Pharm Test 2 level II

  1. Adrenocortical agents are used for what?
    to suppress the immune system

    Mostly short term use
  2. What are some of the goals of suppressing the immune system with adrenal agents?
    • Conserving energy 
    • Relieve inflammation in an acute stage of illness (rheumatoid arthritis)
    • Relief of s/s of inflammation
    • Relief for the adrenal to allow it to return to WNL
    • Organ transplant to prevent rejection
  3. What is the goal of using adrenocortical agents in replacement therapy?
    Maintain levels when the adrenal glands are not functioning properly -
  4. Name the inner core of the adrenal gland:
    • Adrenal medulla - it is part of the (SNS) sympathetic nervous system (fight/flight)
    • Releases Norepinephrine & Epinephrine
  5. What does the adrenal medulla do ?
    releases the neurotransmitters epinephrine and norepinephrine when the SNS is stimulated
  6. ______ are flattened bodies that sit onto of each kidney.
    Adrenal glands
  7. Describe the adrenal cortex:
    • Outer shell 
    • Produces hormones called corticosteroids
  8. Name the 3 types of corticosteroids:
    • Androgens 
    • Glucocorticoids 
    • Mineralocorticoids
  9. What do Androgens control?
    • Male/Female sex hormones
    • Electrolytes 
    • Stimulate protein production 
    • Decrease protein breakdown
  10. Glucocortoids are given for what?
    • Stimulate  an increase in glucose levels for energy
    • Short term treatment of inflammatory disorders
    • Relieve discomfort
    • Give body a chance to heal from the effects of inflammation
  11. What are Mineralocorticoids given for?
    • Affect electrolyte levels and homeostasis 
    • Usually given with corticoids
  12. What are androgens used to treat?
    • Hypogonadism
    • Increase protein growth and red blood cell production
  13. What does GHRH stand for and where is it produced and secreated from?
    • Growth Hormone-Releasing Hormone
    • Hypothalmus
  14. What does TRH stand for and where is it produced and secreated from
    • Thyrotropin-Releasing Hormone
    • Hypothalmus
  15. What does GnRD stand for and where is it produced and secreated from
    • Gonadotropin-Releasing Hormone
    • Hypothalmus
  16. What does CRH stand for and where is it produced and secreated from
    • Corticoid-Releasing Hormone
    • Hypothalmus
  17. What does PRH stand for and where is it produced and secreated from
    • Prolactin-Releasing Hormone
    • Hypothalmus
  18.  What is Simatostain?
    • Growth Hormone-INHIBITING Factor
    • produced by the Hypothalmus
  19. What does PIF stand for ?
    • Prolactin_INHIBITING Factor
    • Produced by the hypothalmus
  20. What does ADH stand for?
    • Antidiurectic Hormone
    • Produced by Hypothalmus
  21. Where is Oxytocin stored/released?
    • Posterior pituitary
    • It is released when stimulated by the hypothalmus
  22. S/S of adreanal crisis:
    • Physiological exhaustion
    • Hypotension
    • Fluid shift
    • Shock and even death  
  23. Treatment for Adreanal Crisis:
    • Massive infusion of replacemnet steriods
    • Constant monitoring and life support procedures
  24. What type of drug is Prednisone (Deltasone)?
  25. What cautions should be noted when giving Prednisone?
    • Diabetes - insulin dose may need to be increased
    • Because this a glucocorticoid that increases the prodiction of glucose
    • ALSO peptic ulcers
  26. What are Beclomethasone and Flunisol used for?
    Respiratory inhailent and nasal spray
  27. What does the aldosterone affect cause?
    Increase blood volume
  28. Glucocorticoids may cause lypogenesis - what is this?
    Fat building
  29. What drugs may increase risk of peptic ulcers?
