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Peds Rotation > EOR 2 pharm part 2 > Flashcards

EOR 2 pharm part 2 Flashcards

1
Q

Common indications for Advair

A

Long-term maintenance tx of asthma, COPD

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2
Q

MOA of Advair

A

Fluticasone is a corticosteroid that has extremely potent vasoconstrictive and anti-inflammatory activity
Salmeterol relaxes bronchial smooth muscle by selective action on beta2-receptors with little effect on heart rate

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3
Q

Common adverse effects of Advair

A 
Upper resp tract infection
Pharyngitis
HA
Sinusitis
Bronchitis
Rash
Angioedema
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4
Q

BBW of Advair

A

LABA such as salmeterol may increase risk of asthma-related death

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5
Q

Drug interactions of Advair

A 
Corticosteroids
Sympathomimetics
TCA
MAOI
All of the above may increase toxicity
BBs may decrease the effectiveness of salmeterol
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6
Q

Major counseling points of Advair

A

Avoid contact with eyes
Rinse mouth after use
Not intended for immediate relief of sx
Use on a regular basis for full effect

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7
Q

Monitoring for Advair

A

PFT
Proper technique/medication adherence
S/sx of asthma/COPD

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8
Q

Common indications for albuterol

A

Relief of bronchospasm with reversible obstructive airway dz
Prevention of exacerbations of bronchospasm
Prevention of exercise-induced bronchospasm

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9
Q

MOA of albuterol

A

Catalyzes the formation of cAMP which can cause relaxation of bronchial smooth muscle

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10
Q

Common adverse effects of albuterol

A

HTN
Tachycardia
Dizziness
Pharyngitis

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11
Q

Clinically sig drug interactions with albuterol

A

Monoamine oxidase inhibitors may increase the toxicity of this medication

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12
Q

Major counseling points for albuterol

A

Do not take more frequently than recommended
Shake the canister well before each inhalation
Clean mouthpiece at least once a week.

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13
Q

Monitoring for albuterol

A

Proper technique
FEV1
Peak flow
Improvement in resp sx

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14
Q

Common indications for oxycodone

A

Moderate to severe pain

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15
Q

MOA of oxycodone

A

Binds to opiate receptors int the CNS causing inhibition of ascending pain pathway

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16
Q

Common adverse effects of oxycodone

A

Constipation
Somnolence
Drowsiness
Dizziness

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17
Q

Renal or hepatic dose adjustments in oxycodone

A

Use with caution in hepatic impairment

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18
Q

BBW for oxycodone

A

Resp depression

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19
Q

Drug interactions with oxycodone

A

Other CNS depressants and alcohol enhance activity of oxycodone
Increased risk of CNS related side effects with benzodiazepines

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20
Q

Monitoring for oxycodone

A

Pain control
Abuse
Misuse
Constipation

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21
Q

MOA of alprazolam

A

Facilitates the inhibitory neurotransmitter action of GABA in pre- and post-synapse

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22
Q

Common adverse effects of alprazolam

A

Drowsiness

Xerostomia

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23
Q

Renal or hepatic dosage adjustments for alprazolam

A

Caution in advanced liver disease

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24
Q

Drug interactions with alprazolam

A

Taking other CNS depressants along with alprazolam can increase drowsiness and risk of respiratory depression

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25
Q

Major counselling for alprazolam

A 
May cause drowsiness
Avoid taking with alcohol
May be habit-forming
XR tablets should be swallowed whole
This med should not be abruptly d/c-ed
26
Q

Common indications of statins

A

HLD
Hypertriglyceridemia
Primary and secondary prevention of cardiovascular dz

27
Q

MOA of statins

A

Inhibitor of HMG-CoA reductase
Results in an increase in the expression of LDL receptors on hepatocyte membranes and a stimulation of LDL catabolism
Also has an effect on total cholesterol and Apo-B, as well as a minor increase in HDL

28
Q

Common adverse effects of statins

A 
CP
HA
N/V/D
Rash
Myalgia
29
Q

Renal or hepatic dosage adjustments in statins

A

Do not use in active liver dz, renal impairment adjust dose

30
Q

Drug interactions with statins

A

Gemfibrozil, erythromycin or immunosuppressive coadministration will likely cause rhabdo or myopathy
Grapefruit juice

31
Q

Counseling for statins

A

Contact doc if muscle pain or tenderness
Maintain low-fat diet
NSAIDs and Tylenol are not acceptable forms of pain relief for myalgia
Limit sun exposure due to photosensitivity
Limit alcohol intake

32
Q

Common indications for montelukast

A

Prophylaxis and chronic tx of asthma in adults and children 2 yrs of age and older
Relief of seasonal rhinitis and perennial allergic rhinitis
Prevention of exercise-induced bronchoconstriction

