Exam 3 Flashcards
(208 cards)
1
Q
3 things that are misuse of drugs
A
- taking meds in the wrong manner
- taking a different dose than prescribed
- taking someone else’s perscription
2
Q
2 physical withdrawals of addiction
A
- increased HR
- N/V
3
Q
4 psychological withdrawal symptoms
A
- emotional
- angry
- irritable
- mood swings
4
Q
term for a patients reduced reaction to a drug because of repeated use
A
tolerance
5
Q
drug tolerance changes the brains ______ pathway
A
reward
6
Q
the minimum point at which something causes you pain
A
pain threshold
7
Q
maximum amount of pain that you can handle
A
pain tolerance
8
Q
class of medications that are designed to relieve pain without loss of consciousness
A
analgesia
9
Q
pain that lasts less than 6 months
A
acute
10
Q
pain that lasts longer than 6 months
A
chronic
11
Q
pain in the organs
A
visceral
12
Q
pain from the skin, muscles, and soft tissues
A
somatic pain
13
Q
pain caused by damage or disease to somatosensory system
A
neuropathic
14
Q
neuropathic pain that is abnormal sensations
A
dysenthesia
15
Q
neuropathic pain that is normally not painful stimuli
A
allodynia
16
Q
WHO step 1 for mild pain
A
non opioid medications
17
Q
WHO step 2 for moderate pain
A
- weak opioid
- non-opioid
- adjuvant analgesic
18
Q
WHO step 3 for severe pain
A
- strong opioid
- non-opioid
- adjuvant analgesic
19
Q
2 types of nonopioid medication
A
- NSAIDs
- acetaminophen
20
Q
non-opioid medication uses (3)
A
- mild/moderate pain
- head ache
- fever
21
Q
side effects of NSAIDs (2)
A
- GI upset
- Bleeding
22
Q
levels to monitor when giving NSAIDs
A
BUN/creatine
23
Q
levels to monitor when giving acetaminophen
A
AST/ALT
24
Q
3 side effects of acetaminophen
A
- N/V
- rash
- anorexia
25
max acetaminophen in a day
4 grams
26
opioids work on the same site as natural _________
endorphins
27
opioids also work to suppress ________ and _______
respirations and cough
28
6 side effects of opioids
- N/V
- constipation
- hypotension
- decreased RR
- urinary retention
- itching
29
reversal agent for opioids
naloxone (narcan)
30
anesthetics cause loss of consciousness by depression of the ______ by decreasing the firing of ______
CNS, neurons
31
2 types of anesthesia
- local
- general
32
type of anesthesia where the patient is still awake but part of the body is suppressed
regional anesthesia
33
inhaled general anesthesia
nitrous oxide
34
2 routes of general anesthesia
IV or inhaled
35
5 side effects of general anesthesia
- cardiac/respiratory depression
- hypotension
- hyperthermia
- N/V
- dyrhythmias
36
example of local anesthesia
lidocaine (xylocaine)
37
regional nerve block anesthesia
bupivacaine (marcain)
38
3 side effects of local/regional anesthesia
- H/A
- hypotension
- rash
39
spinal anesthesia is a needle that goes into the spinal ____
sac
40
epidural anesthesia is a needle that goes into the spinal _____
canal
41
4 cardinal signs of inflammation
- redness
- swelling
- pain
- heat
42
2 inflammatory mediators
- prostaglandins
- cyclooxygenase (COX) enzyme
43
4 different classes of anti-inflammatory rugs
- NSAIDs
- steroids
- DMARDs (disease-modifying antirheumatic drugs)
- antigout drugs
44
1st generation NSAIDs S/E (4)
- GI upset
- bleeding
- ulcers
- tinnitus
45
2nd generation NSAIDs have less side effects and do not effect the _____ and _______ function
GI, platalet
46
4 uses for NSAIDs
- inflammation
- pain
- antipyretic
- decreases platelet aggregation
47
NSAIDs decrease platelet aggregation by inhibiting of _____ enzyme
COX
48
NSAIDs are highly ______ bound
protein
49
NSAIDs cause ______ and ______ retention
sodium, water
50
steroids decrease the ______ response
immune
51
6 things steroids increase
- blood glucose
- BP
- sodium/water retention
- HR
- appetite
- risk for infection
52
steroids can decrease _______ levels
potassium
53
4 things steroids can cause
- osteoporosis
- mood chnages
- irritability
- insomnia
54
to decrease GI upset with steroids you can take them with food or _______ ________
