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200 Cards in this Set
- Front
- Back
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The Factors that contribute to the safety or potential harm of drug therapy during pregnancy are: (3)
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Drug properties, Fetal age and Maternal factors.
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During the ____ Trimester the greatest percentage maternally absorbed drugs gets to the Fetus .
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Last
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Any change in the mothers physiology that could impact the pharmokinetic character of drugs are:(4)
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Absorbtion, Distrubution, metabolism, and excreation
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Drugs that are more toxic in children include: (3)
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Phenobarbital,Morphine and Asprin
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Drugs that children tolerate as well as adults include.
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Atropine, Codine Digoxin, Phenylephren.
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Corticosteriods are only given through____ in children
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Sprays
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Flouriquiniloles antibiotics may damage cartilage, which could lead to deformities in___
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gait
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Characteristics of pediatric patients that play a significant role in dosage calculation (5)
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permeable skin, low stomach acid, Weak mucus in lungs, temperature less regulated, L K are impaired
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The most commonly used OTC for the elderly are (3)
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Analgesics, Laxitives and NSAIDS
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an elderly dev. adverse affects one or more of the medications taken with another medication for more potential adv. effects.
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Perscribing Cascade
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On the elderly, there should be an emphasis on the drugs that are on the (4)
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Liver, Kidney, cardiovascular, CNS
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___ drugs are higher in elderly because they have less body water in which the drug could be less diluted.
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Water Soluble (lean Mass decrease which results in increase body fat)
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____ and ___ drugs are primarily distributed to the fat, and takes longer for elders to process
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hypnotics and sedatives
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Factors that affect the Geriatric patients response to drug therapy. (3)
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slow liver, reduction of blood flow, decreased glomerular filtration rate.
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A syndrome of amnesia and confabulation (making up stories) Associated with chronic ETOH abuse.
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Korsakoff's Psychosis
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A Nuerologic disorder characterized by apathy drowsiness ataxia nystagmus and opthalmoplegia caused by thiamine (vit B1) def.
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Wernicky's encelopathy.
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___ and ___ are the only two analgesics used
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Morohine and Codeine.
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The problem with Heroin is that it has an effect on the ___
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Respiration
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Controversial opiod that is perscribes but also can be abused
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oxycodon
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An opiod that helps treat Chronic opiod independence. dosed 1 day (12-24hr)
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Methadone
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Drug that blocks opiod receptors , good for withdrawl of opiod drugs.
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Naltrexone (free of opiods for 1 week before administer)
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Naltrexone can also be used for
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Alcoholocs
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Inhibits pts from ETOH
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Disfulbrium
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Give Disfulbrium if the patient is not drinking for
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2 weeks
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Morphine and Codeine are mainly used for patients who have
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Back pain
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To take away opiods in the stomach, ___ is given 2-3L
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Drinking charcoal
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An acute treatment drug for opiod users where its a reversal agent for morphine
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Narcan
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___ and ___ are the most commonly abuse stimulants
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coke and amphetamine
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A stronger affect of amphetamine
15-20 time potent |
methamphetamine (crystal)
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Known as the love drug which has a calming effect
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MDMA, E, methalenedioxymethamphetamine
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___ drug that gives a temporary illusion of limitless power and energy and afterward leaves the user feeling edgy and depressed
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coke
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Coke is an ___ powder, taken ___ or ___Which causes ___ and ___
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oderless, snorted, injected dysrythma, and seizures
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Coke known as a date rap drug
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Roofy
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___ drug that gives a temporary illusion of limitless power and energy and afterward leaves the user feeling edgy and depressed
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coke
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Coke is an ___ powder, taken ___ or ___Which causes ___ and ___
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oderless, snorted, injected dysrythma, and seizures
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Coke known as a date rap drug
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Roofy
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Drug that relieves anxiety and insomnia
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Benzodiazapines
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Benzodiazapines are lethal when taken with
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ETOH
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Most commonly abused drug in the world (2-3hrs)
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Marajuana
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A depressant that creates a relaxed, drunken feeling that last 2-8 hours. Commonly used with ETOH
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Roofies (fluntrazepam)THE DATE RAP DRUG.
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Depressant that has the same effects as the nuerotransmiter GABA
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GHB
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Barbituates and Benzodiazapines are known to
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increase the action of GABA
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THC (pot) stimulates the sympathetic NS which affects
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Tachy, hallucination, unsteady gait, anxiety and paranoia
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Is a synthetic FDA approved THC perscription capsule used for indications for symptoms of AIDS and Cancer,
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Dronabinol
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Used to acutely reverse the sedative effects of benzodiazapines. competes the benzo CNS receptors
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Flumazenil
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Sedation used before surgery that is a benzo. also decreases opiod effects
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Valium (diazapam)
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Valium ___ muscle movement, get into ___, and increases ___ thoughts
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relaxes, deep coma, suicidal
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Upper drug that has similar effects as meth
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Ritaline
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treatment for ETOH which gives undesired effects
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Disulfiram
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Smoking releases ___, creates physiological stress. and calming effects relates to___
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epinephrine, increased deep breathing.
