Pharm Exam 3

I recommend not randomizing the cards unless you know the information

Name the synthetic drug that mimics growth hormone (made by recombinant technology) indicated in the treatment of growth failure in adults and children

Name the synthetic drug that mimics growth hormone (made by recombinant technology) indicated in the treatment of growth failure in adults and children

Somatropin

_________ is contraindicated in patients with hypersensitivity to any component of the product and in children with closed growth plates, patients with tumors, and acute illnesses.

Somatropin

Adverse effects that Somatropin may cause include headache, injection site reactions, muscle pain, ___________ or _____________. It is important not to shake the product and is given SUBQ and IM.

Hypoglycemia, hyperglycemia

________ promotes growth by stimulating various anabolic (tissue-building) processes, liver glycogenolysis (raise glucose levels), lipid mobilization from body fat stores, and retention of sodium, potassium, and phosphorus. Also promotes linear growth in children who lack normal amounts of endogenous hormones.

Somatropin

Nursing considerations for Somatropin include?

Monitor levels of thyroid hormones and growth hormone (also include vital signs, intake and outtake, weight)

What synthetic med is the treatment of hypo-pituitary dwarfism?

Somatropin

________ and _______ is used to prevent or control polydipsia (excessive thirst), polyuria, and dehydration in patients with diabetes caused by a deficiency of endogenous ADH

Vasopressin, desmopressin (DDAVP)

_______ is used to control various types of bleeding (in particular GI hemorrhage) and in pulse less arrest and vasodilators shock. Pregnancy category C ; caution in patients who have seizures, asthma, cardiovascular disease, and renal disease.

Vasopressin

________ is useful in the treatment of hemophilia A and Type-I Von Willbrand disease due to its effects on various blood clotting factors.

Desmopressin

Somatropin should be especially monitored in _____________________.

Children

What are two lab levels we need to monitor in patients taking somatropin?

thyroid hormones, growth hormone

What are the adverse effects of somatropin?

headache, muscle pain, altered blood glucose levels

Name the side effects of Somatropin.

Hyperglycemia, Hypoglycemia, pancreatitis

Vasopressin suppresses all the ___________.

urine

What are two physical traits that should be monitored for Somatropin?

Height, weight

You need to stop Somatropin prior to _________________?

epiphyseal closure

What do you need to monitor for patients taking vasopressin?

decrease in urine output, urine osmolarity

What are the adverse effects of vasopressin?

increased BP, fever, headache

You should never ___________ vasopressin!

inhale

Vasopressin is available as a nasal spray or injection for which two routes?

IM, IV

Vasopressin nasal spray is applied _____________to nasal membranes and must not be inhaled!

topically

Desmopressin can also be given by nasal route and is available as DDAVP Rhinal Tube and has an _________________ effect that is about one-tenth that of an equivalent dose given intravenously (IV).

antidiuretic

For vasopressin, it has a rapid onset and its peak plasma concentration starts at ____ hour.

1

For Somatropin, its peak plasma concentration starts at ___ hour.

2-6

For _______, if vasopressin is being used, close monitoring in an intensive care setting is needed with ECG, vital signs, and invasive monitoring methods like arterial lines, central venous pressure lines, and/or arterial blood gases.

shock

Drugs that mimic the action of endogenous pituitary hormones include?

cosyntropin, somatropin, vasopressin, desmopressin

A drug that antagonizes the actions of endogenous pituitary hormones (or cosyntropin, somatropin, vasopressin, desmopressin) is ____________?

octreotide

Intravenous (IV) corticotropin has been replaced by ______________ (Cortrosyn).

cosyntropin

_____________ travels to the adrenal cortex, located just above the kidney, and stimulates the secretion of cortisol (the drug form of hydrocortisone).

