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232 Cards in this Set
- Front
- Back
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Atropine (Category)
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Anti-cholinergic...Parasympathetic antagonist
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Atropine (Side Effects)
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Dry Mouth (Low doses)
Blurred Vision (High doses) Constipation Tachycardia Urinary Retention Sweating Dizziness Confusion |
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Drug used to treat motion sickness
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scopolamine
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Atropine (Uses)
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Used to treat motion sickness, reduce motility in GI and GU tracts, reduces Parkinson's symptoms, dilate airways, dilate pupils for eye exams
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MOA: reversible blockade of postsynaptic cholinergic muscarinic receptors
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Atropine
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Drugs that block the muscarinic receptors
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Muscarinic antagonists
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Name the types of drugs used to treat HIV
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Nucleoside reverse transcriptase inhibitors (NRTIs)
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) Protease inhibitors (PIs) Fusion inhibitors Integrase inhibitors |
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Effective treatment of HIV requires...
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Administration of a combination of drug regimen (HAART)
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First group of drugs used to fight HIV infection
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NRTIs
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NRTIs (Side Effects)
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lactic acidosis, peripheral neuropathy, nausea, diarrhea, fatigue, hyperlipidemia
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MOA: Prevent the synthesis of viral DNA from viral RNA by inhibiting reverse transcriptase enzyme
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NRTI
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_____ incorporate into DNA and cause termination of the DNA chain and termination of viral replication
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NRTI
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Inhibit HIV replication by binding to a portion of the reverse transcriptase, which changes the shape of the enzyme thus directly inactivating it
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NNRTI
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NNRTI (Side Effects)
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Rashes, trouble sleeping (nightmares, vivid dreams, hallucinations), headache, vomitting, diarrhea, dizziness
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MOA: Inhibit the enzyme reverse transcriptase and also inhibit directly the active site of the enzyme
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NNRTI
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These prevent maturation of the HIV virus
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Protease inhibitors
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Protease inhibitors (Side Effects)
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GI symptoms, lipodystrophy (including peripheral fat wasting, central obesity, increased serum triglycerides and cholesterol levels, insulin resistance)
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MOA: Bind to the protease enzyme of HIV-1 and HIV-2, preventing the breakdown of viral polyprotein into the components needed for viral assembly and budding
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Protease inhibitors
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-avir (suffix)
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Protease inhibitors
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AKA entry inhibitors
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Fusion inhibitors
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They bind to the surface glycoprotein on the viral envelope and prevent fusion of the virus to the host cell
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Fusion inhibitors
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Prevent virus from fusing with human cell, reducing entry of the virus into CD4 cells
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Fusion inhibitors
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MOA: Impair the ability of the HIV virus to enter the host cell's surface
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Fusion inhibitors
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Prevents the HIV virus from incorporating the virus DNA in the host genome
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Integrase inhibitors
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Integrase inhibitors (Side effects)
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fever, headache, fatigue, diarrhea
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Standard drug therapy for HIV infection requires ____ drug regimen
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at least 3 drug regimens
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Goal for using multiple drugs (HAART)
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stop the replication of the virus at a number of different stages in its reproductive cycle
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Optimal time to begin HIV therapy
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When CD4 cell count drops to 350 cells/mm3
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What is HAART
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Highly Active Antiretroviral Therapy
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Purpose/Function of HAART
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Delays the progression of HIV disease
Successfully reduces viral components in the blood stream Allow sustained immune function of CD4 lymphocytes |
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Retrovirus that selectively targets the immune system, particularly the CD4 lymphocyte, severely compromising an individual's ability to prevent infection or certain types of cancer
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HIV
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A friend has allergy to Penicillin; she has strep throat. What type of antibiotics should be prescribed for your friend and why
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Must give patient a drug that doesn't have similar structure to the penicillins b/c if pt is allergic to one penicillin, will be allergic to ALL. (B-Lactam class includes penicillins, cephalosporins, carbapenems and monobactams) Must give patient drugs that lack B-lactam ring such as glycopeptides...
