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151 Cards in this Set
- Front
- Back
What is the active metabolite for the pro drug Codeine?
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Morphine
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What is the active metabolite for the pro drug Allopurinol?
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Oxypurinol
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Which 5 drugs must be monitored for concentrations in the whole blood/plasma and targeted for peak and trough?
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1. Dilantin
2. Digoxin 3. Tegretol 4. Lithium 5. Vancomycin |
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What is Peak and Trough?
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Peak: When the drug reaches its peak concentration
Trough: When the drug reaches its lowest minimum concentration •Drugs must be given on time and given within the cycle |
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What is the half-life t1/2 of a drug?
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- The time required for one-half of the total drug amount to be eliminated from the body
- Used to determine the steady state, dosage, and frequency of the drug administration - Help determine when peak and trough occurred |
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What is the steady state?
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- Reached when the rate of absorption = the rate of elimination
- Usually reached with chronic administration equal dosing at equal dosing intervals over period equaling 4-5 biological half lives. |
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What is an Agonist?
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-Drugs which alter the physiology of a cell by binding to plasma membrane or intracellular receptors
- Mimic whats going on - Efficiency: Drug get into all the receptors - Given to patients who are suffering an overdose |
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What is an Antagonist?
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Inhibit or block responses caused by agonists
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Effective Concentration 50% (ED50)
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Concentration of the drug which induces a specified clinical effect in 50% of all subjects.
- Tells us when we are starting to reach market value - Looking for a clinical effect |
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Lethal Dose 50% (LD50)
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Concentration of the drug which induces death in 50% of subjects
- Tells is more research is needed before giving the drug to the population |
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What is the efficacy?
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Degree to which a drug is able to produce the desired response
- The larges amount of a drug needed to produce a response/ effect |
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What is the potency of a drug?
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The amount of drug required to produce 50% of the maximal response the drug that is capable of inducing
- Used to compare compounds within classes of drugs |
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What is the therapeutic index?
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Measurement of the safety of a drug
- Calculation: LD50/ED50 - Calculating the safety of a drug - FDA looks at the therapeutic index to maintain a margin of safety |
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What are the drugs that come from cephalosporins?
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There are 22 cephalosporin
|
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What are the two medications that come from macrolides?
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1. Erythromycin
2. Zihromax |
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What drug comes from aminoglycosides?
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1. Gentamicin combined with Tobramycin
2. Amikacin (has no resistance) |
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What drug comes from sulfonamides?
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1. Sulfamethoxazole (SMZ)
2. Trimethoprim (TPM) |
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What drug comes from fluoroquinolones?
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1. Ciproflaxin
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What are the 5 steps used for the selection of Antibiotics?
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1. Identifying the organism through lab culture
2. Therapeutic Goal 3. Drug sensitivity to the organism 4. Host factors 5. Whenever possible the drug of first choice is used |
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What two lab tests are used to determine drug susceptibility?
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1. Disk diffusion test
2. Broth dilution procedure: a more precise measurement of sensitivity and determines a. MIC: Minimum inhibitory concentration b. MBC: Minimum bacterial concentration |
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What is bacteriostatic?
Which 2 antibiotics are bacteriostatic? |
Inhibits bacterial growth allowing bodies defense mechanisms to remove the invading microorganism
1. Tetracylines 2. Macrolides |
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What is bachtericidal?
Which 6 antibiotics are bactericidal? |
Causes bacterial cell death and lysis
1. Penicillin 2. Cephelosporins 3. Glycopeptide 4. Aminoglycocsides 5. Sulfonamides 6. Floroquinalones |
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What are the shared attributes?
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They depend on the dosage of the drug and area of the body it is being used for
- Septra: acts on both ways depending on the dose strength |
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What are the three shared adverse reactions all antimicrobial agents are capable of producing?
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1. Antibiotic associated colitis
2. Allergic or hypersensitivity reaction (HSR) 3. Suprainfection |
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What are the three types of shared adverse reactions?
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1. Antibiotic Associated Colitis
A. Pseudomembranous colitis caused by c.diff 2. Allergic or Hypersensitive Reaction 3. Suprainfection A. When microbes are resistant to ABX during its use B. ex. Candida (fungus) |
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What medication is used to treat pseudomembranous colitis?
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Metronidazole
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What are the safety concerns associated with the use of ABX?
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1. Toxicity
2. Interactions with other medications 3. Fetal damage/risk to pregnant women |
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What medication is used for VRE?
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Methicillin, the drug of choice unless patient has MRSA
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What are the 3 ways resistance can be transferred?
