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PHARMACOLOGY-TEST4
renal and respiratory---JT
| Question | Answer |
|---|---|
| Anterior Pituitary Hormones | Growth Hormone, Prolactin(breast milk), TSH, ACTH, FSH, LH |
| Uses of Oxytocin (Pitocin) and Adverse Effects | Stimulate Uterine Contractions, Control Postpartum bleeding. Adverse Effects: some associated wth maternal and fetal death. |
| Antidiuretic Hormone as a DRUG: PROTOTYPE | Vasopressin (Pitressin) is the prototype. |
| Antidiuretic Hormone as A Drug: Desmopressin (DDAVP). What are the uses: | Diabetes insipidus (slows down urine output), polyuria, hemophilia (increases factor Viii adn severe bleeding in esophageal. |
| Over Production and Under Production of Growth Hormone results in? | Gigantism-over production. Dwarfism-Defiency. Over production in adult caused by pituitary tumor is Aromegaly |
| What is the Growth Hormone used to treat? | children with a deficiency of endogenous, children with chronic renal failure, turners syndrome, In Adults: used to treat tissue wasting as in Aids. |
| Adrenal Medulla normally secretes: | Catecholamines: NE adn E. Adrenal Medulla is an Anterior Pituary Hormone. |
| Adrenocorticotropic Hormone (ACTH) | Released form Ant. Pituitary and stimulates the release of : Mineralcorticoids, glucocorticoids,adnandrogens and estrogens. |
| Glucocorticoids are secreted by what | secreted by Adrenal cortex |
| Secretion of Estrogen and Progesterone are? | usually insignificatn amounts unless a disease occurs. they are also a glucocorticoids |
| Primary Adrenal Insuiffiency is results in: | Addisons Disease. Destrucion of Adrenal Cortex. Disordes such as: TB, Cancer, Hemorrage, Atrophy, Surgical removal of Glands, prolonged corticosteroids. |
| Addisonian CRISIS IS: | Stimulited by a stressful event: surgery, Acute Illness, Trama, ABRUPT WITHDRAWL OF CORTICOSTEROID THEARPY. |
| Signs and Symptoms of Addisonian crisis | High fever, weakness, Severe Abdominal Pain, Lower back and Leg Pain, Vomiting, Diarrhea, Hypotension, Shock, Coma Death, Circulatory collapse. |
| Treatment of Addisonian crisis | Rapid replacement of fluids, Glucocorticoids |
| Corticosteroid Drugs: Glucocorticoids | Hydarocortisone (prototype), Beclomethasone, Dexamethasone, Fluticasone |
| Corticosteroids: Mineralocorticoids drug | Flurocortisone (florinef) |
| Adverse Effects of Corticosteroids: | CV: heart failure, cardiac edema, hypetension. Endocrine: Growth suppression,mood swings, Cushings Syndrome, retention, electrolyte imbalance, Menstural Irregularities, GI-ulcers SKin-Petechiae, weight gain. |
| Signs and Symptoms of Crushings Syndrome: | Obesity (moon face), muscle weakness related to changes in protein metabolism, loss of collagen and connective tissue, Thinning of skin, Abdominal Straie, Easy bruising, Poor wounds Healing, Altered glucose Metabolism. electrolyte imbalance. |
| crusings signs and symptoms: | Facial hair in women, alterations of the menstrual cycle. |
| Mineralocorticoids are secreted by: Functions? | adrenal cortex(Aldosterone) function: fluid adn electrolyte balance, controls na and water retention in kidneys, |
| What mineralocorticoid drug is used to replace aldosterone: | Fludrocortisone(Florinef) |
| what is diabetes: | chronic metabolic disorder marked by hyperglycemia. caused by: failure of pancrease to oproduce insulin, cellular insulin resistance. |
| what is type 1 Diabetes | autoimmune destruction of insulin secreting beta cells of the pancreas, Juvenil onset, IDDM9insulin dependent diabetes melitus) |
| Type 2 Diabetes: | decreased sensitivity of muscle cells to insulin (resistant) adn decrease in insulin production. |
| 95% of diabetes is: | Type 2 diabetes--(non-insulin dependent) Adult onset, MODY (maturity onset diabetes of youth |
| What organs do not require insulin for absorption of Glucose | brain, liver, intestines, renal tubules |
| Where is insulin secreted and what does it control? | hormone secreted by the beta cells of the pancreas, controls cellular uptake of glucose. |
