PHARM GROUP 7

Question 1

WHAT ARE THE MAIN PHARMACOLOGIC CLASSES USED TO TREAT HTN ?

Answer 1

DIURETICS:
- PROMOTE SODIUM RETENTION, REDUCING ECF VOLUME

SYMPATHOLYTICS:
-AFFECT THE SNS TO LOWER BP

DIRECT-ACTING ARTERIOLAR VASODILATORS:
- RELAX VASCULAR SMOOTH MUSCLE, REDUCING BP

ACE INHIBITORS:
- INHIBIT THE CONVERSION OF ANGIOTENSIN 1 TO ANGIOTENSIN 2, REDUCING VASOCONSTRICTION

ARB’S:
- BLOCK ANGIOTENSIN 2 AT THE RECEPTOR, REDUCING VASOCONSTRICTION AND ALDOSTERONE SECRETION

CALCIUM CHANNEL BLOCKERS:
- REDUCE CALCIUM INFLUC INTO HEART AND VASCULAR CELLS, DECREASING CARDIAC CONTRACTILITY AND VASCULAR TONE

Question 2

WHAT IS THE MOST COMMONLY USED DIURETIC FOR HTN ?

Answer 2

HYDROCHLOROTHIAZIDE

AVOIDED IN PATIENTS WITH RENAL INSUFFICIENCY

Question 3

WHAT IS THE MOA OF INDIRECT ACTING CHOLINERGIC DRUGS ?

Answer 3

INHIBIT ACETYLCHOLINESTERASE, THE ENZYME THAT BREAKS DOWN ACETYLCHOLINE, THEREBY INCREASING THE AVAILABILITY OF ACETYLCHOLINE TO ACTIVATE RECEPTORS

Question 4

WHAT ARE THE NONPHARMACOLOGIC MEASURES TO CONTROL HTN ?

Answer 4

STRESS REDUCTION:
- MEDITATION AND RELAXATION CAN LOWER BP

EXERCISE:
- REGULAR AEROBIC EXERCISE IMPROVES CV HEALTH AND DECREASES BP

SALT RESTRICTION:
- LIMITING SALT INTAKE TO <2G/DAY HELPS PREVENT WATER RETENTION AND LOWERS BP

ALCOHOL MODERATION:
- LIMITING ALCOHOL LOWERS BP BY REUDCING RENIN SECRETION

WEIGHT LOSS:
- DECREASE IN BODY WEIGHT HELPS DECREASE CARDIAC OUTPUT AND PERIPHERAL RESISTANCE, WHICH DECREASES BP

Question 5

PURPOSES AND COMMON FORMS OF SYNTHETIC DERIVATIVES OF TESTOSTERONE

Answer 5

IMPROVE PHARMACOKINETICS AND PHARMACODYNAMICS

COMMON FORMS:
- TESTOSTERONE PROPIONATE
(OILY SOLUTION, LASTS 2-3 DAYS)

• METHYLTESTOSTERONE
  (ORAL/BUCCAL FORM)

Question 6

INDICATIONS FOR HYDROCHLOROTHIAZIDE (HYDRODIURIL)

Answer 6

HTN AND CHF

Question 7

WHAT IS OXYBUTYNIN (DITROPAN) USED FOR AND WHAT ARE THE NURSING CONSIDERATIONS FOR ITS PATCH APPLICATION ?

Answer 7

USED TO TREAT OVERACTIVE BLADDER AND NEUROGENIC BLADDER CONDITIONS

NURSING CONSIDERATIONS FOR THE PATCH:
- REMOVING THE PREVIOUS DOSE
- APPLYING TO CLEAN, DRY, NONHAIRY SKIN
- ROTATING SITES TO PREVENT SKIN IRRITATION

Question 8

WHAT IS OSTEOPOROSIS AND ITS KEY GOALS FOR TREATMENT ?

Answer 8

A CONDITION CHARACTERIZED BY A DECREASE IN BONE DENSITY AND AN INCREASE IN FRACTURE RISK DUE TO WEAKENED BONES

KEY GOALS OF TREATMENT ARE TO INCREASE BONE DENSITY AND DECREASE FRACTURE RISK

Question 9

4 MAIN PARTS OF THE NEPHRON

Answer 9

1. GLOMERULUS (FILTRATION)
2. PROXIMA CONVOLUTED TUBULE
3. LOOP OF HENLE
4. DISTAL CONVOLUTED TUBULE

Question 10

WHAT IS TOLTERODINE (DETROL) USED FOR AND WHAT IS A SIGNIFICANT INTERACTION TO AVOID ?

