EXAM 2

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Christyna
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39937
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EXAM 2
Updated:
2010-10-05 16:01:59
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mostly pharm ah1
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important pts for exams
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  1. antidote for coumadin (anticoagulant warfarin)
    vitamin k
  2. deficiency primarily in chronic alcoholism
    thiamine (vitamin B1)
  3. given to prevent neurotoxicity
    vitamin B6
  4. antidote for iron
    • deforoxamine (Desferal)
    • *iron meds "ferrous" IRON-Fe
  5. chelating agents
    antagonists to metals, treat overdose/poisoning
  6. antacids
    • calcium->constipation
    • magnesium->diarrhea
  7. what decreases acid release?
    histamine (H2) antagonists "tidine" family
  8. what decreases HCL secretions more effectively?
    • proton-pump inhibitors
    • "prazole" family
  9. Mucosa protectives
    • carafate; dissolve, don't crush for NG
    • cytotec-prevent NSAID induced ulcers
  10. GI stimulant (prokinetic agent)
    • SE: drowsiness, fatigue
    • Reglan used as antiemetic
  11. bismuth (primary ingredient in pepto bismol)
    • antibiotic therapy for PUD
    • -ulcer due to H.Pylori
  12. Primary SE of antiemetic:
    drowsiness
  13. Nausea
    • Antiemetics used to TREAT it
    • serotonin used to PREVENT it
    • (serotonin-"estrons" family)
  14. Miscallaneous anti-emetics
    • dronabil (Marino) contains THC
    • scopolamine ("Scop Patch")-used to prevent motion sickness with anticholinergic effects
  15. tegaserod (Zelnorm)
    used for constipation IBS
  16. ocetreotied (Sandostatin)
    growth hormone suppressor that also suppresses GI -> antidiarrheal effect (used for severe diarrhea)
  17. stool softener/surfactant
    daily dose to prevent, not treat, constipation
  18. contact/stimulant
    treat constipation
  19. bulk forming laxative
    freq. used by elderly
  20. osmotic laxative
    • hypertonic substance that pulls flud into GI
    • Milk of Magnesia
    • Fleets enema
  21. polyethylene glycol
    requires 4L q 10min. (of fluids)
  22. hepatic failure results in:
    • hypoproteinemia, increased pressure within portal circulation, and increased levels of aldosterone->results in fluid retention(ascites)
    • treat w/ potassium sparing diuretic
  23. what regulates Na (sodium)?
    aldosterone
  24. lactulose
    • 2-4Xdaily to get rid of ammonia
    • once daily as a laxative
  25. cholestyramine (Questran) "Bile Acid Sequestrant"
    • lowers cholesterol
    • be sure to let powder "settle" before stiring
  26. normal urine output
    • 2-21/2 L/day
    • 1mL/kg/hr
    • 60mL/hr
    • BAD-<30ml/hr
  27. most diuretics act on what system?
    tubular->interferes w/ reabsorption of Na and Cl, thus excreting Na and H20
  28. loop diuretics
    • inhibit electrolye reabsorption in loop of Henle
    • venodialate-so drug of choice for HF
  29. furosemide (Lasix)
    SE: ototoxicity, hyperglycemia, hyperuricemia (problems w/ gout pts) hypokalemia
  30. thiazide & thiazide like diuretics
    • 1st line recommendation for treatment for HTN
    • hydrochlorothiazide "thiazide" family
  31. osmotic diuretics
    • mannitol *dissolve crystals before administration
    • used to decrease cerebral fluid and manage intracranial pressure
  32. carbonic anhydrase inhibitor diuretic
    • decreases pressure in eye (glacoma)
    • management of pt w/ metabolic alkalosis
  33. potassium sparing
    • SE: hyperkalemia
    • diuretic of choice in liver failure pts
  34. aquaretics
    treatment of SIADH -syndrome of antidiuretic hormone
  35. hyperkalemia
    • kayexalate will wash it out
    • give enemas to get kayexalate back
  36. hyperphosphatemia
    aluminum hydrodroxide antacids-rids of phosphorous
  37. what rids phosphate?
    calcium
  38. sodium bicarb (NaHCO3)
    helps w/ pts who have metabolic acidosis
  39. urinary retention
    alpha blocker prescribed
  40. UTI's
    • "azo" for dysuria ->will cause reddish-orange discoloration of urine
    • "sulfa" antibiotics->anti-infective
  41. IVP (Intravenous Pyelogram)
    most commonly used radiological test to evaluate the urinary system
  42. MRI
    • 3-D (better pic.)