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Penicillin (Category)
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B-Lactam
(Bacterial Cell wall inhibitor) |
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Name the types of penicillins
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Penicillin G
Penicillin V Aminopenicillin Antistaphylococcal Penicillin Antipseudomonal Penicillin |
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This penicillin specifically targets B-lactamase containing bacteria
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Antistaphylococcal Penicillin
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First drug choice for many infections
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Penicillins
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Adverse Drug Reactions associated with Penicillins
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GI discomfort
Allergy Urticaria (Hives) Joint swelling Respiratory problems |
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Clinical Uses for treatment (Penicillin)
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Bacterial meningitis
Skin and soft tissue infections UTI Gonorrhea and syphilis |
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If you want to have a quick action of pain medication like Meperidine (Demerol), what is the administration route that would be most effective?
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IV (Parenteral)
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What type of drug is Meperidine (Demerol)
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Analgesic
Schedule II Opioid It is a synthetic opiate agonist belonging to the phenylpiperidine class |
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Meperidine (Demerol)
Route of Admin: (Min) Onset of Action: (Min) Peak time:(Min) Duration:(Hr) |
Route of Admin: Oral and IV
Onset of Action: 15 (Oral) 10-15 (IV) Peak time: 60-90 (Oral) 30-50 (IV) Duration: 4-5 Hrs (Oral) 2-4 (IV) |
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MOA: exerts its analgesic effects by acting as an agonist at the Mu receptors
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Meperidine (Demerol)
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Meperidine (Demerol) Side Effects:
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Drowsiness
Euphoria/Dysphoria Substance dependence Miosis Constipation Decrease in CV function (BP & HR) RESPIRATORY DEPRESSION |
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First choice of drugs for treatment of severe pain
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Opioids
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Pain divided into 3 major categories
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Nociceptive pain
Nueropathic pain Psychogenic pain |
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MOA: Endogenous opioids produced by leukocytes act on the opiod receptors on the sensory neuron and decrease transmission of painful sensation
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Opioid
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What schedule is Meperidine (Demerol)
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Schedule II
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MOA: Decrease the influx of Ca in the presynaptic terminal of the nociceptive C fibers and A delta fibers, preventing the release of neurotransmitters (substance P and glutamate)
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Opiods
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MOA: Increase Potassium influx, resulting in hyperpolarization and a decrease in nerve transmission
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Opioids
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MOA: inhibition of GABAergic transmission in the brain stem, where GABA inhibits a pain inhibitory neuron
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Opiods
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Clinical Applications (Opiods)
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Treatment of Pain
PCA Anesthetic pre-medication or adjunct in general anesthesia Cough suppression Decrease GI motility Decrease anxiety |
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Opioid Adverse effects
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Mental Slowing
Drowsiness (Sedation) Respiratory Depression Hypotension Miosis Euphoria Constipation Urinary Retention Nausea Vomitting Tolerance Physical Dependence Psychological Dependence (Addiction) |
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Name the three classes of opioid receptors
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Mu receptors
Kappa Delta |
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This type of drugs has high affinity for Mu receptors
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Opioid
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Meperidine (Demerol) is a strong? Mild-to-Moderate agonist? Mixed Agonist-Antagonist? Antagonist
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Strong angonist
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Controlled Substance
Schedule 1 |
Drugs available only for research
Heroin, LSD, Marijuana Highest abuse potential |
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Controlled Substance
Schedule 2 |
High abuse potential with likelihood of physical and psychological dependence
They have accepted medical uses Opiods (morphine, oxy, fentanyl) Barbiturates Auto refills not allowed (Must have new prescription) |
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Controlled Substance
Schedule 3 |
Possible mild to moderate physical dependence develops
Codeine, anabolic steroids, barbiturates Up to 5 refills in 6 months |
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Controlled Substance
Schedule 4 |
Limited potential for abuse or dependence
Anti-anxiety drugs, barbiturates, depressants, stimulants No more than 5 refills in 6 month per perscription |
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Controlled Substance
Schedule 5 |
Lowest potential for abuse
Cough syrups and anti-diarrheal meds May be available w/o prescription |
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If a patient has a hypertonic bladder, what type of drug would work to decrease the hyperactivity of the detrusor muscle?
