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Pharmacology > Exam 7- MSK and Endocrine > Flashcards

Exam 7- MSK and Endocrine Flashcards

1
Q

A)The onset of Acromegaly is usually between the ages of 9-21 years old.
B)The person with Gigantism is typically very tall, sometimes up to 7ft.
C)The person with Acromegaly will need to buy a bigger shoe size.
D)The person with Gigantism will not show the symptoms until they are in their older adult years.
E)The person with Acromegaly will commonly have cardiomegaly.

A

B, C, E

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2
Q

Growth hormone replacement therapy has been prescribed for the child with a growth hormone deficiency. Somatropin (Humatrope), a synthetic growth hormone, is administered by which route?

A

sub cutaneously

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3
Q

How frequently should the child on Growth Hormone replacement have bone-age (epiphyseal plate) assessed with an X-Ray?

A

monthly

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4
Q

Prolonged synthetic growth hormone replacement therapy may lead to which one of the following health problems?
A. Hyperthyroidism
B. Asthma
C. Diabetes Mellitus
D. Cushings Syndrome

A

Diabetes Mellitus

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5
Q

T/F Diabetes Insipidus is a disease in which the person has excessive secretion of the ADH.

A

False

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6
Q

A nurse can expect that the person with untreated D.I. will have which of the following symptoms?
A. polyuria
B. decreased urine output
C. Dry mucous membranes
D. pulmonary edema
E. urine specific gravity less than 1.010

A

A, C, E

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7
Q

What is DDAVP? What is another name for this drug?

A

Desmopressin Acetate, a synthetic form of vasopressin hormone
Vasopressin: a hormone regulates the water balance.

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8
Q

T/F: Diabetes Insipidus is treated with drugs such as DDAVP or Vasopressin

A

true

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9
Q

T/F: Both DDAVP and Vasopressin can lead to an adverse effect of vasoconstriction.

A

True , but there is more in Vasopressin

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10
Q

The drug of choice for Diabetes Insipidus, b/c of les severe side effects and can be administered intranasally is ->

A

DDAVP

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11
Q

What are symptoms of hyponatremia? Why would someone with SIADH have hyponatremia?

A

cognitive changes, EKG changes, seizure that can lead to coma
// because all the water retention dilutes the sodium

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12
Q

What are common side effects of DDVAP and Vasopressin, in the treatment of Diabetes Insipidus?

A

hypertension, water intoxication, tachypnea

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13
Q

What is Myxedema? what are some signs and symptoms
What do they need?

A

the result of undiagnosed or untreated hypothyroidism -
they need thyroid hormone every morning without food
everything is sluggish
HR is low
hypothermia
hypotension
hypoventilation
loss of consciousness
weight gain

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14
Q

Which med will someone with Myxedema Coma be treated with

A

IV Levothyroxine

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15
Q

What are signs and symptoms of Graves Disease

A

Tachycardi
excessive perspiration
heat intolerance
nervousness & irritability
exophthalmos
weight loss

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16
Q

What are medications to be taken for hyperthyroidism

A

Propranolol – to decrease the heart rate
Methimazole (Tapazole) –

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17
Q

The patient is being treated with Methimazole for hyperthyroidism (grave’s disease). If the pt is not receiving enough medication, which of the following symptoms might you expect?
A) Constipation
B) Diarrhea
C) Bradycardia
D. Tachycardia
E. Perspiration
F. Dry skin
G. Weight gain
H. Weight loss

A

Diarrhea, tachycardia, perspiration, weight loss

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18
Q

The pt is receiving for the treatment of hyperthyroidism and calls the health clinic and reports a sore throat and fever. The nurse instructs the patient to…
A. Please come to the clinic to have your WBC count checked.
B. You may take acetaminophen for the pain and fever.
C. This is a common adverse effect of Methimazole. Nothing to be concerned
D. Please monitor the fever for the next few days. If you continue to have a fever.

A

A– check the WBC count
Agranulocytosis: low neutrophils and high risk for infection.

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19
Q

What medication might someone with hypothyroidism be prescribed? What will it do to the oxygen demand of the heart?

A

Levothyroxine
Increase oxygen demand of the heart

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20
Q

What are some nurse education points for Levothyroxine?

A

-you can expect to take med for lifetime
-narrow therapeutic window
-take med in the morning on an empty stomach with glass of water
-will take a month for drug to reach therapeutic level
-report any chest pain or SOB

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21
Q

What are some symptoms for someone with Adrenal Insufficiency. What does this mean and what are some signs and symptoms

A

inadequate release of glucocorticoid (cortisol) and mineralcorticoid (aldosterone)
weakness and fatigue
hypotension
hyponatremia
hyperkalemia

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22
Q

What drugs for Addisons Disease?

A

Adrenal insufficiency
Hydrocortisone

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23
Q

A pt with Addison’s Disease has been treated with Hydrocortisone. The provider determines the pt is not receiving adequate mineralocorticoid. What is a Mineral-corticoid agent that can be given to this patient?

