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95 Cards in this Set
- Front
- Back
Pharmacodynamics |
Alters function or process within the body |
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Pharmacokinetics |
Action of the body on a medication |
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Endogenous |
Receptors that occur natural in the body and by the presence of medication and chemicals absorbed in the body |
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4 possibilities of medication binding |
1 passage of ions in cell walls are opened or closed 2 biochemical messenger becomes activated 3 normal cell function prevented 4 normal or abnormal function of the cell begin |
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Exogenous |
From outside the body |
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2 types of chemicals that directly affect cellular activity by binding receptors |
Agonist medication: initiate or alter cellular activity Antagonist medication: prevents endogenous or exogenous chemicals from reaching cell receptors |
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Affinity |
Ability of a medication to bind with a particular receptor site |
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Threshold level |
Initiation or alteration of a cellular activity begins |
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Potency |
Concentration of medication required to initiate cellular response |
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Efficacy |
Initiate or alter cell activity in a desired manner |
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Peak medication |
Will not cause additional cellular action |
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Competitive antagonists |
Temporarily |
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Non competitive agonist |
Permanently bind with receptor sites |
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Schedule 1 |
High abuse potential no medical purpose eg:heorin |
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Schedule 2 |
High abuse potential legitimate medical purpose eg:cocaine |
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Schedule 3 |
Lower potential abuse than schedule 2 eg:ketamine |
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Schedule 4 |
Lower potential abuse then schedule 3 eg: lorazepam |
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Schedule 5 |
Lower potential abuse than schedule 4 eg: narcotic cough medication |
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Placebo |
Positive and negative of an inactive medication |
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Immunity |
Body’s ability to protect themselves from a disease |
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Withdrawal |
Cartoon signs and symptoms from an abrupt cessation of a drug |
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Dependence |
Want or need to keep normal physiological function |
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Synergism |
2 drugs together have greater effect than 2 drugs working independently |
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Tolerance |
Physiological adaptation to the effects of the drug larger dose for same effect |
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Drug abuse prevention control act 1970 |
Categorized medication of potential abuse |
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Alpha 1 |
Vasoconstriction of arteries and veins |
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Alpha 2 |
Insulin restrictions glucagon secretions Lowers blood pressure |
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B1 |
Increase heart rate inotropic Myocardial contractility cronotropic Myocardial conduction dromotropic |
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B2 |
Bronchus and bronchiole relaxation |
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Factors affecting response to medications |
Age: peds and adults have different outcomes for same medications Weight : higher doses for same effect Environment: hyperthermia and hypothermia Genetic factors : certain genetic disease will limit administration of drugs Pregnancy: can effect fetus Psychological factors: race or religion may effect how much main pt may be in |
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Steve’s Johnson syndrome |
Severe possibly fatal medication reaction that mimics a burn |
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Diffusion |
Particles moving from an area of high concentration to an area of low concentration until equal on both sides |
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Filtration |
Moment of fluid from intracellular under high pressure to interstitial fluid through semipermeable membrane |
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Dehydration |
Depletion of the body’s systemic fluid volume |
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Isotonic solution |
A solution that has equal parts solutes and water on either side no shift in water and no change in shape occur |
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9% sodium chloride |
9g/L of sodium |
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Iv technique |
Keep bevel side up when inserting into vein Maintain adequate traction on the vein during cannulation |
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Common iv sites upper arm |
Brachial Cephalic veins Radial ulna distal arm Antecubital veins anterior to elbow |
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Common iv sites lower extremitie |
Dorsal veins on hands and feet |
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Iv catheters colors and sizes |
14g red 16g grey 18g green 20g pink 22g blue 24g yellow |
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Iv complications |
Infiltration causing edema Occlusion blockage Vein irritation bothers pt Thrombophlebitis vein inflammation Hematoma pool of blood around tissue Nerve tendon ligament damage Arterial puncture punctures and artery |
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Bioavailability |
How to administer drugs Gi system to absorb into blood stream Endotracheal: not used anymore Intranasal: through nose naloxone Intravenous: preferred route of administer medications Intaosseous: IO route Intramuscular: muscle route Subcutaneous: under the skin Dental and transdermal: on the skin nitro Sublingual: under the tongue Inhaled or nebulized: inhaled duoneb Rectal: rectally Ophthalmic: eyes |
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Mini and max drip set |
Microdrop set 30-60 drops Macrodrip 10-15 drops |
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External jugular vein complications |
Rolling of vein damaged carotid artery puncture hematoma |
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Desire dose |
Drug amount ordered |
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Concentration |
Total weight of a drug contained in specific volume of liquid |
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Volume |
Amount of liquid in one container |
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Acid base balance |
6.9-7.34 acidosis 7.35-7.45 neutral 7.46-8.0 alkalosis |
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Yield |
Amount of volume on hand |
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Anaphylactic shock signs symptoms treatment |
Signs symptoms: hives swelling respiratory distress Tripod position Treatment 1:1000 0.3mg to 0.5mg im |
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Upper airway anatomy |
Nasopharynx oralpharynx and laryngopharynx, glottic opening nose sinuses |
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Lower airway |
Trachea bronchiole alveoli sacs lobar and segmental bronchi larynx thyroid cartilage Adam’s apple circles ring epiglottis vocal cords |
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Bio transformation |
