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Pharm Exam 3

Terms in this set (163)

short-term therapy to treat dehydration and electrolyte imbalance; travel through capillary walls
crystalloid fluids
fluid enters the cell and swells; causes hemolysis; decrease BP
hypotonic solution
fluid leaves the cell and shrivels
hypertonic solution
proteins/large molecules; increases oncotic pressure
colloids
undiluted, IV push, or faster than 10 mEq/hr
How can potassium NOT be given?
muscle weakness, lethargy, CONFUSION, decreased deep tendon reflex
S/S of hyponatremia
sodium level below 120 mEq
When is a hypertonic solution given?
tetany, twitching (hyperactive muscles)
S/S of hypocalcemia
fatigue, muscle weakenss (hypoactive muscles), kidney stone, EKG changes
S/S of hypercalcemia
in the cells
Where is magnesium mostly found?
calcium gluconate
What is hypermagnesemia treated with?
2.4-4.4 mEq/L
normal lab values for phosphorous
inverse relationship (high and low)
relationship between calcium and phosphorous
heat, redness, swelling, pain, and loss of function
characteristics of inflammation
pyrogens
What causes the heat inflammatory response?
vascular phase and delayed phase
2 phases of inflammation
prostaglandin release: vasodilation, relaxation of smooth muscle, capillary permeability, and sensitivity of nerve cells
vascular phase of inflammation
healing phase
delayed phase of inflammation
cyclooxygenase (COX)
Which enzymes are responsible for inflammatory process?
protects stomach lining, decreases fever, and promotes platelet aggregation
COX-1
triggers pain and inflammation
COX-2
analgesic, antipyretic, and anticoagulatant; INHIBIT COX ENZYMES
What responses do antiinflammatory agents have?
relieves pain
What do analgesics do?
reduce fever
What do antipyretics do?
inhibit platelet aggregation
What do anticoagulants do?
aspirin (aka salicylate)
acetylsalicylic acid
inhibits both COX-1 and COX-2; can cause GI pain and bleeding
What does aspirin do? What can it cause?
vertigo, tendonitis, bronchospams
sensitivities to aspirin?
indomethacin, sulindac, and tolmetin
para-chlorobenzoic acids
treatment of arthritis
What is indomethacin used for?
highly protein bound; must be taken with food
indomethacin
diclofenac sodium and ketorolac
phenylacetic acid derivatives
analgesic and antiinflammatory properties, but no antipyretic properties
diclofenac sodium
first injectable NSAID; analgesic properties for post-op pain
ketorolac
IV, IM, orally, or nasally
How can ketorolac be administered?
ibuprofen
propionic acid derivatives
arthritis; cause gastric irritation, so contraindicated in PUD patients
fenamates
for long-term arthritis with a long half-life
oxicams
COX-1 and COX-2 inhibitors
What category do NSAIDs fall under?
immunosuppressive agents, immunomodulators, antimalarials
disease-modifying antirheumatic drugs (DMARDs)
interleukin 1 (IL_1) receptor antagonists and TNF blockers
immunomodulators
inhibits proinflammatory receptors to reduce inflammation in synovial joints
What do immunomodulators do?
when all other RA drugs have failed
When are antimalarials given for rheumatoid arthritis?
accumulation of uric acid and in the joints, which causes crystals
gout
analgesic and antipyretic, but no antiinflammatory properties; does not interfere with platelet aggregation
acetaminophen
respiratory depression
What is something to look for and monitor when a patient receives opiods?
drugs that treat other problems, but found to also treat pain
adjuvant therapy
naloxone (opiod antagonist)
What medication is given in an opiod overdose?
tyramine, monosodium glutamate, and aspartame
What is found in migraine trigger foods?
myasthenia gravis; allow Ach to get to receptors and cause muscle contractions
What can Ach-inhibitors treat?
cholinergic crisis
What can Ach-inhibitor overdose cause?
-stigmine
suffix for Ach-inhibitors
autoimmune that causes demyelination
multiple sclerosis
immunosuppressants, immunomodulators, muscle relaxants, and corticosteroids
medications used for multiple sclerosis
interferon beta 1a and 1b
common treatments for MS
IM and subq
How is interferon beta 1a administered?
subq only
How is interferon beta 1b administered?
280-300 mOsm/kg
normal serum osmolality
2300-2900 mL/day
normal recommended fluid intake
1200-1500 mL/day
normal amount of urine production by the kidneys
Lactated Ringer's, Ringer's solution, 0.9% NaCl
examples of isotonic solutions
0.45% NaCl
examples of hypotonic solutions
3% NaCl
examples of hypertonic solutions
loop diuretics
What are usually prescribed with PRBCs to prevent circulatory overload?
within cells
Where is most of the body's potassium located?
acidic pulls K+ out of cells; alkalosis put K+ back into cells
Where does K+ move with pH changes?
4.7 g
recommended daily K+ intake
excess loss rather than deficient intake
What usually causes hypokalemia?
never administer IV push or bolus/IM, do not administer undiluted, infuse slowly
rules regarding potassium administration
cerebral edema, altered mental status, confusion, and seizures
S/S of hyponatremia
decrease intracellular water to brain causes cerebral dehydration, seizures, and coma
S/S of hypernatremia
90% in bones and teeth, 5% bound to albumin, and the remainder (5%) is free ionized calcium
Where is calcium located in the body?
increases ionized calcium
How does acidity affect calcium levels?
decreases ionized calcium
How does alkalosis affect calcium levels?
decrease in total calcium, but ionized calcium is not affected
How does low albumin affect calcium levels?
positive Chvostek and Trousseau signs with tetany
What are classic signs of hypocalcemia?
high alert drug
IV calcium administration?
