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ABSN Cohort 19 > Pharm Exam2 > Flashcards

Pharm Exam2 Flashcards

(59 cards)

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1
Q

Levothyroxine (Synthroid)

Dx, fx, prepared from, contains, routes, fx to metabolic rate and additional fx.

A 
Hypothyroidism
↓ TSH
dried animal thyroid glands
T3 and T4
PO or IV
↑ metabolic rate
↑ O2 consumption/ATP hydrolysis
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2
Q 
Levothyroxine (Synthroid)
Side FX (5) with r/o!
A

Anxiety, tachycardia, heat intolerance

!!! - Fever, diaphoresis which r/in Dehydration

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3
Q

Levothyroxine (Synthroid) education and administration tips (3)

A

Ø ↑ or ↓ dose suddenly
Administer w/ full glass of H2O
Prepare for ↑BMR by hydrating as necessary

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4
Q

Glucocorticoids
Primary fx, clinical fx and tx.
3 other fx.

R/t Lipogenesis

A

Increase glucose levels for energy
Blocks inflammation/immune resp. inconj w mineralcorticoids to tx adrenal insufficiency.

↑ fat deposition, ↑ protein breakdown, ↓ protein formation.

Monitor BMI

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5
Q

Glucocorticosteroids: Health Conditions of Concern (5)

A 
Acute infx
Diabetes, ↑ glucose disrupts glucose congtrol
Acute peptic ulcers
Endocrine dz
Pregnancy
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6
Q

Diabetes Type 1 vs Type 2

onset, insulin relation, r/by? 1 - 3

A

Type 1: autoimmune onset in young people, insulin-dependent. Øfx beta cells.
R/by genetics.
Type 2: onset in 40+ yr old people, insulin resistant.
R/by peripheral insulin resistance, ↓pancreas secretion, ↑glucose production by liver

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7
Q

Normal blood sugar range

A

70 - 110 mg/dL

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8
Q

Prior to administering AM insulin, what should you check?

A

Blood Glucose Levels (Rapid Finger Glucose)

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9
Q

Insulin used to treat Rapid Finger Glucose sticks?

A

Short/Rapid acting based on sliding scale

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10
Q

Complications of long term diabetes (9)

A 
Cardiovascular dz
Cerebrovascular dz
Foot ulcers
Atherosclerosis
Retinopathy
Neuropathy
Nephropathy
Hypoglycemia
Liphypertrophy
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11
Q

How to avoid DM complications

3 Control Factors.

A

Control of…
blood glucose
lipid levels
htn

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12
Q

How to reduce lipohypertrophy and hypoglycemia (4)

A 
Rotate sites (1 inch between sites)
Eat a carb snack! oj, grape juice, milk, glucose tabs.
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13
Q

Instructions for diabetic pts?

A

Assess limited access of diet

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14
Q

R/f for Type 2 DM?

A

Obesity indicated by a BMI > 25

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15
Q

Types of insulin (4)

A

Humalog - rapid acting
Humulin R - short acting
Humulin N - intermediate acting
Lantus - long acting

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16
Q

How does surgery influence blood levels? Proper responses (2)?

A

↑ blood glucose levels
monitor with RFG
Use rapid acting (Humalog)

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17
Q

Fx of Garlic r/t glucose (2 fx, 1 r/in)

A

↓ blood pressure and blood glucose

can r/in hypoglycemia

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18
Q

Beta blockers on blood sugar

A

S/S hypo/hyperglycemia are masked by SNS blockades.

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19
Q

Sulfonyureas.
3 Fx and for what pts.
Major s/fx?

A

Antidiabetic agents, ↑ pancreatic secretion of insulin, tx for Type 2 DM

Used in pts w/ still fx’ing pancreas
Major s/fx = ↑ r/o Cardiovascular dz

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20
Q

Metformin (Glucophage)
What? For? Fx (3)?

Monitor what with this (2)?

A

Biguanide for Type2 > 10 yrs old.
↓ liver glucose production by ↓ gluconeogenesis
Also ↑ muscle glucose uptake/use
Monitor renal/liver fx (BUN/Creatinine) especially if receiving IV contrast

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21
Q

Diabetic Ketoacidosis

Cause, fx r/in 7 S/S

A

Incomplete oxidation of fats r/in ketoacids

Excess blood acids r/in ↑ BUN, dehydration, protein in urine, fruity breath, polyuria, SOB, ↑ electrolytes (Na/K)

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22
Q

Respiratory patterns r/t DKA

A

Kassmaul respirations

↑ depth, rate

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23
Q

How does Hyperglycemia cause mental confusion?

A

↑ glucose in blood draws H2O/electrolytes out r/in dehydration which acts on CNS.
Sugar ↑ osmolality of blood and causes CNS to shrink.

