Lungs Flashcards
What are some things that can start an asthma attack
aspirin, beta blockers, Dairy products. mold, Ibuprofen, preservatives, nuts.
4 s/s of asthma
Swelling, mucus, spasms of bronchioles. Maybe cough
COPD
Chronic Bronchitis-Excessive mucus
Emphysema- loss of elasticity and destruction of alveoli
Comorb for COPD
Cardiac disease
Two types of asthma drugs
Quick release and long term
What are the quick release classes for asthma
SABA-Short acting beta2 adrenergic antagonists-Bronc dilators
Anticholenergics-Bronchodilators
Cortico Steroids- Antiinflammatorys
What are the long acting meds for asthma
Mast cell stabilizers-Antiinflammatory
Leukotriene modifiers-Antiinflammatory
Methylxanthines-Bronchodilators
Monoclonal antibodies-Biologic therapy
Where are corticosteroids secreted from? and what kinds are there?
Adrenal gland
mineral- Aldosterone -retention of na and water
Gluco- stress metab
cortisol
gonad-sex hormones
Glucosteroids effects 6
Suppress immune response, promote broncho dilation sim, increase BG, break down lipids for energy. break down bones, stabilize mast cells inhibit inflam mediators.
steroids 4AE
Peptic ulcer, inhibit insulin,
long term osteoporosis,
impaired wound healing
dosing for steroids
low and gradually increase
alternate- intermediate acting-prevent adrenal atrophy
attempt to admin locally to reduce systemically
hydrocortisone kind of steroid and MA
corticosteroid
MA-Replaces glucocorticosteroids, block inflam, and allergic reactions
AE-Long term large doses can make cushings
What are the drug interactions for steroids? 1
Potassium wasting diuretics-increases risk of hypok
NSAIDS-Ulcer
Insulin and oral hypoglycemics- may need to adjust dose
Live vaccines-risk for infection
Patient teaching with steroids
Tapper
If stopped- adrenal glads go into adrenal insufficiency-hypotension, lethargy, renal fail, asthenia, nausea, vomit
Good things about estrogen 4
Increases HDL and Decreases LDL
Help with Menopause
protects boney matrix
Pallative care with men with terminal prostate cancer blocks androgen
Name of estrogen
uses 5
Ma
Conjugated estrogen premarin Hypogonadism oophorectomy post men end prostate cancer Bind to intracellular estrogen receptors-stimulate proteins needs for bio effects of estrogen
AE of estrogen minor 5
Major 7
HA cramping bloating, breast tenderness, vaginal bleeding
PE, DVT, stroke
Increased risk of breast and ovarian cancer
increased risk of endometrial cancer in postmen women
increased risk of dementia
cat x preg
Progestin indications 4
Uterine abnormalities, uterine bleeding, inop endometrial carcinoma, Pre menopause replacement therapy
Progesterone AE 6
major-4
Minor- breast tenderness, breakthrough bleeding, weight gain, depression, N/V
Major-Increased risk of breast cancer, clots, MI- With estrogen
preg x
Hormone Therapy oral contraceptives indications 5
MA
And what do they use
Contraception, Heavy bleeding, acne, endometriosis, Hirsutism,
Prevent ovulation by sending negative feedback message to pituitary- suppresses LH and FSH
Estrogen and progestin
Side Effects of Contraceptives
Minor-4 Major 4 one good thing
Minor-Nausea, breast tenderness, weight gain, breakthrough bleeding.
Major- Thromboemboli disorders.
NO SMOKING-Huge risk of cardio disease esp if over 35
Increased risk of breast cancer and CI if someone has cancer
Preg x
Reduced chance of ovarian and endometrial cancers are reduced
Testosterone functions 5
Promotes synth of erythropoietin Growth of skeletal mm and bone maintenance of libido puberty spermatogenesis
Indication
men 3
women 2
both 2
Hypogonadism, delayed puberty, ED
low libido, Advanced breast cancer
Mm wasting, anemia
Testosterone AE 4
1 bbw
CI 2 and preg cat
Edema-salt and water retention, Increased or decreased libido, Hapatotoxicity-long term use, Sterility,
BBW- Virilization in women and children deep voice and hirutism
CI-Men with breast or prostratic carcinomas
gels should be avoided in boys and women
Cat x
Androgen use
AE 7
Athletes Acne, edems-HTN, depression/mania/aggression Increases LDL and liver tox sterility impotence Testicular atrophy
What is the infertility medication MI for women and men
AE 5
Preg cat?
Clomiphene
W induces ovulation by stimulating the release of LH resulting in maturation of more follicles than normal
M Spermatogenesis
AE- Weight gain, hot flashes, PMS symptoms, multiple gestations, gynecomastia
Cat x
ED med
MA
Sildenafil
Relaxes smooth mm in corpus caverosa- vasodilates the penile arterioles and results in erection
Sildenafil AE 6
CI- 2
alternative med
Hypotension, dizzy, flushing, Prapism- 6 hr, Blurred vison or changes in color
CI- antihypertensives, Organic nitrates-severe hypotension and death.
