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).
2
Q
Step 4 Asthma Treatment
A
Medium Dose ICs and LABA or montelukast
3
Q
Step 2 Asthma Treatment
A
Low Dose ICS or cromolyn or montelukast
4
Q
H. Pylori Treatment
A
Clarithromycin (caution with statins). PPIs can cause false positives.
5
Q
Betaxolol
A
Second Gen Beta-Blocker (Cardioselective)
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.
7
Q
Intermittent Asthma
A
less than or equal to 2 times a week. No nighttime awakenings.
8
Q
Parkinson’s and DA
A
Smooth movement. Substantia nigra to basal ganglia .
9
Q
Furosemide and metoprolol and lisinopril
A
All lower BP (hypotension). Decreased renal blood flow with increase digoxin levels.
10
Q
Stage 1 HTN
A
140-159/90-99
11
Q
Fexofenadine (Allegra)
A
Second Generation H1 blocker. Longer lasting and non sedating. Approved for pilots.
12
Q
Step 1 Asthma Treatment
A
SABA PRN
13
Q
Prochlorperazine (compazine)
A
Anti-emetic. Has anticholinergic effects, CNS depression EPS.
14
Q
Ranitidine (Zantac)
A
H2 blocker. Used as adjunct for uticaria.
15
Q
Citalopram (celexa) Side Effects
A
Insomnia, somnolence, nausea, dry mouth, sexual dysfunction.
16
Q
Velafaxine (Effexor) indications
A
SNRI. MDD, GAD, SAD, panic.
17
Q
Aliskren (tekturna) Side Effects
A
Hyperkalemia, renal impairment, hypersensitivity. Contraindicated in pregnancy.
18
Q
Diphenhydramine (Benadryl)
A
(Nytol, Sominex). First Generation H1 blocker.
19
Q
African Americans and HTN
A
CCB or thiazide
20
Q
Salmerterol/fluticasone
A
LABA + ICS. Control. Thrush and hoarseness.
21
Q
Labetolol
A
Combined Alpha and Beta antagonist
22
Q
Meclizine (Antivert)
A
First Generation H1 blocker.
23
Q
Hydrocodone Schedule
A
Schedule II
24
Q
IBD Treatment
A
Newly diagnosed cases should get a tapering dose of prednisone. adalimumab (humira), infliximab (remicade).
25
Drugs that potentiate Digoxin
Diuretics (except spironolactone), Propranolol, amiodarone, Antibiotics (erythromycin and tetracycline), IV calcium, CCB, quinidine, thyroid hormone.
26
Hyperthyroidism and HTN
BB
27
Norepinephrine in the cerebral cortex
Arousal and attention
28
Nociceptive Pain Treatment
NSAIDs, Tramadol, opiates, muslce relaxants, PT
29
Step 6 Asthma Treatment
Add oral Glucocorticoid.
30
Metoprolol
Second Gen Beta-Blocker (Cardioselective)
31
Spironolactone
potassium sparing diuretic and aldosterone antagonsit (decreases number of sodium channels).
32
Norepinephrine in the hypothalamus
Appetite. Increased NE suppresses appetite.
33
Stage C COPD Treatment
ICS + LABA or LAMA
34
Morphine Schedule
Schedule II
35
Acebutolol
Second Gen Beta-Blocker (Cardioselective)
36
Norepinephrine targets
Limbic lobe, Cerebral Cortex and hypothalamus.
37
Contraindicated in Depression
BB, central alpha blocker
38
Stage D COPD Treatment
ICS+ LABA + LAMA
39
Metoclopramide (reglan)
Prokinetic. Risk of EPS and tardive. SE: cramping and diarrhea.
40
Norepinephrine in the limbic lobe
Mood. Increased/decreased NE release is associated with bipolar disorder.
41
Prazosin ("-zosins") Side Effects
First dose phenomenon (postural hypotension). fatigue, weakness, nasal congestion and HA. Beneficiall effect on lipids and BPH.
42
Bisacodyl (dulcolac)
Stimulant laxative
43
Essential tremor and HTN
BB (nonselctive)
44
Timolol
First Gen Beta-Blocker. Non-Cardioselective.
