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Antivirals may be prescribed for either systemic or local use for oral viral infections. Treatment is considered palliative for lesions caused by HSV, varicella, herpes zoster, or HIV. Palliative means ______.

alleviating a symptom without curing the causative condition

Chronic obstructive pulmonary disease can result in _____, which is an airless condition in the nonexpanded lung. These patients may also develop _______, an abnormal condition of the bronchial tree characterized by irreversible dilation and destruction of the bronchial walls.

atelectasis; bronchiectasis

...influences the way in which drugs for GI disorders act on muscular and glandular tissues

autonomic nervous system

Nasal glucocorticoids, such as fluticasone and triamcinolone, are used to treat seasonal and perennial allergic rhinitis. Since these medications are corticosteroids given percutaneously by inhalation they _____________.

will have minimal systemic effects with topical use

The goals of asthma management are to control airway swelling and avoid asthma triggers. Asthma medications play an important role in managing signs and symptoms, such as coughing, wheezing, dyspnea. The person with asthma should work closely with the doctor to track symptoms and make adjustments to asthma medications as needed. Usually, the person will have 2 types of medications: 1) controller medications for long-term maintenance and prevention and 2) quick-acting, rescue medications for asthma attacks. Match the drug category with the type of asthma medication. There is more than one match per category. 1.inhaled corticosteroids (fluticasone) 2.Short-acting beta agonists (albuterol) 3.leukotriene modifiers (montelukast) 4.long-acting beta agonists (formoterol, salmeterol) 5. xanthines (theophylline) 6. combination inhalers with both LABA and corticosteroid (fluticasone+salmeter) 7. anticholinergic (ipratropium)+short-acting beta agonist (albuterol) 8. oral and intravenous corticosteroids

1. long-term 2. quick-relief 3. long-term 4.long-term 5. quick-relief 6. long-term 7. quick-relief 8. quick-relief

Laxatives and cathartics are used to induce defecation for treatment of constipation or to evacuate the bowel for diagnostic testing. Match the type of agent with its mechanism of action. 1. increase the amount of water in the large intestines so the fecal mass swells, stretching the intestinal wall and increasing peristalsis 2. stimulate peristalsis by swelling, increasing bulk, and modifying consistency of stool to stimulate the intestinal tract 3. stimulate peristalsis by increasing intestinal motility decreasing the time for absorption in the large intestines, resulting in watery stools 4. Coat the stool surface with an oily substance and soften stool to ease defecation 5.decrease the consistency of the stool to reduce surface tension by absorbing water into the stool, lubricating the rectum, and increasing stool bulk 6. bowel cleansing solution comprised of a mixture similar to body fluids causing water and electrolytes not be absorbed within the bowel

1. osmotic laxatives 2. bulk-forming laxatives 3. stimulant laxatives 4. lubricant laxatives 5. stool softness 6. cathartics

Match the drug class used for treatment of gastric disorders with its correct description. 1. alkaline compounds used to neutralize hydrochloric acid 2. protect gastric mucosa from acid secretions and irritating medications 3. inhibit gastric fluid secretions produced by the gastric mucosa histamine receptors, which mediate secretion of gastric acid and pepsin 4.inhibit chemicals essential for the production fo hydrochloric acid 5. inhibit gastric secretions and protect against irritant effects of medications, such as aspirin and NSAIDs 6. decrease secretions and slow peristalsis and spasms by blocking acetylcholine at muscarinic receptors

1.antacids 2. mucosal protectants 3. H2-receptor antagonists 4. proton pump inhibitors 5.prostaglandin analogoues 6. anticholinergics

Based on your understanding of the text, lecture notes and WebMD information, select all true statements about Crohn disease (Links to an external site.)Links to an external site..

