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Nursing school pt 3 > Pharm II- Exam 3 > Flashcards

Pharm II- Exam 3 Flashcards

1
Q
  1. Male Genitourinary Issues x2
  2. What is BPH
  3. how often in men > 60 yrs
  4. How often in men > 90 yrs
A
  1. Benign Prostatic Hyperplasia, erectile dysfunction
  2. Enlarged prostate gland
  3. 50%
  4. 90%
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2
Q
  1. How do drugs work in treating BPH
  2. How long with patient need to take meds
  3. What three drug categories are used to treat?
A
  1. Alleviate symptoms only
  2. entire life
  3. Alpha 1 blocker- selective/nonselective, 5 alpha reductase inhibitors
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3
Q
  1. What do non selective alpha 1 block?
  2. Most common reason ppl discontinue med tx
  3. When should you take this med?
A
  1. Alpha adrenergic receptors, arterioles, used to treat HTN
  2. orthostatic hypotension, headaches
  3. At night to work against SE of hypotension
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4
Q
  1. What does not selective mean?
  2. Examples of nonselective drugs
  3. What is the difference between Selective alpha 1
A
  1. does not select for the prostate (also contraction receptor)
  2. terazosin, doxazosin, alfuzosin
  3. selects for prostate, no effect on BP
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5
Q
  1. Examples of Selective Alpha 1’s
  2. What do 5a reducstase inhibitors do?
  3. How long for improvements
A
  1. Tamsulosin, Sliodosin
  2. reduce size of the prostate
  3. 6-12 mnths
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6
Q
  1. What type of enzyme is 5A reductase
  2. What does dihydrotestosterone do?
  3. Instructions for admin
A
  1. responsible for converting testosterone to dihydrotestosterone
  2. proliferation of prostate cells
  3. Women wear gloves
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7
Q
  1. 5A reductase inhibitor examples
  2. What is the first line agent for BPH?
  3. How is 5A reductase used?
A
  1. Finasteride, dutasteride
  2. Selective Alpha 1 Blocker (without hypertension)
  3. used in combination with either alpha 1 blocker
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8
Q
  1. How does erectile dysfunction occur?
  2. Causes of erectile dysfunction
  3. How is it treated
A
  1. not enough blood flows to the penis during sexual stimulation
  2. psychoemotional, diabetes, HTN, Neurologic, Vascular insufficiency
  3. tx’s the cause
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9
Q
  1. What is the first line therapy for erectile dysfunction
  2. How do they work?
  3. What do cGMP levels do?
A
  1. PDE5 inhibitors
  2. increase cGMP levels
  3. areterial vasodilation, increases blood flow and local BP
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10
Q
  1. What can the increase in cGMP lead to?
  2. Exampes of PDE5 inhibitors
  3. What happens if there is no sexual stimuli?
A
  1. venous occlusion and reduces venous outflow
  2. Sildenafil, tadalafil, vardenafil, avanafil (keep the penis fill)
  3. Ineffective
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11
Q
  1. What affect does Sildenafil (Viagra) have on men who do not have ED?
  2. Is Viagra approved for women?
  3. Does it have an affect on sexual arousal?
A
  1. no effect on erection quality or duration
  2. no
  3. no
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12
Q
  1. What can Viagra treat in women?
  2. What else can PDE5 Inhibitors be used for?
  3. Side effects of PDE5 Inhibitors
A
  1. Pulmonary Hypertension
  2. BPH, pulmonary htn
  3. hypotension, no nitrates, caution with Alpha blockers, priapism
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13
Q
  1. What is priapism?
  2. What is the half life for Tadalfil?
  3. What is the half life for Sildenafil/Vardenafil?
A
  1. persistent and painful erection, if > 4hrs intervention necessary
  2. 17.5 hours
  3. 4 hours
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14
Q
  1. What is the duration of tadalafil?
  2. What is the duration for sildenafil/vardenafil
  3. How long must you wait before taking taldafil with nitrates?
A
  1. 36 hours
  2. 4 hours
  3. wait 48 hrs
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15
Q
  1. How long must you wait before taking sildenafil with nitrates?
  2. What is menopause
  3. Symptoms
A
  1. 24 hours
  2. decrease in estrogen secretion by ovaries
  3. vag dry, urogenital atrophy, hot flahes, sexual disinterest
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16
Q
