EVERYTHING PATHO
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Questions and Answers

What is the primary mechanism of action of H1-receptor antagonists in the treatment of allergic rhinitis?

  • They block the actions of histamine at H1 receptors. (correct)
  • They constrict blood vessels in the nasal mucosa.
  • They stimulate the release of histamine from mast cells and basophils.
  • They increase the secretion of inflammatory mediators.

    • Which of the following is a common adverse effect of first-generation antihistamines?

  • Nasal congestion
  • Drowsiness (correct)
  • Increased mucus secretion
  • Vasoconstriction

    • What is the primary action of mucolytics in the treatment of respiratory disorders?

  • They constrict blood vessels in the lungs.
  • They loosen thick, viscous bronchial secretions. (correct)
  • They stimulate the cough reflex.
  • They decrease the secretion of inflammatory mediators.

    • Which of the following is a contraindication for the use of intranasal corticosteroids?

    <p>Known infections</p> Signup and view all the answers

    What is the primary mechanism of action of beta-adrenergic agonists in the treatment of asthma?

    <p>They relax bronchial smooth muscle.</p> Signup and view all the answers

    Which of the following is a potential adverse effect of cough suppressants?

    <p>Hallucinations</p> Signup and view all the answers

    What is the primary action of expectorants in the treatment of respiratory disorders?

    <p>They reduce the thickness of bronchial secretions.</p> Signup and view all the answers

    Which of the following is a characteristic of second-generation antihistamines?

    <p>They have a less tendency for sedation.</p> Signup and view all the answers

    What is the primary use of inhaled corticosteroids in the treatment of allergic rhinitis?

    <p>To reduce tissue edema and inflammation.</p> Signup and view all the answers

    Which of the following is a nursing consideration for patients using mucolytics?

    <p>Teach patients proper administration techniques.</p> Signup and view all the answers

    What is the primary cause of weakened bone in osteoporosis?

    <p>Calcium not being deposited into the bone</p> Signup and view all the answers

    What is the therapeutic class of Colchicine?

    <p>Antigout</p> Signup and view all the answers

    What is the most common site for gout to occur?

    <p>Big toe</p> Signup and view all the answers

    What is the primary mechanism of action of calcium salts in the treatment of hypocalcemia?

    <p>Suppress the activity of osteoclasts</p> Signup and view all the answers

    What is the primary reason Colchicine is reserved for?

    <p>Clients who cannot tolerate safer agents</p> Signup and view all the answers

    What is the primary adverse effect of alendronate that is rare but serious?

    <p>Osteonecrosis of the jaw</p> Signup and view all the answers

    What is the primary action of Colchicine in the treatment of gout?

    <p>Reduce the incidence of acute attacks</p> Signup and view all the answers

    What is a common adverse effect of Colchicine?

    <p>GI toxicity</p> Signup and view all the answers

    What is the primary mechanism of action of hydroxychloroquine in the treatment of autoimmune disorders?

    <p>Relieving severe inflammation</p> Signup and view all the answers

    What is the primary adverse effect of methotrexate that is related to the gastrointestinal system?

    <p>Ulcerative stomatitis</p> Signup and view all the answers

    What is the recommended route of administration for Colchicine?

    <p>Oral (with meals and a full glass of water)</p> Signup and view all the answers

    What is the primary mechanism of action of allopurinol in the treatment of chronic gout?

    <p>Inhibiting the production of uric acid</p> Signup and view all the answers

    What is the primary nursing consideration for patients taking calcium salts?

    <p>Taking the medication with a full glass of water</p> Signup and view all the answers

    What is the primary contraindication for the use of alendronate?

    <p>Active upper GI problems</p> Signup and view all the answers

    What is the primary adverse effect of xanthine oxidase inhibitors that is related to the kidneys?

    <p>Kidney injury</p> Signup and view all the answers

    When is the pain typically worsened for patients with gastric ulcers?

    <p>30-60 minutes after eating</p> Signup and view all the answers

    What is the primary action of proton pump inhibitors in the treatment of peptic ulcer disease?

    <p>Reducing acid secretion in the stomach</p> Signup and view all the answers

    When should proton pump inhibitors be taken?