    • NO metal objects allowed in room
  43. Cation/anion balance
    • extracellular: NA+, CL-
    • intracellular: K+, Phosphate-
  44. normal serum osmality
    approximately 300 mOsm/L
  45. hypertonic
    • greater concentration of solutes (particles)
    • pulls water into vascular compartments
    • dehydrates cells
  46. hypotonic
    • less concentration of solutes
    • pushes water out of intravascular compartments
    • hydrates cells
  47. lactated ringers
    • isotonic fluid
    • similar to plasma
  48. albumin
    • #1 protein in body
    • must maintain normal amount
  49. requires filters
    blood, manitol, and parental nutrition
  50. Chloride
    95-105mEq/L
  51. Calcium
    8.5-10mg/dL or 4.5-5.5 mEq/L
  52. Magnesium
    1.5-2.5 mEq/L
  53. Phosphorous
    2.5-4.5mEq/L
  54. hypercalcemia
    • HYPOneuromuscular activity-muscle weakness, constipation, risk for kidney stones
    • hyperparathyroidism-long term or high doe of antacid use
  55. hypocalcemia
    • HYPERneuromuscular activity-muscle spasms, seizures
    • hypoparathyrodism
    • complication of renal failure, panctreatitis, rapid blood transfusion, vitamin D deficient
  56. hypomagnesemia
    • malnutrition (chronic alcoholism)
    • prolonged diarrhea
    • HYPERneuromuscular activity
  57. hypermagnesemia
    • poor renal function
    • intake of magnesium containing antacids
    • HYPOneuromuscular activity
  58. Antidote for Magnesium toxicity
    calcium
  59. hyperphosphatemia
    • chronic renal failure
    • HYPERneuromuscular
    • treat w/ aluminum antacids
  60. hypophosphatemia
    • malnutrition
    • hyperparathyroidism
    • HYPOneuromuscular activity
  61. Barium
    • for GI X-rays
    • turns stool chalky white
    • make sure pt is excreting it
  62. contrast dyes
    • kidney dysfunction
    • encourage fluids
  63. metformin
    diabetic pt. stop taking prior to recieving contrast dyes to decrease risk of lactic acidosis
  64. positive TB
    • indiration of 10mm or more in immunocompromised pt.
    • indiration of 5mm is considered positive
  65. radioactive substances
    body fluids may be radioactive
  66. lymph node mapping
    • injection of dye to identify lymph node involement in metastatic cancer
    • dye turnes urine bright turquoise
  67. plasma-interstitial: edema
    • ^venous hydrostatic pressure
    • decreased plasma oncotic pressure
    • ^interstitial oncotic pressure
    • decreased lymphatic outflow
  68. interstitial to plasma
    • ^plasma osmotic-oncotic pressure
    • ^tissure hydrostatic pressure: TED hose
    • hypovolemic shock
  69. hydrostatic pressure at arterial end
    40mmHg
  70. oncotic pressure (a.k.a. colloidal osmotic pressure)
    • 25mmHg
    • attracts water
  71. hydrostatic pressure at venous end
    10mmHg
  72. factors that increase release of ADH
    • increased plasma osmolality
    • decreased circulating volume
    • decreased stress and pain
    • medications/surgery
    • positive pressure ventilators
  73. factors that decrease ADH
    • decreased plasma osmolarity
    • increased effective circulating volume
    • increased BP
    • medications (Dilantin)
  74. Hyponatremia
    • lack of aldosterone-^ renal sodium loss
    • lack of cortisol- ^release of ADH
    • thiazide (NSAID's)-decrease Na+
  75. Hypernatremia
    • kayexalate has ^Na+
    • diabetic pts can't excrete Na+
  76. in Hypokalemia ALKALOSIS
    hydrogen ions shift out of cells and potassium from ECF shifts into cells
  77. Trousseu's sign
    muscle spasm (in arm)
  78. Chvostek's sign
    cheek spasm
  79. thiazide & lithium
    decreases renal calcium excretion
  80. PaCO2
    35-45 mmHg
  81. bicarbonate
    22-26mEq/L
  82. Pa02
    80-100 mmHg
  83. metabolic acidosis
    • SX: disorientation
    • kussmal resp.
