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Pharm Exam 1 > Pharm CH 33 and 34 > Flashcards

Pharm CH 33 and 34 Flashcards

1
Q

inflammation is the protective response to

A

tissue injury and infection

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2
Q

elements sent to the injured site

A

fluid
blood elements
leukocytes
chemical mediators

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3
Q

cause vasodilation, relaxation of smooth muscle, increase capillary permeability, and sensitizes nerve cells to pain

A

prostaglandins

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4
Q

Cardinal S&S of inflammation

A

redness, heat, edema, pain, loss of function

think infection

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5
Q

acute inflammation

A

immediate onset
8-10 days
symptoms resolve

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6
Q

autoimmune disorders resulting in chronic inflammation

A

Lupus
RA

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7
Q

chemical mediators

A

histamines
leukotrienes
bradykinin
complement
prostaglandins

He Let Brittany Come Play

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8
Q

-a key chemical mediator of inflammation that causes vasodilation, smooth muscle constriction, tissue swelling, itching
-Stored where?

A

Histamine
-Stored within mast cells that detect foreign agents or injury that respond by releasing histamine, which initiates the inflammatory response within seconds

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9
Q

increase capillary permeability, attract WBCs to the site of inflammation, cause pain, induces fever

A

Prostaglandins

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10
Q

3 principles when treating inflammation

possible causes

A
  1. indentifying and treating the cause (IV, drain)
  2. using nonpharmacological treatment if possible (ice packs and rest)
  3. treat skin and mucous membranes with topical drugs OTC
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11
Q

goal of pharmacologic anti-inflammatories

A

prevent or decrease intensity of the inflammatory response and reduce any fever

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12
Q

two anti-inflammatory drug classifications

A

NSAIDs
Corticosteroids

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13
Q

life threatening allergic reaction leading to shock or death

A

anaphylaxis

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14
Q

aspirin therapeutic classes

A

nonopioid analgesic
NSAID
antipyretic
inhibits platelet aggregation (stops clotting - high bleed risk)

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15
Q

aspirin pharm class

A

salicylate
COX inhibitor

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16
Q

enzyme that converts omega-3 fatty acid into prostaglandins

A

COX

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17
Q

COX 1 locations and action and administration

A

Location: in all body tissues
Action: protects stomach lining - enhance platelet aggregation - promote kidney perfusion
Admin: oral enteric coating

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18
Q

COX 1 inhibitors examples and action

A

Ex: ASA, iBuprofen, Naproxen
Action: block COX 1 - GI ulcers, bleeding, reduce kidney function

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19
Q

COX 2 location and action

A

L: only after tissue injury at site
A: triggers pain, inflammation and fever

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20
Q

COX 2 inhibitors MOA

A

reduce production of prostaglandins to decrease pain, inflammation and swelling

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21
Q

Actions of aspirin

A

block prostaglandins
pain relief
fever-reducer
anticoagulant
decrease inflammation

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22
Q

when to discontinue aspirin

A

1 week before surgery

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23
Q

Aspirin therapeutic range

A

5-30 mg/dl

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24
Q

Inhibition of COX 1 from aspirin cause what adverse effects

A

gastric bleeding (enteric coating)
tinnitus (hearing loss)
metabolic acidosis

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25
Q

Contraindications of ASA

A

 Do not give to patients receiving anticoagulant therapy: warfarin and heparin
 Do not give to children with Flu or virus symptoms as it may lead to Reye syndrome (swelling in the liver and brain)

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26
Q

dosage of ASA for antiplatelet and pain/fever

A

anti-platelet - 81mg baby aspirin
pain/fever - 350-650 mg ever 4 hours

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27
Q

overdose treatment for ASA

A

activated charcoal

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28
Q

advil therapeutic class

A

analgesic
antiinflamatory
antipyretic

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29
Q

advil pharm class

A

NSAID

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30
Q

action of advil

A

inhibit COX 1 and 2
pain
inflammation
fever
inhibit prostaglandin synthesis
OA, RA, HA, dental
dysmenorrhea

