Pharm Exam 4
What is the difference between IPV and OPV?
-OPV(oral poliovirus vaccine) given orally- the live virus can be passed through stool to others; active form of virus! -IPV (inactive poliovirus vaccine) SUB-Q Each vaccine recommended for use against polio had its advantages and disadvantages. The advantage of the OPV was that it was almost 100 percent effective at preventing polio. Also, because the vaccine virus was present in the stool, about 25 percent of people who came in contact with someone who was immunized, would also be immunized (this is called contact immunity). In the early 1960s, when immunization rates in this country were low, contact immunity was an important feature of OPV. However, despite OPV's 40 years of success, there was an extremely rare but frighteningly dangerous side effect: permanent paralysis. The inactivated polio vaccine (or IPV) is now the only vaccine given in the United States to prevent polio
State a few disorders in which glucocorticoids are used.
1. Rheumatoid arthritis 2. systemic lupus erythematosus 3. inflammatory bowel disease 4. allergy 5. asthma 6. dermatologic disorders 7. neoplasms (abnormal masses of tissue caused by cells dividing more than they should or not dying when they should) 8. prevention of allograft rejection 9. RDS (respiratory distress syndrome) in preterm infants
Insulin U100 means that each ml contains_______units of insulin?
100
What is the recommended daily intake of calcium for adults 19-50 years old?
1000 mg/day or more. 1200 mg/day if >age 50.
A child over 13 years old with no prior vaccination needs_______doses of varicella vaccine administered at least_______ weeks apart?
2;4 (28 days)
What are the clinical signs of hypoglycemia?
Blood glucose < 70 mg/dl Tachycardia Palpatations Diaphoresis Nervousness Blurred vision seizure Fatigue headache
How is osteoporosis diagnosed?
Bone marrow density (BMD) value 2.5 SD below the mean.
Can varicella vaccine be administered to a pregnant woman?
Contraindicated for pregnant women
Which class of drugs used to treat RA slows disease progression, delays joint injury, and is considered highly toxic?
Disease modifying antirheumatic drugs (DMARDs)
When are vaccines contraindicated?
Do not give vaccines if person has had o Anaphylactic reaction to vaccine or part of vaccine o Moderate or severe illness with or without fever
How do glucocorticoids cause bone loss?
Glucocorticoids cause suppression of bone formation by osteoblasts, while accelerating bone reabsorption by osteoclasts. They also reduce intestinal absorption of calcium, causing hypocalcemia.
Why are patients taking glucocorticoids more susceptible to infection?
Glucocorticoids suppress immune responses and phagocytic activity of neutrophils and macrophages → Increased risk of acquiring new infection + increased risk of reactivating a latent infection
What is glycosylated hemoglobin (HbgA1c)?
Glucose interacts spontaneously with Hgb in RBCs to form glycated derivatives that can be measured in the blood. This value serves as an index of average glucose levels over the prior 2-3 months
Graves' disease results from excessive levels of thyroid hormone. A patient with Graves' disease has (hypothyroidism or hyperthyroidism)?
HYPERthyroidism
What is the major complication from insulin treatment?
HYPOGLYCEMIA
Hashimoto's thyroiditis is associated with (hypothyroidism or hyperthyroidism
HYPOthyroidism
What are the adverse effects of DMARDs?
Hepatotoxicity, bone marrow suppression, GI ulceration, & teratogenesis
Explain how shingles occurs
Herpes Zoster, also known as shingles or simply zosters. Develops in 15% of patients, years after childhood chickenpox has resolved. This causes a reactivation of varicella- zosters viruses that have been dormant with in sensory nerve roots. Episodes of zosters begin at neurologic pain in the area of skin supplied by affected nerve roots. Blister like lesions develop within 3-4 days and usually disappear 2-3 weeks later.
State the clinical signs and symptoms of hypothyroidism.
