Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Fludrocortisone

A

affects fluid and electrolytes, causes sodium and water retention, treats adrenal insufficiency and Addison’s disease, aims to help control BP and restore fluid and electrolyte balance

adverse affects: sodium accumulation, potassium depletion

the only drug that has true mineralocorticoid effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fludrocortisone is used in combination with glucocorticoids to replace

A

mineralocorticoid activity in patients who suffer from adrenocortical insufficiency (Addison disease) and to treat salt-losing adrenogenital syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The primary therapeutic outcomes expected from fludrocortisone therapy are

A

control of bp
and
restoration of fluid and electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Premedication assessments for fludrocortisone include

A

indications of electrolyte imbalance
acurate I/O and vitals
signs of infection
baseline assessment for alertness, oriented
ask about previous heartburn, ulcer, or stomach pain
regularly test stools for blood occult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

fludrocortisone dosage

A

PO 0.1 mg daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cortisone or hydrocortisone are also usually administered with fludrocortisone to

A

provide additional glucocorticoid effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fludrocortisone produces marked ______ retention and ________ depletion, which could lead to high blood pressure

A

sodium and water retention
and
potassium depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The major glucocorticoid of the adrenal cortex is

A

cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Glucocorticoids

A

Antiinflammatory, antiallergenic, immunosuppression

used for certain cancers, organ transplant, autoimmune diseases, allergies, shock

Common and serious adverse effects: Electrolyte imbalance, fluid accumulation; susceptibility to infection; behavioral changes for those with a history of mental illness; hyperglycemia; peptic ulcer formation; delayed wound healing; visual disturbances; osteoporosis in the long term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Corticosteroids can mask symptoms of

A

infection, this means that the typical symptoms of an infection (fever for example) may not be seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When glucocorticoids are used to control rheumatoid arthritis, symptom relief is noted within

A

a few days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Glucocorticoids are also effective for immunosuppression in the treatment of

A

certain cancers, organ transplantation, and autoimmune diseases (e.g., lupus erythematosus, dermatomyositis, rheumatoid arthritis); relief of allergic manifestations (e.g., serum sickness, severe hay fever, status asthmaticus); and treatment of shock. They also may be used to treat nausea and vomiting secondary to chemotherapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The primary therapeutic outcomes expected from glucocorticoid therapy are

A
  • Reduced pain and inflammation
  • Minimized shock syndrome and faster recovery
  • Reduced nausea and vomiting associated with chemotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Glucocorticoids are effective in the treatment of certain cancers because of their

A

immunosuppressive properties.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Corticotropin-releasing factor stimulates the release of ____________ from the pituitary gland.

A

adrenocorticotropic hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adrenocorticotropic hormone stimulates the adrenal cortex to secrete ________.

A

cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

As serum levels of cortisol increase, the amount of corticotropin-releasing factor secreted by the hypothalamus is __________.

A

decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Abrupt discontinuation of glucocorticoids may result in ____________ if higher dosages are being received.

A

adrenal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Corticosteroid therapy should be withdrawn _______

A

gradually (steroid taper)

  • Patients who have received corticosteroids for at least 3 weeks must not abruptly discontinue therapy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The time required to decrease glucocorticoids depends on the

A

o Duration of treatment
o Dosage amount
o Mode of administration
o Glucocorticoid being used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Symptoms of abrupt discontinuation of corticosteroids include:

A

 Fever
 Malaise
 Fatigue
 Weakness
 Anorexia
 Nausea
 Orthostatic hypotension
 Dizziness
 Fainting
 Dyspnea
 Hypoglycemia
 Muscle and joint pain
 Possible exacerbation of the disease process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Common and serious adverse effects of glucocorticoids therapy are

A

fluid and electrolyte disturbances
susceptibility to infection
behavioral changes
hyperglycemia
peptic ulcer formation
delayed wound healing
visual disturbances (cataracts)
osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

drug interactions associated with glucocorticoids

A

diuretics (furosemide, bumetanide, thiazides)
warfarin (may alter anticoagulant effects)
oral hypoglycemic agents (may cause hyperglycemia)
rifampin (may enhance metabolism of corticosteroids, reducing therapeutic effect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Synthetic glucocorticoids, also commonly known as _____________, are medications that can be used in clients with decreased adrenal function, such as in adrenal insufficiency; this is also known as Addison disease, and specifically occurs when the adrenal glands don’t make enough endogenous glucocorticoids, so these clients need hormone replacement therapy with synthetic glucocorticoids.

