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PHARM > PHARM EXAM 9 > Flashcards

PHARM EXAM 9 Flashcards

1
Q

helps to prevent excessive secretion of hormones, thereby limiting their physiologic responses.

A

neg. feedback system

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2
Q

growth hormone that stimulates the growth and metabolism of nearly every cell in the body.

A

somatotropin

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3
Q

def. of growth hormone in children can cause?

A

short stature

or

dwarfism

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4
Q

Excess secretion of GH in adults, a rare disorder of the pituitary gland known as _____ causes the bones to become deformed

A

acromegaly

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5
Q

the onset of acromegaly is gradual and leads to enlargement of?

A

small bones of the hands, feet, face, & skull as well as a broad nose, protruding lower jaw, & slanting forehead

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6
Q

tx of acromegaly consists of?

A

combination of surgery

radiation therapy

pharmacotherapy

to suppress GH secretion or block GH receptors

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7
Q

when is pharmacology used in pts with acromegaly?

A

when they are unable to undergo surgical removal of the tumor

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8
Q

one of the medications for acromegaly, is a synthetic growth hormone antagonist structurally related to growth hormone–inhibiting hormone (somatostatin).

A

Octreotide (Sandostatin)

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9
Q

ADH is also called?

A

vasopressin

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10
Q

why is ADH called vasopressin?

A

because it has the ability to constrict blood vessels and raise blood pressure

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11
Q

a rare condition characterized by the production of large volumes of very dilute urine, usually accompanied by increased thirst.

A

DI

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12
Q

Two ADH preparations are available for the treatment of diabetes insipidus:

A

vasopressin & desmopressin

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13
Q

is a synthetic drug that has a structure identical to that of human ADH.

A

vasopressin

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14
Q

vasopressin acts on the ________ to increase their permeability to water, thus enhancing water reabsorption.

A

renal collecting tubules

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15
Q

is the most common form of antidiuretic hormone in use.

A

desmopressin

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16
Q

early sx of hypothyroidism (myxedema)?

A

general weakness
muscle cramps
dry skin

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17
Q

more severe sx of hypothyroidism?

A

slurred speech

bradycardia

weight gain

decreased sense of taste and smell

intolerance to cold environments

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18
Q

Any condition that causes decreased amounts of plasma proteins, such as ___________ can lead to a larger percentage of free thyroid hormone, and hyperthyroidism.

A

protein malnutrition

or

liver impairment

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19
Q

sx of hyperthyroidism

A

increased body metabolism

tachycardia

weight loss

elevated body temp

anxiety

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20
Q

most common type of hyperthyroidism

A

graves dx

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21
Q

an autoimmune disease in which the body develops antibodies against its own thyroid gland.

A

graves dx

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22
Q

other causes of hyperthyroidism are?

A

adenomas of the thyroid

pituitary tumors

pregnancy

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23
Q

Very high levels of circulating thyroid hormone may cause _______, a rare, life-threatening form of hyperthyroidism.

A

thyroid storm

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24
Q

sx of thyroid storm

A

high fever

cardiovascular effects
(tachycardia, heart failure, angina, MI)

CNS effects
(agitation, restlessness, delirium, progressing to coma)
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25
Q

The goal of pharmacotherapy for hyperthyroidism is

A

is to lower the activity of the thyroid and to relieve distressing symptoms.

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26
Q

The two primary drugs for hyperthyroidism

A

propyl-thiouracil (PTU)

methimazole (Tapazole)

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27
Q

how to hyperthyroid drugs work?

A

inhibiting the incorporation of iodine atoms into T3 & T4, which decrease the activity of the thyroid gland

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28
Q

is sometimes administered to destroy part of the gland, which results in a permanent solution

A

radioactive iodine (I-131)

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29
Q

suppresses thyroid function.

A

nonradioactive iodine

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30
Q

The adrenal medulla is triggered by the sympathetic division of the nervous system to secrete

A

NE & E

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31
Q

mobilize the body for long-term stress and influence influence metabolism of nearly every cell in the body.

A

glucocorticoids

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32
Q

regulate plasma by promoting sodium reabsorption and potassium secretion.

A

mineralocorticoids

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33
Q

are mostly male sex hormones (androgens) with small amounts of estrogen.

A

gonadocorticoids

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34
Q

Addison’s disease is primary _______ insufficiency

A

adrenocortical

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35
Q

addison’s has a def of?

A

glucocorticoids and mineralocorticoids

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36
Q

what often causes addison’s dx?

A

autoimmune destruction of both adrenal glands

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37
Q

sx of addison’s

A

N/V
lethargy
confusion
coma

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38
Q

occurs when high levels of corticosteroids are present in the body over a prolonged period.

