chapter 14, 15, 16 pharm meas 218 exam 4

What two principles should be included in the treatment of gout

drink plenty of fluids, and no alcohol

Antispasmodic

drug that acts on the smooth muscle of the intestines to relieve cramping

antispasmodic

drug that acts on the smooth muscle of the intestines to relieve cramping

uricosuric

drug that prevents reabsorption and increases excretion of uric acid through the kidneys

antihyperuricemic

drug that reduces formation of uric acid

oxytocic

drug that stimulates contractions of the uterus

antiarthritic

drug that suppresses inflammation in degenerative diseases of the joints

Anturane, Zyoprim, colchicine

drugs that reduce the formation of uric acid crystals in the joints

oral hypoglycemics

drugs that stimulate the beta cells of the pancreas to secrete insulin

Alendronate, Boniva, Evista

drugs used in the treatment of osteoporosis

corticosteroids

drugs used on the skin because they suppress inflammation, tigten blood vessels, and relieve itching

diabetes mellitus

most common pancreatic disorder, characterized by an inability to use carbohydrates; insulin production is ineffective or not available

contracture

abnormal, permanent shortening of a muscle caused by muscualr atrophy

gardasil is a vaccine that offers protection against human papillomavirus (HPV) which may cause cervical cancer

true

oral contraceptives work by preventing ovulation

true

sexually transmitted diseases may not be completely prevented with condoms

true

synovial capsule

enclosed space between a bone and a joint

Healthy muscles are slightly contracted at all times this is called muscle

tone

what are the possible side effects of testosteroe therapy

when used in women, testosterone can result in masculine side effects. and also lead to retention of salts and thus edema which can usually be controlled with diuretics

Solu-Medrol, prednisone, Florinef

B= INFLAMMATORY DISEASES, ALLERGIC REACTION, REPLACEMENT OF CORTICOSTEROIDS

insulin pump

Battery-operated insulin infusion system connected to a small computer worn on the blet of side that administers small amounts of insulin every hour based on an indivual's daily need for diet and physical exercise.

oxytocin

C. triggers the onset of labor

CHAPTER 16

DEFINITIONS

CHAPTER 14

DEFINITONS

NPH

INTERMEDIATE-ACTING INSULIN

16-2 Describe major disorders that affect the musculoskeletal system

Osteomyelitis- is an infection of the bone, hard to cure Osteoporosis- is a decrease in total bone mass. it results in fractures from a decrease in total bone marrow Osteoporosis - Decrease in total bone mass - Major cause of fractures in postmenopausal women - Bones thin out, become abnormally porous, and are easily broken, or fracture spontaneously Tx: Estrogen, calcium supplements, and a diet rich in calcium alendronate (Fosamax) - bisphosphonate; inhibits osteoclast activity calcitonin raloxifene (Evista) Ibandronate (Boniva) Bursitis-is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. Myositis-means inflammation of the muscles that you use to move your body. An injury, infection, or autoimmune disease can cause it Synovitis-is the medical term for inflammation of the synovial membrane. This membrane lines joints which possess cavities, known as synovial joints. The condition is usually painful, particularly when the joint is moved. The joint usually swells due to synovial fluid collection. Tx: indomethacin (Indocin) naproxen ( Naprosyn ) hydrocortisone (a corticosteroid) injection Gout- is an inflammation of the joints that starts when there is an excess of uric acid in the bloodstream.In gout, or gouty arthritis, the kidneys do not excrete uric acid efficently or, for some reason, the body makes large amounts of uric acid Tx: Colchicine, anti-inflammatory drugs, and corticosteroids Chronic gout may be treated with uricosuric drugs - promote excretion of uric acid May also be treated with antihyperuricemic Drugs - decrease amount of uric acid body produces allopurinol (Zyloprim) Osteoarthritis- is a degenerative joint disease. This conditon slowly destroys the mobile joints Affects weight-bearing joints—spine, hip, and knee Tx: Antiarthritic drugs suppress inflammation in joints Aspirin is drug of choice for pain and inflammation Nonsteroidal anti-inflammatory drugs (NSAIDS) for patients who cannot tolerate aspirin ibuprofen (Motrin); naproxen (Naprosyn); celecoxib (Celebrex) Corticosteroids may be injected during an acute flare up Rheumatoid arthritis- is a chronic inflammatory disease that affects the mobile joints, but is systemic, involving other organs. Tx: disease-modifying agents decrease the permanent effects of the disease Corticosteroids alone or in combination with disease modifying agents TNF-alpha drugs given to improve function entanercept (Enbrel) Drug of choice for moderate to severe rheumatoid arthritis is methotrexate Muscle Pain Many reason for pain in the skeletal muscles (myalgia) Tx: skeletal muscle relaxants - CNS depressants baclofen (Lioresal ) diazepam (Valium) dantrolene (Dantrium) methocarbamol (Robaxin) carisoprodol (Soma) chlorzoxazone (Paraflex; with acetaminophen Parafon Forte) cyclobenzaprine hydrochloride (Flexeril) Bone marrow depression is a serious adverse reaction linked to many drugs, especially antihistamines, tranquilizers, chloramphenicol (Chloromycetin), phenylbutazone (Butazolidin), sulfonamides, antineoplastics, thyroid medications, antidepressants, and diuretics Symptoms: Lack of red blood cells: weakness, pale skin, dyspnea Lack of white blood cells: agranulocytosis, soreness of mucous, fever, chills, extreme fatigue, urinary and vaginal infections Lack of platelets: bleeding from the gums, nose, or gastrointestinal tract Tx: transfusing red blood cells or platelets discontinuing the offending drug(s) providing antibiotics until the white blood cell count is restored treating nondrug-induced cases, such as bone marrow infections or cancer considering erythropoietin to increase the red blood cell count and colony-stimulating factor Leukemia- is an overproduction of white blood cells

CHAPTER 15

REVIEW

Regular insulin

SHORT-ACTING

TRUE OR FALSE

T/F #88-98

ketoacidosis

acidosis caused by a surplus of fatty acids(ketones) in the bloodstream; a complication of diabetes mellitus

Rosiglitazone, Dymelor, Januvia

d= DIABETES MELLITUS

polyphagia

excessive hunger

cretinism

hypothyroidism occuring in infancy and childhood

cervicitis

inflammation of the cervix

Bones are connected to each other by means of

joints

Ultralente

lONG-ACTING INSULIN

critical thinking

osteomyelitis osteoporosis bursitis gout

The skull, spinal column, sternum, ribs, and pelvis________the vital organs of the head,chest,and abdomen

protect

CHAPTER 15

review questions pg 416

libido

sex drive

Leukemia is an overproduction of white blood cells

true

page 408 in book older adult considerations CORTICOSTEROIDS

-Because of other diseses older adults may have, they are at greater risk for side effects of corticosteroids -Lower doses are prescribed because of decreased muscle mass, plasma volume, hepatic metabolism, and renal excretion

Identify the main parts and functions of the female and male internal and external genitalia using correct medical terminology

-Female reproductive system- internal genitalia consist of: 2 ovaries, 2 Fallopian tubes, uterus, and vagina 2 ovaries- are 2 almond-shaped glands located in the pelvis, one on each side of the uterus The ovaries produce ova, the female reproductive cells. Normally once a month, ovulation takes place. That is a single ovum is expelled from the surface of one ovary and travels up the Fallopian tube. An ovum can be fertilized for up to 72 hours after it is released from the ovary 2 Fallopian tubes-where fertilization by sperm may occur The fertilized ovum then implants in the wall of the uterus, where it begins to develop into a human embryo uterus-is designed to contain and nourish the fertilized ovum as it develops. The uterus is pear-shaped, hollow, muscular organ that lies in the pelvis between the bladder and rectum. It opens through the cervix into the vagina. vagina- is a collapsible tubular structure capable of great distention that gives access from outside the body to the internal genitalia. The vagina serves as the lower part of the birth canal and the organ that receives the seminal fluid carrying the sperm from the male -Female reproductive system- external genitalia consist of: Vulva, Mons pubis, labia majora, labia minora urethral meatus, vaginal opening, bartholin's glands, and skene's glands vulva- Consists of the mons pubis, the labia majora, the labia minora, the clitoris, the urethral meatus, the vaginal opening, Bartholin's glands, and the Skene's gland Mons pubis- is a pad of fat that lies over the pubic bone. it is covered with coarse hair. JUST BELOW it are the labia, the -labia majora, and -labia minora that surround the opening of the vagina. clitoris- at the forward tip of the labia is a small organ composed of erectile tissue, sensitive nerve center that becomes engorged during sexual excitation. urethral meatus vaginal opening- the opening to the vagina bartholin's glands-Bartholin's glands (2) are located on either side of the vaginal opening. during sexual excitement, they secrete a lubricating mucus that helps the penis enter the vagina. skene's glands- have no known function -Male reproductive system- internal genitalia consist of : Prostate gland, and seminal vesicles. prostate gland- gland surrounding the male urethra and ejaculatory duct; secretes a thin alkaline substance that makes up the largest part of the seminal fluid. The testes produce millions of tiny sex cells called spermatoza, sperm is collected and matured in a series of coiled tubes called the epididymis., they then pass through a larger tube, the vas dererns. The vas deferens leads from the testes to several storage areas called the seminal vesicles and to the 2 ejaculatory ducts. These 2 ducts pass through the prostate gland and terminate in the urethra, a tube that serves as the terminal portion of the reproductive tract and the passageway for eliminating the reproductive fluid, semen from the body. The prostate gland, the seminal vesicles, and the cowper's glands located on either side of the urethra all produce mucus and fluids that together with the sperm, make up semen. -male reproductive system- external genitalia consist of: penis and scrotum penis -part of the male external genitalia that introduces sperm into the vagina scrotum- a thin, loose, outer layer of skin in which the two testes are suspended, and the penis.