A

corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

__________ and ___________ are endogenous hormones normally produced by the adrenal glands. In clients with impaired adrenal function, these hormones can be administered as replacement therapy.

A

Glucocorticoids and mineralocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

glucocorticoids are used in the treatment of numerous inflammatory conditions, such as

A

asthma, rheumatoid arthritis, and inflammatory bowel disease, as well as preventing organ rejection in transplant recipients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

short-acting glucocorticoids

A

cortisone and hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

intermediate-acting glucocorticoids

A

prednisone, prednisolone, and methylprednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Cortisone needs to be converted into hydrocortisone in the liver in order to be active, so it can only be taken

A

orally

30
Q

hydrocortisone can be given

A

orally, IV, IM, topically

31
Q

Prednisone can only be taken

A

orally

32
Q

prednisolone can be administered

A

orally, IV, or topically

33
Q

methylprednisolone can be given

A

orally, IV, IM, or IA (intra-articularly injected)

34
Q

long-acting glucocorticoids

A

betamethasone and dexamethasone

35
Q

betamethasone and dexamethasone can be taken

A

orally, IV, IM, IA (intra-articularly injected)

betamethasone is also available for topical use

36
Q

Most side effects are related to excess glucocorticoid activity, which can result in iatrogenic Cushing syndrome:

A

mood changes; weight gain predominantly in the back of the neck between the shoulder blades and face, respectively termed buffalo hump and moon facies; skin atrophy and stretch marks; muscle weakness; hyperglycemia; and increased risk of infections.

37
Q

synthetic mineralocorticoids are used to treat conditions where mineralocorticoid levels are low, such as

A

Addison disease and severe congenital adrenal hyperplasia.

38
Q

Fludrocortisone should be used with caution in clients with

A

uncontrolled hypertension, congestive heart failure, hypokalemia, and DM

39
Q

during periods of high stress or illness, the patent will often need to increase their _____________ dose adjustments in order to remain asymptomatic

A

hydrocortisone

40
Q

hydrocortisone therapy is meant to mimic the body’s normal production of cortisol, so they should take the largest dose __________, take the smaller dose __________, and avoid taking the medication in the late afternoon or evenings, when cortisol levels normally decrease.

A

largest dose first thing in the morning

smaller dose in the early afternoon

41
Q

hydrocortisone can lead to

A

hypertension and hypokalemia because of its mineralcorticoid activity

42
Q

Prednisone and other glucocorticoids increase the patient’s risk for developing

A

peptic ulcers

43
Q

early onset adverse associated with the use of prednisolone

A

Hyperglycemia

44
Q

Mineralocorticoids

A

Maintain fluid and electrolyte balance and are used to treat adrenal insufficiency caused by hypopituitarism or Addison’s disease

Fludrocortisone
Aldosterone

45
Q

Glucocorticoids

A

Regulate carbohydrate, protein, and fat metabolism

Glucocorticoids have antiinflammatory, antiallergenic, and immunosuppressant activity.

Cortisone
Hydrocortisone
Prednisone

46
Q

Diseases associated with adrenal glands are

A

Addison’s disease, pheochromocytoma, and hyperpituitarism

47
Q

Premedication assessments for steroids:

A

electrolyte imbalance
i/o, vitals
signs of infection - General malaise, sore throat, low-grade fever
baseline assessment of alertness
hydration
previous treatment for ulcer, heartburn, stomach pain
test stools for occult blood

48
Q

Nursing processes for steroid admin

A

monitor glucose levels, may require insulin
follow body’s normal circadian rhythm (corticosteroids: half dose before 9am, half of dose late afternoon, mineralcorticoids: once daily in evening)
monitor daily weight, i/o
additional dosies may be needed if stress, injury; wear ID bracelet

49
Q

patient education

A

when to call hcp (before a dental procedure, stress dosing)
skin care
stress coping
avoid infections
good nutrition
regular exercise
health maintenance
document

50
Q

All corticosteroids (glucocorticoids and mineralocorticoids) share varying degrees of

A

mineralocorticoid and glucocorticoid effects

51
Q

Should steroids be stopped abruptly?

