How do drugs work in the treatment of asthma?

There are preventative and quick relief drugs to help prevent
symptoms by producing bronchodilation and preventing the release of
leukotrienes and histamines

What are the DCCT trials in terms of diabetes and what did they show?

The Diabetes Control and Complications Trial (DCCT)= major clinical
study conducted from 1983 to 1993 and funded by the National Institute
of Diabetes and Digestive and Kidney Diseases
showed that keeping blood glucose levels as close to normal as
possible slows the onset and progression of the eye, kidney, and nerve
damage caused by diabetes (Insulin dependent diabetes)

How do anti cholinergics work in treating asthma?

bronchodilation due to blocking muscarinic cholinergic receptors

Long term control medications such as Cromolyn sodium and Nedocromil
treat asthma how?

prevent release of leukotrienes and histamine from mast cells
reduce bronchial hyperactivity

What type of asthma is helped long term with Leukotriene receptor
antagonists and leukotriene synthesis inhibitors?

exercise induced and symptoms associated with allergen exposure

Asthma medications that are short acting are administered mostly by
what route? How long will they usually take to work?

inhalation (albuterol)
almost immediately

Asthma medications that are long acting are administered mostly by
what route(s)? What is the primary use of these drugs?

All PO agents are long acting and some are inhaled
used only for long term prophylaxis NOT to abort an ongoing attack

What category of drug used for the treatment of asthma does albuterol
fall in to?

short acting

Atropine derivatives such as Ipratropium are approved for the
treatment of what? How do they work?

COPD, sometimes asthma patients
block muscarinic receptors in bronchi causing bronchodilation

What is the main difference in the treatment of chronic versus quick
relief drugs for asthma?

chronic use preventative medications
quick relief are inhalers used on an as needed basis

What is the principle quick relief drug for asthma?

short acting Beta2-adrenergic agonists like ALBUTEROL
anticholinergics

Why is administration of antiasthmatic drugs by inhalation preferred?

delivered directly to the site of action
rapid relief for acute attacks

What are sulfa drugs used for?

Used for wide variety of bacteria
often used for UTI
local infection

How do Leukotriene modifiers work?

mediate inflammation
decrease leukotriene receptors on bronchial smooth muscle
inhibit leukotriene synthesis

What are the 4 categories of asthma?

step 1: intermittent (PRN)
step 2: mild persistent (regular low dose of inhaled glucocorticoid)
step 3/4: daily meds needed (low-med dose inhaled glucocorticoid
and a long acting inhaled beta 2 agonist)
step 5/6: high dose inhaled glucocorticoid and long acting inhaled
beta2 agonist

What is Type 1 diabetes?

insulin dependent diabetes mellitus, IDDM
juvenile onset
ketosis onset

What is Type 2 diabetes?

noninsulin dependent diabetes mellitus, NIDDM
adult onset

What type of diabetes usually develops during childhood or adolescence?

1

What type of diabetes is usually associated with obesity?

2

Does type 1 or type 2 diabetes carry a risk of ketoacidosis?

1

what is ketoacidosis?

a condition that develops because the individual cannot use glucose
as an energy source so they use fats which make excess ketones which
are acidic

Which type of diabetes is most prevalent?

2

What is the primary defect in type 1 diabetes?

destruction of pancreatic beta cells which are responsible for
insulin secretion

Type 2 diabetes is becoming more common among what group of people?

teens and children
largest increase recently was in 30-39 age group

Symptoms of type 2 diabetes result from the combination of what three things?

insulin resistance
failure of appropriate insulin secretion
increased glucose output by liver

What are the 3 P's associated with diabetes?

polydipsia, polyuria, polyphagia

In type 1 and 2 diabetes, the goal of treatment is to do what?

maintain glucose levels in an acceptable range

What is the glycemic control integrated program that is used in type
1 diabetes?

diet, exercise, and insulin replacement

The core of treatment for type 2 diabetes is what?

diet and exercise

What things increase insulin needs?

infection
stress
obesity
adolescent growth spurt
pregnancy (after first trimester)

what things decrease insulin needs?

exercise and pregnancy in the first trimester

Sulfonylureas are administered orally to do what in the treatment of diabetes?

reduce plasma glucose levels

What is the mechanism of action for Sulfonylureas?

stimulating the release of insulin from pancreatic tissue

What drug used to treat diabetes decreases hepatic output of glucose?

metaformin

what drug used to treat diabetes increases insulin receptor sensitivity?