  1. What is the treatment for menopause
  2. What does it do?
  3. A bone related consequence of estrogen loss?
A
  1. Hormone Replacement Therapy
  2. counteracts symptoms and prevent long term consequences of estrogen loss
  3. osteoporosis
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17
Q
  1. Benefits of HRT
A
  • Relief of hot flashes
  • decrease in atrophy
  • prevent osteoporosis
  • prevent colorectal cancer
  • improved quality of life
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18
Q
  1. Risks of HRT
A
  • Embolism
  • CAD
  • CVD
  • Endometrial cancer
  • breast cancer
  • ovarian cancer
  • dementia
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19
Q
  1. What is the recommended use of HRT
  2. How long should treatment last?
  3. Every woman undergoing HRT receives this (with or without a uterus)
A
  1. lowest dose possible for shortest duration possible
  2. 4-5 years
  3. estrogen
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20
Q
  1. What does a woman with a uterus also get in addition
  2. What is it used for
  3. What does progestin do for the uterus
A
  1. progestin
  2. protect endometrial lining from estrogen stimulation, prevents uterine cancer, increase risk for estrogen induced breast cancer and adverse cardiac
  3. protects it
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21
Q
  1. What drugs can be used for hot flashes (vasomotor sx)
  2. What does anterior pit gland cause?
  3. what does post pit gland cause
A
  1. SSR, SNRI, Clonidine (antiHTN), Gabapentin (antiseizure)
  2. growth hormone deficiency
  3. diabetes insipidus
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22
Q
  1. What does the adrenal gland cause?
  2. What does GH affect?
  3. Example of Growth hormone replacement?
A
  1. Cushings/Addisons, glucos or mineralo’s
  2. tissue and bone
  3. Somatropin
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23
Q
  1. When is synthetic growth hormone administered?
  2. Why?
  3. Why do they need to be administered SQ or IM
A
  1. At night
  2. GH release increases during sleeping hours
  3. they are inactivated in the GI
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24
Q
  1. How often are GH replacement injections received
  2. When must you stop adminstering
  3. Cost of GHT?
A
  1. 6-7 times a week
  2. once epiphseal plate is closed (become an adult)
  3. $20,000-$40,000/ yr
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25
Q
  1. What can prolonged use of GHT conribute
  2. What should you monitor?
  3. Where is ADH secreted from?
A
  1. antagonize insulin, lead to diabetes
  2. Glucose tolerance
  3. Posterior pituitary gland
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26
Q
  1. Another name for ADH?
  2. Action of ADH
  3. ADH deficiency leads to?
A
  1. Vasopressin
  2. keep water, vasoconstricts
  3. diabetes Insipidous
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27
Q
  1. Manifestation of InPISSidus
  2. What agnets are used?
  3. What is the drug of choice?
A
  1. low specific gravity (very dilute urine), increase serum osmolality (hypernatremia), severe dehydration
  2. desmopressin, vasopressin?
  3. desmopressin, not as potent a vasoconstrictor
28
Q
  1. This ADH agent has a duration of 2-8 hours
  2. How is it administered?
  3. what else can it be used for?
A
  1. Vasopressin (Pitressin)
  2. IM or SQ
  3. raise BP
29
Q
  1. What is the duration for desmopressin?
  2. how can it be administered?
  3. SE with both agents?
A
  1. 8- 20 hours
  2. Nasal spray, SQ, IV, or PO
  3. Water intoxication, excessive vasoconstriction.
30
Q
  1. What can water intoxication lead to
  2. What can excessive vasoconstriction lead to?
  3. What affect does thyroid gland have
A
  1. hyponatremia, higher risk with kidney disfunction
  2. Angina, MI, gangrene in the periphery, contraindicated if has CAD
  3. every tissue and organ by controlling metabolic rate
31
Q
  1. Name systems the thyroid gland effects?
  2. Hypothyroid means you have?
  3. When can hypothyroidism occur?
A
  1. Cardiac outpus, oxgen, fat, protein, carbs, body heat regulation, nervous system, menstrual cycle
  2. decrease T3 & T4, high TSH
  3. Any age
32
Q
  1. What is cretinism?
  2. What word should you think when you think hypothyroid?
  3. What happens in GI motility?
A
  1. hypothyroidism in infants, affects growth/development
  2. slow
  3. constipated
33
Q
  1. Signs of hypothyroidsm
  2. How long is treatment
A
  1. weight gain, hair loss, cold intolerance, dry skin, menorrhagia, decreased cardiac contractility and output
