Term
| localized, throbing or sharp pain; bone, skin, muscle |
|
Definition
|
|
Term
| tingling, burning; DM neuropathy, trigeminal neuralgia: |
|
Definition
|
|
Term
| mainly used for neuropathic pain |
|
Definition
|
|
Term
| WHO ladder for tx of pain: |
|
Definition
mild pain - non-opiod, +/-adjuvant
mild to moderate pain - opiod + nonopiod, +/- adjuvant
moderate to severe pain - strong opiod, +/- non-opiod, +/-adjuvant |
|
|
Term
| side effects of Acetaminophen: |
|
Definition
| liver toxicity, increased risk of bleed when taken w arfarin |
|
|
Term
|
Definition
1. prologation of bleeding time
2. renal toxic
3. GI toxic |
|
|
Term
| side effects of aspirin:2 |
|
Definition
1. REYEs syndrome in children
2. drug interactions w NSAIDs |
|
|
Term
| side effects of tramadol:7 |
|
Definition
1. headache
2. dizziness
3. N/V
4. constipation
5. dry mouth
6. seizures
7, CNS supression (DI with those affecting serotonin & NE) |
|
|
Term
| side effects of propoxyphine: |
|
Definition
| it is metabolised into norpropoxyphine that can accumulate and cause seizures |
|
|
Term
| side effects of morphine: |
|
Definition
|
|
Term
|
Definition
1. constipation
2. sedation
3. N/V
4. pruritis
5. respiratory depression |
|
|
Term
|
Definition
| needing higher dose for the same affect |
|
|
Term
| define physical dependance: |
|
Definition
| taking med for long period of time and when the drug is taken away, having rebound sx |
|
|
Term
|
Definition
| cravings, continued use despite adverse affects |
|
|
Term
| 2 types of nocireceptive pain and dif btwn: |
|
Definition
1. somatic nocireceptive: localized, sharp or throbing
2. visceral nocireceptive: not localized, refered pain usually fro minternal organs |
|
|
Term
|
Definition
A: determine which type of pain it is
B: chose severity of pain
C: as pain gets worse of lower levels are not effective move up the ladder
D: you can keep agents from the lower level on as you move up the ladder |
|
|
Term
| define adjuvant and give examples: |
|
Definition
| agent that modifies the effect of other agents while having few if any direct effects when given by itself: ex - anticonvulsants, corticosteroids, antidepressants are adjuvants for pain |
|
|
Term
|
Definition
| level where no analgesic benefits are seen but there are greater risks for side effects or toxicity |
|
|
Term
|
Definition
|
|
Term
|
Definition
| analgesic, antiinflammatory, antipyretic |
|
|
Term
|
Definition
1. NSAID
2. anipyretic
3. analgesic
4. anti-inflammatory
5. anti-platelet |
|
|
Term
|
Definition
| anti-inflammatory, antipyretic, analgesic |
|
|
Term
| Cox-2 inhibitor side effects: |
|
Definition
1. CV complications
2. bleeding risk w warfarin |
|
|
Term
|
Definition
1. codeine: no good for analgesia
2. propoxyphene (darvocet): as good as tylenol but many SEs metabolized portion will accum in renal fail & cause seizures |
|
|
Term
|
Definition
1. morphine (II)
2. hydromorphone (II)
3. hydrocodone (III)
4. oxycodone (II)
5. fentanyl (II)
6. Mepiridine (II) |
|
|
Term
| what kind of pain indicates adjuvant use? |
|
Definition
|
|
Term
| about how long does it take for adjuvants to start helping? |
|
Definition
|
|
Term
| Category A for use during pregnancy: |
|
Definition
| possibility for hars seems remote |
|
|
Term
| Category B for use during pregnancy: |
|
Definition
| animal studies have not demonstrated a fetal risk but there are not human studies OR animal studies show adverse affects but no human studies |
|
|
Term
| Category C for use during pregnancy: |
|
Definition
| animals revealed adverse affects w no control studies in women OR there are no studies at all |
|
|
Term
| category D for use during pregnancy: |
|
Definition
| positive evidence of human fetal risk |
|
|
Term
| category X for use during pregnancy: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| DOC for HTN during pregnancy: |
|
Definition
mild to moderate HTN = methyldopa or labetalol
severe HTN = hydralazene or labetalol |
|
|
Term
| DOC for depression during pregnancy: |
|
Definition
| SSRI (zoloft or prozac) NEVER paxil |
