Pharmacology CPA4 Study Outline PDF

**Study Outline for Pharmacology CPA4 -- 11/25/2024** **Chapter 19** - **Amylin** inhibits glucagon secretion, delays gastric emptying, and acts as a satiety agent. - **Terms to know: Insulin, Glucose, Amylin, Somatosin** - Glycosylated hemoglobin refers to the permanent attachment...

**Study Outline for Pharmacology CPA4 -- 11/25/2024** **Chapter 19** - **Amylin** inhibits glucagon secretion, delays gastric emptying, and acts as a satiety agent. - **Terms to know: Insulin, Glucose, Amylin, Somatosin** - Glycosylated hemoglobin refers to the permanent attachment of glucose to hemoglobin molecules and reflects the average plasma glucose exposure over the life of a red blood cell (approximately 120 days). Glycosylated hemoglobin does not measure fasting, but rather glucose control over time. Glycosylated hemoglobin does not identify complications but could provide data if the patient is at risk. Glycosylated hemoglobin does not check for hyperlipidemia. - **Terms to know: Glucose levels, Hyperlipidemia,** - The symptoms the mother reports are the classic 3 P\'s of diabetes: polyuria, polydipsia, and polyphagia. Classic symptoms of type 1 DM include polydipsia, polyuria, polyphagia, and weight loss. Recurrent infections and visual changes are complications of diabetes. Vomiting, abdominal pain, and sweet breath are signs of diabetic ketoacidosis. Weakness, hypotension, and mental confusion are signs of hypoglycemia. - **Terms to know: Phenylketonuria, Tourette Syndrome** - Insulin promotes cellular glucose reuptake through glucose transporters. Glucagon increases blood glucose levels by stimulating glycogenolysis and gluconeogenesis in muscle and lipolysis in adipose tissue. Melatonin regulates circadian rhythms. Oxytocin responsible for contraction of the uterus and milk ejection in lactating women. - **Terms to know: Glucagon, Glycogenolysis, Gluconeogenesis, Oxytocin, Lactation** **Chapter 20** - Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don\'t already have diabetes. When a baby of a mom, who has gestational diabetes, is still in utero there is a constant high supply of glucose. This causes the baby to increase its fat stores (producing a large baby) and create a lot of insulin to deal with the high glucose it is receiving from mom. BUT once the baby leaves utero, the glucose supply decreases but the baby still has a lot of insulin on board. This can lead to a drop in blood glucose (hypoglycemia) at birth. Page 449 - **Terms to know: HDL, LDL, Triglycerides, Cholesterol** - In Type \| diabetes, the beta cells of the pancreas are destroyed, which leads to a deficit or absence or insulin being produced. In this type of diabetes, insulin will be required for the remainder of the individual\'s lifetime - **Terms to know: Type \| diabetes, beta cells, insulin** - In Type Il diabetes the body\'s cells become resistant to the effects of insulin and do not allow glucose to enter the cell. - **Terms to know: Type Il diabetes, Glucose, Insulin-resistant, Acute, Chronic, pancreatitis,** - The incidence of childhood obesity is rising which increases the likelihood of the development of Type 2 diabetes at an earlier age. - **Terms to know: Contraceptives, Androgenic, steroids, obesity** - Individuals who are obese, are sedentary, have a poor diet, and have a family history of type 2 diabetes are at risk for developing Type II Diabetes. Individuals with pancreatic cancer, osteopenia, and a family history of type 1 diabetes are not at risk for the development of type 2 diabetes. - Hyperglycemia promotes the production of destructive molecules in the body, which interferes with the body\'s natural defense mechanism and hobbles its ability to fight infection and inflammation. The impaired defense mechanism makes way for bacterial and viral infections in the body. - You have many symptoms in diabetic ketoacidosis. These include excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity scented breath, hyperglycemia, acidosis (due to the breakdown of ketones), ketonuria, and confusion. - **Terms to know: Ketoacidosis, Hyperglycemia, Ketonuria, Acidosis, DKA** - Know the difference between Type I and Type II Diabetes - Type I Diabetes: strong genetic component, destruction of the beta cells, peak onset of 12 years of age, and the body cannot store or properly use glucose - Type II Diabetes: body cannot store or properly use glucose, is more prevalent than Type \| diabetes, mainly lifestyle related and develops over time, is associated with long-term obesity **Chapter 22** - An increase in the serum ferritin level would indicate effective treatment. Splenomegaly indicates the anemia has not resolved and would not indicate effective treatment. Phlebotomy is not indicated as a treatment for iron