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Exam 3/ chapters 8-11

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)
Created by: vtlove116



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