Pharm Final Exam Study Guide PDF

Basic Pharm: What are the 4 processes involved in pharmacokinetics? Absorption, distribution, metabolism, excretion What is Bioavailability? The proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect What is...

Basic Pharm: What are the 4 processes involved in pharmacokinetics? Absorption, distribution, metabolism, excretion What is Bioavailability? The proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect What is the first pass effect Metabolism that happens in the liver when a drug is first taken What are the consequences of highly protein bound medications if someone has low protein? Drug toxic is the consequence, it stays in the system and is not able to leave the body What is metabolism (relating to medications) and what organ typically preforms this function? Drug metabolism the body chemically alters drugs so they can be excreted, this process is done in the liver as part of the first pass. Cardio: Name three symptoms of right sided heart faliure? Swelling, Shortness of breath, weight gain Name 3 side effects of ace inhibitors? Dry cough, low blood pressure, high potassium levels How do cardiac glycosides work in the body? What do they treat? What side effects are we monitoring for toxicity? Cardiac glycoside work by inhibiting the sodium-potassium pump, on the cell membranes of the heart muscle cells. They treat heart failure and atrial fibrillation and atrial flutter.The side-effects blurry vision, headache, lightheadededness, rash, sleepiness, abnormal heart rhythms List 2 central acting calcium channel blocker and 1 peripheral acting calcium channel blocker. What side effects are we concerned about with each? The two central acting calcium channel blockers are diltiazem and verapamil, Side effects are constipation, swelling, HR, Allergic reactions and shortness of breath. ABT-639 is a peripherally acting calcium channel blocker that selectively blocks T-type calcium channels, the side effects Drowsiness and euphoric mood List the Lab monitoring and antidote for coumadin and Heparin? The lab that monitors heparin is aptt and the antidote is protamine sulphate. The lab for coumadin is PT and INR, Vitamin k is the antidote Gastro: Which class of medication should be avoided or used with caution because they have been associated with causing gastric ulcers? Nonsteroidal anti-inflammatory (Nsaids) How long should antacids be spaced out from other medications? 1-2 hours before or after What Class of GI medication, used for GERD, Effectiveness is greatly decreased by smoking? Histamine H2 blockers, smoking can increase acid production can lower the effectiveness of the H2 blocker What Class of GI medications completely stops acid production and can lead to stomach infections Proton pump inhibitors during long term use can increase risk of H.pylori Name one contraindication for antidiarrheals?What is the recommended duration of therapy? Constipation or Bowel Impaction kids can take but based on their weight. Respiratory: Common side effects and precautions of first generations Antihistamines? Drowsiness and reduced coordination, reaction of speed time and judgement. What are two key teaching points for a patient taking fluticasone (Flovent) ? Use it regular, even with no signs or symptoms, Report if you have any signs or symptoms of a rash. Name the three layers of the bronchial and what medications would work on each layer? Smooth muscle, they are muscle cells wrapped spirally around the wall, Submucosa, fibroblast embedded in connective tissue, Mucosa basement membrane A patient was given albuterol(Ventolin) Via a nebulizer for an asthma exacerbation The patient calls for the nurse into the room and complains of “shaky” and HR of 120, B/P 130/72, RR 18. Given this assessment data, what does the nurse believe the patient is experiencing? Shaking, tremors and a high heart rate is a common side effects List 3 Side Effects for short term and long term use of systemic Corticosteroids? Long term use of Corticosteroids, needing to increase medication use, withdrawal syndrome, insomnia, elevated blood pressure. Increased blood sugars and infection CNS: What is Narcan and what would it be used for? Narcan is also called Naloxone and it is used to treat opioid overdoses What are the three uses for Nsaids, Additionally what property dose ASA have?List 3 side effects of Nsaids Nsaids are