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xPharm Exam 2 > Exam 2 TQs > Flashcards

Exam 2 TQs Flashcards

1
Q

General Anesthetics

A

administration before sx doe NOT stimulate pts

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2
Q

Surgical Anesthesia

A

Depth of anesthesia level 3

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3
Q

High Minimum Alveolar Concentration (MAC)

A
  • Indicates decreased potency

- decreases with age, pregnancy, low temps, and opiod use

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4
Q

Inhaled Anesthetics

A
  • Causes Hypotension, bradycardia, decreases CO (NOT A-fib)

- halogenated to add stability through increased solubility and potency (IDS)

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5
Q

Sevoflurane

A

useful in pts with myocardial ischemia since it does not cause tachycardia

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6
Q

Malignant Hyperthermia

A
  • Muscle rigidity, rhadomyolysis, fever, tachycardia, acidosis
  • DOC is Dantrolene
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7
Q

GA: IV Anesthetics

A

often used for rapid induction of anesthesia; maintained with inhaled anesthetic

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8
Q

Thiopental

A
  • IV

- Distribution: Plasma –> Brain –> Skeletal muscle –> Fat

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9
Q

Benzodiazepines

A
  • IV
  • bind close to GABA receptor enhancing hyperpolarization and inhibition of further neuronal firing
  • decrease anxiety; sedative
  • Anterograde Amnesia
  • Antidote=Flumazenil

Anxiolytics: Cholodiazepoxide, Lorazepam, Alprazolm, Diazepam (CLAD)
Hypnotics: Triazolam, Midazolam, Temazepam (TMT)

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10
Q

Ketamine

A
  • IV

- dissociative anesthesia–pt appears awake yet is unconscious and does not feel pain

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11
Q

Etomidate

A
  • IV

- cause adrenal suppression

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12
Q

Drugs capable of inducing hyperuricemia and gout

A
  • diuretics
  • salicylates
  • cytotoxic drugs
  • ethanol
  • L-Dopa
  • Pyrazinamide
  • Ethambutol
  • Nicotinic acid
  • Vit B12
  • Cyclosporine
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13
Q

Gouty Nephropathy: Chronic

A
  • Irreversible

- HTN and nephrosclerosis common

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14
Q

Treatment goals of Gout

A

distinguish hyperuricemia with gout from asymptomatic hyperuricemia since long term drug tx in asymptomatic pts is not helpful

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15
Q

Allopurinol

A
  • standard drug for prophylaxis
  • reduces UA synthesis by inhibiting xanthine oxidase
  • indicated for chronic tophaceous gout
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16
Q

Colchicine

A
  • used in onset of acute gouty attack
  • alkaloid isolated form the autumn crocus Colchicum autumnale
  • Max of 12 tablets PO (3mg/24hrs)
  • max total dose of 4mg IV
  • adverse effects of burning throat pain and bloody diarrhea
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17
Q

Oxaprozin

A
  • NSAID

- decreases uric acid levels

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18
Q

Indomethicin

A
  • NSAID
  • most often used to treat acute gout
  • 50-75mg initially then 50mg q6h for 1-2 days, then 25-50mg q8h for 1-3 days
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19
Q

Uricosuric agents

A
  • MOA is excreting more UA
  • NOT oxaprozin
  • for chronic therapy
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20
Q

Probenicid/Sulfinpyrazone

A
  • therapy should not be started until 2-3 weeks after an acute attack due to increased risk of uric stones
  • Probenicid is more likely to cause allergic dermatitis
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21
Q

Fenofibrate

A
  • lipid lowering agent that decreases renal tubular reabsorption of serum UA enhancing its renal excretion
  • uricosuric effect is independent of the lipid lowering effect
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22
Q

Losartan

A

-angiotensin receptor blocker; uricosuric

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23
Q

Febuxostat

A
  • xanthine oxidase inhibitor indicated for the chronic management of hyperuricemia in pts with gout
  • adverse effects of upper respiratory tract infections, muscle and connective tissue symptoms, and diarrhea
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24
Q

Urate oxidase compounds

A
  • oxidizes urate to allantoin (highly soluble, more readily excreted in the urine) and breaks down preexisting UA which allopurinol does NOT
  • Pegloticase is an example
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25
Q

Calcium Carbonate

A

Most effect on LESP

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26
Q

Sodium Bicarbonate

A

Antacid that is Not for chronic use

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27
Q

Aluminum

A

Antacid that causes constipation

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28
Q

Alginic acid (Gaviscon)

A

barrier to reflux; NO acid reduction

29
Q

H2 receptor Antagonists

A

Immunomodulating effects for tx of warts (Cimetidine)

30
Q

Lansoprazole

A
  • Proton pump inhibitor

- has antimicrobial activity against H. pylori

31
Q

Sucralfate

A

Mucosal protective agent

32
Q

Metoclopramide

A

promotility agent used for GERD and diabetic gastroparesis; has extra-pyramidal symptoms

