TERMINOLOGY
Define pathophysiology
The study of a disease process's mechanism based off the cellular and organ changes. This then allows for healthare providers to indentify theraputic measures and practices
The Three Levels of Prevention and Example
Primary- Preventive meausre, this removes the risk for example do not smoke
Secondary- The prevents furthering of the by diagnosis and treatment. E.G screenings and early detection actions
Tertiary- This is rehabilitation and restoration to prevent complications from the disease. E.G physical therapy after an injury
Explain what a controlled substance is? What organization controls them?
A drug that can be abused. This drug requires a prescriber with a DEA number. This drug involves tracking and knowledge of who is recieving it. These drugs are monitored by the Drug Enforcement Administration.
What is homeostasis? How is it achieved? What do disesases to it?
What is the neuroendocrine model? What are the effects on altered hormonal and metabolic regulation in a clinical model?
The neuroendocrine model is the concept of the endocrine system working with the hypothalamus or pituitary gland to send cascade effect of hormones to reestablish homeostasis. If any part of the cascade is impaired then it can disrupt the stimulation or inactivation of a hormone response.
Define etiology
the trigger aka the cause of a specific disease
Acute vs Chronic
An illnes that occurs roughly 3-6 months and chronic a illness that occurs long term, and can have exacerbation and remission
Agonist vs Antagonist
Agonist is a stimulant that mimics our natural process. An antagonist is something that blocks our natural process
Define hypertrophy, metaplasia, atrophy, dysplasia, hyperplasia, metastatic calcification
metaplasia: replacement of one differentiated cell type with another that is not normally present in that tissue. the cell morphology in the lungs alter as a result of smoking
hypertrophy: enlargement of the cells. most often seen in muscle cells or the heart when diseased
dysplaisa: deranged cell growth
hyperplasia: increase in the number of cells
atrophy: weakening of the cells
metastatic calcification: deposition of calcium salts in otherwise normal tissue
Geriatric vs Pediatric considerations
Pediatric: dosage based on weight, slower gastric emptying, pharmacodynamic variability r/t body composition, immature blood-brain barrier, immature kidney & liver lead to decrease metabolism and excretion. Has 80% water composition so water soluable drugs gotta be high in concentration
Geriatric: Impaired distribution bc cardiac output, body mass & fluid. poly pharmacy so drug-drug interaction, altered metabolism (why?), decreased absorption (why?), medication adherence bc congnition (example?) impaired extretion (why?)
Define incidence vs prevalence
Incidence of the number of new cases in a specific population at a given time. These individuals are not sick yet, but at risk for the disease. Example: 1 out of 8 women will have IBS
Prevalence is the amount of cases with the disease at a specific point in time. Example: In 2014 80,000 Americans had herpes
What is the nursing process? Explain
ADPIE. Assess, Diagnose, Plan, Implement, Evaluate.
Pharmacokinetics vs Pharmacodynamics vs Pharmacotherapy
Pharmacokinetics is the process in which a drug moves throught the body. Pharmacodynamics is how a drug affects the body. Pharmacotherapy is the process of how a drug treats, diagnoses the signs, symptoms & disease
Summarize the nervous system
Nervous system is composed of two systems: central nervous system and peripheral nervous system. The central nervous system is composed of the brain and spinal cord. The peripheral nervous system is divided into the autonomic nervous system and somatic nervous system. The autonomic nervous system is divided into the parasympathetic and sympathetic nervous system. The somatic nervous system controls voluntary movement while autonomic controls involuntary movements
Process of sympathetic nervous system
Preganglionic neurons made of cholinergic fibers that release acetylcholine come from thoracic and lumbar area to stimulate postganglionic neurons made up of adrenergic fibers that release norepinehrine. Norepinehrine acts on alpha and beta receptors. The location of where post ganglionic can change what type of chemical is released. sympathetic nervous system stays stimulated by releasing acetylcholine straight to adrenal medula to release epinephrine and norepinephrine into blood stream, this keeps us going in figh or flight. Examples of sympathetic response, dialation of pupil, increased heart rate, decreased saliva, bronchi dilation. These stimulations come from 31 spinal nerves for sympathetic. Your body also stops in investing in non essential functions for the moment.
Define endogenous
A naturally occuring substance in the body. Fr example your hormones are an endogenous substance
Nomencalture of Medications
Chemical Name: based off chemical composition
Generic Name: the non-trademark name based off classification. This is not capitalized. This name is given when the drug is FIRST administered to humans in FDA trials
Brand name: capitalized trademark name by manufacture. The same drug can have different brand names.
Explain the threshold of the dose response curve
Before Threshold: few receptors are bound so the effet is small and the drug is not dectectable in the body yet
After Threshold: the respose is dected so the effect is larger because more receptors are bounded
Plateau: all receptors have been bounded. No matter how much more drug is given there will be no addition response
Explain process of parasympathetic nervous system.
The parasympathic nervous system is you body's decompression and relaxation from the sympathetic. You body wants to undo the fight or flight response to regain homeostasis. Cranial nerves 3,7,9 pre & post ganglionic neurons are made of cholinergic fibers so they release acetylcholine to stimulate the eyes & salivary glands
The vagus nerve releases acetylcholine but synapes to the visceral organ its affecting which heart, lungs, gi system.
The preganglionic neuron from sacral area syapse to wall of pelvic ganglia to release acetylcholine to effect the bladder.
The eyes would constrict, the HR & BP would go down, digestion would resume. The vagus nerve (cranial nerve 10) is the most important in causing our parasympathetic responses.
Regulation of cortisol synthesis & secretion
This is regulated by negative feedback loop. Circandium rhythm and stress is sensed by hypothalamus which release CRH to the anterior pituitary that releases ACTH the stimulates the adrenal cortex to release cortisol. How does cortisol effect metabolism, protein metabolism, and cardiovascular system?
EC
ER
XL
SR/XR
SA
EC- Enteric- coated drugs
ER- Extended release
XL- Extended length
SR/XR- sustained release
SA- sustained action
What do you need to know about a drug to determine whether to administer to a patient?
1) pharmacodynamics
2) pharmacokinectics
3) pharmacotherapy
4) patient factors that would impact the theraputic aspect of the drug
5) patient factors that would cause ADRs
6) drug-drug interactions
7) food-drug interactions
What is the process of pharmacokinetics? Explain
Absorption: Transmission of medication from point of entry to blood stream. What are some administration options? What determines onset?
Distribution: transporting the drug to the site of action. How are they carried? What effects this?
Metabolism: method by which the drug is inactivated or biotransformed by the body. Where? How does P450 system come into play? First pass?
Excretion: elimination of the medication primarily done in the kidneys. If this is not functioning what can happen?
Explain the process of the RAAS system
BP drops -> Sympathetic Nervous System stimulated -> JGA nerve cells in kidneys release renin into circulation -> presence of renin activaties angiotensinogen in liver -> become angiotensin I -> Angiotensin converting enzyment (ACE) on endothelial in lung and kidney transform it to angiotensin II-> vasoconstriction, stimulate posterior pituatry to release ADH (antidiuretic hormone) that keeps in water, stimulate kidneys to keep sodium & water to increase blood volume, potassium will be excreted, aldosterone produced from adrenal cortex on top of kidneys. This increases blood pressure.
HPA axis
Hypothalamus Pituitary Adrenal Axis. The hypothalamus stimulates the pituitary to stimulate the adrenal glands to do whatever mechanism to promote that "fight or flight" response. This is a stress response.