PHARM - Cardiac, Respiratory, Endocrine Flashcards

Question

Mechanism of Action of Angiotensin Receptor Blockers (ARBs)

Answer 1

ARBs block action of angiotensin II from binding to angiotensin II Type 1 (AT₁) receptor but not type 2 receptors (AT₂); allows angiotensin II to bind to AT₂ triggering vasodilation

Answer 2

They both work on the renin-angiotensin-aldosterone-system (RAAS), lowering BP

Answer 3

* helps dilate arteries to the heart * increases oxygen-rich blood flow to the heart * helps relieve angina symptoms or chest pain * also dilates veins in body so they can hold more blood, thus reducing the workload on your heart * however, note that with vasodilation you can flood it to the point where all the workload is taken off of the heart which can cause hypovolemic or cardiogenic shock * can be used for chronic or emergency problems (meds like nitro works almost instantaneously so can be used in emergencies) * pill, sublingual, tablet

Answer 4

Nitrates - are meds derived from nitroglycerin Vasodilators are not derived from nitroglycerin

Answer 5

* HF - when used ith other cardiac medications (such as ACE inhibitors, ARBs, and BBs) * angina pains * HTN

Answer 6

* also called **anti-anginal medications** * Common meds: * **Nitroglycerin** * **Diltiazem** * **Felodipine** * **Nifedipine and Verapamil** * **note:** verapamil - has qualities of vasodilation AND anti-arrhythmics (ONLY used in emergency settings)

Answer 7

* headache - due to vasodilation in brain as well * dizziness, lightheadedness (dropping of BP) * nausea * flushing - because systemic vasodilation * burning or tingling under the tongue for SL (SL can also cause flushed face) * circular patches on skin (ex. nitro patches may localize the dilation)

Answer 8

* prevent calcium from entering the cells of the heart and blood vessel walls (CCB binds to calcium channel to block it) * CCB reduces electrical conduction within the heart and decreased force of contraction of muscle cells * dilates arteries, reuslts in lower BP * slows HR (to allow left ventricle to fill completely, and lowers heart workload) * helps control irregular heart beat

Answer 9

-ve dromotropic, -ve ionotropic, -ve chronotropic

Answer 10

* treating HTN * tx for rapid heart rhythms as it decreases excitability for heart muscles (SVT, uncontrolled a-fib, atrial flutter)

Answer 11

* Amlodipine * Felodipine * Isradipine * Nicardipine * Nifedipine * Verapamil * Diltiazem - vasodilator but also has characteristics of CCBs

Answer 12

* **headache** * **constipation** * **rash** * **nausea** * **flushing** - sign of BP getting too low at certain sites * **edema** - pooling caused by decreased BP * **drowsiness** * **low BP** - may lead to hypovolemic shock overdosing on CCB medications can be lethal, causing hypotension, shock, and body system collapse

Answer 13

* "blood thinners" * used for heart diseases (ex. a- fib) and patients with MI and pacemakers * **anti-coagulants:** slow down body's processes of making clots * **anti-platelets:** prevent blood cells from clumping together to form a clot * without these drugs, clots can block circulation and lead to heart attacks/CVAs * both work to prevent clots but work in different ways

Answer 14

* **cannot be on an anti-platelet** - taken in combination, they both have anti-platelet properties which would increase risk/severity of bleeding * can be on anti-coagulant though

Answer 15

because anytime something foreign enters the body, the body will try and reject it so the body will try to create blood clots to encapsulate the pacemaker (which would cause it to fail) Taking a blood thinner will prevent this problem

Answer 16

* heart disease * poor blood circulation * recent surgeries requiring drainage (such as major abdo or breast surgery where drains are great entry ways for infection and clotting leading to blockages so patients will be placed on blood thinners until drains are removed) * abnormal heart beats (a-fib) * congenital heart defects * clotting conditions - Hx of MI, CVA, angina, DVT, PE

