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Pharmacology > Correlate Review > Flashcards

Correlate Review Flashcards

1
Q

Sildenafil (viagra) and antibiotics

A

Viagra is metabolized by CYP450 so use the smallest dose possible when using with other 3A4 drugs (macrolides except azithro and azoles).

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2
Q

Step 4 Asthma Treatment

A

Medium Dose ICs and LABA or montelukast

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3
Q

Step 2 Asthma Treatment

A

Low Dose ICS or cromolyn or montelukast

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4
Q

H. Pylori Treatment

A

Clarithromycin (caution with statins). PPIs can cause false positives.

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5
Q

Betaxolol

A

Second Gen Beta-Blocker (Cardioselective)

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6
Q

First Gen Beta-Blocker (Non-Cardioselective) Side Effects

A

Bronchospasm, worsen CHF, exercise intolerance, depression, fatigue, raise lipids, imparied glucose tolerance, decreased libido. Avoid abrupt withdrawal.

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7
Q

Intermittent Asthma

A

less than or equal to 2 times a week. No nighttime awakenings.

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8
Q

Parkinson’s and DA

A

Smooth movement. Substantia nigra to basal ganglia .

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9
Q

Furosemide and metoprolol and lisinopril

A

All lower BP (hypotension). Decreased renal blood flow with increase digoxin levels.

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10
Q

Stage 1 HTN

A

140-159/90-99

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11
Q

Fexofenadine (Allegra)

A

Second Generation H1 blocker. Longer lasting and non sedating. Approved for pilots.

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12
Q

Step 1 Asthma Treatment

A

SABA PRN

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13
Q

Prochlorperazine (compazine)

A

Anti-emetic. Has anticholinergic effects, CNS depression EPS.

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14
Q

Ranitidine (Zantac)

A

H2 blocker. Used as adjunct for uticaria.

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15
Q

Citalopram (celexa) Side Effects

A

Insomnia, somnolence, nausea, dry mouth, sexual dysfunction.

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16
Q

Velafaxine (Effexor) indications

A

SNRI. MDD, GAD, SAD, panic.

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17
Q

Aliskren (tekturna) Side Effects

A

Hyperkalemia, renal impairment, hypersensitivity. Contraindicated in pregnancy.

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18
Q

Diphenhydramine (Benadryl)

A

(Nytol, Sominex). First Generation H1 blocker.

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19
Q

African Americans and HTN

A

CCB or thiazide

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20
Q

Salmerterol/fluticasone

A

LABA + ICS. Control. Thrush and hoarseness.

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21
Q

Labetolol

A

Combined Alpha and Beta antagonist

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22
Q

Meclizine (Antivert)

A

First Generation H1 blocker.

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23
Q

Hydrocodone Schedule

A

Schedule II

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24
Q

IBD Treatment

A

Newly diagnosed cases should get a tapering dose of prednisone. adalimumab (humira), infliximab (remicade).

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25
Q

Drugs that potentiate Digoxin

A

Diuretics (except spironolactone), Propranolol, amiodarone, Antibiotics (erythromycin and tetracycline), IV calcium, CCB, quinidine, thyroid hormone.

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26
Q

Hyperthyroidism and HTN

A

BB

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27
Q

Norepinephrine in the cerebral cortex

A

Arousal and attention

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28
Q

Nociceptive Pain Treatment

A

NSAIDs, Tramadol, opiates, muslce relaxants, PT

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29
Q

Step 6 Asthma Treatment

A

Add oral Glucocorticoid.

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30
Q

Metoprolol

A

Second Gen Beta-Blocker (Cardioselective)

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31
Q

Spironolactone

A

potassium sparing diuretic and aldosterone antagonsit (decreases number of sodium channels).

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32
Q

Norepinephrine in the hypothalamus

A

Appetite. Increased NE suppresses appetite.

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33
Q

Stage C COPD Treatment

A

ICS + LABA or LAMA

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34
Q

Morphine Schedule

A

Schedule II

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35
Q

Acebutolol

A

Second Gen Beta-Blocker (Cardioselective)

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36
Q

Norepinephrine targets

A

Limbic lobe, Cerebral Cortex and hypothalamus.