!!!pg 410 instuctions for giving insulin

-Keep insulin at room temperature for up to 4 weeks -Use insulin only with a good expiration date -Rotate insulin suspensions such as NPH, Lente, and Ultralente between the palms of hands -Ensure that suspension insulins are cloudy, such as NPH, Lente, and Ultralente, check that regular insulin is clear -Do not shake vial. If clumps are present after rotating, discard. -Adminster insulin on time so peak action is reached when blood sugar is highest. -Be accurate with correct prescribed dose using only insulin syrine measure in units (U) -Do not massage site after administration

pg 408 in book Pediatric onsiderations CORTICOSTEROIDS

-corticosteroids are used for children for same reasons they are for adults -start with a moderate dose of inhaled steroid -growth retardation is a problem with small doses of inhaled steroid -children generally hae a growth spurt when the steroid is discontinued. -Monitor effects with weight and height measurement

Pg 411 healthcare for today and tomorrow LANTUS

A long acting insulin called insulin glargine (Lantus) is available to allow the body to maintain a steady state of insulin over 24 hours, thus eliminating the need for multiple daily injections Insulin glargine (Lantus) is a human insulin that dissolves more easily in acid than in the pHof subcutatneous tissue. Once injected, if torms a cicropercipitation that releases insulin at a constant slow rate over 24 hours with no peaks. This mimics the body's natural basal rate.

Sprain

A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints. The most common location for a sprain is in your ankle.

Strain

A strain is a stretching or tearing of muscle or tendon. A tendon is a fibrous cord of tissue that connects muscles to bones. Strains often occur in the lower back and in the hamstring muscle in the back of your thigh.

Erectile Dysfunction

A testosterone deficiency may result in erectile dysfunction (impotence) young men- an increase in substance abuse, alochol and other recreational drugs middle aged men- often a result of medical technologies such as bypass surgery, chemotherapy, and organ transplants. a man over 70 as a result of decling testosterone levels. drug used to treat impotence, most commonly treated with Sildenafil citrate (Viagra) Men who take medications containing nitrates, such as nitroglycerin, should not take viagra Inability to achieve or maintain an erect penis. Treatment is based on the caused of the dysfunction Drugs that cause ED methyldopa (Aldomet) used for hypertension propanolol (Inderal) used for hypertension, angina, arrhythmias, and after a heart attack Caused by decreased testosterone Give testosterone parenterally Drugs to treat ED sildenafil citrate (Viagra) tadalafil (Cialis) vardenafil (Levitra)

testosterone

A. stimulates sperm production and development of deep voice and chest and facial hair

a patient asks you how teriparatide (Forteo) works. What is the best response

A. it is used for hypercalcemia b. it prevents osteporosis c. it rebuilds bone d. it inhibits calcium uptake c=it rebuilds bone

When a patient is taking levothyroxine sodium (Synthroid), which of the following side effects should you monitor for?

A. weight gain, moon face, muscle weakness B. Nausea, vomiting, dizziness C. Palpitations, weight loss, tachycardia D. Tremor, abdominal cramps, drowsiness c= palpiations, weight loss, tachycardia

ACTH

A= REPLACEMENT OF PITUITARY HORMONE THAT STIMULATES PRODUCTION OF CORTICOSTEROIDS

Diabetes isipidus is caused by a lack of the --------------hormone

ADH

The gland that sit on top of the kidneys are the -------------glands

ADRENAL

John Sullivan, age 28, is experiencing night sweats, diarrhea, and persistent fever. A physical examination revealed that he is an IV drug user

AIDS acquired immunodeficiency syndrome

pg 411 legal and ethical issues DANGEROUS HERBAL USE

As a result of the expolsion of herbal therapyy in the United states, it is your responsibility to assess whether your diabetic patients are taking herbal supplements. You must stress that herbs have not gone through the same rigorus research as pharmaceuticals and are not approved by the FDA to be sold as drugs. The use of herbs by the diabetic patient can have serious and even life-threatining results. Most herbs cause either a hypoglycemic or hyperclycemic reation that can have devastating effects on the blood glucose level and insulin requirements. If you fail to assess whether the diabetic patient is taking herbs, the patient may receive the wrong dose of insulin which COULD RESULT IN DEATH.

progesterone

B. acts in partnership with estrogen to regulate ovulation and prepare the uterus for pregnancy

16-3 Describe the actions and side effects of drug groups commonly used in the treatment of osteoporosis, gout, osteoarthritis, and rheumatoid arthritis

Bisphosphonates are used in the treatment of osteoporosis. Examples : Fosamax, Actonel, and Boniva. Ts are GI upset such as dyspepsia and diarrhea. Pain in the estremities may also occur. Most of the side effects are cardiac, renal, or gastrointestinal Evista- is an estrogen receptor modulator used to treat osteoporosis Uricosuric drugs are used to treat gout by promoting the excretion of uric acid. Example anturane Antiarthritis drugs are used in the treatment of arthritis to suppress inflammation of the joints. Example asprin Rheumatoid arthritis drugs- the side effects are specific to the type of drug. For example, the side effects of the disease-modifying drugs such as Plaquenil are nausea, abdominal discomfort and rash

power point 1st slide

Bones: made up of organic and inorganic material Joints: the place where two or more bones come together Muscles: work together with bones to allow movement Cartilage: rigid connective tissue; provides support and allows joint movement Ligaments: dense bands of connective tissue that connect bones to bones at joints Tendons: cords of connective tissue Fascia: sheets of connective tissue

Addison's disease is caused by a long-term lack of ------------hormones

CORTICOSTEROID

16-5 Describe the usual care of patients with musculoskeletal disorders

Care begins with giving the patient his or her medication on time handle the patient with care by supporting body parts avoid bumping the bed and sudden jarring movement of theh patient reposition the body parts in natural alignment after moving the patient attend to the psychological needs of the patient

15-7 List several uses of corticosteroids

Corticosteroids are used for hormone replacement therapy, allergic reatctions, and skin inflammations Large doses of corticosteroids are used with many conditions unrelated to adrenal functioning: for some cancers, autoimmune reactions, suppression of immunity in organ transplants, and eye and respiratory disorders, as well as to reduce fever, decrease itching, and suppress inflammation

estrogen

D. stimulates development of breasts, shapeliness, and feminine voice

CHAPTER 15

DRUGS FOR THE ENDOCRINE SYSTEM

CHAPTER 16 PG. 421

DRUGS FOR THE MUSCULOSKELETAL SYSTEM

CHAPTER 14 PG 371

DRUGS FOR THE REPRODUCTIVE SYSTEM

Testosterone

Deeper voice and chest and facial hair, stimulates production of sperm cells Male sex hormones, also called androgens, are secreted in both males and females Main androgen, testosterone, is used in replacement therapy for men when the testes are not producing enough hormone for proper development or sexual activity. Helps relieve the symptoms of breast cancer methyltestosterone (Oreton Methyl, Metandren) fluoxymesterone (Halotestin)

15.4 Hormone Therapy

Diabetes mellitus A condition in which beta cells of the islets of Langerhans in the pancreas do not secrete enough of the hormone insulin Some common symptoms: Hunger (polyphagia) Thirst (polydipsia) Frequent urination (polyuria) Diabetes can appear in childhood or adulthood. In childood (type 1, insulin-dependent diabetes mellitus. adulthood(type 2, non-insulin-dependent diabetes mellitus) overtime, diabetes causes damage to the tissues and organs. especially the heart, kidneys, and eyes. it always carries the danger of complications such as diseases of the blood vessels and nervous system gastronial diabetes is the onset of glucose intolerance during pregnancy Insulin- Major drug for type 1 diabetes Administered by injection because it is destroyed by the gastric secretions Replaces the missing hormone that enables the body to use sugar Dosages are highly individualized and depend on many factors Grouped in four categories: Rapid-acting- Apidra, Humalog, and NovoLog Short-acting- Humulin or Novolin and regular insulin intermediate-acting- NPH and Lente long-acting-Ultralente and lantus popular drugs for diabets control are the intermediate-acting insulins Lente and NPH. They reach their peak effectiveness in about 7 hours and last up to 16 hours. Biosynthetic insulin has come to be used almost exclusively

