exam 2 Flashcards
Cortisol (made from the adrenal gland) has what effect on the body?
Impacts level of awareness and sleep pattern
Cortisol is the wake up hormone
spontaneous emotions
wound healing
What affect do glucocorticoids have on the body?
anti-inflammatory, growth suppressing effects, increasing circulating erythrocytes, increases appetite, promotes fat deposits in the face and cervical areas, decrease serum calcium, and enhances urinary excretion.
what is the most predominant minearalcorticoid
aldosterone
What is the main function of mineralcorticoids (aldosterone)?
retain sodium and water, and excrete potassium
In what instance would corticosteroids be contraindicated?
in patients with active, untreated infections, in patients with hypertension or cardiovascular disorders, and cautious use in post-menopausal women due to risk of osteoporosis.
In patients with diabetes, what complication may they see while taking a corticosteroid?
problems with glycemic control– may become hyperglycemic
What complications could people with UC or peptic ulcer disease see with concurrent corticosteroid use?
increased risk of GI bleeding and perforation
What consideration should you make when administering a corticosteroid to a patient?
Give earlier in the day (preferably before 9AM to prevent insomnia.
Which drugs are choices for the treatment of adrenal insufficiency?
hydrocortisone, cortisone, and prednisone
Prednisone is the most common drug used outpatient
Which drugs are choice in the treatment of inflammation?
Methylprednisolone, prednisone, and triamcinolone or decadron
Which drugs are best to help with immune suppression ?
Prednisone is used because it has a short half-life.
which drugs are best to treat Rheumatoid arthritis?
first-line treatment is NSAID’s. low- dose prednisone can also be used.
What sort of ongoing monitoring is needed for patients on long-term corticosteroids?
weight, electrolytes, glucose, CBC, monitoring for GI bleed, eye exam,
What patient education can be given to a patient taking long-term corticosteroids?
Take medication prior to 9AM
have a diet high in potassium and calcium
diet low in sodium and carbohydrates
what is thought to be the MOA of tylenol?
inhibiting central and peripheral prostaglandin synthesis
where is tylenol metabolized?
the liver
Is ibuprofen or tylenol recommended for pregnant women?
tylenol
which pain medication would be recommended for children’s and infants <6 mos
tylenol
what is the most common adverse drug reaction for NSAID’s?
GI disturbances- take with food to reduce GI upset
What medication can be used for pain associated with osteoarthritis?
tylenol or motrin
What medications can be used for gout?
indomethacin, naproxen, and sulindac
which medication is the drug of choice for fever?
motrin
what medication can be used for primary dysmenorrhea?
NSAID’s (motrin for naproxen) are the drugs of choice
what needs to be monitored during lon term treatment with NSAID’s?
renal function and for presence of a GI ulcer or GI bleed(CBC prior to initiation of therapy and annually)
what slows the absorption of aspirin?
food
what are the major adverse drug reactions with aspirin?
GI irritation, iron deficiency anemia, ototoxic, potential development of Reye’s syndrome, risk of bleeding
what is the gold standard treatment for patients with rheumatoid arthritis?
aspirin
what should patients do at first sign of an MI?
patients should take one 325 mg aspirin tablet
What medication can be used for MI and stroke prophylaxis?
aspirin
what education needs to be given to patients with aspirin therapy?
Take with plenty of water
remain upright for 15 to 30 minutes following
what monitoring needs to be done on patients on long-term aspirin treatment?
random salicylate levels should be drawn 7-10 days following initiation of therapy
Renal function needs to be monitored
CBC
fecal blood testing
