PHARM
True or false: No drug should be administered during pregnancy unless it is clearly needed
TRUE
Mechanism of Action: Agonist vs Antagonist
Agonist: Mimic ACTion - cause same reaction that natural chemicals would cause
Antagonist: BLOCK action - prevent the natural chemical from binding
What are the reactions to remember when administering blood?
Rash, fever, anxiety, & low back pain
What are signs and symptoms of liver failure?
Increased bleeding times, bleeding and bruising
Antiplatelets
Explain the abuse risk and if medical use is acceptable for Schedule I, II, & III drugs
Schedule I: HIGH abuse risk, NO medical use (Ex: Heroin, LSD)
Schedule II: HIGH abuse risk, acceptable for medical use (Ex: opioids, amphetamines)
Schedule III: MODERATE abuse risk, acceptable for medical use (Ex: some sedatives, stimulants, limited narcotics)
What factors affect metabolism?
Age, genetics, disease, concurrent use of other medications
Colloids are always _______?
EXTRA: how can you tell between crystalloids and colloids
Hypertonic
Crystalloids are clear and colloids are not.
alteplase, activase (TPA) are?
Thrombolytics
THINK ACUTE acute MI, acute PE, acute ischemic stroke
What is an Orphan Drug?
EXTRA: What is an incentive to produce an orphan drug?
NOT financially viable, may only be used for rare diseases.
Incentives: tax breaks
Where does the First Pass Effect happen?
The Liver
How many patient identifiers & RNs is required for a blood administration check?
EXTRA: You need vital signs including what?
Two
Extra: A temp
What two isotonic solutions can be bolused?
EXTRA: Which is the only one you can prime blood tubing with?
NS & LR
Extra: NS
HYPERTONIC - 3% NS can be bolused in extreme measures (cerebral edema)
Heparin and Warfarin are?
Anticoagulants
Test PTT - Heparin
Test INR - Warfarin
What is a Black Box Warning?
The strongest warning, indicating the drug has serious or potentially fatal risks
Where are clotting factors made?
What is the antidote for heparin?
Protamine Sulfate
Which fluid starts as isotonic then becomes hypotonic in the body?
D5W
EXTRA: when will you see a reaction? (PRBC)
24 hours
EXTRA: within the first 50 ML (15-30 minutes)
Where is an Enteric Coated tablet absorbed?
Small Intestine
*cannot be split or crushed*
Vitamin K & Calcium do what?
Vitamin K - Synthesis
Calcium - Activation
What do you give when a patient is not bleeding but has a high INR?
Vitamin K
*Kcentra is used when there is too much bleeding due to warfarin*
When is D10W needed ?
Pediatric patients that are TPN Dependent and their TPN is interrupted, sever hypoglycemia
FFP contains what?
coagulation factors