CLM Exam 1 Drugs 1.27.20 Flashcards

Question

diphenhydramine (Benadryl) FDA uses

Answer 1

- allergic conjuctivitis - allergic reaction - allergic rhinitis - anaphylaxis (w/epi or other measures) - common cold - insomnia - motion sickness - Parkinsonism - pruritus (itching) of skin

Answer 2

Competes with histamine for H1-receptor sites on effector cells in the gastrointestinal tract, blood vessels, and respiratory tract; anticholinergic and sedative effects are also seen

Answer 3

- Young children may experience a paradoxical excitation effect (opposite effect of drug - hyperactivity) - may cause anticholinergic effects (elderly pts more susceptible) - avoid concomitant use with MAO inhibitors or CNS depressants

Answer 4

combined inhaled corticosteroids & bronchodilators

Answer 5

- asthma | - COPD

Answer 6

- Budesonide is an anti-inflammatory synthetic corticosteroid w/potent glucocorticoid & weak mineralocorticoid activity. It exhibits a broad range of active inhibition against multiple cell types & mediators involving allergic & nonallergic/irritant mediated inflammation - Formoterol fumarate is a long-acting bronchodilator that exerts agonistic effects on beta(2)-adrenergic receptors, which are found principally in bronchial smooth muscle. The drug increases cyclic-3', 5'-adenosine monophosphate (cyclic AMP) levels by stimulating intracellular adenyl cyclase, the catalyst for the conversion of adenosine triphosphate (ATP) to cyclic AMP. A rise in cyclic AMP leads to bronchial smooth muscle relaxation and blockade of the release of immediate hypersensitivity mediators

Answer 7

- not intended for acute asthma attacks - avoid exposure to chickenpox or measles - report S&S of URI, hypothalamic-pituitary-adrenal (HPA) axis suppression (fatigue, depression, anxiety, hyperglycemia, muscle weakness, immunosuppression symptoms) - DM pts report difficulties with glycemic control - **rinse & spit after each use to prevent fungal infection

Answer 8

agent for RA

Answer 9

- RA - lupus erythematosus - malaria

Answer 10

thought to act as a mild immunosuppressant, inhibiting the production of rheumatoid factor & acute phase reactants. It also accumulates in white blood cells, stabilizing lysosomal membranes & inhibiting the activity of many enzymes, including collagenase & the proteases that cause cartilage breakdown

Answer 11

take with a meal or glass of milk

Answer 12

- ankylosing spondylitis - gouty arthritis - osteoarthritis - pain (acute, mild, moderate) - RA

Answer 13

Inhibition of cyclooxygenase (COX-1 and COX-2), which leads to decreased prostaglandin synthesis

Answer 14

Increased risk for cardiovascular thrombotic events (MI, stroke). Contraindicated in setting of coronary artery bypass graft surgery. Increased risk of GI bleeding, ulceration, and perforation. Elderly are at greater risk for serious GI events.

Answer 15

- avoid in pregnancy after 30wks - may cause premature closure of the ductus arteriousus - avoid non-RX aspirin products or other NSAIDs

Answer 16

- extraction of cataract - pain - eye pain - seasonal allergic conjunctivitis

Answer 17

Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors; has antipyretic, analgesic, and anti-inflammatory properties.

Answer 18

- short term use; 5 days total for acute moderately severe pain. - contraindicated: active or hx of peptic ulcer disease, recent GI bleed or perforation, hx of GI bleeding, advanced renal impairment, risk of renal failure due to volume depletion, also pts on aspirin or NSAIDs before surgery, labor/delivery, and nursing mothers.

Answer 19

- avoid in late pregnancy; may cause premature closure of the ductus arteriousus - (ophthalmic) remove contacts; wait at least 5 minutes before another ophthalmic medication

Answer 20

agent for glaucoma

Answer 21

- ocular htn | - open-angle glaucoma

Answer 22

prostaglandin F2-alpha analogue that reduces the intraocular pressure (IOP) by increasing the outflow of aqueous humor. The main mechanism is increased uveoscleral outflow

Answer 23

- increased brown pigmentation of iris which may be permanent, eyelid skin darkening, eyelash changes which may be reversible after discontinuation - remove contacts, reinsert after 15 mins, wait at least 5 mins between other ophthalmic products