deficiency anemia and would not indicate effective treatment. A rapid decrease (not increase) in fatigue, lethargy, and other associated symptoms is generally seen within the first month of therapy. Figure 22.14. Page 495 - **Terms to know: Hypoglycemia, Hyperglycemia, Hyperthermia** - Erythropoietin is produced in the kidneys, thus if a client is in renal failure, the kidneys will not produce the hormone necessary to stimulate the bone marrow to produce red blood cells as needed. - **Terms to know: Testosterone, Renal failure, Aspirin** - Red blood cells are produced in the bone marrow,. - Patients with thrombocytopenia should avoid aspirin because it reduces platelet adhesiveness, contributing to bleeding. Blowing the nose forcefully should be avoided. The patient should gently pat it with a tissue if needed. Patients should not perform vigorous exercise or lift weights. If the patient is weak and at risk for falling, supervise the patient when out of bed. Instruct patients not to shave with a blade; an electric razor should be used. - **Terms to know: Thrombocytopenia** - The last immature form of a red blood cell is the reticulocyte. If an increased level is seen in the laboratory values, it is a sign of anemia. The body is attempting to make more RBCs at an increased rate which leads to sending out more immature forms of the RBCs from the bone marrow before they are fully mature. - Red blood cell production decreases with age, and life span is also decreased. - Symptoms of iron-deficiency anemia include abnormal paleness or lack of color of the skin, irritability, fatigue, tachycardia, sore or swollen tongue, enlarged spleen, and pica - **Terms to know: PICA, Hepatomegaly** - Aspirin has the ability to decrease platelet function which may cause bleeding. - The most common symptoms of ITP are petechiae (red or purple dots on the skin), bruising and bleeding. When ITP is severe and the platelet count is less than 10,000, patients will often notice petechiae and bruising with minimal contact. Bleeding can occur anywhere but is most typical in the nose, mouth and gut. - **Terms to know: Petechiae Hemolytic Anemia, Thrombocytopenia, Iron deficiency anemia** - **Erythropoietin** is a hormone produced in the kidneys that is sent to the bone marrow to stimulate RBC production. **Chapter 23** - An increase in the serum ferritin level would indicate effective treatment. Splenomegaly indicates the anemia has not resolved and would not indicate effective treatment. Phlebotomy is not indicated as a treatment for iron deficiency anemia and would not indicate effective treatment. A rapid decrease (not increase) in fatigue, lethargy, and other associated symptoms is generally seen within the first month of therapy. - **Terms to know: Splenomegaly, Serum ferritin, Phlebotomy, Anemia** - All types of anemia involve a decreased number of circulating red blood cells (erythrocytes). Increased production of platelets is thrombocytosis, not anemia. Increased excretion of potassium does not accurately describe anemia. A decreased amount of circulating plasma volume occurs in dehydration; anemia involves a decreased quality or quantity of hemoglobin. - **Terms to know: Platelets, Potassium, Circulating blood cells, Anemia** - The definition of thrombocytopenia is a deficiency of platelets in the blood. If a client is in liver failure, the liver will fail to produce thrombopoietin, which is necessary to signal the bone marrow to produce platelets as needed. - **Terms to know: Alcohol liver disease, Rheumatoid arthritis, Emphysema** - The liver is responsible for the production of thrombopoietin. [If an individual suffers from liver damage or failure, there is a high likelihood that platelet production will be decreased]. - Terms to know: Thrombopoietin - The definition of polycythemia is an increase in the red blood cell count. Risk factors include males, smoking, hypertension, testosterone use, history of blood clots, diabetes, and being over the age of 60. - **Terms to know: Polycythemia** - Iron deficiency anemia can be caused by excessive blood loss and causes tiredness. Megaloblastic anemia - The most common causes of megaloblastic anemia are deficiency of either cobalamin (vitamin B12) or folate. Sickle cell anemia - With sickle cell disease, an inherited group of disorders, red blood cells contort into a sickle shape. The cells die early, leaving a shortage of healthy red blood cells (sickle cell anemia), and can block blood flow causing pain (sickle cell crisis). Aplastic anemia - someone who suffers from this condition will have deficiencies in all types of cells due to the suppression of the bone marrow. This can lead to many conditions including anemia and infection. - **Terms to know: Megaloblastic anemia, cobalamin -vitamin B12, Folate, Sickle