Thiazolidinediones

What does insulin do?

stimulates cells to take in glucose
stimulates muscles and liver to store glucose as glycogen
stimulates storage of amino acids and fat
***decrease blood glucose levels

The best regimine in stabilizing levels of insulin and preventing
complications with treatment is to do what?

start with lifestyle changes, initiate with one PO agent
(metaformin), self monitor levels

What are the DCCT trials in terms of diabetes and what did they show?

The Diabetes Control and Complications Trial (DCCT)= major clinical
study conducted from 1983 to 1993 and funded by the National Institute
of Diabetes and Digestive and Kidney Diseases
showed that keeping blood glucose levels as close to normal as
possible slows the onset and progression of the eye, kidney, and nerve
damage caused by diabetes

What is the difference between narrow-spectrum and broad-spectrum antibiotics?

narrow: active against only a few microorganisms
broad: active against a wide variety of microorganisms

How can bacteria become resistant to drugs?

acquired = antibiotic that once took activity against a bacteria but
now is not because the bacteria became resistant, happens by chance
natural = antibiotic was never active against that bug

What is the difference between bactericidal versus bacteriostatic?

bactericidal: drugs are directly lethal to bacteria
bacteriostatic: drugs can slow microbial growth but do not cause
death, immune system must work with the drug

If a patient is allergic to penicillins, what drugs should they avoid?

all penicillin branches and cephalosporins

What are some cautions with tetra cyclines?

They bond go calcium and shouldn't be used with children below age 7
or pregnant women
they deposit in bone and teeth resulting in staining teeth and can
suppress bone growth

Is erythromycin broad or narrow spectrum?

Broad

Is erythromycin bacteriostatic or bactericidal?

Bacteriostatic

What is erythromycin used for?

Patients allergic to penicillins

What are some adverse effects of erythromycin?

GI disturbances

What are sulfa drugs used for?

Used for wide variety of bacteria
ofree used for UTI
local infection

What are adverse effects of sulfa drugs?

GI distress
photosensitivity
crystallization of drug in renal tubules
skin reactIons

The Joint Review Committee on Education in Radiologic Technology
(JCERT) publishes standards that identify or define:
a. radiography and radiation therapy educational practices
b. pharmacology, patient care, and medical ethics as required
content for accredited programs
c. guidlelines and stands for educational programs
d. a and b
e. all of the above

e. all of the above

Jamie is a nuclear medicine technologist. In virtually any state, he
may, for diagnostic or therapeutic reasons, apply or administer:
a. radiation
b. radionuclides
c. venipuncture
d. a and b
e. all of the above

a. a and b

The ASRT supports permitting radiologic technologists to administer:
a. venipuncture
b. contrast media
c. radiopharmaceuticals
d. b and c
e. all of the above

e. all of the above

Keith is preparing a patient who suddenly cannot breathe. The patient
is turning blue, but instead of attending the patient, Keith pretends
nothing has happened. instead, he leaves the room and suggests that a
peer, "see how Mr. Jones is doing. Keith is guilty of:
a. malpractice
b. medical negligence
c. liability
d. a and c
e. all of the above

b. medical negligence

Jamie is frequently asked to perform duties associated with a
speciality for which he has not been educated, although he had had a
certain amount of on-the-job training-- but with little supervision.
Jamie realizes that if anything goes wrong while he performs this
specialized function:
a. the heath care facility is ultimately liable
b. he is liable
c. he will not be expected to have performed in the same manner as
qualified, educated personnel
d. a and c
e. a and b

e. a and b

Betty is being sued for malpractice because she used an outmoded
standard that caused her to inadequately protect a patient. Betty's
defense is that at the time she received radiography training 20 years
ago, the technique she used was the only one taught. She even has her
old textbook for prove this. The most likely response to this defense
is the assertion that:
a. Betty may be personally liable for failing to keep current in
new techniques
b. because Betty can prove that she learned her technique in
school, it is acceptable, though not preferable, that she use it.
c. inadequate time and money are the only excuses considered to be
good reason for being unprepared for changes in a field; neither
applies to Betty's case, so she is liable
d. a and c
e. none of the above

a. Betty may be personally liable for failing to keep current in new technique

The shortened version of a drug's official name is the:
a. chemical name
b. nonproprietary name
c. generic name
d. trade name
e. proprietary name

