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Pharmacy Practice V > Cumulative Final Exam Material > Flashcards

Cumulative Final Exam Material Flashcards

1
Q

What electrolyte changes can occur with Loop Diuretics?

A

DECREASE Potassium and Magnesium
INCREASE Uric Acid

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2
Q

What electrolyte changes can occur with Thiazides?

A

DECREASE Potassium, Magnesium, and Sodium
INCREASE Calcium, Glucose

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3
Q

What electrolyte changes can occur with Potassium Sparing Diuretics?

A

INCREASE Potassium

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4
Q

What electrolyte changes can occur with Spironolactone?

A

INCREASE Uric Acid

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5
Q

Coumadin

A

Warfarin
1. AE: Bleeding
2. DDI: BAMIF
3. CI: Pregnancy

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6
Q

Pradaxa

A

Dabigatran
1. Store in original container
2. Swallow whole
3. AE: Dyspepsia
4. DDI: Pgp + 3A4 Inhibitors = increase concentrations

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7
Q

Xarelto

A

Rivaroxaban
1. 10 mg = take without regard to food
2. 15-20 mg = take with evening MEAL
3. AE: Bleeding
4. DDI: Pgp + 3A4 Inhibitors = increase concentrations

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8
Q

Eliquis

A

Apixaban
1. AE: Bleeding
2. DDI: Pgp + 3A4 Inhibitors = increase concentrations

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9
Q

Savaysa

A

Edoxaban
1. AE: Bleeding
2. DDI: Limit dosage to 30 mg/day when using specific pg inhibitors

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10
Q

HTN Therapy Options for Patients with CKD

A
  1. ACE
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11
Q

HTN Therapy Options for Patients with DM

A
  1. ACE
  2. ARB
  3. Thiazide
  4. CCB
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12
Q

HTN Therapy Options for Patients with CAD

A
  1. BB
  2. RAAS Inhibitor
  3. CCB
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13
Q

HTN Therapy Options for Patients with HF

A
  1. Loops
  2. BB
  3. ACE
  4. ARB
  5. ARA
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14
Q

HTN Therapy Options for Patients with CVB

A
  1. ACE
  2. ARB
  3. Thiazide
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15
Q

HTN Therapy Options for Patients with AFib

A
  1. CCB
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16
Q

What is first line therapy for Chronic Stable Angina?

A
  1. Short Acting Nitrates (Nitrostat) – ACUTE exacerbation ONLY
  2. Beta Blockers – only if they are uncomplicated
  3. CCB – AVOID Non-DP CCBs
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17
Q

What Beta Blockers can be used for Chronic Stable Angina?

A
  1. Propranolol
  2. Atenolol
  3. Metoprolol Succinate
  4. Metoprolol Tartrate
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18
Q

What CCBs CANNOT be used for Chronic Stable Angina?

A
  1. NON-DP CCBs
  2. Felodipine
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19
Q

What is second line therapy for Chronic Stable Angina?

A
  1. Long Acting Nitrates (Isorbide Dinitrate)
  2. Ranolazine
  3. Ivabridine
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20
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age <75 yrs
What is the recommended therapy?

A

High Intensity Statin

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21
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age <75 yrs
4. On maximal statin therapy
5. LDL >70
What is the recommended therapy?

A

Add Ezetimibe

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22
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age >75 yrs
What is the recommended therapy?

A

Start Moderate to High Intensity Statin OR
Continue High Intensity Statin if reasonable

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23
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
What is the recommended therapy?

A

High Intensity Statin

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24
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
3. On maximal statin therapy
4. LDL >70
What is the recommended therapy?

A

Add Ezetimibe

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25
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
3. On maximal statin therapy
4. On maximal ezetimibe therapy
5. LDL >70
What is the recommended therapy?

A

Add PCSK9-Inhibitor

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26
Q

For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD 5%
What is the recommended therapy?

A

Lifestyle Modifications

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27
Q

For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD 5-7.5%
What is the recommended therapy?

A

Discussion, could start moderate intensity statin if needed

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28
Q

For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD 7.5-20%
What is the recommended therapy?

A

Start Moderate Intensity Statin

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29
Q

For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. LDL >70
3. NO Diabetes
4. ASCVD >20%
What is the recommended therapy?

