Patho/pharm Exam 2

Front 1

What is the active metabolite for the pro drug Codeine?

Back 1

Morphine

Front 2

What is the active metabolite for the pro drug Allopurinol?

Back 2

Oxypurinol

Front 3

Which 5 drugs must be monitored for concentrations in the whole blood/plasma and targeted for peak and trough?

Back 3

1. Dilantin
2. Digoxin
3. Tegretol
4. Lithium
5. Vancomycin

Front 4

What is Peak and Trough?

Back 4

Peak: When the drug reaches its peak concentration
Trough: When the drug reaches its lowest minimum concentration
•Drugs must be given on time and given within the cycle

Front 5

What is the half-life t1/2 of a drug?

Back 5

- The time required for one-half of the total drug amount to be eliminated from the body
- Used to determine the steady state, dosage, and frequency of the drug administration
- Help determine when peak and trough occurred

Front 6

What is the steady state?

Back 6

- Reached when the rate of absorption = the rate of elimination
- Usually reached with chronic administration equal dosing at equal dosing intervals over period equaling 4-5 biological half lives.

Front 7

What is an Agonist?

Back 7

-Drugs which alter the physiology of a cell by binding to plasma membrane or intracellular receptors
- Mimic whats going on
- Efficiency: Drug get into all the receptors
- Given to patients who are suffering an overdose

Front 8

What is an Antagonist?

Back 8

Inhibit or block responses caused by agonists

Front 9

Effective Concentration 50% (ED50)

Back 9

Concentration of the drug which induces a specified clinical effect in 50% of all subjects.
- Tells us when we are starting to reach market value
- Looking for a clinical effect

Front 10

Lethal Dose 50% (LD50)

Back 10

Concentration of the drug which induces death in 50% of subjects
- Tells is more research is needed before giving the drug to the population

Front 11

What is the efficacy?

Back 11

Degree to which a drug is able to produce the desired response
- The larges amount of a drug needed to produce a response/ effect

Front 12

What is the potency of a drug?

Back 12

The amount of drug required to produce 50% of the maximal response the drug that is capable of inducing
- Used to compare compounds within classes of drugs

Front 13

What is the therapeutic index?

Back 13

Measurement of the safety of a drug
- Calculation: LD50/ED50
- Calculating the safety of a drug
- FDA looks at the therapeutic index to maintain a margin of safety

Front 14

What are the drugs that come from cephalosporins?

Back 14

There are 22 cephalosporin

Front 15

What are the two medications that come from macrolides?

Back 15

1. Erythromycin
2. Zihromax

Front 16

What drug comes from aminoglycosides?

Back 16

1. Gentamicin combined with Tobramycin

2. Amikacin (has no resistance)

Front 17

What drug comes from sulfonamides?

Back 17

1. Sulfamethoxazole (SMZ)
2. Trimethoprim (TPM)

Front 18

What drug comes from fluoroquinolones?

Back 18

1. Ciproflaxin

Front 19

What are the 5 steps used for the selection of Antibiotics?

Back 19

1. Identifying the organism through lab culture
2. Therapeutic Goal
3. Drug sensitivity to the organism
4. Host factors
5. Whenever possible the drug of first choice is used

Front 20

What two lab tests are used to determine drug susceptibility?

Back 20

1. Disk diffusion test
2. Broth dilution procedure: a more precise measurement of sensitivity and determines
a. MIC: Minimum inhibitory concentration
b. MBC: Minimum bacterial concentration

Front 21

What is bacteriostatic?

Which 2 antibiotics are bacteriostatic?

Back 21

Inhibits bacterial growth allowing bodies defense mechanisms to remove the invading microorganism

1. Tetracylines
2. Macrolides

Front 22

What is bachtericidal?

Which 6 antibiotics are bactericidal?

Back 22

Causes bacterial cell death and lysis

1. Penicillin
2. Cephelosporins
3. Glycopeptide
4. Aminoglycocsides
5. Sulfonamides
6. Floroquinalones

Front 23

What are the shared attributes?

Back 23

They depend on the dosage of the drug and area of the body it is being used for
- Septra: acts on both ways depending on the dose strength

Front 24

What are the three shared adverse reactions all antimicrobial agents are capable of producing?

