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pharm exam 2
Alpha 1 Receptor
Characteristics
Gq Subunit
Increase Vascular Smooth Muscle Contraction
Increase Pupillary Dilator Muscle Contraction
Increase Intestinal and Bladder Sphincter Muscle Contraction
1 min
Alpha 2 Receptor
Characteristics
Gi Subunit
Decrease Sympathetic Outflow
Decrease Insulin Release
Decrease Lipolysis
Increase Platelet Aggregation
Decrease Aqueous Humor Production
2 mins
Beta-1 Receptor
Characteristics
Gs Protein Class
Increased Heart Rate
Increased Contractility
Increase Renin Release
Increased Lipolysis
44 secs
Beta-2 Receptor
Characteristics
Gs Protein Class
Cardiopulmonary
Increased Heart Rate
Increased Contractility
Bronchodilation
Metabolic
Increased Lipolysis
Increased Insulin
Increased Glycogenolysis
Increased Cellular Potassium Uptake
Considerations
Increased Aqueous Humor Production
Vasodilation
Decrease Uterine Tone
2 mins
Opioid Antidote
Antidote
Naloxone
29 secs
Loop Diuretic Education
Furosemide (Lasix)
Indications
Heart Failure
Pulmonary Edema
Acute Renal Failure (ARF)
Edema
Education
Notify the provider of weakness, dizziness, or muscle cramping
Increase Potassium Intake
Check BP Daily
Daily Weights and Monitor IandOs
1 min
IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
3 mins
Blood Types and Compatibilities
ABO Compatibility
No Antigens (Type O Blood)
Universal Donor
A Antigen (Type A Blood)
B Antigen (Type B Blood)
AB Antigen (Type AB Blood)
Universal Recipient
Rhesus (Rh) Compatibility
Rh (Rhesus) Antigen
Never Rh+ to Rh-
Considerations
Blood Transfusion
Obstetric Patient
2 mins
Whole Blood Composition
Characteristics
Plasma
Electrolytes And Other Solutes
Proteins
Albumin
Fibrinogen
Globulins
Water
Formed Elements
Buffy Coat
White Blood Cells (WBC)
Platelets
Red Blood Cells (RBC)
2 mins
Types of Blood Products
Types
Whole Blood
Packed Red Blood Cells
Fresh Frozen Plasma
Immunoglobulins
Clotting Factors
Albumin
Platelets
Considerations
Use within 24 Hours
Washing Removes Antibodies
Irradiation Destroys WBCs
2 mins
Blood Transfusion Administration
Proper Patient Identification
Large Bore Needle
Y Tubing
Baseline Vital Signs
Slow IV Infusion
Monitor During First 15 Minutes or 50 mL of Blood
Monitor for Reactions
Considerations
Do Not Add Anything To Same IV Line
No Dextrose or Lactated Ringers
Jehovah's Witnesses, No Transfusions
3 mins
Transfusion Reactions
Acute Hemolytic
Febrile, Non-Hemolytic
Mild Allergic
Anaphylactic
Circulatory Overload
Sepsis Reaction
Transfusion-Related Acute Lung Injury (TRALI)
Massive Blood Transfusion
2 mins
Epinephrine (Adrenaline)
Mechanism
Alpha and Beta Agonist
Indications
Anaphylaxis
Primary Open Angle Glaucoma (POAG)
Bleeding
Cardiac Arrest
Side Effects
Tachycardia
Hypertension
Tremors
Insomnia
Considerations
Multiple Strengths
2 mins
Myasthenia Gravis Assessment
Weakness with Muscle Use
Diplopia
Ptosis
Dysphagia
Difficulty Speaking
Fatigue
Complications
Cholinergic Crisis
Overmedicated
Myasthenic Crisis
Not Enough Medication
Respiratory Muscle Paralysis
2 mins
Levodopa/Carbidopa (Sinemet)
Mechanism
Increases Dopamine in Brain
Indications
Parkinson's Disease
Side Effects
Nausea and Vomiting
Arrhythmias
Dyskinesia
Psychosis
Orthostatic Hypotension
Considerations
Report Uncontrolled Movements
Darkened Sweat or Urine
Off and On Phenomenon
2 mins
Alzheimer's Disease Interventions
Diagnostic Tests
PET Scan and CT
Mini-Mental State Examination
Interventions
Drug Therapy
Safe Environment
Moderate Exercise
Behavioral Modification
Assistance with Functional Independence
Assistance and Support for Caregiver
2 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
2 mins
Phenytoin (Dilantin)
Mechanism
Blocks Na+ Channels
Indications
Tonic-clonic Seizures
Side Effects
Ataxia
Nystagmus
Sedation
Gingival Hyperplasia
Purple Glove Syndrome
Hirsutism
Rash
Anemia
Considerations
Individualized Dosing
2 mins
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
1 min
Lamotrigine (Lamictal)
Mechanism
Blocks Na+ Channels
Indications
Seizures
Bipolar Disorder
Side Effects
Diplopia
Stevens-Johnson Syndrome
Headache
Aseptic Meningitis
Nausea and Vomiting
Considerations
Screen for Suicide Risk
2 mins
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