Ch 8 Nurs 114

______________ is how drugs are absorbed distributed, metabolized and excreted

Pharmacokinetics

____________ is how drugs affect the body on a cellular level in relation to the target organ.

Pharmacodynamics

___________ refers to the passage of medication from its site of introduction usually the GI tract into general circulation.

Absorption

_______________ also called serum half life is the time required to decrease the drug concentration by one half its original value.

Elimination half time

The ______________ measures the volume of blood form which the medication is eliminated per unit of time.

Clearance rate

_______ also called botanicals, are plant based products that have medicinal properties.

Herbs

Birch bark has similar bioactivity to ______

Aspirin

Willow bark has similar bioactivity to ____________

Aspirin

Meadowsweet has similar bioactivity to ____________

Aspirin

Dong quai has similar bioactivity to ______________

Anticoagulants

Feverfew has similar bioactivity to ______________

Anticoagulants

Garlic has similar bioactivity to ______________

Anticoagulants

Ginkgo biloba has similar bioactivity to ______________

Anticoagulants

Wintergreen has similar bioactivity to ______________

Anticoagulants

Guarana has similar bioactivity to ______________

Caffeine

Kola nut has similar bioactivity to ______________

Caffeine

Ephedra has similar bioactivity to ______________

Ephedrine

Black cohosh has similar bioactivity to ______________

Estrogen

Fennel has similar bioactivity to ______________

Estrogen

Red Clover has similar bioactivity to ______________

Estrogen

Stinging nettle has similar bioactivity to ______________

Estrogen (made me itch like heck. Did not feel like girlie - er)

Thyme has similar bioactivity to ______________

Lithium

Purslane has similar bioactivity to ______________

Lithium

Ginseng has similar bioactivity to ______________

Monoamine oxidase inhibitors (happy pills)

St. Johns wort has similar bioactivity to ___________

Monoamine oxidase inhibitors

Yohimbe has similar bioactivity to ____________

Monoamine oxidase inhibitors

Lobelia has similar bioactivity to ___________

Nicotine

Angelica has similar bioactivity to ____________

Calcium channel blockers

What are the potential adverse effects of black cohosh?

Bradycardia, hypotention, joint pain

What are the potential adverse effects of Bloodroot?

Bradycardia, arrhythmia, dizziness, impaired vision, intense thirst

What are the potential adverse effects of boneset?

Liver toxicity, metal changes respiratory problems

What are the potential adverse effects of Coltsfoot?

fever, liver toxicity

What are the potential adverse effects of dandelion?

interactions with diuretics increased concentration of lithium or potassium.

What are the potential adverse effects of Ephedra?

Anxiety, dizziness, insomnia, tachycardia and hypertension.

What are the potential adverse effects of feverfew?

Interference with blood clotting mechanisms

What are the potential adverse effects of Garlic?

Hypotension, inhibition of blood clotting, potentiality of anti-diabetic drugs

What are the potential adverse effects of ginseng?

anxiety insomnia hypertension tachycardia asthma attacks postmenopausal bleeding

What are the potential adverse effects of goldenseal?

Vasoconstriction

What are the potential adverse effects of guar gum?

hypoglycemia

What are the potential adverse effects of hawthorn

Hypotension

What are the potential adverse effects of hops, skullcap, valerian.

Drowsiness, potentiation of anti-anxiety or sedative medications

What are the potential adverse effects of Kava

Damage to the eyes skin liver and spinal cord from long term use

What are the potential adverse effects of licorice

Hypokalemia hypernatremia

What are the potential adverse effects of lobelia

Hearing and vision problems

What are the potential adverse effects of nettle

hypokalemia

What are the potential adverse effects of senna

Potentiation of digoxin

What are the potential adverse effects of Yohimbe

Anxiety, tachycardia, hypertension, mental changes.

This herb is used for acute non specific diarrhea and topical treatment of mild inflammation of the mouth throat and oral mucosa. In high doses its inhibits platelet aggregation patients with hemorrhagic disorders should avoid.

Bilbery

This herb is used for menopausal sysmptoms such as hot flashes, night sweats and sleeping disturbances. May cause hepatoxicity.

Black Cohosh

This herb is used for osteoarthritis of the knee and rheumotoid arthritis. Patients with organ transplant or lymphocytosis, or autoimmune disease should use with caution. This herb inhibies cytochrome P 450 CYP3A4. Also, this herb may dilate peripheral blood vessels and increase heart rate.

