exam 2 drugs and additional notes Flashcards

1
Q

Contraindications for which drug?
- preexisting CV disease
- taking nitrate
- hypotension

A

sildenafil

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2
Q

s/e
- transient burning and discomfort
- systemic effects if drops are not kept local

s/e
- Well tolerated

s/e
- burn/sting
- dry mouth
- fatigue
- h/a
- blurry vision
- hypotension

s/e
- stinging
- bitter taste
- allergic reactions – conjunctiva or lid reactions

Timolol
brimonidine
betaxolol
Latanoprost
dozolamide

A

Timolol
betaxolol
-
Latanoprost
-
brimonidine
-
dozolamide - 2nd line

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3
Q

___________________Glomerulonephritis
- This type of glomerulonephritis is caused by an underlying systemic disease or infection.

Secondary Glomerulonephritis, Primary Glomerulonephritis

A

Secondary Glomerulonephritis

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4
Q

Bactrim (trimethoprim/sulfamethoxazole)

Ciprofloxacin

treats ______

A

Pyelonephritis

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5
Q

s/e
- Peripheral edema
- Nausea
- Ascites
- Dizzy
- Fatigue
- Pruritis
- Skin rash
- Abdominal pain
- Anemia

cirrhosis treatment
Lactulose or Rifaximin?

A

Rifaximin

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6
Q

pancreatic enzymes
__________ = edema, necrosis, hemorrhage
___________= hemorrhage
___________= fat necrosis
___________ = edema, vascular permeability (fluid seeps into pancreas), smooth muscle contraction, shock
________ = fat necrosis

phospholipase A, trypsin, elastase, kallikrein, lipase

A

pancreatic enzymes
- trypsin = edema, necrosis, hemorrhage
- elastase = hemorrhage
- phospholipase A = fat necrosis
- kallikrein = edema, vascular permeability (fluid seeps into pancreas), smooth muscle contraction, shock
- lipase = fat necrosis

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7
Q

bile flow obstruction -
what causes steatorrhea (fatty stool)

A

no bile salts are getting to stool b/c of obstruction
lack of bile salts decreases fat digestion = fatty stool

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8
Q
  • Also used to treat male pattern baldness – increases hair growth
A

finasteride

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9
Q

male reproductive drugs
MOA
- Inhibits PDE5 which increases and preserves cGMP levels

A

sildenafil (Viagra)

(PDE5 removes cGMP which is a key part of the erection process)

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10
Q

Open angle glaucoma pharmacotherapy -
which drug(s) decreases aqueous humor production

timolol
betaxolol
Latanoprost
brimonidine
dozolamide

A

timolol
betaxolol
dozolamide - 2nd line

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11
Q

s/e

  • h/a
  • flushing
  • dyspepsia - indigestion

which drug?

A

sildenafil

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12
Q

Open angle glaucoma pharmacotherapy -
which drug(s)
decreases aqueous humor production
AND may also increase drainage of aqueous humor

timolol
betaxolol
Latanoprost
brimonidine

A

brimonidine

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13
Q

Open angle glaucoma pharmacotherapy -
which drug(s) Increases outflow drainage of aqueous humor

timolol
betaxolol
Latanoprost
brimonidine
dozolamide

A

Latanoprost

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14
Q

Timolol and betaxolol
Patient teaching:
- Must take, or it will progress to __________
- Apply ___________ pressure with instillation

A

Patient teaching:
- Must take, or it will progress to blindness
- Apply nasolacrimal pressure with instillation

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15
Q

forms of alcoholic liver disease stages

o Fibrosis and scarring alter liver structure
o Irreversible

A
    • Alcoholic cirrhosis
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16
Q

which eye condition would someone come into ED with
-severe eye pain
-Typically Unilateral
-blurry
-halos
-red eyes
-dilated pupil – nonreactive to light
-cloudy cornea

A

closed glaucoma

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17
Q

___________ jaundice is from increased RBC breakdown

A
  • Hemolytic
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18
Q

s/e

  • Bladder irritation
  • Systemic infection
  • UTI type s/s
A

BCG vaccine: intravesical therapy

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19
Q
  1. monitor K+ = _______
  2. Has been associated with increased risk of C diff – monitor = ________

cirrhosis treatment
Lactulose or Rifaximin?

A
  1. Lactulose2. rifaximin
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20
Q

types of kidney stones
UTIs are associated with _______
calcium is associated with ________
gout is associated with ________

A

stuvite
calcium oxalate and calcium phosphate
uric acid

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21
Q

Kidney cancer
Renal cell carcinoma

risk factors
- smoking
- female
- obese
- high fat diet
- OA
- Genetics

which is the most significant risk factor?

