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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
Q

Which antibiotics discolor urine?

A

Nitrofurantoin. Rifampin

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26
Q

Which Abx covers atypicals?

A

Cipro, Levo, Moxifloxacin. Macrolides (Clarithromycin, Azithromycin, Telithromycin)

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27
Q

What labs are consistent with UTI?

A

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

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28
Q

Which OTC for hot flashes?

A

Estroven (has black cohosh and soy)

29
Q

What is some general information about Buspar?

A

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
Q

Which type of DM oral drug should not be taken on empty stomach?

A

Metformin

31
Q

What is Climara used for?

A

Normal vasomotor menopause symptoms. Climara Pro (w/ progesterone) used for surgical (hysterectomy) vasomotor menopause symptoms

32
Q

What does Ginseng do to Warfarin?

A

Decreases its effect

33
Q

Which insulin can be given IV?

A

Only Regular Insulin

34
Q

W patient is on Medrol Dosepak, what are important things to counsel on?

A

Take with food. May cause insomnia

35
Q

Patient on Climara, what do you counsel her on?

A

Apply to a clean dry area. A women with a uterus should also be on progestin

36
Q

What is the site of action of Furosemide (Lasix)?

A

Na-K-Cl pump at the ascending loop of henle

37
Q

When should you tell the patient to take Lispro?

A

Rapid-acting insulin, Inject 15 minutes before meals or immediately after meals

38
Q

What are the symptoms of IVIG?

A

Renal toxicity and HA

39
Q

Patient on pernicious anemia what are recommendations for meds?

A

Take 3 months for symptoms to resolve AND must take meds indefinitely

40
Q

Which demonstrates proper knowledge of Varenicline?

A

This medicine causes nausea

41
Q

Which CCBs cause additive bradycardia w/ propranolol?

A

Verapamil. Diltiazem

42
Q

What are the symptoms of GERD?

A

Chronic cough. Symptoms of asthma. Atypical chest pain

43
Q

What is needed for Time-Dependent Killing?

A

Constant infusion, Multiple daily doses

44
Q

How can Buspirone NOT be taken?

A

PRN like Diazepam

45
Q

What disease states can increase the risk for osteoporosis?

A

Hyperthyroidism. DM Type 2. Cushings Syndrome

46
Q

What is a common and severe ADR of Linezolid requiring discontinuation?

A

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
Q

What are the benefits of Activella (estrogen/northindone for menopause)?

A

Decrease in fracture risk, decrease risk of colorectal cancer

48
Q

What are some of the encapsulated bacteria?

A

H. influenzae type B (Hib). S. pneumoniae (pneumococcus). N. meningitides. Group B Strep (GBS). Klebsiella pneumoniae. Salmonella

49
Q

What clinical characteristics are important in determining antiviral regimen for Hep C?

A

Weight. HCV genotype

50
Q

Why would Elavil likely worsen opioid-induced constipation?

A

Its an anticholinergic

51
Q

Which opioid is least constipating?

A

Transdermal Fentanyl patch

52
Q

What class of drug is Sumatriptan?

A

Selective Serotonin Agonist

53
Q

Which COMT Inhibitor has reports of fatal liver toxicity?

A

Tolcapone

54
Q

What has the least effect on efficacy of Oral Contraceptives?

A

Lamotrigine. Gabapentin

55
Q

What are the effects in relation to weight gain of Valproic acid and Topiramate (anticonvulsants)?

A

Valproic acid increases weight. Topiramate decreases weight

56
Q

How are TCAs and Carbamazepine related?

A

If someone has a hypersensitivity reaction to TCA, carbamazepine is contraindicated

57
Q

Which anticonvulsants are renally eliminated and require dose adjustment?

A

Gabapentin. Topiramate

58
Q

Whats an important note for Topiramate?

A

Precipitate kidney stone, drink plenty of fluid

59
Q

What is the BBW with valproic acid?

A

Pancreatitis

60
Q

How is Diastat administered?

A

Rectally

61
Q

What formulations is Phenytoin available in?

A

Liquid, Chewable tablet, IV formulation

62
Q

Why must patient be aware of importance of good oral hygiene with Phenytoin?

A

May cause gum and mouth sores

63
Q

What is used to reverse opioid overdose?

A

Naloxone

64
Q

What is morphine metabolized by?

A

Hepatic Glucuronidation. NOT CYP 450

65
Q

Phenytoin is effective for all types of seizures except what?

A

Absence

66
Q

What are the ADRs with Levodopa?

A

GI, involuntary movement, efficacy decreases in 3-5 years

67
Q

What is a common ADR with lithium?

A

Polyuria. Lithium induced intentional tremor

68
Q

What are the 1st line therapy options for mood stabilization in patients diagnosed with Bipolar?

A

Lithium and Depakote

69
Q

What are common ADRs of Fluoxetine?

A

Insomnia, GI upset, HA

Thera XI (16 decks)

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