Pharmacology Finals LONG Review LECTURE
What are drugs that cannot be inserted Sublingual
through or given in an NG tube. (SATA). Sustained release
Delayed-release
Enteric-coated
Extended-release (ER)
What do you evaluate before giving PO Patient level of consciousness
medication? Patient ability to swallow
What is the property of the 4 Absorption
Pharmacokinetics that will interfere with ● leaves GI tract and enters the
a drug or the location and destination of bloodstream
the drug? Absorption, distribution,
metabolism, excretion: Problems:
1. food w or w/out & drug
interactions
1. NG-suction, emesis
2. Blood flow
Metabolism
● drugs get broken down by liver
where some of the med is killed
off
Problems:
1. Grapefruit Juice / Other drugs
2. Pt body size/wt, age, activity
level
Distribution
● heart distributes to rest of body
Problems:
1. BBB (blocks drugs from reaching
the brain)
2. Baby; drugs are chemical that can
cause birth defects
3. Protein bound drugs reduce med
availability to the cell
, 4. Decreased blood flow
Excretion
● Meds out of blood, excess is
eliminated by kidneys
Problems:
1. decreased kidney function due to
old age (START LOW & GO
SLOW), dialysis, nephrotoxic
drugs, decreased Cardiac Output.
What makes it difficult to treat BBB (Brain blood Barrier).
someone with a brain tumor or brain
infection?
If a patient has a liver that is damaged, Decrease Dose, since there is no first
what is the dosage adjustment for pass effect due to liver not working
medications?
If a patient has kidney issues, what is Decrease Dose; ½ the regular dose, you
the dosage adjustment? also usually want to do this for the
elderly. (Start slow and go slow)
Metabolism happens in the liver, Term Absorption of oral drugs to GI tracts
for liver taxing a drug via PO route is? passes to intestinal lumen, to the liver,
liver metabolizes some of the drugs to
inactive form and secretes it out and
reduces the effect, what is left over is
the FIRST-PASS EFFECT. (ex.
Ibuprofen 400mg -> liver will absorb
200 mg and only let 200mg through).
What is the time it takes for a drug to Onset
reach the minimum effective
concentration (MEC) after
administration.
1. Definition of MEC: Minimum effective concentration (MEC) is
the minimum plasma concentration of a
, drug needed to achieve sufficient drug
concentration at the receptors to
produce the desired pharmacologic
response.
How to draw peak and trough (timing)? ● Peak: 30 min to 1 hour after
last dose
● Trough: 30 min before next dose
What are the signs and symptoms of Salivation/Sweating
someone that has Cholinergic Effects? Lacrimation
Urination
Diarrhea
GI upset
Emesis
Bradycardia
Bronchoconstriction
Bronchorrhea
What drugs are Cholinergic? Neostigmine
Donepezil
Edrophonium
Pilocarpine
Physostigmine
Pyridostigmine
RN: Caution if Asthma, Bradycardia,
Low Blood pressure.
Note: These drugs can cause a
cholinergic crisis if overdose.
The nurse should question an order for ● Patient with Asthma
cholinesterase inhibitors (Neostigmine, Why? Breathing
Donepezil, Edrophonium) for which exacerbation/making it difficult to
patients? breathe.
● Patient with Bradycardia
Why? Lowers heart rate even
more and can cause a fatal low
heart rate.
● Patient with low blood pressure
, Why? lowers BP even more to a
dangerous level/hypotension.
Name the drugs that can cause birth Teratogens (Cause birth defects) and
defects and cancer Carcinogens (cause cancer).
These can cause Birth defects:
Anticonvulsants
Chemotherapy drugs
Antibiotics Class X
Opioids
Hyperthyroid meds (Radioiodine 1-131)
Some congenital malformations are so
severe they result in grossly deformed
fetuses. Carcinogens cause cancerous
tumors with a characteristically crablike
appearance. Mutagens, teratogens and
carcinogens are similar in that each
causes some form of mutation.
What are the signs and symptoms of Dry as a bone
someone that has Anticholinergic Delirium
Effects? Decreased sweating/secretions
Constipation
Flushing
Hyperthermia
Tachycardia
Mydriasis
What are the effects of Anticholinergic ● Decreased secretions
drugs? ● Dry everything up
● Urinary retention
● Dry mouth
● Blurred vision
● Constipation
An underdose of Johnny DEPPP drugs can Neostigmine (Cholinergic).
cause a Myasthenic crisis, what
medication do we give to treat
Myasthenic crisis?
