Mod 12 Quiz

Question 1

Ointments

Answer 1

-oil or petrolleum based
-highest medication absorption
-create own occlusive film=retains moisture

-shouldnt put on edematous weeping skin or wound (traps more moisture)

Question 2

Powder

Answer 2

-good for moist areas (skin folds)

Question 3

Location

Answer 3

Hairy-lotion preparation is best because its water based

Question 4

Considerations for topical medications

Answer 4

-location
-need for occlusive covering

Question 5

Topical glucocorticoids

Answer 5

-relief of itching and inflammation
-Vehicle: cream, ointment, gel
-wide avaliability in potency
-are absorbes systemically-OCCLUSIVE DSG CAN INCREASE ABSORPTION 10X MORE)
-Absorption is proportional to both duration of use and surface area

Question 6

Factors that increase absorption of topical glucocorticoids

Answer 6

thin skin (eye lids, axilla, face, genitallia), inflammed skin

Question 7

what is the equation that =trouble

Answer 7

High potency + occlusive dsg + large area application + prolonged therapy

Question 8

Adverse effects of topical glucocorticoids local vs systemic

Answer 8

Local: increased risk for infection, irritation, atrophy of dermis/epidermis, thinning of skin, purpura, striae, acne/hypertrichosis with long term use

Systemic: adrenal suppression

Question 9

Subsitute for topical glucocorticoids

Answer 9

Topical benadryl cream-similar effects, anti-itch

Question 10

Glaucoma

Answer 10

leading cause of preventable blindness in the US
-optic nerve damage–> decreased peripheral vision–> loss of central vision
-impedance of flow of aqueous humor increases intraocular pressure (IOP)

Question 11

Primary Open angle glaucoma

Answer 11

-most common
-progressive optic nerve damage
-IOP increase or normal
-painless
-develops over years
-treatment=decreased IOP

Question 12

Treatment for open angle glaucoma

Answer 12

Medications: facilitate aqueous humor outflow or reduce production

First line drugs include:
-beta blockers
-alpha 2 adrenergic agonists
-prostaglandin analogs

Question 13

Goal for open angle glaucoma

Answer 13

reduce IOP=slowed/halt disease progression

Question 14

Acute closed angle glaucoma

Answer 14

-r/t trauma, displacement/trauma to iris–.covers trabecular meshwork–.aqueous humor can not exit another anterior chamber= rapid rise in IOP

-develops suddenly
-intensely painful
-irreversible loss of vision in 1-2 days

Question 15

Treatment for closed angle glaucoma

Answer 15

-beta blockers
-short acting miotics
-carbonic anhydrase inhibitors

Question 16

Beta blockers

Answer 16

-timolol
-Action: reduces productiom of aqueous humor
indications: primarily open angle glaucoma, but can be for acute
Adverse: local stinging, can be absorbed systemically, can cause bronchospasm

Question 17

Contraindications for beta blockers for glaucoma

Answer 17

-heart failure, bradycardia, cardiogenic shock, AV block

Question 18

Prostaglandin analogs

Answer 18

Latanoprost
Action: relax ciliary muscle, which facilitates aqueous humor outflow
Indications: open angle glaucoma

-Adverse: Brown staining of iris, can also increase pigmentation of eyelid and eyelashes

Question 19

Alpha 2 adrenergic agonist

Answer 19

Bromonidine
-Action: reduces production of aqueous humor, and may facilitate outflow, as well as delays optic nerve degeneration, protects retinal neurons from death

Indication: open angle glaucoma

-Adverse effects: dry mouth, burning, FOB sensation, absorbs into soft contacts

CAN CROSS BLOOD BRAIN BARRIER=DROWSINESS, FATIGUE, HYPOTENSION

Question 20

How long should you wait after using Brimonidine to then place contact lens

Answer 20

-15-20 mins before putting on lens-under dosed b/c absorbed in lens not in eye

Question 21

Nonadherence

Answer 21

Factors
-assymptomatic condition
-frequent dosing intervals
-life long treatment
-cost
-age related (forgetfulness r/t dementia, providers failure to continue medications)

Important to monitor adherence and understanding of regimen

Question 22

Monoclonal antibodies (m ABs)

Answer 22

-derived from a human/mouse or rodent/combo

-antigen given to mouse–> antibodies created + tumor cells added= hybridoma

Hybridomas divide without stopping, antibodies are isolated to –> new drug

mABs target specific antigens and activate natural immune response

Question 23

Omalizumab

Answer 23

Indicated for allergy r/t asthma
-combines with free IgE=decrease ability to bind to mast cells
-decrease mast cell activation=decreased bronchospams + inflammation

Question 24

Bezlotoxumab

Answer 24

-indicated for those w/ C.diff and high risk for occurence
-binds to C. diff toxin
-no antimicrobial effects so must be given with ABX

Question 25

Adverse reactions to mABs

Answer 25

enhance immune system–> adverse immune reactions

-anti-drug antibodies produced (ADAs)=inactivation of mAB + dangerous effects

Hypersensitivity reactions (fevers, hemolytic anemias, myalgias)

-anaphylaxis

-CRS (cytokine release storm)

Question 26

Approach to the treatment of cancer

Answer 26

surgery/radiation/drug therapy/immunotherapy

Question 27

Role of drug therapy for cancer treatment

Answer 27

-disseminated cancers/mets
-some localized
-adjunct to surgery/radiation
-immunotherapy leverages bodys own defenses

Question 28

Major classes of drug therapy

Answer 28

-cytotoxic agents (chemo)
-immunomodulating agents
-hormones/hormone antagonists (breast and prostate Ca)
-targeted drugs

Question 29

Cytotoxic agents cell phase specific drugs vs. cell phase nonspecific drugs

Answer 29

Cell phase specific
-only work during a particular cell phase
-toxic during replication
-resting phase cells not harmed
-drugs has to be present during replication

Cell phase nonspecific drugs
-effective during all phases
-cells do not need to be replicating
-generally still more toxic to replicating cells than those at rest

Question 30

Growth fraction=

Answer 30

ratio of proliferating cells to resting cells

Question 31

Cytotoxic drugs are more active against…

Answer 31

cells with a high growth fraction (e.g. lymphoma, hodgkins)