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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
Q

Seizure risk

A

epilepsy, alcohol withdrawal, stroke, head injury, certain infections, hypoxia, hypoglycemia (and other metabolic conditions)

26
Q

What to do during a seizure

A

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
Q

Post-ictal phase

A

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
Q

Glawsgow coma scale

A

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
Q

Advantages of non-pharmacological pain management

A

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
Q

Grave’s Disease

A

autoimmune disorder causing hyperthyroidism; causes weight loss, pt feels hot, anxiety/restlessness, bulging eyes (exopthalmus), diarrhea, tachycardia/palpitations, HTN

31
Q

Laproscopic fundoplication

A

surgery to treat GERD or hiatal hernia; top of stomach wrapped around esophagus

32
Q

GERD

A

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
Q

Crohn’s disease

A

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
Q

Ulcerative colitis

A

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
Q

Hiatal hernia

A

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
Q

Pancreatitis

A

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
Q

Thiamine deficiency causes

A

can happen due to AUD or chronic liver disease and need to supplement

38
Q

Parenteral nutrition indications

A

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
Q

Parenteral nutrition complications

A

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
Q

Enteral nutrition

A

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
Q

Magnesium benefits

A

keeps heart rhythm steady, improves insulin sensitivity, helps rheumatoid arthritis pain, improves bowel evacuation, seizure prophylaxis for AUD

42
Q

AUD

A

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
Q

OUD

A

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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