Drugs of the day 3

Question 1

Metoprolol Tartrate

Answer 1

B: Lopressor
C: Selective beta1 blocker
U: MI, HTN, HF, Angina
SE: Depression, Bradycardia, Dizziness, Fatigue

Question 2

Metronidazole

Answer 2

B: Flagyl
C: Antibiotic & Antiprotozoal
U: Anaerobic infection(DM foot infection, Intra- abd), C-diff( mild 2 moderate) , STD(Trichomoniasis)
SE: Well tolerated

Out-patient - Disulfiram reaction (no alcohol)

Question 3

Micafungin

Answer 3

B: Mycamine
C: Echinocandin antifungal
U: Candida (immunocompromised), Aspergillus
SE: Renal dysfunction, Anemia, HTN, HA

Question 4

Midazolam

Answer 4

B: Versed
C: SA Benzodiazepine
U: Preanesthetic 4 short surgical procedure, PT on mechanical ventilators
SE: Respiratory & Circulatory Depression, Prolonged Sedation

Question 5

Morphine

Answer 5

B: N/A
C: Opiate analgesic
U: Severe Pain
SE: Itching, Respiratory & Circulatory Depression, Constipation, N/V/ Dizziness

PCA Pump

Question 6

Nafcillin

Answer 6

B:N/A
C:Penicillin Abx
U: Non- MRSA Staphylococcal Infection ( DOC)
SE: Hypersensitivity

Question 7

Naloxone

Answer 7

B: Narcan
C: Opioid antagonist
U: Opioid Overdose ( Opiate PT)
SE: Hypertension, Tachycardia, Arrhythmias

Question 8

Nitroglycerin

Answer 8

B: N/A
C: Anti-anginal agent
U: HF, Acute angina pectoris
SE: Hypotension, dizziness, weakness Headache & Flushing ( Topical& Oral),

PVC (polyvinyl chloride tubing ) interaction

Question 9

Norepinephrine

Answer 9

B: Levophed
C: Vasopressor (α1 & β1) >DA
U: Hypotension, Shock ( septic 1st line & cardiogenic)
SE: Skin necrosis, Headaches, Edema, Arrhythmia, Tremors

Question 10

Nalbuphine

Answer 10

B: Nubain
C: Mixed opiate agonist/antagonist
U: Moderate - Severe pain
SE: Sedation, N/V, < resp & circ depression, euphoria, constipation

No withdrawal symptoms

Question 11

Olanzapine

Answer 11

B: Zyprexa
C: Atypical antipsychotic
U: Agitation associated with Schizo or Bipolar mania
SE: EPS, QT prolongation, Hyperlipidemia, Hyperglycemia, weight gain (off label - anorexia) , drowsiness

IM only

Question 12

Ondansetron

Answer 12

B: Zofran
C: Serotonin receptor antagonist
U: Prevent N/V associated w/ chemo, radiation, surgery
SE: QT prolongation, serotonin syndrome, headache, sedation

Question 13

Oxytocin

Answer 13

B: Pitocin
C: Oxytocic agent (contraction)
U: Induce labor(drip), control postpartum bleeding(bolus)
SE: Hypertension, N/V, bradycardia, arrhythmia’s, seizures

Question 14

Palonosetron

Answer 14

B: Aloxi
C: Serotonin receptor antagonist
U: Prevent N/V(chemo, radiation, surgery)
SE: QT prolongation, Serotonin Syndrome, headache

Half life is ~ 40hr > Zofran

Question 15

Pamidronate

Answer 15

B: Aredia (IV)
C: Bone-resorption inhibitor ( inhibit osteoclast activity)
U: Hypercalcemia associated w/ malignancy & metastatic bone disease, Paget’s disease
SE: Electrolyte abnormalities( < K, Ca, Phos), fever, anemia, myalgia

Question 16

Pantoprazole

Answer 16

B: Protonix
C: PPI
U: Stress Ulcer Prophylaxis, GERD, Can take w/ Plavix

H.Pylori Cocktail

Question 17

Penicillin G

Answer 17

B: N/A
C: Penicillin ABX
U: Serious infectious caused by susceptible Strep isolates, DOC neurosyphilis (Treponema pallium)
SE: Hypersensitivity

Question 18

Phenobarbital

Answer 18

B: Luminal
C: Barbiturate anticonvulsant
U: Tonic - Clonic & Partial seizures
SE: Cause SJS, Cardio Depression, bradycardia, hypotension, drowsiness

Question 19

Phenylephrine

Answer 19

B: N/A
C: Vasopressor (α only)
U: Cardio & Septic shock ( not 1st line) hypotension
SE: Arrhythmia, headache, peripheral vasoconstriction ( skin necrosis)

Question 20

Piperacillin / Tazobactam

Answer 20

B: Zosyn
C: Penicillin ABX
U: Infections associated with MDR organisms
including Pseudomonas
SE: Hypersensitivity

Broadest spectrum
β- lactamase inhibitor

Question 21

Potassium chloride

Answer 21

B: N/A
C: Electrolyte
U: Hypokalemia
SE: bradycardia, hyperkalemia, arrhythmia •

Rate of infusion into IV peripheral line should NOT exceed 10mEq/hr
(higher rates associated with arrhythmias)

No IV push

Question 22

Promethazine

Answer 22

B: Phenergan
C: Phenothiazine antiemetic
U: N/V
SE: EPS, anticholinergic, bradycardia, ^Bp, CNS depression (sedation, dizziness, fatigue)

Avoid in elderly
IV not preferred

Question 23

Propranolol

Answer 23

B: Inderal
C: Non-selective beta blocker
U: portal hypertension (cirrhosis pts), Hypertension, arrhythmias
SE: Hypotension, bradycardia, dizziness, headache

Not for COPD or Asthmatic

Question 24

Protamine

Answer 24

B: N/A
C: Antidote
U: Heparin Overdose, neutralize heparin prior to surgery.
SE: Hypotension, bradycardia, flushing

Hypersensitivity in PT w/ Fish Allergy, NPH insulin

Question 25

Tobramycin

Answer 25

B: N/A
C: Aminoglycoside
U: Gram -ve infection
SE: nephrotoxicity, ototoxicity

Take Levels

Question 26

Trimethoprim / Sulfamethoxazole

Answer 26

B: Bactrim
C: Sulfonamide ( Sulfa Allergy)
U: Community aquired MRSA, UTI, Tx & Px of PJP in AIDS PT, Respiratory infection ( for PT who have Pen allergy)
SE: N/V/D, Hypersensitivity, Photo-sensitivity, Hyperkalemia, Anemia

PJP - Pneumocystitis Jiroveci Pneumonia

Question 27

Vancomycin

Answer 27

B: N/A
C: Glycopeptide Abx
U: DOC for MRSA (IV), Gram +ve infection in PT w/ Pen allergy.
SE: Ototoxicity, Nephrotoxicity, Vancomycin Infusion Reaction (VIR)

Draw Levels
Oral Formulation (only Tx Cdiff)

Question 28

Voriconazole

Answer 28

B: Vfend
C: Antifungal
U: DOC for Aspergillus ( mold w/ high mortality rate)
SE: ^ Creatinine Levels, Visual changes ( color blindness)

Question 29

Ziprasidone

Answer 29

B: Geodon
C: Atypical antipsychotic
U: Schiz, Bipolar, agitation in schiz
SE: EPS, QT prolongation, Drowsiness, < weight gain

Caution in Elderly w/ dementia, given IM