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866 Final Exam
866 Final Exam
113
Nursing
Undergraduate 3
12/14/2010

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Cards

Term
Which Schedule of drugs are the most abused and not prescribed?
Definition
Schedule 1
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
Pain perception
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
What is Asthmaticus?
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
PFT's
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
Cor Pulmonale
Term
What is the tx for Bronchitis?
Definition
Bronchodilators and Expectorants for mucous
Term
Which leads to Pink Puffers... Emphysema or Bronchitis?
Definition
Emphysema
Term
Which leads to Blue Bloaters... Emphysema or Bronchitis?
Definition
Bronchitis
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
Corticosteroid Treatment
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
cromolyn (Intal)
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
Gram +
Term
Is hospital acquired pneumonia gram + or gram -?
Definition
Gram -
Term
What is the mainstay of tx for Pneumonia?
Definition
Antibiotics
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
Doubles every 33 days
Term
How many days does it take Non-Small Cell Lung Cancer (NSCLC) to double?
Definition
Doubles every 100 days
Term
What is pleural effusion?
Definition
Abnormal accumulation of fluid in pleural spaces
Term
What is Cytology?
Definition
Study of cells
Term
What is Metastasis?
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
guaifenesin (Robitussin)
Term
What is the mainstay Tx of Tuberculosis (TB)?
Definition
isoniazid (INH)
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
What does Coumadin do?
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
Pulmonary Embolous
Term
What is the antidote for Heparin and Lovenox?
Definition
Protamine Sulfate
Term
What do Thrombolytic/fibrinoltic Agents do?
Definition
Dissolve clots
Term
What is the Thrombolytic/fibrinoltic Agent.. and what is it's antidote?
Definition
stretokinase (Streptase)
Antidote: Amicar
Term
What does Amicar do?
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
HCTZ
Term
Which loop diuretic works on loop of henley and treats CHF?
Definition
Lasix
Term
What do you have to monitor with Diuretics?
Definition
K+ Levels
Term
What is the name of the group of drugs that decrease BP by decreasing PVR?
Definition
Beta-Blockers
Term
What is the Beta-Adrenergic Blocker? (Block stimulation of bet1 receptors, reduces HR and contractility
Definition
metoprolol (Lopressor)
Term
What is the Central Acting Alpha2 Agonists? (Stimulates CNS alpha-adrenergic receptors, Produces decreased sympathetic outflow)
Definition
methyldopa (Aldomet)
Term
What is the Calcium Channel Blocker? (Works on smooth muscles by decreasing ability for muscle to contract --> decreases HR and contractability
Definition
cardizem (Diltiazem)
Term
What is the Calcium Channel Blocker? (Works on smooth muscles by decreasing ability for muscle to contract --> decreases HR and contractability
Definition
cardizem (Diltiazem)
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
Dx by Symphomatology
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
Close
Term
Do Small Diameter nerve fibers cause gate to open or close?
Definition
Open
Term
What are the 2 Large diameter nerve fibers?
Definition
1. A Alpha
2. A Beta
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
Morphine
Term
What is the antidote for morphine?
Definition
Narcan
Term
Which pain drug is a synthetic opioid, Schedule 2, weaker than morphine and a shorter duration of action?
Definition
Demerol
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
Codeine
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
Oxycodone
Term
What is Oxycodone + Acetominophen?
Definition
Percocet
Term
What is Oxycodone + Aspirin (ASA)?
Definition
Percodan
Term
What is the time released Oxycodone called?
Definition
Oxycontin
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
fentanyl (Duragesic)
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
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