Term
Name 4 characteristics of NSAIDs |
|
Definition
-Decrease Inflammation -Analgesia -Decrease Fever (antipyresis) -Decrease Blood Clotting (anticoagulation) |
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|
Term
Useful in treating pain and inflammation associated with acute or chronic musculoskeletal disorders |
|
Definition
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Term
The best known NSAID. Inhibits the synthesis of prostaglandins |
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Definition
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|
Term
Prostaglandins, thromboxanes, and leukotrienes are collectiely known as what? |
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Definition
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|
Term
Help to regulate cell function under normal or pathological conditions. |
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Definition
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Term
Formed by arachidonic acid which is a fatty acid stored in cell membranes |
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Definition
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Term
Influence cardiovascular, respiratory, renal, GI, nervous, and reproductive systems |
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Definition
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|
Term
What is the role of prostaglandins (6) |
|
Definition
-Inflammation (erythema, edema, increase blood flow, increase capillary permeability, increase histamine and bradykinin) -Pain -Fever -Dysmenorrhea -Thrombus Formation (increase platelet aggregation) -Others (HTN, asthma, MS, DM, colon cancer) |
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|
Term
(3) Mechanisms of action for NSAIDS |
|
Definition
-Inhibit cycloxygenase (COX) enzyme -COX enzyme participates in the synthesis of prostaglandins -Inhibition of the COX enzyme is the key to NSAID benefit |
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|
Term
COX enzyme exists in 2 forms. What does COX1 do? |
|
Definition
Mediates normal cell activity |
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|
Term
COX enzyme exists in 2 forms. What does COX2 do? |
|
Definition
Produces prostaglandins in pathological cells which mediate pain and inflammation |
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|
Term
Aspirin and most NSAIDS inhibit what? |
|
Definition
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|
Term
If NSAIDs inhibit COX enzymes, then what benefit is lost? |
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Definition
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|
Term
Selective COX2 inhibitors should do what? |
|
Definition
Reduce the effects of COX2 enzyme while not effecting the COX1 enzyme |
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|
Term
Name 5 uses of Aspirin and other NSAIDS |
|
Definition
1. Treat pain and inflammation 2. Avoid side-effects of opioids 3. Treat fever except in children (aspirin has been associated with Reye Syndrome) 4. Treat vascular disorders (blood clots, HA, TIAs) 5. Cancer prevention |
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|
Term
Name some NSAID side effects |
|
Definition
GI problems Liver dz Renal dz Reye Syndrome in children Delays tissue healing by inhibiting connective tissue formation |
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Term
Is there any evidence that an NSAID has a better therapeutic effect than aspirin? |
|
Definition
No but some may have fewer side effects |
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|
Term
Name 2 common COX2 inibitors |
|
Definition
Celebrex Vioxx (removed from market) |
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Term
Decrease in GI problems and do not inhibit platelet function. Decrease in side effects due to lack of COX1 inhibition. |
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Definition
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|
Term
Is acetominophen an NSAID? |
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Definition
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|
Term
-Has some analgesic and antipyretic effects but does not reduce inflammation. -Used in non-inflammatory disorders to treat pain -Also used as a substitute for aspirin in children to avoid Reye Syndrome |
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Definition
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|
Term
How are most NSAIDs administered? |
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Definition
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|
Term
NSAIDs: -Dose -Absorption -Distribution |
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Definition
Dose varies Absorbs in stomach and small intestine Distribution: plasma proteins and throughout the body |
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Term
How are NSAIDs metabolized and excreted? |
|
Definition
Metabolized via biotransformation in bloodstream and liver. Excreted via kidneys |
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Term
Can be toxic to the liver in high doses |
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Definition
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Term
The most common medication administered to the PT population |
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Definition
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Term
2 primary conditions that affect joints |
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Definition
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Term
A chronic, systemic disorder that affects various tissues but mainly synovium and articular tissue |
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Definition
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Term
RA diagnostic criteria include: (7) |
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Definition
Morning Stiffness Arthritis in 3+ joints Hand joint arthritis Symmetric arthritis Rheumatoid nodules Serum rheumatoid factor Radiograph change |
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Term
