Pharmacology Test 2 chapt 2-4

studies indicate no risk to human fetus

studies indicate no risk to animal fetus, information on humans not available

adverse effects reported in animal fetus, information on humans not available

possible fetal risk in humans reported however consideration of risk to benefits in selected cases warrant use of drugs in pregnant women

fetal abnormalities reported and positive evidence of fetal risk in humans available from animal and human studies. These drugs should not be used if pregnant

Required identification of dangerous or addictive drugs

established legend drugs or Prescription vs non-prescription drugs must carry the legend caution federal law prohibits despensing without prescription

established schedules for controlled substance and promoted drug education & prevention of abuse

Do no harm = nonmaleficence
Do what is best for patient = beneficence

small numbers of healthy subjects
To determine optimal dosage ranges Determine pharmacokinetics

small numbers of afflicted volunteers
Monitored for effectiveness & side effects
Adjustments to therapeutic dosages done

large numbers of afflicted patients
Patients are followed by researchers
Studies include placebo-controlled and double-blind

voluntary studies after being marketed
Done by pharmaceutical companies
Documents proof of effectiveness
Results gathered for 2 years after release

respond better to diuretics than to beta blockers and angiotensin converting enzyme inhibitors, they respond less effectively to beta blockers, calcium blockers, especially dilitzium

respond less effectively to single drug therapy

need lower dosages of drugs such as haloperidol

respond better to lower dosages of antidepressants

require lower dosages of antipsychotic

require lower dosages of antimanic drug

an intergrated system of beliefs values and customs that are associated with a particular group of people generally handed down from generation to generation

the ability to work with patients with proper consideration for culture context which includes patients beliefs systems and values regarding health wellness and illness. it also involves learning about different patients and their specific responses to treatment including drug therapies

ethnic affiliation based on shared culture of genetic heritage or both

the study of the effects of ethnicity on drug responses specifically absoprtion, metabolism, distribution and excreation

often defines as class of individuals with common lineage

Defines the role of the professional nurse
Set minimums of expected safe practice
Further defined in each state’s Nurse Practice Act
What the various levels of nursing can do
Other guidelines come from the American Nurses Association (ANA)

H1-mediate smooth muscle contraction and dilation of capillaries
-H2-mediate acceleration of heart and gastric acid secretion

Allergic rhinitis (hay fever, mold and dust allergies)
Anaphylaxis
Angioneurotic edema
Drug fevers
Insect bite reactions

difference between good & dangerous effects

6 Rights

-increases force contractions and heart rate and thus increase cardiac output and hence blood flow to kidneys
-this in combination with ability to dilate blood increases glomerular filtration rate giving it a diuretic effect

a patient presents with -nausea
-vomiting
-sinus tacycardia
-extrasistole
- palpitations
- hyperglycemia
they are having adverse effects to what class of drug

-do you have a drug allergy
do you suffer fromuncontrolled cardiac dysrhymia
do you have a seizure disorder
have you ever been diagnosed with hyperthyroidism are questions you should ask for which class of drug
-peptic ulcers

do you have drug allergy
do you have an allergy to povidone, lactose, titanium dioxide, cellulose derivatives are questiosn you should ask for which class of drug

does not interact with theophylline, warafin, digoxin, prednisone or oral contraceptive
-phenbarbitol decreases montelukast concentration

-stimulates and enhances beta 2 agonist drugs such as Albuterol
-takes a few weeks to reach full benefit

a patient who is hypersensitive to gloccocorticoids and patients with positive candida sputum should avoid which class of drug

patients with diabetes may require adjustment with dosage because of increased blood glucose levels that occur with this class of drug

drug allergy especially with atropine or soy lecithin
do you have food allergy to peanut oil, peanuts, soy beans and legumes would be appropriate questions to ask a patient who is about to recieve what class of drug

a patient who is experencing
-dry mouth
-nasal congestion
- heart palpitations
-GI distress
-urinary retention
-increase in intraocular pressure
-headache
-coughing
-anxiety
is having an adverse effect to which group of drug

block ACh receptors to prevent bronchoconstriction which indirectly causes airway dilation

this class of drugs has these three mechanisms of action mast cell stabilizers
-leukotriene receptor antagonist
-corticosteroid
-work by stabilizing mast cells to prevent release of inflammatory mediators (histamines)

LTRA's
corticosteroids

known interactions of this class of drug are
- increased levels with erythromycin and ciprofloxacin, influenza vaccine and oral contraceptives
- if patient uses St.Johns wart or smokes dose may need to be increase because these lower levels
-also with char-boiled foods, low carb and high protein foods

traditional antihistamine not generally advised in elderly patients because of hangover effect which can increase risk of falls

expectorant used in symptomatic managment of coughs of varing orgin, thins mucus in respiratory tract has a half life of one hour and is a category C pregnancy drug

used in the treatment of parkinson disease and acute dystonic reactions, motion sickness, and sleep aid

nonopioid antitussive that is safe and non addictive, does not cause CNS depression, contraindicated in cases of drug allergy, asthma, emphysema, and persistant headache. Category C drug

Category B drug contrindicated in patients with known hypertension, nursing mothers, neonate, patients with LRT symptoms

nonsedating antihistamine to be used only once a day, does not distribute to CNS used to relieve symptoms of seasonal rhinitis and chronic urticaria, only contrindication is drug allergy Category B drug

beta 2 specific bronchodilating beta antagonist most commonly used drug in its class dose related adverse effect nausia, increased anxiety, palpitations, tremors, and increased HR available as MDI-metered dose inhaler contraindicated with tachycardia

most commonly used xanthine bronchodilator, maximized effects by keeping blood within a certain target range

has a therapeutic range of 10-20 mcg/ml but 5-15 mcg/ml is what is used in clinical setting

FDA approved to give to children 2 years of age
LTRA that blocks D4 receptors that augments inflammatory response
contraindicated in patients with hypersensitivity to drug Category B drug