Pharmacology Final Review Flashcards

Terms Definitions
norcuron
Vecuronium
q
every
Bactrim
nitrofurantoin
Hydrochlorothiazide
p.318
Apresoline
Antihypertensive
Imodium
Antidiarrheal
oxycodone
supeudol
loperamide
Imodium
lorazepam
ativan
penbutolol
beta nonselective antagonist
diclofenac/ misoprostol
Arthrotec
alpha-blockers
p. 306
Activase
Thrombolytic Agent
phenobarbital
first antieplipetic
divalproex sodium
epival
Sulfur
AntiectoparasiteSE: Skin staining Unpleasant odorLack of systemic effects (good for kids and preggos)TX: Scabies
Amforal
AntiinfectivesAminoglycoside - "Kanamycin"Broad, bactericidal, ototoxic, nephrotoxic, caution in cats, babies, old, NOT in food produx, pneumonia, UTI, infex, conjux, Lepto
WBC
white blood cells
Drug name
p. 341
Type of drug?
Diphenoxylate
Opioid
Antidiarrheal
Doxorubicin
Antineoplastic

anthracycline drug (cell cycle−nonspecific); intercalates between base pairs to disrupt DNA functions and forms cytotoxic free radicals.

Tox-
cardiotoxicity, myelosuppression
DEA
Drug Enforcement Administration
probucol
lowers HDL, LDL
Cis-plastin
(carboplatin and oxaliplatin)
 
"cis-PLAAHT-in" (emesis)
 
used to treat testicular cancer (and bladder, ovary, lungs) 
 
mechanism: acts as alkylating agent covalently binds DNA and cross-links
side-effects:  emesis, renal toxicity (give diuretics),peripheral neuropathy and ototoxicity, myelosuppression
resistance: inc. gluthaione or augmented DNA repair
antithyroid drugs
 
thioamides 
propylthiouracil (PTU) (Propacil)
 
drugs used for hyperthyroidism are designed to block or antagonize the effects of hormones secreted from thyroid gland
prognancy category D; can cause neonatal hypothyroidism 
SSRIs ADVERSE EFFECTS

Anxiety


Drowsiness


Sleep disorders


Sexual dysfunction


Drug interactions


Nausea
phenytoin moa
Na channel block
What is ischemia?
decreased oxygen
which drugs --> agranulocytosis
colchicine
carbamazepine
clozapine
Ganciclovir
Antiviral

effective against CMV; requires bioactivation via thymidine kinase.

Tox-
myelosuppression, nephrotoxicity
Vincristine
Antineoplastic plant alkaloid

cell cycle (M phase)−specific agent; inhibits mitotic spindle formation.

Tox-
peripheral neuropathy. Compare with vinblastine, a congener that causes myelosuppression
Propylthiouracil
Antithyroid drug prototype

reduces iodination of tyrosine and coupling of MIT and DIT in the thyroid; orally active.

Tox-
rash, agranulocytosis (rare)
PDR
Physician's Desk Reference-drug information book.
flupenthixol
Thioxanthines - typical neuroleptics
Acebutolol
Treats hypertension, arrhythmias. Cardioselective with ISA, half-life: 3 h. Beta-1 blocker.
Lapatanib
Mechanism: competitive inhibitor of HER2 and HER1 binding to ATP-binding pocket
 
Treatment: HER2+ Breast Cancer
 
Side Effects: Rash, diarrhea
What is the selective MAOI-B?
selegiline
Sympathomimetic Drugs (mimics)
Stimulate SNSAdrenergenic agonist
HPN + ANGINA
B blocker, CCB
disinhibition
remove inhibition from neuron/groups of neurons to cause excitation
Bisacodyl, Colace (doucasate Sodium) is what type of laxative
Surfactant
pentobarbital
barbiturate

sedative agent, drug of choice for tx of intractable seizures in dogs & cats d/t convulsant agents (ex. strychnine poisoning) or CNS toxins (ex. tetanus), major active ingredient in several euthanasia solutions

largely replaced by ultra-short acting barbiturates b/c of slow induction, long duration of action, inactivated primarily by metabolism (don't use w/ liver dz)
which drug --> gingival hyperplasia
phenytoin
What drug causes:
Tendonitis, tendon rupture & cartilage damage in kids
Fluoroquinolones
Procainamide
Group IA antiarrhythmic drug