A

Start High Intensity Statin

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30
Q

For patients with PRIMARY PREVENTION:
1. LDL >190
What is the recommended therapy?

A

Start High Intensity Statin

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31
Q

For patients with PRIMARY PREVENTION:
1. Age 40-75 yrs
2. Diabetes
What is the recommended therapy?

A

Start Moderate Intensity Statin

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32
Q

Moderate Intensity Statin should reduce LDL by what percentage?

A

30-49%

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33
Q

High Intensity Statin should reduce LDL by what percentage?

A

> 50%

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34
Q

What is the amount of time needed to achieve maximal lowering of LDL?

A

4-5 weeks

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35
Q

For patients with ASCVD and TG 150-499 mg/dL
1. LDL > 100
2. Adherent to max tolerated statin therapy
What is the recommended therapy?

A

Add on Ezetimibe

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36
Q

For patients with ASCVD and TG 150-499 mg/dL
1. LDL 70-99
2. Adherent to max tolerated statin therapy
What is the recommended therapy?

A

LDL or TG lowering non statin therapy, discussion

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37
Q

For patients with ASCVD and TG 150-499 mg/dL
1. LDL <70
2. Adherent to max tolerated statin therapy
What is the recommended therapy?

A

Start Icosapent Ethyl

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38
Q

For patients with DM and TG 140-499 mg/dL
1. Age <50 OR
2. Age >50 w/o ASCVD Risk Factors
3. Adherent to max tolerated statin therapy
What is the recommended therapy?

A

Add Ezetimibe

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39
Q

For patients with DM and TG 140-499 mg/dL
1. Age >50 WITH >1 ASCVD Risk Factors
2. Adherent to max tolerated statin therapy
What is the recommended therapy?

A

Start Icosapent Ethyl

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40
Q

For patients with DM and TG 140-499 mg/dL
1. TG 500-999
What is the recommended therapy?

A
  1. Optimize statin therapy
  2. Add on Fenofibrate
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41
Q

For patients with DM and TG 140-499 mg/dL
1. TG >1000
What is the recommended therapy?

A

Add on Fenofibrate
(alternative: Iscosapent Ethyl or Omega-3-Acid Ethyl Esters)

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42
Q

What are the preferred agents for VTE?

A

DOACs

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43
Q

Pradaxa and Savaysa should be started how many days after parenteral?

A

5-10 days after

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44
Q

What are the first line therapy options for HTN?

A
  1. ACEs
  2. ARBs
  3. CCBs
  4. Thiazides
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45
Q

What drugs can be utilized in the treatment of AFib?

A
  1. Amiodarone
  2. Digoxin
  3. Dofetilide
  4. Metoprolol Tartrate
  5. Flecainide
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46
Q

DOACs can also be utilized as therapy in what type of AFib?

A

Nonvalvular

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47
Q

Warfarin can also be utilized as therapy in what type of AFib?

A

Valvular

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48
Q

What drugs have Symptom Benefit in the treatment of HFrEF?

A

Loop Diuretics

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49
Q

What drugs have Hospitalization Benefit in the treatment of HFrEF?

A
  1. Digoxin
  2. Ivabradine
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50
Q

What drugs have Mortality Benefit in the treatment of HFrEF?

A
  1. ACE
  2. ARB
  3. ARNI
  4. BB
  5. SGLT2
  6. ARA
  7. Isosorbide/Hydralazine
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51
Q

Humalog

A

Lispro - Rapid Acting
Onset: 15-30 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat

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52
Q

Admelog

A

Lispro - Rapid Acting
Onset: 5 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat

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53
Q

Novolog

A

Aspart - Rapid Acting
Onset: 15-30 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat

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54
Q

Fiasp

A

Aspart - Rapid Acting
Onset: 5 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat

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55
Q

Afrezza

A

Rapid Acting
Onset: 10-15 mins
Peak: 2 hrs
Duration: 3-5 hrs
Dosing: Before you eat

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56
Q

Which rapid acting insulin has a U-200 formulation?

A

Humalog

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57
Q

Humulin R

A

Short Acting
Onset: 30-60 mins
Peak: 2-3 hrs
Duration: 6-8 hrs
Dosing: Before you eat

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58
Q

Novolin R

A

Short Acting
Onset: 30-60 min
Peak: 2-3 hrs
Duration: 6-8 hrs
Dosing: Before you eat

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59
Q

What short acting insulin has a U-500 formulation?