Answer 17

* drugs that keep your body from clotting easily by interfering with the blood clotting process * used to prevent ischemic strokes and TIAs * #1 anticoagulant: **warfarin (Coumadin, Jantoven, Marfarin)** * ****Short term therapy - injection * Long term therapy - pill * used to prevent clots from forming or to prevent existing clots from getting bigger * Often prescribed to: people with artificial heart valves, those with irregular heart beats, or those who have had hx of heart attack/stroke

Answer 18

* prevent blood clots; work by making it more difficult for platelets in your blood to stick together (the first step in clot formation) * clopidogrel (Plavix) and aspirin (although ASA has anti-platelet properties but not considered a true anti-platelet) * Sometimes prescribed to: those with hx of ischemic strokes or heart attacks * Are taken on a regular basis for an extended period for prevention of heart attack and stroke

Answer 19

heparin warfarin rivaroxaban apixaban

Answer 20

clopidogrel aggrenox ASA properties

Answer 21

Symptoms are usually on initial onset of taking the drug, then subside/go away all together * increased bruising (such as hematomas) * red or pink urine * stools that are coffee grounds * inreased menstrual bleeding * purple toes - circulation issue (stagnant blood that gets deoxygenated, as well as improper perfusion * pain with temp changes * blood thinners take away temp regulation properties (so ppl often feel cold as blood cannot rise up and stay)

Answer 22

* works by blocking a subtance your body needs to make cholesterol * lowers bad cholesterol (LDL) & has properies to safely prevent heart disease in certain aults (40-75 y.o.) * may also help body reabsorb cholesterol that has built up in plaques on your artery walls, preventing further blockage in your blood vessels and thus heart attacks * related to cardiac meds because of dx of DLD = risk of HTN and MI as well * besides medications, stents can also be used to widen arteries (up to 5 stents - CABG)

Answer 23

* Lipitor (atorvastatin) * Altoprev (lovastatin) * Livalo (pitavastatin) * Pravachol (pravastatin) * Crestor (rosuvastatin) * Zocor (simvastatin)

Answer 24

NTG (nitroglycerin) ASA (aspirin)

Answer 25

* QUICK-ACTING (within minutes) * used as a vasodilator * used to treat angina symptoms - chest pains or pressures (extremely high pressures like pulmonary edema) * helps restore blood flow into the heart * reduces how hard the heart has to work to circulate oxygenated blood * if the pains go away (it was angina); if it doesn't go away (then not angina)

Answer 26

* treat pain, fever, or inflammation * chest pains or MI * used as anti-clotting agent * used to prevent secondary heart attacks or CVAs * for MIs, **must be chewed** (passive diffusion - works in a couple minutes) * Dose: 2 x 80mg ASA (if they've already self-administered prior to EMS arrival and are still having pain, paramedics can dose them again) * Therapeutic dose: 380 - 420 mg of ASA

Answer 27

ASA - will always be beneficial vs nitro may sometimes turn someone into asystole

Answer 28

disease of heart muscles - three types: ## Footnote **hypertrophic** **dilated** **restrictive**

Answer 29

* one side of the heart is excessively large (usually LV) - more muscular/thickened * diastolic dysfunction * risk of sudden death in young athletes * thickened left ventricular wall

Answer 30

* enlargement of all cardiac chambers * systolic dysfunction * MOST COMMON TYPE

Answer 31

* rigid ventricular walls * diastolic dysfunction * LEAST COMMON TYPE

Answer 32

True. It's a finding/secondary disease to some other cause

Answer 33

remember that you cannot determine what kind of cardiomyopathy the patient has (until an autopsy is done) so treatment applies to all types * **anti-arrhythmics:** keeps heart beating with a normal rhythm/prevent arrhythmias * **ACE inhibitors, ARBs, BBs, or CCBs:** lower BP * **anticoagulants:** to prevent formation of blood clots * often used to those who have dilated cardiomyopathy to PREVENT blood clots

Answer 34

* beta blockers, anti-arrhythmics, blood thinners * anyone with a-fib should also already be on a blood thinner (to reduce stroke risk) and beta blocker (to control irregular heart rhythm)