A
  • smoking
    X - male
  • obese
    X- high fat diet
  • OA
  • Genetics

SMOKING = kidney cancer

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22
Q

Calcitriol
Calcium carbonate
Sodium bicarbonate

treats ___________

  1. specifically treats metabolic acidosis
  2. specifically Treats hyperphosphatemia
  3. specifically treats renal osteodystrophy
A

CKD

  1. specifically treats metabolic acidosis - Sodium bicarbonate
  2. specifically Treats hyperphosphatemia - Calcium carbonate
  3. specifically treats renal osteodystrophy - Calcitriol
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23
Q

male reproductive drugs
MOA
- Blocks conversion of testosterone to DHT

A

finasteride - alpha 1 receptors
dutasteride - alpha 1 and 2 receptors

24
Q

H
A
R
P

what are the manifestations and which issue is it associated with

A

-Hematuria
-Azotemia – build-up of waste products
-Retention – Na and water retention + oliguria = edema and high BP
-Proteinuria

Glomerulonephritis

25
Q

MOA
Reduces blood ammonia levels by converting ammonia to ammonium (gets excreted via stool)

cirrhosis treatment
Lactulose or Rifaximin?

A

Lactulose

26
Q

BCG vaccine: intravesical therapy

treats _____

A

Stage 1 bladder cancer

27
Q

Direct acting antiviral therapy

Interferon based regiments

Some require treatment along with a nucleoside analogue med as well

which viral hep gets this treatment?

A

Hep C

28
Q

_________ jaundice is from decreased or obstructed flow of bile, bilirubin can’t get out of liver (r/t gallstones)

A
  • Obstructive
29
Q

Lactulose
Rifaximin

treats _______

A

cirrhosis

Lactulose 1st line
Rifaximin 2nd line

30
Q

pancreatic enzymes

4 =
3 =
1 =
1 =
1 =

A
  • kallikrein = edema, vascular permeability (fluid seeps into pancreas), smooth muscle contraction, shock
  • trypsin = edema, necrosis, hemorrhage
  • elastase = hemorrhage
  • phospholipase A = fat necrosis
  • lipase = fat necrosis
31
Q

forms of alcoholic liver disease stages

o Precursor to cirrhosis
o Inflammation
o Degeneration of hepatocytes
o Irreversible

A
    • Alcoholic steatohepatitis
32
Q

prostate cancer risk factors
- male
- black men
- Asians and native American men
- white men
- OA
- Familial tendency
- High fat diet

A
  • male
  • black men
    X- Asians and native American men
    X- white men
  • OA
  • Familial tendency
  • High fat diet
33
Q

Finasteride ___creases prostate specific antigen (PSA) levels
- measure PSA _____ and _______
- If PSA hasn’t __creased = eval for________

A
  • measure PSA before starting drug and 6 mos after starting drug
  • If PSA isn’t low = eval for prostate cancer
34
Q

sildenafil

treats

1.
2.
3.

A
  • Relief of ED
  • Pulmonary arterial HTN
  • BPH
35
Q

Interferons
Nucleoside analogs

treatment for which viral hep A, B, or C?

A

Chronic Hep B treatment is for these high risk pts only
- Increased AST levels
- Hepatic inflammation
- Advanced fibrosis

36
Q

finasteride
dutasteride
tamsulosin

combination drug for treating BPH?

A

Prototype = dutasteride + tamsulosin

37
Q

forms of alcoholic liver disease stages

o Mild
o Asymptomatic
o Reversible

A
    • Alcoholic fatty liver
38
Q

male reproductive drugs
MOA
- Blocks alpha 1 receptors – relaxes smooth muscle cells in bladder, neck, prostate, and urethra
- Selective for alpha receptors in prostate – will not have systemic effects

A

for BPH

tamsulosin

39
Q

MOA

Inhibitis bacterial RNA synthesis by binding to bacterial DNA

cirrhosis treatment
Lactulose or Rifaximin?

A

Rifaximin

40
Q
  1. Hep _____ vaccine
    - 2 doses, 6 months apart
    - Recommendations
    - All kids 12 months +
    - Special high risk populations
  2. Hep ________ vaccine
    - 3 doses, 4 months apart
    - Recommendation
    - All newborns
A
  1. Hep A
  2. Hep B
41
Q

LFT – liver function tests
indicating liver dysfunction
increase or decrease
1. liver enzymes ALT, AST, Alk Phos
2. Bilirubin
3. Ammonia
4. Protein and albumin
5. PTT prothrombin time

A
  1. increase
  2. increase
  3. increase
  4. decrease
  5. increase
42
Q

s/e
- Impotence
- Decreased libido
- Gynecomastia – abnormal growth breast tissue

s/e
- Well tolerated
- Abnormal ejaculation – doesn’t decrease PSA

which BPH drug(s)?

