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125 Cards in this Set

  • Front
  • Back
Pancreas produce the hormones______ and _____. The ___ cells produce ____ and the ____ cells produce ___
insulin and glucogon
beta, insulin
alpha, glucogen
The pancreas has two glands.. the ____ gland secretes hormones directily into the blood streem, and the ____ gland secretes enzymes into the duodenum via pancreatic ducts
endocrine, exocrine
Symptoms of Diabetes mellitus.
Polyuria- excessive peeing
polydispia- excessive thirst
polyphagia- excessive apetite
unexplianed weight loss
Hyperglycemia
criteria for diagnosis of DM:
Symptoms of diabetes +casual plasma glucose level higher than or equal to ___ mg/dl
200
criteria for diagnosis of DM:
fasting plasma glucose higher than or equal to ___ mg/dl. This is no calorie intake for _ hours
126, 8
criteria for diagnosis of DM:
2 hour postload glucose level higher than or equal to ____mg/dl durin an oral glucose tolerance test. This is a ___ hour fast before this test
200, 12
DM 1, there is lack of ____ production or production of ____ insulin. Affected patients need _____ insulin. Complications of DM is ____ ____. and oral antidiabetic drugs are _____ effective
insulin, or defective, exongenous, DKA, NOT
Most common DM is type _. It is caused by insulin ____ or insulin ____. Tissues in the body are resistant to insulin because a _____ number of insulin receptors and the insulin receptors are ___ responsive
2, resistance, deficiency, reduced, less
major long term complications of DM. Macrovascular (atherosclerotic plaque) coronary artiers, cerebral artiers, peripheral vessels
Microvascular (capillary damage)
Retinopathy- Blindness
neuropathy- vessel damage to the periphery
nephropathy- damage to the kidneys
Hyperglycemia that develops during pregnancy
Gestational diabetes
True or false. Insulin must be given to prevent birth defects
True
Gestational diabetes usually subsides after deliver
True
30% percent of patietns may develop type 2 DM with in 10 to 15 years
true
Screening for DM:
FPG levels higher than or equal to 110 but <126 mg/dl may indicate ______
Impiared glucose tolerace test.
prediabetes
Treatment for DM:
Type 1
___ ____
Type 2
____ _____
___ ___ ____
Insulin when the above no longer provide glycemic contorl
insulin therapy
lifestyle changes
oral drug thera
Insulins for DM is a substitute for the endogenous hormone and the ___ are the same as if it were your own
effects
Insulin restores the diabetic patients ability to ____ carbs, fats and protiens, stores ____ in the liver and converts ____ to the fat stores
metabolize, glucose, glycogen
Insulin was derived from Pigs and Cows. but the most insulin used now is human derived, using recombinant DNA technologies
Goal: tight glucose control, to reduce the incidence of long-term complications
Rapid acting
oonset 5-15 minutes
short duration
Insulin aspart (novolog)
Insulin lispro (humalog)
insulin glulisine (apidra)
Short- acting
onset 30-60 minutes
the only insulin product that can be given by iV bolus, IV infusion
Regular insulin (humulin R, Novolog R
Intermediat acting
Isophane insulin suspension
Insulin zinc suspension
Both have a ___ appearance slower in onset and more prolonged duration than endogenous insulin
NPH, Humulin N and L, Novolin N and L
Cloudy
Long acting
white and opaque
Extendned insulin zinc suspension
Glargine (lantus)
Humulin U
mixing insulin.. ____ frist
fast
in sliding scale:
No insulin < than
2 units
4 units
6 units
call if blood sugar is >
140
141-199
200-249
250-299
300
Oral antidiabetic drugs may not be effective unless the pt makes behavioral and ____ changes
lifestyle
Most common oral drug used is _____ or ____
glucophage, metformin
oral drug thiazoleidinediones enhance sensitivit of _____ receptors. Alpha-glucosidase inhibitors delays ____ of glucose
insulin, absorption
Abnormally low blood glucose is called_____
hypoglycemia
Mild cases are treated with diet of ____ and ____ intake of carbs
protein, lower
The brain needs _____. Hypoglycemia if caught early, causes: ? and later can cause hypothermia, seizures, and coma if not trated
confusion, irritability, tremors sweating.
Oral forms of glucose is 50% ____ in water, ____ and diazoxide
dextrose, glucagon
When the supply of o2 and nutrients in the blood is insufficient to meet the demands of th heart, the heart muscle aches
Angina pectoris
Thehear requires a large supply of ____ to meet the demands placed on it
O2
Poor blood supply to an organ.