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31
Q

advil time til antiinflammatory effects

A

2-3 weeks

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32
Q

administration of advil

A

empty stomach

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33
Q

advil adverse effects

A

 Nausea, gastritis, epigastric pain, dizziness, GI ulceration with hemorrhage
 Long-term use may lead to CKD
 May cause an ↑ risk for MI/CVA
 Greater risk for CVD

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34
Q

acetaminophen therapeutic class

A

antipyretic and analgesic

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35
Q

acetaminophen pharm class

A

centrally-acting COX inhibitor

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36
Q

acetaminophen actions

A

 Reduces fever by direct action at the level of the hypothalamus & dilation of peripheral blood vessels. This allows for sweating & dissipation of heat
 Pain relief

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37
Q

maximum dose of acetaminophen

A

4g every 24 hours

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38
Q

advise patients of contraindication of acetaminophen

A

may cause liver damage
do not take if chronic alcoholic

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39
Q

adverse effects of acetaminophen

A

 Acetaminophen poisoning is very serious
 Symptoms: anorexia, nausea, vomiting, diarrhea (ANVD), dizziness, lethargy,
diaphoresis, chills, abdominal pain
 Excessive use is #1 cause of acute liver failure
 Chronic ingestion results in WBC dyscrasias and CKD
 May cause Stevens-Johnson syndrome (severe blistering of the skin, mucous membranes, genitals, eyes), a medical emergency

40
Q

drug to avoid with acetaminophen bc of bleeding

A

warfarin - blocks metabolism of causing toxic accumulation = bleeding

41
Q

drugs to avoid with acetaminophen due to liver failure

A

ETOH, phenytoin, barbiturates

42
Q

overdose treatment of acetaminophen

A

N-acetylcysteine

43
Q

action of corticosteroids

A

-inhibit biosynthesis of prostaglandins
-suppress immune responses and reduce inflammation

44
Q

types of corticosteroids

A

glucocorticoids - cortisone and dexamethasone
mineralocorticoids - aldosterone and fludrocortisone

45
Q

cortico dose and effects

A

given in high doses
numerous adverse effects
can mask other infections

46
Q

prednisone classes

A

 Therapeutic Class: Antiinflammatory
 Pharmacologic Class: Corticosteroid

47
Q

prednisone admin

A

 Administer deep IM to avoid atrophy or abscesses
 Omit if there are signs of a systemic infection
 Must be tapered slowly off drug

48
Q

adverse effects of prednisone

A

 Long-term use may result in Cushing’s syndrome
 Hyperglycemia
 ↑ for fractures (fx), gastric ulcers
 Use caution in patients with PUD, ulcerative colitis, diverticulitis

49
Q

lab results due to prednisone

A

 Prednisone may inhibit antibody response to vaccines
 Prednisone may ↑ blood glucose
 Calcium, potassium, and thyroxine may ↓

50
Q

any drug/therapy that affects body defenses

A

immunomodulator

51
Q

2 actions of immunomodulators

A

 Some stimulate body defenses so microbes or cancer cells can be effectively attacked
 Some suppress body defenses to prevent organ transplant rejection by the immune system

52
Q

lymphatic system provides body with

A

ability to resist injury and protect body against pathogens
palpate lymph nodes

53
Q

substance that elicits an immune response

A

antigen

54
Q

3 steps of the immune response

A
  1. Recognition of the antigen
    2 .Communication & coordination with other defense cells
  2. Destruction/suppression of the antigen
55
Q

Humoral immunity part 1

A

B cell activation and division
antibody-antigen reaction - antibodies interact and neutralize antigens

56
Q

humoral immunity part 2

A

Memory B cells are formed
memory may last for a lifetime
VACCINES - produce memory cells in advance

57
Q

Process of vaccinations

A

Memory B cells are formed
produce large quantities of antibodies to destroy pathogens
most need follow up doses
antibody production test - titer

