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Pharmacology > Exam #4 > Flashcards

Exam #4 Flashcards

(125 cards)

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1
Q

Hageman Factor

A

Factor 12; first factor activated when a blood vessel/cell is injured; starts cascading effect for clotting

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2
Q

Kinin System

A

Activated by Hageman factor as part of the inflammatory response; includes bradykinins

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3
Q

Arachidonic Acid

A

Released from injured cells to stimulate the inflammatory response through activation of chemical substances

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4
Q

4 Cardinal Signs of Inflammation

A

Heat (calor)-increased blood flow
Swelling (tumor)-fluid leaks, change capillary permiability
Redness (rubor)-increase blood flow, vasodilation
Pain (dolor)-activate pain fibers by histamine/kinin system

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5
Q

Cell injury causes the activation of a chemical called factor XII or ______ factor.

A

Hageman

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6
Q

Injury to a cell membrane causes local release of ______ which causes vasodilation, alters capillary permeability, and stimulates pain perception. Also pulls WBCs to the affected area.

A

Bradykinins

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7
Q

_______ is the widely used NSAID for management of mild to moderate pain.

A

Acetaminophen (Tylenol)

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8
Q

Arachidonic acid causes the release of which three autocoids?

A

Prostaglandins
Leukotrienes
Thromboxanes (vasoconstrictor)

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9
Q

T or F: The rubor component of the inflammatory response occurs when fluid leaks into the tissues as a result of the change in capillary permeability.

A

FASLE; Swelling

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10
Q

NSAIDS: No pain, No flame, and No heat when we meet….

Give Examples:

A

Analgesic, Anti-inflammatory, & anti-pyretic:

Examples: Ibuprofen & Naproxen

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11
Q

NSAIDs: Signs and Symptoms

A 
GI Distress
Dizziness
Rash
Heartburn
Occult blood loss
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12
Q

ASA

A

Aspirin
Anti-inflammatory, Anti-pyretic, Anti-platelet
Mild to Moderate Pain

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13
Q

ASA: Signs & Symptoms

A

Bleeding tendencies
TINNITIS
Stomach pain
Thrombocytopenia (low platelet count)

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14
Q

Colecoxib….. Cel-e-brate good times… Come on!

A

Celebrex-
COX 2 Inhibitor- Increased risk for cardiovascular disorder- Does NOT promote bleeding.

Cel-e-brex no breaks!
Osteoporosis, Rheumatoid Arthritis

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15
Q

Colecomb (Celebrex) Signs & Symptoms:

A 
Dyspepsia (upset stomach)
Diarrhea/Abdominal Pain
Upper Resp. Infections
Peripheral Edema
GI discomfort/irritation
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16
Q

Corticosteroids

“Steroids are in the SONE!”

A

Methylprednisone (Solu-Medrol)
Dexamethasone (Decadron)
Prednisone (Deltasone)

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17
Q

Corticosteroids ACTION:

A

Stop, control, or reduce the inflammatory response (local or systemic) in any part of the body by suppressing the immune system

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18
Q

Corticosteroids ADVERSE EFFECTS:

A

Peptic ulcers
Delayed wound healing
Osteoporosis
Super Infections

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19
Q

LevothyROXine

Sex, Drugs (ROIDS) & ROXkin’ Roll

A

SynthROID
Check thyroid blood test 30 days after change in dose
Too Little: SLOWS you down
Too much: SPEEDS you up

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20
Q

Methimazole

ZOLE stay behind the line… NO Entry for you

A

Tapazole
controls hyperthyroidism & thyrotoxicosis (thyroid storm)
Use prior to SURGERY and RADIOACTIVE IODINE

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21
Q

Methimazole: Signs & Symptoms

A 
Peripheral Neuropathy 
Fever
Rash/pruritus (ITCHY SKIN)
Dizziness
Agranulocytosis (lack of mature WBCs)
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22
Q

Biphosphonates- DRON- ATE the bone?

