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pharmacolgy test 4 > 4 > Flashcards

4 Flashcards

1
Q
  • group of disorders that involve a chronic stereotyped recurrent attack of involuntary behavior or experience or changes in neurologic function caused by electrical activity in the brain that can be recorded via an EEG
A

epilepsey

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2
Q

Each eppileptic episode is termed as a

A

seizure

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3
Q

causes of epilepsey

A
  • infection
  • trauma
  • genetic or birth influences
  • fever
  • metabolic/nutritional alterations
  • neoplasms
  • hereditary
  • degenerative diseases
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4
Q

2 major groups of seizures

A

partial and generalized

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5
Q

simple and complex

A

partial

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6
Q

tonic clonic and absense

A

generalized

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7
Q

consciousness is lost in

A

both types of seizures

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8
Q

petit mal

A

absense

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9
Q

what is a brief loss of consciousness with characteristic EEG waves and little movement

A

peitit mal

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10
Q

petit mal usually begin

A

in childhood

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11
Q

when you have a case of petit mal you are usually

A

unaware that the seizure is happening

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12
Q

no aura or postical state in

A

petit mal

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13
Q

drug of choice for tx for petit mal is

A

ethosuximide or valporic acid

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14
Q

grand mal

A

tonic clonic

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15
Q

in tonic clonic there are

A

long period of unconsciosnes

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16
Q
  • seizure begins by patient becoming rigid and falling to the ground, then jerking begins, finally the patient becomes limp and comatose
  • consciousness returns gradually => confusion, headache, drowsy
A

tonic clonic

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17
Q

drugs used to treat grand mal are

A
  • Valproic acid, phenytoin (Dilantin), Phenobarbital, and carbamazepine
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18
Q
  • Continuous tonic-clonic seizures lasting longer than 30 min. or reoccur before the end of the previous seizure
    • an emergency situation
  • rapid therapy is required
A

status epilepticus

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19
Q

drug of choice for status is

A
  • Parenteral benzodiazepines (Valium [diazepam])
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20
Q

the goal of - Parenteral benzodiazepines (Valium [diazepam]) for status epileptiucsu is

A
  • goal is to control seizures and minimize potential adverse reactions
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21
Q
  • anticonvulsants are CNS depressants that attempt to prevent
A

epileptic seizures without causing excessive drowsiness

- usually taken for life

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22
Q

Carbamzepine

A

tegretol

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23
Q

valproates

A

depakote

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24
Q

phenytoin

A

dilantin

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25
Q
  • Used to treat convulsions
  • Used in dentistry to treat trigeminal neuralgia (tic douloureux)
  • CNS depression and GI tract problems are common side effects
A
  • Carbamazepine (Tegretol)
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26
Q
  • Sedation and drowsiness
  • Deaths have been reported due to hepatic failure
  • Hepatic function tests should be performed
  • bleeding time may be prolonged
  • additive CNS depressant effect
A
  • Valproates (Depakote)
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27
Q
  • Most common barbiturate used in the treatment of epilepsy
  • Used alone or in combination with phenytoin (Dilantin)
  • Used to treat tonic-clonic and partial seizures
  • Most common side effect is sedation
A

phenobarital

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28
Q

most common barbiurate used in epilepsey

A

phenobarbitol

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29
Q

most commonly used hydantoin

A

phenytoin dilantin

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30
Q

phenytoin dilantin is associated with

A

gingival enlargement greater than 50 percent of chronic users

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31
Q

phenytoin dilantin is used to treat both

A

tonic clonic and partial seizures

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32
Q

what can be used to treat trigeminal neuralgia

A

phentyoin

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33
Q

You must monitor blood levels of drug with

A

phentoyoin

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34
Q

some patients when taking phenytoin experiene

A

hirustism

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35
Q

excess hairness of the trunk or face

A

hiristism

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36
Q

term given to the congenital abnormality associated with maternal ingestion of phenytoin

A

fetal hydantoin syndrome

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37
Q
  • Craniofacial anomalies, mirocephaly, limb defects, growth deficiency, and mental retardation
A

fetal hydantoin syndrome

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38
Q
  • management of gingival enlargement includes:
A
  • discontinue phenytoin
  • improve oral hygiene
  • gingivectomy => surgical elimination
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39
Q

management of patient expeirncing tonic clonic seizures

A
  1. moving patient to the floor
  2. tilting the patients head to one side to prevent aspiration
  3. remove objects from the patients mouth
  4. Vitals
  5. 911 if needed
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40
Q
  • occurs naturally in the body, are produced by many tissues, and are formed by the tissues on which they act
A

autacoids

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41
Q

autoscoid antagonists include

A
  1. H1 – H2 receptor blockers
  2. eicosanoids (prostaglandins, thromboxanes, and leukotrienes)
  3. serotonin agonists
  4. angiotensin inhibitors
  5. cytokinins
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42
Q