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37
Q

Contraindicated in Depression

A

BB, central alpha blocker

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38
Q

Stage D COPD Treatment

A

ICS+ LABA + LAMA

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39
Q

Metoclopramide (reglan)

A

Prokinetic. Risk of EPS and tardive. SE: cramping and diarrhea.

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40
Q

Norepinephrine in the limbic lobe

A

Mood. Increased/decreased NE release is associated with bipolar disorder.

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41
Q

Prazosin (“-zosins”) Side Effects

A

First dose phenomenon (postural hypotension). fatigue, weakness, nasal congestion and HA. Beneficiall effect on lipids and BPH.

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42
Q

Bisacodyl (dulcolac)

A

Stimulant laxative

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43
Q

Essential tremor and HTN

A

BB (nonselctive)

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44
Q

Timolol

A

First Gen Beta-Blocker. Non-Cardioselective.

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45
Q

Citalopram (celexa) Indications

A

SSRI. MDD only

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46
Q

CKD and HTN

A

ACEI/ARB

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47
Q

Clorpheniramine (Chlor-trimeton)

A

First Generation H1 blocker.

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48
Q

Risks of PPIs

A

Malabsorption (ca, mg, iron, b12), osteoporosis, respiratory/enteric infections, CKD.

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49
Q

Serotonin in the cerebral cortex

A

Sensation and perception

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50
Q

SSRI/SNRI Black Box Warning

A

Incrased suicidal thinking in children and young adults (monitor closely during first 1-2 months). Trip a manic episode if underlying bipolar disorder. Must taper down gradually.

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51
Q

Dicyclomine

A

Anti-spasmodic used for IBS. Anticholinergic properties. Caution in elderly.

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52
Q

Combined Alpha and Beta antagonist Side effects

A

Orthostatic hypotension, bronchospasm. Really only used in HTN emergencies or after an MI.

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53
Q

NSAIDS and Renal Function

A

NSAIDS cause vasoconstriction of the afferent arterioles

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54
Q

Sertraline (Zoloft) Indications

A

SSRI. MDD, OCD, Panic, PTSD, SAD, nocturnal eating, PMDD

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55
Q

Norepinephrine production site

A

Brianstem

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56
Q

Propranolol

A

First Gen Beta-Blocker. Non-Cardioselective.

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57
Q

Contraindicated in gout

A

diuretics

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58
Q

Neuropathic Pain Treatment

A

Neurontin (gabapentin), Lyrica (pregabalin), Elavil (amitriptyline), Cymbalta (duloxetine), lidoderm patch, spinal cord stimulator, ESI.

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59
Q

Magnesium antacids Side effects

A

Diarrhea

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60
Q

Antihistamines and Breast Feeding

A

Loratadine (Claritin) and Cetirizine (Zyrtec)

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61
Q

Contraindicated in second or third degree block

A

BB, verampamil/diltiazem

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62
Q

Sodium-bicard Side effects

A

Fluid retention (caution in CHF)

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63
Q

Pre-HTN

A

120-139/80-89

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64
Q

Chronic Stable Angina

A

BB

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65
Q

Clonidine and Methyldopa MOA

A

Central acting alpha agonist (alpha2). Reduces SNS vasoconstriction and vascular resistance.

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66
Q

Statins and antibiotics

A

Risk of elevated transaminase levels, myopathy, rhabdomyolysis and ARF. Contraindicated with Erythromycin, itraconazole, niacin and gemfibrozil.

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67
Q

Desvenlafaxine (pristiq) Indications

A

SNRI. MDD only.

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68
Q

Stage 2 HTN

A

greater than 160/100

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69
Q

Fluoxetine (Prozac) Side Effects

A

Insomnia (take in am), HA, Nervousness, decreased libido, diarrhea, anorexia. Longest half life with the broadest effects, least specific for 5HT.

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70
Q

Oral Gluccocotricoids and asthma

A

Prednisone. Used for acute exacerbations. SE: anxiety, agitation, insomnia, increased appetite.

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71
Q

ARB (“-sartans”) MOA

A

Blocks the effect of angiotensin II on the tissue.

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72
Q

Urticaria treatment

A

Second generation antihistamines with an H2 blocker as adjunct. Consider adding a tapering course of steroids.

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73
Q

Opiates and ESRD

A

DOC is fentanyl. Avoid morphine, demerol, vicodin, codeine.

