Term
| Which Schedule of drugs are the most abused and not prescribed? |
|
Definition
|
|
Term
| What is an unbound drug ...active or inactive? |
|
Definition
| only unbound drugs are active, bound drugs are innactive |
|
|
Term
| The Adrenal Medulla secretes what two hormones that cause bronchodialtion and vasoconstriction? |
|
Definition
| Epinephrine and Norepinephrine |
|
|
Term
| What hormones do the Adrenal Gland secrete for stress? |
|
Definition
| Glucocoticoids (cortisol most abundant), Mineralcorticoids (Aldosterone most abundant), Gonadotropic hormones (sex) |
|
|
Term
| What role does the pituitary gland play in stress response ..What is the sequence of cortisol production? |
|
Definition
Anterior Pituitary Gland secretes Adrenocorticotropin. Adrenocorticotropin then stimulates production of cortisol by the adrenal gland.
- Adrenocorticotropin is vital to maintain BP and Blood Glucose Levels
- Cortisol is a stress hormone that is vital to survival |
|
|
Term
| What is the sequence of the HPA Axis (Hypothalamus Pituitary Adrenal Axis)...think cortisol? |
|
Definition
| Hypothalamus (Homeostatic regulator) releases Corticotropin Releasing Hormone (CRH) which stimulates the Anterior Pituitary Gland to secrete Adrenocorticotropin (ACTH) which stimulates the Adrenal Cortex to release Cortisol. |
|
|
Term
| What are endorphins responsible for? ...released in response to stress |
|
Definition
|
|
Term
| How is the Sympathetic Nervous System (SNS) affected by Stress? |
|
Definition
Stress causes the release of catecholamines from the sympathetic neurons and adrenal medulla.
- Catecholamines are "Fight or Flight" hormones. |
|
|
Term
| What are two reasons that steroids are given? |
|
Definition
| Potent anti-inflammatory and Immunosuppressant. |
|
|
Term
| What are the 4 drugs used in Glucosteroid Therapy... What are the three steroids? |
|
Definition
1. Prednisone
2. methylprednisolone (Solu-Medrol)
3. hydrocortisone (Solu-Cortef)
4. beclomethasone dipropionate (Beclovent) - MDI |
|
|
Term
| What are adverse effects of steroids? |
|
Definition
| Mood swings, Muscle atrophy, Cushingoid Appearance |
|
|
Term
| What does compliance mean? |
|
Definition
inability to inhale...lungs can't expand...air can't get in
OBSTRUCTIVE PULMONARY |
|
|
Term
| What does elastic "recoil" mean? |
|
Definition
Can't exhale...lungs can't relax...air can't get out
RESTRICTIVE PULMONARY |
|
|
Term
Which Respiratory problems are a elastic recoil problem...unable to inhale...air can't get in?
RESTRICTIVE |
|
Definition
| Pneumonia, Tuberculosis (TB), Lung Cancer |
|
|
Term
Which Respiratory problems are a compliance problem...unable to exhale...air can't get out?
OBSTRUCTIVE |
|
Definition
| Emphysema, Bronchitis, Asthma |
|
|
Term
| What are the 3 mechanisms that contribute to asthma..and asthma attack? |
|
Definition
1. Mucous
2. Bronchoconstriction
3. Inflammation |
|
|
Term
| What happens with Full remission asthma? ...Partial remission? ...and Acute attack |
|
Definition
Full - Pulmonary Function Test (PFT's) WNL
Partial - No symptoms but PFT's abnormal
Acute Attack - Chest tightness, inspiratory and expiratory wheezes |
|
|
Term
| What is the Gold Standard for Dx Asthma?... And what is the hallmark symptom for Asthma? |
|
Definition
Dx - Pulmonary Function Test (PFT's)
Hallmark Symptom - Cough (initially nonproductive) |
|
|
Term
|
Definition
Acute exacerbations of Asthma that doesnt respond to standard treatment of bronchodilators
- Silent Chest, and Can be Deadly |
|
|
Term
| What is the pathophysiology of Emphysema? |
|
Definition
| Enlargement of air spaces & destruction of lung tissue |
|
|
Term
| What is the pathophysiology of Chronic Obstructive Bronchitis? |
|
Definition
| Obstruction of small airways |
|
|
Term
| What is the hallmark of Emphysema? |
|
Definition
| Gradual increase of breathlessness particularly with exertion (Doing an activity) - Eventually SOB at rest. |
|
|
Term
| What is the cornerstone of Dx for Emphysema? |
