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NPLEX 2 Flashcards > DONE: Pharmacology (core + elective) > Flashcards

DONE: Pharmacology (core + elective) Flashcards

Goes alphabetically, then has big ideas at the end with ZZ. the elective drugs dont have a lot of info on them - mainly just class and sometimes clinical use

1
Q

5-fluorouracil

  • class? what phase does it affect?
  • interacts with?
  • pregnancy?
A

pyrimidine anti-metabolite that blocks methylation and interferes with DNA/RNA synthesis (*S phase) (antineoplastic)

Tx: oral: colon, rectal, breast, stomach, pancreatic cancer
topical: actinic keratosis, superficial BCC

AEs: leukopenia, thrombocytopenia, stomatitis, ulcers, bleeding and diarrhea, hemorrhage, N/V, rashes, hyperpigmentation, alopecia

interacts: may increase warfarin effects, reduce response to vaccines

CI: topical to mucous membranes, exposure to sun, pregnancy D

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2
Q

acetaminophen

  • class?
  • how does it work?
  • when do we mainly use?
  • how much can shut down the liver?
A

Tylenol, non-opioid, non-anti-inflammatory, analgesic, antipyretic
synthetic non-opioid p-aminophenol derivative

inhibition of PG synthesis and blockage of pain impulses in the CNS > pain relief
vasodilation and increased peripheral blood flow in the hypothalamus > fever reduction

Tx: pain (esp when someone has ASA-induced asthma, peptic ulcers, bleeding conditions, gout), fever (esp in children to prevent ASA-induced Reye’s syndrome)

AEs: asthma, skin reactions, hepatotoxic, acute renal tubular necrosis in high doses

interacts: 3 grams taken with alcohol can shut down the liver
contraindications: not to exceed > 4 g/day

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3
Q

acetylcysteine - elective

A

NAC - mucolytic

antidote for acetaminophen overdose

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4
Q

acetylsalicylic acid

  • class? how does it work?
  • cause alkalosis? acidosis? metabolic? resp?
  • amount for which disease?
  • side effects? on blood? GI? kids?
  • pregnancy?
A

Aspirin, Zorprin
NSAID, nonopioid analgesic, antipyretic, antiplatelet
inhibits COX (responsible for synthesis of PG and TX)

Tx:
low dose, usu 81 mg: 1st med given in suspected MI, post ischemic stroke, angina pectoris, TIA
medium dose, usu 500 q 6 hours: fever, pain
high doses up to 4000 daily: RHD, RF, RA

AEs: (mneumonic is ASPIRRIN is HUMBle ForEVER)
Asthma
Salicyclism: dose-dependent reversible vertigo, vomiting, tinnitus, hearing loss
Peptic Ulcers
Irritated GI tract
Respiratory changes at toxic levels - increased, resp alkalosis, resp depression
Reye’s syndrome: swelling in the liver and brain usu when children/adolescents are recovering from a viral infection
Intolerance to glucose at toxic levels
Nephrotoxicity
Hepatotoxicity/Hepatitis, Hyperuricemia even at low doses
*Urticaria, angioedema, rash
Metabolic acidosis at high levels
Bleeding in GI tract, prolonged bleed time thrombocytopenia, bruising
FEVER at toxic levels

prolonged bleed time. thrombocytopenia, rash, bruising,

interacts: alcohol and corticosteroids inc risk of GI ulcer, ASA increases phenytoin levels
contraindicated: hypersensitivity, < 12 yo esp post viral sxs, lactation, hemophilia, hemorrhagic disorders (G6PD), gout, severe renal/hepatic impairment, pregnancy C (D in 3rd trimester)

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5
Q

acyclovir - elective

A

nucleoside analogue

Tx of keratitis (HSV1)

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6
Q

adalimumab

  • class?
  • AEs?
A

TNF-a antagonist/inhibitor, DMARD

Tx AnkSpon, RheumArthritis, UC, inflammatory conditions, psoriatic arthritic, and plaque psoriasis

AEs: inc CPK, can activate latent TB

interacts: live vaccines
contraindicated: TB

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7
Q

albendazole - elective

A

antihelminthic

used to treat cystic hydatid disease - caused by dog tapeworm in the liver lung and abdominal lining

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8
Q

albuterol (salbutamol)

  • class?
  • most common AE?
  • interacts w ? to cause?
A

B2 adrenergic agonist, sympathomimetic: bronchodilator, anti-asthmatic: also decreased uterine contractility

TX: acute asthma, COPD

AEs: fine skeletal muscle tremor esp in hands, HTN, angina, vertigo, drying

interacts: hypokalemia with diuretics, corticosteroids, and xanthines, MAOIs, TCAs, sympathomimetics, sulfamethoxazole, reduces serum levels of digoxin

CI: eclampsia, really any issues in pregnancy

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9
Q

alendronate

  • causes 2 hypo____?
  • directions for taking
A

Fosamax, bone-resorption inhibitor, bisphosphonate
binds to hydroxyapatite crystals in bone, inhibits osteoclast-mediated bone resorption, decreases mineral release and collagen/matrix breakdown in bone

tx: treatment and prevention of OP, Paget’s disease of bone

AEs: hypocalcemia, hypophosphatemia, abd pain, MSK pain

interacts: interfered absorption with multivalent cations - mineral water, coffee, juice, other beverages **take with a full glass of plain water at least 30 minutes before food or drink or anything in the upright position
contraindicated: hyppocalcemia, esophageal abnormalities delaying esophageal emptying, inability to stand or sit upright for 30 minutes

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10
Q

allopurinol

- treats? class?

A

Aloprim, xanthine oxidase inhibitor, antigout
inhibits hypoxanthine > xanthine > uric acid (decreases uric acid without disrupting synthesis of purines

tx: prevention of gout, prevention and tx of hyperuricemia, prevention of uric acid nephropathy in chemo

AEs: GI upset, rash (maculopapular), acute got attack

interacts: antineoplastics (might increase risk of BM suppression), thiazide diuretics (might increase risk of allopurinol tox), amoxicillin and ampicillin could increase risk of rash, alcohol could increase uric acid levels

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11
Q

alprazolam

  • class? how it works?
  • treatment of?
  • most common AE?
  • interacts?
A

Xanax: benzodiazepine: binds to GABA-a receptors (chloride ion channels) and induces them to remain open longer > hyperpolarize the cell > inhibitory effect on CNS > anxiolytic, muscle-relaxant, antoconvulsant, antidepressant, sleep-modifying

Tx: short term management for anxiety panic disorder, GAD, phobias

AEs: drowsiness, memory problems, amnesia-like sxs, disorientation, depression, headache, sleep disturbance, confusion, dizziness

interacts: alcohol and CNS depressants
contraindicated: acute narrow-angle glaucoma, preexisting CNS depression or coma, resp depression, acute pulmonary insufficiency or sleep apnea, severe hepatic impairment, pregnancy D, lactation

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12
Q

alprostadil - elective

A

prostaglandin vasodilator

injection or suppository for treatment of ED

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13
Q

amantidine

  • tx for? how does it work?
  • interacts with?
A

antiviral, antiparkinsonian (anticholinergic): increases neuronal release of DA > can induce psychotic behaviors that look like schizophrenia

Tx: no longer for use in Flu A, for herpes zoster in IC pts, and parkinsons, txs fatigue for MS

AEs: dry mouth, confusion, seizures, psychosis, hallucinations, blurred vision

interacts: enhances antimuscarinics, and anticholinergics and levodopa dont take with CNS stimulants
contraindicated: pregnancy C, lactation, narrow angle glaucoma, epilepsy, seizures, severe renal impairment, gastric ulcers

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14
Q

amiodarone

  • what channels does it effect?
  • effect on ECG?
  • main use is in?
  • adverse effect outside of heart? avoid in which patient population?
  • avoid with which herb? which food? which lifestyle?
  • pregnancy?
A

cardiac ion channel blocker, Antiarrhythmic: blocks K/Na/Ca channels and adrenergic B receptors, prolongs cardiac repol, increase refractory period, slows HR, increases PR and QT intervals

Tx: SVT and ventricular arrhythmias, Vtach, afib (Use in pts with HF who have an arrhythmia)

AEs: pulmonary fibrosis, photosensitivity, heart block, dec HR, hypotension, hypo or hyper thyroidism, hepatotoxic (increased AST/ALT), deposits in cornea and skin gray skin

interacts: increases digoxin levels, antiarrhythmic agents, cyclosporine, phenytoin, increases hypotensive effects with other antiHTN
* SJW* grapefruit sun exposure

contraindications: severe sinus node dysfunction, 2 or 3 AV block, cardiogenic shock, pregnancy D and lactation, neonates < 1 mo

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15
Q

amitriptyline

  • class?
  • tx?
  • AE on ECG?
  • interactions?
A

tricyclic antidepressant: NE and 5HT reuptake inhibitor, blocks muscarinic and a-adrenoceptors

tx of depression and chronic pain, peripheral neuropathy, tension headaches (not cluster or migraine), panic disorder, GAD

AEs: lethargy, anticholinergic effects, hypotension, OD > wide QRS complex

interacts: MAOIS, SSRIs, clonidine, CNS depressants, anticholinergics, antiandrenergics
contraindicated: CVD

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16
Q

amlodipine

  • class
  • what kind of angina can it be used for?
  • most common side effect?
  • avoid with which food?
A

dihydropyridine calcium channel blocker: in cardiac and vascular smooth muscle > inhibits flow of calcium into cells > decreased muscle contraction > peripheral vasodilation > decreased myocardial contractility

Tx: HTN, Prinzmetal’s angina, stable angina

AE: edema, headache, hypotension

interacts: potentiates effects of TZ and ACEIs, avoid combining with BB in people with impaired LV function, has additive BP lowering effects with sildenafil, levels and effects are increased with grapefruit juice
contraindications: severe hypotension, shock, left ventricle outflow obstruction (aortic stenosis)

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17
Q

amoxicillin

  • class
  • treats? which bugs?
  • interacts with which 3 drugs?
  • pregnancy?
A

B-lactam ABX, extended spectrum penicillin: binds to PBP-1A inside the bacterial cell wall, opens the lactam ring, and inactivates the third/last stage of cell wall synthesis

Tx: MAP USE
M: meningitis caused by Listeria monocytogenes
A: acute otitis media, sinusisits, and bronchitis **first line
- effective against gram - rods (H flu)
- gram + cocci (pneumococci and S pyogenes)
- pneumonia
P: peptic ulcers - H. pylori
U: UTIs caused by PEE: proteus, E coli, enterococcus
S: salmonella, used as an alternative to G3 cephalosporin
E: extended spectrum w the use of a B-lactamase inhibitor (clavulanic acid)

AEs: hyperactivity, agitation, insomnia, dizziness, maculopapular rash, exfoliative derm, urticaria, diarrhea, N/V

interactions: increased levels with disulfiram and probenecid, decreased effects with tetracyclines

contraindicated: pen allergy and w/ cephalosporins
* *SAFE in pregnancy and used for UTIs in preg**

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18
Q

amoxicillin/clavulanate

  • why add clav?
  • different AEs?
  • pharm interactions?
A

*adding clavulanic acid makes amoxicillin less susceptible to degradation by B-lactamase- producing bacteria, this decreases antibiotic resistance

everything is the same as amoxicillin except:

AEs: headache, gas, bloating, reversible hepatitis

interactions: increased levels with disulfiram and probenecid, decreased effects with tetracyclines
* not as prevalent with amoxicillin alone, but are more prevalent with co-amoxiclav*

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19
Q

ampicillin - elective

A

penicillin

meningitis

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20
Q

anastrozole

  • class? inhibits which 2 hormones from being made?
  • treats?
  • most common AE?
  • pregnancy?
A

Arimidex, aromatase inhibitor, antineoplastic
- prevents the conversion of androstenedione > estrone, testosterone > E2 by inhibiting aromatase

tx: advanced or locally advanced breast CA, adjuvant in early breast CA

AEs: *hot flashes > vasodilation > fatigue, mood, N/V, weakness, arthritis, pain, pharyngitis, depression

interacts: estrogens decrease efficacy, tamoxifen decreases plasma concentration
contraindications: PREGNANCY X, premenopause

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21
Q

apixaban

A

Xa inhibitor, anticoagulant

afib, stroke prophylaxis, post op prophylaxis, DVT, PE

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22
Q

aripiprazole

  • used to treat? class? which R does it act on?
  • interactions?
A

Abilify: atypical antipsychotic: blocks 5HT and DARs in the limbic system > decreased response to serotonin and dopamine. inhibits H1 receptor, cholinergic R, and a-adrenergic R (however effects at these are much less than typical antipsychotics)

TX: schizophrenia, BD, MDD, irritability associated with autistic disorder

AEs: headache, anxiety, insomnia, SI, nausea, constipation, weight gain

interacts: CYP2D6 and CYP3A4, diabetes - use with caution, grapefruit juice

pregnancy C

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23
Q

atenolol

  • what receptor(s) does it act on?
  • what is the most common AE?
  • pregnancy cat?
A

Beta bLOcker (LOLO > OLOL) (selective B1 (heart only, not lungs) adrenoreceptor antagonist)
- reduces heart rate and contractility, causes vasoconstriction
Tx: GAD, phobias, HTN, angina, reduce CV mortality rate and risk of reinfarction
- AEs: fatigue, hypotension, bradycardia, cold extremities, bronchospasm, headache, nausea, nightmares
- interactions: nitrates and other hypotensives > more hypotension. digoxin > more bradycardia. decreases effects of DA
- contraindications: sinus brady, 1st deg heart block, cardiac failure, cariogenic shock, bronchospastic disease, peripheral vascular disease, caution in diabetes
- pregnancy category D

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24
Q

atezolizumab

A

PD1/PDL1 inhibitor

first line treatment of pts with metastatic non small cell lung cancer

also triple negative breast CA, small cell lung cancer, HCC, melanoma, urothelial carcinoma

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25
Q

atomoxetine - elective

A

Strattera: SNRI - increases levels of NE

ADHD

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26
Q

atorvastatin

  • class
  • most common SE
  • when mixed with this class, risk of rhabdo increases
  • interacts with which supplement? food? lifestyle?
  • pregnancy?
A

HMG-CoA reductase inhibitor, lipid lowering agent: inhibits the enzyme that catalyzes first step in cholesterol synthesis (HMG CoA > mevalonic acid). increases LDL receptors on hepatocytes > liver able to extract LDL and VLDL from serum > inc HDL, dec LDL, dec total chol, dec TGs

TX: reduce LDL, total chol, apo B and TG, inc HDL > primary hypercholesterolemia and mixed dyslipidemia

AEs: hepatic enzyme elevations and dysfunction, myositis, rhabdomyolysis most reported SE is myalgias

interacts: digoxin, fibrates increases risk of rhabdomyolysis, increased serum concentration of OCPs (norethindrone and ethinyl estradiol)
* RYR - dont use together *grapefruit juice *alcohol use - increased hepatic effects

contraindications: active liver disease, porphyria, lactation, PREGNANCY X - must be on contraception if of child bearing age

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27
Q

atropine

  • class
  • antidote for? other uses?
  • adverse effects by receptor?
  • pregnancy?
  • if overdose, what is the antidote?
A

anticholinergic, antiarrhythmic, vagolytic: competitive muscarinic antagonist:

Tx: antidote for cholinesterase inhibitor poisoning nerve gas, insecticide, in the tx of bradycardia in emergencies, urinary incontinence, mydriatic for ophthalmic exams

AEs: dry mouth, constipation, flushing and dry skin, palpitations, arrhythmias, photophobia, raised intraocular pressure

by blocking the following receptors, we see the following SXS
M1: sedation and at high doses psychosis
M2: tachycardia and mild vasodilation
M3: decreased GI motility, urinary retention, cycloplegia with mydriasis

high doses: tachycardia, hyperpyrexia, restlessness, confusion, excitement, hallucinations, delirium, circulatory failure, respiratory depression

interacts: other antocholinergics
contraindications: glaucoma, chronic respiratory disease, sick sinus syndrome, thyrotoxicosis, cardiac failure, pyloric stenosis, BPH, pregnancy C, lactation
* atropine poisoning is tx with cholinesterase inhibitors/physostigmine

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28
Q

azithromycin

  • class? effects?
  • treat what bugs? for what diseases can we give a single dose of?
  • effects on ECG?
  • interacts?
  • pregnancy?
A

macrolide antibiotic: binds 50S

Tx: RTIs (otitis media and sinusitis) caused by *strep, pneumococci, h flu, and legionella. single dose treatment for chlamydial urethritis, chancroid, and mycobacterium avium infections

AEs: MACrolides
Motility enhanced GI disturbances (diarrhea)
Allergic reaction
Cholestatic hepatitis
Cardiac arrhythmias (increased QT interval)

interacts: antacids with Al and Mg. not many drug/drug interactions

Contraindications: liver disease **SAFE in pregnancy

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29
Q

baclofen - elective

A

skeletal muscle relaxant - GABA agonist

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30
Q

beclomthasone - elective

A

corticosteroid - decreased swelling and irritation in the airways

asthma

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31
Q

benzonatate - elective

A

antitussive, non narcotic

cough from the common cold, pneumonia, bronchitis, emphysema, asthma

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32
Q

benzoyl peroxide

- what bacteria is it used against?

