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Patho-Pharm > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Migraine HA

A

hormonal
unilateral w/ or w/o aura
sensitive to light, sound
N/V
relief w sleep, worse w exercise

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2
Q

Cluster HA

A

rare, rapid onset
cortisol
behind eye
conjunctival redness, teary, edema, rhinorrhea
affect ADL

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3
Q

Tension HA

A

most common
unk cause (sustained tension of neck & scalp)
transformed migraine
stress, caffeine OD
infrequent, episodic, or chronic
dull, aching, hat band

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4
Q

Chronic Daily HA

A

unk cause (transformed migraine & tension)
>3 mo
rapid onset

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5
Q

TMJ

A

imbalance joint movement bc poor bite, bruxism, joint problems
referred pain
facial muscle pain, HA, neck, ear ache

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6
Q

3 inflammatory responses

A

Acute
Chronic
Systemic

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7
Q

Acute Inflammation

A

early response, protective, short
*Removes agent & repair tissue
Local or Systemic
local (redness, swelling, heat, pain, loss of function)
systemic (increase WBC, fever, lymph node rxn, anorexia/malaise)

*RICE (rest, ice, compress, elevate)

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8
Q

Chronic inflammation

A

persistent
tissue damage from inflammatory cells
autoimmune disorders
precursor to diseases

*moist heat helps
*long term management:
DMARDS
bio agents targeting mediators
lifestyle mod

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9
Q

Systemic inflammation

A

affects entire body
risk of sepsis, septic shock

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10
Q

inflam Mediator roles

A

chemotaxis (guide leukocytes & plasma proteins to site)
clotting
dilate blood vessels / increase blood flow
stimulate pain receptors
increase cap permeability & WBC
phagocytosis

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11
Q

important Fever Temperatures

A

Norm adult: 96 - 99 F / 35 - 37 C
>65 yo : 1 degree less than max

106 F / 41 C = emergency
*cool rapidly to prevent brain dmg

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12
Q

Fever
factor, cause, s/sx, treatment

A

factors: time of day, age, sex, hormones, exercise, health, environmental temps
cause: error in thermoregulation by hypothalamus due to bacteria, virus, injury, trauma, surgery, MI, PE

*infants <3mo: mild increase dangerous
*elderly: unlikely for fever, even w/ srs infection

s/sx: decreased appetite, HA, hot dry skin, flushed face, thirst, musc ache, increased RR & pulse, kids: Sz

Treatment: antipyretic (acetaminophen), cooling, fluids, simple carbs
*RICE (Rest 48h, Ice, Compress, Elevate)

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13
Q

what is inflammation

A

body’s response to cell dmg

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14
Q

Inflammation: WHY redness? heat? swelling? pain?

A

redness, heat = vasodilation (increased blood flow)
swelling = increased cap permeability
pain = prostaglandin & Chem mediators

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15
Q

pathology of inflammation

A
  1. harmful microbe enters body
  2. cell dmg
  3. release of Chem mediators
  4. increase blood flow (heat, redness)
    increase cap permeability (swelling)
    attracts immune cells
  5. immune cells clean up & promote inflammation (exudate)
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16
Q

NSAID

A

non-steroid anti-inflammatory drugs
“NSIK”
Naproxen
Salicylate/ASA (anti-platelet)
Ibuprofen
Ketorolac (IV)

For pain / inflammation / fever

blocks prostaglandin
1-3h

Adverse:
“NSAIDDS”
Not good for whole body
Sticky blood clot
Asthma/bronchospasm
Increase bleeding
Don’t take on empty stomach
Dmg kidneys
Swelling ♡ (HTN, ♡ disease)

“ASPIRIN”
Abd pain
Salicylism/tox
Peptic ulcer
Increase bleeding
Reyes
Itchy rash
Noise/tinnitus

Contraindication:
-bleeding disorder, anti-coags

Ed:
<3200 mg Ibuprofen max

Labs: BUN, creatinine

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17
Q

anti-Migraine drugs

A

-Ergotamine
-Sumatriptan

aborts migraines

Adverse: dizzy / ergotism (tox) / coronary vasospasm

Contraindication:
pregnancy!
MAOI / SSRI

Ed:
limit use to prevent dependence
*teratogenic

Labs: cardiovascular function

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18
Q

Pain patho

A

transduction
transmission
perception
modulation

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19
Q

pain: transduction

A

stimulus detection
noxious stimuli converts to electrical signals

-prostaglandin: sensitize nociceptors
-bradykinin: activates nociceptors
-histamine: promote inflammation
-substance p: enhance pain signal transmission
-serotonin & cytokines: promote inflammation

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20
Q

pain: transmission

A

signal propagation
pain signals travel frm nociceptors to CNS via

-peripheral nerves / afferent
-spinal cord / dorsal horn
-ascending pathways

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21
Q

pain: perception

A

interpretation of pain

somatosensory cortex: localization & intensity
limbic system: emotional response
prefrontal cortex: cognitive interpretation

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22
Q

pain: modulation

A

pain regulation
inhibit pain via

-endorphins & enkephalins- natural opioids
-serotonin & norepi- suppress pain signals
-GABA- inhibit pain transmission