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1. Transformation
2. Conjugation 3. Transduction |
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What are the characteristics of Penicillin?
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-Broad and Narrow Spectrum
-Bactericidal -Has 30 half life -Affects oral contaceptives - Routes: IM, IV (PO for PCN V) -Inhibit cell wall synthesis |
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What are the three interactions of Penicillin?
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1. Aminoglycocides
2. Oral contraceptives 3. Anticoagulants and potassium supplements |
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What is a beta-lactamase Inhibitor?
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- Must be used with another antibiotic (penicillinase) in a fixed dose combination
|
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What are the characteristics of Cephalosporins?
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-Inhibit cell wall synthesis
- Bactericidal - Route: IV short used - Most used group of ABX -Distributed well in the tissues and fluids - Most are eliminated in the kidneys (need for good kidneys) - Can cause problem with coagulation |
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What would be the first indicator that a person has a problem with coagulation?
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A pink toothbrush
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What is the main Glycopeptide medication?
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Vancomycin
|
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What are the characteristics of Vancomycin?
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-Inhibit cell wall
-Narrow - IV administration only - Used when all else fails, and MRSA - Lots of effects |
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What are the 3 effects of Vancomycin?
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-Throbophlebitis (inflammation of the veins)
- Red Neck Syndrome - Ototoxicity |
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What are the characteristics of Tetracyclines?
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-Broad spec
- Inhibits protein synthesis - Absorption can be delayed by basic substances in stomach - Adverse effects if we dont get the dosage needed -Suprainfection: C.diff and candida |
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What is the characteristics of Microlides?
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- Inhibits protein synthesis
- Broad spec - Bacteriostatic - First line of treatment for protessis - Disolves in the small intestines -PO |
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What are the characteristics of Zpack?
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- Used in leu of patient who is allergic to PCN
- Safe to use in renal dysfunction - Excreted in the colon |
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What is gray syndrome?
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Anaphylaxsis where the peripheral circulation gets shut down
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What are the Characteristics of Gentamycin?
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-Used with Tobramycin
- Quite toxic (causes nephro and oto toxicity) |
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What is the characteristic of Amikacin?
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-Has no bacteria resistance (reserved)
|
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What are the characteristics of Aminoglycosides?
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-Inhibits protein synthesis
- Bacterialcidal - Narrow |
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What are the characteristics of Sulfonamides?
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-Inhibits synthesis of folic acid
- Used for UTI pathogens - Used for chronic bronchitis and pneumonia - Fights the flu |
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What are the 6 adverse reactions of Sulfonamides?
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1. Acute Hemolytic Anemia: RBC may be lost
2. Kernicterus: Interferes w/ bile conjugation (stains the brain) 3. Crystalluria 4. Steven Johnsons Syndrom: Systemic 5. Allergy to sulfa drugs 6. Nausea, rash, diarrhea |
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What are the characteristics of Floroquinolones?
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-Interferes with bacterial DNA synthesis
- Bactericidal - Broad spec |
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What are Floroquinolones effective against?
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1. Anthrax spores
2. e.coli 3. salmonella 4. Campylobacter |
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What are the reactions of Floroquinolones?
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1. N/V
2. Abdominal pain 3. insomnia 4. Pseudomembranous colitis 5. tendonitis (Achilles tendon rupture) 6. SJS 7. OT Prolongation |
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What are the 3 phrophylactic uses of antimicrobial?
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used to prevent the spread of diseases
1. Certain surgeries: GI tract, emergency C sections, perforated organs 2. Dentistry when someone is at risk for bacterial endocarditis 3. Patients who are neutopenic |
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What is prophylactis?
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Used as a preventative to prevent the spread of disease
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What are the 6 effects of antihistamines?
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1. Sedations (take at night)
2. Anticholinergic effects 3. Gastrointestinal distress (take with food) 4. Elderly (fall risk) 5. CNS depression 6. Toxicity |
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What are the two H1 antagonist (1st gen)?
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1. Benedryl
2. Promethazine |
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What are the 4 therapeutic uses of H1 antagonist (1st gen)?
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1. Mild allergy: itchy eyes and itching
2. Sever allergy: flushed face and transfusion 3. Motion sickness 4. Insomnia |
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What is Urticaria?
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Rash
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What are the 2 H1 antagonists (2nd Gen)?
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1. Claritin
2. Zyrtec |
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What are the 2 harmful effects when inhibiting COX 1?