    <p>Before the first major meal of the day</p> Signup and view all the answers

    What is the primary therapeutic use of alosetron?

    <p>Treatment of irritable bowel syndrome with diarrhea (IBS-D)</p> Signup and view all the answers

    What is the primary mechanism of action of antacids in the treatment of peptic ulcer disease?

    <p>Neutralizing stomach acid</p> Signup and view all the answers

    When should antacids be taken in relation to other medications?

    <p>At least 2 hours before or after other medications</p> Signup and view all the answers

    What is the primary adverse effect of diphenoxylate with atropine?

    <p>Constipation</p> Signup and view all the answers

    What is the primary indication for the use of alosetron?

    <p>Female patients with severe IBS-D lasting more than 6 months</p> Signup and view all the answers

    How do antidiarrheal medications like diphenoxylate with atropine work?

    <p>By decreasing intestinal motor activity</p> Signup and view all the answers

    What is the primary evaluation of effectiveness for proton pump inhibitors?

    <p>Reduced original symptoms</p> Signup and view all the answers

    What is the effect of cardiac glycosides on the heart rate?

    <p>Decreased heart rate</p> Signup and view all the answers

    What is the primary indication for the use of digoxin?

    <p>Heart failure</p> Signup and view all the answers

    What is the effect of cardiac glycosides on the gastrointestinal system?

    <p>Decreased appetite</p> Signup and view all the answers

    What is the significance of frequent serum checks in patients taking digoxin?

    <p>To monitor for toxicity</p> Signup and view all the answers

    What is the contraindication for the use of digoxin in patients with ventricular dysrhythmias?

    <p>Due to increased risk of cardiotoxicity</p> Signup and view all the answers

    What is the effect of verapamil on serum levels of digoxin?

    <p>Increased serum levels</p> Signup and view all the answers

    What is the nursing consideration for patients taking digoxin?

    <p>Take apical pulse for 1 full minute</p> Signup and view all the answers

    What is the interaction between digoxin and diuretics?

    <p>Increased risk of hypokalemia</p> Signup and view all the answers

    What is the result of blood backing up into the lungs due to left-sided heart failure?

    <p>Pulmonary edema</p> Signup and view all the answers

    What is the primary mechanism of action of cardiac glycosides in the treatment of heart failure?

    <p>Improving cardiac output</p> Signup and view all the answers

    What is the recommended frequency of serum checks for patients taking digoxin?

    <p>Frequent</p> Signup and view all the answers

    What is the primary adverse effect of cardiac glycosides that is related to the gastrointestinal system?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the interaction between digoxin and verapamil?

    <p>Increased serum levels of digoxin</p> Signup and view all the answers

    What is the primary contraindication for the use of digoxin?

    <p>Ventricular dysrhythmias</p> Signup and view all the answers

    What is the nursing consideration for patients taking digoxin?

    <p>Apical pulse for 1 full minute</p> Signup and view all the answers

    What is the result of the interaction between digoxin and diuretics?

    <p>Increased risk of hypokalemia</p> Signup and view all the answers

    What is the primary reason for monitoring INR levels in patients taking warfarin?

    <p>To assess the effectiveness of anticoagulation therapy</p> Signup and view all the answers

    What is the therapeutic class of warfarin?

    <p>Anticoagulant</p> Signup and view all the answers

    Which of the following herbal medications may interact with warfarin to increase the risk of bleeding?

    <p>All of the above</p> Signup and view all the answers

    What is the normal range for aPTT levels in patients not on heparin?

    <p>30-40 seconds</p> Signup and view all the answers

    What is the primary reason for monitoring platelet counts in patients with thrombocytopenia?

    <p>To detect bleeding complications</p> Signup and view all the answers

    What is the primary contraindication for the use of warfarin in patients with recent trauma?

    <p>Bleeding complications</p> Signup and view all the answers

    What is the pregnancy category of warfarin?

    <p>X</p> Signup and view all the answers

    What is the primary mechanism of action of dabigatran?

    <p>Inhibits thrombin activity</p> Signup and view all the answers

    Which of the following is a contraindication for the use of rivaroxaban?

