Pharm week 2 ch 35, 36, & 37

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ekruge01
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Pharm week 2 ch 35, 36, & 37
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2010-10-27 20:14:53
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some pharmacology questions
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  1. What is hyperthyroidism?
    excessive TH secretion
  2. What are the treatments for hyperthyroidism? (2)
    • 1. "anti-thyroid drugs"
    • 2. radio-active iodide to kill of some thyroid
  3. What are "anti-thyroid drugs"? (2)
    • 1. prevent synthesis of thyroid hormones
    • 2. need to monitor with lab tests in order to assure proper thyroid functioning
  4. What are iodide isotopes?
    radioactive form of iodide, oral or parenteral which destroys thyroid tissue
  5. What kind of precautions may be needed for iodide isotopes? (3)
    • "radiation precautions" with
    • 1. urine
    • 2. stool
    • 3. contact with kids
  6. Clients taking iodide preparations should be observed for what?
    iodism
  7. What are the S&S of iodism? (should be watched for when a person is taking iodide isotopes) (6)
    • 1. gum soreness
    • 2. excessive salivation
    • 3. nausea
    • 4. fever
    • 5. inflammation of the salviary glands
    • 6. metallic taste in mouth
  8. When a person recieves a I 131 injection (sodium iodide) what is a very important fact about after their treatment?
    • They should stay out of close contact with
    • 1. pregnat women
    • 2. children
    • for one week after admintration b/c they will be emitting small doses of radiation
  9. What may a person develop because of a I 131 injection?
    hypothyroidism
  10. What is propylthiouracil?
    anti-thyroid drug
  11. Clients taking propylthiouracil and any other anti-thyroid drugs must immediately report what S&S and why? (3S&S, 1 reason)
    • 1. sore throat
    • 2. fever
    • 3. malaise
    • B/c they may indicate agranulocytosis
  12. What is hypothyroidism? (2)
    • 1. decreased levels of TH
    • 2. increased levels of TSH
  13. What is the treatment for hypothyroidism? (2)
    • 1. synthetic thyroid oral daily (synthroid):take for life
    • 2. need regular lab tests to assess effectiveness
  14. What is levothyroxine sodium?
    Synthetic, pure T4
  15. What is the usual dose for levothyroxine?
    .0125-.2 mg daily
  16. What are the nursing implications for levothyroxine? (3)
    • 1. .1 mg(100mcg) of T4 is approximately equivalent to 65 mg (1 grain)of thyroid USP
    • 2. May also be give IV or IM
    • 3. The IV dose must be prepared immediately before use
  17. What is the parathyroid's function? (2)
    • Regulates:
    • 1. phosphorus
    • 2. Ca
    • in and out of the blood/bone
  18. What is hyperparathyroidism?
    excessive PTH secretion
  19. What is hyperparathyroidism due to physiologically? (2)
    • 1. benign
    • OR
    • 2. malignant
    • TUMOR
  20. What is the treatment of hyperparathyroidism? (2)
    • surgical removal of:
    • 1. tumor
    • 2. some parathyroid tissue
    • OR
    • 3. Lasix to decrease Ca
    • 4. drugs to keep Ca in bone
  21. What is the S&S of hyperparathyroidism?
    Hypercalcemia
  22. What is the key concept Pituitary disorders and treatment? (3)
    • Patient should be under the care of endocrinologist to assess
    • 1. cause
    • and decide
    • 2. surgical
    • OR
    • 3. Hormonal
    • tx is indicated
  23. many hormones cannot be taken orally, why?
    due to destruction by HCl in stomach secretions
  24. what is diabeties insipidus?
    lack of ADH (vasopresin) from posterior pituitary
  25. what are the signs and symptoms of diabeties insipidus?
    • 1. excess urination(polyuria)
    • 2. thirst
  26. what is the treatment for diabeties insipidus?
    provide synthetic ADH (DDAVP, PITRESSIN)
  27. what routes are available for diabeties insipidus? (3)
    • 1. IM
    • 2. IV
    • 3. intra/nasal spray
  28. who are more prone to get type 1 DM?
    children
  29. who are more prone to get type 2 DM
    adults
  30. what is type 1 Dm?
    insuffiecent insullin secretion by ISLETS of LANGERHANS in pancreas.
  31. what is type DM?
    insensitivity to insullin by target organ cells throughout body.
  32. what are the causes of diabeties1 and 2? (4)
    • 1.genetics
    • 2. obesity
    • 3. pregnancy
    • 4. auto immune
  33. what is FBS for DM?