short half−life; similar to quinidine but may cause lupus erythematosus
hematopoietic drugs are?
blood cell stimulants
Acyclovir
antiDNA viral nucleoside analogue results chain termination
Labetolol
Treats chronic hypertension and hypertensive emergencies. Non-selective beta blocker and alpha-1 blocker but with ISA at -2 receptor; blocks NET as well; hepatic injury is a side effect in some patients.
Diazepam
used in management of anxiety disorders, enhances actions of GABA.
Adderall
Class: Amphetamine Action: Reduces the effects of ADHD and NarcolepsySide Effects: irregular heart beat, increased BP, blurred vision, restlessness, motor tics, headache, dizzy, sleep problmes, dry mouth, diarrhea, weight loss, loss of interest in sex, impotence or difficulty having an orgasm.Nursing considerations: Take with full glass of water, do not crush, chew, break, or open an extended release capsule.
example of third-generation cephalosporines
ceftriaxone (Rocephin) IV
Renin
 
Catalyzes the formation of angiotensin I from angiotensinogen
can a patient become benzodiazepine dependent
YES
metabolism
the physical or chemical alteration of the drug in the body
Parkinson's Disease
Def: A progressive neurological disorder caused by loss of dopamine containing neurons in the substantia nigra.

There needs to be a balance of dopamine and Ach for smooth motor coordinated movement. Imbalance between lack of dopamine and Ach results in s/s of Parkinson's. Unopposed Ach stimulation. GABA - rigidity, akinesia, tremors at rest.
Allergic Reactions
Type I
Anaphylactic reactions
Occurs soon after exposure to the drug. Caused by specific type of antibody attached to mast cells.
name an alpha-2 selective adrenergic blocker
yohimbine
uses for acetazolamide
acute altitude sickness
glaucoma
treatment for alkalosis
facilitate eexcretion of weak acid (as seen in tumor lysis syndrome)
Type of drug?
Pancuronium
Nondepolarizing Neuromuscular blocking drug
Selective for motor nicotinic receptors
Type of drug?
Homatropine
Cholinergic antagonist- like atropine
Abciximab
Monoclonal antibody to fibrin receptor (glycoprotein IIb/IIIa) on platelets

Used to prevent clotting after coronary angioplasty
Vasodilator
produces relaxation of blood vessels; lowers blood pressure
Isoniazid
inhibits mycolic acid synthesis req for myocobacterial cell wall
Acetaminophen
not an NSAID, antipyretic and analgesic agent inhibits COX-1 and COX-2,does not possess anti-inflammatory nor anti-coagulant properties, nor does it produce the typical gastric irritation and bleeding associated with other NSAIDs.
Antihistamine that may increase serum salicyclate concentration when used in high doses
Nizatidine
intracutaneous
Injected just beneath the outer layer of skin.
Activated Charcoal, antidote
Class: AntidoteAction: Used as antidote for selected poisons and overdoses.Side Effects: Black stool, constipation, nausea.Contraindications: None knownNursing considerations: know what substance was injested, not all will be affected by this medication, if not sure, call poison control.
Most causes of HF result from dysfunction of the ____ ventricle (systolic & diastolic HF)
 
the ____ ventricle may also be dysfunctional, especially in pulmonary disease (___ ventricular failure)
 
some conditions cause inadequate perfusion despite norm
left
 
right
right
 
CO 
Coumadin (anti-coagulant)
inhibits sythesis of vitamin K dependent clotting factors
cosyntropin
ACTH used in Rx of infantile spasm
Guanabenz/Guanfacine: Class of drug.
Alpha-2 Adrenergic Stimulant (centrally acting?)
A _________________ ____ drug is described as a drug with a high abuse potential, may lead to severe dependence and there are no accepted medical indications. Examples would be heroin, and LSD.
Schedule I
Mineralcorticoids
A class of steroids characterized by their similarity to aldosterone and their influence on salt and water metabolism.
Loop Diuretics are primary tool for treating what
CHF
Context sensitive half life of propofol
<40 minutes
afferent neuron
conducts sensory impulses towards the brain or spinal cord
Clinical uses of Metronidazole.
Giardiasis, amebic dysentery (Entamoeba histolytica), bacterial vaginitis (Gardnerella vaginalis), Trichomonas.
toxicity of INH
hemolysis in G6PD deficiency
neurotoxicity (prevent with B6)
hepatotoxicity
SLE-like syndrome