45
Citalopram (celexa) Indications
SSRI. MDD only
46
CKD and HTN
ACEI/ARB
47
Clorpheniramine (Chlor-trimeton)
First Generation H1 blocker.
48
Risks of PPIs
Malabsorption (ca, mg, iron, b12), osteoporosis, respiratory/enteric infections, CKD.
49
Serotonin in the cerebral cortex
Sensation and perception
50
SSRI/SNRI Black Box Warning
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.
51
Dicyclomine
Anti-spasmodic used for IBS. Anticholinergic properties. Caution in elderly.
52
Combined Alpha and Beta antagonist Side effects
Orthostatic hypotension, bronchospasm. Really only used in HTN emergencies or after an MI.
53
NSAIDS and Renal Function
NSAIDS cause vasoconstriction of the afferent arterioles
54
Sertraline (Zoloft) Indications
SSRI. MDD, OCD, Panic, PTSD, SAD, nocturnal eating, PMDD
55
Norepinephrine production site
Brianstem
56
Propranolol
First Gen Beta-Blocker. Non-Cardioselective.
57
Contraindicated in gout
diuretics
58
Neuropathic Pain Treatment
Neurontin (gabapentin), Lyrica (pregabalin), Elavil (amitriptyline), Cymbalta (duloxetine), lidoderm patch, spinal cord stimulator, ESI.
59
Magnesium antacids Side effects
Diarrhea
60
Antihistamines and Breast Feeding
Loratadine (Claritin) and Cetirizine (Zyrtec)
61
Contraindicated in second or third degree block
BB, verampamil/diltiazem
62
Sodium-bicard Side effects
Fluid retention (caution in CHF)
63
Pre-HTN
120-139/80-89
64
Chronic Stable Angina
BB
65
Clonidine and Methyldopa MOA
Central acting alpha agonist (alpha2). Reduces SNS vasoconstriction and vascular resistance.
66
Statins and antibiotics
Risk of elevated transaminase levels, myopathy, rhabdomyolysis and ARF. Contraindicated with Erythromycin, itraconazole, niacin and gemfibrozil.
67
Desvenlafaxine (pristiq) Indications
SNRI. MDD only.
68
Stage 2 HTN
greater than 160/100
69
Fluoxetine (Prozac) Side Effects
Insomnia (take in am), HA, Nervousness, decreased libido, diarrhea, anorexia. Longest half life with the broadest effects, least specific for 5HT.
70
Oral Gluccocotricoids and asthma
Prednisone. Used for acute exacerbations. SE: anxiety, agitation, insomnia, increased appetite.
71
ARB ("-sartans") MOA
Blocks the effect of angiotensin II on the tissue.
72
Urticaria treatment
Second generation antihistamines with an H2 blocker as adjunct. Consider adding a tapering course of steroids.
73
Opiates and ESRD
DOC is fentanyl. Avoid morphine, demerol, vicodin, codeine.
74
Docusate (colace)
Stool Softener. Safe in pregnancy.
75
Nifedipine ("-pines") MOA
CCB. Dihydropyridines that cause arteriolar smooth muscle relaxation and decrease peripheral resistance. Potent vasodilators.
76
Olopatadine (patanol)
Antihistamine eye drops. Mast cell stabilizer.
77
A-Fib and HTN
BB, verapamil/diltiazem
78
Escitalopram (lesapro) Side Effects
Insomnia, somnolence, nausea, ejaculation disorders.
79
Buproprion (wellbutrin) Side Effects
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.
80
ARB ("-sartans") Side Effects
hypotension and hyperkalemia. Contraindicated in pregnancy.
81
Aliskren (tekturna) MOA
Direct renin inhibitor. Decreases plasma renin activity.
82
Antihistamine Side Effects
Anticholinergic side effects (First generation more so than second). Sedation (First gen). Impotence, urinary hesitancy, sedation, confusion, weight gain, hypersensitivity, prolonged QT (arrhythmias).
83
Montelukast (singulair)
Leukotriene receptor antagonist. SE: URIs, HA, abdominal pain, mood changes.
84
Thiazide MOA
Block sodium reabsorption in the distal convoluted tubule via Na/Cl transporter.
