Final exam info Flashcards by Charles Acevedo

What is the purpose of NSAIDs

Treat mild to moderate pain

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What enzymes do NSAIDs block and what do those enzymes do

Cox 1 - moderate stomach lining, maintain renal lining, regulate platelet activity
Cox 2 - moderate pain and inflammation, lower blood pressure, prevent arterial thrombosis

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What are some examples of a nonselective Cox inhibitors

Ibuprofen, aspirin

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What is an example of a selective Cox 2 inhibitor

Celebrex

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What is Reye’s syndrome and how does it relate to aspirin

Swelling in the liver and Brian

Aspirin may cause Reye’s syndrome in children

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Can pregnant women take NSAIDs

Yes but not in last trimester

They cause closure of ducts, arteriosus and bleeding

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How is acetaminophen different from NSAIDs

Not an NSAID
Treats pain and fever
Does not treat inflammation or anticoagulation
Not associated with GI issues
Risk of overdose and liver toxicity
Often used in OA

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Describe Celebrex

Cox 2 inhibitor
Less GI irritation
Increased risk of cardiac events (HA stroke)
Not used in patients with history of heart disease

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What are some AE of NSAIDS

GI problems, ulcers
CV problems - HTN
Aspirin hypersensitivity - bronchospasm, rhinitis, urticaria
May retard bone healing and growth

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What are some medication classes used for RA

NSAID’s
Glucocorticoid’s
DMARD’s

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What dietary changes may help patients with RA

Low protein diet

High fish oil

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What is viscosupplementation

3-5 injections of hyaluronan

May delay the need for joint replacement for 6 months to a year

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Is glucosamine a beneficial treatment for RA

Results inconclusive

Some patients swear by it

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What is more effective for OA, acetaminophen or NSAIDs

Acetaminophen

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Other than oral how can NSAID’s be administered

Topically

Diclofenac

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How do NSAID’s help RA

Treat pain and inflammation

Do not prevent joint damage

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Describe glucocorticoids

Steroid Hormone
Powerful at decreasing inflammation but with lots of AE
No more than 2-3 injections per year

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Describe how glucocorticoids are used in treatment of RA

Used in acute flareups and early in the disease

Can slow the progression of RA

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What are some AE of glucocorticoids

Osteoporosis
Muscle wasting
HTN
Aggravate Diabetes
Glaucoma
Cataracts
Increased risk of infections
Must wean off to recover
can cause drug induced Cushing's syndrome

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Describe DMARD’s in relation to RA

Essential in early RA to slow disease progression
Current gold standard is methotrexate
Target cytokines to stop inflammatory cascade

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Describe how OA treatment should occur

non-pharmacological measures, weight loss and therapy
Acetaminophen
Topical NSAID's
Viscosupplementation
Possibly glucosamine

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What kind of medications are used in a PCA pump

Opioid analgesics

Morphine Fentanyl

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What is opioid sparing

Combining opioids with non-opioids to decrease the amount of opioid used
Usually combined with NSAID’s

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What are some benefits of a PCA pump

Allows patient to better control pain
As pain fluctuates the patient can self deliver more or less medication
Improved patient satisfaction

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What is loading dose

the use of a single large dose given initially to establish analgesia prior to PCA

What is a demand dose

the amount of drug that is self administered by the patient each time they activate the PCA pump

What is lockout interval

the minimal amount of time allowed between each demand dose

What is 1- and -4 hours limits

can limit total drug that can be delivered

What is background infusion

A small continuous background level of analgesia

What are the 4 types of administration route

IV - peripheral vein Epidural - spine Regional - directly to the anatomical site Transdermal - iontophoresis

``` What are antitussives used for What drug class is this ```

Cough suppression | opioids

What age ranges are antitussives appropriate for

Not for children younger than 18

What are some AE of decongestants

increased HR and BP | rebound effect if used for more than 3 days

Are decongestants meant for short term or long tern use

short term

Why are newer antihistamines less sedative than older ones

Newer ones do not cross the blood brain barrier

What are some AE of antihistamines

Mucosal irritation and discharge

What drugs class is used to thin mucus secretions and what is an example

Mucolytics - Mucosil

What drug class aids in the ejection of mucus and what is an example

Expectorants - Mucinex

What drug classes are used in the treatment of asthma and COPD

Glucocorticoids - asthma | Anticholinergics - COPD

What is an example of a Beta-adrenergic receptor and some AE

Salmeterol | nervous tension, headaches, palpitations, muscle cramps

What is an example of a Leukotriene inhibitor and some AE

