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ABSN Cohort 19 > Pharm Exam2 > Flashcards

Pharm Exam2 Flashcards

1
Q

Levothyroxine (Synthroid)

Dx, fx, prepared from, contains, routes, fx to metabolic rate and additional fx.

A 
Hypothyroidism
↓ TSH
dried animal thyroid glands
T3 and T4
PO or IV
↑ metabolic rate
↑ O2 consumption/ATP hydrolysis
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2
Q 
Levothyroxine (Synthroid)
Side FX (5) with r/o!
A

Anxiety, tachycardia, heat intolerance

!!! - Fever, diaphoresis which r/in Dehydration

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3
Q

Levothyroxine (Synthroid) education and administration tips (3)

A

Ø ↑ or ↓ dose suddenly
Administer w/ full glass of H2O
Prepare for ↑BMR by hydrating as necessary

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4
Q

Glucocorticoids
Primary fx, clinical fx and tx.
3 other fx.

R/t Lipogenesis

A

Increase glucose levels for energy
Blocks inflammation/immune resp. inconj w mineralcorticoids to tx adrenal insufficiency.

↑ fat deposition, ↑ protein breakdown, ↓ protein formation.

Monitor BMI

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5
Q

Glucocorticosteroids: Health Conditions of Concern (5)

A 
Acute infx
Diabetes, ↑ glucose disrupts glucose congtrol
Acute peptic ulcers
Endocrine dz
Pregnancy
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6
Q

Diabetes Type 1 vs Type 2

onset, insulin relation, r/by? 1 - 3

A

Type 1: autoimmune onset in young people, insulin-dependent. Øfx beta cells.
R/by genetics.
Type 2: onset in 40+ yr old people, insulin resistant.
R/by peripheral insulin resistance, ↓pancreas secretion, ↑glucose production by liver

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7
Q

Normal blood sugar range

A

70 - 110 mg/dL

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8
Q

Prior to administering AM insulin, what should you check?

A

Blood Glucose Levels (Rapid Finger Glucose)

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9
Q

Insulin used to treat Rapid Finger Glucose sticks?

A

Short/Rapid acting based on sliding scale

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10
Q

Complications of long term diabetes (9)

A 
Cardiovascular dz
Cerebrovascular dz
Foot ulcers
Atherosclerosis
Retinopathy
Neuropathy
Nephropathy
Hypoglycemia
Liphypertrophy
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11
Q

How to avoid DM complications

3 Control Factors.

A

Control of…
blood glucose
lipid levels
htn

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12
Q

How to reduce lipohypertrophy and hypoglycemia (4)

A 
Rotate sites (1 inch between sites)
Eat a carb snack! oj, grape juice, milk, glucose tabs.
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13
Q

Instructions for diabetic pts?

A

Assess limited access of diet

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14
Q

R/f for Type 2 DM?

A

Obesity indicated by a BMI > 25

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15
Q

Types of insulin (4)

A

Humalog - rapid acting
Humulin R - short acting
Humulin N - intermediate acting
Lantus - long acting

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16
Q

How does surgery influence blood levels? Proper responses (2)?

A

↑ blood glucose levels
monitor with RFG
Use rapid acting (Humalog)

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17
Q

Fx of Garlic r/t glucose (2 fx, 1 r/in)

A

↓ blood pressure and blood glucose

can r/in hypoglycemia

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18
Q

Beta blockers on blood sugar

A

S/S hypo/hyperglycemia are masked by SNS blockades.

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19
Q

Sulfonyureas.
3 Fx and for what pts.
Major s/fx?

A

Antidiabetic agents, ↑ pancreatic secretion of insulin, tx for Type 2 DM

Used in pts w/ still fx’ing pancreas
Major s/fx = ↑ r/o Cardiovascular dz

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20
Q

Metformin (Glucophage)
What? For? Fx (3)?

Monitor what with this (2)?

A

Biguanide for Type2 > 10 yrs old.
↓ liver glucose production by ↓ gluconeogenesis
Also ↑ muscle glucose uptake/use
Monitor renal/liver fx (BUN/Creatinine) especially if receiving IV contrast

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21
Q

Diabetic Ketoacidosis

Cause, fx r/in 7 S/S

A

Incomplete oxidation of fats r/in ketoacids

Excess blood acids r/in ↑ BUN, dehydration, protein in urine, fruity breath, polyuria, SOB, ↑ electrolytes (Na/K)

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22
Q

Respiratory patterns r/t DKA

A

Kassmaul respirations

↑ depth, rate

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23
Q

How does Hyperglycemia cause mental confusion?

A

↑ glucose in blood draws H2O/electrolytes out r/in dehydration which acts on CNS.
Sugar ↑ osmolality of blood and causes CNS to shrink.

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24
Q

Psoriasis

Cause? Topic meds (5), S/S (3)

A

Chronic inflammatory skin dz
Emollients, Keratolytic agents, coal tar, corticosteroids, cacipotriene
Skin is thick, red plaques, silvery scale.