High TSH, low T4. Flat affect, puffy pale face, dry skin, brittle hair and hair loss, lethargy, fatigue, intolerance to cold.
What benefits do antihistamines have in the treatment of the common cold?
Histamine receptor antagonist relieve allergic symptoms by blocking histamine receptors on small blood vessels, capillaries and sensory nerves Antihistamines provide relief of a runny nose, sneezing and irritated eyes by inhibiting histamine. Antihistamines are used in oral and nasal spray forms to treat seasonal and household allergies such as mold, pollen and pet dander
Treatment with GH can lead to (hyperglycemia or hypoglycemia)?
Hyperglycemia (not good for diabetics.) Monitor blood sugar in all patients
What is the Somogyi phenomenon (rebound hyperglycemia)?
Hyperglycemia following an episode of nocturnal hypoglycemia. Cause: Hypoglycemia episode leads to release of counter-regulatory hormones (epinephrine, cortisol, & growth hormone) and stored glucose in the liver
Propylthiouracil (PTU), methimazole (Tapazole) and radioactive iodine-131 are used to treat (hypothyroidism or hyperthyroidism).
Hyperthyroidism
Sulfonylureas stimulate the release of insulin from the pancreas and are used in patients with type 2 diabetes. State the major adverse effect from these oral hypoglycemics.
Hypoglycemia
Is acetaminophen used for its antiinflammatory actions?
INO. Acetaminophen (Tylenol) has analgesic, antipyretic effects but it has no anti-inflammatory effects.
Which of the above (IPV or OPV) is used in this country?
IPV
Why is metformin usually held prior to diagnostic tests using dyes and prior to surgery?
IV radio contrast media that contain iodine pose a risk of acute renal failure, which could exacerbate metaformin-induced lactic acidosis. Should be held 2 days before elected radiography, and resumed 48 hours after.
Why are live vaccines generally avoided in children with HIV or lymphoma?
Immunocompromised patients should not receive live vaccines; immunizations can cause local reactions, fever Severe illness is a contraindication for vaccines because they have a weakened immune system
In a patient with Graves' disease, the TSH would be (elevated or depressed)?
In a patient with Grave's disease the TSH IS LOW! (The T4 is high) The pituitary shuts off the TSH because the T4 is soo high
Where are glucocorticoids produced?
In the adrenal cortex Glucocorticoids are steroid hormones that influence carbohydrate, protein, and fat metabolism They also maintain the functional integrity of the vascular system and muscles
What is the best time of day to administer prednisone?
In the morning before 9am necause this helps minimize the adrenal insufficiency and mimics the burst of glucocorticoids released naturally by the adrenals each morning.
What is the target value HbgA1c for patients with diabetics?
Less than 7 % (ADA) Ideal is 6.5% (AACE)
Tylenol overdose may lead to damage of what organ?
Liver—overdose can cause hepatotoxicity and severe damage Signs and symptoms of OD: hepatic necrosis, nausea vomiting, diarrhea, sweating, abdominal discomfort(early signs) then hepatic injury 48-72 hrs later
What are the clinical signs of Graves' disease?
Low TSH, high T4. dysrhythmias, angina, nervousness, insomnia, increased metabolism, increased temp, skeletal muscle atrophy, weightless.
Being allergic to egg was at one time a contraindication for receiving which vaccine?
MMR
Which vaccines are considered "live viruses"? Which individuals should not receive live virus vaccines?
MMR, Varicella, live Attenuated Influenza Vaccine (LAIV), Oral Polio Virus (no longer available), Rota Tq and Rotarix, Zostavax Do not give to immunocompromised patients because its an active virus
Metformin can cause decreased appetite, nausea and diarrhea. What is the most important rare side effect associated with use of metformin? Can metformin be given to patients with renal compromise?
Metaformin inhibits lactic acid oxidation leading to lactic acidosis.
During times of stress, patients with adrenal insufficiency need (increased or decreased) doses of glucocorticoids?
