final pathophys/pharm - general

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nika.steffan
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153359
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final pathophys/pharm - general
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2012-05-11 02:39:53
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final pathophys pharm general
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final pathophys/pharm - general
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  1. Pharmacology
    Science of drugs including their orientation, composition, pharmacokinetics, therapeutic use, and toxicology
  2. Drugs =
    Chemical that affects the psychological process of living organism
  3. Generic name =
    nonproprietary; given by US gov
  4. 4 sources of drugs
    • 1. Plants
    • 2. Animals and Humans
    • 3. Minerals
    • 4. Chemical substance
  5. 1906 Federal Pure Food and Drug Act
    drug manufacture must list dangerous and addictive substances
  6. Five Rights of medication administration
    • 1. drug
    • 2. time
    • 3. patient
    • 4. route
    • 5. dose
    • 6. documentation
  7. 1912 Sherley Admendment:
    Prohibit fraudulant claims - can't say it does something it doesn't
  8. 1914 Harrison Narcotic Act:
    legal term narcotic; regulate addictive substances
  9. Liver
    metabolizes drugs
  10. kidneys
    excretes drugs
  11. Drug therapy in elderly
    • increased sensitivity due to
    • physiological changes
    • admin problems
  12. What is the main job immune system:
    recognize foreign substances and determine they are "non-self"
  13. What is key to the immune response?

    What is the primary cell of immune system?
    Key to immmune response= Lymphoid Organs!!

    Primary cell = Lymphocytes
  14. What are the primary first responders in Inflammatory response?
    Neutrophils
  15. Bodies 1st, 2nd, & 3rd LINE OF DEFENSE
    First= Natural immunity- skin, mucous membrane, chemical barriers (earwax, fatty acids, tears)

    • Second= Inflammatory response- local response to tissue injury; WBCs; neutrophils first... rapid, non-specific
    • Third= Specific immunity, slow- memory, cell-mediated: T lymphocytes, Humoral: B Lymphocytes (can be indirect)
  16. Complement System
    • Facilitator of humoral response.
    • "Cascade-like" process
  17. IgE --
    a class of immunoglobulins including antibodies that function especially in allergic reactions
  18. What are antibiotics?
    Used to treat bacteria only!
  19. Well known infections caused by bacteria include:
    TB, Salmonella, syphillis, and some forms of meningitis
  20. 4 common mechanism of action for antibiotics
    • 1. Interfere with cell-wall synthesis
    • 2. Interfere with protein synthesis
    • 3. Interfere with DNA and RNA replication
    • 4. Disruption of metabolic reactions w/n cell
  21. Three general uses of antibiotic therapy:
    • 1. Empiric- treat before bac known (haven't tested yet)
    • 2. Definitive- bacteria is known, specific drug to kill it
    • 3. Prophylactic- used to prevent
  22. Disinfectant agents
    bacteriocidal-- kills offending bacteria
  23. How do antibiotics become resistant?
    bacterial genes mutate
  24. Penicillins and Cephalosporins:
    Antibiotic works by inhibition of cell wall synthesis.
  25. Macrolides:
    • Broad spectrum antibiotic
    • Interferes with protein synthesis
    • Most common side effect is stomatitis
  26. Sulfas
    • first totally "man-made" antibiotic
    • cannot kill bac, stops from growing
    • often used in combination with others
  27. Antifungals
    • Work by disrupting fungal cells protein making machinery
    • - Tends to affect immunocompromised ppl
  28. Systemic drug therapy:
    goes through the whole system - not localized like nasal spray
  29. Normal platelet range:
    • Thrombocytes
    • 150,000- 400,000
  30. Thrombocytopenia
    platelet count less than 100,000

    -increased susceptibility to bleeding
  31. Thrombocythemia
    platelet count greater than 400,000

    - hypercoaguability (blood is thickened) , can cause clots .
  32. Leukemia: uncontrolled increase in leukocytes
    Normal WBC= 4.5-10.5

    Types: ALL, CLL, AML, CML
    • Acute lymphocytic leukemia- Child
    • Chronic Lymphocytic leukemia- Elderly men
    • Acute myelogenous leukemia- adults
    • Chronic myelogenous leukemia- adults
  33. 2 most common causes of death in cancer patients:
    • 1. Infections
    • 2. Hemorrhage
  34. What is anemia and what are some causes?
    • to few RBC. (less than 3.6 in women and 4.2 in men)
    • a symptom more than a disease need to find out why

