Pharmacology

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Questions and Answers

What is the primary mechanism of action of antidiarrheal medications?

Slow down peristalsis (correct)

Increase fluid and electrolyte excretion

Speed up peristalsis

Increase gut motility

What is a common side effect of diphenoxylate with atropine (Lomotil)?

Abdominal pain

Dizziness and drowsiness (correct)

Headache

Diarrhea

Which of the following patients should not be given antidiarrheal medications?

Patients with constipation (correct)

Patients with severe dehydration

Patients with electrolyte imbalance

Patients with mild dehydration

What is a potential complication of Camphorated opium tincture (paregoric)?

Pseudomembranous colitis Signup and view all the answers

What is the primary use of antidiarrheal medications?

For moderate to severe diarrhea Signup and view all the answers

What is an important nursing consideration when administering antidiarrheal medications?

Assess fluid and electrolyte status Signup and view all the answers

What is a potential effect of codeine?

All of the above Signup and view all the answers

What is the primary focus of pharmacodynamics?

The examination of the effects of foreign chemicals on living systems Signup and view all the answers

What is the term for the process by which a drug is converted into a more soluble form for excretion?

Biotransformation Signup and view all the answers

Which of the following is NOT a nursing contraindication for anxiolytic and hypnotic agents?

Mixing IV drugs with other drugs to avoid potential drug-drug interactions Signup and view all the answers

What is the primary reason for giving IV medications slowly for anxiolytic and hypnotic agents?

To prevent cardiac problems Signup and view all the answers

Which of the following is a type of drug used to treat glaucoma?

Beta-adrenergic blockers Signup and view all the answers

What is the term for the process by which a drug is distributed to the active site in the body?

Distribution Signup and view all the answers

What is the term for the dynamic equilibrium involving several processes that determines the actual concentration of a drug in the body?

Pharmacokinetics Signup and view all the answers

What is the primary diagnosis method for Irritable Bowel Syndrome (IBS)?

Diagnosis of exclusion Signup and view all the answers

What is the primary goal of lifestyle changes in managing IBS?

To manage stress and anxiety Signup and view all the answers

What is the primary mechanism of action of anticholinergic medications in treating IBS?

Reducing bowel spasms Signup and view all the answers

What is the typical pattern of bowel habits in IBS?

Alternating between diarrhea and constipation Signup and view all the answers

What is the primary indication for the use of Tegaserod in IBS?

Constipation-predominant IBS Signup and view all the answers

What is the term for the excess gas and bloating characteristic of IBS?

Excessive flatulence Signup and view all the answers

What is the primary difference between IBS and inflammatory bowel disease (IBD)?

IBS is a functional disorder, while IBD is a structural disorder Signup and view all the answers

What is the purpose of bulk laxatives, such as Psyllium, in managing IBS?

To add bulk to stool and promote regular bowel movements Signup and view all the answers

What is the primary mechanism of action of sulfonamides?

Inhibiting bacterial synthesis of folic acid Signup and view all the answers

Which of the following bacteria is susceptible to 3rd generation cephalosporins?

Klebsiella Signup and view all the answers

What is the primary use of sulfonamides?

For treating urinary tract infections Signup and view all the answers

What is the characteristic of 4th and 5th generation cephalosporins?

Capable of entering CSF to treat CNS infections Signup and view all the answers

What is the common adverse effect of sulfonamides?

All of the above Signup and view all the answers

Which of the following is a 5th generation cephalosporin?

Ceftaroline Signup and view all the answers

What is the characteristic of 3rd generation cephalosporins?

Effective against Klebsiella and Pseudomonas Signup and view all the answers

What is the mechanism of action of sulfonamides?

Bacteriostatic Signup and view all the answers

Why is multiple drug therapy necessary for treating tuberculosis?

To prevent bacterial resistance and increase the chances of successful therapy Signup and view all the answers

Why are nonpharmacologic techniques used concurrently with medication in treating pain?

To allow for lower doses of drugs with fewer adverse effects Signup and view all the answers

What is the primary advantage of using multiple antitubercular drugs in different combinations?

Lowering the potential for resistance and increasing the chances for successful therapy Signup and view all the answers

Why is it critical to take antitubercular medication for 6 to 12 months, and possibly as long as 24 months?

To ensure that the medication is effective against the tuberculosis bacterium Signup and view all the answers

What is the primary purpose of using antitubercular drugs such as pyrazinamide, isoniazid, and rifampin?

To treat and prevent clients who have a positive TB test Signup and view all the answers

Why is it necessary to take precautions to avoid adverse effects when using antitubercular drugs?

Because the drugs can cause adverse effects Signup and view all the answers

What is the primary reason why single drug use is not recommended for treating tuberculosis?

Because it increases the risk of bacterial resistance Signup and view all the answers

What is the primary goal of using multiple antitubercular drugs in combination?

