Pharmacology Exam: Corticosteroids and Herbs

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Questions and Answers

Which effect is associated with long-term corticosteroid therapy?

Increased immune function

Weight loss over time

Improved inflammatory response

Adrenal atrophy (correct)

What is a critical consideration for patients receiving corticosteroid therapy?

Live vaccines can be administered safely

Daily weight gains over 1 pound are normal

Oral route is preferred for chronic treatment (correct)

Immediate discontinuation of therapy if side effects appear

Which of the following are adverse effects of chronic corticosteroid use?

Osteoporosis (correct)

Enhanced immune system activity

Increased inflammatory responses

Weight loss

What is the preferred lab value for diagnosing thyroid disorders?

TSH levels Signup and view all the answers

Which food interaction can decrease the effectiveness of hypothyroid medications?

Calcium-rich foods Signup and view all the answers

What common medication can accelerate the metabolism of levothyroxine?

Phenytoin Signup and view all the answers

Which statement is true regarding Ginkgo Biloba?

It can cause dangerous interactions with anticoagulants. Signup and view all the answers

Which of the following symptoms should be monitored in infants treated for thyroid deficiency?

Height and weight changes Signup and view all the answers

Which herb is known to increase energy and decrease blood sugar levels?

Ginseng Signup and view all the answers

What effect does Ginkgo-biloba have on blood pressure?

Decreases blood pressure Signup and view all the answers

Which herb can lead to an increased risk of serotonin syndrome when taken with tricyclic antidepressants?

St John's wort Signup and view all the answers

What hazardous effect can result from large amounts of black licorice?

Increased headache and blood pressure Signup and view all the answers

Which vitamin is primarily involved in synthesizing clotting factors and producing red blood cells?

Vitamin K Signup and view all the answers

Which diuretic is known to be the most potent among those listed?

Torsemide (Demadex) Signup and view all the answers

What is a potential effect of taking turmeric?

Decreased inflammation Signup and view all the answers

What should be monitored to ensure safety when administering loop diuretics?

Vital signs, including BP and HR Signup and view all the answers

Which herb is taken to alleviate anxiety and sleep disorders but increases the effects of CNS depressants?

Kava Kava Signup and view all the answers

What is a common indication for administering loop diuretics?

Fluid retention due to edema Signup and view all the answers

What is Pyridoxine (Vitamin B6) known to caution against?

Decreasing the efficacy of Parkinson's medications Signup and view all the answers

Ginger is known to decrease which of the following conditions?

Nausea Signup and view all the answers

Which of the following is a potential adverse interaction of potassium-sparing diuretics?

Increased potassium levels with ACE inhibitors Signup and view all the answers

What effect does melatonin have when taken with certain antidepressants?

Decreases their antidepressant effects Signup and view all the answers

Which strategy is recommended for optimizing the administration of diuretics?

Always monitor serum electrolytes periodically Signup and view all the answers

What is hyperkalemia characterized by?

Serum potassium level greater than 5 mEq/L Signup and view all the answers

Which mineral is most abundant in the body?

Calcium Signup and view all the answers

What is a common adverse effect of magnesium therapy?

Flushing of the skin Signup and view all the answers

What causes hypocalcemia?

Lack of calcium or vitamin D Signup and view all the answers

Which of the following medications is used to treat Parkinson’s disease symptoms?

Levodopa Signup and view all the answers

What is one of the treatment goals for Alzheimer’s disease?

Improving function in ADLs Signup and view all the answers

What side effect is NOT associated with Benztropine?

Weight gain Signup and view all the answers

What is the primary cause of hypermagnesemia?

Advanced renal failure Signup and view all the answers

Which medication should be taken on an empty stomach to enhance absorption?

Levodopa Signup and view all the answers

What is the most common cause of hypokalemia?

Use of loop and thiazide diuretics Signup and view all the answers

Which condition is characterized by muscle weakness and difficulty maintaining balance?

Multiple sclerosis Signup and view all the answers

What severe side effect should be monitored during magnesium therapy?

Neuromuscular blockade Signup and view all the answers

Which of the following conditions is a contraindication for the use of Benztropine?

