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pharmacology test 4 Flashcards

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1
Q

What is the primary function of statins?

A

Lowers cholesterol lvl

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2
Q

What is another name for statins?

A

Hmg COA reductase inhibitors

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3
Q

How can you identify statins in a patient’s medication list?

A

Look for the suffix -statin

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4
Q

What is the mechanism of action of statins?

A

inhibits the Hmg COA from converting to mevalonic acid

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5
Q

What role does the liver play in cholesterol synthesis?

A

the liver releases acetyl-COA which turns into Hmg COA then with Hmg coa-reductase turns regular Hmg COA into mevalonic acid

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6
Q

What enzyme do statins inhibit?

A

Hmg COA-rductase

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7
Q

Why is LDL considered bad cholesterol?

A

low-density-lipoprotein cholesterol likes to get in blood and attatch to blood bessels leading to heart attacks or strokes.

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8
Q

What is the desired level for LDL cholesterol?

A

<100mg/dl

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9
Q

Why is HDL considered good cholesterol?

A

the High Density lipoprotein helps flush the LDL to liver to flush out of the body.

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10
Q

What is the desired level for HDL cholesterol?

A

> 60 mg/dl

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11
Q

What conditions are statins used to treat?

A

high cholesterol levels, premature treatment of CAD, and stabilizing fatty plaques in patients with CAD.(coronary artery disease)

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12
Q

What is the nurse’s role in monitoring patients taking statins?

A

check patients for S.T.A.T.I.N- Sore muscles?, Toxicity w/ grapefruitjuice consumption, Act/Ast monitored, Therapeutic effects (lower LDL, higher HDL), Increased glucose in pt @ riskfor type 2 diabetes mellitus, Not a cure.

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13
Q

What is Statin induced rhabdomylosis?

A

High lvl creatine kinese stop ( 10x upper limit) if not stopped, leads to rhabdomylosis whihc is myoglobin leaking in the blood.

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14
Q

Why should patients avoid grapefruit while taking statins?

A

Grapefruit juice inceases the toxicity of statins

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15
Q

What liver enzymes should be monitored in patients taking statins?

A

ACT / AST

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16
Q

How do statins affect glucose levels in patients at risk for type 2 diabetes?

A

Increases glucose levels

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17
Q

Why are statins not considered a cure for high cholesterol levels?

A

because exersizing and healthy diet are still important to help cholesterol decrease

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18
Q

What is the most common location for deep vein thrombosis (DVT)?

A

The veins in the legs

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19
Q

What are the three components of Virchow’s Triad?

A

Statins, Hypercoaguable, and Endothelial injury. (pooling, wants to clot)

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20
Q

Name two conditions that can cause stasis of blood flow.

A

post-op, and paralysis

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21
Q

What is the role of endothelial injury in DVT formation?

A

to release nitric oxide, so injury makes platelits stick right away. smoking, surgery and venous catheters all cause endothelial injury.

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22
Q

List two risk factors for hypercoagulability.

A

Malignancy, lung cancer, and pregnancy.

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23
Q

What is the first diagnostic step if a D-dimer test is positive?

A

ultrasound the DVT area

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24
Q

What is the preferred treatment for a massive proximal DVT?

