Pharm exam 1 Galen GUARANTEED PASS

Pharm exam 1 Galen ear drops - ANS INSTILL AT ROOM TEMP/ child- down and back/ adult- up and back eye drops - ANS important to instill the eye drop medication into the conjunctival sac (not the eyeball/cornea). inner to outer enema - ANS patient lays on left side pharmacokinetic - ANS what happens in the body once med is administered -Absorption -Distribution/ Binding -Metabolism -Renal Excretion first-pass effect - ANS extent to which drug metabolized by liver before reaching systemic circulation protein binding - ANS protein (usually albumin) binds to medication to help chemicals move through. When the medication is bound to the protein it is not available to perform its action the body free drug - ANS The amount that is left not bound called the__________________and it performs the pharmacologic response pharmacodynamics phase - ANS refers to the effects drugs will have on a patient and the mechanism of their actions. antacids drug absorption - ANS Antacids cause a pharmokinetic interaction which is what the body does to the drug in terms of absorption, distribution, metabolism, and excretion. Antacids increase the PH of gastric juices which causes a decrease in the absorption of weak acid drugs such as tetracycline gastric and intestinal motility influence drug absorption. - ANS Drug absorption is the movement of the drug into the bloodstream after administration (McCuistion & Vuljoin-Dimmagio, 2018, p. 16). The lining of the small intestine is covered in villi that increase the the surface area for absorption and is decreased because of disease or drugs (p.16). Absorption in the small intestine is done by passive transport, active transport, or pinocytosis (p.16). In the GI tract the lining is made up of a mucous membrane composes of lipids and proteins which allows lipid soluble drugs to easily pass through (p. 16-17). If the drug is water soluble it will need a protein or enzyme carrier to pass through (p.17). Benzodiazepine - ANS Alprazolam, Midazolam, Lorazepam,Diazepam NMS or Neuroleptic Malignant Syndrome - ANS Delirium with fever, catalepsy, and muscle rigidity, and blood pressure instability antipsychotics and antiemetics can cause this life threatening condition Local anesthetic - ANS Lidocaine NSAID - ANS Ibuprofen NSAID Cox-2 Inhibitor - ANS Celecoxib non-opiod analgesic - ANS acetaminophen non benzodiazepine - ANS zolpidem Spinal anethesia - ANS Spinal/Epidural Nsaid-Salicylate - ANS Aspirin Anti-gout - ANS allopurinol opioid - ANS morphine sulphate opioid antagonist - ANS naloxone CNS Stimulant-amphetemine-like - ANS Methylphenidate Hydantoin, Antiepileptics - ANS Phenytoin valproate/Mood Stabilizer & Anticonvulsant - ANS valporic acid Barbituate - ANS Phenobarbital antipsychotic nonphenothiazine - ANS haloperidol SSRI - ANS Fluoxetine MAOI - ANS phenelzine sulfate antipsychotic phenothiazine - ANS fluphenazine atypical antipsychotic - ANS aripiprazole tricyclic - ANS amitriptyline serotonin and norephinephrine reuptake inhibitor - ANS venlafaxine mood stabalizer - ANS lithium geriatric considerations - ANS decrease in small bowel surface area, slowed gastric emptying, decreased gastric acid lipid soluble drugs prolonged period of action,lower albumin increased drug availability, higher toxicity. Phenobarbitol bartiuate, uses and considerations - ANS used for seizure, sedation, and insomnia can cause ataxia depression, bradycardia, hypotension, dizziness, confusion, drowsiness, headache, impaired judgement, nightmares, constipation, ED. Monitor for respiratory depression Benzos Alprazolam, Midazolam, Lorazepam,Diazepam Sedative hypnotics - ANS treatment for anxiety and insomnia interactions with grapefruit and green tea acts by suppressing the CNS 15-30 min onset 90% absorbed through GI tract side effects, lethargy, ataxi, dizziness, ect adverse: depression, tolerance, dependence, hypotension, tachy, seizures life threatening; hepatic failure, Stevens-Johnson syndrome do not confuse what about lorazepam and alprazolam - ANS lorazepam=anti-anxiety alprazolam=anxiety and insomnia zolpidem - ANS Sedative-hypnotic Ambien, Ambien CR zolpidem cautions - ANS pulmonary edema renal failure liver dysfunction ear drops - ANS INSTILL AT ROOM TEMP/ child- down and back/ adult- up and back eye drops - ANS important to instill the eye drop medication into the conjunctival sac (not the eyeball/cornea). inner to outer enema - ANS patient lays on left side pharmacokinetic - ANS what happens in the body once med is administered -Absorption -Distribution/ Binding -Metabolism -Renal Excretion first-pass effect - ANS A swallowed pill that goes into the liver through the portal vein where some of the drug becomes inactive protein binding - ANS protein (usually albumin) binds to medication to help chemicals move through. When the medication is bound to the protein it is not available to perform its action in the body True or False - ANS True free drug - ANS The amount that is left not bound called the__________________and it performs the pharmacologic response pharmacodynamics phase - ANS refers to the effects drugs will have on a patient and the mechanism of their actions. How do antacids affect drug absorption? - ANS Antacids increase the PH (alkaline) of gastric juices which causes a decrease in the disintegration process Most drugs (excluding enteric coated or XR) need an acidic environment to break down. Lipid soluble drugs are not able to pass the membrane without a protein/ enzyme carrier. True or false - ANS False In the GI tract the lining is made up of a mucous membrane composed of lipids and proteins which allows lipid soluble drugs to easily pass through. If the drug is water soluble it will need a protein or enzyme carrier to pass through Benzodiazepine - ANS Alprazolam, Midazolam, Lorazepam,Diazepam NMS or Neuroleptic Malignant Syndrome - ANS Delirium with fever, catalepsy, and muscle rigidity, and blood pressure instability What 2 types of medication can cause Neuroleptic Malignant Syndrome? - ANS antipsychotics and antiemetics can cause this life threatening condition Local anesthetic - ANS Lidocaine NSAID - ANS Ibuprofen NSAID Cox-2 Inhibitor - ANS Celecoxib non-opiod analgesic - ANS acetaminophen non benzodiazepine - ANS zolpidem Spinal anethesia - ANS Spinal/Epidural Nsaid-Salicylate - ANS Aspirin Anti-gout - ANS allopurinol opioid - ANS morphine sulphate opioid antagonist - ANS naloxone CNS Stimulant-amphetemine-like - ANS Methylphenidate Hydantoin, Antiepileptics - ANS Phenytoin Valproate - ANS valporic acid Barbituate - ANS Phenobarbital antipsychotic nonphenothiazine - ANS haloperidol SSRI - ANS Fluoxetine MAOI - ANS phenelzine sulfate atypical antipsychotic - ANS aripiprazole tricyclic (TCA) - ANS amitriptyline serotonin and norephinephrine reuptake inhibitor - ANS venlafaxine mood stabalizer - ANS lithium What are Phenobarbitol used for? - ANS Treats seizures, status epilepticus What are 2 main side effects of Phenobarbitol - ANS respiratory depression / sedation nice to know: depression, bradycardia, hypotension, dizziness, confusion, drowsiness, headache, impaired judgment, nightmares, constipation, ED. What does Alprozolam interact with? - ANS Grape fruit / juice While taking benzodiazepines, the patient should avoid drinking alcohol & green tea True or false - ANS True zolpidem - ANS nonbenzodiazepine Ambien, Ambien CR Who am I? Nonbenzodiazepine​ Treats insomnia, take 15-30 min before bed​ Avoid alcohol, OTC sleep meds​ Used short term, can build tolerance​ - ANS zolpidem What is happening during absorption - ANS drug gets into bloodstream What is the primary site for metabolism? - ANS liver What affects absorption? - ANS High fat foods​ Decreased gastric emptying​ Exercise​ GI acidity