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Thera XI > 15 Study Guide 2 > Flashcards

15 Study Guide 2 Flashcards

1
Q

What is a general summary for DMARDS?

A

Disease modifying medication for RA. Slow onset, must bridge w/ NSAIDs if needed. Slow disease progression and joint erosions. Improve functional disability and decrease pain. Interfere with inflammatory process (does NOT treat inflammation)

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2
Q

What hormone is avoided in a female with NO uterus?

A

Progesterone

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3
Q

What combo of hormones is used in females going through menopause who still have a uterus?

A

Estrogen + Progesterone

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4
Q

Which DM med causes no weight gain?

A

Metformin. Januvia (Sitagliptan)

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5
Q

What are the common pathogens that cause Diabetic foot ulcer?

A

S. aureaus, B Hemolytic Strep

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6
Q

If you see a prescription for MTX 7.5mg PO QD what do you do?

A

Do not fill. Most regimens should be QW or 2xW

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7
Q

Which form of Fe (gluconate, fumarate, sulfate) has the least elemental iron?

A

Gluconate has the least

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8
Q

What is the rare side effect of Xolair?

A

Anaphylaxis. BBW: Bronchospasm, Hypotension, Syncope, Urticaria, and/or Angioedema or throat or tongue

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9
Q

Patient has SJS and you need a diuretic, what do you recommend?

A

Erytharcrynic acid (only non-sulfa). Safe to use: Amiloride, Eplerenone, Ethacrynic acid, Spironolactone, Triamterene

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10
Q

What do the results of the Asthma Control Test show?

A

Score of 20+ means asthma is controlled. < 20 not well controlled, < 15 very poorly controlled

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11
Q

How it ICS potency ranked for Asthma?

A

“Follow Busy Bee For Tulips, Mo”: Fluticasone > Budesonide > Beclomethasone > Flunisolide > Triamcinolone > Mometasone

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12
Q

What is a contraindication for an ARB?

A

Pregnancy, Renal artery stenosis, volume depletion, renal/hepatic impairment

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13
Q

What is the treatment of Thyroiditis?

A

Propanolol reduce heart rate/tremors, steroids, etc

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14
Q

Which organism causes CAP?

A

Strep. pneumonia

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15
Q

Which organism can cause Pneumonia in an otherwise healthy person?

A

Mycoplasma pneumonia

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16
Q

What does SAR stand for?

A

Structure Activity Relationship

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17
Q

What is the MOA of GP IIb/IIIa inhibitors?

A

Directly block platelet GP IIb/IIIa receptor on the platelet membrane; inhibit binding of fibrinogen to the GPIIb/IIIa receptor thus inhibiting platelet aggregation

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18
Q

What is the best timing for tPA use with stroke?

A

Give tPA within 3 hours of stroke symptoms (if given after 3 hours, improvement in outcomes starts to decline). Best if < 90 minutes

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19
Q

Which statins have the least 3A4 inhibition?

A

Pravastatin < Rosuvastatin (2C9) < Fluvastatin (2C9)

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20
Q

What are the expected ADRs with Sominex (sleep aid) use?

A

Morning hangover, Constipation, Diarrhea. Sominex is the same as benadryl

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21
Q

How is COX-2 related to heart risk?

A

It increases heart risk

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22
Q

Which insulin replicates basal insulin the best?

A

Lantus - stimulates physiologic basal insulin

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23
Q

HPA axis suppression, which would most likely cause it (prednisone, steroid inhaler, etc.)?

A

Oral corticosteroids - LT prednisone, dexa or methylprednisone use

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24
Q

What are the IVIG infusion related ADRs?

A

HA, dizziness, N/V, flushing, arthralgia, etc.

