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NAPLEX D: > Clinical Fun Facts > Flashcards

Clinical Fun Facts Flashcards

1
Q

Drugs that INCREASE calcium

A

Thiazides, Ca, Vit D

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2
Q

Drugs that DECREASE calcium

A

heparin, bisphosphonate, loop diuretics

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3
Q

Drugs that DECREASE Mg

A

PPIs, loop diuretics

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4
Q

Drugs that INCREASE potassium

A

AE/ARB, K-sparing diuretics, aliskiren
Canagliflozin
Cyclosporine/tacrolimus
Enzalutamide

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5
Q

Drugs that DECREASE sodium

A

SSRIs, loops, carbamazepine, oxcarbazepine

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6
Q

Drugs that DECREASE bicarbonate

A

topiramate

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7
Q

Drugs that INCREASE bicarbonate

A

loops

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8
Q

The major CYP3A4 Inducers

A 
St John's wort
Phenytoin
Oxcarbazepine
Rifampin
Carbamazepine
Smoking
Phenobarbital
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9
Q

The major CYP3A4 inhibitor

A 
Protease inhibitors
Azoles
Cimetidine, cyclosporine, clarithromycin
Macrolides (not azithro)
Amiodarone
Non-DHP CCBs
Grapefruit
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10
Q

Agranulocytosis means???

A

Decrease in multiple cell lines

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11
Q

Gaussian distribution

A

NORMAL distribution

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12
Q

__ % of data within 1 SD

A

68%

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13
Q

Type I error is false negative or false positive?

A

False positive (a)

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14
Q

Type II error is false negative or false positive?

A

False negative (B)

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15
Q

Relative risk v relative risk reduction

A 
RR = rate in treatment v rate in control
RRR = 1 - RR (% less likely in treatment group)
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16
Q

Odds ratio

A

Odds of outcome WITH prior exposure v WITHOUT prior exposure

Expected/unexpected (so exposure+ x no exposure neg/exposure- x no exposure+)

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17
Q

Sensitivity

A 
# true positive/#w/condition
Good sensitivity = no false negatives
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18
Q

Specificity

A 
# true negative/# without condition
Good specifity = no falsae positives
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19
Q

Case control study??

A

Patients with a disease compared to those without the disease (retrospective)

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20
Q

Cohort study??

A

Patients with exposure compared to those without exposure (prospective!)

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21
Q

Which is better - cohort study or case control?

A

Cohort b/c it is prospective

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22
Q

Cost minimization?

A

Equal outcomes so which one is cheapest

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23
Q

Cost-benefit analysis?

A

Benefits - costs –> but the benefits have to be measured in dollars

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24
Q

Cost-effectiveness analysis?

A

Which gets the best outcome per dollar - but both have to have the same outcome measurement

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25
Q

Cost-utility analysis?

A

Assesses outcomes including quality of life/morbidity assessment

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26
Q

Which pharmacoeconomic analysis is most commonly used?

A

Cost-effectiveness analysis

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27
Q

Antipsychotics do better at treating positive or negative symptoms??

A

Positive symptoms

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28
Q

Some drugs that cause psychosis?

A 
Anticholinergics
Cannabis
Dextromethorphan
Dopamine agonists (Sinemet, Requip, Mirapex)
Interferons
Stimulants
Steroids
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29
Q

Invega Sustenna (drug and timeframe)

A

Paliperidone - q4weeks

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30
Q

Abilify Maintenna (drug and timeframe)

A

Aripiprazole - q4weeks

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31
Q

Risperdal Consta (drug and timeframe)

A

Risperidone - q2weeks

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32
Q

Haldol Decanoate (drug and timeframe)

A

Haloperidol - q4weeks

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33
Q

Invega Trinza (drug and timeframe)

A

Paliperidone - q12weeks

Only after 4 months on Sustenna

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34
Q

Black-box warnings for all of the antipsychotics?

A

Worsening symptoms in patients with dementia

Stroke

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35
Q

Chlorpromazine - what potency?

A

Low potency

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36
Q

Thioridazine - what potency?

A

Low potency

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37
Q

Side effect of thioridazine

A

QTc prolongation

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38
Q

Side effect of loxapine

A

bronchospasm

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39
Q

Loxapine potency?

A

Moderate potency

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40
Q

What is the difference between ADEs for high and low potency antipsychotics?

A

High potency - moderate sedation and EPS

Low potency - more CNS effects and anticholinergic effects

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41
Q

Haloperidol - what potency?

A

High potency

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42
Q

Fluphenazine - what potency?

A

High

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43
Q

Thiothixene - what potency?

A

High

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44
Q

Trifluoperazine - what potency?

A

High

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45
Q

Perphenazine - what potency?

A

Moderate

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46
Q

Which of the T-drug antipsychotics causes QT prolongation?

A

Thioridazine

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47
Q

What are the EPS effects?

A 
Dystonia
Akathisia
Parkinsonism
Tardive Dyskinesia
Dyskinesia
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48
Q

Which of the EPS are irreversible?

A

tardive dyskinesia (lip smacking)

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49
Q

What population is most likely to experience dystonias?

A

Young males

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50
Q

How to treat Dystonia?

A

Diphenhydramine and benztropine

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51
Q

How to treat Parkinsonism?

A

Anticholinergics or propranolol (for tremors)

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52
Q

How to treat TD?

A

Stop drug and switch to low risk

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53
Q

How to treat akathisia?

A

Anticholinergics, propranolol, benzos (b/c akathisia has anxiety)

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54
Q

Non-EPS side effects of antipsychotics?

A 
Leukopenia, neutropenia, agranulocytosis
Seizures
CV - increased HR, orthostatic hypotension
Sexual dysfunction
bronchospasms (Loxapine)
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55
Q

Which of the antipsychotics has the most cardiovascular effects?

A

IV haloperidol

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56
Q

What 2nd gen APs cause the most metabolic effects?

A

Clozapine, olonzapine, quetiapine

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57
Q

Which 2nd gen antipsychotic has lowest EPS?

A

Quetiapine

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58
Q

Which 2n gen antipsych causes QT prolongation?

A

Ziprasidone

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59
Q

Which 2nd gen antipsych increase procalcitonin?

A

Risperidone and paliperidone

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60
Q

What are the requirements to use clozapine?

A

Two treatment failures, at least 1 a 2nd generation

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61
Q

How long is an adequate trial of antipsychotics?

