Pharm 2 - Body Defenses & Endocrine

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Author:
MeganM
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268513
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Pharm 2 - Body Defenses & Endocrine
Updated:
2014-03-31 19:14:37
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PHarm
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TAMHSC
Description:
Pharm - Endocrine & BD
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  1. Function of alpha-glucosidase inhibitor?
    • (oral antidiabetic)
    • interferes with carb breakdown & absorption
  2. How do you treat hypoglycemia if it occurs from an alpha-flucosidase inhibitor combined w/ another oral agent?
    treat w/ glucose, not sucrose
  3. Actinon of biguanides.
    • (oral antidiabetic classes)
    • Decreases production & release of glucose from the liver
    • lowers lipid levels
    • promotes wt loss
  4. Action of thiazolidinedione?
    • (oral antidiabetic)
    • decreases production & release of glucose from the liver
    • increases insulin sensitivity in fat & muscle tissue
  5. Thiazolidinedione nursing considerations.
    • (oral antidiabetic)
    • can cause fluid retention and worsening of heart failure
    • therapeutic effects take several weeks to develop
  6. Action of Incretin Enhancers.
    • (oral antidiabetic)
    • slows breakdown of insulin (keeps in bld longer)
    • slows rate of digestion (which increases satiety)
  7. Action of meglitinides (oral antidiabetic).
    stimulates insulin release
  8. Action of sulfonylureas (oral antidiabetic).
    • stimulates insulin release
    • decreases insulin resistance
  9. Oral antidiabetic that is administered shortly before meals.
    meglitinides
  10. Onset, peak, duration of Insulin aspart (NovoLog).
    • (Rapid)
    • 10-20 min
    • 1-3 hrs
    • 3-5 hrs
  11. Onset, peak, duration of Insulin lispro (Humalog)?
    • (rapid)
    • 5-15 min
    • 1-1.5 hrs
    • 3-4 hrs
  12. Onset, peak, duration of Insulin glulisine (Apidra)?
    • (rapid)
    • 15-30 min
    • 1 hr
    • 3-4 hrs
  13. Onset, peak, duration of Insulin regular (Humulin R, Novolin R)?
    • (Short)
    • 30-60 min
    • 1-5 hrs
    • 6-10 hrs
  14. Onset, peak, duration of Insulin suspension (NPH, Humulin N)?
    • (Intermediate)
    • 1-2 hrs
    • 6-14 hrs
    • 16-24 hrs
  15. Onset, peak, duration of Insulin detemir (Levemir)?
    • (long)
    • gradual
    • 6-8 hrs
    • to 24 hrs
  16. Onset, peak, duration of Insulin glargine (Lantus)?
    • (long)
    • 1.1 hrs
    • NO PEAK
    • to 24 hrs
  17. Indication for Ocreotide?
    increased GH
  18. Indication for Desmopressin?
    decreased ADH
  19. Indication for somatropin?
    decreased GH
  20. What is Cushings syndrome?
    • caused by long-term use of hydrocortisone
    • Hyperglycemia
    • Hyperlipidemia
    • Hypernatremia
    • Hypokalemia
    • Edema, HTN
  21. Why is metformin held prior to a cardiac cath or other dye study?
    • 2 days prior and two days after receiving IV radiographic contrast 
    • If not, pt can go into RENAL FAILURE
  22. What is Metformin?
    an antidiabetic agent, most commonly used to manage type II diabetes
  23. The two cells that are packed within a lymph node.
    • lymphocytes & macrophages
    • =recognize anything that is ‘non-self’
  24. 3 nonspecific body defenses.
    • Physical
    • Cellular
    • Process
  25. The 3 cellular barriers.
    • Phagocytes- primary cell of innate immunity, activated once physical barriers are breached 
    • NK cells – Release toxins that kills CA cells or virus-infected cells 
    • Interferons – Antimicrobial proteins
  26. The 2 physical barriers.
    • skin
    • mucous membranes
  27. The process barriers.
    • Complement – Cluster of 20 plasma proteins combine in sequence and order when an infection occurs 
    • *Fever 
    • Inflammation
  28. Chemical mediators released by mast cells.
    • Histamine
    • Bradykinin
    • Complement
    • Leukotrienes
  29. Two cellular branches of immune response.
    • 1) Humoral - triggered when antigen encounters a B-lymphocyte
    • 2) Cell-mediated (T-cell)
  30. Two cells involved in cell-mediated immune response.
    • Helper T-cells (activate most other immune cells)
    • Cytotoxic T cells (travel through body directly killing bacteria, parasites, virus-infection cells and cancer cells)
  31. Which protein receptor is on the membrane of the helper T-cell?
    CD8
  32. Role of Histamine 2?
    • Located in stomach
    • Stimulates secretion of large amounts of hydrochloric acid in the stomach
  33. Role of Histamine 1?
    • causes itching, pain, edema, vasodilation, bronchoconstriction (typical allergic
    • relations) 
    • (present in the smooth muscle of vascular system, respiratory & digestive)
  34. What are prostaglandins and their fxn?
    • Hormones found in every tissue; 
    • -mediates inflammation by causing vasodilation and increased capillary permeability
    • -GI protection through increased bicarbonate and mucous production to protect stomach mucosa from acid
    • -Renal protection – helps maintain
    • renal blood flow
    • -Smoother muscle – helps regulate
    • smooth muscle tone
    • -Blood clotting – increased platelet
    • aggregation to promote clot formation
  35. Two classes of drugs most commonly used to treat inflammation?
    • NSAIDS
    • Corticosteroids
  36. #1 cause of hepatic failure in US.
    Excessive use of acetaminophen (Antipyretic & Analgesic, APAP)
  37. 3 major classes of NSAIDS.
    • Salicylates (Cox1 & Cox2 inhibitors)
    • Ibuprofen (Cox1 & Cox2 inhibitors)
    • Cyclooxytygenase-2 (COX2 inhibitors)
  38. How do NSAIDs work?
    inhibit sythesis of prostaglandins
  39. Two classes most commonly used to treat inflammation?
    ASA & NSAIDs
  40. Types of agents used as immunosuppressants.
    • Calcineurin Inhibitors (cyclosporine)
    • Cytotoxic Agents & Antimetabolites (Axathioprine)
    • Antibiodies
    • Corticosteroids
  41. What is cyclosporine used for?
    prophylaxis of transplant rejection
  42. Contraindications to vaccine administration.
    • pts who are: 
    • immunosuppressed
    • pregnant
    • have cancer
    • HIV (+)
  43. Effects of Cox-2 inhibitors.
    • platelet aggregation 
    • GI irritation
  44. What risks does Celebrex (COX-2 inhibitor) have that other NSAIDs do not?
    risk of MI & stroke

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