Back 24

1. Antibiotic associated colitis
2. Allergic or hypersensitivity reaction (HSR)
3. Suprainfection

Front 25

What are the three types of shared adverse reactions?

Back 25

1. Antibiotic Associated Colitis
A. Pseudomembranous colitis caused by c.diff
2. Allergic or Hypersensitive Reaction
3. Suprainfection
A. When microbes are resistant to ABX during its use
B. ex. Candida (fungus)

Front 26

What medication is used to treat pseudomembranous colitis?

Back 26

Metronidazole

Front 27

What are the safety concerns associated with the use of ABX?

Back 27

1. Toxicity
2. Interactions with other medications
3. Fetal damage/risk to pregnant women

Front 28

What medication is used for VRE?

Back 28

Methicillin, the drug of choice unless patient has MRSA

Front 29

What are the 3 ways resistance can be transferred?

Back 29

1. Transformation
2. Conjugation
3. Transduction

Front 30

What are the characteristics of Penicillin?

Back 30

-Broad and Narrow Spectrum
-Bactericidal
-Has 30 half life
-Affects oral contaceptives
- Routes: IM, IV (PO for PCN V)
-Inhibit cell wall synthesis

Front 31

What are the three interactions of Penicillin?

Back 31

1. Aminoglycocides
2. Oral contraceptives
3. Anticoagulants and potassium supplements

Front 32

What is a beta-lactamase Inhibitor?

Back 32

- Must be used with another antibiotic (penicillinase) in a fixed dose combination

Front 33

What are the characteristics of Cephalosporins?

Back 33

-Inhibit cell wall synthesis
- Bactericidal
- Route: IV short used
- Most used group of ABX
-Distributed well in the tissues and fluids
- Most are eliminated in the kidneys
(need for good kidneys)
- Can cause problem with coagulation

Front 34

What would be the first indicator that a person has a problem with coagulation?

Back 34

A pink toothbrush

Front 35

What is the main Glycopeptide medication?

Back 35

Vancomycin

Front 36

What are the characteristics of Vancomycin?

Back 36

-Inhibit cell wall
-Narrow
- IV administration only
- Used when all else fails, and MRSA
- Lots of effects

Front 37

What are the 3 effects of Vancomycin?

Back 37

-Throbophlebitis (inflammation of the veins)
- Red Neck Syndrome
- Ototoxicity

Front 38

What are the characteristics of Tetracyclines?

Back 38

-Broad spec
- Inhibits protein synthesis
- Absorption can be delayed by basic substances in stomach
- Adverse effects if we dont get the dosage needed
-Suprainfection: C.diff and candida

Front 39

What is the characteristics of Microlides?

Back 39

- Inhibits protein synthesis
- Broad spec
- Bacteriostatic
- First line of treatment for protessis
- Disolves in the small intestines
-PO

Front 40

What are the characteristics of Zpack?

Back 40

- Used in leu of patient who is allergic to PCN
- Safe to use in renal dysfunction
- Excreted in the colon

Front 41

What is gray syndrome?

Back 41

Anaphylaxsis where the peripheral circulation gets shut down

Front 42

What are the Characteristics of Gentamycin?

Back 42

-Used with Tobramycin
- Quite toxic (causes nephro and oto toxicity)

Front 43

What is the characteristic of Amikacin?

Back 43

-Has no bacteria resistance (reserved)

Front 44

What are the characteristics of Aminoglycosides?

Back 44

-Inhibits protein synthesis
- Bacterialcidal
- Narrow

Front 45

What are the characteristics of Sulfonamides?

Back 45

-Inhibits synthesis of folic acid
- Used for UTI pathogens
- Used for chronic bronchitis and pneumonia
- Fights the flu

Front 46

What are the 6 adverse reactions of Sulfonamides?

Back 46

1. Acute Hemolytic Anemia: RBC may be lost
2. Kernicterus: Interferes w/ bile conjugation (stains the brain)
3. Crystalluria
4. Steven Johnsons Syndrom: Systemic
5. Allergy to sulfa drugs
6. Nausea, rash, diarrhea

Front 47

What are the characteristics of Floroquinolones?

Back 47

-Interferes with bacterial DNA synthesis
- Bactericidal
- Broad spec

Front 48

What are Floroquinolones effective against?

