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Pharm Exam 2
Terms in this set (77)
A hormone produced by the alpha cells in the islets of Langerhans that stimulates the conversion of glycogen to glucose in the liver.
A polysaccharide that is the major carbohydrate stored in animal cells.
The breakdown of glycogen to glucose.
A fasting blood glucose level of 126 mg/dL or higher or a nonfasting blood glucose level of 200 mg/dL or higher. Or a hemoglobin A1C (A1C) level greater than or equal to 6.5%.
A blood glucose level of less than 70 mg/dL, or above 50 mg/dL with signs and symptoms
A naturally occurring hormone secreted by the beta cells of the islets of Langerhans in the pancreas in response to increased levels of glucose in the blood.
When the quantity of glucose in the blood is sufficient, the excess is stored as ___ in the liver and, to a lesser extent, in skeletal muscle tissue, where it remains until the body needs it.
.Uncontrolled hyperglycemia correlates strongly with serious long-term _____ and ____ complications
macrovascular and microvascular
____ complications are usually secondary to large vessel damage caused by deposition of atherosclerotic plaque.
______ complications are secondary to damage to the capillary vessels, which impairs peripheral circulation and damages the eyes and kidneys.
When blood glucose levels are high but no insulin is present to allow glucose to be used for energy production, the body may break down fatty acids for fuel, producing ketones as a metabolic by-product. If this occurs to a sufficient degree, ________ ________ may result.
diabetic ketoacidosis (DKA)
Without treatment,___will lead to coma and death.
It is possible for a patient with type __ diabetes mellitus to have normal or even elevated levels of insulin, yet still have high blood glucose levels. Due to insulin receptors being less responsive.
Hypoglycemia resulting from excessive ____ dosing can result in brain damage, shock, and possible death. This is the most immediate and serious adverse effect of insulin.
Oral medications are generally not recommended for pregnant patients because of a lack of firm safety data. For this reason, _____ therapy is the only currently recommended drug therapy for pregnant women with diabetes.____ does not normally cross the placenta.
Effective ____ control during pregnancy is essential because infants born to women with gestational diabetes have a twofold to threefold greater risk for congenital anomalies or stillborn.
Fast acting insulin that has a rapid onset of 15mins. Often used within 15 minutes of mealtime, otherwise hypoglycemia may result.
___ is injected SQ route, onset action of 15mins, peak plasma concentration of 1-2hrs, elimination half life of 80mins, and duration action of 3-5 hrs.
____ insulin is made from human insulin sources using recombinant DNA technology.
Pharmacokinetics: Regular Ins
___ insulin has an onset of 30-60 mins, Peak plasma concentration of 2.5hrs, and duration of action of 6-10hrs
Insulin ______ is the only available intermediate-acting insulin product.is a sterile suspension of zinc insulin crystals and protamine sulfate in buffered water for injection. The suspension appears cloudy or opaque. Often combined with regular insulin to reduce the number of insulin injections per day.
isophane suspension (also known as NPH insulin)
___ insulin has an onset of 1-2hrs, peak plasma concentration of 4-8hrs, and duration of action of 10-18hrs.
long acting. Insulin ____ is normally a clear, colorless solution with a pH of 4.0. Once it is injected into subcutaneous tissue at physiologic pH, it forms microprecipitates that are slowly absorbed over the next 24 hours. DNA-produced insulin analogue and is unique in that it provides a constant level of insulin in the body.
Unlike sulfonylureas,______ does not stimulate insulin secretion and therefore is not associated with weight gain and significant hypoglycemia when used alone.
Contraindication in pts who have renal diseases. Because _____ is primarily excreted by the kidneys, it can accumulate in these individuals, increasing the risk for development of lactic acidosis.
For this class of drugs to be effective, the patient must still have functioning beta cells in the pancreas. Thus these drugs work best during the early stages of type 2 diabetes.
Keep in mind that allergic reactions are less likely to occur with _________ _________ _______because of their similarity with endogenous insulin;
recombinant human insulins
When drawing up two types of insulin in one syringe, always withdraw the______or rapid-acting insulin first.(clear)
The release of excessive amounts of ___ can lead to anaphylaxis and severe allergic symptoms
.All antihistamines compete with histamine for the H1
receptors in the smooth muscle surrounding
blood vessels and _____.
The major diseases that impair the function of the ____ include asthma and chronic obstructive pulmonary disease (COPD), which used to be referred to as emphysema, and chronic bronchitis. All of these diseases have one feature in common; they all involve the obstruction of airflow through the airways.
_____ _____ is defined as a recurrent and reversible shortness of breath. Asthma occurs when the airways of the lung (bronchi and bronchioles) become narrow as a result of bronchospasm, inflammation, and edema of the bronchial mucosa, and the production of viscous (sticky) mucus. This leads to an obstruction of the airflow in the airways and prevents carbon dioxide from leaving the air spaces and oxygen from getting in
Most asthma attacks are short, and normal breathing is subsequently recovered. However, an asthma attack may be prolonged and may not respond to typical drug therapy. This is a condition known as status ____ and is considered a medical emergency.
