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116 Cards in this Set
- Front
- Back
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Best way to prevent antigen exposure for asthma
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avoidance
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Antigen present and IgE and histamine squirts out what do you take?
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cromolyn, steroids
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early response in asthma
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broncho constriction
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What drugs do you give in early response or acute attacks?
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beta agonist, THEOPHYLLINE, muscarinic antagonists
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Late stage asthma attacks what happens and what drugs do yu give?
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inflammation, steroids, cromolyn, leukotriene antagonists
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Bronchoconstriction is mediated by ____ and RELAXATION BY _____.
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1. CHOLINERGIC activity
2. B2 sympathetic activity |
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Inhalers work by blocking ____ with ____ or ipratropium bromide. Or stimulating B2 receptors
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cholinergic activity with atropine (not recommended since bad side effects)
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epinephrine
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non-selective agonist of B2 receptors
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isoproterenol
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non-selective agonist of B2 receptors
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ephedrine
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non-selective agonist of B2 receptors
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albuterol
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selective agonist of B2 receptors
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bitolterol
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selective agonist of B2 receptors
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terbutaline
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selective agonist of B2 receptors
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pirbuterol
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selective agonist of B2 receptors
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salmeterol
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tx as long acting beta blockers for nocternal sleeping asthma. acts as prophylaxis to prevent attack at night
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formoterol
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tx as long acting beta blockers for nocternal sleeping asthma. acts as prophylaxis to prevent attack at night
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relaxes bronchioles by inhibits phosphodiesteraseactivity which increases cAMP . Narrow therapeutic index so can be toxic. related to caffeine
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theophylline
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most anti-inflammatory drugs work by blocking what enzyme
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Cox-2
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prednisone
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given as short 10 day course to control severe asthma. chronic therapy gives osteoporosis, hyperglycemia, increased insulin, cataracts, glaucoma, adrenal atrophy
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beclomethasone
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administered by inhaler. Side effects include greater oral candidiasis, bad taste. Block cox-2
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budesonide
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block cox-2. inhaler. inc candidiasis, taste disturbances. glucocorticoid
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triamcinolone
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block cox-2. inhaler. inc candidiasis, taste disturbances, glucocorticoid
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nedocromil
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mast cell stabilizer
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cromolyn
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mast cell stabilizer
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from arachidonic acid what enzyme is blocked to antagonize leukotrienes?
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5-lipo-oxygenase
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from arachidonic acid what enzyme is blocked to antagonize prostaglandins?
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cyclo-oxygenase. ASPIRIN (NSAIDS) ACT HERE
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What 3 leukotrienesd play major role in process of inflammation?
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C4, D4, E4
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Zafirlukast
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leukotriene receptor antagonist
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montelukast
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leukotriene receptor antagonist
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zileuton
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leukotriene synthesis inhibitor
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binds to human IgE, avoids the release of IgE mediators like mast cells and everything else. Administered by injection. Anaphylaxis is black box warning
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omalizumab
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omalizumab
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prevents IgE. IgE is used to kill parasites so this drug not given in area with lots of parasites.....hahah
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celecoxib
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cox-2 inhibtor
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T/F NSAIDS are contraindicated in asthma patients (severe).
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true. 1000mg tylenol too much
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t/f- non selective beta blockers will exacerbate asthma andf make B2 agonist therapy less effective
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true
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t/f opiate agonist and barbituates can cause asthma attack
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true
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barbituates, phenytonin, rifampin
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increase hepatic metabolism of theophylline making it not work in asthma patients
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cimetidine
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H2 receptor antagonist in stomach. Used as tx for heartburn.
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What drugs can make toxic levels of theophylline?
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Beta blockers, erythromycin, ciprofloxicin,
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ranitidine
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H2 receptor antagonist in stomach. Used as tx for heartburn.
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famotidine
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H2 receptor antagonist in stomach. Used as tx for heartburn.
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nizatidine
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H2 receptor antagonist in stomach. Used as tx for heartburn.