15-3 Identify which hormones are lacking in the conditions of diabetes mellitus, diabetes insipidus, Addison's disease, and hypothyroidism

Diabetes mellitus is a condition in which the beta cells of the islets of langerhans in the pancreas do not secrete enough of the hormone insulin. Alterations in insulin production result in abnormal metabolism of carbohydrates, fats, and proteins. As a result sugar remains in the bloodstream and is excreted in the urine. Diabetes mellitus: not enough insulin is produced, so insulin is used as a replacement therapy Diabetes insipidus: The kidneys are not able to conserve water. Characterized by intense thirst and excretion of large amounts of urine Addison's diseas: Insufficient production of corticosteroids is common. A combination of a mineralocorticosteroid (fludrocortisone) and glucocorticoid (prednisone) is used in the treatment. Hypothyroidism: Disease or destruction of the thyroid gland causes an insufficent amount of thyroid hormones Natural thyroid preparations such as Thyroid or synthetic thyroid preparations such as levothyroxine (Levothroid), liothyronine (Cytomel), and liotrix (thyrolar) are used in the treatment.

Describe the main uses and major side effects of sex hormones in drug therapy

Estrogen Replace female hormones after menopause or following a total abdominal hysterectomy. It is also used to treat osteoporosis and amenorrhea hormone replacement therapy (HRT) estradiol estrone conjugated estrogens (Premarin) Controversial - equine source transdermal estradiol (Estraderm) side effects include weight gain, breast and pelvic discomfort, vaginal discharge, and skin pigmentation progesterone is used for abnormal bleeding, endometriosis, dysmenorrhea, and amenorrhea treatment medroxyprogesterone acetate (Provera, Depo-Provera) megestrol (Megace) side effects include nausea, headaches, and dizziness Testosterone is used in replacement therapy for men when the testes are not producing enough hormone for sexual activity. It also relieves symptoms of breast cancer, promotes building of body tissues, and reverses tissue wasting after a variety of conditions. Main androgen, testosterone, is used in replacement therapy for men when the testes are not producing enough hormone for proper development or sexual activity. Helps relieve the symptoms of breast cancer methyltestosterone (Oreton Methyl, Metandren) fluoxymesterone (Halotestin) side effects include deepening voice and increased body hair

Humlin N

FAST-ACTING

Semilente

FAST-ACTING

16-4 Describe malfunctions of bone marrow and their effects on blood

Failure of the bone marrow to produce enoug of all three components of the blood is called aplastic anemia 3 componets of blood- lack of red blood cells, lack of white blood cells, and lack of platelets. Overproduction of white blood cells is called leukemia Bone marrow disorders include aplastic anemia, or failure of the bone marrow to produce enough of the three components of blood treatment: tranfusing red blood cells or platetelts dicontinuing the offending drug(s) providing antibiotics until the white blood cell count is restored treating non-drug-induced cases, such as bone marrow infections or cancer considering erythropoietin to increase the red blood cell count and colony-stimulating factor

chlamydial infections are common but have no serious effects

False

sexually tranmitted diseases are all easily treated and cured with drugs

False

Recall the hormones produced by the female and male gonads and describe their functions

Female hormones Porgesterone prepares the uterus to carry and nourish the fetus as it grows Estrogen is responsible for a higher voice. Stimulates monthly development of an ovum Male hormone Testosterone gives men a deeper voice, chest hair, and facial hair and stimulates production of sperm cells.

Describe major disorders that affect the reporductive system

Female reproductive disorder Vaginal infections such as vaginitis (inflammation of the vagina) and cervicitis (inflammation of the cervix) Inflammation of the vagina (vaginitis) Yeast infection and trichomoniasis most common Treated with antifungal medications miconazole (Monistat 7) clotrimazole (Gyne-Lotrimin) metronidazole (Flagyl) fluconazole (Diflucan) Endometriosis (endometrial tissue grows outside the uterus) mosjt common symptom is low abdominal pain, described as dull, aching or crampy that occurs one to two days before menustruation and decreases after the onset of menstruation. Abnormal uterine bleeding, backache, painful sexual intercourse, and painful defecation can aslo occur. treatment- danazol (Danocrine) nafarelin (Synarel) Lupron Depot since 1981 Sexually transmitted disease such as acquired immunodeficiency syndrome (AIDS) (transmitted from person to person by means of infected blood, semen, vaginal secretions, and breast milk); herpes simples (enters the body through small breaks in the skin or mucous membranes); gonorrhea (affects the urethra, rectum, and throats of both men and women; it also affects the cervis in women); and chlamydial infections (caused by Chlamydia trachomatis) aids is caused by hiv. unlike other sexually transmitted diseases, it may be latent for as many as 10 years before the onset of symptoms. Therefore an infected person could infect others without even knowing it. Because there is no cure for AIDs, teching should focus on prevention. HIV treatment zidovudine (Retrovir) didanosine (Videx) zalcitabine (Hivid ) stavudine (Zerit) tipranavir (Aptivus) Genital herpes simplex acyclovir (Zovirax) Sexually Transmitted Diseases (STDs) Venereal warts (condylomata acuminata) 80 to 90 percent trichloroacetic acid Podophyllin (10 to 25 percent) Gonorrhea ceftriaxone (Rocephin) Syphilis parenteral penicillin Chlamydial infections- are caused by several strains of chlamydia trachomatis. Infertility and pelvic inflammatory disease (PID) are two complications of chlamydial infections. treatment tetracycline doxycycline (Vibramycin) azithromycin (Zithromax) Male reporductive disorders Prostatitis (infection of the urethra or lower urinary tract) Prostate diseases Prostatitis: inflammation of the prostate is a disease of older men and is the most common urinary tract infection. antibiotics, anti-inflammatory drugs Benign prostatic hyperplasia or hypertrophy (BPH): Hyperplasia, an increase in the number of cells dutasteride (Avodart) finasteride (Proscar) tamsulosin (Flomax) terazosin (Hytrin) prazosin (Minipress) doxazosin (Cardura) alfuzosin (Uroxatral) Benign prostatic hyperplasia (BPH) (new growth of epithelial and stomal elements within the prostate gland) Cancer and infertillity may occur in both females and males. Vaccine called Gardasil offers protection from the most dangerous types of human papilloma virus (HPV), which is the virus that causes most cervical cancers. Most common female cancers in women are breast and uterus. Most common cancer in males is prostate Infertility in females may be related to cervical mucus, ovulation problems, hormonal imbalances, or ednometriosis Infertility in males is related to problems with sperm density, motility, or shape, or with seminal fluid volume or viscosity treatment Infertility Due to male or female infertility clomiphene (Clomid) human chorionic gonadotropin (Pregnyl, Follutein) menotropins (Pergonal)

Describe the actions of gonadotropins, oxytocin, and prolactin

Gonadotropins control ovulation and the production of female hormones by the ovaries Oxytocin stimulates the uterus to start contracting at the beginning of labor and slows postartum bleeding Porlactin signals the mammary glands in the female breasts to produce milk

Pituitary Hormones That Regulate Reproduction

Gonatropins Follicle-stimulating hormone (FSH) Luteinizing hormone (LH)-pituitary hormones that control several functions of the gonads. Oxytocin stimulates uterus to start contracting at the beginning of labor Oxytocin (Pitocin, Syntocinon) or a similar synthetic drug (called an oxytocic ) Stimulates the mammary glands to "let down" the milk each time the infant begins to nurse

15.7 and 15.8 Corticosteroids

Group of hormones secreted by the adrenal cortex Insufficient production of corticosteroids (Addison's disease) can be fatal. Glucocorticoids (cortisone, hydrocortisone, and cortisol) affect fat and carbohydrate metabolism Mineralocorticoids (aldosterone and desoxycorticosterone) regulate the salt/water balance Glucocorticoids often included in drug therapy are: hydrocortisone (Cortef, Hydrocortone) fluticasone (Flonase) cortisone (Cortone) triamcinolone (Aristocort, Kenacort) prednisone (Deltasone) prednisolone (Delta-Cortef) dexamethasone (Decadron, Hexadrol) methylprednisolone (Medrol, Solu-Medrol) Mineralocorticoid fludrocortisone (Florinef ) Uses Allergic reactions, skin inflammations, some cancers, autoimmune reactions, suppression of immunity in organ transplants, and eye and respiratory diseases Suppress inflammation Adverse effects Mask infection and may cause it to spread Old infections can be reactivated and new infections can start Side effects Weight gain, sodium (salt) retention and edema, hypertension, facial rounding (moon face), diabetes, easy bruising, thinning of the skin, failure of wounds to heal, psychological changes, ulcers, osteoporosis, and hyperglycemia

estrogen

Higher voice, breast development and shapeliness in women, stimulates the monthly development of an ovum Replace female hormones after menopause or following a total abdominal hysterectomy hormone replacement therapy (HRT) estradiol estrone conjugated estrogens (Premarin) Controversial - equine source transdermal estradiol (Estraderm)

!!!CAUTION HORMONE DOSES!!!

