NUR2407 / NUR 2407: Pharmacology Exam 2STUDY GUIDE (Latest 2021 / 2022) Rasmussen

Pharmacology Exam 2 Study Guide Endocrine System  Pituitary Gland Ovaries Testes Adrenal Thyroid Parathyroid Pancreas Glucocorticoids  Used for MS (Multiple Sclerosis)  Treats various inflammatory conditions  Ex. Prednisone, dexamethasone, hydrocortisone  Contraindications: known allergy, known infection, lactation  Drug-Drug interaction: Aspirin, Ibuprofen, decreased effects with barbiturates, phenytoin, rifampin  Adverse effects: Increased blood glucose, increased blood pressure, delayed wound healing, fluid retention, weight gain, increased hunger,  Take with food, in the morning, and taper off before stopping Hypo Thyroid Symptoms  Obesity, fatigue, depressed, bradycardia, lower body temps, decreased appetite, weight gain, decreased sexual function  High TSH levels Hyper Thyroid Symptoms  Stimulated nervousness, insomnia, increased basal temp, HTN, tachycardia, increased appetite with weight loss, muscle wasting, goiter  Low TSH levels Thyroid Replacement Agents  Leveothyroxine  Liothyronine  Liotrix  Thyroid  Adverse effects: tremors, nervousness, loss of hair, diarrhea, tachycardia, HTN  Give before breakfast with water, teach about effects, monitor vitals InsuliN  Rapid-Acting includes: lispro (peak 30-90min and duration 2-5 hrs.), Humalog (peak 0.5-6hrs and duration is 20-24hrs), and human insulin aspart (peak 4-8hrs and duration is 22-24 hrs.). Must be given right before meals, no more than 5 minutes.  Short-acting: Onset is 30 min to 1 hour, peak is 2.5-5 hours, and duration is 6-8 hours. This includes regular insulin. Give 30 minutes before meal.  Intermediate acting includes: NPH, Lente, and Humulin N. Contains protamine which prolongs the action of insulin. Onset is 1-2 hours, peak is 6-12hrs, and duration is 18-24hrs.  Long lasting includes insulin glargine (Lantus) with an onset of 1 hour. Evenly distributed over 24 hours. Insulin detmir has a peak of 6-8 hours and lasts 12-24 hours. Hyperglycemia Symptoms  Fatigue, irritation, glycosuria, increased hunger, increased thirst, itchy skin.  Metformin, acarbose, sitagliptin, pramlintide acetate, pioglitazone.  Adverse effects: abdominal bloating, diarrhea, nausea, vomiting, lactic acidosis (sweating, chills, low BP, muscle pain, sleepiness, slow HR, weakness) Hypoglycemic Symptoms  Blurred vision, drowsiness, weakness, tachycardia, shallow respirations, hunger, and diaphoresis, anxious.  Glucose elevating meds: Glucagon onset 1 min, peak 15 min, and duration 9-20 min. Diazoxide onset is 1 hr. and duration is 8 hours. Erectile Dysfunction  Sildenafil, Levitra, and Cialis  ADV. Effects: Headache, flushing, blurred vision, tachycardia, increased hypotension with nitrates, runny nose, and diarrhea. Oral Contraceptives  Estrogen and progesterone  Adv. Effects: clots, MI, CVA, edema, weight gain, depression, and irregular periods. Antibiotics Allergic Response  Mild: Rash, pruritus, and hives. Treated with antihistamines.  Severe: Anaphylactic shock, vascular collapse, laryngeal edema, bronchospasm, and cardiac arrest. Occurs within 20 minutes. Treated with epinephrine, bronchodilators, and antihistamines.  Common adv. Effects: vomiting, diarrhea, itching, rash, abdominal cramps, kidney damage, GI tract toxicity, superinfection, neurotoxicity. Penicillin  Amoxicillin  Adv. Effects: nausea, vomiting, diarrhea, glossitis, stomatitis, bone marrow suppression, rash, fever, lethargy.  Monitor for rash, lowered RBC, WBC, and platelet