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Therapeuticmeds
Question | Answer |
---|---|
pathophysiology-the cell | 1.damage to cell 2.impairment of 1 or more cell structures 3. tissue/organ function affected 4. function of system affected 5. affects spead to another system 6. homeostatis disrupted |
the cell adapts | shrink-become less active, decrease mitochondia demand(atrophy), grow-more active in response to demand(hypertrophy), change-hyperplasia(number), metaplasia(type), dysplasia(structure) |
The cell dies | necrosis-cant meet demands of the nucleus |
tissue healing | 1.regeneration-replace injured tissue w/normal tissue-integrity and func restored 2. scarring-injured cells replaced by connective tissue-integreaty restored not function, |
three phases of healing | inflammation, proliferation and remodelling |
Inflammatory phase | 1. hemostatis-immediate vasoconstriction, activate platelets, control blood loss, 2.Vascular response-vasodialtion, incrase cell permeability, plasa exit vessel enter damaged tissue(edema), 3.cellular respons WBC clear the area of bacteria and dead cells |
Proliferation phase | close the tissue wound-fibroblasts secrete collagen-protien that binds to self and other tissue to create scar, tissue becomes vascularized and new tissue cells form |
Remodeling phase | overlap with proliferation phase, tissue remodeling occurs while collagen still being laid, simultaneous breakdown & deposition of collagen bonds, final collagen strucure forms in response to forces experienced |
Acute inflammation | 1.damaged cells release chemicals-histamine, bradykinins, prostaglandins, cause capillary dilation, increase cell permeability, 2reaction increase BF, plasma &protien enter interstitial space3.protiens in blood interact w.fibrin=collagen clot |
acute inflammation 4+ | chemicals attract luekocytes-prolong inflammation-act as phagocytes, dissolve absorb damaged cells 5. an inflammation continues, increase pressue, blood flow to ara decreased, damage to healthy cells in area=secondary hypoxic injury |
Chronic inflammation | result of long term chemcial irritation and mechanical stress, chemcial action and luekocytes-inhibits tissue healing, same s.s as acute-less intense, persissts until cause of cellular damage is removed |
Signs and Symptoms of Inflammation | P!-tissue damage, inflammatory chemcisas, ischemia--Swelling, erthema, heat-increased blood flowk, plasma fluid in interstiial space-decreased function-p!, local muscle guarding, loos of movement--eccymosis-RBC in the tissue |
NSAIDs-arachidonic acid | arachidonic-produces prostoglandins-basodilate &sensitize receptors to bradykinins& histamin-decrease p!threshold, increased sensiati vity to p! |
lipoxygenase pathway | arachodoinic acid pathway-inflammation w/ asthma |
cycloxygenase COX pathway | COX1 enzyme-production of prostoglandins rsponsible for protection of GI mucosa, maintian renal function, platelet aggregation--COX2 enzyme-production of prostaglandins responsible for inflammation, pain, febver, wound healing |
Non-Selective/traditional NSAIDs | inhipit COX1/COX2 enzyme(inhibit prostoglandins), reduce p!, swelling, fever, prevent"good" prosotglandins tht protect stomach |
Selevtive(celebrex, vioxx, Bextra) | Do not block COX1, COX2 inhibited |
NSAIDs | used as-antiinflammatory, analgesic, antipyretic- lipid soluble:easily absorbed, stomach/sma intestin-produce effects w/in 15-30min, 7-10 days needd to evaluate effectiveness of drug-side effects-heart burn, nausea, diarrhea, constipation, GIbleed, ulscer |
Corticosteriord | usted to treat-asthma, inflammatory bowel disease, tendonitis, bursitis, dermatolical conditions, allergic reactions-how-decreased inflammation by inhibiting synthesys of arachidonic acid-administerd-orally, inhal, inj, topical, transdermal |
corticosteroid side effects | restlessness, dizziness, sleeplessnes, change skin color, unusual hair growth, eye pain, nausea, black stool, fluid retention, skin reaction, menstrual irregularities, prolonged sore throat, fever, tendon ruptures, decreased done density, GI disturbances |
analgesics-acetaminophen | treats-midle/mod p!, fever--dosage-tablets, capsules, chewAVLE, SUPPORISTORES-side effects increase risk for liver toxivity, overdose-does not inhibit platelet aggregation like NSAIDs |
analgesics-narcotics/opiates | treat-mod/sever p!, post-op, cancer--admin-oral, inj, rectal--side effects-drowsiness, euphoria, abuse, constipation--narcotics-oxycodone, demerol, opiates-morphone, codine |
Antibiotics | treat-bacterial inf, admin-oral, IM, IV--side effects-allergic reaction, dependant on drug-interact w/ oral contraceptives-less effective, misuse has lead to MRSA |
bactericidal antibiotics | inhibits synthesis of bacteria cell wall, works to kill invading bacteria |
Bacteriostatic | keeps bacteria from reproducing, allowing the immune system time to kill bacteria-high doesse or in conjunction w/ other antibiotics can kill |
Antihistamines | histamine-chemical mediator released during inflam, 3 types of histamine receptors-h1:respiratory tract, H2:stomach, H3:CSF, |
H1 antihistamines | tret allergies, cold, flue, skin-1st generation: lip soluble, pass blood-brain barrier=drowsy(benadryl), 2nd generation-less lip soluble less drowsiness(claritin, allegra) |
H2 antihistamines | reduce gastric acid production (H2 blockers) |
Decongestants | used to treat-nasal congestionw/ allergies, common cold, how-vasoconstirc blood vessels in nasal passage to help reduce swelling of mucosal membrane, admin-oral(sutafed), nasal spray Afrin-only use 305 days- rebond congestion), |
decongestant side effects | head ache, insomnia, restlessness, nervousness, do not use if HTN, heart diesase, raise heart rate, diabetics check with Md, may change insulin requirement |
Bronchodilators | used to treat-asthma, expand airways, relax bronchial spasm, admin-oral, inhaled(actquicker, fewer side effects) Side effects-side effects-tachycarda, increased BP, increased bloodsugar, nausea, vomit, nervousness, restlessness, diuretic |
Gastrointestinal drugs-antidiarrheals | treat symptoms od diarrhea, not underlying cause, opoids-decrease GI motility(immodium),absorbents-absorbs h2o, increase viscosity of stoll |
GI drugs-laxatives | bulkform-fiber, swells when mixed w/h2o, stimlatesperistalsis-12-72 hrs, osmotic lax-draw h2o to intestinal lumen, increasae peristaltis 1-3 hrs, stimlant-increase bowelmotility, stomach cramps 6-10hrs, stool softeners-soften contents of bowel, prevention |
Gi drugs-antacids | neurtalize stomach acid, used to treat peptic ulcer, heartburn, mild cases of GERD, take after meal, before bed, results:5-15 min, note:reduce absorption of other meds for 2 hrs |
Proton Pump inhibitors(PPI) | decrease acid production, take 30 min prior to meal, dosage depends on condition being treated |
H2 blockers | antagonists to histamine(h2), D acid production, dose dependant on condition being treated |
Antifungals | used to treat-superficial(mucous membrane, skin hair, nailes), systemic-side effects:oral:nausea vomit, abp!, HA, topical:itching burning, skin irritation |
Fungicidals | disrupt cell membrane kill fungus |
Fungistatic | prevent cell prlication, allows immune system to manage infection |
Antivirals | prescription only, used to treat/reduce the duration/severity of: herpes virus, inluenza |