medical conditions exam 1 Flashcards
1
Q
what is a PT’s job in relation to drugs
A
we can’t prescribe or administer in general, we can only administer for modality use like iontophoresis and phonophoresis
2
Q
what type of drug is aspirin
A
anti-platelet
3
Q
if a patient says they are having a lot of inflammation, can you recommend the use of an NSAID
A
NO. but you can educate them on different types of OTCs so they can make the best choice but we can’t recommend use of drugs
4
Q
are drugs removed from the body as active or inactive
A
can be either one depending on the type of drug and how the body responds
5
Q
example of ace inhibitor
A
lisionopril
6
Q
example of calcium channel blocker
A
norvasc
7
Q
what do PTs use drug screenings for
A
precautions and contraindications for PT intervention
8
Q
A
9
Q
what does the FDA do
A
direct drug development, give approval for drug marketing, approve new use for older drugs, monitor use of existing drugs, determine if drugs are safe for humans and if they are effective
10
Q
why are some drugs banned in the US but able to get in other countries
A
FDA determines if they are safe, most other countries just care if they are effective
11
Q
what determines if a drug is rx or OTC
A
OTC have higher theraputic index so side effects are less
12
Q
give examples of classifications of drugs
A
traditional vs generic, biologic vs biosimilar
13
Q
what type of drug must be bioequivalent to the original
A
generic
14
Q
what does bioequivalent mean
A
same dose, strength, ingredients and has the same effect in the blood
15
Q
which type of drug can be analyzed for its components
A
traditional
16
Q
what type of drug comes from living systems like yeast, plants, animals and can’t be replicated
A
biologic
17
Q
what kind of drugs aren’t identical to the original but are usually at a lower cost, but we don’t know how therapeutic they are
A
biosimilar
18
Q
what are examples of natural alternative therapies
A
minerals, fish oil, vitamins, etc
19
Q
what does integrative medicine focus on
A
health vs disease
20
Q
how many stages in drug testing does the FDA have and what is stage 4
A
4 stages, when they continue monitoring for adverse effects even after it’s approved
21
Q
4 steps in pharmacotheraputics
A
AADME
22
Q
what are some things drugs may be used for
A
maintenance, treatment, replacement, prevention
23
Q
chemical name drug
A
long and complicated name, specific compound and structure
24
Q
generic name
A
official name usually used in journals
25
trade name
copyrighted name, assigned by the drug company
26
how many schedules of drugs are there based on the comprehensive drug abuse prevention and control act
5
27
what schedule is marijuana in
used to be 1, but now it's 3
28
what schedule are cocaine, morphine and adderall in
1
29
what schedule is testosterone in
3
30
what schedule are xanax, valium in
4
31
what schedule is robitussin in
5
32
risk factors for THC
stroke, fall, MI
33
what trimester should a pregnant woman make sure she does not consume drugs in
1st trimester
34
def dose
amt drug reach target site
35
def potency
amt needed to produce effect
36
def low dose
no observable effect b/c dose is too low
37
ceiling effect
dose is high so there is no increase in the response
38
which type of drug is immunogenic
biological, NOT chemical
39
which type of drug is stable and has a well-defined structure
chemical
40
what are some pros and cons of biologics
very expensive but better for the body and can be very specific in what they target
41
what is the most important thing for us as PTs to know about drugs out patients are taking
why they are taking the drug
42
what does bioavailability depend on
administrative route and ability to cross membrane barriers
43
2 types of drug administration
enteric and parenteral
44
enteric is also known as
alimentary (through GI)
45
what step of pharmokinetics determines bioavailability
absorption
46
what is drug absorption affected by
dosage, solubility, blood flow, acidity, concentration, diffusion
47
what is distribution of drugs affected by
blood flow, plasma protein, binding, anatomic blood barrier
48
what stage of pharmacokinetics includes the liver breaking it down
metabolism
49
what happens in the metabolism stage
liver changes drug to inactive form which also impacts how quickly it is excreted from the body
50
what organ is involved with elimination stage
kidney
51
what stage of pharmacokinetics is related to clearance or half life
excretion
52
what methods of taking drugs are parental
sublingual/buccal, IV, IM
53
what is a disadvantage about rectal administration and PEG tube
unpredictable where the drug will go in the body
54
example of drug administered via sublingual or buccal