What are drugs that cannot be inserted Sublingual
through or given in an NG tube. (SATA). Sustained release
Delayed-release
Enteric-coated
Extended-release (ER)
What do you evaluate before giving PO Patient level of consciousness
medication? Patient ability to swallow
What is the property of the 4 Absorption
Pharmacokinetics that will interfere with ● leaves GI tract and enters the
a drug or the location and destination of bloodstream
the drug? Absorption, distribution,
metabolism, excretion: Problems:
1. food w or w/out & drug
interactions
1. NG-suction, emesis
2. Blood flow
Metabolism
● drugs get broken down by liver
where some of the med is killed
off
Problems:
1. Grapefruit Juice / Other drugs
2. Pt body size/wt, age, activity
level
Distribution
● heart distributes to rest of body
Problems:
1. BBB (blocks drugs from reaching
the brain)
2. Baby; drugs are chemical that can
cause birth defects
3. Protein bound drugs reduce med
availability to the cell
, 4. Decreased blood flow
Excretion
● Meds out of blood, excess is
eliminated by kidneys
Problems:
1. decreased kidney function due to
old age (START LOW & GO
SLOW), dialysis, nephrotoxic
drugs, decreased Cardiac Output.
What makes it difficult to treat BBB (Brain blood Barrier).
someone with a brain tumor or brain
infection?
If a patient has a liver that is damaged, Decrease Dose, since there is no first
what is the dosage adjustment for pass effect due to liver not working
medications?
If a patient has kidney issues, what is Decrease Dose; ½ the regular dose, you
the dosage adjustment? also usually want to do this for the
elderly. (Start slow and go slow)
Metabolism happens in the liver, Term Absorption of oral drugs to GI tracts
for liver taxing a drug via PO route is? passes to intestinal lumen, to the liver,
liver metabolizes some of the drugs to
inactive form and secretes it out and
reduces the effect, what is left over is
the FIRST-PASS EFFECT. (ex.
Ibuprofen 400mg -> liver will absorb
200 mg and only let 200mg through).
What is the time it takes for a drug to Onset
reach the minimum effective
concentration (MEC) after
administration.
1. Definition of MEC: Minimum effective concentration (MEC) is
the minimum plasma concentration of a
, drug needed to achieve sufficient drug
concentration at the receptors to
produce the desired pharmacologic
response.
How to draw peak and trough (timing)? ● Peak: 30 min to 1 hour after
last dose
● Trough: 30 min before next dose
What are the signs and symptoms of Salivation/Sweating
someone that has Cholinergic Effects? Lacrimation
Urination
Diarrhea
GI upset
Emesis
Bradycardia
Bronchoconstriction
Bronchorrhea
What drugs are Cholinergic? Neostigmine
Donepezil
Edrophonium
Pilocarpine
Physostigmine
Pyridostigmine
RN: Caution if Asthma, Bradycardia,
Low Blood pressure.
Note: These drugs can cause a
cholinergic crisis if overdose.
The nurse should question an order for ● Patient with Asthma
cholinesterase inhibitors (Neostigmine, Why? Breathing
Donepezil, Edrophonium) for which exacerbation/making it difficult to
patients? breathe.
● Patient with Bradycardia
Why? Lowers heart rate even
more and can cause a fatal low
heart rate.
● Patient with low blood pressure
, Why? lowers BP even more to a
dangerous level/hypotension.
Name the drugs that can cause birth Teratogens (Cause birth defects) and
defects and cancer Carcinogens (cause cancer).
These can cause Birth defects:
Anticonvulsants
Chemotherapy drugs
Antibiotics Class X
Opioids
Hyperthyroid meds (Radioiodine 1-131)
Some congenital malformations are so
severe they result in grossly deformed
fetuses. Carcinogens cause cancerous
tumors with a characteristically crablike
appearance. Mutagens, teratogens and
carcinogens are similar in that each
causes some form of mutation.
What are the signs and symptoms of Dry as a bone
someone that has Anticholinergic Delirium
Effects? Decreased sweating/secretions
Constipation
Flushing
Hyperthermia
Tachycardia
Mydriasis
What are the effects of Anticholinergic ● Decreased secretions
drugs? ● Dry everything up
● Urinary retention
● Dry mouth
● Blurred vision
● Constipation
An underdose of Johnny DEPPP drugs can Neostigmine (Cholinergic).
cause a Myasthenic crisis, what
medication do we give to treat
Myasthenic crisis?