58
Q

4 methods of safe effective vaccines

A

 Attenuated: live but weekended microbes that are unable to produce dz unless the patient is
immunocompromised (MMR vaccines)
 Inactivated (killed): microbes inactive by heat/chemicals & are unable to replicate or cause dz
 Toxoid vaccines: contain bacterial toxins that have been chemically modified to be incapable of causing
dz (diphtheria & tetanus toxoids)
 Recombinant technology vaccines: contain partial viral subunits or bacterial proteins generated in a lab.
They do not contain viral genetic material & cannot become infectious (hepatitis B & human papillomavirus
vaccines)

59
Q

live but weekended microbes that are unable to produce dz unless the patient is
immunocompromised (MMR vaccines)

A

 Attenuated

60
Q

the type of response induced by the real pathogen or its vaccine

A

active immunity

61
Q

when preformed antibodies are transfereed or donated from one person to anothers

A

passive immunity - cross the placenta

62
Q

this is given when the development of memory cells is not desirable. It makes
antibodies attack Rh positive blood cells in an Rh-negative mother to protect the fetus if there
is a chance the fetus may be Rh positive

A

RhoGAM:

63
Q

immune globulin

A

pooled antibodies taken from plasma of human donors

64
Q

medication that increase ability of immune system to fight infection and disease
treat cancer and viral infections

A

immunostimulants

65
Q

vaccine used against TB and bladder cancer

A

BCG

not in US but Mexico

66
Q

trigger killer cells to interfere with viral replication

A

interferons

67
Q

interferon alfa - 2b treats
do not give to:

A

K sarcoma and chronic hepatitis
neonates and infants

68
Q

interferon beta -1a and 1b

A

treats MS

69
Q

medications manufactured in a lab by recombinant DNA technology that targets autoimmune diseases and cancers
boost function of immune system
enhance blood cell formation

A

biologic response modifiers

70
Q

drugs inhibiting the immune response

A

immunosuppressants

71
Q

immunosuppressant uses

A

organ rejection
severe inflammatory disorders

72
Q

immunosuppressant cyclosporine actions

A

inhibits helper T cells (doesnt send signal)
less toxic to bone marrow
combination with prednisone
prophylaxis (prevent disease)

73
Q

look out for with cyclosporine

A

WBC not below 4000
Platelets not below 75,000

74
Q

vaccines procedure

A

we want to wait before treating inflammation to let them react
treat fever above a certain degree

75
Q

what to do if ordered NSAID specifies pain but patient has a fever?

A

Call provider to inform about fever and get new order

76
Q

more bleeding

A

increased prothrombin time

77
Q

more clots

A

decreased prothrombin time

78
Q

purpose for baby aspirin

A

reduce clotting

79
Q

purpose for 350 or higher aspirin dose

A

chest pain

80
Q

If ASA smells like vinegar

A

medication is expired - throw away

81
Q

acceptable pain level

A

4 or below

82
Q

what happens when a patient taking NSAIDs consumes alcohol

A

bleeding

83
Q

purpose of evaluation after medication administration

A

measure effectiveness

84
Q

key adverse effect from hydrocortisone use

A

moon face

85
Q

how to stop taking antiinflammatory and antipyretic drugs

A

slowly taper off to avoid adrenal crisis

86
Q

prednisone uses

A

inflammation
asthma bronchospasm
antineoplastic

87
Q

do not give patients prednisone if

A

they have any type of infection

88
Q

how to determine what antibiotic to use

A

culture

89
Q

start broad spectrum antibiotics when

A

after cultures are drawn

90
Q

differential

A

measure each type of WBC individually

91
Q

arthralgia

A

joint pain

92
Q

pregnant women can receive which vaccines

A

flu and covid

93
Q

have on hand when giving vaccines

A

epinephrine (1:1000)

94
Q

types of cytokines

A

interleukins
gamma interferon
TNF

95
Q

advil labs

A

PTT, AST/ALT, decreased HBG/HCT

Pharm Exam 1 (3 decks)

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