Pharmacology 4

Flashcards: Pharmacology - Exam 1 (104A)

Both Sides

What type of medications are used to treat Sinusitis?

broad spectrum antibiotics
sometimes antihistamines, nasal corticosteroid inhalers, analgesics, decongestants and expectorants

12/39

Study:

Learn

Test

Play Games:

Scatter

Space Race

All 39 terms

Print List Print Cards Export Combine

Terms Definitions

List the antiplatelet medications used to treat DVT 1. Aspirin (ASA)
2. ticlopidine hydrochloride (Ticlid)
3. clopidogrel hydrogen sulfate (Plavix)
4. ASA/dipyridamole (Aggrenox)

List the anticoagulant medications used to prevent DVT 1. unfractionated Heparin (low dose subQ)
2. Low molecular weight heparin
3. warfarin (Coumadin)

What do antiplatelet medications do? prevents platelet aggregatin, thus slowing down clot formation

List the LMWH medications commonly used to prevent DVT enoxaparin (Lovenox)
dalteparin (Fragmin)
ardeparin (Normiflo)
tinzaparin sodium (Innohep)
fondaparinux sodium (Arixtra)

What is Heparin? An anticoagulant

What is the antidote for Heparin? Protamine Sulfate

Why is LMWH used over Heparin in some patients? It has a longer 1/2 half and a more predictable response

What do the patient's Ptt levels need to be at when on Heparin therapy? therapeutic levels of Ptt need to be 1-1.5 times the normal level
Ex: If Control is 25-35 seconds then the therapeutic level should be 50-70 seconds)
(Ptt levels greater than 70 seconds - notify Physician)

What does warfarin do? inhibits the synthesis of vitamin K (works in the liver)

what should the INR level be at if a patient is not anticoagulated? <1

what should the INR level be at if a patient is on therapeutic therapy for DVT? for patients w/orthopedic surgery or for prevention of emboli in patients w/a-fib: INR 2-3 times control
**for patients w/prosthetic valve prophylaxis: 2.5-3.5 times the control

What type of medications are used to treat Sinusitis? broad spectrum antibiotics
sometimes antihistamines, nasal corticosteroid inhalers, analgesics, decongestants and expectorants

What types of medications are used to treat patients w/status asthmaticus? potent systemic bronchodilators
steroids
epinephrine
oxygen
IV fluids

What are the Coricosteroids used to treat asthma? anti-inflammatory agents
INHALED:
1. flunisolide (Aerobid)
2. triamcinolone (azmacort)
3. fluticosone (Flovent)
4. budesonide (Pulmicort)
5. beclomethasone (Qvar)

SYSTEMIC:
prednisone

What do corticosteroids do? Decrease the antiinflammatory responses in the airway

What are some side effects of inhaled steroids? fungal infections in the mouth (rinse w/water after use)
headache

What are some side effects of Prednisone? Increased blood sugar in diabetics or puts people at risk for diabetes
insomnia
increased appetite

List the SHORT ACTING Beta-2 agonists (bronchodilators) used to treat asthma 1. albuterol (Proventil, Accuneb) most common
2. levalbuterol (Xopenex)
3. pirbuterol (Maxair)

List the LONG ACTING Beta 2 agonists (bronchodilators) used to treat asthma 1. Salmeterol (Serevent) most common
2. formoterol (Foradil)

What do bronchodilators due for asthma patients? bind to beta 2 agonist receptors in our smooth muscle which results in the relaxation of our airway's smooth muscle

What are some side effects of beta 2 agonists (bronchodilators)? nervousness, restlessness, tremor, chest pain, insomnia, palpitations

List the combination steroid and long acting beta 2 agonist used for asthma 1. fluticasone/salmeterol (Advair)
2. budesonide/formoterol (Symbicort)

List the Anticholinergics used to treat asthma 1. iprtropium bromide (Atrovent)
2. tiotropium bromide (Spiriva)

List the combination anticholinergic and beta 2 agonists used to treat asthma 1. ipratropium bromide/albuterol (Combivent/Duoneb)

What do anticholinergics do? Block the parasympathetic pathway and inhibit anticholerginic receptors in our bronchial smooth muscle tissue and produce local bronchodilation

What are the side effects of anticholinergics? hypotension, headache, nervousness, dizziness

List the Xanthine derivatives used to treat asthma 1. theophylline (Theobid)
2. aminophylline

What should be monitored in patients taking theophylline? DRUG LEVELS - possible toxicity
Signs of toxicity: nausea, anorexia, stomach cramps, diarrhea, confusion, headache, tachycardia, arrythmias, seizures

What do Xanthine derivatives do? Relax smooth muscle in bronchial airways.
Used most often in patients w/needed long-term treatment and control

List the Mucolytics used to treat asthma acetylcysteine (Mucomyst)
guaifenesin (Humabid)