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Parasympathetic antagonist (This would work as a sympathetic agonist...which would decrease urination...fight or flight)
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This drug reduces secretions of many organs such as salivary glands, nose, lungs and stomach
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Atropine
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This drug is a competitive antagonist for the muscarinic ACh receptors
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Atropine
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_____ lowers the parasympathetic activity of all muscles and glands regulated by the parasympathetic nervous system
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Atropine
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CNS includes
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Spinal cord and brain
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ANS includes
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Parasympathetic
Sympathetic |
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Sympathetic Nervous System
Organ and its effect on it |
Eye - Dilates pupil
Heart - Increases rate and force of contraction Lungs - Dilates bronchioles Blood Vessels - Constricts Sweat Glands - Activates sweat secretion Digestive tract - Inhibits peristalsis Kidney - Increases renin secretion Penis - Promotes ejaculation |
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Parasympathetic Nervous System
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responsible for stimulation of "rest-and-digest" activities that occur when the body is at rest, including sexual arousal, salivation, lacrimation (tears), urination, digestion, and defecation.
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Indirect acting muscarinic stimulants
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prolong action of ACh in the synaptic cleft by inhibiting AChE
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Clinical Application of Anticholinergic drugs
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GI problems
Parkinson's Disease Cardiovascular system Motion sickness Properative medication Urinary Tract Respiratory Tract Eye Cholinergic poisoning |
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MOA: bind directly to and activate alpha 1 receptors located in vascular smooth muscles
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Alpha 1 agonists
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Adverse effects of Beta 1 selective agonist
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Angina (Chest pain)
Cardiac arrythmias shortness of breath |
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Stimulation of Beta 2 receptors mediate bronchiole _____
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Relaxation
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Risk Factors for CAD and T2DM
(Case study) |
Obesity, Sedentery, Stress, Deconditioning, hypertension.
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What referrals would you make
(Case study with 44 y/o w/ CAD T2DM) |
Registered dietician
Stress mgmt Weight loss program Physician (Chest pain with stent) |
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Normal Values:
LDL Cholesterol |
Less than 100
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Normal Values:
HDL Cholesterol |
60 and above
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Normal Values:
Trigylcerides |
Less than 150
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Normal Values:
Total Cholesterol |
Less than 200
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Normal Values:
A1C |
Les than 6% (4-6%)
Prediabetic: 6-6.5% Diabetic: >6.5% |
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Normal Values:
Blood Glucose |
Less than 100
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Normal Values:
Hemoglobin (Hb) |
8 - 14 (Women)
10 - 15 (Men) |
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Normal Values:
BMI |
24.9 or less (Normal)
25-29.9 (Overweight) 30+ (Obese) |
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BP:
<120 /<80 |
Normal
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BP:
Pre-hypertension |
120-139/80-89
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BP:
Stage 1 Hypertension |
140-159/90-99
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BP:
Stage 2 Hypertension |
160+/100+
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Normal Values:
PaCO2 |
35 - 45 mmHg
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Normal Values:
PaO2 |
75 - 100 mmHg
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Normal Values:
pH |
7.35 - 7.45
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Normal Values:
HCO3- |
22 - 26 mEq/L
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Chronic metabolic disorder characterized by hyperglycemia associated with either insulin insufficiency or combined insulin insufficiency and insulin resistance
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Diabetes
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DBM is what type of problem
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Multifactorial
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Characteristics of Diabetes Type 1
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Autoimmune disease in which the body produces antibodies that attack the beta cells of the pancreas...