A

anti-acne antibacterial: releases active O2, effective against propionobacterium acnes, keratolytic and desquamative effect, converted to benzoic acid in the skin

Tx: acne

AEs: dryness, peeling, erythema, contact dermatitis

no specific interactions

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33
Q

benztropine - elective

A

anticholinergic

parkinsons disease

AEs: same as belladonna/atropine anticholinergic

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34
Q

bethanechol - elective

A

genitourinary cholinergic

tx: urinary retention

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35
Q

bicalutamide - elective

A

nonsteroidal antiandrogen

prostate CA

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36
Q

bisacodyl

  • class and how does it work?
  • uses
  • excessive use > ?
  • effect on K
  • interacts with ?
A

stimulant laxative: inhibits colonic fluid reabsorption and increases luminal pressure, stimulates peristalsis

tx: before colonoscopy or surgery, acute constipation, constipation due to opioid use (+ docusate)

AEs: excessive use can lead to tolerance and laxative dependence, cramping, nausea, fluid and electrolyte depletion (hypoKalemia)

interactions: do not give antacids or milk within 1 hour of taking
contraindications: obstruction, severe impaction, sxs of appendicitis or acute surgical abd, comiting, rectal bleeding ,gastroenteritis

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37
Q

bismuth subsalicylate

  • actions?
  • treats which bug?
  • weird AF side effect?
  • two drug interafctions?
  • hypersensitivity to what other meds?
  • pregnancy?
A

salicylate (antisecretory), bismuth (antimicrobial anti-inflammatory, fluid transport modifier: stimulates the absorption of fluid and electrolytes across intestinal wall. when hydrolyzed to salicylic acid > inhibits synthesis of PG that is responsible for intestinal inflammation and hypermotility. also binds toxins made by e coli. has weak antacid properties

tx: nausea, heartburn, indigestion, upset stomach, diarrhea, H pylori

AEs: nausea, black tongue and black tarry stools

interactions: increased risk of bleeding when taken with warfarin, could decrease absorption of tetracycline
contraindications: hypersensitivity to ASA, other salicylates, pregnancy C/D, lactation

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38
Q

botulinum toxin - elective

A

neurotoxic protein made by C botulinum: inhibits Ach release > flaccid paralysis

botox, cerebral palsy, refractory overactive bladder, strabismus, hyperhidrosis, migraines

AEs: facial paralysis, muscle weakness, trouble swallowing

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39
Q

bromocriptine

  • how does it work?
  • to treat?
  • adverse effects?
  • interacts with?
  • pregnancy? lactation?
A

Dopamine agonist, antiparkinsonian: an ergot-derived D2 and serotonin receptor agonist: acts on the pituitary gland to block production and release of GH

Tx: hyperprolactinemia, prolactin-secreting adenomas, early parkinsonian syndrome, acromegaly, female infertility, pituitary adenoma (prolactinoma type)

AEs: DOPAA + Ergot-like effects
Disco-like Dyskinesia, hypOtension, Psychosis, confusion, hallucinations and delusions, Agitated GI - nausea, vomiting, Arrhythmias, Ergot-like effects (vasospasm of fingers/toes (raynauds), pulmonary fibrosis

interacts: azole antifungals and macrolide ABX, other ergot alkaloids
contraindications: breast carcinoma, uncontrolled HTN, severe ischemic heart disease, lactation (but is safe in pregnancy B)

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40
Q

budesonide oral - elective

A

corticosteroid

asthma

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41
Q

bupivacaine - elective

A

local anesthetic > prevents depol by binding to Na channels and blocking influx

childbirth, dental work

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42
Q

buprenorphine - elective

A

Suboxone: opioid partial agonist-antagonist

opioid use disorder, acute pain, chronic pain

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43
Q

bupropion

A

Wellbutrin: SARI: inhibits neuronal reuptake of DA, 5HT, and NE

tx: depression, smoking cessation

AEs: GAPS: GI upset, agitation, psychosis at higher doses, somnolence, seizures (at significant high doses)

interacts: MAOIs

CI: seizure disorder, MAOIs, hx of anorexia or bulimia

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44
Q

buspirone

  • class? what R does it work on?
  • advantages over benzos?
A

Buspar: azaspirodecanedione: non benzo anxiolytic: high affinity for 5-HT 1A and 2A receptors, moderate affinity for D2 Rs, NO affinity for GABA Rs.

Txs: GAD

Advantages over benzos: almost no risk of dependence, no withdrawal sxs on abrupt discontinuation, does not cause marked sedation or psychomotor impairments, does not kindof increase CNS depressant effects of other drugs such as benzos, TCAs, alcohol

AEs: nervousness, GI upset, increase in HR and palpitations, miosis, increased BP with MAOIs

contraindications: epilepsy, children < 18, MAOIs

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45
Q

caffeine

  • class?
  • treats?
A

xanthine, CNS stimulant: phosphodiesterase inhibitor: antagonizes central adenosine receptors. CNS and resp stim, bronchodilating and diuretic.

Tx: migraine

Aes: literally everything happening to me while i drink coffee and study for boards

interacts: benzos, cipro, B-adrenergic agonists and ASA

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46
Q

calcipotriol/calcipotriene

  • treats?
  • contraindicated where?
  • can cause increase in which element in blood?
A

synthetic derivative of calcitriol, a form of vit D: evidence suggests it is equiv to natural vitaminD in its effects on proliferation and differentiation of cell types

Tx: moderate plaque psoriasis

AEs: burning, itching, skin irritation

no interactions

contraindicated: on face, hypercalcemia, Vit D toxicity, pregnancy C

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47
Q

calcitonin - elective

A

hormone made by C cell sin the thyroid

increases deposition of Ca and Ph in the bone, lowers blood levels > inhibits Ca resorption by inhibiting osteoclasts. decreased reabsorption of Ca and Ph in the kidneys proximal tubule to decrease plasma Ca concentration

hypercalcemia and Paget’s disease

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48
Q

canagliflozin

  • class and how it works
  • most common AE
  • what class of meds does it interact with and what does it increase the risk of?
  • causes an increase in what risk?
A

SGLT2I: lowers the renal glucose threshold > increases the excretion of glucose by urine

Tx: DM2

AEs: female genital mycotic infections, increased urination, male genital mycotic infections, vulvovaginal pruritus, thirst

interacts: increases the risk of dehydration when used with diuretics
contraindications: 2 fold increase of lower limb amputation in pts who had or had risks of CVD, severe renal impairment with a GFR < 30

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49
Q

cannabis

- how does it effect stuffs in the body?

A

cannabinoid, antiemetic: THC is a central and peripheral acting: increases catecholamines, inhibits parasympathetic activity, inhibits PG biosynthesis

tx: analgesia, antiemetic, appetite stimulant, glaucoma

AEs: lol

interacts: sedatives

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50
Q

capsaicin - elective

A

non narcotic analgesic

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51
Q

carbamazepine

  • how does it work?
  • three main treatments? 1st line?
  • most common side effects?
A

Tegretol: anticonvulsant: inhibits use-dependent Na channels > pain relief seizure control, anticholinergic, central antidiuretic, anti-arrhythmic, muscle relaxant, antidepressant, sedative, and neuromuscular blocking properties

tx of: Ma, Za, Pine: mania (bipolar), seizures, and pain (trigeminal neuralgia 1st line. peripheral neuropathy, AV malformation

AEs: ataxia, dizziness, drowsiness, N/V, dry mouth

interacts: reduces tolerance to alcohol and reduces the half life of doxycycline, decreased efficacy of OCPs, serum levels decrease w phenobarbitol and phenytoin

CI: BM depression, porphyria, pregnancy D (neural tube defects), MAOIs

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52
Q

carisoprodol

  • class? treats?
  • most common AEs?
A

carbamate derivative, skeletal muscle relaxant: blocks interneuronal activity in the descending reticular. formation and spinal cord

TX: painful muscle spasms

AEs: dizziness and drowsiness, nausea, tachycardia, orthostatic hypotension, rash

interacts: opioids and sedative hypnotics

CI: porphyria, lactation

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53
Q

carvedilol

A

alpha and BB

a fib

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54
Q

cefdinir - elective

A

third generation cephalosporin ABX

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55
Q

cefepime

A

cephalosporin ABX

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56
Q

ceftaroline - elective

A

cephalosporin ABX

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57
Q

Ceftriaxone

A

cephalosporin ABX

gonorrhea, PID, meningitis
IV tx of pyelonephritis

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58
Q

cefuroxime - elective

A

second generation cephalosporin ABX

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59
Q

celecoxib

  • class
  • first line for?
  • two most common AEs
  • avoid with with CYP inhibitors?
  • avoid with which surgery?
A

Celebrex, analgesic, NSAID, COX2i
inhibits the conversion of arachidonic acid to PGs without having an effect on PGs

Use: first line for AnkSpon. OA, RA, dysmenorrhea, pain

AEs: most common and headache and hypertension. abd pain, diarrhea, nausea, URTI

interacts: co-admin with fluconazole increases plasma concentrations of celecoxib, avoid coadmin with CYP450 2C9 inhibitors, inc risk of bleeds when used with oral corticosteroids/anticoags/alcohol, NSAIDs might increase risk of CVEs
contraindications: ASA allergy, chronic hepatitis, CABG, pregnancy (D), lactation

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60
Q

Cephalexin

  • class?
  • first line tx of ?
  • most common SE?
  • drug interaction with? causing what?
  • pregnancy?
A

first generation cephalosporin, B-lactam ABX (same MOA)

TX:

  • RTIs: strep pneum and pyogenes
  • otitis media: strep pneum, H flu, staph aur, strep pyo
  • skin infections: staph aur, strep pyo **1st line for cellulitis **mastitis, impetigo
  • bone infections: staph aur, proteus mirabilis
  • UTI (including acute prostatitis): e coli, proteus, kleb

AEs: diarrhea, indigestion, gastritis, abd pain

interacts: metformin effects are increased > sxs of hypoglycemia

contraindicated: allergy to penicillin
* *SAFE in pregnancy**

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61
Q

cetirizine - elective

A

Zyrtec antihistamine

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62
Q

cholera vaccine - elective

A

single dose live vaccine oral
18-64 yo traveling to an area with cholera
- shitty and theyre going to stop making it

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63
Q

cimetidine - elective

A

H2 blocker

heartburn

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64
Q

ciprofloxacin

  • class? effect on?
  • treats what bugs?
  • adverse effects? on ECG?
  • dont take with?
  • contraindicated in which 2 pt populations?
A

fluoroquinolone antibiotic: promotes the breakage of dsDNA and inhibits DNA gyrase

TX: PLUGS from GM
Pseudomonal
Legionella (2nd line to macrolide)
UTIs (1st line)
GI infections (1st line)
S aureus and pneumonia (gram +)
Gonorrhea (gram - )
Meningococcal meningitis
Mycobacteria (2nd line for TB)

also treats: exposure to anthrax but dont yet have sxs and used in combination w the anthrax vaccine

AEs: A PLACE forbidden for <18
Arthropathy (<18 yo)
Adult tendonitits and rupture (esp > 60)
Peripheral neuropathy, worsening MG
Liver toxicity, hepatitis
Agitated GI tract
C diff associated diarrhea
Cardiac QT prolongation
Exfoliative dermatitis

interacts: decreased absorption by cations (antacids, iron, zinc, bismuth), increases serum levels of warfarin, theophylline
* contraindicated in peds d/t risk of irreversible arthropathies and cartilage destruction*, also contraindicated in MG as it can worsen sxs

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65
Q

cisplatin - elective

A

chemo

testicular, ovarian, bladder, cervical, head/neck, lung

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66
Q

clarithromycin

A

macrolide ABX

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67
Q

clindamycin

  • class? when do we use?
  • what do we treat? what bugs?
  • 2 serious AEs?
  • interacts with?
A

lincosamide ABX, protein synthesis inhibitor: indicated for those with severe penicillin allergies: reversibly binds 50S subunit of the ribosome > stunted cell growth

TX: used for infections caused by strep, staph, and other GRAM +, also anaerobes including bacteroides. empyema, topical for mild acne vulgaris, endocarditis prophylaxis (esp when needing dental work)

AEs: pseudomembranous colitis, inc AST/ALT/BR, thrombocytopenia, C diff super infection

interacts: potentiates neuromuscular blocking agents

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68
Q

clobetasol propionate - elective

A

corticosteroid

eczema, contact derm, psoriasis

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69
Q

clomiphene - elective

A

ovulatory stimulant - E agonist or antagonist

female infertility in PCOS to induce ovulation

inc risk of ovarian cancer and weight gain

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70
Q

clonidine

  • what receptors does it act on and where in the body?
  • pregnancy category?
  • explain the clonidine suppression test
A

a2 adrenoreceptor agonist, centrally acting sympathomimetic: stimulates a2 receptors in the brain stem > reduced sympathetic outflow > release of NE is reduced > decrease in vasoconstriction > decrease in CO and HR

Tx: essential, renal, and malignant HTN, severe pain in CA patients, ADHD (if XR version of drug)

AEs: rebound HTN, bradycardia, sedation, constipation, dry mouth, N/V, pruritus, dermatitis if via transdermal patch, anxiety, somnolence, confusion, drowsiness, dizziness, fatigue, headache, vivid dreams

interacts: hypotensive action is potentiated by diuretics, vasodilators, antiHTN. effects are decreased by TCAs and centrally-acting alpha blockers. may enhance toxicity due to digitalis, lithium.

contraindication: disorders of cardiac pacemaker activity and conduction
- pregnancy C

Clonidine Suppression Test: if someone has a pheochromocytoma, clonidine will not suppress Epi/catecholamines

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71
Q

clopidogrel

  • class, how does it work?
  • what does it treat?
  • AEs?
  • CYP interaction?
A

ADP-induced platelet aggregation inhibitor, antiplatelet
irreversibly inhibits the binding of ADP to P2Y12 receptor > blocking ADP plt agg > halts interaction of fibrinogen with platelets and platelet plug formation

Tx: claudication/chronic arterial insufficiency, ischemic stroke, prophylaxis of MI and stroke, ACS/unstable angina, placement of a coronary stent

AEs: BITE: bleeding disorders, Irritated GI tract, TTP (rare), nEutropenia

interacts: NSAIDS inc risk of GI bleeds, high doses increase warfarin levels and inhibit P4502C19* (phenytoin, tamoxifen, NSAIDs), decreased action by *CYP2C19 inhibitors like PPIs
contraindicated: active bleed, coagulation disorder

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72
Q

clozapine - elective

A

atypical antipsychotic

severe schizophrenia

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73
Q

cocaine

- class?