Must increase amounts of glucocorticoids during times of stress
Is GH used once epiphyseal closure has occurred?
NOPE
Which types of insulin are cloudy? Which type of insulin has the most rapid action of action?
NPH and any type of pre-mix (70/30 or 75/25) that contains NPH
Gluccocorticoids are anti-inflammatory agents used to relieve symptoms of severe RA and may also retard disease
Nausea, vomiting, severe diarrhea, and abdominal pain.
Do COX-2 inhibitors prolong bleeding time?
No, it does not decrease platelet aggregation, and hence does not promote bleeding.
Do disease-modifying antirheumatic drugs (DMARDs) have an immediate effect?
No, the onset of disease-modifying antirheumatic drugs (DMARDs) is 3-5 months.
Should live virus vaccines be given to patients taking glucocorticoids?
No, vaccines will not be effective while on glucocorticoids.
Describe the clinical signs of Cushing's syndrome.
Obese Hyperglycemic HTN Facial Striae Moon Face Buffalo Hump Adrenal hormone excess also caused by tumors that secrete adrenal hormones or primary hyperaldosteronism can cause this as well. Treat with aldosterone blockers Clinical Presentation: HTN, hypokalemia, muscle weakness
Can oral hypoglycemics be used during pregnancy?
Oral hypoglycemics are discontinue and switch to insulin Exception: Metformin to manage type 2 in diabetes
Giving immunoglobulin for exposure to hepatitis provides immediate protection and is an example of (active or passive) immunity?
Passive Immunity o Administer preformed antibodies o Gives you immediate protection o Example: Immunoglobins given when exposed to hepatitis
Selective estrogen receptor modulators (SERMs) such as Evista are used to treat___________________?
Postmenopausal osteoporosis, and breast CA
In rheumatoid arthritis (RA) joint destruction is caused by an autoimmune process. What are the goals of treatment?
(1) relieve symptoms (pain, inflammation, and stiffness) (2) maintain joint function and range of motion) (3) minimize systemic involvement (4) delay disease progression.
Should children born prematurely be immunized?
Premature babies can get vaccines - they just follow different schedule
How does propranolol help in the treatment of hyperthyroidism?
Propanalol slows the heart to help treat the tachycardia and angina associated with hyperthyroidism. Because it is not cardioselective it also acts on other organs and treats other symptoms like tremor. Remember, don't give w/asthma.
How would you advise a patient to take alendronate (Fosamax)?
Take in the morning before breakfast on an empty stomach, no food including orange juice or coffee for at least 30 minutes after administration. Take with a full glass of water. Remain upright (sitting or standing) for at least 30 minutes.
Why is regular insulin always drawn up first when combinations of insulin are used?
The NPH will activate or contaminate the rapid acting insulin
When is the third dose of HBV given?
The first dose can be given at any time. The second dose is given 1-2 months after the first dose, and the third dose is given 6 months after the first dose.
What is the treatment of Addison's disease?
Treatment of Addison's Disease i. Given Adrenal Hormone Replacement (hydrocortisone) ii. Must increase treatment amounts during times of stress Must wear medical alert bracelet Have emergency supply
TZDs are contraindicated in patients with _______Diabetes
Type 1
Why should children and teenagers avoid ASA if suspected of having influenza or chickenpox?
Use of ASA in a child with influenza or chickenpox is linked to Reye's syndrome (encephalopathy and fatty liver degeneration). If a child with chickenpox or influenza needs an analgesic/antipyretic, acetaminophen is safer for use.
What is the VAERS?
Vaccine Adverse Event Reporting System in the United States For Vaccine Safety - co-managed by the CDC
why is vasopressin used with caution in patients with coronary artery disease or hypertension?
Vasopressin causes vasoconstriction which can increase preload
State the adverse effects of SERMs.
Venous embolism, fetal harm, and hot flashes.
Rickets and osteomalacia are associated with deficits is vitamin_________?