Back 48

1. Anthrax spores
2. e.coli
3. salmonella
4. Campylobacter

Front 49

What are the reactions of Floroquinolones?

Back 49

1. N/V
2. Abdominal pain
3. insomnia
4. Pseudomembranous colitis
5. tendonitis (Achilles tendon rupture)
6. SJS
7. OT Prolongation

Front 50

What are the 3 phrophylactic uses of antimicrobial?

Back 50

used to prevent the spread of diseases
1. Certain surgeries: GI tract, emergency C sections, perforated organs
2. Dentistry when someone is at risk for bacterial endocarditis
3. Patients who are neutopenic

Front 51

What is prophylactis?

Back 51

Used as a preventative to prevent the spread of disease

Front 52

What are the 6 effects of antihistamines?

Back 52

1. Sedations (take at night)
2. Anticholinergic effects
3. Gastrointestinal distress (take with food)
4. Elderly (fall risk)
5. CNS depression
6. Toxicity

Front 53

What are the two H1 antagonist (1st gen)?

Back 53

1. Benedryl
2. Promethazine

Front 54

What are the 4 therapeutic uses of H1 antagonist (1st gen)?

Back 54

1. Mild allergy: itchy eyes and itching
2. Sever allergy: flushed face and transfusion
3. Motion sickness
4. Insomnia

Front 55

What is Urticaria?

Back 55

Rash

Front 56

What are the 2 H1 antagonists (2nd Gen)?

Back 56

1. Claritin
2. Zyrtec

Front 57

What are the 2 harmful effects when inhibiting COX 1?

Back 57

1. Gastric erosion and ulceration
2. Bleeding tendencies

Front 58

What are the 3 harmful effects when inhibiting COX 2?

Back 58

1.Renal impairment
2. Promotion of Mi and stroke
3. Bleeding tendencies

Front 59

What is the beneficial effect when inhibiting COX 1?

Back 59

1. Protection against MI and Stoke

Front 60

What are the 4 beneficial effects when inhibiting COX 2?

Back 60

1. Suppression and inflammation
2. Alleviation of pain
3. Reduction of fever
4. Protection against colorectal cancer

Front 61

Which 4 drug have non-steroidal anti-inflammatory properties?

Back 61

1. Aspirin
2. Indocin
3. Ibuprofen
4. Toradol

Front 62

What are the 4 characteristics of Aspirin and their functions?

Back 62

1. Anti-inflammatory: Irreversible inhibitor of COX
2. Analgesic: Mild to moderate pain
3. Antipyretic: Reye's Syndrome, caution in peds
4. Anticoagulant: Irreversible inhibitor of COX-1; inhibits platelet aggregation

Front 63

What are the characteristics of Indocin?

Back 63

Therapeutic: Relieves pain, fever, inflammation
Indications: RA, Arthritis, Gout
Side Effects: Urticaria, NVD, abdominal pain (take with food), headache, dizzyness, vertigo

Front 64

What are the characteristics of Ibuprofen?

Back 64

- Like asprin, stronger effects, less GI irritation
oCNS: headache, drowsiness, dizziness
o EENT: tinnitus, visual disturbance
o GI: epigastric distress, nausea, occult blood
o HEMA: prolonged bleeding time
- No alcahol
- can cause peptic ulceration and bleeding

Front 65

What are the characteristics of Toradol?

Back 65

-Powerful analgesic besides morphine with min. anti-inflammatory actions
- Not for long term
Side effects: Urticaria, PUD and abdominal pain, HA/Dizz, Vertigo
- No alcohol
-Step meds if bleeding

Front 66

What is the selective COX 2 inhibitor NSAID?

Back 66

Celebrex

Front 67

What are the characteristics of Celebrex?

Back 67

- Relieves pain and inflammation (last choice for long term)
- Increases risk for MI and stroke
Indications: RA, Grout, Arthritis
SE: Urticaria, abdominal pain, Increased MI and stroke

Front 68

What are the 2 ways acetaminophen is like aspirin?

Back 68

1. Analgesic
2. Antipyretic

Front 69

What are the 3 ways acetaminophen is unlike aspirin?

Back 69

1. No anti-inflammatory actions
2. No platelet aggregation suppression (benefit)
3. Does not cause GI distress

Front 70

What drug is used to combat acetaminophen OD?