A

no, may result in adrenal insufficiency

52
Q

Carefully monitor corticosteroid therapy patients with:

A

Diabetes mellitus - for hyperglycemia
Heart failure
Hypertension
Peptic ulcer disease
Mental disturbance - psychotic behavior
Suspected infections - may mask infection signs

53
Q

Corticosteroid Therapy Drug Interactions

A

Diuretics: Corticosteroids may enhance the loss of potassium

Warfarin: Corticosteroids may enhance or decrease the anticoagulant effects of warfarin

Oral hypoglycemic agents or insulin: Diabetics/prediabetic patients must be monitored for hyperglycemia

54
Q

Corticosteroids do cause a ________ in blood sugar, requiring insulin to _______ the blood sugar level.

A

cause an increase

to lower the blood sugar level

55
Q

rapid acting insulin

A

lispro (Humalog), aspart (NovoLog, Fiasp), glulisine (Apidra), duration 3-5 hours

administered IV or SQ

56
Q

short acting insulin

A

regular, duration 5-8 hours

administered IV or SQ

57
Q

intermediate acting insulin

A

NPH (N) duration 12-18 hours

administered SQ

58
Q

long acting insulin

A

glargine (Lantus, Toujeo, Basaglar), detemir (Levemir), degludec (Tresiba), duration 16-24 hours

SQ just before meals, do not mix with other insulins

59
Q

fixed combination insulins

A

Novolin 70/30 has 70% intermediate-acting and 30% short-acting insulin, 2 different insulins with fixed combinations, 1 intermediate acting and 1 rapid or short acting, Patients often take a combination of rapid-acting insulin for surges in glucose after meals and an intermediate for the period between meals, Fixed combos were developed to simplify dosing

60
Q

Basal-Bolus/sliding scale insulins CLO 2

A

Preferred method of treatment for hospitalized patients with DM, Mimics a healthy pancreas by delivering basal insulin constantly as a basal and then as needed as a bolus, Basal insulin is a long-acting insulin (insulin glargine), Bolus insulin is rapid (insulin lispro or insulin aspart,), The basal insulin is a long-acting insulin administered constantly to keep the blood glucose from fluctuating

Bolus insulin is broken up into meal and correction boluses. Meal boluses are given to reduce blood glucose with the intake of carbohydrates. Correction boluses are any boluses given to bring blood glucose levels back to normal.

Requires frequent monitoring of blood glucose levels

61
Q

metformin (Glucophage)

A

OA

biguanides

decreases glucose in the blood, treats type 2DM, can cause lactic acidosis

62
Q

glipizide (Glucotrol)

A

OA

sulfonylureas

lowers blood sugar by causing the pancreas to produce insulin, treats type 2D

63
Q

repaglinide (Prandin)

A

OA

meglitinides

decreases the amount of glucose by stimulating the pancreas to release insulin, treats type 2D

64
Q

pioglitazone (Actos)

A

OA

thiazolidinediones

increasing sensitivity of muscle and fat tissue to insulin, treats type 2D

65
Q

acarbose (Precose)

A

OA

Alpha-glucosidase inhibitor

inhibits/slows enzymes working to digest sugars. Slowing food digestion helps keep blood glucose from rising very high after meals, treats type 2D

66
Q

sitagliptin (Januvia)

A

OA

dipeptidyl petidase IV (DPP-IV) inhibitor

Prolong life of active GLP-1 and GIP incretin hormones. Treats type 2D

67
Q

canagliflozin (Invokana)

A

OA

sodium-glucose contransporter II Inhibitor

drops glucose reabsorbtion, It lowers blood sugar by causing the kidneys to get rid of more glucose in the urine, treats type 2D

68
Q

dulaglutide (Trulicity)

A

OA

incretin mimetic agents (Glucagon-like peptide - I agonists)

Increases serum insulin and reduces glucose concentrations, delays gastric emptying, reduces appetite, treats type 2D, associated with thyroid tumors in animals

69
Q

glucagon

A

OA

antihypolycemic agent

Breaks down stored glycogen to glucose, It works by causing the liver to release stored sugar to the blood,

Administer SC, IM, or IV. Should respond in 5 to 20 minutes; if not, 1 to 2 additional doses

70
Q

The average rate of insulin secretion in an adult is

A

30 to 50 units a day

Pharm 2 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions