Term
Echinacea (Echinacea pupurea)
USES? |
|
Definition
-Immune Modulation (controversial)
-*Anti Inflammatory |
|
|
Term
Feverfew (Tanacetum parthenium)
USES? |
|
Definition
-Migraine Headache (most often migraine prophylaxis)
-Rheumatoid Arthritis (Anti-inflammatory) |
|
|
Term
Echinacea (Echinacea pupurea)
S/E (w/ IV and oral use)? |
|
Definition
IV- flu like sx's
Oral- unpleasant taste, GI upset, CNS effects (HA, dizziness), allergic rxn (rare) |
|
|
Term
Feverfew (Tanacetum parthenium)
Most common S/E's? |
|
Definition
|
|
Term
| Garlic (Allium sativum)has effects on what general systems/processes of dz? (there is 4) |
|
Definition
-Cardiovascular effects
-Endocrine effects
-Anti-microbial effects
-Antineoplastic effects |
|
|
Term
Garlic (Allium sativum)
S/E's? |
|
Definition
| nausea, hypotension, allergy,bleeding, breath odor, contact dermatitis |
|
|
Term
| Garlic (Allium sativum) should be used cautiously in pts receiving ________ medications |
|
Definition
|
|
Term
| What is Ginseng used for? |
|
Definition
| to improve physical and mental performance |
|
|
Term
|
Definition
| vaginal bleeding and mastalgia (secondary to weak estrogenic properties), CNS stimulation (insomnia, nervousness), HTN |
|
|
Term
| ST. John's Wort (hypericum perforatum) USES? |
|
Definition
-antidepressant
-antiviral
-anticarcinogenic |
|
|
Term
| ST. John's Wort (hypericum perforatum) S/E's? |
|
Definition
photosensitization
hypomania |
|
|
Term
| Saw Palmetto (Serenoa repens/Sabal serrulata) USE? |
|
Definition
| Benign Prostatic Hyperplasia (BPH) |
|
|
Term
| Saw Palmetto (Serenoa repens/Sabal serrulata) S/E's? |
|
Definition
| HTN, HA, decreased libido, impotence,GI upset, abd pain, back pain, urinary retention |
|
|
Term
| Exogenous Dehydroepiandrosterone (DHEA)supplementation is advocated for/used for what (5)? |
|
Definition
-age related d/o's
-weight loss
-reduced heart dz risk
-cancer prevention
-immune system enchancement |
|
|
Term
| Dehydroepiandrosterone (DHEA) S/E's? |
|
Definition
-BPH and cancer
-other cancers: breast
-endocrine: DHEA conversion to testosterone favored in post menopausal women & conversion favors estrogen in men |
|
|
Term
|
Definition
-induce sleep
-jet lag (OTC sleep aid) |
|
|
Term
| Melatonin is contraindicated or should be used cautiously in what pts? |
|
Definition
Women who are pregnant, attempting to conceive, or nursing
(suppresses LH surge and decreases prolactin release) |
|
|
Term
|
Definition
| drowsiness, tachycardia, dysthymia, HA, sporadic cases of movement d/o's and psychoses |
|
|
Term
| You want to avoid Echinacea in what patients? |
|
Definition
avoid in pts w/...