Cosyntropin

Cortisol (Hydrocortisone), secreted by Cosyntropin, has many _____________________, including reduction of inflammatory leukocyte functions and scar tissue formation

anti-inflammatory

Cortisol, secreted by Cosyntropin, also negatively promotes __________ of sodium, which results in edema and hypertension (this isn’t a good thing).

renal retention

_______________is used in the diagnosis and treatment of adrenocortical insufficiency***.

Cosyntropin

The side effects of Cosyntropin include ?

Bradycardia, Tachycardia, Hypertension

What lab levels would you monitor in patients taking Cosyntropin?

Cortisol levels

What is an adverse reaction of Cosyntropin?

electrolyte loss

Another term for when large amounts of diluted urine is peed out? (Basically, the body is making too much urine)

Diabetes insipidus

Name the 3 types of hypothyroidism.

primary, secondary, tertiary

____________ hypothyroidism stems from abnormality in the thyroid gland itself, when the thyroid gland is not able to perform one of its many functions like releasing the thyroid hormones from their storage sites, coupling iodine with tyrosine, trapping iodide, converting iodide to iodine, or any combination of these defects.

Primary

Which of the three types of hypothyroidism is the most common?

primary

_________ hypothyroidism begins at the level of the pituitary gland and results from reduced secretion of Thyroid Stimulating Hormone or TSH.

Secondary

TSH is needed to trigger the releasee of the ____ and ____ stored in the thyroid gland.

T3, T4

__________ hypothyroidism is caused by a reduced level of the thyrotropin-releasing hormone from teh hypothalamus. This ends up reducing TSH and thyroid-hormone levels.

Tertiary

Symptoms of hypothyroidism include?

cold intolerance, weight gain, depression, dry brittle hair and nails, fatigue, constipation, elevated cholesterol

What is the term for “not producing enough thyroid hormones”?

Hypothyroidism

Hyposecretion (not enough) of thyroid hormone in youth may lead to what condition?

Cretinism (severely stunted mental and physical growth due to deficiency of thyroid hormones)

Hyposecretion of thyroid hormone as an adult may lead to what condition?

myxedema (decreased of metabolic rate, loss of mental/physical stamina,

weight gain, firm edema, yellow dullness of skin)

What is the most common drug that causes hyperthyroidism?

amiodarone

Some forms of hypothyroidism may result in the formation of a ___________, which is enlargement of the thyroid gland result from overstimulation by elevated levels of TSH.

goiter

What is the term for “producing too much thyroid hormones”?

Hyperthyroidism

The side effects for Hyperthyroidism include?

Tachycardia, weight loss, diarrhea, always feeling hot, clubbing, bulging eyes, flushing, palpitations, sleep disorder

Hyperthyroidism include what two diseases?

Graves’ disease (Most common), Plummer’s disease (Least common)

_____________ is a severe and potentially life-threatening exacerbation of the symptoms of hyperthyroidism that is induced by stress or infection.

Thyroid storm

What does the thyroid do??? (Thyroid gland lies across the larynx in front of the thyroid cartilage which is also the Adam’s Apple)

creates hormones that regulate metabolism (T4 and T3, calcitonin), growth, and development

What do the parathyroid glands do??? (two pairs of bean-shaped glands behind the thyroid gland)

maintains calcium levels and mobilizes calcium from bones

Thyroid also regulates 2 more things? (*There are 5 in total)

lipid and carbohydrate

Levothyroxine is used to treat _____________?

hypothyroidism

Therapeutic response of using levothyroxine for hypothyroidism would be?

Normal HR (60-100), no fatigue, normal skin (not cool or pale, just normal)

How long does it take for levothyroxine to take effect?

8 weeks

Is levothyroxine safe during pregnancy?

Yes (Category A)

**** When do you take levothyroxine?

In the Morning BEFORE meals at the same time each day

Is levothyroxine an acute or chronic therapy for hypothyroidism?

chronic

Toxicity of levothyroxine includes?

weight loss, Tachycardia, nervousness, irritability, palpitations

Due to the prolonged half-life of this medication, there is an increased risk for toxicity. What is the drug?