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First nicotine free prescription medicine to treat nicotine dependence
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Zyban
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Estrogen are sometimes referred as ____ but some are
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Steroid hormones , non-steroidal
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The most popular estrogen today is known as
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conjugated estrogen (Premarin)
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A nonsteroidal estrogen used in the past that caused genital defects to offspring
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DES
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hormone that plays a role in shaping of body contours, and development of skeleton.
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Estrogen
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Common use for estrogen is to help with ____ to counter its deficiency
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HRT Hormone Replacement Therapy
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The most serious effects of the estrogen hormone is
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thromboembolic events
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___ are a desired effects of the skin when taken estrogen which casues black spots
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chloasma
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Estrogen decreases the activity of ___
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oral anticoagunlants
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___and ___ can decrease its estrogenic effect
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Rifampin St. johns wart
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List 7 Estrogenic agents
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Cenestin, Premarian, estrace, Fempatch, Vivelle, Climara, DES
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The binding of estrogen receptors stimulates (3)
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synthesis of RNA and DNA and proteins
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Development of female secondary sex characteristics
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feminization
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Estrogen regulates (4)
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Menstral disorders, uterine bleeding, menapuasal problems, and as a contraceptive
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Men use ___ as a hormonal therapy for cancers of the reproductive and urinary system
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Estrogen
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Estrogen must be used Judicially due to
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Cancer causing potential
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The 5 main side effects of estrogen are
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Thrombophlebititis (inc. clot)
N/V Breast tenderness Hyperglycemia males-hormone imbalance |
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Estrogen given with Tetracyclic antidepressants causes
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TCA toxicity
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Drug that decreases the effect of estrogen when taken
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nicotine
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Name 4 combined estrogen/progestin products
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prempo, premphase,femhrt, combipatch
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Used in tx of (uterine lining) (4)
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endometriosis,dymenorhhea, amenorhea and to supress ovulation
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Progestin is uselful in the treatment of functional ___ caused by hormonal imbalance, fibroids, uterine cancer
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functional uterine bleeding
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a progestin that stimulates the growth of mam tissue, treat uterine bleeding, prevents endometrial cancer
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medroxyprogesterone (provera, depo-provera)
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Used as a palliative effects for cancer patients and AIDS
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megastrol (Megase)
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The most serious undesirable effects of progestrins (3)
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Liver dysfunction, thrombophlebititis,
pulmonary embolism. |
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There have been reports that progestin agents decreases ___
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Glucose Tolerance When antidiabetic agents are taken
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Progestins are not given to those who have (4)
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thrombophlebitis, liver disease, vaginal bleeding, breast cancer.
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Progestrin is the only ___ given daily
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contraceptive
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Name 6 Contraceptive agents
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Ortho-Novum, Loesterin,Necon, Transdermal contraceptives, Depo-provera, NuvaRing
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Contraceptives increases
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Blood loss
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Contraceptives are contraindicated to
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Breast Cancer
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A contraceptive where estrogen and progestin dose are the same throughout the cycle.
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Monophasic
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Contraceptive that contain fixed estrogen dose but a low progestin
10 day packs or 21-28 day packs |
Biphasic
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Contain 3 different estrogen-progestin ratios that are administered sequentially in 21-28 day packs
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Triphasic
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Name three side effects of taking contraceptives
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Hypo-tension
Thrombophlebititis Bleeding breast |
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Antibiotics Barbituates GGriseofulvin Isoniazid Rifampin ___ effects from ___
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decreases, OCPs
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Anticonvulsants B-blockers, Hypnotics, TCA, Vitamin, ____ effects of the drugs
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OCP decrease
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Supplements considered for women at risk for osteoparosis
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CA and Vit D
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used to treat osteoporosis and piaget's disease.
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Biphosphonates
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this drug works by inhibiting osteoclasts nediated bone absorbtion. First non hormone (estrogen) drug.
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Alendronate (Fosamax)
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A selective estrogen receptor modifier (SERM) that is used mainly in the treatment of post-menapausal osteoperosis
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Relaxofine (Evista)
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drug not used much for osteporosis but cancer
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Tamoxifin (NolVadex)
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Biphosphonates main concern is
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GI upset (give 8 oz of water)
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SERMS main concern is
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hot flashes with leg cramps
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___ supplements can interfere with absorption of biphosphonates and should be spaced 1-2 hrs
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Ca+
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___ decreases the absorption of Evista (relaxofine)
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Ampicillin and cholestyramine
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Evista (raloxifine) can decrease the effects of
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Warfarin
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The newest drug used against osteoparosis, where its derivative is the parathyroid Hrmone.