  30. Giving Glucocorticoids (Prednisone) with what drugs may cause decreased effectivness of the steriod?
    • Salicylates (asprin)
    • Barbituates
    • Phenytoin
    • Rifampin (TB)
  31. Predisone should be taken at what time of the day?
    upon waking
  32. How is prednisone administered?
  33. What to monitor while on Glucocorticoids?
    • Edema
    • Osteoperosis
    • Peptic Ulcers
    • Increased glucose levels
    • Delayed wound healing
    • S/S of Infection
  34. Contraindicated with steroids?
    • Live vaccines
    • Acute infection
    • Lactation
  35. Actions of Mineralcorticoids:
    • Hold sodium and with it water
    • Casues excretion of patassium by acting on the renal tubule
  36. name potassium rich foods :
    • Avacados
    • Bananas
    • Broccoli
    • Grapefruit
    • Peaches
    • Sunflower seeds
    • Lima beans
    • Potatoes
    • Spinach
    • Nuts
    • Prunes
    • Tomatoes
    • Cantaloupe
    • Navy beans
    • Rhubarb
    • Watermelon
    • Dried fruits
    • Oranges
    • Sanka Coffee
  37. Indications for Mineralocorticoids :
    Replacemnet therapy for primary / secondary adreanal insufficiency
  38. Fludrocortisone is contraindicated with what disorders?
    • HTN
    • CHF - may get more fluid back up
    • Cardiac disease - the work load of the heart will be increased due to fluid retention
  39. Cautions while taking Fludrocortisone:
    • Presence of infection
    • High Sodium Intake = should be avoided, will increase BP
  40. Nursing considerations for Fludrocortisone:
    • Monitor for edema
    • Headache
    • Lungs for pulmonary edema
    • weakness
    • Monitor potassium levels - they are retaining sodium and excreeting potassium
  41. What is the function of dieretic agents?
    • Increase sodium excretion
    • Increases the amount of urine produced by the kidneys
  42. Indications for diuretics:
    • Edema with CHF
    • Acute pulmonary edema
    • Liver disease
    • Renal disease
    • HTN
    • Conditions that cause hyperkalemia
    • Glaucoma to decrease fluid pressure
  43. Name a Thiazide diuretic:
  44. Site of action for Hydrochlorothiazide:
    • Blocks the chloride pump.
    • Keeps chloride and sodium in the tubule to be excreted in the urine.
  45. Contraindications for Hydrochlorothiazide:
    • Allergy to Sulfonamides
    • Exsisting Fluid/electrolyte imbalances, and renal/kidney disease
  46. Caution use of Hydrochlorothiazide with what conditions:
    • Gout
    • Lupus (SLE)
    • Diabetes or glucose tolerance abnormalities = may increase glucose levels
    • Bipolar disorder
    • Hyperparathyroidism
  47. Adverse effects of Hydrochlorothiazide:
    • Hypokalemia 
    • Alkalinized  (weakness, cramps, cardiac arrythmias)
    • Alkalinized urine (increase infection)
    • Elevated glucose levels
  48. Normal Potassium levels:
    3.5 - 5.3
  49. Name a Loop Diuretic:
    Furosemide (Lasix)
  50. High ceiling diuretics =
    Loop diuretics
  51. What are the actions of loop diuretics?
    blocks the chloride pump in the acending and descending loops of Henle, and the distal tubule
  52. What time of day should a loop diuretic be taken ?
    early in the day with food to avoid GI upset
  53. Patients taking Furosemide should decrease intake of what?
  54. Patients taking Furosemide should INcrease intake of what?
    • Potassium
    • (orange juice, raisins, banans)
  55. Site of action for Acetazolamide:
    Proximal tubule

    drug =Acetazolamide
  56. what drugs work on the Proximal tubule
    Carbonic anhydrase inhibitors
  57. Site of action for Thiazide diuetics:
    Distal convoluted tubule

    drug = Hydrochlorothiazide
  58. Dose of Furosemide (Lasix):
    40 mg - push over 1-2 minutes (2 minutes to be safe)
Card Set
Pharm Test 2 level II
Pharm hormone drugs