Pharm 546 Flashcards

Terms Definitions
Ciprofloxacin (Cipro),
1
Hypertonic crystalloids
D5NS3%NS
gabapentin
Antiepileptic drug (AED)
bactericidal drugs
kill bacteria
Cholesterol Absorption Inhibitor
Ezetimibe (Zetia)
drug-drug interactions
cyclosporine
warafin
antacids
fibtrates
Insulin types
short-acting:regular insulin
intermediate-acting: NPH
long-acting: glargine
fixed combination: Humulin 50/50
lorazepam (Ativan)
benzodiazepine - sedative/hypnotic
New Drug Development


Stages (preclinical/clinical)
Incorporate (controls, placebo, blinding, randomization)
Costly $$$$$
Phosphodiesterase Inhibitors
DrugsSildenafil (Viagra)Tadalafil (Cialis)ActionsSelective inhibitor of PDE-5 enzymeUsesTreat male erectile dysfunction; pulmonary arterial hypertensionCommon adverse effectsHeadache, flushing of the face and neck, color vision impairmentSerious adverse effectsNitrates are contraindicatedHypotension, dizziness, angina, loss of vision, sustained erection
Antihypertensive
Calcium Channel Blocker
Adverse Effects
 
nausea
AV blocks
headache
flushing
peripheral edema
hypotension
Antibiotics:Tetracycline:Teaching
avoid sunlight/UV light;wear protective clothing and sunscreen
finish prescription
report signs of a superinfection
not for children under 8
not to be used with oral contraceptives
Caffeine
Mood elevation, increased alertness, nervousness, jitteriness, irritability, insomnia, increased respirations, increased heart rate and force of myocardial contraction, relaxation of smooth muscle, diuresis
zolpidem
Benzodiazepine like drug – sedative/hypnotic
Toradol
NSAIDs- 10-60mg/d acute renal failure
 
*Dilute IV and slow push (15 mins) pH*
Penicillins
ActionsInhibit cell wall synthesis, penicillinase-resistant penicillinsIntroduced to kill StaphyloccusInhibit bacterial cell wall synthesisUsesTreat middle ear infections, pneumonia, meningitis, urinary tract infections, syphilis, gonorrheaCommon adverse effectsDiarrhea, electrolyte imbalanceSerious adverse effectsHepatotoxicity, nephrotoxicity
Anticoagulant side effects
BleedRetroperitoneal hemorrhage (Lumbar pain, unilateral bulge)
Sinoatrial node (pacemaker)
initiates each heartbeat
(platelet) Plavix side effects
hemorrhage
rash
dizziness
abdominal pain
back pain
20th century
asprin, phenobarbital insulin and sulfonamides weredeveloped
Contraindications/precautions for buproprion
none noted in textbook
Indications for terbutaline
Asthma, acute bronchospasm, exercise-induced bronchospasm
antimicrobial
any agent that can harm microbes
3 factors of an Ideal Drug
Effective-Safe-Selective
Instruction for Men
Teaching self-care regarding STDsDiscuss good personal hygiene practicesDiscuss appropriate interventions for men with altered sexual functionLatex condoms can be effective in reducing transmission of HIV and some STDs, but are not effective against STDs transmitted by skin-to-skin contact
What is the oil/gas partition coefficient of Des?
18.7
Antiarrhythmics
Lidocaine (Xylocaine)
Nursing Interventions
Always check label
administer bolus followed by continuous infusion
do not administer with food unless prescribed
monitor for hypotension and bradycardia
safety precaution to prevent injury
avoid drink alkalizes the urine: apple juice OK
Where did sulfa come from?
What special population is listed in book (p145)?
administration of ________ results in a viscid and very sticky gel that adheres to the ulcer crater, creating a barrier to back-diffusion of hydrogen ions, pepsin, and bile salts
sucralfate
Atenolol (beta-blocker):evaluation
symptoms of dysrhythmias are decreased
Misfeasance
Negligence; giving the wrong drug or drug dose that results in the client's death
Precautions for beclomethasone
• Hypertension• GI disease (PUD)• Congestive heart failure• Venous thromboembolism disease
Side effects of lamotrigine
-life-threatening rashes (including Stevens-Johnsons)-CNS: dizziness, diplopia, blurred vision, headache-nausea/vomiting
viruses, rickettsia
require a host cell to replicate