where is histamine stored

A

in the mast cells in the intestinal mucosa and in the CNS

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43
Q

histamine is released from tissues in body by

A

normal reactions
abnormal reactions
administration of certian drugs

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44
Q

h1 agonist effets of histamine

A
  1. vasodilation
  2. increased capillary permeability
  3. bronchoconstriction
  4. pain or itching in cutaneous nerve endings
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45
Q

h2 agonist effects of histamine

A
  • Increased gastric acid secretion

serious

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46
Q

adverse reactions of h2 agonist histamine

A

anaphalayxis

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47
Q

drug of choice for anaphylasix is

A

epinephrine parenterally

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48
Q

h2 agonist

A
  • (epi => dilates bronchioles via B2 receptors)
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49
Q

Antihistamines (H1 – Receptor Antagonists)

A
  • antihistamines are agents that are H1 – blockers (prevent or blocks action of histamine)
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50
Q

4 common antihistamines

A
  • diphenhydramine (Benadryl)
  • chlorpheniramine (Chlor – Trimeton)
  • promethazine (Phenergan)
  • loratidine (Claritin)
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51
Q
  • diphenhydramine
A

benadryl

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52
Q
  • chlorpheniramine
A

chlor- trimeton

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53
Q
  • promethazine (
A

phenergran

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54
Q

loratine

A

claritin

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55
Q
  • the H1 – antagonists competitively block or anttagonize histamines effect at:
A
  1. Capillary permeability => less tissues edema
  2. vascular smooth muscle => blocks the dilation of the vascular smooth muscle
  3. bronchial smooth muscle => bronchodilator
  4. nerve endings => suppresses pain and itching
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56
Q

less tissue edema

A

capillary permeability

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57
Q

blocks the dilation of the vascular smooth muscle

A

vascular smooth muscle

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58
Q

bronchodilator

A

broncial smooth muscle

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59
Q

suppress pain and itchinb

A

nerve ending

can produce sedation

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60
Q

principle agent used in OTC sleep aids (Sominex, Nytol)

A

diphendyramine

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61
Q
  • used to treat motion sickness

- also used to treat allergic rhinitis/seasonal hay fever; urticarial attacks (itching)

A
  • meclizine (Dramamine)
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62
Q

meclinzine

A

dramamine

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63
Q
  • they do not cross the blood-brain barrier therefore, no sedation
  • usually more expensive
A

Peripheral (Nonsedating) H1 – Receptor Antagonists

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64
Q

peripheral

A

nonsedating

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65
Q

developed to replace seldane

A

fexofendaine *allegra

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66
Q

fexofendaine

A

allegra

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67
Q

duation of action is 1 2 hours for

A

fexofendaine

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68
Q

doage is 60 mg 2 times a day for

A

fexofenaindeine

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69
Q

astemizole

A

hismanal

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70
Q
  • Non-sedating
  • MUST be taken on an empty stomach

has been taken off markey

A

astemizole

hismanal

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71
Q

astemizole is inhibited by

A

erythromycin/ketoconazole

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72
Q
  • Non-sedating

- Duration of action is 24 hours

A

loratidine claritin

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73
Q
  • Recently released
  • Seasonal rhinitis
  • Duration 24 hours
A

cetizirine zyrtec

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74
Q

cetirizine

A

zyrtec

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75
Q

h2 blocking agents

A
  • Cimetidine (Tagamet)
  • Used for GI problems (acid reflux)
    - Zantac, Pepcid,Axid
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76
Q

a group of agents secreted by the adrenal cortex

- uses in dentistry:

A

adrenocorticosteroids

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77
Q
  • used topically or systemically for the treatment of oral lesions associated with inflammatory diseases
A

adrenocorticossteroids

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78
Q

2 major groups of adreno

A

glucocorticoids

mineralcorticoids

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79
Q

affect intermediate carbohydrate metabolism

A

glucocroticoids

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80
Q

affects the water and electrolyte composition of the body

- the major glucocorticoid present in the body is CORTISOL (hydrocortisone)

A

mineral coritcrotioids

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81
Q

disease produced by a deficiency of adrenocorticosteroids

A

addisons disease

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82
Q

components released from adrenal cortex, which includes glucocorticoids/mineralocorticoids

A

adrenocorticosteroidss

corticosteroids

steroids

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83
Q

agent secreted by the pituitary that causes the release of hormones from the adrenal cortex

A

Adrenocorticotropic hormone (ACTH)

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84
Q

disease caused by an excess of adrenocorticosteroids

- characterized by “moon facies”, buffalo hump (fat deposited on back of the neck) and weight gain

A

cushings syndrome

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85
Q

affects carbohydrate metabolism

A

glucocorticoids

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86
Q

affects the body’s sodium and water balance (fluid levels)

