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NPLEX II TIA > ALL PHARM > Flashcards

ALL PHARM Flashcards

1
Q

what are CCBs used for?

A

HTN, arrythmias

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2
Q

what are ACE-inhibitors used for?

A

uncomplicated HTN, good choice for 55+

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3
Q

what are beta blockers used for?

A

HTN, arrythmias

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4
Q

diltiazem drug class

A

CCB

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5
Q

amlodipine drug class

A

CCB (DIHYDROPYRIDINE)

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6
Q

CI/AEs CCBs

A

AE: constipation (verapamil), worsening angina/MI with initiation (amplodipine)
CI: pregnancy, CHF

NonDHP CCBs (diltiazem, verapamil) - conduction issues; can slow HR and interfere w conduction

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7
Q

are there any adverse effects or CI for amlodipine?

A

CI: preg, CHF (all CCB)
AEs: depletes potassium

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8
Q

verapamil drug class

A

CCB

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9
Q

CI diltiazem

A

pregnancy, CHF (all CCB)

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10
Q

are there any adverse effects or CI for verapamil?

A

CI: pregnancy, CHF (all CCB)
AE: depletes vitamin E

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11
Q

what are the beta blockers? which are the specific B1 BBs?

A

-olols
B1 specific: atenolol, metoprolol

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12
Q

CIs of beta blockers

A

asthma
diabetes
AV bloc/sinus Brady/sick sinus syndrome

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13
Q

AEs beta blockers

A

rebound HTN if not tapered properly

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14
Q

what are the ACE inhibitors?

A

-prils

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15
Q

are there any adverse effects and/or CIs for ACE-inhibitors?

A

CI: pregnancy, angioedema, BL renal artery stenosis, valsartan

AE: dry persistent cough, hyperkalemia, edema, dizziness, renal impairment

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16
Q

what are the ARBs used for?

A

uncomplicated HTN
often used if someone is having ACEi SEs

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17
Q

what are the ARBs?

A

-sartans

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18
Q

are there any AEs or CI for ARBs?

A

CI: pregnancy
AE: hyperkalemia, headache, dizziness

Avoid abrupt discontinuation

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19
Q

what are the alpha 2 agonists?

A

clonidine

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20
Q

what is clonidine used for?

A

emergency BP lowering

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21
Q

clonidine AE/CIs

A

AE: constipation, N/V, unable to stay awake
dec peripheral resistance > mental depression, swelling of lower limbs

CI: liver dz, MAO inhibitors, rebound HTN

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22
Q

what are the alpha 1 antagonists?

A

-zosins

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23
Q

what are alpha 1 antagonists (alpha blockers) used for?

A

HTN, BPH (dec norepi > dec sys resistance)

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24
Q

are there any AEs or CIs for alpha 1 antagonists?

A

AE: syncope (1st dose), anesthia, rare priapism or ED

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25
Q

what are the sympathomimetics? what are they used for?

A

epinephrine
HF, bradycardia, stabilization before pacemaker implantation

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26
Q

what are the K wasting diuretics?

A

thiazide (HCTZ)
furosemide (loop)

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27
Q

aer there any CI or AE for the K wasting diuretics?

A

CI: sulfonamide drugs
AE: hypokalemia, hypertriglyceridemia, inc risk gout, hyperglycemia

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28
Q

what are the K sparing diuretics?

A

triamterene
spironolactone

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29
Q

what drug class are the statins?

A

HMG CoA Reductase inhibitors

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30
Q

what is cholesevalam?

A

bile sequestrant

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31
Q

what is gemfibrozil?

A

fibrate; decrease FFA uptake by liver > lowers VLDL
may inc HDL

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32
Q

are there any AEs or CIs for gemfibrozil?

A

AE: inc homocysteine, DVT, SOB, PE, hemoptysis/URI

CI: liver dz, renal dz, gallbladder dz

Require dose reductions with renal insufficiency

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33
Q

what is ezetimibe?

A

cholesterol absorption inhibitor

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34
Q

are there any adverse effects or CIs for ezetimibe?

A

CI: severe liver disease, cyclosporine, fibrates, pregnancy
AE: inc LFTs (esp with statins), diarrhea, URI, myalgias

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35
Q

what are the antiarrythmics?

A

class I - Na ch blockers: lidocaine, flecicaine
class III - k channel blockers: amiodarone

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36
Q

are there any AEs or CI for class I antiarrythmics?

A

CI: amiodarone, CYP450, digoxin, fluoxetine, paroxetine

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37
Q

are there any AEs or CI for class III antiarrythmics?

A

AEs: pulmonary toxicity, hyper/hypo thyroid, AV block, bradycardia, tremors, blue skin, liver enzyme fluctuations

short term use only, many toxicities ** BB warning

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38
Q

what is digoxin?

A

glycoside; used for HF and afib (rate control)

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39
Q

are there any AEs or CIs for digoxin?

A

AE: dizziness, N/V/D, headache

CI: vfib, AV block, CCB, BB, potassium wasters, abx, amiodarone, quinidine

low K inc MOA digoxin so monitor levels

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40
Q

what are the cardiac vasodilators/nitrates?

A

nitroglycerin
hydralazine
isosorbide monocitrate

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41
Q

are there any AEs or CI for the cardiac vasodilators/nitrates?

