pharm final 3

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kbryant86
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pharm final 3
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2013-12-09 17:38:55
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  1. 4 things used for Inflamm Bowel Disease
    • Aminosalicylates
    • Glucocoritcoids
    • Immunosupressants
    • Immunomodulators
  2. Aminosalicylates
    Suppresses prostaglandin synthesis and migration of inflamm cells

    where we start with IBD

    SE= nausea, fever, rash arthralgias
  3. Glucocorticoids used for anti-inflamm action of IBD
    • For acute symptoms only
    • avoid adrenal suppression b/c it is short acting 

    Dexamethazone / Decadron

    Buesonide / Entocort
  4. Immunosupressant for IBD
    • Not approved for IBD but used for long term suppression
    • takes up to 6 months to see effects
    • INhibits B and T-cells proliferation
    • Anti-inflamm effects 
    •  = Azathioprine

    • stronger and faster that Azathioprine
    • Suppress T-cells and anti-inflamm process
    • for acute symptoms
    •  = Cyclosporine
  5. Immunomodulator
    • Inactivates TNF-a in IBS
    • => a primary inflamm mediator

    • = Infliximab / Remicade
  6. Prokinetic Agent in IBS
    increase tone and motility in IBD

    • Suppresses dopa and serotonin receptors 
    • *Inc. motility by enhancing action of ACh
    • *Sedation and diarrhea countered with antihistamines

    (used in pt with tube feeding and sluggish gut)
  7. Pancreatic Enzymes in IBS
    • given to pt.s w/o enzymes with EVERY meal
    • ->obstruction of pancreas, pancreatitis, pancreatectomy

    secreted into duodenum to break down fats
  8. Immunosuppressants
    • Tx autoimmune diseases
    • prevent transplant rejection
    •  - life long drugs
  9. Most effective immunosuppresant?
    Calcineurin Inhibs
  10. Prograf
    organ rejection only- works twice as well for organ rejection but has twice the SE                               -use for an episode of organ rejection then go back to cyclosporine
  11. Cyclosporin / Sandimmune
    • calcineurin inhib
    • used in transplants
    • Does not cause bone marrow suppression
  12. THE REST OF THE IMMUNOSUPPRESSANTS ARE WRITTEN OUT
    ASD
  13. Anti histamine
    **IN high doses--> CNS stimulation and seizures b/c histamine blocks seizure activity
    • Anti histamine
    • **IN high doses--> CNS stimulation and seizures b/c histamine blocks seizure activity
  14. COX 1
    • cyclooxgenase (product of arach. acid production)
    • the Good Cox
    • -In ALL tissues

    • protects against mucosa-increasing blood flow
    • supports renal function
    • promotes platelet aggregation
  15. inhibition of COX 1
    • gastric erosion
    • renal impairment
    • bleeding
    • prevent MI/stroke
  16. COX 2
    • Bad COX
    • at site of injury
    • mediates inflammation
    • sensitizes pain receptors
    • mediates fever and pain in brain
    • supports renal function
    • vasodilation
    • promotes colon cancer
  17. inhibition of COX 2
    decrease pain, fever inflamm

    • promote renal failure
    • promote embolic events (MI)
  18. ASA and NSAIDS
    • COX inhibitor
    • Stop production of prostaglandins
    • -suppress inflamm
    • -relieve pain
    • -reduce fever

    • risk of:
    • stomach ulcer
    • bleeding
    • renal impairment
  19. ASA
    • Aspirin
    • NON-selective COX inhibitor
    • Irreversible

    • Suppress inflamm, analgesia, and platelets. Reduce fever, relief of dysmenorrhea, colorectal cancer preventtion, Alz's prevention
    • Stroke and MI protection

    SE: GI, bleed, RI, Reye's, ringing in ears
  20. Acetaminophen
    2nd most used drug in US

    • Anti-pyretic and analgesic effects
    • -No inflamm effects
    • -Inhibits prostaglandin synthesis in CNS only

    inhibits metabolism of Warfarin
  21. Acetylcystine / Mucomyst
    Antidote for Acetaminophen overdose
  22. GLUCOCORT WRITTEN OUT
    asd
  23. Tx of DM: oral

    one oral med
    oral insulin is only for type II diabetes and only after diet and exercise don't work