    Causes: excessive blood loss, RBC destruction, decreased RBC production, bone marrow failure,
  35. Benign Tumors
    • Grow slowly in a well defined capsule.
    • Well-differentiated (resemble origin)
    • Non invasive and do not metastasize
    • Reoccurence is rare and only fatal if left untreated
  36. Malignant Tumors
    • Grow rapidly
    • Non-incapsulated so able to invade and spread (metastasize)
    • Poorly differentiated- looks nothing like tissue origin
    • Almost always fatal
  37. Seven Warning Signs of Cancer

    CAUTION
    • Change in bowel or bladder
    • A sore that won't heal
    • Unusual bleeding or discharge
    • Thickening or lumps
    • Indegestion
    • Obvious change in mole
    • Nagging cough or hoarsness
  38. Tumor Grading
    • I = Well differentiated (look like origin)
    • II = Moderately differentiated (less resemblance)
    • III= Poorly Differentiated (minimal resemblance)
    • IV= Very Poorly Differentiated ( NO resemblance to origin)
  39. What is chemotherapy and what is the goal?
    • Drugs to treat cancer. Non-specific (effects all cells in body).
    • Goal = Kill rapidly mulitplying cells.
  40. What is radiation therapy?
    Kill cancer in TARGET cells by damaging DNA.
  41. What is the goal of Immunotherapy and what is an example of this?
    • Goal is for the body to develop specific immune response to cancer cells.
    • An example is interferon--> Similar to a VACCINE
  42. Non-opioid analgesics
    • NSAIDS: Ibuprofen and NSAIDS: anti-inflammatory, pain and fever reducer, (Aspirin antiplatelet)
    • SALICYLATES
    • ACETAMINOPHEN
  43. Morphine- Opiate Analgesic
    • ~Schedule II
    • ~Esp effective againts cont. dull chronic pain
    • ~Binds with Mu and Kappa in CNS and alters perception of pain
    • ~SE: veritgo, faint, lighthead, fatigue, SLEEP, N&V, ^sweat, constipation, hypotension, dry mouth, HA, ab cramp, nervous, confused, low UO, visual disturbances
  44. Schedule 1 drug =
    HIGH potential for abuse
  45. Schedule V drug=
    LOW potential for abuse
  46. Sedative versus Hypnotic

    Major Difference!!
    Sedative - produce calming effect -- reduce nervousness, excitability, irritability

    Hypnotic - induce sleep

    Major difference is degree of CNS depression produced
  47. Sedative-Hypnotic drugs
    • Restoril- 1-2 before HS
    • Halicon- also for psyc dist. !
    • Dalmane- accumulation, "Hangover"
    • Dripivan- Only IV -- Best with ventilated ICU patient
  48. Sympathetic Nervous System
    • Autonomic nervous system preparing the body to react to situations of stress or emergency
    • "Fight or Flight"
  49. 3 Naturally occuring catecholamines:
    • 1. Dopamine (intropin)- precurser of epi and norepi
    • 2. Epinephrine (adrenaline)- principal blood-pressure-raising hormone also used medicinally as a heart stimulant, vasoconstrictor, & bronchodilator.
    • 3. Norepinephrine (Levophed) - precurser of epi
  50. What is a seizure?
    • Sudden, excessive and disorderly discharge of cerebral neurons with alterations in brain function and LOC.
    • Symptom of an underlying disorder.
  51. Types of seizures
    • Epilepsy: recurrent seizures - cause not determines
    • Grand Mal Seizure: most common "gen. tonic-clonic"
    • Partial: brief alteration in brain function
  52. Phases of Grand Mal =
    • 1. Aura - sense of impending seizure
    • 2. Tonic - muslce contration w. ^ tone
    • 3. Clonic - alt contraction w. relax muscles
    • 4. Postical - disoriented, amnesia
  53. Anticonvulsant therapy
    • Stabilize cell membrane by altering Na, K, and Ca transport.
    • Dilatin and Tegretol - stabilize cell excitability
    • Barbituates (Luminal) - inhibit spread of rep. neuron firing
  54. Chronic Neuromuscular disorders.
    • Parkinson's: Tremors caused by Deficient Dopamine
    • Multiple Sclerosis: Painful inflammation caused by demylination
    • Myasthenia Gravis: muscle weakness w/o atrophy caused by ACH receptor destruction
    • Amyotrophic Lateral Sclerosis (ALS): Muscle weakness with atrophy. May be fatal in less than a year

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