Pharm Exam 2

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bndittert
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109558
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Pharm Exam 2
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2011-10-17 11:30:44
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Souter Exam
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Eyes, GI, Asthma, Drugs
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  1. lowers IOP by facilitating aqueous humor flow
    side effects: heightened brown pigmentation of iris, eyelid and eyelashes
    Latanoprost
  2. lowers IOP indirectly by contraction of ciliary muscle and production of miosis
    side effects: local irritation, eye pain, brow ache, renal detachment and decrease in visual acuity
    Pilocarpine
  3. Side effects of optic administration of beta blockers
    Hint: local & systemic
    • Local: conjuctivitis, blurred vision, photophobia and dry eyes
    • Systemic: lungs and heart of great concern
  4. a water-soluble dye that detects lesions of the corneal epithelium. abrasions and other defects turn bright green
    Used topically or IV to assess aqueous humor flow -- IV used to facilitate retinal blood vessels, evaluate diabetic retinopathy and other abnormalities of the retinal vasculature
    Flurorescein
  5. a prokinetic drug that increases GI tone and motility
    used to suppress postoperative N&V, emesis associated w/ cancer chemotherapy, radiation therapy, toxins and opioids
    indications: GERD, CINV and diabetic paraesis
    Reglan
  6. motility antispasmodics
    dicyclomine and hyoscyamine
  7. antibiotic cocktail to treat ulcers
    Nexium (esomeprazole), Amoxicillin, and Clarithromycin
  8. acts topically to disrupt cell wall ofH. pylori, thereby causing lysis and death
    antibiotic
    #1 side effect is black hairy tongue and black stool
    Bismuth (pepto-bismol)
  9. effective antiulcer medication that promotes ulcer healing by creating a protectibe barrier against acid and pepsin
    antiulcer drug/ a mucosal protectan
    dosage 1gm 4x/day, taken 1 hour before meals and at bedtime
    Carafate
  10. this type of treatment are antisecretory agents that suppress acid secretion by blocking (a certain type of) receptors on parietal cells
    H2 receptor antagonists
  11. Examples of (antisecretory agents) H2 receptor antagonists
    Pepcid, Zantac, Axid, Tagamet
  12. an antisecretory agent that enhances mucosal defenses
    an antiulcer drug that prevents gastric ulcers caused by long-term therapy of NSAIDs, helps protect stomach by suppressing secretion of gastric acid, serves as a replacement for endogenous prostaglandins
    side effects: diarrhea, abdominal pain
    Cytotec
  13. prevention and treatment of duodenal ulcers; prevpack pack contains lansoprazole, amoxicillin and clarithromycin
    taken immediately before meals; 15 or 30 mg 1x/day
    side effects: diarrhea, abdominal pain, nausea
    Prevacid
  14. an antibiotic for ulcer therapy
    disrupts cell wall and is good when given with Omeprazole (prilosec, a PPI)
    Amoxicillin
  15. examples of proton pump inhibitors
    Nexium, Prevacid, Omeprazole (prilosec), protonix, aciphex
  16. suppresses acid secretion by inhibiting H+, K+ - ATPase, the enzyme that makes gastric acid
    Proton Pump Inhibitors (ends in "-azole")
  17. an H2 receptor antagonist
    promotes secretion of gastric acid, reduces both volume of gastric juice and its hydrogen ion concentration, suppresses basal acid secretion and secretion stimulated by gastrin and acetylcholine
    since this drug produces selective blockade for H2 receptors, the drug cannot reduce symptoms of allergy
    promotes healing of gastric and duodenal ulcers, drug of choice to relieve s/s of GERD, promote healing of ulcers in pt's w/ Zollinger-Ellsion syndrome, prevents aspiration pneumonitis
    side effects: confusion, hallucinations CNS depression or excitation, etc in elderly pt's w/ hepatic or renal impairment
    Tagamet (cimetidine)
  18. releases carbon dioxide in stomach to cause belching and flatulence
    side effects: constipation, hypercalcemia, metabolic alkalosis, soft tissue calcification and impaired renal function
    Antacids -- Calcium carbonate
  19. Drugs to control and induce vomiting a diarrhea; examples of antiemetics
    Phenegran, Zofrn, Lomotil and Immodium
  20. an opioid, nonspecific antidiarrheal agent, ANTIEMETIC
    used only for diarrhea, taken orally, no significatn side effect on CNS
    Lomotil
  21. antiemetic
