NURS 2407 Pharmacology Exam 1 Study Guide NURS 2407 Pharmacology Exam 1 Study Guide, Exams of Nursing

Download NURS 2407 Pharmacology Exam 1 Study Guide NURS 2407 Pharmacology Exam 1 Study Guide and more Exams Nursing in PDF only on Docsity! NURS 2407 Pharmacology Exam 1 Study Guide Pharmacology Exam #1 Module 1 – Foundations of Pharmacology Key Terms 1. Drug: Any chemical that can affect living processes 2. Pharmacology: The study of drugs and their interactions with living systems 3. Clinical Pharmacology: The study of drugs in humans 4. Therapeutics (AKA Pharmacotherapeutics): The use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy Characteristics of Drugs • Effectiveness: If a drug is not effective, IT SHOULD NOT BE USED!!!! • Safety: No safe drugs; all drugs can cause harm. Does the good outweigh the bad? • Selectiveness: Elicits only the response for which it is given. Properties to Consider • Can the patient afford the medication? • Can the patient physically take the medication? • Consider the route of administration selected • Will this medication interact with other medications the patient is taking? The Nx Process • Assessment o Objective Data: What the nurse sees, smells, feels, hears. o Subjective Data: What the patient says. (Family Hx, HPI, Socioeconomic status, pain level) • Diagnosis (Nursing Dx) • Planning/Goal setting o Realistic, measurable, and timed. • Implementation • Evaluation o Were the goals met? ▪ Yes: Document findings. ▪ No: Document findings, adjust, and try again. 5 Rights of Medication Administration 1. Patient 2. Medication 3. Dose 4. Route 5. Time NURS 2407 Pharmacology Exam 1 Study Guide Enteric: of, relating to, or occurring in the GI tract. Enteric coated medications absorb in the small intestines. Parenteral: outside the GI tract. Fat-soluble (lipid-soluble) & Nonionized (no electrical charge) are most easily absorbed by the GI tract. “Topical” medications include: • Eye drops • Ear drops • Nasal sprays • Respiratory inhalants • Transdermal meds • Sublingual meds 3 Phases of Medication Administration • Pharmaceutic Phase: Process in which the tablet or capsule becomes a solution so it can cross the biologic membrane of the stomach or small intestines. o Only applies to tablets or capsules. • Pharmacokinetic Phase: This is the process of drug movement through the body to achieve drug action. o Absorption: movement of a drug from it’s site of administration into bloodstream. High fat foods increase absorption time. Exercise can decrease drug absorption because blood flow is in peripheral muscles instead of GI tract. o Distribution: The process by which the drug becomes available to body fluids and body tissues from the bloodstream. High affinity for proteins: warfarin and furosemide Low affinity for proteins: Lisinopril and metoprolol Blood Brain Barrier • Blocks about 98% of drugs on the market • Benzodiazepines are able to cross through diffusion = faster onset o Metabolism/ Biotransformation: The chemical alteration of drug structure. o The liver changes lipid-soluble substances to water-soluble substances for renal excretion. NURS 2407 Pharmacology Exam 1 Study Guide • Idiosyncratic Effect: Uncommon drug response resulting from a genetic predisposition. • Allergic Reaction: An immune response to a drug after prior sensitization has occurred. • Paradoxical Effect: The opposite of the intended drug response. • Iatrogenic Disease: Disease produced by drugs. • Physical Dependence: The state in which the body had adapted to drug exposure in such a way that an abstinence syndrome will result if drug use is discontinued. • Carcinogenic Effect: The ability of certain medications or environmental chemicals to cause cancer. • Teratogenic Effect: Drug-induced birth defect. Hepatotoxicity: Damage done to the liver after drugs undergo metabolism QT Interval Drugs: Drugs that can cause QT changes on an EKG, causing lethal dysrhythmias like torsades de pointes. Drug Induced Photosensitivity: Caused by the interaction of a drug and exposure to UVA light which can cause cellular damage. • Using sunscreen with SPF > 15 and wearing protective clothing can help prevent this reaction. Food and Drug Administration (FDA): Designed to allow safe food and drugs to be distributed and sold in the U.S. 5 Drug Categories: Schedule I, II, III, IV, V • I: No accepted medical use in the U.S., or high potential for abuse (LSD, Heroin) • II-V: accepted medical applications but also have high potential for abuse (ADHD, pain, and anxiety medications) Placebo: A psychological benefit from a compound that may not have the chemical structure of a drug effect. Generic Names: Chemical name for a drug. Brand Names: Name the drug is marketed under. Module 2 – Neurological System Medications (1) Autonomic Nervous System • Sympathetic (adrenergic) NURS 2407 Pharmacology