nitroglycerine
55
what type of drug administration is 100% bioavailable
IV and IA
56
what type of administration are phonophoresis and iontophoresis
transdermal
57
what is intrathecal baclofen therapy
uses baclofen to decrease abnormal tone and deliver drug into CSF to manage severe spasticity
58
volume of distribution
ratio of drug administered to the concentration of drug in plasma
59
where are most drugs stored in the body
adipose tissue b/c lipid soluble
60
what are prodrugs
required to be active, liver breaks it down to create a stronger response
61
what should you not take if you are taking tetracycline
antacid b/c decreases antibiotic effects
62
risk of long term NSAID use
stomach ulcer, high BP, increase risk of heart attack
63
def drug selectivity
how the drug knows where to go
64
def affinity
attraction b/w drug and receptor
65
clearance (CL)
volume plasma cleared per unit time, predicts elimination in relation to blood serum concentration
66
what effect of drugs tells us when the next dose should be taken
clearance
67
what does half life ensure
maximum dose is administered at each time
68
what does a higher half life mean
longer time it takes for the drug to leave the system
69
what does a lower half life mean
the dose needs to be taken more often b/c doesn't stay in the body for as long
70
does chemo have a high or low therapeutic index
low b/c it is very dangerous
71
how many of the most prescribed drugs that are prescribed for Americans are for hypertension
6/15
72
what are some conditions that have very costly drugs associated with them
diabetes, hep C, cholesterol
73
what are some of the most commonly prescribed drugs in the US
asthma, diabetes, cholesterol, GERD
74
vyvanse
ADHD
75
lyrica
seizure
76
lantus
DM
77
ventolin
COPD
78
crestor
cholesterol
79
advair
COPD
80
spiriva
COPD
81
januvia
DM
82
2018 GA prescription drug monitoring program
requires MDs to check database before rx opioids or cocaine
83
are analgesics an opioid
yes they are
84
do analgesics relive pain
no, they just alter the perception of pain
85
examples of non-opiods
NSAID, anti-inflammatory, glucocorticoids
86
examples of opiods
codeine, morphine, fetanyl, hydrocodone, heroin
87
what are some effects of opioids
sedation, mood change, constipation, depression, orthostatic hypotension
88
what does a PCA do
allows pt to control amount of opioid given to them via pump, shown to decrease addiction rates and side effects b/c constant supply instead of running out and asking for more
89
what is a benefit of cox 1 and 2 drugs
causes less GI upset
90
functions of acetaminophen
analgesic and antipyretic NOT anti-inflammatory
91
why would a dr combine acetaminophen and opiods
both used for pain relief but when used together the dose of opioid can be less
92
what does NSAID inhibit in the body
prostaglandis
93
what does a steroid do
anti-inflammatory and supresses immune system
94
what negative effects do NSAIDS have
liver damage, distrupt bone and cartilage healing
95
why are steroid packs given as packs instead of just a few doses
want to prevent adrenal suppression from removing it too fast from the body
96
what does a statin do
lower cholesterol in the body by slowing down the production of it
97
examples of statins
crestor, zocor, ezallor, lipitor
98
PPI treats what
GERD
99
example of PPI
nexium
100
what was amoxicillin used to treat for a while until drs realized they were becoming resistant to it
ear infections in kids
101
what does glucophage treat
type 2 diabetes
102
example of glucophage
metformin: leads to an increased response to insulin
103
example of diuretic
hydrocholorathiazide
104
what do diuretics treat
high BP or edema
105
what do ambien or zolpidem treat
insomnia
106
are there different types of drugs for insomnia
yes, some are oral, spray, sublingual depending on the purpose and how quick they would act
107
examples of SSRIs
prozac, zoloft, paxil, celexa, laxapro
108
bupropion and wellbutrin
works on dopamine to increase effectiveness on other drugs instead of increases the dosage of the more intense drug
109
benzodiazepines examples
xanax, valium
110
benzodiazepine purpose
promote sleep, decrease muscle spasm, alcohol withdrawl, anxiety and agitation
111
examples of stimulants
adderall, ritalin, concerta
112
angina
chest pain
113
nitroglyerin
tx angina, is sublingual administration
114
perocet combination of
opioid and acetamenophen
115
what type of drug is hydrocholorothalazide
diuretic, treats HTN and CHF
116
what does hemodynamic stability mean
considered stable based on the lab values available
117
if hematocrit levels are 25% what does that mean for the HCP
decide if they can continue on w/ tx, may or may not depending on clinical judgement
118
what are normal hematocrit levels
37-52 ish
119
how is anemia related to hematocrit and hemoglobin
decreased levels of both, hemoglobin is a better predictor
120
ESR def
rate of RBC settle out of unclotted plasma in 1 hour
121
what does ESR measure
inflammation in the body
122
leukocytosis def
increase in WBC that may be associated w/ malaise, lethargy, fever, bruising
123
what does basic metabolic panel include
electrolyte level, acid-base balance, blood sugar, kidney status
124
when pt is in the hospital is blood sugar expected to be higher or lower than normal
higher
125
what is HBA1c of someone w/ diabetes
>6.5%
126
leukopenia def
decrease in WBC that may be associated w/ anemia, weakness, fatigue
127
what does a liver enzyme test for
billirubin and other enzymes to see what the quantity of them is like
128
what may lead to hypoalbuminum
poor nutrition b/c not getting adequate protein
129
what area of the body would liver problems cause pain
RUQ
130
what do pts w/ DVT usually complain of
dull pain the calf that doesn't go away
131
3 things that together cause cancer
carciongen causes irreversible changes, endogenous + exogenous factors, non-carcinogen agent that promotes growth of cancer
132
what type of cells are platelets
thrombocytes= initiate clotting
133
what is good blood glucose level
140-180 mg/dL
134
what is an increased blood glucose level
200 mg/dL
135
what HBA1c levels are important to know
<5.7% is normal
>5.7 is pre-diabetes
136
what electrolyte is very important for controlling heart muscle function
potassium
137
what are blood urea nitrogen
waste elimated from kidneys
138
what is waste from liver called
bilirubin, recycled into RBC
139
what protein is made by the liver and can lead to poor wound healing
albumin
140
PT
prothrombin time
141
PTT
partial thromboplastin time
142
INR
international normalized ratio
143
normal INR
0.8-1.2
144
what level of INR requires MD consult
>4.6
145
what level of INR increases risk of hemarthrosis during exercise
>3.6
146
what is the leading cause of preventable death in the hospital
DVT
147
why is DVT risky
increase viscosity which decreases blood flow and makes it easier to clot and travel
148
is homan's sign a valid test for DVT
no, don't use it. refer to MD for ultrasound if DVT is suspected
149
tx for DVT
eliquis, pradaxa, xarelto
150
types of cholesterol
HCL- good
LDL- bad
151
5 common places for cancer to spread to
bone, brain, lung, lymph, liver
152
what is most leading cause of death in people under 85 yo
cancer
153
what is the second leading cause of death in children
cancer
154
what is the most fatal type of cancer
lung
155
what is the most aggressive type of cancer
pancreatic
156
what's an example of chemoprevention
preventative mastectomy, taking tomoxiphan; both will prevent breast cancer
157
main risk factors of cancer
> 50, ethnicity, environment, family history, obesity, age of menstration, skin color, etc
158
what is a very good screening tool to prevent a specific type of cancer
colorectal screen= 90%
159
screen for pancreatic cancer
none exists currently
160
who should be screened for ovarian cancer
if have BCRA 1 or 2 mutations
161
difference b/w malignant and benign cells
don't invade, differentiated, encapsulated
compress and invade, undifferentiated, invasive
162
what is a word to describe malignant cells
anaplastic: DNA loses ability to make codes that allow for mature cell function
163
what cancer is associated w/ BCRA 1 and 2 mutaiton
mostly breast cancer but also increase risk for ovarian
164
what is the #1 cause of preventable disease death in the US
smoking
165
what cancers can exercise lead to a decrease in risk
breast and colon
166
what cells are ideal to target in early detection screenings
mataplasia b/c they are reversible
167
are dyslasia cells cancerous or not
no they are not cancerus, they are abnormal and they may progress to be cancerous but at their current state they aren't
168
what is the most advanced type of metaplasia cells
anaplasia, have metastacized
169
what is the most common type of cancer cell
carcinoma, begins in epithelial and moves internal towards the lymph and organs
170
who are carcinoma cells common in
kids like lymphoma and leukemia
171
if a tumor is benign what will its suffix be
-oma
172
what cancers are most associated w/ age
lekemia, breast, GI, prostate, urinary
173
how many grades of cancer are there
4
174
what does grade 1 of cancer mean
best prognosis, least threatening, most differentiated
175
TNM system includes what 3 factors
size/area of tumor, # lymph, metastases presence
176
what are tumor markers
biomarkers made by a tumor that is found in high levels for people with cancer
