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Principles
Principles II
Psychotherapeutic Drugs
Analgesic
Mixed BAG Category
100
What is the name given by Health Canada under the Food and Drugs Act and Food and Drug Regulations
Nonproprietary Name, Generic Name
100
When Jimmy's mother asks you, the nurse, what it means when the Half life of tylenol is 2 hour, what do you say?
Nurse: The time it takes one half of the tylenol in the body to be removed. The rate at which tylenol is REMOVED from body!
100
You give Lithium to a young girl that has Manic bi-polar disorder, she asks you if she can overdose on the drug. What do you say.
You tell her: The therapeutic range for lithium is very narrow. It is quite easy to overdose and also to have no effect. You tell her to take her pills correctly.
100
What is the difference between superficial pain and referred pain?
Superficial pain:nociceptors in the skin or other superficial tissue, and is sharp, well-defined and clearly located Referred- reflective pain, is pain perceived at a location other than the site of the painful stimulus
100
Salicylate toxicity when....
serum levels of salicylate is greater than 300 mcg/ml Adults: tinnitus and hearing loss Children: hyperventilation and CNS effects
200
What is the difference between Pharmacokinetics and Pharmacodynamics?
Pharmacokinetics: What the body does to drug Pharmacodynamics: What the drug does to the body
200
Jimmy's mum is curious why the tylenol isn't working on yet. She says its been 10 minutes why hasn't it worked? As a nurse you know the the time it take tylenol to elicit a therapeutic response is 15 minutes. What is the term for it?
Onset
200
Your patient is on MAOIs, you tell her to eat less foods with tyramine. What are those foods? Why do you tell her that?
Ingestion of foods with amino acid tyramine leads to hypertensive crisis which may lead to cerebral hemorrhage, stroke, coma, or death! Aged cheese, blue cheese Smoked and aged meat, fish, poultry Red Wine (Chianti!!) yummy
200
What are Agonist, Partial Agonist, Antagonist
Agonist: Bind to pain receptor in brain causes analgesic response :) PA: bind to receptor but causes weaker response Antagonist: Reverse effect of agonist and PA on pain receptors, Competes of pain receptors site with no effect
200
When Jimmy's mum, who is on SSRIs for her depression, asks you why the dr says that the drug is highly protein bound, what do you tell her?
The drug will compete for binding sites with other highly protein bound medications, it lead to more free unbound drugs causing longs time for therapeutic effect.
300
What is Intrathecal (give an example)and what route would it be under?
Medication give through the spine, Morphine, Parenteral route
300
Jimmy's mother's boyfriend has been on Tylenol- 3 for 5 years. Jimmy's mother says, OMG he is such an addict! He can't quit! He is wanting more than he does before. What do you tell her?
Boyfriend has a dependence to Tylenol-3 because of he takes the drug regualry. When he doesn't take it, he will develop signs of withdrawal. He also has a tolerance to Tylenol-3 because the of the decreasing response to drug, he needs more and at higher doses to maintain the same effect.
300
Jimmy's mum is on Seroquel, an Antipsychotic, she asks you what extrapyramidal symptoms are?
Involuntary motor symptoms pseudoparkinsonism, akinesia, dyskinesia, akathisia, dystonia, cardiovascular effect!
300
Jimmy's mum is on Hydromorphone, she severe coccyx pain from a fall. You tell her some contraindications as she is very curious. She also wants to know if she took too much, what she needs to reverse the effects.
CNS depression, Respiratory depression, constipation, euphoria!!:) Naloxone hydrochloride: Narcan!!! it binds to receptor site and prevents a response
300
Jimmy's mum just started on SSRIs for depression. Jimmy wants to know what to watch out for.
It take 4-6 weeks for maximum therapeutic effect, monitor mum for potential for self-injury as most patient gain energy to carry out suicidal plans. Make sure to monitor SUBJECTIVE feedback.
400
What is the areas of rapid distribution?
heart, liver, kidneys, Brain
400
Additive effect Synergistic effect Antagonist effect Incompatibility effect:
1) each drug's effect is the same if given alone 2) action becomes greater than if given alone 3) decrease effect than if given alone 4) drugs cause reaction resulting in deterioration of at least one of the drugs
400
Jimmy's mum asks you what Tardive dyskinesia is? She wonders if it was a miss print, "Is is endive instead?"
They are adverse effects related to taking antipsychotics. They cause Late appearing involuntary muscle movements that can last for months or become permanent. So no it is not endive.
400
Jimmy is on Acetaminophen again for pain in the his right knee, he is 7 years old. His mum is asking if there is something else that she could give him such as her aspirin. What do you tell her?
You cannot give aspirin (salicylates) to children under age 12. Reye's syndrome may occur acute encephalopathy and fat infiltration of liver.
400
What are the indications for Acetaminophen?
Analgesic (mild to moderate) Antipyretic (what is that?) Anti-inflammatory (whats that?)
500
What is the biological transformation of a drug
An inactive metabolite, more soluble compound, more potent metabolite
500
Jimmy's mum is on corticosteroids for her dermatitis, she develops cushing disease as a result. She states: Why me? Why am I becoming moon-shaped? Are my genes being mutated? Am I going to develop cancer?
Nurse: you are developing an iatrogenic response, an unintentional adverse effect that is part of your corticosteroid treatment. A change in genetic composition would be a mutagenic effect and a carcinogenic effect would cause cancer. You do not have any of those risks.
500
Which Antidepressant should you not take during Pregnancy? What is its pregnancy category and what does it mean?
TCAs Category C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
500
What are some side effect of taking NSAIDS
GI bleeding, reduced renal function!
500
What are the lifespan considerations that you need to make for Jimmy's younger brother (age 12 months) and Jimmy's grandfather (age 78) in terms of absorption of drugs
Baby: 1st pass is decreased, slow gastric emptying and high pH Grandfather: Slow GI tract and decrease blood flow in GI tract with less surface to absorb. high oH and higher chance of polypharmacy as Grandfather may be on antacids and blood pressure pills.