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Pathopharm > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

3 cells of the gastric gland:

A

chief, mucous, parietal

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2
Q

parietal cell produces and secretes what?

A

hydrochloric acid

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3
Q

what can cause peptic ulcer disease?

A

stress, H. pylori, alcohol, smoking

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4
Q

what are antacids used for?

A

treatment of peptic ulcer disease
prevention of stress-induced ulcers
relief of manifestations of GERD

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5
Q

how do antacids work?

A

neutralize acid and promote gastric mucosal defense mechanisms like secretions of mucus, bicarbonate (helps buffer acidic properties of HCl), and prostaglandins (prevent activation of PP by preventing histamine from binding to its corresponding parietal cell receptors)

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6
Q

magnesium antacids are CI in what patients?

A

renal

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7
Q

aluminum antacids can cause?

A

constipation

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8
Q

magnesium antacids can cause?

A

diarrhea

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9
Q

why do we use aluminum and magnesium antacids together?

A

to counteract their effects (cancel out constipation and diarrhea)

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10
Q

aluminum antacids have the potential to cause what electrolyte issue?

A

hypophosphatemia - Aluminum hydroxide has a high affinity for phosphate. By binding with phosphate, the drug can reduce phosphate absorption, and can thereby cause hypophosphatemia

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11
Q

how often can these drugs be used everyday?

A

up to 7, but 4 is normal

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12
Q

muco-protectant sucralfate needs to be given when?

A

empty stomach

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13
Q

how long to wait before giving other drugs after antacids or sulcrafate?

A

2 hours

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14
Q

sucralfate can cause?

A

constipation

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15
Q

what is GERD?

A

gastroesophageal reflux disease

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16
Q

what are the 3 c’s that start GERD?

A

caffeine, chocolate, coffee

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17
Q

how do histamine 2 receptor blockers (famotidine) work?

A

blocks gastric acid secretion by inhibiting H2 receptors and lowers the concentration of hydrogen ions in the stomach

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18
Q

if a patient needs to take an H2 receptor (famotidine) and an antacid, when is the antacid given?

A

2 hours after

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19
Q

how do PPIs work?

A

bind directly to the hydrogen-potassium-ATPase pump mechanism and irreversibly inhibit the action of this enzyme, which results in a total blockage of hydrogen ion secretion from the parietal cells.

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20
Q

if the patient has a major blockage of HCL what does that make them more susceptible of getting?

A

C. diff

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21
Q

if they are on omeprazole longer than the prescribed dose and start to have abdominal pain, bloody stools, loose diarrhea what should they do ?

A

call the doctor

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22
Q

when should PPIs (omeprazole) be taken?

A

30-60 min before eating (food may decrease absorption)

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23
Q

if a patient is taking an antidiarrheal longer than 5 days with no improvement, what should they do?

A

call the doctor

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24
Q

when do we give opiates and anticholinergics together?

A

opiates decrease transit time of food in the bowel, and anticholinergics slow peristalsis. effects make med unpleasant and discourage abuse of drugs.

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25
Q

the chemoreceptor trigger zone is usually impacted by what 2 neuro receptors?

A

serotonin and dopamine

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26
Q

how does metoclopramide work?

A

promote gastric emptying

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27
Q

the oral form of metoclopramide is used for?

A

GERD and diabetic gastroparesis

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28
Q

which medication has the following side effects:
Tardive dyskinesia: usually from high dose, long-term therapy
EPS: administer an antihistamine (diphenhydramine) to minimize EPSs
Sedation: avoid driving, operating heavy machinery
Diarrhea: monitor for dehydration
Hypotension, SVT
Restlessness, HA, dystonia
Dry mouth

A

metoclopramide

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29
Q

serotonin blockers like “ondansetron” block what receptors in the chemoreceptor trigger zone (CTZ)?

A

serotonin

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30
Q

what are B cells?

A

white blood cells that produce antibodies specific to the antigen that stimulated their production.

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31
Q

what are antibodies?

A

proteins that bind to the antigen of an invader, tagging the invader for attack or directly neutralizing it. The body produces thousands of different antibodies. Each antibody is specific to a given antigen

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32
Q

What are antigens?

A

any substance that the immune system can recognize and thus stimulate an immune response

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33
Q

what is the HLA?

A

Human leukocyte antigens (HLA) are a group of identification molecules located on the surface of all cells in a combination that is almost unique for each person, thereby enabling the body to distinguish self from non-self. This group of identification molecules is also called the major histocompatibility complex.

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34
Q

What are T cells?

A

white blood cells that are involved in acquired immunity. There are three types: helper, killer (cytotoxic), and regulatory.