  2. Life long
34
Q
  1. Name a drug used for hypothyroidism?
  2. How is it usually administered?
  3. When is it administered IV
A
  1. Levothyroxine Sodium, Synthetic T4
  2. PO
  3. Myxedema Coma
35
Q
  1. Signs/Sx of Myxedema
  2. Why should you monitor patient with Cardiac or HTN
  3. How long does levothyroxine take to have an affect?
A
  1. COLD, hypotension, hypoventilation, LOC, coma
  2. increase O2 consumption, may cause angina
  3. 1 month
36
Q
  1. Hyperthyroidism Disease associated?
  2. What type of disease is it?
  3. What happens to patients
A
  1. graves- can lead to the grave
  2. autoimmune
  3. develop antibodies to the TSH receptor sites, stimulate to release more T3 & T4
37
Q
  1. S/Sx of Graves Disease
  2. Tx
A
  1. Rapid pulse, heat, nervousess, exophthalmos, weight loss, goiter (both)
  2. Surgery, Radioactive Iodine, Antithyroid Drugs (inhibit release of T3 & T4)
38
Q
  1. Antithyroid drug category?
  2. Examples
  3. How do they work?
A
  1. Thionamides
  2. Propylthioracil, Methimazole
  3. Do not destroy existing levels of thyroid, just inhibit T3 & T4
39
Q
  1. How long to work? (thionamides)
  2. How is it used
  3. Side effects
A
  1. 3-12 weeks
  2. long term, or to prep for thyroidectomy
  3. Agranulocytosis (sore throat/ fever), hypothyroidism
40
Q
  1. What else can be used in the treatment of Hyperthyroidism?
  2. Name the 2 sections of the adrenal glands
  3. What does the medulla secrete?
A
  1. Propanolol, Beta Blocker 1 & 2
  2. Medulla, Cortex
  3. epinephrine, norepinephrine
41
Q
  1. What does the Cortex secrete
  2. What do glucocorticoids secrete?
  3. What do mineralcorticoids secrete?
A
  1. Corticosteroids
  2. Cortisol
  3. Aldosterone
42
Q
  1. Factors that stimulat the release of cortisol
  2. What is its primary function?
  3. What disease is associated with excess corticosteroids?
A
  1. stress, trauma, surgery, hypotension, illness
  2. regulate blood glucose, antiinflammaotry, immunosuppressant
  3. Cushing Syndrome
43
Q
  1. S/Sx of Cushings?
  2. What happens if you suddenly stop steroids?
  3. Tx of cushings
A
  1. truncal obesity, buffalo hump, moon face
  2. adrenal crisis
  3. discontinue, radiation of tumors, adrenalectomy, meds that suppresss adrenal release (not 1st choice)
44
Q
  1. Name a med that suppresses adrenal release of corticosteroids
  2. How is it used?
  3. What disease is associated with both gluco and mineralcorticoids
A
  1. Ketaconazole, antifungal
  2. higher dose inhibits glucocorticoids, adjunct to surgery or radiation (secondary tx)
  3. Addison’s Disease
45
Q
  1. What does adrenal insufficiency require
  2. What do all patients require?
  3. What do some patients require?
A
  1. lifelong replacement therapy
  2. Glucocorticoid
  3. Mineralcorticoid
46
Q
  1. Manifestation of Addison’s Disease
  2. Tx
  3. why is it the drug of choice?
A
  1. Hypoglycemia, weakness, weight loss, hypotension, hyponat, hyperkalemia
  2. Hydrocortisone, drug of choice
  3. has both gluco-mineral
47
Q
  1. What can you use of additional mineralcorticoid is needed?
  2. Adverse effects
  3. How is hydrocortisone administered?
A
  1. Fludrocortisone, the only mineral available
  2. sodium retention/edema
  3. oral for chronic, IV for acute (may need to increase during times of stress)