A

Humulin R

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60
Q

Humulin NPH

A

Intermediate Acting
Onset: 2-4 hrs
Peak: 4-6 hrs
Duration: 8-12 hrs
Dosing: BID

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61
Q

Novolin NPH

A

Intermediate Acting
Onset: 2-4 hrs
Peak: 4-6 hrs
Duration: 8-12 hrs
Dosing: BID

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62
Q

Lantus

A

Glargine - Long Acting
Onset: 2 hrs
Peak: PEAKLESS
Duration: 24 hrs
Dosing: QD

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63
Q

Levemir

A

Detemir - Long Acting
Onset: 2 hrs
Peak: 6-8 hrs
Duration: 24 hrs
Dosing: QD

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64
Q

Toujeo

A

Glargine - Long Acting
Onset: 2 hrs
Peak: 6-8 hrs
Duration: 36 hrs
Dosing: QD

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65
Q

Tresiba

A

Degludec - Long Acting
Onset: 2 hrs
Peak: 6-8 hrs
Duration: 42 hrs
Dosing: QD

66
Q

Basaglar

A

Glargine - Long Acting
Onset: 2 hrs
Peak: 6-8 hrs
Duration: 30 hrs
Dosing: QD

67
Q

Semglee

A

Glargine - Long Acting
Onset: 2 hrs
Peak: 6-8 hrs
Duration: 24 hrs
Dosing: QD

68
Q

Which TWO long acting insulins are considered bio similar?

A
  1. Basaglar
  2. Semglee
69
Q

Which long acting insulin has a U-200 Formulation?

70
Q

Which long acting insulin has a U-300 Formulation?

71
Q

When should Humalog, Admelog, and Novolog be administered in relation to eating?

A

15 minutes prior to eating

72
Q

When should Fiasp be administered in relation to eating?

A

15 minutes prior to eating or 20 minutes after

73
Q

When should Afrezza be administered in relation to eating?

A

At the beginning of the meal BUT allow the cartridge to sit at room temp for 10 MINUTES before

74
Q

When should Humulin R be administered in relation to eating?

A

30 minutes prior to eating

75
Q

When should Humulin N be administered in relation to eating?

A

Administer once or twice daily

76
Q

When should Lantus, Basaglar, Semglee, and Toujeo be administered?

A

In the evening or before bed

77
Q

When should Levemir be administered?

78
Q

When should Humalog Mix and Novolog Mix be administered in relation to food?

A

15 minutes prior to AM and PM meal

79
Q

When should Humulin Mix be administered in relation to food?

A

30-45 minutes before AM and PM meal

80
Q

Soliqua

A

Insulin Glargine + Lixeisenatide

81
Q

Glucophage/Glumetza Pearls

A

CI = eGFR <30, do not initiate if eGFR 30-45
AE: Diarrhea, GI effects, DECREASED B12
Warning: Lactic Acidosis

82
Q

Sulfonylureas Pearls

A

Amaryl, Diabeta/Micronase, Glucotrol
CI: T1DM and Sulfa Allergy
AE: Weight Gain, HYPOGLYCEMIA, GI Upset
DDI: Beta Blockers can mask symptoms of hypoglycemia

83
Q

When should Amaryl, Diabeta, Glucotrol be taken in relation to food?

A

QD WITH Breakfast

84
Q

Are sulfonylureas independent or dependent of glucose?

A

INDEPENDENT

85
Q

What drugs have the highest risk of HYPOglycemia?

A
  1. Sulfonylureas
  2. Insulin
86
Q

Meglitinides Pearls

A

Prandin and Starlix
CI: T1DM
AE: Weight Gain, Hypoglycemia, GI Upset
DDI: BB

87
Q

When should Prandin and Starlix be administered in relation to food?

A

TID 30 minutes before a meal

88
Q

Are Meglitinides independent or dependent of glucose?

89
Q

Thiazolidinediones Pearls

A

Actos and Avandia
CI: Class 3 or 4 Heart Failure and T1DM
AE: EDEMA, weight gain
Warning: risk for bladder cancer and hepatic dysfunction

90
Q

When should Actos and Avandia be taken in relation to food?