H2-receptor agonist
55
steroids must be _______
tapered
56
medication used for N/V related to surgery, chemo, or vertigo
antiemetic
57
3 side effects of antiemetics
- drowsiness
- dry mouth
- constipation
58
antiemetic that can cause necrosis
promethazine (phenegran)
59
antiemetic that pregnant women can take to help with nausea
ondanestron (zofran)
60
antidiarrheals decrease ________ of GI
hypermotility
61
4 uses for antidiarrheals
- GI illness
- bacteria
- diet
- drug-related diarrhea
62
5 side effects of antidiarrheals
- drowsiness
- dizziness
- urinary retention
- flushing
- dry mouth
63
lomotil is made of ______ and _____
atropine and opioid
64
the atropine in lomotil can cause increased ______ _______ and ______ _______
heart rate and intraocular pressure
65
when taking lomotil, monitor for ________ and decreased ______ _____ because of the opioid in it
constipation, respiration rate
66
2 side effect of immodium
- nausea
- fatigue
67
Pepto Bismol can cause black _____ and _____
stool and gums
68
osmotic laxatives are _______ which means they have more solutes and pull more water into the intestine to move the feces
hyperosmolar
69
laxatives that irritate to intestinal lining
stimulant
70
if the patient is taking _____ ______ laxatives, you must have them drink water or else it will cause a bowel obstruction
bulk forming
71
stool softening laxatives that bring water to the stool
emollients
72
antacids neutralize _____ ____ and reduce _______ activity
HCl acid, pepsin
73
if the antacid contains _______ people wit impaired renal function cannot use them
magnesium
74
2 side effects of antacids
- anorexia
- constipation
75
take antacids ___ to ___ hours after meal time to at bedtime
1 to 3
76
calcium can cause _______ and magnesium can cause ______
constiaption, diarrhea
77
_______ ulcers cause pain right after eating
gastric
78
_______ ulcers cause pain between meals
duodenal
79
inflammatory erosion of the intestinal lining that causes intense burning and gnawing pain between meals
peptic ulcer disease
80
6 risk factors for peptic ulcer disease
- H. pylori
- NSAID use
- stress
- alcohol
- smoking
- caffiene
81
GERD decreases muscles tone of the _______ ______ and it causes regirgitation of stomach contents
esophogeal sphincter
82
4 risk factors for GERD
- obesity
- pregnancy
- hiatal hernia
- gastroparesis
83
4 S/S of GERD
- epigastric pain
- heart burn
- bitter taste
- dry cough
84
GERD medication that blocks histamine receptors to decrease HCl production
H2 blockers
85
4 side effects of H2 blockers
- liver/kidney problems
- agitation
- gynocomastia
- confusion
86
4 side effects of both H2 blockers and proton pump inhibitors
- H/A
- diarrhea
- dizziness
- constipation
87
proton pump inhibitors block HCl production in _______ cells
parietal
88
proton pump inhibitors must be taken _____ meals
before
89
proton pump inhibitors can cause _________ because it disrupts clcium absorption
osteoporosis
90
medication that creates a vicious protective substance that covers the ulcers on the stomach
pepsin inhibitor
91
pepsin inhibitors must be given on an _______ stomach
empty
92
pepsin inhibitors can cause _________
constipation
93
you must wait ____ to ____ hours between pepsin inhibitors and other drugs
1-2
94
2 types of lower UTI
- cystitis
- urethritis
95
1 types of upper UTI
pyelonephritis
96
4 common bacteria that cause UTIs
- E. coli
- proteus
- staph
- candida
97
6 S/S of UTI
- dysuria
- burning
- urgency
- frequency in small amounts
- cloudy
- hematuria
98
nitrofuratoin and fasfomycin can turn the urine _______
brown
99
nitrofuratoin and fasfomycin mst be taken with food and cause ____ upset
GI
100
nitrofuratoin and fasfomycin suppress ________ ______
bacterial growth
101
methanmine helps _______ the urine to help with UTI
acidify
102
drink _____ and _____ juice when taking methenamine
water, cranberry
103
2 things to avoid on methenamine
- citrus
- antacids
104
