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pharmacology
Exam 3/ chapters 8-11
| Question | Answer |
|---|---|
| Immunosuppressants are indicated to | prevent tissue rejection in post-transplant patients |
| These deliver medications directly into the bronchi and lungs for optimal effectiveness: | nebulizers and inhalers |
| Some medications such as intranasal glucocorticoids and leukotriene modifiers must be taken daily in order to build to an effective therapeutic level in the blood stream. This is called | loading process |
| A 12-yr old is admitted to the emergency dept in ob distress. She is coughing, wheezing and having difficulty breathing. Her mother reports the patient has a history of asthma. From the following list, which should be administered for immediate relief? | bronchodilators and systemic glucocorticoids |
| Cyclosporine's mechanism of action is | it inhibits development and function of T4 lymphocytes |
| What would most likely be prescribed to treat a dry, hacking, non productive cough of 2 weeks' duration? | antitussives |
| These first generation histamine blockers are often prescribed for relief of allergy symptoms, nausea and motion sickness | dimenhydrinate, diphenhydramine, promethazine |
| Bc long-term use of these meds can cause suppression of immune system function, inc blood glucose, Cushing's syndrome, moon face, electrolyte imbalances, erythema, osteoporosis + wt gain, they should be prescribed only for cases of severe inflammation | systemic glucocorticoids |
| Which of the following represents asthma prophylaxis? | administration of leukotriene modifers to prevent episodes of asthma in patients with history of asthma |
| Because of this potential side effect, pseudoephedrine and other sympathomimetics should be used for no more than 3-5 days at a time | rebound congestion |
| Explain why histamine blockers are effective for treatment of acute allergic reactions | they block histamine receptors |
| Explain the difference between the effects of 1st generation histamine blockers and 2nd generation histamine blockers | 1st generation are sued for their side effects like diphenhydramine, dimenhydrinate, and promethazine 2nd generation relieve the symptoms caused by histamine |
| Describe common side effects / adverse effects of each of the following when used for the treatment of allergy: a. histamine blockers, first generation | drowsiness fatigue nausea headache dry mouth |
| Describe common side effects / adverse effects of each of the following when used for the treatment of allergy: b. systemic glucocorticoids | weight gain hungry water retention mood swings |
| Describe common side effects / adverse effects of each of the following when used for the treatment of allergy: c. sympathomimetics | secondary hypertension rebound congestion |
| Describe the indications for the use of immunosuppressants, and explain the mechanisms of action and adverse effect(s) of the following: a. cyclosporine | INDICATIONS: flu and rheumatoid arthritis, transplant rejection MOA: inhibits T-cells ADVERSE EFFECTS: risk of fatal infections |
| Describe the indications for the use of immunosuppressants, and explain the mechanisms of action and adverse effect(s) of the following: b. methotrexate | INDICATIONS:Rheumatoid arthritis and severe psoriasis MOA: blocks metabolism of folic acid ADVERSE EFFECTS: risk of deadly infections |
| Describe the common side effects / adverse effects for beta-adrenergic (sympathomimetic) bronchodilators and anticholinergic (parasympathetic) bronchodilators | beta- adrenergic (sympathomimetic) bronchodilator: tremors and nausea/ adverse: seizures, bronchospasm, dysrhythmias anticholinergic (parasympathetic) bronchodilators: increased HR and seizures |
| Identify the three classes of drugs commonly prescribed for asthma prophylaxis | mast cell stabilizers- prevention of bronchospasm leukotriene modifiers- prevent prostaglandin formation corticosteroids inhaler- inhibit inflammatory response |
| Describe the desired effects of a. antitussives b. expectorants c. mucolytics | antitussives- used to stop a dry hacking cough expectorants-to help loosen and expel phlegm mucolytics- help thin mucus in lungs |
| asthma prophylaxis | prevention of asthma attacks |
| dry powder inhaler | used to deliver medications such as inhaled corticosteroids into the lungs |