A

AE: headache, flushing, tolerance, upset stomach
CI: PDE5 inh (sildenafil)
NG CI in sx hypotension, severe anemia, inc ICP, marked Brady or tachy

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42
Q

are there any AEs or CI for hydralazine?

A

AE: N/V, anorexia; prolonged use can cause reversible lupus, deplete B6, and inc hypotensive effects of BP drugs/alcohol

CI: CAD, mitral valve RHD

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43
Q

are there any AEs or CI for isosorbide monocitrate?

A

CI: PDE inhibitors like sildenafil

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44
Q

what is a risk of IV potassium chloride?

A

AP termination > death

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45
Q

what is benzoyl peroxide usually used for and what is its MOA?

A

comolytic, bactericidal
acne

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46
Q

what is isotretinoin usually used for and what is its MOA?

A

dec sebum; acne

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47
Q

are there any CIs or AEs for isotretinoin?

A

black box warning for birth defects

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48
Q

what is tretinoin usually used for and what is its MOA?

A

synth vit A; acne
flammable

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49
Q

what are topical sterids typically used for in dermatology?

A

eczema

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50
Q

mometasone drug class and uses

A

topical steroids; eczema, asthma, hay fever

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51
Q

fluocinonide drug class and uses

A

topical steroid; eczema

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52
Q

triamcinolone drug class and uses

A

topical steroid; eczema
stronger and longer lasting

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53
Q

clobetasol proprionate drug class and uses

A

topical steroid; eczema

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54
Q

are there any AEs or CIs for clobetasol proprionate?

A

AEs: systemic absorption can lead to reversible HPA axis suppresion >
cushings, hyperglycemia, glucosuria, thinning skin/elasticity

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55
Q

mupirocin drug class and uses

A

topical antimicrobial; MRSA, impetigo, wounds

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56
Q

sulfacetamide drug class and uses

A

antimicrobial; acne, seb derm

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57
Q

permethrin drug class and uses

A

scabies, lice

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58
Q

are there any AEs or CIs for permethrin?

A

AEs: pruritis, edema, rash, burning

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59
Q

calcipotriol drug class and uses

A

synthetic vit D; psoriasis

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60
Q

are there any CIs or AEs for calcipotriol?

A

CI: do not use on face
AEs: vit D toxicity, hypercalcemia, dermatitis

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61
Q

adalimumab drug class and uses

A

TNF inhibitor; inflammation modulation
psoriasis, IBD

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62
Q

selenium disulfide drug class and uses

A

used for dandruff, seb derm, tinea

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63
Q

imiquimod drug class and uses

A

immunomodulator; act keritosis, genital warts

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64
Q

are there any AEs or CIs of imiquimod?

A

AEs: local inflammation, flu like sx

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65
Q

MOA botox

A

blocks Ach from NMJ

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66
Q

ipillimumab drug class and uses

A

antineoplastic; melanoma

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67
Q

are there any AEs or CIs for ipillimumab?

A

CIs: pregnancy, chronic infections, MS, immunosuppressed
test for TB before initiation

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68
Q

bupivacaine drug class and uses

A

long acting Na inhibitor; anesthetic

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69
Q

procaine drug class and uses

A

short acting Na inhibitor; anesthetic

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70
Q

olopatadine drug class and uses

A

opth H1 antagonist; allergic conjunctivitis

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71
Q

atropine drug class and uses

A

parasympathoLYTIC; blocks Ach
cycloplegia (accomodation) and mydriasis (pupil dilation)

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72
Q

nepafenac drug class and uses

A

NSAID; pain and inflammation post cataract surgery

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73
Q

cyclosporine drug class and uses

A

opth; chronic dry eyes, scleroderma, sjogrens (oral form used for organ rejection prevention)

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74
Q

latanoprost drug class and uses

A

opth; PG analog; dec IOP by inc aq humor outflow
ocular HTN, glaucoma

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75
Q

timolol drug class and uses

A

BB that dec aq hum formation; glaucoma, ocular HTN

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76
Q

are there any AEs or CIs for timolol?

A

CI: COPD, bronchial asthma, bradycardia, AV block

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77
Q

pilocarpine drug class and uses

A

cholinergic agonist; inc outflow aq humor

glaucoma, dry mouth

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78
Q

sulfacetimide drug class and uses

A

abx; conjunctivitis, superficial ocular infxn, acne, seb derm

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78
Q

are there any AEs or CIs for pilocarpine?

A

AEs: poor low light vision, retinal detachment, iritis

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79
Q

gentamicin drug class and uses

A

conjunctivitis, kerativitis, corneal ulcers, blepharitis

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80
Q

erythromycin drug class and uses

A

superficial ocular lesions

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81
Q

DHEA actions

A

Inc estrogen and testosterone
Dec cortisol

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82
Q

Testosterone is a schedule ___ drug

A

III

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83
Q

Testosterone is used in what scenarios

A

Testosterone <300
Gender affirming care

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84
Q

AE testosterone

A

Transfer to female partner
Peliosis hepatic (blood cysts in liver/spleen)
Liver tumors
Inc LDL

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85
Q

E1 name and uses

A

Estrone
Menopause
Osteoporosis prophylaxis
Marker for menopause and post CA

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86
Q

E2 name, forms, and uses

A

Estradiol
Oral, patch, transdermal
Menopause, osteoporosis

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87
Q

E3 name, uses

A

Estriol
Menopause
Protective

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88
Q

What estrogen is highest in pregnancy?