A

mineralcorticoids

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87
Q

are pallative rather than curative

A

corticosteroids

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88
Q

most extenisive use of coritcosteroids in medinine and dentistry is in the tx

A

of a wide variety of inflammatory allergic conditions

- rheumatoid arthritis, rheumatic fever, lupus, acute bronchial asthma, and severe and acute allergic reactions

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89
Q

is the most common corticosteroid used orally

A

prednisone

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90
Q
  • Topical corticosteroids:
A
  • Hydrocortisone (weakest)
  • Triamcinolone (in between)
  • Augmented betamethasone (most potent)
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91
Q
  • adrenocorticosteroids stimulate acid secretion
A

cautions with ulcer patients

- can exacerbate hypertension

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92
Q

are essential in small quantities for the maintenance of cell structure and
metabolism

A

vitamins

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93
Q

vitamins are

  • they are a group of low-molecular-weight compounds
  • classified into 2 groups:
A
  1. water soluble => vitamins B and C

2. fat soluble => vitamins A, D, E, and K

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94
Q

water soluable

A

b and c

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95
Q

fat soluable

A

a d e k

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96
Q

vitamins act in three ways

A
  1. as coenzymes => water soluble vitamins
  2. as antioxidants => vitamins C & E
  3. as hormones => vitamin A & D
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97
Q

co enzymes

A

water soluable vitamins

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98
Q

antioxidants

A

c and e

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99
Q

hormones

A

a and a

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100
Q

ascorbic acid

A

vitamin c

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101
Q

vitamin c natural sources

A
  • Citrus fruits, green peppers, tomatoes, strawberries, broccoli, raw cabbage, baked potatoes, and papaya
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102
Q

vitamin c is readily destroyed

A

by cooking

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103
Q

RDA for vitamin c is

A

60 mg

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104
Q

required for collagen and wound healing

A

vitamin c

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105
Q

definiecny of vitamin c

A

scurvy

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106
Q
  • Functions of Vitamin C are:
A
  • Collagen formation

- Sythesis of epinephrine/norepinephrine

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107
Q

excess intake of c can

A

intake (1 gm/day) can lead to precipitation of oxalate stones in the urinary tract (kidney stones)
- enhances the absorption of Iron (Fe

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108
Q
  • Thiamine (Vit. B1)
A
  • Pork, whole-grain breads, cereals, pasta, peas, dried brewer’s yeast
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109
Q

thiamine b1 is destroyed by heat greater than

A

100

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110
Q
  • RDA => adult – 1.5 mg (males), 1.1 mg (females)
A

b1

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111
Q

definecny of b1 leads to

A

beriberi - Peripheral neuritis, muscle weakness, paralysis of limbs, enlargement of heart, tachycardia
- oral manifestations

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112
Q

burning tongue with

A

b1 thimanine

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113
Q

most common use of thamine deficiecy is

A

alcholism

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114
Q
  • Wernicke’s encephalopathy/Korsakoff’s associate with
A

b1 thiamine

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115
Q
  • Wernicke’s encephalopathy/Korsakoff’s
A

severe deficiency

- thiamine has also been used as an insect repellant

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116
Q

riboflavin

A

vitamin b2

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117
Q

riboflavin b2 is

A

h20 soluable

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118
Q

best sources for ribovlain b2 is

A

dairy products organ meat liver

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119
Q

what is destroyed by uv radiation

A

b2

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120
Q

RDA range 1.3-1.8

A

b2

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121
Q

b2 maintains integrity of

A

erythrocytes

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122
Q

symptoms of b2 are

A

sore throat and angular cheilitis

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123
Q
  • Most likely seen in alcoholics or patients with severe GI disease causing loss of appetite
A

b2

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124
Q

niacin

A

nicotinic acid

b3

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125
Q

niacin is connected in the body to

A

niacinamide or nicotinamide

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126
Q
  • Deficiency of niacin is called
A

pellegra

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127
Q
  • Sources of niacin are:
A
  • Lean meats, fish, liver, poultry, peas, and whole grains
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128
Q
  • RDA => 15-20 mg
A

b3

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129
Q

pellegra is associated with

A

b3

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130
Q

pellegra can be diagnosed by the three ds

A
  • Dermatitis, diarrhea, and dementia

- burning sensation throughout the mouth and the tongue is beefy red

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131
Q

____ can occur => 1 ASA ½ hour before the niacin is ingested

A

fushing

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132
Q

b3 niacin is useful in the treatment

A

hyperlipidemia

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133
Q

b6

A

pyridoxine

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134
Q

sources of b6

A

whole-grain cereals, meat, peas, eggs

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135
Q
  • RDA => 1.5 – 2 mg/day
A

b6 pyridoxine

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136
Q
  • Vit. — deficiency is rare

- Vit. —is inhibited by isoniazid (INH)