used for pain relief, fever reductions, inflammation reduction. Aspirin treats mild to moderate pain, inflammation or arthritis, lowers the risk of stroke or blood clotting. Bleeding, damage to kidney, bruising, Gastrointestinal issues. What Class of medications is Tylenol? What is the dose limit? Tylenol is a analgesic, it helps treat fevers and pain. What major organ is affected by toxicity of this medication? Tylenol is toxic to the liver in large doses, over 3000 mg in a day. List three adverse reactions of Antiepileptics Drowsiness, mood changes, swollen gums. What generation of anti-psychotics tend to have more side effects? What are those side effects? First generation have more side effects, Bradykinesia, tremor, Tardive dyskinesia, Neuroleptic malignant syndrome Abbreviations: BID=Twice daily TID= three times daily QID= four times daily STAT= now, immediately IM=intramuscular IV= intravenous SQ=Subcutaneous PO=by mouth SL=sublingual OD=right eye OS=left eye OU=both eyes AD=Right ear AS=Left ear AU=both ears PRN= as needed Qh=Every hour Qd=Everyday Qod=Every other day Hs= at night Ad lib= as desired Autonomic NS: Priority assessments for beta blockers Heart rate and blood pressure Describe beta 1 and beta 2 locations and how the body responds when they are blocked? Beta 1 is located in the heart and beta 2 is located in the lungs. Sympathetic Nervous system affects on Cardiac activity (HR & B/P) The SNS increases both hr and blood pressure Lung Bronchi and RR The SNS increases the respiratory rate by causing bronchodilation Pupils The sns dilated the pupils to allow a better vision GI The SNS slows down digestion by reducing motility, and blood flow to the gut. Parasympathetic Nervous system affects on Cardiac activity (HR &B/P) PNS decreases the HR and B/P at rest Lung Bronchi and RR Decreases the respiratory rate by narrowing the airways Pupils PNS constrict the pupils GI PNS allows movement in the GI tracts and increases secretion. What is the expected therapeutic response to atropine given IV? Atropine increases hr and decreased GI and respiratory secretions Anti Infective: These two antibiotics classes have a similar chemical structure and have a potential for cross sensitivity? Penicillin and Cephalosporin both belong to the beta-lactam antibiotic family. Gentamicin is what type of ATB? What labs would you monitor with this? Gentamicin belongs to the class Aminoglycoside, The serum Creatinine and BUN are the labs you would monitor, it can be toxic to the kidneys. What is a peak and trough, and when/why would we use them? Peak and trough are drug levels in the body, Peak is when it is at it’s highest levels, while the trough is the drugs lowest. Describe the symptoms of phlebitis and allergic reaction and what steps the nurse should take with each? Phlebitis is an inflammation in the vein signs and symptoms are redness, warmth and pain in the affected area. Remove the IV, monitor patient and apply heat can reduce symptoms. Allergic reactions depend on the body, but can range from itchy skin to swelling. Prevention by assessment and patient awareness What class of ATB is not for children under 8 and can cause tooth discoloration? Tetracycline are not good for kids under 8 because they can cause tooth discoloration. Hormones: Which class of oral antidiabetics needs to be held 48hr after a CT with contrast? Biguanides also known as Metformin should be held 48hrs after CT scans with contrast Names the three P’s of hyperglycemia Polydipsia which is excessive thirst Polyuria frequent urination Polyphagia Excessive hunger List the symptoms of hypoglycemia, and what nursing actions would you take? The symptoms of hypoglycemia are sweating, shaking, fast heart beat, nervousness or anxiety, irritability and confusion. Response would be to check blood sugar levels, administer fast acting carbohydrates and if it is severe administer glucagon. When giving thyroid replacement medication levothyroxine, what side effects should you teach the patient to seek medications? They have to be taken 30-60 mins before eating breakfast and should be taken at the same time. Side effects can be heat intolerance, sweating, diarrhea. It helps with treating hypothyroidism How long does it take for thyroid suppression medication Tapazole or PTU to take effect? It can 4 to 12 week to see improvement, it does start to function with in 24-36hrs.