ALL PHARM Flashcards
1
Q
what are CCBs used for?
A
HTN, arrythmias
2
Q
what are ACE-inhibitors used for?
A
uncomplicated HTN, good choice for 55+
3
Q
what are beta blockers used for?
A
HTN, arrythmias
4
Q
diltiazem drug class
A
CCB
5
Q
amlodipine drug class
A
CCB (DIHYDROPYRIDINE)
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
7
Q
are there any adverse effects or CI for amlodipine?
A
CI: preg, CHF (all CCB)
AEs: depletes potassium
8
Q
verapamil drug class
A
CCB
9
Q
CI diltiazem
A
pregnancy, CHF (all CCB)
10
Q
are there any adverse effects or CI for verapamil?
A
CI: pregnancy, CHF (all CCB)
AE: depletes vitamin E
11
Q
what are the beta blockers? which are the specific B1 BBs?
A
-olols
B1 specific: atenolol, metoprolol
12
Q
CIs of beta blockers
A
asthma
diabetes
AV bloc/sinus Brady/sick sinus syndrome
13
Q
AEs beta blockers
A
rebound HTN if not tapered properly
14
Q
what are the ACE inhibitors?
A
-prils
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
16
Q
what are the ARBs used for?
A
uncomplicated HTN
often used if someone is having ACEi SEs
17
Q
what are the ARBs?
A
-sartans
18
Q
are there any AEs or CI for ARBs?
A
CI: pregnancy
AE: hyperkalemia, headache, dizziness
Avoid abrupt discontinuation
19
Q
what are the alpha 2 agonists?
A
clonidine
20
Q
what is clonidine used for?
A
emergency BP lowering
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
22
Q
what are the alpha 1 antagonists?
A
-zosins
23
Q
what are alpha 1 antagonists (alpha blockers) used for?
A
HTN, BPH (dec norepi > dec sys resistance)
24
Q
are there any AEs or CIs for alpha 1 antagonists?
A
AE: syncope (1st dose), anesthia, rare priapism or ED
25
what are the sympathomimetics? what are they used for?
epinephrine
HF, bradycardia, stabilization before pacemaker implantation
26
what are the K wasting diuretics?
thiazide (HCTZ)
furosemide (loop)
27
aer there any CI or AE for the K wasting diuretics?
CI: sulfonamide drugs
AE: hypokalemia, hypertriglyceridemia, inc risk gout, hyperglycemia
28
what are the K sparing diuretics?
triamterene
spironolactone
29
what drug class are the statins?
HMG CoA Reductase inhibitors
30
what is cholesevalam?
bile sequestrant
31
what is gemfibrozil?
fibrate; decrease FFA uptake by liver > lowers VLDL
may inc HDL
32
are there any AEs or CIs for gemfibrozil?
AE: inc homocysteine, DVT, SOB, PE, hemoptysis/URI
CI: liver dz, renal dz, gallbladder dz
Require dose reductions with renal insufficiency
33
what is ezetimibe?
cholesterol absorption inhibitor
34
are there any adverse effects or CIs for ezetimibe?
CI: severe liver disease, cyclosporine, fibrates, pregnancy
AE: inc LFTs (esp with statins), diarrhea, URI, myalgias
35
what are the antiarrythmics?
class I - Na ch blockers: lidocaine, flecicaine
class III - k channel blockers: amiodarone
36
are there any AEs or CI for class I antiarrythmics?
CI: amiodarone, CYP450, digoxin, fluoxetine, paroxetine
37
are there any AEs or CI for class III antiarrythmics?
AEs: pulmonary toxicity, hyper/hypo thyroid, AV block, bradycardia, tremors, blue skin, liver enzyme fluctuations
short term use only, many toxicities ** BB warning
38
what is digoxin?
glycoside; used for HF and afib (rate control)
39
are there any AEs or CIs for digoxin?
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
40
what are the cardiac vasodilators/nitrates?
nitroglycerin
hydralazine
isosorbide monocitrate
41
are there any AEs or CI for the cardiac vasodilators/nitrates?
AE: headache, flushing, tolerance, upset stomach
CI: PDE5 inh (sildenafil)
NG CI in sx hypotension, severe anemia, inc ICP, marked Brady or tachy
42
are there any AEs or CI for hydralazine?
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
43
are there any AEs or CI for isosorbide monocitrate?