    <p>All of the above</p> Signup and view all the answers

    What is the primary action of heparin?

    <p>Inactivates several clotting factors</p> Signup and view all the answers

    What is the primary adverse effect of heparin?

    <p>All of the above</p> Signup and view all the answers

    What is the interaction between heparin and oral anticoagulants?

    <p>Increased risk of bleeding</p> Signup and view all the answers

    What is the primary laboratory test used to monitor heparin therapy?

    <p>Activated partial thromboplastin time (aPTT)</p> Signup and view all the answers

    What is the antidote for heparin overdose?

    <p>Protamine sulfate</p> Signup and view all the answers

    What is the primary nursing consideration for patients taking dabigatran?

    <p>Monitor for bleeding</p> Signup and view all the answers

    Which type of diabetes is characterized by insulin resistance?

    <p>Type 2</p> Signup and view all the answers

    What is the therapeutic class of levothyroxine?

    <p>Thyroid hormone replacement</p> Signup and view all the answers

    What is the adverse effect of corticosteroids that is characterized by buildup of fluid in the lower legs?

    <p>Buildup of fluid in the lower legs</p> Signup and view all the answers

    What is the timing of administration for levothyroxine?

    <p>Same time every day before eating</p> Signup and view all the answers

    What is the prototype drug for thyroid hormone replacement?

    <p>Levothyroxine</p> Signup and view all the answers

    What is the mechanism of action of insulin aspart and lispro?

    <p>Lowering blood sugar levels</p> Signup and view all the answers

    What is the onset of action for insulin glargine and detemir?

    <p>1-2 hours</p> Signup and view all the answers

    What is the contraindication for the use of thyroid hormone in the treatment of obesity or weight loss?

    <p>Obesity or weight loss</p> Signup and view all the answers

    What is the adverse effect of sulfonylureas that is characterized by weight gain?

    <p>Weight gain</p> Signup and view all the answers

    What is the nursing consideration for patients taking insulin, in terms of evaluating effectiveness?

    <p>Blood glucose checks</p> Signup and view all the answers

    What is the primary mechanism of action of levothyroxine in the treatment of hypothyroidism?

    <p>Replacing thyroid hormone</p> Signup and view all the answers

    What is the primary adverse effect of corticosteroids that is related to bone health?

    <p>Bone pain</p> Signup and view all the answers

    What is the onset of action of insulin aspart and lispro?

    <p>10-30 minutes</p> Signup and view all the answers

    What is the primary contraindication for the use of thyroid hormone in the treatment of obesity or weight loss?

    <p>Use in the treatment of obesity or weight loss</p> Signup and view all the answers

    What is the primary mechanism of action of fludrocortisone in the treatment of adrenocortical insufficiency?

    <p>Mimicking the effects of natural mineralocorticoids</p> Signup and view all the answers

    What is the primary consequence of abrupt discontinuation of antiseizure medication?

    <p>Increased seizure frequency</p> Signup and view all the answers

    What is the primary mechanism of action of phenobarbital in the treatment of seizures?

    <p>Enhancing the action of GABA</p> Signup and view all the answers

    What is the primary adverse effect of diazepam (Valium) that is related to its use in the short term?

    <p>Tolerance and dependence</p> Signup and view all the answers

    What is the antidote for benzodiazepine overdose?

    <p>Flumazenil</p> Signup and view all the answers

    What is the primary reason for the importance of compliance with antiseizure medication regimens?

    <p>To maintain the correct amount of medication in the body</p> Signup and view all the answers

    What is the primary consequence of increased levels of acetylcholine in patients with Parkinson's disease?

    <p>Decreased function of muscles and worsened posture and balance</p> Signup and view all the answers

    What is the primary therapeutic class of phenobarbital?

    <p>Antiseizure drug</p> Signup and view all the answers

    What is the primary mechanism of action of Levodopa in the treatment of Parkinson's disease?

    <p>Restores dopamine</p> Signup and view all the answers

    What is the primary adverse effect of Pramipexole?

