Patient Care Test 1

International Union of Pure & Applied Chemistry

IUPAC

Chemical Name (IUPAC)

-Used for chemists & benchtop researchers
-Describes extact composition, structural features

Company Name

Code to identify w/in the comany

Street Name

Slang created for highly abused medications

Generic Name

Created by USAN Council (AMA, USD, & APA) while FDA advices
WHO has final approval on generic name
By Law: generic name should be on all advertising, labels, and brochures

Brand Name

Created by the company to trademark ownership of exclusive rights
Approved by FDA
Designed to create emotional connections and imply innovation to consumers

Stem: -cillin

Class: penicillin ATB

Stem: -cycline

Class tetracycline ATB

Stem: -floxacin

Class: flouroquinolone ATB

Stem: -oxetine

Class: SSRI Antidepressant

Stem: -sartan

Class: Angiotensin II Receptor Blocker (ARBs)

Stem: -azole

Class: Antifungal

Stem: -prazole

Class: PPI's

Stem: -olol

Class: Beta-blockers

Stem: -pril

Class: ACE-inhibitors

Stem: -azepam/-azolam

Class: benzodiazepines

Stem: -osin

Class: alpha-blockers

Stem: -nafil/-lafil

Class: PDE5-inhibitors

Stem: -statin

Class: HMG CoA RI's

Rx

Prscription needed to obtain

OTC

Anyone can buy

Behind the Counter (BTC)

Restricted access to prevent missuse/abuse

Ends in a →

add e to make plural

Ends in ax →

change ax to aces

Ends in is →

change is to es

Ends in ix OR ex →

change to ices

Ends in um →

Change um to a

Ends in us →

Change us to i

Superior

Towards head

Inferior

Away from head

Anterior

Infront of/at

Posterior

At/in back

Medial

Towards midline

Lateral

Away from midline

Atomic Position

Standing Erect
Palms facing forward, arms at side
Feet parallel, pointing forward

Frontal (coronal) position

Sagittal Plane

Transverse (horizontal) Plane

Dorsal Cavity

Cranial cavity + Spinal

Ventral Cavity

Throacic cavity + Abdominopelvic cavity + Pelvis

Cervical Spine

C1-C7

Thoracic Spine

T1-T12 (Connected to ribs)

Lumbar Spine

L1-L5 (largest, support spine) → recieves most stress from lifting

Sacral Spine

5 - fused

Coccygeal Spine

3-4 fused pieces (attached to ligaments)

Collect (Step 1)

Subjective + Objective
(Hx of patient + exam + tests)

Assess (Step 2)

Examine the data collected → Answering "How/Where can therapy be improved?"

Plan (Step 3)

How to achieve these improvements
(development of individualized, patient-centered care plan)

Implement (Step 4)

Tells patient the plan and others what you did

Follow Up (Step 5)

Ensure therapy is safe, patient progressing towards goals → If not, revise plan

SOAP

Subjective
Objective
Assessment
Plan

Subjective

What the patient tells you
(Chief complaint + HPI + Medical, Surgical, Family, Social Hx + Symptoms + Rx + Allergies)

Objective

What labs or medical records tell you
(BMP + CBC + Urinalysis + Cultures)

Assessment

Outlines your decision-making in greater detail

Plan

What you plan to do/What patient should do

Serotonin (5-HT)

Inhibitory NT → mood, sleep, digestion
Located in brain + GI system + Heart

Dopamine (D2)

Excitatory NT → thinking, planning, feeling pleasure (reward system), motor control/mvmts
Located in brain + muscles

Histamine (H1)

Excitatory NT → sleep regulation, gastric acid release, immune response (itching)

GABA

Inhibitory NT → calms firing nerves in CNS, helps keep D2 in check

First Gen. Antipsychotics

FGA or "typical"
Blocks dopamine receptors
↑ SE → extrapyramidal symptoms
Less metabolic abnormalities