CI: PDE inhibitors like sildenafil
44
what is a risk of IV potassium chloride?
AP termination > death
45
what is benzoyl peroxide usually used for and what is its MOA?
comolytic, bactericidal
acne
46
what is isotretinoin usually used for and what is its MOA?
dec sebum; acne
47
are there any CIs or AEs for isotretinoin?
black box warning for birth defects
48
what is tretinoin usually used for and what is its MOA?
synth vit A; acne
flammable
49
what are topical sterids typically used for in dermatology?
eczema
50
mometasone drug class and uses
topical steroids; eczema, asthma, hay fever
51
fluocinonide drug class and uses
topical steroid; eczema
52
triamcinolone drug class and uses
topical steroid; eczema
stronger and longer lasting
53
clobetasol proprionate drug class and uses
topical steroid; eczema
54
are there any AEs or CIs for clobetasol proprionate?
AEs: systemic absorption can lead to reversible HPA axis suppresion >
cushings, hyperglycemia, glucosuria, thinning skin/elasticity
55
mupirocin drug class and uses
topical antimicrobial; MRSA, impetigo, wounds
56
sulfacetamide drug class and uses
antimicrobial; acne, seb derm
57
permethrin drug class and uses
scabies, lice
58
are there any AEs or CIs for permethrin?
AEs: pruritis, edema, rash, burning
59
calcipotriol drug class and uses
synthetic vit D; psoriasis
60
are there any CIs or AEs for calcipotriol?
CI: do not use on face
AEs: vit D toxicity, hypercalcemia, dermatitis
61
adalimumab drug class and uses
TNF inhibitor; inflammation modulation
psoriasis, IBD
62
selenium disulfide drug class and uses
used for dandruff, seb derm, tinea
63
imiquimod drug class and uses
immunomodulator; act keritosis, genital warts
64
are there any AEs or CIs of imiquimod?
AEs: local inflammation, flu like sx
65
MOA botox
blocks Ach from NMJ
66
ipillimumab drug class and uses
antineoplastic; melanoma
67
are there any AEs or CIs for ipillimumab?
CIs: pregnancy, chronic infections, MS, immunosuppressed
test for TB before initiation
68
bupivacaine drug class and uses
long acting Na inhibitor; anesthetic
69
procaine drug class and uses
short acting Na inhibitor; anesthetic
70
olopatadine drug class and uses
opth H1 antagonist; allergic conjunctivitis
71
atropine drug class and uses
parasympathoLYTIC; blocks Ach
cycloplegia (accomodation) and mydriasis (pupil dilation)
72
nepafenac drug class and uses
NSAID; pain and inflammation post cataract surgery
73
cyclosporine drug class and uses
opth; chronic dry eyes, scleroderma, sjogrens (oral form used for organ rejection prevention)
74
latanoprost drug class and uses
opth; PG analog; dec IOP by inc aq humor outflow
ocular HTN, glaucoma
75
timolol drug class and uses
BB that dec aq hum formation; glaucoma, ocular HTN
76
are there any AEs or CIs for timolol?
CI: COPD, bronchial asthma, bradycardia, AV block
77
pilocarpine drug class and uses
cholinergic agonist; inc outflow aq humor
glaucoma, dry mouth
78
sulfacetimide drug class and uses
abx; conjunctivitis, superficial ocular infxn, acne, seb derm
78
are there any AEs or CIs for pilocarpine?
AEs: poor low light vision, retinal detachment, iritis
79
gentamicin drug class and uses
conjunctivitis, kerativitis, corneal ulcers, blepharitis
80
erythromycin drug class and uses
superficial ocular lesions
81
DHEA actions
Inc estrogen and testosterone
Dec cortisol
82
Testosterone is a schedule ___ drug
III
83
Testosterone is used in what scenarios
Testosterone <300
Gender affirming care
84
AE testosterone
Transfer to female partner
Peliosis hepatic (blood cysts in liver/spleen)
Liver tumors
Inc LDL
85
E1 name and uses
Estrone
Menopause
Osteoporosis prophylaxis
Marker for menopause and post CA
86
E2 name, forms, and uses
Estradiol
Oral, patch, transdermal
Menopause, osteoporosis
87
E3 name, uses
Estriol
Menopause
Protective
88
What estrogen is highest in pregnancy?
Estriol (E3)
89
What is the strongest natural estrogen?
Estradiol (E2)
90
What is the weakest natural estrogen?