A

4-6 weeks

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62
Q

Tell me about asenapine

A

Sublingual 2nd gen antipsychotic

Metallic aftertaste

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63
Q

Tell me about aripiprazole

A

AKA Abilify
Comes in IM long-acting Maintenna
Causes INSOMNIA, anxiety, akathisia
(Only one that’s insomnia)

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64
Q

Tell me about lurasidone

A

2nd Gen antipsychtoic
Latuda
Neutral metabolic effects
W/food

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65
Q

Tell me about olanzapine

A

Metabolic effects
CYP3A4 - smoking decreases conc
Sedation
Relprevv q2-4week injection, ODT

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66
Q

What’s special about Relprevv

A

Olanzapine IM injection - requires monitoring for 3 hours after injection

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67
Q

Tell me about Paliperidone

A

Invega
Ghost tablets in stools
Increases procalcitonin, EPS

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68
Q

Tell me about quetiapine

A

Seroquel
Lowest EPS
Metabolic effects, somnolence
Without food or <=300kcal for XR

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69
Q

Tell me about risperidone

A

Risperdal

EPS, increased procalcitonin levels

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70
Q

Tell me about ziprasidone

A

Geodon
Increased QTc
Take WITH food

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71
Q

What drug is used for psychosis with PD?

A

Pimavanserin

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72
Q

What drugs are used for TD?

A

Valbenazine (VMAT inhibitor)

Deutrabenazine

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73
Q

What are symptoms of neuroleptic malignant syndrome?

A

Hypertension, muscle rigidity, increase HR/BP/RR

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74
Q

Treatment of neuroleptic malignant syndrome?

A

Stop drug
Cool off with ice
Dantrolene/benzos for muscle relaxation

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75
Q

Progestin-only pills have what administration requirements?

A

Within 3 hours of the same time - or else need 48 hours of alternative contraception

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76
Q

What populations are good for POPs?

A

After childbirth - can be used with breastfeeding

Patients with migraine w/aura (estrogen contraindicated due to stroke risk)

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77
Q

What is the active ingredient in Depo-Provera

A

Medroxyprogesterone

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78
Q

what is unique about Xulane?

A

Has higher AUC –> increased thrombotic risk

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79
Q

Contraindications of estrogen?

A

h/o DVT/stroke, migraine w/aura, breast/ovary/liver cancer

uncontrolled htn

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80
Q

What’s special about drospirenone?

A

Progestin component - with highest VTE risk, lowest water retention/bloating, increases K+

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81
Q

ADE of medroxyprogesterone

A

Decreased BMD (supplement with Ca/Vit D)

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82
Q

How long medroxyprogesterone be used?

A

3 years

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83
Q

How long should back-up contraception be used after starting COC?

A

7 days

or 0 days if started w/in5 days of menses

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84
Q

What is the weight limit for the patch?

A

198 pounds

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85
Q

Which contraceptive needs back up x 1 week unless started on day 1 of menses?

A

Nuvaring

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86
Q

Water or oil-based lubricants?

A

water

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87
Q

What are 3 emergency contraceptives?

A

Paragard (within 5 days)
Plan B (levonogestrel x1 or x2 within 3 days or 5 off-label)
Ella (Ulipristal acetate within 5 days)

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88
Q

ADEs of Plan B

A

NAUSEA

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89
Q

ADEs of Ella

A

HA, nausea, abdominal pain

Delays ovulation - so period can be weird

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90
Q

1st-line treatment for female infertility

A

Clomiphene - SERM

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91
Q

2nd-line treatment for female infertifility

A

Gonadotropins (ie FSH/LH)

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92
Q

What people need a reduction in PDE-5 starting dose?

A

> 65 years old
Taking CYP3A4 inhibitor
Have renal/liver dysfunction
—50% reduction

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93
Q

Time before sex of the PDE-5 inhibitors?

A

Sildenafil: 60 minutes
Tadalafil: 30 minutes
Aranafil: 15-30 minutes
Vardenafil: 60 minutes

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94
Q

Starting doses of PDE-5 inhibitors

A

Aranafil: 50-100 mg
Tadalafil: 10mg
Sildenafil: 50mg
Vardenafil: 10mg

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95
Q

What are the ADEs of PDE-5 inhibitors?

A 
Headache, flushing, dizziness
Priapism
Hearing loss
Vision loss
Hypotension
Impaired color discrimination
Back pain
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96
Q

What class is aloprostadil?

A

PGE1

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97
Q

Storage requirement for aloprostadil?

A

Fridge

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98
Q

Treatment of hypoactive sexual desire disorder?

A

Flibanserin (Addyi)

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99
Q

Contraindication to Flibanserin

A

Alcohol
Cyp3a4 inhibitors
hepatic impairment

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100
Q

ADEs of filbanserin

A

Hypotension, fainting

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101
Q

What BUN:SCr ratio is dehydration

A

> 20:1

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102
Q

Which diuretic class increases calcium?

A

Thiazides

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103
Q

What drugs cause kidney disease?

A 
Polymyxin 
Loop diuretics
Vancomycin
Aminoglycosides
NSAIDs
Amphotericin
Radiographic dye
Tacrolimus/cyclosporine
Cisplatin
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104
Q

Who gets ACE-i’s and ARBs?

A

DM + Proteinuria (albuminuria >30)
HTN + Proteinuria
CKD

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105
Q

What %SCr increase after starting ACE/ARB needs to stop the drug?

A

30% increase

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106
Q

Which drugs needed renal adjustments?

A 
Beta-lactams
Fluconazole
FQ
Xarelto
H2RAs
metoclopramide
Bisphosphonates
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107
Q

When is nitrofurantoin contraindicated?

A

CrCl <60mL/min

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108
Q

What drugs are contraindicated at CrCl <50mL/min?

A

IV voriconazole

TNF-DF

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109
Q

What drugs are contraindicated at CrCl <30mL/min

A

TNF-A
Rivaroxaban, dabigatran
NSAIDs

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110
Q

What drugs are contraindicated at eGFR <30?

A

Metformin

SGLT2-i’s

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111
Q

Which of the phosphate binders isn’t systemically absorbed?

A

Sevelamer (Renvela)

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112
Q

ADEs of calcium-based phosphate binders?

A

Increased calcium

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113
Q

ADEs of aluminum-based phosphate binders?

A

Al accumulation; dialysis dementia

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114
Q

ADEs of aluminum/ca free phosphate binders?

A

Contain iron - Ferric citrate and lanthanaum carbonate
Ferric citrate has iron absorption
N/V/D, constipation

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115
Q

Which Vitamin D is made in skin?

A

Cholecalciferol (D3)

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116
Q

Which vitamin D is made in plants?

A

Ergocalciferol (D2)

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117
Q

What is calcitriol?

A

Vitamin D3

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118
Q

What is cinacalcet?

A

calcimimetic that decreases PTH

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119
Q

Does cinacalcet increase/decrease Ca?

