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150 Cards in this Set
- Front
- Back
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What do Prostaglandins cause?
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Inflammation
increased body temperature platelet aggregation |
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What affect do Prostaglandins have on the reproductive system?
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ripen cervix for delivery
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What affect do Prostaglandins have on the GI Tract?
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reduce output of gastric acid and secrete protective mucous
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What affect do Prostaglandins have on the CNS?
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increase pain and fever
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What affect do Prostaglandins have on the CVS?
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vasodialation and platelet aggregration
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What affect do Prostaglandins have on the respiratory tract?
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bronchoconstriction
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What affect do Prostaglandins have on the renal system?
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increase urine output due to vasodialation
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What affect do Prostaglandins have on allergy/immunology?
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inflammatory chemotaxix
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What controls temperature regulation?
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hypothalmus
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what forms during a fever?
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prostaglandins
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What are the classic signs of inflammation?
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swlling
heat redness pain loss of function |
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What is the body's first response to acute inflammation?
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Vascular response occurs immediately after injury
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What is the body's second response to acute inflammation?
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the cellular response (four phases)
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What are prostaglandins produced from?
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arachidonic acid broken down by enzyme cycloosygenase
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What is the inflammatory response caused by?
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prostaglandins
histamine leukotrines cytokines oxygen radicals enzymes |
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What does the inflammatory response stimulate?
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vascular and cellular response
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What is chemotaxis in relation to inflammation?
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cellular debris and bacteria are made more attracted to WBC
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What is phagocytosis in relation to inflammation?
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neutrophils and monocytes engulf cellular debris
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What is emigration of WBC in relation to inflammation?
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WBC pass thry capillary walls into tissues
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What are NSAIDS?
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any drug that decreases inflammation but is not a steroid
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What are steroids categorized as?
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salicylates and prostaglandin synthetase inhibitors (PSI's)
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How do NSAIDS work?
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by inhibiting the synthesis of prostaglandins
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Which drugs inhibit the synthesis of prostaglandins?
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salicylates (aspirin)
Cox2 Inhibitors Prostaglandin synthetase inhibitors para aminophenol derivatives (acetaminophen) |
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What is aspirin used for?
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headache
neuralgia dynmenorrhea arthralgia postpartum pain myalgia dental pain |
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What is the preferred drug for juvenile arthritis, RA, fever, pleurisy and bursitis?
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ASA
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What is ASA use for in regard to the CVS?
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pericarditis
prevention of MI |
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Which drug is used for the prevention of TIA's?
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ASA
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Where is aspirin abosrbed and how fast is the absorption?
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in the small intestines
30 minutes depending on dosage form |
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Where is ASA metabolized?
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liver
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What is the half life of aspirin
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15 minutes
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Does asa cross the placenta?
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yes
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What are the pharmacodynamic uses of ASA?
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analgesic
anti-inflammatory antipyretic antithrombotic drug |
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What are the antipyretic effects of asa due to?
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inhibition of prostaglandin synthesis in the hypothalamus
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What is the anti-inflammatory action of ASA due to?
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peripheral inhibition of prostaglandin synthesis
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What is the anti-thrombotic effect of ASA due to?
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inhibition of thromboxane A2
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Which patients is ASA contraindicated in?
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salicylate hypersensitivity
peptic ulcer disease bleeding disorders anticoagulation therapy gout renal/hapatic impairment chicken with varicella or flu pregnant and lactating women |
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What drug should snokers and patients with a history of alcohol abuse avoid?
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ASA
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Which drug should be used with caution inpatients with asthma, nasal polyps and hyperuricemia
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ASA
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Which patients should we take precautions with ASA with?
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older than 60
corticosteroid use |
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What is mild aspirin toxicity called?
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salicylism
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Does asa cross the placenta?
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yes
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What are the pharmacodynamic uses of ASA?
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analgesic
anti-inflammatory antipyretic antithrombotic drug |
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What are the antipyretic effects of asa due to?
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inhibition of prostaglandin synthesis in the hypothalamus
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What is the anti-inflammatory action of ASA due to?
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peripheral inhibition of prostaglandin synthesis
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What is the anti-thrombotic effect of ASA due to?
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inhibition of thromboxane A2
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Which patients is ASA contraindicated in?
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salicylate hypersensitivity
peptic ulcer disease bleeding disorders anticoagulation therapy gout renal/hapatic impairment chicken with varicella or flu pregnant and lactating women |
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What drug should snokers and patients with a history of alcohol abuse avoid?
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ASA
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Which drug should be used with caution inpatients with asthma, nasal polyps and hyperuricemia
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ASA
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Which patients should we take precautions with ASA with?
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older than 60
corticosteroid use |
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What is mild aspirin toxicity called?
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salicylism
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What is a sign of salicylism?
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tinnitus
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What is the antidote for salicylate poisoning?
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there is none
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What happens in salicylate poisoning?
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renal failure
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Name some adverse effects of ASA?