A

b6

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137
Q
  • Is destroyed by heating in neutral or alkaline solution
A

folic acid

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138
Q

folic acid sources are

A
  • Sources => liver, fruits and vegetables, wheat germ, and yeasts
139
Q
  • RDA => 180-200 g (micrograms)
A

folic acid

140
Q

deficiency is the most common deficiency in the US and can produce megaloblastic anemia

A

folic acid

141
Q

causes of def in folic acid

A
  • Causes => inadequate diet, pregnancy, chronic alcoholism
142
Q

allergic reactions are rare in

A

folic acid

143
Q
  • Cyanocobalamin
A

b12

144
Q
  • has a cyanide molecule attached to the cobalt atom
A

Cyanocobalamin

145
Q

vitamin b 12

A
  • only sources of Vit. B12 in nature are certain microorganisms that synthesize the vitamin
  • good sources => liver, meat, milk, cheese, and eggs
146
Q
  • RDA => 2 g (micro) with an additional .2 g and .6 g during pregnancy and lactation
A

b12

147
Q

pernicious anemia is associate with

A

b12

148
Q
  • With pernicious anemia
A

a maintenance injection of B12 is recommended once a month for life

149
Q

is important in the metabolism of fats/carbs

A

b12

150
Q

autoimmune disease that prevents the production of intrinsic factor => blood clotting

A

pernicious anemia

151
Q

burning tongue syndrome

A

b12

152
Q
  • B12 supplement is recommended
A

im route 100/month

153
Q
  • Egg yolk, bran, yeast, and beef liver

- RDA => 5-10 mg

A

panthotenic acid

154
Q

required for gluconeogenesis and synthesis of fatty acids and sterols and steroid hormones

A

panthothenic acid

155
Q
  • It is essential to normal epithelial function
A

panthotehnic acid

156
Q
  • Deficiency is rare but can develop in people with liver disease or alcoholism
A

panthotenic acid

157
Q
  • Necessary for normal growth and for maintaining the health and integrity of certain epithelial tissues
A

vitamin a

158
Q
  • Vit. A represents a group of
A

retinoids and carotenoids

159
Q

a and a 2

A

retinoids

160
Q

retonoids are found in

A

orange colored fruits/veg

161
Q

provide the greatest source of Vit. A in most diets

A

carotenes

162
Q
  • Found in => apricots, peaches, tomatoes, carrots, pumpkins, broccoli, spinach, and sweet taters
A

carotenes

163
Q

rda for vitamin a

A

- RDA => 800-1000 refined equivalents (RE) [800-1000 g]

164
Q

is essential for the maintenance of the photoreceptor mechanism of the retina

A

vitamin a

165
Q

vitamin a

A

prevents or reverses the transformation of premalignant cells to malignant cells

166
Q

a def in vitamin a will lead to

A

night blindness (nyctalopia) => impaired vision in dim light

167
Q

nyctalopia

A

night blindnes

168
Q
  • Excessive intake of Vit. A results in a
A

toxic condition

169
Q

toxic condition

A

hypervitaminosis a only after long term daily digestion of more than 50,000 re

170
Q
  • Use or exposure to ——- during pregnancy can cause serious birth defects => pregnancy category “X”
A

retinoids

171
Q

tretinoin

A

retin a

172
Q

isotretinoin

A

accutane

173
Q

etretinate

A

tegison

174
Q

vit a analouges

A
  • Tretinoin (Retin – A)
  • Acid form of Vit. A
  • Used to treat acne (topically)
  • Isotretinoin (Accutane)
  • Used orally for severe cystic acne
  • Pregnancy category “X”
  • Etretinate (Tegison)
  • Treat severe recalcitrant psoriasis
  • Pregnancy category “X”
  • Lifetime ban for being a blood donor
175
Q

vitamin d is a collective term for

A

d2 and d3

176
Q

produced in the skin of mammals by Sunlight (UV rays)

A

d3

177
Q

ergocalciferol

A

d2

178
Q

the form of vitamin D used in vitamin supplements

A

d2

179
Q
  • RDA => 10 mg (400 IU) => child; 5-10m (200-400 IU) => adults
A

vitamin d

180
Q
  • Promotes mineralization of bone by stimulating intestinal absorption of calcium
A

d

181
Q

def of vitamin d in children is known as

A

rickets

182
Q
  • Usually have bones that are unusually soft and easily bent, compressed, or fractured
  • Curving of the spine and bowing of the legs
  • Collapse of the ribs and protrusion of the sternum (pigeon breast syndrome)
A

rickets

183
Q
  • adult deficiency => in d is
A

osteomalacia

184
Q

decreased bone density in

A

d

185
Q

occurs when the equilibrium between resorption and formation of bone becomes negative

