N212 Lecture 5

Question 1

adrenal cortex is the outer or inner layer

Answer 1

outer layer

Question 2

corticosteroid are stored true or false

Answer 2

false, corticosteroids are synthesizes as needed

Question 3

When the level of a corticoid steroid is low what gets released from the hypothalamus

Answer 3

Corticotropin releasing hormone which then travels to the anterior pituitary gland, it triggers the release of ACTH

Question 4

once ACTH is released where does it go

Answer 4

to the adrenal cortex to stimulate production of corticosteroids

Question 5

Cushing’s syndrome is caused by

Answer 5

the over secretion of adrenocortical hormone redistribution of body fat from the arms and legs to the face, shoulders, trunk and abdomen

Question 6

2 reasons of Cushings syndrome

Answer 6

ACTH secreting tumor or by excess use of steroids which leads to retention of water and sodium

Question 7

cause of Addisons disease

Answer 7

undersecretion of the adrenocortical hormone

Question 8

effects of Addisons disease

Answer 8

decreased blood sodium and glucose levels, increased K levels, dehydration and weight loss

Question 9

how do corticosteroids exert their effects

Answer 9

modifying enzyme activity

Question 10

what does glucocorticoids affect

Answer 10

metabolism of carbs, fats, and proteins

Question 11

How do glucocorticoids differ

Answer 11

in their potency, durations of action and extent to their salt and fluid retention

Question 12

glucocorticoids do what

Answer 12

inhibit or help control inflammatory and immune responses

Question 13

how are glucocorticoids administered

Answer 13

inhalation
( for control of steroid responsive bronchospastic states), nasally( for rhinitis and to prevent the recurrence of polyps after removal), topically( for inflammation of eye, ear and skin)

Question 14

corticosteroid contraindications

Answer 14

septicemia, systemic fungal infection, varicella, patients with gastritis, reflux disease, ulcer disease, diabetes, …cardiac, renal or liver dysfunction

Question 15

adverse effects for corticosteroids

Answer 15

hear failure, cardiac edema, hypotension ( caused by electrolyte imbalance) hypokalemia, hypernatremia, convulsions, headache, vertigo, insomnia, cushings syndrome, carb intolerance, hyperglycemia, peptic ulcers, pancreatitis, fragile skin, muscle weakness, hyperglycemia and psychosis

Question 16

what are some corticosteroid interactions

Answer 16

non potassium sparing diuretics ( thiazides, loop diuretics-lasix) which lead to hypocalcemia and hypokalemia

Question 17

what are some other corticosteroid interactions

Answer 17

aspirin, NSAIDs, ulcerogenic drugs

Question 18

corticosteroids inhibit?

Answer 18

immune response when given in combination with immunizing biologics

Question 19

corticosteroids reduce what?

Answer 19

the hypoglycemic effect of antidiabetic drugs and result in elevated blood glucose levels

Question 20

most common oral glucocorticoid for antiinflammatory or immunosuppressant

Answer 20

prednisone

Question 21

prednisone also treats

Answer 21

exacerbations of chronic respiratory illnesses

Question 22

prednisone peak life, half life and duration of action

Answer 22

1-2 hrs, 18-36hr, 36 hrs`

Question 23

most common injectable glucocorticoid drug

Answer 23

methylprednisolone(solu-medrol)

Question 24

main use of methylprednisolone

Answer 24

anti inflammatory or immunosuppressant drug

Question 25

methylprednisolone administered usually by

Answer 25

IV

Question 26

methylprednisolone available in

Answer 26

long acting formulation

Question 27

what is the preservative contained in most injectable formulations that cannot be given to children of 28 days or younger

