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Pharm test 3
Pharm test 3
190
Nursing
Undergraduate 1
04/04/2013

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Term
what anesthetic is used in eye exams?
Definition
topical anesthetics
Term
two most common anesthetics used in eye exams:
Definition
proparacaine HCL
tetracaine HCL
Term
replace tears or adds moisture to eyes and protects eyes during surgery:
Definition
eye lubricants
Term
inflammation of the cornea:
Definition
keratitis
Term
dilates the pupils:
Definition
mydriatics
Term
paralyze the muscles of accommodation:
Definition
cycloplegics
Term
most potent cycloplegics:
Definition
atropine
Term
side effects of cycloplegics:
Definition
tachycardia
photophobia
dry mouth
Term
inflammation of delicate membrane covering the eye ball:
Definition
conjunctivitis
Term
what are three conjunctivitis:
Definition
bacterial, viral and allergic
Term
what is another word for conjunctivitis:
Definition
pink eye
Term
if conjunctiitis is caused by allergies what is given?
Definition
antihistamines
anti-inflammatories
anti-infectivies
Term
used to lower intra-ocular pressure by increasing blood flow to the retina and decreases retinal damage and vision loss:
Definition
cholenergic agent miotics
Term
direct acting miotic that stimulates pupillary and ciliart sphincter muscles
Definition
pilocarpine
Term
side effects of pilocarpine:
Definition
blurred vision, eye pain and eye irritation
Term
systemic effects of pilocarpine:
Definition
flushing, diaphoresis, GI upset, diarrhea, increased salvation and muscle weakness
Term
what should be done when applying pilocarpine:
Definition
gentle digital pressure to nasolacromil drainage system for 1-2 mins after instillation and prevents the drug delivery into nasal mucosa
Term
contradictions for pilocarpine:
Definition
retinal detachment
acute ocular inflammations
avoid absorption of drug with CAD
epilepsy and asthma
Term
toxicity effects of pilocarpine:
Definition
vertigo, bradycardia, hypotension, tremors, seizures and vomiting
Term
what causes open-angle glaucoma:
Definition
diminished outflow of aqueous humor
Term
what causes closed-angle glaucoma:
Definition
triggered by emotions or drugs that dilate pupils
Term
can glaucoma be cured:
Definition
no
Term
what should be avoided while on glaucoma:
Definition
antihistamines and decongestants
Term
what must be done with anticholinergic drugs with glaucoma:
Definition
antagonize their effects
Term
time to wait between beta-blocker eye drops:
Definition
5 mins
Term
fist line of defense for glaucoma:
Definition
beta-blockers
Term
what do beta-blockers do:
Definition
decrease the production of aqueous humor
Term
example of beta-blockers:
Definition
betaxolol HCL
timolol maleate
Term
used for emergency treatment of acute closed angle glaucoma by decreasing vitreous humor volume:
Definition
osmotics
Term
example of osmotic:
Definition
mannitol
Term
what does macular degeneration cuase:
Definition
blindness
Term
what does "wet" mean in macular degeneration:
Definition
rapid progression and loses vision fast
Term
what does "dry" mean in macular degeneration:
Definition
slowly destroys vision over the years
Term
andminstered as monthly injections in the eye:
Definition
ranibizumab
Term
when is ranibizumab most effective:
Definition
early phases of wet ARMD
Term
used for long term treatment of open-angle glaucoma:
Definition
carbonic anhdyrase inhibitor
Term
what might carbonic anhydrase inhibitors cause:
Definition
photosensitivity
Term
what is carbonic anhydrase inhbitors contraindicated for:
Definition
sulfonamide allergy
Term
example of carbonic anhydrase inhibitors:
Definition
travapost
Term
how many drops of eye medication should be used:
Definition
1
Term
how long should be waited between administering eye medication:
Definition
5 mins
Term
what does otic pertain to:
Definition
ear
Term
another name for acute otitis externs:
Definition
swimmers ear
Term
most common pathogen in children with AOM (acute ottitis media)
Definition
strepococcus pneumonia
Term
way to administer ear drops to adults:
Definition
pull up and back on auricle
Term
way to administer ear drops to children:
Definition
pull down and back on auricle
Term
how should ear irrigation be done?