Hormones are powerful chemicals that have profound effects on the human body. They must be administered carefully, according to a dotors's orders. Often the doses are very small. They may be measured in micrograms. The exeption is cortiocsteroids, which are given in large doses to comabat allergic reactions and inflammation.

Diagnosis of Hormone Deficiences

Hormones can be used to find out whether a gland is failing to produce its hormones. suppose for example, that the body lacks a certain adrenal hormone. Is this the fault of the pituitary or the adrenal glands? One way to find out is to administer the pituitary hormone ACTH. If this makes the adrenals secrete the missing hormone, we know the problem lies with the pituitary; the pituitary has not been secreting enough of its own ACTH to stimulate the adrenals. On the other hand, if the dose of ACTH does not stimulate the adrenals, we know the adrenals are not working properly in this situation, the patient will likely be put on a regular course of hormone therapy to replace the missing adrenal hormone.

15-6 Identify the signs and symptoms of hyperglycemia and hypoglycemia

Hyperglycemia: The three cardinal symptoms are polyphagia, polydisia, and polyuria. It is treated with oral hypoglycemics or insulin Polyphagia- excessive hunger polydisia- excessive thirst polyuria- excessive urination Hypoclycemia: The symptoms include increased appetite, nervousness, heart palpitations, cold sweating, shakiness, difficulty concentrating, and blurred vision. The three classifications of oral hypoglycemics are first-generation and second-generation sulfonylureas and miscellaneous oral hypoglcemics First-generation sulfonylureas include Orinase, Tolinase, and Diabinese Second-generation sulfonylureas include glipizide* Glucotrol and glyburdie*Micronase Miscellaneous oral hypoglycemics include Precose, Prandin, and Avandia oral hypoglycemics the patient who responds best to oral hypoglycemic drugs is over the age of 40 has had diabets less than 5 years, is normal weight or obese, has a consistent diet, has never received insulin, or has been controlled on 40 units or less of insulin a day. patients with type 2 (non-insulin-dependent diabetes mellitus Oral hypoglycemics are used when the beta cells of the islets of Langerhans continue to produce some insulin. They stimulate these cells to secrete insulin in response to rising glucose levels diabetes mellitus in the pediatric patient- is type 1 or insulin-dependent diabetes mellitus. children at age 4 or 5 years can begin to check their blood glucose levels. Children at age 9 can begin to administer their own insulin.

Diabetes mellitus is caused by a lack of the hormone

INSULIN

15.9 Administering Insulin

Insulin is given parenterally, and as a healthcare worker, you should not administer it unless you are trained and permitted by law to give medications by infection. Insulin is most commonly given subcuttaneously, although intravenous (IV) administration of regular insulin may be used when rapid onset of action is needed. Rate of absorption depends on the site of injection Rate of absorption is greatest in the abdomen, followed by the arm, thigh, and buttocks. Rotate injection sites in te same anatomical area because of the differences in absorption at the various sites 2 types of insulin can be drawn up into the same syringe, as long as one type is regular insulin. regular should be drawn first A patients dose of insulin is determined and administered (according to a sliding scale) after checking the blood glucose

the following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows

L= lONG-ACTING INSULIN I= INTERMEDIATE-ACTING INSULIN F= FAST-ACTING INSULIN O= ORAL HYPOGLYCEMIC

Lantus

LONG-ACTING

The musculoskeletal system supports the body and gives it the ability to

MOVEMENT

16-1 Describe major parts, functions, and disorders of the musculoskeletal system

Major parts of the musculoskeletal system are the bones, muscles, joints, cartilage, ligaments, fascia, and bursae bones provide the framework for muscles, produce blood cells, act as a storage area for calcium, and protect organs of teh body Joints allow movement and flexibility in the body Skeletal muscles work together with bones to allow movement Smooth mscles line the gastrointestinal tract, urinary tract, blood vessels, airways, and uterus Disorders of the musculoskeletal system include physical injuries, osteomyelitis, osteoporosis, bursitis, myositis, synovitis, gout, osteoarthritis, rheumatoid arthritis, and bone marrow disorders

Drugs During Pregnancy

Minimize bleeding or postpartum hemorrhage ergonovine (Ergotrate) methylergonovine (Methergine) Prevent and treat premature labor by inhibiting uterine contractions ritodrine (Yutopar) Prostaglandins to terminate pregnancy vaginal suppository dinoprostone (Prostin E 2) injectable carboprost (Hemabate

other hormones

Natuarl thyroid (Armour Thryoid, Thyrar, Thyroid US) Synthetic thyroid preperations -levethyroxine (Synthroid, Levothroid), liothyronine(Cytomel), and Liotrix (Thyrolar) somatropin (humatrope) is a pituritary hormone that is used to stimulate growth in pituitary growth hormone deficiency such as hypopituitary dwarfism. Vasopressin tannate (Pitressin) is the antidiuretic hormone (ADH) of the pituitary that regulates reabsoprion of water in the kidneys. it is given to control daibetes isnipidus, a disorder in which too much water is excreted in the urine. Vasopressin casues water to be reabsorbed so tat the patient urinates normally Thyroid supplements are used in the treatment of hypothyroidism, cretinism, myxedema, and thyroid cancer in the prevention and treatement of goiter and in thyroid fuction tests

Glipizide

ORAL HYPOGLYCEMIC

Tolbutamide

ORAL HYPOGLYCEMIC

Diabinese

ORAL HYPOGLYCEMIN

Identify the functions of the male and female reproductive system

One function is to produce sex cells another function is to engage in sexual intercourse The female system has the added function of nourishing and protecting the fetus until it is fully developed for life outside of the womb

Drug management for diabeties

Oral hypoglycemics: Type 2; non-insulin-dependent First-generation sulfonylureas Second-generation sulfonylureas glipizide (Glucotrol) glyburide (DiaBeta, Micronase) Biguanides metformin (Glucophage) Alpha-Glucosidase Inhibitors Thiazolidinediones rosiglitazone (Avandia) Miscellaneous type-2 diabetes drug extenatide (Bydureon) - allows insulin to work more effectively

Chapter 16 REVIEW QUESTIONS

PAGES 436-439

2nd slide

Physical Injuries Strains occur when a muscle is stretched Sprains result from tearing of a ligamen A fracture is a break in the continuity of the structure of a bone Symptoms: pain, edema, decrease in function, and bruising Tx: analgesics Osteomyelitis Infection inside a bone Symptoms: pain near joint, tenderness, and fever Tx: antibiotics; surgery may be necessary

Summarize the various types of contraceptives available, including the effects on adolescent patients

Pill- consists of varying combinations of estrogen and progestin Mini-pill a progestin-only pill (POP) which is a progestin only pill because it contains a small amount of progestin in each tablet and no estrogen. If not taken at the same time each day or forgoten, Higher chance of getting pregenant if missed than regular birth control pill most common adverse reaction is bleeding irregularly or no period at all. Plan B- an emergency contraceptive- within 72 hours of unprotected sex the recommended dose is 2 Preven tablets or 1 plan b tab as soon as possible. Transdermal patch works similar to oral contraceptives. May be applied each weekfor 21 days or for 3 weeks Birth control ring A 2-inch wide transparent, flexible, and one-size-fits-all ring that is inserted into the vagina once a month much like a diaphragm (Nuva Ring Implantable device Matchstick-size device that is implanted in the upper arm, works by releasing a low, steady dose of progestin to prevent pregnancy Implanon Contraceptive counseling is essential as part of a comprehensive health education program

progesterone

Produced during a normal cycle even if fertilization does not occur or after the ovum is fertilized, this hormone prepares the uterus to carry and nourish the fetus as it grows Without fertilization, causes the uterine lining to be shed (menstruation) menorrhea or menses. 45 and 52 the ovaries stop producing estrogen and progesterone and monthly menustaration ceases. this is known as menopause Given for conditions such as abnormal uterine bleeding, inflammation of the uterine lining (endometriosis), dysmenorrhea (painful menstruation), and amenorrhea medroxyprogesterone acetate (Provera, Depo-Provera) megestrol (Megace)