Tadalafil-safer in HF or MI less hypotesnsives.
Surg for BPH
and
Drugs 2
TURRP
5 alpha reductase inhibitors
Alpha adrenergic antagonists
Alpha reductase inhib drug
MA-2
Time?
one more
Finasteride Inhibits conversation of testosterone to dihydrotestosterone shrinks prostate over 3-6 months cant cure if med stops it regrows
AE finasteride 7
Blocks test Decrease libido, gynecomastia impotence infertility Increased hair growth preg women should not handle
What is the alpha adrenergic antag treat?
Name
MA and ine thing about that
and one more thing
BPH
Tamsulosin
selectivly blocks alpha- relaxes smooth mm of bladder neck, prostate gland, and urethra. It is selective- but not like other drugs in the class.
improves urine flow in 1-2 weeks.
Opioids receptors and a little about them
mu-main that helps with high pain rr depression
Euphoria, sedation decreases BP rr constricted pupils and itching causes and constipation
kappa-dysphoric or hallucination
delta
4 indications ops
Cough suppressant, depression, relax, constipation pain
Relaxation and ICP
Relaxation can increase CO2 and CO2 can cause dilation and this can cause ICP
OP classifications
Agonist- Morphine, codeine
Agonist antagonist pentazocine
Antag- naloxone
Blocking opioid receptors
blocking op receptors can bring on withdrawal s/s
Morphine MA AE-11 CI-6 Two more thing
Mu and Kappa receptors
AE Resp depression, orthostatic hypotension, constipation, unrine retention, cough suppression, biliary colic, n, v, dysphoria, euphoria, miosis, itching
CI- preg premature infants, head injury, ICP, COPD other resp issues
FIrst pass effect so PO needs higher dose
equal analgezic dosing-like step down
there other opioid agonist and about them
Meperidine-Toxic metabolites, seizure risk, used for shivering in post op. not so much any more. narcan wont work
Methadone-Orally effective long half life for dependency
Codeine-Cough suppressant for mild to mod pain not for kids
pentazocine
MA
one advantage other drugs
Mixed antag weak at mu and a ag at kappa , low mu lower risks,
no euphoria can give with naloxone
nalburphine and buprenorphine
Tramadol what is it categorized as? MA For? AE2 one CI 3 more things about it.
Mixed opioid and no opioid. Very weak bind to mu. s/n reuptake in spinal cord.
acute or chronic pain. CNS excitation or depression. not for peds.
10x weaker than codine so non op- but can be abused. For mod pain.
First and second gen COx inhib
1-both
2-2- only one drug cela
3 types of NSAIDS
Salicilates, ibuphropen, cylcooxigenase 2
cox 1 desirable effects and what is it
where is it found?
one thing it does
four adverse effects of blocking it
Decrease in acid, increased platelet aggregation, renal protection, vasodilation, bronchodilation
cytoprotective prostaglandins
Endothilium
submucosal blood supply
gastric problems, bleeding, renal impairment, prevention of MI/Stroke
Cox 2 undesirable effects and what is it
where is it found
what does it do? 5
inhibition-4
Inflam, pain, fever, decreased platelet aggregation
Inflammatory prostaglandins
injured tissue- gut and kidney
fever and increased perception of pain supports kidneys, inflammation, sensitizes pain receptors
inhibition- antiinflam, pain alleviation, reduces fever, renal impairment
asprin 1 thing 4 AE Preg class and about that Drug interactions- 5
Asprin irreversibly inhibits cox one
PPI-issues
Hearing loss
liver tox
suppress contractions
preg c or d- Ductus close early, low birth weight, IC hem
warfarin, steroids, alcohol. ibuprofen, acetaminophen,
Non asprin 1 st gen NSAIDS two things compared to asprin one thing its indicated for one thing it is not indicated for 2 drug names and one thing about both
Fewer side effects that ASA bbw increase risk for stroke MI dysmenorrhea no preg no cardio conditions Ibuphrofen-Less stomach upset than aspirin , ketoroloac- No more than five days use
What is the cox 2 inhib
6 things about it
Celecoxib
Less gi, thrombotic issues, watch for kidney and liver issues and increased risk of bleeding.
colorectal polyps protection
dont take with diuretics or ace in because or reduced bp effects.
Acetaminophen
MA
and interactions-2
Inhibits PG in the CNS
alcohol- greater metabolism and liver damage and may inhibit warfarin
Ace is for
and remember why you are putting this what is the other drug that works for this
Osteoarthritis
Asprin
Non biologic dmards drugs and about them
Methotrexate- First line, folic acid antag and imminosupressant used for carcinomas and leukemias and after a kidney transplant. psoriasis and RA GI ulceration, hep tox, preg x
and sulfasalazine sulfonomide daily dosing improvement within one month, RA good for kids, chrons and UC
AE- Gi issues change
Cat x- hepatotoxic
What are the Biologic DMARDS
what class
what three drugs
what is adverse effect
TNF antag pot immuno sup
Etanercept, infliximab, adalimumab
INFECTIONS cancer increases with kids