INH = Injures Neurons and Hepatocytes
Type of drug?
Ondansetron
5HT3 Blocker
Prevents emesis from chemo
Name some adverse effects of combination oral contraceptives:
-clotting
-myocardial infarct
-stroke
-breast cancer
-drug interactions lead to contraceptive failure
Diuretics Indications
idiopathic hypercalcuria, DI, HTN, HF (adjunct), hepatic cirrhois
hydrocortisone
cortate, hyderm - topical steriod low potency
Ephedrine
It acts like amphetamine to stimulate alpha and beta receptors to release NE and can cause a hypertensive episode. Produces bronchial relaxation (beta-2) and mydriasis without cycloplegia (alpha-1).
2 active forms of B12
deoxyadenosylcobalamin and methylcobalamin
Which systems of the P450 system metabolize meds?
CYP 1,2,3
Naloxone is what kind of drug?
opiate receptor antagonist
insulin secretagogues - short acting
 
biguanides 
metformin (Glucophage)
 
acts by decreasing hepatic gluconeogensis & to a lesser extent by enhancing peripheral glucose uptake (primarily muscles)
well absorbed orally
not bound to serum proteins & not metabolized
excretion v ia urine 
Triazolam Specifics
Anxiety and insomnia, (5 hr half life)
These drugs include nonselective blockers and selective β 1 receptor antagonists.
β - Adrenergic Antagonists
antagonist
drugs that join with a receptor and thereby prevent the action of an agonist/produces no pharmacologic effectex: Narcan/blocks effects of Morphine
inhalational anesthetic agents, PK
-excreted via the lung unchanged-minor metabolism and excretion via other routes-metabolites might be toxic-blood-gas partition coefficient (high is more soluble)-lipid solubility is required for potency and penetration of bbb but excessive solubility prolongs recovery time
SSRI's do not effect which drug
Dopamine or Norepinephrine
Allergic Reactions
Cross-reactivity
One drug can trigger an allergic reaction in a pt who has never taken the drug, but has an allergy to chemically similar drug (uncommon).
What does the abbreviation stand for: TO
telephone order
What drug in this class is commonly used for bowel surgery?
Neomycin
Type of drug?
Cephalosporins
Beta-lactam drugs that are less susceptible to penicillinases
what is the receptor preference of isoetharine?
beta 2
vasoconstriction and a vasopressor effect (increased BP)
Beta 1: causes
Pharmacodynamics
the effects of the drug on the body
Streptomycin resistance
Point mutation in rpsL gene (encodes S12 ribosomal gene) or rrs gene encoding 16S ribosom. rRNA
 
Loop Diuretics
 
Used more often in heart failure to decrease fluid and edema, these are more effective at fulid excretion because more reabsoption occurs in loop of henle
 
 
These act on the thick ascending limb of the loop of henle and block the Na/K/2Cl triporter(out of the lumen) so that NaCl and K are not reabsorbed and are excreted in the urine
Mechanism of action: pentazocin
weak antagonist a mu receptors, powerful kappa agonist
thyroid hormone replacement therapy
 