A

cushings syndrome

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39
Q

sx of cushings

A 
adrenal atrophy
osteoporosis
HTN
increased risk of infections
delayed wound healing
acne
peptic ulcers
general obesity
redistribution of fat around the face
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40
Q

what VS are important to asses when giving ADH hormone therapy

A

BP and pulse

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41
Q

what neurological sxs should you watch for in ADH therapy

A

headache and changes in mental status such as drowsiness and confusion

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42
Q

what does desmopression act on?

A

the kidneys to increase water reabsorption

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43
Q

mechanism of action of levothyroxine

A

synthetic form of T4 acting like a thyroid hormone

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44
Q

PTU mechanism of action

A

interfere with the synthesis of T3 & T4 in the thyroid gland

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45
Q

mechanism of action for hydrocortisone

A

its structurally identical with the natural hormone cortisol.

46
Q

the primary use for hydrocortisone?

A

treating adrenocortical insufficiency.

47
Q

AE of hydrocortisone

A

sodium & fluid retentition and CNS effects including insomnia, anxiety, headache, vertigo, confusion, and depression.

48
Q

what may occur in long term therapy of hydrocortisone

A

HTN
tachycardia
peptic ulcer dx
cushings syndrome

49
Q

important about systemic corticosteroid therapy?

A

don’t stop abruptly

it must be tapered off if used for longer than 1-2 weeks

50
Q

acts to decrease blood-glucose levels, having a hypoglycaemic effect.

A

insulin

51
Q

Without insulin, what does glucose do

A

stays in the bloodstream and is not able to enter cells

52
Q

insulin provides for the storage of glucose as?

A

glycogen

53
Q

insulin inhibits the breakdown of?

A

fat & glycogen

54
Q

insulin increases ____ synthesis

A

protein

55
Q

insulin inhibits the production of new glucose from noncarbohydrate molecules–this is called?

A

gluconeogenesis

56
Q

Almost all insulin used today is human insulin made by?

A

recombinant DNA technology

57
Q

the new human insulin is?

A

more effective
causes fewer allergies
creates less resisitance

58
Q

more rapid human insulin

A

humalog

59
Q

more prolonged insulin

A

lantus

60
Q

The most serious adverse effect from insulin therapy is

A

hypoglycemia

61
Q

hypoglycemia can result from?

A

an OD of insulin

improper timing of insulin dose

skipping a meal

62
Q

sx of hypoglycemia include?

A 
tachycardia
confusion
sweating
drowsiness
convulsions
coma
death
63
Q

hyperglycemia can result from

A

undergoes of insulin or oral hypoglycemic

64
Q

sx of hyperglycemia

A

blood glucose over 126

polyuria
polydipsia
polyphagia

weight loss or gain

fatigue

65
Q

type 2 DM is ?

A

insulin resistance

66
Q

target cells become unresponsive to insulin due to a defect in insulin receptor function caused by a lack of sensitivity of insulin receptors at the target cells

A

type 2 DM

67
Q

As cells become more resistant to insulin, blood glucose levels ____ and the pancreas responds by secreting even more insulin.

A

rise

68
Q

Eventually, the hypersecretion of insulin causes beta cell exhaustion, and ultimately leads to

A

beta cell death

69
Q

The majority of people with type 2 DM are

A

obese

have dyslipidemias

will need a medically supervised plan to reduce weight gradually and exercise safely

70
Q

how is type 2 DM controlled?

A 
lifestyle changes
then
noninsulin antidiabetic agents
then
insulin
71
Q

The seven primary groups of antidiabetic drugs for type 2 DM are classified by

A

their chemical structures and their mechanisms of action

72
Q

acts by decreasing the hepatic production of glucose (gluconeogenesis) and reducing insulin resistance.

A

metformin

73
Q

It does not promote ___ release from the pancreas.

A

insulin release

74
Q

side effects of metformin

A

minor and GI related

such as anorexia, nausea, & diarrhea

75
Q

one of the first oral hypoglycemics available,

A

glyburide

76
Q

act by stimulating the release of insulin from pancreatic islet cells and by increasing the sensitivity of insulin receptors on target cells.

A

sulfonylureas

77
Q

AE of sulfonylureas

A

HYPOGLYCEMIA

usually caused by taking too much meds or not eating enough food

78
Q

The mechanism of action is to promote the entry of glucose, amino acids, and potassium into cells; to promote protein synthesis, glycogen formation and storage, and fatty acid storage; and to conserve energy stores by promoting the utilization of glucose for energy needs and inhibiting gluconeogenesis.