85
Contraindicated in Liver Disease
Methyldopa
86
Levaquin Renal dosing (CAP)
Renal dosing is based on the creatinine clearance. Monitor serum levels of the drug.
87
Step 3 Asthma Treatment
Medium Dose ICS
88
Sertraline (Zoloft) Side Effects
Insomnia, HA, Dizziness, fatigue, Decreased libido, somnolence, nausea, diarrhea, anorexia, dry mouth
89
Antiepileptics and antibiotics
such as phenytoin, carbamazepine and phenobarbital. Effects are ptentiated by inhibitors of CYP450: Macrolides (EXCEPT Azithromycin), and the azoles.
90
Serotonin in the hypothalamus
Appetite and sleep
91
Second Gen Beta-Blocker (Cardioselective) Side Effects
Less side effects than first generation. Still raise lipids. Avoid abrupt withdrawal (MI, rebound HTN, bronchoconstriction).
92
Infective Esophagitis
Fluconazole. Beware of interaction with statins (rhabdo and myopathy).
93
Codeine Schedule
Schedule II
94
Buproprion (wellbutrin) Indications
DA reuptake inhibitor. MDD, SAD and smoking cessation. Can be used in combination with SSRIs.
95
MDD treatment plan
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
Nadolol
First Gen Beta-Blocker. Non-Cardioselective.
97
Dopamine Production to Targets
Substantia nigra to basal ganglia Ventral tegmentum to nucleus accumbens/frontal cortex
98
SSRI/SNRI Patient Education
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
Severe asthma
Throughout the day. Night time awakenings weekly.
100
Ondansetron (zofran)
Anti-emetic. QT prolongation and risk of serotonin syndrome.
101
Misoprostol (cytotc)
Prevents ulceration induced by NSAIDs. Contraindicated in pregnancy.
102
Contraindicated in Renovascular Disease
ACEI/ARB, renin inhibitor
103
OCPs and antibiotics
Insufficient evidence but still encouraged to use an alternative form of birth control.
104
ACEI ("-prils") Side Effects
Dry cough, orthostatic hypotension, hyperkalemia, angioedema, elevated creatinine, rash. Contraindicated in Pregnancy.
105
Angina and HTN
BB or CCB
106
Desvenlafaxine (pristiq) Side Effects
Same as SSRIs with adrenergic effects. Insomnia, HA, nervousness, diaphoresis, constipation/diarrhea, dizziness, increased BP, ejaculation/orgasm difficulties.
107
Parozetine (Paxil) Side Effects
Most weight gain of all SSRIs (especially in combo with antipsychotic). Insomnia, HA, Dizziness, fatigue, Decreased libido, somnolence, nausea, diarrhea, anorexia, dry mouth
108
Mild Asthma
more than twice a week
109
Migraines and HTN
BB
110
Contraindicated in hyponatremia
thiazides
111
Stage A COPD Treatment
SABA or SAMA PRN
112
Mitrazapine (Remeron) Side Effects
Somnolence, increased appetite, weight gain, increased cholesterol, constipation, dry mouth. Less sexual side effects than SSRIs.
113
Dilitiazem MOA
Middle ground between the dipines and verapamil.
114
Tylenol with Codeine Schedule
Schedule III
115
Oxymorphone Schedule
Schedule II
116
Contraindicated in Pregnancy
ACEI/ARB, renin inhibitor
117
Verapamil and Diltiazem Indications
Arrhythmias, variant angina, long term angina and a-fib.
118
Famotidine (Pepcid)
H2 blocker. Used as adjunct for uticaria.
119
Promethazine (Phenergan)
First Generation H1 blocker.
120
ACEI ("-prils") MOA
Block the enzyme to stop the formation of angiotensin II. Causes venous dilation (decreases resistance and BP)
121
Anticholinergics and COPD
Relief. Long acting: Tiotripium (spiriva). Short acting: Ipatripium (atrovent). Dry mouth, cough, HA, nausea, blurred vision, dizziness.
122
Pindolol
First Gen Beta-Blocker. Non-Cardioselective.
123
ACEI/ARBs and Renal Function
Vasodilate the efferent arterioles. Increase the risk or hyperkalemia with renal failure.
124
Loops Side Effects
HYPOKALEMIA.