What is important to tell a patient on Mucolytics? KEEP HYDRATED

List the anti-inflammatory (mast cell stabilizers) meds used to treat asthma 1. cromolyn (Intal)
2. nedocromil (Tilade)

What do anti-inflammatory (mast cell stabilizers) do? Prevent the release of histamine and slow reacting substance of aniphylaxis from sensitized mast cells

What are some side effects of mast cell stabilizers? vertigo, headache, fatigue, chest pain, bronchiospasm, cough, unpleasant taste

List the Leukotriene modifiers used to treat asthma 1. zafirlukast (Accolate)
2. montelukast sodium (Singular)
3. zileuton (Zyflo)

What do Leukotriene modifiers do? prevent airway edema and smooth muscle contraction

What is important to know about montelukast sodium (Singular)? It has been know to cause depression and suicidal thoughts (Montel - icide)

What nebulizor medications are used on patients w/asthma? Albuterol
Xopenex
Atrovent
Duoneb

Why are nebulizors used? they provide faster relief than inhalers do

Flashcards: Pharmacology exam 2

Study:	Learn Test

Play Games:	Scatter Space Race

Terms	Definitions
List the antiplatelet medications used to treat DVT	1. Aspirin (ASA) 2. ticlopidine hydrochloride (Ticlid) 3. clopidogrel hydrogen sulfate (Plavix) 4. ASA/dipyridamole (Aggrenox)
List the anticoagulant medications used to prevent DVT	1. unfractionated Heparin (low dose subQ) 2. Low molecular weight heparin 3. warfarin (Coumadin)
What do antiplatelet medications do?	prevents platelet aggregatin, thus slowing down clot formation
List the LMWH medications commonly used to prevent DVT	enoxaparin (Lovenox) dalteparin (Fragmin) ardeparin (Normiflo) tinzaparin sodium (Innohep) *fondaparinux sodium (Arixtra)
What is Heparin?	An anticoagulant
What is the antidote for Heparin?	Protamine Sulfate
Why is LMWH used over Heparin in some patients?	It has a longer 1/2 half and a more predictable response
What do the patient's Ptt levels need to be at when on Heparin therapy?	therapeutic levels of Ptt need to be 1-1.5 times the normal level Ex: If Control is 25-35 seconds then the therapeutic level should be 50-70 seconds) (Ptt levels greater than 70 seconds - notify Physician)
What does warfarin do?	inhibits the synthesis of vitamin K (works in the liver)
what should the INR level be at if a patient is not anticoagulated?	<1
what should the INR level be at if a patient is on therapeutic therapy for DVT?	for patients w/orthopedic surgery or for prevention of emboli in patients w/a-fib: INR 2-3 times control **for patients w/prosthetic valve prophylaxis: 2.5-3.5 times the control
What type of medications are used to treat Sinusitis?	broad spectrum antibiotics *sometimes antihistamines, nasal corticosteroid inhalers, analgesics, decongestants and expectorants
What types of medications are used to treat patients w/status asthmaticus?	potent systemic bronchodilators steroids epinephrine oxygen *IV fluids
What are the Coricosteroids used to treat asthma?	anti-inflammatory agents INHALED: 1. flunisolide (Aerobid) 2. triamcinolone (azmacort) 3. fluticosone (Flovent) 4. budesonide (Pulmicort) 5. beclomethasone (Qvar) SYSTEMIC: *prednisone
What do corticosteroids do?	Decrease the antiinflammatory responses in the airway
What are some side effects of inhaled steroids?	fungal infections in the mouth (rinse w/water after use) headache
What are some side effects of Prednisone?	Increased blood sugar in diabetics or puts people at risk for diabetes insomnia *increased appetite
List the SHORT ACTING Beta-2 agonists (bronchodilators) used to treat asthma	1. albuterol (Proventil, Accuneb) most common 2. levalbuterol (Xopenex) 3. pirbuterol (Maxair)
List the LONG ACTING Beta 2 agonists (bronchodilators) used to treat asthma	1. Salmeterol (Serevent) most common 2. formoterol (Foradil)
What do bronchodilators due for asthma patients?	bind to beta 2 agonist receptors in our smooth muscle which results in the relaxation of our airway's smooth muscle
What are some side effects of beta 2 agonists (bronchodilators)?	nervousness, restlessness, tremor, chest pain, insomnia, palpitations
List the combination steroid and long acting beta 2 agonist used for asthma	1. fluticasone/salmeterol (Advair) 2. budesonide/formoterol (Symbicort)
List the Anticholinergics used to treat asthma	1. iprtropium bromide (Atrovent) 2. tiotropium bromide (Spiriva)
List the combination anticholinergic and beta 2 agonists used to treat asthma	1. ipratropium bromide/albuterol (Combivent/Duoneb)
What do anticholinergics do?	Block the parasympathetic pathway and inhibit anticholerginic receptors in our bronchial smooth muscle tissue and produce local bronchodilation
What are the side effects of anticholinergics?	hypotension, headache, nervousness, dizziness
List the Xanthine derivatives used to treat asthma	1. theophylline (Theobid) 2. aminophylline
What should be monitored in patients taking theophylline?	DRUG LEVELS - possible toxicity Signs of toxicity: nausea, anorexia, stomach cramps, diarrhea, confusion, headache, tachycardia, arrythmias, seizures
What do Xanthine derivatives do?	Relax smooth muscle in bronchial airways. Used most often in patients w/needed long-term treatment and control
List the Mucolytics used to treat asthma	acetylcysteine (Mucomyst) guaifenesin (Humabid)
What is important to tell a patient on Mucolytics?	KEEP HYDRATED
List the anti-inflammatory (mast cell stabilizers) meds used to treat asthma	1. cromolyn (Intal) 2. nedocromil (Tilade)
What do anti-inflammatory (mast cell stabilizers) do?	Prevent the release of histamine and slow reacting substance of aniphylaxis from sensitized mast cells
What are some side effects of mast cell stabilizers?	vertigo, headache, fatigue, chest pain, bronchiospasm, cough, unpleasant taste
List the Leukotriene modifiers used to treat asthma	1. zafirlukast (Accolate) 2. montelukast sodium (Singular) 3. zileuton (Zyflo)
What do Leukotriene modifiers do?	prevent airway edema and smooth muscle contraction
What is important to know about montelukast sodium (Singular)?	It has been know to cause depression and suicidal thoughts (Montel - icide)
What nebulizor medications are used on patients w/asthma?	Albuterol Xopenex Atrovent Duoneb
Why are nebulizors used?	they provide faster relief than inhalers do