    <p>Sudden inability to stay awake</p> Signup and view all the answers

    What is the primary mechanism of action of Latanoprost in the treatment of glaucoma?

    <p>Increase outflow of aqueous humor</p> Signup and view all the answers

    Why is Latanoprost contraindicated in patients with closed-angle glaucoma?

    <p>It reduces the outflow of aqueous humor</p> Signup and view all the answers

    What is the primary adverse effect of Timolol?

    <p>Blurred vision and stinging</p> Signup and view all the answers

    What is the primary mechanism of action of Mementine in the treatment of Alzheimer's disease?

    <p>Reduce the levels of glutamate</p> Signup and view all the answers

    What is the primary nursing consideration for patients taking Pramipexole?

    <p>Avoid activities that require alertness</p> Signup and view all the answers

    What is the primary contraindication for the use of Timolol?

    <p>Asthma</p> Signup and view all the answers

    What is the primary effect of androgens on male reproductive function?

    <p>Restore masculine characteristics</p> Signup and view all the answers

    What is the primary contraindication for the use of testosterone in men?

    <p>Prostatic carcinoma</p> Signup and view all the answers

    What is the primary mechanism of action of PDE-5 inhibitors in the treatment of erectile dysfunction?

    <p>Block PDE-5 enzyme</p> Signup and view all the answers

    What is the primary adverse effect of testosterone therapy that is related to the liver?

    <p>Liver damage</p> Signup and view all the answers

    What is the primary reason for monitoring BP and weight in patients taking testosterone therapy?

    <p>To monitor for fluid retention and edema</p> Signup and view all the answers

    What is the primary indication for the use of testosterone therapy in men?

    <p>Hypogonadism</p> Signup and view all the answers

    What is the primary nursing consideration for patients taking testosterone therapy?

    <p>Monitoring for fluid retention and edema</p> Signup and view all the answers

    What is the primary mechanism of action of alpha 1 adrenergic blockers in the treatment of benign prostatic hyperplasia?

    <p>Relaxing the smooth muscle in the prostate to increase urine outflow</p> Signup and view all the answers

    What is the primary consequence of not donating blood while taking 5-Alpha reductase inhibitors?

    <p>Increased risk of birth defects</p> Signup and view all the answers

    What is the primary indication for the use of Antibiotics in the treatment of Chlamydia?

    <p>Treatment of chlamydial infections in newborns</p> Signup and view all the answers

    What is the primary risk factor for the transmission of Human Papillomavirus?

    <p>Sexual intercourse</p> Signup and view all the answers

    What is the primary mechanism of action of 5-Alpha reductase inhibitors in the treatment of benign prostatic hyperplasia?

    <p>Blocking the conversion of testosterone to dihydrotestosterone</p> Signup and view all the answers

    What is the primary consequence of taking nitrates with phosphodiesterase inhibitors?

    <p>Hypotension, myocardial infarction, and sudden cardiac death</p> Signup and view all the answers

    What is the primary indication for the use of Penicillin in the treatment of Syphilis?

    <p>Treatment of syphilis</p> Signup and view all the answers

    What is the primary mechanism of action of phosphodiesterase inhibitors in the treatment of erectile dysfunction?

    <p>Rapid onset of action, lasting up to 4 hours</p> Signup and view all the answers

    Study Notes

    Respiratory Advantages/Disadvantages of Inhalation Route

    • Antihistamines (H1-receptor antagonists) block actions of histamine at H1 receptor
      • Widely used as OTC remedies for relief of allergy symptoms
      • Examples: fexofenadine (Allegra), loratidine (Claritin), cetirizine (Zyrtec)

    Antihistamines

    • H1-receptor antagonists
      • Examples: Diphenhydramine, Hydroxyzine
      • Adverse effects: Anti-cholinergic effects, Sedation

    Intranasal Corticosteroids

    • Decrease secretion of inflammatory mediator
    • Reduce tissue edema (inflammation)
    • Cause mild vasoconstriction
    • Treatment of perennial allergic rhinitis
      • Prototype drug: Fluticasone (Flonase)