15-5 List the types of insulin available for treatment of diabetes mellitus

Rapid-acting insulin: Apidra, Humalog, and NovoLog onset- 15 mins duration 3-4 hours Short-acting insulin: Humulin or Vovolin and regular insulin onset-30 mins, duration 5-8 hours Intermediate-acting insulin: NPH and Lente, onset-1-2 hours, duration-16-20 hours Long-Acting insulin: Ultralente and Lnatus, onset 4-6 hours, duration 24-28 hours, lantus greater than 24 hours. A patient's need for insulin varies according to diet, amount of exercise, and emotions

Pancreas

Secretes enzymes as a part of the digestive system. It also contains a number of secreting structures that are part of the endocrine sytem. These structures are called the ISLETS of LANGERHANS. They secrete 2 hormones: INSULIN AND GLUCAGON. beta cells (Insulin)- controls the cell's use of sugar. It also stimulates the liver to store extra sugar in the form of glycogen. When the pancreas fails to produce insulin, the cells cannot burn sugar. Instead it remains in the boodstream and is excreted in the urine. This condition is known as DIABETES MELLITUS The hormone alpha cells (glucagon) stimulates the liver to release stored sugar into the bloodstream. It is administered in emergencies when diabetic patients have recieved to much insulin

15-8 Idenfity five possible side effects of long term corticosteroid therapy

Several side effects of long-term corticosteroid thereapy are weight gain, sodium retention, edema, hypertension, and a moon face other side effects include symptoms of diabetes mellitus, easy bruising, thinning of the skin, failure of wounds to heal, psychological changes, ulcers, and osteoporosis

15-1 List the hormones produced by the seven major glands Pituitary gland Thyroid Gland Parathyroid Glands Adrenal Glands (suprarenals) Pancreas Ovaries Testes

Somatropin, secreted by the pituitary gland Thyroxine (T4) and trilodthyronine (T3), secreted by the thyroid gland Parathyroid hormone, secreted by the parathyroid glands Corticosteroids, secreted by the adrenal glands Insulin and glucagon, secteted by the pancreas Estrogen and progesterone, secreted by the ovaries, and testosterone secreted by the testes

15-2 Describe the major disorders of the endocrine system, the symptoms, and the drugs used for treatment.

Symptoms of endocrine disorders are logically related to the specific hormones that are out of balance. Endocrine disorders arise because a gland overproduces, underproduces, or produces its hormones too early or too late. Reasons why glands secrete too much, too little, or too early: Gland may be overdeveloped: Hyperplasia Gland may contain a tumor Genetic factors Gland could be okay, but faulty messages from the pituitar Usually tumors and hyperlasia cause too much hormone production because there are far more secreting cells than normal. In these cases, surgery or radiation treatment may be needed to reduce the number of cells and thus restore normal hormone balance. Somatropin- regulates growth thyroxine- regulates meabolism Parathyroid hormone- regulates the blood calcium level Corticosteroids- there are 2 major groups of corticosteroids: glucocorticoids (cortisone, hydrocortisone, and cortisol) and mineralcorticoids (aldosterone and desoxycorticosterone). Glucocorticoids- stimulate the breakdown of protein molecules into carbohydrates Mineralcorticoids- regulate the body's salt-water balance Epinephrine- is used to treat bronchiol asthma Norepinephrine- is used in the emergency treatment of shock Insulin- controls the cells' use of sugar Adrenocorticotropic hormone (ACTH) stimulates the adrenal cortex to produce corticosteroids Antidiuretic hormone (ADH) regulates reabsorption of water in the kidney tubules

The gland that traps iodine while producing its hormone is the -----------gland

THYROID

Parathyroid Glands -4 small glands located behind the thyroid gland

The hormone they produce is called parathyroid hormone (PTH). The main function of this hormone is to maintain a normal blood calcium level, you must have a certain amount of calcium in the bloodstream for the muscles to work properly. Extra calcium is stored in the bones when the level of calcium is low, the parathyroid glands produce parathyroid hormone to release stored calcium from the bones when the level of calcium is to high, to much calcium is taken from the bones, as a result the bones may become soft and easy to bend if too little parathyroid hormone is produced, the muscles may go into spasms, and convulsions and gradual paralysis may occur. this condition, which affects mainly the face and the hands is called TETANY and can be fatal. symptoms of TETANY are relieved by administration of calcium.

15-4 Define the parts of the endocrine system and symptoms of hormone imbalances

The main parts of the endocrine system the pituitary, thyroid, parathyroid, and adrenal glands and pancreas, ovaries, and testes Symptoms of endocrine disease such as diabetes mellitus include polyphagia, polydipsia, and polyuria

Endocrine system is made up of glands, structures that produce and secrete chemical substances called hormones directly into the bloodstream

They are carried by the blood to sites where they exert their action. Hormones are the main regulators of metabolism, growth and development, reproduction, homeostasis, energy production, and immunity Endocrine glands include the hypothalamus, pituitary, thyroid, parathyroids, pineal, thymus, adrenal, pancreas, ovaries, and testes

pg 409 in book Older adult considerations THYROID

Thyroid disease may be confusing in the older adult because it mimics other diseases such as congestive heart failure. -Levothyroxine (Levothroid) is given for hypothyroidism -because of an increased incidence of cardiovascular adverse reactions an older adult needs to be given smaller doses and monitored very carefully -Propylthiouracil or methimazole (Tapazole) may be prescribed for hyperthyroidism, but radioactive iodine is preferred because it casues fewer side effects

pg 409 in book Pediatric considerations THYROID

Thyroid replacement is required with hypothroidism for normal growth and development -Thyroid started at 6 weeks for congenital hypothryoidism(cretinism) and continued for life -Recommended dose is 10 to 15 micrograms per kilograms of body weight daily -Retardation occurs if replacement therapy is delayed -Propythiouracil or methimazole is used for hyperthyroidism

15.6 Hyperglycemics opposite then the normal definition of hyper

Too little insulin in bloodstream  Early signs: vomiting excessive thirst diarrhea urine with large amounts of sugar(glycosuria) increased appetite Later signs: Dazed (stuporus) respirations deep face is dry and flushed fruity acetone smell to the breath (ketoacidosis) Hyperglycemia is serious and can be fatal Treatment: immediately administer insulin and replace fluid and electrolytes

15-6 Hypoglycemics opposite of the normal definiton of hypo

Too much insulin in bloodstream Symptoms: increased appetite nervousness heart palpatations coldsweating shakiness difficulty concentrating blurred vision Treatment: giving sugar in some easily digestible form, for example: 120-180 mL of orange juice 180-240 mL of regular soft drink 2 packets of sugar 5 or 6 hard candies

Adrenal glands (Suprarenals) 2 adrenal glands superior to the two kidneys vasoconstriction

Two glands, sits on top of (superior to) to the two kidneys Each adrenal gland has two layers: the adrenal CORTEX and the adrenal MEDULLA. ADRENAL CORTEX- is the largest portion of the adrenal gland and secretes 2 hormones called CORTICOSTEROID: GLUCOCORTICOIDS, and MINERALOCORTICOIDS GLUCOCORTICOIDS regulate the metabolism of carbohydrates and fats and have an anti-inflammatory effect MINERALCORTICOIDS help maintain blood volume; promote sodium/water retention and excretion of potassium in the urinary tract ADRENAL MEDULLA- secretes epinephrine and norepinephrine. These hormones help the body meet stressful situations. FIGHT OR FLIGHT response.Increased HR, vasoconstriction, pupil dilation, bronchial dilation Epinephrine and norepinephrine prepare the body to react to emergencies by stimulating the heartbeat, increasing blood pressure, and releasing extra sugar into the bloodsteram. Epinephrine made in the body is also known as adrenaline, as a drug it is used in the treatment of bronchial asthma Norepinephrine is used in the emergency treatment of schok because of its abilty to constrict blood vessels.

