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O'Neil final
Final
73
Pharmacology
Undergraduate 2
05/13/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
Herbal products
Definition
dietary supplements
No real evidence
Term
Pregnancy and meds
Definition
•First trimester is greatest danger from medications.
–Rapid fetal growth

•Greatest drug transfer during third trimester
–Enhanced blood flow to fetus
–Large fetal body surface area


Do not take: Antianxiety, antidepressants, neuroleptic (antipsychotic) – long half lives.
Term
Standing Order
Definition
always open to the pt, like birth control bc you can keep getting it unless prescriber stops the order.
Term
Unit dose
Definition
– made in the form it is supposed to be given in

Ex: prefilled syringes
Term
Pharmacotherapeutics
Definition
the use of drugs and the clinical indications for drugs to prevent and treat diseases
Term
Pharmacokinetics
Definition
what the body does to the drug
–Absorption, Distribution, Metabolism, Excretion
Term
Pharmacodynamics
Definition
The mechanism of drug actions in living tissues
Term
Remember Abbreviations

Ears, Mouth, Meals
Definition
Before meals = AC
After meals = PC
Term
Enteral
Definition
GI tract: PO, sublingual, NGT (nasal gastric tube)
Term
Parenteral
Definition
blood stream: ID, SQ, IV, IM
Term
Topical
Definition
skin, eyes, ears, lungs
Term
High first pass effect
Definition
The metabolism of a drug and its passage from the liver into the circulation – low med availability because it is metabolizes
Term
Iron
Definition
absorbed better with orange juice.
Term
Fast to slow absorption:
Definition
Liquids, elixirs, syrups, suspension solutions, powders, capsules, tablets, coated tablets, and enteric-coated
Term
Combination Dosage
Definition
Multiple drugs for simultaneous dosing (one drug may have side effects and combining different drugs to the same dose will allow you to mask the side effects) –Enhance effectiveness of one ingredient
Term
How do you draw up oral liquids?
Definition
Pour in medicine cup and draw up into oral syringe
Term
NG/GT administration
Definition
HOb 30 degrees
Before you flush, you aspirate. Flush 2/ 30ml, give medication, flush w/ 30ml.
Term
Antacids
Definition
neutralize stomach acid to reduce acid-related disorders (peptic ulcer, heartburn)
•Side effects:
–Magnesium: Diarrhea
–Aluminum and calcium: Constipation
–Calcium: Kidney stones
•Avoid mag and calcium antacids in renal disease
Term
H2Receptor Agonists
Definition
Competitively block the H2 receptors of acid producing cells = Reduce acid secretion

Used in GERD, esophagitis, peptic ulcer
•Side effects: confusion and disorientation, impotence (weakness), thrombocytopenia (low platelet #)
•Smoking decreases effectiveness of these meds
Term
Proton Pump inhibitors
Definition
prevents the movement of hydrogen ions out of parietal cells = stops over 90% of all gastric secretion.
•Erosive esophagitis, poorly responsive GERD, ulcers


sucralfate (ulcer-adherent) – a cytoprotective drug. Covers and protects the ulcer site.
•simethicone (antiflatulent) – Relieve painful symptoms assoc. with gas
Term
sucralfate
Definition
(ulcer-adherent) – a cytoprotective drug. Covers and protects the ulcer site.
Term
simethicone
Definition
(antiflatulent) – Relieve painful symptoms assoc. with gas
Term
Treatment of peptic ulcer disease
Definition
Caused by H pylori → antibiotics.
Term
Fast Distribution
Definition
heart, brain, liver, kidney
Term
Slow Distribution
Definition
skin, muscle, fat,
Term
Protein Bound drugs:
Definition
You need more drug if it is highly protein-bound because proteins can’t leave the blood and won’t be able to go to their sites so you need more available free drugs.
→ Albumin carries majority of protein bound drugs.
Term
Metabolism
Definition
alteration of drug, liver, Cytochrome P450
Term
Excretion Organs
Definition
Primary: kidney, Secondary: liver, bowel.
Term
Peak effect
Definition
highest therapeutic level
Term
Peak
Definition
highest amount of drug in the blood stream.
Term
Why therapeutic drug monitoring?
Definition
◦Verify adequate drug exposure
◦Maximize therapeutic effects
◦Minimize drug toxicity
Term
agonist-antagonist
Definition
binds but only elicits a small response
Term
Enzyme interactions:
Definition
the drug either inhibits or enhances enzyme activity

–Example: NSAIDs block the COX-2 enzymes and reduce prostaglandins throughout the body. As a consequence, ongoing inflammation, pain, and fever are reduced.

Example: Vancomycin inhibits the enzymes needed for the survival of bacteria.
Term
Nonselective interactions
Definition
: drug either physically interferes with or chemically alters cellular structures or processes.
Example: Some chemo drugs like Cisplatin and Carboplatin work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die.
Term
What can..
1) Cure disease
2) Slow progress of disease
3) Prevent a disease
4) Reduce a symptom
Definition
1) Antibiotics
2) Alzheimers
3) Immunization shots
4) Tylenol
Term
Supportive Care
Definition
Recovering patient.
Term
Palliative care
Definition
Dying
Term
Transdermal Patch
Definition
Used for slow, systemic absorption usually over 24 hours.
◦Remove old patch, cleanse site
◦Rotate sites (hairless)
◦Do not touch inside of patch
Term
Nitroglycerin
Definition
Ointment.
BE CAREFUL: do not massage into skin, cover with transparent dressing
Term
Suppositories
Definition
Sims position, gloves, lubrication (water soluble), Insert suppository past the internal rectal sphincter