A

Decrease

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120
Q

Do Vit D analogs increase/decrease Ca?

A

Increase

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121
Q

What are requirements for using ESAs?

A

HgB <10 and must stop before >11 b/c of increased VTE risk

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122
Q

Drugs that increase K+

A 
Drospirenone
ACEs/ARBs/aliskiren
Aldosterone antagonists
Transplant drugs
Bactrim
Canagliflozin
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123
Q

Treatment for hyperkalemia

A
  1. Calcium gluconate (stabilize mycoardium)
  2. Push K intracellular
    Insulin + Dextrose
    Nebulized albuterol
    Bicarbonate
  3. Remove K+
    Loops
    Dialysis
    Keyexalate/Na polystyrene sulfonate
    (separate these from other drugs)
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124
Q

What bicarb level is metabolic acidosis

A

<22mEq/L

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125
Q

How to treat metabolic acidosis

A

Sodium bicarbonate
Sodium citrate
(Monitor Na)

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126
Q

What BMI indicates that a patient can use weight-loss therapy?

A

BMI >30

BMI >27 w/weight-related comorbidity

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127
Q

Tell me about Qsymia

A

Phentermine/Topiramate
Increase HR, hyperthyroidism, glaucoma
Taper due to seizure risk

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128
Q

Tell me about Contrave

A

Naltrexone/bupropion
BBW: Suicidal thinking in adolescents
CI: Opioid use, uncontrolled HTN, seizure disorder, anorexia, pregnancy
Caution w/psych disorders

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129
Q

Tell me about Belviq

A

Lorcaserin
Serotonin agonist
Warning for NMS, serotonin syndrome, hypoglycemia

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130
Q

Tell me about Saxenda

A

Liraglutide

Pancreatitis and medullary thyroid cancer and hypoglycemia and nausea

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131
Q

Tell me about Orlistat

A

Alli/Xenical
Alli available OTC
Requires 30% fat reduction from regular diet
ADEs: GI (flatus and fatty stools)
Requires ADEK supplement (but separate by 4 hours)

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132
Q

Tell me aout other sympathomimetics for weight loss

A

CI with CV disease, hyperthyroidism, glaucoma, pregnancy, drug abose
ADEs: HR/BP, agitation

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133
Q

How long can stimulant weight loss drugs be used?

A

12 weeks maximum

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134
Q

What sreening tool is used for Alzheimer’s and what score indicates cognitive impairment?

A

MMSE

Score <24

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135
Q

What natural products are used in alzheimer’s?

A

Ginkgo
Vitamin E
Vitamin D

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136
Q

ACHe Inhibitors ADEs

A

Decreased HR
Nausea (take in evening or use rivastigmine patch/ODT donepezil)
Insomnia (take in morning)

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137
Q

T/F: Memantine capsules can be sprinkled on food

A

TRUE – even though XR

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138
Q

What is the treatment order for Alzheimer’s?

A
  1. ACHe Inhibitors (ie donepezil)

2. Can add memantadine for mod-severe alzheimer’s OR can use memantadine as monotherapy

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139
Q

What are the acetylcholine esterase inhibitors?

A

Rivastigmine (Donepezil)
Donepezil (Aricept)
Galntamine (razadyne)

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140
Q

Name of donepezil + memantadine?

A

Namzaric

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141
Q

Which systemic steroid is used to treat Addison’s Disease?

A

Fludrocortisone

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142
Q

What are symptoms of Cushing’s syndrome? (the ones you don’t normally remember)

A 
Glaucoma
Acne
Cataracts
Hypothyroidism
Stretch marks
Poor bone health
Hirsuitism
Irregular periods
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143
Q

Equivalency of Steroids

A 
Cortisone: 25 (short-acting)
Hydrocortisone: 20
Prednisone: 5 (Intermediate-acting)
Prednisolone: 5
Triamcinolone: 4
Methylprednisolone: 4
Dexamethasone: 0.75 (long-acting)
Betamethasone: 0.6
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144
Q

What dose of systemic steroid causes immunosuppression?

A

20mg prednisone/day for 2 weeks

or >2mg/kg/day for 2 weeks

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145
Q

First-line treatment for RA

A

Methotrexate

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146
Q

ADEs/warnings of methotrexate

A

Trexall
Hepatotoxicity, teratogenic, mucositis/stomatitis, immunosuppression
N/V/D, alopecia, arthralgia/myalgia
Avoid alcohol

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147
Q

What does folate do with MTX?

A

Reduces hematologic toxicities

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148
Q

How is MTX dosed for RA?

A

weekly!

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149
Q

Hydroxychloroquine ADEs/BBW?

A

Irreversible retinopathy

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150
Q

Sulfasalazine ADEs?

A

Yellow/orange discoloration of skin/urine

SULFA allergy

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151
Q

Leflunomide ADEs?

A

Teratogenic - requires REMS and 2 birth controls

Hepatotoxicity

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152
Q

How long do you have to wait before conceiving after on leflunomide?

A

2 years - unless you use cholestyramine/activated charcoal to increase clearance

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153
Q

What are the anti-TNF DMARDs?

A 
Etanercept (Enbrel)
Certolizumab Pegol (Cimzia)
Adalimumab (Humira)
Infliximab (Remicade)
Golimumab (Symponi)
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154
Q

Which anti-TNFs are IV?

A

Golimumab and Remicade
Both require filter
Remicade requires NS

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155
Q

Which anti-TNFs can only be given with MTX?

A

Remicade and Symponi

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156
Q

Which Anti-TNF SC is given weekly?

A

Enbrel

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157
Q

Which Anti-TNF SC is given monthly?

A

Golimumab

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158
Q

What are the warnings for all anti-TNFs?

A 
Demyelinating disease, reactivation of Hep B, worsening HF, hepatotoxicity, DILE
Latent TB infections
Malignancies
Serious infections
Avoid live vaccines
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159
Q

Where can the anti-TNFs be injected?

A

Humira: Abdomen/thigh

Etanercept/golimumab: abdomen, thigh, upper arm

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160
Q

What class are tofacitinib and baricitinib?

A

JAK inhibitors

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161
Q

ADEs of infliximb?

A

Other Anti-TNFs + infusion reaction (premedicate with APAP, antihistamine, and steroid) and delayed HSR

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162
Q

Other Biologic DMARDs for RA (besides TNFs)

A 
Rituximab (anti-CD20, use with MTX, pre-medicate)
Anakinra (IL-1 antagonist)
Abatacept (CD80/CD86)
Tocilizumab (IL-6)
Sarilumab (IL-6)
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163
Q

Which RA meds require screening for Hep B reactivation before use?