A

Estriol (E3)

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89
Q

What is the strongest natural estrogen?

A

Estradiol (E2)

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90
Q

What is the weakest natural estrogen?

A

Estriol (E3)

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91
Q

Conjugated estrogens are used for what conditions

A

Menopause
Breast CA
AUB

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92
Q

What is pregnenolone? What is it used to treat?

A

Precursor steroid;
Memory issues

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93
Q

Oral micronized progesterone; what is it and what is it used for?

A

Progestin
Contraception
Amenorrhea
PMS

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94
Q

Levonorgestrel; what is it and what is it used for?

A

Plan B, Mirena
Progestin;
Contraceptive
Menorrhagia

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95
Q

Medroxyprogesterone acetate; what is it and what is it used for?

A

Depo; progestin
Contraception
Endo
Prevention of endometrial hyperplasia with use of exogenous estrogen
AUB
Secondary amenorrhea

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96
Q

Norethindrone; what is it and what is it used for?

A

Progestin only contraceptive

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97
Q

Megestrol acetate; what is it and what is it used for?

A

Progestin;
Appetite stimulation
Cachexia
Breast/endo CA

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98
Q

What do the combined oral contraceptives contain? What is included in this class?

A

Estrogen/progestin
- / ethinyl estradiol
Drospirenone -
Norgestimate -
Norelgestromin -

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99
Q

CI / AEs of combined oral contraceptives

A

CI:
smokers
>35
Inc GB dz

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100
Q

Leuprolide class/action and uses

A

Inhibits gonadotropin release
Tx: endo, fibroids

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101
Q

Clomiphene class/action and uses

A

Binds to estrogen receptors/ stim ovulation
Tx;
infertility in PCOS
Psychogenic amenorrhea
Post OCs

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102
Q

CI/AEs clomiphene

A

Potential for ovarian hyperstimulation and liver dysfunction

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103
Q

Metronidazole class/action and uses

A

Bactericidal;
BV, PID

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104
Q

HCG class/action and uses

A

Preg test, induce ovulation
Stimulation test for hypogonadism/male infertility

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105
Q

Finasteride class and uses

A

5 alpha reductase inhibitor (inh testosterone > DHT)
Tx:
Urinary retention
BPH
Hair loss

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106
Q

Alpha 1 antagonists suffix and uses

A

-zosins and tamulosin
HTN/BPH

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107
Q

Alpha 1 antagonists AE/CIs

A

AE: syncope (1st dose), priapism,ED,asthenia, intraoperative floppy iris sydrome during cataract surgery, abnormal erections/ejaculation

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108
Q

How does tamulosin differ from the rest of the alpha 1 antagonists?

A

Not a -zosin
More selective for urinary over BP
Tx: urinary retention, BPH

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109
Q

Phenazopyridine class, uses

A

Urinary analgesic for pain, burning, urgency, frequency
1st line for IC

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110
Q

Phenazopyridine AE/CIs

A

AE:
Discolored contacts
Orange urine
Interferes with UA results

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111
Q

Sildenafil class and uses

A

Phosphoest. Type 5 inhibitor
ED

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112
Q

Sildenafil AE/CIs

A

AE:
Flushing, sudden cardiac death, vision loss

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113
Q

Bethanechol class/uses

A

PS mimetic
Tx:
Urinary retention
Dry mouth
Post Op/PP retention

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114
Q

Bethanechol AE/CIs

A

CI:
Drug/drug with other PSmimetics (such as pilocarpine)

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115
Q

Anticholinergics/Ach antagonists urinary uses

A

Overactive bladder
Spastic conditions

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116
Q

What are the anticholinergics/ACh antagonists?

A

Tolterodine
Oxybutynin
Solifenacin

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117
Q

CI/AEs anticholinergics/ACh antagonists

A

AE: dry mouth, dry eyes, constipation, HA, dizziness

CI: narrow angle glaucoma, gastric/uro retention

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118
Q

What anticholinergics/ACh antagonists are more/less likely to have SEs?

A

Oxybutynin = inc incidence
Solifenacin = dec incidence

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119
Q

What medications are used for DM2?

A

Canagliflozin
Dulaglutide
Exenatide
Livaglutide
Glyburide
Metformin
Pioglitazone
Sitaglipsin

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120
Q

Canaglifozin drug class, MOA, uses

A

SGLT2 antagonist; dec reabsorbed filtered glucose
DM2

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121
Q

Canagliflozin AE/CIs

A

AE: UTI, dehydration, DKA, bladder cancer, hyperkalemia, wt loss, yeast infections
CI: CKD, recurrent UTI, dialysis

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122
Q

Dulaglutide class/MOA/uses

A

Incretic mimetic (dec blood glucose)
DM2

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123
Q

Dulaglutide CI/AEs

A

BB warning: thyroid C cell tumors

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124
Q

Exenatide class/uses

A

GLP1 receptor agonist
DM2

125
Q

Liraglutide class/MOA/uses

A

GLP1 receptor agonist; long acting
Inc glucose dependent insulin section, dec inappropriate glucagon secretion, slows gastric emptying
Dec A1C 1% in DM2