A

amino ester anesthetic: reduces Na permeability and increases action potential threshold
blocks the reuptake of DA > can induce psychotic behavior that resembles schizophrenia

tx: topical anesthesia of accessible mucous membranes

AEs: anxiety, palpitations, tachycardia, HTN, seizures

CI: hypersensitivity to parabens

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74
Q

codeine

  • class?
  • most common AEs?
A

opioid agonist: antitussive and analgesic: blocks opiate receptors for pain relief and suppresses cough by direct action in the medulla

TX: mild-mod pain, cough suppressant, acute diarrhea

AEs: constipation and drowsiness, hypotension, dependence, withdrawal sxs, tachy or brady cardia, lightheadedness

interacts: alcohol, anesthetics, anxiolytics, hypnotics, TCAs, antipsychotics, MAOIs

absolute contraindications: acute abd conditions, diarrhea associated with toxins, respiratory depression, post operative in children after tonsillectomy or adenoidectomy
relative: acute asthma, IBD, resp impairment

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75
Q

colchicine

  • most common AE
  • vitamin interaction
A

Colcrys, colchium alkaloid, antigout drug
inhibits B-tubulin polymerization into microtubules to prevent the activation, degranulation, and migration of neutrophils thought to mediate sxs of gout

tx: acute gout, dont use long term, reduces recurrence of pericarditis

AEs = *diarrhea (80%), GI irritation, nausea, vomiting. [urolithiasis is a result of gout, not colchicine]

interacts: reversible malabsorption of B12 might occur due to ileal mucosal function alteration, response to CNS depressants and sympathomimetics might increase
contraindications: blood dyscrasias. severe renal impairment, pregnancy D, debilitated pts

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76
Q

colesevelam - elective

A

bile acid sequestrant

hyperlipidemia

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77
Q

cromolyn sodium - nebulized - elective

A

mast cell stabilizer

asthma

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78
Q

cyclobenzaprine

  • class? similar to?
  • treats?
  • AEs?
A

skeletal muscle relaxant: structurally similar to TCAs, decreases tonic-somatic motor activities of the a and d motor systems

TX: painful muscle spasms

AEs: drowsiness, dry mouth, headache and dizziness

interactions: many
contraindicated: recent MI, arrhythmia, severe liver disease

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79
Q

cyclophosphamide - elective

A

alkylating agent

anticancer

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80
Q

cyclosporine

  • class
  • treats?
  • avoid with which herb?
A

immunosuppressant, polypeptide ABX

TX: organ transplants, psoriasis, RA, LP, pemphigus vulgaris

AEs: Nephrotoxicity, increased tremor, HTN, headache, hyperLD, hyperplasia of gums, hirsutism

interacts: CCBs, antifungals, ABX, and glucocorticoids all increase concentration. avoid with hypericum
contraindicated: lactation, nephrotoxic drugs and immune suppressants

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81
Q

cyclosporine - ophthalmic - elective

A

immunemodulator

increases tear production in dry eyes

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82
Q

dabigatran - elective

A

direct thrombin inhibitor, anticoagulant

DVT, PE, etc

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83
Q

deferoxamine

  • what it do?
  • most common side effect?
  • dont mix with what?
  • can it be used in preg?
A

Desferal, chelates iron (deFEROXamine)
forms a stable complex that prevents iron from entering chemical reactions. chelates iron from Ferritin and Hemosiderin, but NOT transferrin, cytochromes, or Hgb

Tx: acute and chronic iron overload, hemochromatosis, iron toxicosis, thalassemia

AEs: **blue fingernails/lips/skin, blurred vision, convulsions, difficulty breathing, fast heart beat, hearing problems, skin flushing

interacts: AEs increased when combined with prochlorperazine (schizo) and vit C*
contraindicated: severe renal disease or anuria (excreted renally), pregnancy

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84
Q

denosumab - elective

A

RANK ligand inhibitor

injection for osteoporosis and to increase bone mass in some cancers

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85
Q

desmopressin - elective

A

vasopressin/ADH analogue hormone

Tx: diabets insipidus, noctural enuresis, nocturia, vWF deficiency, hemophilia A

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86
Q

dexamethasone

A

oral corticosteroid for asthma

dexamethasone suppression test in Cushing’s: low doses increases cortisol, high doses decreases cortisol

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87
Q

dextroamphetamine

  • class and how it works?
  • indicated for?
  • most common AE?
  • avoid with what other drugs?
A

Dextrine, amphetamine sympathomimetic

  • blocks the reuptake of DA > can induce psychotic behavior that resembles schizophrenia. amphetamines are non-catecholamine sympathomimetics.
  • raises BP, weak bronchodilating and stimulating resp effects

TX: narcolepsy, ADHD

AEs: appetite loss*, insomnia, abd pain, palpitations, tachycardia, elevation of blood pressure, loss of libido

interacts: GI alkalinizing agents (sodium bicarb), increases absorption of amphetamines, TCAs, MAOIs, and NE
contraindicated: hyperthyroidism, glaucoma, HTN, advanced arteriosclerosis, agitated stated, MAOIs

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88
Q

dextromethorphan

- class? treats?

A

levorphanol derivative, antitussive: central action on cough center in medulla

TX: cough suppressant

AEs: shallow breathing, dizziness, GI disturbance, hallucinations, fever, HTN

interacts: fluoxetine, trazodone, MAOI

CI: at risk of developing resp failure, acute attacks, MAOIs, persistent or chronic cough

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89
Q

DHEA (dehydroepiandrosterone)

  • increases production of? decreases?
  • treats?
  • side effects?
  • contraindicated?
A

anabolic steroid: increases production of estrogens and testosterone, decreases production of cortisol, has a possible effect on NTs

Tx: addisons, adrenal insufficiency, cognitive disorders, depression, ED, immune stimulating, slow or reverse aging, SLE, post menopausal vaginal atrophy, menopausal hot flashes, OP, AD, weight loss

AEs: acne, hirsutism, insomnia, hair loss, aggression, deeper voice

interacts: monitor closely with amiodarone, atorvastatin, buspirone, cortisone, diazepam, warfarin
contraindicated: breast CA, endometriosis, hormone sensitive conditions, ovarian cancer, uterine cancer, uterine fibroids

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90
Q

diazepam

  • class and how it works?
  • treats?
  • interactions?
  • contraindicated?
A

Valium: benzodiazepine: binds to GABA-a receptors (chloride ion channels) and induces them to remain open longer > hyperpolarize the cell > inhibitory effect on CNS

Tx: severe anxiety, insomnia + anxiety, muscle spasms, alcohol withdrawal, seizures, IV anesthesia, mania/delirium (not dementia), panic disorder, GAD, phobias

AE: memory problems, *amnesia-like sxs. daytime sleepiness, disorientation, depression, headache, sleep disturbance, confusion, dizziness

interacts: phenytoin, carbamazapine, phenobarbitol. levodopa. with Lithium > hypothermia. alcohol and other CNS depressants
contraindicated: MG, resp dep, sleep apnea, liver impairment, narrow angle glaucoma, children < 6 mo, pregnancy D, lactation

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91
Q

diclofenac gel - elective

A

topical NSAID

OA

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92
Q

dicyclomine

  • class
  • side effects
  • additive effects with?
  • contraindicated in which muscular disease?
A

muscarinic receptor antagonist, antispasmodic-anticholinergic, smooth muscle relaxant: blocks parasym stimulation of intrinsic nervous system and reduces GI tone and motility, directly relaxes GI smooth muscle

TX: abd pain/cramping associated with IBS

AEs: constipation, dyspepsia, dry mouth, urinary retention, blurred vision, decreased sweating

interacts: additive cholinergic effects with antihistamines and other drugs
contraindications: obstructive GI disease, severe UC, MG, glaucoma, reflux esophagitis, breastfeeding, infants < 6mo

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93
Q

Digoxin

  • through which receptors does it have its action?
  • used for Tx of?
  • effect on K
  • side effects on heart rhythm?
  • herbs to avoid using with? why?
  • heart rhythms to avoid use with?
A
  • cardiac glycoside*, antiarrhythmic:
  • positive inotrope* (increase force), Na/K/ATPase inhibition: increases intracellular Na which in turn suppresses the Na/Ca exchanger > decreased Na influx and Ca efflux > Ca accumulates inside the cell and enhances cardiac contractility
  • decreases HR by increasing parasympathetic outflow at the SA and AV nodes

TX: left ventricular systolic HF, 2nd line choice for decreasing the ventricular rate in atrial flutter

AEs: Gi disturbances (anorexia, N/V/Dia), Arrhythmias (AV nodal block and VFIB), hypokalemia, headache, fatigue, confusion, blurred vision

interacts: diuretics or other agents that cause hypokalemia > cardiac arrhythmias. increased digoxin levels when used with quinidine, ACEIs and CCBs.

drug/herb interactions: hydrastis, convallaria, and leonurus (might increase cardiac effect), Glycyrrhiza (might deplete K stores), SJW (may reduce effect of D)

contraindications: digitalis toxicity, Vtach or fib, obstructive cardiomyopathy

other HF meds: ATBs, K sparing diuretic spiro

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94
Q

diltiazem - elective

A

CCB, calcium chanel blocker

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95
Q

diphenhydramine

  • class? effects on?
  • treats?
  • interacts?
A

Benadryl, antihistamine, sedative, antiemetic, H1 receptor antagonist
blocks H1 and muscarinic Ach receptors, prevents histamine-induced allergic reactions, prevents vestibular stimulation of vomiting center, causes sedation

Tx: allergic reactions, anaphylactic shock, prevention of motion sickness, insomnia, extrapyramidal effects of antipsychotic agents

severe anaphylaxis = 50 mg IV w epi
mild anaphylaxis = 25-50 mg PO q 8 hours for 24 hours

AEs: drowsiness, blurred vision, dry mouth, urinary retention, anorexia

interacts: additive effects with CNS depressants and alcohol, additive anticholinergic effects with TCAs, antagonizes effects of cholinergic meds such as donepezil and neuropleptics. Valerian, SJW, kava kava, and gotu kola might increase CNS depression
contraindicated: hypersensitivity, neonates, lactation

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96
Q

diphenoxylate/atropine - elective

A

anticholinergic

diarrhea

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97
Q

DMPS (dimercaptopropane sulfonate)

A

heavy metal chelator for lead, mercury, arsenic, cadmium sketch b/c some people use it to cure autism (Hg) and is used for dental filling issues

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98
Q

DMSA (dimercaptosuccinic acid)

  • what it do?
  • preg?
A

chelates lead

AEs: N/V/dia, abd pain, gas, increased LFTs, drowsiness

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99
Q

docusate

  • class, how it works?
  • treatment/mode?
A

stool softener, laxative, surface-active/detergent laxative, surfactant: facilitates hydration of feces and softens stool, does NOT stimulate peristalsis

tx: cryptitis, constipation (including due to opioids, given with bisacodyl), anal fissures, fecal impaction (as an enema)

AEs: abd cramping, diarrhea, throat irritation, bitter taste

interacts: mineral oil absorption could be increased
contraindicated: obstruction, undiagnosed abd pain, prolonged use

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100
Q

donepezil

  • how does it work?
  • treats?
  • interactions?
  • exact same as which other drug?
A

Aricept: Acetylcholineesterase inhibitor: inhibits cholinesterase in the CNS

Tx of Myasthenia Gravis, dementia (not delirium), Alzheimers

AEs: GI (diarrhea, nausea, vomiting, increased gastric acid secretion), bradycardia, insomnia

interacts: increased cholinergic drugs, decreases anticholinergic drug effects

relative CI: bradycardia, arrhythmia, CHF, CAD, asthma, COPD, ulcers

rivastigmine, Excelon

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101
Q

doxazosin - elective

A

alpha blocker (all BPH alpha blockers end in osin)

HTN and BPH

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102
Q

Doxorubicin

  • class?
  • treats?
  • risk of?
A

anthracycline, antibiotic antineoplastic

TX: AIDS-related Kaposis, ovarian carcinoma, metastatic breast CA

AEs: leukopenia, thrombocytopenia, N/V, diarrhea, etc

interacts: many, and ABX

Risk of: dilated cardiomyopathy

CI: cardiac disease, neonates, pregnancy, etc

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103
Q

Doxycycline

  • class? acts on?
  • which bugs can it treat?
  • which patient populations (3) is it CI in? why for one of them?
A

tetracycline ABX: binds to 30S and 50S ribosomal subunits causing alteration on the cytoplasmic membrane

Tx: Rickettsia, Chlamydia, Mycoplasma, Borrelia
moderate acne vulgaris, used in combination w the anthrax vaccine, pnemonia, proctitis, sinusitis, gonorrhea and chlamydia if allergic to penicillins, cholera

AEs: *contraindicated in children < 8, risk of tooth discoloration (all tetracyclines), black tongue, photosensitivity, diarrhea, nausea, vomiting

interactions: reduction in efficacy with antacids, calcium, Mg, iron, decreases the effects of penicillins

CI: **children < 8, PREGNANCY D, lactation, severe hepatic dysfunction

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104
Q

drosperinone/ethinyl estradiol - elective

A

Yaz/Yasmin

pregnancy prevention

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105
Q

dulaglutide

A

incretin mimetic, GLP1 agonist (glucagon-like peptide)

DM2

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106
Q

duloxetine - elective

A

Cymbalta - SNRI

depression and anxiety

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107
Q

edetate calcium disodium

  • what it do?
  • whats another drug option that does the same thing?
  • preg?
A

chelates metals (lead)

AEs: F/C, fatigue, myalgia, hypotension, cardiac rhythm changes, glycosuria, proteinuria, numbness, headache, N/V, thirst, increase in LFT, bone marrow suppression, anemia, zinc def, hypocalcemia

CI: anuria, active renal disease, hepatitis

*DMSA does the same thing without as many effects

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108
Q

enoxaparin - elective

A

low molecular weight heparin

DVT, etc

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109
Q

entecavir - elective

A

nucleoside analogue

reduces HBV in long term HBV infection

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110
Q

epinephrine (adrenalin)

- when to use?

A

EpiPen, sympathomimetic, anaphylaxis, bronchodilator, mydriatic
stimulates a and B-adrenergic receptors > relaxation of smooth muscle of the bronchia tree, cardiac stimulation, dilation of skeletal muscle vasculature
-can also be added to local anesthetic to retard diffusion and limit absorption, prolong duration of effect, and lessen danger of toxicity

use: inhaled (acute asthma), IV or IM (anaphylactic shock), eye drops (ocular HTN, open-angle glaucoma

AEs: a TON. urinary retention, hyperglycemia, hypersalivation, hypokalemia, gangrene/necrosis are of note

interacts: inhaled anesthetics, B- or a-blocking agents, methyldopa, guanethidine, drugs that have vasoconstrictor or vasopressor effects, antihypertensives, adrenergic neuron blockers, K depleting drugs, cardiac glycosides, ephedra, yohimbe, TCAs
contraindications: preexisting HTN, occlusive vascular disease. closed-angle glaucoma, arrhythmias or tachycardia. Fingers, toes, lobes, nose, hoes.

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111
Q

epoetin alpha

- treatment of?

A

elective, Epogen
recombinant human erythropoietin, biological response modifier
Epoetin alpha regulates erythropopiesis by: stimulates the differentiation and proliferation of erythroid precursors, release of reticulocytes into circulation, and synthesis of cellular hemoglobin

Tx: anemia

AEs: pyrexia, HTN, vomiting, cough, rash, headache, arthralgias, nausea

contraindications: hypersensitivity to human albumin, uncontrolled HTN

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112
Q

erythromycin - elective

A

macrolide ABX

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113
Q

escitalopram

  • class?
  • treats?
  • most common AE?
  • interaction?
A

Lexapro: SSRI: prevent reuptake of serotonin and potentiates its effects

Tx: GAD, OCD, MDD, eating disorders

AEs: headache, nausea, ejaculation disorder, somnolence, insomnia

interacts: other CNS depressants. fatal with MAOIs, BBs, serotonin syndrome with other serotonergic meds and herbs (weakness, enhanced reflex response, incoordination)
contraindicated: SI, mania, seizures, pregnancy C

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114
Q

Esomeprazole

  • what cell does it act on?
  • 1st line for?
  • can prevent what side effect of NSAID use?
  • what vitamin absorption is decreased d/t drug?
  • increases risk of?
  • interacts with meds? lifestyle?
  • pregnancy?
A

PPI: suppresses gastric acid secretion by inhibition of the H/K-ATPase in the parietal cell, because it acts specifically on the pump it blocks the final step. in acid production and reduces gastric acidity

Tx: 1st line for GERD. PUD, H pylori, prevention of GI bleeds w NSAID use, Zollinger-Ellison syndrome

AEs: headache, flatulence, indigestion, malabsorption of B12. increases risk of hip/wrist/spinal fracture and development of c diff

interacts: amoxicillin could increase levels. it increases the levels of diazepam, phenytoin, and warfarin. take 1 hour away from meals as it decreases absorption of eso.

safe in pregnancy!

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115
Q

estradiol

  • this hormone modulates the secretion of which hormones from the pituitary?
  • when can this be used in breast cancer?
  • when is this contraindicated?
A

estrogens are responsible for the development and maintenance of female repro system and secondary sex characteristics, modulate pituitary secretion of gonadotropins *LH and FSH

Tx: vulvar and vaginal atrophy in menopause, metastatic breast CA, hypoestrogenism, OP, prostate CA

AEs: GI, GU chances, heme disorders, CV and CNS effects, endocrine and metabolic disorders, cholestatic jaundice, local skin reaction, chorea, contact lens intolerance, steeping corneal curvature, PE, carbohydrate intolerance

interacts: could enhance hydrocortisone and prednisolone
contraindicated: undiagnosed vaginal bleeding, thrombophlebitis or thromboembolic disorders, breast carcinoma except in select people with met disease, estrogen-dependent tumors, porphyria, pregnancy X

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116
Q

estriol

  • effects on body
  • treatment?
  • AEs?
  • contraindicated?
A

induces the normalization of vaginal epithelium, mild proliferative effect on the endometrium

TX: menopausal HRT, infertility d/t cervical issues, atrophic vaginitis

AEs: breast pain, nausea, spotting, fluid retention, cervical hyper-secretion

interactions: reduced efficacy when used with activated charcoal, barbiturates, and carbamazepine
contraindicated: pregnancy, thrombosis, estrogen-dep tumors, vaginal bleeding, otosclerosis during pregnancy, previous steroid use

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117
Q

estrogens, conjugated

  • treats?
  • most common SEs?
  • interacts with CYP?
  • contraindications?
A

(Premarin) antineoplastic, antiosteoporotic, replacement hormone, antiandrogenic effect

TX: atrophic vaginitis, female hypogonadism, OP. prostate CA, abnormal uterine bleeding, breast cancer palliation

AEs: *abd pain, back pain, breast tenderness, HA, joint pain, pharyngitis, sinusitis, diarrhea

interactions: *CYP450 3A4 > inhibitors (erythromycin, clarithromycin, grapefruit juice) could increase plasma concentration of estrogens
contraindicated: blood coagulation disorders, breast CA, stroke, MI, DVT, valvular disease, liver disease, DM with vascular involvement, undx abnormal vag bleeding

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118
Q

estrone

  • treats?
  • effects are decreased by?
  • contraindications?
A

naturally occurring steroidal estrogen

TX: HRT, prophylaxis of OP

AEs: (same as estradiol) GI, GU chances, heme disorders, CV and CNS effects, endocrine and metabolic disorders, cholestatic jaundice, local skin reaction, chorea, contact lens intolerance, steeping corneal curvature, PE, carbohydrate intolerance

interacts: effects are decreased by anticonvulsants and folic acid*
contraindicated: (same as estradiol) undiagnosed vaginal bleeding, thrombophelbitis or thromboembolic disorders, breast carcinoma except in select people with met disease, estrogen-dependent tumors, porphyria, pregnancy X

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119
Q

eszopiclone - elective

A

Lunesta: hypnotic

sleeeeeep

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120
Q

etanercept - elective

A

anti-TNF biologic

RA, PsA, plaque psoriasis 9PsO), AnkSp, JIA

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121
Q

exenatide

A

GLP 1 receptor agonist

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122
Q

ezetimibe - elective

A

Azetidinone, lipid lowering agent

hypercholesterol

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123
Q

fentanyl - elective

A

opioid analgesic

used in L&D

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124
Q

fexofenadine - elective

A

Allegra, 2nd gen antihistamine

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125
Q

finasteride
- class?
treats? AEs?

