Patho Final

What is the purpose of the first-pass effect in drug metabolism?

It describes how a drug absorbed from the intestine must first pass through the liver before reaching systemic circulation, where it may be metabolized to an inactive form.

Define Pharmacokinetics.

The study of how drugs move through the body, including absorption, distribution, metabolism, and excretion.

What is a prototype drug?

A well-understood drug that serves as a model for comparing other drugs in its class.

What does 'half-life' refer to in pharmacology?

The length of time needed for the concentration of a drug in the plasma to decrease by one half.

What are the signs and symptoms of anaphylaxis?

Severe allergic reaction characterized by rash, edema, runny nose, and reddened eyes.

List the rights of medication administration.

Right drug, right dose, right patient, right assessment, right route, right time, right reason, right to refuse medication, right documentation, right patient education, right evaluation.

What does the therapeutic index indicate?

The ratio that compares the blood concentration at which a drug becomes toxic to the concentration at which it is effective.

Differentiate between bactericidal and bacteriostatic antibiotics.

Bactericidal antibiotics kill bacteria, while bacteriostatic antibiotics inhibit bacterial growth.

What is the MOA of beta-lactamase inhibitors?

They protect penicillin from being destroyed by beta-lactamase, thus extending its spectrum of efficacy.

Describe the pathophysiology of left-sided heart failure.

Ineffective pumping of the left ventricle leads to blood backing up into the lungs, causing pulmonary congestion.

What is the main adverse effect associated with excessive opioid administration?

Respiratory depression.

What is the mechanism of action (MOA) of acetaminophen?

Inhibits COX in the CNS, reducing pain and fever, but has minimal anti-inflammatory effects.

What should patients be educated on regarding NSAIDs?

They should take with food, avoid concurrent anticoagulants, and monitor for signs of bleeding.

How does insulin help in diabetes management?

Insulin facilitates glucose uptake into cells, lowering blood sugar levels.

What is the impact of hypertension on body systems?

Elevated blood pressure can alter cardiovascular function and lead to complications such as heart failure or stroke.

What is meant by 'enteric-coated' tablets?

These tablets prevent the release of the drug in the stomach and allow for release in the small intestine.

What are superinfections?

Infections that occur due to the overgrowth of resistant organisms when normal flora are disrupted.

What are the main classes of drugs used to manage hypertension?

ACE inhibitors, beta blockers, calcium channel blockers, diuretics, and vasodilators.

What is the primary concern with administering tetracycline?

It can cause staining of teeth in children and should not be used during pregnancy.

What are common symptoms of hyperglycemia?

Polydipsia, polyuria, polyphagia.

What is the role of evidence-based guidelines in medication administration?

They provide a framework for safe and effective medication use based on clinical evidence and best practices.

What is the role of Cytochrome P450 in drug metabolism?

Cytochrome P450 enzymes are involved in the oxidative metabolism of drugs and other compounds, significantly affecting drug clearance and interactions.

Define bioavailability and its significance in pharmacology.

Bioavailability refers to the proportion of a drug that enters circulation when introduced into the body, affecting its therapeutic effectiveness and dosing.

Explain the concept of drug tolerance.

Drug tolerance is a phenomenon where the body becomes less responsive to a drug over time, requiring higher doses to achieve the same effect.

What are the stages of drug development from discovery to market?

The stages include drug discovery, preclinical testing, clinical trials (Phase 1, 2, and 3), regulatory review, and post-marketing surveillance.

What is the importance of pharmacogenomics?

Pharmacogenomics studies how genes affect a person's response to drugs, leading to personalized medicine and improved therapeutic outcomes.

Describe the mechanism of action of anticoagulants.

Anticoagulants prevent blood clot formation by inhibiting specific factors in the coagulation cascade, reducing the risk of thromboembolism.

What are the potential side effects of corticosteroids?

Side effects may include increased blood sugar, fluid retention, mood changes, and increased risk of infection due to immunosuppression.

Explain the concept of therapeutic drug monitoring (TDM).

TDM is the measurement of specific drugs at designated intervals to maintain a constant concentration in a patient's bloodstream, optimizing efficacy and minimizing toxicity.

What is the significance of the blood-brain barrier in drug therapy?

The blood-brain barrier restricts the passage of certain substances from the bloodstream into the brain, impacting drug delivery and efficacy for central nervous system conditions.

What are the common drug interactions associated with antidepressants?

Antidepressants can interact with other medications, leading to increased side effects, decreased efficacy, or serotonin syndrome, especially with SSRIs and MAOIs.

Define the term 'off-label' use in medication.

Off-label use refers to prescribing a medication for an indication, age group, dosage, or route of administration not approved by regulatory authorities.

What are the clinical implications of polypharmacy in the elderly?