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ototoxicity
excessive/abnormal bleeding hepatotoxicity vasoconstriction acute renal failure nephrits/nephrotic syndrome water retention |
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What drugs interact with ASA?
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highly protein bound drugs
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What should be evaluated prior to ASA therapy?
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gross hearing
baseline CBC, platelet, renal and hepatic function |
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Which patients is ASA contraindicated in?
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Pregnancy
under 16/over 60 |
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Which lifestyle/diet and habits in core patient variables should be evaluated?
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use of OTC
alcohol/drug abuse cigarette smoking |
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What can be done to minimize GI affects of ASA therapy?
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administer with food or milk
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What is the prototype for Prostaglandin Synthesis Inhibitors?
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ibuprofen
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What are the pharmacotherapeutic uses for NSAIDS?
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RA, osteoarthritis, mild to moderate pain
primary dysmenorrhea, fever |
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Give the pharmacikinetics of NSAIDS
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80% absorbed in GI tract
analgesic/antipyretic effects in 2-4 hours therapeutic inflammatory response in 2 days-2 weeks plasma half life 2-4 horus |
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What are the pharmacodynamics of NSAIDS?
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-effects secondary to inhibited synthesis or release of prostaglandins
-peripheral action as analgesic |
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Which patients is NSAID therapy contraindicated in?
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-hx or active GI disorders
-alcohol consumption -smokers -third trimester of pregnancy |
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Which patients should NSAIDS be use cautiously with?
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-preexisting hepatic, renal, hematopoietic dynfunction
-over age 60 |
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What are the possible adverse effects of NSAIDS on teh GI system?
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nausea
vomiting diarrhea constipation flatulence abdominal pain peptic ulcer gastritis |
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What are the possible opthalmic adverse effects of NSAIDS?
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blurred vision
decreased visual acuity corneal deposits |
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What are the pharmacodynamics of Celecoxib drugs (celebrex)?
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-selectively block COX 2 and thus decrease adverse effects
-no antiplatelet activity |
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Which antiinflammatory drug may be related to CV risks?
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celecoxibs
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What hypersensitivity are celecoxib drugs contraindicated in?
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salicylate
sulfa allerty |
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Which conditions cause contraindication of acetamenophin use?
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hepatic disease
viral hepatitis alcoholism renal impairment |
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What are the early stages of aceteminophen toxicity?
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anorexia
nausea vomiting pallor disphoresis |
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What are the intermediate stages of aceteminophen toxicity?
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upper quadrant pain
decreased urine output |
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What are the late stages of aceteminophen toxicity?
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jaundice
dramatic increase in prothrombin time elevated aspartate transaminase levels elevated alanine transaminase levels |
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What is the antidote for acetaminophen overdose?
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acetylcysteine
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What are the pharmacodynamics of acetamenophin?
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antipyretic and analgesic effects
reversible weak inhibitor of COX |
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What are the disadvantages of DMARDS?
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slow onset
delay in achieving therapeutic response |
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What is the pathophysiology of RA?
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-systemic inflammatory disease
-autoimmune disorder (70% with rheumatoid factor) -systemic polyarticular inflammatory arthritis |
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What are DMARDS?
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Disease Modifying Antirheumatic Drugs
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What are the pharmacotherapeutics of methrotexate (DMARD)?
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foalte antimetabolite used in treating malignancies and RA
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How is methotrexate administered?
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orally
parentally |
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Where is methotrexate metabolized?
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in the liver and excreded in the kidneys
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What are the pharmacodynamics of methotrexate ?
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exerts immunisuppressive effects by inhibiting replication and function
of T lymphocytes tha stimulate production of cytokines |
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What are the contraindications and precautions in the use of methotrexate ?
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immunosuppression
blood duscrasia pregnancy lactation |
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What are the adverse effects of methotrexate ?
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rash
HA GI effects alopecia suppression of bone marrow |
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What can be done to prevent nephrotoxicity from methotrexate ?
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give plenty of water
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What will interfer with the effectiveness of methotrexate ?
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folic acid - can cause photosynsitivity
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Which pregnancy category is methotrexate?
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X
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Which cultures are more prome to develop GI issues from NSAIDS?
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African
Hispanic |
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What is the immune system composed of?
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hematapoiectic cells
multiple hamatologic-immunologic productin and storage sites |
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How is methotrexate administered?
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orally
parentally |
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Where is methotrexate metabolized?
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in the liver and excreded in the kidneys
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What are the pharmacodynamics of methotrexate ?
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exerts immunisuppressive effects by inhibiting replication and function
of T lymphocytes tha stimulate production of cytokines |
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What are the contraindications and precautions in the use of methotrexate ?
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immunosuppression
blood duscrasia pregnancy lactation |
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What are the adverse effects of methotrexate ?
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rash
HA GI effects alopecia suppression of bone marrow |
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What can be done to prevent nephrotoxicity from methotrexate ?
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give plenty of water
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What will interfer with the effectiveness of methotrexate ?
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folic acid - can cause photosynsitivity
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Which pregnancy category is methotrexate?
