Maryville Pharmacology Exam 1
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1. What are the 5 WHO prescribing guidelines?: 1. define the pt's problem
2. Specify therapeutic objectives
3. choose which drug or treatment is needed
4. Write the Rx and start tx
5. Educate and counsel the pt
6. monitor effect of treatment
2. WHO rx guideline 1: Define the pt's problem . This forms the basis for choosing
and rx-ing the correct treatment.
Consultation should include: complaints, symptoms, diagnosis and relevant charac-
teristics like co-morbidities, co-medication, pregnancy, drug allergies
3. WHO rx guideline 2: Specify the therapeutic objective. What needs to be treated?
4. WHO rx guideline 3: 3a. select the p-drug (prescribers personal drug of first
choice for the indication.)
3b. Is the p-drug appropriate? checking for contraindications, interactions, pregnan-
cy, allergies, etc.
5. WHO rx guideline 4: Write rx and start the treatment.
6. WHO rx guideline 5: Educate and counsel the pt. Intructions and warnings about
the tx.
7. WHO rx 6: Monitor the treatment.
8. Coreg (Carvedilol): *beta blocker used to treat mild to severe CHF, left ventricular
dysfunction following MI, HTN.
*works by causing vasodilation to the peripheral vasculature to decrease the work-
load on the heart.
*Non selective beta blocker and Alpha-1 blocker
*3rd generation beta blocker
*particularly useful in African Americans
*Dose: 0.625 mg-25mg PO BID with food
*administering with food helps prevent postural hypotension
*Education: don't skip doses, take with food
9. hypersensitivty reactions: mnemonic ACID: 1. A-allergic
2.C-cytotoxic
3.I- Immune complex deposition
4. D-delayed
10. Type I hypersensitivity: A-allergic
*IgE mediated- quick onset after exposure
*production of IgE after antigen exposure.
*urticaria, wheezing, rhinitis, anaphylaxis
11. Type II hypersensitivity: C-cytotoxic
*cytotoxic/antibody mediated
, Maryville Pharmacology Exam 1
Study online at https://quizlet.com/_f866x1
* drug binds to RBCs and is recognized by antibody-usually IgG
*complement and cytotoxic T cells are activated
*Rare response
12. Type III hypersensitivity: I-immune complex/IgG/IgM mediated
*antibodies are formed against soluble antigens. ANtigen-antibody complexes are
deposited in tissues such as joints and lungs.
*cause serum sickness. Ex: ceclor (antibiotic)
13. Type IV hypersensitivity: D-delayed- delayed or cell mediated
*cytotoxic T cells are activated
*poison ivy, latex, etc
*causes contact dermatitis
*cytokine storm if there is repeated exposure
14. Grapefruit juice: *increases drug toxicity
*don't drink with SSRIs, calcium channel blockers, statins, benzos
*increases absorption and decreases the metabolism
15. Atropine-class/mechanism of action: *anticholinergic
*inhibits action of acetylcholine and blocks the PNS.
*Increases HR by increasing conduction int eh SA and AV node
16. atropine- indications: *symptomatic bradycardia (sinus, junctional, AV blocks,
causing significant hypotension, ventricular ectopy, angina, etc.)
*organphosphate poisoning
* RSI in peds
*beta blocker and calcium channel blocker overdose
17. atropine- contraindications: *tachycardia
*HTN
*hypothermic bradycardia
*narrow angle glaucoma
18. atropine adverse reactions: drowsiness, confusion, HA, tachycardia, palpita-
tions, dysrhythmias, N/V, paradoxical bradycardia if pushed too slowly or given in
low doses
19. atropine special considerations to know: Pregnancy category C
paradoxical bradycardia can occur with doses lower than 0.1 mg.