Patients tend to be young and NOT OBESE Strong inherited predisposition |
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Signs and symptoms of Diabetes Type 1 and Type 2
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Polyuria (Excessive urination)
Polydipsia (Excessive thirst) Blurred Vision Weight loss even though eating Fatigue |
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Insulin is plentiful, at least at the beginning, but resistance to insulin is present (Describe which type of diabetes)
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Diabetes Type 2
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Which type of diabetes is associated with OBESITY
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Type 2
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Main action of insulin
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To preserve energy stores by stimulating the uptake and storage of glucose, amino acids, and fats after a meal
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Function of insulin in the liver
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Inhibits glycogenolysis and gluconeogensis while enhancing glucogen synthesis
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What are the 4 types of insulin available
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Ultra-short acting
Regular or short acting Intermediate Long-acting |
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Ultra Short-acting
Insulin (Duration) |
Duration: 5 - 7 hours
Act more rapidly but for a shorter time than does regular insulin |
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Intermediate Insulin (Duration)
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18 - 28 hours
Longer duration but slower onset than short acting |
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Long-acting Insulin (Duration)
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18 - 36 hours
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Treat diabetes mellitus by lowering glucose levels in the blood
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Anti-diabetic
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These treat hypertension
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Anti-hypertensive
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Metformin (Category/Class)
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Anti-diabetic drug in the Biguanide class
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Metformin
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Oral anti-diabetic drug in the Biguanide class
Most commonly used anti-diabetic agent It lowers LDL and tryglyceride levels and hypoglycemia Administered Orally twice daily with lunch and dinner |
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Reduce glucose output and increase uptake of glucose by the periphery including skeletal muscle
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Biguanides
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MOA: Reduces gluconeogensis in the liver
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Metformin
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MOA: Suppresses glucose production in liver
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Metformin
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Amlodipine
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Long acting calcium blocker used as an anti-hypertensive and in treating of angina
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Side effects of Metformin
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GI upset
Nausea Diarrhea Vomit Headache Can cause lactic acidosis |
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Amlopdipine (Actions as a anti-hypertensive)
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Acts by relaxing the smooth muscle in the arterial wall (Vasodilation) decreasing total peripheral resistance hence reducing blood pressure
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Amlopdipine (Actions in treating angina)
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Increases blood flow to the heart muscle
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MOA: inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle...Blocks L-type calcium channels in blood vessels with little cardio depression
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Amlopdipine
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Amlopdipine (Class)
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Dihydropyridines (Calcium channel blocker)
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Amlopdipine (Side Effects)
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Reflex tachycardia
MI Flushing of skin Headaches Peripheral edema |
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MOA: Reduce cardiac contractility throughout the heart...decrease atrial and AV nodal activity...reduce smooth muscle contraction producing vasodilation throughout blockage of L-type channels
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Calcium channel blocker
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Calcium channel blockers are vaso____
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Vasodilators
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-pril (suffix)
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ACE inhibitors
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Side effects of Calcium channel blockers
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Dizziness
Flushing of skin Hypotension Reflex tachycardia Peripheral edema Bradycardia CHF Constipation Sweating Tremors |
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These are recommended as first line agents for hypertension (treating)
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Beta-Blockers and Diuretics
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Blocking Beta 2 receptors will...
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Lead to bronchoconstriction (lungs)
decrease glycogenolysis and glucagon secretion (hypoglycemia) |
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ACh is specific for which receptors?
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Cholinergic (Nicotinic)
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Cholinergic drugs stimulate _____ system
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Parasympathetic NS
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Anti-cholinergic inhibit ____ system
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Parasympathetic NS
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Anti-cholinergic stimulate ____ system
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Sympathetic NS
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Describe Muscarinic receptors (M1-M3) found
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M1 - CNS (excitatory)
M2 - GI tract, heart, stomach, bladder M3 - glands, smooth muscle |
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Beta 1 receptor found
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heart and kidneys
block rise in HR and BP |
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Beta 2 found
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smooth muscle
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Beta 3 found
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adipose tissue and some heart muscles
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Alpha 1 found
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smooth muscle
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Diuretics
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Increase the excretion of sodium and water by the kidneys
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Name the major types of diuretics
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Loop
Potassium Sparring Thiazide |
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Potassium- Sparring Diuretic
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Act in the collecting tubule to inhibit sodium reabsorption and potassium excretion
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Thiazide Diuretic
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Inhibit the Sodium/Chloride co-transporter on the luminal membrane of the distal convoluted tubule and proximal collecting duct...Promote sodium and potassium excretion and reabsoprtion of Calcium
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Loop Diuretic
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Inhibit the Sodium/Potassium/Chloride co-transporter on the luminal membrane of the ascending loop of henle, blocking the reabsorption of the sodium/potassium/chloride (electrolytes) from the tubular fluids
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ADR for Loop and Thiazide Diuretic
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Dehydration
Hyperglycemia Hypokalemia Hyponatremia Hypocalcemia |
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Beta-1 receptor
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heart & kidney
blockade decreases heart rate, contractility, and sympathetic activity and decreases renin release |
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Beta-2 receptor
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lungs, liver, pancreas, arteriole smooth muscle
blockade causes bronchospasm and vasoconstriction, decrease insulin secretion |
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B-1 selective will block
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Beta 1 receptors
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Metaprolol
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B-1 selective drug
B-1 antagonist |
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Metaprolol (Uses)
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Angina
Hypertension Arrythmias MI CHF |
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Non-selective beta antagonists block...