-Immune deficiency d/o's (ex. AIDS, CA)
-Autoimune d/o (RA, MS)
-TB
-Immunosuppression |
|
|
Term
Name the Drug Law
-required manufactures to provide the FDA w/evidence of drug safety in the form of a New Drug Application before distributing the agent
-introduced the principle of separating drugs into prescription and nonprescription (OTC) categories |
|
Definition
| Federal Food, Drug, and Cosmetic Act of 1938 |
|
|
Term
Name the Drug Law
-An amendment to the Federal Good, Drug, and Cosmetic Act of 1938
-prohibited the dispensing & refilling of certain kinds of drugs (systemic antibiotics, cortisosteroids & other agents whose unsupervised use may not be safe) except on the prescription of a licensed practitioner |
|
Definition
| Durham-Humphrey Law/Amendment of 1951 |
|
|
Term
Name the Drug Law
-An amendment to the Federal Good, Drug, and Cosmetic Act of 1938
-required manufacturers of new drugs to proceed along set standards of animal and human pharmacological and toxicologic testing; data from each step to be reviewed by FDA |
|
Definition
| Kefauver-Harris Ammendment of 1962 |
|
|
Term
Name the Drug Law
-regulates control of the distribution depressant and stimulant drugs(opiods, barbs, amphetamines) and other classes of drugs designated as possessing abuse potential by the DEA |
|
Definition
|
|
Term
A drug with high abuse potential, no current accepted medical use, may lead to severe dependence, ex. LSD, heroin
SCHEDULE ___ of Controlled substance Act? |
|
Definition
|
|
Term
Abuse potential < Schedule I & II, accepted medical use, mod to low dependence liability relative to drugs of Schedule II, ex. glutethimide
SCHEDULE ___ of Controlled substance Act? |
|
Definition
|
|
Term
A drug with high abuse potential, accepted medical use, may lead to severe dependence, ex. amphetamine, methadone, morphine
SCHEDULE ___ of Controlled substance Act? |
|
Definition
|
|
Term
A drug with low abuse potential, accepted med use, limited dependence liability, ex.phenobarbital, diazepam
SCHEDULE ___ of Controlled substance Act? |
|
Definition
|
|
Term
Less abuse and dependence than Schedule IV, accepted med use, may be sold w/o a prescription, ex. cough preparations containing codeine or similar opiate derivatives
SCHEDULE ___ of Controlled substance Act? |
|
Definition
|
|
Term
WHAT COMPONENT OF THE PRESCRIPTION DOES THIS BELONG?
directions to the patient |
|
Definition
| Transcription/Signature"Sig" |
|
|
Term
| What is included in the Inscription component of the prescription? |
|
Definition
name of drug, unit dosage/strength or amt of drug
Ex. Amoxicillin 125mg/mL suspension |
|
|
Term
| In compliance with the Control Substance Act of 1970 what must appear on any prescription for a controlled or scheduled drug |
|
Definition
|
|
Term
WHAT COMPONENT OF THE PRESCRIPTION DOES THIS BELONG?
directions to the pharmacist
-quantity and dosage form of drug to be dispersed
-# of authorized refills |
|
Definition
|
|
Term
| What is included in the Superscript component of the prescription? |
|
Definition
| patient and provider demographics, the symbol which means “Take Thou”(Rx) |
|
|
Term
|
Definition
| (in an acid environment)crosslinking to produce viscous sticky polymer that adheres to epithelial cells of ulcer craters & inhibits hydrolysis of mucosal proteins by pepsin |
|
|
Term
| Contraindication of Sucralfate |
|
Definition
Renal failure
-risk for Aluminum overload |
|
|
Term
|
Definition
| inhibits HCL secretion (PGE2) and increases bicarb and mucous secretion (PGI2)via activation of EP3 receptors on parietal & epithelial cells |
|
|
Term
| Misopristol S/E's & Contraindications |
|
Definition
-diarrhea, cramps, abd pain
-pregnancy(incr uterine contractions) |
|
|
Term
| What administration instructions would you give a patient you prescribed Sucralfate for? |
|
Definition
Take on an empty stomach 1 hr BEFORE meals & AVOID antacids
(b/c drug activated by stomach acid) |
|
|
Term
| Which class of drugs inhibits H+/K+ ATPase pump and used for GERD, duodenal/gastric ulcers, & H.pylori infxn |
|
Definition
|
|
Term
FETAL THERAPY: Match drug w/ use
_______=Stimulates lung maturation
_______=induces liver enzymes close to term reducing incidence of jaundice
_______=stimulate production of surfactant
_______=tx fetal arrythmias |
|
Definition
Corticosteroids=Stimulates lung maturation
Phenobarbital=induces liver enzymes close to term reducing incidence of jaundice
Betamethasone=stimulate production of surfactant
Antiarrythmic=tx fetal arrythmias |
|
|
Term
TERATOGENICITY
What is the drug teratogenic effect?