A

Rituximab

Anti-TNF

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164
Q

Malar butterfly rash is a sign of what?

A

Systemic lupus erythematous (SLE)

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165
Q

Drugs that induce lupuse

A 
Methimazole
Methyldopa
Minocycline
Isoniazid
TNF inhibitors
Terbinafine
Hydralazine
Procainamide
Propylthiouracil
Quinidines
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166
Q

Belimimumab is used for???

A

Lupus

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167
Q

What vaccines in asthmatic kiddos?

A

Flu and Pneumovax-23

Prevnar-13 only if on high-dose steroids

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168
Q

Using albuterol more than _____ means step up in therapy needed

A

2 times/week

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169
Q

How many inhalations per albuterol inhaler?

A

200

except Ventolin can have 60

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170
Q

What is Xopenox?

A

Levalbuterol (r-isomer of albuterol)

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171
Q

ADEs of ICS?

A

Dysphonia, thrush

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172
Q

Which ICS can be nebulized?

A

Pulmicort (budesonide)

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173
Q

Serevent?

A

Salmterol

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174
Q

Spiriva?

A

Tiotropium

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175
Q

Symbicort?

A

Budesonide/formoterol

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176
Q

Advair?

A

Fluticasone/salmeterol

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177
Q

Dulera?

A

Mometasone/formoterol

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178
Q

Breo?

A

Fluticasone/vilanterol

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179
Q

Which MDIs should NOT be shook?

A

QVAR, Respimat

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180
Q

Dose of montelukast (by age)

A

Adult: 10mg
Child 1-4: 4mg
Child 5-14: 5mg

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181
Q

ADE of LTRAs?

A

neuropsychiatric events

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182
Q

How can montelukast granules be given?

A
  1. straight into the mouth
  2. into 5mL of breast milk/formula
  3. Into spoonful of carrots, rice, apple sauce, or ice cream
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183
Q

what are the LTRAs(drugs)?

A

montelukast
zafirlukast
zileuton

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184
Q

Theophylline MOA?

A

Blocks phosphodiesterase to increase cAMP

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185
Q

Thophylline TDM?

A

Peak of 5-15mcg/mL

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186
Q

Thophylline toxicity

A

Arrhythmias, vomiting, seizures

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187
Q

What drugs can increase theophylline?

A

Cipro
Zafirlukast
Zileuton

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188
Q

What drugs can decrease theophylline?

A

CYP3A4 inducers, ritonavir, high-protein diet and charbroiled meat

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189
Q

Omalizumab MOA? and place in therapy?

A

IgE binding inhibition - allergic asthma

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190
Q

What is omalizumab counseling note??

A

Has to be given in HEALTH CARE SETTING every single time

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191
Q

What are IL5 antagonists for?

A

Eosinophilic asthma

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192
Q

T/F: LABAs can be used for exercise-induced asthma

A

True - use salmeterol 30 minutes before exercise

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193
Q

T/F: Spacers help prevent thrush

A

True

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194
Q

PFM directions for use (when to use)

A

In the morning BEFORE taking medications

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195
Q

How to use PEFR?

A

Compare personal best to daily - need treatment if less than 80% of PB

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196
Q

How long can an open package of Pulmicort Respules last?

A

2 weeks

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197
Q

Washing MDIs?

A

Warm water - but NO water for symbicort/dulera

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198
Q

Washing DPIs?

A

No water!

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199
Q

When should you refer kiddos to urgent care (what temperature)?

A

<3 months: 100.4
3-6 months: 101
>6 months: 103

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200
Q

What is a healthy APGAR store and when is it measured?

A

1 minutes and 5 minutes after birth

Healthy: 7-10

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201
Q

What medication is given at birth to prevent bleeding?

A

IM Vitamin K

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202
Q

What can help PDA close?

A

NSAIDs given within 14 days of birth

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203
Q

Respiratory distress syndrome is caused by deficiency of _____ which should be replaced in most babies born

A

Surfactant

<35weeks

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204
Q

What is nuchal rigidity?

A

Inability to bend the neck

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205
Q

How can you diagnose meningitis n young children?

A

Don’t have typical symptoms

Require lumbar puncture

206
Q

Empiric meningitis treatment in neonates?

A

Ampicillin + cefotaxime or gentamicin

207
Q

Which medication is not use in neonates due to bilirubin-induced brain damage?

A

Ceftriaxone

208
Q

Ceftriaxone use is contraindicated with concurrent use of what med?? Why?

A

IV calcium - precipiates and causes embolisms

209
Q

How to treat RSV?

A

Usually supportive care

Severe w/underlying condition = inhaled ribavirin (Viraozole)

210
Q

what medication is for prevention of RSV disease?

A

Palivizumab (Synagis

211
Q

Who gets RSV prophylaxis?

A

Premature infants (<29 weeks or <32 weeks with chronic lung disease), children with select medical conditions (heart conditions) during RSV season (same as flu)

212
Q

Palivizumab administration?

A

IM (into thigh) monthly

213
Q

Max # of RSV doses?

A

5

214
Q

What is croup?

A

Viral infection that causes stridor, cough, hoarseness

215
Q

How is croup treated?

A

Systemic steroids

Nebulized racemic epinephrine if needed

216
Q

What medication is used for nocturnal enuresis?

A

Desmopressin

217
Q

What med for intestinal gas in infants?

A

Simethicone drops

218
Q

OTC cough and cold meds should not be used in children

A

2 years old

219
Q

What age can APAP be used?

A

0+

220
Q

What age can NSAIDs be used?

A

<6 months

221
Q

First-line constipation in kids?

A

PEG for intermittent constipation

Glycerin suppositories for babies

222
Q

Pediatric dose of APAP?

A

10-15mg/kg/dose every 4-6 h

223
Q

Pediatric dose of ibuprofen?

A

5-10mg/kg/dose every 6-8h

224
Q

What is first-line treatment for tick-borne Rickettsial disease?

A

Doxycycline (even in kids)

225
Q

Topical teething agents with ___ are not recommended in <2 year old

A

Benzocaine

226
Q

Measles symptoms

A

Koplik spots in mouth; maculopapular rash

227
Q

How is measles spread?

A

airborne

228
Q

Difference by Type A and Type B interactions?

A

Type A: Predictable and dose-dependent

Type B: Unpredictable and not dose-dependent

229
Q

4 types of drug allergies

A

Type I: Immediate, IgE-mediated (hives, anaphylaxis, angioedema)
Type II: minutes-hours after exposure
Type III: Immune-complex reactions (hours to weeks)
Type IV: Delayed hypersensitiity reactions (48h-weeks)

230
Q

What type of drug allergy is PPD?