|
|
Term
| DOC for pain during preganacy: |
|
Definition
|
|
Term
| DOC for epilepsy during pregnancy |
|
Definition
| there is no DOC during pregnancy for epilepsy but NEVER use valproic acid |
|
|
Term
| DOC for asthma during pregnancy: |
|
Definition
SAB: albuterol
LAB: pulmicort |
|
|
Term
| DOC for N/V during pregnancy: |
|
Definition
| zofran & pryidoxime + unisom |
|
|
Term
| DOC for heartburn during pregnancy: |
|
Definition
| Tums or CaCO3 then H2 inhibitor |
|
|
Term
| DOC for constipation during pregnancy: |
|
Definition
|
|
Term
| describe 2 dosing strategies to minimize risk when breast feeding: |
|
Definition
1. if single dose admin just before longest sleep period of child
2. if multiple dose take immediately after feeding |
|
|
Term
|
Definition
| drug or chemical that can produce adverse affects in the population |
|
|
Term
| DOC for allergies during pregnancy: |
|
Definition
antihistamine (chlorpheniramine)
intranasal corticosteroid (Rhinocort) |
|
|
Term
| the movements of drugs through the body: |
|
Definition
|
|
Term
|
Definition
Absorption
Distribution
Metabolism
Elimination |
|
|
Term
| action of drugs in the body: |
|
Definition
|
|
Term
| this parameter dtermines the steady state concentration for a drug. determined by blood flow to the organ that is metabolizing or eliminating the drug and efficacy of the organ: |
|
Definition
|
|
Term
| relates the amount of drug in the body to the serum concentration. determined by physiological volume of blood and hoe the drug binds to blood and tissue |
|
Definition
|
|
Term
| time required for serum concentrations to decrease by 1/2 |
|
Definition
|
|
Term
| half life is dependant on: |
|
Definition
| clearance and volume of distribution |
|
|
Term
| the body's total exposure to the drug |
|
Definition
| AUC - area under the curve |
|
|
Term
| fraction of drug absorbed: |
|
Definition
|
|
Term
| describe the first pass affect: |
|
Definition
| blood in GI goes to the liver which may filter the drug some more than others |
|
|
Term
| describe enterohepatic recycling: |
|
Definition
| drugs excreted in teh feces go back through the intestines and can extend the ife of the drug in the body |
|
|
Term
| when the amount of drug taken and excreted is equal |
|
Definition
|
|
Term
| a higher initial dose that gets to therapeutic range faster followed by a lower dose to maintain therapeutic levels |
|
Definition
| loading dose and maintenance dose |
|
|
Term
|
Definition
| Times of maximum/minimum concentrations |
|
|
Term
| a common drug that exibits non-linear pharmacokinetics: |
|
Definition
|
|
Term
| 6 factors that influence drug dose and dosing intervals: |
|
Definition
1. age
2. gender
3. race
4. weight
5. dz sate
6. other drugs |
|
|
Term
| formula for steady state soncentration: |
|
Definition
|
|
Term
| formula for volume of distribution: |
|
Definition
| Vd = Dose/Cp so Cp = Dose/Vd |
|
|
Term
| how many 1/2 lifes of a drug does it take to sompletely clear from the body? |
|
Definition
|
|
Term
| the relationship of 2 preparations of the same drug at the same dose in the same doseage form that have similar bioavailability: |
|
Definition
|
|
Term
| formula for volume of distribution: |
|
Definition
| Vd = total amnt of drug in the body/amnt of drug in the blood |
|
|
Term
| 4 reasons children are at increased risk for dehydration: |
|
Definition
1. higher body surface:volume ratio
2. higher metabolic rates
3. smaller fluid reserves
4. dependent on care takers for fluid |
|
|
Term
| % weight loss in mild/moderate dehydration: |
|
Definition
|
|
Term
| eyes deep set is a sign of |
|
Definition
| mild/moderate dehydration |
|
|
Term
| 7 contraindications for oral rehydration therapy in children w mild/moderate dehydration: |
|
Definition
1. severe dehydration
2. severe sodium imbalance
3. inability to take ORS
4. vomit/stool output >10ml/kg/hr
5. intestinal ileus/obstruction
6. d/o that limits absorption
7. hematochezia |
|
|
Term
| 10 things assessed to determine severity of dehydration: |
|
Definition
1. weight loss
2. tears.