Vitamin D
Glucocorticoids cause
hyperglycemia - They increase blood sugar.
What are the clinical signs of lactic acidosis?
hyperventilation, myalgia, malaise, and unusual somnolence.
hypothyroidism is caused by
malfunction of the thyroid, iodine insufficiency, chronic autoimmune thyroiditis, and Hashimoto's thyroiditis
Severe hypothyroidism is called
mixodema
Thiazolidinediones (TZDs) such as rosiglitazone (Avandia) and pioglitazone (Actos) reduce blood sugar by increasing insulin _________?
resistance
Glucagon is used to treat
severe hypoglycemia in diabetic patients
Name the disorder associated with excessive growth hormone
• Gigantism: excess growth hormone treated with Sandostatin • Acromegaly: a growth hormone excess due to pituitary adenoma (treated w/pituitary surgery): usually in middle aged adults. • Acromegaly presents with skull and brow protrusion, soft tissue swelling, and swelling of internal organs (heart)
7. How is hypothyroidism treated? (high TSH, low free T3 and T4)
• Hypothyroidism is treated with replacement therapy • Usually replace with Levothyroxine (T4) • Rarely do you do replacement with Liothyronine (T3) (most T4 converted to T3 anyways)
How is Graves' disease treated?
• The anti-thyroid drugs Propylthiouracil (PTU) and methimazole • PTU blocks conversion of T3 (inactive) to T4 (active) • Methimazole inhibits thyroid hormone synthesis, is given daily, and is the PREFERRED ORAL AGENT! • Radiation therapy
How should oral levothyroxine be administered?
• Thyroid replacement hormones should be taken in the morning on an empty stomach to increase bioavailability • Should not be taken with calcium or ferrous sulfate b/c they decrease absorption of the hormone • PPI's, histamine blockers, bile acid resins, and orlistat can also decrease absorption
What is the purpose of low-dose aspirin following an MI?
- Aspirin suppresses platelet aggregation by causing inhibition of COX-1 - It will decrease the chance of a second MI or stroke
Prostaglandins protect gastric mucosa.
- When you block prostaglandins in the stomach, you block their protective effect in the gastric mucosa
What are the differences between the 2 influenza vaccine preparations (LAIV and TIV). State contraindications for each.
-Trivalent inactivated influenza vaccine (TIV) contains inactivated viruses and thus cannot cause influenza. Live-attenuated influenza vaccine (LAIV) contains live attenuated influenza viruses that have the potential to cause mild signs or symptoms related to vaccine virus infection (e.g., rhinorrhea, nasal congestion, fever, or sore throat). LAIV is administered intranasally by sprayer, whereas TIV is administered intramuscularly or intradermally by injection. LAIV is licensed for use among nonpregnant persons aged 2-49 years; safety has not been established in persons with underlying medical conditions that confer a higher risk for influenza complications. TIV is licensed for use among persons 6 months and older, including those who are healthy and those with chronic medical conditions -2 types; both want to be given in October or November -Inactive vaccine mostly given! -LAIV Live attenuated influenza vaccine is a nasal spray; narrower range; so cannot give to children under 5 or asthma, diabetes, or immune compromised patients.
Name two of the first generation antihistamines possessing the highest anticholinergic and sedating effects
. CNS sedation is most prominent with (ethanolamines eg,. Diphenhydramine) and (phenothiazines eg. Promethazine)
At what age is the varicella vaccine given?
1 year old
How many mg of calcium in one 8-ounce glass of milk?
300 mg.
How long does it take for levothyroxine (T4) to reach plateau?
4-5 weeks (the half life is 7 days times 5) Levothyroxine is also called SYNTHROID
Repaglinide (Prandin) also stimulates the release of insulin from the pancreas and can lead to hypoglycemia. The difference is that it must be given in association with _________?
A Meglitinide-Must be given before meals
How is diabetes insipidus treated?