Aminosalicylates (sulfasalazine or mesalamine) are used to manage symptoms caused by inflammation. The main symptoms of Crohn disease include abdominal pain, diarrheal stool (possibly bloody) 10-20 times a day, weight loss, and less frequently, mouth sores, bowel blockages, anal fissures and fistulas. Azathioprine and methotrexate are immunosuppressants that may be prescribed if corticosteroids do not attain remission. Diagnostic tests include barium x-ray, colonoscopy, biopsy of diseased tissue (rule out cancer or other disease), and stool analysis (rule out infection)

Mayo clinic community-acquired pneumonia (CAP)

Bacterial pneumonias are treated with antibiotics; however, it may be difficult to identify the causative organism; therefore, if symptoms do not improve, the doctor may select a different antibiotic. mycoplasma pneumonia causes 'walking pneumonia" Steptococcus pneumoniae is the most common cause of pneumonia and can occur on its own or after a cold or flu. Signs/symptoms of dyspnea, chest pain, persistent fever of >102 F, or persistent productive or nonproductive cough are indications to contact the doctor.

true or false patients with asthma or COPD benefit from the use of antitussives to decrease oropharyngeal irritation from productive coughs

False: Patients with productive cough should never have cough suppressed because thickened mucus, or sputum, needs to be cleared from the airways in order to prevent airway obstruction and growth of pathogens

Read the new 2017 AHA/ACC guidelines for management of hypertension in the lecture notes and select all true statements.

First-line and later-line treatments should now include thiazide-type diuretics, calcium channel blockers, ACE inhibitors, or ARBs When initiating therapy for patients of African American descent without chronic kidney disease, use CCBs and thiazides, instead of ACE inhibitors or ARBs An ACE inhibitor, or an ARB, is recommended in all CKD patients with hypertension as either first-line therapy or in addition to first-line therapy While adults with DM and HTN have reduced mortality and improved cardiovascular and cerebrovascular outcomes with treatment to a goal of SBP <150mmHg, the AHA/ACC guidelines continue to recommend a treatment goal of <130/80 mmHG.

Hepatitis is an inflammation of the liver caused by infection by a viral. Select all true statements about this condition and its treatment (refer to the lecture notes and the WebMD article (Links to an external site.)Links to an external site. for treatment recommendations.)

Hepatitis C can be treated with PEG-IFN and ribavirin or by combination oral ledipasvir and sofosuvir Hepatitis B can be transmitted by sexual contact, tattooing or body piercing, snorting or injecting recreational drugs, or healthcare worker receiving accidental needle stick. Hepatitis B may be treated with peginterferon alfa-2b and nucleoside analogues like lamivudine, adefovir, or entecavir.

Merck Manual true statements about hospital-acquired pneumonia

Late-onset HAP or patients with risk factors for antibiotic-resistant organisms are treated with triple therapy (2 drugs with activity against pseudomonas and 1 drug with activity against MRSA) In nonintubated patients, major risk factors for postoperative pneumonia include age >70 years, abdominal or thoracic surgery, and functional debilitation Early-onset pneumonia occurring within the first 4 days of hospitalization without risk of antibiotic-resistant organisms are often treated with ceftriaxone, respiratory fluoroquinolone, ampicillin/sulbactam, or ertapenem while pathogens vary among and within institutions, the most important pathogens include: pseudomonas aeruginosa, methicillin-resistant staphylococcus aureus, and methicillin-sensitive staphylococcus aureus VAP constitutes >85% of all HAP; and P. aeruginosa, MRSA and enteric gram0negative organisms are the most common causative organisms occurring with increasing duration of intubation or hospitalization

"wear and tear arthritis" or --- is a noninflammatory degenerative joint disease which occurs with age as the articular cartilage deteriorates. An autoimmune systemic disease that begins with joint stiffness and progresses to joint fusion is called ---. with --- is an inflammation of the sac of synovial fluid located near certain joints that occurs when the joint is overused, traumatized, infected, or when calcium deposits accumulate causing pain and inability to flex or extend the joint

Osteoarthritis, rheumatoid arthritis, bursitis

Mayo clinic cold sores or oral herpes

The cold sore passes through several stages including tingling/itching to blisters to oozing and crusting. Cold sores are caused by HSV-1, which is closely related to the virus that causes genital herpes (HSV-2). Children under 5 years old may have HSV-1 sores in their mouths; and these lesions may be mistaken for canker sores. Most people who become infected with HSV-q never develop symptoms

When prescribing antihypertensive therapy, patient instruction is important for achieving compliance and preventing the sequelae of poor blood pressure control including MI, stroke, and renal failure. What areas should be addressed to encourage compliance? Select all that apply.