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23
Q

Gate control theory

A

overstimulation can close gate & reduce pain
ex: rubbing an injury decreases pain

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24
Q

pattern theory

A

sensory stimuli make unique patterns, leading to pain perception
shared pathways
ex: light touch = low frequency. deep touch = high frequency of same receptor, perceived as pain

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25
specificity theory
dedicated nerve pathways for pain, for diff sensations ex: pinprick activates specific pain receptors that send signals directly to brain
26
intensity theory
pain occurs when stimulus exceeds a threshold ex: mild tap isn't painful, but is when repeated a lot
27
Acetaminophen
For pain, fever Adverse: Liver dmg / OD *Acetylcysteine = antidote Ed: < 4g/day; no alcohol or other hepatotoxic meds Labs: AST/ALT
28
Opioid agonist
"loow & slooow" -morphine / fentanyl / hydromorphone / codeine For pain / sedation Adverse: -Orthostatic hypotension -NARCSU (OD sx: RR <12, pinpoint pupils, unarousable *antidote = Nalaxone) Ed: Avoid alcohol & CNS depressants (Benzos ends in "lam", "pram") don't drive use stool softeners / fiber / exercise. Stand slowly
29
corticosteroids / steroids
ends in "sone" Inhale: Beclomethasone / Fluticasone Oral: Prednisone / Dexamethasone oral: short term use during severe episode For inflammation / immunosuppression (organ donation, autoimmunity) / adrenal replacement / COPD / asthma / allergy *Epi asap for anaphylaxis Adverse Inhaled: "ROIDDS" Rmbr to take w food Oral thrush- inhaler / hoarse Immunosuppress- taper - cushing Die by hyperglycemia (3 P's) So many ulcers Ed: rinse mouth after using inhaler
30
Absorption / Bioavailability
How quickly a medication takes effect determined by rate & extent of absorption Factors: dose / route / blood flow / Bioavailability / GI function / pH / special formulations / food or other meds Bioavailability: % of drug available after absorption PO = < 100% avail (slower) IV = 100% avail (faster)
31
Distribution
How drug moves through bloodstream to tissues blood flow (poor circulation = delay). ▪ Protein binding (only free drugs are active). ▪ Barriers (blood-brain barrier).
32
pharmacoKinetics
ADME (absorption / distribution / metabolism / excretion) how meds move thru body to reach site of action, metabolism, and excretion
33
Metabolism / First Pass Effect
in Liver by cytochrome P450 enzymes deactivates meds then excretes it First-Pass Effect: Reduction of oral drug concentration due to liver metabolism *PO req higher dose than IV bc a portion of that drug will be excreted
34
Hepatotoxicity, s/sx
meds toxic to Liver S/sx: jaundice / nausea / elevated AST/ALT
35
excretion
Removal of drugs via KIDNEYS, lung, skin, or bile
36
Nephrotoxicity, s/sx
meds toxic to Kidney s/sx: decreased urine output (< 30 mL/hr) / fluid retention / elevated BUN/Creatinine
37
normal AST/ALT
AST= 0-40 ALT= 0-35
38
normal BUN/Creatinine
BUN= 10-20 Creatinine= 0.2 - 0.5
39
Lifespan considerations: Elder, Peds, Preg
Elderly: -Slower metabolism/excretion → risk OD -Consider polypharmacy / Beers Criteria (lists contraindicated rx for elders) Peds: -Immature liver/kidney → weight-based dosing required. -Undeveloped blood-brain barrier → risk of toxicity. Pregnancy: Medications classified A, B, C, D, X (safety levels). *Avoid Category X drugs -Drugs may transfer into breast milk
40
Therapeutic Index
Wide = Safe larger margin between effective and toxic doses Narrow = Danger requires monitoring
41
Peaks & Troughs
blood concentration lvls used for therapeutic monitoring Peaks: Highest plasma concentration. -blood drawn at specific times based on drug’s pharmacokinetics IV = 15-30 min IM = 30-60 min PO = 60 min Troughs: Lowest drug concentration before next dose. -Ensures steady therapeutic levels
42
Half-Life
time for drug concentration to decrease by 50% short half life = freq dosing long half life = less freq dosing but higher toxicity risk
43
Pharmacodynamics
how meds act on body (agonist, antagonist)
44
Agonist
Activates receptor to produce a response
45
antagonist
Blocks receptor to prevent a response
46
partial agonist
Weaker response compared to full agonist
47
Med order -components -types -phone/verbal
Pt name, date/time, med name, dose, route, frequency, Prescriber signature. Routine/Standing: daily use (ex: cholesterol, bp meds) PRN: As needed with specific instructions (pain lvl? freq? bp?). STAT: asap (ex: CP, stroke) *phone/verbal: confirm by reading back
48
Rights of Med Administration
Right patient right drug right dose right route right time right documentation
49
drug interactions
drug-food/herbal -grapefruit juice decrease metabolism, increase risk toxicity drug-drug -Synergistic: enhance effects (ex: alcohol + sedatives) -antagonistic: reduced effects, against ea other (ex: naloxone blocks opioids)