Both Sides

Chlorpromazine

phenothiazine antipsychotic drug

1/90

Study:	Learn Test

Play Games:	Scatter Space Race

Study:

Learn

Test

Play Games:

Scatter

Space Race

All 90 terms

Terms	Definitions
Chlorpromazine	phenothiazine antipsychotic drug
Thiordiazine	phenothiazine antipsychotic drug
Trifluoperazine	phenothiazine antipsychotic drug
Perphenazine	phenothiazine antipsychotic drug
Fluphenazine	phenothiazine antipsychotic drug
Chlorprothixene	thioxanthene antipsychotic drug
Primozide	antipsychotic drug
Molindone	antipsychotic drug
Clozapine	atypical antipsychotic drug; agranulocytosis; higher affinity to D4 than D2; weight gain; hyperlipidemia; type 2 diabetes
Risperidone	atypical antipsychotic drug; prolactin elevation;
Olanzapine	atypical antipsychotic drug; weight gain; hyperlipidemia; type 2 diabetes
Loxapine	atypical antipsychotic drug
Quetiapine	atypical antipsychotic drug
Ziprasidone	atypical antipsychotic drug; cardiac arrhythmias
Aripiprazole	atypical antipsychotic drug; lower weight gain; little effect on prolactin level; no extrapyramidal side effects; does not take away sense of pleasure
Asenapine	atypical antipsychotic drug
Levadopa	Parkinson's drug; used with carbidopa in form of Sinemet; prevents peripheral decarboxylation of L-DOPA to form DA; converted once inside BBB; alleviates all clinical symptoms of Parkinson's, esp bradykinesia; may cause nausea and vomiting, cardiac stimulation, tachycardia, and postrual hypotension. Depression, delusions, anxiety and agitation
Selegiline	Parkinson's drug; selective MAO-B inhibitor; retard breakdown of DA; use with L-DOPA
Rasagiline	Parkinson's drug; selective, irreversible MAO-B inhibitor; retard breakdown of DA; use with L-DOPA
Entacapone	Parkinson's drug; selective COMT inhibitor; without hepatoxicity; retard peripheral O-methylation of L-DOPA so more reaches brain; shorter action
Tolcapone	Parkinson's drug; selective COMT inhibitor; present in blood and organs ; use with L-DOPA + carbidopa; FATAL LIVER FAILURE possible
Bromocriptine	Parkinson's drug; dopaminergic ergot derivative; D2 seletive DA agonist; reserved for patients with on/off symptoms caused by long-term L-DOPA; treat Hyperprolactinemia
Pergolide	Parkinson's drug; dopaminergic ergot; D1 & D2 agonist; WITHDRAWN due to heart valve damage
Pramipexole	Parkinson's drug; non-ergot;D2 (some D3) agonist; sudden day time sleepiness; compulsive behavior; treatment for Restless Legs Syndrome (RLS)
Ropinirole	Parkinson's drug; non-ergot;D2 (some D3) agonist; sudden day time sleepiness; compulsive behavior; treatment for Restless Legs Syndrome (RLS)
Rotigotine	Parkinson's drug; non-ergot;D3/D2/D1 agonist; transdermal delivery= skin patch; sudden day time sleepiness; compulsive behavior; etc
Benzotropine mesylate	Parkinson's drug; Anticholinergic; improve tremor and rigidity more than bradykinesia; dry mouth, blurred vision, urinary retention, constipation, tachycardia, drowsiness, inattention, restlessness
Trihexyphenidyl	Parkinson's drug; Anticholinergic; improve tremor and rigidity more than bradykinesia; dry mouth, blurred vision, urinary retention, constipation, tachycardia, drowsiness, inattention, restlessness
Procyclidine	Parkinson's drug; Anticholinergic; improve tremor and rigidity more than bradykinesia; dry mouth, blurred vision, urinary retention, constipation, tachycardia, drowsiness, inattention, restlessness
Diphehydramine	Parkinson's drug; Anticholinergic; improve tremor and rigidity more than bradykinesia; dry mouth, blurred vision, urinary retention, constipation, tachycardia, drowsiness, inattention, restlessness
Amantadine	antiviral Parkinson's drug; increase DA synthesis/ release; reversible and mild side effects upon withdrawal of drug
Haloperidol	Butyrophenone antipsychotic drug
Droperidol	Butyrophenone antipsychotic drug
Spiroperidol	Butyrophenone antipsychotic drug
Imipramine	Tricyclic Antidepressant; treat temp. enuresis in children; panic mania disorder; ADHD
Trimipramine	Tricyclic Antidepressant
Desipramine	Tricyclic Antidepressant; ADHD
Clomipramine	Tricyclic Antidepressant; OCD
Amitriptyline	Tricyclic Antidepressant
Nortriptyline	Tricyclic Antidepressant; ADHD
Protriptyline	Tricyclic Antidepressant
Doxepin	Tricyclic Antidepressant
Amoxapine	Tricyclic Antidepressant
Maprotiline	Tricyclic Antidepressant
Trazodone	Atypical Antidepressant; "Priapism"!!= painful prolonged erection of the penis leading to impotence in males; selective blocker of serotonin uptake; few cardiotoxic or anticholinergic SE; Sedative;
Nefazadone	Atypical Antidepressant; Hepatotoxicity!! selective serotonin uptake blocker with no anticholinergic or cardiotoxicity effects
Mirtazapine	Atypical Antidepressant; Agranulocytosis!! effects attributed to central alpha 2 adrenergic receptor antagonism--> increase Serotonin and NE level; weight gain and
Bupropion	Atypical Antidepressant; (Zyban made for smokers to quit smoking); Seizure!!!! uncertain mechanism
Fluoxetine	SSRI antidepressant; panic mania disorder; OCD; Eating disorder;
Sertraline	SSRI antidepressant
Paroxetine	SSRI antidepressant
Fluvoxamine	SSRI antidepressant; OCD
Venlafaxine	SNRI antidepressant
Citalopram	SSRI antidepressant
Escitalopram	SSRI antidepressant
Duloxetine	SNRI antidepressant
Tranylcypromine	MAO-I Antidepressant; block oxidative deamination of catecholamines and 5-HT by MAO; "The Cheese Effect" = tyramine--> massive NE release--> hypertensive crisis
Phenelzine	MAO-I Antidepressant; "The Cheese Effect" = tyramine--> massive NE release--> hypertensive crisis
Isocarboxazid	MAO-I Antidepressant; "The Cheese Effect" = tyramine--> massive NE release--> hypertensive crisis
lithium salt	Bipolar treatment; corrects sleep disorder; complete absorption from GI; urine elimination; low therapeutic index; monitor blood for lithium intoxication (sodium depletion); oral route;
Carbamazepine	anticonvulsant for bipolar; anti-manic/depressant
Valproic Acid	anticonvulsant for bipolar; mood stabolizing; often combined with Li
Lamotrigine	anticonvulsant for bipolar; long-term stabilizing effects;
Nitrous Oxide	Gaseous General Anesthetics; Potency very low, never used alone, cannot produce surgical anesthesia (high MAC). Analgesic potency very high. Primary anesthetic can be reduced by 50%. No serious side effects but does induce nausea and vomiting. Reversible megaloblastic anemia due to low Vitamin B12.
Cyclopropane	Gaseous General Anesthetics; Obsolete: explosive and flammable; Potent; Cardiac arrhythmia
Diethyl ether	General Anesthetics volatile liquid anesthetics; Obsolete: explosive and flammable; Slow, potent;Good analgesic; Nausea and vomiting after recovery; Salivation and respiratory secretion: muscarinic/cholinergic blocker used to stop
Halothane	General Anesthetics volatile liquid anesthetics; Moderate speed, extremely potent; Safe; corrodes metal and reacts with rubber; Good hypnotic; poor analgesic/ muscle relaxant; Bradycardia; sensitize heart to catecholamines-->tachyarrhythmia; Caution with Epinephrine! Depress respiration; Halothane hepatitis Malignant hyperthermia - dandrolene = block Ca2+ release = antidote; Pediatric anesthesia= safe in children and infant ; Use with N20 (for analgesia); Elimination: exhalation
