PMCOL 233 Midterm 2

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276 Terms

1

hypochromic anemia

chronic blood loss

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2

megaloblastic anemia

vit b12 or folic acid deficiency (large cells)

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3

pernicious anemia

fewer cells bc of IF deficiency

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4

hematinic agents

iron, folic acid, B12

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5

hematopoietic GF

EPO, gcsf, gmcsf, magakaryocyte,

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6

iron absorption

ferric iron ingested, ferrous iron absorbed

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7

iron formualtions (oral)

ferrous sulfate, ferrous fumarate, ferrous gluconate, polysaccharie iron complex

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8

iron formualtions IV

iron dextran, sodium ferric gluconate, iron sucrose

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9

iron in body

RBC contain majority of iron in Hb

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10

iron side effects

GI distrubances, toxic effects

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11

iron chelators usage

for iron toxicity

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12

iron chelators examples

desferrioxamine, deferiprone, deferasirox

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13

desferrioxamine

forms complex to excrete in urine

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14

deferiprone

orally absorbed alternative to desferrioxamine

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15

deferasirox

alternative but GI bleeding

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16

folic acid mechanism

reduction of folic acid to FH4 and FH2 (FH4 for DNA synthesis)

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17

B12 mechanism

converts methyl FH4 to FH4

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18

EPO

stimulate RBC production

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19

EPO mechanism

released in response to hypoxia form kidneys (10% liver) and inhbits apoptosis to prevent early cell death AND proliferation thru JAK2

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20

EPO side effects

iron deficiency (cant keep up so RBC draw iron from blood), thrombosis (dialysis patients need anticoagulant), hypertension (increased hematocrit and AT2), seizures

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21

aldosterone effect

increases Na reabsorption in kidney and excretes K+

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22

aldosterone triggers

low Na+ increase AT II

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23

loop diuretics examples

furosemide, bumetanide

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24

loop diuretic mechansm

inhibit NA/K/2Cl carrier so Na+ not reabsorbed and 2Cl and K+ pee out

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25

loop diuretics adverse effects

excessive loss, hypovolemia, hypoklemia, alkalosis, hypomagnesaemia, hyperuricemia, reduced renal perfusion, hearing loss, rashes, bone marrow depression, contraindicated w sulfa allergy

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26

thiazides examples

bendroflumethiazide, hydrochlorothiazide

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27

diuretic purpose purpose

edema, heart failure, cirrhosis, nephrotic syndrome, renal failure, hypertension

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28

thiazide purpose

hypertension, mild heart failure, resistant edema, diabetes insipidus, hypertension

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29

thiazide mechanism

bind Cl site of NA/Cl co transporter to stimulate natriuresis and stimulate renin secretion also reduce Ca excretion

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30

thiazide adverse ffects

erectile dysfunction, hypochloremic alkalosis, impaured glucose intolerance, hyponatremia, hypokalemia, rashes

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31

aldosterone antagonists examples

sprionolactone, eplernone

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32

aldosterone antagonist purpose

resistant hypertension, heart failure, hyperaldosteronism, secondary aldosteronism

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33

aldosterone antagonist mechanism

compete w aldosterone to inhibit Na retention and K secretion

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34

aldosterone antagonist adverse effects

hyperkalemia, GI upset, gynecomastia, menstrual disorders, testicular atrophy

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35

triamterene/amiloride

prevent hypokalemia, inhibit Na reabsorption,

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36

triamterene/amiloride adverse effects

hyperkalemia, GI upset

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37

osmotic diuretics

only water excretion

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38

osmotic diuretics adverse effects

risk for precipitating left ventricular fialure, headache, nausea, vomiting

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39

electrolyte disorders

important in renal failure; hypoerphosphatemia; hyperkalemia

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40

antihypertensive for renal failure

ACE inhibitors and ARBs; reduce risk for major CV events

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41

vit D analogues for renal failure (FYI)

used to manage secondary hyperPTH

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42

diuretics in renal failure

treat edema; lower tendenct to develoop hyperkalemia; decrease blood pressure

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43

potassium sparing diuretics in renal failure

should be used cautiously, hyperkalemia associated with heart failure

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44

renal failure and epoeitin

often have impraied EPO levels and anemia; need treatment

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45

hyperphosphatemia

increased blood phosphate levels

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46

chronic kidney disease hyperphosphatemia

hallmark, big risk of CV disease

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47

hyperkalemia

high blood potassium levels; more severe than phosphatemia

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48

medications inducing hyperkalemia

K+ sparing diuretics, NSAIDs, ACE inhibitors

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49

phosphate binding agents

prevent absorption by forming insoluble complexes in GI tract

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50

aluminum hydroxide

bind phosphate in GI

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51

aluminum hydroxide adverse effects

increase Al levels in dialysis patients (toxic)