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24
Q

Psoriasis

Cause? Topic meds (5), S/S (3)

Study These Flashcards
A

Chronic inflammatory skin dz
Emollients, Keratolytic agents, coal tar, corticosteroids, cacipotriene
Skin is thick, red plaques, silvery scale.

25
Isotrentinoin (Accutane) | What is it? Route? Fx? Common Tx for? S/fx?
Teratogen. PO, ↓sebum reduction/anti-inflammatory Used for Acne Severe birth defects
26
How does Acne occur? Onset?
Dz of pilosebaceous unit r/in formation of pustular lesions (inflammatory and noninflammatory). Begins around puberty r/t ↑androgen production
27
Actions prior to administering Anti-fungals (4)
Allergies Monitor BUN/Creatinine C&S Baseline CBC and HH
28
Pressure Ulcers. | What? R/t? Fx on cell? 3 conditions? Stratum corneum tx?
Skin breakdown r/t pressure (cells become hypoxic) Pressure, moisture, O2 deprivation. Stratum Corneum rq. adequate hydration via lotion
29
O2 Deprivation r/t decubitus ulcers?
Lying down puts pressure on cell. | Pressure disrupts capillary flow, r/in O2 deprivation and cell death.
30
Pressure Ulcer Tx (5)
``` Re-position q2hrs Pad bony prominences Keep skin clean/dry Assess regularly Adequate hydration of stratum corneum w/ lotion ```
31
Skin infx education
↑ diameter if infx is ↑ | Mark edges and assess.
32
Skin infx that responds to systemic antibiotics
Acne
33
Skin shearing | What? r/t (4)? Preventions (3)?
sliding of tissue over another r/in stretching, blood vessel angulation, injury, and thrombosis. Move carefully, avoid moving is skin is stuck to surface, pull pt up with draw sheet w/ help
34
Skin neoplasms (3) and poorest prognosis.
Basal cell carcinoma Squamous cell carcinoma Malignant melanoma <--- poorest prognosis
35
Musculoskeletal strains. | What? S/S (4)? common sites (4)?
Stretching/partial tearing of muscle/tendon units. pain, stiffness, swelling, local tenderness lower back, cervical region of spine, knees, ankles
36
Medications for Musculoskeletal strains (5) with special notes.
NSAIDS, Opiods/Narcotics Øtx inflammation, Celebrex, Fentanyl (Duragesic) is most consistent, through transdermal patch, and has least sedative fx.
37
Muscuolskeletal strain S/S on elderly?
W/ age, cologne fibers change. | This r/in ↓elasticity and ↑susceptibility to injury.
38
Stages of Bone Healing (4)
1 - Hematoma formation 2 - Fibrocartilaginous Callus formation 3 - Bony callus formation (ala Ossification) 4 - Remodeling
39
Administration of Morphine. | For? When (2)? Age limit? Route (6)? s/fx (3)? Anti-s/fx?
``` Moderate - severe pain. Pre/Post-op, labor NO AGE LIMIT PO, SubQ, IM, PR, epidural, intrathecal Respiratory Depression, sedation, pinpoint pupils ``` Countered w/ Narcan (Naloxone)
40
GI Bleeding. Color r/t location. | Layman vs. Medical terminology
``` Lower = bright red Upper = dark/brownish red tar ``` Medical Upper = Melena stool Medical Lower = Hematochezia/Frank Blood
41
Peptic Ulcer Dz (PTD) | Goal of tx? Most common causes (3)? Medications (3)
Tx of H. Pylori. Helicobacter pylori, ↑ stress, corticosteroids Antibiotics (Biaxin/Flagyl), Proton pump inhibitors (Protonix/Nexium), and Histamine 2 receptor agonists (Zantac/Pepcid). All 3 make TRIPLE THERAPY!
42
Sucralfate (Carafate) | Fx? Tx for?
Changed by acid in stomach and adheres to ulcer to protect from further injury from acid/pepsin. Tx for acute duodenum ulcers.
43
Misoprostol (Cytotec) | Fx? Concern when administering (3)?
Long term NSAID clients to prevent gastric ulcers. | Excessive bleeding or spotting w/ pregnant women may induce labor, ↑% miscarrage, r/in cervical ripening.
44
H2 blockers. | Fx? Tx for (2)? Drug2Drug interactions? Adfx w/ chronic tx?
↓ hydrochloric acid release in response to gastrin Gastric/Peptic ulcers, ↑ levels warfarin and r/in bleeding. Monitor INR and PT. ↓ libido, impotence, CNS
45
Proton pump inhibitors (PPI) | Fx? Tx for (2)?
↓ gastric acid secretion by inhibiting enzymes r/t acid production Erosive esophagitis and GERD
46
Gastroesophageal reflux Dz (GERD) | %? S/S (3)? Medications and fx (5)