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Triparatrade (forteo)
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Triparatide (forteo)works by modulating the ___ and ___similar to the parathyroid hormone
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Ca+ and Phosphorous
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A substitute derived from salmon comes injectable and nasal spray used in treatment of osteoparosis
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Calcitonin (miacalcin)
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A fertility agent that triggers a low estrogin levels in the brain which increases FSH and LH to increases maturation of ovarian follicles
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Clomiphene (clomid)
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A fertility agent given to infertile male clients to stimulate spermatogenisis. Extracted from urine in postmenapausal women
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Menotropins
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Used to stimulare uterin contractions which mimics oxytocin
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oxytocics
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The 3 main oxytocics are
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Methegrain, RU-486, and Oxytocin (Pitocin)
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These are drugs given to inhibit labor and maintain prgnany
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tocolytics
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The common trait of tocolytics are (2)
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Relax smooth muscle, stops uterine from contracting
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Two main Tocolytics
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Ritrodine, Terbutaline
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Antibiotics should be taken with a ___ and Taken ___
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Full stomach, all fully
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The higher the concentration of the the antibiotic the ____
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more toxic
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Antibiotics could cause ___ Because it knocks out the normal flora
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Yeast infections
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Signs of yeast infections after giving antibiotics would be shown within ___ and ___ would also be see
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48hrs. Fluid
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Antibiotics ___ and ____ are assessed before giving them
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Peak and trough
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Peak is drawn ___ after concentration, Trough is drawn ___ next dose
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30 min. before
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A temperature at ___ shows that the bacteria are multiplying
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102
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A method used to prevent an infection.
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Prophylactic antibiotic therapy
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Certain antibiotics that infants and children may not be able to receive are
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Tetracycleen (teeth), flouroquinolols (cartilage)
sulfonamides (hyperbilirubin) |
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Penicillin are known to be ___ to pregers
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Teratogens
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A person with a ___ could create destruction or lysis when taken penicillin
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G6PD
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Sulfonomides are affected by ___ bacteria
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folic acid
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Sulfa drugs that is often used to treatment of UTI's, and Oppertunistic infections (HIV)
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co-timazole
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An oral sulfa agent which gives a hypoglycemic effect to DM. but used also for siezures
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Sulfureas
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Sulfureas could develope ____
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Kidney Stones
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Bacteria that causes destruction of penicillin
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B-lactamases (penicillinases)
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The least toxic group of antibiotics
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Penicillin
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Penicillin causes ___ when given Lasix and HCTZ
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Hypokalemia
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Drugs that have and -olol ___ the effects of penicillin
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decreases
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Penicillin is given injection ____ because its ___
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slowly, thick
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The antibiotic that is known to destroy a broad spectrum of bacteria
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Cephalosporins
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Cephalosporins are commonly directed towards ___ but varies in ___ and ___
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G-, Anerobic, G+
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Patients who are allergic to penicillin ___ take cephalasporin
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Should not
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Main antibiotic for gonorrhea
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Cephalosporins
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Cephalosporins cause N/V to ___
decreases its affects to ___ |
ETOH, contraceptives
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Cephalosporins absorbtion of ___ decreases its effects
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Fe+
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The Superinfection is caused by the ____ when cephalosporins wipe them out
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c-diff
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Macrolides are considered ___, howerver in high concentrations they may be ___ to some suseptible bacteria
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Bacteristatic, Bacteriocidal
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Azithromycin and clarithromycin are the same as erythromycin only that ____
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there given less and last longer
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Erythromycin have a ___ taste
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bitter
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Erythromycin treats varies disease ranging from ___ and ___
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Lymes disease and Legionare's Disease.
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Macrolides work best with other drugs because of its ___
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Protein Bound Properties
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Erythromycin also treats ___ and ___
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oppertunistic infections (HIV) and STD infections
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Tetracyclines are not given to (4)
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Milk, Iron salts,antacids and pregers
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Tetracyclines differ in relation to (3)
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Oral absorption, Body Tissue, Half-life
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Aminoglycosides are better used for
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Viral infections
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Aminoglycocides are never given
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Orally
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Aminoglycocides ____ are checked because of its effects in ____ and ____
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concentrations, nephrotoxicity, ototoxicity
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Aminoglycocides are mostly given
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ones a day
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Only the ___ levels are checked for because of insuring renal clearance
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trough
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Trough levels of aminoglycocides are measured below____ to prevent from toxicity
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2mcg/ml
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Aminoglycosides are also given ___ to surgery and to ___
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prior neonates
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The main problem Adverse effect of aminoglycosides are ___ which could lead to ___
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ringing of ears Hearing loss
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Hydration is important for aminoglycosides because they are ___
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Highly concentrated
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Aminoglycosides also decrease clooting factor due to
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decrease effects in Vit K
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The two most common aminoglycocides are
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gentomycin Tobamycin
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A very potent broad spectrum antibiotic
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Flouriquinolones
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Flouriquinolones are given specically when there is ____
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An anthrax outbreak
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Flouriquinilones are also given when there is a ____
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bacterial resistance
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primarily used to make steroid hormones, cell membranes, and bile acids.