A 
Prevent osteoclasts from damaging bone
Manage CALCIUM
Alendronate (Fosamax) 
Risedronate (Actonel) 
Ibandronate (Boniva) 
Zoledronate (Reclast)
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23
Q

Calcitonin Salmon

Salmon & Calcium is good for a Healthy diet

A

Calcimar Nasal Spray
Bone resorption inhibitor
Acts on bone to decrease osteoclast activity
ALTER nostrils to decrease irritation

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24
Q

Calcimar: Signs & Symptoms

A 
Calcitonin Salmon:
Nausea with SubQ & IM
Inflammation @ injection Site
Rhinitis with Nasal Spray
Nasal Irritation
Dryness / Soreness
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25
Glucagon | When sugar IS gone!
First for SEVERE hypoglycemia IV preferred, SubQ / IM Reconstituted from powder Do NOT use if NOT clear
26
Glucagon: Signs & Symptoms
Nausea Vomiting HYPOKALEMIA-toxic effect
27
Sulfonylureas:
``` stimulates insulin production in Beta cells Type 2 diabetes ONLY Monitor hypoglycemia AVOID pregnancy/lactation NO Alcohol ```
28
Metformin
``` Glucophage Controls blood glucose for type 2 diabetes SLOW glucose production in LIVER BLOCK absorption in INTESTINE INCREASE effectiveness in MUSCLES tests: FBS and Hemoglobin A1c (HbA1c) CAN be used with other hypoglycemics SAFE for PEDS ```
29
Rapid acting INSULIN
``` Lispro (Humalog) & Regular (Humulin R) Take with meal or just before Sliding scale insulins LISPRO ONLY mixes with NPH, Lente, or Ultralente Regular can give IV ```
30
Intermediate acting INSULIN
NPH
31
Long acting INSULIN
Lantus & Levimer | Do NOT mix with other insulins
32
NSAIDS block _______
Prostaglandin Synthesis Anti-inflammatory, anti-pyretic, analgesic agents
33
Analgesic
compound with PAIN BLOCKING properties
34
Salicylates
Salicyclic acid compound Anti-inflammatory, anti-pyretic, analgesic BLOCKS prostaglandin synthesis
35
2 enzymes blocked by NSAIDS
Cyclooygenase-1 (COX-1) | Cyclooxygenase-2 (COX-2)
36
SERIOUS Adverse effects of salicylates
8th cranial nerve damage | Acidosis
37
Cultural considerations for African Americans using ANTI-INFLAMMATORY
Have DECREASED sensitivity to pain INCREASED risk for GI Complication Requires LARGER doses for effectiveness Monitor closely
38
Signs of Salicylate Toxicity
TINNITIS, Tetany & Cardio/renal/resp. COLLAPSE | Tachypnea, Hemorrhage, excitement, Pulmonary edema, Metabolic acidosis, fever, coma
39
Difference between Acetaminophen and NSAIDS
Acetaminophen does NOT have anti-inflammatory effects that NSAIDs and Salicylates do NSAIDs does NOT have adverse effects with Corticosteroids
40
COX-1 within the body
Present in ALL tissues blood clotting, protect stomach lining, maintain Na+ and water in kidneys Turns arachidonic acid in to Prostaglandin
41
COX-2 within the body
Activates at site of TRAUMA or INJURY when more prostaglandin is needed Celebrex
42
3 drug interactions with NSAIDs
Loop diuretics- decrease effectiveness Beta Blockers- decrease effects of anti-hypersensitivity Lithium toxicity when used with ibuprofen
43
Advantage to start DMARDs early in Tx of arthritis
Alters the course of the inflammatory process | BEFORE damage occurs
44
Corticosteroids
Steroid hormone produced in the ADRENAL CORTEX | includes: androgens, glucocorticoids, & mineralocorticoids
45
The inner core of the adrenal gland is called ______.
Adrenal Medulla
46
_____ stimulate as increase in glucose levels for energy.
Glucocorticoids
47
3 types of corticosteroids:
Androgens Glucocorticoids Mineralocorticoids
48
Sudden stopping of corticosteroid therapy after prolonged used causes an:
Adrenal Crisis
49
What is the "Fight or Flight" response
activation of the stress reaction through SNS | causes release of ACTH & secretion of adrenocortical hormones
50
List 4 hormone actions that result in SNS reaction
INCREASES blood volume causes RELEASE of glucose for ENERGY SLOWS the rate of protein production BLOCKS Inflammation & Immune systems
51
