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2014-03-23 18:31:43
Pharm 1
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  1. Drugs with "car" in them.
    Muscarinic agonists
  2. What effect of alpha stimulation is a big deal for diabetics?
    they decrease insulin secretion which increases BGL
  3. What does alpha stimulation increase?
    afterload, workload, BP, BGL
  4. Why is there a decrease in coronary outflow with alpha stimulants?
    because they cause constriction of the coronary (and cerebral) arteries
  5. What do alpha stimulants decrease?
    • insulin secretion
    •  GI motility
  6. What is SC epinephrine used for?
    to control topical superficial bleeding or delay absorption of local anesthetics
  7. Side effects of alpha adrenergic agonists.
    • increased BP
    • Necrosis if given IV (due to vasoconstriction)
    • bradycardia (reflex slowing of heart)
  8. How would an ANS drug treat angina?
    • increase BF
    • decrease HR, contractility, & workload of heart
  9. How would an ANS drug treat heart FAILURE?
    • increase contractility (pump harder to get more blood out), dilate aorta
    • decrease after load
  10. How do ANS drugs treat BPH? (Benign Prostatic Hypertrophy)
    decrease squeeze, increase flow
  11. How would an ANS drug help in anaphylactic shock?
    • decrease HR
    • bronchodilate
  12. Which organs only receive SYMPATHETIC innervation?
    • spleen
    • sweat glands
    • pilorector muscles
    • most BV
  13. What are the adverse effects of B1 stimulation?
    • tachycardia
    • dysrhythmias
    • angina
    • palpitations
  14. What are the effects of B1 stimulants?
    • Stimulates HEART to increase:
    •     C.O. & force of contraction
    •    HR
    •    conduction
    • -also stimulates renin release & lipolysis
  15. Side effects & adverse effects of B2 adregnergic agonists.
    • *increases BGL*
    • insomnia
    • nervousness
    • dysuria
    • headache/flushing of face
    • ADVERSE: tremors, hyperglycemia
  16. What is a drug given for pre-term labor?
    terbutaline (IV or PO) - a B2 stimulant
  17. Effects of B2 stimulants.
    • bronchodilation
    • decreased bronchial secretions
    • dilates arterioles to skeletal muscle, heart, & lungs
    • glycogenolysis (*can deplete glycogen stores)
    • relaxes detrusor muscle of bladder w/ difficulty urinating
  18. How does a beta-blocker affect a diabetic differently than someone without diabetes?
    It blocks the s/s of hypoglycemia
  19. What type of drugs cannot cross the BBB?
    Catecholamines (Epi, NE, Dopa)
  20. Adrenergic agonist catecholamines are rapidly degraded by what?
  21. By what route are catecholamines administered?
    IV only
  22. Which adrenergic agonists have a short half-life?
  23. Which adrenergic agonists are not broken down by MAO?
    noncatecholamines (terbutaline, ephedrine)
  24. Which adrenergic agonists can be given PO?
    noncatecholamines (terbutaline, ephedrine)
  25. What are the side effects of beta-1 adrenergic agonists?
    • angina
    • altered rhythms of heart:
    •     tachycardia
    •     palpitations
  26. Adrenergic agonists are given with CAUTION to patients with what?
    • Angina
    • Diabetes
    • Dysrhythmias
    • Glaucoma
    • HyPERthyroidism
    • HyPERtension
  27. How do adrenergic agonists interact with MAOI's?
    epinephrine is NOT inactivated (so the levels increase)
  28. How do adrenergic agonists interact with tricyclic antidepressants?
    blocks re-uptake of NE
  29. How do adrenergic agonists interact with general anesthetics?
    May sensitize heart, increasing risk of severe dysrhythmias
  30. With adrenergic agonists, what should a nurse do when administering drugs with alpha activity?
    • Check BP q 2-5 inutes til stable, then q15 min
    • -adjust dosage to maintain systolic BP between 80-100
    • Dilute meds
    • Evaluate IV site continuously - no IVP thru that line!
    • Monitor:
    • -PULSE rate
    • -if > 110, decrease flow rate
    • -EKG strip for dysrhythmias
    • -UOP -should be 30 ml/hr

  31. Why is it important to know if a med is selective or nonselective?
    nonselective can also affect the respiratory system
  32. What med is nonselective?
  33. -olol drugs.
    Beta blockers
  34. -zosin meds.
    Alpha1 blockers
  35. Why should you evaluate an IV site continuously when adinistering adrenergic agonists with alpha activity?
    tissue necrosis may result from infiltration (vasoconstriction)
  36. Antidote for a muscarinic agonist (poisoning).
  37. Antidote for an irreversible cholinesterase inhibitor.
    pralidoxime (protopam)
  38. Antidote for heparin.
    protamine sulfate
  39. What kind of drug is atropine?
  40. What do anticholinergics cause?
    • can't pee (dilated bladder)
    • can't see (dilated & dry eyes)
    • can't spit (dry mouth)
    • can't shit (dry stool)
  41. What kind of drug is used preanesthesia to decrease secretions?
    muscarinic antagonist
  42. "-cur-" drugs.
    neuromuscular blockers
  43. Antidote for cholinergic poisoning.
    Muscarinic antagonist (physostigmine)
  44. "-mine" drugs.
    muscarinic antagonists
  45. Drug used to reverse non depolarizing neuromuscular blockade.
    Parasympathetic stimulant (anticholinesterase inhibitors)
  46. At what level of the drug is a side effect usually seen?
  47. How do you calculate the therapeutic index?
    lethal dose divided by effective dose
  48. Does a high or low therapeutic number indicate it is safer?
  49. If a drug has a TI (therapeutic index) of ______  it has highly increased mortality.
    less than 1
  50. Why do babies have more unbound drugs when administered?
    they have less plasma proteins
  51. increased levels of _____ in pregnant women cause decrease in gastric tone and intestinal motility and delayed gastric emptying.
