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Nursing Pharmacology > Exam 3 Study Guide > Flashcards

Exam 3 Study Guide Flashcards

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1
Q

These are chemical messengers from the various glands in the endocrine system

A

Hormones

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2
Q

How many cells in the body can hormones affect?

A

thousands

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3
Q

How long does it take for an optimal response to be produced for hormones?

A

several days

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4
Q

What kind of changes occur when too little or too much of a hormones is produced?

A

physiological changes

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5
Q

This part of the brain secretes releasing hormones that travel to the pituitary.

A

hypothalamus

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6
Q

What hormones does the anterior pituitary secrete?

A
  1. adrenocorticotropic hormone
  2. thyroid stimulating hormone
  3. growth hormone
  4. prolactin
  5. follicle stimulating hormone
  6. luteinizing hormone
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7
Q

What kind of tissue is in the posterior pituitary?

A

nervous tissue

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8
Q

When is ADH and oxytocin released?

A

in response to nerve impulses from the hypothalamus

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9
Q

Hypersecretion of corticosteroids can cause?

A

Cushing syndrome

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10
Q

Hyposecretion of the adrenal cortex can cause?

A

Addison disease

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11
Q

Hyposecretion of the parathyroid hormone can cause?

A

hypoparathyroidism

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12
Q

Hypersecretion of the parathyroid can cause?

A

hyperparathyroidism

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13
Q

Ketoconazole and mitotane is used for what disorder?

A

Cushing syndrome

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14
Q

What medication(s) are used for Cushing syndrome?

A

ketoconazole and mitotane

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15
Q

What medications are used for Addison disease?

A

hydrocortisone, prednisone

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16
Q

What medication is used for hyperparathyroidism?

A

no medication, surgery is done

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17
Q

What medication is used for hypoparathyroidism?

A

human parathyroid hormone (natpara), vitamin D and calcium supplements

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18
Q

Natpara is used for what disorder?

A

hypoparathyroidism

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19
Q

Hyposecretion of the pituitary causes what disorder?

A

diabetes insipidus

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20
Q

What medication is used for diabetes insipidus?

A

desmopressin (DDAVP, Noctiva, Stimate) and vasopressin

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21
Q

What disorder is caused by hypersecretion of the pituitary?

A

SIADH

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22
Q

What is medication is used for acromegaly?

A

octreotide

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23
Q

Octreotide is used for what disorder?

A

acromegaly

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24
Q

Hypersecretion of the thyroid causes?

A

Gaves disease

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25
Q

Hyposecretion of the thyroid causes?

A

myxedema (adults), cretinism (children)

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26
Q

How is graves disease treated?

A

propylthiouracil (PTU) and I-131

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27
Q

How is myxedema and cretinism treated?

A

thyroid hormone and levothyroxine (T4)

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28
Q

This hormone stimulates growth and metabolism in nearly all cells in body.

A

growth hormone

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29
Q

Sumatotropin is also known as

A

growth hormone

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30
Q

Growth hormone is also known as

A

somatotropin

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31
Q

The deficiency that results in short stature is

A

dwarfism

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32
Q

What should you monitor with growth hormone agents?

A

glucose tolerance and thyroid function

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33
Q

Glucose tolerance and thyroid function are monitored when _______ are administered.

A

Growth hormone agents

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34
Q

This has the same actions as GH (growth hormone).

A

Mecasermin (increlex)

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35
Q

This type of excess secretion results in deformed bones and enlarged small bones of hands, feet, face, and skull.

A

acromegaly

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36
Q

Octreotide is a synthetic GH (antagonist, agonist)

A

antagonist

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37
Q

ADH is secreted from the

A

posterior pituitary

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38
Q

When is ADH secreted?

A

when the hypothalamus senses that the plasma volume has decreased or blood osmolality is too high

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39
Q

ADH is also known as

A

vasopressin

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40
Q

This has the ability to constrict blood vessels and RAISE blood pressure

A

ADH (vasopressin)

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41
Q

ADH deficiency results in which type of diabetes?