levothyroxine (T4) - synthroid, levothroid & others 
synthetically prepared levo isomer of thyroxine (human)
provides only T4 typically 80% of dose is deiodinated to T3
advantages of these preps over desiccated tyroid include reliable potency &the absence of wide swings in serum T4  & T3 levels
highly protein bound (>99%)
half-life is 6-7 days in euthyroid pts & 9-10 d ays in hypothyroid pts
early pts are very sensitive to T4, so start at lower doses
takes up to 6-8 wks to reach steady state
good for maintaining steady state
Amobarbitol or Pentobarbitol
Barb for short to intermediate action for hypnosis/acute sedation
The time required to attain the plateau is ONLY dependent on what?
Half-time for elimination!
Define up-regulation
A drug that causes the formation of more receptors that normal.
When is a drug most effective?
If they are lipophilic.
Be care with these drugs associated with clinically significant drug-drug interactions:
-Blood thinners
-Tricyclic antidepressants
-Monoamine oxidase (MOA) inhibitors
-Amphetamines
-Digitalis glycosides
-Diuretics
-Antihypertensives
what is cholinergic crisis?
In cholinergic crisis, the motor endplate is excessively stimulated by the
accumulating ACh and by the direct action of neostigmine on the motor
endplate nicotinic receptors causing the resting membrane potential to be
depolarized beyond the threshold. At this point, a depolarizing blockade results
and muscle weakness occurs. Additional nerve stimulation or cholinergic
agonist will intensify the muscle weakness.
Adverse effects of ganglionic blockers?
orthostatic HTN, blurred vision, constitpation, sexual dysfuncction
clinical uses of nitroprusside
HTN crisis
aortic dissection (must be given with B blocker)
CHF
What are the stages in development when T levels increase?
-gestation (2 peaks)
-infancy
-puberty
-Mimic the sympathetic nervous system-Stimulate Beta 1 and 2 sites
Indication: To reverse bronchospasm
Physostigmine
Inhibit both AChE and ChE. (Is a cholinomimetic)
Where is Ca2+ and Mg2+ reabsorption enhanced due to a renal lumen made more positive by potassium secretion?
Thich ascending loop
What are the signs of Digoxin toxicity?
Digoxin toxicity signs/symptoms include:
anorexia
nausea
abd. pain
headache
irritability
depression
insomnia
vision changes
antifungal agents:
 
itraconazole (Sporanox)
 
 
injection is now available for the tx of potentially life-threatening fungal infections, including blastomycosis, histoplasmosis and aspergillosis in pts who are intolerant of or refractory to amphotericin B
 
active against many of the same fungi as ketoconazole/fluconazole
 
used for the tx of dermatophyte skin infections unresponsive to topical therapy; used in tx of onychomycosis
 
need acidic envirnoment for best absorption (same as ketoconazole)
 
adverse effects: nausea/vomiting, d iarrhea, and abdominal pain
 
very expensive 
What channel states do class 1B drugs have the greatest affinity for?
Inactive sodium channels
Dobutamine/Dopamine: Class of drug, use
Beta-1 Adrenergic Stimulants - treat heart failure *DOH, my heart is failing, give me some Dobutamine or Dopamine
Define pharmacodynamics
How a drug interacts with the body to cause its effects.
This name of the drug is proper and CAPITALIZED
Brand Name
Describe Atropine toxicity
skin becomes very red, warm and dry: "atropine flush"
This effect is related to thermo-regulation since atropine blocks sweat formation.
Describe Atropine toxicity
“red as a beet, dry as a bone, blind as a
bat, mad as a hatter”]
what types of seizures is topiramate indicated for
simple and complex partial
People with normal levels of NAT are called _____ _______
Fast acetylators [NAT]
how to treat bone marrow suppresion induced by chemo
treat with hematopoietic drugs
Therapeutic levels of lithium
Serum levels of 0.8-0.9 to 1.3-1.4 mEq/L. Toxic at 2.0 mEq/L or greater.
Combination therapy for Germ Cell Tumors
BEP - bleomycin, etoposide, and cis-plastin
contraindications of short-acting B2 agonists:
caution in CHF, HTN, liver disease, elderly
 
caution in DM, glaucoma (they can increase blood glucose & intraocular pressure)
 
contraindicated in pts w/ hyperthyroidism & uncontrolled arrhythmias
 
Beta adrenergic blocking agents antagonize the effects of adrenergic agonists
What are the class 1C drugs? 2
- Flecainide (Tambocor)
- Propafenone (Rhythmol)
Name the 1 "all beta" adrenergic stimulant, and its use.
Isoproterenol - to relieve bronchoconstriction *I’m So Pro at getting oxygen now
What are the chemical forces that are involved with drugs-receptor interactions? Describe each.
Covalent, electrostatic, and hydrophobic bonds.

*Covalent: strong, generally irreversible, less common.

*Electrostatic: varies from strong to weak van der waal forces.