126
Q

Glyburide class/MOA/uses

A

Sulfonylurea; inc insulin
Dec A1C 1-2% in DM2

127
Q

CI/AEs Glyburide

A

AE: hypoglycemia, wt gain, GI upset, skin rxns, photosensitivity
CI: DKA, sulfa allergy

128
Q

Metformin class/MOA/uses

A

Biguanide; dec glucose production in liver and dec intestinal absorption of glucose, improves insulin sensitivity by inc peripheral glucose uptake
Dec A1C by 1.5-2% in DM2

129
Q

Metformin AE/CIs

A

AE: lactic acidosis, GI complaints, dec B12 absorption
CI: CKD, acute/chronic metabolic acidosis
**BB warning for lactic acidosis inc risk in pts with acute HF, dehydration, hepatic/renal impairment, sepsis, or excessive alcohol use

130
Q

Pioglitazone class/MOA/uses

A

Thiazolidinedione; inc target cell response to insulin, dec hepatic gluconeogenesis
Dec A1C by 2& in DM2

131
Q

Pioglitazone AE/CI

A

CI: dont use with exogenous insulin, active bladder cancer, renal/hepatic dysfunction **BB warning may cause/worsen HF

AE: URI, wt gain, hypoglycemia, peripheral edema

132
Q

Sitagliptin class/MOA/uses

A

DPP4 inhibitor; prolongs active incretin (inc insulin sec) for glucose regulation
DM2

133
Q

AE/CI Sitagliptin

A

AE: flu like sx, hypoglycemia with other DM2 meds, pancreatitis, rash, edema
CI: renal insufficiency

134
Q

Name the types of insulin, their time of onset, and duration of effect

A

Glargine: long acting: 12 hr onset, 20-24 hr effect
Lispro: rapid acting: 10-20 min onset, 3 hr effect
Regular: rapid acting: 30-60 min onset, 5 hr effect

135
Q

Fludocortisone uses

A

Adrenal hypoplasia, Addisons

136
Q

Glucagon uses

A

Tx hypoglycemia

137
Q

Bromocriptine class/uses

A

Dopamine agonist
Tx neuro disorders, acromegaly

138
Q

Furosemide class/uses

A

K wasting loop diuretic
HTN/siADH

139
Q

Lugol’s solution components/uses

A

Elemental iodine and potassium iodide
LOW dose tx HYPOthyroid
HIGH dose tx HYPERthyroid

140
Q

USP thyroid components/use

A

Pig T3/T4
Hypothyroidism

141
Q

Levothyroxine class/uses/CI

A

T4; hypothyroidism
CI: uncorrected adrenal insufficiency, acute MI, thyrotoxicosis
**BB warning ineffective when used for wt loss and potentially toxic, esp if euthyroid

142
Q

Liothyronine class/uses

A

T3;
Tx myxedema coma

143
Q

Methimazole class/uses

A

Inhibits synthetic thyroid hormone
Tx hyperthyroid

144
Q

Methimazole CI/AE

A

CI: 1st trimester

145
Q

Propylthiouracil class/MOA/uses

A

Inhibits thyroid peroxidase and conversation of T4>T3 in periphery
Tx: thyroid storm

146
Q

Propylthiouracil AE/CIs

A

AE: inc AST/ALT, fatal hepatotoxicity

147
Q

Apixaban class/uses

A

Oral anticoagulant for nonvalvular a fib

148
Q

Aspirin uses

A

NSAID traditional use
Anticoagulation

149
Q

Clopidogrel class/uses

A

Platelet aggregation inhibitor
Tx atherosclerosis, MI, stroke, PAD, prevention of thrombotic complications

150
Q

Clopidogrel AE/CIs

A

CI: erythromycin, NSAIDs, anticoagulants, breastfeeding, renal/liver dz, pts with hx TIA/stroke, **BB warning to avoid in poor CYP450 metabolizers (ineffective)

AE: bleeding/bruising, rash, pruritis, abdominal pain/GI issues, TTP

151
Q

Heparin class/MOA/uses

A

Anticoagulant; LOW dose inhibitors factor Xa, HIGH dose inactivates factors VIII, IX, X, XII, XII, thrombin, and inhibits fibrinogen > fibrin

152
Q

Heparin CI/AEs

A

CI: estrogens, erythromycin, warfarin

153
Q

Warfarin class/MOA/uses

A

Anticoagulant; interferes with hepatic synthesis of vitamin K

Stroke prevention (a fib/flutter), DVT/PE

154
Q

Phytonadione class/MOA/uses

A

Synthetic vit K1; tx blood clots

155
Q

Phytonadione CI/AE

A

CI: warfarin

156
Q

Enoxaparin class/MOA/uses

A

Anticoagulant; inhibits factor Xa, doesnt inc Pt or Ptt

157
Q

Enoxaparin CI/AEs

A

Spinal/epidermal hematomas

158
Q

Dabigaltran class/MOA/uses

A

Anticoagulant, direct thrombin inhibitor

159
Q

Dabigaltran AE/CIs

A

AE: GI upset due to inc acidification
CI: p-glycoprotein pump inhibitors (quinidine, verapamil, amiodarone)

160
Q

rivaroxaban class/MOA/uses

A

Anticoagulant; inhibitors factor Xa, platelet activation, and fibrin clot

161
Q

Rivaroxaban CI/AEs

A

CI: liver dz, end stage kidney dz
BB warning: do NOT discontinue without speaking to dr due to inc risk stroke!

