Pharm test 5

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saraherin
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213250
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Pharm test 5
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2013-04-18 21:11:20
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Pharm drug on the GI, re[productive system
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  1. How does the sympathetic system effect the GI:
    can slow it down when "fight or flight" system is triggered. 

    decreases muscle tone, secretions, and contractions in the nerve plexus layer of the GI.
  2. Four major activities of the GI system:
    • Secretion
    • Absorption
    • Digestion
    • Motility
  3. Chief cells secrete ______.
    Pepsin
  4. Gastrin and the parasympathetic system stimulate what in the stomach?
    Histamine- 2 receptors
  5. What do the histamine -2 receptors cause in the stomach?
    HCI - hydrochloric acid
  6. Cause of a peptic ulcer?
    Bacterial infection of Helicobacter pylori 
  7. The vomiting reflex is controlled by what ?
    two receptors in the Medulla

    the emetic and the CTZ
  8. THE chemoreceptor trigger zone (CTZ) does what?
    located in medulla, responsible for vomiting, this is the more mature
  9. How do Histamine-2 antagonists work?
    Block the release of hydrochloric acid in response to gastrin
  10. How do proton pump inhibitors work?
    suppress the secretion of Hydrochloric acid into the lumen of the stomach
  11. How do antacids work?
    interact with acids at the chemical level to neutralize them
  12. Most common terms for over production of HCI by the parietal cells?
    • indigestion
    • sour stomach
    • heartburn
    • acid stomach
  13. Symptoms of peptic ulcer :
    • Gnawing 
    • Burning pain the often occurs after meals
  14. How do Antipeptic agents work?
    Coast the stomach to prevent further injury from acid
  15. What do prostaglandins do to treat the stomach ?
    • inhibit the secretion of gastrin
    • AND
    • increase the secretion of mucous lining of the stomach, providing a buffer
  16. What three cells in the stomach make acids?
    • Chief - Pepsinogin breaks down proteins
    • Parietal- HCI secreted by the proton cells
    • Mucous- protective mucus
  17. Prostaglandins do what?
    • 1- protects heart 
    • 2- protects stomach pain/ inflammation
  18. Antacids can alter the _____ balances in the body.
    electrolyte balances
  19. Aluminum Salts in antacids can cause:
    constipation
  20. Magnesium in antacids can cause
    diarrhea
  21. Gaviscon, Maalox, and Mylanta are what type of antacids?
    Combination of aluminum and magnesium

    • AL & MAG  Family:
    • AL has constipation 
    • MAG has diarrhea
  22. How would you take a combination aluminum/magnesium antacid?
    1 -2 hours before or after a meal, not with a meal.
  23. Renal failure is a contra indication for use of what type of antacid?
    Magnesium salts - the kidneys can't excrete the extra magnesium, resulting acumulation
  24. Antacids with Calcium can cause what side effects?
    • Kidney stones
    • Hypercalcemia - increase calcium levels
  25. Antacids with Sodium Bicarbonate can cause what side effects?
    • Increase water retention / bad for hypertension or CHF patients
    • Gas/ belching 
    • Metabolic acidosis / changes to pH
  26. Hyperacidity rebound =
    increase gastric acid secretion - side effect of many GI drugs
  27. Sodium Bicarbonate antacids have a ___ onset.
    • Quick onset, short term duration 
    • Highly soluble
  28. Antacid drug -Drug interations:
    • Inactivation (chelation)  of another drug 
    • Reduced ability of other drugs to be absorbed
  29. Assess for with use of  antacids:
    • Allergies 
    • CHF
    • Hypertension 
    • Pregnancy 
    • Renal disease
    • GI obstruction 
    • Fluid imbalance
  30. Antacids may cause premature dissolving of ___________ medications.
    enteric-coated, resulting in stomach upset
  31. What should you avoid when taking antacids?
    • Caffeine
    • Alcohol 
    • harsh spices (black pepper)
  32. Sodium bicarbonate antacids are highly contraindicated in patients with what impairment?
    • Renal impairment
    • sodium bicarbonate is excreted in the urine and can cause severe electrolyte imbalance in patients that can not effectively excrete it.
  33. Tagament, Pepcid, and Zantac are what type of antacids?
    • H2 Antagonists
    • they reduce HCI acid secretion
  34. All H2 antagonists end in what?
    "tidine"
  35. H2 antagonists will _______ production of acid in the stomach.
    • CHANGE production by selectively blocking the H2 receptor sites.
    • This is before the proton pumps
  36. H2 antagonists are used to treat what ?
    • GERD
    • prevention of ulcers
    • combination for treatment of H. pylori
  37. Contraindications for H2 antagonists:
    • Pregnancy / lactation
    • Hepatic/ Renal dysfunction 
    • They us the CYP 450 enzyme
  38. Adverse effects of H2 Antagonists:
    • Narrow therapeutic index drugs
    • Cardiac arrhythymias 
    • Not in combination with other antacids
    • NO WINE - JUST DINE 
    • NO smoking (decrease effectiveness)
    • NO NSAIDS - block good prostaglandins
  39. Side Effects of Opiates:
    • Drowsiness
    • Sedation
    • Dizziness
    • Respiratory depression 
    • Bradycardia
    • Hypotension
  40. Side Effects of Anticholinergics:
    • Urinary retention
    • Confusion
    • Dry skin
    • Blurred vision
  41. Pepto-Bismol is what type of drug?
    Absorbent anti diarrhea
  42. Kaopectate may cause __________.
    Dark chalky stool
  43. How long does acute diarrhea last?
    2 days - 2 weeks
  44. How long does Chronic diarrhea last?
    3-4 weeks
  45. How do absorbents work?
    coat the wall the walls of the GI tract & Bind to the causative agent for elimination
  46. How do Anticholinergics work?
    • slow the movement of feces though the GI tract
    • decrease intestinal muscle tone and peristalsis
  47. Can't Pee, SEE, SPIT, SHIT are all realated to what?
    anticholinergics
  48. Atropine is an ________ .
    Anticholinergic
  49. How do opiates work?
    Decrease bowel motility (contractions/spasms) & transit time allowing for more electrolytes to be absorbed
  50. Interactions with Absorbents:
    • Aspirin 
    • May decrease absorption of many agents
  51. Antacids will decrease the effect of ______________.
    Anticholinergics
  52. Do not give bismuth subsalylates to what age group?
    • Children under 16 
    • Reyes Syndrome
  53. Do not give anticholergics with a history of:
    • Glaucoma 
    • BPH 
    • Cardiac 
    • Recent bladder surgery
  54. Nursing Implications for anticholinergics:
    • Fluid volume status 
    • Monitor therapeutic effects
  55. Treatment for constipation that will increase bulk:
    Psyllium (metamucil) - take with 8-10 ounces of water
  56. How does Psyllium work?
    Distends bowel to initiate bowel reflex activity
  57. How do Emollients work?
    • Softening/ lubricating stool
    • Promotes more H2O and fat in stool
  58. Example of a stool softener?
    • Colace (ducosate) 
    • Mineral Oil
  59. What does COLACE stand for?
    • Cause of constipation (immobility/FVD)
    • ducOlax common drug 
    • fLuid increase 
    • tAstes bitter 
    • Cardiac / Surgical 
    • Electrolyte changes
  60. How do Hyperosmotic work?
    Increase fecal water content, causing bowel  distention, increased peristalsis & evacuation
  61. goLytely, Sorbital, Lactulose, and glycerine are examples of what?
    Hyperosmotic drugs used to treat constipation
  62. Epsom salt is an example of ...
    Saline / Hyperosmotic treatments for constipation
  63. How does Saline work?
    • causes more water to enter intestines 
    • Magnesium Sulfate
  64. How do Stimulants work?
    increase peristalsis via intestinal nerve stimulation