*Hydrophobic bonds: weak, important in lipid soluble drug interaction with cell membranes, etc.
Explain what cleansing results look like.
Removal of dirt, debris, secretions, or crusts (ex. Hibiclens)
is it OK for women taking lithium to get pregnant
NO -- teratogenic
which cholesterol drugs increase LFTs?
your lft's are not SEF (safe)

statins
ezetimibe
fibrates
What is the spectrum of tatracyclines?
Broad - good for intracellular bacteria
1. differentiate the mechanism of action, indication for use, common adverse effects and nursing implications for Nicotinic acid.
Indication for use: used to treat hyperlipidemia. It reduces the levels of triglycerides and LDL cholesterol levels and raises levels of HDL cholesterol.   Mechanism of action: Inhibits lipolysis in adipose to decrease esterification of triglyceride in the liver and to increase lipoprotein lipase activity.   Adverse effects: flushing of the skin, gastrointestinal distress, abdominal pain, diarrhea, nausea, and vomiting.   Nursing implications: Assess for niacin deficiency, obtain a diet history, serum glucose, uric acid, and hepatic function test.
What happens in Phase two of Biotransformation?
Conjuation of drug with endogenous substance (e.g. acetate or sulfate) for excretion
Name 5 things that determine how drugs are distributed (from book).
1 Physicochemical properties of the drug 2 Cardiac output and regional blood flow 3 Membranes 4 pH 5 Binding of the drug
Beta 2 agonists ore used to treat
Astham and any other conditions resulting from narrowing of bronchioles
How can it be used for leprosy?
rifampin delays resistance to dapsone when used for leprosy
What is the leading cause of mental retardation in the Western world?
ethanol consumption during pregnancy (no safe dose)
Only two types of NSAIDS that dont inhibit platelet aggregation.
COX-2 selective and acetominophen. (these two also dont irriate the stomach that badly)
Higher = aspirin (11)
 
*Heparin (5)
Which drug has a higher Vd, heparin or aspirin?
Why is Prazosin a unique Alpha-1 Adrenergic blocker?
It has a First-Dose phenomenon, where you get lightheaded at first dose
How does the toxicity differ fromTCA's and what are they?
Fewer than TCA's. CNS stimulation - anxiety, insomnia, tremor, anorexia, nausea, and vomiting.
Isoproterenol (what happens to cardiac efficiency?)
Activates beta 1 and beta 2 receptors, but no effect of alpha. The beta activity underlies its cardiovascular effects with positive inotropic and chronotropic effects that lead to an increased cardiac output, but decreased cardiac efficiency and increase.
What is Mg sulfate used to treat? 3
- Control seizures in preeclampsia & eclampia
- Cardiac glycoside-induced arrhythmias
- Polymorphic ventricular tachycardia
effects of bile acid resins on
LDL
HDL
TGs
down a lot (not as much as statins)
none
slightly UP
What should be done after admin. of PPV?
- Have patient wait 30 min.
- Document bottle number and exp. date.
Opiods not only act on the CNS but on the...
gut! it is sensitive to doses of opiates FAR below those requried to produce analgesia
Antiprotozoals
 
 
 
 
Tetracyclines
 
 
bronchodilators:
(antiasthmatics)
albuterol
atropine
formoterol
isoproterenol
Theophylline
terbutaline
levalbuterol
 
Antiinfectives 
(categories)
penicillins
cephalosporins
aminoglycosides
sulfonamides
tetracyclines
monobactam
erythromycins
quinolones
Penicillins
amoxicillin
ampicillin
cloxacillin
 
MAOI's
(antidepressant)
phenelzine 
Cholinesterase Inhibitors
Six Rights
drug 
dose
time
route
patient
documentation
Tricyclics 
(antidepressant)
amitriptyline (ELAVIL)
 
Tetracyclines 
(antidepressants)
mirtazapine (REMERON)
varenicline 
smoking cessation
Coumadin 
antidote:
vitamin K
Nitrates 
amyl nitride
isosorbide
nitroglycerin
penicillin 


·         Penicillin increases the effects of Coumadin (warfarin)
·         W/ patient on iv penicillin (if they have a reaction i.e. difficulty breathing) stop the infusion immediately

·         If pt experiences anaphylactic reaction administer epinephrine and other emergency drugs as ordered. 
antitussive/expectorant
suppress cough reflex and/or liquefying and reducing viscosity of secretions
acetylcysteine
ammonium chloride
benzonatate
codeine
dextromethorphan
diphenhydramine
hydrocodone
veracity
tell the truth
antidote for Benzodiazepines
Flumazenil
SSRI's
(antidepressant)
escitalopram (Lexapro)
sertraline (Zoloft)
vitamin c 
ascorbic acid
 
anticonvulsants
(for seizures)
Barbiturates:
clonazepam (klonopin)
phenobarbital
primidone
Hydantoins:
phenytoin
Succinimides:
ethosuximide
Misc:
Gabapentin (neurontin)
 
