Pharmacology Flashcards

D- dig level 2ng/ml or greater is toxic
I- inhibits sodium potassium ATPase
G-GI or CNS signs indicate adverse effects (N/A for adult toxicity, stomach upset in older child
O-output, intake, and weight should be monitored
X- dont give if pulse is less than 60 bpm
I- indicated for CHF- a-fib
N- note K+, ECG, and renal function tests

N- nervousness (undesirable effect)
A- angina, arrhythmia (undesirable)
S- sugar is increased
C- cardiac arrest
A- allergic reaction
R-respiratory bronchodilator

S- stim alpha and beta adrenergic receptors
H- hypovolemia- should be corrected before using drug
O- output of urine should increase
C- constriction of blood vessels
K- keep monitoring vital signs every 5-15 min

A- avoid alcohol
N- note BP and apical pulse before admin
G- given to relax the vascular smooth system
I- indicated for angina pectoris
N-note for postural hypotension; rise slowly
A- advice client to see medical assistance if pain is unrelieved after 3 doses with 5 min interval

S- suppresses renin angiotensin aldosterone system
W- warn clinet with renal or thyroid diseases
E- ends with pril- captopril (capoten) enalapril (vasotec)
R- rise slowly to reduce orthostatic hypotension
T- treatment of htn
E- evaluate BP

end in lol- atenolol (Tenormin)
B- bradycardia
B- blood pressure too low
B- bronchial constriction
B- blood sugar is masked when low

amlodipine (norvasc), diltiazem (cardizem), nifedipine (procardia)
B- blocks calcium access to cells
I- indicated for htn
L- let client take drug with milk or meal
L- light and moisture- protect

D- diet; increase K+ for all except aldactone
I- intake, output, daily weight monitoring
U- undesirable effects- F&E imbalance
R- review HR, BP, and electrolytes
E- elderly careful, evening dose not recommended
T- take with or after meals and in AM
I- incrase risk of orthostatic hypotension, move slowly
C- cancel alcohol and cigs

prothrombin time is monitored 1.5-2.5 X control is the therapeutic range
Vit K is the antidote
Green leafy veg should be avoided

C- check vital signs, platelte count, and PT
O- observe bleeding
R- review bleeding protocol
A- avoid ASA, may use acetaminophen

PTT must be monitored 1.5-2.5 X control
Antidote is protamine sulfate
hospitalization is required for IV heparin

B- bleeding, brochospasms- undesired effects
L- lowers risk of atherosclerotic events
E- evaluate bruising
E- evaluate liver function
D- do take with food or after meals

competitive inhibitors of HMG-COA reductase, an enzyme necessary for cholesterol biosynthesis
indicated for hypercholesterolemia
atorvastatin (lipitor), simvastatin (zocor)

S- statin is the ending
T- take with food and at bedtime
A- always consume 2-3 L of fluid daily
T- teach client to do exercise and weight reduction as well
T- treat hypercholesterolemia
I- increase fiber in diet
N- never give if with liver disease

M- monitor superinfections
E- evaluate renal/liver function
D- diarrhea- take yogurt
I- inform provider prior to taking other meds
C- cultures prior to initial dose
A- alcohol is out, ask about allergy
T- take full course
E- evaluate cultures, WBC, temp, blood

end in mycin
*serious infections caused by gram- negative infections

G- gulp 10-12 glasses of fluid daily, GI distress (undesirable effect)
O- output and input monitor closely
U- uric acid production decreased, use no alcohol
T- take after meals

G- gingival hyperplasia
U- use alternate birth control
M- mouth care; preventative dental check up
S- soft toothbrush don't stop abruptly

L- level therapeutic 0.6-1.2 meq/l
I-increased urination
T- thirst increased
H- headache and tremor
I- increase fluids

L- local anasthetic
I- ICU popular antiarrythmic
D- digitalis toxicity used
O- orally inactive
C- cinetidine+ propanolol
A- decrease Automacity
I- inactivated Na Channel blocker
N- nystagmus
E- eye blurred vision, ECG change

Beta-1 are therefore primarily in the heart.
Beta-2 primarily in the lungs.

