NR566 Week 1 Study Outline

NR566 Week 1 Study Outline Many questions are written to assess your clinical application of the material from the textbook, in real-world scenarios.

Chapter 21: Drugs Affecting the Endocrine System

•Know the pharmacodynamics, pharmacotherapeutics clinical

use, drug interactions and adverse drug reactions for:

• Biphosphonates The remodeling cycle is initiated by osteoclastic activity. In

response to microfractures and other damage associated with normal wear and tear, osteoclasts are drawn to the damaged area of the trabecula, attach to its surface, and resorb the damaged and surrounding bone, creating a resorption pit (Fig. 21-1).Resorption is accomplished by pseudopodia, which attach tightly to the bone surface and secrete acids and enzymes that dissolve bone. The osteoclasts then leave the area and osteoblasts move in, line up to cover the surface of the pit, and form new bone.•Bisphosphonates adhere tightly to bone and, by inhibiting osteoclastic activity, are potent inhibitors of both normal and abnormal bone resorption.Etidronate, pamidronate, risedronate, alendronate (Fosamx), tiludronate, Ibandronate (bonvia) , zoledronic acid

• oz of water with drug, and remain upright for one hour

pregnancy c except pamidronate and zoledronic acid preg D no chidren no absoluate contraindications except uncorrect hypocalcemia, barretts esophagus and renal insufficiency etidronate avoid with entercolitis, , fractures with pagets disease, all ADRs is musculoskeletal pain , rare reports for osteonecrosis, increased risk for AFIB, GI distress, dyspepsia drug interactions: most common with drugs that affect the GI tract, H2 blocking agents, Ca supplements, antacids interfere with absorption, GI bleed increased risk when on NSAIDS an aspirin, Used for osteoporosis, pagets disease, spinal cord injurys etidronate, postmenopausal women, glucocorticoid induced osteoporosis •o Aromatase inhibitors •o Growth hormones This study source was downloaded by 100000829957125 from CourseHero.com on 12-31-2021 23:54:34 GMT -06:00

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•o Pancreatic enzymes •o Insulin •o Oral hypoglycemic agents •o Thyroid medications

•Also know:

• Bioavailability of bisphosphonate drugs and appropriate patient

education Aspirin may decrease the bioavailability of tiludronate by up to 50% when taken 2 hours after the tiludronate. Although indomethacin increases the bioavailability of tiludronate by 2- to 4-fold, the bioavailability is not significantly altered by diclofenac; therefore, each NSAID must be considered individually.Patient education: The oral drugs should be taken first thing in the morning, at least 30 minutes prior to other medications, beverages, or food (60 min for ibandronate).Etidronate and tiludronate should be taken 2 hours before any food. Alendronate, ibandronate, risedronate, and tiludronate should be taken with 8 oz of plain water.Mineral water, coffee, orange juice, and other beverages greatly reduce absorption. If supplemental calcium or antacids are taken, the bisphosphonate must be administered at least 1 hour before these other drugs. If a daily dose is missed, that dose should be skipped and the patient should resume taking the drug the next morning.

• Adverse effects associated with long-term use
• Specifics about administration and education regarding

pancreatic enzymes

• Common adverse effects with aromatase inhibitors
• Drugs associated risk for bone loss which should be monitored

Chapter 33: Diabetes Mellitus

•Clinical signs & symptoms •Risk factors & associated complications •Diagnostic criteria This study source was downloaded by 100000829957125 from CourseHero.com on 12-31-2021 23:54:34 GMT -06:00

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•Criteria for screening asymptomatic adults •Differentiate between onset, peak and duration of insulin and oral hypoglycemic agents (table 33-4) •Know treatment algorithms •A1C treatment goal •Calculate an appropriate daily dose of insulin for initiation of insulin therapy •Insulin treatment algorithm for Type 1 DM •A1C monitoring during oral or insulin diabetes management •Correlate mean plasma glucose level according to A1C (table 33-6) •Clinical manifestations of diabetic autonomic neuropathy •Hypoglycemia treatment (amount of carbohydrates and examples) •Storage of insulin •Drug monitoring with metformin •Antidiabetic medications associated with photosensitivity •Antidiabetics to avoid in the elderly & why •Improving patient compliance with diabetes treatment •Diabetic medications to avoid when taking digoxin This study source was downloaded by 100000829957125 from CourseHero.com on 12-31-2021 23:54:34 GMT -06:00

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•Classes of diabetes medications •Diabetic medications with need for renal dose adjustment •Diabetic medications associated with increased risk for genital mycotic infections

•Chapter 41: Hyperthyroidism and Hypothyroidism

•Clinical signs & symptoms, risk factors, associated symptoms and diagnosis •Time anticipated for total reversal of hyperthyroid symptoms with methimazole •Other drugs used to provide symptomatic relief •Routine testing with drug therapy •Recommended dietary iodine intake •Drugs that increase metabolism of T4 •Symptoms of hyperthyroidism and hypothyroidism •Hyperthyroid drugs with risk for hepatic toxicity •Bile acid sequestrants absorption and administration •Levothyroxine administration instructions •Differentiate between primary and secondary hypothyroidism and hyperthyroidism This study source was downloaded by 100000829957125 from CourseHero.com on 12-31-2021 23:54:34 GMT -06:00

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