Back 70

Mucomyst

Front 71

What are the two common corticosteroids?

Back 71

1. Solu cortif
2. Medrol

Front 72

Why are corticosteroids used?

Back 72

- Treat local inflammation disorders (those affecting the skin)
- Systemic inflammatory disorders requiring potent and aggressive therapy for control

Front 73

What are the 2 Anti-Gout Drugs?

Back 73

1. Uric Acid Inhibitor (Allopurinol)
2. Urcosurics (Benemid)

Front 74

What are the six manifestations of gastroinenstinal tract disorders?

Back 74

1. Dysphagia
2. Esophageal pain
3. Abdominal pain
4. Vomiting
5. Intestinal gas
6. Alterations in bowel patterns

Front 75

What is dysphagia and its three categories?

Back 75

- Problems with swallowing; erosions on the esophagus
1. Uncoordinated neuromuscular sequence
2. Altered esophageal peristaltic activity
3. LES dysfunction/lesions

Front 76

What are the two manifestations of esophageal pain?

Back 76

1. Heartburn (GERD)
2. Midsternal Pain (result of esophageal distention may present with odynophagia: painful swllowing

Front 77

What are the characteristics of GERD?

Back 77

- Stomach contents and acid go up to the esophagus through the LES
- Due to multifactoria LES pressure challenged
- Made worse by lying down

Front 78

What are the treatments for GERD?

Back 78

-PPI's are the most effective drug for suppressing the secretion of gastric acid
- Nexium (little purple pill)
- Prevacid, Protonix (usually given through IV)
- Problems with long term use changing the pH of the stomach

Front 79

What are the three types of Abdominal Pain?

Back 79

1. Visceral Pain: Stretching, distending or inflammation of abdominal organ
2. Somatic Pain: Injury to the stomach
3. Referred Pain: felt at a location distant from the source of pain

Front 80

What are the 10 manifestations of vomiting?

Back 80

- GI disorders
. Bastroenteritis: inflammation of the GI tract
. Alterations in motility
. Obstruction: blood/feces
- Non GI disorders
. Pregnancy: due to hormone alterations
. Infection
. F & E disorders
. Metabolic
. Endocrine
. Cardiac
. Labyrinthine

Front 81

What are the four classes of anti emetics and their drugs?

Back 81

1. Serotonin antagonist: Zofran
2. Dopamine antagonist: Phenergan
3. Anticholinergic primarily due to antihistamine: Benedryl
4. Cannabinoids: Marinol (Stomach sedation)

Front 82

What are the side effects associated with anti emetics?

Back 82

Serotonins: block the chemoreceptor trigger zone(CTZ) and vaginal neurons in the upper GI track. --> hypertension
Crosses the BBB
. Dizzyness, H/A, diarrhea, sedation (depression of CNS)
. Sedation: make sure the patient is breathing

Front 83

What are the nursing implications of anti emetics?

Back 83

- Assess the type of nausea (anticipatory, acute, delayed)
- Better at suppressing than preventing

Front 84

What are the manifestations of Intestinal gas?

Back 84

-Normally occurs because of swallowed air
- Bacterial and digestive actions on the stomach contents
Problem: no outlet = abdominal distention

Front 85

Manifestations of alterations in bowel patterns?

Back 85

Normal bowel movements: 2-3 times per day - 1/week

Front 86

What are the four uses of laxatives?

Back 86

1. Stool sample for diagnosis
2. Cleansing prior to surgery
3. Prevention of impaction of a bedridden pt
4. Correction of constipation ass. with pregnancy or opioids

Front 87

What are the three times we would not use laxative?

Back 87

1. Disorders of the bowel
2. Cramping or Appendicitis
3. Not for the use of a daily bowel movement

Front 88

What is a laxative effect?

Back 88

The production of a soft formed stool over 1 or 2 days

Front 89

What is laxative catharsis?

Back 89

The prompt fluid evacuation of the bowel

Front 90

What are the 7 assessments a nurse should do prior to giving a laxative?

Back 90

1. The last BM and type
2 Diet and exercise regimen
3. Frequency use of laxatives
4. Illness, age, and medications
5. Absence of contraindicated conditions
6. Pts beliefs bout BM's
7. Existing dehydration, malnutrition, and electrolyte imbalance must be taken into consideration

Front 91

What are the 6 nursing interventions prior to giving a laxative?