To prevent bacterial resistance and increase the chances for successful therapy Signup and view all the answers

Study Notes

Pharmacodynamics

Pharmocodynamics is the science dealing with interactions between the chemical components of living systems and foreign chemicals, including drugs, that enter those systems.
It examines how a drug affects living tissues within an organism.
The actual concentration of a drug in the body results from a dynamic equilibrium involving several processes:
- Absorption from the site of entry
- Distribution to the active site
- Biotransformation (metabolism) in the liver
- Excretion from the body

Anxiolytics and Hypnotic Agents

Barbiturates include:
- Amobarbital (Amytal Sodium)
- Pentobarbital (Nembutal)
- Phenobarbital (Luminal)
- Secobarbital (Seconal)
Nursing contraindications:
- Assess for baseline status before beginning therapy and for occurrence of any adverse effects
- Do not mix IV drugs with any other drugs to avoid potential drug-drug interactions
- Give parenteral forms only if oral forms are not feasible
- Give IV medications slowly to avoid potential cardiac problems
- Provide standby life-support facilities in case of severe respiratory or hypersensitivity reactions
- Taper dose gradually to avoid precipitating seizures and withdrawal syndrome
- Provide support measures

Pharmacotherapy of Glaucoma

Selected drugs for glaucoma:
- Prostaglandins
- Beta-adrenergic blockers
- Alpha2-adrenergic agonists
- Carbonic anhydrase inhibitors
- Cholinergic Agonists (Miotics)

Antidiarrheals and Opioids

Mechanism of action: slows peristalsis, allowing for more fluid and electrolyte absorption
Primary use: for moderate to severe diarrhea
Drugs:
- Diphenoxylate with atropine (Lomotil)
- Codeine
- Loperamide (Imodium)
- Difenoxin +atropine (Motofen)
- Camphorated opium tincture (Paregoric)
- Bismuth salts
- Lactobacillus acidophilus
- Octreotide (Sandostatin)
Side effects and nursing considerations:
- Assess fluid and electrolyte status
- Assess for blood in stool
- Do not use if constipation should be avoided
- Assess patient's ability to get out of bed safely
- Antidiarrheals contraindicated in some patients, such as those with severe dehydration, electrolyte imbalance, liver, and renal disorders, and glaucoma

Irritable Bowel Syndrome (IBS)

Also known as spastic colon or mucous colitis
Common disorder of the lower gastrointestinal tract
Symptoms:
- Abdominal pain, bloating, excessive gas, and colicky cramping
- Diarrhea alternating with constipation
- Mucus in stool
Causes:
- Functional bowel disorder
Treatment:
- Supportive, symptomatic treatment
- Lifestyle changes, including dietary changes and relaxation therapy
- Altered bowel habits
- Bulk laxatives, such as psyllium
- Anticholinergic medications, such as dicyclomine (Bentyl)
- Tegaserod

Cephalosporins

Mechanism of action: inhibits bacterial cell wall synthesis
3rd generation:
- Cefdinir, cefixime, cefotaxime, ceftazidime, ceftriaxone
- Longer duration of action, resistant to beta-lactamase
- Drug of choice for klebsiella, pseudomonas, Neisseria, salmonella, proteus, and H. influenza
4th and 5th generation:
- Cefepime, ceftaroline
- Effective against organisms that develop resistance to earlier cephalosporins
- 4th generation: capable of entering CSF to treat CNS infections
- 5th generation: effective against MRSA

Sulfonamides

Mechanism of action: suppresses bacterial growth by inhibiting bacterial synthesis of folic acid (bacteriostatic)
Wide spectrum against both gram-negative and gram-positive bacteria
Also known as folic acid inhibitors
Primary use: for urinary tract infections, Pneumocystis carinii pneumonia, and shigella infections of the small bowel
Drugs:
- Trimethoprim-sulfamethoxazole (Bactrim, Septra)
- Sulfadiazine
Side effects and nursing considerations:
- Monitor for hypersensitivity to the drug
- Monitor adverse effects
- Monitor for agranulocytosis

Antitubercular Drugs

Mechanism of action: inhibits bacterial growth and replication
Multiple drug therapy is necessary because the Mycobacteria grow slowly, and resistance is common
Using multiple drugs in different combinations during the long treatment period lowers the potential for resistance and increases the chances for successful therapy
Precautions to avoid adverse effects are required, and the drugs will be required for a longer period than 1 month

Pain Management

Nonpharmacologic techniques, such as relaxation techniques and guided imagery, can be used as an adjunct to medication for pain management
Rationale: may allow for lower doses of drugs with fewer adverse effects

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Description

This quiz covers the concept of pharmacodynamics, which deals with the interactions between drugs and living systems, including how drugs affect the body and living tissues.