metheamine cannot be taken with _______ or else it causes urine crytsals
Bacrtim
105
4 side effects of sulfonamides
- GI upset
- urine crystals
- photosnesitivity
- rash
106
3 things to not take with fluoroquinolones
- dairy
- antacids
- iron
107
4 side effects of fluoroquinolones
- GI upset
- photosensitivity
- neuropathy
- diminsihed renal function
108
fluoroquinolones can cause ______ with older adults
tendonitis
109
urinary analgesic
phenzaopyridine
110
3 side effects of phenazopyridine
- H/A
- GI upset
- red/orange urine
111
do not take phenazopyridine with _______ dysfunction
renal
112
the endocrone system produces hormones that are synthesized from ______ _____ and ________
amino acids and cholesterol
113
2 categories of hormones
- proteins/small peptides
- steoids
114
master gland that helps all other glands secrete hormones
pituitary
115
2 hormones secreted by thr thyroid to maintain metabolism
T3 and T4
116
2 glands on the thyroid that regulate calcium levels
parathyroid glands
117
the adrenal glands secrete _______ that help maintain homeostasis
steroids
118
the adrenal glands regulate ______ and _____- balance and help play a role in metabolism
fluid and electrolyte
119
3 things that increase when the thyroid is stimulated
- CO
- O2 consumption
- Carb use
120
low thyroid levels
myxedema
121
7 S/S of hypothyroidism
- lethargy
- memory impairment
- emotional changes
- slow speech
- dry skin
- weight gain
- cold intolerance
122
hypothyroidism causes an increase in ______ levels
TSH
123
severe/emergent hyperthyroidism
thyroid storm
124
most common type of hyperthyroidism
Graves disease (thyrotoxicosis)
125
8 S/S of hyperthyroidism
- rapid pulse
- palpitations
- excess perspiration
- heat intolerance
- irritability
- bulging eyes
- weight loss
- goiter
126
medication for hypothyroidism
levothyroxine sodium
127
3 uses for levothyroxine sodium
- goiter
- hypothyroidism
- hashimoto (thyroiditis)
128
levothyroxine sodium is ______ bound so it interacts with a lot of medications
protein
129
7 side effects of levothyroxine sodium
- N/V
- anorexia
- diarrhea
- H/A
- weight loss
- amenorrhea
- tachycardia
130
you must take levothyroxine sodium at the same time everyday, before _______
breakfast
131
tell patients taking levothyroxine sodium to monitor for ______ pain and rapid ______ _____
chest, heart rate
132
7 foods that inhibit the thyroid
- strawberries
- peaches
- pears
- peas
- cabbage
- kale
- radishes
133
anti-thyroid med used to inhibit hormone synthesis
methiamozole (tapazole)
134
anti-thyroid med that inhibits the conversion of T3 and T4
propylthiouracil (PTU)
135
propylthiouracil can be really band for your _______
liver
136
anti-thyroid med that reduces the size and vascularity of the thyroid
iodine-potassium iodide (SKKI)
137
iodine-potassium iodide is diluted and given through a _______
straw
138
2 corticosteroids produced by the adrenal glands
- cortisol
- aldosterone
139
syndrome caused by adrenal HYPERsecretion
Cushing's
140
2 causes of adrenal hypersecretions
- tumor
- extended use of steroids
141
9 signs and symptoms of Cushing's syndrome
- hyperglycemia
- hypertension
- muscle wasting
- peptic ulcers
- cataracts
- hypervolemia
- hypernatremia
- hypokalemia
- weight gain
142
disease caused by adrenal HYPOsecretion
Addison's disease
143
Addison's disease is an __________ disease
autoimmune
144
9 signs and symptoms of Addison's disease (adrenal hyposecretion)
- hypoglycemia
- muscle weakness
- fatigue
- N/V
- tachycardia
- hypovolemia
- hyponatremia
- hyperkalemia
- anemia
145
corticosteroids promote _______ retention and ________ excretion
sodium, potassium
146
steroids suppress ________ and _______ function
inflammation and adrenal
147
6 uses for steroids
- inflammation
- dermatological
- autoimmune
- asthma
- prevent organ rejection
- head trauma
148
6 side effects of steroids
- moon face
- hyperglycemia
- hypertension
- psychoses
- thin skin
- peptic ulcers
149
take steroids with _______
meals
150
