Pharm II - FINAL
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Pharm II - FINAL
Comprehensive Review 1st 2nd semester Pharm
What are the 5 rights of the patient?
What is Pharmaceutics?
How the drug dosage affects the body
What is the 1/2 life of a drug?
How long it takes 1/2 of the drug to go through pharmacokinetics
Where does Absorption take place?
Where does Distribution take place?
What is the first pass effect?
It is where 1/2 of the drug is taken out by the liver before the body can use it
Where does Metabolization take place?
Where does excretion take place?
Kidney (& breast milk)
The nurse is giving a medication with a high first pass affect. The Doctor changes the route from IV to PO - what does the nurse anticipate of the oral dose?
A higher dose needs to be administered.
What is a mechanism that knows no age?
What age related changes might be contributing to a different reaction to taking medicine?
What physiologic changes take place in pregnancy?
Increased risk for drug toxicity because the mobility of the bowel has been decreased allowing for a longer time for absorption
When do most teratogenic effects occur?
1st trimester - (31-81days)
What is physiologically different about infants related to medicine?
They are at increased risk for adverse reactions because their organs are immature resulting in an increased sensitivity.
When does gastric motility mature in infants?
Dosing in children: Under age 1 - ?
give LOWER dose
Dosing in children: Older than 1 year of age - ?
Increase the dose
What can glucocorticoids cause in children?
What can Tetrcyclines cause in children?
Discoloration of teeth
What can Sulfonamides cause in children?
What can Aspirin cause in children?
What can Fluorquinolones cause in children?
Anytime an IV drug is changed to PO - what would you expect the dosage to be?
Which has a faster onset - PO or IV?
What are the contraindications to Oral Contraceptives?
Family history of DVTs
What drugs decrease the effectiveness of Oral Contraceptives?
St. Johns Wart
What drugs do Oral Contraceptives decrease the effectiveness of?
What drugs do Oral Contraceptives increase the effectiveness of?
What are Tocolytics (terbutaline, nitedipine, indomethacin) used for?
Uterine relaxant to stop contractions
When should taking Yaz be avoided?
when taking drugs with K+ because it has aldosterone in it
When should a vaginal suppository be given?
At night due to itching & discharge
What is a side effect on Heparin?
What is Oxytocin given for?
To induce labor or to stop PP hemorrhage
What is an adverse effect of Oxytocin?
How do you prevent STI?
Condom & Abstinence
How is Vulvovaginitis prevented?
Avoid bubblebaths, thongs, fragrant lubes
Wear cotton underwear
Void & wash after sex
What is the treatment for Vulvovaginitis?
Metronidazote topical or vaginal
(Diflucan only given 1 day treatment)
Pros of tight glycemic control?
Prevent organ damage
Cons of tight glycemic control?
More at risk for hypoglycemic events
Which type of diabetes is it more important to keep a tight glucose control?
Type 1 Diabetes (70-110)
What are the rapid acting insulins?
What are the Long acting insulins?
(take once daily - do not mix with IV)
What are the regular insulins?
Which insulins can you give IV?
Regular (Humulin & Novolin)
Which insulin should you never mix?
What is significant about the drug interaction between insulin & beta blockers?
Beta blocker mask the symptoms of hypoglycemia (tachycardia palpitations). Therefor the defense mechanisms of hypoglycemia are being altered - which makes hypoglycemia worse.
How does drug dosage need to be altered for hypothyroidism during pregnancy?
Drug dosage needs to be increased
If not recieving appropriate amount of thyroid medication - what might it cause during the first semester?
What does steroid use cause in relation to diabetes?
Steroids cause hyperglycemia, so insulin dosages need to be increased.
R131 Iodine Patient Teaching:
Must be over 30
CI in lactation & pregnancy
Half life is 8 days
2-3 mos. for full effect
3 ft. away from people
Avoid public places/services
Don't share items
What occurs during the 3rd trimester of pregnancy for women?
Renal blood flow is increased and excretion is increased.
Why must Catecholines (epi, norepi) be given IV?
Because they can't cross the blood brain barrier
What drug is given to treat Parkinson's?
SE of Levodopa?
Darken sweat & urine
CI of Levodopa?