25
Q

Isotrentinoin (Accutane)

What is it? Route? Fx? Common Tx for? S/fx?

A

Teratogen. PO, ↓sebum reduction/anti-inflammatory
Used for Acne
Severe birth defects

26
Q

How does Acne occur? Onset?

A

Dz of pilosebaceous unit r/in formation of pustular lesions (inflammatory and noninflammatory).
Begins around puberty r/t ↑androgen production

27
Q

Actions prior to administering Anti-fungals (4)

A

Allergies
Monitor BUN/Creatinine
C&S
Baseline CBC and HH

28
Q

Pressure Ulcers.

What? R/t? Fx on cell? 3 conditions? Stratum corneum tx?

A

Skin breakdown r/t pressure (cells become hypoxic)
Pressure, moisture, O2 deprivation.
Stratum Corneum rq. adequate hydration via lotion

29
Q

O2 Deprivation r/t decubitus ulcers?

A

Lying down puts pressure on cell.

Pressure disrupts capillary flow, r/in O2 deprivation and cell death.

30
Q

Pressure Ulcer Tx (5)

A 
Re-position q2hrs
Pad bony prominences
Keep skin clean/dry
Assess regularly
Adequate hydration of stratum corneum w/ lotion
31
Q

Skin infx education

A

↑ diameter if infx is ↑

Mark edges and assess.

32
Q

Skin infx that responds to systemic antibiotics

A

Acne

33
Q

Skin shearing

What? r/t (4)? Preventions (3)?

A

sliding of tissue over another r/in stretching, blood vessel angulation, injury, and thrombosis.

Move carefully, avoid moving is skin is stuck to surface, pull pt up with draw sheet w/ help

34
Q

Skin neoplasms (3) and poorest prognosis.

A

Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma <— poorest prognosis

35
Q

Musculoskeletal strains.

What? S/S (4)? common sites (4)?

A

Stretching/partial tearing of muscle/tendon units.
pain, stiffness, swelling, local tenderness
lower back, cervical region of spine, knees, ankles

36
Q

Medications for Musculoskeletal strains (5) with special notes.

A

NSAIDS, Opiods/Narcotics Øtx inflammation, Celebrex, Fentanyl (Duragesic) is most consistent, through transdermal patch, and has least sedative fx.

37
Q

Muscuolskeletal strain S/S on elderly?

A

W/ age, cologne fibers change.

This r/in ↓elasticity and ↑susceptibility to injury.

38
Q

Stages of Bone Healing (4)

A

1 - Hematoma formation
2 - Fibrocartilaginous Callus formation
3 - Bony callus formation (ala Ossification)
4 - Remodeling

39
Q

Administration of Morphine.

For? When (2)? Age limit? Route (6)? s/fx (3)? Anti-s/fx?

A 
Moderate - severe pain.
Pre/Post-op, labor
NO AGE LIMIT
PO, SubQ, IM, PR, epidural, intrathecal
Respiratory Depression, sedation, pinpoint pupils

Countered w/ Narcan (Naloxone)

40
Q

GI Bleeding. Color r/t location.

Layman vs. Medical terminology

A 
Lower = bright red
Upper = dark/brownish red tar

Medical Upper = Melena stool
Medical Lower = Hematochezia/Frank Blood

41
Q

Peptic Ulcer Dz (PTD)

Goal of tx? Most common causes (3)? Medications (3)

A

Tx of H. Pylori.
Helicobacter pylori, ↑ stress, corticosteroids
Antibiotics (Biaxin/Flagyl), Proton pump inhibitors (Protonix/Nexium), and Histamine 2 receptor agonists (Zantac/Pepcid).
All 3 make TRIPLE THERAPY!

42
Q

Sucralfate (Carafate)

Fx? Tx for?

A

Changed by acid in stomach and adheres to ulcer to protect from further injury from acid/pepsin.
Tx for acute duodenum ulcers.

43
Q

Misoprostol (Cytotec)

Fx? Concern when administering (3)?

A

Long term NSAID clients to prevent gastric ulcers.

Excessive bleeding or spotting w/ pregnant women may induce labor, ↑% miscarrage, r/in cervical ripening.

44
Q

H2 blockers.

Fx? Tx for (2)? Drug2Drug interactions? Adfx w/ chronic tx?

A

↓ hydrochloric acid release in response to gastrin
Gastric/Peptic ulcers,
↑ levels warfarin and r/in bleeding. Monitor INR and PT.
↓ libido, impotence, CNS

45
Q

Proton pump inhibitors (PPI)

Fx? Tx for (2)?