3. urine
4. eyes
5. fontanells
6. mental status
7. pulse
8. BP
9. breathing
10. cap refill |
|
|
Term
| IV for acute correction of hyponatremia: |
|
Definition
|
|
Term
| 2 isotonic solutions for acute resuscitation from severe dehydration: |
|
Definition
|
|
Term
| formula for % dehydration |
|
Definition
| pre-illness weight - illness weight/pre-illness weight |
|
|
Term
| calculate maintenance fluid for a 17kg pt. |
|
Definition
1. first 10kg = 1000ml
2. next 7kg get 50ml ea = 350ml
3. 1350ml/day = 56.25ml/hr |
|
|
Term
| calculate maintenance fluid for 28kg pt. |
|
Definition
1. first 10kg = 1000ml
2. next 10kg = 500ml
3. next 8kg get 20ml ea = 160ml
4. 1660ml/day = 69.16ml/hr |
|
|
Term
| calculate maintenance fluid for 7kg pt: |
|
Definition
1. 100ml/kg x 7kg = 700ml/day
2. 29.16ml/hr |
|
|
Term
| 4 IV solutions for hypotonic dehydration |
|
Definition
1. D5W
2. D10W
3. 1/4 NS
4. 1/2 NS |
|
|
Term
| 2 IV solutions for isotonic dehydration: |
|
Definition
|
|
Term
| IV solution for hypertonic dehydration: |
|
Definition
|
|
Term
| immunizations: provides life long immunity |
|
Definition
|
|
Term
| side effects of live attenuated vaccine: |
|
Definition
w/n one week may see sx similar to dz but less severe - cellular response
2. rare: can revert to dz causing forms
3. contraindicated in immunocomprimised
4. allergic rxns |
|
|
Term
| mechanism of action for live attenuated vaccines: |
|
Definition
| virus replicates causing natural immune response |
|
|
Term
| onset of effectiveness for live attenuated vaccine: |
|
Definition
| onset wn one week and life long immunity |
|
|
Term
| requires booster w most protection after 2-3 doses: |
|
Definition
|
|
Term
| mechanism of action for inactivated vaccines: |
|
Definition
|
|
Term
| adverse affects of inactivated vaccine: |
|
Definition
|
|
Term
| 5 no good excuses for not having a vaccine: |
|
Definition
1. mild illness
2. abx
3. pregnancy/breast feeding
4. premature birth
5. non-specified allergies |
|
|
Term
| 4 valid contraindications to vaccination: |
|
Definition
1. pregnancy for live vaccines
2. immunosupressioin for live vaccines
3. severe illness
4. recent blood products; circulating Ab in donor blood will bind to vaccine |
|
|
Term
| required childhood vaccines:11 |
|
Definition
1. DTap
2. Flu
3. Pneumococcal
4. Hep A/B
5. Polio
6. HiB
7. MMR
8. Varicella
9. HPV
10. Meningococcal
11. rotavirus |
|
|
Term
| target group and frequency for Tdap: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| vaccines indicated for adults:7 |
|
Definition
1. Tdap q10yrs
2. Flu yearly
3. Pneumovax 1dose then 2dose @5yrs
4. HepA/B at risk
5. MMR/Varicella if not given as a child
6. Pertsis replaced by Tdap
7. Herpes zoster once over 60yo |
|
|
Term
| how is diptheria transmitted? |
|
Definition
| direct phys contact or droplet |
|
|
Term
| is diptheria still a threat in the US |
|
Definition
|
|
Term
|
Definition
|
|
Term
| population at highest risk for tetanus? |
|
Definition
|
|
Term
| who should not receive the intranasal flu vaccine? |
|
Definition
1. prego
2. immune comp
3. asthma
4. infants
5. egg allergy |
|
|
Term
| how often should adults be vaccinated for pneumococcal dz? |
|
Definition
|
|
Term
| how do you get infected with hep A |
|
Definition
|
|
Term
| side effects of varicella vaccine |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| 5 conditions that contraindicate topical decongestant use: |
|
Definition
1. MI
2. angina
3. CAD
4. Arrhythmia
5. <6mo |
|
|
Term
| 8 conditions that contraindicate oral decongestant use: |
|
Definition
1. MI
2. angina
3. CAD
4. Arrhythmia
5. HTN
6. hyperthyroidism
7. BPH
8. narrow angle glaucoma |
|
|
Term
| antitussives are contraindicated in:3 |
|
Definition
1. persistant/chronic cough related to asthma
2. COPD
3. smoker |
|
|
Term
| 3 contraindications to antihistamines: |
