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P1-f FoundPharm > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

drug labeling is regulated by

A

FDA; Prescribing information/package insert

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2
Q

What is the intent of the design of the package insert

A

To simplify the format of the package inserts to make them more “user-friendly” and practical. The ultimate intent is to improve safety and drug efficacy

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3
Q

overt or covert promotion of off label uses is

A

prohibited

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4
Q

Physicians Desk Reference

A

compilation of package inserts for major brand name products

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5
Q

Drug facts and comparisons

A

organizes drugs by therapeutic class and cost

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6
Q

AHFS drug infomration

A

evaluates drugs

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7
Q

Somatic pain

A

localized pain

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8
Q

Visceral pain

A

deeper pain

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9
Q

NSAID treatment of neuropathic and psychosomatic pain

A

low response

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10
Q

Nociceptive pain

A

acute, signal of tissue damage

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11
Q

Endings of non-narcotic analgesics

A

-profen and -fenac

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12
Q

salicylate

A

precursors to NSAIDs

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13
Q

pharmacologic classification of NSAIDs

A

Cox inhibitor (related inhibition of protaglandins)

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14
Q

Properties of NSAIDs

A

Analgesic, antipyretic (fever), anti-inflammatory

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15
Q

Aspirin is the name for

A

Acetylsalicylic Acid

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16
Q

aspirin irreversibly inhibits

A

platelet function (8-10 days)

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17
Q

Max dose of aspirin

A

3.9G q 24h

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18
Q

Aspirin dosage

A

325 to 650 mg q4h

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19
Q

DDI for aspirin

A

warfarin and NSAIDs

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20
Q

Asprin for children

A

not recommended (life threatening condition possible): Reye’s syndrome - following a virus

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21
Q

Non-selective inhibitor of cyclo-oxyenase (COX)

A

inhibits COX 1 and 2

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22
Q

Ibuprofen Brands

A

Advil, Motrin

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23
Q

Naproxen

A

Naprosyn, Aleve

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24
Q

Diclofenac

A

Voltaren

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25
Q

Opthalmic NSAIDs

A

Bromfenac, nepafenac

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26
Q

Keterolac

A

Toradol, short term <5d relief of moderately severe pain (can compare to morphine), good for post op pain

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27
Q

Forms of ketorolac

A

Tablets, injection (IV or IM), Intranasal

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28
Q

Partially selective inhibitors of COX

A

Etodolac and Meloxicam

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29
Q

Benefits of partially selective inhibitors

A

less likely to cause platelet aggregation or GI bleeding

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30
Q

ADRs of NSAIDs

A

Coagulation disordees, increeased risk of mascarriage (should be avoided during 3rd trimester)

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31
Q

Reye’s syndrome

A

in aspirin

32
Q

Severe but rare adverse skin reactions

A

Stevens Johnson syndrome, Toxic Epidermal Necrolysis

33
Q

Excedrin Migraine

A

Aspirin, acetaminophen, caffeine

34
Q

COXIBs are

A

the most selective of the NSAID class, no cardio side effects

35
Q

generic for Celebrex

A

celecoxib

36
Q

Indications for celecoxib

A

Osteoarthritis and RA, Dysmenorrhea, Familial Adenomatous Polyposis (reduce proliferation of polyps in the colon)

37
Q

contraindications - celecoxib

A

caution in patients at risk for stroke and heart attack; contraindicated in patients who have had open heart surgery

38
Q

acetaminophen brand

A

Tylenol

39
Q

acetaminophen is the selection of choice for

A

12 yo andyounger, pregnant 3rd trimester, GI toxicity risk, patients on warfarin or other anticoagulant

40
Q

max daily dose of acetaminophen

A

4000mg in 24h (12 tablets 325mg or 8 tablets extra strength; for patients consuming more than 3 alcoholic beverages per day dose should be less

41
Q

counseling tips for acetominophen

A

take with food, is effective but not as effective as NSAIDS, do not combine products

42
Q

acetaminophen toxicity

A

may result in hepatoxicity

43
Q

opioid now refers to

A

all narcotic pain killers, naturally or synthetically derived

44
Q

Phenanthrenes

A

Morphine, Codeine, Heroin (diacetylmorphine), hydromorphone, hydrocodone, benzhydrocodone, oxycodone, oxymorphone, levorphanol, naloxone, buprenorphine

45
Q

Phenylpiperadines

A

Fentanyl, Alfentanil, remifentanil, sufentanil, meperidine

46
Q

Diphenylheptanes

A

Methadone

47
Q

Side effects of opioids

A

Analgesia, Euphoria/Diysphoria, Respiratory Depression, Physical Depression, Sedation - CNS depression, Miosis - pupillary constriction, Reduction in GI motility

48
Q

Strong Agonists

A

Alfentanyl, Fentanyl, Heroin, Meperidine, Morphine, Remifentanil,
Sufentanil, hydromorphone, levorphanol.

49
Q

Moderate/Low Agonists

A

Codeine, Oxycodone, Hydrocodone, Benzhydrocodone.

50
Q

Mixed Agonists

A

Buprenorphine, Butorphanol, Pentazocine

51
Q

Antagonists

A

Naloxone, Naloxegol, Naltrexone

52
Q

Other analgesics

A

Tramadol, Tapentadol

53
Q

Classifications of pain for opioid use

A

Acute pain (severe only), non cancer chronic pain, chronic cancer pain, neuropathic pain (usually doesn’t respond to NSAID but may respond to antidepressants)

54
Q

Opioid applications other than analgesia

A

Anasthesia, palliative sedation, antidiarrheals, antitussives

55
Q

Chronic compulsive use of opioids

A

Opioid use disorder

56
Q

Stupor

A

Reduced consciousness

57
Q

PDMP

A

Prescription Drug Monitoring Programs

58
Q

REMS

A

Risk evaluation and mitigation strategy : Educational resources for prescribers, medication guides

59
Q

DEA Status

A

Controlled substance status

60
Q

Prescription Blanks for controls

A

DEA +NPI, serial number, One per blank, Telephone not allowed for CII, Post dated blanks for 90 day supply, 30 day limit to fill prescription (not 1y),

61
Q

Refilling CII

A

no refills

62
Q

Refilling CIII-V

A

5 refills within 6 months

63
Q

Partial filling of Controls

A

DEA allows it, but remainder must be provided within 72 hours

64
Q

Quantity limits

A

120 units for 30 days

65
Q

Initial prescriptions for acute non cancer pain, opioid naiive

A

5 day supply

66
Q

How to identify a valid prescription

A

Red and Green Flags

67
Q

Labeling for opioids

A

Cautionary Labels, Federal Law prohibits transfer

68
Q

Opioid Dosage Guidelines

A

start with min dose, route of administration, immediate vs controlled release, patient factors

69
Q

Abuse deterrent formulations

A

Resist crushing or dissolving, or release an opioid antagonist

70
Q

Immediate release is for

A

breakthrough pain, to discourage abuse and buildup of tolerance

71
Q

Opioid BBW

A

Children, hypoventilation, not to be split chewed or dissolved, don’t abruptly stop treatment, baby can be effected, somnolence

72
Q

Opioid Contraindications

A

Respiratory depression, bronchial asthma, convulsive disorders, addiction prone, treatment of diarrhea

73
Q

Opioid pregnancy category

A

C (because of withdrawal syndrome in babies)

74
Q

NAL

A

Narcotic Antagonists

75
Q

Naloxone

A

should be made available

P1-f FoundPharm (5 decks)

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