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diphenhydramine
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strong alpha and muscarinic blockade (sleepy sleep) used for allergy, sleep aid, motion sickness
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dimenhydrintae
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strong alpha and muscarinic blockade (sleepy sleep) used for allergy, sleep aid, motion sickness
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chlorpheniramine
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used for allergy. much reduced CNS and dec sedating as benadryl
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cyclizine
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used for allergy. much reduced CNS and dec sedating as benadryl
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fexofenidine
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used for allergy. no side effects or CNS effects
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loratidine
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used for allergy. no side effects or CNS effects
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cetirizine
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used for allergy. no side effects or CNS effects
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what class of drugs have anti-emetic properties?
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antihistamines (H1), antimuscarinics (M1), dopamine (D2), seratonin (5-HT3)
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in old people what receptor effects can lead to old people falling from orthostatic hypotension?
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alpha receptora
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where do all immune cells originally come from
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hemotopoetic stem cells
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prednisone and dexamethasone
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potent immunosuppressive agents. used in glomerulonephritis and myasthnia gravis,
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how does predinisone and dexamethasone work?
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block lymphocyte cell proliferation, block changes that result is tissue destruction.
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Patients with adrenal insuffenciency should recive therapy and gain glucocorticoid levels close to ___mg during surgery
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100mg
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After glucocorticoid therapy during surgery how long should patient recieve hydrocortisone?
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hydrocortisone q 8 hrs for next 1-2 days
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What is in hydrocortisone that can elict asthma attack
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sulfites
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what effect does glucocorticoids have on diabetics?
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hyperglycemia.
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cyclophosphamide
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used with prednisone in lymphoid immunosuppression. for autoimmune disease. stop b cells at proliferation
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chlorambucil
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used with prednisone in lymphoid immunosuppression. for autoimmune disease. stop b cells at proliferation
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azathioprine
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purine antagonist used with prednisone in lymphoid immunosuppression. for autoimmune disease. stop b cells at proliferation
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methotrexate
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used with prednisone in lymphoid immunosuppression. for autoimmune disease. floic acid analogs. stop b cells at proliferation
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mycophenolate
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prevent RNA synthesis and cellular proliferation. used to help organ not be rejected.
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leflunomide
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prevent RNA synthesis and cellular proliferation. used to prevent autoimmune disease like rhematoid arthritis
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Drug of choice for transplant rejection
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cyclosporine
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working by blocking calcineurin activation of T lymphocyte activation
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cyclosporine
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tacrolimus
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work against T-cell activation
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sirolimus
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work against T-cell activation
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Major side effect of cyclosporine and tacrolimus
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nephrotoxcity
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major side effect of sirolimus
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hepatic toxicity
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What does normal blood sugar usually stay around?
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60-150 mg/Dl
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classical signs of diabetes mellitus
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ketoacidosis, hyperglycemia, polyuria (lots of urine), polydipsia (always thirsty), polyphagia (always hungry), weight loss
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Lispro
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short acting and short duration insulin (fastest acting one). less than 15min onset. 3-4 hr duration
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t/f regular insulin is the only approved IV insulin
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true
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isophane
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intermediate acting insulin. 1-3 hr onset. Lasts all day
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tolbutamide
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sulfonylurea. releases endogenous insulin from pancreas, increase cells to regular insulin. only effective in type 2 diabetes (non-dependent insulin)
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acetohexamide
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sulfonylurea. releases endogenous insulin from pancreas, increase cells to regular insulin. only effective in type 2 diabetes (non-dependent insulin)
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glyburide
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sulfonylurea. releases endogenous insulin from pancreas, increase cells to regular insulin. only effective in type 2 diabetes (non-dependent insulin)
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glipizide
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sulfonylurea. releases endogenous insulin from pancreas, increase cells to regular insulin. only effective in type 2 diabetes (non-dependent insulin)
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repaglinide
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sulfonylurea. releases endogenous insulin from pancreas, increase cells to regular insulin. only effective in type 2 diabetes (non-dependent insulin)
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rosiglitazone
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enhance tissue sensitivity to insulin so it needs endogenous insulin to work.