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74
Q

Docusate (colace)

A

Stool Softener. Safe in pregnancy.

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75
Q

Nifedipine (“-pines”) MOA

A

CCB. Dihydropyridines that cause arteriolar smooth muscle relaxation and decrease peripheral resistance. Potent vasodilators.

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76
Q

Olopatadine (patanol)

A

Antihistamine eye drops. Mast cell stabilizer.

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77
Q

A-Fib and HTN

A

BB, verapamil/diltiazem

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78
Q

Escitalopram (lesapro) Side Effects

A

Insomnia, somnolence, nausea, ejaculation disorders.

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79
Q

Buproprion (wellbutrin) Side Effects

A

Insomnia, HA, nausea, weight loss, dry mouth, tachycardia, dizziness. Less Sexual side effects compared to SSRIs. Avoid in patients with seizure disorder (lowers the seizure threshold) and anorexia.

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80
Q

ARB (“-sartans”) Side Effects

A

hypotension and hyperkalemia. Contraindicated in pregnancy.

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81
Q

Aliskren (tekturna) MOA

A

Direct renin inhibitor. Decreases plasma renin activity.

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82
Q

Antihistamine Side Effects

A

Anticholinergic side effects (First generation more so than second). Sedation (First gen). Impotence, urinary hesitancy, sedation, confusion, weight gain, hypersensitivity, prolonged QT (arrhythmias).

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83
Q

Montelukast (singulair)

A

Leukotriene receptor antagonist. SE: URIs, HA, abdominal pain, mood changes.

84
Q

Thiazide MOA

A

Block sodium reabsorption in the distal convoluted tubule via Na/Cl transporter.

85
Q

Contraindicated in Liver Disease

A

Methyldopa

86
Q

Levaquin Renal dosing (CAP)

A

Renal dosing is based on the creatinine clearance. Monitor serum levels of the drug.

87
Q

Step 3 Asthma Treatment

A

Medium Dose ICS

88
Q

Sertraline (Zoloft) Side Effects

A

Insomnia, HA, Dizziness, fatigue, Decreased libido, somnolence, nausea, diarrhea, anorexia, dry mouth

89
Q

Antiepileptics and antibiotics

A

such as phenytoin, carbamazepine and phenobarbital. Effects are ptentiated by inhibitors of CYP450: Macrolides (EXCEPT Azithromycin), and the azoles.

90
Q

Serotonin in the hypothalamus

A

Appetite and sleep

91
Q

Second Gen Beta-Blocker (Cardioselective) Side Effects

A

Less side effects than first generation. Still raise lipids. Avoid abrupt withdrawal (MI, rebound HTN, bronchoconstriction).

92
Q

Infective Esophagitis

A

Fluconazole. Beware of interaction with statins (rhabdo and myopathy).

93
Q

Codeine Schedule

A

Schedule II

94
Q

Buproprion (wellbutrin) Indications

A

DA reuptake inhibitor. MDD, SAD and smoking cessation. Can be used in combination with SSRIs.

95
Q

MDD treatment plan

A

Antidepressants (SSRIs are first line), +/- psychotherapy, follow up in 1-2 weeks (SE profile), instructions on when to contact provider, crisis line number, community resources. Refer if PHQ-9 is greater than 16.

96
Q

Nadolol

A

First Gen Beta-Blocker. Non-Cardioselective.

97
Q

Dopamine Production to Targets

A

Substantia nigra to basal ganglia Ventral tegmentum to nucleus accumbens/frontal cortex

98
Q

SSRI/SNRI Patient Education

A

Takes 2-8 weeks to have effect. Side effects usually occur during the first few days and resolve in a week. Do not stop abruptly (need taper).

99
Q

Severe asthma

A

Throughout the day. Night time awakenings weekly.

100
Q

Ondansetron (zofran)

A

Anti-emetic. QT prolongation and risk of serotonin syndrome.

101
Q

Misoprostol (cytotc)

A

Prevents ulceration induced by NSAIDs. Contraindicated in pregnancy.

102
Q

Contraindicated in Renovascular Disease

A

ACEI/ARB, renin inhibitor

103
Q

OCPs and antibiotics

A

Insufficient evidence but still encouraged to use an alternative form of birth control.