c. generic name

A legend drug is one that:
a. was accepted and put on the market by 1906 and is still in use
today (e.g., morphine)
b. was sold before the 1912 "Opium Conference" at the
Hague but is no longer used (now that drugs are regulated) because it
is dangerous
c. requires a prescription
d. a and c
e. b and c

c. requires prescription

Radiopaque contrast agents fall into the category of:
a. nonproprietary drugs
b. generic drugs
c. legend drugs
d. over-the-counter drugs
e. schedule C-I drugs

c. legend drugs

A patient from out of town has her physician phone in a verbal order
for an emergency filling of her prescription. The pharmacist realizes:
a. a verbal order is not legal across state lines; he cannot fill
this order
b. a verbal order does not necessarily constitute a valid
prescription unless it is signed
c. a verbal order is not legal unless it is transcribed, by a
certified medical professional, to an order form at the verbal order
of the prescriber
d. a and c

b. a verbal order does not necessarily constitute a valid
prescription unless it is signed

Schedule _____ drugs are prescription drugs with the highest
potential for abuse.
a. C-I
b. C-II
c. C-III
d. C-IV
e.C-V

a. C-I

The radiography department where Steve works stores some controlled
substances in addition to radiopaque agents and contrast media. Steve
is asked to review routine security measures the department used to
store these substances. Precautions Steve's department should be
taking include:
a. storing of the drugs under double lock and key
b. requiring at least one signature for removing the medication from
the supply bin
c. accounting for all drugs once a day at the end of each employee shift
d. having the same employee verify the count of every C-II drug, for
consistent monitoring
e. ensuring that each day's drug count agrees with the previous
shift's count

a. storing of the drugs under double lock and key

At the end of his shift, Steve discovers that the drug count for
schedule II drugs is inaccurate by one dosage unit--that is, one
dosage unit is missing. If it cannot be accounted for by reviewing
that day's drug administrations, what should Steve do?
a. Nothing yet. In the morning he should question physicians who
have access to the medication bin. In emergencies, physicians may
remove these drugs without having to immediately sign them out
b. He should report the missing unit to the state agency, such as
the Bureau of Narcotics and Dangerous Drugs
c. He should report the illegal displacement to the federal DEA
d. He should first conduct an internal investigation by contacting
hospital security.
e. a, d, and b-- in that order

b. He should report the missing unit to the state agency, such as the
Bureau of Narcotics and Dangerous Drugs

Mrs. Jefferies arrives at the cardiology outpatient clinic in a major
research hospital. She is moving out of state and demands to take her
patient chart with her. The waiting room receptionist is unsure what
to do; she receives the following piece of advice. Which one is correct?
a. "You can make a copy of it, but ultimately, the chart is
property of the patient.You can be subject to liability if you don't
turn it over to her within 24 hours"
b. The chart belongs to the physician Mrs. Jefferies saw in this
clinic. You'll need his permission to give her a copy, particularly if
the data in her cart were included in a research study.
c. "See whether or not she has insurance. Patient charts belong
to whoever is the primary source of payments."
d. The patient chart is always legal medical record, so it belongs
to the hospital itself.
e. None of the above

d. "The patient chart is always a legal medical record, so it
belongs to the hospital itself.

Most hospital medical records use a _____ format.
a. POMR
b. PDR
c. AHFS
d. BNDD
e. DEA

b. PDR

Lisa is reviewing a variety of drug reference products in an effort
to choose the one that best suits her department. In comparing
several, she notes that the drug reference _____ is extensively
referenced under separate cover.
a. Physician's Desk Reference
b. Facts and Comparisions
c. American Hospital Formulary Service Drug Information
d. Handbook on Injectable Drugs
e. Drug Interaction Facts

b. Facts and Comparisions

David works for a pharmaceutical company. His job includes
supervising the process by which a certain group of drugs are
compounded for initial delivery into the body. One might say that
David is involved in:
a. biopharmaceuticals
b. drug vehicle production
c. dosage form production
d. b and c
e. all of the above

e. all of the above

A patient is prescribed an oral medication. It is crucial that its
active ingredients not be released until the medicine reaches the
small intestine. The problem is how to deliver an oral medication
without its activity being chemically destroyed or altered by stomach
acids. In what form should this medication be delivered?
a. compressed tablet
b. controlled-release tablet
c. sublingual dose form
d. enteric-coared tablet
e. none of the above

c. enteric-coated tablet