Exam 5 Flashcards
What is closed angle glaucoma? Open angle? What is the problem? What is the damage it causes?
Closed angle: medical emergency. Acute problem, actively going blind
Open angle: chronic, too much fluid or insufficient drainage. Canal of schlem, drainage of fluid. If unable to drain the pressure increases
Eye may make too much aqueous humor, with pressure less than 30 or less than it causes pain
Puts pressure on the optic nerve
What med class is timolol? What does it treat? How does it work? Adverse effects? Who is it contraindicated with? Why?
non-selective beta blocker
open-angle glaucoma
Decreases the production of aqueous humor
blurry vision, bradycardia, CHF, depression, burning, stinging
Asthma and obstructed airways, heart issues, diabetics
It vasconstricts,
What is the prostaglandin analogue med for open-angle glaucoma? What does it do? Adverse effect?
latanoprost
increases outflow of aqueous humor
can pigment eye lashes and eyelid skin
What is a cholinergic med for closed angle glaucoma? What does it do?
pilocarpine
causes pinpoint pupils and bradycardia because it is cholinergic
What is a secondary treatment for open-angle glaucoma? What does it do? Which similar med if for closed angle emergent glaucoma?
dorzolamide
decreases aqueous humor production
acetazolamide
What diuretic is indicated with closed angle glaucoma? What happens if that fluid is taken of so quickly?
mannitol
HF, electrolyte imbalances. pulmonary edema, peripherial edems becausee a ton of fluid is being pulled
What is best for inner ear infections, otitis media? Why? What is best for swimmer’s ear, otitis externa?
amoxicillin
because it needs a systemic antibiotic because it’s tough to get the antibiotic there with a drop.
ciprofloxacin w/ dexamethasone
What are the antidotes for the following:
acetaminophen
anticholinergic drugs
benzos
beta-adrenergic blockers
CCBs
digoxin
heavy metals
opioids
acetylcysteine
physostigmine
flumazenil
glucagon
calcium/insulin/IV glucose
digibind
chelator
naloxone
What is used if there is a toxin inthe stomach?
activated charchoal
What is a chelating agent for heavy metals?
dimercaprol
What are good sources of vitamin A? What can it do with oral contraceptives?
liver, egg, whole mil, butter, green and yellow vegs
Increase hypervitaminosis
What does vitamin D help with
maintain clacium and phosphate levels
What is vitamin K vital for? What is it an antidote for? Who is it given to as a matter of course?
clotting factors
warfarin
newborns to help with clotting
What are the B vitamins affected by alcoholism? What is B6? What is a side effect? Food sources?
Vitamin B 1, 2, 3, 6 and 9
pyridoxine
peripherial neuropathy
yeast, wheat, corn, organ meats
What is B9? Who is at risk for deficiency? With macrocytic anemia what are the 3 important triad needed?
folic acid
alcohol, malabsorption, pregnancy, macrocytic anemia
folate, B12 and iron
Who may need B12 supplementation? Food sources
malabsorption, begetarianism, macrocytic anemia, gatritis and perniscous anemia
meats, liver, kidenys, fortified cereals
What is the adverse effects of ferrous sulfate? What can be done if not tolerated in GI?
GI upset, black stool, constipation, hemochromatosis (too much iron), stains of teeth
IV iron
What must bedone sith potassium chloride? Is it painful?
must be diluted
yes
What is an additional indication of magnesium sulfate in addition to being used as a laxative? SE?
stop preterm labor
diarrhea, muscle weakness, heart
what is a formula supplementation for someone with a functioning GI tract? Malabsorption or not fully functioning? What is for most sever contition? What can be very specific (a la carte)?
polymeric formula
monomeric/elemental
oligomeric/semi-elemental
modular
What are complications of TPN
mechanical
metabolic: hyper or hypoglycemia, fluid overload
sepsis
What is a med that blocks lipid absorption? What are the icky side effects?
orlistat
wet farts, oily stool, fecal urgency
can inhibit fat-soluble vitamin absorption, must separate for a 2 hours
What is a med that is a sympathetic stimulator to help with obesity?
phentermine
What can be done outside of medications for stomach ulcerations?
stop alcohol, smoking, spicy foods, NSAIDS, etc…
How is H. pylori treated?
1 PPI, 2 antibiotics and pepto:
omeprazole
amoxicillin
metronidazole
pepto bismol
What is the histamine reducer for gastric acids? Is it a daily basis drug? What is a risk? why?
famotidine
yes
pneumonia, reduces body’s defenses agiainst infection
What are adverse effects of omeprazole?
b12 deficiency, malabsorption of iron and calcium, osteoporosis, GI infections, N/D, HA
What is the risk of sucralfate?
it’s like a sugar. Diabetics–be minful of glucose
What helps with protect from the effects of chronic NSAID use? Who is it contraindicatedin?
misoprostol
pregnancy X, can cause abortion
What does metoclopramide affect? What is it indicated ofr? What can it cause? If it reduces dopamine who is it contraindicated in?
dopamine antagonist
N/V from chemo, post-operative N/V, GERD, lazy stomach
EPS, dystonia symptoms, sedation
EPS, parkinson’s, bowel obstruction
What can be given for constipation?
senna
What is a osmotic sugar for constipation?
lactulose
With psyllium what is patient education about preventing constipation?
2-3 L water a day
full glass before and after taking
What is for dirrhea? why does it have atropine?
diphenoxylate
so it is not abused
What is used with ulcerative colitis and chrohn’s to reduce inflammation? AEs?
sulfasalazine
N/V/D, dyspepsia, steven’s johnson, photosensitivity, liver toxicity, bone marrow supression
What must you be careful with ondansteron?
QT prolongation
What is commonly used with cystic fobrosis or pancreatic secretion deficiency? What is a strange allergy to be aware of with this med?
pancrelipase
pork allergy
what is a med for post-op N/V similar to ondansteron?
aprepitant
What helps increase appetitie when there is chronic nausea, such as with AIDs?
dronabinol
What is an anticholinergic to dry up post-op secretions and N/V?
scopolamine
What is dimenhydrinate? What is the most common adverse effect?
dramamine
sedating, fatique
What is for females only with IBS? why is it contraindicated in men?
alosetron
seen to cause ischemic colitis and death
What is used for IBS with constipation or chronic constipation? What does it cause
lubiprostone
GI upset
Where can estrogen cause cancer? What is pt is a smoker?
breast, ovarian, endometrial, blood clots
go with progesterone only
What are SE of testosterone? PT education?
agression, acne, increased hair growth, liver, hyperlipidemia, prostate cancer, breast cancer
No grapefruit, wash hands
What is used for prostate and hair growth? Is it short term or long term?
finasteride
long term, takes 4-6 months to shrink prostate
What is the short term prostate drug? AE?Why?
tamsulosin
OH, opens up vessels
What is the med for erectile dysfunction and HT? What should pt avoid?
sildenafil (Viagra)
avaoid grapefruit, take 4 hours to sexual activity
What helps with infertility?
clomiphene
What can induce labor? Contraidications?
oxytocin
unripe cervix, genital herpes, hx of multiple births, prolapsed umilical cord
What is B2 agonist for asthma?
terbutaline
What is given to reduce neonatal respiratory distress to increase lung function?
betamethasone