A taxia
B lood dyscrasia
C left lip
D upuytrens / Vit D deficiency
E xfoliation of skin & Stevens Johnson's
F its
G I upset/gum hypertrophy
H epatitis/hairy

A taxia
B ehavioral disturbance
C oncentration decreased/coma
D epression/drowsy/diplopia

C ough
A naphylaxis
P alpitations
T aste
O rthostatic hypotension
P otassium elevated
R enal impairment
I mpotence
L eukocytosis

C-cushings syndrome
O-osteoporosis
R-retardation of growth
T-thin skin n easy brusibility
I-infections n immunosupression
C-cataract n glaucoma
O-odema
S-supression of HPA axis
T-thining n ulceration of gastric mucosa
E-Emotional disturbance
R-rise in BP
I-Increase in hair growth(hirsuitism)
O-otherz like fetal abnormalties n hypokalemia
D-diabetes mellitus precipitation
S-stria

Digoxin,
Diuretics,
Dilators

STOP breathing":
Sedatives and hypnotics
Trimethoprim
Opiates
Polymyxins

If you forget your TB drugs, you'll die and might need a PRIEST":
Pyrazinamide
Rifampin
Isoniazid (INH)
Ethambutol
STreptomycin

"You'd get a respiratory infection if you shoot an ARO (arrow) laced with viruses into the lungs":
ARO:
Amantadine
Rimantadine
Oseltamivir

stomach problems
alters PSA
watch for bloody urine

before couldn't think well.. now can think better!

a major complication with this medicine is lactic acidosis

0.5 ml

3 times

identify sensitivity to contact materials such as soap, pollen, and dyes.. allergen on patch is placed in contact with back, arms, or thighs. Patch is left in place for 48 hours. Site is aired for 15 min, then read. Wheal is the definitive reaction measured from 1+ to 4+. Emergency equipment must be available in case of anaphylaxis.

1-2 min

down and back
*older than 3 up and back
They should remain in position for a few min after application

vigorously 5-6 times prior to use. The client may position her mouth around the device or 2-4 cm in front of mouth

not to be shaken, and the client should place the mouthpiece between lips.

*For DPI and MDI client should exhale and then inhale the med deeply through the mouth for 3-5 sec and then hold breath for 5-10 sec.

the spacer keeps the med in the device longer and thereby facilitates delivery of the med to the lungs and decreases the amount of med deposited in the oropharynx. This is beneficial for the delivery of glucocorticoids

tragus of the ear with finger

refrigerated! Remove foil wrapper and lubricate supposiory if needed. Instruct client to retain med and not expel it. Rectal suppositories are insterted beyond the internal sphincter and vaginal suppositories are inserted with an applicator.

used for irritating meds, solutions in oils, and aqueous suspensions.
common sites are the ventrogluteal, dorsogluteal, deltoid, and vastus lateralis (peds).
needle gauge 22-25, 18-27 needle size
1 1/2 inch long and inject 90 degree angle.

1-3 ml. If a greater amount is required it should be divided into 2 syringes and two different sites should be used.

prevents medication from leaking back into subcutaneous tissue
used for meds that cause visible or permanent skin stains such as certain iron preps

tuberculin testing or checking med/allergy sensitivities
may be used for cancer immunotherapy
small amount of solution 0.01-0.1 ml in a tuberculin syringe with a fine gauge needle 26-27 in lightly pigmented, think skin, hairless site. 10-15 degree angle

They should not be crushed or diluted as med will be absorbed at a faster rate than recommended.

immediately after breastfeeding so this will minimize med concentration in the next feeding

pt in lithotomy position, elevate hips with pillow
remain in position for 5-10 min after application
wash applicator with warm soapy water after each use.

