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P2 Top 200 > 51-75 > Flashcards

51-75 Flashcards

1
Q

Liraglutide

A

Brand: Victoza, Saxenda MOA: Glucagon-like peptide 1 (GLP-1) analog which increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, increases B-cell growth/replication, slows gastric emptying, and decreases food intake Schedule: legend Dosing: Victoza (DM): 0.6mg SC once daily x 1wk, then 1.2mg SC once daily (max 1.8mg) Saxenda (weight loss): 0.6mg to 3mg once daily Contraindication(s):  History or family history of medullary thyroid carcinoma  Patients with multiple endocrine neoplasia syndrome type 2  Pregnancy BBW: • Thyroid C-cell tumor risk Key Points:  Hypoglycemia, especially when used in combination with sulfonylureas  Injection site reaction; Rotate injection sites  Pancreatitis symptoms: severe stomach/upper abdominal pain radiating to back, persistent n/vNausea and Vomitting- eat slower & smaller meals to avoid overeating

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2
Q

Lisdexamfetamine dimesylate

A

Brand: Vyvanse MOA: Promotes release of dopamine and norepinephrine from their storage sites in the presynaptic nerve terminals Schedule: II Dosing: 30mg to 70mg once daily Max: 70mg/day Contraindication(s):  MAOI use within 14 days BBW: • Abuse and dependence Key Points:  Insomnia  decreased appetite  XerostomiaIncreased blood pressure

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3
Q

Lorazepam

A

Brand: Ativan MOA: Enhances the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to chloride ions Schedule: IV Dosing: Anxiety: 2mg to 6mg in two to three divided doses Insomnia: 0.5mg to 2mg q HS (if >65yo: max 1mg) Contraindication(s):  Acute narrow-angle glaucoma  Severe respiratory insufficiency  Hypersensitivity to polyethylene glycol - IV only  Sleep apnea BBW: • Risks from concomitant use with opioids Key Points:  Drowsiness and sedation  Avoid alcohol or other sedating agents  IV formulatoin can cause propylene glycol toxicity

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4
Q

Meloxicam

A

Brand: Mobic MOA: Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors Schedule: legend Dosing: 7.5mg to 15mg once daily Max 15mg/day Contraindication(s):  History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDS  Use in the setting of CABG surgery BBW: • Serious cardiovascular thrombotic events • Serious gastrointestinal bleeding, ulcerations, and perforation Key Points:  Take with food  May cause nephrotoxicity; look for changes in urine frequency/production  May cause GI bleed; report any blood in vomit, sputum and/or black tarry stool, or severe upper GI pain immediately to prescriberTake only as directed or as needed for pain

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5
Q

Memantine

A

Brand: Namenda MOA: NMDA antagonist Schedule: legend Dosing: IR: 5mg to 20mg daily (Doses greater than 5mg to be given in two evenly divided doses) XR: 7mg to 28 mg once daily Contraindication(s):  Hypersensitivity BBW: • None Key Points:  Insomnia  Hallucinations  DizzinessAgitation

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6
Q

Metformin

A

Brand: Glucophage, Fortamet, Glumetza MOA: Decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity Schedule: legend Dosing: IR: 500mg BID or 850mg once daily (Max 2550mg/day) ER: 500mg to 1000 mg once daily (Max 2000mg/day) Contraindication(s):  Severe renal dysfunction (CrCl less than 30ml/min  Acute or chronic metabolic acidosis BBW: • Lactic acidosis Key Points:  Nausea and Vomitting; take with food  Gas, bloating, diarrhea- develop tolerance with continued use; Tiitrate dose/XR formulation may reduce GI side effects  Risk for lactic acidosis, ensure hydration and follow renal dosing guidelines

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7
Q

Methadone

A

Brand: Dolophine, Methadose MOA: Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression Antagonizes NMDA receptors Schedule: II Dosing: Pain: 2.5mg q 8 to 12 hours initially, then titrate up to effective dose Drug detoxification: 80mg to 120mg daily Contraindication(s):  Significant respiratory depression  Acute or severe asthma  GI obstruction, including paralytic ileus (known or suspected)  Hypercarbia BBW: • Addiction, abuse, and misuse • Life-threatening respiratory depression • Life-threatening QT prolongation • Accidental ingestion (oral formulations) • Neonatal opioid withdrawal syndrome • Conditions for distribution and use of methadone products for the treatment of opioid addiction • Cytochrome P450 interaction • Risks from concomitant use with benzodiazepines or other CNS depressants Key Points:  If for addiction must be prescribed in methadone clinic by “X-DEA” prescriber. If for pain must state “for pain” on prescription  Drowsiness, Sedation, and Constipation  Complex kinetics, Avoid frequent dose changes (i.e.