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35
Q

Main purpose of the immune system:

A

distinguish self from non-self and to protect the body from foreign material (antigens), including cancer

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36
Q

Two types of immunity:

A
  1. The humoral response (or antibody‐mediated immunity) involves B cells that recognize antigens or pathogens that are circulating in the lymph or blood
  2. The cell‐mediated response involves mostly T cells and responds to any cell that displays aberrant MHC (Major histocompatibility complex ) -AKA- (HLA markers) including: cells invaded by pathogens, tumor cells, or transplanted cells.
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37
Q

what are primary immunodeficiency diseases - (PIDD)?

A

a group of disorders caused by inherited or genetic defects in the cells and tissues of the immune system.

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38
Q

what are secondary immune deficiency diseases?

A

when the immune system is compromised due to an environmental factor. Examples of these outside forces include HIV, chemotherapy, severe burns or malnutrition.

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39
Q

Type 1 – allergic reactions are what type of immune response?

A

IgE

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40
Q

this drug stimulates all adrenergic receptors

A

epinephrine

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41
Q

how do antiviral drugs work?

A

kill or suppress virus by destroying virions or inhibiting the ability of viruses to replicate

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42
Q

what is acyclovir used to treat?

A

HSV1 (oral), HSV2 (genital), VZV

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43
Q

What is VZV?

A

Activation of Herpes varicella zoster virus (VZV) (Shingles)

Inflammation of dorsal root ganglia, usually along dermatomes

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44
Q

the patient should have a lot of what when receiving acyclovir?

A

fluids

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45
Q

what labs need to be monitored with acyclovir?

A

clearance of drug, kidney (BUN, creatinine)

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46
Q

what are the FACTS of the flu?

A

fever, aches, chills, tiredness, sudden onset

47
Q

what should be given within 48 hours of being exposed/start showing signs of the flu?

A

oseltamivir

48
Q

when is flu season?

A

November to april

49
Q

what is a common complication of the flu?

A

pneumonia

50
Q

how does oseltamivir work?

A

stops budding irons from escaping infected cells and spreading through the body, stops the action of the neuraminidase enzymes and stop their work in the body

51
Q

what is the difference between CD4 count and viral load?

A

CD4- WBC that fight infection
viral load- amount of virus a person has

effectiveness of treatment: increase CD4 count and decrease viral load

52
Q

HIV replication is best suppressed by?

A

combo or cocktail of drugs to disrupt HIV replication at multiple stages

53
Q

HAART therapy is a?

A

combo or cocktail of drugs

54
Q

what is nicoceptive pain?

A

pain from physical damage to the body

55
Q

what are the 2 types of pain?

A

somatic (pain from skin, muscle, soft tissue)

visceral (pain from internal organs)

56
Q

what is neuropathic pain?

A

damage to peripheral nerve or CNS

57
Q

acute pain?

A

sudden onset, generally a precipitating event or illness can be identified.
increase pulse, RR, b/p, diaphoresis.
pain control with eventual elimination.

58
Q

chronic pain?

A

persistent, may start acute but continues, cause may be unknown.
flat affect, decrease physical activity, withdrawn.
focus on enhancing quality of life, often use adjunctive therapies.

59
Q

what is adjunctive therapy?

A

Used in conjunction with opioids & nonopioids, often developed for other purposes, can also be non-med therapies (music, relaxation, massage, acupuncture, heat/cold)

60
Q

what is inflammation?

A

immunologic defense against tissue injury, infection, or allergy

61
Q

what are causes of inflammation?

A

infection, trauma, surgical intervention, burn, frostbite, autoimmune processes (such as RA)

62
Q

clinical manifestations of local inflammation?

A

redness, heat, swelling, pain, loss of function

63
Q

clinical manifestations of systemic response?

A

increased WBC, malaise, nausea, anorexia, increased pulse and RR, fever

64
Q

for soft tissue injuries, what is RICE?

A

rest, ice, compression, elevation

65
Q

what is RA?

A

immune response gone wild.

Prostaglandins
•Following injury, arachidonic acid is converted into prostaglandins, thromboxane, and leukotrienes.
•Considered proinflammatory
•Potent vasodilators

66
Q

clinical manifestations of RA/JIA?

A

Symmetric involvement
Fluid accumulation and synovial swelling
Pannus: granular tissue
Eroded cartilage
Ankylosis: extreme stiffness or joint fusion

67
Q

therapeutic management of RA?

A

no cure, goal is to relieve pain, slow or stop joint damage, improve ability to function, modified tools to perform ADLs

68
Q

therapeutic management of JIA?

A

no specific cure, goals to preserve function & prevent deformities, physical & occupational therapy, sometimes outgrows

69
Q

what meds do we give for RA?

