NR 565 - advanced pharmacology
midterm - Chamberlain
During what trimester is a pregnant woman most at risk for adverse drug reactions with potential long term consequences? - ~ANSWER 1st trimester (fetus most at risk d/t rapid growth)
What is BEERS criteria? - ~ANSWER Recommendations of medications inappropriate for elderly (65 and older), prescriber ultimately decides
What is the CYP450 (cytochrome P450) - ~ANSWER liver enzyme system where medications are metabolized, can either be inducers or inhibitors and create drug-drug interactions CYP450 inducers - ~ANSWER Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
CYP450 inducers pneumonic - ~ANSWER "Bullshit Crap GPS INDUCES rage"
CYP450 inducer drug names - ~ANSWER Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas
CYP450 inhibitors - ~ANSWER inhibit metabolism, increase blood levels of medications
CYP450 pneumonic - ~ANSWER "VISA credit card debt INHIBITS spending on designers like CK to look GQ" CYP450 inhibitors drug names - ~ANSWER Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine
Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic properties of drugs? - ~ANSWER increase glomerular filtration rate leads to increase durg excretion increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
Examples of medications that can be teratogenic - ~ANSWER Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES).
How is absorption of intramuscular medications different in neonates? - ~ANSWER slow and erratic due to low blood flow in muscles first few days of life Why is absorption of medication in the stomach increased in infancy? - ~ANSWER delayed gastric emptying
Some medications that should be avoided in the pediatric patient? - ~ANSWER glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with sulfonamides, levofloxacin (antibiotics) aspirin (Severe intoxication from acute overdose)
what should be included in medication administration patient education? - ~ANSWER dosage size and timing
route and technique of administration
duration of treatment
drug storage
nature and time course of desired responses
nature and time course of adverse responses
finish taking antibiotic
What are some things that put the elderly patient at higher risk for adverse drug reactions? - ~ANSWER reduced renal function polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
midterm - Chamberlain
During what trimester is a pregnant woman most at risk for adverse drug reactions with potential long term consequences? - ~ANSWER 1st trimester (fetus most at risk d/t rapid growth)
What is BEERS criteria? - ~ANSWER Recommendations of medications inappropriate for elderly (65 and older), prescriber ultimately decides
What is the CYP450 (cytochrome P450) - ~ANSWER liver enzyme system where medications are metabolized, can either be inducers or inhibitors and create drug-drug interactions CYP450 inducers - ~ANSWER Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
CYP450 inducers pneumonic - ~ANSWER "Bullshit Crap GPS INDUCES rage"
CYP450 inducer drug names - ~ANSWER Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas
CYP450 inhibitors - ~ANSWER inhibit metabolism, increase blood levels of medications
CYP450 pneumonic - ~ANSWER "VISA credit card debt INHIBITS spending on designers like CK to look GQ" CYP450 inhibitors drug names - ~ANSWER Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine
Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic properties of drugs? - ~ANSWER increase glomerular filtration rate leads to increase durg excretion increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
Examples of medications that can be teratogenic - ~ANSWER Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES).
How is absorption of intramuscular medications different in neonates? - ~ANSWER slow and erratic due to low blood flow in muscles first few days of life Why is absorption of medication in the stomach increased in infancy? - ~ANSWER delayed gastric emptying
Some medications that should be avoided in the pediatric patient? - ~ANSWER glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with sulfonamides, levofloxacin (antibiotics) aspirin (Severe intoxication from acute overdose)
what should be included in medication administration patient education? - ~ANSWER dosage size and timing
route and technique of administration
duration of treatment
drug storage
nature and time course of desired responses
nature and time course of adverse responses
finish taking antibiotic
What are some things that put the elderly patient at higher risk for adverse drug reactions? - ~ANSWER reduced renal function polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