| What Testing is Done for Diabetes | Fasting blood glucose, Two hour glucose tolerance test, random glucose greater than 200mg/dl. Hemoglobin A1C |
| Routes of Diabetes Medications: | PO-not insulin, IV-only regular, SC-subcutaneous. |
| Insulin Stimulating: SUlfonylureas | (glucotrol)glipizide. stmulate insulin secretion from teh beta cells of pancreas, improves insulin sensitivity in tissues |
| Insulin Stimulating: Meglitinides | (Prandin) Repaglinide ----Diabetes med-stimulate insulin production in teh pancrease. |
| What is the Insulin Sensitizing Drug that inhibits glucose | Metformin(GLUCOPHAGE) biguanides-inhibits hepatic glucose production and increase peripheral tessue sensitivity. |
| What is the insulin sensitizing drug that decreases resistance-----Thiazolidinediones Why is there an FDA warning? | Actos (pioglitazone)decrease insulin resistance in skeletal muscles. Avandia (rosiglitazone)-WARNING-precipitated CHF |
| ACARBOSE (PRECOSE)is what type of insulin drug? | ABSORBTION DELAYING-delays glucose absorption and digestion of carbs. Hypoglycemia-iv or im glucose is absorbed, juice will not work b/c gi track. |
| Blood glucose of 0-120? | 0 insulin |
| BG or 121-250 | 4u regular insulin |
| BG 251-350? | 6u reg. insulin |
| BG 351-400 | 8u reg. insulin |
| BG Greater than 400 | CALL MD |
| What is Insulin Shock? | often in patients with Type 1, major adverse reactions to to insulin. |
| What is Diabetic Ketoacidosis? | uncontrolled diabetes, bg levels are high but no insulin is present. Type 1 condition. |
| Treatment for DKA | fluid and electrolyte replacement adn insulin therapy |
| Patient Teaching for Thyroid drugs | report chest pain,weight loss, tremors,life long,keep follow up visits, refill with same brand,children may suffer from hairloss but its reversible, children w/ aggressiveness,keep journal of energy adn appetite levels,3 mts to see full theraputic effects |
| When should the patient take his/her thyroid medication? | Should be taken with a snack or meal, at same time, never stop abruptly, stop eating foods high in iodine: soy, tofu, seafood and some breads, cold tolerance should be reported, decrease na. |
| Long Acting Insulin: | ultralente/lantus: onset 2-4 hrs, peak action: 8-14 hr, duration of action 18-24 hr. |
| Intermediate Acting: | NPH, Lente: Onset 1-2 hrs, peak 4-8 hr, duration is 10-18hr. |
| Rapid Acting Insulin: | Regular: onset is 30-60 min, peak 2-4 hr, duration is 6-8 hrs. |
| Very Rapid acting Insulin: | Lispro: onset 5-15 min, Peaks 1-2 hrs, duration is 4-6 hr. |
| What are some Hypoglycemia symptoms: | nausea,anxiety,pale,slurred speech,decreased loc,hypotension,rapid pulse,diaphoresis,seizures |
| Treatment of Hypoglycemia: | based on loc give:::iv or IM, give glucose not sucrose-is diagested more easliy. are they able to swallow:::give juice. |
| Functions of Histamine: | cns nerve transmission,capillary dilation,smooth muscle constricion in stomach and lungs, stimulate gastric secretions, increase heart rate, increase body secretions(runny nose) |
| what are antihistamines: | drugs that compete for the histamine receptor sites, block action of histamine |
| When to use Anti-histamines | w/nasal allergies, upper respiratry viral infection, motion sickness, parkinson's disease(DRYS SECRETIONS) sleep aid |
| When to NOT use Anti-histamines | Known Drug allergy, not first line in severe asthma, narrow angle glaucoma, hypertension. |
| name 2 Non-sedating Anti-histamines | Cetirizine (zyrtec) Loratadine(clariitin) |
| Traditional Anti-histamines ---name 2 | Sedating-Chlorpheniramine (chlor-trimiton) Diphenhydramine (benadryl) prototype |
| Anticholinergic Effects of Anti-histamines(parasympathetic) | drowsiness, vision changes, difficult urination, constipation, dry mouth, do not give to pt with trouble peeing. |
| What are Three groups of decongestants | Adrenergics, Anticholinergics, Topical corticosterioids |
| MOA of decongestants | Constrict small arterioles in nasal passages. OTC meds----(oxymetazoline) afrin, neo-synephrine |
| WHAT IS AN ANTITUSSIVE DRUG? | A DRUG THAT REDUCES COUGHING, OFTEN BY INHIBITING NERUAL ACTIVITY IN THE COUGH CENTER |
