NR 565 Study Guide Latest Version Rated A+

NR 565 Study Guide Latest Version Rated A+ Pharmacokinetics study of drug movement throughout the body through for basis process - absorption -distribution - metabolism - excretion Absorption movement of drug from it site of administration to blood. factors affecting absorption rate of dissolution, surface area, blood flow, lipid solubility, pH partitioning, routes of administration Is Barbituates an inducer or an inhibitor inducer St. Johns wort an inducer or inhibitor inducer Careamazepine inducer or inhibitor inducer Rifampin inducer or inhibitor inducer alcohol inducer or inhibitor inducer Phenytoin inducer or inhbitor inducer Griseofulvin inducer or inhibitor inducer Phenobarbital inducer or inhibitor inducer Sulfonyureas inducer or inhibitor inducer Valproate inducer or inhibitor inhibitor Isoniazid inducer or inhibitor inhibitor Sulfonamindes inducer or inhibitor inhibitor Amiodarone inducer or inhibitor inhibitor Chloramphenicol inducer or inhibitor inhibitor Ketoconazole inducer or inhibitor inhibitor Grapefruit juice inducer or inhibitor inhibitor Quinadine inducer or inhibitor inhibitor Examples of pure opioid agonists Morphine, Codeine, Meperidine What is used to calculate patients overdose risk Calculated MME when do you refer someone to the pain clinic? When they are taking over 120 MME per day PDMP what is it database containing info regarding all scheduled medications prescribed to a patient include who and the amount. Why is PDMP important TO prevent Over dose and OUD when should naloxone be presrcibed if a patient is at risk for OUD, has a hx of non fatal OD, or are on higher dose of opioids greater than 50 MME/ day Behaviors that predict controlled sub abuse Mental health, former non fatal OD, Schedule 1 drugs substances with no currently accepted medical use and high potential for abuse. Ex: Heroin, LSD, Marijuana, Ecstasy Schedule II substances with high abuse potential potentially leading to severe psychological or physical dependence. Ex: Vicoidn, cocaine, methadone, dilaudid, Demerol, oxycodone, fentanyl, Adderall, ritalain Schedule III substances with moderate to low potential for physical and psychological dependence. Ex: products containing less than 90mg of codeine, ketamine, anaboic steroids, testosterone Schedule IV substances with low potential for abuse and low risk of dependence. Ex: Xanax, Soma, Darvon, Valium, Ativan, Ambien, Tramadol Schedule V Sub with lower potential for abuse than Schedule IV Ex: cough preparations with less than 200mg of codeine per 100ml. Lomotil, Lyrica. How should osteoarthritis be treated with non pharmacological tx such as yoga, heat and non opioid medications such NSAIDs and Acetaminphen Black box warning on methadone QT longation and may cause Torsades de Pointes Risk factors for OUD Severe W/D s/s, uncontrolled pain, psychological distress, SI Renal and Hepatic insufficnecy can experience increased peak effect and longer duration of action for meds. Pnts >65yrs have decreased renal function and med clearance thus they have a smaller therapeutic window. Buprenorphine and Naloxone Benefit of using this combination Buprenorphine and naltrexone can block the effects of other opioids when taken concurrently Use of pregabalin for chronic pain tx neuropathic pain, diabetic neuropathy and fibromyalgia. May cause sedation and dizziness. It is a schedule 5 drug. Sedation, dizziness, and ataxia are more commonly linked to pregabalin. What can be caused by COX-2 inhibitors and NSAIDs. Gastrointestinal bleeding may be caused What order is HTN medications usually prescribed Thiazide diuretics, ACEI, ARBs, CCBs What HTN medications are best for someone with DM Diuretics, ACEIs, ARBs, CCB What HTN medication is best to use for someone during pregnancy or wishing to become pregant. Labetalol or Methyldopa Ethnic groups impacted by certain drugs classificationgs African Americans should start with diuretics d/t higher incidence of mortality from HTN. ACEis and BB should be used with this population if they are comorbidities, Monotherapy with ACEI and BB is less effective Considerations when carbamazepine is prescribed with warfarin carbamazepine decreases the effect of warfarin and must be monitored closley for effectivness Beta Blockers work by decrease cardiac oxygen demand through blockade of specific receptors in the heart Prescribing rules for schedule II drugs All prescriptions forschedule II drugs must be typed or filled out in ink or indelible penciland signed by the prescriber. Alternatively, prescribers may submit prescriptions usingan electronic prescribing procedure. Oral prescriptions may be called in but only inemergencies, and a written prescription must follow within 72 hours.Prescriptions forschedule II drugs cannot be refilled. However, a DEA rule allows a prescriber to writemultiple prescriptions on the same day—for the same patient and same drug Examples of beta blockers propranolol, atenolol, metoprolol, lbetalol, timolol What happens if you stop a beta blocker abruptly patients with angina it can exacerbate s/s