Answer 35

FALSE. giving patient with RVI nitro will dilate heart and bottom it out, leading to asystole (i.e. induce hypotension and cardiac arrest)

Answer 36

* nitro and ASA (exception is RVI) * STENTS (bypass ER and straight to HIU) * ALWAYS put defib pads on in case of VSA

Answer 37

in the first few hours

Answer 38

SBP \<120 DBP \< 80

Answer 39

SBP: 120 - 129 DBP: \<80

Answer 40

SBP: 130-139 OR DBP: 80-89

Answer 41

SBP: 140 or higher OR DBP: 90 or higher

Answer 42

SBP \> 180 and/or DBP \>120 **consult doc immediately**

Answer 43

* ACE inhibitors * ARBs * Diuretics * Beta blockers * Calcium channel blockers * Renin inhibitors

Answer 44

1. **Reliver inhalers (MDIs):** metered dose inhalers 2. **Corticosteroids** (aerosol or powdered inhalant) 3. **Long-acting muscarinic antagonist** - going against wet symptoms (dries cough up 4. **Short-acting muscarinic antagonist** 5. **Combination puffers** - multiple meds combined into one puffer

Answer 45

Metered dose inhalers - meaning that there is a certain amount of doses with every inhaler

Answer 46

yes - therefore it must be documented when given to patients (because oxygen can hurt a patient)

Answer 47

**Oxygen dissociation curve:** describes the relationship between partial pressure of oxygen and oxygen saturation of Hb (i.e. how saturated Hb would be with oxygen at given partial pressres of oxygen) * in COPD patients, oxygen dissociation curve is shifted to the right meaning decreased Hb affinity for oxygen (so more readily released by Hb as a compensatory response to unload oxygen at the tissue levels since COPD patients are adapted to being SOB)

Answer 48

1) asthma 2) COPD 3) emphysema 4) pneumonia 5) pulmonary edema 6) CHF 7) Croup

Answer 49

ASS-FACE ## Footnote **A: allergens** (e.g pollen, moulds) - most common cases in childhood which resolve with age and then just turn into allergies **S:** **Smoke/scented products -** cigarettes, perfumes **S: Stress and anxiety** - due to hyperventilation **F: Food preservatives and certain medications** - allergic reaction closing airways (causing bronchoconstriction) **A: Arthropods** (eg. dust mites) **C: Cold air** - cold temps causing bronchoconstriction **E: Exercise** - increases resp rate

Answer 50

* recurrent and reversible SOB * can also be associated with anaphylaxis * occurs when airways of lungs become narrowed due to: * bronchial spasms (bronchoconstriction), bronchial mucosa inflammation/edema, production of mucous * alveolar ducts/alveoli remain open but airflow to them is obstructed (does not affect alveoli, just bronchi) * Sx: difficulty breathing, wheezing

Answer 51

* **Bronchodilators** * **Epinephrine:** for status asthmaticus (for severe forms of asthma attacks that may lead to respiratory failure) * **Oxygen**

Answer 52

* usually taken via inhaler or nebulizer (allows meds to go directly into lungs) * quick-relief meds used for flare ups (work within minutes) - bronchodilators * relaxes airways and loosens mucous from lungss * long-term (preventative) medications: used to reduce chronic inflammation that causes the Sx

Answer 53

* continuous inflammation of the bronchi and bronchioles * two main types: chronic bronchitis and emphysema * often occurs due to prolonged exposure to bronchial irritants (cigarettes, polluted areas, workplaces) * alveoli are filled with mucous to the point where they no longer have normal inhalation/exhalation capabilities * white and yellow phlegm * Sx: adventitious sounds on auscultation, progressive SOB, cyanotic * aka **blue bloaters** * to be Dx with bronchitis, productive cough for 3 months is needed

Answer 54

* stopping irritant * smoking cessation * bronchodilators (ventolin) * oral steroids * inhaled steroids * combination inhalers