- Patient remains supine for 5-10 minutes
- Splitting suppositories not recommended
Term
Ophthalmic route -
Definition
Patient lies down or assumes High-fowlers with head tilted back.. Nurse pulls down the skin below eye. Drops or ointment are instilled into conjunctival sac. No contact lenses.
Term
Otic route
Definition
- Pull pinna down and back in child
- Pull pinna up and back in adult
- Patient remains on side for 5 min after drops
Term
Inhalation route: Why so great?
Definition
Readily absorbed locally with quick action due to rich vascular capillary network
Term
Metered Dose Inhalers (MDIs)
Definition
- Delivers a measured dose with each “puff”
◦Propellent
◦Spacer
◦1-2 min between puffs
◦2-5 min between different meds
◦Rinse mouth after steroid
Term
Dry Powder Inhalers
Definition
- No need to shake canister or use a spacer
- Take deep inhalation and hold breath for 5-10 seconds.
- Requires forceful inhalation to break up the powder
- Difficult for patients younger than 6 years.
Term
Beta-adrenergic agonists
Definition
albuterol
◦Stimulate the adrenergic receptors in the sympathetic nervous system (SNS) which assists in bronchial muscle relaxation=bronchodilation (and cardiac stimulation=tachycardia) + tremors
Term
Anti-cholinergics
Definition
ipratropium

Blocks anticholinergic receptors, which prevents bronchoconstriction. Works well in combo with albuterol
Term
Leukotriene receptor antagonists
Definition
singulair

◦Leukotrienes are produced in response to allergens and cause inflammation, bronchial constriction, and ↑mucous. – stopping leukotriene effects.
◦Long-term med, not for acute attacks
Term
Corticosteroids
Definition
pulmicort, beclovent

Reduce inflammation by stabilizing cell membranes so they don’t release bronchoconstricting substances

Works well with albuterol
Term
Epidural
Definition
Spine
Term
Intrathecal
Definition
in between sheeths
Term
Intraosseous
Definition
Bone
Term
Intraperitoneal
Definition
Peritoneal space
Term
Intra-artcular
Definition
Joints
Term
Insulin and Tuberculin syringes
Definition
Insulin in units.

Tuberculin in ml.
Term
Intradermal
Definition
1ml syringe, 25-28 gauge needle, 1/4 – 5/8 inch needle, Insert needle at 5º-15º angle up to about 3mm, inject, visualize bleb. Do not massage area

Once a patient has received
BCG—do NOT do TB skin testing
(false positives).
Term
Subcutaneous
Definition
Max 1ml volume, 1-3 ml syringe, 25-27 gauge needle, 3/8-5/8" needle, Inject at 45º or 90º angle. If 2 inches of tissue can be grasped use 90º. If 1 inch of tissue can be grasped use 45º

Sites: outer aspect upper arms, abdomen (2" away from umbilicus), upper thighs
Term
Intramuscular
Definition
Up to 3ml of volume (1ml for children). 1-3 ml syringe, 21-25 gauge needle, 1-1 ½ inch needle. Inject at 90 degrees


- Deltoid for immunizations (adults/children)
- Vastus lateralis for infant immunizations
- Ventrogluteal for IM meds in adults
Term
Immunizing drugs
Definition
- Can offer long-lasting immunity to 20+ infections
- May be given SQ, IM (check drug book)
Term
Toxoids
Definition
Detoxified exotoxins which stimulate antitoxin antibodies (diphtheria and tetanus caused by toxin-producing bacteria)
Term
Contraindications to Vaccines
Definition
Mild illness is NOT a contraindication for vaccines

- Allergy to the vaccine or its components (eggs) may be a contraindication

- Minor reactions often occur
◦Rise in temp, and warm, tender, red skin
◦May give acetaminophen/ibuprofen (not aspirin), warm compresses

- After receiving an immunization, a patient or parent should call if:
◦High (>103) or prolonged fever
◦Rash and/or itching
◦Shortness of breath or ANY resp involvement
Term
DO NOT USE abbreviations:
Definition
U: Unit
QD: Every day.
QOD: Every other day.
Term
Vaccine preparation
Definition
have to write out lot number and manufacturer (Lots come in batches, so if it’s not potent enough, they can find the batch and see who’s gotten the rest of the batch).
Term
Sample drug order:
Definition
Pt name, date and time, drug name, dose, route, frequency, prescribers signature
Term
Common Conversions:

Tsp, Tblsp, ml, oz, kg, lbs
Definition
1 teaspoon = 5ml
1 tablespoon = 3 teaspoons (15ml)
1 ounce = 2 tablespoons (30ml)
1 kg= 2.2 pounds
Term
Medication Error
Definition
preventable
Term
Adverse drug reaction
Definition
undesirable effect at therapeutic dose
Term
Allergic reaction
Definition
hypersensitivity immune response
Term
Idiosyncratic reaction
Definition
unexpected in a particular patient
Term
How many people died every year from med errors?
Definition
98,000
90% from IV meds.
Insulin: #1 killer.
Poor communication 50% of med errors.
Term
Drifting
Definition
behavioral choices that create risks.
Term
3 steps required for medication reconciliation?
Definition
1) Verification: Collect patient info
2) Clarification: professional review of meds
3) Reconciliation: investigate discrepancies

On admission, status change, pt transfer, discharge.
Term
Reporting of Error
Definition
Your professional responsibility to report
Assess the patient situation first
Alert the prescriber and the nurse manager
Provide follow-up care, testing, or antidotes
Complete forms as required documenting the facts:
Incident report
Unusual occurrence reports
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