EOR #7 pharm part 2

Question 1

Common indications of methotrexate

Answer 1

Carcinoma
Non-Hodgkin’s lymphoma
Psoriasis
Rheumatoid arthritis

Question 2

MOA of methotrexate

Answer 2

a folate antimetabolite that inhibits DNA synthesis, repair, and cellular replication. Methotrexate irreversibly binds to and inhibits dihydrofolate reductase, inhibiting the formation of reduced folates, and thymidylate synthetase, resulting in inhibition of purine and thymidylic acid synthesis, thus interfering with DNA synthesis, repair, and cellular replication. Methotrexate is cell cycle specific for the S phase of the cycle. Actively proliferative tissues are more susceptible to the effects of methotrexate.

Question 3

Common adverse effects of methotrexate

Answer 3

Rash
Nephrotoxicity
Hepatotoxicity
Cough
Anemia

Question 4

Renal or hepatic dosage adjustments of methotrexate

Answer 4

Renal CrCl 10-50: should receive 50% of the recommended dose
CrCl <10: the medication should be avoided
Consider dose adjustment in liver impairment

Question 5

BBW of methotrexate

Answer 5

Malignancy, Preservative containing formulations/diluents (injection), Pregnancy, Bone marrow suppression, Renal impairment, Hepatotoxicity, Methotrexate-induced lung disease, Gastrointestinal toxicity, Diluents, Malignant lymphomas, Tumor lysis syndrome, Skin reactions, Potentially fatal opportunistic infections, Radiotherapy

Question 6

Clinically significant drug interactions with methotrexate

Answer 6

NSAID
Phenytoin
PCN

Question 7

Major counseling points of methotrexate

Answer 7

Take on empty stomach
Stay well-hydrated
Avoid EtOH or salicylates

Question 8

Monitoring parameters of methotrexate

Answer 8

Decrease in carcinoma/non-Hodgkin’s lymphoma/psoriasis/RA
Long-term SCr
AST/ALT

Question 9

Common indications of phenazopyridine

Answer 9

Dysuria

Question 10

MOA of phenazopyridine

Answer 10

Unknown

Question 11

Common AEs of phenazopyridine

Answer 11

HA

Hepatotoxicity

Question 12

Renal or hepatic dose adjustments of phenazopyridine

Answer 12

Renal CrCl <50: dosing intervals should be 16 hrs

Question 13

Major counseling points of phenazopyridine

Answer 13

This med may cause your urine to turn orange or red while taking it

Question 14

Monitoring parameters of phenazopyridine

Answer 14

Urinary discomfort control

Question 15

Common indications of diltiazem

Answer 15

Angina pectoris
HTN
Temporary control of AFib or atrial flutter and rapid conversion of paroxysmal supraventricular tachycardias to sinus rhythm

Question 16

MOA of diltiazem

Answer 16

Inhibits the influx of calcium ions across specific cellular membranes (slow channels) which dilates coronary arteries and arterioles, inhibits coronary spasm, lowers arterial blood pressure, and slows SA and AV conduction.

Question 17

Common AEs of diltiazem

Answer 17

Peripheral edema
Bradycardia
Flushing
HA
AV block
Dizziness

Question 18

Renal or hepatic dose adjustments with diltiazem

Answer 18

Caution use with severe hepatic impairment

Question 19

Clinically significant drug interactions with diltiazem

Answer 19

Increases effect of other antihypertensive drugs

Question 20

Major counseling points of diltiazem

Answer 20

Take on empty stomach at least one hour before or two hours after a meal

Question 21

Monitoring parameters of diltiazem

Answer 21

Decrease in BP, HR

S/sx of angina, AFib, SVT