Exam 1 Study Guide o Neurotransmitter: Norepinephrine ▪ Alpha 1 ▪ Alpha 2 ▪ Beta 1 ▪ Beta 2 o Adrenergic Agnostic ▪ Also called: Adrenergic ▪ Also called: Sympathomimetics o Vasoconstriction = increased blood pressure. o Increased contractility of the heart and increased heart rate. o Bronchodilation. o Liver stimulation increases blood sugar. o Pupil dilation. o Alertness • Parasympathetic (cholinergic) o Neurotransmitter: Acetylcholine ▪ Nicotinic ▪ Neuromuscular ▪ Affect skeletal muscle ▪ Muscarinic ▪ Stimulate smooth muscle ▪ Slow heart rate o Cholinergic Agnostics ▪ Cholinergic ▪ Parasympathomimetic o Stimulates urination o Increases salivation and tear production o Increases GI peristalsis • Adrenergic Blockers o adrenergic antagonists o sympatholytic Blocks access to the adrenergic receptor sites. • Anticholinergics o Cholinergic Antagonists o Parasympatholytic Blocks the parasympathetic nerves, the adrenergic nervous system dominates. Parkinsonism Too little dopamine and too much acetylcholine. NURS 2407 Pharmacology Exam 1 Study Guide • Carbidopa/Levodopa (Sinemet) NURS 2407 Pharmacology Exam 1 Study Guide ▪ Gingival hyperplasia • Patient Teaching: Good oral hygiene ▪ Blood pressure ▪ Teratogenic o Suppresses seizures w/o depressing the CNS. • Oxcarbazepine (Trileptal) o Side Effects ▪ Neurologic side effects ▪ Steven-Johnson Syndrome ▪ Nystagmus ▪ Multiorgan hypresensitivity reactions o Avoid driving & alcohol • Phenobarbital (Luminal) o inhibition of GABA o Side Effects ▪ Hypoventilation ▪ Hypotension ▪ Bone Marrow Suppression o Use activated charcoal. Drugs for Muscle Spasm and Muscle Disorder • Baclofen (Lioresal) o Suppresses hyperactive reflexes withing the spinal cord. o Adverse Side Effects o CNS depression o Urinary Retention • Cyclobenzaprine (Flexmid) o Reduces tonic motor activity o Ineffective for spasticity o Adverse Reactions o CNS depression o Anticholinergic effects CNS Stimulants and ADHD Increases the activity of CNS neurons • Methylphenidate (Ritalin) • Dexmethylphenidate (Focalin) o Also treats narcolepsy • Side Effects o Insomnia o HTN NURS 2407 Pharmacology Exam 1 Study Guide o Weight loss o Cardiac dysrhythmias Module 3 – Neurological System Medications (2) Dopamine: Cognition, hormones, emotions, movement. Norepinephrine: Arousal, attention, mood, concentration, anxiety. Acetylcholine: Smooth muscle, dilates pupils, body secretions. Serotonin: Regulates sleep, mood, nausea. Neuroleptic Malignant Syndrome • High Fever (>105 F) • Muscle Rigidly. • Irregular Pulse • Tachycardia • Altered Mental Status • Tx: Dantrolene Serotonin Syndrome • Cognitive Changes o Agitation o Confusion o Euphoria o Hallucinations • Autonomic Changes o Tachycardia o HTN o Fever o Arrythmias • Neuromuscular Changes o Tremor o Hyperreflexia o Ataxia o Seizures Extrapyramidal Syndrome • Psuedoparkinsonism o Pill Rolling o Tremors o Shuffling Gait • Acute Dystonia NURS 2407 Pharmacology Exam 1 Study Guide o Sustained Muscle Contraction • Akathesia o Restless Legs • Tardive Dyskinesia (TD) o Involuntary wormlike movement of head, neck, face, trunk, and tongue. ▪ IRREVERABLE EPS Tx (Early) • Anticholinergics • Benzodiazepines • Beta Blockers • Reduce Dosage EPS Tx (Late) • Reduce Dose Prevention of HTN Crisis Avoid • Cheese • Meat • Chocolate • Bananas • Raisins • Fermented goods Schizophrenia First Generation Antipsychotics (Typical/Conventional) Treats positive & negative symptoms • Chlorpromazine (Thorazine) • Haloperidol (Haldol) • Blocks: o Dopamine (EPS – Parkinsonism) o Acetylcholine (Anticholinergic) o Histamine (Drowsiness) o Norepinephrine ( B/P & HR) • Contraindicated in Parkinson’s Disease. • Can lead to EPS & NMS. Second Generation Antipsychotics (Atypical) • Clozapine (Clozaril) • Olanzapine (Zyprexa) • Treats positive and negative symptoms. NURS 2407 Pharmacology Exam 1 Study Guide Increases Dopamine • Bupropion (Wellbutrin) • Increases appetite • Increases Sexual desire and pleasure • Smoking cessation Bipolar Disorder Bipolar 1: Mixed or Mania Bipolar 2: Hypomanic/Depression • Lithium o Used for Mania or Depression o Avoid Sodium-free diet & Dehydration o Reduces Euphoria o Teratogenic o Do not mix with ACE inhibitors & NSAIDS o Palpitations & Dysrhythmias = levels. • Divalproex Sodium/Valproate (Depakote) o Gather baseline CBC o Causes thrombocytopenia o Teratogenic • Carbamazepine (Tegretol) o metabolism of itself, warfarin, and oral b/c o Side Effects ▪ Amenia ▪ Thrombocytopenia ▪ Fever & Sore throat Anxiolytics Benzodiazepines Increases GABA in the CNS • Lorazepam (Ativan) • Diazepam (Valium) • Alprazolam (Xanax) • Reversal Agent: Flumazenil (Romanzicon) • Short term use • Helps treat alcohol withdrawal • Side Effects o Confusion o Amnesia NURS 2407 Pharmacology Exam 1 Study Guide o Anticonvulsant Azapirones • Buspirones o No sedation or dependency