Synergism 


when the combined effects of 2 drugs acting simultaneously are greater than the algebraic sum of the individual effects of these drugs, the drugs are acting synergistically
Warfarin/Coumadin (anticoag)
PT/INR- Daily at firstCommon oral med
Arterial anastomoses
Arterial connections that ensure that when one of the blood-supplying arteries is damaged, flow is maintained from the other areteries.
Antiplatelet
Aspirin, Plavix
Contraindications
active bleed, severe liver impairment, underlying coagulation disorder, ulcer disease, thrombocytopenia
NE interactions
Beta blockers lower NETCA's lower NE
Rectal administration
position patient on left side
**wear gloves**
unwrap medication from foil
lubricate tip of medication with water based jelly
insert at least 1 inch
have patient remain lying on side for 15-20 minutes
Antibiotics:Tetracycline:
Administration
Tetracycline should be taken on an empty stomach, at least 1 hour before or 2 hours after meals or snacks. Do not take tetracycline with food, especially dairy products such as milk, yogurt, cheese, and ice cream. with water only
Drug interaction
an altered or modified action or effect of a drug as a result of interaction with one or more drugs
Side effects of buproprion
• Generally well-tolerated• Most common: agitation, headache, dry mouth, constipation, weight loss, GI upset, dizziness, tremor, insomnia, blurred vision and tachycardia• Most adverse: seizures (can occur when dosage is too high). Risk greatly increased in pts with predisposing factors (i.e. head trauma, CNS tumor, preexisting seizure disorder and use of meds which lower seizure threshold)• Like all antidepressants, may increase risk of suicide in children, adolescents and young adults
Side effects of valproic acid
thrombocytopenia, pancreatitis, and liver failure. GI- nausea, vomiting, diarrhea, dyspepsia, indigestion, weight gain
Interactions with zolpidem
increases CNS depression with other CNS depressants
Clinical Testing
Phase II


ü  Phase II (patients 500-5000, on drug 3-6 yr)
o   Small select group of patients to determine potential use of the drug with respect to the disease
o   Compare results with Phase I for
§  Therapeutic utility and dosage range in diseased patients
Pharmacokintic interaction
Drugs taken together that may alter absorption, distribution, metabolism or excretions
Beta-lactamases
enzymes produced by some bacteria and are responsible for their resistance to beta-lactam antibiotics like penicillins, cephalosporins (are relatively resistant to beta-lactamase), These antibiotics have a common element in their molecular structure: a four-atom ring known as a beta-lactam. The lactamase enzyme breaks that ring open, deactivating the molecule's antibacterial properties.1st Generation: these are destroyed by beta-lactamases Basically, 3rd & 4th generation are more effective against sepsis. The higher the number, the broader the spectrum.
Antihypertensive
Angiotension Converting Enzyme (ACE)
blocks the conversion of angiotensin I to angiotensin II
What do Inotropes do?
Increase contractile strengthFor later shockDig, Dobutamine, Dopamine
Lopressor (antihypertensive): action
a selective beta blocker that selectively blocks beta 1 receptors; decreasing cardiac output, peripheral resistance, and cardiac oxygen consumption; and depresses renin secretions
propranolol Hcl (inderol LA) beta-adrenergic blocker: evaluation
absence of chest pain
Carbamazepine (tegretol)Assess
patients of Asian descent get a genetic blood test before starting therapy with carbamazepine
check renal and hepatic function
Schedule 5 controlled substances...C5
Medically accepted drugs. Very limited potential for dependenceEX: opiod-controlled substances
MOA of baclofen
Acts within the spinal cord to suppress hyperactive reflexes involved in regulation of muscle movement.The precise mechanism of reflex attenuation is unknown.
Contraindications/Precautions for zileuton
not effective against an acute asthma episode b/c effects are not immediate
three major groups of microbials
antibacterial drugs, antifungal drugs, antiviral drugs
Preg Category A
Control Studies, no fetal effects 1st trimester- no potential risk for 2nd and 3rd
Name 4 drug classes for coagulation
1. Anticoagulants2. Antiplatelets3. Thrombolytics4. Hemostatics/Antifibrinolytics
B-blockers
Meds for CAD
reduce BP in individuals who are hypertensive
how do you choose ur antiB
culture and sensitivities
(important for "hard" antiB)
two cannabinoids_______ and ________ are approved for medical use in the US
dronabinol (marinol) and nabilone (sesamet)
(Albuterol) Proventil: Bronchodilator: teaching
stop drug if paradoxical bronchospasm occurs
use MDI correctly:
1. shake the inhaler
2. clear nasal passages and throat
3.breathe out
4. place mouthpiece well into mouth and seal with lips
5. hold breathe for several seconds and exhale slowly
1970: the controlled substances act
designed to remedy the escalatiing problem of drug abuse
Interactions of isocarboxaid
MAOIs can interact with many drugs to cause potentially disastrous results:Indirect-acting sympathomimetic agents, TCAs, SSRI, antihypertensives, meperidine, dietary tyramine.MAOIs inhibit hepatic metabolism of many drugs, leading to toxic effects.