A

methotrexate

70
Q

expected PA of methotrexate

A

immunosuppression: decrease joint inflammation and joint damage

71
Q

complications of methotrexate

A

GI ulceration, increase risk of infection, liver damage, bone marrow suppression

72
Q

nursing interventions for methotrexate

A

Watch for S&S of infection, watch for bleeding, watch for jaundice, may take 3-5 months to work so often give NSAID at the beginning

73
Q

what are ibuprofen (NSAIDS) used for?

A

inflammation, pain, fever

74
Q

complications of ibuprofen

A

GI upset, heartburn, nausea, ulcerations bleeding

75
Q

nursing interventions for ibuprofen

A

monitor for signs of bleeding, take with food/milk, recommend a proton pump inhibitor, report symptoms of embolic events

76
Q

what is opioid use disorder?

A

chronic disease, changes the brain chemistry (affecting dopamine, the reward center)

77
Q

symptoms of overdose?

A

respiratory depression, pinpoint pupils, unconsciousness

78
Q

what do we do for drug overdose?

A

naloxone and promote getting professional help

79
Q

acetaminophen use?

A

analgesia for mild to moderate pain, fever reduction (no anti-inflammatory or anticoagulant effects)

80
Q

complications of acetaminophen?

A

liver damage, hypertension

81
Q

daily limit for acetaminophen for hx of alcoholism

A

2000 mg/day

82
Q

morphine use

A

analgesia for moderate to severe pain

83
Q

morphine complications

A

respiratory depression, constipation, itching, hypotension, urinary retention

84
Q

morphine med admin

A

IV- dilute slowly (give over 4-5 min), get baseline VS & monitor, give to cancer patients on a schedule, have naloxone nearby

85
Q

morphine nursing interventions

A

monitor vs, hold for RR <12, encourage fiber and stool softener, monitor I&O

86
Q

naloxone use

A

reversal of opioid effects (blocks opioid receptors)

increase RR, BP, pulse

87
Q

naloxone complications

A

increase RR, BP, pulse
abstinence syndrome (HTN, vomiting, tremors)
pain will be back full force

88
Q

naloxone med admin

A

prepare to give every 2-3 minutes until reversed

89
Q

naloxone nursing interventions

A

monitor VS, have oxygen and resuscitative equipment ready, person with opioid use disorder keep with them, can buy without prescription in pharmacy

90
Q

what is SBIRT?

A

screening, brief intervention, referral to treatment

91
Q

what does SBIRT provide?

A

routine and universal screening for everyone
evidenced based care
ongoing transition from primary care to treatment

92
Q

what is gout?

A

increased uric acid levels

93
Q

where does gout affect?

A

starts in great toes, occur in ursae, tendons, joints

94
Q

s&s of gout

A

joint pain, stiffness, limited range of motion, itching, joint inflammation, tophi, erythema

95
Q

nursing intervention of gout

A

manage pain, monitor joint inflammation, meds, assist with range of motion, nutrition, promote hydration

96
Q

therapeutic use of allopurinol

A

treat the hyperuricemia that causes gout

97
Q

complications of allopurinol

A

agranulocytosis, aplastic anemia, potentially fatal skin conditions

98
Q

allopurinol nursing interventions

A

Baseline uric acid level level, CBC, liver & kidney function, drink at least 3 liters of fluid per day, monitor for signs of hypersensitivity syndrome, can give with meals to help with GI effects, report bleeding, and/or easy bruising, metallic taste, can cause cataract

99
Q

which disorder comes from a problem with the thyroid itself?

A

hypothyroidism

100
Q

what disorder uses methimazole?

A

hyperthyroidism

101
Q

what disorder needs thyroid replacement?

A

hypothyroidism

102
Q

what disorder needs an anti-thyroid drug?

A

hyperthyroidism

103
Q

what disorder has the following signs: bulging eyes, weight loss, muscle wasting, fine-straight hair

A

Hyperthyroidism

104
Q

what disorder has the potential of crisis thyroid storm?

A

hyperthyroidism

105
Q

what disorder has the following symptoms: cold, low energy, weight gain, dry skin

A

hypothyroidism

106
Q

what med increases metabolic rare, protein synthesis, cardiac output, renal perfusion, oxygen use, body temp, blood volume, and growth?

A

levothyroxine

107
Q

what med takes 6-8 weeks to work?

A

levothyroxine

108
Q

what med blocks synthesis of thyroid hormones and prevents the oxidation of iodide?

A

methimazole

109
Q

what med can take 1-2 weeks to be evident but 3-12 for full effect?

A

methimazole

110
Q

which med needs to be taken without food?

A

levothyroxine

111
Q

which med would I want to see a decreasing TSH?

A

levothyroxine

112
Q

what med should one avoid soy? (thermoreg)

A

levothyroxine

113
Q

what med could potentially cause agranulocytosis? (thermoreg)

A

methimazole

114
Q

which thermoreg med is a pregnancy cat D?

A

methimazole

Pathopharm (5 decks)

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