A

diabetes insipidus

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42
Q

What does ADH act on?

A

the collecting ducts

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43
Q

This is the most common drug for treating diabetes insipidus.

A

desmopressin

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44
Q

ADH (increases, decreases) serum osmolality.

A

decreases

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45
Q

Does thyroid hormone increase or decrease basal metabolic rate?

A

increase

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46
Q

Parifollicular cells secrete

A

calitonin

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47
Q

Thyroid hormone consists of T__ and T___

A

T4, T3

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48
Q

Is T4 converted to T3 or is T3 converted to T4?

A

T4 is converted to T3

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49
Q

Is T3 or T4 more biologically active?

A

T3

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50
Q

This is a carrier protein in the plasma that attaches to thyroid hormone

A

TBG (thyroxine-binding globulin)

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51
Q

This part of the brain tells the posterior pituitary what to do.

A

hypothalamus

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52
Q

What are some adverse effects of desmopressin?

A

headache, nasal congestion, water intoxication, hyponatremia

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53
Q

What is the mechanism of action for Desmopressin?

A

a synthetic analog of human ADH acts on the kidneys to increase water reabsorption, contracts smooth muscle of the vascular system, uterus, and GI tract

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54
Q

Water intoxication, headache, nausea, mild abdominal pain, and hypotension are adverse effects of what medication?

A

Desmopressin

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55
Q

True or False. The thyroid affects every cell in the body.

A

TRUE

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56
Q

Abnormal thyroid levels can occur due to the disease within the _______, ________, or _________

A

thyroid gland, pituitary, or hypothalamus

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57
Q

This disorder is due to a poorly function thyroid.

A

hypothyroidism

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58
Q

This disorder is due to decreased TSH production by the pituitary

A

hypothyroidism

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59
Q

What is the etiology of hypothyroidism?

A

it is an autoimmune disease, surgical removal of the thyroid, and aggressive treatment with antithyroid drugs

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60
Q

This is the most common cause of hypothyroidism in the US.

A

Hashimotos

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61
Q

What are some early symptoms of hypothyroidism?

A

weakness, muscle cramps, dry skin

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62
Q

Slurred speech, bradycardia, weight gain, decreased sense of taste and smell, and cold intolerance are severe symptoms of

A

hypothyroidism

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63
Q

In labs, what would show hypothyroidism regarding TSH, T3, and T4?

A

elevated TSH, decreased T3 and T4

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64
Q

True or False. Goiter must be present in hypothyroidism.

A

False. it can be present or absent

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65
Q

What is the standard medication to treat hypothyroidism?

A

levothyroxine

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66
Q

What is the most common form of hyperthyroidism?

A

grave’s disease

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67
Q

The body develops antibodies against its own thyroid gland in which disorder?

A

hyperthyroidism

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68
Q

Increased metabolism, tachycardia, weight loss, elevated body temperature, and anxiety are symptoms of what disorder?

A

hyperthyroidism

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69
Q

This is very high levels of circulating thyroid hormone.

A

thyroid storm

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70
Q

What is the treatment for thyroid storm?

A

remove all or part of the thyroid

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71
Q

What is monitored to evaluate progress of of therapy for hypothyroidism?

A

serum TSH level

72
Q

This medication is contraindicated in pregnant patients, crosses placenta more readily for hyperthyroidism.

A

Methimazole

73
Q

This is used to suppress thyroid function prior to thyroidectomy, to treat thyroid storm, to reduce thyroid vascularity prior to surgery, or to protect the thyroid after radiation exposure.

A

Non-radioactive iodine

74
Q

What percentage of epinephrine does the adrenal medulla secrete?

A

75%-80%

75
Q

75%-80% of _____________ is secreted by the adrenal medulla

A

Epinephrine

76
Q

What percentage of norepinephrine does the adrenal medulla secrete?