104
Q

ACEI (“-prils”) Side Effects

A

Dry cough, orthostatic hypotension, hyperkalemia, angioedema, elevated creatinine, rash. Contraindicated in Pregnancy.

105
Q

Angina and HTN

A

BB or CCB

106
Q

Desvenlafaxine (pristiq) Side Effects

A

Same as SSRIs with adrenergic effects. Insomnia, HA, nervousness, diaphoresis, constipation/diarrhea, dizziness, increased BP, ejaculation/orgasm difficulties.

107
Q

Parozetine (Paxil) Side Effects

A

Most weight gain of all SSRIs (especially in combo with antipsychotic). Insomnia, HA, Dizziness, fatigue, Decreased libido, somnolence, nausea, diarrhea, anorexia, dry mouth

108
Q

Mild Asthma

A

more than twice a week

109
Q

Migraines and HTN

A

BB

110
Q

Contraindicated in hyponatremia

A

thiazides

111
Q

Stage A COPD Treatment

A

SABA or SAMA PRN

112
Q

Mitrazapine (Remeron) Side Effects

A

Somnolence, increased appetite, weight gain, increased cholesterol, constipation, dry mouth. Less sexual side effects than SSRIs.

113
Q

Dilitiazem MOA

A

Middle ground between the dipines and verapamil.

114
Q

Tylenol with Codeine Schedule

A

Schedule III

115
Q

Oxymorphone Schedule

A

Schedule II

116
Q

Contraindicated in Pregnancy

A

ACEI/ARB, renin inhibitor

117
Q

Verapamil and Diltiazem Indications

A

Arrhythmias, variant angina, long term angina and a-fib.

118
Q

Famotidine (Pepcid)

A

H2 blocker. Used as adjunct for uticaria.

119
Q

Promethazine (Phenergan)

A

First Generation H1 blocker.

120
Q

ACEI (“-prils”) MOA

A

Block the enzyme to stop the formation of angiotensin II. Causes venous dilation (decreases resistance and BP)

121
Q

Anticholinergics and COPD

A

Relief. Long acting: Tiotripium (spiriva). Short acting: Ipatripium (atrovent). Dry mouth, cough, HA, nausea, blurred vision, dizziness.

122
Q

Pindolol

A

First Gen Beta-Blocker. Non-Cardioselective.

123
Q

ACEI/ARBs and Renal Function

A

Vasodilate the efferent arterioles. Increase the risk or hyperkalemia with renal failure.

124
Q

Loops Side Effects

A

HYPOKALEMIA.

125
Q

Duloxetine (cymbalta) Side Effects

A

Insomnia, somnolence HA, Dizziness, fatigue, nausea, anorexia, dry mouth, contstipation/diarrhea, sexual dysfunction. Doesn’t increase BP like other SNRIs. Contraindicated in liver disease.

126
Q

Scabies Antihistamine Choice

A

Hydroxyzine (Atarax) stops the itching and helps with sleep. Treatment also includes permethrin cream 5%.

127
Q

Drugs that Cause Constipation

A

Anti-psychotics, aluminum hydroxide, dicyclomine (bentyl), antidepressants, CCBs, calcium, opiods.

128
Q

Second Gen Beta-Blocker (Cardioselective) Indications

A

Good to treat HTN if previous MI, Stable CHF, angina or A-fib

129
Q

Nociceptive Pain

A

Injury to tissues. Somatic or visceral.

130
Q

Ketotifen (zatidor)

A

Antihistamine eye drops. Mast cell stabilizer.

131
Q

Potassium sparing Diuretics Side Effects

A

Don’t combine with ACEI/ARBs due to risk of hyperkalemia. Not great diuretics, may be combined with loops to balance potassium effects.

132
Q

Albuterol

A

Short acting beta agonist. SE: tachycardia, tremor, nervousness, dizziness.

133
Q

Triamterene

A

potassium sparing diuretic. Inhibits Na/K exchanger in the collecting tubule independent of aldosterone.

134
Q

Magnesium Hydroxide

A

Osmotic Laxative

135
Q

NSAIDS and ACEI/ARB and Diuretics

A

BAD NEWS. Increased risk of AKI.

136
Q

H2 blockers Indications

A

Quick onset for on-demand relief. Most effective at decreasing night time acid production.