    Mucolytics

    • Directly loosen thick, viscous bronchial secretions
    • Break down chemical structure of mucus molecules
    • Mucus becomes thinner and can be removed more easily by coughing
      • Prototype drug: Acetylcysteine (Mucomyst)

    Cough Suppressants (Antitussives)

    • Dampen cough reflex
    • Used for coughs due to allergies or common cold
    • Do not use for emphysema, bronchitis, liquid aspiration
      • Prototype drug: Dextromethorphan (Delsym, Robitussin DM)

    Asthma Rescue Drugs - Beta-Adrenergic Agonists

    • Activate the sympathetic nervous system
    • Relaxes bronchial smooth muscle
    • Bronchodilation, widening the airway, making breathing easier
      • Prototype drug: Albuterol (ProAir)

    Musculoskeletal Disorders and Medications

    • Gout
      • Treatment: Colchicine (anti-gout drug, decreases inflammation caused by gout)
      • Adverse effects: GI toxicity, bone marrow suppression
    • Hypocalcemia
      • Treatment: Calcium salts (calcium supplement)
      • Adverse effects: Hypercalcemia, spasms
    • Osteoporosis
      • Treatment: Biphosphonates (suppress activity of osteoclasts, inhibit bone resorption)
      • Adverse effects: Esophageal irritation, GI issues, hypocalcemia
      • Prototype drug: Alendronate (Fosamax)
    • DMARDs (Disease-modifying antirheumatic drugs)
      • Examples: Hydroxychloroquine (Plaquenil), Methotrexate
      • Adverse effects: GI upset, loss of hair, anorexia, headaches, mood changes, ocular effects

    Gastrointestinal Disorders and Medications

    • Peptic Ulcer Disease (PUD)
      • Treatment: Proton pump inhibitors (reduce acid secretion in the stomach)
      • Prototype drug: Omeprazole (Prilosec)
      • Adverse effects: Generally minor
    • Irritable Bowel Syndrome with Diarrhea (IBS-D)
      • Treatment: Alosetron (selective blockade of 5-HT3 receptors)
      • Adverse effects: Constipation, GI toxicity
      • Contraindications: Chronic constipation, history of bowel obstruction
    • Antidiarrheal
      • Examples: Diphenoxylate with atropine, Loperamide
      • Mechanism of action: Decrease intestinal motor activity, decrease fluid secretion, enhance mucosal absorption

    Cardiovascular Disorders and Medications

    • Heart Failure
      • Treatment: Cardiac glycosides (positive inotropic effect, negative chronotropic effect, improved stroke volume and cardiac output)
      • Prototype drug: Digoxin
      • Adverse effects: Dysrhythmias, cardiotoxicity
    • Anticoagulants
      • Examples: Warfarin, Dabigatran (Pradaxa), Rivaroxaban (Xarelto)
      • Adverse effects: Bleeding
      • Interactions: Many medications and herbals

    Coagulation Disorders and Medications

    • Thrombocytopenia
      • Treatment: Oral anticoagulants (inhibit action of vitamin K, synthesis of clotting factors)
      • Prototype drug: Warfarin
      • Adverse effects: Bleeding
      • Interactions: Many medications and herbals
    • Heparin (parenteral anticoagulant, indirect thrombin inhibitor)
      • Adverse effects: Bleeding, heparin-induced thrombocytopenia (HIT)

    Endocrine Disorders and Medications

    • Diabetes Mellitus
      • Treatment: Insulin (Type 1 and 2), Oral hypoglycemics (Type 2)
      • Adverse effects: Hypoglycemia
      • Prototype drug: Aspart (NovoLog), Lispro (Humalog)
    • Thyroid Disorders
      • Hypothyroidism
        • Treatment: Thyroid hormone replacement
        • Prototype drug: Levothyroxine (Synthroid)
      • Hyperthyroidism
        • Treatment: Beta blockers, thionamides
    • Adrenal Disorders
      • Cushing's syndrome
        • Treatment: Corticosteroids (reduce inflammation)
        • Prototype drug: Hydrocortisone
      • Addison's disease
        • Treatment: Mineralocorticoids (mimic effects of natural mineralocorticoids)
        • Prototype drug: Fludrocortisone### Endocrine Disorders and Medications
    • Diabetes Mellitus:
      • Type 1: totally insulin dependent
      • Type 2: insulin resistant
    • Cushing's Syndrome:
      • ACTH production and corticosteroid medications
    • Hypo/Hyperthyroidism:
      • Hyperthyroidism: excessive T3 and T4, leading to increased metabolism
      • Hypothyroidism: insufficient T3 and T4, leading to decreased metabolism
    • Levothyroxine:
      • Mechanism of action: thyroid hormone replacement
      • Adverse effects: hyperthyroidism effects
      • Nursing considerations: serum TSH levels, timing of administration, and black box warning