A

20%-25%

77
Q

20%-25% of ______________ is secreted by the adrenal medulla.

A

Norepinephrine

78
Q

What are the three classes of steroid hormones?

A
  1. Gonadocorticoids
  2. Mineralocorticoids
  3. Glucocorticoids
79
Q

Mineralocorticoids regulate plasma volume by promoting

A

sodium reabsorption and potassium excretion by renal tubules.

80
Q

When plasma volume falls, kidney secretes _________, which results in production of Angiotensin II.

A

renin

81
Q

When plasma volume falls, kidney secretes renin, which results in production of Angiotensin (I, II)

A

Angiotensin II

82
Q

Angiotensin II causes Aldosterone secretion, promoting ______________ retention.

A

sodium and water

83
Q

What steroid hormone class includes cortisol, corticosterone, and cortisone?

A

Glucocorticoids

84
Q

Corticosteroids = __________corticoids and ___________corticoids

A

mineralocorticoids and glucocorticoids

85
Q

Glucocorticoids suppress __________________________ responses

A

inflammatory and immune responses

86
Q

Glucocorticoids Increase the sensitivity of

A

vascular smooth muscle to norepinephrine and angiotensin II.

87
Q

This glucocorticoid effect promotes

A

bronchodilation

88
Q

Glucocorticoids promote bronchodilation by making bronchial muscle more responsive to

A

sympathetic nervous system activation.

89
Q

Glucocorticoids increase the breakdown of the _________

A

bony matrix

90
Q

Glucocorticoids increase the breakdown of bony matrix which results in

A

bone demineralization

91
Q

Which part of the brain releases secretes corticotropin-releasing factor (CRF).

A

hypothalamus

92
Q

CRF travels to the pituitary where it causes the release of

A

adrenocorticotropic hormone (ACTH).

93
Q

ACTH travels through blood to reach

A

adrenal cortex

94
Q

Cortisol levels in the blood rise, providing (positive, negative) feedback to the hypothalamus and pituitary

A

negative

95
Q

Cortisol levels in blood rise, providing negative feedback to the

A

hypothalamus and pituitary

96
Q

Adrenocortical insufficiency is the lack of adequate

A

corticosteroid production

97
Q

Adrenocortical insufficiency is the lack of adequate corticosteroid production, caused by Hyposecretion of _____________ and inadequate secretion of

A

adrenal cortex, ACTH

98
Q

Hyposecretion of the adrenal cortex is (primary, secondary) insufficiency?

A

primary insufficiency

99
Q

Inadequate secretion of ACTH from the pituitary is (primary, secondary) insufficiency?

A

secondary insufficiency

100
Q

This closely resembles ACTH and is used to diagnose the cause of the adrenocortical insufficiency.

A

Cosyntropin (Cortrosyn)

101
Q

Cosyntropin (Cortrosyn) closely resembles ACTH and is used to diagnose the cause of the

A

adrenocortical insufficiency.

102
Q

Hypoglycemia, fatigue, hypotension, increased skin pigmentation, and GI disturbances are symptoms of

A

adrenocortical insufficiency

103
Q

____________ are used as replacement therapy for adrenocortical insufficiency

A

Corticosteroids

104
Q

Corticosteroids are used as replacement therapy for

A

adrenocortical insufficiency

105
Q

(Low, high) plasma cortisol and high plasma ACTH indicate that adrenal gland is not responding to ACTH stimulation.

A

low

106
Q

Which adrenocortical insufficiency is more common?

A

secondary

107
Q

Which adrenocortical insufficiency is rare?

A

primary (Addisons)

108
Q

Without ACTH stimulation, the adrenal cortex shrinks and stops secreting endogenous corticosteroids which is called

A

adrenal atrophy

109
Q

What are the symptoms of abrupt stopping of corticosteroid medication?