To avoid falls, take care when changing position from sitting/lying to standing if applicable-smoking cessation, decrease alcohol intake, manage stress frequent sips of water, chewing gum or hard candy (sugar-free) may alleviate dry mouth associated with diuretics decrease sodium intake, control weight, and increase activity with a routine exercise program Maintain adequate hydration if taking prescribed diuretics and take with food if GI upset occurs

Ms. Mallory, age 67, has a history of angina pectoris for which Dr. Merry has prescribed nitroglycerin patches and nitroglycerin tablets. What should the health care provider teach Ms. Malllory about use of this medication? Select all that apply.

Transdermal nitroglycerin patches should be rotated on a daily basis and not be worn more than 10-12 hours per day Nitroglycerin sublingual tablet should are not to be swallowed, crushed or chewed, but placed under the tongue until fully dissolved Nitroglycerin SL should be stored in the container in which it was provided and tightly capped between uses

Rimantadine and amantadine are used in prophylaxis and treatment of influenza A infections and should only be used in the documented presence of an influenza A virus epidemic.

True, The CDC does not recommend the routine use of adamantanes because of the fast development of resistance

Second-generation antihistamines, such as cetirizine, fexofenadine, and loratadine, act by blocking peripheral H1-receptor sites; therefore, they do not cross the blood-brain barrier easily and are safer to use with CNS depressants and the elderly.

True: these 2nd generation antihistamines do not as readily depress the CNS

Based on your text, lecture notes and the National Digestive Diseases Information Clearinghouse Web site information, select all true statements about ulcerative colitis (Links to an external site.)Links to an external site..

Ulcerative colitis is a chronic disease with characteristic inflammation and ulceration of the inner lining of the colon and rectum, generally occurring in people between the ages of 15-30, and may be a cause or a result of an immune system disorder. The most common symptoms of UC are abdominal discomfort and blood or pus in diarrheal stool While blood tests might identify inflammation (high WBCs) or anemia (decreased hemoglobin) and include stool tests to rule out infection, flexible sigmoidoscopy or colonoscopy are the most accurate methods for diagnosing UC and ruling out other s/s causes. Treatment of UC includes aminosalicylates, immunomodulators and/or anti-TNF biologic

Mac, age 2, has a cough and nasal congestion because of an upper respiratory infection. Mac visits Dr. Merry because he has begun to wheeze. Mac's mother is concerned that he might have asthma and require corticosteroids. Dr. Merry checks Mac and finds that besides a URI, he also has otitis media. Dr. Merry would have to perform further diagnostic tests to determine if Mac had asthma, which might be treated with corticosteroids; however, at this point he has ordered only decongestants. Asthma is ______.

a disease of the thracheobranchial tree characterized by paroxysmal constriction of bronchial airways due to inflammation: Wheezing is a high-pitched whistling sound made while breathing that occurs from narrowing of the airways. Asthma is an inflammatory condition that can cause wheezing. But it is not the only reason - an allergic reaction, infection, tumor or foreign object in the airways can also result in wheezing.

Bone and connective tissue disease can cause fusion and immobility of joints, termed ---. One disease condition of the vertebrae, similar to rheumatoid arthritis, causing stiffening is termed ---. This is an inflammatory disease that can cause some of the vertebrae in the spine to fuse together making the spine less flexible and resulting in a hunched-forward posture

ankylosis, ankylosing spondylitis

Drugs that are used to suppress appetite are called... These drugs are for...term treatment of obesity because of the danger of..., which is the psychological dependence on a drug that results from repeated use.

anorexiants, short, habituation

Nasal decongestants help to shrink swollen membranes of the nasal passages with a resultant decrease in nasal drainage. Topical products may cause nasal staining and burning, and zinc-based sprays may also cause ---, which is lacking the sense of smell. Prolonged daily use of nasal decongestants may cause ---, which is a reflex response of nasal congestion due to prolonged depression of mucous membrane secretions by a medication

anosmia, rebound congestion

Susie Smith is a 52-year old with a congenital aortic valve defect. She recently had aortic valve replacement surgery (AVR) with placement of a mechanical valve. The doctor has told her that she will need to be on ______ therapy for the rest of her life to prevent _______, which could result in a stroke.