  52. How is absorption rate affected in pregnant women?
    they have delayed gastric emptying, which meand drugs remain in GI tract longer and extends absorption time
  53. How does preganancy affect respiratory drugs?
    • progesterone increases pulmonary BF, tidal volume and minute volume by 40%, 
    • so respiratory agents are absorbed in larger quantities
  54. Beta-blockers antagonize the effects of _______ which means what for heart?
    • catecholamines
    • decreased HR, force, & conduction
  55. Antidote to BB?
    atropine or isoproterenol (B-agonist)
  56. Alpha blockers are used to treat what?
    • BPH
    • Hypertension
    • Migraines (prevents, doesn't treat)
    • Glaucoma
    • Stage fright
  57. Renin release is normally stimulated by ______, which is why ______ inhibit their release.
    • catecholamines
    • beta-blockers
  58. What do MAOs do?
    break down catecholamines
  59. What does an anticholinesterase do?
    stops breakdown of ACh
  60. How does ACh affect the HR?
    decreases it
  61. What type of drugs are used to treat glaucoma?
    • Muscarinic agonists
    • Anticholinesterase
  62. Function of muscarinics
    • relieve intraocular pressure (glaucoma)
    • relieve urinary retention
    • promote GI motility
  63. What kind of drugs act to decrease BP in an emergency and nonselectively inhibit the entire ANS?
    nicotinic ANTagonists
  64. Three things that a neuromuscular blocker can cause.
    • Hyperkalemia (transient release of K+ due to depolarization)
    • increased intraocular pressure
    • decreased BP
  65. Antidote for muscarinic antagonists (atropine).
  66. How does ACh affect the muscles?
    activates skeletal muscles
  67. Tetracycline has an affinity for _____.
    bone (calcium) which can make teeth dark gray and can stain teeth in young kids
  68. ______ inhibits the P450 system which increases the ______ of a drug.
    • Grapefruit
    • toxicity
  69. If a drug decreases the P450 system, what does that mean?
    metabolism is decreased
  70. What is the P450 system?
    Drug metabolism that takes place in the liver
  71. ________ drugs go back into the bloodstream; while _____ drugs get urinated out.
    • lipid-soluble;
    • ionized
  72. ______ drugs are NOT filtered by the glomeruli.
  73. What is Lovenox?
    a low-molecular-weight heparin (SQ)
  74. How is the dosage for Lovenox calculated?
    based on pt's wt
  75. Thrombolytics are more effective if given within ____ of clot formation.
    4 hours
  76. How is hemophilia treated?
    • By replacing the missing clotting factor or
    • by inhibiting coagulation
  77. Examples of CCBs.
    • amlodipine (Norvasc)
    • diltiazem (Cardizem)
  78. What is significant about adenosine?
    it opens K+ channels and can stop the heart
  79. What are CCBs used for?
    angina and High BP (vasodilate coronary arteries)
  80. What are Na+ channel blockers used for?
    to suppress cardiac arrythmias
  81. What is lodocaine?
    a sodium channel blocker
  82. What drug blocks K+ channels?
  83. What are SSRIs?
    • treat depression; ex:
    • -Prozax & Luvox
  84. What is Lasix?
    a loop diuretic to increase urine and Na+ output for treatment of edema
  85. If the peak of a drug is too high or too low, what does that mean?
    adjust the dose
  86. If the trough of a drug is too high or too low, what does that mean?
    adjust the time interval
  87. If the peak of a drug is normal, but trough is too high, how do you fix it?
    space out the doses
  88. ______ is a platelet enhancer that is not given within 24 hours of chemotherapy.
  89. Concurrent use of ____ with thiazide or loop diuretics may cause serious hypokalemia.
    neumega (platelet enhancer)
  90. What type of WBC is stimulated by G-CSF?
  91. What type of WBC is stimulated by GM-CSF?
    Neutrophils & Macrophages
  92. What is the ADP receptor blocker prototype drug?
  93. "pharin" drugs.
  94. ______ disorders are caused by too much clotting.
  95. _______ disorders are caused by too little clotting.
  96. When are thrombolytics such as streptokinase given?
    stemi in progress
  97. Nimotop (nimodipine) drugs work on _____ ______.
    cerebral vessels
  98. What kind of drug would you give to a pt to stop spasming after brain surgery, or a closed head injury?
    nimotop (nimodiPINE)
  99. A side effect of CCB (veinous).
    persistent peripheral edema
  100. A side effect of a CCB (arterial).
    Orthostatic hypotension
  101. How does a CCB interact with digoxin?
    increases serum digoxin levels
  102. Action of centrally acting adrenergic inhibitors.
    • inhibit alpha -1 stimulation
    • decrease BP
    • decrease HR, & contraction
  103. Centrally acting adrenergic inhibitors exacerbate the action of ______.
    other CNS depressants
  104. What major side effect can occur after a few days of Nipride (vasodilator, IV)?
    CNS toxicity, cyanide toxicity in RF