Back 91

1. Identify the high risk patients for constipation
2. Identify the appropriateness for laxative use
3. Educate regarding laxative, use, abuse, and what constitutes a BM
4. Know if it is bulk forming or surfactant laxative
5. Must be taken with a lot of H2O
6. Educate the patient that laxatives are only for a short term

Front 92

What are the four mechanisms of diarrhea?

Back 92

1. Osmotic: Nonabsorbable substance draws H2O into the intestines
2. Secretory: Excessive mucosal secretion of fluid and electrolytes
3.Exudative: Crohn's disease, IBS-D, and Ulcerative Colitis
4. Motility: Due to the resection of the SI there is less time for absorption

Front 93

What are the 4 steps prior to giving an anti-diarrheal agent?

Back 93

1. First look at what is causing the diarrhea
2. Dx & Rx the underlying cause
3. Replacement of lost fluid and salts
4. Relief of cramping & reducing the passage of unformed stools

Front 94

What are the two types of antidiarrheal agents?

Back 94

1. Nonspecific: symptoms relief only
2. Specific: Agents that treat the underlying cause of the diarrhea

Front 95

What are the specific antidiarrheal agents treating?

Back 95

1. Infectious diarrhea
2. Inflammatory bowel syndrome (IBS)
3. Inflammatory bowel disease (IBD)

Front 96

What are the types and medications of non specific antidiarrheal agents?

Back 96

1. Opioids: the most effective antidiarrheal:
1. Lomotil
2. Imodium
-both have atropine, makes patients feel badly; helps with spasms and decreases chance of abuse.
2. Anticholinergic spasmodics
3. Bulk formers

Front 97

What is the treatment for IBS?

Back 97

Bulk formers

Front 98

What are the characteristics of Infectious diarrhea?

Back 98

- Occurs from bacteria or protozoa found in the body
- Flagyl is the best medication combined with a fluid replacement
- Important to get all the bacteria out prior to giving an antidiarrheal agent

Front 99

What are the characteristics of Inflammatory Bowel Disease (IBD)?

Back 99

- Inflammation of the bowel
- Genetic predisposition
- Exaggerated response to normal flora in the bowel

Front 100

What are the two types of IBD?

Back 100

1. Ulcerative colitis
2. Crohn's disease

Front 101

What are the characteristics of Ulcerative Colitis?

Back 101

- Inflammatory disease of the colon and most severe in the rectum
- There is an ulcer in the bowel

Front 102

What are the characteristics of Crohn's Disease?

Back 102

- Inflammation of the GI tract and extends to all layers of the intestinal wall (Mouth to anus)
- Massive interference in the absorption of nutrients

Front 103

What are the treatments for Crohn's disease?

Back 103

1. Corticosteriods (inflammation)
2. ABX: Flagyl used when the WBC is elevated at >10,000
- No cure

Front 104

What are the treatments for Ulcerative Colitis?

Back 104

1. Corticosteroids (Inflammation)
2. ABX: Use in toxic mega colon
- Avoid colonectomy

Front 105

What is Diverticular Disease?

Back 105

- Acquired herniation's of the mucosa and submuscosa of muscle coat of colon

Front 106

What are the two forms of diverticular disease?

Back 106

1. Diverticulosis: Presence of diverticula in the colon
2. Diverticulitis: Inflammed

Front 107

What are the manifestations of diverticular disease?

Back 107

- decreased colon motility
- Increased liminal pressure
- Low fiber diets
- Colon wall defects

Front 108

What is the treatment for diverticular disease?

Back 108

- ABX
- Drain the abscess

- Surgery not the best answer- can lead to obstruction later

Front 109

What are the signs and symptoms of diverticulitis?

Back 109

1. LL abdominal pain
2. Low grade fever
3. Nausea, vomiting
4. Blood in stool

Front 110

What are the 5 treatments of Diverticulitis?

Back 110

- Depends on severity, Prevention is best
1. High fiber: preventing constipation
2. Antibiotics
3. Antispasmodic
4. Pain meds
5. Colon resection if necessary

Front 111

What is peptic ulcer disease and its 5 causes?

