NLN PHARMACOLOGY REVIEW EXAM -91 QUESTIONS AND ANSWERS ALREADY GRADED A+

Administration Routes: Sublingual Administration □ absorbed in mucosa of oral cavities □ rapid onset of action □ Place tablet on floor of mouth, close mouth. Do not swallow, hold under tongue until dissolve. □ Use spray on floor of mouth under tongue and close mouth. Administration Routes: Buccal □ place tablet between gum and cheek near back of mouth, close mouth and keep in place until dissolve □ slower to dissolve and absorb than sublingual Brainpower Read More Administration Routes: Intramuscular Injections □ Given in the vastus lateralis in children up to 3 □ Spread skin taught to bring muscle near surface of skin, with dart-like motion insert needle at 90 degrees □ Aspirate to determine if needle enter a blood vessel. If there is blood return discard the needle and meds and start procedure over Administration Routes: NGtube/Gtube □ NG usually temporary; G-tube for longer term □ Follow instructions re crushing, dissolving medication - no sustained release meds Administration Routes: Eye Drop Administration □ (1)Clean exudates from eye; (2) tilt head toward side of affected eye; (3) pull lower eyelid down; (4) have pt. look up; (5) instill drops in conjunctival sac formed by lower lid (not onto the eye); (6) Apply gentle pressure for 30 sec to 1 min over inner cantus next to nose (this prevents absorption through the tear duct and drainage of the medication). Close eyes gently massage the eyes to distribute the meds. □ Slow absorption except in infants where they readily absorb Administration Routes: Eye Ointment □ Same as eye drop except it is expressed directly into the conjunctival sac from the inner canthus to the outer canthus. Close eyes and gently massage to distribute the medication Definition: Definition: Agranulocytosis / Neutropenia / agranulocytopenia □ Definition: Acute decrease in the number of granulocytes/leukopenia (WBC) in peripheral blood □ Causes include: treatment with broad spectrum PCN, sulfonamides or cephalosporin (piperacillin, tazobactam, cetazidime, ticarcillin, gentamycin), bone marrow transplant, chemotherapy, radiation. □ Generally is impaired resulting from bone marrow depression by drugs and chemicals or replacement by a neoplasm(oral lesion, ulcer necrotic, gingivitis, buccal mucosa □ Lymphadenopathy, lymphadenitis may be prevalent. □ Could lead to respiratory infection, ulceration of mouth colon, high fever, UTI. But may be asymptomatic Definition: Chelating Agents □ A form of detoxification □ Chelating therapy involves an injection or oral administration of ethylene diamine Tetra acetic avide (a synthetic amino acid which attaches to toxic substance such as lead, cadmium, aluminum and other metal in the blood to facilitate their removal from the body.) □ May be used to treat hardening of the arteries, heart attack, stroke, arthritis and gangrene because of its ability to remove excess calcium from the body. Definition: EDTA: Ethylenediaminetetraacetic Acid □ Use in children with lead level between 45&70 micron/dl. □ EDTA binds to lead in blood and excreted by the bowel and kidney. EDTA may be toxic to kidney. Monitor urine output. □ GIVE THIS BY IV. Dose depends on weight of child, severity of the poison. Agent is given every 4 hours for 5 days. A second course may be needed if there is a rebound in the blood level. Give oral and IV fluid to enhance excretion □ Do not use EDTA with hypocalcemia or hypokalemia. OTHER AGENTS □ British antiLewisite (BAL) does not give with iron supplement and avoid in pt. with plant allergy. Give this by IM □ Succimer (Chemer) □ Chemet - oral medication - Do not give in pt. with encephalopathy Definition: Epixtaxis □ Nose bleed. Can be anterior or posterior. Posterior is more serious. □ Due to rupture of blood vessels within richly perfuse nasal mucosa spontaneous or initiated by trauma □ Blood can come up through the eye, can also flow down the stomach causing nausea, vomiting Treat epistaxis □ cauterization with silver nitrate, calcium alginate mesh, nasal cavity packed with sterile dressing ribbon gauze, absorbent dressing or saline sprayed into the nose □ Ice pack to forehead or back of the neck □ pinch septum of nose for 5 minutes □ DO NOT pack nose with tissue or gauze Definition: Half-Life Half-life □ The time it takes for a medication to lose half of its pharmacologic or physiologic effect □ To calculate half-life: There is a formula but the easiest way to decrease count. □ Example: half- life is 1 hour. Start 100% 1 hr. 50% 2 hrs. 25% 3 hrs. 12.5% 4 hrs. 6.25% Question - Half-life of 'xyz' medication is 1 hour. After 3 hours, what percentage of the medication will be left? A = 12.5% Definition: Paradoxical Reaction □ A response to a drug (or medical treatment) that is the opposite to the usual response, such as agitation produced in an individual patient by a drug which is ordered to sedate or calm a person. Definition: Sustained release/time release/extended release/controlled release □ Pills or capsule formulated to dissolve slowly and release drug over time. □ They can often be taken less frequently, keep steadier levels of the drug in the bloodstream □ Contain in a matrix of insoluble substance (e.g. Acrylics) the drug swells up to form a gel so that the drug has first to dissolve in matrix then exit through the outer surface. □ Cannot be crushed, dissolved or opened Classification Stems: -terone Androgen ex. testosterone (Testoderm) Classification Stems: -pril Ace Inhibitors ex. enalapril (Vasotec) Classification Stems: -pressin Antidiuretic hormones ex. desmopressin (DDAVP) Classification Stems: -statin Antilipidemic ex. atorvastatin (Lipitor) Classification Stems -vir Antiviral ex. ritonavir (Norvir) Classification Stems: Benzodiazepines Most others end in? Benzodiazepines: include alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), estazolam (ProSom), and triazolam (Halcion). Most others end with -pam: diazepam (Valium) Classification Stems: -lol Beta Blockers ex. atenolol (Tenormin) Classification Stems: -pine Exception? CCB ex. amlodipine (Norvasc) Some exceptions include diltiazem (Cardizem), verapamil (Isoptin) Classification Stems: -mide Carbonic anhydrase inhibitors ex. acetazolamide (Dimox) Classification Stems: est- Estrogens ex. conjugated estrogen (Premarin)