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Nurs212 > N212 Lecture 5 > Flashcards

N212 Lecture 5 Flashcards

1
Q

adrenal cortex is the outer or inner layer

A

outer layer

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2
Q

corticosteroid are stored true or false

A

false, corticosteroids are synthesizes as needed

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3
Q

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

A

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

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4
Q

once ACTH is released where does it go

A

to the adrenal cortex to stimulate production of corticosteroids

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5
Q

Cushing’s syndrome is caused by

A

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

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6
Q

2 reasons of Cushings syndrome

A

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

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7
Q

cause of Addisons disease

A

undersecretion of the adrenocortical hormone

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8
Q

effects of Addisons disease

A

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

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9
Q

how do corticosteroids exert their effects

A

modifying enzyme activity

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10
Q

what does glucocorticoids affect

A

metabolism of carbs, fats, and proteins

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11
Q

How do glucocorticoids differ

A

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

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12
Q

glucocorticoids do what

A

inhibit or help control inflammatory and immune responses

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13
Q

how are glucocorticoids administered

A

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)

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14
Q

corticosteroid contraindications

A

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

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15
Q

adverse effects for corticosteroids

A

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

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16
Q

what are some corticosteroid interactions

A

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

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17
Q

what are some other corticosteroid interactions

A

aspirin, NSAIDs, ulcerogenic drugs

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18
Q

corticosteroids inhibit?

A

immune response when given in combination with immunizing biologics

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19
Q

corticosteroids reduce what?

A

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

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20
Q

most common oral glucocorticoid for antiinflammatory or immunosuppressant

A

prednisone

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21
Q

prednisone also treats

A

exacerbations of chronic respiratory illnesses

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22
Q

prednisone peak life, half life and duration of action

A

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

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23
Q

most common injectable glucocorticoid drug

A

methylprednisolone(solu-medrol)

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24
Q

main use of methylprednisolone

A

anti inflammatory or immunosuppressant drug

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25
Q

methylprednisolone administered usually by

A

IV

26
Q

methylprednisolone available in

A

long acting formulation

27
Q

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

A

benzyl alcohol

28
Q

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

A

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

29
Q

dexamethasone is a synthetic corticosteroid available in

A

systemic and ophthalmic formulations

30
Q

dexamethasone is used to treat

A

inflammation, allergic conditions, burns

31
Q

dexamethasone can be used on

A

eye, eyelids, conjunctiva and cornea

32
Q

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

A

ocular, variable, immediate, long

33
Q

an abrupt withdrawal of adrenal drugs can cause

A

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

34
Q

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

A

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

35
Q

in long term therapy for glucocorticoids, what is preferred

A

alternate dosing to help with minimizing adrenal suppresion

36
Q

analgesics are given for

A

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

37
Q

adjuvant analgesic drugs are

A

not primarily designed to control pain

38
Q

pain is

A

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

39
Q

WHO 1st step analgesic ladder is

A

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

40
Q

WHO 2nd step analgesic ladder

A

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

41
Q

WHO 3rd step analgesic ladder

A

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

42
Q

example of nonopioid analgesics

A

tylenol

43
Q

tylenol is similar to

A

aspirin which is a salicylates

44
Q

mechanism of action for tylenol

A

blocks pain impulses peripherally by inhibiting prostaglandin synthesis

45
Q

tylenol uses

A

analgesic and antipyretic effects

46
Q

indications for tylenol

A

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

47
Q

contraindications for tylenol

A

liver dysfunction, possible liver failure

48
Q

taking tylenol is dangerous if taken with

A

other drugs that are hepatotoxic

49
Q

prostaglandin synthesis is

A

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

50
Q

max dosage for a healthy adult

A

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

51
Q

ovedose of tylenol cause

A

hepatic necrosis, hepatotoxicity( liver damdge)

52
Q

antidote for overdose of tylenol

A

acetylcysteine regimen ( used to prevent liver damage)

53
Q

NSAIDS MOA

A

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

54
Q

aspirin(salicylate) uses are

A

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

55
Q

salicylate (aspirin) used for

A

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

56
Q

side effects for salicylate ( aspirin)

A

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

57
Q

Reyes syndrome is

A

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

58
Q

opiod drugs used for

A

pain relieving drugs known as opioid analgesics

59
Q

morphine and codeine are from

A

opium poppy

60
Q

opioid drugs are

A

resynthetic drugs that bind to opiate receptors for pain

61
Q

strong agonists are

A

morphine, hydromorphone(dilaudid) oxycodone, oxymorphone

62
Q
A

Nurs212 (4 decks)

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