Levothyroxine

Methimazole (also called Topzole), treats what condition?

hyperthyroidism

Adverse reactions of methimazole (topzole) would be?

Agranulocytosis (low neutrophils), Hepatitis (monitor liver values)

How does it take for Methimazole (Topzole) to work ?

1-2 weeks

Is it okay to abruptly stop taking Methimazole (Topzole)?

NO

When should you take Methimazole?

In Morning before meals

Methimazole can also cause _________ bones.

weak

_______________ is a medicine that reduces the amount of acid produced in the stomach, preventing stomach ulcers, heartburn, acid reflux, and Zollinger-Ellison syndrome.

Methimazole

Propylthiouracil or PTU drug is classed as a pregnancy type ____ drug (high fetal risk), however, it is used in the first trimester.

D

How long till symptoms improve when using Propylthiouracil (PTU)?

2 weeks

Methimazole and ________ act by inhibiting the incorporation of iodine molecules into the amino acid tyrosine (T3 and T4); this impedes the formation of thyroid hormone (Treating Hyperthyroidism).

PTU (Propylthiouracil)

Symptoms of Hypokalemia include?

Hypotension, muscle weakness, Paralytic ileus, lethargy, increase in urine

PPI or Proton pump inhibitors all end with what suffix?

-prazole

Side effects of PPI’s would be?

Headache, nausea, abdominal pain

Adverse reactions of PPI’s ?

Osteoporosis, blocks acid secretion (H2-blocker)

When to take PPI’s?

30 minutes before first meal of day (usually in morning)

You should take PPI’s with what two other essentials? ******

calcium and Vitamin D

PPI drugs also helps prevent development of _________ due to surgery *****

ulcers

PPIs bind directly to the __________________________ mechanism and irreversibly inhibit the action of this enzyme resulting in total blockage of hydrogen ion secretions from the parietal cells.

hydrogen-potassium-ATPase pump

______________, in relation to PPIs, can cause complications such as bacterial overgrowth, intestinal metaplasia, and hip fracture. However, food absorption is not affected.

Achlorhydria

All of the PPI drugs can be used in combination with antibiotics to treat patients with ________________.

H. pylori infections

PPI’s increase levels of phenytoin and diazepam. There may be an increased chance of bleeding in patients who are taking both a PPI and warfarin. PPI’s also interact with the absorption of ___________.

digoxin

Food and ___________ may delay the absorption of PPIs.

Sucralfate

H2 receptors, also referred to as H2 blockers, have a long or short lasting relief?

long

H2 Receptors usually end in what suffix?

-tidine

H2 receptors blocks ___________ in the stomach

acid secretion

Side effects of H2 Receptors include ??

stomach Infx (Acid helps fight Infx, but this medication blocks acid secretion)

When to take an H2 Receptor drug?

30 mins before meals

H2 receptors can treat 2 main conditions?

ulcers, GERD

H2 receptor drugs interact with what two medications?

diazepam, phenytoin

Antacids neutralize the stomach _______, not long lasting.

quickly

What are the 4 nonprescription salts that have been used in acid-related disorders and are antacids? (HINT: SCAM)

sodium bicarbonate, calcium, aluminum, magnesium

Those with heart failure and hypertension should not take ________ with high sodium content (I.E Sodium bicarbonate***) (SCAM**)

Antacids

Antacids containing magnesium should be avoided in patients with ____________.

renal failure

Side effects or adverse reactions of using antacids containing calcium would be?

Constipation, kidney stones, hypercalcemia, nausea, alkalosis, headache

Antacids containing Aluminum hydroxide has the main side effect or adverse reaction of ______________?

Constipation

When to take antacids containing Aluminum OR Magnesium?

Take 1 hour after meals, 3 hours after, and at bedtime (NEVER with meals or other meds)

Antacids containing magnesium will have what side effects?

upset stomach, diarrhea