A

Once DAILY

91
Q

DPP-4 Inhibitor Pearls

A

Januvia, Onglyza, Tradjenta, Nesina
AE: HA, Arthralgia, Pharyngitis
Warning: Pancreatitis

92
Q

When should Januvia, Onglyza, Tradjenta, and Nesina be taken in relation to food?

A

Once DAILY

93
Q

Are DPP-4 Inhibitors independent or dependent on glucose?

94
Q

When should you dose adjust Januvia and Onglyza?

95
Q

When should you dose adjust Nesina?

96
Q

SGLT-2 Inhibitor Pearls

A

Invokana, Farxiga, Jardiance, and Steglatro
CI: Dialysis
AE: Increased Urination, UTI, Genital fungal infections
Warning: lower limb amputations

97
Q

When should you administer Invokana, Farxiga, Jardiance, and Steglatro in relation to food?

A

Once DAILY

98
Q

When should you AVOID Invokana and Jardiance?

99
Q

When should you AVOID Farxiga and Steglatro?

100
Q

GLP-1 Agonist Pearls

A

Byetta, Victoza, Adlyxin, Trulicity, Ozempic, Rybelsus, Mounjaro
AE: Nausea, Diarrhea, and HA
Warning: Pancreatitis

101
Q

When should you administer Byetta in relation to food?

102
Q

When should you administer Victoza and Adlyxin in relation to food?

103
Q

When should you administer Trulicity, Ozempic, and Mounjaro in relation to food?

104
Q

When should you administer Rybelsus in relation to food?

A

PO 30 Minutes prior to FIRST food

105
Q

Are GLP-1 Agonists independent or dependent of glucose?

106
Q

Precose Pearls

A

CI: GI Disorders and IBD
AE: Flatulence and Diarrhea
Warning: Increased LFTs

107
Q

When should you administer Precose in relation to food?

A

TID PO with FIRST BITE of food
SKIP dose if you SKIP a meal

108
Q

Symlin Pearls

A

CI: Gastroparesis
AE: Nausea
Counsel: Admin in thigh or abdomen

109
Q

When should you administer Smylin in relation to food?

A

TID SQ with MEALS

110
Q

How do you calculate the Total Daily Dose TDD?

A

0.5 units/kg/day

111
Q

How do you calculate the Rapid Acting Correction Factor CF?

A

1800/TDD
“give 1 unit for every CF over target”

112
Q

How do you calculate the Regular Correction Factor CF?

A

1500/TDD
“give 1 unit for every CF over target”

113
Q

How do you calculate the Insulin-to-Carbohydrate Ratio?

A

500/TDD = Insulin to Carb Ratio
“give 1 unit for every __ grams of carbs”

114
Q

What is the MOA of Biguanides?

A

Decrease hepatic glucose production, improved insulin sensitivity, decreased GI carb/glucose absorption

115
Q

What is the MOA of Sulfonylureas?

A

Increased insulin secretion by beta cells, glucose INDEPENDENT, insulin secretagogue

116
Q

What is the MOA of Meglitinides?

A

Increased insulin secretion by beta cells, glucose DEPENDENT, insulin secretagogue

117
Q

What is the MOA of TZDs?

A

Decreased hepatic glucose production, improved insulin sensitivity

118
Q

What is the MOA of DPP4 Inhibitors?

A

Increased insulin secretion by beta cells, decreased glucagon secretion, increases activity go GLP1 and GIP

119
Q

What is the MOA of SGLT2 Inhibitors?

A

Decreased reabsorption of filtered glucose to increase excretion

120
Q

What is the MOA of GLP1 Agonists?

A

Increased insulin secretion by beta cells, decreased glucagon secretion, delayed gastric emptying, increased satiety

121
Q

What is the MOA of Precose?

A

Decreased GI carb/glucose absorption

122
Q

What is the MOA of Symlin?

A

Delayed gastric emptying, decreased postprandial glucagon secretion, decreased appetite

123
Q

Bentyl Pearls

A

Dicyclomine- Anticholinergic
CI: Glaucoma, Urinary/GI Obstruction, Severe UC, MI, or CVD

124
Q

Levsin/Levbid Pearls

A

Hyoscyamine- Anticholinergic
CI: Glaucoma, Urinary/GI Obstruction, Severe UC, MI, or CVD
DDI: Antacids and Alcohol

125
Q

Lomotil Pearls

A

Diphenoxylate/Atropine- Opioid Agonist+Anticholinergic
Short term use within 10 DAYS

126
Q

Bentyl, Levsin/Levbid, and Lomotil are anticholinergics used for what?

