NURS 20025 Final

pharmacology

the study of drugs and their interactions with living systems

Phase 1 clinical trials

What phase of clinical trials includes that use of healthy volunteers

Phase 4 clinical trials

What phase of clinical trials includes the drug being available to all

Nurse Practice Act

statute in each state and territory that regulates the practice of nursing

United States Pharmacopeia

authoritative list of drugs, formulas, and preparations that sets a standard for drug manufacturing and dispensing

Food and Drug Administration

legal regulatory body regulates the development and sale of drugs

Pregnancy category x

drug category has demonstrated in both animals and humans a result of fetal abnormality

Pregnancy category c

drug category does not have any controlled studies in animals or humans

Schedule 2 controlled substances

Substances with high potential for abuse and currently accepted medical uses. Abuse may lead to severe psychic or physical dependance.

Examples - Opium, Morphine, Fentanyl, Methadone, Cocaine, and Oxycodone

Schedule 5 controlled substances

Substances with very low potential for abuse and currently accepted medical uses. The substances has very limited physical or psychological dependence liability.

Examples - Codeine mixtures, Ephedrine

Pharmacodynamics

what the drug does to the body

Pharmacokinetics

The process by which drugs are absorbed, distributed within the body, metabolized, and excreted.

-what the body does to the drug

therapeutic index

estimates the margin of safety of a drug

loading dose

A high dose of a drug given rapidly to achieve effective concentration is

parenteral drugs

Drugs given outside of the GI tract are considered

enteral drugs

Drugs given through the GI tract

will be affected by first pass

Stating that a drug is highly protein bound means that they will have a longer or shorter duration of action

Longer

The type of drug allergy that can be an emergency and can cause difficulty breathing

anaphylactic

parasympathetic nervous system (cholinergic)

the rest and digest piece of the ANS

sympathetic nervous system (adrenergic)

the fight or flight piece of the ANS

What are the three neurotransmitters in the sympathetic system

norepinephrine, epinephrine, dopamine

Beta 2 medications are going to have an effect primarily on the

Lungs

The parasympathetic system has what effect on the bladder

promote bladder emptying

An adrenergic agonist medication is used to mimic which system

sympathetic

Epinephrine can be very potent, what are two side affects you can assess for

cardiac dysrhythmias and decreased urinary output

What medication is available OTC that is similar to ephedrine

pseudoephedrine/Sudafed

Clonidine, an alpha specific adrenergic agonist, can be used for the treatment of

HTN, chronic pain, opiate withdrawal

Nonselective adrenergic blocking agents, such as carvedilol (Coreg), will have an effect on both

Beta 1 and Beta 2

When administering a beta blocker, prior to administration of this medication what VS should you monitor

heart rate and blood pressure

The goal of bethanechol (Urecholine) is to stimulate _______________ and promote ________________

peristalsis, bladder emptying

Acetylcholine is the neurotransmitter found in which system

parasympathetic

What can you teach your patient to do about some of the unpleasant side effects from anticholinergic agents

-dry mouth: hard candy, artificial saliva

-constipation: fluid, fiber, stool softener

For blood pressure control, what receptor is responsible for stimulating the sympathetic system to increase or decrease blood pressure

baroreceptors

Inotropic drugs will affect what part of the heart

strength of the contraction

A negative chronotrope will have what affect on the heart

decrease heart rate

What system becomes activated when the blood pressure within the kidneys falls too low

renin angiotensin aldosterone system

What is a side effect from abruptly stopping a beta blocker

rebound angina and rebound hypertension

What is a unique adverse effect from taking an ACE inhibitor

persistent dry cough, ace cough

What class of medication is used to decreases muscle contraction, and is a negative inotrope

calcium channel blocker

Vasodilators will have what effect on the patients blood pressure

decrease blood pressure

What symptoms will your patient display that has right sided heart failure

-dependent extremity edema

-JVD/JVP

What symptoms will your patient display that has left sided heart failure

-tachypnea

-dyspnea

-orthopnea

When giving digoxin, often times the physician will order a loading dose, why

to quickly achieve therapeutic levels

What is the level for digoxin toxicity

>2

What is unique about the affect nitrates have on the body

they affect both veins and arteries

-assess blood pressure before administering

To treat high cholesterol, what category of medication is usually combined with ezetimibe (Zetia)