Estriol (E3)
91
Conjugated estrogens are used for what conditions
Menopause
Breast CA
AUB
92
What is pregnenolone? What is it used to treat?
Precursor steroid;
Memory issues
93
Oral micronized progesterone; what is it and what is it used for?
Progestin
Contraception
Amenorrhea
PMS
94
Levonorgestrel; what is it and what is it used for?
Plan B, Mirena
Progestin;
Contraceptive
Menorrhagia
95
Medroxyprogesterone acetate; what is it and what is it used for?
Depo; progestin
Contraception
Endo
Prevention of endometrial hyperplasia with use of exogenous estrogen
AUB
Secondary amenorrhea
96
Norethindrone; what is it and what is it used for?
Progestin only contraceptive
97
Megestrol acetate; what is it and what is it used for?
Progestin;
Appetite stimulation
Cachexia
Breast/endo CA
98
What do the combined oral contraceptives contain? What is included in this class?
Estrogen/progestin
- / ethinyl estradiol
Drospirenone -
Norgestimate -
Norelgestromin -
99
CI / AEs of combined oral contraceptives
CI:
smokers
>35
Inc GB dz
100
Leuprolide class/action and uses
Inhibits gonadotropin release
Tx: endo, fibroids
101
Clomiphene class/action and uses
Binds to estrogen receptors/ stim ovulation
Tx;
infertility in PCOS
Psychogenic amenorrhea
Post OCs
102
CI/AEs clomiphene
Potential for ovarian hyperstimulation and liver dysfunction
103
Metronidazole class/action and uses
Bactericidal;
BV, PID
104
HCG class/action and uses
Preg test, induce ovulation
Stimulation test for hypogonadism/male infertility
105
Finasteride class and uses
5 alpha reductase inhibitor (inh testosterone > DHT)
Tx:
Urinary retention
BPH
Hair loss
106
Alpha 1 antagonists suffix and uses
-zosins and tamulosin
HTN/BPH
107
Alpha 1 antagonists AE/CIs
AE: syncope (1st dose), priapism,ED,asthenia, intraoperative floppy iris sydrome during cataract surgery, abnormal erections/ejaculation
108
How does tamulosin differ from the rest of the alpha 1 antagonists?
Not a -zosin
More selective for urinary over BP
Tx: urinary retention, BPH
109
Phenazopyridine class, uses
Urinary analgesic for pain, burning, urgency, frequency
1st line for IC
110
Phenazopyridine AE/CIs
AE:
Discolored contacts
Orange urine
Interferes with UA results
111
Sildenafil class and uses
Phosphoest. Type 5 inhibitor
ED
112
Sildenafil AE/CIs
AE:
Flushing, sudden cardiac death, vision loss
113
Bethanechol class/uses
PS mimetic
Tx:
Urinary retention
Dry mouth
Post Op/PP retention
114
Bethanechol AE/CIs
CI:
Drug/drug with other PSmimetics (such as pilocarpine)
115
Anticholinergics/Ach antagonists urinary uses
Overactive bladder
Spastic conditions
116
What are the anticholinergics/ACh antagonists?
Tolterodine
Oxybutynin
Solifenacin
117
CI/AEs anticholinergics/ACh antagonists
AE: dry mouth, dry eyes, constipation, HA, dizziness
CI: narrow angle glaucoma, gastric/uro retention
118
What anticholinergics/ACh antagonists are more/less likely to have SEs?
Oxybutynin = inc incidence
Solifenacin = dec incidence
119
What medications are used for DM2?