A

Nausea, Vomiting
, Lethargy, Confusion, Coma

110
Q

(Acute, chronic) adrenocortical insufficiency requires replacement therapy, to achieve the same physiological level of hormones in the blood seen with normal adrenal function.

A

Chronic adrenocortical insufficiency

111
Q

What are non-endocrine disorders that corticosteroids are used for?

A

allergies, asthma, cancer, edema, inflammatory bowel disease, rheumatic disorders, shock, skin disorders, and transplant rejection prophylaxis

112
Q

This disorder is commonly caused by long-term therapy with high-dose corticosteroids.

A

Cushing syndrome

113
Q

Cushing’s Disease caused by pituitary tumor producing excess

A

ACTH

114
Q

This blocks synthesis of corticosteroids, lowering serum levels.

A

Ketoconazole (Nizoral)

115
Q

Should ketoconazole be used during pregnancy?

A

No

116
Q

This inhibits ACTH secretion by pituitary, which reduces corticosteroid secretion from the adrenals.

A

Pasireotide (Signifor)

117
Q

This is the leading cause of death in the US

A

Diabetes

118
Q

What serious complications can be caused by diabetes?

A

stroke, heart disease, blindness, kidney failure, amputations

119
Q

This organ is Located behind the stomach, between duodenum and spleen, essential to digestive and endocrine systems.

A

Pancreas

120
Q

The (endocrine, exocrine) function is Responsible for secretion of several enzymes that assist with digestion

A

exocrine

121
Q

In the (endocrine, exocrine) function Cell clusters called Islets of Langerhans secrete insulin and glucagon

A

endocrine function

122
Q

Insulin (increases, decreases) blood glucose levels.

A

decreases

123
Q

Glucagon (increases, decreases) blood glucose levels

A

increases

124
Q

Without ______ glucose remains in the bloodstream and can not enter cells

A

insulin

125
Q

Insulin has a (hypoglycemic, hyperglycemic) effect

A

hypoglycemic

126
Q

Insulin has a hypoglycemic effect: as glucose leaves the blood serum glucose levels (fall, rise)

A

fall

127
Q

Insulin provides storge of glucose as glycogen in the

A

skeletal muscle and liver

128
Q

Insulin inhibits the breakdown of

A

fat and glycogen

129
Q

This is the production of new glucose from non-carbohydrate molecules

A

Gluconeogenesis

130
Q

Glucagon: Maintains adequate levels of

A

serum glucose between meals.

131
Q

When blood glucose levels fall, ________ is secreted.

A

glucagon

132
Q

Hyperglycemic hormones include:

A

Epinephrine, Thyroid hormone, Growth hormone, Glucocorticoids

133
Q

Hyperglycemic drugs include:

A

Corticosteroids, NSAIDs, Diuretics

134
Q

Hypoglycemic drugs include:

A

Alcohol, Lithium, Angiotensin-converting enzyme (ACE) inhibitors, Beta-adrenergic blockers

135
Q

Etiology of diabetes mellitus

A

combination of genetic and environmental factors. Sedentary lifestyles, stress, consumption of high calorie foods.

136
Q

This type of diabetes is often diagnosed in childhood.

A

type 1 diabetes

137
Q

Type 1 diabetes was also called

A

juvenile diabetes

138
Q

What percentage of type 1 diabetes is diagnosed in childhood?

A

5-10%

139
Q

What percentage of Type 1 diabetes is diagnosed in adulthood

A

25%

140
Q

excessive urination is called

A

polyuria

141
Q

increased hunger is called

A

Polyphagia

142
Q

increased thirst is called

A

Polydipsia

143
Q

Hyperglycemia—fasting glucose >

A

126 mg/dL

144
Q

high levels of glucose in the urine is called

A

Glucosuria

145
Q

What percentage of HbA1c indicates diabetes?

A

6.5%

146
Q

Untreated DM produces long-term damage to arteries, leading to

A

heart disease, stroke, kidney disease, and blindness.