|
Definition
1. narrow angle closure glaucoma
2. BPH
3. COPD |
|
|
Term
| contraindications for antacid use:2 |
|
Definition
|
|
Term
| 7 contraindications to bulk laxative use: |
|
Definition
1. fluid restriction
2. ulcerations
3. obstruction
4. strictures
5. impactions
6. dysphagia
7. <6yo |
|
|
Term
| 2 contraindications for stimulant laxatives: |
|
Definition
|
|
Term
| 3 local ADR of topical decongestants: |
|
Definition
1. burning/stinging
2. sneezing
3. increased nasal discharge |
|
|
Term
| 5 systemic ADR of topical decongestants: |
|
Definition
1. tremors
2. anxiety
3. restlessness
4. brady/tachycardia
5. HTN |
|
|
Term
| 4 systemic ADR of oral decongestants: |
|
Definition
1. CNS stimulation
2. palpitation
3. tachycardia
4. tremor |
|
|
Term
|
Definition
1. CNS depression
2. bradycardia
3. resp depression
4. hypotension
5. constipation |
|
|
Term
| 2 ADRs of dextromethorphan: |
|
Definition
1. abd discomfort
2. dizziness |
|
|
Term
|
Definition
1. gastric irritation (take w water)
2. nausea
3. vomiting |
|
|
Term
| 8 possible ADRs of antihistamines: |
|
Definition
1. drymouth
2. difficult urination
3. constipation
4. excitation
5. sedation
6. confusion
7. blurred vision |
|
|
Term
|
Definition
1. HA
2. dry mouth
3. somnolence
4. nervousness |
|
|
Term
|
Definition
1. hypernatremia
2. alkalosis
3. acid rebound
4. milk-alkali syndrome
5. bowel perforation |
|
|
Term
| 6 ADRs of calcium carbonate: |
|
Definition
1. hypercalcemia
2. alkalosis
3. acid rebound
4. milk-alkali syndrome
5. constipation
6. kidney stones |
|
|
Term
| 5 ADRs of aluminum hydroxide: |
|
Definition
1. aluminum toxicity
2. constipation
3. hypophosphatemia
4. osteomalacia
5. osteoporosis |
|
|
Term
| 3 ADRs of magnesium hydroxide: |
|
Definition
1. hypermagnesemia
2. kidney stones
3. osmotic diarrhea |
|
|
Term
| 7 ADRs of H2 antagonists: |
|
Definition
1. abd pain
2. diarrhea
3. constipation
4. nausea
5. vomiting
6. HA
7. drowsiness |
|
|
Term
|
Definition
1. abd pain
2. diarrhea
3. constipation
4. nausea
5. vomiting
6. HA
7. dizziness |
|
|
Term
| 5 ADRs of bismuth subsalicylate: |
|
Definition
1. discoloration of tongue
2. dark,black stools
3. increased bleeding risk
4. tinnitus
5. reyes syndrome |
|
|
Term
|
Definition
1. oily spotting
2. abd pain
3. urgency
4. flatus w discharge
5. oily/fatty stools |
|
|
Term
| define: premature neonate: |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| reasons for medication errors in children: |
|
Definition
| dosing errors, compounding errors, obese children, transcription errors |
|
|
Term
| most accurate measuring device for oral liquid medications: |
|
Definition
|
|
Term
| 3 dosing guidlines in determining pediatric medication dosing: |
|
Definition
1. age based dosing regimens
2. body weight based dosing
3. body surface area based dosing |
|
|
Term
| advantage/disadvantage of age based dosing: |
|
Definition
easy to use in everyday practice
assumes ADME same in all pts |
|
|
Term
| advantage/disadvantage of bodyweight dosing: |
|
Definition
advantage: peds pt have higher clearance based on weight than adults
disadvantage: no established cut off, can result in exceeding adult recommendations |
|
|
Term
| advantage/disadvantage of body surface area dosing: |
|
Definition
advantage: more precise dosing scheme
disadvantage: more difficult calculations & require child height which is sometimes hard to get and results in inconsistencies |
|
|
Term
|
Definition
|
|
Term
calculate dosing: 35lb pt c otitis media give amoxicillin q12h x10d...
Amox = 80-90mg/kg/day |
|
Definition
1. 35lbs/2.2 = 15.9kg
2. 15.9 x 80mg = 1272.72mg/day
3. 1272.72mg/2 = 636.36mg Q12H
4. amox comes 400mg/5ml
5. 636.36mg x 5ml = 3180mg/5ml/400 = apx 8ml PO Q12H |
|
|
Term
|
Definition
|
|
Term
|
Definition
| centrally acting analgesic for moderate to moderately severe pain |
|
|