Most common C/O. Upset/sour stomach and heartburn. H2 blockers - ↓ HCL release in response to gastrin PPI - ↓ HCL secretion into lumen of stomach Antacids - neutralize acids GI protectants - coat ulcer Prostaglandins - ↓ gastrin, ↑ mucus lining secretion
47
Liver Failure | Cause? How to Dx? Regular fx stopped? S/S (4)? Medications (2)?
Unknown cause but r/in accumulation of neurotoxins in blood (ammonia) Presence ammonia in blood and cerebral circulation. Conversion of ammonia to urea. ↓ mental alertness, ↑ confusion, ↑ convulsions, Asterixis (flapping tremor) Non-absorbable antibiotics (neomycin) and Lactulose
48
Portal HTN | What (2)? S/S (4)?
↑ resistance of flow in portal venous system and ↑ portal venous pressure Ascites, esophageal varices, confusion, and forgetfulness
49
Kupffer cells. | What? Fx (consumes 3 things where)?
Large resident macrophages (aka Stellate macrophages) Phagocytose old/defecive blood cells, bacteria, and other foriegn material from portal blood as it flows through sinusoid. IT'S A FILTER!
50
Cirrhosis | What? Associated w/? S/S? Acute or Chronic? Early signs (3)?
End-Stage chronic liver dz. Most liver tissue is replaced with fibrous tissue. Associated w/ alcoholism. S/S portal HTN. Chronic. Early signs are ascites, weight loss, jaundice.
51
Antidiarrheal Agents. Fx? Common mechanisms (3)? Term to describe GI motility?
De-stimulates GI tract for symptomatic relief from diarrhea. Bismuth Subsalicylate inhibits local reflexes Loperamide slows muscle activity Opium Derivatives fx CNS to slow GI. GI motility = peristalsis
52
Laxative Agents. | For what pts? Condition tx'd with lactulose (Chronulac)?
Patients w/ cerebral aneurysms and post MI. | Hepatic encephalopathy
53
Pancreatitis. | What? Cause for acute? Fx on pancreatic tissues? Most likely contributing factor?
Reversible inflammatory process of pancreatic acini by premature activation of enzymes Autodigestion r/in acute vers. R/in potential tissue damage and multi-organ failure. Likely r/t long term alcohol abuse.
54
Types of Hepatitis (5) ``` r/t Liver damage? How to Dx? Least lethal? Spread by fecal-oral? Which can be prevented by immunization? ```
A - fecal/oral self limiting and least virulent (food) B - intercourse, needle sharing, blood (healthcare) C - unclearable chronic carrier condition D - parenteral IV/drug users, occurs often with B E - water-borne, self limiting endemic (↑mortality w/ pregnant ♀) Liver inflammation r/in bile backup which destroys tissue and causes scarring Dx through ↑ serum aminotransferase levels (AST and ALT), ↑ bilirubin and alkaline phosphates, and Hep antibodies in blood. Hep A Hep A Hep B and A
55
H. Pylori. What to avoid when treating for it (4) Contraindication w/ Triple Therapy (3)?
Aspirin, NSAIDS, grapefruit, antacids. | Alcohol, anti-coagulant therapy, disulfiram
56
Irritable Bowel Syndrome, | What? Hallmark S/S?
Chronic/recurrent intestinal S/S not explained by structural or biochemical abnormalities. Ab. pain relieved by defection w/ freq. ▲ in consistency and frequency of stools.
57
Inflammatory Bowel Dz. | 2 types w/ diagnostics?
Chrons: 5 - 6 liquid Øblood stools may have pus/mucus Ulcerative Colitis: 10 - 20 liquid +blood stools w/ mucus. ↑ ESR and crypts of Leiberkuhn.
58
Esophageal Cancer | 2 types? S/S (3)? How Dx? r/t (2)?
Adenocarcinoma and Squamous cell carcinoma Dryphagia, anorexia, fatigue Dx w/ endoscopic surveillance and esophageal dysplasia. r/t Barret esophagus and long-standing GERD
59
C. Diff Full name? What? %flora in humans? Tx? S/S? How does it occur? What does it do (4)?
Clostridium Difficle. Gram+ Spore forming Bacillus. 1-3% normal flora in humans. Tx with broad-spectrum antibiotics. Abdominal cramping/Diarrhea. Disruption of normal intestinal flora b/c antibiotics, diet, etc. Binds to/damages intestinal mucosa r/in inflammation and necrosis. Interfere w/ protein synth, ↑ capillary permeability, ↑ peristalsis

ABSN Cohort 19 (28 decks)

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