Study for Pharmacology

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ceph- or cef-

cephalosporin antibiotics

-cycline

Tetracycline antibiotics

-floxacin

Fluoroquinolone antibiotics

-mycin/micin

Aminoglycoside antibiotic

-romycin

Macrolide antibiotics

-azole

Antifungal

-vir

antivirals

-sartan

cardiac drug - angiotensin 2 receptor blocker

-dipine or -mil

cardiac drug - calcium channel blocker

-pril

cardiac drug - ACE inhibitor

-zosin

cardiac drug - alpha-adrenergic blocker

-prazole

gastrointestinal drug - proton pumb inhibitor

-tidine

gastrointestinal drug - histamine H2-blockers

-ide

diuretic

-lam or -pam

benzodiazepines

-parin

anticoagulant

-sone

anti-inflammatory corticosteroid

-statin

HMG-CoA Reductase Inhibitor (lower cholesterol and lipids)

-triptan

Antimigraine - seratonin (5-HT1d) agonist

-coxib

Cox-2 inhibitor

-ase

digistive enzyme or thrombolytic

-lax

laxative

-mab

monoclonal antibody

-cillin

penicillin antibiotics

-olol

cardiac drug - beta-adrenergic blocker

Children's dose =

(safe dose/kg) * (weight of child in kg)

When does our body physiological function start declining?

Between 24-30 yrs of age by 1% each year.

The Nursing Process

Assess
Diagnose
Plan
Intervention
Evaluation

6 Rights of Drug Administration

Drug
Dose
Documentation
Pt.
Route
Time

Hepatic Function Labs

AST, ALT, Alkaline Phosphatase (PT, aPTT)

Renal Function

BUN
Serum Creatine
Creatine Clearance

CBC

H&H
WBC
RBC
Platelets

How do I treat angina?

Nitroglycerin

How do I treat Afib?

Warfarin sodium (Coumadin)

How do I treat CHF?

Digoxin

How do I treat Dysrhythmias & shock state?

Epinephrine

How do I treat HypoTN?

Dopamine

How do I treat normal HTN?

Clonidine
Metoprolol
Verapamil

How do I treat severe HTN?

Fenoldopam

How do I treat radio contrast dye procedure?

Fenoldopam

How do I treat Asthma/COPD/emphysema?

Albuterol

How do I treat nasal congestion?

Pseudophedrine

How do I treat TB?

Isoniazid + (ehtambutol, rifampin or streptomycin, pyrazinamid (PZA))

How do I treat constipation?

psyllium

How do I treat diarrhea?

Diphenoxylate HCl c atropine sulfate

How do I treat heartburn?

aluminum hydroxide

How do I treat GERD?

omeprazole

How do I treat ALS (Lou Gherig's Disease)?

riluzole

How do I treat Alzheimer Disease?

Rivastigmine

How do I treat anaphylaxis?

epinephrine and diphendydramine and corticosteroids

How do I treat a cholinergic crisis?

atropine sulfate

How do I treat closed-head trauma?

levetiracetam (Keppra)

How do I treat digitalis intoxication?

propranolol

How do I treat acute gout?

colchicine

How do I treat chronic gout?

probenecid, allopurinol

How do I treat Hansen's Disease (leprosy)

rifampin

How do I treat hyperthyroidism?

radioactive iodine

How do I treat migraines?

sumatriptan

How do I treat parkinson's disease?

carbidopa-levodopa

How do I treat a prostatic outflow obstruction?

prazosin

How do I treat UTI?

ciproflaxin, Bactrim

How do I treat fungal infection?

amphotericin B

How do I treat avian or swine flu?

oseltamivir

How do I treat cytomegalo virus (CMV)?

ganciclovir

How do I treat herpes?

acyclovir sodium

What are S&S of hepatotoxicity?

hepatitis, jaundice, increased liver enzyme fx

What are S&S of nephrotoxicity?

decreased UO, increased BUN, increased serum creatine, altered pH, electrolyte imbalances

What are S&S of neurotoxicity?

drowsiness, auditory & visual changes, restlessness, nystagmus, tonic-clonic seizures

What are S&S of ototoxicity?

tinnitus, vertigo

What are S&S of allergic reaction?

release of histamine, redness, itching, swelling, rash, hives, bronchoconstriction, anaphylaxis.