Answer 55

* condition where air spaces enlarge as a result of dstruction of alveolar walls * the surface area where gas exchange takes place is reduced; impaired effectiveness of respirations * alveoli burst allowing oxygen to get pushed into the sac that holds the alveoli * oxygen then gets metabolized with CO₂ as byproduct * irreversible * Sx: SOB all the time; cherry coloured skin (due to metabolized oxygen that is now CO₂ buildup) - aka **pink puffers** * no ability to create pressure for inhalation and expiration (so pursed lip breathing helps to build pressure) * PHysiologically, the rib cage becomesbarrel chested to take pressure off lungs

Answer 56

* **Bronchodilators** - to relax bronchiolar muscles and improve airflow * **Corticosteroids** - to reduce inflammatory reponse * **Oxygen**

Answer 57

* common respiratory problem in young children (always a secondary problem to another cause such as a cold or upper respiratory tract infetion UTRI) * causes swelling and narrowing in the voice box, windpipe and airways that lead to the lungs * Adults have linear airways vs children (up to 8 y.o.) have cone shaped aiways so when it's inflamed, the airway is significantly narrowed in children leading to the hallmark barking cough * can develop into asthma as you grow up; once a child gets croup, they are more likely to get it again * tends to occur in the fall and water * Main Sx: haarsh barking cough (like a seal)

Answer 58

* moist air (such as humidifier) * cold or cool air * fluid and anti-pyreitc for fever (bc of URTI) * emergency treatment: EPI 1:1000 via nebulizer (misted with oxygen and inhaled for bronchodilation)

Answer 59

**1) Salbutamol - aka ventolin** (blue rescue inhaler) **2) Atrovent** - bronchodilator

Answer 60

* large group of sympathomimetics (adrenergic) * stimulates beta-2 adrenergic receptors throughout the lungs (bronchial smooth muscles to caused relaxation) * used during acute phase of asthmatic attacks * quickly reduces airway constriction to help restore normal air flow

Answer 61

* begins with a specific receptor stimulated and ends with airway dilation * activation of beta 2 receptors activate cyclic addenosine monophosphate which relaxes smooth muscle in the airway resulting in bronchodilation and inccreased airflow * patients are usually instructed by their physicians to take 3 doses of their medications prior to calling paramedics if their symptoms do not improve

Answer 62

* Relief of bronchospasm related to respiratory disorders (treatment of asthma and bronchitis or other pulmonary disease) * treatment and prevention of acute attacks * used in hypotension and shock * used to produce uterine relaxation to prevent premature labour (uterotonic aspects) * ex. albuterol, salbutamol, ventolin

Answer 63

SALBUTAMOL (Ventolin, or albuterol in US) * used to treat/prevent bronchospasm in patients with asthma, bronchitis, and emphysema) * DIRECTLY targets beta-2 adrenergic receptors * ventolin also works on beta cells in the heart so it may increase HR (so lots of ventolin may have side effects of palpitations and heart racing) * can be nebulized * blue MDI

Answer 64

* a short-acting muscarinic antagonist * long term use (usually daily use) aka **NON EMERGENCY INHALER** * relaxes muscles in airway and increases airflow to lungs * used to prevnt bronchospasms; used for bronchitis, emphysema, or COPD * White, green, and yellow MDI

Answer 65

* anti-inflammatory properties * used for chronic asthma, primarily given to those with COPD (to enlarge alveoli and thus lung space) * **does not** relieve symptoms of acute asthmatic attacks * come in oral or inhaled forms * inhaled forms reduce systemic effects * may take several weeks for full effects to be seen

Answer 66

* **Flovent:** prevents asthma - solid orange puffer * **Pulmicort:** controls and prevents wheezing and SOB caused by asthma (i.e. more long-term use for prevention and cannot relieve acute asthma symptoms during an attack) - bullet inhaler * **Beclomethasome:** controls and prevents wheezing and SOB caused by asthma, similar to Pulmicort

Answer 67

* treatment of bronchospastic disorders that are not controlled by conventional bronchodilators * not considered FIRST LINE drugs for management of acute asthmatic attacks or status asthmaticus

