Pharm 1 Final

comprehensive :(

which vitamins are water soluble

B complex

C

which vitamins are fat soluble

K

A

D

E

____ soluble vitamins pose less risk for toxicity because they aren’t stored in the body when taken in excess (water/fat)

water

most common mineral/lyte to be found in excess

potassium

If a pt has excessive potassium levels, what is used to treat this

kayexalate

how does kayexalate work

it treats excess potassium levels by binding to potassium in the gut and releasing it into the stool to cause the pt to poop

If a pt has renal failure, what issue does this pose in regard to their potassium levels

the kidneys are unable to rid of it

swallowing involves the use of ____ muscles

25

what does triggering the emetic zone cause to happen

stimulates vomiting

what does triggering the chemoreceptor trigger zone cause to happen

nausea and vomiting, triggered by irritants to the back of the throat

obesity is created when ___ > ___

intake > expenditure

what two drugs are used to treat obesity

phentermine

orlistat

what is the adrenergic anorexiant used to treat obesity

phentermine

what is the lipase inhibitor used to treat obesity

orlistat

How does phentermine help to treat obesity

suppresses the appetite by stimulating the satiety center

phentermine slows the reuptake of ___ and ___

serotonin

norepinephrine

If a pt is taking phentermine, what is the time frame that this drug should be limited to

taken short term

less than 3 months

adverse effects of phentermine (5)

dry mouth

constipation

tachycardia

hypertension

hyperactivity

If a pt is taking phentermine to treat their obesity, what should they avoid while taking this med

avoid other types of stimulants

how does orlistat work to treat obesity

decrease fat absorption and caloric intake by binding to gastric and pancreatic lipases and inhibiting them

if a pt is taking orlistat, what are adverse effects to be aware of

abd pain

fecal urgency and incontinence

fatty/oily stools

if treating a pt who is obese, what are the two most important values to monitor and assess

BMI

waist circumference

if a pt is obese, what is a realistic weight loss goal for them to achieve

1-2 lb loss per week

normal pH range for stomach acid

1.5-3.5

if a pt has PUD, what happens within their body

erosion of mucosal layer of the stomach, which causes acide to reach the inner layers of the GI tract

which bacteria can cause PUD

H pylori

s/s of a pt having PUD (2)

painless bleeding

stomach pain

(both get worse at night or on an empty stomach)

what is GERD

the LES is incompetent, meaning the sphincter is unable to properly close and causes regurgitation of stomach acid into the esophagus

s/s of GERD

heart burn in pm or after meals

GERD can cause barrett’s esophagus, what is this

scar tissue builds up in the esophagus

what lifestyle changes can a pt implement to treat PUD/GERD (5)

reduce alcohol/tobacco consumption

reduce stress

eliminate spicy foods

eliminate NSAID use

eliminate caffeine use

which two meds are antacids used to treat PUD/GERD/heartburn

Mylanta

Tums

how do antacids work to treat PUD/GERD

neutralize/reduce gastric acid by increasing pH so it becomes less acidic

adverse effects of mylanta, which is used to treat PUD/GERD (4)

constipation

diarrhea

osteomalacia (weakened bones via prevention of phosphate absorption)

alkalosis

If a pt has renal failure, which med should be avoided that is used to treat PUD/GERD

magnesium based antacids (Mylanta)

If a pt has renal failure, why would we want to avoid the use of magnesium based antacids such as mylanta

renal failure creates excessive magnesium levels, and increasing magnesium levels with this med can cause toxicity

what are the histamine-2 antagonists used to treat PUD/GERD

cimetidine

famotidine

(end in -tidine)

how do histamine-2 antagonists work to treat PUD/GERD

block production of hydrochloric acid

most concerning side effect of taking histamine-2 antagonists such as cimetidine and famotidine

high doses given IV can cause heart arrhythmias

the proton pump inhibitor (PPI) used to treat PUD/GERD/H Pylori

omeprazole

(end in -prazole)

how do PPIs work to treat PUD/GERD/H Pylori

prevent the release of gastric acid

what is the best med to use to treat PUD/GERD

omeprazole

most concerning side effect of taking omeprazole

osteoporosis

if a pt is taking omeprazole, when should they be taking this med

before food consumption

when should drugs to treat PUD/GERD be taken

on an empty stomach

not with other medications

if a pt is taking a PPI, which drug should be avoided taking simultaneously because its antiplatelet action can cause a bad drug to drug interaction

clopidogrel

what foods/habits should a pt avoid if they have PUD/GERD (6)

fats

chocolate

citrus

coffee

alcohol

smoking

a pt who is experiencing PUD/GERD should consume ___ and ___ meals to reduce amount of acid production

