Nursg 302 exam 1

pharmacotherapy

the application of drugs for treating and preventing disease and pain

therapeutic classification (what disease), pharmacologic classification (molecular level)

What are the 2 classes of how drugs are organized?

chemical, generic (lowercase), trade (capitalized)

What are the 3 ways we name drugs and how do you identify them?

bioavailability

the physiologic ability for a drug to reach target cells and produce effect

patient, drug, dose, time, route

What are the 5 rights?

with MAR when removing from storage, when prepping, before administration

What are the 3 checks?

STAT

give drug immediately & only once

ASAP

drug should be given within 30 minutes

PRN

drug given as needed

before meals

ac

as desired

ad lib

morning

AM

twice a day

bid

capsule

cap

drop

gtt

hour

h/hr

intramuscular

IM

intravenous

IV

number

no

after meals

pc

by mouth

PO

afternoon

PM

four times per day

qid

every number hours

qnh

take

Rx

tablet

tab

three times a day

tid

standing order

an order written in advance of a situation, carried out under specific circumstances

enteral

route of entry the goes down the mouth

sublingal/buccal

when the tablet in the mouth is NOT swallowed, con consumption until dissolved these are rapidly onset

topical

route applied to skin/mucus membrane to produce a local effect

parenteral

route that is intradermal, subcutaneous, or intramuscular intravenous

pharmokinetics

the study of drug movement throughout the body + how body deals with it

absoprtion

movement from site of administration across membranes to circulating fluids biggest factor in time

distribution

transport of drugs throughout the body

metabolism

how a drug is converted to be removed from body, also known as biotransformation

first pass effect

when drugs go from the stomach to the hepatic circulation to the liver where it is inactivated and pushed back to the general circulation

excretion

how the body gets rid of waste, primarily done by the kidneys but can be done by the gallbladder as well with bile

minimum effective concentration

amount of drug required to produce a therapeutic effect

toxic concentration

level of drug that will result in serious adverse affects

therapeutic range

plasma concentration between minimum effective concentration and toxic concentration

loading dose

when a higher dose is given so the plateau is reached faster

plasma half-life T1/2

the length of time needed to decrease drug plasma concentration in half

pharmocodynamics

how medicine changes in the body

median effective dose ED50

dose that produces response in 50% of a group

median lethal dose LD50

dose that kills 50% of animals

median toxicity dose TD50

dose that produces toxicity in 50% of patients

LD50/ED50

what is the formula for the **therapeutic index** where a bigger number is safer?

potency

an increase of this makes a therapeutic effect at a lower dose

efficacy

magnitude of maximal response that can be produced from a drug

agonists

a drug that binds to and produces the same response as an endogenous chemical, sometimes has a greater response

partial agonist

a drug that binds to receptors but produces a weaker less effective response

antagonist

drug that occupies receptors to prevent action, changes pharmokinetics

Assess, diagnose, planning, implement, evaluate

What does ADPIE stand for?

sentinel events

unexpected occurrences involving death, injury, or risk threat

teratogen

an agent to which an embryo/fetus is exposed to which causes damage, most risk happen 3-8 weeks in

Absorption slower, distribution diminished, decreased metabolism, excretion

how is ADME affected in older adults?

275-295 mOsm/kg

what is normal osmolarity?

hypertonic

what causes water to move from the interstitial space to plasma

hypotonic

what causes water from the plasma to interstitial space

ADH release, aldosterone, thirst

What is inhibited during hypervolemia and stimulated during hypvolemia?

crystalloids

IV solutions with electrolytes, used to replace fluids, increase urine output, and can move to interstitial fluids

normal saline 0.9%, hypertonic saline 3%, hypotonic saline 0.45%, lactated Ringer’s (isotonic)

Name the 4 crystalloid solutions

5%, D5W

what is the % of dextrose you can add to crystalloid solutions + they name in water?

Colloids

molecules too big to cross capillary membrane, increases osmotic pressure by drawing water to it

5% albumin, hetastarch in 6% normal saline

What are the two most used colloid solutions?

3.5 to 5 mEq/L

What is the normal range for potassium?

135 to 145 mEq/L

what is the normal range for sodium?

thirst, fatigue, weakness, muscle twitching, convulsions, alerted mental status

What are signs of hypernatremia?

low-salt diet, hypotonic IV, diuertics (if hypervolemia)

what are treatments for hypernatremia?

nausea, vomiting, cramping, muscle twitching, tremors

What are signs of hyponatremia?

loop diuretics, replace sodium

what some treatments for hyponatremia?

no p wave peaked T wave, diarrhea

what are signs of hyperkalemia?

restrict dietary sources, dialysis, loop diuertic, glucose

what are treatments for hyperkalemia?

T wave inversion elevated U wave, cardiac arrest

What are signs of hypokalemia

Potassium supplements 20 mEq

What are treatments for hypokalemia?

hypoventilation/ shallow breathing, airway constriction, damage to respiratory center in medulla

What are some respiratory origins of acidosis 7.35?

hyperventilation

What are some respiratory origins of alkalosis 7.45?

severe diarrhea, kidney failure, DM, excess alcohol, starvation

what are the metabolic origins of acidosis?

constipation, ingestion HCO3, diuretics that decrease K, severe vomiting

What are the origins for metabolic Alkalosis?

lethargy, confusion, coma, deep rapid breaths

Symptoms of acidosis?

convulsions, nervousness, slow shallow respirations?

Symptoms alkalosis?

ammonium chloride, use slowly

treatment for alkalosis

increasing Ph, treat acidosis, alkalosis or hypokalemia

What are the mechanisms of action, primary use, and adverse affects of prototype sodium bicarbonate

adrenergic receptors, alpha or beta

What receptors does the SNS use, what does it divide into?

cholinergic receptors, muscarinic

What receptors does the PNS use, what does it divide into?

Acetylcholine (ACH)

neurotransmitter of the PNS

norepinephrine (NE)

neurotransmitter of the SNS

synthesis, prevent storage, influence release, prevent destruction/reuptake, bind to receptor site

what 5 mechanisms can drugs use to affect synaptic transmission?

bethanechol (urecholine), direct: ol, ine, indirect: mine zil

What is the cholinergic drug prototype name nad how do you identify the rest direct and indirect?

activate PNS, glaucoma, urinary retention, myasthenia gravis, Alsheimer

What are cholinergic drugs mechanism of action and what is it used to treat?

salivation, sweating, increased muscle tone, urinary frequency, bradycardia

What are the adverse effects of cholinergic drugs?

atropine (atropair, atropisol), inhibit PNS

What are the cholinergic blocking agents names, mechanism of action?

peptic ulcers, IBS, mydriasis, cyclopledia, bradycardia, preanestheic, asthma

What are cholinergic blocking agents primary use?

tachycardia, dry mouth, constipation, urinary retention, dry eyes, decreased sweating

What are the adverse effects of cholinergic blocking agents?

B1- andrenergic receptors

a receptor in the heart and kidneys used to increase heart rate and force contraction, release renin

B2- adrenergic receptors

a receptor in all sympathetic target organs except the heart, inhibits smooth muscle, used for **lungs**

B3- adrenergic receptors

a receptor in adipose tissue and urinary bladder, used for lipolysis and relaxing the detrusor muscle

A1- adrenergic receptors

a receptor in all sympathetic target organs except the heart, constricts the blood vessels, and dilates pupils

A2- adrenergic receptors

a receptor in presynaptic neuron. inhibits NE