4 effects medication absorbed in the body An inactive substance becomes active An active medication changes into another active medication An active medication may be completely or partially inactive Transforms into a substance easily secreted |
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Function of lower airway |
Breathing and keeping the trachea rigid |
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Larnyngospasm |
Uncontrolled contraction of vocal cords |
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Atelectasis |
Collapse of alveolar spaces of the lungs |
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Tidal volume |
Amount of air moved in and out of the lungs in one relaxed breath Males adult 500ml 7ml/kg |
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Fio2 fraction of inspired oxygen |
Percentage of oxygen in inhaled air |
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Respiration’s |
Exchange of gases between a living organisms and its environment |
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Ventilations |
Mechanical process of moving air into and out of the lungs in two separate phases inhalation and expiration |
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Metabolic rate for sleeping vs respiratory rate during sleep |
Drops to as low as 15% while sleeping. Respiratory rate during sleep stays at 12-20breaths per minute |
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Positive pressure ventilation |
Pushing airflow into the lungs until ventilatior breathe is terminated |
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Negative pressure ventilation |
Normal breathing |
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First pass metabolism of a medication |
Drug is reduced before reaching systemic circulation |
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Hypocarbia |
Decreased carbon in the body creating deep or rapid breathing. Hyperventilating Alkalosis |
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Hypercarbia |
Too much carbon in the body. Longer times of expiration. Hypoventilation. Acidosis |
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Anoxia |
Absent of oxygen |
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Hypoxia |
Supply of oxygen reduced to tissues |
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Orthopnea |
Severe shortness of breathe laying down usually relieved by sitting up |
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Managing pt airway |
Check lung sounds Count respiratory rate Monitor spO2 and Capnography NC to NRB bvm cpap (if needed) intubation with bvm to ventilator |
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Challenges to using bvm |
Facial trauma, dentures, lodged airway, fighting bvm |
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Procedure for using bvm |
Kneel at patients head Open airway using head tilt chin lift or jaw thrust Insert opa or npa Assemble bvm and place on high flow Bring jaw to mask using 3 fingers Use c and e clamp Squeeze bag until chest rises is visible. Squeeze every 5-6 seconds adult Ped every 3-6 seconds |
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Pulse ox |
Measure oxygen in the hemoglobin in the blood |
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Oral airway procedure |
Patient is unconscious and does not have a gag reflex Measure opa from corner of mouth to ear lobe Adults insert hook facing up until reaches end of the soft pallet turn 180 degrees until flange rest on pt lips Ped inert hook facing down until flange rest on lips |
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Medication elimination |
2 types zero order and first order Zero order substance removed regardless amount in body First order is medication eliminated by plasma levels |
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Opa insertion |
Patient does have a gag reflex. Measure from corner of nose to ear lobe. Use water base lubricant before inserting. Insert into larger nostril bevel facing the septum until flange rest on patients nostril |
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Cpap effects |
Pushes more oxygen across the aveolar membrane. Also forces interstitial fluid back into pulmonary circulation |
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Indications for cpap |
Pt is alert and follows commands Moderate respiratory distress with underline copd pulmonary edema acute asthma pneumonia and chf Respiratory distress after submersion |
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Application of cpap |
Assemble equipment Connect cpap to oxygen tank Place over nose and mouth and secure to patients head Make sure seal for patient is intact Adjust peep as needed. 5-10cm h2O is acceptable |
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Complications of cpap |
Claustrophobia, pneumothorax, hypotension and aspiration |
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Tracheotomy |
Surgical opening to the trachea |
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Stoma |
An orifice that connects the trachea to the outside air |
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Laryngectomy |
Removal of the larynx |
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Endotracheal intubation (et tube) |
Passing an et tube through the glottic opening and sealing the tube with a cuff inflated against the trachea wall |
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Et tube indications |
Airway management due to coma respiratory/cardiac arrest Impending respiratory arrest Prolonged ventilation support Absence of gag reflex Traumatic brain injury Unresponsive Impending airway compromise |
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Half life |
Time needed for an average person metabolism or elimination of 50% in the plasma |
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Confirmation of et tube placement |
No sounds coming from the epigastrium. Equal chest rise and bilateral breath sounds. Easily compress bag mask device. Waveform capnography or colorimetric etco2 detector or esophageal detector device |
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Dope acronym for post intubation deterioration |
Displacement of et tube Obstruction of secretions Pneumothorax Equipment failure bag manually |
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Io insertion and sites |
Handheld battery powered driver. Easy insertion with minimal pressure. Io sites humeral bone tibia distal tibia |
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Intercellular fluid |
Fluid within cells in which most of the body’s potassium is contained 40-45% |
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Sodium |
A chemical that surrounds the cells in the body |
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Osmosis |
Movement of concentration from an area of low concentration to an area of high concentration to equalize on both sides |
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Open cricothyrotomy vs needle cricothyrotomy (translaryngeal catheter ventilation) |
Open cricothyrotomy: Infection, larger et tube, subconscious emphysema (crackling under the skin) serve bleeding, perforating esophagus, damaging larynx nerves. Damaging thyroid glands. Needle cricothyrotomy: severe bleeding, air leak around the site, subcutaneous emphysema, |
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Meds that lower b/p and heart rate |
Beta blockers b1 hr lower cardiac output lower bp lower lol ending drug names Calcium channel blocker heart rate contraction lower pine ending drug names Receptor blockers keeps bp from rising heart relaxation sartan ending drugs Ace inhibitors bp down Prill ending drugs |
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Airway Management meds |
Etomidate, ketamine short acting. Benzodiazepines airway maintaining sedation. Am ending medication eg:lorazepam Beta 2 drug bronchospasm albuterol levalbuterol terbutaline and epinephrine Beta agonist ipatropium bromide decrease mucus Corticosteroids for inflammation eg prednisone. Medications ending in one Leukotriene receptors antagonist allergies and asthma Long term eg; montelukast Lukast ending James |