Test 6 Flashcards
desmopressin (DDAVP) mechanism of action
MOA: increase renal tubule permeability (reabsorption of water)
hydrocortisone (Solu-Cortef) indication, side effects
I: used to suppress the inflammatory and immune response.
Side Effects: Hypertension, osteoporosis, PUD, irritability, moodiness, weight gain
* Cushing syndrome occurs when high levels of corticosteroids are present in the body over a prolonged period of time
ketoconazole (Nizoral) indication, mechanism of action
I: treatment for cushing syndrome (when high corticosteroids)
MOA: decreased ACTH secretion
tadalafil (Cialis), sildenafil (Viagra) contraindications, side effects
c: contraindications; if taking nitrates, (dangerous hypotension-death),
s/e: hypotension, priapism (erection for more than 4 hrs.)- dangerous blood flow.
Contact dr!
Causes of male erectile dysfunction
o vascular: smoking, HTN, obesity, cardiovascular disease (30-60% of cause)
o medications: SSRIs, TCA, ACE inhibitors, beta blockers, alpha blockers, thiazide
diuretics
o psychogenic: depression
finasteride (Proscar) indication, mechanism of action
o I: Tx for benign prostatic hyperplasia
o MOA: 5-alpha reductase inhibitor: blocks conversion of testosterone to the more potent
hormone (DHT) which prostate gland enlargement is dependent on.
Oral contraception patient teaching
o combination of estrogen and progesterone. acts by preventing ovulation via negative
feedback to the pituitary which suppress LH and FSH.
o No smoking (high risk for blood clots)
o SE: weight gain, breast tenderness, N/V
o can cause increast breast cancer risks
o must take pill daily, if missed pill- use another form of protection during that cycle.
o watch for blood clots- contraindicated if Hx of blood clots
progestin (Minipill) indication, mechanism of action
o I: progestin only (used when estrogen is contraindicated) - hx of blood clots, hx of thromboembolism, lactating, smoking.
o MOA: thickens cervical mucosa and thins endometrial lining
o 91% effective
Oxytocics indication
o I: uterine stimulant for labor (inducing)
o reduces postpartum hemorrhage
▪ Emergency contraception administration
ASAP- (levonorgestrel): 2 doses 12 hours apart; given within 72 hrs.
Preven: give with antiemetic; another morning after pill. Affects progesterone and estrogen
Another emergency contraceptive: Paraguard IUD; prevent ovulation, not abortive
Abortive drugs: mifepristone (Mifeprex) before 7 weeks and misoprostol good any time.
▪ Magnesium Sulfate mechanism of action, indication
o I: type of tocolytic (prevents pre-term labor)
o MOA: slows uterine contractions
▪ Hormone replacement therapy patient teaching
o HRT provides relief from menopause symptoms and to prevent the long-term
consequences of estrogen loss (osteoporosis)
o combinations of estrogen and progesterone
o SE: DVT, PE (blood clot risks)
o smoking increases risks of MI and stroke
o increased estrogen= increased clotting factors
o estrogen- endometrium growth
conjugated estrogen (Premarin): progesterone not needed if Hx of
hysterectomy
conjugated estrogens/medroxyprogesterone (Prempro): may start bleeding
again
Hyperthyroidism and Hypothyroidism S/S, and treatment goals
thyroid hormones stimulate the basal metabolic rate of nearly all tissue
o Hypothyroidism: congenital or acquired disorder. Congenital hypothyroidism results
in a condition known as cretinism
causes: thyroid gland or pituitary dysfunction, iodine deficiency, use of some
medications (lithium, amiodarone, radiographic dye with iodine, kept
tablets), and radiation.
Hashimoto’s thyroiditis is an autoimmune disorder of the thyroid gland and is
the most common cause in the US
affects nearly all major organ systems, and this hypometabolic state is marked by a gradual onset of these s/s:
weakness, fatigue, weight gain, decreased appetite, cold intolerance, bradycardia, hypotension, subnormal body temp, rough skin, memory issues, constipation, myxedema (swelling c waxy skin)
levothyroxine (Synthroid)- thyroid hormone replacement
start c low dose, low and slow to avoid cardiovascular disease
take in the morning
o Hyperthyroidism (Graves disease) is autoimmune disorder accompanied by
ophthalmopathy and goiter. Tx surgery or drugs that reduce production of thyroid
hormone
goiter: over or under activity of gland- often times not obvious
iodine deficiency or gland inflammation
s/s: weight loss, irritability, hunger, tachycardia, sweating, muscle cramps,
exophthalmos, vision loss, unable to close eyes (corneal ulcerations)
▪ Diabetes Mellitus Type 1 &2, who is at risk, pathophysiology
o type 1:
Risk: Children, young adults, usually younger than 35yrs
Patho: caused by absolute lack of insulin due to autoimmune destruction of
pancreatic islet cells. If untreated, results in serious chronic conditions due to
damage of the cardiovascular and nervous system.
increased BG damages nerves, weakens walls of small vessels, reduces nitric
oxide (vasodilator)
usually children, young adults, usually younger than 35 yrs
s/s: polyuria, polydipsia, polyphagia, weight loss, fruity breath (DKA), body
uses fat and muscle for energy instead, so ketones in blood (very acidic) and
DKA
o type 2: much more common (90-95% of DM), caused by:
At risk: usually older than 35 yrs
Patho: lack of sensitivity of insulin receptors at target cells (insulin resistance)- signal
not sent to cells
deficiency in insulin secretion: beta cells burn out over time bc pancreas
works too hard
if untreated results in same chronic conditions as type 1 DM
s/s: same as type 1, plus blurred vision, fatigue, recurrent infections
Hemoglobin A1c test, glucose lab values
o used to understand long-term glycemic control (glucose sticks to hemoglobin and
becomes glycosylated)
o normal level <5.7
o prediabetic 5.7-6.4
o diabetic >6.5
BG 60-110
