TCDHA pharm midterm Exam, Exams of Nursing

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Patients with chronic pain should be managed with? - CORRECT ANSWERS- nonopioids and referred to appropriate specialists Tramadol (Ultram) - CORRECT ANSWERS-An orally administered nonopioid with weak analgesic activity naloxone (Narcan) - CORRECT ANSWERS-block the therapeutic and toxic actions of opioids pentazocine (Talwin) - CORRECT ANSWERS-The only mixed opioid available for oral use. most likely to produce dysphoric reaction Fentanyl Family - CORRECT ANSWERS-short-acting, parenterally administered agonist opioid analgesic that is used perioperatively or during general anesthesia what opoid is primarily to treat any opioid addicts (eg. Heroin addicts) - CORRECT ANSWERS-Methadone Codeine - CORRECT ANSWERS-Most commonly used opioid in dentistry and is often combined with acetaminophen (Tylenol #3) for oral administration A patient with a true allergy to codeine should NOT be given an analgesic in that group. this includes - CORRECT ANSWERS-oxycodone, hydromorphone, hydrocodone, and dihydrocodone. Treatment for overdose - CORRECT ANSWERS-naloxone what should be used to control dental pain in addicts? - CORRECT ANSWERS-NSAIDs what is an advantage of NSAIDs - CORRECT ANSWERS-not addictive, tollerance does not develop, no withdrawal syndrome. an addict will develop tolerance to the effect of opioids, except? - CORRECT ANSWERS-Miosis and constipation Use of opioids is NOT contraindicated in - CORRECT ANSWERS-hypertensive pts cause of death with overdose? - CORRECT ANSWERS-Respiratory depression Combining an opioid with a nonopioid analgesic produces an additive analgesic effect with fewer adverse reactions? - CORRECT ANSWERS-True What do aspirin, acetaminophen, ibuprofen, and codeine have in common? - CORRECT ANSWERS-analgesic opoid agonist by which all others are measured? - CORRECT ANSWERS-Morphine

NSAIDs GI effects - CORRECT ANSWERS-Can increase acid secretion. NSAIDs are similar to aspirin in? - CORRECT ANSWERS-analgesic, antipyretic, and anti-inflammatory. NSAID peak - CORRECT ANSWERS- 1 - 2 hr Most useful drug group for treatment of dental pain - CORRECT ANSWERS-NSAIDs drug used most safely in pt who have arthritis - CORRECT ANSWERS-Aspirin a drug interaction between aspirin and Warfarin can result in? - CORRECT ANSWERS- significant bleeding If allergic to ASA (aspirin) cannot give? - CORRECT ANSWERS-NSAID because of cross hypersensitivity (e.g.:Ibuprofen) opioid of choice when there is an allergy to aspirin - CORRECT ANSWERS-Codeine in association with Reye's syndrome what is now used for fever or pain in pediatric and adolecents to reduce chances? - CORRECT ANSWERS-ACETAMINOPHEN and NSAIDs what does aspirin do in relation to bleeding? - CORRECT ANSWERS-irreversibly interferes with clotting mechanism by reducing platelet adhesiveness most frequent side effect associated with ASA - CORRECT ANSWERS-gastrointestinal (GI) effects the ability of aspirin to reduce fever results from what? - CORRECT ANSWERS- inhibition of prostaglandin synthesis in the hypothalamus ASA analgesic is used for - CORRECT ANSWERS-low to moderate pain For severe pain you should consider? - CORRECT ANSWERS-opioids ASA peak effect on an empty stomach - CORRECT ANSWERS-30 min Aspirin have what actions - CORRECT ANSWERS-anti-inflammatory, antipyretic, analgesic, and antiplatelet most useful and common Salicylate to reduce pain - CORRECT ANSWERS-Aspirin Clients pretreated with α-adrenergic blocking agents and then given epinephrine exhibit a predominance of beta effects (vasodilation), which does what? - CORRECT ANSWERS-this is called epinephrine reversal since it lowers BP.

Adrenergic (sympathomimetic) agents should not be used in persons with uncontrolled?