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1. Gastric erosion and ulceration
2. Bleeding tendencies |
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What are the 3 harmful effects when inhibiting COX 2?
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1.Renal impairment
2. Promotion of Mi and stroke 3. Bleeding tendencies |
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What is the beneficial effect when inhibiting COX 1?
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1. Protection against MI and Stoke
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What are the 4 beneficial effects when inhibiting COX 2?
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1. Suppression and inflammation
2. Alleviation of pain 3. Reduction of fever 4. Protection against colorectal cancer |
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Which 4 drug have non-steroidal anti-inflammatory properties?
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1. Aspirin
2. Indocin 3. Ibuprofen 4. Toradol |
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What are the 4 characteristics of Aspirin and their functions?
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1. Anti-inflammatory: Irreversible inhibitor of COX
2. Analgesic: Mild to moderate pain 3. Antipyretic: Reye's Syndrome, caution in peds 4. Anticoagulant: Irreversible inhibitor of COX-1; inhibits platelet aggregation |
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What are the characteristics of Indocin?
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Therapeutic: Relieves pain, fever, inflammation
Indications: RA, Arthritis, Gout Side Effects: Urticaria, NVD, abdominal pain (take with food), headache, dizzyness, vertigo |
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What are the characteristics of Ibuprofen?
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- Like asprin, stronger effects, less GI irritation
oCNS: headache, drowsiness, dizziness o EENT: tinnitus, visual disturbance o GI: epigastric distress, nausea, occult blood o HEMA: prolonged bleeding time - No alcahol - can cause peptic ulceration and bleeding |
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What are the characteristics of Toradol?
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-Powerful analgesic besides morphine with min. anti-inflammatory actions
- Not for long term Side effects: Urticaria, PUD and abdominal pain, HA/Dizz, Vertigo - No alcohol -Step meds if bleeding |
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What is the selective COX 2 inhibitor NSAID?
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Celebrex
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What are the characteristics of Celebrex?
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- Relieves pain and inflammation (last choice for long term)
- Increases risk for MI and stroke Indications: RA, Grout, Arthritis SE: Urticaria, abdominal pain, Increased MI and stroke |
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What are the 2 ways acetaminophen is like aspirin?
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1. Analgesic
2. Antipyretic |
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What are the 3 ways acetaminophen is unlike aspirin?
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1. No anti-inflammatory actions
2. No platelet aggregation suppression (benefit) 3. Does not cause GI distress |
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What drug is used to combat acetaminophen OD?
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Mucomyst
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What are the two common corticosteroids?
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1. Solu cortif
2. Medrol |
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Why are corticosteroids used?
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- Treat local inflammation disorders (those affecting the skin)
- Systemic inflammatory disorders requiring potent and aggressive therapy for control |
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What are the 2 Anti-Gout Drugs?
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1. Uric Acid Inhibitor (Allopurinol)
2. Urcosurics (Benemid) |
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What are the six manifestations of gastroinenstinal tract disorders?
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1. Dysphagia
2. Esophageal pain 3. Abdominal pain 4. Vomiting 5. Intestinal gas 6. Alterations in bowel patterns |
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What is dysphagia and its three categories?
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- Problems with swallowing; erosions on the esophagus
1. Uncoordinated neuromuscular sequence 2. Altered esophageal peristaltic activity 3. LES dysfunction/lesions |
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What are the two manifestations of esophageal pain?
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1. Heartburn (GERD)
2. Midsternal Pain (result of esophageal distention may present with odynophagia: painful swllowing |
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What are the characteristics of GERD?
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- Stomach contents and acid go up to the esophagus through the LES
- Due to multifactoria LES pressure challenged - Made worse by lying down |
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What are the treatments for GERD?
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-PPI's are the most effective drug for suppressing the secretion of gastric acid
- Nexium (little purple pill) - Prevacid, Protonix (usually given through IV) - Problems with long term use changing the pH of the stomach |
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What are the three types of Abdominal Pain?
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1. Visceral Pain: Stretching, distending or inflammation of abdominal organ
2. Somatic Pain: Injury to the stomach 3. Referred Pain: felt at a location distant from the source of pain |
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What are the 10 manifestations of vomiting?
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- GI disorders
. Bastroenteritis: inflammation of the GI tract . Alterations in motility . Obstruction: blood/feces - Non GI disorders . Pregnancy: due to hormone alterations . Infection . F & E disorders . Metabolic . Endocrine . Cardiac . Labyrinthine |
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What are the four classes of anti emetics and their drugs?