A

Thrombectomy

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25
What mnemonic can help remember the causes of pulmonary embolism (PE)?
F.A.T.A.L - Fat embolus, Air embolus, Thrombus (DVT), Amniotic embolus, Less common (septic embolus)
26
What is the most common symptom of a pulmonary embolism?
Pleuritic chest pain, dyspnea, hemoptysis
27
What is the significance of the S1 Q3 T3 pattern on an ECG?
its used to see if theirs a sign of right heart strain.
28
What is the preferred diagnostic test for a high probability of PE?
CPTA test
29
What is the initial treatment for a hemodynamically unstable patient with a massive PE?
thrombolysis or reperfusion treatments
30
What preventive measures can be taken for hospitalized patients at risk of VTE?
pharmacological ex. LMWH, subcutaneous heparin, mechanical (pneumatic compression).
31
What is diabetes mellitus characterized by?
high levels of blood glucose
32
What are the two most commonly encountered types of diabetes?
Type 1: insulin producing cells are destroyed Type 2: insulin ressistant and deficeincy
33
What is insulin and how does it work in the body?
beta cells form pancreatic lipases, starts secreting insulin, stimulating glucose uptake by cells.
34
What happens when blood glucose levels fall too low?
pancrease relases glucagon, opposite effect of insulin. acts on liver breaking down stored glycogen into glucose.
35
How is human insulin reproduced?
recombinint human technology using bacteria or yeast.
36
Why is insulin typically administered by subcutaneous injection?
insulin is succeptiple to degregation in gstric intestinial tract, only affective subutaneously and injections.
37
What are the three major categories of insulin preparations based on their action?
rapid/ short acting (Lispro, Aspart, glusine) Short 2-8hr (regular) Intermediate 1-18hr (nph) isophane
38
What modifications are made to insulin molecules to create rapid-acting analogs?
they modified amino acids sequence to make molecules less likely to aggregate
39
What is NPH insulin and how does it differ from rapid-acting insulins?
adittion of zinc and protamine to regular insulin resulting in less soluble solution and delayed absorption.
40
What are the long-acting insulins mentioned in the transcript?
detemine/ glargine/ deglutide
41
What is amylin and what is its function?
produced by pancrease, decrease gastric emptying and lowering postprandial glucoge, and promotes satiety.
42
what is the only amylin mimetic currently availible in the market?
Pramlintide
43
what are incretins and what is their role in the body?
they are a group of metabolic hormones secreted by the gut in response to food digestion. Stimulates pancreases to produce more insulin.
44
how do GLP-1 mimetics benefits patients with diabetes
in theory it increases insulin helping reduce glucose.
45
what is the function of DPP-4 inhibitors?
dpp-4 inhibitors inhibits the dpp-4 hormone to promote GLP-1 and GLP
46
how do sulfonylureas stimulate insulin secreations?
sulfonylureas bind to and inhibit the activity of ATP sensitive potassium channels, triggering membrane depolarization causing an influx and insulin secretion. (glimepiride, glyburide and glipizide)
47
what are the common side effects of sulfonylureas?
hypoglycemia and weight gain
48
how do glinides differ from sulfonylureas in their mechanism of action?
binds to ATP sensitive potassium channels from different sites and with different kinetics then sulfonylureas.
49
what is the main blood glucose lowering activity of biguanides? (metformin)
reduction of hepatic glucose production and slows intestinal absorption of glucose and increases insulin sensitivity.
50
what is the primary mechonaismim of thiazoldinediones? (pioglitazone and rosiglitazone)
selectively activates nuclear receptors called peroxisome proliferator activated receptors gamma -PPAR- gamma. once activated it binds to DNA triggering expression and repression of specific genes encoding proteins that regulate glucose and lipid metabolism and insulin signal transduction. Leads to increased insulin sensitivity in adipose tissue skeletal muscle and liver. Inhibition of hepatic glucose production. promotes Falk. acid uptake and utilization in adipocytes which decreases fatty acid concentrations leading to increased uptake of glucose.
51
WHAT ARE THE COMMON SIDE EFFECTS ASSOCIATED WITH THAIZOLDINEDIONES?
WEIGHT GAIN AND GLUID RETENTION AND PRERPHIAL EDEMA. POSSIBLE HEPATOXICITY
52
How do sodium-glucose contrasporters-2 inhibitors work? (conagloflozin and dapagliflozin)