Poor blood supply to the heart muscle, atherosclerosis, CAD
Necrosis or death of cardiac tissue
Ischemia
ishemic heart disease
myocadial infarction
Types of angina
chronic stable angina, unstable angina, vasospastic angina
info
Therapeutic objectives is to ____ blood flow to the ishemic heart muscle and ____ myocardial oxygen demand
increase, decrease
Nitrates cause ____ due to relaxation of smooth muscles and used to prevent and ____ angina
vasodialation, treat
Vaodilation results in ____ myocardial o2 demands. Causes dilation in both ___ and ____ coronary vessels. Result is ____ to iischemic myocardial tissue. Nitrates alleviate coronary artery spasms
reduced, large and small. O2
Prevent tolerance by allowing nitrate free periods at ____ for 8 hours before appplying new patch
bedtime
when taking nitroglycerin, instruct patients not to chew SL forms and stinging will occur means that the drug is still potent
info
Potency of NTG is lost in about _ moths after the bottle has been open.
3
NTG should be stored in airtight dark glass bottel with a metal cap. No _____ filler becaue this works against potency
cotton
if angina pain occurs.
Stop activity
take SL NTG and wait 5 minutes. repeat 2 more times if no relief. call 911
info
How to tell if NTG is working
BP decreases 10 mmH/g or pulse rises 10bpm
Tenormin, Lopressor, Inderal, Corgard. any thing that endes in LOL
Beta blockers:
Mechanism of action for B- blockers:
__ receptors on the heart are blocked. ____ the HR, results in decreased myocardial O2 demand and increased o2 delivery to the heart. _____ myocardial contractility helping to conserve energy or decrease demand
B1 receptors, Decrease, Decrease
B-Blockers block the harmful effects of _______, thus improving survival after MI
catecholamines
B-blockers are used for angina, antihypertensive, cardiac dysrhythmias, cardioprotective effects, migraines and dstage fright
info
Adverse effects of beta blockers. Bradycardia, hyptension, dizziness, fatigue, mental depression, lethargy drowsiness
info
Patients taking b blockers should monitor pulse rate daily and report any rate lower than __ beats per minute
60
B- blockers are for ___ term prevention not immediate relief, and should never be ____ discontinued due to risk of rebound hypertensive crisis
long, abruptly
Patients using beta blockers should report weight gain of _ lbs in 1 day or _ lbs in 1 week
2, 5
Verapamil (calan, isoptin)
Diltiazem (cardizem)
Nifedipine (procardia)
amlodipine (norvasc)
Calcium channel blockers
CCB is used for coronary artery vasodialation, reduces the workload of the heart which reduces myocardial need for o2
Before administering CCB, need health history, obtain baseline VS and assess for drug interactions
Grapefruit juce will affect ____
CCB
4 stages of BP measurements
Normal
Pre
stage 1
stage 2
120/80
121-129/81-89
130-149/90-99
150/100
True or false.. the DBP is not longer considered to be more dangerous than the SBP
true
What should be the first drug therapy for patients with hypertension
Thiazide diuretic
Hypertension can be defined by its cause which is unknown cause, known as essential idiopathic, or primary.. 90% of cases
Known cause of hypertension is called secondary and is 10% of the cases
which system slows the heart rate and decreases the speed of conduction through the AV node
parasympathetic
This nervous system stimulates the heart to beat faster, speeds conduction through the AV node, and causes the heart muscle to contract harder
Sympathetic nervous system
Baroreceptors are located int he ____ and________ _____
aorta and carotid
The left ventricle puts out _ liters of blood per minute
5
Antihypertensive drugs
Beta blockers
Block vaso_______, decrease heart rate, decrease cardiac muscle contaction increase blood flow to kidney awhich leads to a decrease in renin
constiction
Beta blockers reduce heart rate through the B1 blocade
info
Alpha blockers_ Dilate arteries and veins which reduces peripheral vascular resistance and thus decreases blood pressure
info
ACE
Angiotensin Converting Enzyme inhibitors
ACE is often used as first-line ddrugs for HF and hypertension.
True
ACE inhibits antiotensin 1 to becomming Angiotensin 2 Which causes a potent vasoconstrictor and causes ____ secretion from the adrenals
aldosterone
Aldosterone stimulates ___ and ____ resorptoin
sodium and water
Reabsorption of water and sodium increases ____ ____ and _____ and _____
blood volume, preload, BP
ACE results in systemic vascular resistance, vasodilation which decreases the ____ ____
Blood pressure
Drug of choise in hypertensive pt with HF is ____
ACE
What type of hypertension drugs are these?