Back 111

- Injury ulceration of the esophagus, stomach, or duodenum
- Defense mechanisms inappropriate acid secretion pepsin
1. H.pylori infection
2. NSAID use
3. Severe illness, systemic and or emotional trauma, stress
4. Smoking
5. Alcohol abuse

Front 112

What are the treatments for Peptic ulcer disease?

Back 112

- Diagnosis: Breath test (see if ammonia is being produced by h.pylori, stool sample
- Goals: Gastric Acidity and heal the mucosa
1. PPI (Prilosec)
2. H2 Antagonist (Zantac)
3. ABX: 14 day course of triple drug treatment
4. Comprehensive program to stop contributory activities

Front 113

What are the two purposes of PPI's?

Back 113

1. Used primarily for GERD
2. Binds to and irreversibly blocks the pp in gastric mucosal cells

Front 114

What are the 4 types of PPI's?

Back 114

1. Prilosec
2. Protonix
3. Prevacid
4. Nexium

Front 115

What are the characteristics of Prilosec?

Back 115

- Inhibition of K+, H+, and ATPase which make up the PP
- A 30 mg dose can reduce gastric acid secretion by 97% in 2 hours and last for 3-5 days
- Kidneys and Liver must be in place

Front 116

What are the adverse effects of PPI's?

Back 116

Short term: H/A, diarrhea
Long term: Esophageal and esophageal cancer leasions due to prolonged gastric acid secretions
- Overgrowth of bacteria and candida

Front 117

What are the 4 nursing interventions when giving PPI's?

Back 117

1. Instruct to take capsule whole
2. Administer immediately prior to meals
3. Therapy for healing of ulcers takes 6-8 weeks
4. Educate regarding the signs and symptoms of GI bleeding

Front 118

What are the two H2 blockers?

Back 118

1. Zantac
2. Tagamet

Front 119

Where are the H2 receptors found (5)?

Back 119

- Important when blocking histamine, we are blocking both
1. Gastric Parietal cells
2. Vascular smooth muscles
3. CNS
4. Heart
5. Uterus

Front 120

What are the characteristics of Tagamet?

Back 120

- Promotes healing of ulcers by suppressing secretion of gastric acid
- Administered PO, IM, IV (food decreases the rate)
- Crosses BBB: dizzyness and vertigo
- Medication interactions

Front 121

What are the characteristics of Zantac?

Back 121

- Histamine receptor antagonist
- Taken with or without food
- Avoid Cigarettes, alcohol, ASA, NSAIDS
- Eat smaller more frequent meals
- Wait 1 hour before antiacids or other meds
SE: Black tarry stool

Front 122

What are the differences from Zantac and Tagamet?

Back 122

- More potent with less side effects than tagamet
- Less drug interactions than tagamet
- No anti-androgenic effects
- Dose not cross BBB

Front 123

What is Irritable bowel syndrome?

Back 123

- Irritability is intermittent
- 2nd most reason for missed days from work

Front 124

What are the 4 characteristics of tumors on the right side?

Back 124

-Anatomical Location: Cecum and ascending colon
-Obstruction: unusual r/t growth does not encircle the colon
-Manifestations: Pain and lower right quadrant mass
-Stool: Black tarry: occult bleeding

Front 125

What are the 4 characteristics of tumors on the left side?

Back 125

-Anatomical Location: Descending colon and rectum
-Obstruction: Cancers frequent r/t encircling the colon
-Manifestations: Progressive abdominal distention cramping
-Stool: Blood or mucous

Front 126

What are the two disorders of the gallbladder?

Back 126

1. Cholelithiasis
2. Acalculous Cholecydistis

Front 127

What are the characteristics of Cholelithiasis?

Back 127

- Lodging of gall stone in the cystic duct
- Most common form of gallstone is cholesterol
- Risk factors: oesity, middle age, female, gallbladder, pancreatic, or ileal disease

Front 128

What are the treatments for Cholelithiasis?

Back 128

- Surgery (abdominal or laproscopic) preferred

- Non surgical: Chemodissolution: dissolving the gall stone partially or completely

Front 129

What is the metabolism process of bilirubin?

