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Peds Rotation > EOR 2 pharm part 1 > Flashcards

EOR 2 pharm part 1 Flashcards

1
Q

Common indications for HCTZ

A

Adjunctive therapy in edema associated with CHF, hepatic cirrhosis, forms of renal dysfunction, or control of HTN

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2
Q

MOA of HCTZ

A

Inhibits reabsorption of sodium and chloride at the distal renal tubule

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3
Q

Common adverse effects of HCTZ

A 
Dry mouth
Muscle cramps
Weakness
Orthostasis
Photosensitivity
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4
Q

Renal or hepatic dosage adjustments for HCTZ

A

CrCl <10 mL/min- use not recommended

Contraindicated with anuria

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5
Q

Clinically significant drug interactions: HCTZ

A

Decreases effect of sulfonylureas

May cause digitalis-induced arrhythmias with digoxin

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6
Q

Major counseling points for HCTZ

A

Take in the AM
Avoid excessive sunlight exposure
Store in cool, dry place away from sunlight
If dose is missed, skip it and return to normal schedule

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7
Q

Monitoring parameters for HCTZ

A

BP
Potassium
Hemodynamic status
Edema in fluid overload pts

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8
Q

Common indications for tramadol

A

Management of moderate to moderately severe pain

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9
Q

MOA of tramadol

A

Mu-opioid agonist

Inhibits reuptake of serotonin and norepinephrine

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10
Q

Common adverse effects of tramadol

A

Dizziness/vertigo
Nausea
HA
Drowsiness

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11
Q

Renal or hepatic dosage adjustments for tramadol

A 
IR: CrCl <30 mL/min: 50-100 mg every 12 hrs, max 200 mg/day
ER: should be avoided if CrCL <30 mL/min
Cirrhosis: 50 mg every 12 hrs, should be avoided in pts with severe (Child-Pugh class C) hepatic dysfunction
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12
Q

Clinically significant drug interactions for tramadol

A

May potentiate effects of MAOIs, TCAs
Increased risk of seizure when given with SSRIs, TCAs, and opioids
Carbamazepine decreases levels of tramadol

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13
Q

Major counselling points for tramadol

A

May cause drowsiness- use caution when operating machinery/driving
Avoid alcohol while taking this medication
May take with food or milk to avoid GI upset
Do not split, crush or chew ER tabs
Take only as directed
Store in cool dry place away from kids and sunlight
If dose is missed, skip and return to nl dosing schedule
May produce psychological and physical dependence with continuous use
Could potentially lower the seizure threshold
Use with caution in pts with h/o seizures

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14
Q

Monitoring parameters of tramadol

A

Pain control
Misuse
Abuse

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15
Q

Common indications of Tylenol #3

A

Relief of mild-to-moderate pain

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16
Q

MOA of Tylenol #3

A

Acetaminophen: Believed to inhibit the synthesis of prostaglandins in the CNS and peripherally block pain impulse generation; produces antipyresis from inhibition of hypothalmic heat-regulating center
Codeine: Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and responses to pain, causes cough suppression by direct central action in the medulla; produces generalized CNS depression

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17
Q

Common adverse effects of Tylenol #3

A 
Hepatotoxicity
SJS
Constipation
Dizziness/drowsiness
HA
Lightheadedness
18
Q

Renal or hepatic dosage adjustments for Tylenol #3

A

Hepatic: use with caution may cause hepatotoxicity

19
Q

Black box warnings for Tylenol #3

A

Hepatotoxicity and ultra-rapid metabolism of codeine to morphine

20
Q

Clinically significant drug interactions for Tylenol #3

A

Alcohol

21
Q

Major counseling points for Tylenol #3

A

Do not use any other product including OTC with APAP
Avoid alcohol
Do not exceed 3-4 gm/day of APAP

22
Q

Common indications for gabapentin

A

Adjunctive therapy for partial seizures

Tx of postherpetic neuralgia, bipolar, peripheral neuropathies

23
Q

MOA of gabapentin

A

The exact MOA is unknown

24
Q

Common adverse effects of gabapentin

A 
Somnolence
Dizziness/drowsiness
Sedation
Confusion
Ataxia
25
Q

Renal or hepatic dosage adjustments for gabapentin

A

400 mg 3x/day when CrCl >60 mL/min
300 mg 2x/day when CrCl 30-60 mL/min
300 mg once per day when CrCl 15-30 mL/min
300 mg every other day when CrCl <15 mL/min

26
Q

Clinically significant drug interactions with gabapentin

A

Antacids reduce bioavailability of gabapentin

27
Q

Major counseling points for gabapentin

A

Avoid taking with alcohol
Given at least 2 hrs after antacids
Avoid abruptly discontinuing medication

28
Q

Monitoring parameters of gabapentin

A

Unusual behavior or mood changes

Improvement in pain or psych sx as appropriate

29
Q

MoA of prednisone

A

Stimulate/inhibits transcription of mRNA, resulting in synthesis of specific enzym es that carry out its antiallergy and anti-inflammatory effects

30
Q

Common adverse effects of prednisone

A 
Blurred vision
Upset stomach
N/V
Cushing's syndrome
Peptic ulceration
Increased susceptibility to infection
Osteoporosis (chronic use)
31
Q

Clinically significant drug interactions with prednisone

A 
May antagonize effects of anticholinesterases, barbiturates, rifampin
Phenytoin may increase metabolism
Estrogens may decrease metabolism
Ketoconazole may increase effects
May decrease salicylate effectiveness
32
Q

Major counseling points of prednisone

A

Take medication only as prescribed
Do not d/c use without consulting a physician
May take with food or milk if GI upset occurs
Store in a cool dry place away from kids and sunlight
If a dose is missed, take it as soon as possible
May see an increase in BG readings in diabetics while on this medication

33
Q

Monitoring parameters of prednisone

A 
BG
BP
Decrease in inflammation where appropriate
Long-term osteoporosis
Kyphosis
Cushings
34
Q

MOA of metoprolol

A

Selective inhibitor of beta1-adrenergic receptors

Competitively blocks beta1- receptors, with little or no effect on beta2-receptors

35
Q

Common indications for metoprolol

A

Mangement of HTN
Long-term tx of angina pectoris
Tx of stable, symptomatic heart failure of ischemic, hypertensive, or cardiomyopathic origin

36
Q

Common adverse effects of metoprolol

A

Dizziness
Hypotension
Bradycardia
Fatigue

37
Q

Major counseling points in metoprolol

A

Pts with heaert failure should contact their physician if their sx worsen
Take with food
Do not abruptly d/c
Take whole or halved tablets without chewing or crushing
Use caution while operating machinery
Can mask hypoglycemic sc in diabetics

38
Q

BBW in metoprolol

A

Ischemic heart dz

When stopping, gradually decrease doses over a 1-2 wk period

39
Q

Drug interactions with metoprolol

A

Toxic effects may be increased with verapamil

40
Q

Monitoring for metoprolol

A

BP
HR
EKG is used for dysrhythmias

Peds Rotation (12 decks)

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