|
Definition
|
|
Term
| What is Emphysema treated with? |
|
Definition
| Bronchodilators and Anti-inflammatory agents |
|
|
Term
| What is the distinguishing characteristic of Bronchitis? |
|
Definition
| Obstruction secondary to mucous |
|
|
Term
| What is a classic sign of Bronchitis? |
|
Definition
| Persistent productive cough |
|
|
Term
| What is the name of Right sided heart failure? |
|
Definition
|
|
Term
| What is the tx for Bronchitis? |
|
Definition
| Bronchodilators and Expectorants for mucous |
|
|
Term
| Which leads to Pink Puffers... Emphysema or Bronchitis? |
|
Definition
|
|
Term
| Which leads to Blue Bloaters... Emphysema or Bronchitis? |
|
Definition
|
|
Term
| What is the use of the Beta-agonist drug albuterol (Proventil)? |
|
Definition
1st line treatment for acute asthma attacks
Onset = Minutes |
|
|
Term
| What is the use of the Anticholinergic drugs ipratropium bromide (Atrovent) and tiotropium bromide (Spiriva)? |
|
Definition
Used prophylactically/maintenance of emphysema and bronchitis
Onset = slow and prolonged |
|
|
Term
| What is the use of the Methylxanthine: theophylline (TheoDur)? |
|
Definition
Second line treatment of Asthma, Bronchitis, and Emphysema
-Bronchodilation secondary to smooth muscle relaxation |
|
|
Term
| What is the cornerstone for long term asthma therapy? |
|
Definition
|
|
Term
| What is the major SE of Corticosteroid Therapy... and What is it's treatment? |
|
Definition
Thrush
Tx = Anti-fungal Agent |
|
|
Term
| What is the major SE of Corticosteroid Therapy... and What is it's treatment? |
|
Definition
Thrush
Tx = Anti-fungal Agent |
|
|
Term
| What do Leukotriene Modifiers do...and which respiratory problem are they used for? |
|
Definition
| Leukotrienes cause inflammation, bronchoconstrictions, and mucous production...modifiers inhibit theses actions. - Used for prophylaxis chronic asthma treatment |
|
|
Term
| What are the 2 common Leukotriene Modifier drugs? |
|
Definition
1. zafirlukast (Accolate)
2. montelukast (Singular) |
|
|
Term
| What do Mast Cell Stabilizers do.. and what respiratory problem are they used? |
|
Definition
Stop mast cells from releasing bronchoconstrictive and inflammatory enzymes.
- Used prophylactically for acute asthma attacks in chronic asthma patients |
|
|
Term
| What is the common drug of Mast Cell Stabilizers? |
|
Definition
|
|
Term
| What is the pathophysiology of Pneumonia? |
|
Definition
| Inflammation/Infection of functional part of lungs |
|
|
Term
| What are the 3 modes of transmission of Pneumonia? |
|
Definition
1. Aspiration
2. Inhalation of microorganisms
3. Spread from blood |
|
|
Term
| Is community acquired pneumonia gram + or gram -? |
|
Definition
|
|
Term
| Is hospital acquired pneumonia gram + or gram -? |
|
Definition
|
|
Term
| What is the mainstay of tx for Pneumonia? |
|
Definition
|
|
Term
| What is the pathophysiology of Lung Cancer? |
|
Definition
| A malignant tumor in lower respiratory tract |
|
|
Term
| How many days does it take Small Cell Lung Cancer (SCLC) to double? |
|
Definition
|
|
Term
| How many days does it take Non-Small Cell Lung Cancer (NSCLC) to double? |
|
Definition
|
|
Term
| What is pleural effusion? |
|
Definition
| Abnormal accumulation of fluid in pleural spaces |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Process by which cancer spreads from the place it first arose as a primary tumor to a distant location in the body |
|
|
Term
| What are the 2 Anti-histamines? |
|
Definition
1. diphenhydramine (Benadryl) - Highly Sedating
2. loratadine (Claritin) Non-Sedating |
|
|
Term
| What are the 2 Decongestants... PO and Topical/Nasal Spray? |
|
Definition
1. pseudoephedrine PE (Sudafed PE) PO
2. (Afrin) Topical/Nasal Spray |
|
|
Term
| What is the Anti-Tussive... suppresses cough? |
|
Definition
| dextromethorphan DM (Sudafed DM) |
|
|
Term
| What is the Expectorant drug... thins out excessive secretions? |
|
Definition
|
|
Term
| What is the mainstay Tx of Tuberculosis (TB)? |
|