Definition
gently
Term
skin issue with flat and varying colors:
Definition
macules
Term
raised, palpable less than 1 cm diameter
Definition
papules
Term
raised, fluid, filled less that 1 cm diameter:
Definition
vesicles
Term
hard, rough, raised and flat on top:
Definition
plaques
Term
what does ototoxicity mean:
Definition
causes hearing loss
Term
what medications are ototoxic:
Definition
lasix
nsaids
erythromycin
gentamicin
vancomycin
Term
what can skin eruptions result from:
Definition
viral infections (herpes simplex, herpes zoster)
fingal infections
bacterial infections
Term
what does tinea pedis mean:
Definition
athlete's foot
Term
what does tinea capitis mean:
Definition
ringworm
Term
cerumen is known as:
Definition
earwax
Term
loosen and removes impacted wax:
Definition
ceruminolytics
Term
ways to remove chronic impaction of earwax:
Definition
1-2 drops of olive or mineral oil
Term
what should be taught to a client when using ear drops:
Definition
dont massage area
intruct not to put foreign objects in ear
instruct to take medication as prescribed
encourage client to keep follow-up
Term
examples of ceruminolytics:
Definition
hydrogen peroxide, burrows solution and acetic acid (vinager)
Term
allergic type of skin reaction that has no flakes:
Definition
eczema
Term
most common skin disorder in the US:
Definition
acne vulgaris
Term
what is acne vulgaris:
Definition
formation of papules, nodules and cysts on face, neck, shoulders and back
Term
what age group contains 90% of acne:
Definition
adolescents
Term
non-pharmalogical measures for acne:
Definition
gently cleanse several times a day
avoid vigorous scrubbing
well-balanced diet
decreasing emotional stress
Term
what does mild acne require:
Definition
may require gentle cleansing combined with the use of keratolytics (benzol peroxide)
Term
how can keratolytics be applied:
Definition
cream
lotion
gel
once or twice a day
Term
what is an issue with tetracycline?
Definition
photosensitivity (needs to use sunscreen)
Term
things about accutane:
Definition
pregnancy class X
must use two methods of contraception
most monitor liver, glucose and lipids
contraindicated in diabetic clients on oral agens
Term
chronic skin disorder:
Definition
psorasis
Term
what is psoriasis:
Definition
flaky skin with erythematous papules and plaques with silvery scales
Term
how is psorasis treated:
Definition
keratolytics (salicyclic acid) coal tar products
Term
how much faster is cell growth and turnover:
Definition
5 times faster
Term
three types of burns:
Definition
heat
electric
chemicals
Term
what causes contact dermatitis:
Definition
chemical or plant irritation
Term
what causes drug induced dermatitis:
Definition
adverse reaction to drug therapy and can be life threatening
Term
non-pharmalogical treatment for dermatitis:
Definition
acoid direct contact with irritant
immediately cleasne the area
Term
pharmalogical measures for treatment of dermatitis:
Definition
wet dressing with acetic acid
calamine lotion with zinc oxide
benadryl for persistent itching
glucocorticoid creams
Term
information about first degree burn:
Definition
superficial on epidermis
is red and painful
Term
third degree burn:
Definition
pearly white skin, charred and no pain
involves everything
Term
second degree burn (deep):
Definition
mottled, blistering, intense pain
Term
second degree burn (superficial):
Definition
blistering and very painful
Term
what does silcer sulfadiazine do for burns:
Definition
kills infection
Term
what is the most common burn treatment:
Definition
silver sulfadiazine
Term
how does silver sulfadiazine work:
Definition
acts on cell membrane and cell wall to produce bactericidal effects
Term
what does mafenide acetate do for burns:
Definition
prevents infection
Term
what might mafenide acetate cause:
Definition
acid-base imbalance
Term
what is negative feedback:
Definition
when on thing goes up the other goes down or when something goes down the other goes up
Term
what are the three types of hormone pharmacotherapy:
Definition
replacement (used because person is unable to secrete enough endogenous hormones)
mimic by increasing production of an exaggerated response
inhibit by blocking actions of endogenous hormones
Term
given to block effects of overactive thyroid:
Definition
PTU
Term
what directs the pituitary gland:
Definition
hypothalamus
Term
what is the casacade for the endocrine glands:
Definition
hypo > hormone > pitutatry > hormone > target tissue
Term
what is somatotropin:
Definition
growth hormone
Term
stimulates the growth and metabolism of cells:
Definition
somatotropin (growth hormone)
Term
deficiency of growth hormone:
Definition
dwarfism
Term
excess secretion of growth hormone by possible pituitary tumor:
Definition
acromegaly
Term
other name for ADH:
Definition
vasopressin
Term
how does ADH act:
Definition
