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Pharm - Quiz 4

Neoplasia; endocrine

The Endocrine System Consists of glands that secrete hormones Hormones are released as changes in the body occur Hormones are transported by the blood through the body
What is hormone action is controlled by? negative feedback mechanism
Parafollicular cells in the parathyroid secrete calcitonin Parathyroid gland is big in calcium homeostasis
Thyroid releasing hormone (TRH) from the hypothalamus stimulates the pituitary gland to produce and secrete thyroid stimulating hormone (TSH)
thyroid stimulating hormone (TSH) stimulates the thyroid gland to produce and secrete thyroid hormones into the blood
That does the Thyroid Hormone do? Regulates basal metabolic rate Critical to growth of the nervous system
Hypothyroidism by insufficient secretion of TSH or thyroid hormone
myxedema Hypothyroidism in adults
Signs and symptoms of myxedema Everything SLOWS down: Slowed body metabolism Slurred speech Bradycardia Weight gain Low body temperature Intolerance to cold
Treatment for hypothyroid Levothyroxine (Synthroid)
Levothyroxine (Synthroid) side effects Hyperthyroidism and the associated side effects
Hyperthyroidism Too Much Thyroid Hormone Secreted
Graves’ disease severe form of hyperthyroidism
Hyperthyroidism S and Sx Increased body metabolism Tachycardia Weight loss High body temperature Anxiety
Hyperthyroidism treatment Propylthiouracil (PTU) (Propacil) Anti-thyroid hormone Can take a while to be effective – up to 12 wks
Adrenal Glands Lie atop the kidneys; Cortex - Corticosteroids Medulla - Epinephrine and norepinephrine
Adrenal Cortex Secretes corticosteroids (2 classes) Glucocorticoids Mineralocorticoids
Mineralocorticoids Aldosterone Increases the renal absorption of sodium in exchange for potassium More sodium and water retention in body
Glucocorticoid CRF (corticotropin-releasing factor) secreted from the hypothalamus; Causes release of ACTH (adrenocorticotropic hormone) from the pituitary glands; During long-term stress, mobilize the formation of glucose (release of cortisol); Potent anti-inflammatory
Adrenocortical Insufficiency Decrease production of corticosteroid
Adrenocortical Insufficiency S and SX Hypoglycemia Fatigue Hypotension GI disturbances
Addison’s Disease Primary adrenocortical insufficiency; rare; Deficiency of both glucocorticoids and mineralocorticoids Treated with glucocorticoid replacement therapy
Secondary Adrenocortical Insufficiency Common; Results from long-term therapy with glucocorticoids that is abruptly discontinued…pituitary has received message to stop secreting ACTH
Glucocorticoids Are Used to Treat: Inflammatory and immune responses: Allergies, seasonal rhinitis, asthma Contact dermatitis and rashes Hodgkin’s disease, leukemias, lymphomas Shock Rheumatoid arthritis, ankylosing spondylitis, bursitis Ulcerative colitis, Crohn’s disease Hepatic,
Cushing’s Syndrome Adverse Effect Can Occur During Long-Term use of glucocorticoids
Cushing's syndrome S an SX Adrenal atrophy Osteoporosis Increased risk of infections Delayed wound healing Peptic ulcer Accumulation of fat around shoulders and neck Moon face Buffalo hump Mood and personality changes Hyperglycemia
Common glucocorticoids (end in sone or lone) Predinisone (Deltasone) Hydrocortisone (Solu-cortef) Methylprednisolone (Solu-Medrol) Dexamethasone (Decadron) Betamethasone (Celestone) Fetal lung development
glucocorticoids nursing considerations D/C gradually Always use at the smallest dose possible for the shortest time possible Stay away from IV – go for the least invasive route
Somatotropin Growth Hormone; secreted by the pituitary gland; Administered prior to the closure of the growth plates or is not effective
Growth Hormone Medications for Dwarfism in Children Somatrem (Protopin) Somatropin (Humantrope) Not approved to stimulate growth in short children