Methoxyflurane	General Anesthetics Obsolete: nephrotoxicity Slowest, most potent Sweet vapor Less cardiac respiratory depression than halothane Better analgesic and muscle relaxant Low dose given discontinuously do not cause F- toxicity Used during first stage of labor Elimination: liver metabolism free F- renal failure
Enflurane	General Anesthetics Moderate speed; potent Sweet vapor Use with N2O (for analgesia) Better muscle relaxant than halothane Elimination: exhalation; small portion liver metabolism>free F- > may cause renal toxicity in lengthy procedures Seizure possibility; avoid use in seizure prone individuals Nausea and vomiting in recovery
Isoflurane	General Anesthetics Most used inhalation anesthetics Isomer of enflurane No cardiac depression/sensitization of myocardium/ seizure No renal toxicity
Desflurane	General Anesthetics Successor to isofurane Extremely fast No metabolism toxicity free
Sevoflurane	Like other halogenated agents Little metabolism some renal toxicity; no perm. Damage
Methohexital sodium	General Anesthetics Ultra short acting Barbiturates Seconds to work Bad analgesics; increase pain level Hypotension; bronchospasm Extensive metabolism (95%) by liver
thiopental sodium	General Anesthetics Ultra short acting Barbiturates Seconds to work Bad analgesics; increase pain level Hypotension; bronchospasm Extensive metabolism (95%) by liver
Balanced anesthesia	 Barbiturate (or N2O) for hypnosis  Opiate for analgesia  Neuromuscular blocker for muscle relaxation
Ketamine	General Anesthetics "special K"; "dissociative anesthesia": immobility, sedation; analgesia; amnesia Unpleasant dreams/hallucination days/weeks after use Ok in children Only used in high risk patients who cannot use vapor anesthetics
Propofol	General Anesthetics New and popular Fast action Clear-headed recovery; good for outpatient use Awake minutes after cessation of drug Profound respiratory depression and hypotension
Fentanyl	Opioid G.Anesthetics -- analgesia, sedation, respiratory depression + droperidol= Innovar: produce "Neuroleptic" effects; use for minor surgical/diagnostic procedures Slow induction + Nitrous Oxide = unconsciousness
Alfentanil	Opioid G.Anesthetics -- analgesia, sedation, respiratory depression
Sufentanil	Opioid G.Anesthetics -- analgesia, sedation, respiratory depression
Remifentanil	Opioid G.Anesthetics -- analgesia, sedation, respiratory depression Rapid onset (<1min) and ultra-short duration (5-10 min)
Cocaine	Local anesthetics Topical use only due to pronounced toxicity Block catecholamine reuptake by nerve terminal in CNS/PNS Potentiation of SNS-->vessel constriction; up blood pressure and heart rate Block Dopamine reuptake by A10 dopamine neurons-->euphoria; abuse
Ethyl aminobenzoate	Local anesthetics Topical use only
Procaine	Local anesthetics standard; infiltration method slow onset and short duration
Tetracaine	Local anesthetics slow onset, longer duration greater toxicity and potency than procaine or lidocaine Spinal anesthesia
Lidocaine	Local anesthetics potent, versatile, faster and longer duration than procaine, more potent often administered with Epi to be rapidly absorbed Sedation and dizziness Cardia antiarrhythmic agent
Mepivacaine	Local anesthetics Like lidocaine with longer duration; not used topically
Dibucaine	Local anesthetics Most potent, toxic, and longest acting available as ointment in US
Bupivacaine	like mepivacaine with longer acting (6-24 hrs) epidural route can cause cardiac toxicities
Thiothixene	thioxanthene antipsychotic drug