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1. Serotonin antagonist: Zofran
2. Dopamine antagonist: Phenergan 3. Anticholinergic primarily due to antihistamine: Benedryl 4. Cannabinoids: Marinol (Stomach sedation) |
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What are the side effects associated with anti emetics?
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Serotonins: block the chemoreceptor trigger zone(CTZ) and vaginal neurons in the upper GI track. --> hypertension
Crosses the BBB . Dizzyness, H/A, diarrhea, sedation (depression of CNS) . Sedation: make sure the patient is breathing |
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What are the nursing implications of anti emetics?
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- Assess the type of nausea (anticipatory, acute, delayed)
- Better at suppressing than preventing |
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What are the manifestations of Intestinal gas?
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-Normally occurs because of swallowed air
- Bacterial and digestive actions on the stomach contents Problem: no outlet = abdominal distention |
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Manifestations of alterations in bowel patterns?
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Normal bowel movements: 2-3 times per day - 1/week
|
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What are the four uses of laxatives?
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1. Stool sample for diagnosis
2. Cleansing prior to surgery 3. Prevention of impaction of a bedridden pt 4. Correction of constipation ass. with pregnancy or opioids |
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What are the three times we would not use laxative?
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1. Disorders of the bowel
2. Cramping or Appendicitis 3. Not for the use of a daily bowel movement |
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What is a laxative effect?
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The production of a soft formed stool over 1 or 2 days
|
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What is laxative catharsis?
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The prompt fluid evacuation of the bowel
|
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What are the 7 assessments a nurse should do prior to giving a laxative?
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1. The last BM and type
2 Diet and exercise regimen 3. Frequency use of laxatives 4. Illness, age, and medications 5. Absence of contraindicated conditions 6. Pts beliefs bout BM's 7. Existing dehydration, malnutrition, and electrolyte imbalance must be taken into consideration |
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What are the 6 nursing interventions prior to giving a laxative?
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1. Identify the high risk patients for constipation
2. Identify the appropriateness for laxative use 3. Educate regarding laxative, use, abuse, and what constitutes a BM 4. Know if it is bulk forming or surfactant laxative 5. Must be taken with a lot of H2O 6. Educate the patient that laxatives are only for a short term |
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What are the four mechanisms of diarrhea?
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1. Osmotic: Nonabsorbable substance draws H2O into the intestines
2. Secretory: Excessive mucosal secretion of fluid and electrolytes 3.Exudative: Crohn's disease, IBS-D, and Ulcerative Colitis 4. Motility: Due to the resection of the SI there is less time for absorption |
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What are the 4 steps prior to giving an anti-diarrheal agent?
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1. First look at what is causing the diarrhea
2. Dx & Rx the underlying cause 3. Replacement of lost fluid and salts 4. Relief of cramping & reducing the passage of unformed stools |
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What are the two types of antidiarrheal agents?
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1. Nonspecific: symptoms relief only
2. Specific: Agents that treat the underlying cause of the diarrhea |
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What are the specific antidiarrheal agents treating?
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1. Infectious diarrhea
2. Inflammatory bowel syndrome (IBS) 3. Inflammatory bowel disease (IBD) |
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What are the types and medications of non specific antidiarrheal agents?
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1. Opioids: the most effective antidiarrheal:
1. Lomotil 2. Imodium -both have atropine, makes patients feel badly; helps with spasms and decreases chance of abuse. 2. Anticholinergic spasmodics 3. Bulk formers |
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What is the treatment for IBS?
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Bulk formers
|
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What are the characteristics of Infectious diarrhea?
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- Occurs from bacteria or protozoa found in the body
- Flagyl is the best medication combined with a fluid replacement - Important to get all the bacteria out prior to giving an antidiarrheal agent |
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What are the characteristics of Inflammatory Bowel Disease (IBD)?
|
- Inflammation of the bowel
- Genetic predisposition - Exaggerated response to normal flora in the bowel |
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What are the two types of IBD?
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1. Ulcerative colitis
2. Crohn's disease |
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What are the characteristics of Ulcerative Colitis?
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- Inflammatory disease of the colon and most severe in the rectum
- There is an ulcer in the bowel |
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What are the characteristics of Crohn's Disease?
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- Inflammation of the GI tract and extends to all layers of the intestinal wall (Mouth to anus)
- Massive interference in the absorption of nutrients |
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What are the treatments for Crohn's disease?
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1. Corticosteriods (inflammation)
2. ABX: Flagyl used when the WBC is elevated at >10,000 - No cure |
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What are the treatments for Ulcerative Colitis?
|
1. Corticosteroids (Inflammation)
2. ABX: Use in toxic mega colon - Avoid colonectomy |
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What is Diverticular Disease?