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52

calcium carbonate

binds phosphate in GI tract

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53

calcium carbonate effects

increase calcium levels: helps hypocalcemia in CKD but may cause calcification

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54

sevelamer hydrochloride

non calcium based phosphate binder; anion exhcange resin

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55

sevelamer hydrochloride effects

less likely to lead to tissue calcification, lowers LDL cholestrol, GI disturbances, affects fat soluble vitamin absorption, dont use in hypophsophatemia or bowel obstruction

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56

how to treat hyperkalemia

cation exchange resin to bind potassium in colon

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57

sodium or calcium polystyrene sulfonate

binds K in colon in exhcange for Na or Ca

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58

sodium or calcium polystyrene sulfonate and sorbitol effects

increased risk for GI, bleeding, ischemic cholitis, perfroation, constipation

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59

glucose + insulin mechanism

insulin activates Na/K ATPase to move K into cells

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60

salbutamol

B2 agonist linked to Na/K ATPase - causes K uptake into cells

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61

desmopressin

vasopressin analogue for nocturnal enuresis in kids

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62

desmopressin mechanism

acts on V1 V2 receptors to faciliate water reabsopriton

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63

desmopressin adverse effects

water intoxication (hyponatremia)

hypotension when low cardiac output

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64

anticholinergics for incontinence

mAChR antagonists to prevent contraction s

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65

M3 selective antagonists

darifenacin, solifenacin

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66

nonselective mAChR antagonists

oxybutinin, tolterodine

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67

mirabegron

B3 agonist

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68

mirabegron mechanism

B3 agonist in detrusor smooth muscle to induce relaxation and increase bladder capacity

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69

mirabegron adverse effects

BP, bladder pain, dry mouth, headache, dizzy, less UTI likelihood

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70

2 types hormonal contraceptives

combined pill, progestogen only

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71

combined pill

ethinyletradiol + progestogen

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72

2nd gen progestogens (3)

noresthisterone, levonorgestrel, ethynodiol

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73

3rd gen progestogen (2)

desogestrel, gestodene

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74

combined pill mechanism

estrogen inhbits FSH to suppress follicular deveoopment, and progestogen inhbits LH to prevent ovulation; discourages implantation

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75

combined pill adverse effects

nausea, tender breasts, flushing, breakthru bleeding, dizzy, depression, acne, weight gain, thromboembolism

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76

combined pill benefits

reduce ovarian/ endometrial cancer risk, decreased menstrual symptoms, reduced iron deficient anemia

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77

progestogen only pill

taken daily no breaks for people who experience complications from estrogen

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78

progestogen only pill mechanism

makes cervical mucus inhospitable to sperm, inhbits implantation, and alters motility/secretions of fallopian tubes

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79

progestogen only pill adverse effects

irregular bleeding, less reliable,

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80

emergency contraception effects

nausea and vomiting

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81

levonorgestrel

emergency contraception

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82

long acting progestogen only

depot medroxyprogestogen IM

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83

oxytocin

nonapeptide to promote contraction- receptor expression induced by estrogen

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84

oxytocin mechanism

Gq GPCR yo increase Ca2+ to activate calmodulin and stimulate MLCK

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85

oxytocin adverse effects

hypotensio/ reflex tachycardia, sustained contractions reducing blood flow and O2 delivery leading to fetal death/distress, uterine rupture, antidiuretic effects

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86

ergometrine

only works onrelaxed uterus to cause contraction

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87

ergometrin emechanism

a- adrenoreceptors and also 5HT receptors

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88

ergometrine adverse effects

vomiting by activating D2 receptors in CTZ, vasoconstriction and increased blood pressure

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89

mifepristone

induce medical abortion when followed by prostaglandin

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90

mifepristone mechanism

antiprogestogen; compettiive anatagonist to sensitize uterus to prostaglandins

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91

prostaglandins mechanism

analogs to induce myometrial contraction

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92

dinoprostone, gemeprost

prostaglandin E2 analog

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93

carboprost

prostaglandin F2a analog

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94

atosiban

inhibit uterine motility (delay labour)

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95

atosiban mechanism

competitive antagonist of oxytocin receptor; decrease IP3 decrease Ca prevent MLCK activation

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96

treat infertitlity examples

clomiphene, gonadorelin, follitropin, lutropin

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97

GnRH

buserelin, leuprorelin, goserelin, nafarelin

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98

clomiphene mechanism

estrogen antagonist to promote gonadotropin release by inhibiting estrogen affects; promotes FSH secretion

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99

infertility drugs adverse effects

flushing, vaginal dryness, bone loss

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100

clomiphene adverse effect

reversible ovarian enlargement

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