acts on collecting tubules in kidneys to tell them to hold onto water
Term
when is ADH secreted:
Definition
secreted from pituitary when hypothalamus senses decreased plasma volume or increase osmolarity in plasma
Term
What is type 2 diabetes:
Definition
insulin resistant
Term
what can insulin receptor become more responsive with:
Definition
exercise and healthy diet
Term
why do we give long acting insulin:
Definition
somogyi phenom
Term
stored form of glucose:
Definition
glycogen
Term
what does insulin inhibit:
Definition
gluconeogenesis (release of fatty acids from liver/ stops production of glucose from fats and proteins)
Term
onset and peak of intermediate insulin:
Definition
onset 1-2 hours
peak 6-14 hours NPH
Term
onset and peak of long acting insulin:
Definition
onset 1 hours
lantus has no peak lasts 24 hours
levemir peak is 6-8 hours lasts 24 hours
Term
onset of rapid insulin:
Definition
5-15 mins
Term
novolog peak:
Definition
1-3 hours
Term
humalog peak:
Definition
1-1.5
Term
apidra peark:
Definition
1 hour
Term
humulin R:
Definition
has short onset
peak 1-5 hours
Term
what is type 1 diabetes:
Definition
beta cell destruction so no insulin is created
Term
cells that make insulin:
Definition
beta
Term
cells that make glucagon:
Definition
alpha
Term
cells that make the islets of langerhans:
Definition
cluster of cells
Term
what is central diabetes insipidus:
Definition
inability to secrete adequete ADH
due to head trauma, neurosurgery and IICP
Term
what are the two issues with diabetes insipidus:
Definition
dehydration
hypernatremia
Term
what is nephrogenic diabetes insipidis:
Definition
inability of the kidenys to respond to ADH
Term
result of Diabetes insipid us:
Definition
wasting fluids
Term
another term for central diabetes:
Definition
neurogenic
Term
medical management of diabetes insipidis:
Definition
restore volume by giving synthetic ADH
desmopressin acetate or vasopressin or thiazide diuretics
Term
what is the drug of choice for diabetes insipidus?
Definition
desmopressin acetate (drug of choice because it doesnt affect BP that much)
Term
how does a thiazide diuretic help diabetes insipidus?
Definition
helps tubule respond to ADH in nephrogenic diabetes insipidus
Term
what is the thyroid responsible for:
Definition
metabolism
Term
what is needed to make the thyroid hormones:
Definition
iodine
Term
what is relaeased when T4 and T3 are low:
Definition
TSH
Term
what is the strongest stimulation of the throid hormone:
Definition
the cold
Term
where do we get the major source of iodine:
Definition
table salt
Term
hyperthyroid is known as:
Definition
graves disease
Term
hypothyroid issues are:
Definition
myxedema
hashimotos
Term
what is a sign of hyperthyroidism:
Definition
bulging eyes
Term
issues with hyperthyroidism:
Definition
high metabolism
high everything
tachycardia
weight loss
increased temp
anxiety
Term
autoimmune disorder of the body develops antibodies against own thyroid:
Definition
Grave's disease
Term
drugs that inhibits the incorporation of atoms into T3 and T4:
Definition
propylthiouracil
methimozole
Term
radioactive isotope that destroys overactive thyroid cells
Definition
sodium iodid-131
Term
very high levels of thyroid hormone that can be life threatening:
Definition
thyroid storm
Term
symptoms of thyroid storm:
Definition
increased fever, tachycardia, angina, MI, agitation, delirum and coma
Term
treatment for thyroid storm:
Definition
decrease fever while trying to avoid shivering, replace fluids and electrolytes, beta blockers and antithyroid drugs
Term
what causes thyroid storm:
Definition
person becomes ill and sends thyroid into overdrive
Term
another word for hypothyroidism:
Definition
maxedema
Term
s/s of hypothyroidism (maxedema):
Definition
weakness, muscle cramps, dry skin, bradycardia, decreased sense of stimuli, intolerance to cold
Term
autoimmune disease where the person produces antichodines that attack the thyroid and is the number one cause of hypothyroidism:
Definition
hashimotos disease
Term
what can induce hypothyroidism due to its high iodine content:
Definition
amiodarone (cordarone)
Term
issue with hypothyroidism:
Definition
goiter
Term
what casues a release of coritsol:
Definition
released by stress
Term
what does cortisol do?
Definition
increase BS
Term
what hormone does the medulla produce:
Definition
epi
Term
what hormone does the cortex produce:
Definition
cortisone
aldosterone
Term
what med is like Vit. D that controls calcium by having the body waste phosphrous andretaining calcium:
Definition
calsatrol
Term
issues with Ca and P in the parathyroid:
Definition
Ca goes up P goes down
Ca goes down P goes up
Term
how does the hypothalamic cascade work?
Definition
hypothalamus release hormone > this stimulates the pitutary to release ACH > adrenal gland is stimulated which stimulates the kidneys and cortisol is released
Term
who showed steriods be stopped?
