Chamberlain Pharmacology Exam 1

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What is pharmaceutics
The dosage form that determines the rate of drug dissolution

What is pharmacodynamics
What the drugs do to the body.. therapeutic effects

What is pharmacokinetics
What the body does to the drug..movement of drugs through the body

What is the process of pharmacokinetics
Absorption, distribution, metabolism and excretion

List the absorption routes of drugs by mouth from fastest to slowest
Sublingual
Liquid Suspension
Capsule
Tablet
Enteric coated tablets
Extended release tablets

What type of drugs are absorbed into the GI tract and metabolized by the liver. This results in a reduce amount of bioavailability or active drug in the circulatory system. therefor this type of drug has a higher dose to allow for the effect
Oral drugs

What form of drugs are affected by the first pass effect
Elixir, tablets and capsules

What are considered enteral drugs
Elixirs, tablets and capsules

What drugs are not affected by the first pass effect
IV, sublingual, transdermal patch, suppository (parenteral drugs)

What is the First Pass Effect
Initial liver metabolism

Drugs not affected by first pass effect are considered
parenteral (IV, sublingual, transdermal patch and suppositories)

What is half life of a drug
The time it takes for half of a drug dose to be eliminated from the body
Ex: 200mg ibuprofen has a half life of 2 hours, 100 mg will be remaining in the body after 1 half life or 2 hours. After 2 half lives (4 hours) only 50 mg will be left etc etc etc

Rate of distribution depends on what
Vascular permeability, blood flow and perfusion

What is it called when drugs become available to action sites.
Example low levels of albumin and immunigloblins (blood proteins) results in problems with toxicity because there are fewer binding sites for the drug
Distribution

What causes free drugs to float around the body causing toxicity
Low protein/Low albumin level

What are areas of fast distribution
Heart, liver and kidneys

What are areas of slow distribution
Muscle, fat and skin

What are the normal lab values for Albumin
3.5-5.5g/dL

What is metabolism of drugs
The use and transformation of drugs so that they can be excreted from the body

Why do neonates and infants have poor metabolism and excretion of drugs
They have immature liver and kidneys

Where are many drugs metabolized and excreted
Liver and excreted through the kidneys

Genetic conditions that affect how the liver metabolizes drugs
Fast acetylators and slow acetylators

Many drugs are bio-transformed through which enzyme
cytochrome P-450 and fat soluble metabolics that are easy to eliminate

What are slow acetylators
People who take a longer time to clear certain drugs from the live. They may experience a higher level of drug side effects because the drug stays in the system longer

Which 2 organs are the major drug excreters
Liver and kidneys (important in young and old due to ineffectiveness)

Where are drugs excreted (10 total possibilities)
Liver
Kidney (urine)
Hair
Skin
Breath
Saliva
Sweat
Feces
Milk
Bile (breaks down and excrete lipids and other toxins)

What are the 6 rights
Right Patient
Right Drug
Right Route
Right Dose
Right Time
Right Documentation

What is definitive therapy
administering antibiotics based on culture and sensitivity results…preferred method and most common

What are drug dosages
They likely need be decreased in pts with chronic liver and renal failure, concurrent meds metabolized by the same pathway

What are drug routes
IV, Transdermal patch, oral, sublingual, sub Q, IM, suppository

What is empiric therapy
Administering antibiotics prior to getting culture and sensitivity results ( UTI, STREP)

What is a PEAK blood draw
Highest concentration of drug in system usually drawn 1 hour after drug is given IV

What is a Trough blood draw
Lowest concentration of drug in system usually drawn right before next does

What is prophylactic therapy
Administering antibiotics as a preventative measure without a culture and sensitivity. Example..giving antibiotics before a surgical procedure to prevent infection

What is a superinfection
When high doses of an antibiotic kills the normal flora another infection can occur simultaneously which is resistant to the antibiotic given to the original infection

What is the Narrow therapeutic window
A narrow margin of safety because they have more potential for toxicity

Therapeutic window
Margin of effectiveness and safety of a drug

What are disinfectants
They destroy and kills organisms on non living objects
Example: Lysol

What is a secondary infection
An infection that occurs after the first infection is gone. Example UTI

What is an antiseptic
May inhibit but not necessarily kill growth on living tissue. Example: Neosporin and Bactine

Antibiotic and acetaminophen are both metabolized through where
Liver and can cause toxicity if combined

What is bacteriostatic
It inhibits bacterial growth
Example: Clindamysin

What are 2 types of antibiotics
Bacteriostatic and Bactericidal

What is bactericidal
Kills the bacteria
Example: PCN

Gram positive antibiotic are _____ to antibiotics
Susceptible

Gram negative antibiotics are ____ to antibiotics
Resistant

Why is it a priority to take a blood sample for culture and sensitivity before starting antibiotic therapy
To determine which microbe and which antibiotic is most effective..important to know if it is gram positive or negative

What is a therapeutic response of antibiotic therapy
Decrease in fever..WBC is normal range…decrease red and inflammation..decrease drainage and pain

What is the normal WBC
4500-10000 mmm3

What can food/drug interactions due
Decrease absorption
Example: Milk and cheese will decrease the absorption of Tetracycline

What are Sulfonamides
A class of antibiotics- Crystalluria is common in urine
-Drink lots of fluids, hydration is key
-Sulfamethoxazole (Bactrim) can interact with warfarin (Coumadin) and increase bleeding time.
**Important for nurse to understanding clotting time for patient (Prothrombin Time PTT) as well as International Normalized Ratio (INR)