Flashcards: pharmacology basics

Both Sides

what is pharmacokinetics

absorption, distribution, metabolism, excretion of drugs by the body

Flashcards: Pharmacology Exam 2 Part 2

Both Sides

Why is heparin NOT administration by mouth?

Not absorbed in GI

1/80

Study:

Learn

Test

Play Games:

Scatter

Space Race

All 80 terms

Terms	Definitions
Why is heparin NOT administration by mouth?	Not absorbed in GI
How is heparin administered?	by IV or subcutaneous (SC) route
How long is the onset action of heparin when given by IV?	immediate
What is the half life of heparin?	short half life of 1.5 hours (except for patients with kidney or liver disease)
Where is heparin metabolized?	in liver
Where is heparin excreted?	in Kidneys
What are the therapeutic uses of Heparin?	-Massive venous thrombosis (fibrin meshwork of clot) such as DVT(deep vein thrombosis), or post op venous thrombosis -Pulmonary embolism -Acute myocardial infarction (AMI) -Open heart surgery -Renal dialysis
In what measured unit does heparin come prepared as multiples of?	1,000 units
What are the adverse effects of heparin?	-Bleeding -heparin induced Thrombocytopenia -Hypersensitivity Reactions -Osteoporosis (long term tx) -Hematoma & Irritation, injection site
What is the antidote for heparin?	Protamine Sulfate
What are the contraindications of heparin?	-Bleeding disorders (esp uncontrollable bleeding) -Thrombocytopenia -Immediate post-op -After lumbar puncture
What are the drug interactions of heparin?	-NSAIDs (i.e. aspirin, Aleve = ↑ bleeding) -Aspirin -valproic acid (Depakene) -Thrombolytics -2nd generation Cephalosporins -Example: Cefotan
What is PTT?	Partial thrombloplastin time (PTT)
Why would you monitor PTT?	...
enoxaparin (Lovenox)	low-molecular weight heparin
What is the mechanism of action for enoxaparin (Lovenox)?	Inactivate factor Xa
What are the therapeutic uses of enoxaparin (Lovenox)?	DVT prophylaxis (prevention of DVT), prevention of ischemic MI complications for non-wave or unstable angina
How is enoxaparin (Lovenox) administered?	SC
What is the antidote of enoxaparin (Lovenox)?	Protamine Sulfate
What is the half life of enoxaparin (Lovenox)?	longer than heparin
When is enoxaparin (Lovenox) the drug of choice?	pregnancy
What are the adverse effects of enoxaparin (Lovenox)?	bleeding, pain or inflammation at injection site
What is the generic/trade for an oral anticoagulant?	warfarin (Coumadin)
What is the mechanism of action of warfarin (Coumadin)?	prevents biosynthesis of clotting factors VII, IX, X, prothrombin (synthesis of Vitamin K
What dietary supplement should one avoid while using warfarin (Coumadin)?	Vitamin K
What is the antidote of warfarin (Coumadin)?	Vitamin K
What are the therapeutic uses of warfarin (Coumadin)?	-Long term prophylaxis: DVT, Atrial fibrillation -Prevention of thromboembolism for patients with prosthetic heart valves -Pulmonary embolism -Reduce risk of recurrent MI, TIAs
What is the route of administration for warfarin (Coumadin)?	Absorbed PO
What is the half-life of warfarin (Coumadin)?	Long half-life: 6 hrs - 2 ½ days
What must be monitored while using warfarin (Coumadin)?	Must monitor signs of bleeding for a few days, even if warfarin is discontinued
Where is warfarin (Coumadin) metabolized?	in liver
How is warfarin (Coumadin) eliminated?	in urine and feces
What are the adverse effects of warfarin (Coumadin)?	-Bleeding, hemorrhage -Fetal abnormalities
List of warfarin (Coumadin) drug interactions?	NSAIDs, aspirin, Sulfa drugs such as Bactrim, heparin, phenytoin, vitamin K, oral contraceptives, cholestyramine
What is PT?	prothrombin time (PT)
Why should PT be monitored?	...
What is PT w/ INR	prothrombin time with international normalized ratio
What are the therapeutic doses for atrial fibrillation INR?	2.0-3.0
What INR for high-risk of clotting?	2.5-3.5
How frequently should PT INR be monitored?	Must monitor PT INR frequently as ordered by clinician or hospital protocols
What levels go up with warfarin treatment?	warfarin levels