147
Q

What symptom is common in untreated DM?

A

nerve degeneration

148
Q

DKA primarily occurs in what type diabetes

A

Type I DM

149
Q

Goal of insulin therapy is to strictly

A

maintain blood glucose levels within normal range

150
Q

Administering insulin when not enough glucose is present in the blood can lead to serious hypoglycemia and coma. This can happen when:

A

a meal is skipped after proper insulin administration
with heavy exercise

151
Q

In diabetes, this is abdominally anchored, release small SQ doses at predetermined intervals, manual boluses if necessary.

A

Insulin pumps

152
Q

Sudden onset of symptoms for hypoglycemia are

A

Pale, cool, moist skin, Confusion, Lightheadedness, Weakness, Anxiety, Blood glucose <50 mg/dL

153
Q

Mild to moderate hypoglycemia can be reversed by

A

consuming foods that contain glucose.

154
Q

The quickest way to reverse severe hypoglycemia it to give

A

iv glucose in a dextrose solution.

155
Q

Glucagon can be given by what route

A

IV, SQ, or IM.

156
Q

Waning insulin is when glucose levels rise in response to

A

declining insulin during night

157
Q

What is the dawn phenomenon?

A

between 0400 and 0800, the body produces cortisol and growth hormone, which cause glucose level to rise

158
Q

This is a rebound drop in glucose (related to excessive insulin dose, alcohol intake, or a missed meal), followed by nighttime release of hormones that elevate glucose (epinephrine, cortisol, glucagon).

A

Somogyi phenomenon

159
Q

This is an antiphyperglycemic drug used along with insulin

A

Pramlinitide (Symlin)

160
Q

Synthetic form of amylin, hormone release by beta cells of

A

pancreas with insulin

161
Q

In this type of diabetes Target cells become unresponsive to insulin, although pancreas produces sufficient amount.

A

Type 2 DM

162
Q

Activity of insulin receptors can be increased by

A

physical exercise and lowering the amount of circulating insulin.

163
Q

Type 2 dm is usually controlled with

A

non-insulin antidiabetic drugs (after exercise and diet have failed).

164
Q

These stimulate release of insulin and increase receptor sensitivity.

A

Sulfonylureas

165
Q

This decreases hepatic production of glucose (gluconeogenesis), and reduce insulin resistance.

A

Biguanides

166
Q

This blocks enzymes in the small intestine that break down complex carbs to monosaccharides

A

Alpha-glucosidase inhibitors

167
Q

These decrease insulin resistance and block gluconeogenesis

A

Thiazolidinediones or glitazones

168
Q

Meglitinides stimulate

A

insulin release

169
Q

Incretin enhancers—mimic the actions of

A

incretins or reduce their breakdown

170
Q

These are hormones released by the small intestine to signal the pancreas to increase insulin secretion, and the liver to stop producing glucagon.

A

Incretins

171
Q

Why are autonomic drugs important?

A

, because they mimic involuntary bodily functions.

172
Q

What are the four fundamental classes of autonomic drugs?

A
  1. Cholinergic drugs
  2. Adrenergic drugs
  3. Cholinergic blocking drugs (anticholinergics)
  4. Adrenergic blocking drugs (adrenergic antagonists)
173
Q

The brain and spinal cord are located in which system?

A

central nervous system

174
Q

all nervous tissue all nervous tissue are located in which system?

A

peripheral nervous system

175
Q

Name the actions of teh nervous system.

A
  1. Recognizing changes in the internal and external environments
  2. Processing and integrating the environmental changes that are perceived
  3. Reacting to the environmental changes by producing an action or response
176
Q

What organs and tissues does the ANS regulate?

A

Heart, Digestive tract
, Respiratory tract, Reproductive tracts, Arteries, Salivary glands, Portions of the eye

Nursing Pharmacology (3 decks)

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