inhibits glucose transporter located in the proximal convoluted tubules or the kidneys. Leads to increased urinary glucose excretion and removes blood glucose levels.
53
what is the alpha glucosidase and what is the re role in carbohydrate digestion? (acarbose and miglitol)
enzyme located in intestinal brush border that is responsible for breaking down carbohydrate into simple sugars. EX glucose so when alpha-glucosidase inhibitor blocks the absorption of glucose is delayed. resulting in lower postprandial glucose in drugs.
54
diabetes mellitus
non insulin dependent (type 2). insulin isnt able to lower blood glucose.
55
Hyperglycemia
excess glucose in blood, occurs when insulin is not being secreted in sufficient quantity. leads to problem with wound healing, high blood pressure and nerve damage.
56
Hypoglycemia
too little glucose levels in blood, and can cause death. treated by small dose of glucose (hard candy), glucose preparations (insta-glucose gel or B-D glucose), if patient unable to tolerate or unconscious and glucagon injection can be used.
57
insulin dependent diabetes mellitus (IDDM)
characterized by hyperglycemia. decreases or lack of insulin secretions, commonly diagnosed in childhood, can occur at any age. Genetics, virus exposure, and pancreatic injuries can contribute to developing IDDM.
58
Ketoacidosis
serous complication of diabetes, occurs when the body lacs sufficient insulin to process sugar, leading to burning fats for energy this leads to a height build up of ketones.
59
Negative feedback stsrem
controlled by the hypothalamus gland , located in the brain, also referred to as the self regulating system
60
Non-insulin dependent diabetes mellitus (NIDDM)
type 2 diabetes, insulin producing glucose levels don't lower. produces more insulin, but cannot keep up with body's needs for insulin. genetics, sedentary lifestyle, and obesity are contributing actors for NIDDM.
61
The LPN is reviewing the medication administration record for a patient who received Lantus (long-acting) insulin. Order reads: Accu-Chek before meals and at bedtime with sliding scale insulin aspart subcutaneous Which finding warrants immediate intervention?
Last dose of Lantus administered 48 hours ago.
62
At 10 p.m. the LPN notes that one of the patients has a blood glucose of 451. What action by the nurse is best?
Use rapid-acting or regular/short-acting insulin for correction.
63
The LPN performs a routine finger stick to check glucose and obtains a reading of 279 g/dL. The LPN would anticipate standing orders to provide sliding scale coverage with which of the following types of insulin?
Regular
64
The LPN provides a patient with daily long-acting insulin at bedtime. The patient states, “I’ve never really understood why I take insulin at night when I eat during the day.” Which response by the nurse is best?
“This type of insulin that lasts 24 hours for sustained control of your blood sugar.”
65
The LPN prepares to administer chlorpropamide to a type 2 diabetic patient. Which priority assessment should the nurse perform?
Monitor blood glucose level closely
66
A patient with type 2 diabetes is taking rosiglitazone. Which mechanism of action does this medication use to improve glucose balance?
Increases insulin sensitivity
67
A nurse is reviewing best practice methods for home insulin administration with a newly diagnosed type 2 diabetic patient who has transitioned to insulin therapy. Which information is essential for the nurse to include in the teaching plan?
Once left at room temperature, an opened insulin vial should be used for only 30 days and then discarded
68
The LPN is teaching an insulin-dependent patient about rotating injection sites. Which of the following items should be included in the teaching plan? (Select all that apply.)
Provision of a chart to help the patient indicate injection sites, Helps to increase absorption of medication Prevents skin irritation
69
An LPN is preparing to administer an insulin admixture (30 units regular and 15 units NPH) to a patient. Which should the LPN implement? (Select all that apply.)
Draw up the regular insulin first, then the NPH. Use an alcohol prep to clean each vial prior to use.
70
An LPN supporting a patient who has recently been taught how to provide self-injection of insulin recognizes that the patient understands the teaching if which of the following sites are chosen? (Select all that apply.)
Front of the abdomen about 2 inches from the belly button Back of the upper arm Top of the thigh slightly lateral of midline
71

Pharmacy Tech Practicum (48 decks)

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