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8
Q

Methotrexate

A

Brand: Rasuvo, Trexall MOA: Irreversibly inhibits dihydrofolate reductase, interfering with DNA sythesis, repair, and cellular replication Schedule: legend Dosing: Psoriasis: 10mg to 25mg PO, SQ, or IM once weekly Rheumatoid arthritis: 7.5mg PO, SQ, or IM mg once weekly Contraindication(s):  Breastfeeding  Pregnancy  Liver disease BBW: • Intrathecal and high-dose therapy • Appropriate use • Pregnancy • Bone Marrow Suppression • Hepatotoxicity • Renal impairment • Pneumonitis • Gastrointestinal toxicity • Secondary malignancy Key Points:  Do not take the next dose if the patient is sick  Take with folic acid as instructed by the prescriber  Side effects such as mucositis, GI upset, nephrotoxicity may occurMake sure to follow instructions on getting routine bloodwork; Make sure patient is NOT pregnant or intends to get pregnant

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9
Q

Methylphenidate

A

Brand: Concerta, Daytrana, Ritalin MOA: Blocks the reuptake of norepinephrine and dopamine into presynaptic neurons Schedule: II Dosing: IR: 10mg to 60mg daily in 2 to 3 divided doses (Max 60 mg/day) ER: 20mg once daily, Max 60 mg/day (Concerta: Max 72 mg/day) Contraindication(s):  MAOI use within 14 days  Marked anxiety, tension, or agitation  Glaucoma BBW: • Abuse and dependence Key Points:  Insomnia  Weight Loss  TachycardiaHypertension

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10
Q

Methylprednisolone

A

Brand: Depo-Medrol, Medrol, Solu-Medrol MOA: Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability Schedule: legend Dosing: Asthma: 40mg to 60mg per day. May give in divided doses Allergic Conditions: Taper per Dosepak instructions Anti-inflamatory: 4mg to 48mg in 1 to 4 divided doses initially followed by a gradual reduction to the lowest possible effective dose Contraindication(s):  Systemic fungal infection  Intrathecal administration  Live or attenuated vaccines BBW: • None Key Points:  Increase in glucose  Poor wound healing  Edema, Weight gain

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11
Q

Mirtazapine

A

Brand: Rameron MOA: Central presynaptic alpha2-adrenergic antagonist effects, which results in increased release of norepinephrine and serotonin. It is also a potent antagonist of 5-HT2 and 5-HT3 serotonin receptors and H1 histamine receptors and a moderate peripheral alpha1 Schedule: legend Dosing: 15mg to 45mg q HS Contraindication(s):  MAOI use within 14 days  Use with linezolid BBW: • Suicidality and antidepressant drugs Key Points:  Drowsiness  Weight gain  Xerostomia

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12
Q

Mometasone

A

Brand: Nasonex, Asmanex, Elocon MOA: Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability Schedule: legend Dosing: Nasal: 2 sprays into each nostril once daily Oral inhalation: 1 inhalation once daily to BID Contraindication(s):  Hypersensitivity to milk proteins  Primary treatment for acute asthma BBW: • None Key Points:  Oral thrush  Take the medication as scheduled  Upper respiratory tract infectionHeadache

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13
Q

Montelukast

A

Brand: Singulair MOA: Antagonizes leukotriene receptors, leading to relaxation of bronchial smooth muscle Schedule: legend Dosing: 10mg once daily Contraindication(s):  Hypersensitivity BBW: • None Key Points:  Take in the evening  Cough  Bronchitis

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14
Q

Naproxen

A

Brand: Aleve, Anaprox, Naprosyn MOA: Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors Schedule: legend Dosing: IR: RX: 500mg to 1000mg daily in two evenly divided doses 12 hours apart ER: 750-1000 once daily Contraindication(s):  History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDS  Use in the setting of CABG surgery BBW: • Serious cardiovascular thrombotic events • Serious gastrointestinal bleeding, ulceration, and perforation Key Points:  Take with food  May cause nephrotoxicity; look for changes in urine frequency/production  May cause GI bleed; report any blood in vomit, sputum and/or black tarry stool, or severe upper GI pain immediately to prescriberTake only as directed or as needed for pain

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15
Q

Nortripyline

A

Brand: Pamelor MOA: Increases the synaptic concentration of serotonin and/or norepinephrine in the central nervous system by inhibition of their reuptake by the presynaptic neuronal membrane pump Schedule: legend Dosing: 25mg TID or QID, may titrate to 150mg/day Contraindication(s):  MAOI use within 14 days  Use in acute recovery phase of MI  Use with linezolid BBW: • Suicidality in children and adolescents Key Points:  Heart arrythymias  Dry mouth, dry eyes, constipation, urinary retention (anticholinergic)  TremorSedation; take at bedtime if it causes sleepiness

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16
Q

Olanzapine

A

Brand: Zyprexa MOA: Antagonist of dopamine and seratonin type two receptor sites Schedule: legend Dosing: 5mg to 20mg PO once daily Contraindication(s):  None BBW: • Increased mortality in elderly patients with dementia-related psychosis • Postinjection delirium/sedation syndrome (Zyprexa Relprevv) Key Points:  Weight gain  Increased glucose  drowsinessIncreased prolactin levels