A

Type IV

231
Q

What type of drug allergy is anaphylaxis?

A

Type I

232
Q

What type of allergy is hemolytic anemia?

A

Type II

233
Q

Who develops REMS?

A

Manufacturer (approved by FDA)

234
Q

What are MedGuides and when should they be dispensed?

A

Patient-friendly handouts
At each fill - original and refill
Not required inpatient

235
Q

What scale is used to determine the likelihood an event was caused by a drug?

A

Naranjo Scale

236
Q

What is TTP?

A

Blood clots forming throughout body – causes bleeding/purpura on the skin

237
Q

What drugs cause TTP?

A

Clopidogel and Ticlopidine

238
Q

What drugs to avoid with peanut and soy allergies?(3)

A

Propofol
Clevidipine
Progesterone

239
Q

What drugs/vaccines to avoid with egg allergy (4)

A

Propofol
Clevidipene
Yellow fever vaccine
Flu vaccines (FluBlok has no egg, others can still be used)

240
Q

What drugs contain sulfa (that I didn’t already know) - 3?

A

Acetazolamide
Zonisamide
Darunavir
(NOT sulfate)

241
Q

Does desenstivation cure an allergy?

A

Nah

242
Q

What is the name of the EpiPen with voice instructions?

A

Auvi-Q

243
Q

BBW of rituximab?

A

Infusion reactions

244
Q

Main treatment for MS?

A 
Glatiramer acetate (Capoxone)
INterferon Beta products
245
Q

Which MS treatment for pregnancy?

A

Glatiramer acetate

246
Q

ADEs of glatiramer acetate?

A

Injection site reactions, dyspnea, diaphoresis

247
Q

ADEs of interferon beta products?

A

psychiatric disorders, injection site necrosis, increased LFTs, thyroid dsyfunction, flu-like symptoms (pre-medication)

248
Q

Which interferon can be injected q2weeks?

A

Peginterferon B-1A (Plegridy)

249
Q

ADEs of flingolomid (Gilenya)

A

Decreased HR

Macular edema, hepatotoxicity, myelosuppression

250
Q

How often are TNF inhibitors administered?

A

Either weekly (etanercept) or every other week (adalimumab and certolizumab)

251
Q

First-line treatment for Raynaud’s?

A

CCBs (nifedipine)

252
Q

Sjogren’s syndrome treatment - dry eyes?

A

Artificial tears, Restasis, Lifitegrast

253
Q

Sjogren’s syndrome treatment - dry mouth?

A

Xylitol gum, lozenges, antimicrobial mouthwash, oral muscarinics (pilocarpine)

254
Q

Treatment for psoriasis

A
  1. Phototherapy
  2. Topical: steroids, tazarotene (Retinoid), coal tar, calcipotriene (Vit D analog), anthralin, topical calcineurin inhibitors
  3. Systemic: Retinoid, PDE4 inhibitors, IL antagonists, MTX, hydroxyurea
255
Q

Which topical psoriasis options to go on face?

A

Steroids and calcineurin inhibitors

256
Q

Natural products used in anxiety (4)

A

Kava
St John’s Wort
Valerian
Passion flower

257
Q

1st line treatment for anxiety?

A

SSRIs/SNRIs (takes 4 weeks)

258
Q

2nd line treatment for anxiety? (3)

A

Buspirone (takes 2-4 weeks)
TCAs
Hydroxyzine

259
Q

Can buspirone be used with MAO inhibitors?

A

Nah

260
Q

Which benzodiazepines are preferred in elderly patients? Why?

A

Lorazepam
Omazepam(?)
Temazepam
(LOT)

Inactive metabolites

261
Q

Which benzos preferred for anxiety?

A 
Clonazepam
Lorazepam
Alprazolam
Diazepam
(CLAD)
262
Q

Antidote for benzos?

A

Flumazenil

263
Q

Toxicity of benzos?

A

Ataxia

264
Q

Which benzo comes IM?

A

Midazolam

265
Q

What drugs decrease seizure threshold?

A

Abx: PCNs, FQs, carbapenems
Pain: Meperidine, tramadol
Psych: Buspirone, clozapine, lithium
Misc: chantix, theophylline

266
Q

What are ADEs of all antiepileptic drugs?

A

BBW for suicidal thoughts
Osteoporosis/decreased BMD (take Ca/VitD)
Teratogenicity (take folate)
CNS depression

267
Q

Equation for phenytoin corrected?

A

Phenytoin = phenytoin/(0.2*alb+0.1)

268
Q

Which AEDs have worst side effects in kids?

A

Lamotrigine

Topiramate/zonisamide

269
Q

Which drugs increase GABA?

A

benzos, valproic acid

270
Q

Which drugs block Na channels?

A

carbamazepine, phenytoin, lamotrigine, topiramate

271
Q

Which drugs block Ca channels?

A

Keppra, gabapentin, ethosuximide

272
Q

What are the broad spectrum AEDs?

A

Lamotrigine
Valproate
Keppra
Topiramate

273
Q

Lamotrigine ADE

A

SJS (titrate dose)

274
Q

Levetiracetam ADEs

A

psychiatric events, somnolence, fatigue

275
Q

Topiramate ADEs

A 
Hyperammonemia
Oligohydrosis
Metabolic acidosis
Weight loss/anorexia
Fetal toxicity
nephrolithiasis
Closed-angle glaucoma
276
Q

Volpric acid ADEs

A 
Fetal harm (decreased IQ)
Hyperammonemia
Weight gain
Thrombocytopenia
Alopecia
Hepatotoxicity
277
Q

TDM for valproic acid

A

50-100

278
Q

TDM for carbamazepine

A

4-12

279
Q

TDM for phenobarbital

A

20-40

280
Q

TDM for phenytoin

A

10-20

281
Q

Carbamazepine ADEs

A

skin reactions, aplastic anemia, agranulocytosis, SIADH, fetal harm

282
Q

What HLA test for carbamazepine/oxcarbazepine?

A

HLA-B*1502

283
Q

Lacosamide ADE

A

QT prolongation

284
Q

Oxcarbazepine ADEs

A

hyponatremia, SJS?TEN

285
Q

Phenobarbital ADE

A

Tolerance, dependence, hangover effect, resp depression

286
Q

Prodrug of phenobarbital

A

Primidone

287
Q

Max Phenytoin/Fosphenytooin infusion rate

A

50mg/min and 150PE/min

288
Q

ADEs of phenytoin

A

SJS, fetal harm, extravasation(Purple Glove)

289
Q

Phenytoin toxicity

A

Nystagmus, diplopia, ataxia

290
Q

Chronic phenytoin ADEs

A

hepatotoxicity, gingival hyperplasia, hair growth

291
Q

what med used for absence seizures?