A

5 alpha reductase inhibitor: blocks conversion of Testosterone > DHT

TX: BPH, male pattern baldness

AEs: gynecomastia, decreased libido, impotence, reduced volume of ejaculate, testicular pain

CI: children, pregnancy X be careful with partners rubbing off on them

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126
Q

fingolimod - elective

A

sphingosine-L-phosphate receptor modulator (immune modulator)

MS, lung complications of COVID -19

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127
Q

flecainide - elective

A

antiarrhythmic

afib, paroxysmal SVT

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128
Q

Fluconazole

  • class, effects what?
  • treats?
  • most common AE?
  • pregnancy?
A

synthetic azole: decreases ergosterol synthesis by interfering with CYP450 > inhibiting cell membrane formation (candida, C neoformans, H capsulatum, Mycosporum, trichophyton)

TX: candidiasis (oral, esophageal, systemic), BM transplant prophylaxis, cryptococcal meningitis, candida UTIs, candida balanitis

AEs: headache, N, V, abd pain, diarrhea, gas

interacts: warfarin and oral hypoglycemics, phenytoin, cyclosporine, zidovudine, sulonylureas, carbamazepine, thiazides

Contraindications: Not safe in pregnancy or lactation for systemic fungal infections, Is safe for one time vaginal yeast dose.Pregnancy C/D

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129
Q

fludrocortisone - elective

A

corticosteroid

Addisons disease

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130
Q

fluocinonide - elective

A

high potency corticosteroid

eczema, seb derm

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131
Q

fluoxetine

  • class?
  • 1st line for?
  • describe serotonin syndrome
  • interactions
A

Prozac SSRI

Tx: GAD, OCD, 1st line in depression and panic disorder, bulimia nervosa, social phobia

AEs: of SSRIs: sick stomach, sexual dysfunction, restlessness, insomnia, serotonin syndrome w MAOIs

  • serotonin syndrome sxs: cognitive (headache agitation, mental confusion, hallucinations, coma), autonomic effects (shivering, sweating, hyperthermia, vasoconstriction, tachycardia, nausea, diarrhea, dilated pupils), somatic (myoclonus, hyperreflexia, tremor)
    interacts: CNS depressants, MAOIs, TCAs

CI: MAOIs

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132
Q 
fluticasone (nasal spray and inhaled)
 - class?
 - treats?
 - most common AEs? weird AE?
interactions?
A

corticosteroid: vasoconstrictive and anti-inflammatory activity

TX: allergic rhinitis, nasal polyps, asthma (not acute asthma), swallowed in eosinophilic esophagitis

AEs: URTI and headache, candidiasis, pharyngitis, dysphoria, cough, rhinitis, nasal congestion, hypertrichosis, cushings syndrome

interactions: CYP4503A4
contraindicated: hypersensitivity to milk or milk proteins, status asthmaticus, acute bronchospasms

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133
Q

furosemide

  • which receptors and which part of kidney?
  • effects on uric acid, water, Ca, Mg, Na, Cl, K, ammonia, renin
  • two most common AEs
  • causes acidosis? alkalosis? resp? metabolic?
  • at high doses and with what class of ABX, can cause?
  • avoid in which allergy?
  • avoid with which herb?
  • pregnancy category?
A

Loop diuretic, K wasting antihypertensive: inhibits reabsorption of Na and Cl in the medullary portion of the ascending LOH > causes excretion of water, Ca, Mg, Na, Cl, K, ammonia. Uric acid excretion is reduced. increases plasma renin levels > secondary hyperaldosteronism

Tx: manages fluid overload in CHF, pulmonary edema,ARF, nephrotic syndrome, hepatic cirrhosis. hyperkalemia, hypercalcemia

AEs: hyperuricemia and hypokalemia, metabolic alkalosis, hypoMg/Ca/Na, reversible ototoxicity at high doses, reactive in sulfa allergies

interacts: analgesics reduce action. antagonizes hypoglycemics, muscle relaxants and gout drugs. increased risk of ototoxicity when used with aminoglycoside ABX. enhances antiHTN effects. antagonized by corticosteroids. phenytoin may reduce effects.
* with glycyrrhiza > can cause rapid K loss

contraindicated: severe Na and water depletion, hypersensitive to sulfonamides, hypokalemia, hypernatriemia, precomatose states d/t liver cirrhosis, ARF, Addison’s disease
Pregnancy C

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134
Q

gabapentin

  • class?
  • treats?
  • AEs?
A

Neurontin: anticonvulsant: structurally related to GABA, but action is unknown

tx for postherpetic neuralgia, peripheral neuropathy, epilepsy

AEs: DASH: dizziness, drowsiness, ataxia and tremor, somnolence, headache, overall very well tolerated

interacts: cimetidine, antacids

CI: lactation

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135
Q

gemfibrozil

  • adverse effect in GI and other system?
  • if no response in how many months, do we d/c?
  • med interactions (2)?
  • pregnancy?
A

fibric acid derivative (fibrate), antiHLD (VLDL formation reducer): stimulates lipoprotein lipase (breaks down TGs into VLDL and chylomicrons and removed from circulation), also decrease hepatic cholesterol biosynthesis

Tx: elevated cholesterol, decrease TGs, mildly decrease LDL/increase HDL

AEs: *gallstones from increasing cholesterol in the bile, GI upset, elevated liver enzymes, myositis, *rhabdo

should treat hypothyroidism, diabetes, or other forms of secondary hyperlipidemia before starting therapy. if there is no response in 3 mo, stop TX.

interacts: fibrates compete with warfarin and this may potentiate effects of warfarin. statins > muscle cramping, myopathy, rhabdo.
contraindicated: severe liver or renal disease, primary biliary cirrhosis, GB disease, statins, pregnancy C

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136
Q

gentamicin drops - elective

A

aminoglycoside ABX

blepharitis, conjunctvitis

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137
Q

glatiramer acetate - elective

A

immune modulator: stops body from destroying myelin

MS

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138
Q

glucagon - elective

A

glycogenolytic agent - causes the liver to release stored sugar into the blood and relaxes smooth muscles of the stomach

severe hypoglycemia

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139
Q

glyburide

  • class, what it do?
  • common side effect and why we dont take it concurrently with what 4 other drugs?
  • contraindicated in what 4 situations?
A

sulfonylurea hypoglycemic: closes ATP-sensitive K channels and prevents K efflux and depolarizing pancreatic B cells, causing influx of Ca and releasing insulin > increase the amount of insulin secreted

tx: DM2

AEs: *hypoglycemia, photosensitivity, weight gain

interacts: should take daily with meals. potentiated by alcohol, anti-inflamatories, salicylates, sulfonamides (all increase effect of hypoglycemia). effects are decreased by diuretics, steroids, thyroid, and phenytoin
contraindicated: DM1, hypoglycemia, DKA, sulfa allergy

140
Q

guaifenesin

  • class? - tx?
  • effects labs?
A

propanediol derivative expectorant: increases the volume and reduces the viscosity of sputum

TX: productive cough

AEs: N/V, GI, dizzy, drowsy, *decreased uric acid levels

CI: chronic or persistent cough

141
Q

H influenza type B conjugate

- contraindicated?

A

active immunity by stimulating production of endogenous Abs

CI: < 6 weeks old

142
Q

haemophilus influenzae (Hib) vaccine - elective

A

for people < 5 yo

4 total shots

143
Q

haloperidol

  • class? AEs?
  • treats?
  • contraindicated?
A

phenylbutylpiperidine, antipsychotic: blocks D2R in the limbic system, H1R, cholinergic R, a-adrenergic R > lots of AEs

tx: positive sxs of schizophrenia (hallucinations and delusions), tourette syndrome, delirium, agitation

AEs: sedation (H1), anticholinergic effects, orthostatic hypotension (aAR), extrapyramidal sxs - akinesia (loss of voluntary movement), akathisia (motor restlessness), tardive dyskinesia (involuntary oral facial movements) - (DA), galactorrhea and amenorrhea (due to inc PRL d/t DA inhibition)

interactions: carbamazepine, CNS depressants, fluoxetine, lithium
contraindicated: CNS cdepression, seizures, parkinsons

144
Q

heparin

  • how does it work?
  • used to treat?
A

Hepalean
binds to anti-thrombin III to accelerate its action (inhibits fibrinogen > fibrin) > decreases ability to clot

Tx: DVT, PE, thromboembolic events, acute MI

AEs: hemorrhage, prolonged clotting time, thrombocytopenia, myalgia, skin irritation, burning of feet/chills/anaphylaxis

interacts: oral anticoagulants has additive effect, salicylates and other anti plt drugs has additive effect
contraindicated: active bleeding disorders, inaccessible ulcerative lesions and wounds, caution in mild hepatic or renal disease

145
Q

hepatitis A and B vaccines

- what kind of vaccine are they? who cant have them?

A

hep A Ag: formaldehyde-inactivated hep A virus
*egg sensitivity

hep B surface Ag
*egg sensitivity

146
Q

heroin

- class?

A

opioid agonist, narcotic

tx: pain, MI, pulm edema, chronic pain

AEs: addiction

147
Q

HPV quadrivalent

  • what type and what strains?
  • what ages?
A

Gardasil - recombinant vaccine HPV 6, 11, 16, 18

AEs: normal ones, tonic-clonic movement and seizure like activity

ages 9-26

148
Q

human chorionic gonadotropin - elective

A

injection used with fertility drugs to increase chances of fertility, helps produce T in men or adolescents, cryptorchidism, weight loss

149
Q

hydralazine - elective

A

peripheral arterial vasodilator, HTN

Hydralazine is an antihypertensive medication that can cause a lupus-like syndrome, including glomerulonephritis. If this does occur, symptoms may persist for years after the patient discontinues the medication, however, most people find that symptoms resolve soon after discontinuing the causative agent. Other medications that can cause a lupus-like syndrome include chlorpromazine, sulfasalazine, procainamide, carbamazepine, ethosuxamide, phenytoin, quinidine, amiodarone, some beta blockers, some calcium channel blockers, and many others.

150
Q

hydrochlorothiazide

  • class
  • how it effects Na, K, Cl, Mg, and Ca, glucose
  • allergy with what other class?
  • avoid with which herb?
  • causes acidosis? alkalosis? resp? metabolic?
A

thiazide diuretic: inhibits NaCl transporter in the distal tubule > increases excretion of Na, K, and Cl. decreases Ca excretion in people with Ca kidney stones

Tx: HTN, CHF, edema, nephrolithiasis, osteoporosis in people with hypercalciuria, nephrogenic diabetes insipidus

AEs: HYPONa, Cl, Mg, tension, and volume depletion. HypoKalemic metabolic alkalosis (K and H are related)
HYPERCa, uricemia, gout, glycemia, sensitivity (sulfonamide based), photosensitivty with the sun

interacts: causes hyponatremia if used with carbamazepine, potentiates hypotensive effect of a blockers and ACEI. concurrent use with alcohol, barbiturates, and opioids might enhance orthostatic hypotension. antiHTN effects reduced by corticosteroids, NSAIDs. enhances the nephrotoxicity of NSAIDs. glycyrrhiza can contribute to K depletion
contraindicated: severe hepatic or renal impairment, addisons dz, preexisting hypercalcemia, anuria, sulfonamide drug sensitivities

151
Q

hydrocodone

- class? treats?

A

opioid agonist: antitussive and analgesic: phenanthrene derivative

TX: pain and cough

AEs: constipation, drowsiness, CNS effects, dry mouth, sweating, flushing, decreased libido, miosis, convulsions, euphoria, sedation

interacts: CNS depressants, cimetidine, metoclopramide, opioid antagonists, alcohol

CI: obstructive airway disease, infants and children, resp depression

152
Q

hydrocortisone

  • retention of 2 things, depletion of 2 things?
  • enhanced effect in people taking?
  • contraindicated in?
A

AHydrocort, intermediate corticosteroid
anti-inflammatory (suppresses migration of PMN leukocytes and reversal of increased capillary permeability) and immunosuppressive

tx: inflammation, acute or chronic adrenal insufficiency

AEs: sodium and fluid retention, K and Ca depletion, muscle wasting, osteoporosis, gi disturbance and bleeding, increase appetite and delayed wound healing, hyperglycemia, glycosuria, DM, obesity, moon facies, buffalo hump, increases susceptibility to infection

interacts: thiazides might enhance hyperglycemia and hypokalemia, peptic ulcers or bleeds with NSAIDs, alcohol and GI irritation, reduced efficacy while using carbamazepine/phenytoin/barbituates, mutual inhibition with cyclosporine, enhanced effect in people taking estrogen or OCPs
contraindications: viral/fungal infections, TB or syphilis lesions, bacterial infections unless also used with chemo

153
Q

hydroxychloroquine

  • class?
  • treats?
A

aminoquinolone, antimalarial, antirheumatic, anti-inflammatory

Tx of RA, SLE, malaria/plasmodium

AEs: retinopathy, hair loss, photosensitivity, tinnitus, myopathy, psychosis, seizures, cardiomyopathy

interacts: alcohol and digoxin
contraindicated: visual field changes, long term in children

154
Q

hydroxyzine

  • class? what does it block?
  • treats?
  • AE?
A

piperazine derivative, anxiolytic, antihistamine, sedative-hypnotic: blocks H1 receptors on GI tract, blood vessels, and respiratory tract. antimuscarinic properties, skeletal muscle relaxant, bronchodilating, antiemetic.