Captopril (capoten), Enalapril (vasotec) Lisinopril, and quinapril)
ACE
Captopril and lisinopril are NOT prodrugs
ACE Inhibitors
Drug inactive when administered form. bust bey bio transformed in liver to have an affect
Prodrug
ARB
Antiotensin II Recptor blockers
These drugs let antiotensin I turn into angiotensin II but blocs the receptors that recieve angiotensin II
ARB
ARB and ACE Block vasoconstriction and release of aldosterone
true
Losartan (Cozaar, Hyzaar), Valsartan (diovan), Eprosartan (teveten), Irbesartan (avapro)
ARBS
This drug causes smooth muscle relaxation by blocking the binding calcium to its receptors, preventing muslce contraction. This causes decreased peripheral smooth muscle tone and decreased systemic vascular resistance, resulting in decreased Bp
CCB
Benzothiazepines (diltiazem, Phenylalkamines (verapamil) Dihydropyridines (amlodipine, nicardipine, nifedipine)
CCB
Thiazides are most commonly used diuretics for hypertension
info
Hydralazine (apresoline) Sodium nitroprusside (nipride)
vasodilators
This is caused by a viral infection that invades tissues of upper respiratory tract, cuasing upper respiratory infection URI
Common Cold
Mucosal irritation also causes release of several inflammatory and vasoactive substances, dilating small blood vessels in the nasal sinuses and causing nasal congetsion
info
Treatment of the common cold is -______ only, not curative
symptomatic
Two histamine receptors:
this mediates smooth muscle contractions and dilation of capillaries
Mediates the acceleration of the heart rate and gastric acid secretion
H1
H2
Antihistamines have several properties, antihistaminic, anticholinergic, sedative
info
Antihistimes blocks ____ at the H1 receptor
histamine
Histimines cause _____, increased GI and respiratory secretions, and capillary permeability
Vasodilation
Histamines ___ vessles, Antihistimine _____ dilation
dilates, reduces
Stimulates salivary, gastric, lacrimal, and bronchial secretions
histamines
reduces salivary, gastric, lacrimal and bronchial secretions
antihistimines
____________ is used for nasal allergies, allergic reactions, parkinsons disease, and sleep disorders
antihistimines
Fexofenadine (allegra), Loratadine (claritan),cetirizine (zyrtec)
Antihistimines.
Oral decongestants are exclusively adrenergics. sudafed
INFO
Topical nasal decongestants, use no longer than 5 days. Raises BP. Afrin
info
Topical nasal steroid decongestants. Beconase, pulmicort, nasacort, flovent, azmacort. if not better after 3 weeks D/C
info
Site of action for nasal decongestants
Blood vessels surrounding nasal sinuses
respiratory secretions and foreign objects are naturally removed by the ??
Cough reflex
Congested, removes excessive secretions. what type of cough
Productive cough
Dry cough is what type of cough
nonproductive
Coughing is harmful after what?
surgery
Opiod and nonopiods are used for _____ coughs!
nonproductive
nonopiods and Opiods ____ the cough reflex by direct action on the cough center in the medulla
sepresses
Antitussives are used to ____ the cough reflex when the cough is nonproductive and/or harmful
stop
Benzonatate (tessalon), Dextromethorphan (vicks 44), Opiods (robitussin, dimatane)
Antitiussives
Drucs that reduce the mucous down
Expectorants
guaifenesin (mucinex)
Expectorant
Drugs that accelerate the rate of urine formation. Result is the removal of sodiumand water
Diuretic drugs
what percentage of soidum is reabsorbed in the blood stream in the ascending loop of henle
20-25%
what percentange is reabsorbed in the convoluted tubules
5-10%
Acetazolamide (diamox)
carbonic anhdrase Inhibitors (CAIs)
Inhibition of carbonic anhydrase reduces H+ ion concentration in renal tubules. As a result there is increased excretion of everything. Reabsorption of water is decreased and urine volume is increased
Carbonic anhydrase Inhibitors
Bumetanide (bumex) ethacrynic acid (edecrin) furosemide (lasix)
torsemide (demadex
loop diuretic
This diuretic acts directly on the ascending limb of the loop of henle to hinbit chloride and soidum reabsorption
Loop
This diuretic woks mostly in the proximal tubule, Nonabsorbable, producin an osmotic effect, pulls water into the renal tubules fromthe surrounding tissues. Inhibits tubular resorption of water and solutes, producing a rapid diuresis
Osmotic diuretic
Mannitol (osmitrol)
osmotic diuretic
Amiloride (midamor) spironolactone (aldactone) triamerene (dyrenium
Potassium-sparring diuretics.
work in collecting ducts and distal convuluted tubules, interfere with soidum potassium exchange. binds to aldosterone receptors, blocks reabsorption of sodium and water
Potassium diuretics
hydrochlorothiazide, chlorothiazide, trichlormethiazide,
thiazide diuretics
zaroxolyn
thiazide like
used for most hypertensions
Hydrocholorthiazide
this pulls h20 in the renal tubule
osmotic