162
Q

Desmopressin class/MOA/uses

A

DDAVD/syn vesmopressin
Inc renal permeability to h20 > dec urine vol > inc osmolality
Tx: DI, coagulation disorders

163
Q

Pentoxifylline class/MOA/uses

A

Xanthine derivative/PDE inh (dec blood viscosity)
Tx: PAD, dec pain/numbness/weakness in extremities

164
Q

Pentoxifylline AE/CIs

A

AE: GI upset

165
Q

Alprostadil class/MOA/uses

A

Vasodilator, PG; tx ED, congenital heart defects

166
Q

Epoetin Alfa class/MOA/uses

A

Stimulates erythropoiesis
Tx anemia of chronic disease, use with CA therapy

167
Q

DMPS class/MOA/uses

A

Chelator of gold, mercury, arsenic

168
Q

DMPS CI/AE

A

CI: liver insufficiency, pregnancy cat C

169
Q

DMSA class/MOA/uses

A

Chelates lead, mercury, arsenic, gold

170
Q

DMSA CI/AE

A

CI: pregnancy cat C

171
Q

Edetate calcium disodium class/MOA/uses

A

Chelates lead (out of bone), calcium, zinc, manganese, and iron
Tx: lead poisoning, hypercalcemia, CAD, digoxin arrhythmias

172
Q

Edetate calcium disodium CI/AEs

A

CI: renal failure, hypokalemia, hypokalemia, pregnancy cat B

173
Q

Deferoxamine class/MOA/uses

A

Chelates iron
Tx: hemochromatosis, thalassemia, aluminum toxicosis with dialysis

174
Q

Deferoxamine CI/AEs

A

AE: neurotoxic long term, inc risk cataracts
CI: kidney dz, pregnancy category C

175
Q

Penicillamine class/MOA/uses

A

Chelates copper, mercury, lead(urine); dec IgM RF
Tx: Wilson’s, cyst inertia, RA / used w heparin in IVF

176
Q

Penicillamine CI/AE

A

AE: skin lesions (long term use), leukopenia, aplastic anemia
CI: penicillin allergy, renal dz, synergistic toxicity with gold, chloroquine, phenylbutisone; pregnancy category C

177
Q

Anastrazole class/MOA/uses

A

Aromatase inhibitor; irreversible inhibition of estrogen formation from androgen precursors
Tx: infertility, tx/prevent estrogen dependent breast CA

178
Q

Anastrazole AE/CI

A

AE: inc risk osteoporotic fractures

179
Q

Atezolizumab class/MOA/uses

A

Monoclonal ab;
Tx urothelial carcinomas, non small lung CA, hepatocellular carcinoma

180
Q

Bicalutamide class/MOA/uses

A

Non steroidal anti androgen
Tx: stage D2 metastatic carcinoma of the prostate

181
Q

Bicalutamide CI/AEs

A

CI: severe hepatic impairment (long half life)

182
Q

Doxorubicin class/MOA/uses

A

Anthracycline; chemo; topoisomeras inhibitor
Tx: ovarian cancer, AIDS related kaposi sarcoma, multiple myeloma

183
Q

Doxorubicin CE/AE

A

AE: myelosuppresion, cardiotoxicity, liver impairment

184
Q

Paclitaxel class/MOA/uses

A

Mitosis inh;
Tx: metastatic breast CA, lung CA, pancreatic adenocarcinoma

185
Q

Paclitaxel AE/CI

A

AE: neutropenia

186
Q

Pembrolizumab class/MOA/uses

187
Q

Vinblastine class/MOA/uses

A

Vinca alkaloid/mitosis inhibitor
IV use only
Tx: breast CA that is unresponsive to surgery/hormone therapy, Hodgkins

188
Q

Trastuzumab class/MOA/uses

A

Monoclonal ab, HER 2 inhibitor
Tx: HER 2 + breast CA

189
Q

Octreotide class/MOA/uses

A

GH antagonist/somatostatin mimetic; inhibits GH, glucagon, and insulin
Tx: GH receptor tumors, TSH secreting pituitary tumors, carcinoid syndrome, intestinal peptide secreting tumors

190
Q

Octreotide AE/CI

A

AE: cardiac conduction disturbances, arrhythmias, GB sludge, hypo/hyper glycemia

191
Q

Thalidomide class/MOA/uses

A

Inhibits angiogenesis
Tx: leprosy, multiple myeloma, solid and heme malignancies

192
Q

Thalidomide AE/CI

A

Black box warning for birth defects

193
Q

Megestrol acetate class/MOA/uses

A

Progestin with anti estrogenic properties; app stimulation for cachexia, breast/endo CA, OCP

194
Q

5-fluorouracil class/MOA/uses

A

Inhibits DNA/RNA synthesis
Palliative management of carcinoma, narrow margin of therapy

195
Q

5-Fluorouracil AE/CI

A

AE: heme toxicity, GI hemorrhage, death

196
Q

Methotrexate class/MOA/uses

A

DMARD, immunosuppressant
Tx: breast CA, lung CA, non Hodgkin’s lymphoma

197
Q

Valoxifene class/MOA/uses

A

Anti estrogen effect in uterus and breasts; prevention of breast CA

198
Q

Tamoxifen class/MOA/uses

A

Adjunctive tx of breast CA, DCIS

199
Q

Alkylating agents CI/AEs

A

BB - cumulative renal toxicity, myelosuppresion, N/V, Ototoxicity, anaphylaxis

200
Q

What are the alkylating agents?