``` Singulair Cold symptoms Diarrhea Ear infection Fatigue Flue symptoms Headache Heartburn Itch skin or rash ```

What medications are used in short and long term management of asthma

Short term - beta adrenergic receptors - bronchodilator | Long term - glucocorticoids - reduce inflammation

Describe decongestants

``` Alpha 1 adrenergic receptors Dry up mucosa Increase HR and BP Can be used for nose bleeds Not to be used for more than 3 days ```

What are leukotriene inhibitors used for

good for exercise induced asthma

What are the effects of aluminum vs magnesium antacids

aluminum - constipation | Magnesium - diarrhea

What medications should not be taken with antacids

Digoxin, warfarin, antibiotics

Why might someone getting an allergy shot be given an H2 blocker

H2 blockers treat peptic ulcers and GERD

What is a typical treatment of H.Prlori infection

antibacterial and PPI's

What is used to treat GERD and wha are the AE

H2 blockers | AE - headache, dizziness, GI problems

What 2 drug classes are used as antidiarrheal agents

Opioid derivatives | Bismuth salicylate

Describe antacids with aliminum

Inhibit H.pylori Enhance prostaglandins Constipation

Describe antacids with magnesium

Diarrhea

Describe proton pump inhibitors and AE

More effective than H2 blockers at treating ulcers and GERD May treat H. pylori AE - fracture, gastric polyps, decreased magnesium, dementia

What hormones does the thyroid secrete, what are their functions

T3 - T4 Growth and development Cellular metabolism regulate body heat

What are some clinical uses of mineralocorticoids

diuretic

What does the parathyroid secrete and what is its function

parathyroid hormone | Calcium homeostasis, increases calcium in blood

What does the pancreas secrete and what is its function

insulin and glucagon Insulin decreases blood glucose Glucagon decreases blood sugar

What does the adrenal cortex secrete and what is its function

Glucocorticoids and mineralocorticoids Gluco - regulate glucose metabolism Mineral - regulate fluid and electrolytes

What does the adrenal medulla secrete and what is its function

Epinephrine and norepinephrine | Facilitate increased physical activity

What do the gonads secrete and what is its function

Estrogens, androgens, progesterone | Sexual characteristics

What triggers the release of glucocorticoids naturally

Stress

What are indications for glucocorticoid use

antiinflammation immune suppression effect on metabolism

What are mineralocorticoid antagonists used for

heart failure and hypertension

What are mineralocorticoid agonists used for

Addison's disease, Heart failure | men can develop breasts, weight gain, peripheral edema

What are common signs of hyperthyroidism

nervousness, weight loss, diarrhea, tachycardia, heat intolerance

What are common signs of hypothyroidism

lethargy, weight gain, constipation, bradycardia, cold intolerance

What medications are used to treat hyperthyroidism

antithyroid agents, radioactive iodidem beta blockers

What is used to treat hypothyroidism

levothyroxine, liothyronine, armor thyroid

what causes hyperthyroidism

graves disease, tumor

what causes hypothyroidism

idiopathic, hashimoto disease, low iodine intake

What medication class is used to treat osteoporosis, what are AE

parathyroid alendronate - fosamax Osteonecrosis of the jaw, atypical fractures, GI issues, need to be upright after taking

What are some side effects after too much vitamin D

``` arrhythmias renal failure HTN HA GI issues ```

What is normal glucose level

70-110mg

What are some long term affects of poorly controlled blood sugar levels

``` Retinopathy Nephropathy Poor wound healing HTN MI CVA Peripheral neuropathies ```

What are Fluoroquinolones used to treat and some AE

UTI's It is an antibacterial AE - photosensitivity, nephrotoxicity, ototoxicity

What are common side effects with Fluoroquinolones

tendinopathies | often of the achilles

what is an example of a Fluoroquinolones

levaquin

suffix mycin indicates

Antibacterial