PHARM 2 EXAM 4 FINAL REVIEW!!!.docx

PHARM 2 EXAM 4 REVIEW

Propylthiouracil (PTU)-

This drug is used for hyperthyroidism, Grave’s Disease. If working properly, you will see decreased anxiety and return to normal heart rate, decreased insomnia, and tremors. Adverse effect is liver dysfunction and agranulocytosis. If working, TSH levels will increase and T4 will decrease. Monitor: AST/ALT. Notify physician of sore throat, fever.

Metformin-

This is the preferred oral treatment for diabetes type 2. Adverse effect is GI, nausea, diarrhea, upset stomach. Take it with meals to prevent that. Works in the liver, taken with alcohol can cause lactic acidosis. It is a biguanide, and you do not take it 48 hours prior to or after dye. Monitor: your kidneys bc hard on the kidneys

Calcitonin-

Decreases calcium by inhibiting bone reabsorption

Lugol’s Solution-

Type of iodine used to treat thyroid storm, inhibits the release of thyroid hormones from the thyroid gland decreasing the amount of thyroid hormone in circulation.

Glimepiride-

This is an oral anti diabetic, it is a sulfonylurea used to manage type 2 diabetes by stimulating the pancreas to release more insulin, hoping to lower the blood glucose levels.

Desmopressin-

Synthetic form of ADH used to treat diabetes insipidus, reduces excessive urine output by increasing water reabsorption in the kidneys leading to concentrated urine. A thirst would indicate that it is being effective. Available as oral, intranasal, sublingual, SubQ, and IV push.

Dulaglutide-

This is a once weekly GLP1 receptor agonist used to manage type 2 diabetes. It is administered subQ any time of the day with or without food just take it on the same day each week. Nausea and decreased appetite are common especially during the first 2 weeks of therapy.

Filgrastim-

Colony stimulating factor used to stimulate bone marrow to produce white blood cells especially the neutrophils. It is given SubQ at least 24 hours after chemotherapy. It can cause splenic rupture. Inspect for particles or discoloration. You must assess the absolute neutrophil count and white blood cells before administering.

Cyanocobalamin-

Used for pernicious anemia caused by B-12 deficiency. This is your B-12 replacement. Give SubQ or IM preferably use the Z- Track method because it needs to be deep IM. Life long replacement.

Methotrexate-

Common prescribed for certain cancers. Ulcerative colitis, psoriasis, rheumatoid arthritis. It inhibits DNA synthesis in cell replication. Reduces inflammation and suppresses the immune system. Monitor LFT, pulmonary, CBC, seizures, skin assessment, assess renal function. Educate on the side effects. Can give it IM. Also used for ectopic pregnancies.

Negative Feedback-

Process by which body regulates hormone levels

Cosyntropin-

Synthetic form of ACTH used in the ACTH stimulation test to diagnose adrenal cortical insufficiency. Helps assess adrenal glands ability to produce cortisol in response to stimulation. Always obtain baseline cortisol level before administering.

Methimazole-

Anti-thyroid medication used to treat hyperthyroidism. Adverse effects are agranulocytosis and liver toxicity. Monitor White Blood Cells.

Ferrous Sulfate-

Take months for storage to replenish and symptoms to improve. Constipation is a common adverse effect so we tell them fluids and fiber and if that doesn’t help use stool softener. Take one hour prior or two hours after meals. Take on an empty stomach or with vitamin C to enhance absorption. Calcium impairs absorption, no antacids. It treats iron deficiency anemia.

Cortisol-

Glucocorticoid hormone that helps regulate the body’s response to stress, metabolism, immune function and inflammation.

Regular Insulin-

Often administered using a sliding scale. Can be given SubQ or IV.

Vitamin D-

Essential for the body to absorb and use calcium effectively. Helps the intestines to absorb calcium from food and supplements.

Levothyroxine-

For hypothyroidism, Hashimoto’s. Monitor levels. Take on an empty stomach 30-60 minutes prior to breakfast. Lifelong medication. BBW do not take for weight loss.

Aspart-

Short acting insulin. 10-15 minutes. Need breakfast.

Ketocanazole-

Anti fungal medication that inhibits cortisol production. It is used to treat Cushing’s disease, especially in cases where surgery or radiation is not immediately feasible. HTN and a Buffalo hump are common chronicle manifestations of Cushing’s. Requires acidic gastric environment for proper absorption. Do not take with PPI’s (Proton Pump Inhibitors). Risk of hepatotoxicity.