What are S&S of anaphylaxis

acute resp. distress, significant hypoTN, edema, tachychardia, cyanosis, pale/cool skin, convulsions

What are S&S of hypersensitive reaction?

n/v/d

What is a paradoxical reaction?

unusual, abnormal, perhaps contrary to the AE expected rom the drug.

What are S&S of EPS?

loss of muscle control (muscle twitching and tremors)
Parkinson'like effects (cog-wheeling, fine tremors)
Akathisia (restlessness)
Tardive dyskinesia (involuntary facial distortions, ect).

What are S&S of Seratonin Withdrawal Syndrome?

Flu-like symptoms
Light headedness, dizziness, or both
Uneasiness, restlessness
Sleep and sensory disturbances
Headache

What are S&S of cholinergic crisis?

increased salivation, sweating, and GI motility
bradycardia
flaccid paralysis
respiratory failure

What are S&S of myasthenia crisis?

muscle weakness, SOB, inability to move or swallow

How do you know if your pt. is having a cholinergic or myasthenia crisis?

Challenge dose of Edrophonium
improvement: myasthenia crisis

What are S&S of anticholinergic effect?

Can't see, can't pee, can't spit, can't poop

What are S&S of anticholinergic overdose?

mad as a hatter, deus as a bone, red as a beet, blind as a bat

What are S&S of digitalis toxicity?

earliest symptoms are GI, visual (yellow and green halos), cardiac irregularities (most serious)

What are S&S of superinfection?

diarrhea, sore mouth, vaginal itching

What are S&S of blood dyscrasia?

changes in CBC

Which drugs in small doses can kill children?

beta-blockers
calcium chanel blockers
clonidine

What is the number one cause of death by overdose across all ages?

acetaminiphen via hepatotoxicity?

Pregnant pts can only safely receive which category of drugs?

A and B

What is the different between non-adherence vs. non-compliance?

non-adherence (unable to follow therapy)
non-compliant (not willing or having no desire to follow therapy)

Which drugs should your never abruptly stop?

Beta-blockers

If a drug is metabolized via P450 the pt. should not consume what kind of juice?

Grapefruit

How can a pt. avoid orthostatic hypoTN?

change positions slowly

How long do antidepressant medication take to have full therapeutic effect? What are concerns during this period of time?

Therapeutic effect may take weeks. In the meantime there is an increase risk for SI due to an increase in energy

What is the most important pt. teaching regarding MAOIs?

They should not be taken with other medications and maintain a diet s tyramine and tryptophan

What is important to remember about anti-gout drugs?

They are not given to treat increased uric acid s presence of gout

What is the number one reason for digitoxicity?

Hypokalemia. Must maintain a steady diet of salt/pottasium

Do anticoagulant dissolve clots?

NO!!!

What drugs dissolve clots?

Trimbolytic Agents like alteplase/Activase -given within 3 hours of MI

How do we treat microbial infections?

Right drug for the right bug.

What is the most common AE of penicillin?

n/v/d

What is the number one reason for bacteria resistance?

poor hand washing habits by staff

what should we do as nurses before administering any drug?

Triple check

Can long-acting or enteric-coated drugs be opened, crushed, or chewed?

NO

What does enteral mean?

Oral route

What does parenteral mean?

avoids GI route

What is the difference between a Syrup and an Elixirs?

Syrups are sugar base and Elixirs have EtOH (be careful c polypharmacy!)

Before you administer a medication through a G-tube you should...?

Verify placement and then elevate the HOB

What is the max IM dose to the deltoid?

1 mL

What is the max IM dose to any muscle other than deltoid

3 mL

What is a good location for an IM for an elderly?

Ventrogluteal

What is a good location for an IM for pre-todlers?

Vastus lateralis

Lidocaine and epinephrine should never be administered simultaneously to which body parts?

Ears, nose, fingers, nose, and genitelia

How long does it take to reach steady state?

4-5 half lives

When should we make drug adjustments?

After reaching steady state.

What is the therapeutic index?

difference between ED50 and LD50

What drugs have narrow therapeutic ranges?

