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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
Contraindications of ASA
 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)
26
dosage of ASA for antiplatelet and pain/fever
anti-platelet - 81mg baby aspirin pain/fever - 350-650 mg ever 4 hours
27
overdose treatment for ASA
activated charcoal
28
advil therapeutic class
analgesic antiinflamatory antipyretic
29
advil pharm class
NSAID
30
action of advil
inhibit COX 1 and 2 pain inflammation fever inhibit prostaglandin synthesis OA, RA, HA, dental dysmenorrhea
31
advil time til antiinflammatory effects
2-3 weeks
32
administration of advil
empty stomach
33
advil adverse effects
 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
34
acetaminophen therapeutic class
antipyretic and analgesic
35
acetaminophen pharm class
centrally-acting COX inhibitor
36
acetaminophen actions
 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
37
maximum dose of acetaminophen
4g every 24 hours
38
advise patients of contraindication of acetaminophen
may cause liver damage do not take if chronic alcoholic
39
adverse effects of acetaminophen
 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
drug to avoid with acetaminophen bc of bleeding
warfarin - blocks metabolism of causing toxic accumulation = bleeding
41
drugs to avoid with acetaminophen due to liver failure
ETOH, phenytoin, barbiturates
42
overdose treatment of acetaminophen
N-acetylcysteine
43
action of corticosteroids
-inhibit biosynthesis of prostaglandins -suppress immune responses and reduce inflammation
44
types of corticosteroids
glucocorticoids - cortisone and dexamethasone mineralocorticoids - aldosterone and fludrocortisone
45
cortico dose and effects
given in high doses numerous adverse effects can mask other infections
46
prednisone classes
 Therapeutic Class: Antiinflammatory  Pharmacologic Class: Corticosteroid
47
prednisone admin
 Administer deep IM to avoid atrophy or abscesses  Omit if there are signs of a systemic infection  Must be tapered slowly off drug
48
adverse effects of prednisone
 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
lab results due to prednisone
 Prednisone may inhibit antibody response to vaccines  Prednisone may ↑ blood glucose  Calcium, potassium, and thyroxine may ↓
50
any drug/therapy that affects body defenses
immunomodulator
51
2 actions of immunomodulators
 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
lymphatic system provides body with
ability to resist injury and protect body against pathogens palpate lymph nodes
53
substance that elicits an immune response
antigen
54
3 steps of the immune response
1. Recognition of the antigen 2 .Communication & coordination with other defense cells 3. Destruction/suppression of the antigen
55
Humoral immunity part 1
B cell activation and division antibody-antigen reaction - antibodies interact and neutralize antigens
56
humoral immunity part 2
Memory B cells are formed memory may last for a lifetime VACCINES - produce memory cells in advance
57
Process of vaccinations
Memory B cells are formed produce large quantities of antibodies to destroy pathogens most need follow up doses antibody production test - titer
58
4 methods of safe effective vaccines
 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
live but weekended microbes that are unable to produce dz unless the patient is immunocompromised (MMR vaccines)
 Attenuated
60
the type of response induced by the real pathogen or its vaccine
active immunity
61
when preformed antibodies are transfereed or donated from one person to anothers
passive immunity - cross the placenta
62
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
RhoGAM:
63
immune globulin
pooled antibodies taken from plasma of human donors
64
medication that increase ability of immune system to fight infection and disease treat cancer and viral infections
immunostimulants
65
vaccine used against TB and bladder cancer
BCG not in US but Mexico
66
trigger killer cells to interfere with viral replication
interferons
67
interferon alfa - 2b treats do not give to:
K sarcoma and chronic hepatitis neonates and infants
68
interferon beta -1a and 1b
treats MS
69
medications manufactured in a lab by recombinant DNA technology that targets autoimmune diseases and cancers boost function of immune system enhance blood cell formation
biologic response modifiers
70
drugs inhibiting the immune response
immunosuppressants
71
immunosuppressant uses
organ rejection severe inflammatory disorders
72
immunosuppressant cyclosporine actions
inhibits helper T cells (doesnt send signal) less toxic to bone marrow combination with prednisone prophylaxis (prevent disease)
73
look out for with cyclosporine
WBC not below 4000 Platelets not below 75,000
74
vaccines procedure
we want to wait before treating inflammation to let them react treat fever above a certain degree
75
what to do if ordered NSAID specifies pain but patient has a fever?
Call provider to inform about fever and get new order
76
more bleeding
increased prothrombin time
77
more clots
decreased prothrombin time
78
purpose for baby aspirin
reduce clotting
79
purpose for 350 or higher aspirin dose
chest pain
80
If ASA smells like vinegar
medication is expired - throw away
81
acceptable pain level
4 or below
82
what happens when a patient taking NSAIDs consumes alcohol
bleeding
83
purpose of evaluation after medication administration
measure effectiveness
84
key adverse effect from hydrocortisone use
moon face
85
how to stop taking antiinflammatory and antipyretic drugs
slowly taper off to avoid adrenal crisis
86
prednisone uses
inflammation asthma bronchospasm antineoplastic
87
do not give patients prednisone if
they have any type of infection
88
how to determine what antibiotic to use
culture
89
start broad spectrum antibiotics when
after cultures are drawn
90
differential
measure each type of WBC individually
91
arthralgia
joint pain
92
pregnant women can receive which vaccines
flu and covid
93
have on hand when giving vaccines
epinephrine (1:1000)
94
types of cytokines
interleukins gamma interferon TNF
95
advil labs
PTT, AST/ALT, decreased HBG/HCT

Pharm Exam 1 (3 decks)

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