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Pharm II - Week 6
Bone and Joints
| Question | Answer |
|---|---|
| Zostrix and Icy Hot are also known as ____, which is essentially _____ | Capsaicin! Chili pepper |
| Capsaicin interferes with ____ transmission and changes _____ channels and _____ transport | Pain; Na channels, Ca transports |
| True or false: capsaicin is good for muscle and joint pain, but not for nerves since the spiciness will actually cause pain | False. Good for nerve pain too |
| Calvin and Hobbes discover a capsaicin-based cream. Hobbes has paw pain, so he decides to apply it onto his hands. How long should he keep the cream on? | 30 minutes max. Wash hands after |
| Hobbes' paws are starting to burn like crazy. Calvin folds his arms and says smugly, "Well, I don't have to take that!" Is Calvin correct? | Yes, capsaicin not meant for children |
| Hobbes thinks the capsaicin cream burns too much. He's panicking. The nurse tells him he should do what next? | Wash with soapy water and use a lower concentration next time |
| Calvin's dad has back pain and uses Icy Hot. But he grumbles that the useless thing doesn't work! How should the RN respond? | Capsaicin-based medications may take 1-2 weeks to relieve pain |
| List at least four drugs affecting Calcium levels and bone mineralization | Calcium, Vit D, Biphosphates, Teriparatide |
| What is the total serum Ca level range? | 9-10.5 mg/dL |
| While giving report, you mention your pt.'s Ca is out of whack. Your clinical instructor says, "Calcium is regulated by multiple things. What else could be out of whack?" You answer smartly, | 1) absorption of intestines, 2) renal excretion, 3) resorption or deposit of Ca in bone |
| A nursing student decides she needs to add more Ca to her diet! She takes chocolate chewy supplements and feels very proud of herself. What issue is she forgetting? | Calcium taken PO is POORLY absorbed (only 1/3). Calcium absorption increases with parathyroid hormone and vitamin D |
| True or false: 90% of Ca is stored in our bones | False. 98% |
| Serum Ca level will pary with serum ___ (not an electrolyte) | Albumin |
| True or false: If serum album is altered, free/ionized Ca level can be obtained at a higher range (11-12.0 mg/dL) | False! Ionized Ca level obtained at LOWER range: 4.5-6.6 mg/dL |
| Calcium, vitamin D, _____, and _____ are all needed for healthy bones | Parathyroid hormone; Calcitonin |
| What's the difference between osteomalacia, osteopenia, and osteoporosis? | Osteomalacia - soft bones. Osteopenia - lower than normal bone density (common after menopause). Osteoporosis (low bone mass, risk of Fx) |
| True or false: Paget's disease is the result of vitamin D deficiency | False. Rickets is caused by lack of vitamin D |
| A pt. with Paget's disease will have poor _____ bone | Remodeled |
| PO Calcium means _____ _____. | Dietary supplements |
| When giving Ca IV, you would monitor _____ system and give the med ____ | Cardiac; slowly |
| True or false: Vitamin D2 is found in plants | True |
| True or false: Vitamin D3 comes from sunlight. Due to differences in metabolism, D2 and D3 have somewhat different effects. | False. Have similar effects |
| How do you Dx osteoporsis? | Bone density scan (wrist, spine, hip) and FRAX (risk tool by WHO assess Hx, age, gender, wt) |
| The drug of choice for osteoporsis is _____, because they _____ bone _____ | Biphosphates; inhibit bone resorption (which prevents Fx and Tx bone loss) |
| Biphosphates given PO are called _______ and ____. They are given how often? | AlendronATE/Fosamax. IbandronATE/Boniva. Daily or weekly |
| Bisphosphates given IV are called _____. They're given how often? | Zolendronate/Reclast. Once a year. |
| To Tx osteoporsis you would give biphosphates on top of what else? | Ca, Vit D, weight bearing exercises |
| True or false: nowadays longterm estrogen replacement is no longer advised for Px of bone loss | True. It IS used to Tx osteoporsis however! |
| Alendronate (Fosamax) is given ____, and has ____ absorption. | PO, poor |
| True or false: Alendronate/Fosamax should be taken on a full stomach and with lots of water | False. Should be taken on EMPTY stomach with lots of water |
| When a pt. asks why she must stay upright for half an hour after taking Fosamax, the nurse responds, | By sitting upright, it reduces your risk of esophageal ulceration/irritation |
| But HOW does alendronate work??? | Decreases number and activity of osteoclasts. |
| RNs with pts. taking biphosphates should be aware the pt. may present with a _____ | Atypical femur fracture (see ppt.) |
Created by:
choel
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