Canagliflozin
Dulaglutide
Exenatide
Livaglutide
Glyburide
Metformin
Pioglitazone
Sitaglipsin
120
Canaglifozin drug class, MOA, uses
SGLT2 antagonist; dec reabsorbed filtered glucose
DM2
121
Canagliflozin AE/CIs
AE: UTI, dehydration, DKA, bladder cancer, hyperkalemia, wt loss, yeast infections
CI: CKD, recurrent UTI, dialysis
122
Dulaglutide class/MOA/uses
Incretic mimetic (dec blood glucose)
DM2
123
Dulaglutide CI/AEs
BB warning: thyroid C cell tumors
124
Exenatide class/uses
GLP1 receptor agonist
DM2
125
Liraglutide class/MOA/uses
GLP1 receptor agonist; long acting
Inc glucose dependent insulin section, dec inappropriate glucagon secretion, slows gastric emptying
Dec A1C 1% in DM2
126
Glyburide class/MOA/uses
Sulfonylurea; inc insulin
Dec A1C 1-2% in DM2
127
CI/AEs Glyburide
AE: hypoglycemia, wt gain, GI upset, skin rxns, photosensitivity
CI: DKA, sulfa allergy
128
Metformin class/MOA/uses
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
Metformin AE/CIs
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
Pioglitazone class/MOA/uses
Thiazolidinedione; inc target cell response to insulin, dec hepatic gluconeogenesis
Dec A1C by 2& in DM2
131
Pioglitazone AE/CI
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
Sitagliptin class/MOA/uses
DPP4 inhibitor; prolongs active incretin (inc insulin sec) for glucose regulation
DM2
133
AE/CI Sitagliptin
AE: flu like sx, hypoglycemia with other DM2 meds, pancreatitis, rash, edema
CI: renal insufficiency
134
Name the types of insulin, their time of onset, and duration of effect
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
Fludocortisone uses
Adrenal hypoplasia, Addisons
136
Glucagon uses
Tx hypoglycemia
137
Bromocriptine class/uses
Dopamine agonist
Tx neuro disorders, acromegaly
138
Furosemide class/uses
K wasting loop diuretic
HTN/siADH
139
Lugol’s solution components/uses
Elemental iodine and potassium iodide
LOW dose tx HYPOthyroid
HIGH dose tx HYPERthyroid
140
USP thyroid components/use
Pig T3/T4
Hypothyroidism
141
Levothyroxine class/uses/CI
T4; hypothyroidism
CI: uncorrected adrenal insufficiency, acute MI, thyrotoxicosis
**BB warning ineffective when used for wt loss and potentially toxic, esp if euthyroid
142
Liothyronine class/uses
T3;
Tx myxedema coma
143
Methimazole class/uses
Inhibits synthetic thyroid hormone
Tx hyperthyroid
144
Methimazole CI/AE
CI: 1st trimester
145
Propylthiouracil class/MOA/uses
Inhibits thyroid peroxidase and conversation of T4>T3 in periphery
Tx: thyroid storm
146
Propylthiouracil AE/CIs
AE: inc AST/ALT, fatal hepatotoxicity
147
Apixaban class/uses
Oral anticoagulant for nonvalvular a fib
148
Aspirin uses
NSAID traditional use
Anticoagulation
149
Clopidogrel class/uses
Platelet aggregation inhibitor
Tx atherosclerosis, MI, stroke, PAD, prevention of thrombotic complications
150
Clopidogrel AE/CIs
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
Heparin class/MOA/uses
Anticoagulant; LOW dose inhibitors factor Xa, HIGH dose inactivates factors VIII, IX, X, XII, XII, thrombin, and inhibits fibrinogen > fibrin
152
Heparin CI/AEs
CI: estrogens, erythromycin, warfarin
153
Warfarin class/MOA/uses
Anticoagulant; interferes with hepatic synthesis of vitamin K
Stroke prevention (a fib/flutter), DVT/PE
154
Phytonadione class/MOA/uses
Synthetic vit K1; tx blood clots
155
Phytonadione CI/AE
CI: warfarin
156
Enoxaparin class/MOA/uses
Anticoagulant; inhibits factor Xa, doesnt inc Pt or Ptt
157
Enoxaparin CI/AEs
Spinal/epidermal hematomas
158
Dabigaltran class/MOA/uses
Anticoagulant, direct thrombin inhibitor
159
Dabigaltran AE/CIs
AE: GI upset due to inc acidification
CI: p-glycoprotein pump inhibitors (quinidine, verapamil, amiodarone)
160
rivaroxaban class/MOA/uses
Anticoagulant; inhibitors factor Xa, platelet activation, and fibrin clot
161
Rivaroxaban CI/AEs
CI: liver dz, end stage kidney dz
BB warning: do NOT discontinue without speaking to dr due to inc risk stroke!
