Maryville University Pharmacology NURS615 Pharm Exam 3 with Complete Solutions

Maryville University Pharmacology NURS615 Pharm Exam 3 with Complete Solutions Corticosteroids/glucocorticoids/steroids - Answer ️️ -What hormones are produced by the adrenal gland and maintain homeostasis? Cortisol - Answer ️️ -What is an endogenous glucocorticoid? 1. Glucocorticoids 2. Mineralcorticoids 3. Adrenal Sex Hormones - Answer ️️ -What are the 3 categories of steroid hormones? 1. Inhibits the immune and inflammatory system 2. Inhibits arachidonic acid metabolism 3. Inhibits production of ILK-1, TNF, and other cytokines 4. Impairs lymphocytes and inhibits tissue repair - Answer ️️ -What is the MOA of corticosteroids? hydrocortisone, prednisone, methyprednisolone, dexamethasone - Answer ️️ - Examples of glucocorticoid medications Life-threatening conditions or severe disabling symptoms - Answer ️️ -What is long-term glucocorticoid use indicated for? Self-limiting conditions - Answer ️️ -What is short-term glucocorticoid use indicated for? 1. Osteoporosis 2. Worsens diabetic control and increases blood glucose (diabetics need more insulin) 3. Promotes gastric secretion and causes abdominal pain, N/V (Report black tarry stools) - Answer ️️ -What are the adverse effects of glucocorticoids after 6 months of use? Within the first 3 months - Answer ️️ -When does bone density begin to decline because of a decrease in calcium from glucocorticosteroid use? 1. Retains sodium and water 2. Increases appetite 3. Promotes fat deposit in cervical area and face 4. Increases uric acid 5. Delerium, insomnia, mood alterations, anxiety 6. Adrenal suppression 7. Poor wound healing, thin skin, acne, ocular damage - Answer ️️ -General adverse effects of glucocorticosteroids 1. To avoid recurrent activity of underlying disease 2. To avoid possible cortisol deficiency resulting from the HPA axis and HPA suppression during steroid therapy - Answer ️️ -Why must glucocorticosteroids be tapered? 1. Administer for short courses and then taper; do NOT abruptly withdrawal - Answer ️️ -How should glucocorticosteroids be discontinued? In the morning - Answer ️️ -When is the ideal time to administer prednisone? 1. Severe infections 2. Allergy - Answer ️️ -When are glucocorticosteroids contraindicated? 1. Low carb, low sodium, and high protein diet 2. Increase calcium and vitamin D 3. Monitor weight, edema, blood glucose, blood pressure, potassium, electrolytes, and CBC - Answer ️️ -What is patient education for glucocorticosteroid use? Decreases inflammation by decreasing the movement of leukocytes into tissues containing urate crystals -- this affects the way the body responds to the uric acid -- DECREASES swelling and pain - Answer ️️ -What is the MOA of colchicine? Prophylaxis of gout flares in adults (or to treat Behcets syndrome) - Answer ️️ - What is the indication of colchicine? Not a cure and does not prevent the disease from progressing - Answer ️️ -Is colchicine curative? 1.2mg followed by 0.6mg 1 hr later (for 1.8mg total) - Answer ️️ -What is low- dose colchicine? 1.2mg followed by 0.6mg every 4-6hours (for 4.8mg total) - Answer ️️ -What is high-dose colchicine? Low-dose is AS EFFECTIVE as high-dose with LESS side effects - Answer ️️ - Is high or low-dose colchicine preferred? DIARRHEA (make sure this is in patient teaching) - Answer ️️ -What is the main side effect of colchicine? Prevents formation of uric acid by inhibiting xanthine oxidase - Answer ️️ -What is the MOA of allopurinol (Zyloprim)? Taken DAILY to prevent formation of uric acid crystals - Answer ️️ -How often is allopurinol (Zyloprim) taken? Gout may worsen initially with therapy - Answer ️️ -What is important patient teaching for febuxostat (Uloric)? Patients should be treated with NSAIDs concurrently - Answer ️️ -What should treatment with febuxostat (Uloric) be combined with for the first 6 months? 1. BUN 2. Creatinine 3. LFTs (most anti-gout meds can be associated with hepatotoxicity 4. Uric acid levels - Answer ️️ -Wha