Pharmacology lecture exam 1 study guide

Pharmacokinetics

• absorption

• distribution

• metabolism

• excretion

Liver failure in pharmacokinetics affects what system

metabolism

Therapeutic index

ratio of the drugs toxic level compared to the level of the therapeutic ratio

Pediatric patients in medication administration: assess the functions of which organs

• function of kidneys and live

• weight

• allergies

• BUN, Creatinine, AST, ALT

Patient education and teaching needs should consider

• language barriers

• poverty

• access

• pride

• beliefs on medicine

Pharmacokinetics in the elderly issues

• polypharmacy

• gastric ph

• slower liver and metabolism

• GFR

• BUN and creatine

• kidneys and nephrons decrease

In pregnancy which gestational age would you expect the fetus to have a high risk of teratogenic exposure and drug induced development effects

1st trimester

How can a nurse avoid medication errors

check the label three times

Nurses role in reporting medication errors

document everything and notify manager or supervisor

Near miss

Event or situation that did not produce patient injury, but only because of chance and must be reported

Key assessment to avoid drug toxicity in newborns

assess the liver because its not fully developed

empiric therapy

antibiotic (avoid treatment delays)

supplemental therapy

Vitamins, IV fluids, electrolytes

maintenance therapy

prevents chronic becoming worse (important for diabetes and hypertension)

palliative therapy

symptom management (for pain, nausea, vomiting)

9 Rights

• person

• dose

• medication

• refusal

• documentation

• patient

• indication

• time

• route

When nurses see older adults with polypharmacy they should assess what

assess kidney function (BUN, creatinine, GFR)

If medication is confirmed safe for a pregnant mother it’s important to educate her what if she doesn’t want her the med to reach the infant.

take medication after breastfeeding

Duration of action of drug means

• how long affect

• therapeutic response

Pharmacokinetics in patients with renal disease or ESRD have issues with which phase

excretion

In the last trimester or pregnancy drugs could transfer to the fetus due to

blood flow (advanced blood flow and fetus size)

Polypharmacy

taking multiple meds (five or more)

Treatment for MRSA

5th generation of Ceftaroline

What teachings would you provide patients who take tetracycline

photosensitivity, avoid the sun, and tanning beds

Penicillin allergies

• hives

• pruitis

• angioedema

• Steven’s Johnson syndrome (rash, blister)

• GI uspet

Cephalosporins

• Gi upset

• cross sensitivity to those with PCN allergy

When allergy occurs due to taking Vancomycin what action should the nurse do

slow down medication

Adverse reactions to Aminoglycosides

• nephrotoxcitiy

• ototoxicity

• affect balance and coordination

• parathesia

• headache

• vertigo

• rash

• dizziness

Quinolone (ciprofloxacin) expected adverse reactions

• rendon rupture

• tendonitis

Acne and on Tetracycline (doxycycline) patient education should be taught that

• eat with food

• discoloration of the teeth

Patient reports side affects x2 weeks that they are having fever, watery diarrhea, abdominal cramps. What could it be

C diff (caused by too much antibiotic use)

Patient reports superinfection what is the cause

the antibiotic is killing all good bacteria

Macrolides (Azithromycin, Erthroycin) is used to treat

• URI

• Syphilis

• Lyme disease

• Gonorrhea

• Chlamydia

What drug can’t be used with lactated rings

3rd generation Ceftriaxone (Rocephin)

Clindamycin adverse affects

C diff

Vaginal superinfections from antibiotic therapy can be treated with which drugs

• miconazole

• Fluconazole

MAAR medication administration records include what information

• patients full name and date of birth

• allergies

• weight

• diagnoses

• med’s name, strength, route, form for treatment

• how long to take med and how many per day

Antibiotic therapy one week before surgery is called

Prophylactic

What medication is give to control bladder spasms in a patient with a UTI

AZO (Phenazoprydime)

Do interactions between drugs only occur with prescription drugs

No, ALL

Peak should be drawn when (highest drug concentration

After infusion (1 - 2 hours)

Trough is drawn when (lowest drug concentration)

Before next dose pf Vancomycin (30 minutes)

Do prescribers always order drugs with a low/narrow therapeutic index

no because therapeutic index is good response to drug

With new diagnoses the new drug ordered nurse can expect

Starts off with the lowest dose then increase if needed

Which medication has a high or wide therapeutic index?

amoxicillin

What should the nurse do FIRST if a medication error occurs

assess the patient

Nursing process

• assess

• diagnose

• planning

• implementation

• evaluation

before antibiotic therapy which labs should be reviewed by nurse

• blood cultures

• BUN/ Creatinine

• ALT

• AST

• urine culture

• CBC (white blood cells)

Which med could be initiated while waiting for specimen results

broad spectrum antibiotic

Blood culture specimen

Cephalosporins

Cephalosporins → stop bacteria from making Cell wall → Bacteria die

Cephalosporins generation one

Cefazolin, Cephalexin

Cephalosporins generation two

Cefaclor

Cephalosporins generation three

Ceftriaxone

Cephalosporins generation four

Cefepime

Cephalosporins generation five

Ceftaroline (treats MRSA)

What is Aztreonam

• Aztreonam → Cell wall → Gram-negative bacteria

• works against gram negative

Aztreonam indications

• 🫁 Pneumonia

• 🚽 Urinary tract infections (UTIs)

• 🩸 Blood infections (septicemia)

• 🦠 Intra-abdominal infections (usually with another antibiotic)

• 🦴 Bone and joint infections

• 🧴 Skin and soft-tissue infections

What is Telithromycin

Telithromycin is an antibiotic in the ketolide class that prevent protein making.

Telithromycin indications

• Bacterial infection

• antibiotic resistance

IV antibiotic uses a shorten IV tubing called

secondary

Synergistic means

two drugs work together to have a stronger effect than either one would have alone.

Supplemental therapy vs empiric therapy

• supplemental = adds to the main treatment

• empiric = Strats trwtanment before the exact cause is known

Antagonistic means

drug blocks or reduces the effect of another drug or substance.

Medication reconciliation occurs when

• first when admission

• second when transferred

• third when discharged

Metronidazole indications for use include

• anaerobic organisms

• intraabdominal/ gynecological infections

• treats protozoal infections like trichomoniasis

Meropenem IV ordered to a patient how long would you infuse this drug

60 minutes

which drug is the most appropriate drug to fight protozoal infection

metronidazole

In metronidazole therapy what is contraindicated

• NO alcohol 24 hours before taking and up to 36 hours after

• B after first trimester in pregnancy

Influenza A/B

Oseltamir and Zanamivir

HSV and varicella zoster virus treatment

Acyclovir

CMV (treatment/ prevention)

Ganciclovir

Bacteriocidal vs bacteriostatic

• bactericidal = kills bacteria

• bacteriostatic = inhibits growth of susceptible bacteria

Disinfectant vs antiseptic

• disinfectant = kill organisms on non living areas (stronger)

• antiseptics = inhibits growth of organisms (weaker)

ethical issues

• notify of patient

• possible consequences for nurses

Common confused Drug names

• SALAD (sounds alike, look alike )

• LASA (look alike, sound alike)

Drug recall

• 1 (most severe)

• 2

• 3