Caused by an autoimmune response in genetically susceptible patients. Formation of antibodies that initiate phagocytes and lymphocytes. Phagocytes and lymphocytes cause production of cytokines, eicosanoids, and destructive enzymes (proteases, collagenases) |
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Definition
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|
Term
Drugs have 2 goals in treating RA |
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Definition
Decrease Inflammation Slow/stop disease progression |
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|
Term
Name the 3 categories of RA drugs |
|
Definition
NSAIDs Glucocorticoids (corticosteroids) Disease-modigying antirheumatic drugs |
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|
Term
Name the 2 most common medications for RA |
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Definition
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|
Term
Adverse effects of NSAIDs |
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Definition
Primarily gastric ulcer or hemorrhage |
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|
Term
Extremely effective in treating inflammation. Does not slow disease progression. Increases anti-inflammatory protein production and inhibits pro-inflammatory substances production. |
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Definition
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|
Term
Blocks pro-inflammatory prostaglandin production. Also inhibits macrophages and T lymphocytes |
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Definition
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|
Term
Name some adverse effects of Glucocorticoids |
|
Definition
-Breaks down muscle, tendon, and bone -Osteoporosis -Can cause ms weakness, atrophy, HTN, DM, glaucoma, and cataracts |
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|
Term
Do DMARDS (Disease-Modifying antirheumatic drugs)alter RA progression? |
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Definition
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|
Term
Most of these inhibit the function of monocytes and lymphocytes that are responsible for joint inflammation and destruction. |
|
Definition
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|
Term
|
Definition
Antimalarial Drugs Azathioprine (Imuran) Etanercept (Enbrel) Gold Therapy Leflunominde (Arava) Methotrexate Penicillamine |
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|
Term
Which form of arthritis is more common? |
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Definition
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|
Term
Virtually everyone over 75 has this to some degree. Only mild inflammation in most cases. Articular/cartilage damage is the primary concern |
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Definition
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|
Term
|
Definition
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|
Term
Hyaluronan is injected into the joint to restore synovial fluid viscosity. |
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Definition
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|
Term
Used to produce GAGs, proteoglycans, and hyaluronic acid |
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Definition
Glucosamine and Chondroitin |
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Term
A sustained, reproducible increase in BP. Can lead to CVA, HF, Renal dz and blindness |
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Definition
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|
Term
Short-term control of BP is by the what? |
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Definition
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|
Term
Long term control of BP is by what? |
|
Definition
kidney control of fluid balance |
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Term
Cardiac Output X Total Peripheral Resistance = |
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Definition
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|
Term
What are common causes of HTN? |
|
Definition
Exact cause unknown. Maybe a combo of internal and external factors such as diet, stress, predisposition, smoking, and alcohol abuse |
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|
Term
Once HTN is diagnosed it seems to progress: (3) |
|
Definition
-Decrease baroreceptor refex sensitivity -Increased kidney discharge -Increased vascular resistance |
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|
Term
Increases the formation/excretion of urine, thus decreases vascular fluid volume to serve as an antihypertensive |
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Definition
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|
Term
Inhibits Na reabsorption thus increasing fluid excretion |
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Definition
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|
Term
Inhibits Na and Cl reabsorption thus increasing fluid excretion |
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Definition
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|
Term
Prevents K from being excreted from kidneys; prevents Na reabsorption; increases fluid excretion |
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Definition
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|
Term
|
Definition
Hypnatremia and hypokalemia can result in cardiac and metabolic problems, weakness, and fatigue |
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Term
Decreases HR thus reduces CO |
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Definition
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|
Term
What are some side effects of beta blockers |
|
Definition
Bronchoconstriction (asthma) and depressed HR |
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|
Term
Blocks vascular smooth muscle receptors thus decreases vascular resistance |
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Definition
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|
Term
