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Patho/Pharm 2 Exam1 > Patho/Pharm 2 Exam1 > Flashcards

Patho/Pharm 2 Exam1 Flashcards

1
Q

H pylori treatment regimen

A

clarithromycin, amoxicillin, PPI such as omeprazole

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2
Q

Valproic Acid (Depakote)

A

anti seizure/epilepsy; black box warning for hepatotoxicity, contraindicated in cirrhosis; pregnancy category D

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3
Q

Phenobarbital (Luminal)

A

barbiturate and anti seizure; used during status epilepticus; serious ADR is SJS/TEN (fever, edema, erythematous rash w blistering and sloughing)

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4
Q

Phenytoin (Dilantin)

A

anti seizure/epilepsy; very narrow range between therapeutic and toxic so monitor blood levels; contraindicated w renal or hepatic impairment; ADRs aplastic anemia, low WBC/platelets, liver necrosis

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5
Q

Dantrolene Sodium (Dantrium)

A

skeletal muscle relaxant and only drug that treats malignant hyperthermia

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6
Q

Fludrocortisone (Florinef)

A

mineralocorticoid for replacement therapy in Addison’s disease, usually combined w glucocorticoid; enhances Na absorption and K excretion; contraindicated in HTN, active infections, CKD; can interact w aspirin; ADRs HTN, edema

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7
Q

Growth Hormone Supplementation

A

for otherwise healthy/well nourished child under 5th percentile for height; give before growth plates close in puberty; HGH therapy can cause hyperglycemia and increased insulin resistance

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8
Q

Ketoconazole (Nizoral)

A

cortisol suppressing agent to treat Cushing’s disease; avoid in pregnancy

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9
Q

Radioactive iodine

A

treatment for hyperthyroidism and thyroid cancer; destroys hormone producing cells in thyroid; avoid visitors esp pregnant women/children after treatment

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10
Q

Corticosteroids

A

treat adrenal insufficiency (Addison’s), inflammatory/allergy disorders, prevent organ transplant rejection; ADRs cushing’s syndrome, PUD (don’t take on empty stomach), fluid/Na retention, osteoporosis, hyperglycemia, immune suppression; contraindicated for AUD (avoid alcohol when taking), aspirin use, infections, GI or liver disease, avoid live vaccines; don’t abruptly stop, must taper off; pregnancy C, can cross placenta

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11
Q

Gabapentin (Neurontin)

A

FDA approved as anti-seizure when taken with other AED; off label for neuropathic pain, anxiety, AUD

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12
Q

Sumatriptan (Imitrex)

A

anti-migraine; serotonin receptor agonist; aborts acute migraine, most effective when taken at first sign of aura

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13
Q

Sulfasalazine (Azulfidine)

A

DMARD for IBD (crohn’s/UC); anti-inflammatory; avoid aspiring when taking; may inhibit absorption of digoxin

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14
Q

Succinycholine (Anectine)

A

skeletal muscle relaxant; muscle paralysis for pt on ventilator or in surgery; can cause malignant hyperthermia and cardiac arrest if pt has hyperkalemia

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15
Q

Propofol (Diprivan)

A

general anesthetic; contraindicated in people with egg allergy and pregnant/lactating women

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16
Q

Pancrelipase (Creon)

A

pancreatic enzymes; given in chronic pancreatitis or cystic fibrosis when lack of pancreatic enzymes causes malabsorptive disorders

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17
Q

Methadone

A

treatment for OUD, withdrawal symptoms; opioid agonist; must be given at methadone clinic so pt must travel there everyday; best for pt w long history of use and high tolerance who needs lots of support (clinic); important to remember that for pt on this, its their baseline so it should not be considered a pain med if they ever need pain meds; start low dose (30-40mg) and work up

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18
Q

Buprenorphine/naloxone

A

treatment for OUD, withdrawal symptoms; opioid agonist-antagonist; better for pt w mild to moderate dependence needing less support (no clinic); bc often given with naloxone must make sure pt does not have any opiates in system or they will go into acute withdrawal; usually come in SL film or tablet so make sure pt lets it dissolve, not swallow it

19
Q

Naltrexone (ReVia)

A

treatment for OUD; must be opioid free for 7-10 days to avoid acute withdrawal symptoms; best for pt w mild to moderate dependence; if pt ever needs pain meds and is on this med try to give non-opioid; can be oral daily or a long-lasting IM injection

20
Q

Bulk forming laxatives

A

may need several doses over 1-3 days for effect; if taken with insufficient water can swell in esophagus and cause obstruction; never give to pt with undiagnosed abdominal pain!

