week 6 pharm

Question 1

which drugs are first generation NSAIDS

Answer 1

ibuprofen and naproxenwh

Question 2

which drugs are second generation NSAIDS

Answer 2

celecoxib (slightly more GI protection)

Question 3

how is aspirin different from the other NSAIDS

Answer 3

thins the blood and prevents MI and stroke

Question 4

what is the MOA of NSAIDS

Answer 4

block prostaglandin via COX1 and COX2

Question 5

which disease do we usually treat with NSAIDS first

Answer 5

rheumatoid arthritis

Question 6

why is aspirin contraindicated in patients under 18 years

Answer 6

it can cause Reyes syndrome

Question 7

whats the difference between first generation and second generation NSAIDS

Answer 7

first generation: inhibits both COX1 and COX2

second generation: Inhibits only COX 2

Question 8

what happens when you inhibit COX 1

Answer 8

usually the harmful effects (gastric erosion and ulceration, bleeding, renal impairment)

Question 9

what happens when you inhibit COX2

Answer 9

not too many adverse effects, it does all the good things.
it may cause renal impairment and promotion of MI and stroke due to the fact that it suppresses vasodilation (to stop swelling)

Question 10

are NSAIDS safe for pregnancy

Answer 10

no

Question 11

what is prednisones mechanism of action

Answer 11

it mimics natural cortisol which is an immunosuppressant and anti-inflammatory hormone.

Question 12

can you use prednisone for a long period of time

Answer 12

no

Question 13

prednisone indication

Answer 13

autoimmune disorders like Rheumatoid arthritis

Question 14

what does cortisol do

Answer 14

reduces inflammation, increases blood sugar, increases blood pressure

Question 15

how can you decrease the adverse effects of prednisone

Answer 15

you can give as an injection to the affected area

Question 16

what are the major adverse effects of prednisone ad how are they all related

Answer 16

think about what cortisol does:
- fluid retention which will cause hypokalaemia, high BP, weight fain
- it will cause hyperglycemia which can increase risk for infection and slow wound healing
and it overall suppresses immune system
- it also causes mood issues because its a stress hormone

Question 17

which drug should you not give with prednisone

Answer 17

NSIADS

Question 18

what are the symptoms of adrenal deficiency

Answer 18

anorexia, N/V, weakness, fatigue, dyspnea, low BP, hypoglycemias.

Question 19

what drug class is methotrexate (rhrumatrex)

Answer 19

it is a disease modifying anti rheumatic drug (DMARD)
It kills reply dividing cells

Question 20

what is the MOA of methotrexate

Answer 20

it blocks folic acid, which is important in cell division. it inhibits DNA synthesis and cell reproduction and suppresses the immune system.

Question 21

what is the indication for rheumatrex/methotrexate

Answer 21

rheumatoid arthritis.

Question 22

what is the fastest acting RA drug

Answer 22

methotrexate, therapeutic effects seen within 3-6 weeks

Question 23

which RA drug slows its disease progression

Answer 23

methotrexate

Question 24

what are the adverse effects of methotrexate

Answer 24

since it kills rapidly devising cells, were going to see bone marrow suppression, GI ulceration, hepatic fibrosis, inflammation of the lung tissue (pneumonitis)

Question 25

what is the main contraindication with methotrexate

Answer 25

pregnancy and breastfeeding

Question 26

whats the difference between infliximab and Methotrexate

Answer 26

Both are DMARDs but infliximab is a runout necrosis factor antagonist.

Question 27

what is tumour necrosis factor

Answer 27

a protein in out body that coordinates and signals inflammatory response that is in overdrive in RA

Question 28

which drug do we usually give with infliximab

Answer 28

methotrexate

Question 29

why does infliximab cause immunosuppression

Answer 29

because TNF plays a role in responding opportunistic infection, so without it there is large room for infection

Question 30

what is a unique issue that infliximab may cause, what should nurses monitor for

Answer 30

heart failure, nurses should monitor for edema, weight gain, SOB, crackles

Question 31

how does allopurinol help with gout

Answer 31

gout is accumulation of uric acid in the joints which causes pain. allopurinol is a xanthine oxidase inhibitor.
xanthine oxidase is an enzyme required for uric acid formation.

Question 32

how would kidney disease cause gout

Answer 32

Kidney disease will result in the kidneys having a harder time processing uric acid, which will make it accumulate in the body

Question 33

what is a unique hypersensitivity reaction with allopurinol;

Answer 33

rash, fever, liver and kidney dysfunction

Question 34

what does calcium do in the body

Answer 34

required for the structural integrity of homes. It helps with bone reabsorbtion and bone formation

Question 35

what does alendronate do

Answer 35

it reduces the number and activity of osteoclasts. its mimics a chemical compound found in the bone

Question 36

what is the indication for alendronate

Answer 36

Osteoporosis

Question 37

how long does alendronate usually work for

Answer 37

it is often used for less than 5 Yeats, but the effects can last up to 10 years

Question 38

why would alendronate cause esophagitis

Answer 38

it would usually occur with prolonged contact with the esophegeal musosa if the drug fails to pass completely into the esophagus. (too much contact with the mucosa)

Question 39

should you stop taking alendronate if the patient experiences musculoskeletal pain?

Answer 39

no

Question 40

what are some rare adverse effects with alendronate

Answer 40

ocular inflammation, weird femur fractures

Question 41

how should you instruct a patient to take alendronate

Answer 41

take in the am on an empty stomach and don’t eat for 30 mins after
take with a full glass of water and sit upright for at least 30 mins after to avoid esophagitis