anticoagulation; thromboembolism

Kim is flying to Europe in 2 weeks. She has had motion sickness during previous air trips and does not want to be nauseated on this long flight. She asks Dr. Merry if there is a medication she can take to prevent nausea. Use this case scenario in answering Questions 4-5. What type of medications could Dr. Merry prescribe (Use the overall drug category name that means "against vomiting")?...A significant side effect of many drugs in this category (particularly the anticholinergics and antihistamines) is...which can lead to falls and/or accidents when operating heavy machinery (e.g., driving a car).

antiemetic drowsiness

Mac, age 2, has a cough and nasal congestion because of an upper respiratory infection. Mac visits Dr. Merry because he has begun to wheeze. Mac's mother is concerned that he might have asthma and require corticosteroids. Dr. Merry ordered only a decongestant for Mac and not an antihistamine because __________.

antihistamines do not primarily act as cough suppressants or decongestants

medications given after recent MIs or strokes or in patients with peripheral vascular disease are in the category of ---, which act to suppress aggregation of platelets

antiplatelet

The FDA alert for medication class of --- identifies a rare adverse effect termed ---, which is a severe bone disease causing tissue death of the maxilla and mandible

bisphosphonates; osteonecrosis of the jaw

One type of medication of the treatment of osteoporosis is delivered via nasa spray, which is absorbed into the capillaries in the nasal mucosa. --- is a man-made protein similar to one found in people, other mammals, and some types of fish and birds. Its mechanism of action is to reduce the activity of osteoclasts, allowing for an increase in bone mass

calcitonin salmon

_______ medications may change the heart rate by affecting the nerves controlling the heart, or by changing the rhythm produced by the sinoatrial nerve thus converting the heart beat to a normal sinus rhythm. Positive effects ____ heart rate; while negative effects _____ heart rate.

chronotropic; increase; decrease

as degenerative arthritis progresses, there is increasing joint instability, decrease in range of motion and increase in pain as the bone enlarges and deforms the joint. A crackling sound that occurs on movement is termed---. In autoimmune arthritis, synovitis with resultant formation of granulation tissue, or --- occurs. This results in tissue overgrowth and scarring causing joint ankylosis

crepitus, pannus

______ is a nonsalicylate used as an anti-arthritis and anti-inflammatory. Education for patients taking this drug includes routine liver function tests and to report signs of jaundice, nausea, or fatigue because of the potential for ____.

diclofenac, hepatotoxicity

_________, abbreviated as ____ are a group of medications used to treat moderate to severe rheumatoid arthritis when salicylates and nonsalicylates have not been effective. These medications include gold salts, immunosuppressant agents, immunomodulators, and antimalarials.

disease-modifying anti rheumatic drugs; DMARDs

Antihypertensive agents are classified into 5 major categories. Match the category of medication to its mechanism of action. Block reabsorption of sodium and chloride allowing more water to be excreted to increase urinary output decrease cardio output, inhibit renin secretion, and interfere with the RAA mechanism; no longer recommended as first-line treatment of high BP Block the binding of aldosterone in RAA mechanism absorption alpha-receptor blackade causing vasodilation and decreased peripheral vascular resistance Stimulate sympathetic nerves to function at a higher than normal level reducing blood pressure, pulse rate, and cardiac output interfere with relate of norepinephrine from nerve endings or block receptors in vascular smooth muscles to reduce vascular tone in veins inhibit binding of angiotensin II in vascular smooth muscle preventing vasoconstriction and increasing blood pressure slow angiotensin II formation to lower blood volume and blood pressure by causing peripheral vasodilation, renal vasodilation and suppression of aldosterone-mediated volume expansion

diuretics beta-blockers aldosterone receptor antagonists alpha-beta blockers centrally-acting adrenergic inhibitors peripherally-acting adrenergic inhibitors angiotensin II receptor antagonist angiotensin- converting enzyme inhibitor