Radioactive I-131-

Used to treat hyperthyroidism. Used after thyroid cancer. Works by targeting and destroying thyroid tissue. Helps reduce excessive thyroid hormone production. Can be used to prepare for surgery. Safety precautions are avoid close contact to other people, sleep in separate beds, use separate utensils, if anything spills on floor you have to report it.

Glycogen-

This is a polysaccharide that stores glucose in the liver and muscles which can be converted back to glucose when the body needs energy.

Dapagliflozin-

This is an oral anti diabetic. An SGLT2 inhibitor used to manage type 2 diabetes by helping the kidneys remove glucose from the blood stream increasing glucose secretion in the urine. Can cause dehydration. Do NOT take with alcohol. And it can cause you to become dizzy and dry mouth.

Parathyroid Hormone (PTH)-

Increases calcium by stimulating bone reabsorption.

Glipizide-

Stimulates insulin release and should be taken with or shortly before meals to prevent hypoglycemia. Take at the same time each day to maintain consistent blood sugar control. It is oral.

Doxorubicin-

This a chemotherapeutic agent. It is cardiotoxic. Adverse effects is damage to the heart muscle leading to heart failure. There must be a baseline preformed prior to. It is a vesicant so it can cause severe tissue damage. If it infiltrates you must stop the drug immediately.

Tamoxifen-

This is a selective estrogen receptor modulator (SERM). Commonly prescribed for hormone receptor positive breast cancer. Works by blocking the estrogen receptors on breast cancer cells preventing estrogen from stimulating their growth. Used in both early stage and metastatic breast cancer. Must continue to have mammograms.

Thyroid Storm-

This is a severe condition caused by excessive thyroid hormones. Key signs high fever, tachycardia, agitation, restlessness, angina and HTN.

Epoetin Alfa-

Stimulates the production of Red blood cells (RBC). Can increase the risk of thrombolytic events like a DVT or a PE. Can cause or worsen HTN due to increased RBC production. New onset confusion and tremors can indicate a neurological complication. Gently shake the vial.

Corticosteroids-

Long term use can lead to bone density loss. Have regular scans. Suppresses the immune system. Report signs of infection. Monitor Blood sugar. Do not abruptly stop can cause adrenal insufficiency. Take with food to decrease GI upset. Can cause Cushingoid features.

Insulin-

Promotes the uptake of glucose into cells helping to lower blood glucose levels. Plays a key role in maintaining normal glucose homeostasis. Promotes the conversion of glucose to glycogen. Helps cells absorb glucose.

Glucagon-

Secreted by the pancreas in response to decreased glucose levels. Stimulates the liver to release stored glucose or glycogen into the blood stream. Can cause N/V, you want to place them on their side after administering to prevent aspiration. This is what you give IM if they have hypoglycemia.

Thyroid-Stimulating Hormone (TSH)-

Released from the pituitary gland. Stimulates the release of T3 and T4.

Hydrocortisone-

Long term effects include a moon face, weight gain, HTN and mood changes aka cushingoid features. Complications include skin thinning and delayed would healing, bone loss. Commonly prescribed to replace cortisol in clients with Addison’s disease. Adverse effect is elevated blood glucose, hypokalemia, hypernatremia, suppressed immune response, increased risk of infection. If pt has hypokalemia they will be complaining about muscle cramps in the leg. Severe leg pain like Charlie Horse in leg.

Glargine-

Long acting insulin. Maintain consistent blood glucose control. Administer at the same time each day.

Octreotide-

Somatostatin analogue that inhibits growth hormone release from the pituitary gland. Reducing the elevated levels of growth hormone characteristics like acromegaly. Can cause hypoglycemia or hyperglycemia by affecting the insulin secretion. Rotate SubQ sites to prevent tissue irritation.

Vincristine-

This is a chemotherapeutic agent that can cause peripheral neuropathy, tingling, numbness or weakness in the hands and feet.

***With chemotherapeutic agents- not safe during pregnancy, suppresses bone marrow function increasing the risk for neutropenia and serious infection. Use a soft bristled toothbrush, rinse your mouth with saline after meals to prevent mouth sores. Administer an antiemetic prior to to help decrease N/V. Administer prophylactic antibiotics to decrease the risk of infection. NO GRAPEFRUIT.

***How do you mix insulins?

-Pull out of refrigerator, roll the vial, disinfect tops, CLOUDY, CLEAR, then you draw clear and then cloudy. (NPH to regular and then regular to NPH)

*You’re Not retired you’re a registered nurse*