Answer 68

* pharyngeal irritation * coughing * dry mouth * oral fungal infections (thrush) - that's why you need to instruct patients to rinse their mouths after use of corticosteroids * systemic effects are rare because low doses are used in inhalation therapy

Answer 69

rinse their mouth with warm water (to avoid oral fungal infections i.e. thrush)

Answer 70

It doesn't matter, can take whichever first

Answer 71

* they stabilize membranes of cells that release harmful bronchoconstricting substances (i.e. leukocytes/WBCs) * increase responsiveness of bronchial smooth muscles to beta-adrenergic stimulation

Answer 72

* aka fluticasone * an orange inhaler * prevents release of substance in the body that causes inflammation * used to prevent asthma attacks (but not completely) - will NOT treat and asthma attack that has already begun * may be used together with Flovent diskus with an oral steroid medicine

Answer 73

* aka budesonide * purple, turbo inhaler * used to control and prevent symptoms (wheezing and SOB) caused by asthma * the powder is inhaled after twisting the body of the inhaler to grind it up into powder * works directly in the lungs to make breathing easier by reducing swelling

Answer 74

* **Spiriva** (light green) * generic name: Tiotropium * used to control and prevent Sx (such as wheezing, SOB) * Helps control and prevent an asthma attack or COPD exacerbation from happening, long acting and will probably last 24/h before needing another dose * life long - NOT FOR ACUTE EPISODES

Answer 75

* Atrovent: bronchodilator * used in treating Sx of asthma, colds, allergies, COPD due to pulmonary disease * yellow and green * PREVENTER not a rescue inhaler

Answer 76

* inhalers that are a combination of bronchodilators and corticosteroids * not a rescue inhaler * used to stop or treat Sx of asthma or COPD (emphysema, chronic bronchitis) * lowers swelling in breathing passages and lungs * bronchodilators open up air passes to make breathing easier

Answer 77

* Combivent * Advair * Symbicort

Answer 78

* MDI containing combination of albuterol (Ventolin) and ipratropium (Atrovent) * both bronchodilators to relax muscles in airways & increase air flow to lungs * used as an inhaled medication to **prevent bronchospasm** in COPD, and often a supplementary medication so prescribed alongside other medications * orange and green

Answer 79

* used to prevent asthma, prevent flare ups/exacerbations of COPD associated with bronchitis or emphysema * in people with COPD, Advair is LT treatment * in person with asthma, it's ST treatment until Sx are well-controlled with other meds * purple inhaler (powder inside), diskus

Answer 80

* contains combination of budesonide (Pulmicort) and formoterol * Budesonide: steroid that reduces inflammation in body * Formoterol: bronchodilator that relaxes muscles in airways to improve breathing * used for asthma (ST treatment) * used for COPD (LT treatment) * can be for anyone, any age

Answer 81

* hypothalamus * pituitary gland * pineal gland * thyroid and parathyroid glands * pancreas * thymus * ovaries (in female) * placenta (during pregnancy) * testicle (in male)

Answer 82

* hypo/hyperglycemia * DKA * thyroid and adrenal emergencies * menopause (if associate with vaginal bleed, may be vaginal/uterine cancer) * Diabetes insipidus vs Diabetes Mellitus * Hypothyroidism * Hyperthyroidism = Graves Disease * Addison's Disease * Cushing's Disease

Answer 83

* rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine * urine is insipid (i.e. diluted and colourless) - body cannot properly concentrate urine * people with DI have normal blood glucose levels however kidneys cannot balance fluid in the body allowing the glucose to travel to the cells

Answer 84

* more common form of diabetes * a disease manifested by a dysfunctional pancreas (congenital, burdened pancreas by high cholesterol, obesity, surgery, etc.) * pancrease doesn't produce enough insulin to control the amount of glucose/sugar in blood * two forms: Type 1 (IDDM) and Type 2 (NIDDM)

Answer 85

**Normal range:** 4-7 mmol/L **Pre-diabetic:** 8-10 mmol/L **To be cognitively aware:** at least 4.0 mmol/L

Answer 86

Type I diabetes (because this is juvenile diabetes so you gotta be a smol bean)

Answer 87

**Insulin-dependent Diabetes Mellitus (IDDM)** * pancreas does not produce insulin (∴ insulin dependent) * immune cells destroy the beta cells in the pancreas * without insulin the cells of the body are not able to take sugar into the cells to be used for energy (which is the main fuel of the cell) * the type of insulin taken depends on need for fast vs gradual onset, dose, longevity, efficacy etc.