The terms chronic bronchitis and emphysema are no longer used but are now included within the ____ diagnosis
____ does NOT stabilize mast cells or prevent release of histamine and other substances, but does bind to histamine receptors and prevent the actions of histamine.
___ causes vasoconstriction and decreases permeability.
These drugs are called peripherally acting antihistamines because they do not readily cross the BBB.
When a pt is prescribed an inhaled Beta 2 agonist(Albuterol) and an inhaled ____. Inhale the beta 2 agonist and then inhale the ____.
COPD level of severity ____ is FEV1 is greater than or equal to 80% predicted
COPD level of severity ___ is FEV1 is 50%-80% predicted
COPD level of severity ___ is FEV1 is 30%-50% predicted
COPD level of severity ___ is FEV1 is less than 30% predicted
What are some various depressive disorders
Major depressive disorder (MDD)
Seasonal affective disorder
Premenstrual dysphoric disorder(PMDD)
Substance-induced depressive disorder
Acute phase of MDD
Severe clinical findings of depression
TX is generally 6-12 weeks
potential need for hospitalization
reductive of depressive manifestations is the goal of tx
Continuation phase of MDD
Increased ability to function
● Treatment is generally 4 to 9 months in duration.
● Relapse prevention through education, medication
therapy, and psychotherapy is the goal of treatment.
Maintenance phase of MDD
Remission of manifestations
This phase can last for years
Prevention of future depressive episodes is the goal of treatment
Risk factors for MDD
Family hx or personal hx
stressful life event
twice as common in females age 15-40
older than 65yrs
MDD neurotransmitter deficiencies includes
Serotonin & Norepinephrine
Imbalances of the neurotransmitter ____,____,_____,____ and possibly glutamate can play a role in the occurrence of depression.
norepinephrine, dopamine, acetylcholine, GABA
Affective disorders, also called mood disorders, are characterized by changes in mood and range from mania (exaggerated emotions) to depression (fewer emotions or emotional range). Some patients may exhibit both mania and depression, and this is referred to as _____disorder.
_____is a form of mania that is less severe that lasts at least 4 days accompanied by 3 or more manifestations of mania. Hospitalization is not required, pt is less impaired. This can progress to mania though
An abnormally elevated mood, which can also be described as expansive or irritable, usually requires hospitalization. ___ episodes last at least 1 week.
4 or more episodes or hypomania or acute mania within one year
Bipolar ____ disorder: Pt has at least one episode of mania alternating with major depression.
Bipolar ___ disorder: pt has one or more hypomanic episodes alternating with major depressive episodes.
__ disorder: pt has at least 2 years of repeated hypomanic manifestations that do not meet the criteria for hypomanic episodes alternating with minor depressive episodes.
an uncommon but serious adverse effect associated with the use of antipsychotic drugs and characterized by symptoms such as fever, cardiovascular instability, and myoglobinemia (presence in the blood of muscle breakdown proteins)
Neuroleptic Malignant Syndrome (NMS)
adverse effect from antipsychotics of involuntary motor symptoms similar to those associated with Parkinsons disease( akathisia and acute dystonia)
____ ___ adverse effect of long term use of antipsychotics. Involuntary contractions of oral and facial muscles and choreoathetosis
Patient should take ____ 2-3 doses daily due to half-life. They should also consume an adequate amount of fluid and sodium. Category D, teratogenic (especially during 1st trimester) This is a mood stabilizer med.
To be considered a nosocomial infection(healthcare associated) the patient must acquire infection greater than ____ hrs after admission
____ is one of the most common organism that cause healthcare associated infections
(MRSA) methicillin-resistant staphylococcus aureus
Most common health care associated infections include
UTIs, surgical site infections, bloodstream infections, and pneumonia.
Most common mode of transmission
___ is able to kill organisms and is used only on nonliving objects to destroy organisms.
Disinfectant( aka cidal agents)
____ generally only inhibits growth of microorganisms but does not necessarily kill them and is applied exclusively to living tissue.
Antiseptic ( aka static agents)
Healthcare-associated infection (HAI) are more difficult to treat because the causative microorganisms are most ___ ___ and virulent.
antibiotic therapy tailored to treat organism identified with cultures
treatment of an infection before specific culture information has been reported or obtained
treatment with antibiotics to prevent infection, as in intra abdominal surgery or after trauma
Antibiotic therapy is said to be ____ when these signs and symptoms do not improve.
_____-spectrum antibiotics are those that are active against numerous organisms (gram-positive, gram-negative, and anaerobic). ____-spectrum antibiotics are effective against only a few organisms.
Once the results of culture and sensitivity testing are available, it is always better to use an antibiotic that targets the ____ organism identified (i.e., a narrow-spectrum antibiotic). Overuse of ___ ___ antibiotics contributes to resistance.
Antibiotic use is strongly associated with the potential for the development of ____.
_______ can occur when antibiotics reduce or com-pletely eliminate the normal bacterial flora.
The most common symptoms of C. difficile colitis are watery diarrhea, ____ pain, and fever.
_____ and sulfonamides are two broad classes of antibiotic to which many people have allergic anaphylactic reactions.
Sets with similar terms
diseases exam 4
chapter 49a- diabetes mellitus
7 Ch 46 & 48
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