127
Q

Lotronex

A

Alosetron- 5HT3 Antagonist
AE: Constipation
Warning: Ischemic Colitis – REMS
FEMALES ONLY

128
Q

Lotronex is for WOMEN ONLY and used for what?

129
Q

Viberzi

A

Eluxadoline- Mu-Opioid Receptor Agonist
DDI: OATP1B1 Inhibitors
Warning: Pancreatitis and Severe Constipation

130
Q

Viberzi has a pancreatitis risk but it is used for what?

131
Q

Imodium

A

Loperamide- Peripheral Mu-Opoid Receptor Agonist
CI: Diarrhea secondary to infection
Warning: CNS infection

132
Q

Imodium is OTC and can be used for what?

133
Q

Miralex

A

PEG- Osmotic Laxative
May take 48-96 hours for effect

134
Q

CoLyte

A

PEG+Electrolytes- Osmotic Laxative

135
Q

Chronulac

A

Lactulose- Osmotic Laxative
AE: Gas or Abdominal Discomfort
May take 24-48 hours for effect

136
Q

How do you titrate Chronulac?

A

Titrate to 2-3 stools/day

137
Q

Miralax, CoLyte, and Chronulac are Osmotive Laxatives that draw water into the intestine to hydrate and soften stool, what are they used for?

138
Q

Senokot

A

Senna- Stimulant Laxatives
QD at HS
Administer 2hrs before or after other meds
Onset within 6-24 hrs

139
Q

Senokot is used for what?

140
Q

Colace

A

Docusate- Stool Softener
DDI: Do NOT COMBINE with Mineral Oil
May take 12-72 hrs for effect

141
Q

Colace is a prevention method used for what?

142
Q

Amitiza

A

Lubiprostone- Pro-Secretory Agent
CI: GI Obstruction
AE: NAUSEA, diarrhea, abdominal pain, and HA
TAKE WITH FOOD
FEMALES >18 yrs ONLY

143
Q

Amitiza is used in females ONLY for what?

144
Q

Linzess

A

Linaclotide- Pro-Secretrory Agent
CI: GI obstruction and use in pediatrics <6 yrs
AE: Diarrhea, abdominal pain
Take on EMPTY stomach

145
Q

Linzess is CI’d in children less than 6 yrs, but used in what?

146
Q

Relistor

A

Methylnaltrexone- PAMORA
Warning: Risk of GI perforation
NEVER use in GI Obstruction or Impaired Integrity

147
Q

Prucalopride

A

Motegrity- Selective 5-HT Agonist
AE: Suicidal Ideation

148
Q

Relistor (PAMORA) and Prucalopride (Selective 5-HT Agonist) are both used in what?

149
Q

For Opioid Induced Constipation, what is first line?

150
Q

Combination of at least 2 types of Laxatives such as osmotic + stimulant or stimulant + stool softener is recommended before what?

A

Escalating Therapy

151
Q

In Opioid-Induced Constipation, what is recommend for administration and escalation?

A

SCHEDULED USE
Escalate to mu-opioid antagonist

152
Q

Compazine

A

Prochlorperazine
CI: Movement disorders
AE: Drowsy/Dizzy/Blurred Vision/EPS

153
Q

Phenergan

A

Promethazine
CI: IM/IV/SQ AVOIDED due to risk of tissue injury
AE: Drowsy, Anticholinergic, EPS

154
Q

Zofran

A

Ondansetron
AE: QT Prolongation

155
Q

Reglan

A

Metoclopramide
CI: GI obstruction, EPS
AE: QT Prolongation

156
Q

What is the limit of use for Reglan?

157
Q

What are the ALARM symptoms for GERD?

A
  1. Trouble or Pain swallowing food
  2. Vomiting with blood, or bloody/black stools
  3. Unintentional weight loss
  4. Choking
158
Q

Warfarin has an interaction with what CYP2C9?

159
Q

Aspirin has an interaction with what drug that causes decreased cardio protection?

160
Q

Aspirin has an interaction with what drug that causes increased GI bleed risk?

Pharmacy Practice V (19 decks)

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