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Cholesterol
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function as an energy source and are stored in adipose tissue.
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Triglycerides
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The risk of CHD in clients with levels of cholesterol
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>300mg/dl
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Negative Risk Factors: of cholestrol
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High HDL cholesterol >60 – if the HDL is >60, subtract one risk factor
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The most potent of all the drugs available for decreasing plasma concentration of LDL
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HMG-CoA reductase inhibitors (Statins)
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Statins)lower blood cholesterol by decreasing the rate of cholesterol production and inhibiting the enzyme necessary for
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the liver to produce cholesterol.
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Recommended by the NCEP as 1st line drug therapy for hypercholesterolemia
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HMG-CoA reductase inhibitors (Statins)
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commonly used to decrease total cholesterol, LDL & triglycerides and increase HDL.
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Lipitor
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They are taken every day usually with the evening meal or HS.
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HMG-CoA reductase inhibitors (Statins)
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Action: resins bind bile, preventing the resorption of the bile acids from the small intestine.
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Bile Acid Sequestrants (bile acid binding resins)
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Effective and inexpensive combination with other antilipemic drugs to enhance the lipid lowering effects
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Niacin (Nicotinic Acid, Vitamin B)
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Niacin (Nicotinic Acid, Vitamin B) are effective in lowering triglyceride, total cholesterol, and LDL levels. Also increases the
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HDL.
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Niacin is used in much larger doses when used as a
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vitamin.
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Primarily affect the triglyceride levels but also lower the total cholesterol and LDL
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Fibric Acid Derivatives (fibrates)
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Only member of a brand new class used to treat dyslipidemia.
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Cholesterol absorption inhibitor
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Cholesterol absorption inhibitor Drug
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Ezetimibe (Zetia)
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A new mechanism of action in that it inhibits absorption in the small intestine of cholesterol and related sterols.
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Ezetimibe (Zetia)
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Antilipidemics are mainly just called
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statins
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An antilipedimic given to patients who have higher levels of >500
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Livoza
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___is responsible for recycling good choloesterol
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HDL
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A person with CHD would show levels greater than
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>300
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Diabetic patients have a higher risk for CHD and therfore should only have
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70 of its cholesterol
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Exercise _____ cholesterol and Dieting ____ Cholesterol
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increases HDL, decreases LDL
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Cholesterol levels greater than ___ are recomended to take an antilipidemic agent
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190
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Statins are effective because they ___ and ____
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decrease LDL to 30-40% and HDL to 50%
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Main contraindications to patients who take statins is
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Myopathy (muscle pain)
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Bile acids Sequestriants affects ____
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fat soluble drugs ADEK
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Naicin should be given in ___ 1.5-6g a day
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two divided doses
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Antilipidemic drug that inhibits the synthesis of lipids
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fibrates (fibric acid derivitaves)
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Fibrates main concern is that it might cause
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GB diseas
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A person taking antilipidemics should be assessed
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before they go to surgery
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maintain sex characteristics, one of which is the growth and maintenance of the prostate.
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adrenogens
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is a synthetic which is derived from both progesterone and testosterone that possesses weak androgenic activity.
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Danazol
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Some of the most devasting SE of anabolic steroids occur
in ___where they cause ___ |
liver, Pylosis (blood filled liver)
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Primary use is replacement therapy IM, transdermal patch. The patches attempt to mimmic the normal circadian variation in testosterone
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Adrogen
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Testoderm is always applied to ___ androgerm is always ____. Testosterone im should be given ___
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scrotal, everywhere, deep in muccle
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helps to ease the passage of urine made difficult by the enlarged prostate by lowering DHT
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Proscar
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It has been noted that men taking Proscar had ____
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Increased hair growth
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dangerous if taken with nitrates HA,BP,flushing,dyspepsia are the most common adverse effect reported.
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Viagra
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Statins take ___ to ___ of reduction
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6 to 8 weeks
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Statins are contraindicated with patients who are ___ and ___
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less than 10 and ETOH
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this is a condition involving the breakdown of muscle protein leading to myoglobinuria, in patients who are taking statins
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Rhabdomyolysis
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Rhabdomylosis can be prevented by
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stopping statin
|
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Rhabdo.One advantage of Lipitor is that it can be dosed at
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Anytime
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