| rebound congestion | worsening of the original congestion due to a dependence on the nasal passage |
| loading process | the initial loading dose is a higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose |
| vaccine | suspension of attenuated microorganisms administered to induce active immunity to infectious diseases |
| metered dose inhaler | is a pressured inhaler that delivers a certain amount of medication to the lungs in the form of short bursts |
| Describe the two goals in asthma treatment | -stop asthmatic episodes in process -prevent further episodes |
| Explain the purpose of inhalers and nebulizers in treating COPD | nebulizers deliver medication into the lungs and bronchus in a fine mist inhaled inhalers delivers a certain amount in mist or powdered form |
| Explain why intranasal steroids are ineffective for acute allergic reactions and leukotriene modifiers and mast cell stabilizers are ineffective for acute asthma episodes | intranasal steroids are ineffective for acute allergic rxn because they must build to an effective level in the blood stream leukotriene modifiers and mast cell stabilizers are ineffective for acute asthma episodes bc 1 to 2 week loading processes req. |
| antitussives | INDICATIONS: dry couch |
| biologic response modifiers | INDICATIONS:boost immune system |
| bronchodilators | INDICATIONS: Chronic bronchitis |
| expectorants | INDICATIONS: common cold, bronchitis |
| glucocorticoids, intranasal | INDICATIONS: rhinitis and nasal polyps |
| glucocorticoids, systemic | INDICATIONS: endogenous uveitis, immunosuppressive therapy |
| Histamine1 blockers (H1 blockers) | INDICATIONS: nausea and vomitting, vertigo, rhinitis, and insomnia |
| immunosuppressants | INDICATIONS:Rheumatoid arthritis, flu |
| leukotriene modifiers | INDICATIONS:Asthma prophylaxis |
| mast cell stabilizers | INDICATIONS:Asthma Prophylaxis |
| Drug Class: cortisone, hydrocortisone, prednisolone, prednisone | NSAIDS and glucocorticoids |
| Drug Class: cyclosporine, methotrexate | immunosuppressants |
| Drug Class: dimenhydrinate | histamine blockers |
| Drug Class: diphenhydramine | histamine blockers |
| Drug Class: interferon, BCG vaccine | Biologic response modifiers |
| Drug Class: promethazine | histamine blockers |
| Define a. antidiarrheal b. antiemetic c. cathartic (when used in treatment for constipation or bowel prep) | a. antidiarrheal ontrol nausea, vomiting, and diarrhea b. antiemetic control of nausea and vomiting c. cathartic cause faster and more complete bowel emptying |
| define colloids (when used for fluid replacement) | proteins, other larger molecules that remain suspended (i.e., albumin, Dextran 40, Hetastarch, plasma protein fraction) |
| define crystalloids (when used for fluid replacement) | mineral salts, electrolytes (i.e., Normal saline, Ringer’s lactate, Lactated Ringer’s; D5W) |
| diuretic | Medications that produce diuresis- act of increasing urine output |
| emetic | given to induce vomiting in cases of drug overdose and ingestion of poisons |
| laxative | medications for treatment of constipation, are classified based on their MOA |
| H2 receptor antagonists | MOA in treatment of peptic ulcer and GERD: 1st drugs of choice for treatment of active peptic ulcer, prevention of ulcer recurrence, and treatment of GERD – they block the H2 receptors, which in turn reduces the amount and acidity of hydrochloric acid. |
| Proton pump inhibitors | MOA in treatment of peptic ulcer and GERD for short-term treatment – block production of hydrochloric acid, but in a different manner: they block production of hydrogen ions (protons) in the parietal cells, in turn blocks production of HCL |
| antacids | MOA in treatment of peptic ulcer and GERD: compounds of aluminum, magnesium and calcium neutralize the hydrochloric acid |
| Describe recommended treatment protocol for Crohn’s disease and ulcerative colitis, and explain why long-term application of anti-inflammatories and immunosuppressants is usually warranted | anti-inflammatory medications to reduce bleeding; analgesics for pain associated with flare-ups; immunosuppressant medications to suppress the immune response, since these are auto-immune conditions; vitamins to treat or prevent anemia. |
| Explain why antihistamines (histamine blockers) are sometimes used to treat nausea and vomiting | they suppress the H2 histamine receptors, thereby reducing production of hydrochloric acid blocks histamine receptors in the vomiting center of the brain |
