Maryville University Pharmacology NURS615
Pharm Exam 3 Questions and Correct Answer
What hormones are produced by the adrenal gland and maintain homeostasis?
✓ ~: Corticosteroids/glucocorticoids/steroids
What is an endogenous glucocorticoid?
✓ ~: Cortisol
What are the 3 categories of steroid hormones?
✓ ~: 1. Glucocorticoids
2. Mineralcorticoids
3. Adrenal Sex Hormones
What is the MOA of corticosteroids?
✓ ~: 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
Examples of glucocorticoid medications
✓ ~: hydrocortisone, prednisone, methyprednisolone, dexamethasone
What is long-term glucocorticoid use indicated for?
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✓ ~: Life-threatening conditions or severe disabling symptoms
What is short-term glucocorticoid use indicated for?
✓ ~: Self-limiting conditions
What are the adverse effects of glucocorticoids after 6 months of use?
✓ ~: 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)
When does bone density begin to decline because of a decrease in calcium from
glucocorticosteroid use?
✓ ~: Within the first 3 months
General adverse effects of glucocorticosteroids
✓ ~: 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
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Why must glucocorticosteroids be tapered?
✓ ~: 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
How should glucocorticosteroids be discontinued?
✓ ~: 1. Administer for short courses and then taper; do NOT abruptly withdrawal
When is the ideal time to administer prednisone?
✓ ~: In the morning
When are glucocorticosteroids contraindicated?
✓ ~: 1. Severe infections
2. Allergy
What is patient education for glucocorticosteroid use?
✓ ~: 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
What is the MOA of colchicine?
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✓ ~: 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
What is the indication of colchicine?
✓ ~: Prophylaxis of gout flares in adults (or to treat Behcets syndrome)
Is colchicine curative?
✓ ~: Not a cure and does not prevent the disease from progressing
What is low-dose colchicine?
✓ ~: 1.2mg followed by 0.6mg 1 hr later (for 1.8mg total)
What is high-dose colchicine?
✓ ~: 1.2mg followed by 0.6mg every 4-6hours (for 4.8mg total)
Is high or low-dose colchicine preferred?
✓ ~: Low-dose is AS EFFECTIVE as high-dose with LESS side effects
What is the main side effect of colchicine?
✓ ~: DIARRHEA (make sure this is in patient teaching)
What is the MOA of allopurinol (Zyloprim)?
✓ ~: Prevents formation of uric acid by inhibiting xanthine oxidase