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Pharm Exam 1 Review

Terms in this set (57)

EC
Enteric coated. Dissolves in intestines
ER
Extended Release. Released over time
EL
Extended length.
SR 0r XR
Sustained release
SA
Sustained action
Parenteral
Injectable Drugs
Onset and Absorption
IV: Immediate and complete. Immediate onset.
Subcutaneous and Intramuscular:
Rapid, but if highly water soluble and good blood flow
Slow, poorly water soluble and blood flow is slow or impaired
Pharmakoinetics
Absorption
Distribution
Metabolism
Excretion
Absorption
Movement of drug from site of administration to various tissues
First Pass Effect
Some of the drug may eliminate and can be less than what the patient initially ingests
Bioavalibility
Amount of drug available after passing through the liver
Distribution
Movement of drug by circulatory system to intended site of action
Metabolism
Liver responsible. Changes that occur in a drug. To a more or less potent form, to a more soluble form or to an inactive form.
Bio transformation
Change that occurs in drugs chemical nature
Metabolite
New or altered form of drug ( a by product of metabolism)
Excretion
Elimination of drug or its metabolites through various parts of body, kidneys, GI tract, skin or lungs
Half life of drug
-Time it takes for drug to decrease in amount by half.
-Reflects how quickly and efficiently a drug metabolizes and excretes.
-Decrease in functioning of kidney or liver increase half life of drugs
Onset
Amount of time it takes to create a response
Peak
Time it takes to demonstrated its full therapeutic effect
Duration
Length of time the therapeutic lasts
Peak Level
Point in time when drug is at its highest
Trough Level
Point in time when drug is at its lowest
Agonists
Bind with receptor and have greater than typical response (makes something happen)
Antagonists
Drugs that bind to a receptor and block response or less than typical response. ( Prevent action from happening)
Benadryl
Many different therapeutic uses.
Allergies: Antihistaminic effect
Motion sickness:
Hypnotic effect: Sedative effect
Parkinson's disease: Anticholinergic effect (dries)
Non- Therapeutic
Unintended effects that occur at a therapeutic effect
Side Effects
Unintended effects that commonly occur and are mild
Adverse Effects
Unintended and unexpected effects that are most sever. Can be life threatening
Anaphylatic Shock
Exaggerated: Response the body's immune system to drug
Precipitates: Massive release of histamine and other chemical mediators
Symptoms: Swelling of eyes, face, mouth and throat. Difficulty breathing, rapid heart rate, extremely low B/P, Cardiac arrest
How to treat Anaphylatic Shock
-Establish airway and O2 therapy
-Give Epinephrin to raise blood pressure and dilate bronchi
-Give benadryl to block additional release of histamine
-Give Pepcid
-Give Steroids
Drug Tolerance
Bodys decreased response to drug that it receives over a period of time.
MD must increase does.
Tolerance to narcotics can occur 10-14 days of consecutive drug therapy
Cumulative Drug Effect
Occur when amount of drug patient receives is greater than excreted
Common in older adults who have decreased cardiac and kidney function.
Liver or kidney function
Need to decrease does accordingly
Drug Toxicity
When Pt. receives drug in excessive does. Draw serum to test drug levels and monitor for signs and symptoms
TB Drugs
-isoniazid, pyrazinamide, ethambutol, rifapentine.
-Combo of 3-4 medications to treat TB, take with Vitamin B Complex.
-Side Effects: neuropathies, hepatotoxiciy, seizure, dyscrasias (disordered state of body)
-Do not take with liver disease, gallbladder disease
-Taken for 6-9 months, avoid alcohol.
-Monitor LFT's
amphotericin (Fungizone) Antifungal
Because of side effects must premedicate patient with Benadryl and Tylenol. Monitor CBC, electrolytes, BUN, Cr, Nystatin pts. must swish and swallow. Can be highly toxic. Side effects fever, chills, hypotension
ciprofloxacin (Cipro)
Bactericidal, they disrupt the DNA.
Treats: UTI'S, severe lower resp. infections, renal, bone and joint infections.
Adverse effects: Achilles tendon rupture
gentamycin (Garamycin) Aminoglycosides
Powerful bactericidal, disrupt protein synthesis
Monitor BUN and Cr. Must monitor peak and trough levels
chloroquine (Aralen) Antimalarial or Antiprotozoan
Inhibits parasitic growth
Side effects: blurry vision, photophobia, pruritus (itchy skin)
Special Considerations: Need to wear glasses, travelers to areas with malaria need prophlaxis, monitor CBC
tetracycline (Sumycin or Doxycycline) Tetracycline
Acne vulgaris and unusual infections (rocky mtn fever, spotted fever, Chlamydia, H. pylori
Side Effects: yellow teeth, hepatotoxicity, photosensitivity
Contraindications: Do not give to children younger than 8, exposure to ultraviolet light, serious liver or renal failure.