What are some side effects of alpha blockers? |
|
Definition
Reflex tachycardia and orthostatic HTN |
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|
Term
Inhibits the release of norepinephrine thus decreases excitation of heart and vascular smooth muscle |
|
Definition
Presynaptic Adrenergic Inhibitors |
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|
Term
Causes vasodilation thus decreasing peripheral resistance. Side effects include reflex tachycardia, dizziness, weakness, nausea, HAs, and fluid retention |
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Definition
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|
Term
Blocks the conversion of angiotensin I and II thus preventing vasoconstriction |
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Definition
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|
Term
Inhibits vascular smooth muscle by preventing Ca influx, decreases vascular resistance, and decreases HR |
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Definition
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|
Term
Beta Blockers have been shown to reduce what? |
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Definition
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|
Term
A pain that results from ischemic heart dz. Causes chest compression/tightness and sometimes pain radiating to the jaw, left arm, or back. Caused by physical exertion but can occur at rest or sleep |
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Definition
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|
Term
Dilate vascular smooth muscle; vasodilation causes decreased cardiac work; decreasing cardiac work decreases myocardial oxygen demand. |
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Definition
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|
Term
The best known antianginal drug. Can be administered sublingually or transdermally. |
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Definition
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|
Term
Block beta-1 receptors which decrease myocardial contraction; decreases HR and cardiac force output; decreases myocardial oxygen demand |
|
Definition
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|
Term
Blocks Ca entry into smooth vascular muscle. Decreases ms contraction, decreases cardiac work due to vasodilation, decreases myocardial oxygen demand, increases coronary artery blood flow, and increases myocardial oxygen supply. |
|
Definition
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|
Term
Name the 2 most common anticoagulants |
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Definition
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|
Term
Any significant deviation from normal cardiac rhythm. If untreated, impaired cardiac pumping, CVA and/or heart failure may occur |
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Definition
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|
Term
During cardiac ms contraction and relaxation, an exchange of K, Na, and Ca ions occurs. Why is this important for pharm? |
|
Definition
Some drugs affect the movement of these ions to normalize arrhythmias |
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|
Term
Abnormal pulse generation - injury or dz may render the SA and AV nodes incapable. Abnormal pulse conduction - dz or damage may result in action potential delay or action. Simultaneous abnormalities of impulse generation and conduction - combination of both. |
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Definition
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|
Term
Bind to Na channels that are open (activated) or closed (inactivated). Normalizes the rate of Na entry into cardiac tissue and normalizes rhythm. |
|
Definition
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|
Term
Decrease excitatory effects of the SNS (norepi and epi) on the heart. Results in deceased HR. Also slows down myocardium conduction. Side effects include poor cardiac pumping resulting in heart failure (rare) |
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Definition
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|
Term
Delay repolarization of cardiac cells which lengthens the time between action potentials. Results in slowing/stabilizing the HR. Side effects include an initial increase in arrhythmia. |
|
Definition
Drugs that prolong repolarization |
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|
Term
Controls arrhythmias by altering excitability and conduction of cardiac tissues. Blocks Ca entry into myocardial and vascular smooth muscle. |
|
Definition
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|
Term
What is the primary concern for people taking medications for cardiac arrhythmias?c |
|
Definition
Common to increase arrhythmia. Must monitor closely |
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|
Term
A condition where the heart is unable to pump sufficient blood to peripheral tissues. Caused by some form of cadiac disease or dysfunction. Causes accumulation of fluid int he lungs and peripheral tissues. |
|
Definition
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|
Term
Symptoms include peripheral edema and decreased physical capacity. Caused by various mechanisms - cardiac cell disturbances, altered genetic myocardial proteins, changes in neurohormonal factors. |
|
Definition
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|
Term
Name the 2 basic goals in the pharmacology treatment of CHF> |
|
Definition
1. Improve pumping ability of heart 2. Decrease cardiac workload |
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|
Term
Name a common drug that works to increase myocardial contraction |
|
Definition
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|
Term
Improves cardiac pumping ability; increases CO; often used in combo with other drugs as well. Increases intracellular Ca thus increasing contractibility. Inhibits SNS thus decreasing heart stress/deman and relaxes vasculature smooth muscle. |
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Definition