TX: anxiety, pruritus, chronic urticaria, preop sedation, allergies

AEs: CNS depression, paradoxical CNS stimulation*, tinnitus, more

interacts: addictive CNS depression when taken w antidepressants, antihistamines, opioids, sedative-hypnotics, other CNS depressants
contraindications: porphyria, neonates, pregnancy X in 1st trimester, C in 2/3

155
Q

hyoscyamine - elective

A

anticholinergic and antispasmodic

IBS, cramps, parkinsons, MG, etc

156
Q

ibuprofen

  • class?
  • AE?
  • do not combine with?
  • pregnancy?
A

Motrin, Advil: NSAID, analgesic, antipyretic
central and peripheral effects, inhibits COX to reduce PG synthesis, prevents formation of TXA2 by plt agg

Tx: pain, inflammation, fever

AEs: dizziness, epigastric pain, heartburn, nausea, rash, tinnitus, edema, vomiting, headache decreases cartilage synthesis, secondary nephrOtic syndrome

interacts: decreases ACEI, BBs, and diuretic effects. increased risk of GI bleed with warfarin. do not combine with ASA
contraindications: active peptic ulcer, hypersensitivity, neonates with CHD, necrotizing enterocolitis, active bleeds, third TM (causes fetal heart defects)

157
Q

imiquimod - elective

A

immune response modifier

genital and anal warts

158
Q

indomethacin - elective

A

NSAID

159
Q

infliximab - elective

A

TNF-a inhibitor

RA, crohns, UC, ank spo, plaque psor, psor arth

160
Q

influenza vaccine

  • what kind of vaccine?
  • what happens when taken with ASA?
  • who cant have it?
A

inactivated vaccine

increased Ab response w ASA

*egg sensitivity

161
Q

insulin

  • two times we use it in TX?
  • contraindication (also a side effect)
  • what meds(3) can increase needs?
  • what meds (3) can increase needs?
  • what lifestyle choice increases need?
  • whats the difference between glargine, lispro, and regular
A

pancreatic hormone: replaces endogenous insulin in DM

Tx: DM, DKA
DM1: uses a long-acting insulin + pre-meal and pre-snack injections of rapid acting

AEs: hypoglycemia (contraindication)

interactions: BBs can mask hypoglycemia, thiazides and steroids can increase insulin needs. alcohol and most NSAIDs, sulfonylureas, and warfarin can decrease insulin requirements

lispro (aspart insulin): rapid onset, peak 1 hour, lasts 3-4 hours
regular insulin: rapid onset, peak 2-3 hours, lasts 5-7 hours
glargine (ultralente,detemir): slow onset, peak 12 hours, long acting 24 hours

162
Q

interferon alpha 2 (INF-2)

  • class?
  • TX
  • AEs?
  • can be fatal if combined with ?
A

antineoplastic, antiviral: alpha interferons bind to cell surface receptors and block viral protein synthesis

TX: chronic hepatitis B/C, cancer (leukemia, melanoma, kaposis), genital warts (acuminata), polycythemia vera

AEs: IFN ALPHA
Inhibition of bone marrow > leukopenia, anemia
Flu like sxs
Neurotoxicity: depression and psychosis
Autoimmune disorders
Liver enzyme elevations
Proteinuria
Hypotension and tachycardia
Alopecia

interacts: reduces clearance of theophylline (makes it potentially fatal), enhanced myelosuppression
contraindicated: AI hepatitis, AI disease, transplant recipients, infants, Pregnancy C

163
Q

interferon B1

  • class?
  • treats?
  • AEs?
  • interaction with ? could be fatal?
A

antineoplastic, antiviral: alpha interferons bind to cell surface receptors and block viral protein synthesis

TX: reduces exacerbations in MS

AEs: IFN ALPHA
Inhibition of bone marrow > leukopenia, anemia
Flu like sxs
Neurotoxicity: depression and psychosis
Autoimmune disorders
Liver enzyme elevations
Proteinuria
Hypotension and tachycardia
Alopecia

interacts: reduces clearance of theophylline (makes it potentially fatal), enhanced myelosuppression
contraindicated: AI hepatitis, AI disease, transplant recipients, infants, Pregnancy C

164
Q

ipilimumab

A

yervoy, monoclonal Ab

melanoma

165
Q

ipratropium bromide

A

short-acting antimuscarinic and anticholinergic bronchodilator

used in maintenance tx of COPD

AEs: URTI, dry mouth and sinusitis, constipation, cough, tachycardia, UTI, pupil dilation, etc

contraindicatedL allergy to milk proteins, lactose allergy

same drug as tiotropium bromide, but shorter acting

166
Q

irbesartan - elective

A

ARB

167
Q

isoniazid

  • used to treat?
  • most common AEs?
A

isonicotinic acid: inhibits mycolic acid synthesis

TX: latent or active TB

AEs: mild increase in LFTs, peripheral neuropathy, loss of appetite, nausea, vomiting

interactions: CYP450, phenytoin

168
Q

isosorbide mononitrate - elective

A

nitrate

angina

169
Q

isotretinoin

  • how does it work? to treat what?
  • most common side effect? effect on lab values?
  • supplement interaction? pharm interactions?
  • pregnancy?
A

Accutane: retinoid, anti-acne: reduces sebaceous gland size and sebum production, regulates cell proliferation and differentiation

Tx: acne rosacea, severe acne vulgaris

AEs: chelitis, increased ESR*, conjunctivitis, irritation, hyperTG, decreased HDL and increased LFTs, hair thinning, inc platelet count, pruritis, epistaxis, skin fragility, dry nose, joint pain

interacts:additive toxicity with vitamin A, decreases efficacy of progesterone in OCPs, incresed risk of bone loss with phenytoin, increased risk of osteoporosis with systemic corticosteroids, PREGNANCY X, lactation

170
Q

ivermectin - elective

A

antihelminthic

head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis, filariasis

*covid - 19 * not proven to be useful, but likely is

171
Q

ketamine

- class? use?

A

NMDA receptor antagonist: direct actions on the cortex and limbic system > cataleptic state where the pt is withdrawn from the surrounding environment

Tx: anesthesia

AEs: HTN, increased CO, increased intracranial pressure, hallucinations, vivid dreams, tachycardia, tonic-clonic movements

interacts: muscle relaxants

CI: HTN, CVA, eye injury, raised ocular intracranial pressure, psychotic disorders

172
Q

ketoconazole - elective

A

azole antifungal

173
Q

ketorolac - elective

A

NSAID

174
Q

lamotrigine - elective

A

anticonvulsant or antiepileptic

seizures, epilepsy, bipolar

175
Q

lansoprazole - elective

A

PPI

176
Q

latanoprost (ophthalmic solution)

  • class?
  • treats?
A

prostaglandin, antiglaucoma
analogue of PG F2a > reduces intraocular pressure by increase the outflow of aqueous humor

Tx: ocular HTN, open-angle glaucoma

AEs: increase brown in irises, blurred vision, burning and stinging, itching, conjunctival hyperemia

177
Q

leuprolide - elective

A

GnRH agonist, antineoplastic

advanced prostate CA, endometriosis, fibroids

178
Q

levodopa-carbidopa

- how does it work? treats?

A

Sinemet: dopamine precursor: levodopa is converted to DA in the CNS, carbidopa inhibits the degradation of levodopa

Tx: parkinsons disease

AEs: dyskinesias, hallucinations, psychiatric problems - depression with or without SI

interacts: pyridoxine, carbidopa, amantadine, anticholinergics, amphetamine, sympathomimetics
contraindicated: lactation, narrow angle glaucoma, acute phase of MI

179
Q

levofloxacin - elective

A

fluoroquinolone ABX

180
Q

Levonorgestrel (IUD)

  • how does it work?
  • what does it contain?
  • serious risk with it? MC side effect?
A

A progestin only IUD (Mirena): inhibits ovulation by negative feedback on the hypothalamus > reduced FSH and LH

TX: menorrhagia, pregnancy prevention

AEs: *vaginal bleeding alterations, **ectopic pregnancy, acne, ovarian cysts, headache, abd pain, breast pain, fluid retention, edema, changes in libido

interacts: cyclosporine
contraindications: PREGNANCY X, undx vaginal bleeding, severe arterial disease, liver adenoma, porphyria, hydatiform mole, breast CA, liver shit

181
Q

levothyroxine

  • used to treat? how?
  • 2 med interactions?
  • why is it contraindicated in uncorrected adrenal insufficiency?
A

tetraiodothyronine/T4, thyroid hormone: converted to T3 in peripheral tissues which binds nuclear receptors, increases gene transcription > increases metabolic rate, protein synthesis, gluconeogenesis, cell growth and differentiation, CNS development

Tx: hypothyroidism

AEs: insomnia, irritability, tachycardia, wt loss, sxs of hyperthyroidism

interacts: bile acid sequestrants decrease its absorption, estrogens can increase thyroid requirement
contraindicated: untreated subclinical or overt thyrotoxicosis, MI, uncorrected adrenal insufficiency > thyroid hormone can precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids

182
Q

lidocaine - elective

A

local anesthetic

also an antiarrhythmic

183
Q

liothyronine

  • what is it and what does it treat?
  • effects on glycogen? gluconeogenesis?
  • what 2 other things can it treat?
A

synthetic T3: raises BMR, increases the utilization and mobilization of glycogen stores, promotes gluconeogenesis

tx: hypothyroidism, non-toxic goiter, myxedema

AEs: (all < 3%): tachycardia, hypotension, MI

interacts: NaI
contraindicated: acute MI, thyrotoxicosis, untreated adrenal insuff. caution in angina, CVD, hypopituitarism, DM.

184
Q

liraglutide

  • class, what it do baby boo
  • treatment of?
  • most common side effect?
  • weird side effect?
  • why avoid consumption with virtually any other drug?
  • avoid if you have a HX of what 2 things?
A

GLP1 receptor agonist, incretin mimetic, analogue of human glucagon like peptide 1: increases insulin secretion in the presence of elevated blood glucose, delays gastric emptying to decrease postprandial glucose, decreases glucagon secretion

Tx: DM, obesity

AEs: nausea, diarrhea, vomiting, constipation, headache, anti-liraglutide Abs*

interacts: because it slows gastric emptying, it carries the risk of decreasing rate of absorption of other drugs, esp those with a narrow therapeutic index
contraindications: hx of medullary thyroid carcinoma, MEN2, pregnancy (because wt loss is contraindicated)

185
Q

Lisinopril

  • what happens to renin and aldosterone d/t this drug?
  • most common side effect?
  • most reported side effect?
  • effect on K? Hgb? serum creat?
  • drugs to avoid taking with?
  • pregnancy cat?
A

ACEI used in HTN, CHF, tx and prevention of DM neuropathy, decreased mortality in pts within 24 hours of an MI

  • competitively inhibits ACE from converting angio I > angio II (a vasoconstrictor) which in turn decreases vasoconstriction, increase plasma renin, and reduces aldosterone
  • AEs: dizziness is most common, dry/persistent cough, HA, fatigue, URTI, CP, weakness, orthostatic effects, hypotension, hyperkalemia, impotence, dec Hgb, inc serum creat, teratogen, severe hypotension and angioedema could be fatal
  • interactions: decreased levels with antacids, decreased effect with NSAIDs and salicylates, inc risk of hyperkalemia with K sparing diuretics and trimethoprim, inc risk of hypoglycemia with insulin, inc hypotensive and/or nephrotoxic with TZ diuretics
  • contraindications: angioedema, BL renal artery stenosis
  • pregnancy: D in 2/3 TM, cautiously if BFing
186
Q

Lithium

  • class? effects?
  • treats?
  • monitor?
  • interactions?
A

Mood stabilizer, antimanic agent: decreases response to 5HT and NE by decreasing cyclic adenosine monophosphate (cAMP) and inositol triphosphate

TX: bipolar disorder (BD)

monitor serum levels - normal should be between 0.5 and 1.5. above 2.5 is severe toxicity

AEs: polyuria, fatigue, impaired memory, acne, tremor, muscle weakness, ECG changes, GI, hypothyroidism leukocytosis

interacts: diuretics, NSAIDs and fluoxetine, neuromuscular blocking agents

CI; renal or CVD, sodium depletion, dehydrated, hypothyroidism

187
Q

loperamide

  • class?
  • can be used in X but not Z?
  • which 3 herbs does it interact with?
A

anti motility agent, opioid analogue, piperidine derivative: activates opioid receptors in the GI smooth muscle > inhibition of Ach release > decreased gut peristalsis

Tx: mild-mod acute diarrhea, chronic diarrhea caused by IBD (can use in crohns, do not use in UC), decreases volume of ileostomy drainage

AEs: constipation, drowsiness

interacts: additive with CNS depressants (kava, chamomile, valerian)
contraindications: bloody diarrhea, high fever, infectious diarrhea, pseudomembranous colitis, abd pain without diarrhea, acute UC, < 2 yo

188
Q

loratidine

  • class?
  • most common AE?
  • interacts?
A

(Claritin) H1 receptor antagonist (second generation antihistamine)
does not block muscarinic receptors or cause sedation
Txs: seasonal allergies, chronic idiopathic urticaria
-AEs: headache is most common, fatigue, giddiness, dizziness, dry mouth, nausea, somnolence
-interacts: additive with CNS depressants
-contraindicated: liver disease, acute asthma attack, pneumonia, lower respiratory disease

189
Q

losartan - elective

A

ARB

190
Q

lugol solution

  • what is it used for and how does it work?
  • side effect?
  • interacts with 5 kinds of drugs?
  • what could excessive iodine cause?
A

iodine replenisher, radiation protectant (thyroid), antihyperthyroid

  • strong iodine produces a rapid remission of sxs by inhibiting the release of thyroid hormone into circulation. strong iodine: reduces thyroid vascularity, firms glandular tissue, shrinks size of individual cells, re-accumulates colloid in the follicles, and increases bound iodine > all of these actions when given prior to surgery help facilitate a thyroidectomy.
  • it also protects the thyroid gland by blocking thyroidal uptake of radioactive isotopes of iodine in administration of radioactive isotopes

tx: hyperthyroidism, thyroid storm, protection before and after radioactive iodine treatment

AEs: N/V, diarrhea, metallic taste in mouth, fever, headache, runny nose, sneezing, acne

interacts: ACEIs, ARBS, water pills (K sparing diuretics), lithium, drugs that contain K
contraindications: excessive iodine could cause hypothyroidism, use in caution w renal impairment

191
Q

mebendazole

- treats what? how?

A

antihelminthic benzimidazole: destroys worm’s microtubules in intestinal cells to block the uptake of Glc and other nutrients

Tx: 1st line for pinworms, hookworm, roundworm, and whipworm

AEs: ALL BENT
Angioedema, Alopecia, Liver enzyme elevation, Bone marrow suppression, Epigastric disturbance, Neurological, Teratogenicity

interactions: reduced levels with enzyme inducers (phenytoin, carbamazepine)
contraindicated: infants and children < 2 yo, pregnancy C

192
Q

meclizine OTC - elective

A

antiemetic, antihistamine

193
Q

Medroxyprogesterone Acetate

  • how does it work? what does it work on?
  • most serious side effect?
A

DepoProvera: synthetic progestogen that converts the proliferative phase of endometrium > secretory phase, has androgenic and anabolic activities but no estrogenic effects

TX: endometriosis and contraception

AEs: depression, fluid retention, fatigue, insomnia, dizziness, headache, nausea, breast tenderness, weight gain or loss, anorexia, cholestatic jaundice, pain at the injection site **this birth control has bone mineral density loss as an adverse effect, where other Progestin only have inc risk of ectopic*

interacts: reduced efficacy with aminoglutethimide, enzyme inducing drugs (carbamazepine, phenobarbital, phenytoin)
contraindicated: thromboembolic disorders, cerebral apoplexy, severe liver dz, endx vaginal bleeding, incomplete abortion, hormone-dependent carcinoma, pregnancy X

194
Q

megestrol acetate - elective

A

Progesterone, antineoplastic

txs sxs of weight loss and los of appetite in AIDS-related cachexia, breast cancer or endometrial cancer

195
Q

melatonin

A

tryptamine sedative: secreted by the pineal gland

Tx: disturbed biorhythms, sleep disorders

AEs: increased seizure activity, drowsiness, headaches, disruption of normal circadian rhythm, worsening depressive sxs

contraindicated: immunosuppressant treatment

196
Q

meloxicam - elective

A

Mobic NSAID

197
Q

memantine - elective

A

NMDA receptor antagonist

severe dementia in AD

198
Q

meningococcal conjugate vaccine - elective

A

protects against 4 types of N meningitides

get at 11-12 and booster at 16

199
Q

meningococcal polysaccharide

  • what is used as an adjuvant?
  • who cant have it?
A

meningococcal serogroup A, C, Y, and W-135 - polysaccharide antigens are individually conjugated to *diphtheria toxoid protein carrier

CI in infants < 6 weeks

200
Q

meslazine (mesalamine) - elective

A

aminosalicylate

ulcerative colitis

201
Q

Metformin

  • class, how it works?
  • side effects?
  • interaction with lifestyle? 2 meds?
A

biguanide: increases the number and affinity of insulin receptors in the peripheral tissue, decreases hepatic glucose output, decreases glucose absorption from the gut, increases glucose uptake and utilization in skeletal muscle and adipose tissue, doesn’t usually cause hypoglycemia, can be used with other antidiabetic agents
tx: DM2

AEs: lactic acidosis, agitated GI tract (diarrhea, cramps, N/V), NO hypoglycemia, B12 def in higher doses and long term users

interactions: alcohol can increase risk of lactic acidosis, cimetidine and furosemide can increase effects

contraindicated in renal failure, metabolic acidosis, and DM1

202
Q

methadone

- used to treat?

A

opioid agonist, opioid detox adjunct
TX: analgesia, opioid dependence, heroin detox

AEs: normal ones of opioids, QT prolongation

interacts: a lot
contraindicated: acute respiratory depression, acute bronchial asthma, acute alcoholism, paralytic ileus, intracranial pressure or head injury

203
Q

methimazole - elective

A

thionamide

hyperthyroidism - BULLET!!