treat bacterial, viral, and fungal infections

are effective against a few species of microorganisms such as gram positive cocci, gram positive bacilli, and gram neg aerobes

effective against a wide variety of microorganisms

specimens for a culture and sensitivity test

around the clock to maintain therapeutic blood levels

rash
anaphylaxis
suprainfection
organ toxicity (nephrotoxicity and ototoxicity)
decrease oral contraceptives effectiveness

weaken the bacterial cell wall

gram + cocci such as streptococcus pneumonia (pnuemonia and meningitis)infectious endocarditis, streptococcus pyogenes (pharyngitis)

meningitis - gram neg cocci and for treatment of syphillus

no, b/c penicillin inactivates aminoglycosides when mixed in same IV solution

observe client 30 min following admin of parenteral penicillin
monitor clients kidney function and cardiac and electrolyte status

cephalosporins, grouped into 4 generations. they are broad spectrum with a high therapeutic index that treat UTI, post op infections, pelvic infections, and meningitis

food, oral cephalosporin suspensions should be stored in the refrigerator.

prevent bacteria from reproduction

meropenem, beta lactam antibiotics that destroy bacterial cell wall
effective for serious infections like pneumonia, peritonitis, and uti cause by gram positive cocci, gram neg cocci and bacilli, and mixed aerobic and anaerobic bacteria.

beta lactam antibiotics destroy bacterial cell wall
*drug of choice for serious infections caused by methicillin resistant staph and c-diff

1-2 hrs after completion of IV infusion. Appropriate peak levels are between 30-40 mg/ml

clear breath sounds, wound healing, improvement of sx of antibiotic associated pseudo colitis symptoms such as resolution of diarrhea and negative stool cultures for c-diff.

other meds- doxycycline. Broad spectrum antibiotics that inhibit microorganism growth by preventing protein synthesis (bacteriostatic). Tx acne. 1st line med for rickettsia (rocky mountain spotted fever, typhus fever, infections of urethra or cervix caused by chlamydia, lyme disease, anthrax, GI infections caused by h.pylori and periodontal disease.

children under 8, yellow/brown tooth discoloration
avoid taking it at bedtime to reduce the risk of esophageal ulceration

should take tetracyclines at least 1 hr before and 2 hr after taking food and supplements containing calcium and mag

doxycycline and minocycline

erythromycin, clindamycin, axithromycin, etc
slows the growth of microorganisms by inhibiting protein synthesis. At high doses it can be bactericidal.

treat infection in clients with a penicillin allergy. ex) diptheria, whoop cough, chlamydia.

antihistamines, theophyline (asthma med), carbamazepine (anticonvulsant), and warfarin (anticoagulant). result in toxicity

bactericidal antibiotics disrupt protein synthesis. med of choice against aerobic gram neg bacilli

ototoxicity and nephrotoxicity

30 min after admin IM or IV.

TMP- bactrim. inhibit bacterial growth by inhibiting synthesis of folic acid. folic acid is essential for production of DNA, RNA, and proteins.

for uti caused by e.coli and other infections (otitis media, bronchitis, shigellosis, pneumonia)

clients with a folate deficiency, b/c it increases the risk of megaloblastic anemia. Avoid use in pregnancy and lactation risk of kernicterus increases. Do not use if creatinine clearance is less than 15 ml/min

on an empty stomach with a full glass of water

isoniazid INH, streptomycin, ethambutol, pyranzinamide

highly specific for mycobacteria. Inhibits growth of mycobacteria by preventing sysnthesis of mycolic acid in cell wall. Indicated for active and latent use.
latent- INH only daily for 6 months
active- multiple med therapy including INH, rifampin, pyrazinamide, and/or pyridoxine daily for 6 months.