162
Desmopressin class/MOA/uses
DDAVD/syn vesmopressin
Inc renal permeability to h20 > dec urine vol > inc osmolality
Tx: DI, coagulation disorders
163
Pentoxifylline class/MOA/uses
Xanthine derivative/PDE inh (dec blood viscosity)
Tx: PAD, dec pain/numbness/weakness in extremities
164
Pentoxifylline AE/CIs
AE: GI upset
165
Alprostadil class/MOA/uses
Vasodilator, PG; tx ED, congenital heart defects
166
Epoetin Alfa class/MOA/uses
Stimulates erythropoiesis
Tx anemia of chronic disease, use with CA therapy
167
DMPS class/MOA/uses
Chelator of gold, mercury, arsenic
168
DMPS CI/AE
CI: liver insufficiency, pregnancy cat C
169
DMSA class/MOA/uses
Chelates lead, mercury, arsenic, gold
170
DMSA CI/AE
CI: pregnancy cat C
171
Edetate calcium disodium class/MOA/uses
Chelates lead (out of bone), calcium, zinc, manganese, and iron
Tx: lead poisoning, hypercalcemia, CAD, digoxin arrhythmias
172
Edetate calcium disodium CI/AEs
CI: renal failure, hypokalemia, hypokalemia, pregnancy cat B
173
Deferoxamine class/MOA/uses
Chelates iron
Tx: hemochromatosis, thalassemia, aluminum toxicosis with dialysis
174
Deferoxamine CI/AEs
AE: neurotoxic long term, inc risk cataracts
CI: kidney dz, pregnancy category C
175
Penicillamine class/MOA/uses
Chelates copper, mercury, lead(urine); dec IgM RF
Tx: Wilson’s, cyst inertia, RA / used w heparin in IVF
176
Penicillamine CI/AE
AE: skin lesions (long term use), leukopenia, aplastic anemia
CI: penicillin allergy, renal dz, synergistic toxicity with gold, chloroquine, phenylbutisone; pregnancy category C
177
Anastrazole class/MOA/uses
Aromatase inhibitor; irreversible inhibition of estrogen formation from androgen precursors
Tx: infertility, tx/prevent estrogen dependent breast CA
178
Anastrazole AE/CI
AE: inc risk osteoporotic fractures
179
Atezolizumab class/MOA/uses
Monoclonal ab;
Tx urothelial carcinomas, non small lung CA, hepatocellular carcinoma
180
Bicalutamide class/MOA/uses
Non steroidal anti androgen
Tx: stage D2 metastatic carcinoma of the prostate
181
Bicalutamide CI/AEs
CI: severe hepatic impairment (long half life)
182
Doxorubicin class/MOA/uses
Anthracycline; chemo; topoisomeras inhibitor
Tx: ovarian cancer, AIDS related kaposi sarcoma, multiple myeloma
183
Doxorubicin CE/AE
AE: myelosuppresion, cardiotoxicity, liver impairment
184
Paclitaxel class/MOA/uses
Mitosis inh;
Tx: metastatic breast CA, lung CA, pancreatic adenocarcinoma
185
Paclitaxel AE/CI
AE: neutropenia
186
Pembrolizumab class/MOA/uses
SCC tx
187
Vinblastine class/MOA/uses
Vinca alkaloid/mitosis inhibitor
IV use only
Tx: breast CA that is unresponsive to surgery/hormone therapy, Hodgkins
188
Trastuzumab class/MOA/uses
Monoclonal ab, HER 2 inhibitor
Tx: HER 2 + breast CA
189
Octreotide class/MOA/uses
GH antagonist/somatostatin mimetic; inhibits GH, glucagon, and insulin
Tx: GH receptor tumors, TSH secreting pituitary tumors, carcinoid syndrome, intestinal peptide secreting tumors
190
Octreotide AE/CI
AE: cardiac conduction disturbances, arrhythmias, GB sludge, hypo/hyper glycemia
191
Thalidomide class/MOA/uses
Inhibits angiogenesis
Tx: leprosy, multiple myeloma, solid and heme malignancies
192
Thalidomide AE/CI
Black box warning for birth defects
193
Megestrol acetate class/MOA/uses
Progestin with anti estrogenic properties; app stimulation for cachexia, breast/endo CA, OCP
194
5-fluorouracil class/MOA/uses
Inhibits DNA/RNA synthesis
Palliative management of carcinoma, narrow margin of therapy
195
5-Fluorouracil AE/CI
AE: heme toxicity, GI hemorrhage, death
196
Methotrexate class/MOA/uses
DMARD, immunosuppressant
Tx: breast CA, lung CA, non Hodgkin’s lymphoma
197
Valoxifene class/MOA/uses
Anti estrogen effect in uterus and breasts; prevention of breast CA
198
Tamoxifen class/MOA/uses
Adjunctive tx of breast CA, DCIS
199
Alkylating agents CI/AEs
BB - cumulative renal toxicity, myelosuppresion, N/V, Ototoxicity, anaphylaxis
200
What are the alkylating agents?