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pioglitazone
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enhance tissue sensitivity to insulin so it needs endogenous insulin to work.
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metformin
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reduces glycogenolysisand hepatic glucose formation
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acarbose
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decrease GI absorption of carbs which reduces dietary intake not insulin
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miglitol
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decrease GI absorption of carbs which reduces dietary intake not insulin
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what happens with high aspirin doses in diabetic?
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hyperglycemia
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what is included in dental emergency kits to break down glycogen to glucose in minutes?
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glucagon
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disease is lack of ADH in pituitary gland. want lots of water aND PEE a lot
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diabetes insipidous
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desmopressin acetate
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replaces ADH and increases urinary concentration. diaetes insipidous
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vasopressin
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replaces ADH and increases urinary concentration. diaetes insipidous
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in nephrogenic diabetes insipidous what drug do you give them?
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desmopressin, HCTZ and low soidum diet
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T/F- should you alter your tx as dentist for diabetes insipidous?
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no
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T/F- more people are hypothyroid than hyperthyroid
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true
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Thyroid gland secrets more T4 than T3. Hypothalamus- TRH- Anterior pituitary- TSH- Thyroid gland- T3,T4
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ture
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somatostatin, dopamine, high levels of glucocorticoids
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inhibits relaese of TRH from hypothalamus.
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What 2 things are used to diagnose hypothyroidism
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Free T4 and TSH levels
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Low T4 and high TSh means?
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thyroid not working
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Low T4 and Low TSH means?
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hypothalmus not working right
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Liotrix
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used as therapy for hypothyroidism. Don't mix w/ epinephrine
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Liothyronine
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used as therapy for hypothyroidism, don't mix w/ epinephrine
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Propylthiouracil
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antithyroid drug, inhibits thyroid hormones. Inhibitsw iodine to thyroglobulin.
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methamizole
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antithyroid drug, inhibits thyroid hormones. Inhibitsw iodine to thyroglobulin.
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T/F- iodide can not substitute for antithyroid drugs
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true- it cannot.
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Ipodate and beta blockers
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inhibit T4 to be broken down to T3.
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The dialy intakes of iodide is 30-100 mg to protect thyroid from radiation.
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true- hyperthyroidism is treaterd with radiactive iodide.
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What drugs are used for thyrotoxicosis?
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Beta blockers. They block some of the effects of hyperthyroidism. They cause lower heart rate, reduce tremor. Can cause bronchospasm though
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what meds do you give during a thyroid storm?
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anti-thyroid drugs, Beta antagonist, corticosteroids, potassium iodidie, IV glucose and saline.
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Bisphosphonates reduce osteoporsis by ____%
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50%
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Parathyroid hormone
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increases calcium reabsorption from urine ANd bone. (Release the hounds and calcium PTH)
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calcitriol (vit D)
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produced from liver and kidney. Increases absorption from GI tract, decreases rwenal elimination and increases calcium resorptions from bone.
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calcitonin
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decreases bone resorption from bone and retakes the Ca in blood into bone. (Keep the Calcium calcitonin)
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Estrogen
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Has role in Ca absorption (retention). Long term use leads to breast and cervicaal cancer
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alendronate
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stabilize bone structure and reduce bone resorption. PROMOTES NEW BONE FORMATION. esophageal ulcerations!!!! Do not lie down 30 min. Drink a lot of water
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risedronate
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stabilize bone structure and reduce bone resorption
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What 3 emergency drugs do we have for asthma attack
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Alupent (albuterol inhaler), aminophylline, epinephrine 0.5ml 1:1000
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Adrenal crisis- circulatory collapse, sweating, headache, weak pulse, coma. What drug do we give them
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Solu-Cortef100mg vial
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