Diabetes Mellitus in the Pediatric Patient

Type 1, or insulin-dependent diabetes mellitus Treatment is insulin Parents are responsible at first, then child assumes responsibility for self-management Children at age 4 or 5 years can begin to check their blood glucose levels Children at age 9 can begin to administer their own insulin

Complications of diabetes

Urinary and vaginal infections Blood vessel diseases that lead to vision problems, gangrene, foot and leg problems, and dental problems

oral contraceptives

Very effective if taken as prescribed "The Pill" contains varying combinations of estrogen and progestin Three combination types of pills Monophasic, which provides the same amount of estrogen and progestin throughout the cycle Alesse, Brevicon, Cryselle, Demulen, Lo/Ovral, Nordette, Portia, Sprintec, and Yasmin biphasic, in which there is the same amount of estrogen in each tablet with a lower progestin in the first part of the cycle and a higher concentration in the last part of the cycle Necon 10/11 and Ortho-Novum 10/11 triphasic, where both the estrogen and progestin may be the same or vary throughout the cycle of medication Cyclessa, Ortho-Novum, 7/7/7, Tri-Norinyl, and Triphasil Adverse reactions associated with the pill: Hypertension, migraine headaches, depression, dizziness, nausea, vomiting, bloating, diarrhea, abdominal cramps, breakthrough bleeding, amenorrhea during and after treatment, and changes in the menstrual flow Contraindicated in women who have experienced angina, a myocardial infarction, have coronary artery disease, breast cancer, endometrial cancer, or thrombophlebitis, Not recommended for women who smoke Mini-pill, which is a progestin-only pill (POP) Most common adverse reaction is bleeding irregularities such as irregular periods, spotting between periods, or no periods at all New oral contraceptive that eliminates menstrual periods for as long as a woman takes it levonorgestrel/ethinyl estradiol (Lybrel) Plan B or Preven-Kit available for emergency contraception Used for unprotected intercourse or suspected contraceptive failure Must be taken within 72 hours of unprotected intercourse. OTC for women 18 years and older need Rx for women 17 and under Transdermal birth control system-New patch is applied each week for 21 days or for 3 weeks norelgestromin/ethinyl estradiol ( Ortho Evra ) transdermal system Birth control ring A 2-inch wide transparent, flexible, and one-size-fits-all ring that is inserted into the vagina once a month much like a diaphragm (Nuva Ring) Implantable Device Matchstick-size device that is implanted in the upper arm, works by releasing a low, steady dose of progestin to prevent pregnancy Implanon

Pregnancy and Childbirth

When an ovum is fertilized and attaches itself to the lining of the uterus, it begins to develop into a fetus, and pregnancy is the result. 266 days or 9 months, development is complete. Several weeks before delivery, the uterus lowers into the pelvis. This is called "lightening" because it gives the mother a sense of decreased abdominal pressure and distention. two other pituitary hormones are involved in childbirth. Oxytocin stimulates the uterus to start contracting at the beginning of labor. A dose of oxytocin or simalar sythetic drug called oxytocis may be used to bring about or strengthen labor when a delay would endanger mother or child., it may also be given to slow postpartum (after-childbirth) uterine bleeding. when the baby is born, prolactin signals the mammary glands in the female breast to produce milk. after delivery drugs such as eronvine(Ergotrate) and methylergonovine (Methergine) may be given to minimize bleeding or postpartum hemorrhage premature labor is labor that occurs before the 37th week of prgnancy and is a major problem in obstetrics. Ritodrine (Yutopar) is used to prevent and treat premature labor by inhibiting uterine contractions alternately uterine contractions can be induced by prostaglandins for the purpose of pregnancy termination (abortificients) Some prostaglandins include the vaginal suppository dinoprostone (Prostin E2) and injectable carboprost (Hemabate)

15.9 Describe the procedure for administering regular- and intermediate-acting insulin in one syringe, and what factors affect the insulin needs of a diabetic patient

When mixing regular and intermediate insulin in one syringe, draw up the regular insulin first. PG 413-414 IN PHARM BOOK

how long does it take for humalog insulin to start working in the body?

a. 15 mins b. 30 mins c. 1 hour d. 4 hours A= 15 MINS

The FDA has made Plan B available over the counter to women of what age

a. 18 years of age b. 21 years of age c. 17 years of age d. no specific age criteria the book says 17 years of age but the power point says 18 and over without a prescription. a= 18 years of age

Which of the following directions should you follow when adminstering insulin?

a. Use an insulin syringe to draw up the insulin b. Keep the insulin in the refirgerator c. Shake the vial of insulin to make sure it is mixed d. Massage the site after the insulin is adminstered A= USE AN INSULIN SYRINGE TO DRAW UP THE INSULIN

which of the following insturctions should you five a patient receiving a uricosuric drug

a. avoid lying down after taking a dose b. avid high-purine foods c. restrict fluids d. increase physical activity b=avoid high-purine food

Match the drug categories or uses to the drugs

a. drugs used in the treatment of osteoporosis b. drugs that reduce the formation of uric acid crystals in the joints c. muscle relaxants d. corticosteroid sometimes injected into the synovial capsule to reduce joint inflammation e. enteric-coated asprin f. antiarthritic drugs

Which of the following are side effects of glyburdie (DiaBeta)?

a. euphoria, insomnia b. delayed wound healing, muscle weakness c. gi upset, diarrhea or constipation d. headache, palpitations C= GI UPSET, DIARRHEA OR CONSTIPATION

monitor a patient taking carisoprodol (soma) for which of the following side effects

a. fatigue, lethargy, sedation b. heartburn, headache, tinnitus c. diarrhea, nausea, vomiting d. rash, dizziness, weight gain d= rash, dizziness, weight gain

You should monitor a patient taking sildenafil citrate (Viagra) for which of the following

a. fluid retention, abdominal discomfort, urinary retention b. bradycardia, constipation, peripheral neuropathy c. hypotension, depression, confusion d. headache, nasal congestion, hypertension d= headache, nasal congestion, hypertension

which of the following should you include in the education given to a patient receiving hormone replacement

a. have mammogram every 5 years during therapy b. follow a low-sodium diet c. smoke in moderation d. report bleeding when stopping hormone therapy replacement b= follow a low sodium diet

which of the following oral contraceptives are monophasic pills

a. necon 10/11, ortho-novum 10/11 b. alesse, lo/ovral c. cyclessa, ortho-novum 7/7/7 d. triphasil, tri-norinyl B. Alesse, Lo/Ovra

wich drug is the teatment of choice for syphilis

a. parenteral penicillin b. ceftriaxone (rocephin) c. stavudine (zerit) d. Azithromycin (zithromax) a= parenteral penicillin

patients with which two conditions should use celecoxib (Celebrex) with caution

a. peptic ulcer disease and cardiovascular disease b. rheumatoid arthritis and muscle pain c. gout and osteoporosis d. urinary retention and constipation a=peptic ulcer disease and cardiovasular disease

match the functions to the hormones

a. prepare the body to cope with stress b. regulates the reabsorption of water in the kidney c. regulates growth d. suppress inflammation e. regulates the amount of calcium in the body

A patient ask you why prednisone (Deltasone) has been prescribed. What is the most appropriate answer to give the patient?

a. regulate growth b. regulate the blood sugar c. replace the deficent hormone d. suppress inflammation D= SUPPRESS INFLAMMATION

match hormone functions in regulating human reproduction to the hormones

a. stimulates sperm production and development of deep voice and chest and facial hair b. acts in partnership with estrogen to regulate ovulation and prepare the uterus for pregnancy c. triggers the onset of labor d. stimulates development of breasts, shapeliness, and feminine voice

monitor a patient taking asprin for which of the following side effects

a. tinnitus, viual disturbances, urianry retention b. tachycardia, fatigue, constipation c. pruritus, rash, stomatitis d. indigestion, gastointestinal bleeding, headache d= indigestion, gastrointestinal bleeding, headache

Epinephrine and norepinephrine

a= PREPARE THE BODY TO COPE WITH STRESS

match the drug uses to the drug names

a= replacement of pituitary hormone that stimulates production of corticosteroids b= inflammatory diseases, allergic reaction, replacement of corticosteroids c= diabetes insipidus d= diabetes mellitus

AIDS

acquired immunodeficiency syndrome (AIDS) sexually transmitted disease caused by the human immunodeficiency virus HIV

hyperplasia

actual increase in the number of cells

glucocorticoids

adrenal corticosteroids that regulate the metabolism of carbohydrates and fats by body cells and have an inflammaotry effect

puberty

age at which the reproductive organs become functional and secondary sex characteriscs appear

Humira, etanercept, Plaquenil

antiarthritic drugs

abortifacients

anything used to terminate pregnancy

15.7, 15.8 Corticosteroids

are a group of hormes secreted by the adrenal cortex. Insufficent production of corticosteroids (Addison's disease) can be fatal. the pituitary may not produce enough ACTH to stimulate corticosteroid productin in the adreanal cortex. Or the adrenal cortex itself may not work properly, in both cases, corticosteroids can be used to replace the missing hormone 2 major groups of corticosteroids, each group having diffent functions: (1) the glucocorticoids ( cortisone, hydrocortisone, and cortisol) affect fat and carbohydrate metabolis; (2) the minearl corticoids (aldosterone and desoxycorticosterone) regulate the salt-water balance

Ovaries and Testes

are the sex glands, or gonads They are responsible for the different physical characteristics of males and females and for the manufacture of sex cells for reproduction. The female gonads are the ovaries. The male gonads are the testes. The ovaries located in the pelvis of the female, secrete the hormones estrogen and progesterone. The testes, located in the scrotum of the male, produce testosterone, the male hormone HOWEVER both males and females have both types of hormones in their bodies.