Cisplatin
Cyclophosphamide
201
Cisplatin class/MOA/uses
Chemo, cross links DNA
202
Cyclophosphamide class/MOA/uses
DMARD, cross links DNA
Tx: cancers of ovaries, blood, breast, lymph, nerves, retinoblastoma
203
Statins AE/CI
AE: hepatotoxicity, HA, myalgia, CPK inc
CI: pregnancy, liver dz, avoid grapefruit juice
204
Signs of digoxin overdose
Green/yellow halos around eyes
Loss of appetite, confusion, bradycardia, arrhythmias, double vision
205
Where along the urinary tract do loop diuretics act?
Ascending loop of henle
206
Where along the urinary tract do TZ diuretics act?
DCT
207
Where along the urinary tract do K sparing diuretics act?
CD
208
Furosemide CI/AE
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
CI/AE K sparing diuretics
AE: inc triglycerides, gynecomastia (spironolactone), skin rash
CI: anuria, renal impairment, hyperkalemia, BB warning for spironolactone for tumor risk
210
Warfarin CI/SE
CI: BB warning for major or fatal bleeding!, pregnancy (X)
AE: bleeding, skin necrosis, purple toe syndrome
211
What are the direct oral anticoagulants?
Apixaban
Rivaroxaban
Dabigatran
212
AE/CI direct oral anticoagulants
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
MOA direct oral anticoagulants
Dabigatran - directly inhibits thrombin
Others - factor Xa inhibitors
214
CI iron supplementation
Stomach issues, peptic ulcers, UC
Hemochromatosis, hemolytic anemia
215
Folic acid supplementation AE
Flushing, bronchospasm, malaise, skin rash
216
What are the GLP 1 agonists?
Dulaglutide
Liraglutide
217
CI/AE of GLP1 agonists?
CI: renal impairment, fhx medullary thyroid cancer/MEN2
AE: inc risk pancreatitis, n/v/d, wt loss
218
AE insulin
Wt gain
Hypoglycemia
Hypokalemia
219
BB warning estrogen or progesterone therapy
Inc risk endometrial CA and breast CA
Inc risk dementia in women >65
220
BB warning testosterone
Secondary exposure in women and children
221
CI/AEs 5 alpha reductase inhibitors
CI: women of childbearing age, pregnancy, children
AE: inc risk high grade prostate cancer
222
CI for pharmaceuticals for diarrhea
Acute UC, colitis, bacterial diarrhea (inc risk of toxic megacolon), pregnancy, dehydration
223
Class and uses for loperamide
Opioid analogue; acute nonspecific diarrhea/chronic IBD
224
Class and uses for Diphenoxylate/atropine
Diarrhea opioid; prolongs transit time
225
Class and uses for Octreotide
Somatostatin analogue/GH antagonist
Diarrhea/flushing in cancer
226
Meds for N/V suffixes
-zines (be careful, there are other meds with -salazine)
Diphenhydramine
Ondansetron
Metoclopramide
227
Class and uses for Promethazine
Phenothiazine derivative; antidopaminergic, anticholinergic, antihistamine
Tx motion sickness
228
CI/AE promethazine
AE: CNS depression, post op pain, anticholinergic effects
CI: inc mortality in elderly with dementia induced psychosis
229
Class/uses and AE/CI for Meclizine
H1 antagonist; tx motion sickness
AE: CNS depression, sedation
CI: other H1 drugs/CNS depressants
230
Class for diphenhydramine
H1 antagonist
Used for allergic reactions, N/V
231
Class and uses for Scopolamine
PS Lytic, tx motion sickness
232
AE/CI scopoloamine
AE: drowsiness, xerostomia (dry mouth)
CI: angle closure glaucoma
233
Class and uses for Ondansetron
SSR antagonist, 5HT3 receptor blocker
Tx N/V from chemo
234
Class and uses for Metoclopramide
Antiemetic; blocks dopamine and serotonin receptors
Tx: GERD, diabetic gastroparesis, N/V from chemo
235
AE metoclopramide
Tardive dyskinesia (irreversible) with use > 12 weeks
236
Class and uses for Docusate
Stool softener; pulls water into fecal matter
237
Class and uses for Sodium phosphate enema
Saline laxative; used before colonoscopy
238
List some bulk forming and osmotic supplements
Bulk forming; Psyllium (take w water)
Osmotic: magnesium, vitamin C
239
Class and uses for Sucralfate