A

osteoporosis

186
Q

osteoporosis vitamin d occurs in

A

thin white female smokers

predisposing to fractures

187
Q
  • recommended calcium intake of ——–mg recommended for post-menopausal
A

1200-1500

188
Q
  • 3 drugs for the management of osteoporosis:
A
  • Fosamax, Etidronate (Didronel), Calcitonin (Miacalcin)
189
Q

etidronate

A

didronel

190
Q

miacalcin

A

calcitonin

191
Q

functions as a antioxidant

A

vitamin e

192
Q
  • Sources => vegetable oils, greens and vegetablesq
A

e

193
Q

rda of e is

A

10-30

194
Q

def of e is

A

anemia

195
Q
  • Dose for protective cardiovascular effect is —IU for vitamin e
A

400

196
Q
  • Occurs in green vegetables => alfalfa, cabbage, spinach, egg yolks, liver
A

k

197
Q
  • RDA => males – 40-80 g; females – 45-65 g
A

k

198
Q

e is assential for four clotting factors

A

(II, VII, IX, and X)

199
Q
  • Antagonized by anticoagulant drugs (warfarin)
A

k

200
Q

iron
zinc
calcium

A

minterals

201
Q

iron

A

fe

202
Q

found as hemoglobin

A

iron

203
Q

____ of the iron in the body is essesential

A

80

204
Q

rgan meats (heart/liver), brewer’s yeast, egg yolks, oysters, red meats, and dried beans

A

iron

205
Q
  • RDA => males – 10 mg/day; females – 15 mg/day
A

iron

206
Q
  • Basic function is to allow movement of O2 and CO2 from one tissue to another
A

iron

207
Q

def of iron is

A

anemia

208
Q

decrease in the quality or quantity of RBC’s

A

anemia

209
Q
  • sources => seafood and meat
  • RDA => 15 mg/day
  • Required to transport CO2 in blood and eliminate it in the lungs
  • Deficiency can affect reproduction and can stunt growth
A

zinc

210
Q
  • 5th most prevalent element in the body
A

calcium

211
Q

calcium is in

A
  • present in bones, teeth, and extracellular fluids
212
Q
  • RDA => 800-1500 mg
A

calcium

213
Q

caclicum can be

A
  • Can be used parenterally to elevate serum calcium in an emergency
  • Also used during CPR, treatment of hyperkalemia, and hypermagnesemia
214
Q

patients taking dilantin may exhibit

A

vitamin d def

215
Q

are secreted by endocrine glands

- pituitary, thyroid, parathyroid, pancreas, adrenals, gonads

A

hormones

216
Q

s a small endocrine gland located at the base of the brain

A

pituitary gland

217
Q
  • Called the “master gland” => regulates effect on other endocrine glands and organs of the body
A

pituitary gland

218
Q

pituitary gland definicieny is

A
  • deficiency is known as hypopituitarism
  • produces decreased metabolism - Addison’s disease
  • dwarfism - decreased libido
  • diabetes - retarded dental
  • hypothyroidism development
219
Q
  • hypersecretion of pituitary hormones can produce
A
  • sexual precocity (premature development)
  • goiter
  • Cushing’s disease
  • Acromegaly
  • Gigantism
220
Q

premature development

A

sexual precocity

221
Q

growth hormone

A

somaotropin

222
Q
  • Secretes growth hormone (somatotropin), luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH)
  • FSH/LH used in the treatment of infertility
A

anterior piuitary

223
Q

posteriour pituiatry secretes two hormones

A

vasopression and oxytocin

224
Q

used for the treatment of transient diabetes insipidus

A

vasopression

225
Q

used to induce labor, control postpartum hemorrhage, and induce postpartum lactation

A

oxytocin

226
Q
  • Thyroid gland secretes 2 iodine containing thyroid hormones:
A
  • Thiiodothyronine (T3) and tetraiodothyronine (T4 – thyroxine)
227
Q
  • 50-125 mg/day
  • iodine deficiency is known as goiter
  • marine life is the only common food that is naturally rich in iodine
  • use of iodized salt has lead to a decrease in goiter
A

iodine

228
Q
  • Thyroid hormones are synthesized from
A

iodine and tyrosine

tsh stimulates release

229
Q

also secreted by the thyroid, regulates calcium metabolism

A

calcitonin

230
Q
  • Hypofunction of the thyroid in
A

cretinism

231
Q
  • Hypofunction of the thyroid in
A

myxedema

232
Q
  • Main characteristics are mental/physical retardation
A

hypthyroidism

233
Q
  • Most commonly used hormone for replacement therapy
A

levothyroxine (synthroid)

