Pharm 5

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Pharm 5
2015-11-09 20:56:31

Pharm exam 5
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  1. Afrin complications
    • only use 3-5 days cause of rebound congestion.
    • Not for long term use. 
    • Addictive
    • Also can cause minor stinging and drying of mucus membranes
    • *is an intranasal sympathomimetic - most commonly used decongestant
  2. antihistamine receptors
    antihistamines are drugs which selectively block the actions of histamine at the H1 receptor

    Also referred to as H1 receptor antagonist
  3. antihistamine AE
    • drowsiness
    • Dry mouth
    • tachycardia
    • hypotension
    • may cause photosensitivity
    • *some pt's exhibit CNS stimulation, sometimes called paradoxical excitation
    • **anticholinergic effects: Can't poop, can't pee, hot as a hatter red as a beet
  4. benadryl side effect to report
    report to doc if can't pee = urinary hesitancy
  5. expectorant indication
    • used for dry, non-productive cough
    • promotes mucus secretion by making mucus thinner and easier to move
    • Ex: guaifenesin, robitussin, mucinex
  6. intranasal glucocorticoid administration
    • *used to treat sx of allergic rhinitis
    • administer 1-3 wk prior to exposure
    • avoid swallowing
    • Ex:  Fluticasone (Flonase)
    • *alternative to mast-cell stabilizers
  7. Opioid antitussive indication
    • severe cough remedy
    • In many OTC cough meds, marked DM for dextromethorphan (↤ name)
    • not warrantied for asthma or COPD pt
  8. oral and intranasal decongestant differences
    intranasal has fewer side effects

    oral has more systemic effects, response time is slower. Has chemical used to make meth
  9. pseudoephedrine illegal use
  10. pseudoephedrine side effects
    HTN, CNS stimulant, insomnia & anxiety