Definition
taper off of them
Term
syndrome with increased secretion of cortisol
Definition
cushings syndrome
Term
cushings syndrome that occurs in patients recieving cortisol meds:
Definition
exogenous
Term
cushings syndrome caused by a tumor on adrenal or pitutitary gland: (weight gain, MS loss and depression)
Definition
endogenous
Term
disease with adrenal insufficiency due to increased amount of steriod hormones in spite of adequate ACTH:
Definition
addisons disease
Term
symptoms of addisons disease:
Definition
fatigue, low BP, GI problems and decreased appetite
Term
antiadrenal agents for CUshing's:
Definition
metryrapone
ketoconazole
Term
what should ketoconconazole not be taken with:
Definition
trolazolom (holcion)
Term
blocks the cortisol formation in adrenal:
Definition
ketoconazole
Term
what drugs are used with someone who has addisons disease:
Definition
glucocorticoids such as prednisone or hydrocortisone
Term
stimulates release of insulin, increases cell sensitivity:
Definition
sulfonylureas (glyburide and glipzide)
Term
decreases gluconeogensis,,,, and decreases insulin resistance:
Definition
biguamides (metformin)
Term
blocks the enzyme in sm intestine that breaks down carbs into monosaccharides
Definition
alpha-glucosidase inhibitors (acarbose)
Term
reduces insulin resistance and inhibits gluconeogensis:
Definition
thiazolidinediones (actos, avenida)
Term
stimulates the release of insulin:
Definition
meglitinides (prandin)
Term
secred by intestine following a meal that signals the pancreas to produce insulin and signals liver to stop producing glucagon:
Definition
incretin hormone (byetta and januvia)
Term
mimics effects of incretin:
Definition
byetta
Term
blocks enzyme that destroys incretin:
Definition
januvia
Term
Side effects of adrenocorticotropic hormone
Definition
nausea, vomiting, increased appetite, mood swing, petechiae, water and sodium retention, hypokalemia, hypocalcaemia
Term
Drug interactions with adrenocorticotropic hormone:
Definition
increased potential for ulcer formation and hypoprothrombinemia with aspirin and NSAIDs, may increase potassium loss with thiazide and loop diuretics
Term
Patient education about adrenocorticotropic hormone:
Definition
adhere to drug regimen, decrease salt intake to avoid edema, report side effects such as edema or muscle weakness
Term
how does ADH relate to DI:
Definition
ADH promotes water reabsorption from the renal tubules to maintain water balance. So a deficiency of ADH can lead to a fluid volume deficit due to large amounts of water being excreted. This is known as diabetes insipidus.
Term
Calcitriol side effects
Definition
anorexia, nausea, vomiting, diarrhea, cramps, drowsiness, headache, dizziness, lethargy and photophobia
Term
Calcitriol drug interactions
Definition
increased cardiac dysrthmias with digoxin and verapamil / decreased calcitrol absorption with cholestyramine
Term
what does calcitriol do?
Definition
treats hypothyroidism and manage hypocalcemia in chronic renal failure
Term
Calcitriol patient education
Definition
report symptoms of tetany, report signs of hypercalciema, inform health care provider about pregnancy
Term
what do glucocorticoid inhibitors do?
Definition
inhibit glucocorticoid synthesis, temporary treatment of clients with cushing syndrome
Term
what do glucocorticoids do?
Definition
decreases inflammatory occurrence as an immunosuppressant
Term
which type of diabetes is the only one that should take oral anti-diabetic medication:
Definition
type 2 only
Term
Metform mode of action
Definition
control hypoglycemia in type 2 diabetes
Term
Metform side effects:
Definition
dizziness, fatigue, headache, agitation, bitter or metallic taste, anorexia, nausea, vomiting, diarrhea
Term
Glipizide interactions:
Definition
alcohol may produce a disulfiram like reaction / hypoglycemia may be potiated by oral anticoags, MAOIs, salicylates, probenecid, sulfonamides, cimetidine, clofibrate and phenylbutazone
Term
Side effects of glipizide:
Definition
drowsiness, headache, confusion, anxiety, hunger, anorexia, nausea, constipation, diarrhea
Term
Mode of action of glipizide
Definition
controls hypoglycemia in type 2 diabetes
Term
Synthroid drug interactions
Definition
increased cardiac insufficiency with epi / increased effects of anticoags, decongestants and depressants
Term
Synthroid mode of action
Definition
treats hypothyroidism, myxedema and cretinism
Term
Synthroid side effects:
Definition
nausea, vomiting, diarrhea, cramps, tremors, nervousness, insomnia, headache, weight loss
Term
what is myxedema?
Definition
swelling of the skin and underlying tissues giving a waxy consistency
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