| Name the MAIN DIFFERENCE between the various types of diuretics | primary difference among the diuretic sub-classes is where they act. Each category acts in a different part of the glomerulus. In addition, some cause potassium depletion and others do not. |
| Name the MAIN SIMILARITY among the various types of diuretics | act by blocking resorption of sodium |
| Explain the indication for treating peptic ulcer with an antibacterial, and why this treatment is reserved for the worst cases of this type of peptic ulcer | for treatment of peptic ulcer caused by Helicobacter pylori; reserved for worst cases due to long-term administration required; (not appropriate for treatment of GERD) |
| Explain why celiac disease and cystic fibrosis tend to cause chronic diarrhea, with malabsorption and malnutrition | -steatorrhea (excessive fats in the stool) -is also responsible for the malabsorption syndromes associated with these conditions |
| Explain why it is necessary to monitor blood potassium levels and to possibly give potassium supplements to patients taking diuretics | -some cause potassium depletion With all other diuretics, physicians usually recommend increased intake of potassium-rich foods, or potassium supplements. (Example: spironolactone) |
| Explain why laxatives are sometimes prescribed prophylactically | given after childbirth or surgery, or for individuals with a propensity for constipation |
| antacids | INDICATIONS: GERD or peptic ulcers |
| antidiarrheals | INDICATIONS: for diarrhea |
| antiemetics | INDICATIONS: post op nausea and vomiting |
| diuretics | INDICATIONS: high blood pressure, glaucoma, and edema |
| emetics | INDICATIONS: poisoning |
| H2 blockers | INDICATIONS: Duodenal ulcers, gastric ulcers, Zollinger-Ellison disease |
| IV fluid replacement agents | INDICATIONS: Dehydration |
| laxatives and stool softeners | INDICATIONS: Constipation |
| proton pump inhibitors | INDICATIONS: Peptic Ulcers and GERD |
| drug class anticholinergics | INDICATIONS: COPD , overactive bladdar, GI disorders |
| drug class diphenhydramine, dimenhydrinate, promethazine | DRUG CLASS: Allergy, hay fever, and common cold |
| drug class furosemide (Lasix) | DRUG CLASS: Edema |
| drug class normal saline,/Ringer’s Lactate/ dextrose in water/ sodium chloride | DRUG CLASS: Dehydration |
| drug class plasma protein fraction/ Dextran 40/ Hetastarch | DRUG CLASS: Hemorrhage, burns, surgery, or trauma |
| drug class esomeprazole (Nexium)/ omeprazole (Prilosec)/ lansoprazole (Prevacid | DRUG CLASS: Erosice esophagitis, GERD |
| drug class cimetidine (Tagamet)/ famotidine (Pepcid)/ ranitidine (Zantac) | DRUG CLASS: Duodenal or gastric ulcer, GERD |
| Pharmaceutical treatment for Addison's disease | glucocorticoid replacement |
| Pharmaceutical treatment for benign prostatic hyperplasia | alpha blockers to relax smooth muscle in the prostate |
| Pharmaceutical treatment for Cushing's syndrome | involves switching to alternate-day dosing when possible of corticosteroids |
| Pharmaceutical treatment for diabetes insipidus | artificial antidiuretic hormone replacement ex: vasopressin, desmopressin, and lypressin |
| Pharmaceutical treatment for diabetes mellitus 1 | insulin injections of daily or multiple times each day to prevent complications and death |
| Pharmaceutical treatment for diabetes mellitus 2 | start with dietary and lifestyle changes and if blood sugar levels don't come down then oral hypoglycemics are administered ex: metformin and glipizide and maybe insulin injections |
| Pharmaceutical treatment for Primordial Dwarfism | sometrem or somatropin |
| Pharmaceutical treatment for Erectile Dysfunction | vasodilators ex: sildenfil, vardenafil, and tadalafil |
| Pharmaceutical treatment for Grave's disease | propylthiouracil |
| Pharmaceutical treatment for Myxedema | synthetic thyroid replacement medications ex: levothyroxine |
| Differentiate between short acting, immediate acting, and long acting insulin | short acting- peaks 2-4 hours immediate acting - peaks 4-12 hours long acting insulin- peaks 6-20 hours |
| Differentiate between monophasic, biphasic, and triphasic contraceptives | monophasic- estrogen and progesterone levels kept constant biphasic- estrogen remains constant and progestin increases triphasic contraceptives-estrogen and progestin differ through |