    60-110 mg/dL
  34. what is the tx for type 1 DM?
    insullin injections
  35. what is the treatment for type 2 DM?
    oral agents, if severe insullin
  36. what are the treatments for both DMs? (3)
    • 1. dietary control
    • 2. lifestyle managment
    • 3. in depth education of client/ caregiver
  37. what is insullin?
    protien based horomone secreted by pancreas islets of langerhans
  38. what 2 hormones does the pancreas secrete?
    insullin 1 and glucagon
  39. what is insullins function?
    allow glucose to enter cell from blood
  40. what is the function of glucagon?
    convert glycogen in liver to glucose (glycogenolysis)
  41. (IMPORTANT CONSIDERATIONS OF INSULIN) Cannot be taken orally because?
    stomach enzymes destroy it
  42. (IMPORTANT CONSIDERATIONS OF INSULIN) What are the routes for insulin? (2)
    • 1. Subcu (pump or injection)
    • 2. intranasally
  43. (IMPORTANT CONSIDERATIONS OF INSULIN) Is fragile so must be stored? (2)
    • 1. proper temp.
    • 2. not shaken (just rolled and warmed up to room temp. before administering)
  44. (IMPORTANT CONSIDERATIONS OF INSULIN) What are the types of insulins? (3)
    • 1. beef
    • 2. pork
    • 3. human
  45. (IMPORTANT CONSIDERATIONS OF INSULIN) Reuse of injections sites may result in?
    lipodystrophy (a loss of fat from ejection sites over time)
  46. what is lipodystrophy?
    a loss of fat from injections sites over time
  47. (IMPORTANT CONSIDERATIONS OF INSULIN) Must be used with diet customizable to? (2)
    • 1. type of insulin
    • 2. client activity
  48. How is insulin medication measured?
    Units
  49. (IMPORTANT CONSIDERATIONS OF INSULIN) Administeration requires proper? (2)
    • 1. syringe size
    • 2. type of needle
  50. What should you always check before giving insulin?
    BS
  51. How many nurses are required to sign off on an insulin injection?
    2
  52. What is regular insulin?
    short acting, peaks in 1-5 hours
  53. What is regular insulin used to treat?
    hyperglycemia (only had it for a few hours)
  54. What does regular insulin look like?
    clear, like water, in vial
  55. When giving a mixed injection of insulin, what is always important to note?
    ALWAYS draw regular insulin FIRST when giving injection.
  56. What is the insulin name for short-acting insulin?
    regular
  57. What are the trade names for regualr insulin? (3)
    • 1. Novolin R
    • 2. Humulin R
    • 3. lletin ll (pork)
  58. What are the onsets of action for Humulin R & Novolin R?
    30-60 min
  59. When is the peak of action for Humulin R & Novolin R?
    1-5 hours
  60. What is the duration of action for Humulin R & Novolin R?
    6-10 hours
  61. What is the appearance of all regular insulin?
    clear
  62. The onset of action and peak of action are more rapid for?
    lletin ll (pork)
  63. What is the duration of action for lletin ll (pork)?
    4-12 hours
  64. What is the insulin names for intermediate acting insulin? (2)
    • 1. NPH
    • 2. Lente
  65. What are the trade names for intermediate acting insulin? (3)
    • 1. Novolin N
    • 2. Humulin N
    • 3. lletin ll NPH (pork)
  66. What is the onset of action for novolin N and Humulin N?
    1-2 hours
  67. What is the peak of action for novolin N and Humulin N and lletin ll NPH (pork)?
    6-14 hours
  68. What is the duration of action for novolin N and Humulin N?
    16-24 hours
  69. What is the appearance for all intermediate acting insulins?
    cloudy
  70. The onset of action for lletin ll NPH (pork) is?
    more rapid than 1-2 hours
  71. The duration of action for lletin ll NPH (pork) is?
    >16-24 hours
  72. What is a type of long lasting insulin?
    ultralente
  73. What is th duration of action for long lasting insulin?
    24-28 hours
  74. When does long lasting insulin peak?
    6-20 hours
  75. what is the safest route of injection for insulin?
    subcu
  76. what are oral hypoglycemic agents? (2)
    • 1. drugs which act to stimulate pancreas to release more insulin
    • 2. increase binding of insulin at cell membrane receptor sites
  77. What are oral hypoglycemic agents a tx for?
    DM II
  78. Oral hypoglycemic agents must only be used in conjunction with? (2)
    • 1. thorough client education program
    • 2. follow-up supervison
  79. What is one type of oral hypoglycemic agent?
    Sulfonlyureas
  80. What do sulfonlyureas help with? (2)
    • 1. lowering BS
    • 2. cause insulin release from beta cells
  81. How long have we been using first-generation sulfonlyureas?
    many years
  82. How long have we been using sencond-generation sulfonlyureas?
    recently
  83. First generation sulfonlyureas drugs are less?
    strong than 2nd
  84. 2nd generation sulfonlyureas drugs have less?
    side effects
  85. Who should NOT use sulfonlyurea? (2)
    • 1. DM 1
    • 2. allergies to sulfonamides (sulfa drugs)
  86. What are 6 important key points about sulfonlyureas?
    • 1. must take before meals and eat right after
    • 2. patient need DM education
    • 3. hypoglycemic S&S will occur if meals are skipped or patients exercises vigoriously
    • 4. do not skipp doses
    • 5. call dr if side effects are too untolerable
    • 6. diet is just as important as the drug
  87. Whatt are the 2 safety considerations for people with DM?
    • 1. Instruct patient to wear DM ID
    • 2. instruct pateints not to take any drug without consulting pharmacist/dr.