204
Q

methocarbamol - elective

A

muscle relaxant

205
Q

methotrexate

  • class
  • form of anemia as AE?
  • pregnancy?
A

antimetabolite and anti-folic acid

TX: choriocarcinoma and other trophoblastic tumors, leukemias, severe psoriasis, LP, pemphigus vulgaris, RheumArth, cancer, MS

AEs: megaloblastic anemia (form of macrocytic), N/V, stomatitis, hepatotoxicity, leukopenia, thrombocytopenia, nephropathy

interacts: decreased effectiveness with folic acid

CI: severe renal or hepatic involvement, alcoholic liver, disease, pregnancy X, breast feeding

206
Q

methylphenidate

  • class and how it works?
  • treats?
A

Ritalin, piperidine derivative, methylphenidate class
- increases the release of NE > stimulates impulse transmission in the resp system and CNS

TX: narcolepsy and ADHD

AEs: central stimulation (anxiety, insomnia, tremor, euphoria), CV stimulation (HTN, angina, arrhythmia, tachycardia), GI (anorexia, emesis, diarrhea, abd pain), risk of tolerance, abuse potential and dependence

interacts: antiHTN, phenytoin, TCAs
contraindications: glaucoma, tourettes, serious heart disease, when used with MAOIs > severe HTN reaction

207
Q

methylprednisolone (exact copy of prednisone)

A

oral CS for asthma

Medrol, adrenal glucocorticoid, endocrine-metabolic agent
decreases inflammation by suppressing the migration of PMN 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

Tx: for inflammation and autoimmune conditions: acute asthma, giant cell arteritis, ITP, rheumatoid arthritis, allergies, SLE, transplants, carditis, pemphigus vulgaris and bullous pemphigoid, acute gout (esp in pts w kidney disease)

AEs: IM the HOPE
Iatrogenic Cushings, Infections
Myopathy (loss of mass and weakness)
Hypokalemia, Hypomania
Osteoporosis, Osteonecrosis of femoral/humeral heads
Peptic ulcers, Pancreatitis
Edema (angio or pulm), Eye disorders (cataracts, glaucoma)

interacts: NSAIDS (increased risk of GI ulcer), decreased effect with barbituates and phenytoin, decreased effect of salicylates and vaccines, alcohol can increase GI irritation
contraindicated: serious infections (except TB and meningitis), varicella, systemic fungal infections

208
Q

metoclopramide

  • class, how it works
  • AEs
  • contraindicated in ?
A

D2 receptor antagonist, antiemetic, GI stimulant: acts on the chemoreceptor trigger zone of the medulla, blocks activation of the vomiting reflex pathway. also enhances motility in GI and increases gastric emptying without effecting secretions. increases duodenal peristalsis > decreases intestinal transit time and increases LES tone

tx: 2nd line for GERD, nausea and vomiting assoc with cancer chemo or radiation

AEs: METoclopramide effects:
mental effects: agitation, anxiety, insomnia, drowsiness
Extrapyramidal effects: dystonia, tardive dyskinesia permanent
Tuberoinfundibular effects: amenorrhea-galactorhea d/t hyperPRL

interacts: increased sedative effects with CNS depressants, synergistic toxicity with DA antagonists (promethazine, antipsychotics), antagonized by antimuscarinics and opioids, reduces absorption of digoxin
contraindications: gi hemorrhage, parkinsons, perforation, epilepsy, pheochromocytoma, other drugs known to cause extrapyramidal symptoms (phenothiazines, butyrophenones)

209
Q

metoprolol - elective

A

beta blocker

210
Q

Metronidazole

  • class
  • first line for ?
A

nitroimidazole antiprotozoal: protein synthesis inhibition and cell death

Tx: *first line for anaerobic bacteria: Bacteroides fragilis (abd/pelvic/pulm infections), C diff (pseudo colitis), and H pylori (ulcers)
also anaerobic protozoal: Trich, Amoeba, Giardia

AEs: M-NIDA: Metallic taste, Neurotoxicity, Irritated GI, Disulfiram-like reaction, Allergy

contraindicated: antimicrobials, phenytoin, breastfeeding

211
Q

minocycline - elective

A

tetracycline ABX

212
Q

mirtazapine - elective

A

alpha-2-antagonist antidepressant

213
Q

misoprostol

  • what does it act on? what does it increase?
  • adverse effects and contraindications?
  • pregnancy?
A

prostaglandin E1 analogue, anti-ulcer agent: inhibits gastric acid secretion directly by binding to PG receptor on parietal cell > increases bicarb, decreases volume and pepsin, protects tight junctions and increases thickness of mucus layer

Tx: GI protectant, gastritis, NSAID damage

AEs: MAAD: menstrual irregularities (also used in therapeutic abortion), abortion in pregnant women, abd cramps, diarrhea

interacts: mg antacids could increase diarrhea risk, could enhance therapeutic effect of carbetocin (avoid use), food decreases absorption rate

pregnancy X

214
Q

MMR vaccine

  • what kind?
  • contraindicated in?
A

ProQuad - LIVE vaccine for measles, mumps, and rubella

  • could reduce the diagnostic effect of TB tests

CI: pregnancy**, active untreated TB

215
Q

modafinil

  • class? how it works?
  • treats?
  • serious side effect?
  • CYP interactions?
  • avoid in issues with the ?
A

nonamphetamine CNS stimulant: appears to reduce GABA-mediated neurotransmission

txs fatigue in MS, and improve wakefulness in excessive daytime sleepiness in narcolepsy

AEs: headache, rhinitis, insomnia, personality disorders, tremor, anxiety, palpitations

interactions: CYP2C19, CYP3A4, cyclosporin, OCPs, warfarin, TCAs, alcohol

CI: HTN, arrhythmias, LVH, CP, MVP

216
Q

mometasone

- used to treat what 3 things?

A

strong, topical corticosteroid: anti-inflammatory, antiasthmatic

Tx: asthma, tx and prevention of nasal sxs of allergies (runny nose, sneezing, itchy nose), nasal polyps

217
Q

montelukast

  • class?
  • most common AE?
A

LT receptor antagonist, antiasthmatic

tx: asthma, eosinophilic esophagitis, allergic rhinitis

AEs: headache

interacts: phenobarbital, phenytoin, peripheral edema w prednisone

218
Q

morphine

- treats?

A

opioid agonist

TX: pain, cough, during labor

AEs: most common are pruritus, urinary retention, vomiting, constipation, headache, somnolence. OD > seizures, resp depression, fatal

interacts:the norms

CI: norms

219
Q

mupirocin

  • how does it work?
  • what does it treat? which bugs?
  • contraindicated in burns because?
A

protein synthesis inhibitor, topical antibiotic: binds to isoleucyl transfer RNA synthetase, active against gram + and some gram -

tx: impetigo due to staph or strep, eradication of nasal colonization of staph aureus, infected traumatic lesions

AEs: burning, stinging, pain, itching, erythema, dryness, tenderness, dermatitis, rash

no common interactions

contraindications: burns - toxic amounts of PEG could be absorbed

220
Q

naloxone

- treats? class?

A

opioid antagonist, antidote to opioid overdose**

has little to no effects if opioids are not present

caution: CVD or seizures

221
Q

naltrexone

  • class?
  • when is it used? not used?
A

opioid antagonist

Tx: substance abuse - opioids and alcohol

interacts: could increase insulin requirements
contraindicated: people who are currently dependent on opioids**

222
Q

naproxen

  • main side effect?
  • increased risk of seizures with which class?
  • contraindicated in pts with which surgery?
A

Aleve, analgesic, NSAID, anti-inflammatory, antipyretic
inhibits COX and platelet aggregation

Tx: inflammatory conditions (RA, OA, AnkSpon, migraine, dysmenorrhea), pain

AEs: abd pain, constipation, dizziness, drowsiness, headache, heartburn, nausea, GI bleeding, GI ulcers, edema, tinnitus

interacts: decreased effect of antihypertensives, might increase levels of cyclosporine, increased risk of seizures with fluoroquinolones, reduce efficacy of diuretics, alcohol might enhance GI irritation
contraindications: ASA or NSAID allergy, CABG

223
Q

neomycin/polymyxin B/hydrocortisone - elective

A

outer ear infections - usually ear drops

224
Q

nepafenac - elective

A

NSAID ophthalmic - post cataract surgery

225
Q 
nicotine (transdermal)
 - class and how it works?
A

cholinergic smoking cessation agent
- nicotine is a ganglionic and CNS stimulant > paralyzes all autonomic ganglia after stimulating the respiratory system. larger doses produce a medullary-type convulsions > paralysis

AEs: skin reactions, vasculitis, anxiety, vivid dreams, insomnia, nausea, etc

interacts: adenosine, bupropion, theophylline, BBs
contraindicated: children, recent CVA, acute MI, angina, severe arrhythmias

226
Q

nitrofurantoin

  • class? effect on?
  • treats?
  • AEs? rare? blood effect?
  • avoid with which class?
  • contraindicated in which disease? pregnancy?
A

Macrobid, 5-nitrofurantoin derivative: interfere with cell metabolism and cell wall synthesis, inhibits acetyl CoA

TX: uncomplicated UTIs and prophylaxis

AEs: touching liquid NITRO causes PAIN
Pulmonary Toxicity - rare
Anemia (hemolytic) in people with G6PD def
Irritated GI
Neurotoxicity

interacts: antagonistic effects with quinolones
contraindicated: severe renal impairment, G6PD def, < 3 mo, pregnancy at term, L&D, lactation

227
Q

nitroglycerin

- most common AE

A

organic nitrate vasodilator, antianginal: releases NO into the vascular smooth muscle causing vasodilating, increasing coronary blood flow and decreasing myocardial O2 demand

Tx: 2nd med given in suspected MI, prevention of angina due to CAD, refractory HF

AEs: headache*, low BP, reflex tachycardia, transient LOC

interacts: increases vasodilative effect of sildenafil, may increase hypotensive effect with other antiHTN and alcohol
contraindications: severe anemia, sildenafil in the last 24 hours

other anginal meds: BBs, CCBs

228
Q

norelgestromin/ethinyl estradiol patch

- treats? how does it work?

A

inhibits gonadotropin secretion from the pituitary, prevents follicular maturation and ovulation, stimulates growth of mammary tissues

TX: contraception

AEs: HA, nausea, menstrual cramps, breast symptoms

contraindications: breast CA, arterial thromboembolic disease, thrombophlebitis, DVT, PE, liver disease or tumors

229
Q

norethindrone - elective

A

2nd generation progestin

contraception

230
Q

Norgestimate/Ethinyl Estradiol (oral)

  • how does it work?
  • pregnancy?
A

Mononessa: norgestimate inhibits the secretion of gonadotropins from pituitary, prevents follicular maturation and ovulation, stimulates growth of mammary tissue

tx: contraception

AEs: GI, changes in appetite or weight, fluid retention, edema, acne, chloasma, allergic skin reactions, urticaria, depression, libido, hair loss, hirsutism, fatigue, drowsiness, insomnia, fever, headache, alterations on cycles, lipid levels, and LFTs

contraindicated: undx vaginal bleeding, thromboembolic disorders, breast cancer, estrogen-dependent tumor, liver disease, pregnancy X

231
Q

nystatin

  • class? what does it effect?
  • treats?
A

polyene antifungal: binds sterols in the cell membrane > leaks out intracellular components

TX: topical for candida albicans

AEs: uncommon, normal topical SEs

232
Q

octreotide - elective

A

somatostatin analogue

decreases GH, antidiarrheal

acromegaly, carcinoid tumor, VIPoma

233
Q

olopatadine ophthalmic - elective

A

antihistamine eye drop

234
Q

omeprazole - elective

A

PPI

235
Q

ondansetron

  • class?
  • interaction?
  • caution?
A

SSRA, antiemetic: blocks 5-HT3 receptors in the chemo zone of brainstem and GI tract

tx: nausea and vomiting

AEs: headache, dizziness, constipation

interacts: CYP450
caution: pts with liver failure

236
Q

oral osmotics - elective

A

Miralax, Milk of Magnesia, Sorbitol

draw water into the colon to soften poo poo

237
Q

oseltamivir

- which strains does it work against? resistant?

A

tamiflu, antiviral: neuraminidase inhibitor
prevention and TX of influenza - works for A H3N2 and B strains. resistant to A H1N1

AEs: N/V, abd pain, bronchitis

238
Q

oxybutynin - elective

A

anticholinergic, antimuscarinic

urinary urgency and frequency in overactive bladder

239
Q

oxycodone

- class?

A

opioid agonist, narcotic analgesic

tx: analgesia

AEs: micturition difficulties, ureteric or biliary spasm, antimuscarinic effects, hallucinations, dysphoria, dependence, miosis, decreased libido, constipation, insomnia

interacts: TCAs, serotonergic drugs, metoclopramide, diuretics

CI: resp depression, alcoholism, porphyria, pregnancy D, children < 18

240
Q

oxymetazoline (nasal spray)

  • how does it work?
  • side effect?
A

Afrin, Vicks Sinus 12 Hour. imidazoline, decongestant
- vasoconstricting effect on mucosal blood vessels and reduces edema

tx: nasal congestion

AEs: long term use can cause rebound congestion. headache, insomnia, tachycardia, HTN, nervousness, nausea, dizziness, palpitations, arrhythmia

contraindicated: glaucoma, hyperthyroidism, heart disease, HTN, children < 6

241
Q

oxytocin (Pitocin)

- treats?

A

posterior pituitary hormone, uterine stimulant: induces a rhythmic contraction during labor, increases the tone and amplitude of uterine contractions at small doses

TX: postpartum hemorrhage, labor induction, incomplete or inevitable abortion

AEs:

fetus: jaundice, arrhythmias, bradycardia, CNS damage, seizure, retinal hemorrhage, low Apgar
mother: hypotension, reflex tachycardia, nasal irritation, rhinorrhea, lacrimation, uterine bleeding, violent contractions, hypertonicity, spasm, nausea, vomiting

interactions: HTN when given with a caudal block, hypotension and bradycardia if given with cyclopropane anesthesia

CI: cephalopelvic disproportion, abnormal presentation of fetus, hydraminos, previous C section, hyper active or tonic uterus, uterine rupture, contraindicated vaginal delivery, fetal distress, pre-eclamptic toxicity, pregnancy X

242
Q

paclitaxel

  • what phase of cell cycle?
  • kinds of cancer?
A

mitotic inhibitor, antineoplastic (M phase specific)

TX: advanced ovarian cancer, NSCLC, metastatic ovarian or brain cancer

AEs: diarrhea, nausea, vomiting, alopecia, anemia, leukopenia, thrombocytopenia, peripheral neuropathy, arthralgias, myalgias

interacts: cyclosporine, doxorubicin, diazepam
contraindicated: pregnancy X, nursing, alcoholism or liver disease, blood dyscrasias

243
Q

pantoprazole - elective

A

PPI

244
Q

paroxetine - elective

A

paxil, SSRI

245
Q

pembrolizumab

A

keytruda, immunotherapy

advance NSCLC, melanoma, triple negative breast CA, lots of other CAs

246
Q

penicillamine

  • what it do? treat?
  • preg?
A

chelates copper, As, Pb (PeniCillAmine)

Tx: wilson’s disease, arsenic poisoning, lead poisoning, RA

AEs: bone marrow suppression, dysgeusia, anorexia, vomiting, diarrhea, can cause secondary nephrotic syndrome

contraindicated: penicillin allergy, renal insufficiency, pregnancy D

247
Q

penicillin G

A

**usually IV or IM* - penicillin VK usually oral

B-lactam antibiotic: binds to specific penicillin binding proteins inside the bacterial cell wall, penicillin G inhibits the third and last stage of bacterial cell wall synthesis, cell lysis is mediated by bacterial cell wall autolytic enzymes

RHD
used in combination w the anthrax vaccine

248
Q

penicillin VK

  • route?
  • class? how does it work?
  • what bugs/disease does it treat?
  • weird AE?
  • avoid taking with which 3 pharms?
A

**usually oral* - penicillin G usually IM or IV

B-lactam antibiotic: binds to specific penicillin binding proteins inside the bacterial cell wall, penicillin G inhibits the third and last stage of bacterial cell wall synthesis, cell lysis is mediated by bacterial cell wall autolytic enzymes

treats: GRAM + bacteria:
strep (URTI, scarlet fever)
pneumococcal (RT, otitis media)
staph (skin and soft tissue)
bacillus anthracis, corynebacterium diphtheria

treats: limited GRAM - bacteria, however can be used in some meningococcal disease (Neisseria meningitides)

AEs: black hair tongue, diarrhea, nausea, oral candidiasis

interacts: decreased effect with doxycycline, increases effect of MTX, decreases effect of BBs
contraindications: penicillin allergy, cephalosporins

249
Q

pentoxifylline

  • how does it work? what does it treat?
  • what med does it interact with?
  • contraindicated with products containing?
A

Trental, xanthine derivative, hemorrheologic
reduces blood viscosity by increasing the deformability of leukocytes and erythrocytes > decreases neutrophil adhesion and activation, improves blood flow for claudication/PAD

Tx: peripheral vascular disease, cerebrovascular disorders, claudication

AEs: N/V, dizziness, HA, flushing, angina, palpitations, cardiac arrhythmias, hepatitis, jaundice, blood dyscrasias, agitation, sleep, hypotension, thrombocytopenia, intrahepatic cholestasis

interactions: AEs are increased if used with ciprofloxacin, as cipro increases levels of pentoxifylline
contraindications: hypersensitivity to products containing *xanthine (caffeine, theophylline, theobromine), recent cerebral or retinal hemorrhage, porphyria

250
Q

permethrin

- what bugs? how does it kill em?