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|
Term
Side effects of digitalis |
|
Definition
Toxicity. Signs include N&V and CNS disturbances (fatigue, confusion) |
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|
Term
Drug that works to decrease cardiac workload (4) |
|
Definition
1. Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors) 2. Beta Blockers 3. Diuretics 4. Vasodilators |
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|
Term
Inhibits vasoconstriction |
|
Definition
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|
Term
Reduce excessive sympathetic stimulation of the heart |
|
Definition
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|
Term
Decrease congestion in lungs and periphery by eliminating fluid; also decrease cardiac workload by decreasing fluid |
|
Definition
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|
Term
Decrease peripheral resistance; decreases the amount of blood returning to the heart resulting in decrease in workload |
|
Definition
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|
Term
Prevents excessive hemorrhage from damaged vessels. Inadequate blood clotting can lead to excessive blood loss and overactive clotting can cause thrombogenesis |
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Definition
Blood coagulation/hemostasis |
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|
Term
Influenced by hyperlipidemia which is a chronic increase in plasma lipids. |
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Definition
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|
Term
Can cause cholesterol to be deposited on arterial walls (artherosclerosis) which can lead to thrombosis formation and infarction |
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Definition
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|
Term
Involves the activation of various clotting factors; ultimately leads to conversion of prothrombin to thrombin; thrombin enzyme converts fibrinogen to fibrin which forms a mesh-like structure (clot) |
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Definition
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|
Term
Tissue plasminogen activator converts plasminogen to plasmin; plasmin enzyme breaks down fibrin mesh; destroys clot. |
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Definition
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|
Term
Primarily includes heparin and warfarin (Coumadin) |
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Definition
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|
Term
Promoes the role of antithrombin III which binds to clotting factors and makes them inactive. |
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Definition
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|
Term
Impairs hepatic synthesis of several clotting factors. Side effects include hemorrhage; joint/back pain may indicate hemorrhage; GI distress |
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Definition
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|
Term
Inhibits synthesis of prostaglandins; prevents platelet-induced thrombus formation. Use to treat and prevent MI; prescrived to those who have risk factors for MI such as CAD. |
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Definition
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|
Term
Breakdown and dissolve clots that have already formed. Converts plasminogen to plasmin. Very useful in treating acute MI; can re-establish blood flow caused by coronary occlusion; prevents or reverses damage. |
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Definition
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|
Term
Is aspirin a thrombolytic drug or antithrombolytic drug? |
|
Definition
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|
Term
A hyperlipidemia drug that inhibits HMG-CoA reductase which is an enzyme that assists in the synthesis of cholesterol |
|
Definition
HMG-CoA Reductase Inhibitor (Statins) |
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|
Term
The mechanisms of action is unclear for this hyperlipidemia drug. But may increase lipoprotein lipase enzyme activity; thus decreases triglyceride levels. |
|
Definition
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|
Term
Responsible for mediating gas exchange between the air and our bloodstream. |
|
Definition
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|
Term
These drugs treat symptomatic coughing and irritation from cold, allergies, and respiratory tract infections. |
|
Definition
Respiratory tract irritation and secretion drugs |
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|
Term
Suppress coughing associated with cold and minor irritations. Recommended for short-term use only. Coughing is a defense mechanism that can help expel mucous and foreign material. |
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Definition
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|
Term
Inhibits the cough reflex through a central mechanisms or inhibits the effects of histamine. Sedation is a common side effect. |
|
Definition
Antitussives (Codeine, hydrocodone, hydromorphone) |
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|
Term
A decongestant that binds to alpha 1 receptors in blood vessels of the mucosa causing vasoconstriction; dries up the mucosal vasculature and decreases congestion. |
|
Definition
Alpha 1 Adrenergic Agonists |
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|
Term
The side effects for Alpha 1 Adrenergic Agonists inlude headache, dizziness, nausea, HTN, and palpitations. What is a common one? |
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Definition
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|
Term
Used to treat respiratory allergic response to allergies. |
|
Definition
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|
Term
Involved in normal regulation of physiological functions including allergic reactions. |
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Definition
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|
Term
