Karch ch.

2
First pass: pertains to kidneys & liver
Age: nothing to do with blood-brain barrier, its all about how one
reacts/toxicity in body

Ch. 3 toxic effects of drugs

Adverse effects
- Adverse reaction: side effects of taking iron pills, like constipation, brown
stool
- Drug’s action on body causes reaction, like iron in this case
Types
- Primary: overdoes
- Secondary: causing undesired effects such as when taking tylenol, it
takes away headache, but given cramps.
- Hypersensitivity: little reaction for primary or secondary effect of drug.
- Should be no immune reaction
- Ex. we want to montior rash closely to make sure it doesnot spread
- Happens once
- Nothing crazy happening,
- Ex. rash, cold sore in mouth, redness in IV site
- Giving potassium through IV, burning veins
- Drug allergy: body forms antibody everytime I take, body reacts
- Rashes in entire body
- Need epinephrine pen
- Type I reaction: on the spot reaction
- Type 2: delayed effect, shows adverse effects in 24 hrs

- Superinfection: there’s normal flora in vagina, rectum, gut, mouth

- ex. Diarrhea thats why sometimes when people are prescribed
antibiotics, are given probiotics after.
- role as a nurse is to asset
- blood dyscrasia: bone marrow suppression
- ex. Chemo meds
- being in hospital is a stressor
- lack of family support
- diagnosis
 Toxicity
Liver injury:
- Assessment: fever, jaundice (for black people: monitor eyes)
Renal injury:
- Assessment:
- Our waste product from body comes in form of urea
Poisoning:
Sensory effects: drugs can effect on ocular (eye) and auditory (ear)

Neurological Effects
- The overall goal is to prevent injury & falls

Teratogenicity
- Category A:
- Category B: tested on animal, not on humans
- Category C:
- D:
- X: you do not give medications at all

Ch.4 The Nursing Process in Drug Therapy & Patient Safety

-ADPIE, Evaluation is ALWAYS ongoing
-Assessment: Collecting data
- History
- Physical examination
- Psychosocial assessment: patients perception of disease & the
cause
Know all Nurse’s role-medication rights
- 8
Ch.4 cell injury, aging & death
Reversible cell injury
Cellular adaptation
- Atrophy: persisting injury can lead to cell atrophy. Meaning causing same
damage at same place
- Shrinking in size to come back better
- Hypertrophy: increase i size
- Hyperplasis: increase on number
- cells starting to make cancer cells
- Metaplasia: converting one cell type to another
- You see physical changes
- Once you get here, will not go to normal cell
- Ex. see lung tissue in brain
- Dysplasia: disorderly grown
Irreversible cell injury
- Our own cells try to damage cells
Etiology of cellular injury
Cellular aging
- When we age, our cells age as well
Molecular genetics
Genetic code
Regulation of the genome
- Whatever is on slides just know 2

Ch.6 genetic & developmental disorders

Congenital disorders: caused by air in the development of fetus. Defect
you have before you come. Something that's present at birth, result of the
environment, genetic or both. (structural damage to organ, we don’t
see)
Ex. autism, a child who’s born paralyzed, coarctation of aorta, born with a
hole in heart
Congenital malformation: (structure), someone who is born with
“incomplete” (structural damage to organ we can see)
Principles of inheritance
Female: 2 x chromes
Male: 1 x and 1 y chromosome
Phenotype: things you can see. With congenital malformation
Genotype: things you can’t see. Ex. blood work. With congenital
disorders
Genetic issue: preg. Mom with environmental toxin cause baby a mutation
Ex. mom lives in crisis homeless shelter, does not cause mutation
3-9 weeks of gestation: fetal vulnerability. mom should be away from
environmental toxins
Birth injury: anything that happens during birth
 Ex. lack of oxygen, child can’t breath due to placenta wrapped around
baby neck, mom losing oxygen during push
Vs low birth weight & immaturity at birth (immaturity of organ): not in
mom’s control, child can’t breath properly that went to NICU
Diagnosis, counseling & gene therapy

Ch.7
Neoplasia:
Bening: dones’t want control over other cells
Malignant: cells want to invade everywhere
Epidemiology and cancer risk factors
Multistep of carcigonesis
Angiogenesis: where is this cell coming from
Grading: how we treat
genetic/molecular testing: we see if this is a familial thing. If we should
start informing family
Effects of cancer on body
Cancer therapy
Chemo: kills cell
Radiation: shrinks
Ch.14
Protein tyrosine kinase inhibitor: -sine is amino acid
Ex. patient show up with pancreatic cancer, see what the cell made up of in
lab, they tell theyre made of kinase family. Lets try guanine, if not
tyrosine… then move on to treatment.
Ch.8
Probiotic: we want to develop the normal flora
Antibiotic: we’re trying to use that to kill the bad bacteria & infections
Microbial virvulence: how much load that has on body
Hypersensistiy level: one boy reacts different from another
Narrow pecturm: have culture and sensitivity back
Broad spectrum:
Ch.9 antibiotics
Ch.10 antiviral agents
Meds go by: body weight, hypersensitivity, and culture sensitivity
Ch.11 antifungal