Back 129

- A biproduct of the destruction of aged RBC
- Gives bile greenish tint
- Causes the yellowness of Jaundice
- Can stain the brain
-Hemoglobin splits --> bound in the bloodstream to albumin --> taken to the liver --> excreted

Front 130

What are the two disorders of the Pancreas?

Back 130

1. Acute Pancreatitis
2. Chronic Pancreatitis

Front 131

What are the characteristics of Acute Pancreatitis?

Back 131

- Pancreatic duct obstructed
- Release of enzymes, activation of autodigestion of the pancreas

Front 132

What are the characteristics of Chronic Pacreatitis?

Back 132

- Persistence of symptoms from inflammatory lesions from weeks to months

Front 133

Why is 75 % of the livers blood supply venous?

Back 133

- The liver must pick up the nutrients from the small intestines

Front 134

What are the 3 functions of the liver as a digestive organ?

Back 134

1. Bile-salt secretion
2. Processing and storage of fats, carbohydrates, and proteins absorbed by the intestines
3. Processing and storage of vitamins and minerals

Front 135

What are the 2 functions of the liver as an endocrine organ?

Back 135

1. Metabolism of glucocorticoids, mineralcorticoids, and sex hormones
2. Regulation of carbohydrate, fat, and protein metabolism

Front 136

What are the 4 functions of the liver as a Hemotologic organ?

Back 136

1. Temporary storage of blood
2. Removal of bilirubin form the bloodstream
3. Hematopoiesis in certain disease states
4. Synthesis of clotting factors

Front 137

What are the 4 functions of the liver as an excretory organ?

Back 137

1. Excretion of bile pigment
2. Excretion of cholesterol via bile
3. Urea synthesis
4. Detoxification of drugs and other foreign substances

Front 138

What is the cause of portal hypertension?

Back 138

- Obstruction in the liver caused by gallstones or tumor

Front 139

What are Gastroesophygeal varicies and their characteristics?

Back 139

- Buldging blood vessels
Treatment: IV- vita K
- Somatosatin works to close the blood vessels
- Endoscopic band ligation keeps the vessels from rupturing

Front 140

What are the manifestations of Jaundice?

Back 140

- Bilirubin is not conjugated and does not get where it needs to be to breakdown fats
- Hyperfilirubinemia: high levels of bilirubin occurs when there is hemolysis

Front 141

What is the pathology of cirrhosis?

Back 141

- Scaring of the liver, end stage of liver
- Diffused hepatic fibrosis resulting in the alteration of blood flow and hepatic function

Front 142

What are the clinical manifestations of cirrhosis?

Back 142

- No early signs and no changes until 80% of liver is damaged
- may present first in another system as in upper GI bleed

Front 143

What are the 6 liver function tests?

Back 143

1. AST: Aspartate aminotransferase
2. ALT:Alanine aminotransferase
3. Serum albumin
4. PT: Prothrombin time
5. PTT: partial thromboplastin time
6. INR: International normalized ratio

Front 144

What is Hepatitis?

Back 144

- Inflammation of the liver parenchyma (specific cells of the liver)
- Liver is unable to do its 12,000-18,000 functions in the body
Phototherapy: Activates the liver, causes bilirubin to be conjugated

Front 145

What are the 5 effects of the activated mu receptors?

Back 145

1. Sedation
2. Analgesia
3. Dependence
4. Decreased GI Mobility
5. Euphoria
6.

Front 146

Why do the drugs activate the mu receptors?

Back 146

Because the mu receptors are the most receptive and located in the dorsal horn

Front 147

What are the 5 opioid analgesic full agonist drugs?

Back 147

1. Morphine
2. Demerol
3. Fentanyl
4. Oxycodone
5. Hydromorphine

Front 148

What are the adverse effects of Morphine?

Back 148

1. N/V/C and biliary colic (spasms in the biliary; causes gallbladder pain)
2. Dizzyness, hypotension, fatgue
3. Dry mouth, urinary retention, confusion
4. Respiratory Depression: not given to pts with low RR

Front 149

What is the antagonist used if the pt respiratory rate drops to 12 beats and becomes hypotensive?

Back 149

Narcam

Front 150

What drug is given with Demerol?

Back 150

Phenergan

Front 151

What drug is given for as an opioid antagonist?

Back 151

Narcam or Naloxone
- Withdrawls will be immediate
- Neonatal resuscitation durg