234
Q

cold intolerancle with

A

hypthyroidism

235
Q

2 forms of hypthyroidism

A

graves and plummer

236
Q

diffuse toxic goiter => enlarged, highly vascular

A

graves

237
Q

toxic nodular goiter => nodules within gland

A

plummer

238
Q
  • heat intolerance
  • exophthalmos (protruding eyes)
  • excess levels of circulating thyroid hormone produce thyrotoxicosis
  • the use of epinephrine should be avoided if poorly treated or untreated thyrotoxic patients => arrhythmias and cardiac arrest
A

hyperthyroidism

239
Q
  • treatment of hyperthyroidism:
A
  1. radioactive iodine 131I \ both will create hypothyroidism
  2. thyroidectomy / (Tx with synthroid after)
240
Q
  • 2 1 hormones secreted by the islets of Langerhans if the pancrease are:
A
  • insulin (fuel storage) + glucogon (fuel mobilization)
241
Q

insulin

A

fuel storage

242
Q

glucogon

A

fuel mobilzation

243
Q
  • insulin (fuel storage) + glucogon (fuel mobilization)
A

diabete mellitus

244
Q

classes of diabete mellitus

A
  • Classifications:
  • Type I (IDDM)
  • Type II (NIDDM)
245
Q
  • new criteria for the diagnosis of DM is 2 consecutive fasting blood sugars of greater than — mg/dL
A

126

246
Q

3 ps in diabetes mellitus

A
  • 3 P’s => polyphagia, polydipsia, and polyuria
247
Q

type 1

iddm

A
  • Usually in patients younger than 30 years
  • Results from an autoimmune destruction of the pancreatic  cells
  • Complete lack of insulin secretion
  • Without insulin => FATAL
  • Tx with injections of insulin
248
Q

type 2 niddm

A
  • Older than 40 years
  • Pancrease secretes enough insulin to prevent Ketoacidosis, but not enough to normalize plasma glucose
  • Type II has a slower onset, less severe symptoms, lack of Ketoacidosis
  • Treated first with diet and exercise, then oral agents, and then insulin
249
Q
  • complications of diabetes:
A
  • susceptible to dental caries
  • xerostomia
  • periodontal disease
  • delayed wound healing
  • can cause blindness
  • gangrene => feet/legs
250
Q

measure of the patients glucose control at the time that the blood is sampled

A

serum gluclose

251
Q
  • Tx of hypoglycemia
A
  • Awake => fruit juice, cake icing, glucose gel

- Unconscious => IV dextrose (50%)

252
Q
  • Insulin

- Administered by

A

sq injection

  • Insulin
  • Administered by
253
Q

nph

A

neutral protein hagedorn

assoc with inslunin

254
Q
  • Lowers blood glucose but used alone, does not produce hypoglycemia
  • Dose 500-2550 mg divided into 2-3 daily doses
A

glucophage

255
Q
  • Increases the breakdown of glycogen to glucose, elevating blood glucose
A

glucagen

256
Q
  • disease treated are asthma, COPD, and upper respiratory tract infections
A

respiratory drugs

257
Q

patients have a persistent life-threatening bronchospasm despite drug therapy

A

status asthmaticus

258
Q
  • Reversible airway obstruction with inflammation

- Precipitated by: allergens, exercise, stress, and upper respiratory infections

A

asthmas

259
Q

copdd

A

chronic obstructive pulmonary disease

260
Q
  • Irreversible airway obstruction associated with chronic bronchitis or emphysema
A

copd

261
Q

is associated with almost all COPD’s

A

smoking

262
Q

is a result of chronic inflammation of the airways and excessive sputum production

A

chronic bronchitis

263
Q

is a result of chronic inflammation of the airways and excessive sputum production

A

emphysema

264
Q

sympathomietic agents

A

adrenergic agonists

265
Q
  • produce bronchodilation by stimulation of  receptors in the lungs
A

sympathomeitic agents

266
Q

drugs used to treat respiratory disease

symp agents

A

non selective

selective
sustained b

267
Q

a. epinephrine and isoproterenol => bronchodilation by stimulating 2 – receptors

A

nonseletive non specific b

268
Q

a. albuterol => inhalation or orally
b. 1st line of Tx for asthma
c. drugs of choice for emergency Tx of acute asthma attack

A

selective specific b2

269
Q

a. salmeterol (serevent) => new
b. onset is delayed and duration lasts approx. 12 hours
c. NOT used for management of acute asthma attack
i. Onset 10-20 min

A

sustained b

270
Q

mdi

A

metered dose inhalers

271
Q

mdi advantages

A
  • Delivers the medication directly into the bronchioles
  • Bronchodilator effect is greater than a comparable oral dose
  • Inhaled dose can be accurately measured
  • Onset of action is rapid
  • MDI’s are compact, portable, and sterile
272
Q

disadvaages of mdi

A
  • difficult to use properly

- can be abused

273
Q
  • medications available in MDI’s:
A
  •  - agonists
  • corticosteroids
  • cromolyn
  • Ipratropium and Leukotriene – blocking drugs
274
Q

common inhalers include

A

beclomethasone, triamcinolone, and fluticasone

275
Q

treat asthmas

A

corticosteroids

276
Q
  • Candidiasis can result from chronic use
A

cortic

277
Q
  • Usually added to the treatment regimen when asthmatic patients uses more than 3 inhalations of albuterol weekly
A