20. Types of cholinergic receptors: 1. Muscarinic (G protein linked)
-M2- health and smooth muscle
-M3- glands and endothelium
-M1,4,5-nerves
2. Nicotinic receptors (ion channel mediated)
- Nm-Skeletal muscle
Study online at https://quizlet.com/_f866x1
1. What are the 5 WHO prescribing guidelines?: 1. define the pt's problem
2. Specify therapeutic objectives
3. choose which drug or treatment is needed
4. Write the Rx and start tx
5. Educate and counsel the pt
6. monitor effect of treatment
2. WHO rx guideline 1: Define the pt's problem . This forms the basis for choosing
and rx-ing the correct treatment.
Consultation should include: complaints, symptoms, diagnosis and relevant charac-
teristics like co-morbidities, co-medication, pregnancy, drug allergies
3. WHO rx guideline 2: Specify the therapeutic objective. What needs to be treated?
4. WHO rx guideline 3: 3a. select the p-drug (prescribers personal drug of first
choice for the indication.)
3b. Is the p-drug appropriate? checking for contraindications, interactions, pregnan-
cy, allergies, etc.
5. WHO rx guideline 4: Write rx and start the treatment.
6. WHO rx guideline 5: Educate and counsel the pt. Intructions and warnings about
the tx.
7. WHO rx 6: Monitor the treatment.
8. Coreg (Carvedilol): *beta blocker used to treat mild to severe CHF, left ventricular
dysfunction following MI, HTN.
*works by causing vasodilation to the peripheral vasculature to decrease the work-
load on the heart.
*Non selective beta blocker and Alpha-1 blocker
*3rd generation beta blocker
*particularly useful in African Americans
*Dose: 0.625 mg-25mg PO BID with food
*administering with food helps prevent postural hypotension
*Education: don't skip doses, take with food
9. hypersensitivty reactions: mnemonic ACID: 1. A-allergic
2.C-cytotoxic
3.I- Immune complex deposition
4. D-delayed
10. Type I hypersensitivity: A-allergic
*IgE mediated- quick onset after exposure
*production of IgE after antigen exposure.
*urticaria, wheezing, rhinitis, anaphylaxis
11. Type II hypersensitivity: C-cytotoxic
*cytotoxic/antibody mediated
, Maryville Pharmacology Exam 1
Study online at https://quizlet.com/_f866x1
* drug binds to RBCs and is recognized by antibody-usually IgG
*complement and cytotoxic T cells are activated
*Rare response
12. Type III hypersensitivity: I-immune complex/IgG/IgM mediated
*antibodies are formed against soluble antigens. ANtigen-antibody complexes are
deposited in tissues such as joints and lungs.
*cause serum sickness. Ex: ceclor (antibiotic)
13. Type IV hypersensitivity: D-delayed- delayed or cell mediated
*cytotoxic T cells are activated
*poison ivy, latex, etc
*causes contact dermatitis
*cytokine storm if there is repeated exposure
14. Grapefruit juice: *increases drug toxicity
*don't drink with SSRIs, calcium channel blockers, statins, benzos
*increases absorption and decreases the metabolism
15. Atropine-class/mechanism of action: *anticholinergic
*inhibits action of acetylcholine and blocks the PNS.
*Increases HR by increasing conduction int eh SA and AV node
16. atropine- indications: *symptomatic bradycardia (sinus, junctional, AV blocks,
causing significant hypotension, ventricular ectopy, angina, etc.)
*organphosphate poisoning
* RSI in peds
*beta blocker and calcium channel blocker overdose
17. atropine- contraindications: *tachycardia
*HTN
*hypothermic bradycardia
*narrow angle glaucoma
18. atropine adverse reactions: drowsiness, confusion, HA, tachycardia, palpita-
tions, dysrhythmias, N/V, paradoxical bradycardia if pushed too slowly or given in
low doses
19. atropine special considerations to know: Pregnancy category C
paradoxical bradycardia can occur with doses lower than 0.1 mg.
20. Types of cholinergic receptors: 1. Muscarinic (G protein linked)
-M2- health and smooth muscle
-M3- glands and endothelium
-M1,4,5-nerves
2. Nicotinic receptors (ion channel mediated)
- Nm-Skeletal muscle