Definition
|
|
Term
| What is Tuberculosis (TB)? |
|
Definition
| An infection of Mycobacterium |
|
|
Term
| What are the other 4 drugs other than isoniazid (INH) that are used to treat Tuberculosis (TB) inhibiting protein synthesis... And what do you need to monitor with these drugs? |
|
Definition
1. rifampin (Rifadin)
2. pyrazinamide (PZA)
3. ethambutol (Myambutol)
4. Streptomycin
- Monitor LFT's |
|
|
Term
| What are the steps to a blood clot formation? |
|
Definition
| Injured vessels activate the coagulation cascade, which causes release of clotting factor. The clotting factor comes in contact with collagen from damaged vessel. Initiates platelet aggregation and platelet adhesion which makes platelets sticky. |
|
|
Term
| What do Anti-platelets do? |
|
Definition
| Inhibit platelet aggregtion |
|
|
Term
| What are the 2 Antiplatelets.. And what do they do? |
|
Definition
1. Aspirin (ASA) - Prevent formation of Thromboxane A2
2. Plavix - Blocks ADP receptors |
|
|
Term
| What do anticouglants do? |
|
Definition
| prevent clot formation prophylactically |
|
|
Term
| What are the 3 Anticoagulants PO and IV? |
|
Definition
1. Coumadin
2. Heparin
3. Lovenox |
|
|
Term
|
Definition
| Interferes with vitamin K dependent clotting factors |
|
|
Term
| What labs do you need to monitor with Coumadin and What is the antidote? |
|
Definition
Monitor PT/INR
Antidote: Vit. K |
|
|
Term
| What does heparin prevent besides clots? |
|
Definition
|
|
Term
| What is the antidote for Heparin and Lovenox? |
|
Definition
|
|
Term
| What do Thrombolytic/fibrinoltic Agents do? |
|
Definition
|
|
Term
| What is the Thrombolytic/fibrinoltic Agent.. and what is it's antidote? |
|
Definition
stretokinase (Streptase)
Antidote: Amicar |
|
|
Term
|
Definition
| Prevents the lysis of fibrin, promoting clot formation and restoring hemostasis |
|
|
Term
| Which statin inhibits HMG - CoA reductase enzyme (which inhibits cholesterol production? |
|
Definition
Lipitor
- Monitor LFT's
- Causes Muscle and Liver problems |
|
|
Term
| what does cholestyramine (Questran) do? |
|
Definition
| Inhibits lipolysis (break down of lipids) and decreases subsequent hepatic fatty acid uptake |
|
|
Term
| What does fenofibrate (Tricor) do? |
|
Definition
| Treats Cholesterol and high Triglycerides by making liver produce less triglycerides and destroys already made triglycerides |
|
|
Term
| Which Diuretic is the 1st line treatment of HTN? |
|
Definition
|
|
Term
| Which loop diuretic works on loop of henley and treats CHF? |
|
Definition
|
|
Term
| What do you have to monitor with Diuretics? |
|
Definition
|
|
Term
| What is the name of the group of drugs that decrease BP by decreasing PVR? |
|
Definition
|
|
Term
| What is the Beta-Adrenergic Blocker? (Block stimulation of bet1 receptors, reduces HR and contractility |
|
Definition
|
|
Term
| What is the Central Acting Alpha2 Agonists? (Stimulates CNS alpha-adrenergic receptors, Produces decreased sympathetic outflow) |
|
Definition
|
|
Term
| What is the Calcium Channel Blocker? (Works on smooth muscles by decreasing ability for muscle to contract --> decreases HR and contractability |
|
Definition
|
|
Term
| What is the Calcium Channel Blocker? (Works on smooth muscles by decreasing ability for muscle to contract --> decreases HR and contractability |
|
Definition
|
|
Term
| What do you have to monitor with all Beta-Blockers? |
|
Definition
HR and BP
- Hold Med if SBP less than 100 or HR less than 60 |
|
|
Term
| What are the 2 Antihypertensive drugs that are ACE Inhibitors? (Block Angiotensin enzyme from converting angiotensin 1 to angiotensin 2) |
|
Definition
1. captopril (Capoten)
2. cozaar (Losartan) |
|
|
Term
| What are the 3 common areas in the brain for a stroke? |
|
Definition
1. Middle Cerebral Artery
2. Basilar Artery
3. Posterior Cerebral Artery |
|
|
Term
| What happens in Right Sided CVA? |
|
Definition
Left paralyzed
Spacial perceptual deficits
Quick Impulsive Behavior
Memory Deficits |
|
|
Term
