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Pathophys > N398 Post Midterm > Flashcards

N398 Post Midterm Flashcards

1
Q

Metformin

A

Class: insulin sensitizer
*does not stimulate insulin secretion from pancreas

Action: inhibits glucose production in liver

  • reduces glucose absorption in gut
  • sensitizes insulin receptors in target tissues

AE: GI: decreased appetite, nausea, diarrhea
*does not cause hypoglycemia, contraindicated within 48 hours of IV contrast

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2
Q

Thiazoloidinediones

A

Class: Glitazones

Action: Reduce insulin resistance and decrease glucose production; usually used in combo with other agents, “turning on your genes”

AE: fluid retention, hypoglycemia
CYP450

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3
Q

Glipizide (is a 2nd generation sulfonyrea)

A

Class: 2nd generation sulfonyrea

Action: Stimulates release of insulin from pancreatic islets
*if pancreas doesn’t work, this doesn’t work!

AE: hypoglycemia

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4
Q

Lispro

A

Class: Fast acting insulin

Onset 15-30 minutes
Peaks 0.5-2.5 minutes
AE: hypoglycemia

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5
Q

Regular Insulin

A

Class: regular insulin

30-60 minutes onset
Peak 1-5 hours

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6
Q

NPH Insulin

A

Class: long acting insulin

1-2 hour onset
Duration is more than 12 hours

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7
Q

Repaglinide

A

Class: meglitinides

Action:
Stimulates insulin release from the pancreas

AE: hypoglycemia

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8
Q

Sitagliptin (DPP4 inhibitors)

A

Class: oral anti hyperglycemic agents

Action: enhances the effects of incretin hormones
*incretin hormones: stimulate glucose dependent release of insulin and suppress postprandial release of glucagon

DPP-4 INACTIVATES incretin hormones, so by inhibiting DPP-4, sitagliptin thus enhances incretin

AE: upper respiratory tract infections, headace, inflammation in nasal passages and throats
-hypoglycemia, pancreatitis, anaphalazis

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9
Q

Liraglutide

A

Class: anti diabetic medication

Action: Incretin mimetic (suppress appetite and inhibit glucagon secretion)
bind to GLP-1 receptors and stimulate glucose dependent insulin release

Note: only SQ

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10
Q

Pioglitazone

A

Action: decreases insulin resistance

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11
Q

Carbamazepine

A

Class: AED-used for partial seizures and tonic-clonic seizures

Action: Suppresses high-frequency neuronal discharge in and around seizure focci

AE: CNS- nystagmus, blurred vision, ataxia, vertigo, unsteadiness, Hematologic- bone marrow suppression, anemia, aplastic anemia

KNOWN TERATOGEN; promotes ADH secretion and water retention

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12
Q

Phenytoin

*IV option

A

Class: traditional AED

Action: Used for many diff types of seizures; selective inhibition of sodium channels

  • slows recover of sodium channels from the inactive state to the active state
  • entry of sodium into neurons is inhibited; suppression of action potentials

AE: gingival hyperplasia, dermatologic effects, rash

  • pregnancy teratogenic!
  • With IV admin; dysrhythmia, hypotension, purple glove syndrome

exhibits saturable kinetics; lower dose, SMALLER half life! 1st order kinetics
-minimal changes in dose, large changes in concentration

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13
Q

Fosphenytoin

A

Class: AED

Action: Converted to phenytoin in the body; easier to administer and less adverse effects

  • does not cause purple glove
  • decreased incidence of hypotension
  • may be infused faster vs. phenytoin
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14
Q

Valproic acid

A

Class: anticonvulsant

AE: GI upset

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15
Q

Divalproex

A

Class: AED

Action: Suppressions of high-frequency neuronal firing through sodium channel blockade

  • suppresses calcium influx through T-type calcium channels
  • augment inhibitory influence of GABA

AE: nausea, vom
Hepatotoxicity- can be fatal (avoid in less than 2 yari of age)
Pancreatitis, hyperammonemia, teratogenic

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16
Q

Levetiracetam

A

Class: AED

Action: actually, we don’t even know! used for many different types of seizure disorders

  • Minimally metabolized
  • KEPPRA!

AE: Mild to moderate side effects *compared to the other older ones which have lots of SE

17
Q

Mannitol

A

Class: osmotic diuretic

Action: raises serum osmolarity

AE: dehydration, decrease BP, electrolytes, watch your serum osmolarity

18
Q

Albuterol

A

Class: Short acting beta 2 agonist

Action: rescue inhaler for asthma and COPD
-relieves acute bronchospasm and prevention of exercise induced bronchospasm

AE: tachycardia, tremor, hypokalemia

  • immediate benefit lasts 30-60 minutes
  • there is no MAX of albuterol
19
Q

Ipratropium

A

Class: Anticholinergic

Action: Anticholinergic (blocks the action of acetylcholine)
block muscarinic receptors in bronchi (bronchodilation)

short acting, used to relieve bronchospasm

20
Q

Montelukast

A

Class: oral leukotriene receptor antagonist

anti-inflammatory treatment of asthma

Action:
Suppress effects of leukotrienes (reduce inflammation, bronchoconstriction, airway edema)

Metabolized by CYPP450

21
Q

Beclomethasone (inhaled)

A

Class: Inhaled corticosteroid
*controller medications

Action: *anti inflammatory treatment

AE:

  • Oropharyngeal candidiasis (thrush)
  • dysphonia (crackly voice)
  • can promote bone loss
22
Q

Ranitidine

A

Class: H2 Receptor Antagonist

Action: Suppresses the secretion of gastric acid by selective blocking H2 receptors in parietal cells lining stomach

AE: -caution in preg

  • multiple drug interactions (CYP450)
  • doses need to be adjusted in renal insufficiency
23
Q

Sucralfate

A

Class: mucosal protectant

Action: Acidic environment changes sucralfate into thich substrate that adheres to an ulcer for up to 6 hours- protects the ulcer from further injury

AE: 
Constipation 
Caution in preg
Use cautiously in renal failure (minimal absorption of aluminum salt) 
May interfere w absorption of other meds
24
Q

Antacids (Calcium carbonate & magnesium hydroxide)

A

Class: antacid

Action: Neutralize gastric acid and inactivate pepsin- potential muscosal protection due to stimulation of production of prostaglandins

AE: Constipation and diarrhea
Caution in pregnancy
Avoid in those with GI perforation or obstruction
Caution in renal dysfunction

25
Q

Sulfasalazine

A

Class: anti-inflammatory; 5-aminosalicylates

Action: Decreases inflammation by inhibiting prostaglandin synthesis

AE: blood disorders, anemia (contains sulfa)

26
Q

Omeprozol

A

Class: Proton Pump Inhibitor

Action: Irreversible inhibits H+, K+, ATPase (proton pump), blocks gastrin production

AE: Drug interaction w CYP2C19- Clopidogrel/Plavix
Long term use increases risk of osteoporosis

27
Q

Digoxin

A

Class: Cardiac Glycosides

Action: Inhibits Na-K-ATPase Pump; alters the electrical activity of the heart
-Favorable effect on neurohormonal systems
-increases Cardiac Output
-increases ionotropy
(often used for afib or cardiac dysrhythmias to correct them)

AE: cardiac dysrhythmias
principal non cardiac toxicities are CNS and GI related
-anorexia, nausea, vom, visual disturbances (halos around objects)

28
Q

Furosemide (Lasix)

A

Class: Loop Diuretic

Action: inhibit sodium, potassium, and chloride reabsorption in the loop of henle in the kidney to decrease water retention

AE: hypokalemia, hypotension, dehydration
*good for pt with kidney disease

29
Q

Hydrochlorothiazide

A

Class: Thiazide diuretics

Action: inhibits sodium reabsorption in the distal tubules of the kidneys (decreased water absorption)
mild diuresis

AE: hypokalemia
*ineffective with low GFR

30
Q

Spironolactone

A

Class: Potassium-sparing diuretic (aldosterone antagonist)

Action: dumps out sodium but allows potassium to stay

AE: hyperkalemia, gynecomastia in men, Monitor potassium

31
Q

Nitroglycerin

A

Class: Organic nitrate

Action: Dilates veins and decreases venous return (preload) which decreases oxygen demand

AE: drug interactions; phosphodiesterase Type 5 inhibitors

  • tolerance can occur rapidly (1 day)
  • related to depletion of sulfahydryl groups
32
Q

Lisinopril

A

Class: ACE inhibitor

Action: angiotensin converting enzyme inhibitor
(no vasoconstriction, body will not hold onto salt, you will diurese)

Adverse Effects:
-persistent cough, hyperkalemia, teratogenic, angioedema (big tongue)

Nursing Considerations:
shown to slow progression of kidney injury in pts with diabetes

33
Q

Losartan

A

Class: Angiotensin Receptor Blocker

Action: prevents fluid retention, vasodilation, activation of RAAS system

Adverse Effects:
-teratogenic, angioedema, hyperkalemia

Nursing Considerations:
often used in combination therapy

34
Q

Metoprolol

A

Class: Beta Adrenergic Blocker

Action:

  • decreases cardiac output
  • suppresses reflex tachycardia caused by vasodilators
  • reduces release of renin (in kidneys, reduces the RAAS system input)
  • lowers HR
  • long term use reduces peripheral vascular resistance

Adverse Reactions:
bradycardia, heart block, bronchoconstriction

Nursing Considerations:
monitor heart rate
-watch for patients with asthma, COPD

35
Q

Hydralazine

A

Class: vasodilator

Action: Selective dilation of arterioles (little or no venous effects)
in combo w nitrates (isosorbide dinitrate)

AE: hypotension, tachycardia, lupus like syndrome

36
Q

Paroxetine

A

Class: antidepressant SSRI

Action: inhibits serotonin reuptake from brain synapses and stimulates serotonin activity in the brain

AE:

37
Q

Amitriptyline

A

Class: Tricyclic antidepressant

Action: Blocks neuronal reuptake of NE and serotonin

AE: orthostatic hypotension, sedation, anticholinergic effect, cardiac toxicity, seizures

38
Q

Bupropion

A

Class: Atypical antidepressant
(good alternative to SSRIS)

Action: Unclear MOA; DA blockade, NE reuptake

AE: agitation, headache, dry mouth, constipation, weight loss, seizures
can also be used to quit smoking

39
Q

Alprazolam

A

Class: Benzodiazepine

Action: CNS: depress neuronal function at multiple sites; reduces anxiety, promote sleep, muscle relaxant
CV: IV admin can cause hypotension
Resp: resp depressant

AE: can have abrupt withdrawl sx, CNS depression, resp depression, anterograde amnesia

Pathophys (2 decks)

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