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X
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Which cultures are more prome to develop GI issues from NSAIDS?
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African
Hispanic |
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What is the immune system composed of?
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hematapoiectic cells
multiple hamatologic-immunologic productin and storage sites |
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How is methotrexate administered?
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orally
parentally |
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Where is methotrexate metabolized?
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in the liver and excreded in the kidneys
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What are the pharmacodynamics of methotrexate ?
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exerts immunisuppressive effects by inhibiting replication and function
of T lymphocytes tha stimulate production of cytokines |
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What are the contraindications and precautions in the use of methotrexate ?
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immunosuppression
blood duscrasia pregnancy lactation |
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What are the adverse effects of methotrexate ?
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rash
HA GI effects alopecia suppression of bone marrow |
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What can be done to prevent nephrotoxicity from methotrexate ?
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give plenty of water
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What will interfer with the effectiveness of methotrexate ?
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folic acid - can cause photosynsitivity
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Which pregnancy category is methotrexate?
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X
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Which cultures are more prome to develop GI issues from NSAIDS?
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African
Hispanic |
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What is the immune system composed of?
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hematapoiectic cells
multiple hamatologic-immunologic productin and storage sites |
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What are the types of functional hematopoiectic cells?
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RBC's
WBC's Platelets |
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What are the essential components of the immune system?
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hamatopoietic cells
barrier defenses nonspecific immune response specific immune response immunity |
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What are the pathophysiological consequences of hematoligic failure?
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aplastic: deficient cell production
anemia: reduced circulating RBC's functional iron deficiency abnormalities in WBC counts thrombocytopenia: low platelet count |
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What is the pharmacotherapetuic use of epoetin alfa?
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anemia associate with chronic renal failure
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How is epoetin alfa administered?
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IV or SC
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What are the pharmacodynamics of epoetin alfa?
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stimulates production of RBC's
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What are the ocntraindications associated with epoetin alfa?
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uncontrolled hypertension
sensitivity to human albumin |
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What are the precautions to be taken with epoetin alfa?
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-not to be started in HIV + patients with elevated BP
-avoid as replacemtn for transfusion in chronic renal failure |
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What is erythropoietin?
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A hormone produced by the kidney that promotes the formation of red blood cells
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What is the risk of the hematocrit level rising too fast when treated with epoetin alfa?
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cardiac problems
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What are the adverse effects of epoetin alfa?
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HTN
H/A nausea.vomiting tachycardia |
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What should you not do to epoetin alfa after reconstituting it?
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shake the drug
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How long can it take for epoetin alfa to show its full effect on the hematocrit?
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8 weeks
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How much can the hematocrit safely rise in two weeks with the use of epoetin alfa?
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4 points
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What are the pharmacotherapeutics for filgastrim?
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used to increase the neutrophil count in patients with cancer
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How is filgastrim administered?
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sub-q
IV bolus |
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What should increase within 1-2 days of starting filgastrim therapy?
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WBC count
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What are the pharmacodynamics for filgastrim?
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production of neutrophils
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What is a contraindication with filgastrim?
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E. coli derived proteins
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What are the precautions with filgastrim?
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patients with myeloid malignancy
pregnancy category C |
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What are the adverse effects of filagristin?
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-medullary bone pain
-H/A to decreased platelet count |
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What are cytokines?
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immunologic toxins produced by WBC's
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What are the pharmacodynamics for rituximab?
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causes cell lysis
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What are the pharmacotherapeutics for rituximab?
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non-hodgkins lymphoma
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How should rituximab be administered?q
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show IV infusion
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What are the infusion related effects of rituximab?
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fever
flushing chills rigors uticaria |
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What are soem adverse effects of rituximab?
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bronchospasm
hypotension angioedema throat swelling |
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What drugs are contraindicated with rituximab?
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vaccinations
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What should be done prior to the administering of rituximab?
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premedicate with antipyretics and antihistamines to decrease severity of response
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What is a common immunosuppressant drug?
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cyclosporine
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What are the pharmacotherapeutics of cyclosporine?
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prevent transplant rejectin
prevent graft v host disease |
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How is cyclosporine metaoblized?
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by the P 450 enzyme
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What are the pharmacodynamics of cyclosporine
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suppression of cell-mediated immune reactions
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What are some adverse effects with cyclosporine?
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renal dysfunction
tremor hirsutism HTN gum hyperplasia nephrotoxicity hepatoxicity skin malignancies |
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Which labs should be monitored when administering cyclosporine?
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BUN
creatine WBC RBC |
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Why should cyclosporine not be administered with grapefruit juice?
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decomposes the drug
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What side affect is not apparent with the use of cyclosporine?
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infection but does not show symptoms due to repression of the immune system
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How is cyclosporine administered?
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orally
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When should immunizations be used with caution?
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immunocompromised persons
personw with chronic illnesses after drug transufsion in combination with other biologic drugs |
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Why should personw with compromised immune systems be vaccinated?
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to prevent complications from vaccine preventable diseases
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