HMG-CoA Reductase Inhibitor/ Statin

One side effect of taking niacin is hot flashes, what can you instruct your patient to do to help decrease this side effect

take an aspirin 30 minutes before

What is the mechanism of action for heparin

inhibits thrombin (platelets from clumping)

What condition may indicate the need for your patient to be on warfarin (Coumadin)

-atrial fibrillation

-prosthetic valve

-joint replacement

Reversal Agents for Blood Thinners

-Heparin and Low Molecular Weight Heparins: protamine sulfate

-Vitamin K Antagonists (warfarin): Vitamin K

-Oral Direct Thrombin Inhibitors: Idracizumab (praxbind)

-Thrombolytic Agents: Aminocaproic acid

Common Cold

A virus that invades tissue in the upper respiratory tract causing inflammation and an inflammatory response is

Atelectasis is defined as

collapse of alveoli

sinusitis

Sinus cavities that become blocked from inflammation is

asthma

Reversible bronchospasms

Antitussives are used to suppress what

cough reflex

what patients are antitussives contraindicated in

-patients who need to cough

-asthma and emphysema

-addiction history

-currently driving

-pregnancy

How long should an individual use topical nasal decongestants

3-5 days

Why are there many drug interactions between oral decongestants and other OTC products

may also contain pseudoephedrine

Why is it contraindicated to use budesonide (Pulmicort), a topical nasal steroid decongestions, when you have an acute infection

they block the inflammatory response

What is the main difference between first and second generation antihistamines

-second generation have less anticholinergic effects

How long should an individual use an expectorant for

a week or less

Mucolytics are used to help loosen thick bronchial secretions, what condition would be a contraindication for these medications to be used

-acute bronchospasms

-peptic ulcers

-esophageal varices

What is the purpose of bronchodilators on the lungs

dilate the lungs

What type of medication delivery system uses compressed air to change the liquid to a fine mist that is inhaled

nebulizer

What is the main goal of inhaled steroids

to prevent respiratory distress

What are 2 risk factors associated with PUD

-family history

-blood type O

-smoking, caffeine, ETOH

-pulmonary or kidney disease

-stress

-medications

-H pylori

What are 2 causes of GERD

-incompetent LES

-pyloric stenosis

-hiatal hernia

-motility disorder

-obesity

-elderly

What are 2 non-drug treatments for PUD/GERD

-lifestyle changes: ETOH, tobacco, weight management, decrease stress, eliminate foods

Why would a patient be prescribed sucralfate (Carafate)

ulcer healing

Pantoprazole (Protonix), a PPI should be administered when in relation to a meal to be most effective

20-30 minutes prior

A prostaglandin is used to protect the stomach lining, what patients are considered high risk for ulcer development that may be prescribed this medication

-elderly

-debilitate

-history of ulcers

Pancrelipase (Creon), a digestive enzyme, should be administered when in relation to a meal to be most effective

prior to the meal

What medications can cause constipation

-opioids

-anticholinergics

-antihistamines

-antacids

-iron supplements

How do bulk stimulants work

-pull water into GI tract

-increase the size of fecal mass

Your patient has had intractable hiccups, what medication may you see ordered

-prochlorperazine (Compazine)

-promethazine (Phenergan)

What category of antiemetics would you see prescribed for motion sickness

anticholingerics/antihistamines

When you give a 5-HT3 Receptor blocker for the treatment of nausea and vomiting related to chemotherapy, when should it be administered

30-60 minutes prior to the start of chemotherapy