137
Q

Azelastine (Optivar)

A

Antihistamine eye drops

138
Q

Mitrazapine (Remeron) Indications

A

Presynaptic alpha 2 antagonist (enhances noradrenergic and serotonergic transmission). Often used in elderly patients with depression, sleep, and increased appetite.

139
Q

Verapamil and Diltiazem Side Effects

A

Diarrhea (verapamil). Bradycardia, SA node dysfunction, heart block.

140
Q

BPH and HTN

A

Alpha blocker (zosins)

141
Q

Moderate asthma

A

Daily

142
Q

Thiazide Side Effects

A

hypokalemia, hyperuricemia, hyponatremia, hypercalcemia, hypertriglyceridemia, hypercholesteremia.

143
Q

Post MI and HTN

A

ACEI/ARB, BB, Adlo agonist

144
Q

Bisoprolol

A

Second Gen Beta-Blocker (Cardioselective)

145
Q

Loratadine (Claritin)

A

Second Generation H1 blocker. Longer lasting and non sedating. Approved for pilots and breast feeding (category B).

146
Q

Cetririzine (Zyrtec)

A

Second Generation H1 blocker. Longer lasting and non sedating (Most sedation of second gen). Ok for breast feeding (category B).

147
Q

Loop Diuretics

A

Furosemide, torsemide, bumetanide

148
Q

Methadone Schedule

A

Schedule II

149
Q

Serotonin in the Limbic Lobe

A

Mood. Decreased serotonin release is correlated to mood disorders and OCD

150
Q

Acute COPD exacerbation treatment

A

Albuterol/ipratropium (duoned) SVN, intensify SABA +/- SAMA, Oral steroids, Antibiotics (macrolide or fluoroquinolone) if 2/3 of the cardinal symptoms (dyspnea, sputum volume, purulent sputum).

151
Q

MDD Treatment length

A

at least 4-9 months after determining therapeutic dose. Risk of reoccurence should have 1-3 years of treatment. Multiple episodes or comorbid disorders will have indefinite treatment.

152
Q

Carvediolol

A

Combined Alpha and Beta antagonist

153
Q

Fluoxetine (Prozac) Indications

A

SSRI. MDD, OCD, Bulemia, panic, PMDD, depression with bipolar disorder (combined with olanzapine (zyprexa)).

154
Q

Diluadid Schedule

A

Schedule II

155
Q

Addiction pathaway

A

Pleasure and reward. DA from Ventral tegmentum to nucleus accumbens/frontal cortex.

156
Q

Metformin and Renal Function

A

Contraindicated in ARF due to the high risk of lactic acidosis.

157
Q

Clonidine and Methyldopa Side Effects

A

Orthostatic hypotension, sedation, drowsiness, avoid abrupt withdrawal (rebound HTN). Used only for refractory HTN.

158
Q

Verapamil MOA

A

CCB. Diphenylalkylamines. Less vasodilation. Has negative ionotripic and chronotropic properties.

159
Q

Azelastine + fluticasone (Dymista)

A

Antihistamine nasal spray

160
Q

Antihistamine Contraindications

A

BPH and glaucoma (closed angle).

161
Q

Serotonin Targets

A

Limbic Lobe, Hypothalamus, cerebral cortex.

162
Q

Parozetine (Paxil) Indications

A

SSRI. MDD, Panic, OCD, GAD, PTSD, SAD, PMDD

163
Q

Step 5 Asthma Treatment

A

High Dose ICS and LABA or montelukast

164
Q

Thiazide Diuretics

A

HCTZ, Chlorothiazide, Metolazone. First line choice for african americans.

165
Q

Duloxetine (cymbalta) Indications

A

SNRI. MDD. neuropathic pain (DM) and fibrimyalgia.

166
Q

Anaphylaxis Treatment

A

Epinephrine! Diphenhydramine (benadryl). IM glucocorticoid (dexamethasone). Famotidine (pepcid).

167
Q

Amiloride

A

potassium sparing diuretic. Inhibits Na/K exchanger in the collecting tubule independent of aldosterone.

168
Q

Osteoporosis and HTN

A

Thiazides

169
Q

Serotonin Production Site

A

Brainstem

170
Q

Contraindicated in Angioedema

A

ACEI

171
Q

Cimetidine

A

H2 blocker. CYP450 and antiandrogen effects.

172
Q

Escitalopram (lesapro) Indications

A

SSRI. MDD and GAD.