 

Route of Administration (Pros/Cons)
Inhalation

 


ü  Pro: Large surface area to administer to & is extremely vascularized
o   Systemic achieve effects (ie give O2, or anesthesia)
ü  Con: hard to regulate in those that smoke (thickened scarring) 
How does sildenafil (viagra) work?
It restores erectile response by selectively inhibiting the reuptake of cGMP in corpus cavernosa.
Prinzmetal Angina
 
chest pain that occurs at reast and is caused by vasospasms
the most common side effects of ondansetron include _____,___,& _____
headache, diarrhea, and dizziness
Theophylline (Theodur):xanthine bronchodilator: Administration
give around the clock and use extended release tablets at bedtime
if GI upset occurs, take with a glass of water after meals
don't dissolve, chew, or crush tablets
Nursing implications for albuterol
-short acting, thus can be used for acute asthma episodes
routes of administration affected by first pass


o   enteral route (GI tract) stomach, small intestine, large intestine must go through the LIVER via the hepatic portal vein before getting to the heart to circulate
What is the name of a drug class for sexual dysfunction?
Phosphodiesterase inhibitors.
what is the action of natrecor
relaxes smooth muscle and dilates arteries and veins
ranitidine differs from cimetidine in that ranitidine ___________.
is more potent than cimetidine, produces fewer adverse effects, and causes fewer drug interactions
Chemotherapy is defined as ________, whereas antibiotic is defined as _____, and an antimicrobial drug is defined as _____
the use of chemicals against invading organisms; a chemical produced by one microorganism that has the ability to harm other microbes; any agent, natural or synthetic, that has the ability to kill or suppress microorganisms
What are the 5 factors that determine how drugs cross the placenta?
1. Lipid solubility.2. Molecular size.3. Placental transporters.4. Protein binding.5. Placental and fetal drug metabolism.
how does ACE inhibitors help in the treatment of heart failure
Increase peripheral resistance, which decreases cardiac output and further increases on the failing heart (decreases preload and afterload)


Clinical use of manipulation of pH to affect pharmacokinetic processes


Some meds can alter the environment of the kidneys to prevent absorption or increase absorption. 
What are the side effects & adverse reactions of carbonic anhydrase inhibitors?
1. Fluid & electrolyte imbalances.2. Metabolic acidosis.3. N/V, anorexia.4. Confusion.5. Orthostatic hypotension.6. Hemolytic anemia.7. Renal calculi.
If you give epi at a concentration of 1:100,000 while your patient is getting a volatile what is the maximum you can give in 1 hour in mls and how many mg would this be?
30mls per hour total (0.3 mg)
Monophasics come in 21 and 28 tablet packs. How many in the 28 are active?
21 are active, 7 are placebo which are used as a reminder that the pack is about to finish.
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