3 actions of Glucocorticoids
INCREASE glucose production Stimulate fat deposition & protein breakdown Inhibit protein formation
52
How do African American respond to methlyprednisolone
INCREASED TOXICITY- especially when used immunosuppression after renal transplant including steroid induced DM & are 4x likely to develop end-stage renal disease
53
What effects do corticosteroids have on glucose levels?
INCREASES blood sugar | disrupts glucose control
54
Mineralocorticoids _____ Na+ reabsorption in renal tubules, leading to Na+ and water ______ & _______ K+ excretion.
Mineralocorticoids INCREASE Na+ reabsorption in renal tubules, leading to Na+ and water RETENTION & INCREASE K+ excretion.
55
Paget's disease
Genetically linked disorder of overactive osteoclasts that are replaced by enlarged and softened bony structures
56
Thiomides
Drugs used to prevent the formation of thyroid hormone in thyroid cells, lowering thyroid hormone levels
57
Biphosphonates
Drugs used to block bone resorption & lower serum Ca+ levels
58
Parathormone
Hormone produced by parathyroid glands- responsible for maintaining Ca+ levels in conjunction with Calcitonin
59
Negative Feedback System
Control system in which increasing levels of a hormone lead to decrease levels of releasing stimulating hormone, leads to decreases hormone levels, allows control of the endocrine system
60
6 actions of thyroid hormones
INCREASE metabolic rate of body tissue INCREASE O2 consumption/Resp./HR INCREASE rate of fat/protein/carb metabolism GROWTH & MATURATION
61
Thyroid hormones regulate the rate of _______ in almost all cells of the body
Metabolism
62
5 S/Sx of hypothyroidism
``` Lethargy, Bradycardia Pale/coarse/dry THICK skin Cold intolerance DECREASED appetite Weight GAIN ```
63
5 S/Sx of Hyperthyroidism
``` Anxiety/Insomnia Tachycardia Flush/warm/moist/sweaty THIN skin Heat intolerance INCREASED appetite Weight LOSS ```
64
3 medications that adversely interact with Thyroxine
Cholestyramine- (cholesterol drug) alters absorption Oral anticoagulant- Increase risk for bleeding Digitalis/Theophylline- toxicity
65
Adverse Effects of Thiomides
Thyroid suppression | epigastic distress, nephritis, BONE MARROW suppression, neuritis, VERTIGO, N/V, urticaria
66
4 functions of Calcium in the body
Membrane transport system Conduction of nerves impulses Muscle contraction Blood Clotting
67
Adverse effects most commonly seen with ANTI-HYPOCALCEMIA are related to ________.
GI upset
68
calcitriol
regulates the absorption of calcium and phosphate from the small intestine Mineral resorption in the bone Reabsorption of phosphate from the renal tubules Increase serum Ca+ levels
69
Normal Ca+ level range
9-11
70
Cretinism
Occur in Children that do NOT have a thyroid gland or a nonfunctioning gland
71
Endocannabinoid receptors
receptors found in the adipose tissue, muscles, liver, & GI tract Signaling system within the body in a state of energy gain
72
Glycosylated hemoglobin
A blood glucose marker that provides a 3 month average of blood glucose levels
73
Ketosis
Breakdown of fats for energy, resulting in an increase in ketones to be excreted from the body
74
Sulfonylureas
Oral anti-diabetic agents used to stimulate the pancreas to release more insulin
75
What is the leading energy source for the human body is stored for rapid release in times of stress
Glucose
76
Challenges related to diabetic management in children and teems
Faster metabolism & lack of body reserves Desire to be NORMAL causes noncompliance METFORMIN is SAFE for kids
77
3 ethnic groups MORE LIKELY to develop Diabetes Mellitus
African Americans Native Americans Hispanic Americans
78
Therapeutic actions for Insulin
PROMOTES glucose storage TRANSPORTS metabolites & ions STIMULATES the synthesis of glycogen from glucose
79
Indications for Insulin
Hypoglycemia Hyperglycemia Diabetes Mellitus
80
List three variables that would cause blood glucose levels to vary, possibly requiring change in dose