ADH replacement: Diabetes insipidus (DI) is a condition characterized by excessive thirst and excretion of large amounts of severely diluted urine, with reduction of fluid intake having no effect on the concentration of the urine. The most common type in humans is central DI, caused by a deficiency of arginine vasopressin (AVP), also known as antidiuretic hormone (ADH).
When should patients be advised to discontinue ASA and NSAIDs prior to surgery?
ASA remains in the system for the life of the platelet (8 days); both ASA and NSAIDs create risk of bleeding if not discontinued; must minimize blood loss during parturition and elective surgery
Vaccination produces (active or passive) immunity?
Active Immunity = body produces its own antibodies Vaccination is an active form of artificial immunity - antigens are introduced so your body produces Antigens can include microbes, proteins, and plant toxins
What are the severe adverse effects of the DTaP vaccine?
Acute encephalopathy - caused by Dtap
Addison's disease is due to a deficiency of_________________?
Addison is due to deficiency of adrenal hormones from cancer, infection and autoimmune disease Clinical Presentation i. Weakness, emaciation, hypoglycemia, increased pigmentation of skin, hyperkalemia, hypotension
When do women experience accelerated bone loss?
After menopause with continued loss for several years (2%-3% per year).
Allopurinol (increases or decreases) uric acid levels?
Allopurinal decreases uric acid levels.
There are two drugs that lower blood sugar by inhibiting digestion and absorption of dietary carbohydrates thereby reducing the rise in blood sugar that occurs after meals. These two drugs (Precose and Glyset) are called ____________ inhibitors.
Alpha-Glucosidase
What are the severe adverse effects of the MMR vaccine?
Anaphylaxis can occur with MMR
Should a child receiving antibiotics receive a vaccine?
Antibiotics do not prevent them from getting a vaccine
What is the recent warning regarding Avandia?
Avandia was assoc with MI and sudden cardiac death.
State lifestyle measures that promote bone health.
Avoid smoking and ETOH. Regular weight-bearing exercise prevents bone loss.
Name the antihistamine that is delivered via nasal spray.
Azelastine (Astelin) nasal spray
If a patient was taking regular insulin before breakfast at 7:30 a.m., when would they be at greatest risk for hypoglycemia?
Before lunch when the insulin is at its peak
What happens to these signs if the patient is receiving a beta-blocker?
Beta blockers suppress tachycardia and Palpatations masking the hypoglycemic event
Why are C-peptide levels measured in patients with diabetes?
C-peptide levels approximate insulin levels Assess beta function
What is the purpose of the National Vaccine Injury Compensation Program?
Compensates people who have been injured by vaccines
What is the primary difference between COX-1 and COX-2 inhibitors?
COX-1 ("Good COX" ) vs. COX-2 ("Bad COX") The most notable difference involves the COX 1 inhibitors' effect on breaking down gastric mucosa. COX 1 inhibitors cause gastric ulceration, while COX-2 inhibitors do not cause gastric ulceration. It is more beneficial to inhibit COX-2 because suppressing the "bad COX" results in more beneficial effects than adverse effects.
Galactorrhea is the abnormal production of breast milk. Pituitary tumors can cause excessive levels of prolactin that stimulate production of breast milk. Name a drug used to inhibit excessive production of prolactin (hyperprolactinemia).
Cabergoline (Dostinex) inhibits prolactin release
Which COX-2 inhibitor contains sulfa and should not be taken by patients with sulfonamide allergy?
Celecoxib (Celebrex) contains sulfaprecipitate allergic reaction
What are the most common complications of varicella disease in children and adults?
Chicken pox in children Adults- zoster outbreak is a rash - very painful rash - usually only on one side of body. Vesicular rash is common (fluid filled bubbles) Post nerpetic Neuralgia - devastatingly painful - can occur after a zoster outbreak. Adult - sequalla - extremely painful outbreak
The enzyme cyclooxygenase (COX) increases prostaglandins.