17
Q

Oxycodone

A

Brand: OxyContin, Roxicodone MOA: Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression Schedule: II Dosing: IR: 5mg to 20mg q 4 to 6 hours PRN ER tablet: 10mg to 80mg q 12 hours PRN ER capsule: 9mg q 12 hours PRN Contraindication(s):  Significant respiratory depression  Acute or severe asthma  GI obstruction, including paralytic ileus (known or suspected) BBW: • Addiction, abuse, and misuse • Life-threatening respiratory depression • Accidental ingestion • Neonatal opioid withdrawal • Cytochrome P450 3A4 interaction • Risks from concomitant use with benzodiazepines or other CNS depressants • Risk of medication errors (oral solution) Key Points:  Drowsiness and sedation  Constipation  Avoid alcohol or other sedating agentsRespiratory Depression

18
Q

Oxycodone and APAP

A

Brand: Endocet, Percocet MOA: See individual agents Schedule: II Dosing: IR: 2.5mg to 10mg q 6 hours PRN. Do not exceed acetaminophen 4 g/day ER: 2 tablets q 12 hours. Do not exceed acetaminophen 4 g/day Contraindication(s):  Significant respiratory depression  Acute or severe asthma  GI obstruction, including paralytic ileus (known or suspected) BBW: • Addiction, abuse, and misuse • Life-threatening respiratory depression • Accidental ingestion • Neonatal opioid withdrawal syndrome • Cytochrome P450 3A4 Interaction • Hepatotoxicity • Risks from concomitant use with benzodiazepines or other CNS depressants Key Points:  Drowsiness and sedation  Constipation  Avoid alcohol or other sedating agents and other acetaminophen containing productsRespiratory Depression

19
Q

Paroxetine

A

Brand: Paxil, Pexeva MOA: Selectively inhibits serotonin reuptake in the presynaptic neurons Schedule: legend Dosing: IR: 20mg to 60mg once daily CR: 25mg to 62.5mg once daily (Max 75mg once daily) Contraindication(s):  MAOI use within 14 days  Use with linezolid  Pregnancy BBW: • Suicidality and antidepressant drugs Key Points:  Drowsiness and insomnia  Dry mouth  Decreaed Libido/Ejaculatory disordersQTc prolongation

20
Q

Phenytoin

A

Brand: Dilantin, Phenytek MOA: Stabilizes neuronal membranes and decreases seizure activity by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses Schedule: legend Dosing: 300mg to 600mg daily in two to three evenly divided doses Contraindication(s):  History of acute hepatotoxicity attributable to phenytoin  concurrent use of delavirdine BBW: • Cardiovascular risk associated with rapid infusion (injection) Key Points:  Altered Mental Status  Decrease in WBCs  Gingival hyperplasiaHirsutism

21
Q

Pioglitazone

A

Brand: Actos MOA: Selective PPARgamma agonist which improves target cell response to insulin Schedule: legend Dosing: 15mg to 45mg once daily Contraindication(s):  NYHA Class III/IV Heart failure BBW: • Congestive heart failure Key Points:  peripheral edema  worsening heart failure  weight gaintakes weeks to show effects on BG

22
Q

Pneumococcal conjugate vaccine

A

Brand: Prevnar 13 MOA: Promotes active immunization against invasive disease caused by S. pneumoniae Schedule: legend Dosing: Single 0.5mL IM dose Contraindication(s):  Severe allergic reaction to any diphtheria toxoid-containing vaccine BBW: • None Key Points:  Chills  Skin Rash  Local Erythema Arthralgia

23
Q

Pneumococcal Polysaccharide Vaccine

A

Brand: Pneumovax 23 MOA: Promotes active immunization against invasive disease caused by S. pneumoniae Schedule: legend Dosing: Single 0.5mL IM dose Contraindication(s):  Severe allergic reaction to pneumococcal vaccine BBW: • None Key Points:  Chills  Skin Rash  Local ErythemaArthralgia

24
Q

Potassium Chloride

A

Brand: K-tab, Klor-Con, Micro-K MOA: Provides potassium, the major intracellular cation, for various metabolic functions Schedule: legend Dosing: 20mEq to 100mEq daily in 1 to 4 evenly divided doses (Max single dose 20mEq to 25mEq) Contraindication(s):  Hyperkalemia, renal failure, and conditions in which potassium retention is present  Structural, pathological, and/or pharmacologic cause for delay or arrest in passage through the GI tract BBW: • None Key Points:  Hyperkalemia  IV Form - phlebitis

25
Q

Prednisone

A

Brand: Daltasone MOA: Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability Schedule: legend Dosing: 5mg to 60mg once daily Contraindication(s):  Administration of live attenuated vaccines with immunosuppressive doses of predisone  Systemic fungal infections BBW: • None Key Points:  Increase in glucose  Poor wound healing  EdemaWeight gain

P2 Top 200 (19 decks)

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