A

Cisplatin
Cyclophosphamide

201
Q

Cisplatin class/MOA/uses

A

Chemo, cross links DNA

202
Q

Cyclophosphamide class/MOA/uses

A

DMARD, cross links DNA
Tx: cancers of ovaries, blood, breast, lymph, nerves, retinoblastoma

203
Q

Statins AE/CI

A

AE: hepatotoxicity, HA, myalgia, CPK inc
CI: pregnancy, liver dz, avoid grapefruit juice

204
Q

Signs of digoxin overdose

A

Green/yellow halos around eyes
Loss of appetite, confusion, bradycardia, arrhythmias, double vision

205
Q

Where along the urinary tract do loop diuretics act?

A

Ascending loop of henle

206
Q

Where along the urinary tract do TZ diuretics act?

207
Q

Where along the urinary tract do K sparing diuretics act?

208
Q

Furosemide CI/AE

A

CI: anuria, cross reactivity with sulfa drug allergy, ototoxicity
AE: BB warning for profound loss of fluids/electrolytes, hypertriglyceridemia/hyperglycemia, hypokalemia, inc risk gout

209
Q

CI/AE K sparing diuretics

A

AE: inc triglycerides, gynecomastia (spironolactone), skin rash
CI: anuria, renal impairment, hyperkalemia, BB warning for spironolactone for tumor risk

210
Q

Warfarin CI/SE

A

CI: BB warning for major or fatal bleeding!, pregnancy (X)

AE: bleeding, skin necrosis, purple toe syndrome

211
Q

What are the direct oral anticoagulants?

A

Apixaban
Rivaroxaban
Dabigatran

212
Q

AE/CI direct oral anticoagulants

A

CI: mechanical prosthetic heart valves, hepatic impairment **BB warning for pts receiving neuraxial anesthesia or spinal puncture due to risks of hematomas

Premature discontinuation can inc risk thrombotic events

SE: bleeding, anemia, dyspepsia/abdominal pain

213
Q

MOA direct oral anticoagulants

A

Dabigatran - directly inhibits thrombin
Others - factor Xa inhibitors

214
Q

CI iron supplementation

A

Stomach issues, peptic ulcers, UC
Hemochromatosis, hemolytic anemia

215
Q

Folic acid supplementation AE

A

Flushing, bronchospasm, malaise, skin rash

216
Q

What are the GLP 1 agonists?

A

Dulaglutide
Liraglutide

217
Q

CI/AE of GLP1 agonists?

A

CI: renal impairment, fhx medullary thyroid cancer/MEN2

AE: inc risk pancreatitis, n/v/d, wt loss

218
Q

AE insulin

A

Wt gain
Hypoglycemia
Hypokalemia

219
Q

BB warning estrogen or progesterone therapy

A

Inc risk endometrial CA and breast CA
Inc risk dementia in women >65

220
Q

BB warning testosterone

A

Secondary exposure in women and children

221
Q

CI/AEs 5 alpha reductase inhibitors

A

CI: women of childbearing age, pregnancy, children

AE: inc risk high grade prostate cancer

222
Q

CI for pharmaceuticals for diarrhea

A

Acute UC, colitis, bacterial diarrhea (inc risk of toxic megacolon), pregnancy, dehydration

223
Q

Class and uses for loperamide

A

Opioid analogue; acute nonspecific diarrhea/chronic IBD

224
Q

Class and uses for Diphenoxylate/atropine

A

Diarrhea opioid; prolongs transit time

225
Q

Class and uses for Octreotide

A

Somatostatin analogue/GH antagonist
Diarrhea/flushing in cancer

226
Q

Meds for N/V suffixes

A

-zines (be careful, there are other meds with -salazine)
Diphenhydramine
Ondansetron
Metoclopramide

227
Q

Class and uses for Promethazine

A

Phenothiazine derivative; antidopaminergic, anticholinergic, antihistamine

Tx motion sickness

228
Q

CI/AE promethazine

A

AE: CNS depression, post op pain, anticholinergic effects

CI: inc mortality in elderly with dementia induced psychosis

229
Q

Class/uses and AE/CI for Meclizine

A

H1 antagonist; tx motion sickness

AE: CNS depression, sedation
CI: other H1 drugs/CNS depressants

230
Q

Class for diphenhydramine

A

H1 antagonist

Used for allergic reactions, N/V

231
Q

Class and uses for Scopolamine

A

PS Lytic, tx motion sickness

232
Q

AE/CI scopoloamine

A

AE: drowsiness, xerostomia (dry mouth)
CI: angle closure glaucoma

233
Q

Class and uses for Ondansetron

A

SSR antagonist, 5HT3 receptor blocker
Tx N/V from chemo

234
Q

Class and uses for Metoclopramide

A

Antiemetic; blocks dopamine and serotonin receptors

Tx: GERD, diabetic gastroparesis, N/V from chemo

235
Q

AE metoclopramide

A

Tardive dyskinesia (irreversible) with use > 12 weeks

236
Q

Class and uses for Docusate

A

Stool softener; pulls water into fecal matter

237
Q

Class and uses for Sodium phosphate enema

A

Saline laxative; used before colonoscopy

238
Q

List some bulk forming and osmotic supplements

A

Bulk forming; Psyllium (take w water)
Osmotic: magnesium, vitamin C

239
Q

Class and uses for Sucralfate

A

Pepsin inhibitor
Tx: duodenal ulcers

240
Q

Class and uses for Misopristol

A

Prostaglandin E1 analog

Dec risk of bleeding ulcers due to NSAID use

241
Q

CI/AE misopristol

A

CI: pregnancy (abortifacient)

