pharm final

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128 Terms

1
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know some NSAIDs & antigout drugs
2
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what is pharmacology?
study or science of drugs
3
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what is pharmacokinetics?
study of what the body does to the drug (ex: absorption, distribution, metabolism, excretion)
4
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what is pharmacotherapeutics?
clinical use of medications to prevent or treat illness

defines principles of drug actions (ex: cellular processes that change in response to the drug)

drugs are organized into classes
5
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what is absorption?
movement of medication from the injection site into the bloodstream
6
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what is albumin?
most common protein

carries the majority of protein-bound drugs
7
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what does decreased production of proteins by the liver cause?
decreased protein-binding of drugs & increased circulation of free drugs
8
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what is the first pass effect?
a large portion of a drug is chemically changed into inactive metabolites by the liver

causes small bioavailability
9
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do oral drugs have a high first pass effect?
yes
10
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do transdermal drugs have a high first pass effect?
no
11
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what is prophylactic therapy?
treatment to prevent an infection
12
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what are some examples of prophylactic therapy?
antihistamines before giving vancomycin to prevent red man syndrome

tamiflu for a patient who has been exposed to the flu
13
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what is empiric therapy?
treatment of an infection before knowing what it actually is, based on what is most likely happening
14
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what are some examples of empiric therapy?
giving antibiotics for a UTI before tests come back to confirm
15
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how do medications generally affect pediatric patients?
the liver & kidneys are immature, causing impaired drug metabolism & excretion
16
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how do medications generally affect older adult patients?
decline in organ function, causing increased risk for adverse effects & toxicity

the number of intact nephrons is decreased, causing less acidic gastric pH & increased fat content

usually on multiple medications a once (polypharmacy)
17
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what should be assessed when administering medications to patients in general?
age

allergies & dietary habits

sensory, cognitive, & motor-skill deficits

financial status & limitations

list of health-related care providers

list of medications, existence of polypharmacy, & self-medication practices

lab results

history of smoking & alcohol use

risk situations related to drug therapy (beers criteria)
18
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what is the common perception of questions in african cultures?
asking personal questions of someone you just met is considered intrusive & improper
19
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what is the common perception of eye contact in african cultures?
direct eye contact is considered rude
20
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what are some biological variations of people of african descent?
keloid formation, sickle cell anemia, lactose intolerance, skin color
21
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what is the common perception of respecting others in asian cultures?
have high respect for others, but especially authority figures
22
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what is the common perception of hand-shaking in asian culture?
usually are not comfortable shaking hands with the opposite sex
23
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what are some biological variations of people of asian descent?
many drug interactions, lactose intolerance, skin color, thalassemia (deficient hemoglobin)
24
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what is the common perception of expressing feelings in hispanic cultures?
expressing negative emotions is considered impolite
25
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what is the common perception of eye contact in hispanic cultures?
avoiding eye contact is considered attentive & respectful
26
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what is the common perception of touching in hispanic cultures?
considered acceptable between two people in a conversation
27
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what are some biological variations of people of hispanic descent?
lactose intolerance, skin color
28
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what is the common perception of tone of voice in native american cultures?
speaking in a low tone of voice is common
29
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what is the common perception of touch in native american cultures?
light touch of a person’s hand is preferred over a firm handshake
30
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what are some biological variations of people of native american descent?
lactose intolerance, skin color, cleft uvula problems
31
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of the cultures reviewed, which are present-oriented?
african, asian, & native american
32
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what do most medication errors occur from?
breakdown in medication use system
33
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do most medication errors occur because of individual error?
no
34
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which drugs are most commonly involved in severe medication errors?
CNS drugs, anticoagulants, & chemotherapeutic drugs
35
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what are some issues that contribute to errors?
organizational issues

education system issues

sociological factors

use of abbreviations
36
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what are some interventions that can be use to emphasize safety & prevent errors?
using two patient identifiers

not administering medication if you did not draw up or prepare yourself

minimizing verbal or telephone orders

never assuming

using generic names

requiring a second nurse to administer high-risk medications
37
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what is some patient education that should be included with analgesics?
notify physician with signs of allergic reaction or adverse effects

don’t use other medications without checking with the provider
38
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what is prophylactic therapy for pain management?
medicate before the pain becomes severe to provide adequate analgesia
39
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is pain management purely pharmacological interventions?
no
40
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what are some adverse effects of opioid analgesics?
constipation (can be prevented with increased fluid, fiber, exercise, etc.)