Answer 88

1) when there is an excess amount of glucose in the body (such as after a meal), it causes the pancrease to give off insulin 2) insuling can will carry the glucose into the cells of the body (glucose cannot get into cells independently) - **carrier-mediated facilitated transport** 3) fatal if you don't have insulin because NO GLUCOSE can be delivered to the brain

Answer 89

**Non-insulin dependent diabetes mellitus (NIDDM)** * patients are capable of producing insulin (i.e. normal pancreas) however that insulin is not used properly by the body (and producing less insulin) * so less glucose is taken up into the cells * eventually insulin resistance will happen because pancreas can't keep up with high loads of glucose, and eventually will stop working * these individuals may also need insulin but NOT be type I - you'd be able to tell because they are also on other oral diabetic meds as well

Answer 90

beta cells in pancreas

Answer 91

YES! lifestyle changes, etc.

Answer 92

humulin novolin

Answer 93

* classified as a hormone * binds to a receptor on the cell membrane to facilitate transport of glucose into cells & lowers blood sugar * type of insulin required will be determined by lifestyle * usually found in the fridge

Answer 94

* oral hypoglycemic agents OR oral anti-hyperglycemic agents * there are different classes of ani-diabetic drugs and their selection depends on nature of diabetes, age, and situation of person, and other factors

Answer 95

* insufficient intake of sugar or excessive dosing/action of medication * most common reaction experienced by diabetic * bodies' response is to release glucagon which mobilizes glucose stored in the liver and muscle in the form of glycogen (which breaks down into glucose) - i.e. **glycogenolysis**

Answer 96

* \<4 mmol/L * lightheadedness, sick, dizziness * **\*note:** if a diabetic person drops \<4, they are still functionally quite well ((vs. a nondiabetic person who may be unconscious at the same BGL)

Answer 97

* mild Sx: eat (hangry) * mod to severe: \<4 or someone who presents as unconscious * IV access - dextrose (D10) which takes seconds to work (vs. glucagon takes ~5min); increases blood glucose concentrations * glucagon * oral glucose

Answer 98

* natural sugar, not a hormone * increases blood glucose * anti-hypoglycemic agent * immediate onset and action (within 30 seconds) since if follows zero order kinetics * _short acting_ meaning they have to eat afer to keep their blood surgar high after initial dextrose administration

Answer 99

* hormone * IM administration (if IV not accessible) * makes its way to the pancreas to stimulate glycogenolysis * mobilizes glucose stored in the liver and muscle in the form of glycogen * converts liver glycogen into glucose * patients may not show immediate improvement secreted by the pancreas in response to low blood sugar

Answer 100

* Treatment of choice (or use of glucose tablets) * simple sugars for a patient to eat (apple/orange juice, PB) * patients would need a patent airway and increased GCS * if not immediate improvements are noted, you need to follow with glucagon adminsitration * advise patient to eat food/take tablets/paste after IV dextrose (because after the initial tx, it'll wear off and patient would crash again)

Answer 101

blood oxygen glucose

Answer 102

* abnormally high blood sugar (fasted blood sugar) * hallmark sign of diabetes or pre-diabetes * BGL can range from 8 to 18-20 mmol/L * Sx: increased thirst and frequent urination

Answer 103

metformin glyburide ^ both oral hypoglycemic agents

Answer 104

* class of medication: **biguanide** * primary function is to _reduce glucose production by the liver_ * also promotes glucose uptake by skeletal muscles to reduce circulating glucose levels * lowers blood sugar * useful in delaying continued problems in obsese individuals (used for type II diabetes)