A

ethosuximide (Zarontin)

292
Q

ADEs of felbamate?

A

Hepatic failure, anemia

293
Q

ADEs of zonisamide

A

sweating, weight loss, nephrolithiasis

294
Q

ADEs of vigabatrin (sabril)

A

Vision loss

295
Q

Natural products for hypertension

A

Fish oil, coenzyme Q10, L-arginine, garlic

296
Q

What BP cut-off for treatment in pregnancy?

A

160/105

297
Q

Drugs to use in HTN in pregnancy

A

Labetalol
Nifedipine XR
Methyldopa

298
Q

CrCl needed for thiazide

A

> 30mL/min

299
Q

ADEs of thiazides

A

increased LDL/TG/BG

300
Q

which antihypertensives decrease lithium clearance?

A

Thiazides

ACEs/ARBs

301
Q

ADEs of DHPs

A

gingival hyperplasia

302
Q

When should nifedipine IR be used?

A

NOT after heart attack

Really only in pregnancy

303
Q

What’s up with clevidipine?

A

DHP CCB
Has soybean/eggs
Lipid emulsion
12h BUD

304
Q

What is the caloric content of clevidipine?

A

2kcal/ml

305
Q

Contraindication to ACEs?

A

Bilateral renal artery stenosis

306
Q

How long washout for ACEs/ARBs and neprilysn?

A

ACEs: 36 hours
ARBs: none

307
Q

Which beta-blockers need to be with food?

A

Carvedilol

Metoprolol tartrate

308
Q

what is the conversion of metoprolol tartrate PO to IV?

A

1:2.5

309
Q

What is the conversion of carvedilol to carvedilol xr?

A

3.25:10

310
Q

MOA of nebivolol?

A

B1 and NO

311
Q

Which Beta blockers are intrinsic sympathomimetic activity?

A

Acebutalol, pindolol, peributolol (do not use post-MI)

312
Q

ADEs of alpha-2 agonists?

A

Rebound HTN, dry mouth, dizziness, constipation, bradycardia, hypotension

313
Q

Methyldopa contraindicated with what med?

A

MAO inhibitors

314
Q

Methyldopa ADEs

A

Hemolytic anemia, DILE

315
Q

How often is clonidine applied?

A

weekly

316
Q

What are the vasodilators?

A

Hydralazine and minoxidil

317
Q

minoxidil ades

A

fluid retention, increased HR, hair growth

318
Q

What is aliskirenin

A

Direct reinin inhibitor (like ACEs/ARBs)

319
Q

How much to decrease BP in first in hour in hypertensive emergency?

A

25%

320
Q

Age of RFs for ACS?

A 
M>45
F>55
FH:
M<55
F<65
321
Q

When should cardiac enzymes be checked?

A

Onset and 6 hours later

322
Q

PCI should be performed within __ hours

A

2hours

323
Q

What meds are used post-MI?

A

MONA
GAP
(GLP antagonists, P2Y12 inhibitors, anticoagulants)

324
Q

What are the glycoprotein IIb/IIIa antagonists?

A

Abciximab
Eptifibatide
Tirofiban

325
Q

What meds to avoid after ACS?

A

NSAIDs and IR nifedipine

326
Q

Which P2Y12 causes dyspnea?

A

Ticagrelor

327
Q

Which P2y12 needs to stay in original container?

A

Prasugrel

328
Q

Which P2y12 is contraindicated in stroke?

A

prasugrel

329
Q

How to transition from cangrelor to oral P2y12?

A

Give loading dose of oral after discontinuing

330
Q

Dose of alteplase in ACS?

A

100mg

331
Q

Drug interaction with clopidogrel?

A

CYP2C9 inhibitors - omeprazole and esomeprazole

332
Q

How long to continue beta-blocker after ACS?

A

3 years

333
Q

What is simple compounding?

A

adding ingredient per manufacturer (reconstituting)

334
Q

What is the sensitivity requirement for torsion balance?

A

within 5mg;

Min Wt Quan = SR/acceptable error rate

335
Q

When do use each type of mortar/pestle?

A

Glass: liquids
Porcelain: Blending powders
Wedgewood: Crushing dry crystals

336
Q

What 2 types of documentation for nonsterile compounding?

A 
Master formulation record (recipe)
Compounding record (products including lot #'s, Rx#, etc)
337
Q

What to do if no expiration date?

A

pharmacist assigns one within the next 3 years

338
Q

Comminution

A

Decreasing particle size by grinding/crushing/vibrating

339
Q

Trituration

A

Mix thoroughly (grinding or shaking liquid)

340
Q

Levigation

A

Grinding by adding small amount of liquid

341
Q

Pulveration by intervention

A

Dissolving crystal in water

342
Q

Solute v suspension v emulsion

A

Solute: dissolved in solvent for homogenous mixture
Suspension: Solid dispersed in liquid
Emulsion: liquid dispersed in liquid

343
Q

BUD of non-sterile compounding

A

Oral liquid: 14 days
Topical liquid: 30 days
Nonaqueous: 6 months

344
Q

What causes migiraine?

A

Vasodilation

345
Q

What medication is contraindicated in patient with aura?

A

Estrogens (increased stroke risk)

346
Q

Natural products used for migraine - 7

A 
Caffeine
Magnesium
Butterbur
Coenzyme Q10
Feverfew
peppermint
Riboflavin
347
Q

Drug classes used for migraines

A

APAP, NSAIDs, caffeine
Triptans
Ergotamines
Opioids/butalbitol/tramadol

348
Q

Triptan mechanism

A

5HT-1 agonist (vasoconstriction)

349
Q

Contraindications to triptans

A

Cerebrovascular disease, uncontrolled HTN, ISHD, PVD

350
Q

How many doses of triptans allowed?

A

2, then must wait 24 hours

351
Q

Triptan with long half-life?

A

Frovatriptan (Frova) and naratriptan (Amerge)

352
Q

Which triptans can be used in kids

A

Almotriptan, zolmitriptan, treximet, rizatriptan

353
Q

Which triptans are CI with MAOIs?

A

Sumatriptan, rizatriptan, zolmitriptan

354
Q

ADEs of triptans

A

high BP, parasthesia, triptan sensations (heaviness in chest)

355
Q

Rizatriptan DF

A

Tablet and ODT

356
Q

Sumatriptan DF

A

SC, nasal spray, nasal powder

357
Q

Zolmitriptan

A

ODT, nasal spray

358
Q

Treximet

A

Sumatriptan + naproxen (dispense in original container)

359
Q

Ergotamine mechanism

A

Non-selective serotonin agonists

360
Q

Ergotamine contraindications

A

CYP3A4 inhibitors, ISHD, uncontrolled HTN, pregnancy

361
Q

Ergotamine ADEs

A

Peripheral ischemia, cardiovascular effects

362
Q

DF of dihydroergotamine

A

injection and nasal spray

363
Q

Schedule of butalbitol products

A

III (abuse/dependence)

364
Q

Which of the nasal sprays do NOT need primed?

