Do drugs act by creating new functions or by modifying existing functions in the body?
How do opium drugs enter the cell?
drugb receptors in the brain >>chemicals normally found in the blood binding is determined by chemical structure of the drug >>opiods produce analgesic response
A drug absorbed from the lining of the mouth enters portal circulation or systemic circulation first?
systemic circulation through cappilaries in t he mouth
What is the diffrence between the routes orally (PO) and sublingually (SL)
Orally= portal -> liver >>systemic circulation
Sublingually= capillaries >> sytemic circulation
Why do older adults have less ability of drugs to bind to albumin?
reduced renal function, malnourished,and changes in ratios of water, fat and lean muscle mass
what should the client be taught regarding making up a missed dose of a perscribed med?
To not double up the missed dose, but to take the missed dose as soon as remembered unless with in 2 hoursof next scheduled dose. report to the doctor if two doses missed
What are three causes of noncompliance with perscribed meds?
1. misunderstanding of the instructions
2.unable to get perscription filled
3. intolerable side effects
What should be assessed when a client is taking a GI stimulant?
check bowel sounds >> note when they return to usual pattern
What is the desired action on the GI tract of atropine?
blocks parasympathetic nervous system >> antispasmotic, relaxes smooth muscles
What type laxative is docusate?
wetting agent >> takes 1-2 days for effect >> used to reduce straining
When stimulant laxatives are abused what untoward situations can occur?
dehydration and electrolyte imbalance
What effect does the laxative, lactulose, have on ammonia?
lowers blood ammonia (liver failure) prevents protein absorption
Which type antacid causes diarreah? Which type causes constipation?
magnesium >> diarreah
aluminum and calcium >> constipation
How should an antibiotic prescription be taken?
full antibiotic perscription should be taken with out interruption
What is the definition of super-infection?
infection that arises during antibiotic treatment. they involve organisms that are resistent to the antibiotic origiannly used. broad spectrum antibiotics kill normal flora that lead to oppurtunistic infections
What is the action on an organism of sulronarnides?
blocks bacterial synthsis of folic acid >> bacteriocidal
What is the definition of antibiotic resistince, and what causes antibiotic resistence to devolop?
organism adapts so that drug therapy no longer effective
inherited>>stable gentic trait
plasmid>>DNA pieces seperated from cell
What is the action on an organism of an aminoglycoside?
inhibits bacterial protein synthesis and affects the cell membrane
What are the two major side effects of aminoglycoside?
nephrotyoxic >> monitor renal function
ototoxic (loss of equilibrium and loss of hearing) >> monitor auditory during therapy report buzzing and assess balance
What is the correct way to take nystatin oral suspension?
hold in mouth >> swish >> gargle >> then swallow
Why should the blood level of an antibiotic trough level be obtained?
drawn before dose is due and felects the lowest serum level >>lab results will be given in a spectrum from lowest to toxic
What nursing action best prevents the devolopment of drug resistence in clients with tuberculosis?
Directly Observed Therapy (DOT)
What foods are high in potassium that the client taking a loop diuretic or thiazide diuretic should eat?
What major side effect is caused by all; meds that lower B/P? What are clients instructed to do to lessen this side effect?
how frequently can nitroglycerin (NTG) tablets be taken? When should a client go to an emergency facility?
What is the theroputic theophylline serum level so that a time released theophylline capsule can be given?
What are the causes of hyperfunction of glands which requires that drugs to block hormone production be given?
During the peak of a dose of insulin, the patient should be monitored for possible occurence of what situation?
What action does anticholinergic eye drops have on the eyes?
dilates pupils to better examine the eye
Which eye drops are a carbonic anhydrase inhibitor?
dorzolamide (trusopt) >> decreases formation of aqueous humor
What are the side effects of latanoprost (xalatan) eye drops?
brown pigment in iris and changes in eye color
List the steps for administering eye drops. Which should be given first, eye drops or ointments? When two are used how long a period should there be between applications?
place in lower conjunctiva sac>>occlude the naso-lacrimal duct for 1 minute>>wash hands between meds > wait 3 minutes between application > give drops before ointment >> glucocorticosteroids first
What is the major neurotransmitter of the sympathetic nervous system?
epinephrine, norepinephrine, dopamine
What major behavioral characteristic of patients with depression must constantly be monitored and prevented even when anti-depressant meds are given?
thoughts of suicide
When taking the MAO inhibitor: nardil, what should the patient not drink?
anything high in tyramine >> wine
Alcohol has what effect on the central nervous system?
CNS depressant >> sedation, dis-inhibition, anesthesia
A patient should be instructed to take tacrine (cognex) at what time of the day?
Alzheimer's patients should take it at bedtime once a day
State the action of interferon-b (betaseron) and describe how and when it is administered to a patient with Multiple Sclerosis?
given IM every other day to suppress immune response and reduce spasticity
List the objective indicators of pain
increased pulse and respiration, elevation in B/P, perspiration, dilation of pupils, crying, grimacing, and restlessness
What is the action of alloprinol (zyloprim)?
inhibits formation of uric acid crystals and prevents gout attacks
For what types of pain are opiods used?
moderate to severe pain associated with trauma, surgery, heart attack, biliary or uteral pain, inflammation, and cancer
What are the side effects of the opiods: demeral and dilaudid?
constipation, urinary retention, hypotension, pinpoint pupils
What can the patient not do after recieving curare?
diaphragm is paralyzed and spontaneous respiration stops
When taking capecitabine (xeloda), what factors may intiate or worsen the side effects of Hand and Foot syndrome?
take with food > drink 2000-3000 ml/fluid/day >metabolite can accumulate in the skin > heat and pressure aggravate the condition
What colony stimulating factor stimulates the production of 1.platlets? Of 2.WBC? Of 3.RBC?
1.neumega > platlets
2. neupogen > WBC
3. epogen > RBC