    May cause Cramps
  65. Castor Oil, Senna & Cascara are examples of :
    Stimulants
  66. All laxatives can cause:
    Electrolyte Imbalances !!
  67. Patients should not take laxatives or cathartic if they are experiencing:
    nausea, vomiting, or abdominal pain with unknown etiology
  68. What should you asses before giving a laxative?
    Bowel Sounds
  69. Vomiting is a ____ ____ ____ to various stimuli.
    Complex Reflex Reaction 

    is often not beneficial in clinical conditions
  70. Emetics cause what?
    vomiting 

    No longer recommended for at-home use
  71. Antiemetics are used for what?
    Decrease/ prevent  nausea or vomiting
  72. Centrally Acting Antiemetics:
    • Phenothiazines 
    • Nonphenothiazines 
    • Anticholinergics / antihistamines (sea sick)
  73. How do Phenothiazines  work?
    Depress carious areas of CNS  for treatment of nausea/vomiting
  74. Adverse effect of pheonthiazines?
    Drowsiness
  75. How do ANTIpheonothiazines work?
    reduce responsiveness of the nerve cells in the CTZ  to circulating chemicals that induce vomiting
  76. Anticholinergics / antihistamines how do they work as antiemetic?
    block the transmission of the impulses to the CTZ
  77. Adverse effects of Anticholinergics / antihistamines:
    Drowsiness
  78. Adverse reaction to Serotonin receptor blockers?
    headache
  79. Zophran is an example of a _____ antiemetic?
    Serotonin Receptor blocker
  80. Serotonin Receptor blocker adverse effect?
    • HEADche
    • drowsiness
    • Constipation
    • Urinary Retention
  81. Nursing implications for CNS depressants for antiemetics:
    Asses for Hydration, electrolytes, safety, allergies, Fluid volume status - oral hygiene - daily weights
  82. Anabolic effects include:
    Tissue building / mass
  83. Anabolic testosterone is _______.
    synthetic
  84. Male steroid hormones or _______ act like testosterone.
    androgens
  85. Indications for Androgens:
    • Hypogonadism
    • Breast cancer in women by blocking release of FHS / block estrogen
    • Sever weight loss
  86. Androgens work by increasing the retention of what?
    • Nitrogen
    • Sodium 
    • Potassium
  87. Androgens increase protein _______.
    anabolism - make more redblood cells, and make more protein and not break it down
  88. Androgens are indicated for use in males for:
    Hypogonadism
  89. Cautions with use of androgens:
    • Liver Function (cause small holes in the liver)
    • Cardiovascular disease (enlarged heart/ Cardiomyopothy)
  90. Adverse effects of Androgens:
    • Acne
    • Edema
    • Hirsutism (hair growth)
    • Deepening of voice
    • Oily skin & hair
    • Testicular atrophy 
    • Weight gain
  91. Alfa blockers are used for :
    • Hypertension 
    • BPH
  92. Mini "sins" =
    • adverse effects of Alfa blockers that end in "sins"
    • orthostatic hypotension
    • increased heart rate / drowsiness 
    • need to recumbent for 3-4 after initial dose
  93. Finasteride & Dutasteride are used to treat what ?
    • prostate 
    • help block androgens to decrease the size of the prostate
    • Block production of testosterone

    • CAN NOT donate blood for 6 months 
    • be handles by pregnant women

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