Answer 27

benzyl alcohol

Question 28

methylprednisolone dose, onset, peak, half life, duration of action

Answer 28

10-40mg q4h, immediate, 30min, 3-4hr,24-36hr

Question 29

dexamethasone is a synthetic corticosteroid available in

Answer 29

systemic and ophthalmic formulations

Question 30

dexamethasone is used to treat

Answer 30

inflammation, allergic conditions, burns

Question 31

dexamethasone can be used on

Answer 31

eye, eyelids, conjunctiva and cornea

Question 32

dexamethasone route, onset of action, peak, duration of action

Answer 32

ocular, variable, immediate, long

Question 33

an abrupt withdrawal of adrenal drugs can cause

Answer 33

decrease in or no production of endogenous glucocorticoids which results in adrenal insufficiency

Question 34

why would an H2 receptor or PPI order be given with glucocorticoids

Answer 34

minimize GI upset and minimize ulcer formation ( these drugs are ulcerogenic)

Question 35

in long term therapy for glucocorticoids, what is preferred

Answer 35

alternate dosing to help with minimizing adrenal suppresion

Question 36

analgesics are given for

Answer 36

relieve pain without causing loss of consciousness, painkillers, opioid analgesics, adjuvant analgesic drugs

Question 37

adjuvant analgesic drugs are

Answer 37

not primarily designed to control pain

Question 38

pain is

Answer 38

unpleasant sensory and emotional experience associated with actual or potential tissue damage

Question 39

WHO 1st step analgesic ladder is

Answer 39

nonopioid (with or without adjuvant medication) after the pain has been identified or assessed, if pain continues step 2

Question 40

WHO 2nd step analgesic ladder

Answer 40

opiods with or without nonopioid and with or without adjuvants. if pain continues step 3

Question 41

WHO 3rd step analgesic ladder

Answer 41

opiods indicated for moderate to severe pain, administered with or without nonopioid or adjuvant medications

Question 42

example of nonopioid analgesics

Answer 42

tylenol

Question 43

tylenol is similar to

Answer 43

aspirin which is a salicylates

Question 44

mechanism of action for tylenol

Answer 44

blocks pain impulses peripherally by inhibiting prostaglandin synthesis

Question 45

tylenol uses

Answer 45

analgesic and antipyretic effects

Question 46

indications for tylenol

Answer 46

mild to moderate pain, fever and alternative for those who cannot take aspirin

Question 47

contraindications for tylenol

Answer 47

liver dysfunction, possible liver failure

Question 48

taking tylenol is dangerous if taken with

Answer 48

other drugs that are hepatotoxic

Question 49

prostaglandin synthesis is

Answer 49

cellular damage cause by thermal, mechanical or chemical stimuli which results in release of excitatory neurotransmitters ( prostaglandins, bradykinin, substance P and histamine)

Question 50

max dosage for a healthy adult

Answer 50

3000mg/day, 2000mg for older adults and those with liver disease

Question 51

ovedose of tylenol cause

Answer 51

hepatic necrosis, hepatotoxicity( liver damdge)

Question 52

antidote for overdose of tylenol

Answer 52

acetylcysteine regimen ( used to prevent liver damage)

Question 53

NSAIDS MOA

Answer 53

inhibitions of the leukotriene pathway ( one of the groups that cause inflammation) - the prostaglandin pathway (inflammation)

Question 54

aspirin(salicylate) uses are

Answer 54

inhibits platelet aggregation and antithrombotic effect ( treatment of MI and other thromboembolic disorders)

Question 55

salicylate (aspirin) used for

Answer 55

headache, neuralgia ( nerve pain) myalgia ( muscle pain) and arthralgia ( joint paint)

Question 56

side effects for salicylate ( aspirin)

Answer 56

increased heart rate, hypoglycemia, hyperglycemia, nausea, vomiting, diarrhea

Question 57

Reyes syndrome is

Answer 57

acute and potential life threatening condition of neurological deficits that can lead to coma and liver damage.

Question 58

opiod drugs used for

Answer 58

pain relieving drugs known as opioid analgesics

Question 59

morphine and codeine are from

Answer 59

opium poppy

Question 60

opioid drugs are

Answer 60

resynthetic drugs that bind to opiate receptors for pain

Question 61

strong agonists are

Answer 61

morphine, hydromorphone(dilaudid) oxycodone, oxymorphone