A

Triptans

365
Q

Who gets migraine ppx?

A

just has to decrease QoL

366
Q

What meds are used for migraine PPX

A 
Beta-blockers
Topiramate
Valproate
TCAs (amitriptyline)
Venlafaxine
Erenumab (aimovig)
Botox (>15 migraine days/month)
367
Q

Erenumb mechanism

A

Calcitonin gene-related peptide antagonist

368
Q

Aimovig

A

Erenumab

369
Q

How many types per week can acute drugs be used?

A

2-3 weeks

370
Q

Natural product for acne

A

Tree oil

371
Q

Natural product for cold sore

A

Lysine

372
Q

OTC acne treatment

A

Benzoyl peroxide (the best)
Salicylic acid
Azelaic acid
Adapalene

373
Q

Differin

A

Adapalene

374
Q

How long do retinoids take to work?

A

4-12 weeks

375
Q

ADEs of retinoids

A

teratogenic and photosensitivity

376
Q

How to apply retinoids

A

Pea size all over face for ~20 minutes

377
Q

Topical antibiotics used for acne

A

Erythromycin, clindamycin, dapsone gel

378
Q

Isotretinoin ADEs

A

Teratogen (requires 2 forms of BC for 1 month)

Dryness

379
Q

What oral antibiotics for acne?

A

Minocyclin (Solodyn)

Doxycycline

380
Q

Alopecia treatment

A

Finasteride (takes 3 months to work)

Minoxidil

381
Q

Propecia

A

Finasteride

382
Q

Rogane

A

Minoxidil

383
Q

Treatment for thinning eyelashes

A

Bimatoprost (Latisse)

384
Q

Topical cold sore treatment

A

Docasanol (Abreva) - OTC

Acyclovir (Zovirax) - Rx

385
Q

Danduff treatment

A

SElenium sulfide, pyrithione zind, coal tar

2nd line: Ketoconazole shampoo

386
Q

Nizoral

A

Ketoconazole shampoo (A-D is OTC)

387
Q

Diapar rash treatment

A

topical azoles, hydrocortisone

388
Q

Eczema treatment

A
  1. moisture
  2. topical steroids/antihistamines
  3. topical calcineurin inhibitors or topical PDE-4
  4. IL-4 (Dupilumab)/oral immunosuppressants
389
Q

Protopic

A

Topical tacrolimus

390
Q

Elidel

A

Pimecrolimus (topical CNI)

391
Q

ADEs of topical CNI

A

Photosensitivity, lymphoma, skin cancer

392
Q

Fungal skin infection tx

A

Terbinafine, clotrimazole, ketoconazole

393
Q

Lamisal AT

A

terbinafine

394
Q

Extina

A

Ketoconazole

395
Q

Lotrisone

A

Betamethasone/clotrimazole

396
Q

Fungal nail infection tx

A

Terbinafine or itraconazole for a year

397
Q

How to diagnose fungal nail infection

A

KOH

398
Q

Terbinafine ADE

A

hepatotoxocity

399
Q

Itraconazole CI

A

HF

400
Q

Fungal vaginal infection treatment

A 
Monistat (miconazole)
Teraconazole
Clotrimazole
Butaconazole
1, 3, or 7 days
Fluconazole - 1 day
401
Q

OTC test for vaginal fungal infection

A

Vagisil Screening Kit

402
Q

Genital warts tx

A

Imoquimod

403
Q

Hemorrhoid treatment

A

Fiber
Phenylephrine
Hydrocortisone
Witch hazel (for itching)

404
Q

Preparation H

A

Phenylephrine

405
Q

First-line Lice treatment

A

Pyrethrin (Rid)

Permethrin (Nix)

406
Q

Lindane ADE

A

Neurotoxicity (only for refractory lice)

407
Q

Scabies treatment

A

Premethrin

Ivermectin

408
Q

What’s in triple antibiotic ointment

A

Polymyxin, bacitracin, neomycin

409
Q

MRSA topical treatment

A

Mupirocin

410
Q

Cortisporin

A

Bacitracin, neomycin, polymyxin B, hydrocortisone

411
Q

Pinworms tx

A 
Pyrantel pamoate (reese's) - 3 tx over 3 weeks
Mebendazole, albendazole
412
Q

What steroids available OTC?

A

Hydrocortisone 0.5% and 1%

413
Q

ADEs of topical steroids

A

Telangectasia
Rosacea
Skin thinning
Pigment changes

414
Q

Sunburn SPF requirement

A

15-30 q2h, reapply after swimming

415
Q

Topical steroid potency

A 
Clobetasone
Betamethasone
Mometasone ointment
Fluocinonide ointment
Fluocinonide cream
Mometasone cream
Triamcinolone cream
hydrocortisone
416
Q

Clobex

A

Clobetasone

417
Q

Diprolene

A

Betamethasone

418
Q

Elocon

A

Mometasone

419
Q

Lidex

A

Fluocinonide

420
Q

Kenalog

A

Triamcinolone

421
Q

Cortaid

A

Hydrocortisone

422
Q

Concerning weight change for CHF

A

2-4lbs/day or 3-5lb/week

423
Q

When to fluid restrict

A

<1.5L in Stage D

424
Q

OTC for CHF

A

Hawthorn
CoQ10
Fish oil

425
Q

Drugs that worsen HF

A

IFNs
Class I antiarrhythmics
Itraconazole
TNF inhibitors

426
Q

Who gets BiDil

A

AAs or people who can’t use ACE/ARB

427
Q

When to use ivabradine

A

HR >70bpm

428
Q

Which loop has highest ototoxicity?

A

Ethacrynic acid

429
Q

Lab changes from loops

A

Increased BS, TG, cholesterol, bicarbonate

430
Q

Equivalency of loops

A

Bumetanide 1 mg
Torsemide 20mg
Furosemide 40mg PO = 20mg IV
Ethacrynic acid 50mg

431
Q

ADEs of BiDIl

A

Syncope, tachyphylaxis (requires 10-12 hournitrate free interval)

432
Q

Digoxin is a ___inotropic and __ chronotropic

A

Positive inotrope

Negative chronotrope

433
Q

Digoxin therapeutic range for HF

A

0.5-0.9

434
Q

Dig toxicity

A

N/V, loss of appetite, bradycardia

435
Q

Dig electrolyte abnormalities

A

Decrease K, Mg, increased Ca

436
Q

Corlanor

A

Ivabradine

437
Q

Ivabradine ADEs

A

AF, phosphenes, QT prolongation, HTN

438
Q

What potassium DF is open capsules?