177
what viruses are associated w/ cancer
EBV, HIV, leukemia, Hep B&C
178
why are metastasis especially concerning
even after they are killed w/ chemo or radiation they can come back in 15-20 years
179
what are some yellow flags in patients who could have cancer
24 hour pain, unexpected pain, weight loss/gain
180
what is the goal of neoadjuvant therapy
shrink the cancer before typical treatment begins
181
what are examples of neoadjuvant therapy
chemo, radiation, hormone
182
who is adjuvant therapy given to
lower cancer reoccurance risk because it may be undetectable
183
what does cancer surgery do
take out some tissue for pain relief, to relieve obstruction or debulk (take out entire thing)
184
fulguration tx
uses electrical current to destroy the cancer
185
excisional vs incisional biopsy
remove tumor and normal tissue vs use for diagnostic purposes and only take out tumor
186
what is radiofrequency ablation therapy
high energy radio waves that use needles to kill cancer
187
what is a thoroscopic treatment for cancer
use a tube with a video camera to create an incision in the chest
188
what are some benefits of robotic cancer treatment
decrease in blood loss, more accurate
189
what is en bloc resection
removing the entire tumor without taking part of the capsule
190
pros of cryosurgery
limited side effects, less money and less recovery time
191
what types of cancers can be treated with cryosurgery
liver, prostate, cervical, bone
192
what is an advantage of radiation therapy
increase the dose to the tumor and use the other tissues much less
193
what are some side effects of radiation therapy
red skin, looks burned, peeling after, xerostomia, mycositis, alopecia
194
what is the goal of radiation therapy
break down the chemical bonds to shrink the tumor
195
what do about half of patients use for cancer treatment
radiation therapy
196
what is the difference b/w adjuvant and prophylactic radiation
near the original site, gets to it before the cells spread
197
side effects of radiation
aloplecia and erythema may be long lasting
198
example of systemic treatment
iodine injected to kill thyroid cancer
199
what does chemotherapy do
mutates the DNA of cells to do apoptosis or be self-destructive
200
types of chemotherapy
oral, topical, IV, IA, injection
201
what type of cancer treatment may be used after surgery
chemo
202
what are some side effects of chemotherapy
anemia, increased infection risk, nausea, decrease dual task stability, increase fall risk, decrease vision and executive function
203
most common and effective chemo administration
IV
204
when are cancer patients immunocompromised
only during treatment itself, not after the treatment
205
what are some benefits of target therapy
stimulate immune system to destroy cells in specific areas, protect healthy cells
206
what does hormone therapy do
stop the production of some hormones in the uterus, prostate, breast, etc
207
what are the stages of a clinical trial
1. determine safe dose, 2. investigate efficacy, 3. considered safe
208
what are most lung cancer cells
non-small cell carcinoma (80-85%)
209
what type of lung cancer spreads faster and is more fatal
small cell carcinoma
210
what PT tx is related to lung cancer
dry needling of levator scapula, train posture and rib cage
211
who's most likely to get lung cancer
smokers who are >65 yo
212
cause of prostate cancer
no known cause
213
risk factors for prostate cancer
STI, vasectomy, smoking, obesity
214
where does prostate cancer rank in most common for men
2nd most common, behind lung cancer
215
who is most likely to get prostate cancer
african american males over 50 yo
216
s/s of prostate cancer
polyuria, urinary hesitation, blood in urine, irritation
217
what's the survival rate for prostate cancer
very high, especially in the long term
218
what test should be done for prostate cancer
PSA, biopsy, DRE (feel for bumps)
219
breast cancer def
abnormal cells that accumulate in milk ducts
220
what genes are associated w/ breast cancer
BRCA 1 and BRCA 2 mutation
221
what tests can be done to screen for breast cancer
breast exam, ultrasound, mamogram
222
if breast cancer is caught early what's the treatment and survival rate like
very good prognosis if caught early
223
where is breast cancer metastasis most likely found in
bone after breast tissue
224
is breast cancer common
yes, 1/8 women in the US have it
225
how has the death rate of melanoma changed over time
increased prevalence but great decreas in death rate b/c it is treatable
226
who's most at risk for melanoma
less than 50 yo females and greater than 50 yo males
227
warning signs of melanoma
abnormal shape, asymmetrical, large, multicolor