corticoster

278
Q

reduces inflammation within nasal cavities

A
  • Beclomethasone (Vancenase)
279
Q

beclomethasone

A

vancenase

280
Q

pathway inhibitors

A

leuokttriene
zafiruklast
cromolyn

281
Q

produce bronchoconstriction

A

leukotrienes

282
Q

is an example of leuko

A
  • Zafirlukast (Accolate) is an example

- Increases the effect of warfarin

283
Q

cromolyn

A

nasal crom

284
Q

least toixic of al asthma meds

A

cromolyn nasalcrom

285
Q
  • effective only for the prophylaxis of asthma
  • prevents the antigen induced release of histamine, leukotrienes, and other substances from sensitized mast cells
  • least toxic of all asthma medications
  • available OTC for allergic rhinitis
A

cromolyn nasalcrom

286
Q
  • Consists of theophylline (Theo-Dur), caffeine, and theobromine
A

methyxanthines

287
Q
  • Theophylline used to treat
A

chronic asthma, chronic bronchitis, and emphysema

288
Q
  • Erythromycin can increase serum levels of —–e => toxicity
A

theophylline

289
Q

is an old remedy for asthma

A

atropine

290
Q

ipratropium

A

atrovent

291
Q

drugof choice for copd

A

ipratropium

292
Q
  • Low lipid solubility makes it bronchoselective
  • Minimized side effects
  • Drug of choice for COPD
A

ipratriprium

293
Q

upper respiratorany agents

A 
nasal decongestants
expectorants
acetylcysteine
antitussives
detrometorphan
294
Q

drugs promoting the removal of exudates or mucus from the respiratory passages

A

expectorants

295
Q

destroy or dissolve mucus

A

mucolytics

296
Q

Robitussin)

- Most popular expectorant

A

guaifensestin

297
Q

musmomyst

A

acetylcysteine

298
Q
  • Loosens secretions in pulmonary diseases

- Used orally as an antidote for acetaminophen toxicity

A

acetyclinsteine

299
Q
  • May be opioids or related agents used for the symptomatic relief of non productive cough
A

antitussives

300
Q
  • The DM in cough medicines (Robitussin DM)

- Opioid-like compound suppressing the cough reflex by its direct effect on the cough center

A

dextromethrophan

301
Q

gastrointensital drugs

A

ucler and gerd

302
Q

GERD gastroesophael reflux disease

A
  • “heart burn”
  • most prevalent GI disease in the US
  • stomach contents flow backward through the cardiac sphincter, up into the esophagus (esophagitis)
  • can be interpreted as a heart attack
303
Q

gerd treated in 2 ways

A
  • treated in 2 ways:
    1. decrease the acid in the stomach
    2. constrict the cardiac sphincter
  • antacids are used for acute relief of symptoms
304
Q
  • Occur in stomach or small intestines
  • Most related to the organism Helicobacter Pylori
  • Some develop as a result of chronic NSAID use
A

ulcers

305
Q

drugs to treat gi disase

A

histamine, ppi, antacids, simethicone, antiemetics

306
Q
  • Block and inhibit basal and nocturnal gastric acid secretion
  • Cimetidine (Tagamet) is prototype
  • Axid, Pepcid, and Zantac => all OTC now
  • Smoking increase acid production and reduces the effects of H2 – blockers
A

histmaine 2

307
Q
  • Omeprazole (Prilosec) => 1st PPI
  • Potent inhibitor of gastric acid secretion
  • Nexium
A

ppi

protion pump inhibitors

308
Q
  • Acute Gastritis => most common type => heart burn or upset stomach
  • Partially neutralize hydrochloric acid in the stomach
  • Sodium bicarbonate rapidly neutralizes gastric acid
  • Preferred antacid ingredients => calcium carbonate, aluminum and magnesium salts, and magnesium-aluminum hydroxide gels
  • Rolaids, Tums, Gaviscon, Mylanta, Maalox, etc.
A

antacids

309
Q

simethicone

A

mylicon gas x

310
Q
  • Used to relieve flatulence (gas
A

simethicone

311
Q
  • Used to control nausea
  • Promethazine (Phenergan) and prochlorperazine (Compazine)
  • Dimenhydrinate (Dramamine)/meclizine (Bonine) => motion sickness
A

antiemetics

312
Q
  • The most critical time for the fetus is developing.
  • Administered drugs may cause severe birth defects.
  • Dental tx: Intra/extraoral examination after completion of medical/dental history, dental prophylaxis, oral hygiene instructions. No radiographs unless absolutely necessary.
  • Avoid elective dental treatment.
  • Nursing shortly after the mother has taken a drug orally will produce the least potential problems in the infant.
  • Nursing is contraindicated if certain drugs are ingested. Breast milk must be expressed and discarded.
A

first trimesters

313
Q
  • The most optimal time for dental treatment to be completed.
  • Comprehensive dental care may be performed – dental radiographs should be avoided if possible
A

second tri

314
Q
  • It may be uncomfortable for the patient to lie flat on their back.

FDA Pregnancy Categories – A, B, C, D, and X

A

third tri

315
Q
  • Nursing shortly after the mother has taken a drug orally will produce the least potential problems in the infant.
  • Nursing is contraindicated if certain drugs are ingested. Breast milk must be expressed and discarded.
A

true

316
Q

local anesthitics may

A
  • May cause fetal bradycardia if administered in large doses.
  • May cause fetal bradycardia if administered in large doses.
317
Q

lidocaine is a cat

A

b

318
Q

has been shown to be teratogenic in rats and rabbits (category C).