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25
Which antibiotics discolor urine?
Nitrofurantoin. Rifampin
26
Which Abx covers atypicals?
Cipro, Levo, Moxifloxacin. Macrolides (Clarithromycin, Azithromycin, Telithromycin)
27
What labs are consistent with UTI?
Leukocyte esterase (trace to large). White cell casts WBC > 5-10. Bacterial cell count (moderate to many). Those 3 are diagnostic.... nitrates, blood, protein are not
28
Which OTC for hot flashes?
Estroven (has black cohosh and soy)
29
What is some general information about Buspar?
20-30mg/d divided BID-TID. Start 7.5mg BID, not prn. Its a 5HT1A partial agonist so no sedative, anticonvulsant, muscle relaxant activity
30
Which type of DM oral drug should not be taken on empty stomach?
Metformin
31
What is Climara used for?
Normal vasomotor menopause symptoms. Climara Pro (w/ progesterone) used for surgical (hysterectomy) vasomotor menopause symptoms
32
What does Ginseng do to Warfarin?
Decreases its effect
33
Which insulin can be given IV?
Only Regular Insulin
34
W patient is on Medrol Dosepak, what are important things to counsel on?
Take with food. May cause insomnia
35
Patient on Climara, what do you counsel her on?
Apply to a clean dry area. A women with a uterus should also be on progestin
36
What is the site of action of Furosemide (Lasix)?
Na-K-Cl pump at the ascending loop of henle
37
When should you tell the patient to take Lispro?
Rapid-acting insulin, Inject 15 minutes before meals or immediately after meals
38
What are the symptoms of IVIG?
Renal toxicity and HA
39
Patient on pernicious anemia what are recommendations for meds?
Take 3 months for symptoms to resolve AND must take meds indefinitely
40
Which demonstrates proper knowledge of Varenicline?
This medicine causes nausea
41
Which CCBs cause additive bradycardia w/ propranolol?
Verapamil. Diltiazem
42
What are the symptoms of GERD?
Chronic cough. Symptoms of asthma. Atypical chest pain
43
What is needed for Time-Dependent Killing?
Constant infusion, Multiple daily doses
44
How can Buspirone NOT be taken?
PRN like Diazepam
45
What disease states can increase the risk for osteoporosis?
Hyperthyroidism. DM Type 2. Cushings Syndrome
46
What is a common and severe ADR of Linezolid requiring discontinuation?
Myelosuppression: Monitor CBC weekly, esp if > 2 week of therapy, pre-existing myelosuppression, other myelosuppressive drugs, or chronic infection treated with other antibiotics. Consider stopping if myelosuppression occurs or worsens
47
What are the benefits of Activella (estrogen/northindone for menopause)?
Decrease in fracture risk, decrease risk of colorectal cancer
48
What are some of the encapsulated bacteria?
H. influenzae type B (Hib). S. pneumoniae (pneumococcus). N. meningitides. Group B Strep (GBS). Klebsiella pneumoniae. Salmonella
49
What clinical characteristics are important in determining antiviral regimen for Hep C?
Weight. HCV genotype
50
Why would Elavil likely worsen opioid-induced constipation?
Its an anticholinergic
51
Which opioid is least constipating?
Transdermal Fentanyl patch
52
What class of drug is Sumatriptan?
Selective Serotonin Agonist
53
Which COMT Inhibitor has reports of fatal liver toxicity?
Tolcapone
54
What has the least effect on efficacy of Oral Contraceptives?
Lamotrigine. Gabapentin
55
What are the effects in relation to weight gain of Valproic acid and Topiramate (anticonvulsants)?
Valproic acid increases weight. Topiramate decreases weight
56
How are TCAs and Carbamazepine related?
If someone has a hypersensitivity reaction to TCA, carbamazepine is contraindicated
57
Which anticonvulsants are renally eliminated and require dose adjustment?
Gabapentin. Topiramate
58
Whats an important note for Topiramate?
Precipitate kidney stone, drink plenty of fluid
59
What is the BBW with valproic acid?
Pancreatitis
60
How is Diastat administered?
Rectally
61
What formulations is Phenytoin available in?
Liquid, Chewable tablet, IV formulation
62
Why must patient be aware of importance of good oral hygiene with Phenytoin?
May cause gum and mouth sores
63
What is used to reverse opioid overdose?
Naloxone
64
What is morphine metabolized by?
Hepatic Glucuronidation. NOT CYP 450
65
Phenytoin is effective for all types of seizures except what?
Absence
66
What are the ADRs with Levodopa?
GI, involuntary movement, efficacy decreases in 3-5 years
67
What is a common ADR with lithium?
Polyuria. Lithium induced intentional tremor
68
What are the 1st line therapy options for mood stabilization in patients diagnosed with Bipolar?
Lithium and Depakote
69
What are common ADRs of Fluoxetine?
Insomnia, GI upset, HA

Thera XI (16 decks)

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