Answer 105

* classified as secretagogues (sulfonylureas) * aka glicazide * triggers beta cells to release insulin (to increase glucose uptake and lower blood sugar levels) * lower risk of GI problems than with Metformin * for type II diabetes

Answer 106

* \>20 mmol/L blood sugar * occurs most commonly in patients with IDDM * KEY problem is a lack of insulin * no sugar to use energy so body breaks down fat with produces acid and chemicals known as ketone bodies (breakdown of fat into glucose) * sweet candy breath, +ve ketone bodies in urine (via ketone strip)

Answer 107

1) has IDDM 2) has abdo pain 3) N/V 4) blood sugar is 16+

Answer 108

* correction of dehydration * IV fluids * insulin * Complications: heart complication and acidosis - need to be corrected

Answer 109

* promote diuresis - increased production of urine * aka water pills/pee pills * designed to increase water and sodium expelled from the body as urine, reduces amount of fluid in the body * designed to help with HTN (but diuretics are typically not the #1 choice for HTN, usually put on other meds) * lowers BP as it controls urine production in the kidneys

Answer 110

HTN edema - gravitational pooling (such as those sitting in wheelchairs) kidneys not functioning well CHF

Answer 111

1) thiazide diuretics 2) loop diuretics 3) potassium-sparing diuretics

Answer 112

* most commonly prescribed diuretic * often used to treat HTN * decreases fluids in the body but also causes blood vessles to relax * examples: * **chlorothiazide** * **hydrochlorothiazide (HCTZ)** * **indapamide**

Answer 113

* often used to treat HF * most common: furosemide (tiny yellow pill)

Answer 114

* reduces fluid without losing potassium (where other diuretics may cause pt to lose K+ and end up with arrhythmias) * Rx'd for patients with already low potassium * doesn't work as well at reducing BP as others * risk: liver failure (cirrhosis) - low potassium * common meds: * **amiloride** * **spironolactone** * **triamterene**

Answer 115

* varying range of severities (from goiters that need no tx to life threatening cancer) * most common thyroid problems involve abnormal production of thyroid hormones * anti-psychotics can also chemically destroy your thyroid

Answer 116

hyperthyroidism

Answer 117

hypothyroidism

Answer 118

* aka Graves disease * common cause of hyperthyroidism * over production of thyroid hormone * causes enlargement of thyroid * other Sx: * exophthalmos (bulging eyes) * heat intolerance * anxiety

Answer 119

**1) Toxic adenomas:** nodules develop ini thyroid gland and begin to secrete thyroid hormones, upsetting body's chemical balance; some goiters may contain several of these nodules **2) Subacute thyroiditis:** inflammation of thyroid gland causes gland to "leak" excess hormones, reuslting in temporary hyperthyroidism that generally lasts a few weeks but may persist for months **3) Pituitary gland malfunctions or canerous growths in thyroid gland:** rare

Answer 120

* condition with insufficient thyroid hormone production * Sx: puffy face, enarlged thyroid, weight gain, lethargy, restlessness, diarrhea, restless leg syndrome, sleep disturbances, can't uptake nutrients * If untreated for long periods of time, this condition can bring on a myxedema coma, a rare but potentially fatal condition that requires immediate hormone treatment

Answer 121

1) **exposure to excess amounts of iodide:** cold and sinus meds, heart med amiodarone, certain contrast dyes given prior to Xrays may expose you to too much iodide **2) Lithium** **3) removal of thyroid gland:** surgically removed (thyroidectomy) or chemically destroyed (such as by drug methimazole [tapazole] which is usually used to treat hyperthyroidism)

Answer 122

* aka **levothyroxine** * synthetic hormone which replaces hormone normally produced by the thyroid gland to regulate body's energy and metabolism * given when thyroid does not produce on its own

Answer 123

Addisons Disease Cushings Disease They are the exact opposite of each other (symptoms, cause, etc.)