ADH

b= REGULATES THE REABSORPTION OF WATER IN THE KIDNEY

during sexual excitement, the ________secrete a lubricatin mucus that helps the penis enter the vagina

bartholin's glands

Harry jackson, aage 62 is having more and more trouble urinating lately. The doctor thinks something may be blocking the urethra. Harry says this is the same condition that several friends his age have had

benign prostatic hyperplasia (BPH)

a small, fluid-filled puch in a patient;s shoulder joint is inflamed. this is causing swelling, pain and stiffness. the doctor plans to inject hydrocortisone directly into the joint to reduce the inflammation

bursitis

Inserting Vaginal Medications

by hand: insert the rounded end of the suppository along the posterior wall of the vaginal canal, the length of an index finder (approximately 3-4 inches) By applicatior: Fill the applicator with cream and insert it 2-3 inches into the vagina. Push down on the applicator plunger to release the medication into the vagina, allowing equal dstribution along vaginal wall

Somatropin

c= REGULATES GROWTH

Vasopressin tannate

c= diabetes insipidus

Bones are living tissue. They get their hardness from deposists of the mineral

calcium

Nancy bullock had an unusual vaginal discharge that caused itching and burning, but she ignored it. Now the doctor says that the infection has spread to the opening of the uterus

cervicitis

hormones

chemical substances secreted by glands that regulates many body functions; each hormone has specified functions

osteoporosis

condition in which there is a decrease in total bone mass; major cause of fractures in postmenopausal women

ligaments

connective tissue fibers that attach one bone to another

tendons

connective tissue fibers that form a cord and connect muscles to bones

part of a comprehensive health education program for adolescents is________________counceling

contraceptive

Hydrocortisone

corticosteroid sometimes injected into the synovial capsule to reduce joint inflammation

Corticosteroids

d= SUPPRESS INFLAMMATION

CHAPTER 14 REVIEW QUESTIONS PG 388

define these terms

The endorine glands include the hypothalamus, pituitary, thyroid, parathyroids, pineal, thymus, adrenal, pancreas, ovaries, and testes

diagram on page 394 of pharm book

hypothyroidism

disorder caused by a decrease in circulating thyroid hormones

hyperthyroidism

disorder caused by an increase and sustained release of thyroid hormones

bone marrow depression

disorder of the blood-forming tissue that produces erythrocytes (red blood cells) leukocytes (white blood cells) and platelets

type 2, non-insulin-dependent diabetes mellitus ( NIDDM)

disorder that usually affects individuals who are obese and over age 35; insulin may be part of treatment

type 1, insulin-dependent diabetes mellitus (IDDM)

disorder wherein there is an inability to metabolize carbohydrates as a result of insulin deficency; insulin must be given for treatment

Antihyperuricemic

drugs are used to treat hyperuricemia, the state of having too much uric acid in the blood.

Parathyroid hormone

e= REGULATES THE AMOUNT OF CALCIUM IN THE BODY

Akiko Niki has an inflammation of the uterine lining, and her doctor has placed her on progesterone therapy

endometriosis

Ecotrin

enteric-coated aspirin

oral contraceptives contain varying combinations of _________and ___________

estrogen and progesterone

List all the therapeutic uses you can think of for sex hormones (both male and female)

estrogen, progesterone,and testosterone

polydipsia

excessive thirst

polyuria

excessive urination

amenorrhea

failure to menustrate; missed menstrual period

osteoporosis is caused by too much estrogen

false

Rheumatoid arthritis is caused by wear and tear of the joints

false The cause is unknown and there is no specific cure. some researchers think the cause may be genetic, perhaps from an infection or form of autoimmune response in which the body reacts to its own tissues as if they were foreign invaders like allergens and microoganisms

Osteomyelitis is a decrease in total bone mass

false, is an infection inside a bone

Surgery is frequently used to treat osteoporosis

false, treatment consist of relieving the pain, protecting the joinst from additional injury and restoring joint functin antiarthritc drugs asprin is the drug of choice and is used for pain control and inflammation nonsteroid ant-inflammatory cotrticosteroids my be injected for acute flare ups nonpharmalogical treatements consist of application of heat or cold and range motion exercise

ortho evra is an implantable birth control device

false, it is a transdermal patch

Gout is a conditon that results from too little uric acid in the bloodstream

false, to much

female gonads

female gonads, ovaries, secrete the hormones estrogen and progesterone

estrogen

female hormone

progesterone

female hormone

ova singular OVUM

female reproductive cells (singular ovum)

fascia

fibrous membrane that supports and covers muscles

Complete the following

fill in the blank

complete the following

fill in the blanks

disordes that best match

fill in with these choices cervicitis endometriosis benign prostatic hyperplasia (BPH) acauired immunodeficiency syndrome (AIDS) genital herpes simplex

engorgement

filling up of a body part with blood or another fluid (ex: penis engorement prior to intercourse, breast engorgement with milk in nursing mothers)

Glycogen

form of glucose stored in the liver or muscles for release as the body needs it

Sara Davis is diagnosed with a sexually transmitted viral disease and treated with acyclovir (Zovirax)

genital herpes simplex

the external and internal reproductive organs in both males and females are called

genitalia

Glycosuria

glucose in the urine

glycosuria

glucose in the urine

icreasing levels of uric acid in a patient are causing crystals to form in teh cartilage around the joints. a dose of colchicine relieves the pain in his joints within a few hours

gout

endometriosis

growth of endometrial tissue outside the uterus

hormone therapy

hormone replacement is the most commmon use of hormones in drug therapy replacement is necessary whenever hormones are mssing because of either gentic defects in the glands, surgical removal of glands, or production of poor-quality hormones. Some hormones and hormonelike drugs are used because of actions that are not related to the endocrine system example- the anti-inflammatory action of the adrenal corticosteroids. Most hormones used for drug therapy are taken from animals: hogs, cattle, sheep, and horses. A few hormones have been synthesized in the laboratroy.

mineralocorticoids

hormone secreted by the adrenal cortex that maintains normal blood volume and promotes sodium and water retention and urinary excretion of potassium

Glucagon

hormone secreted by the pancreas that raises the level of blood sugar, counteracts effects of insulin

thyroxine

hormone secreted by the thyroid gland; regulates the speed of metabolism in body cells

HIV

human immunodeficiency virus causes the sexually transmitted disease acquired immunodeficiency syndrome (AIDS)

Puberty

in girls , it is marked by the first menstrual flow, breast changes, growth of pubic and axillary hair, and a rapid increase in height and weight also occur. in boys experience enlargement of the testicles, growth of pubic and axillary hair, rapid increase in height, and a change in the voice. 1 in 10 adolcent girls-apporximately 1 million girls under the age of 20-become pregnant every year.

benign prostatic hyperplasia or hypertrophy (BPH)

increase in the epithelial and stromal tissue within the prostate

osteomyelitis

infection inside a bone

sexually transmitted diseases (STD) sexually transmitted infections (STI)

infectious disease spread by intimate sexual contact; amontg the STDs are syphilis, gonorrhea, genital herpes, chlamydia, and AIDS

vaginitis

inflammation of the vagina

prostatitis

inflammation ofthe prostate gland

antidiabetic agents

insulin and oral hypoglycemics

Thyroid Gland

is wrapped around the trachea just below the larynx, or voice box. Stimulated by TSH released from pituitary gland. It secretes 2 thyroid hormones and thyrocalcitionin. The 2 thyroid hormones are thyroxine (t4) and triodothyronine (t3). These thyroid hormones control metabolism. Metabolism refers to the rate at which all cells produce energy (heat, muscle strength, etc). When the thyroid produces EXTRA (T4) and (T3) it is known as *hyperthyroidism. Metabolic rate increases and increase in temp, respiration, heart rate, and nervous and muscular activity and a feeling of warmth. example GRAVES DISEASE When the thyroid produces TOO LITTLE (T4) and (T3) it is known as *hypOthyroidism, cretinism, myxedema) causes cell metabolism to slow down. Signs of *hypOthyroidism include intolerance to cold, personality changes, fatigue, dry skin, brittle nails, slow speech, and weight gain. example CRETINISM or MYXEDEMA ADEQUATE (T4) andd (T3) the thyroid needs IODINE, a mineral that is present in vegetables and seafood. REQUIRE iodine for production availability of iodized table salt helps people take in enough iodine to fulfill the needs of the thyroid Thryrocalcitonin helps maintain a normal blood calcium