242
Q

Class and uses for Cimetidine

A

H2 antagonist antacid

243
Q

AE/CI cimetidine

A

Inc serum albendazole concentrations

244
Q

PPI sufffixes/names and differences

A

-prazole

Omeprazole - first rx for GERD
Pantoprazole - IV form available
Lansoprazole - oral diss tablets and suspension
Esomeprazole - longer duration/more bioavailability

245
Q

Uses for proton pump inhibitors

A

GERD
Zollinger-Ellison syndrome
Erosive esophagitis

246
Q

AE/CI PPIs

A

Inc risk hip fractures
B12 malabsorption
Rebound hypersecretion when d/c

247
Q

Drug classes used for IBD

A

Mild-moderate: 5-aminosalicylates
Mod-severe (short term): corticosteroids
Mod-severe with other tx failure: biological/TNF blockers

248
Q

Suffixes and names for the 5-aminosalicylates

A

-Salazine (be careful not to mix up with -zine from N/V meds)

Sulfasalazine
Mesalazine

249
Q

What are 5-aminosalicylates used for?

A

Mild-moderate UC and some forms of CD

250
Q

AE 5-aminosalicylates

A

Gastric distress, HA, N/V, oligospermia, anorexia, fever

251
Q

What drug class is used for short-term management of moderate to severe IBD flares?

A

Corticosteroids

252
Q

What corticosteroids are used for IBD flares?

A

Budesonide (grapefruit inc concentration, echinacea dec)
Prednisone
Prednisolone (better choice than prednisone w liver dz because doesnt require conversion by liver to become active)
Methylprednisone
Dexamethasone (potent, long duration of action)

253
Q

CI/AE corticosteroids

A

Taper to avoid adrenal insufficiency
Long term risks include osteoporosis, weight gain, DM, and inc risk of infection

254
Q

AE biologics/TNF blockers

A

Infection
Lymphoma
Lupus
TB activation
Bone marrow failure

255
Q

Class and uses for Adalimumab

A

TNF blocker, sub Q injection; modulates inflammation
Severe IBD, psoriasis

256
Q

Class and uses for Infiximab

A

TNFa blocker, IV - IBD flares

257
Q

AE/CI infiximab

A

Lupus like syndrome

258
Q

Class and uses for Ursodeoxycholic acid

A

Bile acid supplement
Tx: primary biliary cirrhosis

259
Q

AE/CI ursodeoxycholic acid

A

AE: back pain, arthralgia, arthritis, alopecia, pharyngitis

260
Q

Class and uses for Dicyclomine

A

Anticholinergic, antispasmodic
Dec gastric acid secretion

Tx: IBS

261
Q

Class and uses for Hyoscyamine

A

Inhibits Ach in periphery

Adjunct tx peptic ulcers, neurogenic bladder/bowel/IBS, visceral spasm, spastic bladder, “drying agent” in rhinitis

262
Q

AE/CI hyoscyamine/Anticholinergics

A

CI: glaucoma, obstructive pathologies, severe UC, myasthenia gravis

263
Q

Class and uses for Phentermine

A

SympathoMIMETIC amine
Anoretic; Decreases appetite

264
Q

penicillins (class) MOA/uses

A

inhibits cell wall synthesis
bactericidal
gram + organisms

265
Q

penicillin uses/AEs

A

gram+cocci, anaerobes
syphilis
AE: N/V, rash, seizure anaphylaxis, neurotoxic, nephrotoxic

266
Q

amoxicillin class/uses

A

penicillin
gram+/-
prophylaxis for dental procedures

267
Q

are penicillins safe during breastfeeding?

A

generally yes

267
Q

ampicillin class/uses

A

penicillin
gram+/-
prophylaxis for dental procedures

268
Q

amoxicillin/clauvulanate uses

A

clauv addition makes amoxicillin effective against beta lactamase producing organisms

269
Q

cephalosporins MOA/uses/AE

A

bactericidal, inhibit cell wall synthesis
broad spectrum
AE: maculopapular rash, serum sickness, GI distress
some pts have cross allergy with penicillin

270
Q

are cephalosporins safe during breastfeeding?

271
Q

cephalexin class/uses

A

cephalosporin 1st gen
gram - coverage
gets into CSF
URI/GI/cutaneous

272
Q

cefuroxime class/uses

A

2nd gen cephalosporin
more gram -
URI, GI, STI, lyme

273
Q

ceftriaxone class/uses

A

3rd generation cephalosporin
gonorrhea

274
Q

chlamydia tx

A

doxycycline
azithromycin

275
Q

cefdinir class/uses

A

3rd gen cephalosporin

276
Q

cefepime class/uses

A

4th gen cephalosporin

277
Q

ceftaroline class/uses

A

5th gen cephalosporin
MRSA

278
Q

tetracyclines MOA & AE

A

broad spectrum, inhibit protein synthesis

AE: intracranial HTN, GI distress, rash, photosensitivity, prolongs QT, can cause permanent discoloration of teeth enamel in children
CI: pregnancy, children <8, breastfeeding

279
Q

are tetracyclines safe for breastfeeding?