Liver function tests are elevated

admin 50-20 mg of vit b6 daily

on an empty stomach 1 hr before meals or 2 hrs after. Can taken INH with meals if GI upset occurs.

prevents reproduction of viral DNA
med of choice for HSV, chicken pox, and cytomegalovirus.

tx of choice for CMV retinitis in immunocompromised clients with HIV, transplant clients at risk for CMV infection. Med of choice for CMV (cytomegalovirus).

stop treatment. Cell counts improve within 3-5 days.

it is tetratogenic, women should avoid pregnancy during course of therapy and for 90 days after the end of therapy. males should be informed about sterility.

IV bolus, it should be administered by IV infusion slowly over 1 hr or longer. Clients should understand than acyclovir diminishes symptoms but does not cure the virus. For topical admin advise client to put on rubber gloves to avoid transfer of virus to other areas of body.

ciproflaxacin (cipro), levaquin, floxin
inhibits the activity of DNA gyrase, an enzyme needed for the replication of bacteria
broad spectrum antimicrobials used for gram - and gram +, klebsiella, ecoli

risk of achilles tendon rupture

N, V, diarrhea, discomfort, dizzy, light headed

quinolones.. contraindicated in children, pregnancy
potential for permanent cartiladge dammage

12 hours for 60 days

sulfanomides

metronidazole (flagyl)
only effective against anaerobic bacteria

GI discomfort, dry mouth, metallic taste, dark urine (harmless effect of med), CNS symptoms (stop med)

no more bloody muscoid diarrhea,
has formed stool, neg stool for ameba and giardia. Negative blood cultures for anaerobic organisms in the CNS

synercid
inhibit protein synthesis or bacterial cells
Treat VRE and MRSA

Alter cellular RNA synthesis and phosphate metabolism
tx- tb
S/E- N, V, A, abdominal cramps
serious- red greeen vision change, confusion, hallucination, blurred vision

decrease neurologic side effects

prevent RNA synthesis by inhibiting DNA dependent RNA polymerase
use- eliminate meningococci and H. influenza type b, hib from asymptomatic carriers
s/e- reddish orange discoloration of secretions

acts on fungal cell membranes to increase cell permeability which results in leakage of intracellular cations leading to cell death. These agents can be fungistatic (slow growth) or fungicidal (destroys fungus).

clotrimazole, miconazole, ketoconazole, nystatin,

tx systemic life threatening fungal infections. Administration of amphotericin B should be infused slowly over 2-4 hr by IV route. Renal dammage can be lessened with administration of 1L saline solution on the day of amphotericin B infusion.

antifungal used to tx superficial fungal infections; dermatophytic infections, tinea pedis, tinea cruiris.

fever, chills, rigors, h/a 1-3 hr after innitiation. Pretreat with diphenhydramine (Benadryl) and aspirin. Meperidine or dantrolene may be given for rigors
use lipid based prep of amphotericin B to minimize reactions

stop cell division and new growth
tx ringworm
s/e N,V, abdominal cramps

produce antibodies IgA, IgD, IgG, IgE, or IgM

activate B cells and are responsible for teh delayed hypersensitivity reaction

destroy target cells directly causing death of the microorganism

dosese at birth, 1-2 months and 6-18 months

doses at 2, 4, 6, 15 to 18 months, and at 4-6 yrs

11-12 years

every 10 years following DTAP

dose at 2, 4, 6, and at 12-15 months

dose at 2, 4, 6 to 18 months, and at 4-6 yrs

12- 15 months and at 4-6 years

single dose at 12-18 months or 2 doses administered 4 weeks apart if administered after age 13

dose at 2,4,6, and 12-15 months

2 doses 6 months apart after age 12

begin at age 6 months (october through november)

a dose at age 11-12 years

pregnant women and children who are allergic to eggs, gelatin, and neomycin
client with hx of thrombocytopenia, or thrombocytopenic purpura
immunocompromised children
clients with advanced HIV
for clients who recently recieved blood products or immunoglobulins