| Identify the two warnings associated with sildenafil, vardenafil, and tadalafil | -cause over dilation of the blood vessels if taken with another vasodilator -causes vasodilation of the penis and can't subside and eventually constricts blood flow in the penis which can lead to tissue dam |
| Potential impact on Cardiovascular ischemia | leads to cardiovascular disease, myocardial infarctions and heart failure |
| Potential impact on diabetic retinopathy | leads to retinal damage and blindness |
| Potential impact on diabetic neuropathy | inflammation of the nerves leads to neuropathy with pain, tingling and numbness |
| Potential impact on intranasal insulin | possible treatment for Alzheimer's disease and other forms of dimentia |
| Potential impact on diabetic renal disease | lead to kidney damage and failure |
| Estrogen, Progestin, and Oxytocin | Drug Class: female sex hormones |
| Levothyroxine | Drug Class: thyroid hormones |
| Metformin and Glipizide | Drug Class: anti-diabetics |
| Sildenafil, Vardenafil, and Tadalafil | Drug Class: phosphodiesterase inhibitors |
| Male sex hormones | Indications: low sperm count, ED, depression, loss of muscle mass |
| Alpha sympatholytics | Indications: treat anxiety, panic disorder and PTSD |
| Female sex hormones estrogen and progesterone | Indications: menopause |
| Female sex hormones oxytocin | Indications: Rh problems, maternal diabetes, preeclampsia |
| Insulin | Indications: Type 1 and type 2 diabetes Mellitus |
| Synthetic thyroxine | Indications: Myxedema |
| Oral hypoglycemics | Indications: Diabetes Mellitus 2 |
| Oral contraceptives | Indications: acne, dysmenorrhea |
| Anti-thyroid agent | Indications: Graves Disease |
| Vasodilators that cause penile erection | Indications: ED |
| Human growth hormone | Indications: Dwarfism |
| Tocolytics | Indications: premature labor |
| Synthetic antidiuretic hormone (ADH) | Indications: Polyuria, polydipsia, and glycosuria |
| Name the two categories of antispasmodics (muscle relaxants) and describe the mechanism of action for each | -Centrally acting muscle relaxants – CNS depressants; depress the reflex impulse conduction within the spinal cord (ex: benzo.) -Direct acting muscle relaxants – act directly on the affected muscle (examples: dantrolene, botulinum toxin.) |
| Explain why calcium supplements and Vitamin D are prescribed for treatment of osteomalacia and osteoporosis. | Vit D is a preventative for osteomalacia, and Ca supplements for osteoporosis. Vit D and Ca are both necessary. Vit D (absorbed from the sun, dairy products and fortified foods) --> calcitriol in the kidneys. Calcitriol --> Ca absorption in the GI tract. |
| Describe pharmaceutical and non-pharmaceutical treatment options for osteoarthritis | •Selective Estrogen-Receptor Modulators (SERMS) - antiresorptives block bone resorb by binding to the estrogen receptors to dec bone resorption (ex: Tamoxifen, Raloxifene) •Bisphosphonates – medications inc bone density by inhibiting bone resorption |
| Describe pharmaceutical and non-pharmaceutical treatment options for rheumatoid arthritis | - Both forms of arthritis may benefit from NSAIDS, acetaminophen, topical pain relievers for inflammation and swelling, and antidepressants -injectable gold salts |
| Explain what tumor necrosis factor is, and explain the mechanism of action for tumor necrosis factor blockers in the treatment of rheumatoid arthritis | -Tumor necrosis factor is an immune sys protein that triggers the inflammation process to respond to bacterial toxins. -MOA for RA medications block production of the protein, which in turns prevents or reduces the inflammatory process |
| Describe the bone formation / resorption process, and explain how antiresorptives such as bisphosphonates and selective estrogen-receptor modulators (SERMs) treat osteoporosis by influencing that process | -destruction of bone is called resorption. Growth of new bone is deposition. Bone resorption outpaces bone deposition, resulting in weak, porous bones subject to fracture -(SERMS) - these block bone resorption -Bisphosphonates – increase bone density |
| Differentiate between superficial partial-thickness burns, deep partial-thickness burns, and full-thickness burns | -Superficial partial thickness burns – involve damage to the epidermis. -Deep partial thickness burns – involve destruction of the epidermis and part of the dermis -Full thickness burns- destruction of all skin layers and often the underlying tissues |