A

NO not safe for pregnancy or breastfeeding

280
Q

doxycycline class/uses

A

tetracycline
chlamydia, lyme, acne, periodontal dz

281
Q

minocycline class / uses

A

same as doxy;
chlamydia, lyme, acne, periodontal dz

282
Q

macrolide abx suffix

283
Q

macrolide MOA/AE

A

bacteriostatic, target bacterial DNA synthesis

AE: prolong QT interval, acute cholestatic hepatitis

284
Q

are macrolides safe during pregnancy/breastfeeding?

A

NO pregnancy
yes breastfeeding

285
Q

azithromycin class/MOA

A

macrolide, aminoglycoside
bronchitis, non-gonococcal urethritis, cervicitis, chancroid, chlamydia

NOT SAFE IN PREG

286
Q

clarithromycin class/MOA

A

macrolide, aminoglycoside
PUD triple therapy, bronchitis, non-GC urethritis, cervicitis, chancroid

NOT SAFE IN PREGNANCY

287
Q

erythromycin class/MOA

A

macrolide
m pneumonia, pertussis, neonatal c pneumonia, strep throat, URI, gram -

288
Q

neomycin/polymixin b/hydrocortisone class/uses and AE/CI

A

aminoglycoside (neomycin)
otitis externa, other surface infxns
AE: neomycin is OTOTOXIC, can cause perm SN hearing loss
CI: neomycin allergy; dont rec for first time user

289
Q

gentamicin class/MOA, AE/CI

A

aminoglycoside
optic drops; conjunctitivits, iritis, etc

AE: ototoxic

290
Q

clindamycin class/MOA and AE/CI

A

lincosamide; alternative to penicillin
gram + cocci and many anaerobes

AE: c diff

291
Q

vancomycin class/MOA

A

glycopeptide;
vanquish MRSA, infective endocarditis, pseudomembranous colitis from c diff
gram +

292
Q

sulfonamides MOA

A

interfere with bacterial folic acid synthesis

293
Q

sulfamethoxazole/trimethoprim class/MOA and AE/CI

A

sulfonamide
UTI, OM, URI, pneumocystis, travelers diarrhea

AE: N/V, rash, seizures, nephrotoxic, hepatic necrosis, dermatitis, SJS/TEN

CI: pregnancy/BF, G6PD def, infants with hyperbilirubinemia

294
Q

sulfacetamide class/MOA

A

sulfonamide
acne, seb derm, conjunctivitis, and other superficial infxns

295
Q

nitrofurantoin class/MOA, uses, AE/CI

A

nitrofuran
bacteriostatic at low conc, bactericidal at high

UTI, take w food

CI: G6PD def, last month of pregnancy, BF, renal impairment

296
Q

floroquinolones MOA & AE/CI

A

broad spectrum

AE: BLACK BOX (tendinopathies/achilles tendon rupture), cartilage damage, peripheral neuropathy, ototoxicity

CI: breastfeeding, <18 (can arrest growth plate in children)

297
Q

are flouroquinolones safe during breastfeeding?

298
Q

ciprofloxacin class/MOA & CI/AE

A

flouroquinolone * BB tendinopathy*
broad spectrum; UTI, URI, cutaenous/joint/bone/abdominal infxns

caution: inc risk of nephrotoxicity when used with cyclosporine

299
Q

levofloxacin class, MOA, CI/AE

A

flouroquinolone * BB tendinopathy*
broad spectrum; UTI, URI, cutaenous/joint/bone/abdominal infxns

caution: inc risk of nephrotoxicity when used with cyclosporine

300
Q

rifaximin class/MOA, uses

A

bacteriostatic abx
inhibits DNA and RNA
c diff, IBS, diarrhea

301
Q

antitubercular drugs MOA, AE/CI

A

inhibits cell wall in mycobacterium tuberculosis

AE: hepatotoxic, nephropathies, GI disturbance, rash, sexual side effects

Caution: must be used long term (12-18 months) which causes severe hepatotoxicity and depletes B6

302
Q

what are the antitubercular drugs?

A

isoniazid
rifampin

303
Q

isoniazid flouroquinolone class/MOA/uses

A

antitubercular; inhibits cell wall synthesis in mycobacterium tuberculosis

304
Q

rifampin class/MOA/uses

A

antitubercular; inhibits cell wall synthesis in mycobacterium tuberculosis

305
Q

fluconazole class, uses, AE/CI

A

triazole antifungal
AE: hepatotoxic
caution: BF with premature infant

306
Q

ketoconazole class, uses, AE/CI

A

triazole antifungal; similar to fluconazole

307
Q

nystatin class, uses, AE/CI

A

antifungal
PO/PV topical for candida; poorly absorbed

308
Q

terbinafine class, uses, AE/CI

A

antifungal; onychomycosis

caution: hepatotoxicity (monitor LFTs)

309
Q

what are drugs that require therapeutic drug monitoring?

A

digoxin
pheytoin
lithium
carbamazepine
theophylline

NPLEX II TIA (21 decks)

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