NRSG 2100 Final Review (all units)

Pharmacology

The study of medicine, including their administration, their sites of action, and their effects

Pharmacotherapy

The use of drugs for prevention and treatment

Drug

Anything that helps prevent, cure, or reduce symptoms of a medical condition.

Therapeutic

What the drug is treating

Pharmacologic

How the drug acts in the body

Prototype

An example within a class

United States Pharmacopeia

Quality/Purity & Strength

FDA

Safety, efficacy, and security of drugs

Scheduled controlled substances recognize

Abuse & Dependency potential of specific drugs

Is schedule I or schedule V worse?

Schedule I

Decreased excretion would _____ the drug in the blood

Increase

Someone with kidney disease would have decreased excretion and may need _____ doses.

Lower

Where are receptors located?

On the cell membrane

Antagonist

Block a response

Peak

Highest plasma concentration of a drug

Trough

Lowest plasma concentration of a drug

Side Effect

Types of drug effects that are predictable and which may occur at therapeutic dose.

Teratogen

Drug that may cause birth defects

Anaphylaxis

Most serious allergic reaction. A medical emergency. Is life threatening.

Carcinogen

Drug that may cause cancer

Additive effect

When 2 different drugs from the same therapeutic class are used together for a greater response.

Inhalers have _____ absorption

rapid

An AM dose following a high fat breakfast would effect the absorption how?

It would slow it

If more than 3 high protein bound meds were ordered you could expect the dose to be ____ than usual.

Lower (they are competing)

92% protein bound drug has ___ available to client

8%

Nursing Diagnosis is

Built from the assessment

What are some variables that affect drugs crossing the placenta?

-Size

-Concentration

-Solubility

-Ionized

What is the best IM site for infants?

Vastus Lateralis

What are the 2 methods of calculating a pediatric dosages?

Body weight & surface area

What are some ways geriatrics misuse drugs?

Underuse, overuse, erratic use, changing doses, self-prescribing

With IV epinephrine what will be used?

ECG cardiac monitor

Why would propranolol not be good for a girl with asthma to take?

Propranolol is a nonselective beta blocker, it could cause her to have a bronchospasm

Sympathetic Neurotransmitter

Norepinephrine

Parasympathetic Neurotransmitter

Acetylcholine

Bethanechol the direct acting Chollergic agonist is used to

decrease urinary retention

You could expect to administer _____ to someone experiencing cholinergic crisis

Atropine

What types of medication would be inappropriate for a patient with hypertension?

Any type of sympathetic agonist would increase BP and not be good.

Acetaminophen & Asprin are hard on the

Liver

What is the anecdote for acetaminophen overdose?

Acetylcysteine by IV

What toxic effects might be present with aspirin overdose?

Tinnitis, Rye Syndrome, GI problems

If someone is allergic to Aspirin what could the nurse administer to help reduce their fever?

Acetaminophen

Localized Inflammation

Redness, Swelling, Pain

Generalized Inflamamtion

Increased Leukocytes, elevated erythrocyte sedimentation rate, fever, HA, loss of appetite, weakness .

When someone is overdosing on Acetaminophen the patient INITIALLY experiences

N,V, & GI cramping

When someone builds up a tolerance

A larger dose of opiod analgesic is required to maintain the original effect

Adverse effects of Narcotics related to safety include:

-Respiratory depression

-Orthostatic Hypotension

What is the anecdote for Narcotics?

Nalaxone (narcan)

Colchicine is a medication used for gout. It works by:

Inhibiting the response of WBC in the inflammatory process

Allopurinol is a medication used for gout. It works by:

Blocking the action of xanthine oxidase & prevents the formation of uric acid. (Taken daily as a preventive measure)

What is the anecdote for benzodiazapines?

FLumazenil

Common side effects of Lorazepam include

Constipation, dry mouth, CNS depression, drowsiness, excessive sedation, impaired motor coordination, confusion, and orthostatic hypotension

Common side effect of Zolpidem

Sleep walking, sleep eating (sleep behaviors)

What receptors affect Benzodiazapines?

