Suah Shared "pharm 4" - 74 Picmonics

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pharm 4

Human Immunodeficiency Virus (HIV) Assessment
Assessment
RNA Retrovirus
CD4+ Helper T Cells
Primary Infection
Flu-like Symptoms
Lymphadenopathy
Symptomatic Stage
Fatigue
Diarrhea
Unexplained Weight Loss
White Spots on Tongue
Persistent Fever
Night Sweats
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2 mins
Human Immunodeficiency Virus (HIV) Stages
Primary Infection
Within 3 Weeks
Flu-like Symptoms
Asymptomatic Stage
Years
Symptomatic Stage
CD4+ < 500
AIDS
Opportunistic Infections
CD4+ < 200
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2 mins
Human Immunodeficiency Virus (HIV) Diagnosis
HIV-1/2 Antigen/Antibody Immunoassay
HIV-1/2 Antibody Differentiation Immunoassay
Nucleic Acid Testing (NAT)
Viral Load
Polymerase Chain Reaction (PCR) in Neonates
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3 mins
Human Immunodeficiency Virus (HIV) Interventions
Interventions
Adequate Nutrition
Small Frequent Meals
IV Hydration
Emotional Support
HIV Medications
HAART
Considerations
Transmission Education
Strict Asepsis for Invasive Procedures
Treat Opportunistic Infections
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2 mins
HIV Prophylaxis Medications
CD4+ < 200
TMP-SMX
Pneumocystis Pneumonia
CD4+ < 100 Susceptible to Toxoplasma Gondii
CD4+ < 50
Mycobacterium Avium and Intracellulare
Azithromycin If Delayed Therapy
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2 mins
NRTIs for HIV (Drug Names)
Nucleoside Analog
DEALSZ
Didanosine (DDI)
Emtricitabine (FTC)
Abacavir (ABC)
Lamivudine (3TC)
Stavudine (d4T)
Zidovudine (ZDV)
Nucleotide Analog
Tenofovir (TDF)
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2 mins
HIV Vaccines
HAV
HBV
HPV
Influenza
Meningococcus
Pneumococcus
Tdap
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vaccine safe during pregnancy
Immunoglobulins
RhoGAM (Rh Immune Globulin)
toxoid
tetanus toxoid
inactivated vaccines
[Tdap] tetanus toxoid-reduced diphtheria toxoid-acellular pertussis
3rd trimester
Influenza
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Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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2 mins
H2 Receptor Blocker
"-tidine" Suffix
Indications
Gastroesophageal Reflux Disease (GERD)
Peptic Ulcer
Mechanism
Block Histamine H2 Receptors
Parietal Cells
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51 secs
Proton Pump Inhibitors (PPIs)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Inhibit H+/K+/ATPase
Side Effects
Hip fracture
Pneumonia
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2 mins
H2 Receptor Blocker Side Effects
Side Effects
Decrease Creatinine Clearance
Cimetidine
Crosses Blood-Brain Barrier
Anti-Androgen
Inhibits Cytochrome P450
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1 min
Cimetidine and Ranitidine (H2 Receptor Blockers)
-tidine Suffix
Mechanism
H2 Receptor Blocker
Indications
Suppress Gastric Acid Secretion
Side Effects (All)
Pneumonia
Side Effects - Cimetidine
Anti-androgen Effects
CNS Changes
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2 mins
Sucralfate (Carafate)
Mechanism
Creates Protective Barrier
Indications
GI Ulcers
Side Effects
Constipation
Considerations
Require Acidic Environment
Give on Empty Stomach
Oral Suspension Available
May Decrease Absorption of Other Meds
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2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
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1 min
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
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2 mins
Peptic Ulcer Disease
Peptic Ulcer Disease
Decreased mucosal protection against gastric acid
Heartburn (Pyrosis)
Melena
Hemorrhage is the most common complication
Duodenal
Duodenal: Pain Relieved by Eating
Weight gain
90% are caused by H. Pylori infection
Increased gastric acid
Zollinger-Ellison Syndrome
Hypertrophy of Brunner glands
An ulcer on the posterior wall of duodenum -> Žbleeding from gastroduodenal artery
More likely to perforate (anterior > posterior)
Duodenal Tx: Triple Therapy for H. Pylori
Gastric
Gastric: Pain Caused by Eating
Weight loss
75% are due to H. Pylori
NSAID
Increased risk of carcinoma
Biopsy margins to rule out malignancy
Ruptured gastric ulcer on the lesser curvature of stomach -> Žbleeding from left gastric artery
Tx: Gastric Ulcer Octreotide
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Irritable Bowel Syndrome (IBS) Assessment
Abdominal Pain
Relieved by Defecation
Alternating Diarrhea and Constipation
Fatigue
Excessive Flatulence
Sensation of Incomplete Evacuation
Considerations
Stressors
Food Intolerances
More Common in Women
Rule Out Other Disorders
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2 mins
Irritable Bowel Syndrome (IBS) Interventions
Interventions
Identify Triggers
Increase Fiber Intake
Probiotics
Anticholinergics
Tricyclic Antidepressants (TCAs)
Loperamide
Linaclotide
Medications for Women
Tegaserod (Zelnorm)
Lubiprostone (Amitiza)
Alosetron (Lotronex)
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2 mins
Helicobacter Pylori
Characteristics
Gram-Negative
Bacilli
Curved
Polar Flagellum
Catalase-Positive
Oxidase-Positive
Disease
Gastric and Duodenal Ulcers
Ammonia
Alkaline Environment
Gastric adenocarcinoma
MALT lymphoma
Diagnosis
Serology IgG antibody
Stool antigen
Urease positive breath test
Biopsy
Treatment
2 ABX and PPI
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2 mins

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