Polypharmacy increases the risk of adverse drug interactions, side effects, and medication non-adherence in elderly patients due to complex regimens.

Explain the mechanisms behind drug resistance in bacteria.

Drug resistance occurs primarily through genetic mutations and the acquisition of resistance genes, which can alter drug targets, enhance drug efflux, or degrade the drug.

What are the signs of liver toxicity due to medication?

Signs include jaundice, elevated liver enzymes, abdominal pain, nausea, vomiting, and fatigue.

What role do human leukocyte antigens (HLAs) play in drug hypersensitivity reactions?

HLAs are involved in the immune response, and certain HLA types are associated with an increased risk of drug-induced hypersensitivity reactions.

Ondansetron

Causes headache.

Feverfew

Do not take if you are pregnant.

Timolol (for Glaucoma)

Must be taken for the rest of your life.

Gentamicin Peak and Trough

Peak: 30 minutes after administration; Trough: 30 minutes before next dose.

Allopurinol (for Gout)

Increase fluid intake.

Digoxin

Causes nausea and loss of appetite.

Ear Medications for 5-year-olds

Pull ear up and back for administration.

Eye Drops Administration

Administer drops in the conjunctival sac.

Aspirin Adverse Effects

Causes tinnitus.

Captopril

Monitor for cough.

Beta Blocker

Monitor for postural hypotension.

Furosemide

Can cause hyperuricemia.

Iron Supplements

Take in between meals.

Potassium Chloride

Take the extended-release form whole.

Acetaminophen/Ibuprofen/Aspirin

All can cause tinnitus.

Acetaminophen Overdose

May cause jaundice.

Docusate Sodium

Take with a whole glass of water.

Senna

Do not give for bowel obstruction.

Mixing Insulin Order

Draw clear insulin (regular) before cloudy (NPH).

Digoxin Poisoning

Monitor for signs of toxicity.

Anticholinergic Side Effect

Constipation is a common side effect.

Beta Blockers and Asthma

Do not take beta blockers with asthma.

Liquid Medication Administration

Do not vigorously shake the bottle.

Fluid Overload Symptoms

Confusion, dyspnea, jugular venous distension (JVD), and bloated belly.

Elevated BUN and creatinine

Patient should receive a lower dose.

Extreme adverse drug reactions

Black box warnings.

S/S of Thiamine deficiency

Peripheral neuropathy and ataxia.

ACE inhibitor

Is a pharmacological class.

Antihypertensive

Is a therapeutic class.

Ondansetron

Serotonin antagonist and antiemetic.

Aluminum, calcium, and magnesium in antacids

Cause constipation.

Morphine tolerance

Morphine no longer works due to developed tolerance.

Psyllium or Metamucil

Laxative that increases bulk.

Fastest oral drug absorption route

Oral disintegrating, buccal, wafers, and liquids.

Bismuth subsalicylate

Antiulcer should not be used if allergy to aspirin.

Liver

Metabolizes drugs.

Sucralfate

Mucosal protectant antiulcer drug (take before meals).

Drug pregnancy category D

Known fetal risk exists, but benefits might outweigh risks.

Phenytoin (Dilantin)

Antiseizure med that delays influx of sodium (rash and hyperplasia).

Famotidine

H2 receptor antagonist (stops acid in the stomach).

Therapeutic index

Ratio that compares working to toxicity.

H. pylori

Bacteria that increases stomach acid.

Prototype

Drug model.

Thiazide diuretic

Diuretic that is added to beta blocker care.

Benztropine mesylate

Central acting cholinergic receptor antagonist.

Schedule 5 drug

The least likely of the controlled substances to be misused.

First pass effect

Enters hepatic circulation in the liver.

Protein binding of medications

Affects distribution.

Timolol

Beta blocker used for glaucoma that decreases aqueous humor formation and increases aqueous humor outflow.

Metoprolol/Beta Blockers

Check heart rate and blood pressure.

ACE inhibitors

Cause hyperkalemia.

Benadryl

Causes hyper - Idiosyncratic reactions.

Erythromycin AE

Abdominal cramps and nausea (macrolides cause GI AE).

Gentamicin and vancomycin

Both are nephrotoxic.

C. diff treatment

Treated with metronidazole (clindamycin can cause C. diff).

Monitoring requirements

Monitor BUN and creatinine daily and peak and trough every 3 days.

Diphenhydramine

H1 receptor antagonist.

Lisinopril and ACE inhibitors AE

Causes hyperkalemia.

Ejection fraction of 40%

Signs and symptoms of left-sided heart failure include crackles and dyspnea.

Blood sugar of 52

Administer D50%.

Regular insulin

Can be given IV.

DKA management

Administer regular insulin IV or fluids.

Metformin AE

Abdominal bloating and diarrhea.

Phenobarbital monitoring

Monitor for respiratory depression and hypotension.