Cyclooxygenase (COX)—enzyme that converts arachidonic acid into prostaglandins - Prostaglandins promote inflammation, mediate fever, and sensitize receptors to painful stimuli - COX inhibitors are used to suppress inflammation & relieve pain and fever o ADVERSE EFFECTS of COX Inhibitors: - Gastric ulceration - Bleeding - Renal impairment - Promotion of MI and stroke (secondary to suppressing vasodilation)
How is diabetic ketoacidosis teated?
DKA is a life-threatening emergency. Treatment is directed at correcting hyperglycemia and acidosis, replacing lost water and sodium, and normalizing potassium balance. Begin with IV fluids and electrolytes, followed as possible by IV insulin. Insulin levels must be reduced slowly, by about 50mg/dL/hr.
What information needs to be recorded in the patient's record for each vaccination?
Date of vaccination Rout and site of vaccination Vaccine type, manufacturer, lot number, and expiration date Name, address, title of person providing vaccine Dosage is almost always 0.5 mL but read package insert (could be a multipack)
Diabetes insipidus is the result of (excess or decreased) levels of ADH?
Decreased ADH causes diabetes insipidus
Children who are candidates for GH replacement have (decreased or excess) serum levels of growth hormone?
Decreased serum growth hormone
What are the adverse effects of Fosamax?
Esophagitis is the greatest concern. Musculoskeletal pain, ocular problems, Osteonecrosis of the jaw Atrial fibrillation, Rare reports of atypical femoral fractures
Cushing's syndrome results in (excess or decreased) levels of glucocorticoids?
Excess
What are the causes of Cushing's syndrome?
Excess adrenal hormone secretion caused by tumors (treat by removing tumors) Primary hyperaldosteronism (treat w aldosterone blockers) Cushing syndrome can develop from a cause that originates outside of your body (exogenous Cushing syndrome). Taking corticosteroid medications in high doses over an extended period of time may result in Cushing syndrome.
How is DM diagnosed?
Fasting blood sugar > or = to 126 mg/dl Or Random check > 200 mg/dl Or HbA1c greater than 6.5 pre-diabetes HbA1c 5.7 - 6.4 impaired fasting glucose (IFG) 100-125 mg/dl
What is the Dawn phenonomen?
Fasting hyperglycemia due to increases in growth hormone in the dawn hours.
What is the major difference between first generation and second generation antihistamines?
First generation H1 receptor antagonist frequently caused significant sedation and anticholinergic effect, second generation agents rarely cause either.
When is MMR contraindicated?
Gelatin or Neosporin allergy, in pregnancy and immunocompromised patients
How do you disperse the particles in suspension prior to administration in order to prevent frothing that can make dosing of NPH insulin inaccurate?
Gently roll the vial between the palms of hands
What are the clinical signs of tetanus?
Give Tetanus booster every 10 years (tdap is ideal because we are seeing waning immunity of pertussis) The time between becoming infected with Clostridium tetani bacteria and the person showing symptoms of tetanus is usually 3-10 days Muscular stiffness in the jaw, "lock jaw" is first sign Neck stiffness, difficulty swallowing, swelling, fever, stiffness in the stomach muscles, and muscular spasms
What is the role of glucocorticoids in the treatment of RA?
Gluccocorticoids are anti-inflammatory agents used to relieve symptoms of severe RA and may also retard disease
What problems may cause a patient taking metformin to be more prone to lactic acidosis?
Inhibits oxidation, leading to lactic acidosis. Metaformin is not to be used in patients with renal insufficiency (decreases metaformin excretion), who are more prone to increased lactic acid production (liver disease, severe infection, or hx of lactic acidosis), patients who consume alcoold to excess, and pt's with shock and other conditions that can lead to hypoxemia. Lactic acid toxicity is a potentially fatal condition.