1.5-2.5 mEq/L
normal lab values for magnesium
98-106 mEq/L
normal lab values for chloride
GI bleed
adverse effect of ibuprofen
celecoxib
example of COX-2 inhibitor drug
kidneys
What should you assess in a person with gout?
colchicine for pain, allopurinol for treatment
medications used for gout
cyclobenzaprine
common muscle relaxant
cardiac disorders; DON'T MIX WITH ALCOHOL OR CNS DEPRESSANTS
contraindications for cyclobenzaprine
anticholinergic effects
side effects of cyclobenzaprine
10-20 mcg/mL
therapeutic index range for acetaminophen
nalbuphine
What medication is effective for labor pain?
sumatriptan
5-HT receptor antagonist; antimigraine
erythromycin
What is usually prescribed to patients with a hypersensitivity to penicillin?
allergic reaction, superinfection, organ toxicity
adverse reactions to antibacterials
penicillin and erythromycin
examples of narrow-spectrum antibiotics
tetracycline and cephalosporins
examples of broad-spectrum antibiotics
gram-positive bacteria
What kinds of organisms do penicillin and erythromycin act against?
secondary infection that occurs when the normal flora are disturbed from antibiotics
What is a superinfection?
bactericidal
What is the classification of penicillin G?
they attack the penicillins; AKA penicillinases
What are beta-lactamases?
penicillins or cephalosporins
What are beta-lactam antibiotics?
a penicillin that is unaffected by food
What's special about amoxicillin?
ampicillin and amoxicillin
examples of broad-spectrum penicillins
clavulanic acid, sulbactam, and tazobactam
3 beta-lactam inhibitors
can get into CSF
What is important about a fourth-generation cephalosporin?
effective against MRSA
What is important about a fifth-generation cephalosporin?
GI disturbances, increased bleeding, and nephrotoxicity
side effects and adverse reactions of cephalosporins?
erythromycin
What was the first macrolide?
GI disturbances
side effects and adverse reactions of macrolides?
should not be used with other macrolides
drug interactions of macrolides?
vanocmycin (for MRSA)
most commonly used glycopeptide
against drug-resistant S. aureus, cardiac prophylaxis, and used for people with PENICILLIN ALLERGIES
What is vancomycin effective against?
red man syndrome
What does rapid IV vancomycin cause?
magnesium/aluminum antacids, milk, or iron
drug and food interactions of tetracyclines
to treat acne
What is doxycycline treat?
discolored teeth
adverse reaction of doxycycline
inhibiting bacterial growth of folic acid
How do sulfonamides fight infection?
it's the first line treatment for TB
What is isoniazid (INH) used to treat?
peripheral neuropathy
What is a common problem with INH?
thrush
What is it called when Candida albicans affects the mouth?
antifungal; treats candida
What is nystatin?
cold sores
HSV-1
genital herpes
HSV-2
treats herpes simplex
What does acyclovir sodium treat?
treats malaria
What does chloroquine phosphate treat?
tapeworms; enter through contaminated food
cestodes
GI infections
What does metronidazole treat?
ADHD
What do stimulants treat?
falling asleep in normal waking hours
What is narcolepsy?
norepinephrine and dopamine
What neurotransmitters do amphetamines stimulate?
methylphenidate
example of amphetamine-like drugs
ADHD; increase focus
What do amphetamine-like drugs treat?
before bed because insomnia can result
When should methylphenidate not be given? Why?
schedule II
What kind of drug is methylphenidate?
before meals
When should methylphenidate be taken?
alcohol, driving, abrupt discontinuation
What should be avoided when taking methylphenidate?
suppress appetite
What do anorexiants do?
anorexiants do not have serious side effects
What is the difference between anorexiants and amphetamines?
stimulate respiration
What do analeptics do?
xanthines (caffeine and theophylline)
What are examples of analeptics?
intermediate-acting hypnotics cause a hangover afterwards
What's the difference between short-acting and intermediate-acting hypnotics?
severe respiratory disorders
contraindications for hypnotics
they should not be used for longer than 2 weeks
What is important to know about barbituates?
sedative
What are barbituates?
-pam and -lam
suffix for benzodiazepines
they are antianxiety and sedative-hypnotics
What do benzodiazepines do?
nightmares and amnesia
side effect of benzodiazepines?
xanax
example of a benzodiazepine?
short-term treatment of insomnia (less than 10 days)
What are nonbenzodiazepines used for?
ramelteon
example of a melatonin agonist?
decreases REM sleep
What does ramelteon do?
laughing gas
nitrous oxide
supports microbial growth and can increase risk for infection
What can propofol put a patient at risk for?
below L1 and adults and L3 in children; subarachnoid space
Where are spinal anesthetics injected?
low and slow; flaccid paralysis, paralytic ileus
S/S of hypokalemia
tight and contracted; hyperactive bowel, increased DTR
S/S of hyperkalemia
maintain BP, blood volume, and pH
3 main functions of sodium
calm and quiet in all organs
S/S of hypermagnesemia
no sheriff BUCK WILD!; abnormal eye movements and diarrhea
S/S of hypomagnesemia
keep the 3 B's strong; bones, blood (clotting factors), and beats (heartbeats)
What is the 3 main functions of calcium?
PHOSPHATE; does the opposite!
calcium's worst enemy??
decreased LOC
side effect of metabolic acidosis
hypo: deflated and depressed
hyper: big and bloated
hypo- and hypernatremia phrases?
hypo: low and slow
hyper: tight and contracted
hypo- and hyperkalemia phrases?
hypo: swollen and slow
hyper: T and C signs
hypo- and hypercalcemia phrases?
hypo: BUCK WILD
hyper: calm and quiet
hypo- and hypermagnesemia phrases?
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