What nursing measures should be taken while using warfarin (Coumadin)?	-Monitor CBC & for signs of bleeding -Monitor other labs to get baseline and monitor renal and liver function -Must wear ID bracelet -Safety (use soft bristle toothbrush/no use of razors)
What patient education is required for use of warfarin (Coumadin)?	-Disease process -Rationale for taking drug -Mechanism of action, Adverse effects, drug/food interactions, when to report to clinician when problems occur, frequent laboratory monitoring & explain why it's important, follow up -avoid vigorous activities contact sports like football
ID a few antiplatelet drugs	aspirin clopidogrel (Plavix) ticlopidine (Ticlid) prasugrel (Effient) cilostazol (Pletal) pentoxifylline (Trental) abciximab (ReoPro) eptifibatide (Integrilin) tirofiban (Aggrastat)
What is the mechanism of action for aspirin?	Suppresses platelet aggregation
What are the therapeutic uses of aspirin?	-Prevention of MI -Prevention of stroke (patients with history of TIAs)
What are the adverse effects of asprin?	-Increase risk of GI bleed, peptic ulcer disease (PUD) -Increase risk of hemorrhagic stroke -Bleeding
What is the mechanism of action for ticlopidine (Ticlid)?	similar to aspirin
What are the therapeutic uses of ticlopidine (Ticlid)?	prevention of thrombotic stroke
What is the mechanism of action for clopidogrel (Plavix)?	prevent platelet aggregation, antiplatelet; works like aspirin more expensive than aspirin
What is the therapeutic use of clopidodrel (Plavix)?	Prevention of ischemic stroke
What is the mechanism of action for dipyridamole (Persantine)?	suppresses platelet aggregation
What is the therapeutic use of dipyridamole (Persantine)?	Prevention of thromboembolism after heart valve replacement
What is the adverse effect of dipyridamole (Persantine)?	Similar to those seen in Aspirin
What is the mechanism of action for cilostazol (Pletal)?	platelet inhibitor and vasodilator
What is the therapeutic use of cilostazol (Pletal)?	intermittent claudication (such as arterial insufficiency)
What is the adverse effect of cilostazol (Pletal)?	Peripheral edema, GI discomfort including diarrhea
ID thrombolytic drugs	streptokinase (Streptase) alteplase
What is the mechanism of action for streptokinase (Streptase)?	-Catalyzes conversion of other plasminogen into Plasmin -Clot Buster!
What is the therapeutic use of streptokinase (Streptase)?	-Acute MI -DVT -Massive pulmonary emboli
What are the adverse effects of streptokinase (Streptase)?	-Bleeding -Hypotension -Fever -Antibody production
What are the mechanisms of action for alteplase?	-a.k.a. Tissue Plasminogen Activator (tPA) -Promotes plasminogen to plasmin (which digests fibrin matrix of clots) -Clot Buster!!
What is the therapeutic use of alteplase?	-Acute Myocardial Infarction (MI) -Pulmonary Embolism (PE)
What are the adverse effects of altplase?	-Bleeding/Hemorrhage! -Intracranial bleeding
What is the final step in clot formation?	...
Discuss the difference of Thrombosis and Embolus	...
How does Warfarin (Coumadin) suppresses coagulation?	...
Heparin and Enoxaparin both inactivate factor Xa? A. True B. False	...
Which laboratory test would the nurse use to monitor the patient on Warfarin therapy? Heparin therapy?	...
List one important Nursing Diagnosis for patient receiving anticoagulant, antiplatelet, or thrombolytic drug and discuss why.	...
What is the antidote for heparin overdose? Enoxaparin overdose?	...
What class of drugs are used to prevent arterial thrombosis?	...
Discuss the clinical manifestation of arterial thrombosis	...
What class of drugs are the following? Ticlopidine (Ticlid) ? Clopidogrel (Plavix) ? Give most common indication for each	...
How does aspirin suppresses blood clotting?	...
What are the signs and symptoms of DVT?	...
What is the serious complication of DVT?	...
What are thrombolytics? How can you lower risk of bleeding on patient receiving thrombolytic? Contraindications?	...
ID anticoagulants	fondaparinux (Arixta) warfarin (Coumadin) heparin enoxaparin (Lovenox) tinzaparin (Innohep)
What is the mechanism of action of heparin?	Inactivates thrombin and factor Xa → suppression of fibrin

