Pharm exam 3

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created 8 years ago by jenkarmata
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Spring 2014 CAC Nursing program.
updated 8 years ago by jenkarmata
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1

Lispro

Rapid acting!

Onset 15-30mins * have meal ready prior to giving*
Peak= 0.5-1.5hrs
Duration= 3-6.5hrs

2

Regular Insulin: Humulin R

Is this insulin Rapid acting or long acting?

Rapid acting-

Onset= 30-60mins
Peak= 1-5hrs
Duration 6-10hrs

3

Lantus

Long acting- * cannot be mixed w/other insulins in
same syringe*
Onset 70mins- no peak effect
Duration= 24hrs

4

glucagon: pgs- 565,566, hypoglycemia 592-593

What is glucagon?

A hormone secreted by the ALPHA cells of the pancreas that breaks down stored glycogen to glucose, resulting in elevated blood glucose levels.
* Also aids in converting amino acids to glucose (gluconeogenesis)

5

metformin (Glucophage): 579-580
Is a Biguanide

* Only Biguanide available in the US.
* Unless contraindicated, it's the initial drug of
choice for treatment of type II diabetes

6

Glucagon is dependent on the presence of _______ to convert amino acids to glucose (gluconeogenesis).

glycogen

7

______ has essentially no action in cases of starvation, adrenal insufficiency, or chronic hypoglycemia.

Glucagon

8

Glucagon Uses:

To treat hypoglycemic reactions in patients w/diabetes mellitus.

9

______ decreases hepatic glucose production by inhibiting glycogenolysis and gluconeogenesis, reducing absorption of glucose from the small intestine, and increasing insulin sensitivity, which improves glucose uptake in peripheral muscle & adipose cells.

Metformin

10

Radioactive Iodine-131: 600
What is it & what does it do?

It's a radioactive isotope of iodine. When administered, it is absorbed into the thyroid gland in high concentrations.
*This liberated radioactive isotope destroys the hyperactive thyroid tissue, with essentially no damage to other tissues in the body.

11

Synthroid: 599

* Used for treatment of hypothyroidism, replacing deficient T3 & T4 hormones.
* Levothyroxine (T4) is now considered the drug of choice for hormone replacement in hypothyroidism.

12

Steroids:

...

13

Testosterone: 617

The dominant male sex hormone. It is the primary natural androgen produced by the testicles.

14

What is the action of androgens?

They are responsible for the normal growth & development of male sex characteristics.
A. Growth & maturation of the prostate
B. Seminal vesicles
C. Penis & scrotum
D. The development of male hair distribution
E. Laryngeal enlargement & vocal cord thickening
F. Alterations in body musculature & fat
distribution.

15

Uses for androgens:

To treat hypogonadism & androgen deficiency as well as for palliation of breast cancer in postmenopausal women w/certain cell types of cancer (suppress cancer cell growth).

16

Hypogonadism-

Reduction or absence of hormone secretion or other physiological activity of the gonads (testes or ovaries).

17

The 4 benzodiazepines approved for use as anticonvulsants are?

1. Diazepam
2. Lorazepam
3. Clonazepam
4. Clorazepate

18

Clonazepam

is useful for the oral treatment of the below listed seizures in children:
Absence
Akinetic
Myoclonic

19

Clorazepate is used with other ________ agents to control partial seizures.

antiepileptic

20

Diazepam & lorazepam must be administerd _____________ to control seizures; they are the drug of choice for treating status epilepticus.

intravenously

21

Diazepam administered as a ______ gel may be used to prevent breakthrough seizures.

rectal

22

What is a breakthrough seizure?

An epileptic seizure that occurs despite the use of anticonvulsants that have otherwise successfully prevented seizures in the patient.

23

Diazepam: seizures 292-294; antiemetic 547

Act as antiemetics through a combination of effects including:
-Sedation
-Reduction in anxiety
-Possible depression of the VC
-Amnesic effect (excess sedation)

24

Benzodiazepines: Therapeutic outcome

The primary therapeutic outcome expected from benzodiazepine antiemetics is relief of-
* Nausea & vomiting

25

Premedication assessment for Benzodiazepines:

1. Review routine blood studies to detect blood
dyscrasias & hepatotoxicity.
2. Perform a baseline assessment of the patient's
speech pattern, degree of alertness &
orientation to name, place & time.
3. Review pt.'s medical record to document the
frequency of seizure activity.

26

Therapeutic outcomes from Diazepam:

1. Reduced frequency of seizures & reduced injury
from seizure activity
2. Minimal adverse effects from therapy.

27

Lorazepam

Used primarily to treat insomnia but may also be used for preoperative anxiety and status epilepticus.

28

Administration:

Lorazepam

IM, IV, Tablets, Oral solution & by injection

29

Lorazepam: seizure 292-294; anxiety 245; antiemetic 547

...

30

Xanax: anxiety disorders 245

...

31

Valium: 245, 293

...

32

Levadopa: 226, 229-230, 233

...

33

Carbidopa: 226, 229-230, 233

...

34

Prozac: 259-260

...

35

selegiline: depression 258-260, Parkinsons 226, 229-231

...

36

Lithium: 271-272

...

37

Wellbutrin (burpropion): depression 266

...

38

Amitriptyline: depression 259-260, 264

...

39

Haldol: 277-278; 283-285; 542-545

...

40

clozapine: psychosis 277, 278; 283-285

...

41

dilatin: seizures 293

...

42

lamictal: seizures 299

...

43

morphine: 321-322

...

44

NSAIDS: pain mgt 312; 331-336

...

45

Aspirin:

...

46

acetaminophen: 321-322

...

47

Seizure care

* Clear area
* protect head
* Do not leave patient
*

48

neuroleptic malignant syndrome:280

...

49

Benzodiazepines

The most commonly used type of sedative-hypnotic.

50

The most common side effects of benzodiazepines include:

*Drowsiness or sedation
*Loss of muscle coordination
*Behavior changes (nervousness, confusion)
*Loss of appetite
*Cardio- Transient hypotension when arising

51

For status epilepticus which 2 benzodiazepines are used for treatment?

1. diazepam- Diastat,Valium (can be given rectal)
2. lorazepam- Ativan

52

The SERIOUS ADVERSE effects of benzodiazepines include:

A. confusion, agitation, hallucinations, amnesia
B. Blood dyscrasias- routine CBC labs
C. Hepatotoxicity- Liver function tests (ALT, AST,
GGT)