    used to prevent N&V associated w/ radiotherapy and anesthesia by blocking serotonin (5-HT) peripherally, centrally, and in small intestines; very effective by itself but even more effective when combined w/ dexamethasone (glucocorticoid used for nausea associated w/ chemotherapy)
    side effects: N/A
    Zofran (ondansetron)
  22. used to treat diarrhea and reduce the volume of discharge from ileostomies by suppressing bowel motility and from suppressing fluid secretion into the intestinal lumen
    Immodium
  23. antihistamine, H1 receptor antagosits (sedative), and antiemetic
    acts on CTZ (chromoreceptor trigger zone) to decrease vomiting, increases CNS stimulation; acts on blood vessels, GI and respiratory ssytem; decreases allergic response
    side effects: dizziness, drowsiness, poor coordination, fatigue, euphoria, confusion, parasthesia, neuritis, EPS, and neuroleptic malignant syndrome
    Phenergan
  24. drugs to relieve constipation
    laxatives, catharsis, Purgative (go lytely)
  25. soften stool and reduce painful elimination
    leisure, relatively mild effect
    laxative
  26. prompt fuid eevacuation out of bowel
    effect: relatively fast and intense
    Cathertics
  27. 4 types of laxatives
    bulk-forming, stimulant, surfactant, and osmotic laxatives
  28. a laxative safe for people w/ cardiovascular or renal problems and if they are dehydrated
    osmotic + bulk-forming laxative
    Purgative (go lytely)
  29. produces soft, formed stool 1-3 days after onset of treatment
    bulk-forming laxative
  30. produces a soft stool several days after onset of treatment
    surfactant laxative
  31. produces a semi-fluid stool w/in 6-12 hours
    stimulant laxative
  32. produces a soft or semi-fluid stool in 6-12 hours
    osmotic laxative
  33. a stimulant laxative
    site of action in colon; stimualtes peristalsis and softens feces by increaing secretion of water and electrolytes into intestine and decreasing water and electrolyte absorption
    unique among stimulant laxatives b/c it can be administered recal suppository and orally
    Bisacodyl
  34. examples of 5-HT3 receptor antagonists
    • Zofran (ondansteron), granosetron, dolasetron, palonosetron
    • ends in "-tron"
  35. receptors located in the CTZ and on afferent vagal neurons in upper GI tract; relieves CINV
    what additional drug would you expect to administer concurrently w/ these type of drugs
    • 5-HT3 receptor antagonists
    • dexamethasone
  36. common, chronic inflammatory disorder of the airways (airway inflammation results from immune respnse to known allergens)
    asthma
  37. identify 2 current treatments options for asthma
    anti-inflammatory drugs and bronchodilators
  38. small, hand-held, pressurized device that delivers a measured dose of drug w/ each actuation
    must begin to inhale prior to activating device, wait 1 minuted between puffs if 2 puffs are need, typically 1-2 puffs, hand-lung coordination required
    1 expansion
    metered-dose inhalers
  39. these devices are available to be used w/ MDI devices and attach directly to the MDL. they increase delivery of the drug to the lungs and decrease deposition of the drug on oropharyngeal mucosa. some of these devices contain one-way valves that activate upon inhalation, so a person needs good hand-lung coordination. some of the devices have alarms that'll sound when inhalation is too rapid
    spacers
  40. small machines used to convert a drug solution into a mist for inhalation. droplets in mist are much finer than those in inhalers. inhalation done w/ facemask or mouthpiece. takes several minutes to deliver the same amount of the drug contained in 1 puff from an inhaler.
    USED WHEN PT'S ARE RESISTANT TO BRONCHODILATERS. BRONCHODILATION - LUNGS KEEP EXPANDNG AND EXPANDING compared to an inhaler where you only get 1 expansion
    nebulizers
  41. drugs most commonly used in inhalers
    ALBUTEROL (beta drug), cromolyn, zieluton, singulair, theophylline, ipitoprium
  42. this drug is used for prophylaxis of asthma; suppresses bronchial inflammation
    what would you expect patient outcome to be?
    • Cromolyn
    • pt will have suppressed/decreased inflammation
  43. relaxes smooth muscles of bronchi, bronchioles, and pulmonary blood vessels; inhibits the enzyme phophodiesterase, thus increasing cyclic AMP, which promotes bronchodilation
    this drug is a methylxanthine employed in asthma, has a narrow therapeutic index therefore dosage must be controled
    side effects: GI disturbances, nervousness, irritability, cardiac dysrythmias, tachycardia, palpitations and hyperglycemia
    theophylline
  44. appropriate plasma levels for theophylline
    considered toxic at what level?