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- Acquired herniation's of the mucosa and submuscosa of muscle coat of colon
|
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What are the two forms of diverticular disease?
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1. Diverticulosis: Presence of diverticula in the colon
2. Diverticulitis: Inflammed |
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What are the manifestations of diverticular disease?
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- decreased colon motility
- Increased liminal pressure - Low fiber diets - Colon wall defects |
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What is the treatment for diverticular disease?
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- ABX
- Drain the abscess - Surgery not the best answer- can lead to obstruction later |
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What are the signs and symptoms of diverticulitis?
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1. LL abdominal pain
2. Low grade fever 3. Nausea, vomiting 4. Blood in stool |
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What are the 5 treatments of Diverticulitis?
|
- Depends on severity, Prevention is best
1. High fiber: preventing constipation 2. Antibiotics 3. Antispasmodic 4. Pain meds 5. Colon resection if necessary |
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What is peptic ulcer disease and its 5 causes?
|
- Injury ulceration of the esophagus, stomach, or duodenum
- Defense mechanisms inappropriate acid secretion pepsin 1. H.pylori infection 2. NSAID use 3. Severe illness, systemic and or emotional trauma, stress 4. Smoking 5. Alcohol abuse |
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What are the treatments for Peptic ulcer disease?
|
- Diagnosis: Breath test (see if ammonia is being produced by h.pylori, stool sample
- Goals: Gastric Acidity and heal the mucosa 1. PPI (Prilosec) 2. H2 Antagonist (Zantac) 3. ABX: 14 day course of triple drug treatment 4. Comprehensive program to stop contributory activities |
|
What are the two purposes of PPI's?
|
1. Used primarily for GERD
2. Binds to and irreversibly blocks the pp in gastric mucosal cells |
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What are the 4 types of PPI's?
|
1. Prilosec
2. Protonix 3. Prevacid 4. Nexium |
|
What are the characteristics of Prilosec?
|
- Inhibition of K+, H+, and ATPase which make up the PP
- A 30 mg dose can reduce gastric acid secretion by 97% in 2 hours and last for 3-5 days - Kidneys and Liver must be in place |
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What are the adverse effects of PPI's?
|
Short term: H/A, diarrhea
Long term: Esophageal and esophageal cancer leasions due to prolonged gastric acid secretions - Overgrowth of bacteria and candida |
|
What are the 4 nursing interventions when giving PPI's?
|
1. Instruct to take capsule whole
2. Administer immediately prior to meals 3. Therapy for healing of ulcers takes 6-8 weeks 4. Educate regarding the signs and symptoms of GI bleeding |
|
What are the two H2 blockers?
|
1. Zantac
2. Tagamet |
|
Where are the H2 receptors found (5)?
|
- Important when blocking histamine, we are blocking both
1. Gastric Parietal cells 2. Vascular smooth muscles 3. CNS 4. Heart 5. Uterus |
|
What are the characteristics of Tagamet?
|
- Promotes healing of ulcers by suppressing secretion of gastric acid
- Administered PO, IM, IV (food decreases the rate) - Crosses BBB: dizzyness and vertigo - Medication interactions |
|
What are the characteristics of Zantac?
|
- Histamine receptor antagonist
- Taken with or without food - Avoid Cigarettes, alcohol, ASA, NSAIDS - Eat smaller more frequent meals - Wait 1 hour before antiacids or other meds SE: Black tarry stool |
|
What are the differences from Zantac and Tagamet?
|
- More potent with less side effects than tagamet
- Less drug interactions than tagamet - No anti-androgenic effects - Dose not cross BBB |
|
What is Irritable bowel syndrome?
|
- Irritability is intermittent
- 2nd most reason for missed days from work |
|
What are the 4 characteristics of tumors on the right side?
|
-Anatomical Location: Cecum and ascending colon
-Obstruction: unusual r/t growth does not encircle the colon -Manifestations: Pain and lower right quadrant mass -Stool: Black tarry: occult bleeding |
|
What are the 4 characteristics of tumors on the left side?
|
-Anatomical Location: Descending colon and rectum
-Obstruction: Cancers frequent r/t encircling the colon -Manifestations: Progressive abdominal distention cramping -Stool: Blood or mucous |
|
What are the two disorders of the gallbladder?
|
1. Cholelithiasis
2. Acalculous Cholecydistis |
|
What are the characteristics of Cholelithiasis?