Second Gen. Antipsychotics

SGA or "atypical"
Blocks dopamine & serotonin receptors but prefers serotonin
↓ extrapyramidal symptoms
Serotonin receptors → Found in GI, Heart → more metabolic abnormalities → ↑ glucose, lipids, & wt gain

First Gen. Antipsychotic MOA

Non-selectively blocks dopamine

Drugs in First Gen. Antipsychotic

haloperidol - Haldol

haloperidol

Haldol
First Gen. Antipsychotic
Schizophrenia, hyperactive behavior in kids, Tourette's syndrome

BBW: haloperidol - Haldol

↑ risk of death in patients w/ dementia
"chemical restraint"

SE: haloperidol - Haldol

extrapyramidal symptoms (tardive dyskinesia & Neuroleptic malignant syndrome)

Second Gen. Antipsychotic MOA

Partial agonist @ dopamine & serotonin

Second Gen. Antipsychotic Drugs

aripiprazole - Abilify
lurasidone - Latuda
olanzapine - Zyprexa
quetiapine - Seroquel
risperidone - Risperdal
ziprasidone - Geodon

aripiprazole

Abilify
Second Gen. Antipsychotic

lurasidone

Latuda
Second Gen. Antipsychotic

olanzapine

Zyprexa
Second Gen. Antipsychotic

quetiapine

Seroquel
Second Gen. Antipsychotic

quetiapine (Seroquel) MOA

X dopamine & serotonin
X histamine & α-1 & α-2 adrenergic

risperidone

Risperdal
Second Gen. Antipsychotic

risperidone (Risperdal) MOA

X dopamine & serotonin
X histamine & α-1 & α-2 adrenergic

ziprasidone

Geodon
Second Gen. Antipsychotic

ziprasidone (Geodon)

X dopamine & serotonin
X histamine & α-1 & α-2 adrenergic

SE: Second Gen. Antipsychotic

QT prolongation

CP: Second Gen. Antipsychotic

X Grapefruit
w/ food

CI: Second Gen. Antipsychotic

△ CYP3A4

Monitor: Second Gen. Antipsychotic

Elevated BS, lipids, & Wt gain

CP: quetiapine (Seroquel)

Eye exam for cataracts

SE: quetiapine (Seroquel)

somnolence, dry mouth (due to blocking of histamine)

SE: risperidone (Risperdal)

hyperprolactinemia (excessive prolactin)

CP: zipradisone (Geodon)

Higher risk for QT prolongation

Hypnotic (Z-drugs) MOA

↑ GABA activity by selective agonism → calms CNS firing

drugs in Hypnotic (Z-drugs)

eszopiclone - Lunesta
zolpidem - Ambien, Edluar, Intermezzo

eszopiclone

Lunesta
Hypnotic (Z-drugs)
Insomnia

zolpidem

Ambien, Edluar, Intermezzo
Hypnotic (Z-drugs)
Insomnia

CP: Hypnotic (Z-drugs)

Schedule IV → Controlled

BBW: Hypnotic (Z-drugs)

Complex behaviors (sleep walking, sleep driving, ect)

CP: Hypnotic (Z-drugs)

Take at bedtime
W/out food
X ETOH & CNS ↓

Short-term SE: zolpidem (Ambien, Edluar, Intermezzo)

drowsiness, dizziness

Long-term SE: zolpidem (Ambien, Edluar, Intermezzo)

dizziness, drugged feeling, lethargy

Benzodiazepine + Hypnotic MOA

Mimics GABA

Drugs in benzodiazepine + hypnotic

temazepam - Restoril

temazepam

Restoril
benzodiazepine + hypnotic
Insomnia

CP: temazepam (Restoril)

Schedule IV (controlled)
Safer in elderly or liver impaired

BBW: temazepam (Restoril)

W/ opioids → sedation, resp. depression, coma, or death

CI: temazepam (Restoril)

△ ETOH & CNS ↓ → worsens drowsiness