33
Q

MOA of montelukast

A

Selective leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor

34
Q

Common adverse effects of montelukast

A 
HA
Influenza
Cough
Abd pain
Dyspepsia
Dizziness
35
Q

Drug interactions with montelukast

A

Phenobarbital may increase metabolism

May decrease the metabolism of paclitaxel, rosiglitazone, and repaglinide

36
Q

Counseling for montelukast

A

Indicated for chronic tx of asthma and should be taken regularly even when the pt is asymptomatic
Not intended to treat asthmatic attacks
Singulair granules can be given either directly in the mouth or mixed with a spoonful of soft food

37
Q

Monitoring for montelukast

A

FEV1
Peak flow
Unusual changes in mood
Improvement of s/sx of asthma

38
Q

Indications for meloxicam

A

OA

RA

39
Q

MOA of meloxicam

A

Inhibits cyclooxygenase resulting in a decreased biosynthesis of prostaglandins

40
Q

Adverse effects of meloxicam

A 
Abd pain
Diarrhea
Dyspepsia
Flatulence
Nausea
41
Q

Renal or hepatic dosage adjustments for meloxicam

A

Caution with sig renal and hepatic impairment

42
Q

BBW for meloxicam

A

Use is contraindicated for tx of perioperative pain the setting of CABG
Associated with increased risk of adverse cardio thrombotic events (MI, stroke)
Increased risk of GI irritation, inflammation, ulceration, bleeding,a nd perforation

43
Q

Drug interactions with meloxicam

A

Increased risk of bleed in pts taking warfarin and other NSAIDs
Chronic use with NSAIDs and SSRIs/SNRIs increases risk of GI bleeds

44
Q

Counseling for meloxicam

A

Avoid alcohol and concomitant use of other NSAIDs

May require up to 2 wks to see noticeable improvement in arthritic conditions

45
Q

Monitoring for meloxicam

A

Improvement in inflammation/pain

46
Q

Common indications for trazodone

A

Depression

Insomnia

47
Q

MOA of trazodone

A

Inhibits serotonin uptake in the brain

48
Q

Adverse effects of trazodone

A 
Drowsiness
Dry mouth
Hypotension
Dizziness
Fatigue
Confusion
Nightmares
49
Q

BBW for trazodone

A

Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder or other psychiatric d/os

50
Q

Drug interactions with trazodone

A

Alcohol and other CNS depressants may potentiate drowsiness
May increase effectiveness of phenytoin
Grapefruit juice may increase plasma levels
CYP3A4 inhibitors may decrease metabolism of trazodone
Chronic use with NSAIDs and SSRIs/SNRIs increases risk of GI bleeds

51
Q

Counseling points of trazodone

A

Take with food to enhance absorption
May cause drowsiness- use caution when operating machinery/driving
Avoid alcohol while taking this medication
Stop taking this drug and seek medical attention in the event of prolonged penile erection
Store in cool dry place away from kids and sunlight
If dose is missed, skip it and return to nl dosing schedule

52
Q

Monitoring parameters of trazodone

A

Improvement of sleep/mood

Unusual mood changes or suicidal thought

53
Q

Common indications for Coumadin

A

Prophylaxis or tx of pulmonary embolism or venous thrombosis
Treatment of a fib with embolization
Adjunct in tx of coronary occlusion

54
Q

MOA of Coumadin

A

Antagonizes synthesis of vit K dependent clotting factors II, VII, IX, and X, as well as proteins C and S

55
Q

Adverse effects of Coumadin

A

Bleeding
Bruising
Nausea
Diarrhea

56
Q

Renal or hepatic adjustments for Coumadin

A

No definitive adjustments- monitor INR closely in renal and hepatic impairment

57
Q

BBW for Coumadin

A

May cause major or fatal bleeding

58
Q

Drug interactions of Coumadin

A

Enhanced anticoag effects with alcohol, allopurinol, amiodarine, adrenocortical steroids, cimetidine, disulfiram, erythromycin, metronidazole, salicylates, Bactrim/Septra, and thyroid medications
Decreased anticoag effects with carbamazepine, cholesyramine, rifampin, and vit K

59
Q

Counseling of Coumadin

A

Take only as directed
Avoid alcohol and aspirin-containing drugs
Do not begin or d/c other medications without first consulting your physician
Store in a cool dry place away from kids and sunlight
If dose is missed, take it as soon as possible
If it is closer to the time of your next dose, skip the missed dose and resume nl dosing schedule- do not double doses
Be consistent with the amount of green leafy vegetables eaten

60
Q

Monitoring of Coumadin

A

INR
Bruising
S/sx of bleeding

Peds Rotation (12 decks)

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