| Opoid antitussive: | Codeine adn Hydrocodone suppress the cough reflex through direct action on the cough center in the medulla, also have a analgesia and drying effect on mucosa |
| Non opoid antitussive: | dextromethorphan work in same way but dons not have analgesic properties b/c its not an opoid |
| expectorants | aid in teh expectoration: cough up and spitting out: of excessive mucus, by breaking down and thinning out secretions. |
| Asthma Signs and symptoms | Dyspnea, wheezing, chest tightness, cough sputum production |
| Beta Adrenergic Agonists-dilation | Drugs that stimulate the beta 2 receptors (located in lungs) causing bronchodilation |
| Beta Adrenergic Agonist DRUGS | Albuterol-Proventil, Ventolin, fast acting--rescue inhelor |
| Emergency Treatment for Asthma Attack | Albuterol: prevention and treatment of broncoconstriction. |
| Side effects of Adrenergic Agonist: | nervosness, restlessnes, tremor, chest pain, palpitations |
| Xanthine deritives-a respiratory drug are used for what? | used to dilate the airways in patients ex. asthma, and used as an adjunct drug in COPD, used as prevention of asthma attacks b/c slow acting. |
| Adverse effects of Xanthine Deritives | N, V, and anorexia. gastroesophageal reflux during sleep, dysrhythimas and palpitations |
| Xanthine Dreritives | Theophyphylline and Aminophyllin |
| what is a second line drug for use in asthma and copd | Theophyphylline |
| What two anticholinergics are used to treat COPD- | ipratropium and tiptropium |
| What does ipratropium do (Atrovent)? | inhibits cholinergic receptors resulting in bronchodilation, maintene therapy for chronic bronchitis adn emphysema. Inhalation |
| Anti-Inflammatories | Corticosteroids:::Beclomethasone(quar) Flunisolide (aerobid) Fluticasone (flovent)::: PO, Ihhaled IV |
| ADR's of Antiinflammatories | Headache, agitation, depression, dizziness, hrseness, cataracts, adrenal suppression, CANDIDA(RINSE MOUTH AFTER USE) |
| Nursing Considerations of inhaled meds | wait 5 min between drugs, bronchodilators first, rinse after use, |
| what are ANTILEUKOTRINES | lEUKOTRINES ARE RELAESED when triggered by antigen, caues bronchoconstriction, mucuc and inflammation, antileukotrines inhibits these actions |
| ADR's of Antileukotrines | fatigue headache weakness(rare) |
| Mast Cell Inhibitors | prevent release of bronchoconstrictive substances (histamines) drugs are: Intal (cromolyn) |
| Adverse Effects of Mast Cell Inhibitors | cough irritation of throat and trachea nasal irritation. |
| mast cells release | histaine, heparin, prostaglandins |
| Bisphosphonates | inhibit osteoclasts(break down bone) which enhances bone mineral density fosamaxz boniva |
| Diabetes Insipidus | is a condition characterized by excessive thirst and excretion of large amounts of severely diluted urine cuased by severe deficient of ADH |
| When is an inhalor spacer used? | patients that are new to the asthma and that do not know how to use an inhalor |
| receptor site for estrogen | uterus |
| ACTH stimulates the release of What? | mineralcorticoids, glucocorticoids, androgens adn estrogens |
| what insulin should never be mixed with another insulin?? | Lantus |
| Whar are they signs and symptoms of Hypothyroidism(myxedema)---- (SLOW)? | anorexia, intolerance to cold, weight gain, bradycardia, edema |
| An enlarger goiter in a patient can be hyper or hypothyroidism? | Both |
| Graves Disease is Hyperthyroidism what are the signs and symptoms | enlarged thyroid, exopthalmos (enlarged eyes), weight loss, insomnia, hand tremors, dysrhythmias |
| Treatment (meds) for Hypothyroidism | thyroid, Synthroid(levothyroxin)-synthetic |
| Treatment (meds) Hyperthyroidsm | propylthiouracil, tapazole, radioactive iodine |
| An autoimmune disease of the thyroid is ? | Graves disease |
| Patient teachiing for thyroid medication | may take 3-4 wks to work, routine lab work needed, take in am to avoid insomnia, Never discontinue w/o MD order |
| Patient teaching for Osteoporosis meds: | MUSt be taking on empty stomach and pt must be able to sit up for 30 minutes |
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