Pharmacology • ↑gastric motility-↑gastric

emptying↓aborsoption

• Drug polymorphism- ppl react to • ↓liver enzymes-↓metabolism of

drugs differently drugs↑toxicity

• 1 oz= 30 ml • MAOI + tyramine foods= bad—

hypertension—beer and chicken
• 1 tbsp= 15 ml
• ↓BP ↓blood flow↓drug distribution
• 1tsp=5ml
• Old ppl-↑gastric acid and fat but
• Bevel-pointed open part
everything else is↓
• Hub- comes in contact c tip of
• Food and Drug act of 1906 and
syringe
1938
• Ad- right ear As- left ear Au-both
• Harrison Narcotic Drug Act of 1914
ears
• Controlled Substance Act of 1970
• Od- right eye Os- left eye Ou-both
eyes • BacterioSTATIC- inhibit

• Oral drugs- 3 phase 1) • BacterioCIDAL- kill

pharmaceutics- dissolution:
disintegration 2)pharmacokinetics-
process of drug movement [what
the body does to the drug]
3)pharmacodynamics- interactions
bet chems of living systems
• 4 processes under
pharmacokinetics 1) absorption 2)
distribution 3) Metabolism 4)
excretion
• Rate limiting-time it takes for the
drug to disintegrate and dissolve
and become available
• Therapeutic level- bet toxic and
minimum effective level
• CHLUVIDS
• Synergism- combo leads to greater
response than individual drugs
• Potentiation- a drug with no effect
enhances the effect of the 2nd drug
• Addition- combo yields the same
effect as a single drug would
• Inhibition of cell wall synthesis-PCV
• Alteration in membrane
permeability-ANPC
• Inhibit chon synthesis- ATEL
• Interference c cell metabolism-
STIR
• Neostigmine- prostigmin short
acting
• Pyridostigmine-intermediate-
mestinon
• Ambenonium chloride-long acting-
mytelase
• Endrophonium- short acting-
tensilon
• Amantadine- antiviral drug-acts on
dopamine receptors—for drug
induced parkonsism
• COMT inhibitors- increases amount
of levodopa conc. In the brain
• Dantrolene- p. acting muscle
relaxant
• Aqueous pen g- painful short
duration
• Procain pen- less painful
• Pen v-less potent than pen g—mild
to moderate
• Pen-ase resistant pens- less
effective than pen g against gram
+ microbes
• Clavulanic acid- ↑abx effect and
↓resistance
• st
Faz&exin- 1 gen cephalosporin
• Cefotaxime&ceftri- 3rd gen
cephalosporin
• Short acting sulfo-sulfisoxazole
• Intermediate acting sulfo-
sulfamethoxazole
• Lincosamides not compatible c-
PABA-phenytoin,
ampicillin,barbiturates,
aminophylline
• Interfere with DNA gyrase-
fluoroquinolones—causes cartilage
damage to growing kids
• Fe- needed most during the last 20
wks of preggo
• Highly ionized-crosses less easily
• Low-weight-crosses easily
• Folic acid-neural tube defects 180
nonp 400-800-preg
• Aspirin-delays labor and increases
bleeding
• Ritodrine- increase in systolic
• Exosurf-protein free surfactant
• Simethicone- antiflatulents
• Dad+--mom(-)—kid+
• RHOGAM- c in 72 hrs of delivery
• Vit k to baby- 1mg/.5ml
• ASA+virus[flu or chicken pox]=
reye’s syndrome
• Para-aminophenol derivative-
acetaminophen
• Para-cholorbenzoic acid-
prostaglandin inhibitor
• Propionic acid derivatives- ALL END
IN fen
• Cardiac glycosides- inhibit Na and
K pump w/c increases intracellular
Ca
• Inotrophic- vigor/strength of
contraction
• Chronotrophic- heart rate
• Dromotrophic- conduction of heart
cell
• Check apical pulse before giving
digoxin
• Fast Na channel blockers-
decreases conduction, velocity,
and automaticity
• Beta adrenergic blockers-diminish
sns response
• C. acting sympatholytics- stimulate
alpha 2 receptors decrease sns
activity
• Direct acting arteriolar
vasodilators- relax smooth muscle
of arteries
• ↓icp and iop-osmotic diuretics
 • Aminoglycosides+loop diuretics= • station -1 or -2--above level of ischial
hearing impairment spines

• Osmotic d-crystallization-low temp • stations +1 or +2—below level of

ischial spines
• Mgmt. of epilepsy, mountain
sickness, and m. alkalosis- • station +3 or +4—crowning
carbonic anhydrase
• only bear down during true
• ACE+Ksparing d- hyperkalemia contractions