What is specific to Levodopa that you do not do with any other drug?
take Drug Holidays
Normal "side effects" of Levodopa?
On & Off Phenomona - first 2 years the drug works great then after that it starts to wear off and around year 5 it doesn't work anymore
How should you mix insulins?
Clear (regular) before Cloudy (NPH)
Breastfeeding related to taking medicine?
Breast feed immediately before taking medicines
Beta blocker/calcium channel blockers
Adverse effect of Cyclosporine?
What interacts with Cyclosporine?
What are some side effects on Nitroglycerin?
What is the the therapeutic effect of Digoxin?
Increases myocardial contractility - slows down heart rate & cardiac output is increased!
Therapeutic range of Digoxin?
0.5 - 0.8
S/S of Digoxin Toxicity?
Halos around lights (visual probs)
Patient teaching for Nitroglycerin pill?
Place under tongue to work - should tingle!
Store in original, dark container
Replace every 3 months
Store at room temperature
Patient teaching for nitroglycerin patch?
Take off 8 hrs/day to prevent tolerance
What is nitroglycerin contraindicated with?
Beta & CC Blockers
Patient teaching when taking Nitroglycerin?
When having chest pain place under tongue (should feel tingle) & rest
Take 1 every 5 minutes until pain is gone - may take a total of 3 pills
Which drug has a "First Dose Effect"?
Prazosin (alpha-1 antagonists)
What are alpha-1 antagonists used to treat?
BPH & Hypertension
Pheochromocytema & Reynauds
Side effects of Alpha-1 antagonists?
What is Adenosine used to treat?
Paroxysmal Supraventricular Tachycardia (SVT)
How should you give Adenosine?
IV push RAPIDLY!
SE of Adenosine?
When when you give Lidocaine?
Ventricular Tachycardia (decrease PVCs)
Therapeutic Range of Lidocaine?
1.5 - 5
What drug manages Lidocaine toxicity?
What is DoButamine used to treat?
What is Dopamine used for?
Shock - Increase CO & renal perfusion (protects kidneys)
What are the side effects of Resperine?
What is Resperine used for?
Hypertension (not preferred)
What do Beta Blockers end in?
What do ACE Inhibitors end in?
Metaprolol is what type of beta blocker and where does it work on to reduce BP?
Reduces BP in the Heart
Propanolol is what type of beta blocker and where does it work on to reduce BP?
Reduces BP in the Heart & Lungs
Metaprolol or Propranolol??
Contridicated in Asthma pts.
If someone is wanting to stop taking BetaBlocker what should they do?
Contact physician and taper off of dose
When should you hold a Beta Blocker?
What is the drug of choice for anaphalactic shock?
Adverse Effects of Epinephrine?
When is Epinephrine used?
-vasoconstriction & bronchialdilation
Patient teaching for Alzheimers Disease?
Drugs may slow the prognosis a little but will not prevent further damage from occuring
What test is there for Lovanox?
What drug do you give for Torsaddes de Pointe?
What does Methyldopa do?
Decreases BP in sitting and standing individuals
Macrocrytic or Microcrytic:
Macrocrytic or Microcrytic:
Macrocrytic or Microcrytic:
Decresased MCV, MCH, and MCHC=
iron deficiency anemia
Increased MCV, MCH, and RDW=
vitamin b12 and folic acid
What is the treatment for Cardiac Arrest?
If a patient does not have nitroglycerin and they are experiencing chest pain what should they do?
Chew 325mg of Aspirin
What lab measures Coumadin?
What lab measures Heparin?
Why do you use Heparin And Coumadin together?
Heparin is a short term therapy that is used until Coumadin gets to its therapeutic level then wears off
Complications of Heparin?
H ypersensitivity reaction
When would you use Heparin?
Populations at risk for anemia?
chronic blood loss
How should you take iron?
with vitamin C aids absorption
Ca blocks so dont take with milk
What type of food should you avoid with nasal vitamin b 12 supplement?
Normal values for PTT
How much Folic acid should you take if you aren't pregnant?
How much Folic Acid should you take if you are pregnant?
5,000 - 10,000
A person needs the drug to function normally
Physiological response to a stimulus after prolonged use