GABBA

What Indirect acting Cholinergic medication is used to treat Alzheimer?

Donepezil

What are some common adverse effects of Donepezil the indirect acting cholinergic medication?

Diarrhea, GI bleeding, liver dysfunction

Common side effects of ADHD medications

Insomnia, weight loss, irritability, tachycardia, increased BP

Chollinergic medications are contraindicated for patients with:

-Asthma

-Bowel obstruction

-Bradycardia

T/F

Acetaminophen is the number one cause of liver failure

True

Parkinsons disease is caused by

A decrease of dopamine in the brain

Medications to treat parkinsons disease include:

-Dopiminergics

-Anticholinergics

Common side effects of Levedopa (dopaminergic med for parkinsons)

Involuntary chreiform movements, orthostatic hypotension, psychosis, diskiesia.

Levodopa is combined with Carbidopa to

Prevent the breakdown of levodopa in the GI tract and lower the dose.

Muscle spasms are caused by

Traumatic injury or overworking of a muscle group

Muscle spasticity is caused by

Something such as a spinal cord injury

Muscle spasms are treated with

Central Acting Drugs (Cyclobenzaprine)

Common adverse effect of Cyclobenzaprine is

Drowsiness

Muscle spasticity is treated with

Direct Acting (Dantrolene sodium)

Side effects of Caclium Carbonate include:

-Hypercalcemia, Problems at IV site, Kidney stones

Muscle twitch/muscle spasm would be s/s of Hypo or hyper calcemia?

Hypocalcemia

What types of medications are used to treat Osteoporosis?

Bisphosphonates & SERMS

When taking alendronate it is important to

sit upright for 30 minutes after taking the medication

Glitazone-Rosaglitazone

Increase cells sensitivity to insulin, decrease cells resistance

Blood pressure is affected by

CO & Peripheral resistance

Common adverse effect of Lisonopril

Cough!

Why is Lisonpril used over Losartan?

It COSTS less.

Lisinopril

Prevents angiotensin I from becoming angiotensin II

Losartan

Prevents angiotensin II from acting on target organs

What are the Ca++ channel blocker classes?

Dihydropyridines (arterial) & Nondihydropyridines (arterial & cardiac)

Nifedipine causes ______ to the heart & Verapamil causes ______to the heart

Tachycardia, bradycardia

Type 1 Diabetes

Requires insulin from outside of the body

1st line treatment of hypertension include

Thiazide Diuretics

ACE inhibitors

Ca++ channel blockers

Therapeutic effect of ACE Inhibitors & ARBS include

-Decrease release of aldosterone

-Increase Vasodilation

-Prevent cardiac remodeling

Common side effects of Ca++ channel blockers

-HA

-Flushing

-Drowsiness

What side effect would adrenergic blockers have on the lungs?

Bronchoconstriciton

Hypotension when taking a antihypertensive medication med would be considered

Adverse effect

Goal for treatment of Heart failure

-Decrease preload (fluid)

-Decrease after load (BP)

-Inhibit RASS and Sympathetic nervous system

Anecdote for Warfarin

Vit K

Albuterol is

Bronchodilater used for acute asthma attacks

Common adverse effects of albuterol include

Tachycardia, palpations

Acetylcysteine is used to

Change the chemical structure of secretions (breaks them down)

Antacids work by

Neutralizing the pH of hydrochloric acid in the stomach and reducing the digestive action of pepsin

Aluminum Hydroxide causes

constipation

Drugs to treat H.Pylori

Antibiotics, PPI, Bismuth

Sucralfate

Reacts with gastric acid to make a thick substance which adheres to the gastric or duodenal ulcer surface protecting it from further injury or irritation

PUD can occur

In esophagus, stomach, or small intestine

Stress ulcers may result from the following

Severe burns that require intensive care unit hospitalization.

Which of the following patient teaching points needs to be included for the patient receiving isoniazid?

Avoid alcohol

Before administering an anti-emetic to a patient experiencing N & V the nurse should first assess

Bowel sounds