A

pyrethroid, pediculicide: anti lice, ticks, fleas, mites, and other arthropods. acts on the nerve cell membrane to disrupt Na channel current > delayed repol and paralysis of the pest

Tx: sarcoptes scabiei and lice

AEs: mild and transient burning and stinging, pruritis

interactions: none w topical
contraindications: hypersensitivity

251
Q

phenazopyridine

  • class?
  • use?
A

nonopioid analgesic, urinary analgesic AZO dye

use: pain and irritability in cystitis, prostatitis, urethritis

AEs: hemolytic anemia, discoloration of urine and other bodily fluids, staining contact lens, crustal deposits in urinary tract

CI; renal or liver imapirment

252
Q

phenelzine

  • class? how does it work?
  • treats?
  • AEs? interacts?
A

MAOI* the only MAOI in this list: increases endogenous concentration of NE, DA, and 5HT

Tx: atypical depression, panic disorder

AEs: postural hypotension, dizziness, headache, drowsiness, sleep disturbance, fatigue, rash, decreased sexual ability, constipation, wt gain, urinary retention, leukopenia, hepatitis, jaundice, weakness, tremor, blurred vision

interacts: additive w anticholinergics, enhances AEs of B-agonists, Lithium. additive CNS depression with alcohol or other CNS depressants. increased AE with levodopa

CI: uncontrolled HTN, CVD, CHF, pheochromocytoma, LFTs, renal disease. CI with ALL antidepressants and anything that has an effect on catecholamines

253
Q

phentermine

  • class? used for?
  • AEs?
A

Adipex, weight loss agent and appetite suppressant sympathomimetic
- indirect sympathomimetic with a and B adrenergic agonist activity: stim the cerebral cortex to reduce appetite

tx: obesity

AEs: palpitations, tachycardia, HTN, overstimulation, euphoria, psychosis, changes to libido and impotence

interacts: antacids and carbonic anhydrase inhibitors decrease its excretion. urinary acidifiers increase its excretion. dont use w sympathomimetics. risk of arrhythmias with TCAs, reduces serum concentrations of phenytoin and phenobarbital
contraindicated: pulmHTN, HTN, hyperthyroidism, CVD, glaucoma, history of alcohol or drug abuse, within 12 days of MAOIs, lactation

254
Q

phenylephrine

  • how does it work?
  • treats?
  • adverse effect when used ophthalmogically?
A

Sudafed PE and nasal spray: sympathomimetic and alpha and weak B adrenergic agonist

Tx: nasal congestion, or mydriasis if used as an eye dropper

AEs: normal ones, plus: mydriasis, difficulty peeing, urinary retention, hyperglycemia, lactic acidosis. ophthalmic solutions could liberate pigment granules from the iris causing corneal clouding or damage

interacts: BBs, MAOIs
contraindicated: HTN, vtach, closed angle glaucoma

not to be confused with pseudoephedrine = Sudafed (has potential for abuse)

255
Q

phenytoin

  • class? used for?
  • 1st line for?
  • side effects?
  • drug interactions?
A

Dilantin: anticonvulsant: increases efflux/decrease influx of Na in motor cortex > stabilization of membranes > antiseizure. antiarrhythmic by shortening action potentials

tx: GPS: 1st line for generalized tonic-clonic seizures, partial seizures, and status epilepticus (after diazepam or lorazepam), sxs of arteriovenous malformations

AEs: PHENyTOIN
Peripheral neuropathy (but can also tx PN)
Hyperplastic gingiva, Hirsutism
Enlarged LNs
Nystagmus, diplopia, ataxia, sedation
Teratogen - fetal hydantoin syndrome
Osteomalacia (decreases vitD levels) and megalOblastic anemia (decreases folate levels)
Inhibits insulin secretion > DM, Induces SLE
Nausea and vomiting

interacts: lithium, acyclovir, antineoplastics, benzodiazepines, cipro, CYP2C9, CYP2C19, folic acid, antiarrhythmics, anticonvulsants, antipsychotics, BBs, CCBs, chloramphenicol, corticosteroids, doxycycline, estrogens, HMG-CoA-RIs, methadone, theophylline, TCAs
contraindicated: sinus bradycardia, *heart block , Pregnancy D

256
Q

pilocarpine - elective

A

cholinergic miotic

reduces pressure in the eye, treats angle closure glaucoma, ocular hypertension, constrict the pupil, and for dry mouth

257
Q

pioglitazone

  • how does it work?
  • which line is it for DM?
  • increases risk of what?
  • effects on TGs, HDL, LDL
  • which CYP 450?
  • pregnancy?
A

thiazolidinedione: activates peroxisome proliferator-activated receptor - Y in adipose tissue, skeletal muscle, and liver. increases gene transcription, insulin sensitivity, and glucose transporters in muscle and adipose tissue, suppresses hepatic glucose output
tx: DM2, 2nd line choice, can be used alone or in combination with metformin or insulin

AEs: GLITAbone: gain of weight, liver toxicity, increased fluid retention (edema), TG lowered (but HDL and LDL raised ), avoid in pts with HF or liver disease, bone fractures are increased in upper arms/feet/hands in female pts

interacts: CYP450 3A4, might reduce levels of contraceptives
contraindicated: HF, liver disease. Pregnancy C - insulin is preferred however

258
Q

pneumococcal polyvalent

- for?

A

Pneumovax - S. pneumonie capsular Ags

259
Q

polio vaccine

A

now inactivated since 2000

oral is given in other countries

260
Q

potassium chloride - elective

A

oral or injection to prevent or treat hypokalemia

261
Q

PPD skin test

- what is a +?

A

antigenic purified protein derivative of mycobacterium tuberculosis

used to diagnose TB: inject 0.1mL intradermally and read result in 48-72 hours > + if there is a 10 mm induration

262
Q

pramipexole

- used in? how does it work?

A

Mirapex: dopamine agonist: a nonergot DA R agonist used as an adjunct to levodopa or as a monotherapy

TX: PD, restless leg syndrome

AE: sudden onset of sleep without drowsiness, confusion, drowsiness, hallucinations, dyskinesia

interacts: antipsychotics, cimetidine, sedatives or alcohol
contraindications: can shut down lactation

263
Q

prednisolone - elective

A

corticosteroid

arthritis, inflammatory conditions

264
Q

prednisone

-side effects

A

Deltasone, adrenal glucocorticoid, endocrine-metabolic agent
decreases inflammation by suppressing the migration of PMN 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

Tx: for inflammation and autoimmune conditions: acute asthma, giant cell arteritis, ITP, rheumatoid arthritis, allergies, SLE, transplants, carditis, pemphigus vulgaris and bullous pemphigoid, acute gout (esp in pts w kidney disease)

AEs: IM the HOPE
Iatrogenic Cushings, Infections
Myopathy (loss of mass and weakness)
Hypokalemia, Hypomania
Osteoporosis, Osteonecrosis of femoral/humeral heads
Peptic ulcers, Pancreatitis
Edema (angio or pulm), Eye disorders (cataracts, glaucoma)

interacts: NSAIDS (increased risk of GI ulcer), decreased effect with barbituates and phenytoin, decreased effect of salicylates and vaccines, alcohol can increase GI irritation
contraindicated: serious infections (except TB and meningitis), varicella, systemic fungal infections

265
Q

pregabalin

  • class?
  • treats?
  • most common AEs?
A

Lyrica: anticonvulsant, analgesic: GABA analogue that binds to Ca channels in the CNS

TX: neuropathic pain, fibromyalgia, post-herpetic neuralgia, partial seizures

AEs:dizziness > somnolence > ataxia* > preipheral edema and weight gain > dry mouth > fatigue, tremor, blurred vision

interacts: ACEIs, CNS depressants, rosiglitazone

pregnancy C

266
Q

pregnenolone

- treats?

A

precursor to steroid hormones

for *memory enhancement

267
Q

procaine - elective

A

local anesthetic in dentistry

268
Q

prochlorperazine

  • class?
  • treats?
  • most common AE? lifestyle AE? long term use AE?
  • 3 herb interactions?
  • pregnancy?
A

piperazine phenothiazine*, antiemetic, anxiolytic, antipsychotic: blocks D2 R antidopaminergic effects > increased DA turnover. also blocks anticholinergic and alpha-adrenergic receptors > sedation, muscle relaxation, hypotension

Tx: schizophrenia, severe nausea/vomiting, psychosis

AEs: inability to sit still, sedation, anticholinergic effects, can cause photosensitive reaction to sun exposure, tardive dyskinesia with long term use

interacts: additive antocholinergic effects with antihistamines, TCAs, and drugs used in parkinsons. angelica and hypericum both increase photosensitivity. kava increases dystonic reactions
contraindications: coma, severe CNS depression, poorly controlled seizures, subcortical brain damage, severe HTN, severe CVD, lactation, children < 2. pregnancy C

269
Q

progesterone (oral micronized)

  • secreted by?
  • effects on body?
  • tx?
  • contraindicated?
A

a progestin: the main hormone secreted by the corpus luteum, induces secretory changes in the endometrium, promotes mammary gland development, relaxes the uterus, blocks follicular maturation and ovulation, maintains pregnancy

TX: amenorrhea, dysfunctional uterine bleeding, contraception, PMS

AEs: GI disturbances, appetite and weight change, fluid retention, edema, acne, skin rash, depression, headache, fever, fatigue, breast changes, hirsutism, libido changes, altered menstrual cycles or irregular menstrual bleeding

interacts: enhanced clearing with carbamazepine, phenobarbital, phenytoin, could inhibit cyclosporine metabolism
contraindications: thrombophlebitis, severe liver impairment, undx vaginal bleeding, incomplete abortion, hormone-dependent carcinoma, as a DX test for pregnancy, pregnancy

270
Q

promethazine - elective

A

phenothiazine, antiemetic, 1st generation antihistamine

allergies, motion sickness, sedative

purple drank/sizzurp = promethazine + codeine

271
Q

propranolol

  • what receptor(s) does it act on
  • name 6 AEs
  • what sxs could occur if you stop it abruptly
A

Beta bLOcker (LOLO > OLOL) (B1 and B2 adrenoreceptor antagonist - heart and lungs)
- reduces heart rate and contractility (B1), causes vasoconstriction, increase in respiratory smooth muscle constriction/bronchoconstriction (B2)
Tx: hypertension, angina, arrhythmias, migraine prevention, post-MIs, cardiomyopathy, GAD, phobias
- AEs: 2BBS: bradycardia, bronchospasm, sadness, blood vessel spasm/peripheral vascular disease, blunted hypoglycemia in DMs, sexual dysfunction
- interactions: nitrates and other hypotensives > more hypotension. digoxin > more bradycardia. decreases effects of DA
- contraindications: sinus Brady, 2nd/3rd degree heart block, cardiac failure, cariogenic shock, severe hemorrhage, asthma/COPD, peripheral vascular disease, caution in diabetes, dont stop abruptly (tachycardia and rebound HTN)
- pregnancy category C

272
Q

propylthiouracil (PTU)

  • class and how does it work?
  • side effects? one is severe and dangerous, can be seen on labs?
  • med interaction?
  • pregnancy?
A

thioamide derivative: binds to thyroid peroxidase and inhibits the conversion of iodide > iodine which inhibits the production of new thyroid hormone, as iodine is needed

Tx: hyperthyroidism

AEs: AAASH: Agranulocytosis (leukopenia), Alopecia, Arthralgia, Skin rash (maculopapular pruritic), Hepatitis, cholestatic jaundice

interacts: increase the effect of blood thinners (warfarin)
contraindicated: hypothyroidism, pregnancy D

273
Q

pseudoephedrine

  • brand name? risk?
  • how it works?
  • treats?
A

Sudafed abuse potential > used to make meth
alpha and B-adrenergic agonist, decongestant
- vasoconstriction of respiratory mucosa (a) and bronchial relaxation, increased heart rate and contractility (B)

Tx: nasal congestion

AEs: angina, rebound congestion, fear, confusion, psychotic, reduced appetite, cerebral hemorrhage, reflex bradycardia, tachycardia, hypotension and dizziness, fainting, flushing, etc

interacts: HTN and arrhythmia risk when given with cardiac glycosides, quinidine, or TCAs. increased vasoconstriction with ergot alkaloids or oxytocin. MAOIs > HTN crisis
contraindicated: HTN, pheochromocytoma
* not to be confused with phenylephrine (Sudafed PE)*

274
Q

quetiapine - elective

A

atypical antipsychotic

schizophrenia, bipolar, mania, depression

275
Q

raloxifine

  • agonist of? antagonist of?
  • top 4 AEs
A 
Evista, SERM, selective estrogen receptor modulator, endocrine-metabolic agent
selective agonist (on bone by preventing bone loss and on cholesterol metabolism by decreasing total and LDL chol) OR antagonist (estrogen effects leading to dev of breast and uterine cancer)

Tx: prophylaxis of postmenopausal osteoporosis

AEs: hot flushes, flu syndrome, leg cramps, arthralgia, sleep disorders, peripheral edema, vag bleeding, rashes, GI disturbance, HTN, headache, sinusitis

interacts: with warfarin could reduce PT response time
contraindications: active or past history of VTEs, hepatic and severe renal impairment, pregnancy X and lactation

276
Q

ramipril

A

ACEI

277
Q

Ranitidine

  • what does it inhibit? what cell does it act on? through which receptor?
  • most common AE?
  • dont take with which 2 meds? lifestyle?
  • pregnancy? breastfeeding?
A

H2 antagonist, anti-ulcer agent: competitively inhibit histamine at the gastric parietal cell H2 receptor > inhibition of gastric acid and secretion at the H/K proton pump > promotes the healing of ulcers and relieves GI discomfort

tx: PUD, dyspepsia, stress-induced gastritis, GERD

AE: headache, nausea, vomiting, diarrhea, constipation, abd pain

interacts: antacids could interfere with absorption, might interfere with warfarin clearance, watch closely for bleeding, smoking could increase gastric acid secretion and worsen disease (avoid)
contraindications: breastfeeding, gynecomastia, it IS safe in pregnancy

278
Q

RGE vaccine

  • for what? what kind of vaccine?
  • contraindicated?
A

Rotarix, RotaTeq
LIVE, attenuated - active immunity

for the prevention of rotavirus gastroenteritis

AEs: normal ones, nasopharyngitis, bronchospasm, otitis media, hematochezia, seizures

CI: SCID, infants with a hx of intussusception, uncorrected congenital malformation of the GI tract

279
Q

rifampin

  • treats?
  • weird SE? common SE?
A

rifamycin derivative: inhibits DNA-dependent RNApol

tx: TB, leprosy, prophylaxis of meningitis and Hib

AEs: red discoloration of tears/urine/saliva/sweat, elevated LFTs

interactions: CYP - lots of interactions, can reduce OCP efficacy
contraindicated: live bacterial vaccines, antivirals

280
Q

rifaximin - elective

A

macrolactam

IBS and travelers diarrhea

281
Q

risperidone

  • acts on?
  • treats?
  • side effects? lab value?
A

atypical antipsychotic: blocks 5HT and DA Rs mostly. also H1 and a-adrenergic.

Tx: schizophrenia, can improve choreic movements in Huntingtons patients, delirium (not dementia)

AEs: aggressive behavior, dizziness, extrapyramidal symptoms, insomnia, increased PRL

interactions: DA agonists, carbamazepine, CNS depressants

CI: lactation

282
Q

rivaroxaban - elective

A

Xa inhibitor

anticoag

283
Q

rivastigmine - elective

A

exact same as donepezil, copied below:

Acetylcholineesterase inhibitor: inhibits cholinesterase in the CNS

Tx of Myasthenia Gravis, dementia (not delirium), Alzheimers

AEs: GI (diarrhea, nausea, vomiting, increased gastric acid secretion), bradycardia, insomnia

interacts: increased cholinergic drugs, decreases anticholinergic drug effects

relative CI: bradycardia, arrhythmia, CHF, CAD, asthma, COPD, ulcers

284
Q

salmeterol

  • class? when to tuse?
  • black box?
A

long acting B2 agonist: increases cAMP, relaxes bronchial smooth muscles, inhibits the late phase of allergen-induced bronchoconstrictions

tx: asthma when used with glucocorticoids, prevents nocturnal and exercise- induced attacks. not for use in acute bronchospasm
* given BID, is slower and longer acting than albuterol*

AEs: black box warning for asthma-related death, tachycardia, headache, nervousness

interacts: BB, caffeine

CI: status asthmaticus, acute asthma

285
Q

scopolamine - elective

A

aka hyoscine (tropane alkaloid): antimuscarinic - blocks acetylcholine,

transdermal patch for motion sickness, N/V

286
Q

selenium sulfide

- treats what? how?