Antidiuretic Hormone Increases water absorption by kidneys…conserves water in body Also called vasopressin…raises blood pressure if secreted in large amounts Diabetes insipidus - deficiency of ADH Massive amounts of urination
Diabetes Insipidus TX Vasopressin (Pitressin) Desmopressin used for enuresis (bed wetting) - nasal spray
Cancer characterized by abnormal, uncontrolled cell division
Cancer cells Lose normal functions Invade surrounding cells Can metastasize- the abnormal cells travel to distant sites where they populate new tumors
Adenoma benign tumor of glandular tissue
Lipoma benign tumor of adipose tissue
Malignant Tumors Rapid growth, can easily metastasize Resistant to treatment Can results in death
Carcinoma any malignant tumor derived from epithlial
Sarcoma tumor from connective tissue (bone, fat, muscle, etc)
Leukemia blood-forming cells
Lymphoma lymphatic tissue
Glioma central nervous system
Associated with a higher risk of acquiring cancer Smoke Environment Sun Dietary HPV
Chemicals in tobacco smoke Responsible for one-third of all cancers
chemical carcinogens associated with the workplace Asbestos - lung cancer Benzene - leukemia
Physical Factors Associated with Cancer Exposure to large amounts of x-rays - leukemia Ultraviolet (UV) light from the sun - skin cancer
Biological Factors Viruses - associated with 15% of all human cancers; Examples - herpes simplex viruses types I and II, Epstein-Barr virus, papillomavirus, cytomegalovirus; Immune system suppression (HIV patients Transplant patients)
Oncogenes predispose client to certain cancers
Healthy Lifestyle Habits to Lower CA Risk Eliminate tobacco use and exposure to secondhand smoke Limit/eliminate alcohol use Reduce animal fats in diet Increase fiber in diet - plant sources Exercise regularly Keep weight within normal guidelines Exam body monthly for abnormal lumps and ski
Radiation Therapy High doses of ionizing radiation aimed directly at tumor May follow surgery Sometimes used for palliation with inoperable cancers - shrink size of tumor Relieve pain, difficulty breathing or swallowing
Chemotherapy Transported through blood - potential to reach every cancer cell Some drugs cross blood-brain barrier - treat brain tumors Some drugs instilled directly into body cavities - treat bladder cancers Different classes affect different stages of the cancer’
Cancer drug classifications Alkylating agents Antimetabolites Antitumor antibiotics Plant alkaloids/natural products Hormones and hormone blockers Biologic response modifiers Miscellaneous drugs
Alkylating Agents Most widely used antineoplastic drugs; Act by chemically binding to nucleic acids (DNA) and inhibiting cell division; Cyclophosphamide (Cytoxan)
Antimetabolites Are drugs that chemically resemble essential building blocks of the cell; When CA cells attempt to construct proteins or DNA, they use the antimetabolite drug instead of the normal building blocks - This disrupts metabolic pathways; Methotrexate(Mexate)
Other uses for Antimetabolites Rheumatoid arthritis Psoriasis Ectopic pregnancy M.S.
Antitumor Antibiotics Not widely prescribed because of their cytotoxicity, but very effective against certain tumors; Cardio toxic; Doxorubicin (Adriamycin)
Plant alkaloids/natural products Chemicals with antineoplastic activity have been isolated from a number of plants - Derived from the periwinkle plant; Vincristine (Oncovin)
Hormones and Hormone blockers Used to slow the growth of hormone-dependent tumors (reproductive hormones); Anti-estrogen blocker chemo used for breast cancer - Many take is prophalaxis; Tamoxifen (Nolvadex)
Biologic Response Modifiers Biologic response modifiers stimulate the body’s immune system No not kill CA cells directly, but stimulate the body’s immune system to fight the CA; Interferon alfa 2 (RoferoneA, Intron A)
Miscellaneous Anticancer Drugs Some other miscellaneous drugs given to limit or counteract the toxicity of antineoplastics Epoetin alfa (Epogen, Procrit)- stimulates RB production to limit anemia
Created by: MarieG