    Sulfonylureas = introduced as oral antidiabetis meds, but hypoglycemia was major side effect
  24. short duration: rapid-acting
    • given in association with meals. Controls postpradnial blood glucose
    • given subQ and via continuous SC pump
    • can be given IV-rare

    clear solutions (except NPH)
  25. short duration: slower acting
    • given in association with meals. control postprandial blood glucose
    • -SubQ, IM, IV, via pump
    • BEST IV form of insulin
  26. intermediate acting
    twice daily to control b/w meals and at night
  27. long duration
    • precipitates in human pH and slowly dissolves
    • -lasts 24 hours

    • mostly given at night, but time may vary
    • DO NOT mix or give IV
    • SubQ only

    clear solution
  28. Levothyroxine / T4 Synthroid
    Hypothyroid

    • Converted into T3 (active form) in the body
    • Accelerates the degrad of Vit K
    • Interacts w/ many drugs and food
    • BRAND NAME is best
  29. Liothyronine / T3-Cytomel
    Hypothyroid

    • Short 1/2 life
    • Twice daily use
    • used as an additive to Synthroid regiment when needed
  30. Thyrotoxic crisis
    • Hyperthyroidism
    • Thyroid storm
    • Excessive levels causing seizures, coma, death

    • will really increase metab rate
    • Load up with Potassium Iodine or Iodide Salts on theory that too much will shut the thyroid down
  31. Propylthiouracil / PropylThyrocil

    Methimazole / Tapazole
    Hyperthyroid

    • blocks T3/4 production
    • Tx for 6-12 months, then stop
    • Used in conjunction with Beta Blockers --> block thyroid symptoms
    • agranulocytosis
  32. Iodine 131
    Hyperthyroid

    • radioactive isotope taken up byt he thyroid
    • Not toxic to other tissues

    can become Hypothyroid
  33. PTH activates Vit D to decrease blood Ca++
  34. Calcitonin
    • used in ca++ control
    • decreases plasma levels
    • inhibits reasorp from bone
    • inc. ca++ excretion

    • Some foods (spinach) decrease Ca++ absorp
    • Glucocorticoids  increase Ca++ excretetion and decrease GI absrop
  35. Hypocalcemia
    • increases neuromuscular exitability
    • -spasms, tetany, convulsions

    caused from deficiency of PTH, Vit. D, or calcium
  36. Tx for Hypercalcemia
    • IV saline, promote urination --> for life threatening situation
    • Give calcitonin --> dec. mobilization from bone
    • Eat bran --> dec. intestinal absorption
    • can use diuretics --> increase Ca+ excretion
  37. Edetate Disodium / EDTA
    • Chelating agent that binds ca+ in the blood
    • used for sever hypercalcemia

    • binding increases excretion
    • rapid reduction of serum ca+
    • -can result in profound hypocalcemia
    • used as anti-coag in blood drawing tubes
  38. Alendronate / Fosamax
    Bisphosphonate used for osteaporosis

    absorbed by osteoclasts, decreasing their activity

    • Taken on empty stomach, swallow whole, full glass h2o, and sit up for 30 minutes after
    • -avoid esophagitis
  39. SERMS and osteoporosis
    • estrogen effects some tissue
    • - preserves bone density, lowers cholesterol, pro-coagulant

    • Anti-estrogran effects in others
    • - prevents cancer in breast and endometrium
  40. 3 types of cancer drugs
    • cytotoxic agents= direct kill
    • Hormones and hormone antagonists= interfere with hormone dependent tissues
    • Targeted drugs= created to bind to specific molecules
    •   = monoclonal antibodies
  41. Anti-Metabolites
    cytotoxic dx
  42. alkylating agents / Platinum compounds
    cytotoxic dx
  43. anti-tumor antibiotics
    cytotoxic agents
  44. Mitotic Inhibitors
    Cytotoxic agent
  45. Topoisomerase Inhibs
    Cytotoxic agent
  46. what classification drug is used for prostate cancer?
    Androgen Deprivation
  47. SERMS
    • Selective estrogens receptors modulators
    • 'Anti-estrpgens'

    Used for Breast cancer

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