Cancer
What is cancer? Benign vs malignant tumors?
Disease when abnormal cells divide without control and are able to invade other tissues.
Benign- encapsulated, not invasive, well differentiated, low mitotic index, does NOT metastasize.
Malignant- not encapsulated, invasive, poorly differentiated, high mitotic index, does metastasize.
Where is the central stress response?
HPA
What drugs are used to treat generalized anxiety disorder?
Lorazepam (also used to treat status epilepticus) , Diazepam (also used to treat spasticity), Paroxetine, Venlafaxine.
{ALL four prototypes}
What is EPS? What is Schizophrenia?
Pseudoparkinsonism, Acute dystonia, Akathisia, and Tardive dyskinesia. (Know slide 187 on blueprint slides)
Schizophrenia- disordered thinking and reduced ability to comprehend reality. 3 types of symptom- positive, negative, and cognitive.
What are Tricyclic Antidepressants (TCAs)?
What are Monoamine Oxidase Inhibitors (MAOIs)?
TCAs:
Use- drug of choice for depression, bipolar disorder
MOA- block monoamine transmitters {serotonin and NE}
MAOIs:
- As effective as SSRIs and TCAs but more hazardous.
- Risk of hypertensive crisis by eating tyramine rich foods ( pepperoni, salami, cheese, beer, wine, and nuts)
Use: atypical depression
MOA: inactivates monoamine neurotransmitter (NE, serotonin, and dopamine)
Cancer stages?
0- early form
I- localized
II- early advanced
III- spread to lymph nodes
IV- spread to other parts of the body
What is the pathway?
Hypothalamus (CRCH) --> Anterior Pituitary (ACTH) --> Adrenal Cortex (CORTISOL).
Drugs used to treat panic disorder, social anxiety, and PTSD?
Paroxetine & Venlafaxine.
What is the low potent and high potent antipsychotic agents? Their MOA? Use?
Low potency- chlorpromazine
Hight potency- Haloperidol
MOA: suppresses symptoms by blocking dopamine2 receptors in the mesolimbic area of the brain.
Use: Schizophrenia
ADHD: what % cases go into adulthood? Drug therapy?
60% going into adulthood with ADHD.
Drug therapy: methylphenidate.
What is angiogenesis?
Growth of new vessels. These vessels will advance and have vessels around the tumor stealing resources from the body resulting in weight loss.
What is the coping mechanism for stress?
Maladaptive or adaptive. This is how an individual copes with stress. If the individual does not cope properly this can lead to future problems.
What drug is used to treat OCD?
Paroxetine
What is Neuroleptic syndrome (NMS)? Treatment?
NMS- rare, serious reactions to anti-psyc medications. Risk of death without treatment. Orthostatic hypotension, anticholinergic effects and agranulocytosis are present.
Treatment: dantrolene
What is Alcohol Use Disorder (AUD)?
Relapsing disorder, impaired control over drinking.
Withdrawal facilitating drugs: Lorazepam, Clonidine
Abstinence maintaining drugs: Naltrexone, Disulfiram
What are some major toxicities of cancer chemotherapy?
Bone marrow suppression, neutropenia, thrombocytopenia, anemia (treatment erythropoietin that promotes RBC production), and Digestive injury (IMPORTANT: Nausea and vomiting: simulation of TMZ)
Do internal and external factors contribute to stress?
Yes, these factors will result in the stress and how the person deals with the stress.
What drug is a SSRI? What drug is a SNRI? What is the difference between an SSRI and a SNRI?
SSRI- Paroxetine, serotonin reuptake inhibitor
SNRI- Venlafaxine, serotonin and NE reuptake inhibitor
Withdrawal of antipsychotics, what can happen?
What is depot?
Can precipitate a mild abstinence syndrome and symptoms are related to chronic cholinergic blockade. This can be avoided by tapering the medication.
Depot- injectable formulations used for long term therapy of schizophrenia. Given every 2-4 weeks. More side effects are present if given SubQ, less side effects are present if given IM.
What is the most important element in managing poisoning?
What are the antidotes of poison treatment?
4 ways to prevent further absorption of poisons?
Most important element: supportive care
Naloxone: reverses poisonings by heroin and other opioids (morphine)
Physostigmine: treatment of poisoning by atropine and other anticholinergic drugs.
4 ways: 1) Activated charcoal, 2) gastric lavage & aspiration, 3) whole-bowel irrigation, 4) surface decontamination
What must health care providers do when dealing with the Cytotoxic drugs? What was first used as chemotherapy?
Follow the precautions and dispose properly.
First chemo: Nitrogen Mustard
What are stress-related disorders?
Acute Stress- effects the fight or flight response
Chronic Stress- long term stress that was not relieved and can lead to more serious diseases.
PTSD
Antidepressants who are some cautions?
- Warn patients to ALWAYS taper the medication (withdrawal can occur)
- Cannot be used as PRN
- May increase risk of suicide
- Paroxetine (SSRI) can have birth defects
What is Chlorpromazine? Use?
It is the first modern antipsychotic medication, with a low potency.
Belongs to the phenothiazine family.
Use: Schizophrenia
Tablets and injection are available.
Weapons of terrorism:
What is anthrax?
What is Ricin?
Anthrax:
- Aerobic gram-positive bacteria. Enters the body via skin or mucous membranes of the respiratory tract, NOT transmitted person to person.
- This occurs mostly in war, prevention of a vaccine is given to military, vets, and lab workers. Due to them being in risk of contact with anthrax.
Treatment- Ciprofloxacin
Ricin:
- toxic present in castor beans, extraction from the "marsh: when beans are processed to make castor oil.
- Can be inhaled, ingested, or injected.
Treatment- purely supportive, no antidote, vaccine in development