Answer 124

* condition caused by inadequate production of steroid hormones and/or secretion by adrenal cortex (cortisol and aldosterone) which typically play an important role in regulating many functions of the body * considered primary insufficiency - because adrenal cortex is damaged resulting in low production of steroid hormones (little to no cortisol) * can be life threatening

Answer 125

* extreme fatigue * weight loss * hyperpigmentation * decrease in BP - fainting * salt cravings: to replace lost electrolytes (Na+) * N/V/D and abdo pain

Answer 126

* severe adrenal insufficiency caused by insufficient levels of the hormone cortisol (can result from Addisons diesase) * Fever * Syncope * Convulsions * Hypoglycemia * Hyponatremia * V/D * Patient may also present with abdo pain, hypotension, headache, fever, abdnormal ECG, and loss of appetite

Answer 127

* hydrocortisone injection (can reset crisis within 1 hour of injection) * treat and transport with IV fluids and check capillary blood sugar (CBS) monitoring, and provide glucose if needed (glucagon will likely NOT have an effect) * CTAS 1

Answer 128

* disorder that occurs when body has high levels of cortisol hormone * Causes: * pituitary gland is releasing too much ACTH * tumor or excess growth of pituitary gland * Sx: weight gain, obesity * buffalo hump (fat pad b/w shoulder blades) or forehead * fatty deposits on abdomen * round moon shaped face * dark purple stretch marks * breast tissue on males, bruises easily * pendulus or apron belly * thin arms and legs

Answer 129

body's main stress hormone (built in alarm system) that works with certain parts of your brain to control mood, motivation, and fear

Answer 130

high cholesterol

Answer 131

Common specific causes: * eating poor diet * sedentary (inactive) lifestyle * pregnancy (weight gained during pregnancy can be difficult to lose an eventually lead to obesity) Other causes: * not sleeping enough, which can lead to hormone changes that make you feel hungrier and crave certain high calorie foods * genetics - affecting how body processes food into energy and how fat is stored * growing older: less muscle mass and slower metabolic rate, making it easier to gain weight

Answer 132

No. Being a larger person may be hereditary but not obesity

Answer 133

* results from sedentary lifestyle, obesity, genetics, environmental lifestyle * Symptoms: * chest pain/angina (due to plaque buildup and ischemic sx) * heart attack * stroke * pain while walking caused by blocked arteries that are unable to send blood to the legs

Answer 134

* Lipitor (atorvastatin) * Lescol (fluvastatin) * Mevacor (lovastatin) * Altocor (also lovastatin) * Pravachol (pravastatin) * Livalo (pitavastatin) * Zocor (simvastatin)

Answer 135

* prescribed to people who continue to be at high risk of heart disease (need to be taken for life) * blocks enyme in liver that helps to make cholesterol, leading to a reduction in your blood cholesterol level * reduces risk of heart attacks and strokes as it lowers cholesterol levels and reduces chance of fatty deposits of LDL building up in blood vessels that lead to ishemic events

Answer 136

* two types: combination pill (has estrogen and progestin) or a mini pill (only estrogen) * Estrace * Estrogen * Femara * Alesse, Aviane, Diane, Yaz, Yasmine

Answer 137

* OTC herbal supplements: ex. St. Johns Wort may affect effectiveness of BCP * Cigarette smoking and BCPs - can cause pulmonary embolus * SSRIs and antibiotics: may reduce efficacy of pill and pregnancy may result

Answer 138

* can be used for cross sex hormone therapy, menopausal hormone replacement therapy * administed by injections, patches, or gels * differing types: * estrogen vs testosterone replacement * feminizing hormone therapy vs masculinizing hormone therapy

Answer 139

* have significant impact on physical appearance * estrogen and progesterone makes hips widen and breasts grow in size as they produce female sex characteristics * the opposite can be said for taking masculiniing hormones (testosterone, spironolactone)

Answer 140

* bloot clots * elevated levels of triglycerides * stroke * hyperkalemia * T2 diabetes * HTN * weight gain * infertility * men who are cisgender have less risk for breast cancer * CV disease