Anticipated eating Exercise activities Stress levels
81
Polycystic Ovary Syndrome and use of metformin
Alters metabolic changes to allow ovulation or stop follicle development INCREASES insulin sensitivity DECREASES androgen & LH to allow ovulation
82
First Generation of Sulfonylureas have INCREASE incidents in ________.
CARDIOVASCULAR DISEASE
83
list three 2nd generation sulfonylureas | "Sulfonylureas takes insulin for a r-IDE"
Glimepiride (Amaryl) Glipizide (Glucotrol) Glyburide (DiaBeta)
84
________ occurs when the body burns fat instead of glucose for energy.
Ketoacidosis Ketones Ketosis (occurs in DKA)
85
Where does Tylenol work?
HYPOTHALUMUS | CNS
86
Antidote for Tylenol
Acetalsistine
87
How much Tylenol can you take in 24 hours
4 grams
88
Action of DMARDs (Tanercept):
Manage PAIN from arthritis T&F receptors Comes from Chinese Hamsters/rats
89
A drug is an ANALGESIC if:
it REDUCES pain
90
Antipyretics block _______.
FEVER
91
Which medication can be given IV, if oral analgesics can not be given?
Tylenol
92
What is important during assessment for Ibuprofen use?
Eval RENAL function
93
Can pediatric patients take Corticosteroids?
YES
94
Symtpoms of Steroid use
``` Weight gain Fragile skin & brittle nails Increase appetite Mood swings Insomnia ```
95
Do NOT use steroids in:
Pregnant/lactation Open sores (topical) SEVERELY infected patients (can mask symptoms)
96
A patient on steroids is experiencing an irregular sleep cycle, what can a nurse do to improve the situation?
Take steroids in the early morning
97
Mineralcorticoids block:
Inflammation & stimulate fat production
98
Drug of choice for anti-thyroid in PEDS
Methamozole
99
INCREASED TSH level vs DECREASED TSH level
``` INCREASED = hypothyroidism DECREASED = hyperthyroidism ```
100
#1 precaution of iodine solution
Stains teeth | Use a STRAW
101
Parathyroid removal:
``` #1 cause: ACCIDENTAL REMOVAL because parathyroid is on the thyroid ```
102
The thyroid system works on a ______ type of system
Negative Feedback System
103
Drug of choice to replace thyroid hormone in PEDS
Levothyroxine (Synthroid)
104
Glucocorticoid action:
Release GLUCOSE for energy | Used for inflammatory effects
105
Mineralcorticoid action:
Used for adrenal insufficiency urine retention Electrolyte balance Homeostasis
106
what electrolyte/minerals aide in parathyroid function?
Calcium Magnesium Phosphorus
107
Prototype of hypocalcemia
Calcitriol | vitamin D compound
108
Prototype & Classification for parathyroidism
Alendronal *** Take w/ full glass of water in morning (calcitonin Salmon) Classification: Bisphosphanate
109
Side effects of calcitonin salmon
Nausea / Vomiting | Local irritation at site
110
Thyroid gland hormones rely on:
Iodine in our diet
111
Goiter is associated with
Hyperthyroidism
112
Thyroid replacement indicates an _______.
Iodine insufficiency
113
Parathyroid hormone (PTH) is important for _____.
Calcium regulation
114
Needs for insulin
NO Beta cells Sensitivity to insulin is decreased Lack of receptor sites
115
2 types of insulin that are not to be given with any other insulin
Lantus & Levimer
116
Signs & Symptoms of DKA
RAPID, DEEP respirations FRUITY breath DEHYDRATION to cellular level
117
DKA can NOT occur in _______.
Type 2 diabetes
118
Sulfonylureas are used for _____
Type 2 diabetes
119
Type 1 diabetes requires _____ cells to stimulate insulin production
BETA
120
Metformin is in what classification
Biguonaride
121
What ethnic groups have an increased risk for Diabetes Mellitus
African Americans Native Americans Hispanic Americans
122
Hyperthyroidism indicates _____ disease
GRAVES disease
123
What disease should mineralcorticoids NOT be given to the elderly?
Heart Failure and CAD | because mineralcorticoids cause RETENTION
124
Glucagon is given for:
HYPOglycemia
125
Lab test significant to Diabetes Mellitus
HbA1c - Hemoglobin A1c

Pharmacology (6 decks)

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