Meds for Rheumatoid Arthritis
hyperglycemia symptoms


·         Increased thirst
·         Headaches
·         Difficulty concentrating
·         Blurred vision
·         Frequent urination
·         Fatigue (weak, tired feeling)
·         Weight loss
FLAX 
common uses:
constipation, atherosclerosis, hypercholesterolemia, constipation, bladder inflammation.
adverse effects:
diarrhea
drug interactions:
antidiabetic drugs. Anticoagulant drugs
chorea
irregular spasmodic involuntary movements of limbs or facial muscles
ANTIDOTE FOR OPIATES
NALOXONE (NARCAN)
blood products
cryoprecipitate
fresh frozen plasma
packed red blood cells
plasma protein fraction
whole blood
PT 


Normal: 11-13 sec
On anticoagulant: 18 sec
Miscellaneous antidepressants
buPROPion (Wellbutrin)
duloxetine (Cymbalta)
trazadone (Desyrel)
Antidiabetics
 
Insulin isophane suspension (NPH)
Regular insulin (Humulin R)
Insulin glargine (Lantus)
Insulin detemir (Levemir)
Metformin (Glucophage)
pioglitazone (Actose)
Sitagliptin (Januvia)
 
 
Aminoglycosides
 
 
"Mycin"
 
*Toxic to kidneys and ears
Amphetamines 
for ADHD and narcolepsy. (dextroamphetamine and amphetamine aspartate a.k.a. adderall)
NMB's


Prevent nerve transmission in skeletal and smooth muscles, leading to paralysis.
Used with general anes. For surgery.
Paralyze skeletal muscles required for breathing
BE SURE THE PATIENT IS MECHANICALLY VENTILATED PRIOR TO ADMINISTERING NMBD
NEVER MISTAKENLY GIVE AN NMBD! THE PERSON WOULD BE UNABLE TO MOVE OR SPEAK BUT WOULD BE FULLY CONSCIOUS OF WHAT IS HAPPENING TO THEM.
USE ONLY AS AN ADJUNCT TO GENERAL ANESTHESIA!!!!
adrenergic blockers:
cause venous dilation.
used for hypertension
 
Indications:
angina, cardioprotective, dysrthythmias, migraine, antihypertensive, heart failure, glaucoma (topical use)
Adrenergic drugs
stimulate sympathetic nervous system
mimic effects of SNS neurotransmitters *norepinephrine, epinephrine, dopamine.
Alpha and Beta Adrenergic
TYPES OF PAIN 
 
Somatic (skeletal muscles)
Visceral (organs)
Deep (below skin level)
Visceral and superficial

usually Superficial (skin)requires opioids for relief.
Somatic pain responds to nonopioid analgesics.
 
Antituberculars 
inhibit RNA or DNA of bacilli
streptomycin
ethambutol
pyrazinamide
Digoxin 
therapeutic range
therapeutic:  0.5-2 
Give potassium supplements if potassium is less than 3, or foods high in potassium (bananas, oj)
parenteral 
route of administration


·         Intradermal  (inj under the epidermis)
·         Subcutaneous (inj into adipose beneath dermis)
·         Intraarterially (arterial)
·         Intramuscularly (inj of the muscle beneath the subcutaneous adipose)
·         Intrathecally (through the theca of the spinal cord into the subarachnoid space.)
·         Intraarticularly (joint)
·         Intravenously  (through vein)
Cholinergics
prevent destruction of acetylcholine used for myasthenia gravis, bladder and urinary distention
Benzodiazepine 
for alcohol withdrawal
for overdose of the benzo Ativan, give Romazicon (flumozenil)
adhd meds