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Block B-1 and B-2 receptors
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-olol (suffix)
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Beta Blocker
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MOA: competitive antagonists of B-adrenoceptors, exert central inhibitory effect on sympathetic activity, reducing vascular resistance
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Metaprolol
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Blocks rennin release from kidneys resulting in reduction in circulation angiotensin II and aldosterone
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Metaprolol
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lungs, liver, pancreas, arteriole smooth muscle
blockade causes bronchospasm and vasoconstriction, decrease insulin secretion will produce what type of vaso effect? |
Vasodilation effect
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Why is Metaprolol (Beta Blocker) given to someone with hypertension?
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Reduce HR and contractility resulting in reduction of cardiac output and blood pressure
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Blockage of beta 2 receptors in lungs leads to?
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Bronchoconstriction
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What is the best way to monitor the level of exertion on someone taking Metaprolol
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RPE (0 = nothing ; 10 = very,very heavy)
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Is hydroclorothiazide necessary to control this person's hypertension? (Case Study)
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Hydroclorothiazide is a diuretic...it decreases the absorption of sodium (promotes sodium and potassium excretion and calcium reabcorption)...This drug is given to lower the blood volume (plasma volume) which makes the heart work less
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Hydroclorothiazide (Class)
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Thiazide Diuretic
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MOA: promote sodium and potassium excretion...reabsorption of calcium...decrease in blood pressure via excretion of sodium and water through kidneys
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Hydroclorothiazide
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Hydroclorothiazide (Adverse Effects)
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Fluid depletion (Dehydration)
Hypokalemia Nausea, fatigue, weakness, leg cramps, polyuria, hypotension, excessive sweating, mental changes Arrythmias (concerning potassium levels being to high or low) Hyperglycemia |
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Therapeutic Concerns (Diuretic)
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Muscle weakness or cramping
Orthostatic hypotension which increases risk of falls Avoid sudden changes in position Monitor hydration level Urinary incontinence worsens with age Decrease in exercise capacity |
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According to current evidence would another regimen of drug more effective in terms of results and adverse effects to control patients hypertension (Case Study)
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Take away Metaprolol b/c it gives angina (chest pain) and give patient another drug such as a calcium channel blocker
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This drug is useful for patients with conditions that may contraindictae the use of Beta Blockers
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Calcium Channel Blockers
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MOA: blockade of calcium influx into arterial smooth muscle producing vasodilation and decreased peripheral resistance
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Calcium Channel Blocker
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Calcium Channel Blockers produce vaso_____ and _____ peripheral resistance
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produce vasodilation and decrease peripheral resistance
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Why did this patient experience chest pain in the gym? Give the possible physiological reasons for this symptoms
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The heart might have not been receiving enough oxygen to keep up with the demands placed on it (Patient has history of angina)...Chest pain could have been caused by Metaprolol as one of its side effects is chest pain...
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Hydrocodone (Class)
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Opioid
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What Schedule does Hydrocodone fall under?
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Schedule III
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MOA: Acts at opioid receptors in the CNS to produce analgesia, euphoria, sedation...Actis in medullary cough center to depress cough reflex
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Hydrocodone
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What drug am I? Opioid, Schedule III, work by binding to Mu receptors in the brain, blocking impulses of pain going to the cortex
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Hydrocodone
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Hydrocodone (Adverse Effects)
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CNS: Sedation, clamminess, sweating, headache, vertigo, floating feeling, lethargy, confusion
GI: Dry mouth, anorexia, constipation, nausea, biliary tract spasm Dermatologic: Rash, hives, pruritus, flushing, warmth, sensitivity to cold |
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Hydrocodone
Route of Admin: Onset of Action: Min Peak Time: Min Duration: Hrs |
Route of Admin: Oral
Onset of Action: 10 - 30 Min Peak Time: 30 - 60 Min Duration: 4 - 6 Hrs |
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Was the patient's pain medication (Hydrocodone) fully effective when he started PT activities? Admin 8:30 PT Gym 9:30
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Yes...Peak effect is 30-60 minutes
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Does hydrocodone have a side effect on blood pressure or heart rate?