A

finasteride
dutasteride

tamsulosin

43
Q
  • Alcoholic fatty liver
  • Alcoholic cirrhosis
  • Alcoholic steatohepatitis

rank from mild to severe forms of alcoholic liver disease stages

A
    • Alcoholic fatty liver
    • Alcoholic steatohepatitis
    • Alcoholic cirrhosis
44
Q
  • Live vaccine
  • Stimulates inflammatory response in bladder
  • Goal is for immune system to recognize cancerous cells and attack
A

BCG vaccine: intravesical therapy

treats bladder cancer

45
Q

Hyperosmotic laxative
treats cirrhosis

Lactulose
Rifaximin

A

Lactulose

46
Q

which issue is associated with
fat
female
forty

A

Cholelithiasis

  • Obesity
  • Female
  • Middle aged
  • Use of oral contraceptives
  • Rapid weight loss
  • Native American
  • Genetics
  • Pancreatic or ileal disease
47
Q

BCG vaccine: intravesical therapy

Pt instructions
1. Empty bladder
2. Instill BCG vaccine into bladder – dwell time ___ hours
3. Change position q ___ mins

  • ______ for 6 hours post treatment
  • watch for infection
  • Take weekly for 6-12 weeks
  • Live vaccine – don’t give to _______
A

Pt instructions
1. Empty bladder
2. Instill BCG vaccine into bladder – dwell time 2 hours
3. Change position q 15 mins

  • Disinfect urine for 6 hours post treatment
  • watch for infection
  • Take weekly for 6-12 weeks
  • Live vaccine – don’t give to compromised immunity
48
Q

Manifestations of AKI
- Oliguria (goal is >30ml/hr or <400ml/24hr)
- begins 1 day after hypotensive event and lasts 1-3 weeks
- FVE
- Metabolic acidosis and waste product accumulation (azotemia/uremia) – no excretion, build up of waste
- Hyponatremia – no excretion, dilution issue
- Hyperkalemia – no excretion, accumulation issue
- Neurologic disorders – r/t hyponatremia

so treatment could be
1.
2.
3.

A
  1. diuretic = for FVE and associated accumulations
  2. dextrose and insulin = for hyperkalemia
  3. sodium polystyrene sulfonate = for hyperkalemia
49
Q

timolol or betaxolol contraindications:
- same as oral beta blockers
- asthma
- COPD
- Sinus bradycardia
- Heart failure

A

timolol

50
Q

Disadvantage of ___________ treatment
- Prolonged
- Costs
- s/e
- high relapse

A

chronic hep B
Interferons
Nucleoside analogs

51
Q

__________________Glomerulonephritis
- This type of glomerulonephritis is caused by a direct insult to the glomeruli themselves.

Secondary Glomerulonephritis, Primary Glomerulonephritis

A

Primary Glomerulonephritis

52
Q

cirrhosis treatment
Lactulose
T/F
- Reduction of ammonia absorption in hepatic encephalopathy
- high ammonia levels alone is an indication
- must have s/s of hepatic encephalopathy and high ammonia levels to be an indication

A
  • Reduction of ammonia absorption in hepatic encephalopathy
  • Not just given for high ammonia levels – must have s/s of hepatic encephalopathy
53
Q
  • Females caution in handling – tetragenic for preg. Women, may cause birth defect in male fetus
A

finasteride

54
Q

___________ jaundice is from liver is unable to take up bilirubin from blood, or unable to conjugate it

A
  • Hepatocellular
55
Q

sildenafil safety teaching:
- don’t take with _______ – will pass out b/c of drop in BP
- what do you do if you have chest pain or signs of heart attack during sex?
- _________ is a rare side effect that would require patient to seek emergency care
- don’t take more than ___ per day
- priapism – erection is painful or lasts >___ hours = medical emergency

A

safety teaching:
- don’t take with nitrates – will pass out b/c of drop in BP
- chest pain or signs of heart attack during sex = call 911
- sudden loss of vision in eye(s) or hearing
- don’t take more than 1 per day
- priapism – erection is painful or lasts >4 hours = medical emergency

56
Q
  • Males can’t donate blood while taking this med
A

finasteride