Carbamazepine-->
Diethylstilbestrol-->
Lithium-->
Thalidomide--> |
|
Definition
Carbamazepine-->Neural tube defects
Diethylstilbestrol-->vaginal adenosis, vaginal adenocarcinoma
Lithium-->Ebstein's anomaly
Thalidomide-->Phocomelia |
|
|
Term
| Name the 4 Teratogenic Mechanisms? |
|
Definition
1. Effect on Maternal tissue (ex. cocaine->abortion)
2.Diminish delivery of O2 and nutrients (ex. cocaine->vasoconstriction)
3. Alterations during differentiation (ex. excess Vit A-> bone dysfxn, liver damage; excess niacin->ocular dysfsn)
4. Vitamin or Mineral deficiencies (ex. folic acid def->neural tube defect) |
|
|
Term
| Diseases during pregnancy that require treatment |
|
Definition
| Diabetes, Arrhythmias, Depression, Psychosis,Cancer, Chronic conditions (epilepsy) |
|
|
Term
| 6 Factors affecting Drug Transfer to the Fetus |
|
Definition
1. Physiochemical properties
2. Amount of Drug Reaching Fetus
3. Exposure Rate
4. Duration of Exposure
5. Tissue Distribution
6. Stage of Development |
|
|
Term
| The duration of exposure of the fetus to a drug can be increased if the fetus takes in the drug eliminates it into the amniotic fluid and takes in the drug again repeating that cycle...WHAT IS THAT CALLED? |
|
Definition
|
|
Term
| When is the fetus LEAST vulnerable to teratogens? MOST? |
|
Definition
| 1st 2 weeks; 1st trimester |
|
|
Term
| If a teratogen disrupts the development of an organ/body part early there will most likely be _______ defects; later _______ defects |
|
Definition
| morphological; physiological |
|
|
Term
DRUG AFFINITY FOR SPECIFIC TISSUES
Tetracycline->
Quinine->
Corticosteroids->
Phenytoin->
Warfarin-> |
|
Definition
Tetracycline-> teeth, liver
Quinine-> retina
Corticosteroids-> Adrenal gland
Phenytoin-> Adrenal gland
Warfarin->face, bone deformations |
|
|
Term
| What are the physiochemical properties of drugs that affect transfer to the fetus? |
|
Definition
Lipid solubility
Degree of Ionization
Protein Binding
Molecular Size
Placental Metabolism
Placental Transport |
|
|
Term
| Name 3 factors that INCREASE placental transfer of drugs; DECREASE |
|
Definition
INCREASE:
Lipid Solubility
Nonionized state
High maternal-fetal gradient
Increased fetal acidity
Molecular weight <600
Low protein binding
Increased placental blood flow
Larger surface area
DECREASE:
Incr diffusion distance
High molecular charge
High molecular weight
Highly protein bound
Drug alterd or bound by placental enzymes
Decr maternal blood flow
drugs highly metabolized by mother |
|
|
Term
REMEMBER CHILDREN ARE NOT LITTLE ADULTS!
What are 2 of 4 reasons children are very susceptible to drug toxicity? |
|
Definition
-Prone to hypersensitivity
-Immature kidney & liver
-Relative insufficiency of drug binding proteins
-Immature BBB |
|
|
Term
| 4 factors that create difficultly in dispensing medications to children |
|
Definition
-measuring errors
-spitting
-spills
-polytherapy |
|
|
Term
| Out of the drugs affecting mobility in the elderly which do NOT cause sedation? |
|
Definition
-Beta-adrenergic blockers
-Antihypertensives |
|
|
Term
| Out of the drugs affecting mobility in the elderly which drug class causes cardiac arrhythmias and tremors? |
|
Definition
| Tricyclic antidepressants (TCA'S) |
|
|
Term
AGE RELATED CHANGES IN ORGAN BLOOD FLOW RATES
With/As a fxn of age there is a _____ in blood flow rate to what areas of the body? |
|
Definition
| DECREASE; brain, heart, liver, kidney, tissue |
|
|
Term
| Name 4 physiologic fxns that decline with age |
|
Definition
-Heart: conduction velocity, cardiac index
-Lung: vital capacity, max breathing capacity
-Kidney: standard GFR, standard renal plasma, standard renal plasma flow
-Misc: basal metabolic rate, standard cell water |
|
|
Term
| Geriatric Barriers of Compliance (5) |
|
Definition
1. Regimen complexity
2. Miscommunication
3. unresolved pt concerns
4. Physical disabilities
5. Chronic Dz |
|
|
Term
| What is the preferred Tx for rapid relief of Dyspnea in asthmatics? |
|
Definition
| Short acting beta-agonist (ex. albuterol) |
|
|
Term
At VERY high doses which class of asthmatic drugs can cause these adverse effects?