A

human regular insulin

79
Q

primary use for human regular insulin

A

by it self to lower blood glucose levels in pts with type 1 DM

or in combo with other agents in type 2 DM

emergency management of diabetic ketoacidosis

gestational diabetes

80
Q

AE of human regular insulin

A

HYPOGLYCEMIA

irritation at injection sites may occur, including lipohypertrophy

weight gain

81
Q

the accumulation of fat in the area of injection

A

lipohypertrophy

82
Q

The mechanism of action is to decrease the hepatic production of glucose and reduce insulin resistance in target cells.

A

metformin (Glucophage)

83
Q

when do you plan insulin administrations and peak times?

A

around mealtimes

84
Q

hold insulin dose if blood sugar is less than?

A

70 mg/dL, then report to provider

85
Q

assess for signs of hypoglycemia, especially around the time of ?

A

insulin peak activity

86
Q

what labs to check before oral hypoglycemic therapy?

A 
electrolytes
glucose
A1C level
lipid profile
hepatic & renal function studies
87
Q

Regulation of the female reproductive system is achieved by hormones from the

A

hypothalamus,
pituitary gland,
and ovary

88
Q

secretes gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

A

hypothalamus

89
Q

Both of these pituitary hormones act on the ovary and cause immature ovarian follicles to begin developing.

A

FSH & LH

90
Q

create two interrelated cycles that occur on a periodic, monthly basis, the ovarian and uterine cycles.

A

the rising and falling of levels of pituitary hormones

91
Q

are used for hormone replacement therapy (HRT) during and after menopause to treat unpleasant symptoms of menopause and to prevent the long-term consequences of estrogen loss.

A

estrogen-progestin combinations

92
Q

In 2002 the results of a large clinical study, the Women’s Health Initiative (WHI) suggested that HRT increased risks of

A

cardiac problems
stroke
breast cancer

93
Q

HRT appears to prevent

A

osteoporotic bone fractures

and may protect against colorectal cancer

94
Q

Because of the risk of thromboembolism in HRT, monitor the patient closely for signs and symptoms of thrombus or embolus, such as

A 
such as pain in calves, 
limited movement in legs, 
dyspnea, 
sudden severe chest pain, or 
anxiety.
95
Q

Encourage the patient to report signs of what if on HRT?

A 
depression
decreased libido
headache
fatigue
weight gain
96
Q

When using HRT to treat male patients, inform them that secondary female characteristics, such as ___ may occur?

A

higher voice
sparse body hair
increased breast size

impotence may also occur

97
Q

contains a mixture of different natural estrogens

A

HRT

98
Q

HRT is used as replacement for female sex hormones to exert several positive metabolic effects, including

A

an increase in bone density and a reduction in LDL cholesterol.

99
Q

The primary use is for postmenopausal replacement therapy and to

A

treat abnormal uterine bleeding due to hormonal imbalance.

100
Q

AE of HRT

A

nausea, fluid retention, edema, breast tenderness, abdominal cramps and bloating, acute pancreatitis, appetite changes, acne, mental depression, decreased libido, headache, fatigue, nervousness, and weight gain.

101
Q

note personal or family history of ____ disorders in pt with estrogen and progestin therapy

A

thromboembolic

102
Q

is released from the hypothalamus and stimulates the release of hormones from the pituitary.

A

gonadotropin-releasing hormone (GRH)

103
Q

regulates sperm production in men.

A

Follicle-stimulating hormone (FSH)

104
Q

regulates the production of testosterone, an androgen secreted by the testes and the primary hormone contributing to the growth, health, and maintenance of the male reproductive system;

A

luteinizing hormone (LH)

105
Q

is also responsible for maturation of the male sex organs and the secondary sex characteristics of men.

A

testosterone

106
Q

androgens inlcude

A

testosterone
adrostenedione
dehydroepiandrosterone (DHEA)

107
Q

is a lack of sufficient testosterone secretion by the testes.

A

hypogonadism

108
Q

Primary hypogonadism is due to

A

testicular disorder

109
Q

secondary hypogonadism is due to lack of?

A

FSH or LH

110
Q

Pharmacotherapy with androgens increases ____ and corrects __________.

A

Libido; erectile dysfunction

111
Q

AE of testosterone?

A

increased or decreased libido and salt and water retention, causing edema, and a diuretic may be indicated.

Liver damage is rare, although it is a potentially serious adverse effect with high doses.

112
Q

what to check for in adrogen therapy?

A

BP at each visit

weight and presence of edema

hepatic-function labs periodically

PHARM (11 decks)

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