|
- Lodging of gall stone in the cystic duct
- Most common form of gallstone is cholesterol - Risk factors: oesity, middle age, female, gallbladder, pancreatic, or ileal disease |
|
What are the treatments for Cholelithiasis?
|
- Surgery (abdominal or laproscopic) preferred
- Non surgical: Chemodissolution: dissolving the gall stone partially or completely |
|
What is the metabolism process of bilirubin?
|
- A biproduct of the destruction of aged RBC
- Gives bile greenish tint - Causes the yellowness of Jaundice - Can stain the brain -Hemoglobin splits --> bound in the bloodstream to albumin --> taken to the liver --> excreted |
|
What are the two disorders of the Pancreas?
|
1. Acute Pancreatitis
2. Chronic Pancreatitis |
|
What are the characteristics of Acute Pancreatitis?
|
- Pancreatic duct obstructed
- Release of enzymes, activation of autodigestion of the pancreas |
|
What are the characteristics of Chronic Pacreatitis?
|
- Persistence of symptoms from inflammatory lesions from weeks to months
|
|
Why is 75 % of the livers blood supply venous?
|
- The liver must pick up the nutrients from the small intestines
|
|
What are the 3 functions of the liver as a digestive organ?
|
1. Bile-salt secretion
2. Processing and storage of fats, carbohydrates, and proteins absorbed by the intestines 3. Processing and storage of vitamins and minerals |
|
What are the 2 functions of the liver as an endocrine organ?
|
1. Metabolism of glucocorticoids, mineralcorticoids, and sex hormones
2. Regulation of carbohydrate, fat, and protein metabolism |
|
What are the 4 functions of the liver as a Hemotologic organ?
|
1. Temporary storage of blood
2. Removal of bilirubin form the bloodstream 3. Hematopoiesis in certain disease states 4. Synthesis of clotting factors |
|
What are the 4 functions of the liver as an excretory organ?
|
1. Excretion of bile pigment
2. Excretion of cholesterol via bile 3. Urea synthesis 4. Detoxification of drugs and other foreign substances |
|
What is the cause of portal hypertension?
|
- Obstruction in the liver caused by gallstones or tumor
|
|
What are Gastroesophygeal varicies and their characteristics?
|
- Buldging blood vessels
Treatment: IV- vita K - Somatosatin works to close the blood vessels - Endoscopic band ligation keeps the vessels from rupturing |
|
What are the manifestations of Jaundice?
|
- Bilirubin is not conjugated and does not get where it needs to be to breakdown fats
- Hyperfilirubinemia: high levels of bilirubin occurs when there is hemolysis |
|
What is the pathology of cirrhosis?
|
- Scaring of the liver, end stage of liver
- Diffused hepatic fibrosis resulting in the alteration of blood flow and hepatic function |
|
What are the clinical manifestations of cirrhosis?
|
- No early signs and no changes until 80% of liver is damaged
- may present first in another system as in upper GI bleed |
|
What are the 6 liver function tests?
|
1. AST: Aspartate aminotransferase
2. ALT:Alanine aminotransferase 3. Serum albumin 4. PT: Prothrombin time 5. PTT: partial thromboplastin time 6. INR: International normalized ratio |
|
What is Hepatitis?
|
- Inflammation of the liver parenchyma (specific cells of the liver)
- Liver is unable to do its 12,000-18,000 functions in the body Phototherapy: Activates the liver, causes bilirubin to be conjugated |
|
What are the 5 effects of the activated mu receptors?
|
1. Sedation
2. Analgesia 3. Dependence 4. Decreased GI Mobility 5. Euphoria 6. |
|
Why do the drugs activate the mu receptors?
|
Because the mu receptors are the most receptive and located in the dorsal horn
|
|
What are the 5 opioid analgesic full agonist drugs?
|
1. Morphine
2. Demerol 3. Fentanyl 4. Oxycodone 5. Hydromorphine |
|
What are the adverse effects of Morphine?
|
1. N/V/C and biliary colic (spasms in the biliary; causes gallbladder pain)
2. Dizzyness, hypotension, fatgue 3. Dry mouth, urinary retention, confusion 4. Respiratory Depression: not given to pts with low RR |
|
What is the antagonist used if the pt respiratory rate drops to 12 beats and becomes hypotensive?
|
Narcam
|
|
What drug is given with Demerol?
|
Phenergan
|
|
What drug is given for as an opioid antagonist?
|
Narcam or Naloxone
- Withdrawls will be immediate - Neonatal resuscitation durg |