• CORRECT ANSWERS-hypertension, angina, or hyperthyroidism Sympathomimetic agents will stimulate salivary flow from ONLY the - CORRECT ANSWERS-Submaxillary and Sublingual glands On administration of an agent, heart rate increases because of a direct effect on the heart. However, total peripheral resistance decreases dramatically. As a consequence, systolic blood pressure increases only slightly, and mean arterial pressure typically falls. This agent is? - CORRECT ANSWERS-Isoproterenol β1- receptors - CORRECT ANSWERS-stimulates heart muscle; increase heart rate β2- receptors - CORRECT ANSWERS-smooth muscle inhibition or relaxation α-receptors - CORRECT ANSWERS-cause excitation, contraction and thus vasoconstriction in smooth muscles (increase blood pressure) Anticholinergic (parasympatholytic) Agents effects on eye? - CORRECT ANSWERS- cause mydriasis and cycloplegia (paralysis of accommodation) of eye Ipratropium - CORRECT ANSWERS-an anticholinergic inhaler used to treat asthma Anticholinergic (parasympatholytic) Agents prevent action of acetylcholine (ACh) at? - CORRECT ANSWERS-Postganglionic parasymphathetic endings. The primary objective of drug therapy in the treatment of glaucoma (eye disease) is - CORRECT ANSWERS-Inhibition of cholinesterase Cholinergic (Parasympathomimetic) Drugs contraindictions - CORRECT ANSWERS- Hypothyroidism is not a relative contraindication or caution with the use of cholinergic agents; however, hyperthyroidism is because it may cause an increased risk of atrial fibrillation. Cholinergic (Parasympathomimetic) Drugs effects on cardiovascular - CORRECT ANSWERS-negative chronotropic and negative inotropic actions; (An decrease in contraction and force): ATROPINE - CORRECT ANSWERS-will block the action of ACh at the postganglionic endings in the PANS When the enzyme that normally destroys acetylcholine (ACh) is inhibited, the concentration of ACh builds up, resulting in? - CORRECT ANSWERS-PANS stimulation

Idiosyncrasy - CORRECT ANSWERS-Neither a side effect nor an allergic reaction. May be genetically determined allergic reaction TYPE IV - CORRECT ANSWERS-delayed hypersensitivity reaction. ex;poisen ivy allergic reaction TYPE III - CORRECT ANSWERS-immune complex allergic reaction TYPE II - CORRECT ANSWERS-cytotoxic/cytolytic allergic reaction TYPE I - CORRECT ANSWERS-immediate the most critical time for teratogenicity - CORRECT ANSWERS-Early in pregnancy (first trimester) drug allergy - CORRECT ANSWERS-neither predictable or dose-related side effect - CORRECT ANSWERS-dose-related, predictable and acts on non target organs toxic reaction - CORRECT ANSWERS-predictable, dose-related, acts on target organs What are Transdermal Patches? - CORRECT ANSWERS-Designed to provide continuous controlled release of medication through a semipermeable membrane over a given period after application of drug to the intact skin - eliminates the need for repeated oral dosing. FIRST-PASS EFFECT - CORRECT ANSWERS-when drugs given orally, they pass through the hepatic (liver) portal circulation which can inactivate some drugs what organ is involved in first-pass effect - CORRECT ANSWERS-Liver oral administration advantages - CORRECT ANSWERS-simplest way to introduce drug into system, safest, least expensive, most convenient main excretion route - CORRECT ANSWERS-Kidney ACTIVE TO INACTIVE metabolism - CORRECT ANSWERS-most common, drugs go into body active, are biotransformed in liver and come out inactive INACTIVE TO ACTIVE metabolism - CORRECT ANSWERS-go into body inactive (termed prodrug), are biotransformed in liver and come out active ACTIVE TO ACTIVE metabolism - CORRECT ANSWERS-go into body active, are biotransformed in liver and come out active in another form (gives prolonged effect)

Distribution occurs when? - CORRECT ANSWERS-a drug moves to various sites in the body, including its site of action in specific tissues When the acidity of the tissue ↑, (as in instances of infection), the effect of a local anesthetic ↓ Therefore, the local anesthetic is a - CORRECT ANSWERS-weak base factors all aid (speed up) in the rate of transfer across membranes - CORRECT ANSWERS-Non-ionized or uncharged, Lipid-soluble, pH↑ Passive Transfer - CORRECT ANSWERS-is simple diffusion Active Transfer - CORRECT ANSWERS-the substance is transported against a concentration gradient or an electrochemical gradient Facilitated Diffusion - CORRECT ANSWERS-does NOT move across a concentration gradient PHARMACOKINETICS - CORRECT ANSWERS-The study of how a drug enters the body, circulates within the body, is changed by the body and leaves the body Lethal Dose (LD) - CORRECT ANSWERS-median lethal dose when one half of the subjects die Efficacy - CORRECT ANSWERS-maximum intensity of effect or response that can be produced by a drug Absolute Potency - CORRECT ANSWERS-absolute potency of a drug is immaterial as long as an appropriate dose is administered Potency - CORRECT ANSWERS-the amount of drug required to produce an effect (related to a drugs strength). can be expressed in ED Pharmacokinetics - CORRECT ANSWERS-study of how a drug enters the body, circulates within the body, is changed by the body, and leaves the body Pharmacopoeia - CORRECT ANSWERS-book containing directions for the identification of samples and the preparation of compound medicines, and published by the authority of a government or a medical or pharmaceutical society. Pharmacognosy - CORRECT ANSWERS-study of the physical, chemical, biochemical and biological properties of drugs, drug substances or potential drugs or drug substances of natural origin as well as the search for new drugs from natural sources". It is also defined as the study of crude drugs. ac: - CORRECT ANSWERS-before meals