·         take meds on empty stomache 45 min before eating for max effect
·         weaning is necessary 
St. Johns Wort
Common uses: 
depression, anxiety, sleep disorder,nervousness.
Adverse effects: 
Gi upset, fatigue, dizziness, confusion, dry mouth, photosensitivity
DRUG INTERACTIONS:
MAOI, selective serotonin reuptake inhibitors, cyclosporine, tetracycline, tyramine-containing foods, opioids, digoxin, estrogen, theophylline.
Anticholinergics
used to decrease secretions before surgery, decrease gi motility, treat dystonia
malignant hyperthermia
uncommon but potentially fatal. reaction to general anesthesia. 
rapid increase in body temp, hr, rr, and muscular rigidity
Digoxin 
(cardiac glycoside)
b4 administering: check electrolyte levels, drug levels, apical pulse (1min) if pulse is <60 bpm or >100bpm hold and notify prescriber. 
Antidote: digoxin immune Fab. give over 30min parenteral (sometimes as iv bolus)
Enteral 
(route of med admin)


·         Oral meds
·         Sublingual meds(under tongue)
·         Buccal (between cheek and gum)
topical route of med. administration 


·         Transdermal
·         Inhaled
ANTIDOTE FOR BARBITURATES
NO ANTIDOTE
ABC'S OF CARE
undesired effects of thrombolytic therapy


·         Internal bleeding
·         Intracranial bleeding
·         Superficial bleeding
·         Hypersensitivity
·         Anaphylactoid reactions
·         Nausea
·         Vomiting
·         Hypotension
·         Cardiac dysrhythmia
hyperglycemia
 Fasting blood glucose of 126mg/dl or higher. Non fasting of 200 or higher
MED'S AND THE ELDERLY
SPECIAL CONSIDERATOIN WHEN GIVING:
OPIATES
SEDATIVES
NSAIDS
ANTICOAGULANTS
ANTICHOLINERGICS
ANTIDEPRESSANTS
ANTIHYPERTENSIVES
CARDIAC GLYCOSIDES
CNS DEPRESSANTS
sodium polystyrene sulfonate 
(potassium exchange resin)
for hyperkalemia
given orally usually
1mEq of potassium is lost per gram of resin administered.
can lower calcium and magnesium
muscle relaxers
mechanism of action
action: 
depressant effect on cns, result in relaxation and mild weakness of muscles. decrease force of muscle contraction and decrease in muscle stiffness
Lithium 
therapeutic range:
0.6-1.5 
 
monitor sodium levels and keep within 135-145 mEq/L
This drug is used for mania and bipolar, also for maintenance for prevention of such episodes.
Drug interactions: thiazide diuretics, angiotensin converting enzyme inhibitors, calcium channel blockers, and nsaids.
Lithium available PO only.
carbamazepine and seizures:
carbamazepine may worsen myoclonic or absence seizures.
Amantadine (symmetrel)
used as antiviral for influenza as well as for early parkinsons. 
avoid anticholinergics and cns stimulants.
Plasma Protein Factor
Same as cryoprecipitate. Manage acute bleeding
patients who have migraines 
avoid tyramine foods 
(beer, wine, aged cheese, artificial sweeteners, chocolate, caffeine.)
OPIOIDS 


When giving opioids:.
Assessment focus on vitals, allergies, respiratory disorders, respiratory function, presence of head injury, level of alertness, gi function, avoid with ppl who have biliary disease. Liver and kidney function should be assessed
alpha 1 adrenergics
for nasal congestion:
epinephrine, ephedrine, naphazoline, oxymetazoline, phenylephrine and tetrahydrozoline
Treatment for severe hyperkalemia
iv admin of sodium bicarbonate
calcium gluconate
 
follow up with sodium polystyrene sulfonate or hemodialysis.
meds for adhd in peds
baseline:
weight, height, growth and development, vitals, cbc, sleep patterns.
pediatric assessment and opioids


Never split suppositories of an adult dosage (o.d. can occur easily)
Report the following symptoms immediately:
Dizziness, lightheadedness, drowsiness, hallucinations, changed level consciousness, sluggish pupil response,
IF THESE OCCUR HOLD MEDS UNTIL PRESCRIBER RESPONDS
ALWAYS WATCH VITALS WHEN GIVING OPIOIDS TO PEDS IF RR DROPS BELOW 12 HOLD MEDS AND NOTIFY PRESCRIBER
B-Adrenergic Agonist responses
(beta is primarily in the heart)
relax- bronchial, gi, uterine smooth muscle
 
glycogenolysis
 
cardiac stimulation
Short acting insulin
 
Regular insulin (Humulin R)
can be given by i.v. 
onset of action 30-60 min
duration: 6-10 hr
/ 216
Term:
Definition:
Definition:

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