Cat's claw

This herb is used for Inflammation of the GI tract and GI spasms. Topically it is used for inflammation of the skin and mucous membranes and bacterial infections of the skin.

Chamomile

This herb is used for supportive therapy for colds and infection of the respiratory and urinary tract. Should be avoided in pts taking immunosuppressant drugs.

Echinacea

This herb is used for atopic dermatitis and eczema but it may be an unmasking of temporal lobe epilepsy. May improve blood flow and nerve conduction deficits in diabetes.

Evening Primrose

This herb is used to lower cholesterol prevent hardening of arteries and treat minor respiratory infections. Use with caution because it inhibits platelet aggregation if taken with warfarin, asprin, or NSAIDs.

Garlic

This herb is used for prevention of motion sickness and its anti inflammatory properties. However, it is contraindicated in active gallbladder disease, anti-platelet aggregation is common must discontinue use 7 to 10 days prior to surgery.

Ginger

This herb is used to treat degenerative and vascular dementia, peripheral artery occlusive disease vertigo and tinnitus. Use with caution due to potential for interaction with anticoagulant and anti-platelet medications. Also, can increase blood glucose in type II diabetics.

Ginkgo Biloba

This herb is used as a restorative agent for invigoration during time of fatigue stress and convalescence.

Ginseng

This herb is used to treat congestive heart failure. However, it may potentiate the action of digitalis and beta blockers.

Hawthorn

This herb is approved for the treatment of chronic venous insufficiency night cramps and itching. Use with caution due to bleeding time changes in patients taking anticoagulants.

Horse Chestnut

This herb is used for the treatment of anxiety or depression. However, there are serious concerns about liver toxicity and the decreased effectiveness of warfarin.

Kava

This herb is used for the treatment of inflamed upper respiratory tract infections and gastric / duodenal ulcers. However, it is contraindicated in liver disorders congestive heart failure or edema. Can increase blood pressure and interacts with diuretics corticosteroids and anti hypertensives.

Licorice

This herb is used for benign prostatic hypertrophy. does not affect prostate-specific antigen levels or drug interactions.

Saw palmetto

This herb is used for the treatment of mild to moderate depressive moods anxiety and nervousness. Potential for decreased cyclosporine levels; decreased effectiveness of warfarin possible decreased digoxin levens avoid in patients taking multiple medications.

St Johns wort

This herb is used for restlessness mild sleep promoting agents in nervous and anxiety related sleep disturbances. In theory there is a potential additive effect when taken with central nervous system depressants.

Valerian

The gradual ____% to ___ % decline in hepatic blood flow begins around the age of 40 and can affect serum concentration and the volume of distribution of substances that are metabolized more extensively bu the liver.

30 to 50%

Malnutrition further decreases ___________ levels thereby increasing both the therapeutic and adverse effects of highly protein bound medications.

Serum albumin

True or false.

Over the counter remedies are always save even in extra strength doses.

False

_____________ refers to the use of multiple medications often from multiple sources.

Polypharmacy

__________refers to medication takeing patterns that differ form the prescribed pattern including missed doses failure to full prescriptions or medications taken too frequently or at inappropriate times.

Medication non-adherence

Increasing public pressure led to the legislation creating the ___________ prescription drug program.

Medicare Part D

Magnesium or aluminum containing antacids may bind with ____________ in the stomach

Tetracycline

Ciprofloxacin and anticonvulsants inhibit metabolism of _________

Warfarin

Phenobarbital increases metabolism of ________

Warfarin

Furosemide can interfere with elimination of _________

salicylates (asprin)

Sodium bicarbonate can enhance excretion of _________, __________ and __________

Lithium tetracyclines, and salicylates

Diphenhydramine may interfere with effect of ____________ agents

cholinergic agents Ex. tacrine, donepezil

_______________ taken with codeine has a greater analgesic effect then taken alone

Acetaminophen

Verapamil or diltiazem may have additive effect when taken with a __________

beta blocker

True or false

Ingestion of food may delay absorption of cimetidine digoxin, and ibuprofen.

true

True or false

Calcium decreased absorption of tetracycline. A high protein or high fiber meal decreases the absorption of levodopa

true

True or false

Caffeinated tea and fiber intake interfere with iron absorption.

True

True or false

High fat foods increase serum levels of griseofulvin.

true

True or false

Vitamin K decreases the effedtiveness of warfarin.

True

True or false

Charcoal broiling of foods deministhes the effectiveness of aminophylline or theophylline

true

True or false

A high protein diet increases the metabolism of theophylline.

True