A

antiseborrheic, antifungal: cytostatic effect on cells of the epidermis to reduce corneocyte production, can block enzymes responsible for epithelial growth

tx: tinea versicolor, dandruff/seborrhea

AEs: transient itching, irritation, burning

contraindications: dont use in eyes, mouth, anus, or vagina

287
Q

sildenafil

  • how does it work?
  • most common AE?
  • absolutely avoid with?
A

phosphodiesterase inhibitor: PDE degrades cGMP in the corpus cavernosum, when inhibited > smooth muscle relaxation and inflow of blood to the corpus cavernosum

TX: ED

AE: headache, epistaxis, insomnia, tachycardia

interacts: alpha blockers, nitrates

CI: nitrates > fatal hypotension

288
Q

simvastatin - elective

A

statin

289
Q

sitagliptin

  • class and how it works?
  • interacts with what other antidiabetics?
  • contraindicated in?
A

DDP-4: dipeptidyl peptidase 4 inhibitor: DDP-4 rapidly inactivates incretin, by inhibiting this enzyme and therefore increasing incretin > helps to increase insulin release and decrease circulating glucose

TX: DM2

AEs: nasopharyngitis > diarrhea > headache > constipation > peripheral edema > nausea > pharyngitis > OA

interacts with: insulin and sulfonylureas, increased risk of hypoglycemia

contraindicated: DM1, DKA

290
Q

sodium phosphate enema

  • class, how it works?
  • phosphate component also does?
  • side effects including Ca, Na, and Ph effects
A

phosphoric acid salt, saline laxative: exerts osmotic effect in the SI by drawing water into the lumen of the gut and producing distention, promoting peristalsis and evacuation of bowels. phosphorus also participates in bone deposition, calcium metabolism, utilization of B complex vitamins, buffer in acid/base equilibrium

tx: colonoscopy, natural cathartic laxative, constipation

AEs: ARF, hypocalcemia, hypernatremia, hyperphosphatemia

contraindicated: children 2-11 and elderly, dont use when there is N/V/severe abd pain, caution in renal impairment or ascites

291
Q

solifenacin - elective

A

antispasmodic

overactive bladder

292
Q

somatropin - elective

A

growth hormone

GH def, Turner syndrome, short stature

293
Q

Spironolactone

  • 3 effects/class
  • where in the kidney does it block receptors
  • effect on K
  • AEs
  • what should we monitor while on this med?
  • do not combine with which drugs?
  • causes acidosis? alkalosis? resp? metabolic?
A

Aldosterone Antagonist, K sparing diuretic, anti-androgen: binds receptors in the DVT to increase Na and water excretion, but decrease K excretion. decreases T levels by inhibiting 17-20-desmolase and increasing conversion of T > E2

Tx: HTN, CHF, edema, hypokalemia, primary hyperaldosteronism

AEs: *gynecomastia, impotence, irregular menses, hyperkalemia monitor , *metabolic acidosis, gastric distress, peptic ulcers

interactions: hyperkalemia with ARBs or K supplements
contraindications: anuria, acute renal insufficiency, significant impairment of renal excretory function, Addisons disease or other conditions assoc with hyperkalemia

294
Q

sucralfate

  • treats?
  • most common SE?
  • avoid use with?
A

sucrose-sulfate-aluminum complex, pepsin inhibitor: possibly stimulates PG synthesis or creates a physical barrier to protect the GI tract from stomach acid and promotes bicarb production

Tx: duodenal ulcer, stress ulcer

AEs: constipation

interacts: requires an acidic environment to work, avoid with antacids, H2 blockers, PPIs
contraindications: hypersensitivity

295
Q

sulfacetamide - elective

A

topical antiobiotic for acne, dandruff, seb derm, skin infections

296
Q

sulfasalazine

  • class
  • treats?
  • 6 common AEs
  • food interaction? med?
  • contraindication?
  • pregnancy?
A

DMARD, folate antagonist, salicylate - sulfonamide analog
anti-inflammatory

Tx: IBD (Crohns and UC), AnkSpon, RheumArthritis

AEs: anorexia, headache, nausea, vomiting, gastric distress, reversible oligospermia

interactions: reduced absorption of folic acid and digoxin
* supplement with folic acid

contraindications: hypersensitivity to sulfasalazine, sulfonamides, or salicylates, intestinal or urinary obstruction, porphyria, < 2 yo, pregnancy C/D, breastfeeding

297
Q

sumatriptan

  • class?
  • used in which headaches?
A

triptan - 5HT1 agonist: vasoconstriction of cranial arteries and/or inhibition of neurogenic inflammatory process in the CNS

Tx: migraine and cluster headaches (not tension) abortive

interacts: ergotamines

CI: not to be used prophylactically in pts with basilar or hemiplegic or ophthalmologic migraine, sulfonamides allergy

298
Q

tacrolimus - elective

A

immune suppressant

organ transplants

299
Q

Tamoxifen - elective

A

SERM

ER+ Breast Ca

300
Q

tamsulosin

  • class? how does it work?
  • treats?
  • interacts?
A

Flomax: alpha 1 adrenergic antagonist alpha blocker (all BPH alpha blockers end in osin) - causes smooth muscle relaxation: blocks DHT from binding to stromal and epithelial receptors

TX: BPH, bladder outlet obstruction, ureteral calculi, hepatic or renal impairment

AEs: abnormal ejaculation, arthralgia, orthostatic hypotension, dizziness, headache, rhinitis, infection

interacts: CYP2D6, CYP3A4

CI: lactation

301
Q

terazosin - elective

A

alpha 1 blocker (all BPH alpha blockers end in osin)

BPH and HTN

302
Q

terbinafine

  • what does it inhibit?
  • what does it treat and how long should it be used for?
  • toxic to what organ?
A

allylamine, antifungal: inhibits squalene epoxidase (main enzyme in sterol synthesis), results in an ergosterol deficiency in the fungal cell walls, can use against dermatophytes and some yeast

Tx: dermatophytosis/fingernail infections (6 weeks) toenails (12 weeks), first line oral for onychomycosis of nails

AEs: elevated liver function tests, slightly hepatotoxic, anorexia, diarrhea, vomiting

interacts: increases hepatotoxicity with other hepatotoxic drugs, increases SSRI, BB, MAOI, and warfarin effects
contraindications: active or chronic liver disease, renal disease, lactation

303
Q

testosterone

A

men: sexual dysfunction
women: hot flashes

improved libido, inc bone mass, increased sense of well-being

304
Q

tetanus (DTaP and Tdap) vaccines

  • for what?
  • adverse effect?
A

adsorbed diphtheria, tetanus (clostridium tetani), whole-cell or acellular pertussis

AEs: unusual crying

305
Q

thalidomide - elective

A

sedative drug used to relieve nausea in pregnancy > phocomelia/deformities
did not damage the fetus if taken after 42 days gestation

also used in leprosy and cancer

306
Q

timolol - elective

A

beta blocker

also used to reduce pressure in the eye

307
Q

tiotropium bromide

  • treats?
  • most common AEs?
  • same as? but?
A

long-acting antimuscarinic and anticholinergic bronchodilator

used in maintenance tx of COPD

AEs: URTI, dry mouth and sinusitis, constipation, cough, tachycardia, UTI, pupil dilation, etc

contraindicatedL allergy to milk proteins, lactose allergy

same drug as ipratropium bromide, but longer acting

308
Q

tizanidine - elective

A

short acting muscle relaxant

spasticity associated with MS or spinal cord lesions

309
Q

tofacitinib

  • class?
  • treats?
  • most common AE?
  • CYP?
A

JAK inhibitor, immune modulatory: prevents th body from responding to cytokine signals

tx of RA

AEs: increase in infection, URTI, headache, diarrhea, nasopharyngitis, UTI, HTN

interacts: CYP450 3A4, immunosuppressive drugs
contraindicated: active TB and severe infections

310
Q

tolterodine

  • class?
  • main treatment?
  • CYP?
A

anticholinergic, urinary antispasmodic
competitive antagonist at postganglionic muscarinic (affects bladder and salivation) receptors

Tx: urinary incontinence

AEs: tachycardia, dry mouth, dry eyes, headache, dizziness, blurred vision, abd pain

Interacts: drugs that inhibit CYP2D6 (fluoxetine, amiodarone, cimetidine) *remember TOlteroDin6 (2D6)

Contraindications: urinary retention, gastric retention, uncontrolled narrow-angle glaucoma

311
Q

topiramate - elective

A

anticonvulsant

migraine *preventive, seizures, epilepsy

312
Q

tramadol - elective

A

opiate analgesic

313
Q

trastuzumab - elective

A

monoclonal Ab

HER2 + breast and stomach cancer

314
Q

trazodone
- class? effects?
- treats?
interactions?

A

triazolopyridine derivative, anxiolytic: 5HT2 antagonist and serotonin reuptake inhibitor

tx: depression, panic, anxiety

AEs: drowsiness, dry mouth, headache, blurred vision, N/V

interacts: MAOIs

CI: recent MI, pregnancy, SI

315
Q

tretinoin

A

topical retinoid for acne

316
Q

triamcinolone

  • class? activity?
  • tx?
A

oral corticosteroid: minimal to no mineralocorticoid activity: suppresses migration of PMN leukocytes and fibroblasts and reversing cap permeability

TX: Rheumatic and arthritic disorders, dermatoses, MS, inflammatory and allergic conditions

AEs: small amount - joint swelling, contusions, sinusitis, cough

interactions: mifepristone (used in abortion)
contraindications: systemic fungal infection, ITP, live or live attenuated vaccines

317
Q

triamterene - elective

A

diuretic - of DRT and CD - decreases RA of Na, increases RA of K > decreases the RA of water

318
Q

Trimethoprim/Sulfamethoxazole (TMP-SMZ)

  • class? effects?
  • treats? bugs?
  • blood AE?
  • contraindicated?
A

folate antagonist antibiotic: TMP inhibits folate redox, SMX inhibits folate synthesis

TX:Pneumocystis Carinii pneumonia in AIDS, RTIs (alternative to B-lactams for S pneumonia, Moraxella, H flu), 1st line for prophylaxis in animal bites, 2nd line for cellulitis, UTIs and prostatitis caused by gram - rods (proteus, e coli, enterobacter, kleb, serratia), SI infections caused by shigella and salmonella

AEs: TMP: Thrombocytopenia and leukopenia, Megaloblastic anemia, Preventable with concurrent use of folinic acid

Interacts: additive folate def with phenytoin and MTX. could potentiate sulfonylureas, increase TZ diuretic thrombocytopenia, increased risk of bleeding with warfarin

contraindicated: sulfa allergy, megaloblastic or folate deficient anemia, SLE, < 2 mo, Pregnancy D, G6PD

319
Q

triple antibiotic Neosporin

- what 3 antibiotics are in it?

A

(NEOmycin, baCitracin, POlymyxin B)
tx: minor cuts, scrapes, and burns

AEs: allergic contact dermatitis

CI: eyes, large areas

320
Q

ursodeoxycholic acid (ursodiol) - elective

A

bile acid

decreases cholesterol, increases bile acid flow

321
Q

USP thyroid

A

dessicated Armour Thyroid

hypothyroidism

322
Q

valacyclovir

  • good against?
  • effects blood levels how?
A

nucleoside analogue, antiviral. rapidly converted to acyclovir by gut and liver > inhibits DNA synthesis and viral replication for *HSV 1 and 2, VZV (shingles)

tx: shingles and herpes, prophylaxis of CMV in IC pts

AEs: HA, nausea, diarrhea, elevated AST and ALT, neutropenia and nasopharyngitis

interacts: increased nephrotoxicity w other NT drugs

323
Q

valproate (divalproex) - elective

A

potentially a Na channel blocker and GABA increaser

epilepsy, bipolar disorder, migraine prevention

324
Q

valsartan

  • class
  • most common side effect
  • effect on K
  • pregnancy category
A

angiotensin II receptor antagonist: blocks ARs > blocks effects of angio II (vasoconstriction, increased renal pressure, simulates aldosterone production > increased salt and water retention) > decreases peripheral vascular resistance, decreases effective circulating volume in the body

Tx: HTN, HF in pts who cannot use ACEIs, reduce CV death in stable pts after MI

AEs: *dizziness, hyperkalemia, hypotension

interacts: if combined with K-sparing diuretics or K supplements, can cause hyperkalemia
contraindicated: PREGNANCY D: because it acts directly on RAAS system can cause injury or death to fetus. dont use in lactation either

325
Q

vancomycin - elective

A

cell wall synthesis inhibitor/glycopeptide ABX

treats colitis after abx treatment

326
Q

varenicline

  • how it works?
  • AEs to be aware of?
A

chantix: nicotinic Ach R partial agonist: acts on the mesolimbic DA system to prevent nicotine stimulation (or at least to a lesser degree than nicotine)

AEs: nausea, insomnia, abnormal dreams, suicidal ideation

interacts: other NRT

CI: nonsmokers

327
Q

varicella vaccine

A

for chicken pox

contraindicated in pregnancy - as well as MMR

328
Q

venlafaxine

  • effects?
  • treats?
  • interctions?
A

Effexor: antidepressant: S, NE, and DA RI

tx: depression, panic disorder, GAD, social enxiety

AEs: asthenia, dry mouth, diaphoresis, abnormal ejaculation, impotence

interacts: MAOIs > neuroleptic malignant syndrome (hyperthermia, seizures, death)

329
Q

verapamil - elective

A

CCB, calcium channel blocker

330
Q

vinblastine

  • what phase does it effect?
  • treats?
  • med interaction?
A

mitotic inhibitor, antineoplastic (specific to M phase) - arrests metaphase, blocks glutamic acid utilization, inhibits purine synthesis, TCA cycle, and urea formation, interferes with NA and protein synthesis

tx: hodgkin lymphoma, testicular cancer, lymphocytic lymphoma, kaposis

AEs: anemia, leukopenia, myelosuppression, alopecia

interacts: phenytoin

CI: severe bone marrow suppression, bacterial infection, porphyria, elderly, pregnancyD

331
Q

vitamin K1 - elective

A

given to BBs to prevent bleeding /HDN

332
Q

Warfarin

  • class? how does it work?
  • AEs?
  • nutrition advice when prescribing?
  • foods to avoid when prescribing? - what about these?
A

Coumadin
Anticoagulant, coumarin derivative
inhibits the synthesis of Vit K dep coag fators, will not effect an established thrombus

Tx: prevention and TX of venous thromboembolism, MI, afib, DVT, PE

AEs: ABC broadcasts the WAR: abortion, birth defects, bleeding with an increased PT, cutaneous necrosis

interactions: avoid major changes in foods high in Vit K (green veggies), increased effects by (acetaminophen, androgens, BBs, corticosteroids, omeprazole. phenytoin), increased effect by agents that inhibit platelets (cephalosporins, NSAIDs, penicillin, salicylates, onion, garlic, ginger, ginkgo)

contraindicated: hemorrhagic tendencies, surgery, peptic ulcer, severe HTN, bacterial endocarditis, CV disorders, aneurysms, pericardial effusion, eclampsia and preeclampsia, threatened abortion, alcoholism, severe hepatic and renal impairment
- pregnancy category X

333
Q

zidovudine (ZDU) and azidothymidine (AZT)

  • class?
  • tx?
A

nucleoside analogue reverse transcriptase inhibitors (NRTIs): thymidine analogue which inhibits DNA replication

TX: AIDS, HIV, HIV prophylaxis

AEs: headache, N/V/weakness, rash, diarrhea, anemia

interacts: benzos increase HA, methadone, myelosuppressive drugs
contraindications: lactation. pregnancy C

334
Q 
zolpidem
 - class? what Rs?
treats?
 - AEs?
 - interactions?
A

nonbarbiturate hypnotic, sedative binds to BDZ Rs of GABA complex in the cerebellum > strong sedative, mild anxiolytic. rapid onset, short duration

TX: insomnia

AEs: rebound insomnia on abrupt discontinuation, additive effects w CNS agents, has less SEs than benzos

interactions: TCA, alcohol
contraindicated: severe hepatic insufficiency

335
Q

zoster vaccine

A

Shingrix

for prevention only, of shingles

336
Q 
ZZ. class of antibiotics used in pertussis?
name 3
A

macrolides: azithromycin, erythromycin, clarithromycin

337
Q

ZZ. drugs that are a pregnancy category X

A

warfarin, raloxifene, atorvastatin, isotretinoin, misoprostol, anastrozole, methotrexate, estradiol, estrone, levonoregestrel, medroxyprogesterone, norgestimate, oxytocin, hydroxyzine, finasteride, thalidomide

338
Q

ZZ. drugs that are sulfa allergy reactive

A

sulfasalazine, sulfonamide ABX (SMX-TMP), dapsone

might be OK: HCTZ, furosemide, glyburide, glimepiride, celecoxib, imitrex

339
Q

ZZ. Drugs that deplete folate

A

5 FU, anti-folates (MTX, SMX-TMP), phenytoin, OCPs, anticonvulsants, alcohol, antacids, anti-inflammatories, ABX, anticonvulsants, biguandies, bile acid sequestrants, diuretics, H2 antagonists

340
Q

ZZ. drugs to avoid with Glycyrrhiza

A

HCTZ, furosemide, digoxin

341
Q

ZZ. drugs used in peptic ulcers

A

to eradicate H. Pylori, use the following ABCs of TreatMent:

Amoxicillin
Bismuth
Clarithromycin
Tetracycline
Metronidazole
342
Q

ZZ. list the sympathomimetic drugs - with which herbs do we not want to combine with?

A

dextroamphetamine, methylphenidate, oxymetazoline, pseudoephedrine, phenylephrine, phentermine

343
Q

ZZ. salicylate drugs

A

aspirin, bismuth subsalicylate, magnesium salicylate

344
Q

ZZ. which 2 drugs are first line for acute diverticulitis?

A

metronidazole + a quinolone (cipro) or TMP-SMX

345
Q

ZZ. drugs that can cause a lupus like reaction

A

hydralazine, chlorpromazine, sulfasalazine, procainamide, carbamazepine, ethosuxamide, phenytoin, quinidine, amiodarone, some beta blockers, some calcium channel blockers, and many others.

NPLEX 2 Flashcards (13 decks)

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