severe febrile illness
occurence of encephalopathy 7 days after administering DTAP immunization
an occurence of seizure within 3 days of vaccination

prior hx of anaphylactic reaction
an allergy to bakers yeast

no, vaccine is grown in eggs and may contain small amount of egg proteins. conduct a skin test prior to administration

annually after age 50, earlier if specific risk factors

one dose at age 65 and revaccinate every 6-8 years after initial vaccination

passive immunity and provide gamma globulin antibodies
effective when- prevention of infection and increase platelets

within 6 days of measles exposure, 7 days of hep B exposure, and within 14 days of hep A exposure

immunostimulant enhance host immune response and reduce proliferation of cancer cells

hairy cell leukemia, chronic myelogenous leukemia, malignant melanoma, AIDS

flu like sx, bone marrow suppression, alopecia, cardiotoxicty, neurotoxicity, hypotension

antihypertensives, retrovir ( increase risk of neutropenia), theophylline

store med in refrigerator and do not freeze. Administer at room temp. Do not shake vial. Admin subcutaneously or IM as prescribed.

cyclosporine, glucocorticoid, prednisone, cytotoxics, imuran, prograf, rehumatrex

suppression of the proliferation of b cells and t cells.
immunosuppressants are used for the tx of autoimmune disorders, RA, SLE, myasthenia gravis, early type 1 diabetes.

famvir, inhibit viral replication, tx recurrent infections of genital herpes and acute herpes zoster

hiv inhib viral replication. Used in combin with other antiviral agents to HIV-1.

H1 receptors which results in blocking histamine release in the small blood vessels, capilaries, and nerves during an allergic reaction.

contraindicated during the third trimester of pregnancy for mothers who are breastfeeding and for newborns. Newborns are sensitive to the sedation effects of this med

cytoxan, methotrexate, rheumatrex,
destroy cancer cells as well as healthy cells by preventing the replication of DNA.

bone marrow suppression
GI discomfort,
alopecia
mucositis
reproductive toxicity- males sperm bank before tx
hyperuricemia- elevated levels of uric acid may cause renal dammage
* administer allopurinol is uric acid level is elevated.

individualized

before the occurence of hair loss

postponed 3-6 months.

no, but it has analgesic and antipyretic effects

tinnitus, sweating, headache and dizziness, respiratory alkalosis

1 week

food, milk, water to reduce gastric discomfort

provides analgesia w/o anti-inflammatory. Ketorolac should ne used no more than 5 days. Usually started as a parenteral administration and then progresses to oral doses.

4 g

mucomyst

places client at risk for bleeding, watch for bruising, petechia, hematuria,

act on the mu receptors, produces analgesia, respiratory depression, euphoria, and sedation,
relieve of moderate to severe pain

12 bpm

CNS depressants (barbituates, benzo's, and consumption of alcohol)

for distention by palpating the lower abdomen area every 4-6 hr

premature infants and after biliary tract surgery

do not administer more than 600 mg/24 hr and limit its use to less than 48 hrs

don't, it can further lower BP...

intravenously slowly over a period of 4-5 min, have narcan and resuscitation equipment available.

on a fixed schedule around the clock, not when necessary

morphine

stadol and talwin
low potential for abuse
less respiratory depression
cause analgesia, sedation, and decrease GI motility
tx- of mild to moderate pain

cramping, htn, vomitting, may be precipitated when given to clients who are physically dependent on opiod agonsits.

tx of opiod overdose
reversal of respiratory depression
S/E- tachypnea and tachycardia
abstinence syndrome may also occur

IV,IM, or SC. Do not administer orally.

tricyclic antidepressants- elavil
anticonvulsants- tegretol, neurontin, dilantin
CNS stimulant- ritalin, dexedrine
antihistamine- vistaril
glucocorticoids- decadron, deltasone
biphosphonates- didronel and aredia

*used in combin with opiods, cannot be used as a substitute