Litium carbonate (0.5 - 1.3 mEq/L)
Digoxin (0.5 - 2.0 ng/mL)

What is the first sign of anemia?

Sore throat

What is preemptive intervention?

It is the use of adequate pain medication that results in lower total qty of drug use. The infusion pump is an example.

Who should not receive narcotic analgesics?

Pts. how have had head injury or have a depressed level of consciousness.

What is a hypoglycemia agents?

An agent that lowers blood glucose levels. The biggest side effect is hypoglycemia.

What is an antiglycemic agent?

An agent that halts the further increase of blood glucose levels.

What is a prandiol insulin?

One that is given with a meal.

What is a basal insulin?

One that is given without a meal.

What is an ACE inhibitor?

Number 2 anti=HTN drug. Blocks the conversion of Angiotensin I to II. Angiotensin II might help avoid and increase in BP and vasoconstriction.

What is an A2RB?

Angiotensin II Receptor Blocker.

What is an SSRI?

Selective Seratonin Reuptake Inhibitor. Increases Seratonin levels.

What is a Proton Pump Inhibitor?

Inhibit the action of the gastric proton pump, reduces gastric acid production.

What is an opiod?

Narcotic Analgesic. Decreases the perception of pain and increases the pain tolerance.

What is an NSAID?

Non Steroidal Anti-Inflamatory commonly used as piano killers and fever reduction agents?

What is a HMG-CoA Reducer Inhibitor?

Inhibit the body's cholesterol production

What is a Diuretic?

Primarily used as an anti-HTN. Promote evacuation of water front he body, decrease the load on the cardiovascular system.

What is a Calcium Channel Blocker?

It is an anti-HTN that blocks calcium channels in cardiac muscle and blood vessels, slowing down the activity.

What is a Beta Blocker (B1)?

It is an anti-HTN that blocks adrenaline receptors decreasing the flight or fight response and thus affecting the heart.

What is a benzodiazepine?

It is a n anti-anxiety agent, muscle relaxer, sedative, and hypnotic.

What is an anti-diabetic/sulfonylureas?

lowers glucose levels in the blood. Only used for Type II.

What is an anticonvulsant?

Suppress the rapid firing of neurons in the nervous systems. Anti-epileptic or anti-seizure drug.

What is an antibiotic?

It is an agent that inhibits there reproduction of new bacteria cells.

What do we call drugs that mimic the effects of norepinephrine?

adrenergics, sympathomimeitcs, adrenergic agonist.

What do we call drugs that block the effects of norepinephrine?

Sympatholytics, adrenergic blockers, adrenergic antagonist?

What do we call drugs that mimic the effects of acetylcholine?

Cholinergic drugs, parasympathomimetics, cholinergic agonists, cholinomimetics, cholinergic stimulants.

What do we call drugs that block the effects of acetylcholine

anticholinergic, parasympatholytics, cholinergic antagonists.

With what drug do we worry about first dose syncope?

prazonin (Minipress)

What is the drug category of:
epinephrine (Adrenalin)
phenylephrine (Dristan, Neo-synephrine)
clonidine (Catapress)
dopamine (Intropin)
fenoldopam (Corlopam)?

adrenergic antagonist

Cathecolamine drugs (norepinephrine, epinephrine, isoproterenol, dopamine, dobutamine) can't

be taken orally
cross the blood-brain barrier
be taken with MAO and COMT
They must also be infused because of their brief duration of action.

What is the most important nursing implication with clonidine (Catapress) and Metropolol (Lopressor)?

NEVER ABRUPTLY STOP THERAPY

What is the drug category of:
prazosin (Minipress)
metroprolol (Lopressor, Toprol XL)?

Adrenergic Antagonists

When using fenoldopam (Corlopam) how does the nurse achieve the optimal BP?

Titrating every 15 min

What is the drug category of:
pilocarpine (Akarpine)
nicotine (Nicotrol)
neostigmine (Prostigmin)?

Cholinergic Agonist

Hoe do we treat open-angle-glaucoma?

Pilocarpine (Akarpine)

How do we treat myathesnia gravis?

neostigmine (Prostigmin)

What is the drug category of:
atropine sulfate

Anticholinergic

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