• • during labor-assume sim’s position—

prevents supine hypotension
NCM • tachycardia for baby- >160/min
• 1500/small boxes • bradycardia for baby- < 110/min
• 300/big boxes • fetal acidosis- 7.2
• Presentation- relation of long axis of • ritgen’s maneuver- support the
mother to long axis of fetus perineum by applying pressure
• LOA-most common position for fetus • crede’s maneuver—putting pressure
@ birth—FHT is heard at left lower on the fundus by physician or nurse
quadrant
• brandt-andrews maneuver- removal of
• Normal amount of blood lost placenta from mother
during labor and delivery- 250-
350ml • if uterus is boggy and not contracted-
massage OR put ice-cap
• Green bag of water- meconium
staining • >500 ml of blood loss during labor is
considered hemorrhage
• Yellow bag of water-blood
incompatibility • Chorion membrane-outermost
membrane
• Pink bag of water-indicates bleeding
• Placenta formed by chorionic villi and
• Late • Acti • transi deciduas basalis
nt ve tion
• Endoderm- GIT, RT,
• comp • cer • cervi
lete vica cal • Mesoderm- REPRO, CIRC, BONES,
effac l dilata cartilage, and muscles,
eme dila tion
nt tati is • Ectoderm- CNS and PNS
on comp
• Organogenesis- 8wks
begi lete
ns • NS-3rd or 4th week
• station zero (0)- fetus is at level of
• CV system- 16th day of life
ischial spines—engagement
• Ossification- 12th wk
• UT-12th wk—500ml is excreted/day
• Hegar’s sign-softening of lower uterine
segment
• Goodell’s sign—softening of cervix
• Chadwick’s sign- light pink-- violet
• Montgomery’s tubercles- glands of
areola
• High estrogen leads to stuffiness
• Clotting factors- 9, 10, 72
• Relaxin-!!!
• C. luteum dies during 16th week
• Full term->37 wks
• Muscle cramps during preg—dec. Ca
levels
• Uterine soufflé-blood rushing thru the
large vessels of the uterus
• Prenatal checkup- 1-7mos.
Once/month, 7-8th mos. Q other week,
9th month. q week
• LMP- 01-05-2009—[-3 +7] 10 12 2009,
or Sept. 12- june 19
• 60g/day increase in preg women
• Decrease CHO intake coz of HPL—
insulin antagonist
• AOG-mcdonald’s rule- height (CM)x2/7
–for woman over 200lbs subtract 1
from height
• Fetal weight- johnson’s rule—height-
12 or 11x155…12 if head is below
ischial spines or engaged..11 if head is
above ischial spines---add 1 for pts
over 200lbs
• Leopolds’s- 1) what lies in the fundus
2) location of fetal back and small
parts 3)face head part of pt. what
occupies pelvic inlet 4) face feet part
of pt. detect flexion, position and
station
• Palpitations-sudden movement
• Funic soufflé- blood rushing thru
umbilical cord
• 4-5 mos- heartbeat is heard
• 1st 6-8 weeks aftr delivery—
puerperium period
• Post-partum day 1- 1 fingerbreadth
day 2- 2 fingerbreadths day 3-3
fingerbreadths..10th day cannot be
palpated
• Uterine contractions after delivery—
after pains
• Breastfeeding-period will return c in 3-
4 mos. Not boobfeeding- period
comes back in 8 weeks
• Episiorraphy care- ice for 1st 24 hrs
then heat lamp for 20 min. x3-4 a day
—sim’s position
• Full bladder is resonant..empty
bladder is dull
• Dysuria for preg- pour warm or cold
water over perineum
• 150ml of residual urine—leave
catheter in for 12-24 hrs
• Don’t massage if + for homan’s sign
• ARM RAISING- strengthen abdominal
muscles
• 3rd day of boob tension—engorgement
• Cold compress- no boob feeding
• Warm compress- boob feeding
• Taking in- mother focus’ on herself
• Taking hold- strong interest for baby
• Letting-go phase- adopts a new role
• Erythema toxicum- new born
rash..appears first few days of life
• suction mouth before nose
• APGAR- HR. Resp effort. MUSCLE
TONE. REFLEX irritability. COLOR
• Length of baby- 650 in.
• Chest circumference- 31-33 cm
• Head circumference- 33-35 cm
• 30-50rr for baby
• 100/50 for baby
• Crede’s prophylaxis- eye ointment
• Physiologic jaundice- occurs on 2 nd
or
3rd day—gone by 2nd wk of life
• Anterior fontanelle- 12-18 mos
• Posterior fontanelle- 2nd month
• Witch’s milk- thin watery fluid
• Foramen ovale- fossa ovalis
• Ductus arteriosus[connects
descending aorta to left pulm. Artery]
—ligamentum arteriosum
• Ductus venosus[left umbilical vein
thru liver to inf. Vena cava-
ligamentum venosum
• Boob-fed babies- 3-4 light
yellow..sweet smelling
• Bottle-fed- 2-3 bright yellow—stanky
• Touch-most developed sense at birth
• Epidural- above meninges
• Intrathecal- c in meninges
• pulsus paradoxus- 5-10
• orthostatic bp- 5-15
• indirect coombs- for bt
• sv x hr= co
• estrogen= ^coagulation
• 1-3 min for ortho testing
• central cyanosis= poor arterial
circulatiomu
• v co= brady and tachy
• pmi= 5th ics mid clavicular
• bruit=aortic stenosis
• s3s4= gallops
• plural frictipn rub=inspiration
• mi= 30 min felt arm crushing
• angina= 15min felt near sternum
squeezing
• parox. nocturnal dyspnea- 2-4hrs after
sleep. relieved sitting up 15-20 min
• stress of heart= ^blood glucose
• pulmonary vein= from lungs to heart
o2 rich
• ^ hydrostatic pressure= fluid goes
from intravascular to interstitial
• ascending venography- foot
• descending ""- femoral vein for valve
incompetence
• plasma- maintain bllod volume
• rbc-7.5um 105-120 days
• neutrophils-localizing and immobilizing
pathogens
• eosinophils- reduce ige allergic
reactions

• hemohilia= only males

• blacks- .5g/dl less

• agranulocytosis=granulocytopenia

• gastrectomy= no intrinsic factor

• no liver= no clottong factors

• 4o packs- 60-70 %

• reg smoker- 13fold

• 2nd hand smoker- 1.5%

• haziness at top- tb at middle-

pneumonia bottm- hydrothorax

• chest1:2

• kussmauls resp- associated with

acidosis dm and crf

• thoracic excursion- 3-5cm

• pneomonia- ^frem on r. lung

• perfusion scan- injected in peripheral

vein

• 3 incisions for endoscopic thoracotomy