  88. When unsure if a patient is haveing a insulin reaction or diabetic ketoacidosis what do you treat for?
    Treat for insulin reaction (too low BS)
  89. Insulin reaction is treated with?
    4 oz of rapidly absorbable sugar if client is conscious, follow with simple carb or regularly scheduled meal
  90. If someone with an insulin reaction is unable to swallow how may you treat them?
    apply syrup or sugary paste to buccal mucosa
  91. With a insulin reaction, family members should be able to reconstitute and adminster?
    glucagon
  92. Insulin is not required for clients who are fasting for other tests (T or F)
    true
  93. 1. What may mast the S&S of hypoglycemia? 2. B/c of this patients must be aware of?
    • 1. beta-adrenergic blocking agents.
    • 2. MUST BE AWARE OF subtle indicators like dizziness and weakness
  94. What are the mainstays of tx for someone with TYPE 2 DM? (2)
    • 1. diet
    • 2. excercise
  95. Excessive hypoglycemia may occur in clients taking what when they have DM 2?
    oral hypoglycemics
  96. Drugs that intensify the hypoglycemic action of oral hypoglycemics are? (9)
    • 1. salicylates
    • 2. phenylbutazone
    • 3. sulfonamides
    • 4. monoamine oxidase inhibitors
    • 5. clofibrate
    • 6. probenecid
    • 7. dicumarol
    • 8. NSAIDs
    • 9. chloramphenicol
  97. Ovaries secrete what with the influence of FSH and LH? (2)
    • 1. estrogen
    • 2. progesterone
  98. What are the 2 functions of the ovaries?
    • 1. control ovulation
    • 2. control uterine lining shedding and growth
  99. IUD causes what physiologically and releases what?
    • CAUSES: endometrial inflammation
    • RELEASES:exogenous hormones
  100. What are the 3 functions of exogenous hormones?
    • 1. inhibit ovulation
    • 2. make cervical mucus difficult to transverse
    • 3. thins endometrial lining which egg needs to implant well
  101. Certain exogenous hormones increase your risk of ectopic pregnancy? (t or F)
    true
  102. PRL levels affect fertility, in other words?
    breastfeeding moms often DO NOT ovulate (usually)
  103. Do females secrete testosterone?
    yes
  104. What is the testes function?
    secrete testosterone for sperm development
  105. What is the placenta?
    temporary endocrine hormone during pregnancy
  106. What does the placenta secrete? (3)
    • 1. estrogen
    • 2. progesterone
    • 3. human chorionic gonadotropin (HCG or "pregnancy test hormone")
  107. People are at a higher risk of what 2 things because of exogenous hormones?
    • 1. blood clots
    • 2. strokes
  108. Estrogen/progesterone products are contraindicated by what 2 disorders?
    • 1. thrombophlebitis
    • 2. thromboembolic
  109. PAtients with long term therapy of estrogen products should be check periodically for? (2)
    • 1. weight
    • 2. BP
    • (Estrogen products increase them)
  110. What S&S should be reported for people using estrogen products?
    uterine bleeding
  111. Long use of progesterone products is associated with what S&S? (5)
    • 1. edema
    • 2. weight gain
    • 3. GI disturbances
    • 4. breast swelling
    • 5. depression
  112. When should a person avoid the use of progesterone products?
    when they are pregnat
  113. What should be reported if a person is using progesterone products? (2)
    • 1. visual disorders
    • 2. migraine
  114. What does androgen products cause? (3)
    • 1. sodium &
    • 2. water
    • RETENTION
    • 3.increase BP (check frequently)
  115. What is BPH?
    begning prostatic hyperplasia
  116. What is PSA?
    prostate specific antigen
  117. (clients taking androgen hormone inhibitors) before taking what 2 drugs, a baseline PSA should be conducted to rule out prostate cancer as a reason for BPH?
    • 1. dutasteride
    • OR
    • 2. finasteride
  118. (clients taking androgen hormone inhibitors) should always use protection when having intercourse with a pregnat woman because?
    The semen could hurt a male fetus because of the drugs presence in it
  119. Pregnant woman should not be in contact with what drug because it could hurt a male fetus?
    dutasteride capsules

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