% of relapse and resuming symptoms. This is why some pts given depo meds in shot forms that they give every 2-3 weeks, compliance is better because don't have to take every day |
| Generalized Seizure Absence (petit mal) | lasts a few seconds, usually in kids, staring off to space, no response to verbal commands, fluttering eyelids or jerking, misdiagnosed as ADD or day dreaming |
| Simple Partial (focal) Seizure | 1 extremity/side (olfactory, auditory, and visual hallucinations, intense emotions, twitching |
| Complex Partial (psychomotor) seizure | aura, brief period of confusion or sleepiness after with no memory of seizure, fumbling with or attempting to remove clothing, no response to verbal commands |
| Generalized Seizure Atonic (drop attack) | falling or stumbling for no reason, fasts a few seconds, aura (preceding) |
| Generalized Seizure Tonic-Clonic (grand mal) | aura (preceding), intense muscle contracting (tonic phase) followed by alternating contraction and relaxation of muscles (clonic phase) , cry at beginning as air leaves lungs, loss of bowel/bladder control, shallow breathing with periods of apnea, lasts 2-3 minutes, disorientation and deep sleep after seizure (postictal state) |
| Special Syndromes Febrile Seizure | tonic-clonic activity lasting 1-2 min, rapid return to consciousness, occurs in kids 3 months to 5 years |
| Special Syndromes Myoclonic Seizure | large jerking movements of major muscle groups (like an arm); falling from a sitting position or dropping what is held |
| Special Syndromes Status Epilepticus | considered a medical emergency, continuous seizure activity that can lead to coma or death, lasts more than 30 min, concerned with airway, O2 saturations, monitor for change in color, and prevent injury |
| what food should a person with kidney failure avoid | Na |
| what foods should a person taking non K sparing diuretics take | foods with K (bananas) |
| Major depression | affects 5-10% of adults in US, diagnosed by having a depressed affect and at least 5 of the following symptoms (difficulty sleeping or sleeping too much, extremely tired or without energy, abnormal eating patterns, vague physical symptoms, inability to concentrate or make decisions, feeling of despair, guilt or misery; lack of self worth, obsessed with death (expressing a wish to die or commit suicide), avoid psychosocial and interpersonal interactions, lack of interest in physical appearance or sex, delusions or hallucinations. |
| Dysthymic Disorder | less severe depression symptoms that may prevent a person from feeling well or functioning normally |
| Postpartum Depression | up to 80% of women experience this during first several weeks after birth of newborn. 10% experience major depression within 6 months related to dramatic hormonal shift that occur during post delivery. Additional situational stresses like more responsibility may affect onset. Medical treatment may help |
| Seasonal Affective Disorder | associated with enhanced release of the brain neurohormone melatonin due to lower light levels. Exposing pts on regular basis to specific light therapy may relieve SAD depression and prevent further episodes |
| Psychotic Depression | expression of intense mood shifts and unusual behaviors. Depressive signs and loss of contact with reality, hallucinations, delusions, disorganized speech patterns are usually observed. Often treatable with antipsychotic meds |
| Akathisia | cant sit still (restless leg syndrome), can't relax |
| Dystonia | muscle spasm, nonstopping, continuous |
| Ataxia | uncontrolled or lack of gross muscle movements due to litium toxicity |
| Tardove dyskinesia | type of extrapyramidal effect from antipsychotic drugs and antiparkinson drug, classic sign: wormlike movement of tongue |
| NMS | due to antipsychotic drug toxicity |
| Extrapyramidal effects | adverse side effect of drug toxicity, could be sticking tongue out (from reglin) |
| what do Diuretics do? | increase urine output |
| when do you know diuretics are working? | a lot and your daily weight and edema and BP and heart rate starts to go down. |
| Loop Diuretics (High Ceiling) | most effective, treat general edema associated with heart failure, hepatic cirrhosis and chronic renal failure, used with moderate/severe fluid retention and when other diuretics don't work. |
| Thiazide Diuretics | largest most frequently prescribed class, treats mild-moderate hypertension and mild-moderate edema from heart, liver, and renal failure. Less effective at producing diuresis than loop and ineffective in pts with severe renal failure |
| Potassium-Sparing Diuretics | Increases diuresis without affecting K levels. Less effective than loop. |
| Resp Acidosis | pH below 7.35, CO2 above 45 caused by hypoventilation |
| Metabolic Acidosis | happens if given too much aspirin, diabetes and diarrhea excessive alcohol, starvation causes this; HCO3 below 22 |
| Resp Alkalosis | pH above 7.45, CO2 below 35, cause by hyperventilation, |
| Met Alkalosis | HCO3 above 26, caused by constipation, excess sodium antacids, diuretics that cause potassium depletion, severe vomiting |
| Situational anxiety | anxiety about a test |
| Normal Osmolality | 275-295 |
| osmalality below 275 | fluid deficit: dehydration and shock |
| osmolality above 295 | fluid excess: heart failure, water retention, hypertension, pulmonary edema, liver failure, kidney failure |
| Normal sodium | 135-145 |
| hyponatremia | Na below 135, NV, anorexia, abdominal cramping |
| Hypernatremia | Na above 145, thirst, fatigue, weakness, muscle twitching, lowered level of consciousness. |
| Normal Potassium | 3.5 - 5 |
| Hypokalemia | K below 3.5, muscle weakness, lethargy, anorexia, dysrhythmias, cardiac arrest |
| Hyperkalemia | k above 5, dysrhythmias, heart block, twitchin, fatigue, paralysis |
| Albumin is a | - colloid |
| a colloid is a : | blood product and volume expander |
| what should you look for If you give volume expanders | increase in BP and urine output because introducing more fluids |
| Normal Salines | Crystalloids - give other than colloids because they are cheaper |
| what is the Best way for teens and adults to replace fluid | drink water |
| Levadopa treats | Parkinson's disease, may take 6 months to work |
| Lasix are a : | diuretic, makes you lose water, may get orthostatic hypotension |
| Flexiril | DOC muscle relaxant, works on CNS relaxant, relaxes muscle and decrease resp rate |
| on adult, what is the first thing to go if sick? | BP |
| Chlorozil | treats schizophrenia, pos and neg behaviors |
| Risperidol | antipsychotic drug |
| What do you give within 60 min if you give a toxic level of a drug? | activated charcoal |
| Haldol | schizophrenia, antipsychotic, |
| What might you get if you take too much psychotic drug? | TD (tardic dyskinesia) |
| Luminol | Phenobarb, treats seizures, works on GABA - increases release which brings down excitability of brain |
| what shhould you educate pts on Dilantin about? | good oral care |
| what shouldnt you do with Dilantin, antiseizure, antipsychotic meds? | stop suddenly because may enhance symptoms |
| Lithium | bipolar disorder |
| Ritalin | treats ADHD, don't give after 4 (last dose at noon or 2), |
| when should you give give beta 1 and 2? | to asthmatic to relax smooth muscles, some drugs may excite this. |
| what is the wrost thing you can do to an asmatic? | inhibate - will throw into bronchospasms |
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