33
Q

Iso-osmotic Electrolyte Colonic Lavage solutions

A

laxative that causes purge by excess volume

34
Q

Fecal softeners

A

most effective is mineral oil which dissolves and prevents absorption of fat soluble vitamins

35
Q

Dronabinol

A

cannabinoid used for refractory chemo-related emesis

36
Q

Serotonin Receptor Antagonists

A
  • -setron

* Granisetron and Dolsetron–pure 5HT3 antagonist

37
Q

Azathioprine

A

-prodrug for tx of IBD

38
Q

Methotrexate

A

antidote is Leucovorin

39
Q

Tegaserod

A

selective 5HT4 partial agonist for tx of IBS

40
Q

Probiotics

A

problems–unknown whether organisms still living when administered, shown to cause infection in susceptible pts, manufacturing is not regulated and products not approved by FDA

41
Q

Crofelemer

A

for symptomatic relief of non-infectious diarrheas in adult pts with HIV/AIDS on anti-retroviral therapy

42
Q

Complementary medicine

A

used together with conventional medicine

43
Q

Integrative medicine

A

involves the use of conventional medicine with evidence based safe and effective CAM therapies

44
Q

Herbal remedies

A
  • products taken by mouth that contain a dietary ingredient intended to supplement the diet
  • NOT Tobacco
45
Q

Herbs

A

more dilute than conventional medicine

46
Q

Homeopathy

A

belief that one can build resistance to disease

47
Q

Dietary Supplement Health and Education Act of 1994 (DSHEA)

A
  • regulates dietary supplements as foods - includes vitamins, minerals, herbal remedies, amino acids and tissue extracts
  • must state, “This product has not been evaluated by the FDA and is not intended to diagnose, treat, or prevent any disease”
48
Q

USP Certification (DSVP)

A

volunteer organization that tells the consumer that the product contains the stated ingredients, is pure, and meets limits for contaminants

49
Q

Safety issues for Herbs

A
  • unknown consequences of long term therapy
  • NOT for children under 3yo
  • contamination/adulteration is possible and not detected
  • high levels of heavy metals
  • drug interactions
50
Q

Echinacea

A

short term immunostimulant that becomes immunosuppressive after 10 days

51
Q

Slippery Elm, White Willow

A

alternative meds for cold and flu that contain saliclyates (cause Reye syndrome in children)

52
Q

St. John’s Wort

A

used to treat depression; may help precipitate serotonin syndrome if used with other antidepressants

53
Q

Fish oil/ Omega 3

A

used for lipid lowering/cardioprotective effects

54
Q

Ephedra

A

aka Ma Huang; removed from the market due to abuse potential and cardiac risk

55
Q

Ginger

A

used for motion sickness or seasickness

56
Q

Asthma

A

-goal of treatment is to prevent chronic and troublesome symptoms
-onset early in life
symptoms vary daily, mainly at night/early morning
-reversible
-allergy, rhinitis, and/or eczema also present

57
Q

Short acting Beta-agonists (SABA)

A

-used for quick-relief (rescue)

58
Q

Inhaled corticosteroids

A
  • currently recommended as 1st line asthma treatment (Beclometasone, Fluticasone) to control and prevent progression
  • also severe COPD
59
Q

Nebulizer

A

preferred route of administration for children <2 years

60
Q

COPD

A
  • IRREVERSIBLE
  • cigarette smoking is primary cause in US: accounts for 90% of COPD in US; 15-20% of all smokers develop COPD
  • onset in mid-life
  • symptoms slowly progressive
  • dyspnea during exercise
  • Flu vaccine is a must in these patients!
61
Q

Bronchodilators

A
  • central to symptom management of COPD
  • combining bronchodilators is preferred over high doses of a single agent
    • FDA panel says risks outweigh benefits on two asthma drugs (want a corticosteroid with a B2 agonist instead of 2 B2 agonists)
62
Q

Combivent

A

Albuterol (SABA) and Ipratropium (anticholinergic) for bronchodilation

63
Q

Anticholinergics

A
  • 1st line in acute asthma (during exacerbation, NOT as controller med)
  • COPD (controller med)
64
Q

Leukotriene Receptor Blockers

A

-examples are Montelukast, Zafirlukast
-NOT used in COPD
-inhibits inflammatory action of leukotrienes
-minimal AE of headache, nausea, myalgia
0drug interactions: phenobarbital, rifampin, erythromycin, ASA, Warfarin

65
Q

Selective Phosphodiesterase type 4 inhibitor

A

Roflumilast

66
Q

Methyllxanthines

A

phosphodiesterase inhibition causing bronchodilation; step 3 2nd line alternative for control of asthma symptoms

67
Q

Mast cell stabilizers

A

Cromolyn (unpleasant taste)

68
Q

Omalizumab

A

treatment of moderate to severe allergic asthma

xPharm Exam 2 (8 decks)

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