1/36

Study:	Learn Test

Play Games:	Scatter Space Race

Study:

Learn

Test

Play Games:

Scatter

Space Race

All 36 terms

Terms	Definitions
what is pharmacokinetics	absorption, distribution, metabolism, excretion of drugs by the body
what is pharmacodynamics	biochemical and physical effects of drugs, and mechanisms of drug actions
what is pharmacotherapeutics	use of drugs to prevent and treat diseases
what are the different types of names a drug can have	long chemical, generic, or proprietary/trade/brand
what different types of grouping are used to classify drugs	pharmacological class or therapeutic class
what is the pharmacological class	sharing similar characteristics, eg beta-andrenergic
what is the therapeutic class	grouped by what they're used for eg anti-hypertensives
what use are buccal/subllingual and lingual administration	prevent alteration in the stomach/ small intestine
what use is gastric administration	when oral route can't be used
what use is intradermal administration	allergy, TB tests
what use is intramuscular adminstration	rapid action, large doses
what use are IV adminstrations	go into the bloodstream
which vessels are used for IV	veins
what use is oral adminstration	cheap, convenient, safe. has to be conscious and able to swallow
what use are suppositories	local effect, or can be absorbed systemically through mucosa
what good is the respiratory route	rapid, self administerd metered dose inhaler
what good is subcut adminstration	more rapid into bloodstream than mouth
what factors affect absorption rate	route, intestinal factors, liver 1st pass, blood flow to admin site, pain, stress, contents of stomach, drug form, other drugs or food interactions
what is drug absorption	from adminstration until it becomes available for body use
what is the distribution phase	process by which the drug is delivered to the tissues and fluids of the body
what factors are associated with distribution	blood flow, solubility, protein binding
what part does blood flow play in distribution	highest blood flow (heart, liver, kidneys) get served first
what part does solubility play in distribution	can drugs cross cell membranes or blood brain barrier
what role does protein binding play in distribution	binding to protein makes drugs inactive. 80% = highly protein bound
what is drug metabolism	biotransformation or body's ability to change a drug from its dosage form to water soluble that can be excreted
what ways are there for drug metabolisis	into inactive metabolites, from one active into a different active metabolite, or from inactive drugs to active
what are pro drugs	inactive drugs which become active after being metabolised
where are most drugs metabolised	mostly liver, also kidneys, plasma, intestines
what can affect metabolism	liver disease, liver circulation, genes, environment, stress, smoke, developmental age
what is drug excretion	elimination from the body
where are drugs excreted	mostly kidneys, also lungs, sweat, mammary, intestines, skin
what is the half life of a drug	time for half of the drug to be eliminated from the body
what affects the half life	absorption, metabolism and excretion rates
what is the steady state	rate of drug administration equals rate of excretion
how long does it take for a drug given once to be completely elimintated	about 4 or half lives
how long does it take for a regularly administered drug to reach steady state	about 4 or 5 half lives

Flashcards: Pharmacology Exam 1 (obj. 1-31)

Both Sides

Half-life

the time required for half of the drug to be eliminated from the body

11/42

Study:	Learn Test

Play Games:	Scatter Space Race

Study:

Learn

Test

Play Games:

Scatter

Space Race

All 42 terms

Terms	Definitions
What are the 4 categories of drugs?	-"legend" or prescription drug -OTC or non-prescription drug -investigational drugs -street or illicit drugs
What can you use if you don't know the name of the drug but you know what it looks like?	PDR (Physician's Desk Reference)
Chemical name	Precise description that identifies the chemical structure
Generic name (nonproprietary)	Non-capitalized name of the drug given by United States Adopted Names Council
Offical name	Usually same as generic name (listed by USP and NF)
Trade/Brand name (proprietary)	Given by drug company
Absorption	process of the drug going "from the site of administration, into the body fluid", to the site of action.
Distribution	process of drug being "carried from site of absorption to site of action"
Metabolism (biotransformation)	"breakdown of the drug to a water soluble form" for secretion
Excretion (elimination)	how the drug gets out of the body
Half-life	the time required for half of the drug to be eliminated from the body
Examples of mild allergic reactions	rash, headache, vomiting, and nausea
Example of a severe allergic reaction	anaphylaxis
Idiosyncratic response	opposite effect of the drug (adverse reaction)
Drug tolerance	resistance to an effect of a drug so you require a higher dosage. Can be "physical tolerance" or "psychological tolerance"
Synergistic effect	drugs interact with results greater than their individual actions
Antagonistic effect	one drug diminishes the action of another drug
Displacement	2 drugs, capable of the same function, compete with receptors making them not as effective
Additive effect	excessive drug effect when taking similar drugs with the same outcome
Incompatibility	2 drugs cannot be given together or else the results will be altered
An example of a drug-food interaction	herbal remedies
What can influence the drug response in children?	Body weight and immature organs
What can influence the drug response in the elderly?	Multiple drugs from many resources and decreased kidney function
How can weight influence the drug response?	A person with increased body weight may need an increase in dosage
How does gender play a role with drug response?	Males and females have different body composition (males have more muscle than females)
How can disease effect drug response?	Diseases can affect the client's response to medication by the absorption and distribution
How long do IV medications take to start affecting a patient?	several minutes
Which route of administration is the easiest for patients but the slowest to take effect?	orally
6 rights of the medication administration	Right client, right drug, right dose, right route, right time, right documentation, and the right to refuse
Which medications should not be crushed?	Extended release pills, buffered coating pills, and enteric-coated pills
What are the two ways you can check for the right client?	Have the client say their full name and check the client's ID wristband
If the patient has a nasogastric or G-tube, how should you administer the medications?	Crush the medications (verify if the meds can be crushed)
If the nasogastric or G-tube is clogged, you should....	flush the tube with water
Don't break medications if...	it is not scored
Needle size of IM injections	-21-23 guage -1 in to 1½ in needle
Syringe size of ID injections	1mL
Angle of subcutaneous injections	45° angle into the subcutaneous tissue
Angle of intramuscular injections	90° angle into the muscle tissue
Angle of intradermal injections	10° - 15° angle into the dermis
Sim's position	Patient lies on their side with one leg bent
To administer ear drops in young children...	the pinna should be pulled down and back
To administer ear drops in adults...	the pinna should be pulled up and back