173
Q

HTN Treatment Goals

A

140/90 unless older than 60 (without CKD or DM) then 150-90.

174
Q

Ceftriaxone renal dosing (CAP)

A

No adjustment needed

175
Q

Nifedipine (“-pines”) Side Effects

A

reflex tachycardia, HA, flushing (short term). Edema. Less affect on contractility.

176
Q

Systolic Failure and HTN

A

ACEI/ARB, BB, Diuretic, aldosterone agonists.

177
Q

Stage B COPD Treatment

A

LAMA or LABA

178
Q

Atenolol

A

Second Gen Beta-Blocker (Cardioselective)

179
Q

PPI indications

A

Reflex esophagitus. Takes 3-4 days to work. Take every morning before breakfast. Caution of rebound effect.

180
Q

Ocycodone Schedule

A

ScheduleII

181
Q

PUD Treatment

A

PPI, amoxicillin and clarithromycin. Can add bismuth subsalicylate.

182
Q

Fentanyl Schedule

A

Schedule II

183
Q

Azelastine (Astelin)

A

Antihistamine nasal spray

184
Q

Digoxin and metoprolol interaction

A

Both cause bradycardia which can lead to an AV block

185
Q

Digoxin and Furosemide Interaction

A

Loop diuretics can cause hypokalemia which increases digoxin toxicity.

186
Q

Velafaxine (Effexor) Side Effects

A

Same as SSRIs with adrenergic effects. Insomnia, HA, nervousness, diaphoresis, constipation/diarrhea, dizziness, increased BP, ejaculation/orgasm difficulties. Take with food. Must be tapered (impending sense of doom).

187
Q

Contraindicated in hyperkalemia

A

Aldo antagonists, ACEI/ARB, renin inhibitor

188
Q

DOC for Reflux esophagitus

A

PPIs (prazoles).

189
Q

Vasospastic Angina DOC

A

CCB

190
Q

Contraindicated in Bronchospastic Disease

A

BB

191
Q

Naphazoling (naphcon A)

A

Antihistamine eye drops

192
Q

Fluticasone (flovent)

A

low dose ICS

193
Q

Promethazine (phenergan)

A

Anti-emetic. SE: Sedation, CNS/Respiratory depression. Contraindicated in children less than 2 due to respiratory depression.

194
Q

Soma Schedule

A

Schedule IV

195
Q

MDD Screening

A

PHQ-9. 5-9 (minor), 10-14 (moderate), 15-19 (mod-severe), 20 or more (severe).

196
Q

Warfarin and Antibiotics

A

Ciprofloxacin, macrolides (erythromycin, azithromycin), metronidazole, bactrim are contraindicated. Almost all antibiotics can potentiate warfarin but inhibiting the intestinal flora that produces vitamin K.

197
Q

Azithromycin Renal dosing (CAP)

A

No adjustment needed

198
Q

Dimenhydrinate (Dramamine)

A

First Generation H1 blocker.

199
Q

Loop MOA

A

Blocks Na/K/2Cl transporters in the thick ascending limb.

200
Q

Fluoroquinolones (floxacins)

A

Don’t combine with cations (ca, mg, al, iron). Will reduce the absorption of fluoroquinolones. At least take 2-4 hours apart.

201
Q

MDD DSM-V Criteria

A

Five or more symptoms (SIGECAPS) for at least 2 weeks. At least one symptom must be depressed mood or lost of interest/pleasure.

202
Q

MDD Presentation

A

SIGECAPS. Sleep, Interest (lack), Guilt, Energy (decreased), Concentration (indecisiveness), Appetite, Psychomotor (agitation or retardation), Suicidal ideation.

203
Q

Poison Ivy Treatment

A

Steroid cream (triamcinolone) and Second gen antihistamine (zyrtec). Steroid taper if not improving.

204
Q

Raynaud’s and HTN

A

CCB (dipines)

205
Q

Penbutolol

A

First Gen Beta-Blocker. Non-Cardioselective.

206
Q

Prazosin (“-zosins”) MOA

A

Alpha antagonist. Reduces NE constriction leading to vasodialtion.

207
Q

Hydroxyzine (Atarax)

A

(vistaril) First Generation H1 blocker. Extremely sedating.

Pharmacology (24 decks)

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