small and frequent

what is misoprostol used to tx

PUD/GERD

reason that a pt would be taking misoprostol

taken to inhibit mucosal damage from NSAID intake and prevent GI bleeding

BBW for misoprostol

abortifacient - can cause an abortion

Which med used to treat PUD/GERD should NOT be given if someone is pregnant

misoprostol

how does sucralfate work to help pts with PUD/GERD

lines the GI tract in a protective coating to prevent/treat ulcers

when should a pt be taking sucralfate

2 hours after other meds, because this med prevents absorption of them

(if taken before other meds, the meds will not be able to be absorbed into the body)

if a pt has H Pylori, how long will treatment take

2 weeks

Triple therapy used to treat H Pylori

PPI

Amoxicillin

Clarithromycin

quadruple therapy used to treat H Pylori

Amoxicillin

Clarithromycin

PPI

bismuth subsalicylate (pepto-bismul)

why are antibiotics given for PUD caused by H Pylori

H Pylori is a bacteria

A hemodialysis pt should avoid taking which med used to treat PUD/GERD

Mylanta (don’t give to pts with renal failure)

what is the phenothiazine used to treat nausea

promethazine

how does promethazine work to treat nausea

change responsiveness of CTZ

side effects of promethazine

drowsiness

dry mouth

urinary retention

which medication should NOT be given SUBQ that helps to treat nausea because it can cause tissue death

promethazine

promethazine is contraindicated in who because it can cause respiratory depression

children under 2

BBW for promethazine

avoid in children under 2

don’t give subq

antihistamine used to treat nausea, vomiting and motion sickness

hydroxyzine

how do antihistamines work to treat nausea, vomiting and motion sickness

block action of histamine on CTZ, has anti-cholinergic side effects

adverse effects of hydroxyzine

drowsiness

dizziness

dry mouth

urinary retention

which is the only drug used to treat nausea and vomiting that doesn’t cause severe drowsiness

ondansetron (zofran)

what is the best drug choice for treating nausea and vomiting

ondansetron (zofran)

MT: ondansetron = on deck to treat n/v

what is the 5-HT3 receptor blocker used to treat nausea and vomiting

ondansetron (zofran)

major adverse effect of ondansetron (Zofran)

prolonged QT interval

If a pt has a prolonged QT interval, which medication used to treat n/v should be avoided

ondansetron (zofran)

what is the substance P / neurokinin I antagonist used to treat n/v

aprepitant

what medications is aprepitant used in combo with

5-HT3 receptor antagonists

ondansetron

corticosteroid

a pt is receiving chemotherapy in 1 hour, which medication should be given in anticipation for the n/v they will be experiencing

aprepitant

MT: prep for chemo

what is the biggest adverse effect of aprepitant

heart arrythmias

how long before chemo should a pt take aprepitant

1 hour beforehand

which drug is given to treat delayed n/v

aprepitant

use of metoclopramide

increases bowl motility to help with n/v

use of dronabinol

contains cannibis to treat n/v in chemo pts

use of scopolamine

prevention of n/v with motion sickness

a pt needs a patch placed behind their ear to help treat their n/v in relation to motion sickness, which medication is being administered

scopolamine

if a pt is taking n/v medications, what types of medications should they avoid taking in combination with these

other meds that cause CNS depression

what should a pt avoid when taking medications for n/v

avoid driving (meds are CNS depressants)

A pt is taking promethazine, which medication(s) should the pt avoid taking with this med

any CNS depressants

which laxative is a bulk forming laxative that helps to add bulk to stool and absorbs more water to help soften the stool

psyllium

what is psyllium used for

treat constipation

add bulk to diarrhea

what are the contraindications for psyllium

bowel obstruction

fecal impaction

purpose for using lubricants, such as mineral oil, to help with constipation

lubricates the stool

purpose for using surfactants to help with constipation

allows water to enter stool to make it softer and easier to pass

cathartics, such as bisacodyl, are used for what

rapid movement of stool to help with bowel prep or constipation

how do cathartics work

they irritate the GI mucosa to allow stool to pass rapidly

bisacodyl, a type of ___, is used to pass stool quickly

cathartic

contraindications for using bisacodyl

abd pain

bowel obstruction

fecal impaction

___ cathartics are the most potent type

saline

use of saline cathartics

bowel prep pre-op

examples of saline cathartics

magnesium citrate

milk of mag

polyethylene glycol

how do saline cathartics work

causes diarrhea to empty the bowels

which laxative helps to treat high ammonia levels d/t liver failure

lactulose