    Corticosteroids

    • Hydrocortisone:
      • Mechanism of action: reduces inflammation
      • Adverse effects: fluid buildup, high blood pressure, and upset stomach
      • Nursing considerations: monitor bone pain and bone health, toxicity, and long-term use
    • Fludrocortisone:
      • Mechanism of action: mimics natural mineralocorticoids
      • Adverse effects: retention of sodium and water
      • Nursing considerations: monitor weight, BP, breath sounds, and urine output, and contraindications

    Insulin

    • Type 1 Diabetes:
      • Aspart, Lispro, Regular, NPH, Glargine, and Detemir
      • Onset, peak, and duration for each type
    • Adverse effects: hypoglycemic effects
    • Nursing considerations: S/S of hypoglycemia, evaluation of effectiveness, and blood glucose checks

    Neurological Disorders and Medications

    • Parkinson's Disease:
      • Decreased dopamine and increased acetylcholine levels
      • Medication classes: dopamine-enhancing drugs, NMDA receptor antagonists, and anticholinergics
    • Seizures:
      • Medication classes: antiseizure drugs, sedatives, and antidepressants
      • Adverse effects: rebound effects, adrenal gland atrophy
      • Nursing considerations: compliance, timing of administration, and controlled substance schedule

    Dopamine Enhancing Drugs

    • Levodopa:
      • Mechanism of action: restores dopamine
      • Adverse effects: uncontrolled movements, loss of appetite, nausea, and orthostatic hypotension
      • Nursing considerations: may be unable to self-medicate, do not abruptly withdraw

    Prostaglandin Analogs

    • Latanoprost:
      • Mechanism of action: enhances outflow of aqueous humor to lower IOP
      • Adverse effects: local effects within the ocular region
      • Nursing considerations: remove contacts and avoid touching the eye or eyelashes with the dropper

    Male/Female Reproductive Disorders

    • Hypogonadism:
      • Lack of sufficient testosterone secretion
      • Symptoms: diminished appearance of secondary sex characteristics, erectile dysfunction, and low sperm counts
    • Androgens:
      • Mechanism of action: supports male reproductive function
      • Adverse effects: increase/decrease libido, fluid retention, edema, liver damage, and virilization
      • Contraindications: known/suspected prostatic carcinomas, pregnancy, and pre-existing prostatic enlargement

    Erectile Dysfunction

    • PDE-5 Inhibitors:
      • Mechanism of action: blocks PDE-5 enzyme to increase blood flow to the penis
      • Adverse effects: hypotension, headaches, flushing, nasal congestion, priapism, and sudden hearing loss
      • Nursing considerations: rapid onset, avoid high-fat meals and grapefruit juice

    Benign Prostatic Hyperplasia

    • Alpha 1 Adrenergic Blockers:
      • Mechanism of action: opens the prostate for outflow of urine and relaxes smooth muscle
      • Adverse effects: hypotension
      • Nursing considerations: monitor BP, rise slowly from sitting/lying position, and first dose phenomenon

    Chlamydia

    • Symptoms: silent symptoms, Chlamydial conjunctivitis, and Chlamydial pneumonia
    • Assessment: risk factors, emotional support, partner awareness, and education
    • Medications: antibiotics

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    Test your knowledge of respiratory medications, including antihistamines, mucolytics, cough suppressants, expectorants, inhaled corticosteroids, and asthma rescue drugs. This quiz covers their mechanisms of action, adverse effects, and nursing considerations.

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