Cell Crisis, Aplastic Anemia** - Basophils migrate into tissues and clean up dead cells. - **Terms to know: Basophils, Eosinophils, Monocytes, Neutrophils** - Monitoring hydration status is important during an acute exacerbation of polycythemia because the patient is at risk for fluid overload or underhydration. - **Terms to know: Polycythemia, Thrombocytopenia, Polycythemia, Leukocytes** - An individual with neutropenia is at risk for developing an infection therefore needs to be placed in reverse isolation. - A circumstance which might put an individual with sickle cell disease in a hypoxic state should be avoided because it could trigger a sickle cell crisis. At high altitudes there is decreased oxygen. \| - Applying only compression dressing after a bone marrow examination is effective in reducing pain and discomfort without measurable differences in bleeding and hematoma, suggesting that compression dressings alone could be effective in lowering pain and discomfort following bone marrow examination. - Anemia can cause the following symptoms: fatigue, shortness of breath, pallor, and dizziness or fainting. - Pancytopenia describes having low levels of all three blood cell types: red blood cells, white blood cells and platelets - A definitive diagnosis of Hodgkin\'s disease is made if Reed-Sternberg cells are found on pathologic examination of the excised lymph node. Lymphoblasts are immature cells found in the bone marrow of patients with acute lymphoblastic leukemia. Gaucher\'s cells are large storage cells found in patients with Gaucher\'s disease. Rieder\'s cells are myeloblasts found in patients with acute myelogenous leukemia. - **Terms to know: Lymphoblastic cells, Gaucher's cells, Reed-Sternberg cells, Rider's cells** **Chapter 35** - Candidiasis: Causes include: Decreased normal bacterial flora (antibiotics) Increased estrogen/progesterone levels Decreased immune system activity Results in: Inflammation (ex: vulvar pruritic condition), thick odorless discharge. - **Terms to know: Bacteria flora, Estrogen, Progesterone, Pruritic condition, Candidiasis, Syphilis, Herpes, Scabies** - One of the common manifestations seen in an individual suffering from syphilis is a skin rash - In a vasectomy (Vas deferens) (ectomy -- removal) the tube that carries sperm from each testicle (vas deferens) is cut and sealed - Features of PCOS: Irregular and infrequent menstrual cycle Anovulatory Infertility Hirsutism Obesity Insulin resistance Metabolic syndrome Endometrial hyperplasia - **Terms to know: Polycystic Ovary Syndrome, Anovulatory, Infertility, Metabolic syndrome,** - Hirsutism - Antibiotics often destroy normal vaginal flora, facilitating overgrowth of Candida albicans and causing a yeast infection. Ectopic pregnancy does not lead to vaginitis or yeast infection. Presence of hirsutism is associated with polycystic ovary syndrome. Increased caffeine intake is associated with premenstrual syndrome and premenstrual dysphoric disorder. - **Terms to know: Ectopic pregnancy, Candida albicans, Vaginitis, Yeast infection,** - premenstrual syndrome, premenstrual dysphoric disorder **Chapter 36** - The most common complaint of men with BPH is decreased urine stream. Infertility is not associated with benign prostatic hypertrophy. Sexual dysfunction could be associated with BPH, but it is not as common a complaint as decreased stream. A painful prostate is not a frequent complaint of men with BPH. - Condoms are always needed for sexual intercourse even with simultaneous treatment with partners. - Testicular cancer is highly treatable and curable and occurs in younger adult men. It also has an increased likelihood to occur in white men. - **Cryptorchidism** is an undescended testicle. - **Terms to know: Cryptorchidism, Hydrocele, Varicocele, Orchitis** - Cremasteric reflex is a superficial reflex found in human males that is elicited when the inner part of the thigh is stroked. Stroking of the skin causes the cremaster muscle to contract and pull up the ipsilateral testicle toward the inguinal canal. The absence of the reflex is considered to be diagnostic for testicular torsion. The cremasteric reflex has been reported to be absent in 100% of cases of testicular torsion, making it a potentially useful sign in this diagnosis. - **Terms to know: Cremasteric reflex, Epididymitis, Testicle, Testicular torsion** - Many men with gonorrhea are asymptomatic. When present, signs and symptoms of urethral infection include dysuria or a white, yellow, or green urethral discharge that usually appears one to fourteen days after infection. In cases where urethral infection is complicated by epididymitis, men with gonorrhea may also complain of testicular or scrotal pain. - **Terms to know: Gonorrhea, Candidiasis, Chancroid, Trichomoniasis**