Binds to H1 receptors in the vascular and respiratory tissues |
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Definition
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|
Term
Blocks histamine from binding to the H1 receptors; decrease the allergic response. Side effects can include sedation, fatigue, incoordination, N&V. |
|
Definition
Antihistamines such as Tavist, Dramamine, Benadryl, Claritin, and Actifed |
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|
Term
Decrease viscosity of respiratory secretions |
|
Definition
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|
Term
Facilitate production and ejection of mucus |
|
Definition
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|
Term
What is the primary mucolytic drug? |
|
Definition
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|
Term
What is the only expectorant listed by the FDA? |
|
Definition
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|
Term
What are the treatment goals for COPD drugs? |
|
Definition
Reduce bronchial constriction |
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|
Term
Administered via inhaler or nebulizer. Stimulates Beta-2 receptors reslting in bronchodilation. Side effects = Prolonged use may increase bronchial response, cardiac irregularities, nervousness, tremors. |
|
Definition
Beta-Adrenergic Agonists (Albuterol, Epinephrine) |
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|
Term
Results in bronchodilation. May inhibit phosphodiesterase (PDE) enzyme in bronchial smooth muscle; increase cAMP; cause bronchodilation. May also act as an adenosine antagonist; adenosine stimulates bronchocontriction |
|
Definition
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|
Term
Side effects of Xanthine Derivatives? |
|
Definition
Toxicity, nausea, confusion, irritability, cardiac arrhythmias, seizures. |
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|
Term
Cause bronchodilation. Prevents acetylcholine (from the PSN) from binding to cholinergic mucosa receptors; preventing bronchoconstriction. Side effects include dry mouth, constipation, tachycardia, and confusion. |
|
Definition
Anticholinergics (Atropine and Atrovent) |
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|
Term
Reduces inflammation associated with COPD disorders. Includes Cortisone, Dexamethasone, and Prednisone |
|
Definition
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|
Term
Prevent bronchospasm not bronchoconstriction in pts with asthma. Must be administered before asthma episode. |
|
Definition
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|
Term
May inhibit the release of inflammatory mediators (histamine, leukotrienes). Side effects are minimal. |
|
Definition
Cromones (Cromolyn sodium and nedocrmil sodium) |
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|
Term
Treatment of bronchial asthma |
|
Definition
Bronchodilators (beta-adrenergic agonist, xanthine derivatives, and glucocorticoids) |
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|
Term
Results in excessive viscous secretions. Results in pneumonia, pulmonary fibrosis, and infections. |
|
Definition
|
|
Term
|
Definition
Bronchodilators, Mycolytic/Expectorants, and glucocorticoids |
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|
Term
2 primary types of adrenocorticosteroids |
|
Definition
Glucocorticosteroids Mineralcorticoids |
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|
Term
Controls glucose metabolism and body's ability to deal with stress. |
|
Definition
Glucocorticoids (cortisol, corticosterone) |
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|
Term
Maintain fluid and electrolyte balance |
|
Definition
Mineralocorticoids (aldosterone) |
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|
Term
The precursor of this is cholestrol. All steroid hormones share similar chemical structures. Adding a H+ ion to testosterone synthesis makes estradiol. By manipulating chemical side-groups, pharmacologists develop more effective drugs. |
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Definition
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|
Term
Released on a cyclic basis peaking at 8 am in humans. Prepares human for increased activity. |
|
Definition
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|
Term
Alter protein synthesis by directly effecting the cell nucleus. Alters the transcription of DNA genes. Exert anti-inflammatory effects by increasing anti-inflammatory and decrease inflammatory protein synthesis |
|
Definition
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|
Term
Increase blood glucose and liver glycogen. This is the result of affecting glucose, fat, and protein metabolism |
|
Definition
Glucocortcoid Physiological Effects |
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|
Term
They inhibit genetic stimulation of inflammatory cells. They inhibit production of pro-inflammatory protoglandins and leukotrienes. |
|
Definition
Glucocorticoids anti-inflammatory effects |
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|
Term
Inhibit the immune response (immunosuppression) by the same means of inhibiting inflammation. Inhibit key components of immune response (T cells) |
|
Definition
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|
Term
4 Clinical uses for glucocorticoids |
|
Definition
Replacement therapy Evaluate endocrine dysfunction Inflammation Immunosuppression |
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|
Term
3 Glucocorticoid Side effects |
|
Definition
Adrenocortial suppression due to negative feedback, cushing syndrome, and tissue breakdown |
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|
Term
|
Definition
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|
Term
Regulates/increases fluid and electrolyte levels. Increase levels of angiotensin II stimulate aldosterone production. Helps to prolong the antihypotensive effect. |
|
Definition
Mineralocortoids (aldosterone) |
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|
Term
Why might you use mineralocorticoids? |
|
Definition
To treat Addison Disease (replacement therapy) |