Special Considerations: CANNOT give with dairy products or antacids. Decreases contraceptive effectiveness
cimetidine (Tagament) Histamine2 Receptor
Action: decreases the amount of stomach acid. Increases pH of stomach.
Side Effects: Decreases libido, many CNS effects (confusion, lethargy, depression, restlessness, seizures) gynomastia (man boobs)
Do not give to children under 12
diphenoxylate (Lomotil) Diarrhea
Given with atropine (relaxes smooth muscle) Discourages abuse because atropine has so many side effects. Pupils dilate, dries mouth.
Classes of Anti-nausea drugs
Serotonin Antagonists, Antihistamines, Prokinetics
Culture and Sensitivity with Antibiotics
Sensitivity analysis determines the effectiveness of antibiotics against microorganisms (germs) such as bacteria that have been isolated from cultures.
dimenhydrinate (Dramamine)
scopolamine (Transderm Scop)
Motion sickness
Block H1 receptors
omeprazole (Prilosec
pantoprazole (Protonix)
iansoprazole (Prevacid)
esomerprazole (Nexium)
Proton Pump Inhibitors
Indications: ulcers, dyspepsia, GERD, erosive esophagitis
Action: Decrease gastric acid production
Side Effects: Bone loss with long term use (take calcium and vitamin D and exercise)
Special Considerations: take on empty stomach 1 hour before meals. Milk increases acid production
sucralfate (Carafate)
Ulcers
Coats ulcers, creates a barrier between stomach and gastric secretions
Give on empty stomach
Do not give with antacids
ranitidine(Zantac)
cimetidine (Tagament)
famotidine (Pepcid)
Ulcers, heart burn, dyspepsia, GERD,
Decreases amount of stomach acid, increases pH
Side Effects: nausea, vomiting, diarrhea and constipation
misoprostol (Cytotec) Prostoglandin E Analogues
Prevents gastric ulcers, long term NSAID use
Action: decrease gastric acid secretion, increase bicarbonate (base)
Side effects: diarrhea, nausea, dyspepsia and abd pain. May cause menstrual spotting
Do not take if pregnant, Pregnancy X
aluminum hydroxide(Amphogel)
Milk of Magnesia (MOM)
calcium carbonate (Tums)
magnesium and aluminum hydroxide (Magaldrate)
Antacids
Peptic Ulcers, GERD
Action: Neutralize gastric acid
Side Effects: Constipation with calcium and aluminum
Diarrhea with magnesium
Aluminum are the only antacids safe for clients with renal failure
Do not take with GI perforation, obstruction
amoxicillin (Amoxil)
metroindazole(Flagyl)
tetracycline(Sumycin)
Treats Helicobactor pylori
Kills bacteria in cell wall
Combine with H2 blocker or a PPI to treat. and also Pepto
trimethoprim/sulfamethoxazole
(Bactrim, Septra)
Side Effects: Stevens-Johnson Syndrome, Folic acid deficiencies
Special Considerations: do not take with alcohol causes a disulfiram like reaction. Monitor bowel function, monitor CBC and urinalysis, drink 2-3 liters of fluid a day. use alternate contraceptive
alosetron (Lotronex) Irritable Bowel Syndrome
Only women take this drug. Diarrhea
Action: Decrease pain, peristalsis, increase absorption of water and sodium
Contraindications: Report constipation, abd pain, or rectal bleeding immediately and stop taking drug
lubiprostone(Amitiza) IBS
Used in men and women for constipation
Action: Decrease pain, increase peristalsis and secretions of water and electrolytes.
Contraindications: severe diarrhea- Stop drug immediately, Diverticulitis, Crohns disease, Ulcerative Colitis, Volvulus(colon goes into itself), intestinal obstruction
Dont give if pt. has diarrhea
psyllium (Metamucil)
calcium polycarbophil (Fiber Con)
methylcellulose (Citrucel)
Bulk forming laxative, increases parastalsis
Do not give with a GI obstruction or narrowed of intestinal tract (can rupture)
bisacodyl (Dulcolax)
senna (Ex-Lax)
castor oil
cascara sagrada
Stimulant laxatives
Stimulates peristalsis
Side effects: diarrhea, cramps, burning proctitis( burning of anus)
Do not give with a GI obstruction or narrowed of intestinal tract (can rupture)
vancomycin (Vancocin)
-Action: bactericidal causes cell wall death
-Indications: Treats life threatening infections(staph, meningitis, osteomyelitis)
-Side Effects: ototoxicity, nephrotoxicity (BUN and creation decrease)
-Adverse Side Effects: Red mans syndrome (hypotension, flushing of face and trunk when given too fast) Anaphylaxis
-Need to do peak and trough levels. Monitor renal and hearing
Pregnancy Category D and X
D: There is positive evidence of human fetal risk, but potential benefits may warrant use of in pregnant women despite potential risks
X: Have demonstrated fetal abnormalities. Positive evidence of fetal risk. Risks outweigh the benefits
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