    • muscle twitching
    • changes in LOC
    • decreased pH
    • decreased HCO3
  84. metabolic alkalosis
    • SX: nausea & vomiting
    • diarrhea
    • restlessness
    • slow resp.
    • arrhythmias
    • ^pH
    • ^HCO3
  85. respiratory acidosis
    • SX: rapid, shallow resp.
    • dyspmea
    • disorientation
    • muscle weakness
    • decreased pH
    • ^pCO2
  86. respiratory alkalosis
    • SX: tingling of extremities
    • confusion
    • deep-rapid breathing
    • seizures
    • ^pH
    • decreased pCO2
  87. ROME
    • R espiratory
    • O pposite
    • M etabolic
    • E qual
  88. Colloids
    *volume expanders*
    • Albumin 5% or 25%
    • Hetastarch
    • Dextran
  89. glucocorticosterioids
    • "sone" family
    • Rhinocort
  90. beta 2 selective
    abluterol-most common used inhaler
  91. Xanthines (methlyxanthine)
    • similar to caffeine effects (bronchodialating)
    • "phylline" family
    • therapeutic level 10-20 mcg/mL **
  92. leukotriene antagonists
    • asthma prophylaxis
    • "lukast" family
    • inhibits inflammation
  93. intranasal gluccocorticoids
    most effective for allergic rhinitis
  94. antihistamines
    anticholinergic (short acting)
  95. peripheral acting histamines
    • non-sedating
    • "ine" family
  96. First Line Drug:
    INH (isoniazid)
    • SE: neurotoxicity
    • B6 given to prevent
  97. First Line Drug:
    rifampin
    turns body fluids reddish orange
  98. Atrovent
    • long acting
    • Spiriva
  99. beta adrenergic
    long acting
  100. serevent
    • short acting
    • alupent, proventil, maxair
  101. ventilation
    mechanism of body to inspire and expire air
  102. respiration
    involves a 3 phase process
  103. atmospheric pressure
    • 760mmHg
    • +4 for expiration (764)
    • -6 for inspiration (754)
  104. atmospheric air
    • 21% Oxygen
    • 78% Nitrogen
    • 1% other gases
  105. hemoglobin norms
    • M: 13.5-18g/dL
    • F: 12-16
  106. hematocrit norms
    • M: 40-50%
    • F: 38-47%
  107. RBC norms
    • M: 4.2-6
    • F: 3.6-5
  108. HCO3 norms
    22-26 mEq/L
  109. Respiratory sounds
    • vesicular: I>E
    • bronchovesicular: I=E
    • bronchial: I<E
  110. compliance (distensibility)
    amount of movement of chest when breathing
  111. diffusion
    gases moving from higher to lower concentration
  112. WBC norms
    5000-10,000
  113. platelet count norms
    150,000-400,000/mm3
  114. glucose norms
    70-110 mg/dL
  115. BUN norms
    10-20
  116. Creatinine norms
    • M: 0.6-1.2 mg/dL
    • F: 0.5-1.1 mg/dL
  117. HDL norms
    • M: >45
    • F: > 55
  118. LDL norms
    <70mg
  119. normal ejection rate
    • 60-70%
    • 70 bpm
    • 70 mL of blood
    • =4.9 L CO (cardiac output)
  120. loss of water
    • isotonic: normal loss
    • hypotonic: less than 135mEq/dL-loss of Na & H2O
    • hypertonic: more than 145mEq/dL-excess Na, decreased H2O
  121. what most likely causes FVE (fluid volume excess)?
    blood
  122. what is the main sign of FVE?
    SOB
  123. calcium and phosphorous are interrelated
    • ^calcium, decrease phosphorous
    • decrease calcium, ^phosphorous

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