Should a child with a cough or mild fever receive a vaccine? What about a fever of 103 degrees?
It is ok to administer vaccines If it's a low grade fever or mild illness (100 or below is ok) Do not give with high fever
What is the MOA of DPP4 inhibitors such as sitagliptin (Januvia)?
Januvia enhances the actions of incretin hormones, endogenous compounds that (1) stimulate glucose-dependent release of insulin, (2) suppress postprandial release of glucagon (a hormone that decreases glucose production in the liver). Both actions keep blood glucose level from climbing too high. So, it inhibits dipeptidyl peptidase 4 (DPP-4), and enzyme that inactivates the incretin hormones.31. Which drugs used to treat DM should be avoided in patients with a history of pancreatitis. Exenatide, Sitagliptin (Januvia)/DPP-4 inhibitors
Metformin (Glucophage) does not promote insulin secretion or cause hypoglycemia. How does metformin lower blood sugar in diabetic patients?
Metformin suppresses gluconeogenesis, enhances glucose uptake and utilization by muscle Max dose = 2000 mg/day
Give an example of a DMARD used to treat RA that is contraindicated in pregnancy.
Methotrexate. This causes fetal death and congenital abnormalities
Give an example of a COX-2 inhibitor that is considered safer than NSAIDs in the causation of gastric ulcers.
Second-generation NSAID, Celecoxib (Celebrex) is considered safer in the causation of gastric ulcers, especially for short term use because it only inhibits COX-2 and does not inhibit COX-1, "the good cox" , that produces the protective gastric mucosa. However, it is important to note, they are more dangerous in other ways; they increase the risk of MI and stroke.
What is the effect of histamine2 receptor stimulation?
Secretion of gastric acid. Histamine acts directly on parietal cells of the stomach to promote acid release.
When is DTaP contraindicated?
Severe febrile illness, Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component
Give an example of a patient that would be inappropriate for treatment with radioactive iodine.
Someone under the age of 30 or someone that is pregnant or lactating
What are the clinical signs of diabetes mellitus (DM)?
Sustained hyperglycemia Polyuria-excess urine Polydipsia-excessive thirst Ketonuria-ketones in urine Depression Blurry vision Impaired wound healing Weight loss Acanthosis nigricans-brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds
What is the name of the gland that regulates calcium balance in the body?
The parathyroid gland
What are the mechanisms by which glucocorticoids interrupt the inflammatory response?
They inhibit synthesis of prostaglandins, leukotrienes and histamine to reduce swelling, warmth, redness and pain.
Why are doses of glucocorticoids discontinued with a drug taper?
They must give the adrenal glands time to learn how to function again on their own; Taper over 7 days (depending on time using the drug), so that adrenal glands can learn again how to make their own glucocorticoids
Name three drug classes that increase blood sugar.
Thiazide diuretics Sympathomimetics Glucocorticoids Antipsychotics Possibly statins
Why are glucocorticoids withdrawn gradually?
Withdrawal of glucocorticoids must be done slowly because you can cause adrenal hormone insufficiencies after the discontinuation of use. You can get a recurrence of the underlying disease as the glucocorticoid is being withdrawn You can also get steroid withdrawal symptoms You can also possibly cause Cushing's syndrome! (www.ncbi.nlm.gov)
What are the effects of H1 (histamine) receptor stimulation on the following:
a. Blood vessels and capillaries: Vasodilation b. Bronchi: Bronchoconstriction c. Skin: Vasodilation is prominent in the skin of the face and upper body, causing the area to become warm and flushed
COX one inhibitors have the following effect on:
a. Gastric mucosa-gastric erosion and ulceration b. Platelets- reduced platelet aggregationbleeding tendencies c. Kidney- renal impairment d. Brain-reduces fever and pain e. Uterus-inhibits contractions at term
hypothyroidism in infancy is called
cretinism
In a patient with hypothyroidism, the TSH would be (elevated or depressed)?
elevated