| What happens in Left Sided CVA? |
|
Definition
Right Paralyzed
Speech/Language Deficits
Slow, Cautious, Behavior
Memory Deficit |
|
|
Term
| What does a CT show in stroke patients? |
|
Definition
| Shows hemorrhage or large infarct (Does not pick up new ischemic Damage |
|
|
Term
| What is a MRI best for in stroke patients? |
|
Definition
| Best for new ischemic problems or small infarcts |
|
|
Term
| What do the P-waves, R-waves, and T-waves show in the heart on and EKG? |
|
Definition
P-waves: (S1 or Lubb) atrial contraction
R-waves: (QRS) ventricular contraction
T-waves: Heart Relaxing |
|
|
Term
| How are small vessel (Lacunar) strokes diagnosed because they are too small for a CT? |
|
Definition
|
|
Term
| Which locates the exact site of an abnormality - and involves contrast dye? ...CT, MRI, or Angiography |
|
Definition
| Angiography -locates the exact site of an abnormality - and involves contrast dye |
|
|
Term
| Do Large Diameter nerve fibers cause gate to open or close? |
|
Definition
|
|
Term
| Do Small Diameter nerve fibers cause gate to open or close? |
|
Definition
|
|
Term
| What are the 2 Large diameter nerve fibers? |
|
Definition
|
|
Term
| What are the 2 Small diameter nerve fibers? ...Which is Myelinated causing fast pain and which is Un-myelinated causing slow pain? |
|
Definition
1. A Delta (myleniated)
2. C Fibers (un-mylenated) |
|
|
Term
| What are the 3 cortexes in the Thalamus for pain and what do they do? |
|
Definition
Sematosensory Cortex - Evaluates intensity/location of pain
Associate Cortex - Involves emotion, perception and meaning
Limbic Cortex - Involves emotion |
|
|
Term
| To decrease pain, what nerve fibers should you stimulate through touch? |
|
Definition
| A alpha and A beta to close gate (Large Nerve Fibers) |
|
|
Term
| What is a ceiling effect? |
|
Definition
| where increased doses dont result in an increased pain relief but instead increased side effects |
|
|
Term
| What is the Gold standard drug of choice for severe pain? |
|
Definition
|
|
Term
| What is the antidote for morphine? |
|
Definition
|
|
Term
| Which pain drug is a synthetic opioid, Schedule 2, weaker than morphine and a shorter duration of action? |
|
Definition
|
|
Term
| Which pain drug is derived from opium and is effective aginst mild to moderate pain, has a ceiling effect (PO) and is a analgesic at 30 mg and a anti-tussive at 10 mg? |
|
Definition
|
|
Term
| Which pain drug is the #1 drug used on the street and medsurg floors, semi-synthetic derivative of codeine but more potent, and is a Schedule 2 drug and PO only? |
|
Definition
|
|
Term
| What is Oxycodone + Acetominophen? |
|
Definition
|
|
Term
| What is Oxycodone + Aspirin (ASA)? |
|
Definition
|
|
Term
| What is the time released Oxycodone called? |
|
Definition
|
|
Term
| What is the pain drug that is a synthetic opiod for moderate to severe chronic pain, schedule 2, is a pure opiod agonist and comes in transdermal patches and lozenges? |
|
Definition
|
|
Term
| What are the 2 Non-Opiod Analgesics? |
|
Definition
1. Tylenol
2. Aspirin (ASA) |
|
|
Term
| What type of pain is tylenol used for and what is its antidote? |
|
Definition
mild to moderate pain
Antidote= Mucomyst |
|
|
Term
| What is the onset...peak...duration for rapid acting insulin? what are the rapid acting insulins? |
|
Definition
Onset 0-15 minutes
Peak 1 hour
duration 3 hours
- Humalog and Novolog |
|
|
Term
| What is the onset...peak...duration for short acting insulin? what are the short acting insulins? |
|
Definition
onset 30 - 60 min.
peak 2 -3 hrs.
duration 4-6 hrs.
- Regular insulin |
|
|
Term
| What is the onset...peak...duration for intermediate acting insulin? what are the intermediate acting insulins? |
|
Definition
onset 1 - 2.5 hrs
peak 6 - 12 hrs
duration 18- 24 hrs
- Humilin N and Novolin N |
|
|
Term
| What is the onset and duration for Long acting insulin? what are the Long acting insulins? |
|
Definition
Onset 2 -4 hours
Duration 24 hours
- Lantus and Levemir |
|
|