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|
Term
The primary male hormone is testosterone and is a what? |
|
Definition
|
|
Term
estrogens (estradiol) and progestins (progesterone) |
|
Definition
|
|
Term
Are all male and female hormones considered steroids? |
|
Definition
|
|
Term
Clinical uses for androgens |
|
Definition
Replacement Therapy Catabolic States or Pathologies Delayed Puberty Breast Cancer Anemia Hereditary Angioedema |
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|
Term
Primarily seen in athletes or weight lifters. Can promote strength and muscle growth (anabolic steroid). Liver damage, HF, cardiomyopathy, CVA, MI, behavior changes, impaired sperm production,e tc. |
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Definition
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|
Term
Clinical uses for estrogen and progesterone |
|
Definition
-Primarily oral contraceptives -Replacement therapy -Hypogonadism -Failed ovarian development -Menstrual Irregularities -Endometriosis -Carcinoma |
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|
Term
Pancreatic endocrine function secretes 2 primary hormones |
|
Definition
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|
Term
What is primary role of insulin and glucagon? |
|
Definition
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|
Term
Also plays a role in fat and protein metabolism |
|
Definition
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|
Term
A defect in production and/or function of insulin. |
|
Definition
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|
Term
Primary role is to lower blood glucose by increasing glucose entry into peripheral tissues. |
|
Definition
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|
Term
Promotes storage of protein in muscle and lipids in adipose tissue. It encourages protein synthesis by increasing DNA activity in protein synthesis. Inhibits protein breakdown. |
|
Definition
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|
Term
Stimulates the production of triglycerides. Inhibits lipid breakdown. |
|
Definition
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|
Term
Considered to be the hormonal antagonist to insulin. Increases blood glucose levels and prevetns hypoglycemia. Increases glycogen breakdown in the liver which results in the increase in blood glucose |
|
Definition
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|
Term
Can cause damage to neural and vascular structures. |
|
Definition
|
|
Term
Increase Glucose = Increase Insulin Decrease Glucose = _____Glucagon |
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Definition
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|
Term
Lack of insuline produced |
|
Definition
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|
Term
The lack of adequate utilization of insulin in the peripheral tissues |
|
Definition
|
|
Term
|
Definition
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|
Term
Can result in glycosuria (increase glucose excretion). Promotes fluid excretion thus dehydration. |
|
Definition
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|
Term
Can cause ketoacidosis which can result in coma or death |
|
Definition
|
|
Term
|
Definition
Control blood glucose levels |
|
|
Term
This is too large of a polypeptide to be absorbed orally. Typically injected into the subcutaneous tissue. May be adminisered intravenously in severe cases. |
|
Definition
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|
Term
Treats hypoglycemia induced by insulin or oral hypoglycemic drugs. Increases glucose release from liver. Administered by injection |
|
Definition
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|
Term
Marked by rapid, uncontrolled cell proliferation and conversion of normal cells to undifferentiated state. Excessive cell proliferation results in tumors/neoplasms. Can be benign or malignant. |
|
Definition
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|
Term
Limit cell proliferation by killing or altering the growth of cancer cells |
|
Definition
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|
Term
Attack healthy cells as well so there will be some adverse effects. Most inhibit DNA/RNA synthesis or inhibit cell division. |
|
Definition
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|
Term
Sometimes classified by whether they act at a specific phase of cell division. |
|
Definition
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|
Term
Exert effects at a certain stage of cell division |
|
Definition
Cell-Cycle-Specific (CCS) |
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|
Term
Exert their effect during any stage of cell division. More general and effect overall tissues. |
|
Definition
CCNS (Cell-Cycle-Nonspecific) |
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|
Term
% of proliferating cells to total neoplastic cells |
|
Definition
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|
Term
These cells are more susceptible to antineoplastics because they are the cells that are causing the problems. |
|
Definition
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|
Term
Every malignant tumor cell must be destroyed to eliminate cancer. |
|
Definition
|
|
Term
These drugs affect good tissue as well as cancer tissue |
|
Definition
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|
Term
Induces binding of DNA strands; prevents DNA replication and function; kills cell |
|
Definition
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|
Term
Compee/interfere with normal metabolites during cell biosynthesis |
|
Definition
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|
Term
Known as the antimitotic drugs because they inhibit cell division |
|
Definition
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|
Term
Does not directly destroy cancer cells; affects the regulation of cell division or the immune system. |
|
Definition
Interferons and Interleukin-2 |
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|
Term
Contain platinum. Form strong links in DNA strands; inhibits DNA replication and function. |
|
Definition
|
|
Term
|
Definition
|
|