    Contradicted in pt w/ HTN

    Advise pt because it can be used to make meth, pharmacist has to log purchases. Will be asked to show ID
  11. Ch 39
    12 ?'s
  12. asthma medication teaching
    • Teach how to reduce asthma attacks:
    • Avoid triggers
    • keep taking meds, even when you feel good
  13. asthma pathophysiology
    • Is an inflammatory disease which includes bronchospasm
    • Along with bronchoconstriction, an acute inflammatory response stimulates histamine secretion, which increases mucus and edema in the airways
  14. beta agonist adverse effect
    • *most effective for relieving acute bronchospasm
    • Tachy, palpitation, HA, throat irritation, tremor, nervousness, restlessness
    • Ex: Albuterol
  15. Bronchodilators mechanism of action
    • blocks parasymp. nervous system
    • relaxes smooth muscle
    • beta2 agonist
    • Ex:  
    • Ipratropium (Atrovent)
    • Theophylline (Theo-Dur) ... related to caffine
  16. Dry powder inhaler mechanism
    • DPI
    • process of inhalation delivers a fine powder directly to the bronchial tree
    • activated by inhalation
    • Ex:  Turbuhaler and Rotahaler
    • *should be noted there is a potential to produce systemic effects by inhalation because there is always some degree of drug absorption across pulmonary capillaries.
  17. Glucocorticoid inhalation side effect
    • needs to be limited to under 10 days
    • AE is thrush in mouth (oral candidiasis)
    • Important to rinse mouth after use
    • DONT use during attack
  18. inhalation therapy teaching
    • Proper use of inhaler:
    • Use spacer if instructed
    • Shake inhaler (or load tablet/pwder)
    • press inhaler while inhaling
    • rinse mouth after using
    • rinse inhaler & spacer w water daily
    • *If using bronchodilator and corticosteroid, use broncho first, wait 5-10 mins, then use cortico to ensure drug reaches deeper in bronchi
  19. inhaled drug advantages
    • the respiratory system offers a rapid and efficient mechanism for delivering drugs
    • enormous surface area of bronchioles and alveoli, and rich blood supply to those areas, results in almost instantaneous onset of action
  20. inhaler education
    • inhale deeply and hold each breath as long as you can
    • Some inhalers can cause fungal infection, important to rise mouth after and SPIT! don't swallow
  21. ipratropium contraindication
    • *Advent, is an anticholinergic = bronchodilator
    • No for pts with glaucoma, renal disorders or enlarged prostate (BPH=Benign Prostatic Hyperplasia) 
    • Not for kids less than 12 yrs
  22. Leukotriene mechanism of action
    • reduces leukotrienes, which are mediators of immune response
    • Ex: Zafirlukast (Accolate)
  23. Zalfirlukast indications
    used for asthma prophylaxis
  24. ch 40
    7 ?'s
  25. antacid side effects
    • magnesium or aluminum may cause diarrhea (MOM)
    • Calcium may cause constipation
    • Can also cause or aggravate kidney stones
    • increased level of magnesium in blood (those w renal failure)
  26. bismuth mechanism with H-pylori
    • Pepto
    • inhibits bacterial growth
  27. GERD treatment goal
    reduce gastric acid secretion
  28. intrinsic factor purpose
    • secreated by parietal cells
    • essential for the absorption of vitamin B12
  29. misoprostol side effects
    • *also called Cytotec, used to treat PUD
    • inhibits gastric secretion, stimulate protective mucosa
  30. PPI teaching
    • administer before breakfast on an empty stomach
    • Capsules and tablets should not be chewed, divided or crushed
    • May be taken with antacids
    • Prego Cat C
  31. PUD risk factor
    • #1 cause is H. Pylori infection
    • family history
    • tabacco
    • caffeine
    • glucocorticoids
    • NSAIDs
    • Stress
    • Increased Gastric Acid
  32. Sucralfate administration
    • also called Carafate
    • Take on empty stomach, 4x daily
    • Has protective coating, consisting of sucrose and an antacid to protect lining
  33. Ch 41
    6 ?'s
  34. Compazine side effects
    • Is a type of phenothiazine, used to treat N/V
    • causes dry mouth
  35. lomotil mechanism of action
    • slows peristalsis and allows water reabsorption
    • *is diphenoxylate w atropine
  36. metamucil administration
    • is a bulk-forming laxative 
    • mix w/ at least 8 oz water, fruit jouice or milk, and administer immediately
    • follow each dose with an additional 8 oz of liquid
    • observe older adults closely for possible aspiration
  37. orlistat side effects
    • used in obesity to absorb fat
    • if pt eats too much fat, may have oily stools
    • includes flatus w discharge, abd pain and discomfort
  38. stimulant laxative administration
    • take with water to help absorption
    • should only be used occasionally as they may cause laxative dependence
  39. stool softeners mechanism
    • promote water absorption into intestine
    • Mostly used to prevent constipation
    • Ex: Docusate (Colace, Dulcolax)
  40. ch 42
    7 ?'s
  41. B12 deficiency complications
    causes pernicious anemia
  42. calcium absorption
    can be inhibited by inadequate intake of calcium rich foods, lack of vit D, chronic diarrhea, or decreased secretion of parathyroid hormone
  43. lipid soluble vitamin side effects
    • normal dose no side effects
    • high dose: N/V fatiuge, irratibility, night sweats, alopecia, dry skin
  44. Parenteral nutrition complication
    • infection ~ need to check temp
    • High blood glucose ~ check blood sugar
    • can also cause bloating
  45. TPN prevention of complications
    check temp and blood sugar
  46. Vegetarian nutritional deficiencies
    • also in Vegans
    • Vit B12 
  47. vitamins in pregnancy
    • folic acid 
    • prevent neural tube defect
  48. How are herbal supplements regulated
    In US, viewed as dietary supplement
  49. herbal supplements testing
    • Have not been tested in prego women
    • don't know safety, so not labeled for safety
  50. What herbs interfere with K
    • Certain herbs increase bleeding
    • *all start with G
    • Green tea
    • garlic
    • ginsing
    • ginger
    • ginkgo
    • evening primrose