Medications, such as verapamil, are used as antidysrhythmics and for treating angina pectoris because of vasodilating properties. This medication has a negative _____ effect and acts to decrease conduction of cardiac electrical impulses.

dromotropic

OxyGel and Peroxyl with the active ingredient of hydrogen peroxide are used in the treatment of minor mouth irritations. The hydrogen peroxide forms gas bubbles and works as an oxygenating and weak antibacterial agent using ______ to loosen tissue debris and reduce bacteria.

effervescence

Medications used to treat defective purine metabolism fall into two categories. Identify medications used to treat acute gout and those used to treat chronic gout. febuxostat allopurinol colchinine probenecid pegloticase

febuxostat: chronic gout allopurinol: chronic gout colchinie: acute gout probenecid: chronic gout pegloticase: chronic gout

_____ are powerful drugs that can quickly reduce inflammatory responses and pain in treating joint diseases such as rheumatoid arthritis. They are produced from hormones secreted by the adrenal cortex and can be administered to palliate arthritis - either taken orally or by intra-articular injection. To maximize benefits, but minimize potential side effects, these drugs are usually prescribed in low doses and/or for short durations

glucocorticostoids

Cardiac _____ are plant substances that yield a sugar plus an active ingredient and exert a positive _____ effect to increase the force of myocardial contraction. Digoxin is an example of this type of medication and is prescribed to slow the heart rate and improve the forcefulness of the heart beat.

glycosides; ionotropic

Jason Mack is receiving chemotherapy after radical orchidectomy for testicular cancer. What medication might be administered to aid the body in fighting infection?

hematopoietic stimulant

agents that inhibit the normal reactions of the immune system and are used to treat rheumatoid arthritis are known as---. These medications fall into the category of disease-modifying anti rheumatic drugs. the fastest acting of the DMARDS and first choice medication in this group is generic

immunosuppressants, methotrexate

Mac, age 2, has a cough and nasal congestion due to an upper respiratory infection. Mac visits Dr. Merry because he has begun to wheeze. Mac's mother is concerned that he might have asthma and require corticosteroids. After assessment, Dr. Merry ordered pseudoephedrine liquid 5cc PO q4-6h prn. He instructs Mac's mother to call if her child develops any of the following side effects _______ (mark all that apply).

insomnia, blurred vision, nausea and/or vomiting, nervousness and restlessness

Severe calf muscle pain that occurs during exercise because of inadequate blood supply to the lower extremities is called-- Treatment may include--- to relax smooth muscles of the peripheral arterial walls and---to improve blood flow and lower blood viscosity in peripheral tissues.

intermittent claudication, peripheral vasodilators, hermorrheologic

Blood pressure is controlled by complex interactions among nervous, hormonal and renal systems. When the blood pressure drops, the adrenal glands secrete epinephrine to elevate cardiac output and blood pressure. Simultaneously the RAA mechanism is also activated. Place in order from 1-4 the steps in this mechanism for maintaining blood pressure homeostasis starting with a decrease in blood pressure.

kidney secrete renin plasma protein angiotensinogen is synthesized and converted in the liver to angiotensin I Angiotension I is converted to angiotensin II by enzymes in the lung tissue Angiotensin II causes vasoconstriction and stimulates adrenal cortex to secrete aldosterone

Loss of bone mass can result in both traumatic and non traumatic fractures of the hips, vertebrae, or wrists. Lumbar vertebral fractures can result in ---, which is an abnormal condition of the spine characterized by increase convexity in the curvature of the thoracic spine as viewed from the side

kyphosis

Zafirlukast is an oral asthma maintenance medication that prevents bronchoconstriction, production of mucus, and inflammation. It acts by blocking _______, a group of metabolites that function as chemical mediators of allergic reactions and inflammation and are implicated in the inflammatory responses in asthma.

leukotrienes

Gaviscon and Gelusil are examples of aluminum and magnesium salts mixed to form _____ compounds to prevent diarrhea and constipation which can occur with use of these chemical compounds alone. Simethicone is the most common active ingredient in antiflatulant medications, also known as _____.