Pepsin inhibitor
Tx: duodenal ulcers
240
Class and uses for Misopristol
Prostaglandin E1 analog
Dec risk of bleeding ulcers due to NSAID use
241
CI/AE misopristol
CI: pregnancy (abortifacient)
242
Class and uses for Cimetidine
H2 antagonist antacid
243
AE/CI cimetidine
Inc serum albendazole concentrations
244
PPI sufffixes/names and differences
-prazole
Omeprazole - first rx for GERD
Pantoprazole - IV form available
Lansoprazole - oral diss tablets and suspension
Esomeprazole - longer duration/more bioavailability
245
Uses for proton pump inhibitors
GERD
Zollinger-Ellison syndrome
Erosive esophagitis
246
AE/CI PPIs
Inc risk hip fractures
B12 malabsorption
Rebound hypersecretion when d/c
247
Drug classes used for IBD
Mild-moderate: 5-aminosalicylates
Mod-severe (short term): corticosteroids
Mod-severe with other tx failure: biological/TNF blockers
248
Suffixes and names for the 5-aminosalicylates
-Salazine (be careful not to mix up with -zine from N/V meds)
Sulfasalazine
Mesalazine
249
What are 5-aminosalicylates used for?
Mild-moderate UC and some forms of CD
250
AE 5-aminosalicylates
Gastric distress, HA, N/V, oligospermia, anorexia, fever
251
What drug class is used for short-term management of moderate to severe IBD flares?
Corticosteroids
252
What corticosteroids are used for IBD flares?
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
CI/AE corticosteroids
Taper to avoid adrenal insufficiency
Long term risks include osteoporosis, weight gain, DM, and inc risk of infection
254
AE biologics/TNF blockers
Infection
Lymphoma
Lupus
TB activation
Bone marrow failure
255
Class and uses for Adalimumab
TNF blocker, sub Q injection; modulates inflammation
Severe IBD, psoriasis
256
Class and uses for Infiximab
TNFa blocker, IV - IBD flares
257
AE/CI infiximab
Lupus like syndrome
258
Class and uses for Ursodeoxycholic acid
Bile acid supplement
Tx: primary biliary cirrhosis
259
AE/CI ursodeoxycholic acid
AE: back pain, arthralgia, arthritis, alopecia, pharyngitis
260
Class and uses for Dicyclomine
Anticholinergic, antispasmodic
Dec gastric acid secretion
Tx: IBS
261
Class and uses for Hyoscyamine
Inhibits Ach in periphery
Adjunct tx peptic ulcers, neurogenic bladder/bowel/IBS, visceral spasm, spastic bladder, “drying agent” in rhinitis
262
AE/CI hyoscyamine/Anticholinergics
CI: glaucoma, obstructive pathologies, severe UC, myasthenia gravis
263
Class and uses for Phentermine
SympathoMIMETIC amine
Anoretic; Decreases appetite
264
penicillins (class) MOA/uses
inhibits cell wall synthesis
bactericidal
gram + organisms
265
penicillin uses/AEs
gram+cocci, anaerobes
syphilis
AE: N/V, rash, seizure anaphylaxis, neurotoxic, nephrotoxic
266
amoxicillin class/uses
penicillin
gram+/-
prophylaxis for dental procedures
267
are penicillins safe during breastfeeding?
generally yes
267
ampicillin class/uses
penicillin
gram+/-
prophylaxis for dental procedures
268
amoxicillin/clauvulanate uses
clauv addition makes amoxicillin effective against beta lactamase producing organisms
269
cephalosporins MOA/uses/AE
bactericidal, inhibit cell wall synthesis
broad spectrum
AE: maculopapular rash, serum sickness, GI distress
some pts have cross allergy with penicillin
270
are cephalosporins safe during breastfeeding?
yes
271
cephalexin class/uses
cephalosporin 1st gen
gram - coverage
gets into CSF
URI/GI/cutaneous
272
cefuroxime class/uses
2nd gen cephalosporin
more gram -
URI, GI, STI, lyme
273
ceftriaxone class/uses
3rd generation cephalosporin
gonorrhea
274
chlamydia tx
doxycycline
azithromycin
275
cefdinir class/uses
3rd gen cephalosporin
276
cefepime class/uses
4th gen cephalosporin
277
ceftaroline class/uses
5th gen cephalosporin
MRSA
278
tetracyclines MOA & AE
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
are tetracyclines safe for breastfeeding?