50
Multifactorial
Conditions caused by a combo of genetic, environmental, and lifestyle factors. ex: T2DM
51
Idiopathic
Diseases with an unknown or unclear cause
52
Iatrogenic
Conditions resulting from medical treatment or intervention
53
pathophysiology
study of mechanism of disease
54
pathogenesis
how disease evolves/develops, from initial cause to clinical manifestations.
55
Local vs. Systemic
Local: confined to one area systemic: affects whole body
56
Remission vs. Exacerbation
remission: period of sx improvement exacerbation: worsening sx
57
Morbidity
Incidence of illness in a population
58
Mortality
Death rates caused by a disease
59
Primary Prevention
Prevents disease before it occurs ex: vaccine
60
Secondary Prevention
early detection, prevent worsening ex: screenings
61
Tertiary Prevention
manage established diseases and prevent complications ex: physical therapy
62
atrophy
decreased cell size due to less demand / stimulation
63
hypertrophy
Increase cell size due to more demand.
64
hyperplasia
Increase in cell number
65
metaplasia
Replacement of one cell type with another to adapt to stress
66
dysplasia
Abnormal cell growth, often a precursor to cancer
67
causes of cell injury
1. infection - pathogen cause cell dmg 2. physical injury- trauma, mechanical stress 3. thermal injury- extreme heat/cold 4. toxins - endogenous (internal toxins) or exogenous (external toxins) 5. deficit- lack of O2 or nutrients
68
Apoptosis
Programmed cell death without inflammation replaces old cells w/ new
69
necrosis
Uncontrolled cell death causing inflammation and tissue damage
70
structural hierarchy
cells > tissue > organ > organ system
71
Asthma patho / sx / meds
Chronic inflammation causing airway hyperresponsiveness airway inflam / bronchoconstriction / mucus triggers: allergens (smoke) / infection / exercise / cold air s/sx: wheezing / dyspnea / cough / tight chest / nocturnal sx meds: beta-2 agonists / steroids / anticholinergics / leukotriene modifiers / theophylline
72
Beta-2 Agonist
"buterol" *Albuterol (fast acting, rescue) *Formoterol (long acting, management) bronchodilator Adverse: T= tremor, toss/turn, tachycardia Ed: "B before C" use before exercise rinse mouth after using inhaler avoid caffeine take in AM
73
Anticholinergics
Ipratropium Bronchodilation blocks secretions Adverse: "dry" cant see, spit, pee, poop ed: hydrate
74
Leukotriene Modifiers
Montelukast inflammation Adverse: mood Ed: take PM avoid NSAID
75
Theophylline
"old school albuterol" Long-term for asthma / COPD when other treatments fail Bronchodilator Adverse: T= tremor, toss/turn, tachy *toxicity (sz, arrythmia, vomit) ed: take as prescribed, avoid caffeine/smoke *monitor blood lvls regularly
76
Decongestants
"fed up w" *Pseudoephedrine *Phenylephrine relieve nasal congestion Adverse: insomnia / rebound congestion contraindication: HTN ed: take in AM dont exceed rec dose
77
Antitussives
Dextromethorphan (non-opioid) Codeine (opioid) suppress cough Adverse: drowsy / nausea / dry mouth Opioid adverse: NARCSU ed: non-opioid: take w water / PRN opioid: use stool softeners / take w food avoid alcohol, driving
78
Anti-histamines
allergy 1st gen = drowsy = Diphenhydramine 2nd gen = non drowsy = Loratadine Adverse 1st: drowsy / dry mouth Ed 1st: take PM / dont drive Ed 2nd: once daily avoid alcohol, hydrate
79
Expectorants
*Guaifenesin loosens mucus use w/ productive cough Adverse: rash / HA / N/V ed: hydrate
80
Mucolytics
*Acetylcysteine loosens mucus *antidote for Acetaminophen OD Adverse: rash / N/V / bronchospasm smells bad ed: hydrate
81
COPD
inflammation of alveoli and bronchioles Asthma, Emphysema, or chronic Bronchitis sx appear when lung function < 50%
82
Emphysema
enlargement of air spaces in alveoli/acini caused by smoking or genetic (AAT deficiency) Centriacinar: smoking, dmg alveoli Panacinar: genetic, dmg entire alveolus of upper lungs proteolytic enzymes dmg elastin in lungs = alveoli can't recoil nor release CO2 s/sx: barrel chest / crackles / puffing / dyspnea on exertion / hypoxia
83
Chronic Bronchitis
repeated inflammation of bronchi and bronchioles due to irritants or infection, causing excess mucus cause: smoking, pollutants s/sx: productive cough / mucus / dyspnea / accessory muscle breathing / cyanosis
84
Pneumonia
inflammation of lungs caused by pathogens (bacteria, virus, fungi) via droplets; impairs gas exch community (typical- bacteria) or hospital (atypical- virus, fungi, FB) acquired Aspiration: inhale items not meant for lungs Consolidation: solid mass in lungs s/sx: typical- productive cough / sputum / fluid in lungs / fever / consolidation atypical- unique sx / nonproductive cough

Patho-Pharm (8 decks)

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