Pharm Midterm 1, Module 5 Flashcards
(30 cards)
What are the 3 classes of pain meds
Non-opioid analgesics (acetaminophen and NSAIDS), opioids (hydromorphone, morphine) and adjuvant analgesics (gabapentin, amitriptyline)
Use and action of acetaminophen (what is the point of taking it, and how does it work?)
Inhibits synthesis of prostaglandins, reduces pain and fever
What organ can acetaminophen damage?
Liver. Use cautiously in patients with liver failure
What are the uses of NSAIDs (why take them) ?
Analgesic, antipyretic, antiinflammatory
What is the effect of NSAIDs on the stomach
As a result of the inhibition of COX1 by an NSAID, there is decreased protection of the stomach lining and gastric irritation and bleeding may occur.
How do NSAIDs work?
Main action is to inhibit prostaglandin action by blocking
COX (key enzyme involved in the synthesis of
prostaglandins).
what are the two main COX enzymes?
COX 1 – present in many tissues; involved in blood clotting,
protecting stomach, and maintaining sodium and water
balance in kidneys
◦COX 2 – more active at sites of trauma
Knowing that the following are normal actions of COX1, what happens when it is blocked (side effects of ibuprofen)? ; involved in blood clotting,
protecting stomach, and maintaining sodium and water
balance in kidneys
Increased risk for bleeding, irritation of the stomach/GI bleed, nephrotoxicity
what are the properties of ibuprofen?
Anti-inflammatory
Antipyretic
Analgesic
What are the 3 corticosteroid classes?
Glucocorticoids, mineralocorticoids, androgens
What make up the HPA axis?
Hypothalamus, anterior pituitary gland, ACTH (adrenocorticotropic hormone), adrenal glands
What are the effects of glucocorticoids (cortisol)?
Powerful metabolic effects / stress response Glucose metabolism Reduce inflammation Suppression of the immune system Influence sleep pattern and mood Decrease bone formation and increase bone breakdown Increase calcium excretion Cause lipogenesis (formation and storage of fat in body)
what are the effects of mineralocorticoids (aldosterone)?
retention of sodium and water and
excretion of potassium; essential for maintenance of
fluid and electrolyte balance, blood pressure and
blood volume
What is the use of Prednisone?
Mostly used as anti-inflammatory and modifies the normal immune response
Given what you know about
the action of glucocorticoids and mineralocorticoids,
what would you worry about for overexpression side
effects (magnified action)?
Hyperglycemia, increased bone breakdown and excretion of Ca+ (weak bones), fat gain, increased water and sodium retention (hypertension, edema, weight gain), hypokalemia
Beta cells release \_\_\_\_\_\_\_ to \_\_\_\_\_\_\_ blood glucose. ◦Alpha cells release \_\_\_\_\_\_\_ to \_\_\_\_\_\_\_ blood glucose.
insulin, lower
glucagon, increase
Action of insulin
Primarily to facilitate the
transfer of glucose into cells for cellular metabolism
Also, promotes storage of glucose as glycogen, and inhibits gluconeogenesis
Action of Biguanide (Metformin)
primarily to encourage the liver to store more
glucose and release less and try to make the receptors
more sensitive to insulin
Action of Sulfonylurea (Glyburide)
stimulate beta cells to release insulin
Action of hyperglycemic agent glucagon
increase serum glucose; encourage glycolysis
(breakdown of stored glycogen to glucose
What are the main differences between insulins
onset, peak, duration.
Hormones of the adrenal CORTEX
cortisol, aldosterone
Hormones of the adrenal medulla
Epinephrine and Norepinephrine
Aldosterone would be secreted in response to what?
Low blood volume, low blood pressure, high blood potassium