A

bupivacaine

319
Q
  • Mepivacaine and procaine have not been tested thus designated as category
A

c

320
Q

is the local anesthetic of choice for the pregnant woman.

A

lidocaine

321
Q
  • Does not produce adverse affects in the fetus if small doses are administered.
  • vasoconstrictor should not be utilized for short appointments.
A

epinephrine

322
Q

Used in the lowest possible dose, for the shortest amount of time.

A

anagelisics

323
Q

Aspirin – Studies in animals suggest that aspirin:

A
  • May cause birth defects involving the eyes, CNS, GIT, and skeleton.
  • Well controlled studies in humans have not demonstrated the aspirin increases the incidence of birth defects.
  • Use of aspirin during the third trimester may prolong gestation, complicate delivery and increase the risk of maternal or fetal hemorrhage.
324
Q
  • Produce effects similar to aspirin, may complicate delivery.
A

nonsteroidal anti inflm agents

325
Q
  • Ibuprofen is designated as
A

category B and is the NSAIA of choice for the nursing mother.

326
Q
  • No controlled human studies have been performed; may be associated with fetal renal changes in large doses.
A

acetaminphen

327
Q
  • Other than codeine, the opioids have not been associated with teratogenicity.
A

true

328
Q
  • Use of codeine in the first trimester may lead to abnormalities in the respiratory, gastrointestinal, cardiac, and circulatory system as well as cleft lip and palate.
A

true

329
Q

near term use of opoids may produce

A

resp depression in the infant

330
Q
  • Should be used only when there is definite indication.
A

antiinfective agent

331
Q

penicillin a

A
  • Should be used only when there is definite indication.
332
Q
  • Other than the estolate form, appears to be safe for use during pregnancy.qerythromycin
A

erythromyic

333
Q
  • Not associated with teratogenicity, however, should not be used unless specific indications exist.
A

cephalosprins

334
Q
  • Contraindicated during pregnancy because of adverse affects to the fetus.
  • Cross the placenta and are deposited in fetal teeth and bone.
  • Deciduous teeth become stained and fetal bone growth inhibited.
  • Not known if amount excreted in nursing mother is enough to harm the infant.
A

tetra

335
Q
  • Should be used only for bacteria resistant to penicillin.
A

clindimyicn

336
Q
  • Contraindicated in the first trimester.
  • If the drug must be administered to a nursing mother, the breast milk should be expressed and discarded. During treatment and forty-eight hours after the last dose.
A

metroniadizole

337
Q
  • Safely administered during pregnancy to treat oral candida infections.
  • Not well absorbed into the systemic circulation when taken orally or topically.
A

nystatin

338
Q
  • No adverse reactions noted but nystatin is more likely safer.
A

clotrimazole

339
Q
  • Teratogenic in animals; producing abnormal number of digits.
  • If it must be used in nursing mothers, breast milk should be expressed and discarded during therapy and for 72 hours after ingesting the last dose.
A

ketoconazole

340
Q

antianxiety agents

A

nitrous oxide
benzodipines
barbituas

341
Q
  • Chronic exposure to trace amounts are associated with higher rates of spontaneous abortion and birth defects regardless of whether a man or woman was exposed.
A

nitrous oxide

342
Q
  • Use in the first trimester may lead to an increased risk of congenital malformations such as cleft palate, cleft lip, and neural tube defects.
  • Benzodiazepines are indicated for use during pregnancy only for the treatment of status epilepticus.
  • Chronic ingestion may produce fetal addiction, floppy infant syndrome or neonatal flaccidity.
  • Not recommended for nursing mothers.
A

benzodiapines

343
Q
  • Phenobarbital is thought to be teratogenic.

- May be safe for nursing mothers, look for signs of sedation in the infant.

A

barbiturates

344
Q

alchol

A
  • Strong evidence it is teratogenic.
  • Fetal Alcohol Syndrome is associated with changes that occur in an infant exposed to excessive intake of alcohol by the mother. Involves abnormalities in growth retardation, CNS abnormalities, and facial dysmorphology (microcephaly, microphthalmia, short palpebral fissures, and thin lips). Also show more tremors, hypertonia( muscle spasms), restlessness, crying, and abnormal reflexes.

pharmacolgy test 4 (1 decks)

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