the pancreas secretes _______ and tells the liver to secrete _______
glucagon, glucose
151
pancreas secretes _______ which suppresses glucagon and makes you feel full
amaline
152
insulin helps ______ move into your cells from your blood stream
sugar
153
4 signs and symptoms of hyperglycemia
- polyuria
- polydipsia
- polyphagia
- sweet breath
154
6 signs and symptoms of hypoglycemia
- H/A
- nervousness
- sweating
- tremors
- rapid pulse
- confusion
155
in type ____ diabetes the pancreas isn't producing any insulin at all
1
156
in type 2 diabetes the pancreas produces a little bit of insulin, but _____ cells are tired and develop insulin resistance
betaa
157
diabetes can lead to _______ ______ disease
peripheral arterial
158
diabetes can lead to _____ failure or disease
kidney
159
____ to ____ grams of simple carbs can help with hypoglycemia
10 -15
160
2 uses for inuslin
- type 1 diabetes
- hyperglycemia
161
insulin can cause ______ _____ as a side effect
insulin shock
162
you must ______ insulin after opening it
refrigerate
163
stress can cause blood glucose to _____
raise
164
rapid-acting insulins (3)
- lispro (humalog)
- aspart (novolog)
- glulisine (apidra)
165
rapid-acting insulin onset
5-15 minutes
166
rapid-acting insulin peak
30 minutes to 3 hours
167
rapid-acting insulin duration
2 to 5 hours
168
short-acting insulin med
regular (humulin R; novolog R)
169
short-acting insulin onset
30 minutes to 1 hour
170
short-acting insulin peak
2 to 4 hours
171
short-acting insulin duration
6 to 8 hours
172
intermediate-acting insulins (2)
- isophane
- NPH (humulin N; novolin N)
173
intermediate-acting insulin onset
1 to 2 hours
174
intermediate-acting insulin peak
6 to 12 hours
175
intermediate-acting insulin duration
18 to 24 hours
176
long-acting insulin example
Glargine (lantus)
177
long-acting insulin onset
1 hour
178
long-acting insulin peak
evenly distibuted
179
long-acting insulin duration
24 hours
180
combination insulin example
humulin 70/30
181
2 oral anti-diabetic medications
- sulfonyureas
- biguanides
182
sulfonylureas stimulate _____ cells to produce more insulin
beta
183
oral anti-diabetic meds are used for type ___ diabetes
2
184
3 side effects of sulfonylureas
- hypoglycemia
- abdominal pain
- tachycardia
185
give sulfonylureas before ________
breakfast
186
do not give sulfonylureas to patients with ________ or ______ dysfunction
kidney, liver
187
biguanides decrease hepatic production of _______ from stored ______
glucose, glycogen
188
biguanides diminshes increase in serum glucose after a _______
meal
189
6 side effects of biguanides
- dizziness
- fatigue
- H/A
- agitation
- bitter metallic taste
- diarrhea
190
hold biguanides for 48 hours after and before ____ ______ ____ or else the kidneys will be damaged
IV contrast dye
191
do not drink _______ with biguanides
alcohol
192
take biguanides with _______
meals
193
sodium-glucose co-transporter 2 for type 2 diabetes
invokana
194
invokana must be used in combination of ______ and _____
diet and exercise
195
Invokana works with the _____ to excrete glucose in the urine
kidneys
196
4 risks using Invokana
- kidney problems
- UTIs
- yeast infections
- electrolyte imbalance
197
Invokana is preg category ___
C
198
amylin analogue for type 1 and 2 diabetes
Symlin
199
symlin is used with _____ therapy
insulin
200
symlin decreases post meal ______ and _____
glucose and glucagon
201
give symlin ______ meal via SQ but NEVER in the _____
before, arm
202
glucagon-like peptide-1 agonists ussed for type 2 diabetes
Exenatide (byetta, bydureon)
203
Exenatide improves ______ _____ responsiveness and enhances ______ secretion
beta cell, insulin
204
Exenatide slows down ______ production from liver
glucose
205
Exenatide is preg category ___
C
206
3 places to give Exenatide
- arm
- thigh
- abdomen
207
on patients taking Exenatide, monitor for _____ _____ tumors and _________
thyroid C-cell, pancreatitis
208
once weekly injection that responds to when blood sugar rises
trulicity