48
Q
  1. Name glucocorticoid agents?
  2. What does Dexamethasone treat
  3. Why is prednisone used?
A
  1. Dexamethasone, prednisone
  2. inflammation from cerebral adema, allergic rx
  3. inexpensive
49
Q
  1. SE’s of corticosteroids when insufficient adrenal secretion
  2. When using steroids for non endocrine disorders
  3. Why are steroids used?
A
  1. minimal, dose required is small
  2. dose is higher, more side effects
  3. allergies, asthma, inflammation, immunosuprression (SE, cushings)
50
Q
  1. When steroids are stopped abruptly, S/Sx
  2. What do you do?
  3. When is parathyroid gland released
A
  1. N/V, lethargy, confusion, coma
  2. immediate IV hydrocortisone
  3. when serum Calcium levels are low
51
Q
  1. Where is calcitonin secreted from?
  2. What does it do
  3. what is hyperparathyroid treated
A
  1. Thyroid glands
  2. decreases calcium, stores it in the bone
  3. Calcitonin-Salmon
52
Q
  1. How is chemotherapy selected
  2. Is chemo local or systemic
A
  1. By the type and extent of malignancy, amount of time normal cells need to recover
  2. Systemic
53
Q
  1. SE’s of chemo
A
  • rapidly growing normal cells
  • N/V
  • lining of GI
  • Mucositis
  • Alopecia
  • Fatigue
  • Skin, hair
  • Myelosuppression (anemia, thrombyctypoenia, neutropenia)
54
Q
  1. What can result in rapid destruction of cells
  2. What can be prescribed to lower levels
  3. What can be used for N/V
A
  1. The release of uric acid
  2. Allopurinol
  3. Antiemetics- Reglan, or -setrons (Zofran)
55
Q
  1. Due to teratogenic effects of chemo, what needs to be prescribed?
  2. What drugs can be used for ulcers in the mouth?
  3. Is it okay for pt to receive live vaccinated shots?
A
  1. Contraception
  2. Antifungals- nystatin or clotrimazole
  3. no!
56
Q
  1. What drug can be used to protect the Gi Lining
57
Q
  1. Cell cycle non specific drug
  2. Cell cycle specific
  3. What is the G0 phase
A
  1. Act during any phase of the cell cycle including G0 phase
  2. act druing a specific phase, for RAPID GROWING
  3. resting phase
58
Q
  1. When can estrogen be used?
  2. Cell cycle non spec Category
  3. Cell cycle specific Category
A
  1. slows the growth rate of prostate cancer in males
  2. alyklating drugs, anti-tumor anitbiotics, homrones
  3. antimetabolites, mitotic inhibitors
59
Q
  1. What is nadir
  2. SE of chemo drugs
A
  1. the lowest point
  2. Stomatitis, neutropenia, anemia, thromboycytopenia, anorexia, emesis
60
Q
  1. Common drugs to treat stomatitis
  2. What drugs can be used to treat neuropenia
  3. Tx of Anemia
A
  1. Carafate oral
  2. Interferon, -grastim drugs
  3. Ferrous Sulfate- iron supplement
61
Q
  1. Tx of Thrombocytopenia
  2. Anorexia
  3. Tx of Emetics
A
  1. steroids slow platete destruction, transfusion
  2. Control the Nausea and Vomiing
  3. Reglan, -setron
62
Q
  1. Parent teaching w/ Somatropin
  2. Contraindications
  3. What other condition can it be used for
A
  1. correct reconsitituion, report pain @ injection site,
  2. When ephyses is closed, dec response w/ steroids
  3. Turner Syndrome
63
Q
  1. What drug can be administered for hypoparathyroidism
  2. What drug may decrease its effectiveness
  3. What is an off label use for fuldrocortisone
A
  1. Calciferol, Vitamin D
  2. steroids
  3. orthostatic hypotension
64
Q
  1. What disease process should you use caution when taking fludrocortisone
  2. What specific electrolyte do you want to monitor with this drug?
  3. Patient education
A
  1. Addison’s diesase
  2. hypokalemia, potassium
  3. lifelong treatment
65
Q
  1. Dexamethasone therapeutic class
  2. When may this drug be used in babies
  3. Adverse reactions of this drug
A
  1. anti-inflammatory
  2. ARDS at birth
  3. peptic ulcer, decreased wound healing, depression, euphoria
66
Q
  1. Prednisone therapeutic class
  2. Off label use
  3. This drug has similar SE’s as dexa, what are some other
A
  1. Antiinflammatory
  2. hypercalcemia
  3. muscle wasting, osteoporosis, hyperglycemia
67
Q
  1. What medication is an antidote for hemorrhagic cystitis
  2. What could this med cause a false positive
  3. What might patient experience with this med
A
  1. Mesna
  2. ketones in the urine
  3. unpleasant taste in mouth

Nursing school pt 3 (13 decks)

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