What are antibiotics
Generally aimed at killing bacteria

What are antimicrobials
aimed at inhibiting or destroying microbes such as viruses, parasites, or fungi

What are Penicillins (PCN)
A class of antibiotics- same family as Cephalosporins.
*Patients allergic to PCN can have allergic reactions to cephalosporins too

What do you do if a patient has difficulty breathing when Penicillin is administered by IV
Stop IV infusion of penicillin 1st, then vital signs and call physician

What are Cephalosporins
Same family of antibiotic as PCN

What are Quinolones
Class of antibiotic-
Example: Levofloxin (Levaquin)
Serious side effect: Tendonitis/tendon rupture

What are Macrolides
Class of antibiotic-
Example: Clarithromycin (Biaxin) used to treat strep throat, pneumonia, skin infections, H. pylori infection, Lyme disease.
Can cause tinnitus and ototoxicity
**Works by interrupting protein synthesis in bacterial cells
-Half-life determines how frequently it’s taken per day

What is Clarithromycin
A type of Macrolides- made from erythromycin
Clarithromycin has a longer half life the erythromycin
**Erythromycin- Ototoxicity (hearing loss, tinnitus) Shorter half life

What are Tetracyclines
Class of antibiotic
-Permanent discoloration of teeth if taken before 8 YO
-Can decrease effect of oral contraceptives
-Photosensitivity is side effect (avoid sunlight)
-A lot of water to avoid nausea & subsequent anorexia
-Dairy products decrease effectiveness as well as antacids (they inhibit absorption of antibiotic)

Vancomycin (Vancocin)
Antibiotic- used to treat gram positive bacteria such as MRSA- does NOT work against gram negative bacteria
-Needs to be administered over 60 min. or can cause Red Man Syndrome

What are Aminoglycosides “mycins”
Class of antibiotic-
Example: gentamicin sulfate (Garamycin) is nephrotoxic
-Dehydration can increase toxicity in kidneys- urine is concentrated

**assess for decreased urinary output & if so, INCREASE fluids.
-Nephrotoxicity exacerbated when aminoglycosides taken with Cefazolin (Ancef)
-Ototoxic- hearing loss, tinnitus

Nitrofurantoin (Macrodantin)
Antibiotic- Used to treat UTI’s can cause upset stomach. Take with food to avoid GI distress

Antibiotics generally decrease the effectiveness of this:
Oral contraceptives

What is red man syndrome characterized by
Flushing and itching of neck, face and torso within 5-10 min

Patients on antibiotic therapy can present with this symptom:
White patches in their mouth

*notify healthcare provider- could be minor or serious

These two things can occur with antibiotic therapy and could be fatal
Neutropenia & agranulocytosis

What is Agranulocytosis
When absolute neutrophil count (ANC) is <100/microliter of blood (Normal= 1500) *can lead to death from blood infection

Dairy, especially milk and cheese decreases the effectiveness of which class of antibiotics
Tetracycline

What is Neutropenia
Low number of neutrophils <1700 Can lead to death

What are Antimicrobials
Drugs aimed at destroying other microbes that cause infections such as viruses (HIV), parasites (malaria), and fungi (Candida)

Research has show that this drug prevents transmission of HIV from HIV-infected pregnant women to the infant. FDA Category C
Zidovudine (Retrovir)

Antivirals
Kill healthy cells too, while killing viruses

Nitrofurantoin may turn urine what color
Red/Brown

Rifampin has many drug interactions and may cause urine, saliva, and sweat to turn this color
Orange

Antituberculosis Drugs
Patients should NOT stop taking anti-TB meds- mycobacterium can grow, make patient sicker & become antibiotic resistant.
-Must take at same time every day to keep blood concentration consistent
Avoid alcohol- it exacerbates liver toxicity
Peripheral neuropathy can occur
Can decrease effectiveness of oral contraceptives

What is Retrovir
Anti viral that prevents transmission of HIV to fetus from infected mothers (Category C)

What is Amphotericin
A systemic anti antifungal. Common adverse effects with IV administration of Amphotericin B include fever and nausea

What is a side effect of Metronidazole (FLAGYL)
Usually given IV
Turns urine reddish brown…harmless

What are the most common side effects with antibiotics
Nausea, vomiting, diarrhea, headache and anorexia

Do not take these if pregnant, breast feeding, under 2, renal or hepatic problems
Sulfonamides

Take Sulfonamides with a full glass of water to prevent this
Crystallization in urine, neutropenia, & agranulocytosis

“ototoxic” and “nephrotoxic” go with:
“mycins”

What form of absorption bypasses the first pass effect
Sublingual

What are the parental routes
Other drugs then the GI tract

What is bioavailability
The extent to which drug can be used by the body

How should you administer HIV antivirals such as Acyclovir
Slowly over an hour

Why do anti viral cells also kill healthy cells
They live on our healthy cells

Can antivirals cure an infection
No, but they can make the pt more comfortable

Pharmacodynamics(how drugs work) involve which of the following way
Receptors, Enzymes and non selective cells

Which antibiotic should not be taken with food
Tetracycline

What are the 3 types of antibiotic therapy related to culture and sensitivity and which is most common
Definitive, Empiric, and Prophylactic…. Definitive

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Pharmacokinetics Absorption–>Distribution–>Metabolism–>Excretion Absorption The movement of drug from site of administration to various tissues of the body. WE WILL …

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