Closed-angle glaucoma Signup and view all the answers

Study Notes

Long-Term Corticosteroid Treatment

Corticosteroids suppress inflammation and immune responses.
Prolonged use leads to adrenal atrophy.
Avoid live vaccines while on steroids.
Weight gain of over 2 lbs in a day warrants attention.
Oral route is preferable for chronic conditions.
Higher doses accelerate adrenal atrophy (2-4 weeks).

Adverse Effects of Chronic Corticosteroids

Suppressed immune system.
Reduced inflammatory response.
Increased risk of GI bleeds and peptic ulcers.
Increased risk of osteoporosis.
Behavioral changes.
Metabolic changes and fluid retention.

Replacement Therapy and Drug Interactions

Interactions with potassium-wasting drugs and anticholinesterase agents.
Avoid live vaccines.
Interactions with insulin and oral medications.

Thyroid Physiology and Disorders

Low blood thyroid levels trigger negative feedback loops via TRH (thyrotropin-releasing hormone) and TSH (thyroid-stimulating hormone).
Thyroid releases T3 and T4 (hormones).
TSH is the preferred lab value.
Low TSH is considered "good" for thyroid function.
Primary hypothyroidism involves low T4 and high TSH.
Hashimoto's thyroiditis shows abnormal antithyroid antibody levels.

Pharmacotherapy of Hypothyroid Disorders

Phenytoin accelerates the metabolism of levothyroxine.
Certain foods can interact with levothyroxine.
Monitor patients taking warfarin for bleeding risk.
Monitor infants, especially for growth and development.
Ginkgo Biloba's flavonoids are dangerous for anticoagulant users.

Herb-Drug Interactions

Saw Palmetto can decrease BPH symptoms, urination, iron absorption, and oral contraceptive effectiveness.
Turmeric can help decrease inflammation, infection, and stomach problems but can enhance anticoagulant effectiveness.
Vitamin K (AquaMEPHYTON) helps the body produce RBCs and clotting factors.
Pyridoxine (Vitamin B6) may decrease the effectiveness of Parkinson's medications.
Ascorbic Acid (Vitamin C) enhances iron absorption.

Fluid Imbalance

Body fluids travel between intracellular and extracellular compartments.
Imbalance between intake and output can cause shock and dehydration.
Electrolyte Imbalances involve monitoring K+, Mg2+, and Ca2+ electrolyte levels.

Pulmonary Edema

Maintaining potassium balance is important for pulmonary edema.
Insulin plays a key role in maintaining potassium balance.
Hyperkalemia has a serum level >5 mEq/L.
Hypokalemia has a serum level < 3.5 mEq/L.

Electrolyte Imbalances (Continued)

Hypermagnesemia involves serum levels > 1.05 mmol/L.
Hypomagnesemia has serum levels < 0.65 mmol/L, and is caused by renal problems and loop diuretics.
Hypercalcemia has serum values > 2.5 mmol/L.
Hypocalcemia has serum values < 2.1 mmol/L.
Adverse effects for Magnesium imbalances include diarrhea, flushing, sedation or confusion.
Adverse effects for Calcium imbalances include constipation, nausea, and vomiting.

Parkinson's Disease

The goal is to balance dopamine and acetylcholine.
Dopamine agonists increase dopamine, and anticholinergics block acetylcholine.
Levodopa is taken on an empty stomach, and high protein diets should be avoided.

Benztropine Use

Used to treat extrapyramidal side effects.
Adverse effects include sedation, constipation, blurred vision etc.
Avoid use in patients with closed-angle glaucoma, myasthenia gravis, and urinary obstruction.
Risk of paralytic ileus is present.

Multiple Sclerosis

Exact cause unknown; characterized by demyelination.
Muscle spasms can be treated with NSAIDs and skeletal muscle relaxants.
Cyclobenzaprine is a muscle relaxant; used to treat muscle spasms.
Consider drug safety and precautions like avoid driving or operating heavy machinery.

Liver Function Tests and Nonpharmacological Therapies

Check liver function when necessary.
Avoid alcohol with many treatments.
Physical therapies, such as exercises, increase movement and prevent contractures.
Herbal remedies like black cohosh, castor oil packs and capsaicin can be used topically.
B-complex vitamins, specifically B6, may be helpful.

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Description

This quiz covers important topics related to corticosteroid therapy, including its effects, critical patient considerations, and interactions with thyroid medications. Additionally, it addresses the use of herbal supplements and their potential effects and interactions. Test your knowledge on these essential pharmacological concepts.