A

↓ gastric acid secretion by inhibiting enzymes r/t acid production
Erosive esophagitis and GERD

46
Q

Gastroesophageal reflux Dz (GERD)

%? S/S (3)? Medications and fx (5)

A

Most common C/O.
Upset/sour stomach and heartburn.
H2 blockers - ↓ HCL release in response to gastrin
PPI - ↓ HCL secretion into lumen of stomach
Antacids - neutralize acids
GI protectants - coat ulcer
Prostaglandins - ↓ gastrin, ↑ mucus lining secretion

47
Q

Liver Failure

Cause? How to Dx? Regular fx stopped? S/S (4)? Medications (2)?

A

Unknown cause but r/in accumulation of neurotoxins in blood (ammonia)
Presence ammonia in blood and cerebral circulation.
Conversion of ammonia to urea.
↓ mental alertness, ↑ confusion, ↑ convulsions, Asterixis (flapping tremor)
Non-absorbable antibiotics (neomycin) and Lactulose

48
Q

Portal HTN

What (2)? S/S (4)?

A

↑ resistance of flow in portal venous system and ↑ portal venous pressure
Ascites, esophageal varices, confusion, and forgetfulness

49
Q

Kupffer cells.

What? Fx (consumes 3 things where)?

A

Large resident macrophages (aka Stellate macrophages)
Phagocytose old/defecive blood cells, bacteria, and other foriegn material from portal blood as it flows through sinusoid.
IT’S A FILTER!

50
Q

Cirrhosis

What? Associated w/? S/S? Acute or Chronic? Early signs (3)?

A

End-Stage chronic liver dz. Most liver tissue is replaced with fibrous tissue.
Associated w/ alcoholism.
S/S portal HTN.
Chronic. Early signs are ascites, weight loss, jaundice.

51
Q

Antidiarrheal Agents.
Fx? Common mechanisms (3)?
Term to describe GI motility?

A

De-stimulates GI tract for symptomatic relief from diarrhea.
Bismuth Subsalicylate inhibits local reflexes
Loperamide slows muscle activity
Opium Derivatives fx CNS to slow GI.
GI motility = peristalsis

52
Q

Laxative Agents.

For what pts? Condition tx’d with lactulose (Chronulac)?

A

Patients w/ cerebral aneurysms and post MI.

Hepatic encephalopathy

53
Q

Pancreatitis.

What? Cause for acute? Fx on pancreatic tissues? Most likely contributing factor?

A

Reversible inflammatory process of pancreatic acini by premature activation of enzymes
Autodigestion r/in acute vers.
R/in potential tissue damage and multi-organ failure.
Likely r/t long term alcohol abuse.

54
Q

Types of Hepatitis (5)

r/t Liver damage?
How to Dx?
Least lethal?
Spread by fecal-oral?
Which can be prevented by immunization?
A

A - fecal/oral self limiting and least virulent (food)
B - intercourse, needle sharing, blood (healthcare)
C - unclearable chronic carrier condition
D - parenteral IV/drug users, occurs often with B
E - water-borne, self limiting endemic (↑mortality w/ pregnant ♀)

Liver inflammation r/in bile backup which destroys tissue and causes scarring
Dx through ↑ serum aminotransferase levels (AST and ALT), ↑ bilirubin and alkaline phosphates, and Hep antibodies in blood.
Hep A
Hep A
Hep B and A

55
Q

H. Pylori.
What to avoid when treating for it (4)
Contraindication w/ Triple Therapy (3)?

A

Aspirin, NSAIDS, grapefruit, antacids.

Alcohol, anti-coagulant therapy, disulfiram

56
Q

Irritable Bowel Syndrome,

What? Hallmark S/S?

A

Chronic/recurrent intestinal S/S not explained by structural or biochemical abnormalities.
Ab. pain relieved by defection w/ freq. ▲ in consistency and frequency of stools.

57
Q

Inflammatory Bowel Dz.

2 types w/ diagnostics?

A

Chrons: 5 - 6 liquid Øblood stools may have pus/mucus
Ulcerative Colitis: 10 - 20 liquid +blood stools w/ mucus.
↑ ESR and crypts of Leiberkuhn.

58
Q

Esophageal Cancer

2 types? S/S (3)? How Dx? r/t (2)?

A

Adenocarcinoma and Squamous cell carcinoma
Dryphagia, anorexia, fatigue
Dx w/ endoscopic surveillance and esophageal dysplasia.

r/t Barret esophagus and long-standing GERD

59
Q

C. Diff
Full name? What? %flora in humans? Tx?

S/S? How does it occur?
What does it do (4)?

A

Clostridium Difficle.
Gram+ Spore forming Bacillus.
1-3% normal flora in humans.
Tx with broad-spectrum antibiotics.

Abdominal cramping/Diarrhea.
Disruption of normal intestinal flora b/c antibiotics, diet, etc.
Binds to/damages intestinal mucosa r/in inflammation and necrosis.
Interfere w/ protein synth, ↑ capillary permeability, ↑ peristalsis

ABSN Cohort 19 (28 decks)

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