Answer 24

antihistamine

Answer 25

- idiopathic urticaria | - perennial allergic rhinitis

Answer 26

selectively inhibits the effect of H(1)-receptors

Answer 27

- avoid alcohol or other CNS depressants - can be broken in half to correctly dose children - may cause nasopharyngitis, xerostomia, and pharyngitis, as well as pyrexia, cough, and epistaxis in children 12 and under

Answer 28

antihistamine

Answer 29

- idiopathic urticaria | - seasonal allergic rhinitis

Answer 30

a long-acting tricyclic antihistamine, selectively blocks peripheral histamine H(1)-receptor activity

Answer 31

Rapidly disintegrating tablets may be taken with or without water

Answer 32

agent for RA

Answer 33

- acute lymphoid leukemia - juvenile idiopathic arthritis - severe psoriasis - severe RA

Answer 34

An anti-metabolite that interferes with DNA synthesis, repair, and cellular replication by inhibiting dihydrofolate reductase. In rheumatoid arthritis, the methotrexate mechanism of action is unknown, but it may have an effect on immune function. Methotrexate controls the psoriasis process of increased proliferation in the rate of epithelial cell production in the skin.

Answer 35

- severe toxic rxns including embryo-fetal toxicity

Answer 36

- drug is administered weekly - avoid pregnancy during and 6mths after final dose - if subq teach proper technique for placement of injections

Answer 37

leukotriene receptor antagonist

Answer 38

- asthma | - perennial and seasonal allergic rhinitis

Answer 39

selective and active leukotriene receptor antagonist. It binds to cysteinyl leukotrienes (CysLT) type-1 receptors found in human airway (smooth muscle cells and macrophages), which prevents airway edema, smooth muscle contraction and other respiratory inflammation. The leukotrienes are also released from the nasal mucosa after allergen exposure where montelukast sodium may inhibit symptoms of allergic rhinitis

Answer 40

- not for acute asthma attacks - may cause aggressive behavior, agitation, dream disorder, hallucinations - asthma pts should take dose in the evening

Answer 41

opioid analgesic

Answer 42

chronic moderate to severe pain

Answer 43

pure opioid agonist, selective to the mu receptor, with primary actions in the brain through transitory stimulation prior to depression. In the CNS, it promotes analgesia and respiratory depression by decreasing brain stem respiratory centers response to carbon dioxide tension and electrical stimulation. It also decreases gastric, biliary and pancreatic secretion, induces peripheral vasodilation and promotes opioid-induced hypotension due to histamine release

Answer 44

addiction, abuse, misuse

Answer 45

- avoid alcohol and other CNS depressants - swallow whole or sprinkle contents on a teaspoonful of soft food, swallow immediately (do not chew) - do not suddenly d/c

Answer 46

opioid analgesic

Answer 47

chronic severe pain

Answer 48

opioid agonist that is fairly selective for the mu receptor. It may bind to other opioid receptors at high doses. It is a full opioid agonist and there is no analgesic ceiling effect

Answer 49

- addiction, abuse, misuse - concomitant use of oxycodone ER with all cytochrome P450 3A4 inhibitors may result in an increase in oxycodone plasma concentrations

Answer 50

- report breathing difficulties - take with food to ensure consistent plasma levels - swallow whole or sprinkle on soft food, swallow immediately - do not chew - do not d/c - avoid alcohol and other CNS depressants

Answer 51

corticosteroid

Answer 52

- adrenal insufficiency - sever allergic condition - asthma - cerebral edema - collagen disease - disorders: endocrine, eye, GI, hematopoietic structure, respiratory, skin - exac. of acute MS - Hodgkin's disease - hypercalcemia of malignancy - idiopathic thrombocyopenic purpura - inflammatory disorder of musculoskeletal system - leukemia - palliative therapy - Mycosis fungoides - Neoplastic disease - Nephrotic syndrome - Non-Hodgkin's lymphoma - Polymyositis - Renal transplant rejection - Rheumatoid arthritis; Adjunct - Sjögren's syndrome - Transplantation of heart - Trichinosis, With neurologic or myocardial involvement - Tuberculosis of meninges

Answer 53

Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability; suppresses the immune system by reducing activity and volume of the lymphatic system; suppresses adrenal function at high doses. Antitumor effects may be related to inhibition of glucose transport, phosphorylation, or induction of cell death in immature lymphocytes. Antiemetic effects are thought to occur due to blockade of cerebral innervation of the emetic center via inhibition of prostaglandin synthesis.

Answer 54

- avoid exposure to chickenpox or measles - take with food or milk to minimize GI upset - avoid alcohol and smoking this may increase risk for osteoporosis