A

Micro-K

439
Q

What Potassium DF is dissolvable tablets?

A

Klor-Con M

440
Q

what drugs can cause PAH?

A

SSRIs in pregnancy and cocaine

441
Q

Treatment of PAH

A 
Wwarfarin
Loops
Digoxin
CCBs (if vasoreactive responders - NOT verapamil)
Vasodilators (if non-responders)
442
Q

What are the vasodilators for PAH?

A

Prostacyclin analogs
PDE-5 inhibitors
Endothelin Receptor Antagonists
SGC

443
Q

Prostacyclin analogues ADEs

A

Rebound PH when d/c
Jaw pain
Infusion site reaction

444
Q

What’s important about PG infusion?

A

Cannot have interruptions in infusion

445
Q

Flolan (& administration requirements)

A

Epoprostenol - PG
Protect from light
Ice for stability

446
Q

ERA ADEs

A 
Embryo-fetal toxicity
Hepatotoxicity
Decreased HgB/Hct
Fluid retention
HA
447
Q

ERA drugs

A

-sentan
Bosentan
Ambrisentan
Macitentan

448
Q

Which ERA decreases OC?

A

Bosentan

449
Q

What is sGC?

A

guanylate cyclase stimulator - riociguat (Adempas)

450
Q

Riociguat ADEs

A

embryo-fetal toxicity

decreased BP, HA

451
Q

Riociguat Drug interactions

A

NITRATES and PDE-5s

452
Q

What drugs cause pulmonary fibrosis

A 
Amiodarone
Bleomycin
Dronedarone
MTX
nitrofurantoin
sulfasalazine
453
Q

Harriet Lane book

A

Pediatric dosing

454
Q

Who does NDA approval

A

Center for Drug Evaluation and Research

455
Q

Red Book

A

Drug pricing

456
Q

Orange book

A

therapeutic equivalencies

457
Q

Purple book

A

biological products/biosimilarities

458
Q

Pink book

A

vaccines

459
Q

Yellow book

A

International travel

460
Q

Green book

A

Animal products

461
Q

Pink Sheet

A

Pharma/industry

462
Q

Red book Pediatrics

A

Peds ID/vaccinations

463
Q

Compounding resources (3)

A

Allen’s
Merck Index
Remington

464
Q

Sanford Guide

A

ID

465
Q

International drug info

A

Index Nominum
Martindale
USP Dictionary

466
Q

King Guide

A

IV drug comptability

467
Q

Goodman and Gilman’s

A

Pharmacology

468
Q

Brigg’s

A

Pregnancy

469
Q

Hale’s

A

Pregnancy

470
Q

How long to take antihistamines before motion sickness?

A

30-60 minutes

471
Q

How long to use scopolamine patch before motion sickness?

A

4 hours

472
Q

Does Scop patch needed removed before MRI?

A

Yes

473
Q

Scop patch ADE

A

Pupil dilation, anticholinergic

474
Q

CI for antihistamines

A

Glaucoma

475
Q

What are the antihistamines for motion sickness?

A

Cyclizine
Diphenhydramine
Dimenhydrinate
Meclizine

476
Q

Dramamine

A

Dimenhydrinate

477
Q

Meclizine

A

Dramaminen Less Drowsy

478
Q

Ae limit for promethazine

A

> 2 years old (and Rx only)

479
Q

Drugs contraindicated with G6PD deficiency

A 
Chloroquine
Dapsone
Methylene Blu
Nitrofurantoin
Primarquine
Probenecid
Quinidine
Quinine
Rasburicase
Sulfonamide
480
Q

Drugs affected by albumin

A

warfarin
phenytoin
valproate
calcium

481
Q

What is the insulin breakdown product used to tell T1 from T2DM?

A

C-peptide

482
Q

Digoxin therapeutic goal for AF

A

0.8-2

483
Q

PT is falsely increased by what drug?

A

Daptomycin

484
Q

Folate decreased by what drugs?

A

Phenytoin, phenobarb, MTX, bactrim

485
Q

Eosinophis indicate what infection

A

Parasite

486
Q

What CBC indicates viral infection?

A

Lymphocytes

487
Q

FAST means

A

Face
Arms
Speech
Time

488
Q

Treatment for ischemic stroke

A

alteplase

489
Q

Max dose of alteplase in stroke

A

90mg

490
Q

Criteria for giving alteplase

A

Within 3 hours of symptoms, BP <185/110

491
Q

Secondary prevention after stroke?

A

Antiplatelets - aspirin or clopidogrel o rdipyridamole/ASA

492
Q

What is the most important RF for stroke?

A

hypertension

493
Q

Yosprala

A

Omeprazole + ASA

494
Q

Aggrenox

A

Dipyridamole + ASA

495
Q

Dipyridamole ade

A

Inhibits adenosine in platelets and increases cAMP

496
Q

What medication for intracerebral hemorrhage?

A

Mannitol (to decrease ICP)

497
Q

What medication for acute subarachnoid hemorrhage?

A

Nimodipine - prevents ischemia

498
Q

ROA for nimodipine

A

Oral - canNOT give IV

Can open capsules to get liquid

499
Q

What are the different incontinence types?

A

Urge - from PD/DM/neuropathy
Stress - from laughing/physical exertion
Overflow - from BPH
or MIXED

500
Q

What muscle causes the symptoms of OAB? What receptors?

A

Detrusor

M3 receptors

501
Q

Treatment for OAB?

A

Kegel exercises
Anticholinergics
B3 agonists
Botox (LAST LINE)

502
Q

Treatment of nocturia

A

Desmopressin

503
Q

What anticholinergic for OAB is not selective?

A

Oxybutynin

504
Q

oxybutynin DFs

A

Patch (Oxytrol), tablet (Ditropan), gel (Gelnique)

505
Q

What anticholinergic for OAB is non-selective and why does this matter?

A

Solifenacin, tolterodine, darefnacin, fesoterodine

Fewer CNS effects

506
Q

Vesicare

A

Solifenacin

507
Q

B3 agonist MOA

A

relaxes detrusor muscle

508
Q

B3 agonist

A

Mirabegron (Myrbetriq)

509
Q

ADEs of Mirabegron

A

HTN, less dry mouth

510
Q

Desmopressin CIs

A

Patients with risk from fluid retention - HF, uncontrolled HTN

NAPLEX D: (3 decks)

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