125
Duloxetine (cymbalta) Side Effects
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
Scabies Antihistamine Choice
Hydroxyzine (Atarax) stops the itching and helps with sleep. Treatment also includes permethrin cream 5%.
127
Drugs that Cause Constipation
Anti-psychotics, aluminum hydroxide, dicyclomine (bentyl), antidepressants, CCBs, calcium, opiods.
128
Second Gen Beta-Blocker (Cardioselective) Indications
Good to treat HTN if previous MI, Stable CHF, angina or A-fib
129
Nociceptive Pain
Injury to tissues. Somatic or visceral.
130
Ketotifen (zatidor)
Antihistamine eye drops. Mast cell stabilizer.
131
Potassium sparing Diuretics Side Effects
Don't combine with ACEI/ARBs due to risk of hyperkalemia. Not great diuretics, may be combined with loops to balance potassium effects.
132
Albuterol
Short acting beta agonist. SE: tachycardia, tremor, nervousness, dizziness.
133
Triamterene
potassium sparing diuretic. Inhibits Na/K exchanger in the collecting tubule independent of aldosterone.
134
Magnesium Hydroxide
Osmotic Laxative
135
NSAIDS and ACEI/ARB and Diuretics
BAD NEWS. Increased risk of AKI.
136
H2 blockers Indications
Quick onset for on-demand relief. Most effective at decreasing night time acid production.
137
Azelastine (Optivar)
Antihistamine eye drops
138
Mitrazapine (Remeron) Indications
Presynaptic alpha 2 antagonist (enhances noradrenergic and serotonergic transmission). Often used in elderly patients with depression, sleep, and increased appetite.
139
Verapamil and Diltiazem Side Effects
Diarrhea (verapamil). Bradycardia, SA node dysfunction, heart block.
140
BPH and HTN
Alpha blocker (zosins)
141
Moderate asthma
Daily
142
Thiazide Side Effects
hypokalemia, hyperuricemia, hyponatremia, hypercalcemia, hypertriglyceridemia, hypercholesteremia.
143
Post MI and HTN
ACEI/ARB, BB, Adlo agonist
144
Bisoprolol
Second Gen Beta-Blocker (Cardioselective)
145
Loratadine (Claritin)
Second Generation H1 blocker. Longer lasting and non sedating. Approved for pilots and breast feeding (category B).
146
Cetririzine (Zyrtec)
Second Generation H1 blocker. Longer lasting and non sedating (Most sedation of second gen). Ok for breast feeding (category B).
147
Loop Diuretics
Furosemide, torsemide, bumetanide
148
Methadone Schedule
Schedule II
149
Serotonin in the Limbic Lobe
Mood. Decreased serotonin release is correlated to mood disorders and OCD
150
Acute COPD exacerbation treatment
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
MDD Treatment length
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
Carvediolol
Combined Alpha and Beta antagonist
153
Fluoxetine (Prozac) Indications
SSRI. MDD, OCD, Bulemia, panic, PMDD, depression with bipolar disorder (combined with olanzapine (zyprexa)).
154
Diluadid Schedule
Schedule II
155
Addiction pathaway
Pleasure and reward. DA from Ventral tegmentum to nucleus accumbens/frontal cortex.
156
Metformin and Renal Function
Contraindicated in ARF due to the high risk of lactic acidosis.
157
Clonidine and Methyldopa Side Effects
Orthostatic hypotension, sedation, drowsiness, avoid abrupt withdrawal (rebound HTN). Used only for refractory HTN.
158
Verapamil MOA
CCB. Diphenylalkylamines. Less vasodilation. Has negative ionotripic and chronotropic properties.
159
Azelastine + fluticasone (Dymista)
Antihistamine nasal spray
160
Antihistamine Contraindications
BPH and glaucoma (closed angle).
161
Serotonin Targets
Limbic Lobe, Hypothalamus, cerebral cortex.
162
Parozetine (Paxil) Indications
SSRI. MDD, Panic, OCD, GAD, PTSD, SAD, PMDD
163
Step 5 Asthma Treatment
High Dose ICS and LABA or montelukast
164
Thiazide Diuretics
HCTZ, Chlorothiazide, Metolazone. First line choice for african americans.