21
Q

Cyanocobalamin (Vitamin B12)

A

usually given to treat pernicious anemia; monitor H/H, retic count and RBCs to see how treatment is going

22
Q

Orlistat (Xenical)

A

anti obesity lipase inhibitor; blocks lipase action in GI tract to prevent fat absorption; for pt with BMI over 30 or over 27 with other complications; ADRs incl flatus w discharge, oily stool abdominal pain; contraindicated in cholestasis, malsbsorptive disorders, anorexia/bulimia

23
Q

Vitamin D

A

maintains blood Ca and phosphorus levels to support bones and muscles, reduces inflammation, supports immune system, improves mood, improves heart function

24
Q

Status epilepticus

A

excessive seizure activity where the person does not have time to recover between seizures; a tonic-clonic seizure lasting more than 5 minutes/30 minutes or more of prolonged seizures

25
Seizure risk
epilepsy, alcohol withdrawal, stroke, head injury, certain infections, hypoxia, hypoglycemia (and other metabolic conditions)
26
What to do during a seizure
protect patient is biggest goal; have them on their side, pillow behind their head, padded bed rails, bed in lowest position, observe and time seizure
27
Post-ictal phase
period after seizure; patient will be confused/disoriented, will not remember seizure; may have lost bowel/bladder control; check their vitals and do a neuro assessment
28
Glawsgow coma scale
to assess LOC; check 3 areas for score of 3-15 Eye opening: -spontaneous: 4 -to sound: 3 -to pressure/pain: 2 -none: 1 Best verbal: -alert and oriented: 5 -confused, but talking: 4 -saying words: 3 -making sounds: 2 -none: 1 Best motor: -obeys commands: 6 -localizes pain: 5 -normal flexion: 4 -abnormal flexion: 3 -extension: 2 -none: 1
29
Advantages of non-pharmacological pain management
avoid the ADRs of pain meds incl respiratory depression, hypotension, constipation, sedation, potential for dependence etc; best to have a combo of med and non-pharm to allow for lower dosing
30
Grave's Disease
autoimmune disorder causing hyperthyroidism; causes weight loss, pt feels hot, anxiety/restlessness, bulging eyes (exopthalmus), diarrhea, tachycardia/palpitations, HTN
31
Laproscopic fundoplication
surgery to treat GERD or hiatal hernia; top of stomach wrapped around esophagus
32
GERD
decreased closure of lower esophageal sphincter that allows gastric acids to reflux into esophagus and damage epithelium; causes "heartburn" feeling, may also present as chronic cough, sore throat and wheezing; goal of treatment is to reduce gastric secretions causing reflux, accomplished with PPIs and avoiding things like alcohol, fatty food, chocolate, coffee, nicotine
33
Crohn's disease
IBD that can affect any part of GI tract from mouth to anus; inflammation of all layers of mucosa; have "skip lesions"/cobblestone effect where healthy tissue is next to inflamed tissue
34
Ulcerative colitis
IBD that mainly affect rectum and large intestine; inflammation of only a few layers; don't have cobblestoning; common treatment is with colostomy or ileostomy;
35
Hiatal hernia
part of stomach pushes upward through diaphragm and into thorax; S/S incl esophagitis, dysphagia, epigastric discomfort, belching, sub-sternal burning; treat with weight loss, small meals, limit coffee, avoid cigarettes, don't lie down after eating, sleep w HOB elevated; may need surgery
36
Pancreatitis
inflammation of pancreas; pancreatic enzymes released too early and start digesting pancreas leading to necrosis/infection; may be acute (often due to gallstones) or chronic (often related to AUD)
37
Thiamine deficiency causes
can happen due to AUD or chronic liver disease and need to supplement
38
Parenteral nutrition indications
should ONLY be for patient with non-functioning GI tract/unable to tolerate any enteral feedings; can be total or partial (usually lacks lipids, indicated when central vein cannot be accessed)
39
Parenteral nutrition complications
mechanical (puncture/injury w improper placement; can get air/fluids into lungs), metabolic (fluid overload, hyperglycemia; pt may be given insulin even if not diabetic), deficiencies, infection (only sterile dressing changes), infiltration
40
Enteral nutrition
oral or via G/NG tube; pt must have functioning GI tract; give formula with all essential nutrients, diff formulas for different indications; complication can be aspiration, always make sure HOB elevated during feedings
41
Magnesium benefits
keeps heart rhythm steady, improves insulin sensitivity, helps rheumatoid arthritis pain, improves bowel evacuation, seizure prophylaxis for AUD
42
AUD
complete CIWA scale to assess how withdrawal will go; put on benzodiazepine taper bc suddenly stopping alcohol can cause seizures; there are meds for AUD but for some need to be alcohol or opiate free for certain amount of days or else will go into acute withdrawal; may have vitamin deficiencies in B1, B6, B9, magnesium, phosphorus
43
OUD
do urine drug screen, understand use habits, COWS scale to assess withdrawal, monitor for complications like endocarditis or cellulitis if IV user, offer methadone/buprenorphine when withdrawal symptoms start

Patho/Pharm 2 Exam1 (1 decks)

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