| describe appropriate treatment protocol: superficial partial-thickness burns | Treatment – cool water or cool compress; topical anesthetics;ibuprofen or acetominophen |
| describe appropriate treatment protocol: deep partial-thickness burns | Treatment – cool water or cool compress; topical anesthetics;ibuprofen or acetaminophen; elevate area above the heart; do not open blisters; if blisters open, apply antibiotic ointment |
| describe appropriate treatment protocol: full-thickness burns, | Treatment (requires advanced emergency response) fluid replacement to prevent or treat for shock; monitor for DIC (disseminated intravascular coagulation) and treat as warranted; pain management. |
| Describe the primary adverse effect associated with some bisphosphonates | Osteonecrosis (death of bone) of the jawbone is an adverse effect |
| Identify the beneficial use of botulinum toxin | acts only on very limited muscles, they are not effective at controlling the pain-spasm-pain cycle |
| drug class: • alendronate, ibandronate, risedronate (you probably know these as Fossamax, Actonel and Boniva) | Biphosphonates |
| drug class: • tamoxifen, raloxifene | Selective Estrogen-Receptor Modulators (SERMS) |
| name the general treatment given here: • acne and rosacea | Treatment of both includes antibiotic therapy (doxycycline); retinoid-like compounds(adapalene, tretinoin); and topical ointments such as tretinoin (prescription only) and benzoyl peroxide and salicylic acid (OTC.) |
| name the general treatment given here: • atopic and contact dermatitis | Treatment of both types may include top glucocorticoids, systemic corticosteroids, and diphenhydramine. Id and avoidance of the irritant(s), along w/ aggressive skin support (emollients, avoidance of harsh, drying soaps) can lessen exacerbations. |
| name the general treatment given here: • candidiasis and tinea antifungals | Antifungal medications are available in topical and systemic forms |
| name the general treatment given here: • herpes simplex, herpes zoster, human papilloma virus (HPV) | Treatment is specific to the causative organisms -topical applications to eradicate existing warts, or surgical removal |
| name the general treatment given here: • bacterial skin infections such as impetigo, folliculitis and acute necrotizing fasciitis | Treatment for these and other bacterial skin infections includes antibacterials (systemic or topical); analgesics; and anti-inflammatories. |
| name the general treatment given here: • osteomalacia and rickets | Vitamin D and Calcium supplements |
| name the general treatment given here: • lice | consists of antiparasitic agents that include pediculicides for pediculi and removal of the nits from hair with a special comb |
| name the general treatment given here: • psoriasis | Treatment options include topical glucocorticoids, immunosuppressants, retinoids, topical Vitamin D cream, emollients and photochemical therapy |
| name the general treatment given here: • scabies | consists of antiparasitic agents that include scabicides for scabies |
| name the general treatment given here: • syphilis, gonorrhea and other bacterial STDs | specific to the causative organism in each case Penicillin, metronidazole, or topical applications |
| name the general treatment given here: • trichomoniasis | Metronidazole an antiprotozoal |
| DRUG CLASS: • antifungals | INDICATIONS: Candidiasis and Tinea |
| DRUG CLASS: • antispasmodics, centrally-acting | INDICATIONS: Cerebral Palsy, Hungtington's Disease, Tourette's Syndrome, and seizure disorder |
| DRUG CLASS: • antispasmodics, directacting | INDICATIONS: Cerebral Palsy, Hungtington's Disease, Tourette's Syndrome, and seizure disorder |
| DRUG CLASS: • bisphosphonates | INDICATIONS: Osteoporosis and osteomalacia |
| DRUG CLASS: • retinoid-like compounds | INDICATIONS: Acne and Rosacea |
| DRUG CLASS: • selective estrogenreceptor modulators (SERMs) | INDICATIONS: Osteoporosis and osteomalacia |
| DRUG CLASS: • topical anesthetics | INDICATIONS: Superficial partial thickness burns |
| DRUG CLASS: • tumor necrosis factor (TNF) blockers | INDICATIONS: Rheumatoid arthritis |
| DRUG CLASS: • uric acid inhibitors | INDICATIONS: Acute gout arthritis (gout) |
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