malgaldrate; carminatives

Alendronate is one of the bisphosphonates used to treat osteoporosis. check all correct statements

mechanism of action is to inhibit osteoclast activity and bone resorption with no direct effect on bone formation contraindications or precautions include GI disease, dysphagia, esophageal stricture, esophagitis, gastritis, GERD, hiatal hernia, and inability to stand or sit upright The description of alendronate use includes treatment and prevention of osteoporosis and corticosteroid-induced osteoporosis, and management of paget's disease

A progressive, autoimmune disorder---, characterized by skeletal muscle weakness and fatigue, is caused by loss of acetylcholine receptors that block spinal and nerve simulation and prevent muscles from over responding to stimuli. A class of medication that blocks cholinesterase and allows acetylcholine to accumulate thus increasing muscle strength and function is called ---

myasthenia graves, cholinesterase inhibitors

a/an --- results when the coronary arteries are blocked resulting in necrosis to the myocardium. if the blockage is caused by a thrombus, a/an --- can be effective treatment if given within 6 hours of chest pain onset

myocardial infarction, thrombolytic

match the antianginal agent with its mechanism of action: 1. dilate systemic vessels to reduce cardiac work and oxygen consumption by relaxing vascular smooth muscle thus decreasing venous return to the heartandreducing blood pressure and workload 2 .reverse sympathetic heart stimulation to decrease heart rate and force of contraction preventing myocardial ischemia and pain; often used for chronic management of angina 3. interfere with movement of calcium ions through cell membranes preventing vascular smooth muscle contraction resulting in vasodilation and increased blood flow to the heart

nitrates beta-adrenergic blockers calcium channel blockers

Reglan (metoclopramide) is a/an _____ used to stimulate GI motility by lowering esophageal sphincter pressure and accelerating gastric emptying and movement of food through the intestines for treatment of GERD, chemotherapy-induced nausea and vomiting, and gastroparesis.

prokinetic agent

A beta-blocker, such as _____, can be used to treat angina pectoris resulting from exercise, stress, or physical exertion because it decreases the heart rate and force of contraction and lowers oxygen use. When titrating this medication, the clinician should take the apical pulse at the ______ prior to administration of the drug. It is withheld if the pulse is less than 50 bpm.

propranolol; point of maximum impulse

One method to control motion sickness or nausea is to apply a 72-hour patch that is placed behind the ear for continual release of medication. The name of this anticholinergic (antihistamine) medication is ...

scopolamine

The principal action of histamine is vascular dilation and contraction of smooth muscles of the bronchial tree and GI tract. The person with allergic rhinitis is sensitized to histamine release in the respiratory tract with resulting signs and symptoms of ______. Select all that apply.

sneezing, dyspnea, itching and watery eyes

Albuterol is a beta-adrenergic agent that may be delivered via a hand-held metered-dose inhaler into the mouth. It is important to instruct the patient to gargle after each use of the medication to prevent throat irritation and _____.

stomatitis

Trauma, nutritional deficiencies, chemotherapy, infections and dental disorders, as well as systemic diseases, may cause inflammation of the mouth termed...Treatment is determined based on the causative factor. For example, oropharygeal candidiasis is treated with Mycelex lozenges or Nilstat troches, which are oral...Herpes or varicella lesions of the mouth may be treated with topical oral..., such as acyclovir or penciclovir ointment.

stomatitis antifungals antivirals

Patients starting on most immunomodulators and TNF inhibitors should have a tuberculin skin test as a baseline before treatment.

true: Because these drugs block or change the immune response, individuals can become more susceptible to serious infections like tuberculosis, bacterial sepsis, and histoplasmosis, and even cancers.

One of the first biologicals approved by the FDA to treat autoimmune diseases such as moderate to severe rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis are called ____. These medications (e.g., adalimumab, infliximab, certolizumab pegol, and golimunab) act by inhibiting the protein, produced by white blood cells that provides signals for regulation of cell growth and function during immune response and inflammation.

tumor necrosis factor inhibitors