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Both...Medication is an opioid which will slow heart rate thus reducing blood pressure (Bradycardia & hypotension)
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Should you continue the Patient's Therapy session after this episode? (Case Study 1)
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If the chest pain goes away within 5 minutes it is ok to continue
If Nitroglyceride is taken and angina doesn't go away (unstable angina) then STOP |
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Treatments for Stable Angina
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Nitrates (Decreases O2 consumption)
Beta Blockers (Decreases O2 consumption) Calcium channel blockers (Increases coronary blood flow) |
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Dilates the systemic veins and arterioles as well as the large and medium sized coronary arteries
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Nitrates (Nitroglycerin)
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Nitroglycerin (Class)
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Nitrates
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Nitroglycerin is a vaso____
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vasodilator
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How is Nitroglycerin administered
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Sublingual (Enteral, but not affected by first effect)
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Bacterial cell wall inhibitors that lack a B-lactam ring
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Glycopeptides
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MOA: Inhibit cell wall synthesis by attaching to the end of the peptidoglycan precursor unit...they prevent the addition of new units to the peptidoglycan chain
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Glycopeptides
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These do not bind to penicillin-binding proteins
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Glycopeptides
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What do you think happened to patient? What drug can be used to treat patient? (Case Study 2...gardener, mixing fertiilizer)
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Organophosphate exposure
Tx: Atropine (Anti-cholinergic) |
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Atropine is a _____ antagonist
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Parasympathetic antagonist
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Sympathomimetic
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Drugs that mimic somatic nervous system
Designed to facilitate NE or Epinephrine or activate the adrenergic receptors |
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Symptoms observed in patient? (Case study 3: construction worker, paraplegia, prescribed Flurazepam to be taken before bed)
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Decreased level of attentiveness in the morning
Excess lethargy & drowsiness Slurred Speech Poor carryover Decreased motility |
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Symptoms observed in patient could be due to? (Case study 3: construction worker, paraplegia, prescribed Flurazepam to be taken before bed)
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Flurazepam (Dalmane) is taken too close to bed time
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Flurazepam (Dalmane) (Class)
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Benzodiazapine
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MOA: act by binding to the GABA receptors and facilitating the opening of chloride channel
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Flurazepam
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Depresses the level of alertness...inhibiting the excitatory in brain
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Flurazepam
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Flurazepam (Dalmane)
Adverse Effects |
Sedation
Vertigo Dizziness Dysarthia (motor speech disorder) Ataxia |
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This drugs is used in patients with mild to moderate insomnia (difficulty sleeping)
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Flurazepam (Dalmane)
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Flurazepam
Peak blood levels Elimination (1/2 life) |
Peak blood levels: 1 -2 hours
Eliminatin: 40 - 100 hours |
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Is tthere another category of drugs that would be a better choice than Flurazepam? Why?
(Case Study 3) |
Polysynaptic inhibitors because have a shorter half life
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may decrease polysynaptic reflex activity in the spinal cord thus decreasing alpha and gamma motor neuron excitability relaxation of skeletal muscle occurs (prevents increase tone & contraction of the muscle)
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Polysynaptic inhibitor
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useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures.
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Benzodiazepine
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Short- and intermediate-acting benzodiazepines are preferred for the treatment of ______; longer-acting benzodiazepines are recommended for the treatment of ____
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Short = Tx of insomnia
Long = Tx of anxiety |
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This drug type is used in relief of muscle spams
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Polysynaptic inhibitors
Benzodiazepine |
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Polysynaptic inhibitors (Adverse Effects)
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Sedation
Drowsiness Dizziness Dry Mouth Nausea Vertigo Ataxia Heachache Physical Dependence |
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Would changing the timing of administration of Flurazepam improve patients performance?
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To improve performance medication must change to something like polysynaptic inhibitor...Changing the timing doesn't really help due to the long half-life
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Digoxin (Lanoxin) is prescribed for?