Seizures, Toxic encephalopathy, hyperthermia, brain damage |
|
Definition
|
|
Term
Which asthmatic drugs...
•Inhibit immediate allergic response to antigen but DOES NOT relieve response once initiated
•Inhibit mediator release from bronchial mast cells |
|
Definition
|
|
Term
| The most important muscarinic cholingergic receptor anticholingergics work on is... |
|
Definition
M3 (mediating smooth muscle
contraction and mucous gland secretion in airway)
but works on M1-4 |
|
|
Term
| Name 4 Adverse effects of corticosteroids used for asthma |
|
Definition
Hypothalamic–pituitary–adrenal axis suppression
Bone resorption
Carbohydrate and lipid metabolism
Cataracts
Skin thinning
Purpura
Dysphonia
Candidiasis
Growth retardation |
|
|
Term
WHO AM I?
•Does NOT directly relax smooth muscle
•Little effect on acute constriction, and doesn’t affect mast cells
•Induced apoptosis in inflammatory cells (eosinophils and TH2 lymphocytes)
•Reduce the # of inflammatory cells in airways and damage to epithelium |
|
Definition
|
|
Term
TYPE A or TYPE B ADRxn?
-exaggeration of drugs normal pharmacological action @ therapeutic doses
-predictable
-dose dependent
-high Incidence & morbidity
-low mortality
-tx: adujust dose |
|
Definition
|
|
Term
Describe TYPE B ADRxn
-predictability
-dose-dependence
-morbidity
-mortality
-tx |
|
Definition
-predictability= (-)
-dose-dependence= (-)
-morbidity= (low)
-mortality= (high)
-tx= (STOP) |
|
|
Term
FREQUENCY CLASSIFICATION
> If a drug causes a rash in 13% of pts that ADR is ________
>If 1 in a 1000/5 cases in 3 yrs get the rash it is _____
>If 5% of pts get the rash it is ____
>If less than 1% but >1:100(0.1%) than it is _________ |
|
Definition
> If a drug causes a rash in 13% of pts that ADR is *COMMON
>If 1 in a 1000/5 cases in 3 yrs get the rash it is *VERY RARE
>If 5% of pts get the rash it is *OCCASIONAL
>If less than 1% but >1:1000 than it is *RARE |
|
|
Term
NAME THE DRUG INTERACTION TYPE
Ex. Phenergan(R), an antihistamine, when given with a painkilling narcotic such as Demerol(R) intensifies its effect, there by cutting down on the amount of the narcotic needed. |
|
Definition
Potentiation
-increased effect of a toxic agent acting simultaneously w/ a nontoxic one
-a+b=A |
|
|
Term
NAME THE DRUG INTERACTION TYPE
Ex. taking a dose of alcohol and a dose of a barbiturate (2 depressantss) causing a coma
1+1=5 |
|
Definition
Synergism
-both are depressants and alone may not cause a coma but together more likely because more depression
- combined effect of 2 chemicals > sum of effect of each agent alone |
|
|
Term
NAME THE DRUG INTERACTION TYPE
EX. barbiturate and a tranquilizer given together before surgery to relax the patient
1+1=2 |
|
Definition
Additive
-combined effect of 2 chemical =sum of the effect of each individual agent when given alone |
|
|
Term
| Give 2 of the 4 subtypes of Antagonistic drug reactions |
|
Definition
-functional or physiological antagonism
-chemicl antagonism or inactivation
-Dispositional antagonism
-antagonism at the receptor |
|
|
Term
PharmacoKINETIC or PharmacoDYNAMIC?
Drug effects the absorption, distribution, metabolism, and excretion of another drug |
|
Definition
|
|
Term
| What is the general criteria for establishing that an adverse effect is caused by a drug the pt is taking? |
|
Definition
1. Is the chronology from admin of drug and onset of untoward event/rxn appropriate?
2. Is the rxn a known pharmacologic effect or adverse effect of the drug?
3. Can the pts illness or non pharmacologic therapy account for the rxn?
4. What happens when the drug is discontinued (dechallenged)?
5. What happens when the patient resumes taking the drug, either accidental or intentionally (rechallenge)? |
|
|