orthostatic hypotension (instruct patient to change positions slowly)

respiratory depression (contact physician immediately)
41
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what are some contraindications for morphine?
use of CNS depressants or severe respiratory conditions
42
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what is an example of a nonopioid analgesic?
acetaminophen
43
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what is status epilepticus?
multiple seizure occur with no recovery between them
44
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what can status epilepticus cause?
hypotension, hypoxia, brain damage, or death
45
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is status epilepticus an emergency?
YES
46
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what is required after status epilepticus?
usually lifelong AED therapy
47
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what can long term use of phenytoin cause?
gingival hyperplasia, acne, hirsutism, & dilantin facies
48
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is phenytoin protein-bound?
highly
49
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what should be monitored with phenytoin?
serum albumin levels (if low, toxicity can occur)
50
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what is gabapentin used for?
neuropathic pain, adjunct to help with seizures
51
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what do beta blockers usually end in?
olol
52
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what do beta blockers do? (MOA)
reduce transmission of impulses in the heart, which lowers heart rate & blood pressure
53
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what should patients do when taking beta blockers?
take radial pulse for a full minute & notify provider if pulse is less than 60 bpm
54
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what is an example of a beta blocker?
metoprolol
55
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what are beta blockers used for? (indications)
HTN, HF, dysrhythmia
56
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what is a contraindication of beta blockers?
asthma
57
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what are the adverse effects of beta blockers?
bradycardia & hypotension
58
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what should be monitored with beta blockers?
BP & HR
59
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what do ACE inhibitors usually end in?
pril
60
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what is an example of an ACE inhibitor?
lisinopril
61
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what is the first line cardiac drug for non-black people?
ACE inhibitors
62
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what are ACE inhibitors used for? (indications)
HTN, HF
63
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which cardiac drugs have renal protective effects?
ACE inhibitors
64
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what are the adverse effects of ACE inhibitors?
fatigue, dizziness, mood changes, **dry cough**, hyperkalemia, **angioedema**
65
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what are calcium channel blockers used for? (indications)
HTN, dysrhythmia, raynaud’s phenomenon
66
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what are contraindications of calcium channel blockers?
acute MI, AV block, hypotension
67
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what are the adverse effects of calcium channel blockers?
hypotension, palpitations, constipation, dyspnea
68
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what can all anti-dysrhythmic drugs cause?
dysrhythmias
69
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what is classified as hypertension for patients 60 or older?
greater than 150 systolic __or__ greater than 90 diastolic
70
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what is classified as hypertension for patients younger than 60 or with chronic kidney disease or diabetes?
greater than 140 systolic __and__ greater than 90 diastolic
71
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which cardiac drugs should be used first for african american people?
thiazides or CCBs
72
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which NSAID has an antiplatelet effect?
aspirin
73
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which patients should aspirin not be given to?
patients with renal dysfunction
74
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what is aspirin used to treat?
MIs, thromboembolic events, prophylaxis
75
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what is one of the first drugs given in the ER?
aspirin
76
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what are some factors that predispose a patient to digoxin toxicity?
**hypokalemia**, use of pacemaker, hepatic dysfunction, hypercalcemia, dysrhythmia, hypothyroidism, respiratory conditions, renal disease, & increased age
77
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which diuretics can be used in patients with cardiac conditions?
furosemide (monitor potassium)
78
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what can potassium imbalance cause?
cardiac dysrhythmias
79
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what is the normal range for potassium?
3\.5-5
80
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can all forms of lidocaine be given IV?
no, forms with epinephrine need to be used as a local anesthetic
81
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which dysrhythmias is lidocaine strictly used for?
ventricular arrhythmias
82
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what are the adverse effects of lidocaine?
bradycardia, blurred vision, mood swings, dizziness, drowsiness, **twitching** (from blockage of sodium channels)
83
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does nitroglycerin have a high first pass effect?
yes
84
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what is the most important drug used for angina?
nitroglycerin
85
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what are some contraindications of nitroglycerin?
severe anemia, closed-angle glaucoma, hypotension, severe head injury, **use of erectile dysfunction drugs (slidenafil)**
86
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what are the adverse effects of nitroglycerin?
tolerance, reflex tachycardia, postural hypotension
87
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what does metformin do?
decreases production of glucose by the liver

decreases intestinal absorption of glucose

increases uptake of glucose by the tissue
88
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what are the adverse effects of metformin?
GI upset, metallic taste, lactic acidosis
89
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what is the first line drug for diabetes?
metformin
90
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is metformin used for type 1 DM?
no
91
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what are the contraindications of metformin?
renal or hepatic disease
92
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what is a normal creatinine level?
0\.6-1.2
93
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what are some rapid-acting insulins?
lispro, aspart, glulisine
94
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what are some short-acting insulins?
regular
95
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what are some intermediate-acting insulins?
NPH
96
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what are some long-acting insulins?
detemir
97
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how should insulins be drawn up?
insulin needles

clear before cloudy (prevents contamination)
98
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what is an adverse effect of all antibiotics generally?
c. diff
99
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what do quinolones end in?
floxacin
100
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what are some examples of quinolones?
ciprofloxacin, levofloxacin