    • (5-15 in peyton's notes) 10-20 from book
    • levels above 20 are considered toxic
  45. makes cough more productive by stimulating the flow of respiratory tract secretions (guiafesin)
    (stimulates flow of respiratory tract secretions to make cough more productive)
    expectorant
  46. suppresses cough, some act w/ CNS and some act peripherally (dextromethorphan)
    antitussives
  47. reacts directly w/ mucous to make it more watery (mucomyst) to help make cough more productive
    (makes mucous more watery to make cough more productive)
    Mucolytics
  48. effects of antihistamines in mild allergic reactions
    • in mild allergies are caused largely by histamine, so they are generally responsive to antihistamines
    • suppose to decrease nasopharyngeal secreations, itching and tickling that causes sneezing
  49. effects of antihistamines in severe allergic reactions
    histamines play a much smaller role in anaphylaxis therefore antihistamines are of little help for treatment
  50. side effects of antihistamines on allergic reactions
    • sedation (most common) dizziness, confusion, nausea, vomiting, diarrhea
    • ANTICHOLINERGIC EFFECTS: DRYING OF MUCOSA MEMBRANES IN MOUTH, NOSE AND THROATE, urinary hesitancy, constipation
  51. these 2 things differ in antihistaminic efficacy and the ability to cause sedation and muscarinic blockade
    1st generation vs 2nd generation antihistamines
  52. CNS depression (SEDATION)
    side effects: dry mouth, urinary hesitancy, drowsiness
    1st genertion antihistamine
  53. nonsedating antihistamines, poor cross of BBB, largely devoid anticholinergic effects, now available OTC
    2nd generation antihistamines
  54. inhibits leukotriene formation; bronchodilator; pt's will be able to breathe easier
    Singulair (montelukast)
  55. glucocorticoids, msot effective in antiansthma drug available
    teaching?
    side effects?
    • inhaled steroids
    • teaching: take on fixed schedule, used spacer if using MDI w/ CFCs but no spacer if using MDI w/ HFA
    • side effects: oropharyngeal candidasis (hoarsness) and dysphonia (difficulty speaking), adrenal suppression, osteoporosis, decreased growth in kids, hyperglycemia, and PUD
  56. reduced outflow of aqueous humor through chamber angle, causing IOP to gradually increase since fuid cannot leave the eye at the rate it is produced OR narrowed angle and forward displacement of iris
    glaucoma
  57. fuid pressure w/in the eye
    intraocular pressure
  58. powerful suppressant of acid secretion; approved for short-term therapy of duodenal ulcers, gastric ulcers, erosive esophagitis, and GERD. long-term therapy for Zollinger-Ellison synfrome
    dosing: take before meal
    Prilosec (PPI, omeprazole)
  59. approved for treatment and prevention of duodenal ulcers and treatmet of gastric ulcers, GERD, and hypersecretory states (Zollinger-Ellison syndrome)
    Pepcid (H2 receptor antagonsit, Famotidine)
  60. this drug is similar to Prilosec - a powerful suppressant of acid secretion; approved for short-term therapy of duodenal and gastric ulcers, erosive esophagitis, and GERD. long-term therapy fr hypersecretory states (Zollinger-Ellison syndrome)
    this drug achieves higher BP, lasts longer
    side effects: headache, diarrhea
    Nexium (esoemeprazole, PPI)
  61. antibiotic
    very effective against sensitive strains of H. pylori/ resistance
    do not take if pregnant and don't consume alcohol
    Flagyl (Metronidazole)
  62. surfactant laxative, type 3
    alter stool consistency by lowering surface tension, which facilitates penetration of water into feces
    produces a soft stool after several days of onset treatment
    Docusate
  63. prototype surfactant
    docusate sodium
    Colace
  64. dopamine antagonists
    suppresses emesis by blocking dopamine receptors in CTZ. reduces emesis associated w/ surgery, cancer chemotherapy and toxins
    what are the extrapyrimidal symptoms?
    Phenothiazines and EPS
  65. helps colon absorb water to soften feces and increase thier mass; effect is leisurely and relatively mild
    fiber laxative
  66. a PPI
    for duodenal and gastric ulcers, GERD and hypersecretory states (Zollinger-Ellison syndrome)
    Protonix (Pantoprazole, PPL)
  67. 2nd generation (nonsedating) H1 antagonist antihistamine, poorly cross BBB, administered orally and through nasal spray
    a metered spray used for allergic fhinits
    Azelastine
  68. for allergic rhinitis and chronic idiopathic urticaria, causes more sedation than other 2nd generation antihistamines, but less sedation that 1st generation antihistamines
    side effects: drowsiness, fatigue, dry mouth/nose/throat
    Zyrtec
  69. a sympathomimetics that is used for nasal decongestion; causes vasoconstriction (shrinks swollen membranes), only relieves stuffiness
    what do you combine sympathomimetics with?
    • Afrin
    • combine sympathomimetics + antihistamines
  70. for allergic rhinites, asthma and common cold; blockade of cholinergic receptors inhibits glandular secretions, thereby decreasing rhinorrhea; does not readily cross membranes
    side effects: nasal drying and irritation
    Ipratropium bromide

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