165
Duloxetine (cymbalta) Indications
SNRI. MDD. neuropathic pain (DM) and fibrimyalgia.
166
Anaphylaxis Treatment
Epinephrine! Diphenhydramine (benadryl). IM glucocorticoid (dexamethasone). Famotidine (pepcid).
167
Amiloride
potassium sparing diuretic. Inhibits Na/K exchanger in the collecting tubule independent of aldosterone.
168
Osteoporosis and HTN
Thiazides
169
Serotonin Production Site
Brainstem
170
Contraindicated in Angioedema
ACEI
171
Cimetidine
H2 blocker. CYP450 and antiandrogen effects.
172
Escitalopram (lesapro) Indications
SSRI. MDD and GAD.
173
HTN Treatment Goals
140/90 unless older than 60 (without CKD or DM) then 150-90.
174
Ceftriaxone renal dosing (CAP)
No adjustment needed
175
Nifedipine ("-pines") Side Effects
reflex tachycardia, HA, flushing (short term). Edema. Less affect on contractility.
176
Systolic Failure and HTN
ACEI/ARB, BB, Diuretic, aldosterone agonists.
177
Stage B COPD Treatment
LAMA or LABA
178
Atenolol
Second Gen Beta-Blocker (Cardioselective)
179
PPI indications
Reflex esophagitus. Takes 3-4 days to work. Take every morning before breakfast. Caution of rebound effect.
180
Ocycodone Schedule
ScheduleII
181
PUD Treatment
PPI, amoxicillin and clarithromycin. Can add bismuth subsalicylate.
182
Fentanyl Schedule
Schedule II
183
Azelastine (Astelin)
Antihistamine nasal spray
184
Digoxin and metoprolol interaction
Both cause bradycardia which can lead to an AV block
185
Digoxin and Furosemide Interaction
Loop diuretics can cause hypokalemia which increases digoxin toxicity.
186
Velafaxine (Effexor) Side Effects
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
Contraindicated in hyperkalemia
Aldo antagonists, ACEI/ARB, renin inhibitor
188
DOC for Reflux esophagitus
PPIs (prazoles).
189
Vasospastic Angina DOC
CCB
190
Contraindicated in Bronchospastic Disease
BB
191
Naphazoling (naphcon A)
Antihistamine eye drops
192
Fluticasone (flovent)
low dose ICS
193
Promethazine (phenergan)
Anti-emetic. SE: Sedation, CNS/Respiratory depression. Contraindicated in children less than 2 due to respiratory depression.
194
Soma Schedule
Schedule IV
195
MDD Screening
PHQ-9. 5-9 (minor), 10-14 (moderate), 15-19 (mod-severe), 20 or more (severe).
196
Warfarin and Antibiotics
Ciprofloxacin, macrolides (erythromycin, azithromycin), metronidazole, bactrim are contraindicated. Almost all antibiotics can potentiate warfarin but inhibiting the intestinal flora that produces vitamin K.
197
Azithromycin Renal dosing (CAP)
No adjustment needed
198
Dimenhydrinate (Dramamine)
First Generation H1 blocker.
199
Loop MOA
Blocks Na/K/2Cl transporters in the thick ascending limb.
200
Fluoroquinolones (floxacins)
Don't combine with cations (ca, mg, al, iron). Will reduce the absorption of fluoroquinolones. At least take 2-4 hours apart.
201
MDD DSM-V Criteria
Five or more symptoms (SIGECAPS) for at least 2 weeks. At least one symptom must be depressed mood or lost of interest/pleasure.
202
MDD Presentation
SIGECAPS. Sleep, Interest (lack), Guilt, Energy (decreased), Concentration (indecisiveness), Appetite, Psychomotor (agitation or retardation), Suicidal ideation.
203
Poison Ivy Treatment
Steroid cream (triamcinolone) and Second gen antihistamine (zyrtec). Steroid taper if not improving.
204
Raynaud's and HTN
CCB (dipines)
205
Penbutolol
First Gen Beta-Blocker. Non-Cardioselective.
206
Prazosin ("-zosins") MOA
Alpha antagonist. Reduces NE constriction leading to vasodialtion.
207
Hydroxyzine (Atarax)
(vistaril) First Generation H1 blocker. Extremely sedating.