NO not safe for pregnancy or breastfeeding
280
doxycycline class/uses
tetracycline
chlamydia, lyme, acne, periodontal dz
281
minocycline class / uses
same as doxy;
chlamydia, lyme, acne, periodontal dz
282
macrolide abx suffix
-romysin
283
macrolide MOA/AE
bacteriostatic, target bacterial DNA synthesis
AE: prolong QT interval, acute cholestatic hepatitis
284
are macrolides safe during pregnancy/breastfeeding?
NO pregnancy
yes breastfeeding
285
azithromycin class/MOA
macrolide, aminoglycoside
bronchitis, non-gonococcal urethritis, cervicitis, chancroid, chlamydia
NOT SAFE IN PREG
286
clarithromycin class/MOA
macrolide, aminoglycoside
PUD triple therapy, bronchitis, non-GC urethritis, cervicitis, chancroid
NOT SAFE IN PREGNANCY
287
erythromycin class/MOA
macrolide
m pneumonia, pertussis, neonatal c pneumonia, strep throat, URI, gram -
288
neomycin/polymixin b/hydrocortisone class/uses and AE/CI
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
gentamicin class/MOA, AE/CI
aminoglycoside
optic drops; conjunctitivits, iritis, etc
AE: ototoxic
290
clindamycin class/MOA and AE/CI
lincosamide; alternative to penicillin
gram + cocci and many anaerobes
AE: c diff
291
vancomycin class/MOA
glycopeptide;
vanquish MRSA, infective endocarditis, pseudomembranous colitis from c diff
gram +
292
sulfonamides MOA
interfere with bacterial folic acid synthesis
293
sulfamethoxazole/trimethoprim class/MOA and AE/CI
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
sulfacetamide class/MOA
sulfonamide
acne, seb derm, conjunctivitis, and other superficial infxns
295
nitrofurantoin class/MOA, uses, AE/CI
nitrofuran
bacteriostatic at low conc, bactericidal at high
UTI, take w food
CI: G6PD def, last month of pregnancy, BF, renal impairment
296
floroquinolones MOA & AE/CI
broad spectrum
AE: BLACK BOX (tendinopathies/achilles tendon rupture), cartilage damage, peripheral neuropathy, ototoxicity
CI: breastfeeding, <18 (can arrest growth plate in children)
297
are flouroquinolones safe during breastfeeding?
NO
298
ciprofloxacin class/MOA & CI/AE
flouroquinolone *** BB tendinopathy***
broad spectrum; UTI, URI, cutaenous/joint/bone/abdominal infxns
caution: inc risk of nephrotoxicity when used with cyclosporine
299
levofloxacin class, MOA, CI/AE
flouroquinolone *** BB tendinopathy***
broad spectrum; UTI, URI, cutaenous/joint/bone/abdominal infxns
caution: inc risk of nephrotoxicity when used with cyclosporine
300
rifaximin class/MOA, uses
bacteriostatic abx
inhibits DNA and RNA
c diff, IBS, diarrhea
301
antitubercular drugs MOA, AE/CI
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
what are the antitubercular drugs?
isoniazid
rifampin
303
isoniazid flouroquinolone class/MOA/uses
antitubercular; inhibits cell wall synthesis in mycobacterium tuberculosis
304
rifampin class/MOA/uses
antitubercular; inhibits cell wall synthesis in mycobacterium tuberculosis
305
fluconazole class, uses, AE/CI
triazole antifungal
AE: hepatotoxic
caution: BF with premature infant
306
ketoconazole class, uses, AE/CI
triazole antifungal; similar to fluconazole
307
nystatin class, uses, AE/CI
antifungal
PO/PV topical for candida; poorly absorbed
308
terbinafine class, uses, AE/CI
antifungal; onychomycosis
caution: hepatotoxicity (monitor LFTs)
309
what are drugs that require therapeutic drug monitoring?
digoxin
pheytoin
lithium
carbamazepine
theophylline