Ligaments are strong bands of connective tissue that hold bones together

ligaments are dense bands of connective tissue that connect bones to bones at joints such as the elbow joint provide meovent while maintaining stability

endometrium

lining of the uterus

Hypoglycemia

low blood sugar, can be the result of administering to much insulin

gonads

male and female sex glands These hormones---estrogen, progesterone, and testosterone---are not single hormones but represent groups of related hormones

male gonads

male gonads, testes, produce the male hormone testosterone

testosterone

male hormone that influences development of masculine characteristics; androgen that occurs naturally in the testes

spermatoza also known as sperm

male reproductive cells; also known as sperm

testes

male reproductive gland singular( testis)

lactation occurs when the ___________glands in the breast go into production

mammary

The spongy part of bone where blood cells are produced and fat is stored is called the bone

marrow

hypoglycemia

means low blood sugar can be the result of administering too much insulin

iodine

mineral needed by the thyroid to produce thyroxine

what are the possible side effects of estrogen therapy (including oral contraceptives)

most common side effects of hormone replacement therapy are weight gain, breast and pelvic discomfort, GI disturbances, vaginal discharge, and skin pigmentation

myalgia

muscle pain

Robaxin, Flexeril, Soma, Parafon Forte

muscle relaxant

Tetany

muscle spasms caused by a lack of calcium in the bloodstream

tetany

muscle spasms caused by lack of calcium in the bloodstream

skeletal muscles

muscles responsible for body movement

arthritis

name for several disorders of the joints, each having different causes and treatements (examples: gouty arthritis, osteoarthritis, rheumatoid arthritis)

insulin

naturally occuring hormone secreted by the beta cells in the islets of Langerhans in the pancreas in response to increased blood glucose levels

menopause

naturally occurring end of menustration, usually between the ages of 45 and 52

Insulin

naturally occurring hormone secreted by the beta cells in the islets of langerhans in the pancreas in response to increased blood glucose levels

menorrhea also known as menses

normal menustration; also known as menses

muscle tone

normal, slightly contracted state of skeletal muscles that keeps them prepared for action

How is ibandronate (Boniva) taken

orally

a patient has developed an infection in the leg bone near the knee joint. He is taking antibiotics, and surgery is planned to drain the infected material from the bone

osteomyelitis

an older adult patient has been instructed to eat a diet rich in calcium, and she is taking small doses of hormones. this is because her bones have become very porus and fracture easily

osteoporosis

female sex cells, the ova are produced by the

ovaries

dysmenorrhea

painful menustration

adrenals

paired glands covering the superior surface of the kidneys; made up of the adrenal cortex, which secretes steroids, an the adrenal medulla, which secretes epinephrine and norephinephrine

postpartum

period after giving birth

gonadotropins

pituitary hormones that stimulate the gonads (ovaries and testes) to secrete hormones

Hypothalamus is the director

portion of the pituitary gland linked to the brain; controls many body functions such as tempretaure, sleep, and appetite

ovulation

release of an ovum from an ovary

What four foods are high in purine

sardines, meat soups, chicken, salmon, crab, veal, bacon, prok, beef, and ham vegies- asparagus, shell beans, lentils, mushrooms, peas, and spinach

myxedema

severe and long-standing hypothyroidism; the term is often used synonymously with hypothyroidism

gonads

sex glands in which reproductive cells are formed; ovaries and testicles

herpes simplex (genital)

sexually transmitted disease that results in painful genital lesions

Smooth muscles allow movement in the gastrointestinal tract and blood vessels, whereas _______muscles allow movement of the bones

skeletal muscles

Pituitary Gland master gland

small gland the size of a pea, located at the base of the brain. The pituitary stalk connect the pituitary to the hypothalamus although the pituitary is one gland, it has 2 lobes: the anaterior lobe and the posterior lobe. The anterior lobe is particularly important in sustaining life. One gland, it has two lobes Anterior lobe particularly important in sustaining life secretes the stimulating hormones (FSH, LH, TSH, somatotropin, etc) Posterior lobe Secretes oxytocin, ADH Known as the "Master Gland" One of the hormones it secretes is the growth hormone, somatrotropin, which promotes skeletal, visceral, and general growth. If too much growth hormone is produced, the body grows to fast and becomes overly large. When this occurs in a child it is called GIGANTISM. In adulthood, it is called ACROMEGALY Too little of the hormone results in stunted growth or dwarfism other pituitary hormones control the secretions of the sex glands, the thyroid gland, and the adrenal glands because it controls the hormone production of other glands, the pituitary in known as the master gland.

Bursa

small, fluid-filled sac that cushions places where bones and muscles rub together (plural) bursae

bursa plural- bursae

small, fluid-filled sac that cushions places where bones and muscles rub together (plural) bursae

glands

specialized epithelial tissue that secretes hormones Glands, or structures, that produce and secrete chemical substances called hormones directly into the bloodstream, to regulate many body functions

Strains are injuries to muscles and tendons, whereas____are injuries to ligaments

sprains

symptoms - polydipsia, poluria, polphagia, fruity breath confusion problem= treatment

symptoms- nervousness, shakiness, blurred vision, cold sweating, palpitations, increased appetite, difficulty concentrating problem=HYPOGLYCEMIA treatment= GIVING SUGAR IN SOME EASILY DIGESTABLE FORM

What are three side effects of the COX-2 inhibiotr celecoxib (Celebrex)

tachycardia, fatigue, anxiety,depression,nausea,vomiting,constipation,dry mouth

Bundles of tissue that connect muscles to bones are called

tendons

male sex cells, the sperm are produced by the

testes

fetus

the developing child in utero from th third month after conception until birth

Hormone control system

the level of hormones in the blood is constanly adjusted to meet the body's requirements. The hypothalamus and pituitary for a partenership in running the hormone chemical message system. the hypothalamus can stimulate or inhibit the pituitary according to conditions inside and outside the body. Because of this link, the endocrine system is influenced by the nervous system. thus emotions, fears and moods have an impact on body processes throu hormone stimulation as well as nerve stimulation the levels of circulating hormones provide feedback to the control system. As metioned hormones are distributed throughout the bloodstream. When the proper hormone level is reached, the hypothalamus signals the pituitary to stop stimulating hormone production. example pitutary excretes ACTH, transported by the bloodstream to the adrenal cortes. The ACTH then stimulates the adrenal cortex to produce corticosteroids. These help liberate extra sugar and fat for the body to bur energy. When the hypothalamus senses that there are enough corticosteroids in the bloodstream. it signals the pituatry to cancel the order for ACTH. The adrenal cortex then stops secreting its hormone until they are needed again.

metabolism

the rate at which cells produce energy such as heat and muscle strength; also known as biotransformation

15.6 Hyperglycemics and Hypoglycemics

too little insulin in the bloodstream Hyperglycemia- is serious and can be fatal if not caught early and treated. hypoglycemia-to much insulin in the bloodstream, they occur as a result of strenous physical effort, overly large doses of insulin, or eatingto little food. These situations cause all the blood sugar to be burned off so that the level of sugar in the bloodstream is to low treatment consist of giving sugar in some easily digestiable form. 120-180 ml of orange juice, or regular soft drink, two packets of sugar, or 5 or 6 hard candies to increase the blood sugar level quickly. In extreme cases glucose or glucagon may be given parenterally. peak effect -varies according to the individual patients physical conditon and level of activity

After middle age, calcium is no longer deposited in the bones, causing the development of osteoporosis

true

An inflammation of the synovial capsule is known as synovitis

true

Lack of estrogen is a factor in the development of osteoporosis

true

androgens is another word for male sex hormones

true

endometriosis can be a factor in infertility

true

testosterone relieves the symptoms of breast cancer

true

Aplastic anemia is a bone marrow disorder

true Because the red bone marrow produces most of the important components of the blood, any disorder that affects the bone marrow can create serious problems. Failure of the bone marrow to produce enough of all three components of blood is called aplastic anemia lack of red blood cells-weakness, pale skin (), dyspnea lack of white blood cells- agranulocytosis, soreness of mucous membranes in the mouth and throat, fever, chills, extreme fatigue, and urinary and vaginal infections. lack of platelets-bleeding from the gums, nose or gastrointestinal tract: signs of hemorrhage uder the skin such as purpura, petchiae, and ecchymoses

Myalgia is pain in the skeletal muscles

true Muscle pain originates in any of the muscles in the body. The medical term for muscle pain is myalgia. Muscle pain may arise due to injury or overexertion, infections of the soft tissues, or inflammatory conditions.

Crystals of uric acid deposited in the cartilage around joints can cause the joints to become red, hot, swollen, and painful

true because the uric acid is not completely excreted, crystals of the acid are deposited in the cartilage around the joints such as those of the big toe, ankle, knee and elbow the deposits cause the joints to become red, hot, swollent and painful. chronic gount may be treated with uricosuric drug

NuvaRing is an alternative to the birth control pill

true, it is much like the diaphram

diabetic coma

unconsciousness caused by too little insulin accompanied by increased caloric intake, physical or emotional stress, or undiagnosed diabetes mellitus; also known as diabetic ketoacidosis

semen leaves the male body through a tube called the ________which is shared with the urinary system

urethra

the structure that holds the fertilized ovum while it develops inside the woman's body is the

uterus

the tubular structure that serves as the birth canal is called the

vagina

the perineum consists of the entire female genital area between the ______and the ____________

vulva and the anus

Atrophy

wasting away of body tissue (example: atrophy of a muscle from lack of use)

atrophy

wasting away of body tissue (example: atrophy of a muscle from lack of use)