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mild to moderate CHF and treating abnormal heart rhythmn (atrial fibrillation)
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Digoxin (Lanoxin) (Class)
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Digitalis glycoside
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This drug is a positive inotropic agent
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Digitalis glycoside - Digoxin
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Drug enhances cardiac contractility by increasing the availability of free intracellular calcium to interact with contractile proteins
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Digoxin
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Digoxin increases the ____ & ____ of heart contractions
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Strength & vigor
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Digoxin increases the force of contraction of the heart muscle by
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Inhibiting the activity of an enzyme (ATPase) that controls movement of calcium, sodium, and potassium into heart muscle
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Digoxin Side Effects
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Angina
Digitalis toxicity Tachycardia Dysrhythmia Visual and Bowel disturbances SOB Nausea, Diarrhea, Vomiting Gastric irritation Dizziness Headache |
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Enalapril (Vasotec)
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ACE inhibitor
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Enalapril is a vaso_____
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Vasodilator (decreases peripheral resistance)
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What does enalapril do?
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Blocks the action of ACE (doesn't allow angiotensin II synthesis)...This blockage causes vasodilation and diuresis (urine production) decreasing peripheral resistance
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Angiotensin II
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Vasoconstrictor...contributes to the development of HTN by constricting arteries and stimulating aldosterone release which stimulates sodium reabsorption from kidneys
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Enalapril used for treating
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High blood pressure
CHF (in combination with other drugs) |
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Enalapril
(Side Effects) |
Dry, persistent cough
Rashes Hypotension Hyperkalemia Angioedema Diarrhea, nausea, vomiting Headache, fatigue angina hypersensitivity Fainting Sore/Swollen throat Loss of apetite |
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Enalapril may increase which (potassium/sodium/chloride) levels?
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Potassium levels...Therefore, increased risk of hyperkalemia when enalapril is given with potassium supplements or drugs that increase K levels
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Amiloride (Midamor) (Class)
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Potassium-sparring diuretic
|
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Amiloride (Midamor) Uses
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Used with other diuretics to treat high blood pressure...
Helps prevent low blood potassium levels caused by other diuretics |
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Amiloride is called a water pill and causes...
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your bosy to get rid of extra salt and water while also preventing the kidneys from getting rid of too much potassium
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|
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Amiloride (Midamor)
Side Effects |
Headache
Dizziness Nausea Vomiting Loss of apetite AB pain Gas Diarrhea |
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What changes can cause an increase effectiveness of Amiloride (Midamor)
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Lifestyle changes...stress reduction, exercise, dietary changes etc
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MOA: Directly blocks epithelial sodium channel...inhibiting sodium reabsoprtion in distal convoluted tubules, collecting ducts in kidneys
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Amiloride (Midamor)
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If a patient is at risk for hypokalemia (can be due to other diuretics) which drug can be given?
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Amiloride (Midamor)...its a potassium sparring diuretic
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Reduce BP by reducing plasma volume
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Diuretics
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Low levels of ____ in the body can increase risk of digitalis toxicity
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Potassium...So must be careful with patients taking diuretics
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Symptoms of digitalis toxicity
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Confusion
Irregular pulse Loss of appetite Nausea, Vomiting, Diarrhea Palpitations Visual changes |
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Which diabetes is not linked to obesity?
|
Diabetes Type 1
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Exogenous insulin is mostly need in which type?
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Type 1
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Type 1 diabetics depend on?
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external insulin (usually injected subcutaneously) for their survival b/c the hormone is no longer produced internally
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What precautions should be taken by this athlete (Case Study 5)
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Watch Blood glucose levels
Timing of eating, dose, exercise, drugs Need to plan around team's schedule |
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Exercise and Diabetes
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It is difficult for individuals with diabetes to maintain necessary metabolic adjustments...
Exercise acts similarly to insulin by stimulating GLUT4 transporters in muscle and improving pathways for glucagon storage... It improves insulin sensitivity Hypoglycemia can occur during before and after exercise |
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What is the side effects of Insulin?
|
HYPOGLYCEMIA
Headache, fatigue, Hunger Tachycardia Sweating Anxiety Confusion |
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How should the insulin regimen be modified for the athlete? (Case study 5)
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Take insulin 1-2 hours before practice...Eat before practice...Take a snack is practice is going to be long
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What guideline should PT go over with the athlete to avoid incidences of hypoglycemia?
|
Adjust their nutrition & insulin regimen for safe participation
Teach how to self monitor glucose levels and their responses to physical activity Advise when to eat and to take snacks for long practices |
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Peak effect of regular insulin
|
2 hours
|
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Short acting insulin peak time
|
1 hour
|
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If glucose levels below 100 patient should
|
Eat a snack
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If patient glucose levels above 250
|
STOP exercise
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