A

Fludrocortisone

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24
Q

Who would get Cushings Syndrome?
A) The patient treated with Hydrocortisone for Addison’s Disease
B) The pt treated with a corticosteroid medication long term for treatment of rheumatoid arthritis
C) The patient treated with Levothyroxine for hypothyroidism.
D. The patient treated with propranolol to control HR with hyperthyroidism.

A

A & B
The patient treated with Hydrocortisone for Addison’s Disease
The pt treated with a corticosteroid medication long term for treatment of rheumatoid arthritis
*anytime someone is on systemic prolonged glucocorticoid meds *

25
Q

What is Ketoconazole (Nizoral) used for?

A

Cushings Syndrome

26
Q

What is Somatropin (Humatrope) used for?

A

Growth Hormone Deficit

27
Q

What is Propylthiouracil (PTU) used for? What would you use if you couldn’t find this drug?

A

Hyperthyroidism
Methylmizole

28
Q

what does it mean if something inhibits osteoclast activity?

A

it will decrease bone resorption (the break down of bone)

29
Q

what does osteopenia mean? What will the team recommend for this pt?

A

precursor for osteoporosis
*vitamin D, weight bearing exercises, calcium pills

30
Q

S/S of hypercalcemia

A

kidney stone

31
Q

When do Chvostek and Trousseau signs show up?

A

hypocalcemia

32
Q

What is a medication that promote bone formation?

A

Teriparatide (forteo)

33
Q

How does Alendronate (Fosamax) work?

A

decrease bone resorption

34
Q

The nurse is preparing Alendronate (Fosamax).
Which of the following are True?
A. Drug increases osteoclast activity
B. Drug has a narrow therapeutic range and high toxicity risk
C. drug must be given with food to decrease the GI effects
D. The pt must be upright for 30 min after administration

A

D. The pt must be upright for 30 min after administration

35
Q

ADRS of Bisphosphonates
administration details

A

-dronate

empty stomach
-any food will decrease absorption
-full water glass to decrease
-sitting up
ADRs: esophagitis lead to ulcer, cancer
atypical femur fracture
necrosis of the jaw

36
Q

What is the drug category of Raloxifene?
What is the MOA
What are the ADRS

A

drug category is SERM
it works by binding to estrogen receptors in the bones
Adrs: thromboembolism and stroke

37
Q

Ibandronate MOA is

A

inhibits bone resorption by decreasing osteoclast activity

38
Q

Calcitonin

A

hormone that moves calcium from blood stream to the bone

39
Q

Teriparatide
what is it and what is the black box warning?

A

increases bone deposition by osteoblasts

40
Q

Calcitriol

A

vitamin D supplement

41
Q

Denosumab

A

Monoclonal antibody that decreases formation and function of osteoclast

42
Q

Tum

A

calcium supplement

43
Q

treatment of rheumatoid arthritis -

A

NSAID and Glucocorticoid at first, and the DMARD but that takes longer to come into effect

44
Q

NSAIDs for RA b/c –>

A

anti-inflammatory and analgesic effects

45
Q

Which of the lab tests should be monitored for DMARD, methotrexate?
A) potassium and sodium
B) AST and ALT
C. CBC
D. T4 and TSH
e. Vitamin D

A

AST and ALT liver function
CBC

46
Q

What is innacurate about Methotrexate?
A. drug is sometimes used to treat cancer
B. blood checks need to happen on the reg
C. call doctor if experience yellowing of eyes or skin
D. i should start to feel better within a few days

A

D - doesnt work right away

47
Q

What is an ADR of the DMARD Etanercept Enbrel)?

A

systemic infections due to immunosuppressant activity
b/c it blocks one of the inflammatory mediators

48
Q

ADRS of TNF (tumor necrosis factor)

A
49
Q

Allopurinol what does it do

A

prevention of future gout attacks
Inhibits uric acid formation

50
Q

Naproxem

A

treat acute symptoms during gout attack (it is NSAID)

51
Q

Probenecid

A

prevent future gout attacks
increases uric acid excretion

52
Q

Prednisone

A

treat acute symptoms during gout attack

53
Q

Indomethacin

A

treat actute symptoms during gout attack

54
Q

Colchicine

A

antiinflammatory

55
Q

What is the difference between muscle spasm and spasticity?

A

spasm: caused by injury or overuse, involuntary contractions

spasticity: caused by damage to upper motor neurons in theCNS, muscles are in constant state of contraction

56
Q

Pt is prescribed Baclofen for muscle ________. Where will work? What are ADRS

A

spasticity, within the CNS as a depressant
ADRS are drowsiness, fatigue, hypoventilation, dizziness

57
Q

Which of the following drugs used to treat muscle spasticity works directly on the skeletal muscles?

A

dantrolene

58
Q

A pt experiences muscle spasms . Prescribed Cyclobenzaprine (flexeril). What is a pt teaching regarding this drug?

A

dont drive your car while taking this medication
(anything that requires alertness)

Pharmacology (18 decks)

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