Answer 10

TREATS URINARY FREQUENCY, URGENCY, AND URGE INCONTINENCE

PATIENTS SHOULD AVOID GRAPEFRUIT JUICE BECAUSE IT CAN ENHANCE THE TOXICITY OF THE DRUG THROUGH THE CYTOCHROME P-450 3A4 LIVER PATHWAY

Question 11

WHAT IS ESSENTIAL HTN AND HOW COMMON IS IT ?

Answer 11

AKA PRIMARY HTN

HAS NO IDENTIFIABLE CAUSE AND IS THE MOST COMMON TYPE, ACCOUNTING FOR ABOUT 90% OF ALL HTN CASES

Question 12

ADVERSE EFFECTS OF SPIRONOLACTONE

Answer 12

• HYPERKALEMIA
• GYNECOMASTIA
• HEADACHE
• DIZZINESS
• CRAMPS

Question 13

PERI-MENOPAUSE

Answer 13

THE TRANSITIONAL PERIOD LEADING UP TO MENOPAUSE. CHARACTERIZED BY FLUCTUATING HORMONE LEVELS

SYMPTOMS
- CYCLES BECOME IRREGULAR
- INSOMNIA
- HOT FLASHES
- IRRITABILITY
- HEADACHES
- MEMORY LAPSES
- DECREASED LIBIDO
- VAGINAL DRYNESS
- JOINT ACHES AND PAINS

Question 14

PREMARIN (CONJUGATED ESTROGEN)

Answer 14

INDICATIONS:
- HRT FOR MENOPAUSE SYMPTOMS
- MODERATE TO SEVERE VASOMOTOR SYMPTOMS OF MENOPAUSE, VAGINAL DRYNESS, AND ATROPHY

MOA:
- DEVELOPS AND MAINTAINS FEMALE GENITAL SYSTEM, BREASTS, AND SECONDARY SEX CHARACTERISTICS

CONTRAINDICATIONS:
- KNOWN DRUG ALLERGY
- ESTROGEN DEPENDENT CANCERS SUCH AS BREAST CANCER
- UNDIAGNOSED ABNORMAL VAGINAL BLEEDING
- PREGNANCY AND LACTATION
- ACTIVE THROMBOLYTIC DISORDERS (STROKE, THROMBOPHLEBITIS, HYPERCOAGULABLE STATES)

Question 15

HOW DOES HTN VARY AMONG DIFFERENT ETHNIC GROUPS ?

Answer 15

BLACKS:
- DEVELOP HTN EARLIER WITH HIGHER MORTALITY RATES. THEY HAVE LOW- RENIN HTN WHICH MAKES BETA BLOCKERS AND ACE INHIBITORS LESS EFFECTIVE. ALPHA-BLOCKERS, DIURETICS AND CALCIUM CHANNEL BLOCKERS ARE MORE EFFECTIVE

ASIANS:
- HAVE A HIGHER SENSITIVITY TO BETA-BLOCKERS AND OTHER ANTIHYPERTENSIVE MEDS, SO LOWER DOSES ARE OFTEN REQUIRED

INDIANS:
- SHOW RESISTANCE TO BETA BLOCKERS, NECESSITATING THE USE OF OTHER CLASSES OF HYPERTENSIVES

Question 16

WHY IS ADRENERGIC STIMULATION NOT SUITABLE FOR PATIENTS WITH GLAUCOMA ?

Answer 16

ADRENERGIC STIMULATION CAUSES PUIL DILATION (MYDRIASIS) WHICH INCREASES INTRAOCULAR PRESSURE AND CAN EXACERBATE GLAUCOMA

Question 17

WHAT ARE THE NOTICEABLE EFFECTS OF SYMPATHOMIMETICS ?

Answer 17

1. PUPILS DILATE
2. MOUTH GETS DRY
3. NECK AND SHOULDER MUSCLES TENSE
4. HEART PUMPS FASTER
5. CHEST PAINS AND PALPITATIONS
6. SWEATING
7. MUSCLES TENSE FOR ACTION
8. HYPERVENTILATION
9. INCREASED OXYGEN DEMAND FOR MUSCLES

Question 18

WHAT DO DOPAMINERGIC RECEPTORS DO WHEN STIMULATED ?

Answer 18

DILATE THE BLOOD VESSELS OF RENAL, MESENTERIC, CORONARY, AND CEREBRAL ARTERIES, INCREASING BLOOD FLOW TO THESE TISSUES

Question 19

SSRI’S

Answer 19

REDUCE SEVERITY OF VASOMOTOR SYMPTOMS AND DEPRESSION

MAY RELIEVE IRRITABILITY AND MOOD CHANGES

EXAMPLE)
SERTRALINE AND FLUOXETINE

Question 20

4 COMMON ANTICHOLINERGIC SIDE EFFECTS

Answer 20

DOCU
D - DRY MOUTH
O - ORTHOSTATIC HYPOTENSION
C - CONSTIPATION
U - URINARY RETENTION