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Pharm 1 Jack > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

class of Clotrimazole/ Lotrimin

A

antifungal

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2
Q

indication of Clotrimazole/ Lotrimin

A

superficial mycoses such as tinea pedis, tinea cruris and ring worm as well as yeast vaginitis

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3
Q

MOA of Clotrimazole/ Lotrimin

A

binds to ergosterol molecules on the fungal cell membrane and causes membrane leakage during cell division

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4
Q

class of Nystatin/ Mycostatin

A

antifungal, may be used both topically and systemically

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5
Q

indication of Nystatin/ Mycostatin

A

superficial mycoses such as ring worm, tinea pedis, tinea cruris and treatment of oral candidiasis (thrush) as well as esophageal and vaginal Candida Cryptococcus is also sensitive to Nystatin

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6
Q

MOA of Nystatin/ Mycostatin

A

binds to ergosterol molecules on fungal cell membrane resulting in loss of membrane integrity death of the fungal cell

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7
Q

Nystatin/ Mycostatin is used as prophylaxis in patients who are at risk for

A

fungal infections, such as AIDS patients with a low CD4+ count and patients receiving chemotherapy

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8
Q

side effects of Nystatin/ Mycostatin

A

negligible oral absorption allows for diminished side effects. N/V possible. GI absorption also minimal and most orally administered Nystatin is passed unchanged in stool.

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9
Q

current drug of choice for onychomycosis

A

Terbinafine/ Lamisil

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10
Q

Terbinafine/ Lamisil is mainly effective on group of fungi known as

A

dermatophytes

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11
Q

Terbinafine/ Lamisil treats onychomycosis of the toenail or fingernail due to

A

dermatophyte Tinea unguium

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12
Q

common side effects of Terbinafine/ Lamisil

A

discomfort, diarrhea, and nausea as well as headache. Less commonly, elevated liver enzymes, hepatitis, liver damage and even liver failure have been reported

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13
Q

class of Fluconazole/ Diflucan

A

antifungal, both topical and systemic

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14
Q

indication of Fluconazole/ Diflucan

A

superficial mycoses such as yeast vaginitis as well as systemic or meningeal mycotic infections by fungi such as Cryptococcus or Histoplasmosis

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15
Q

MOA of Fluconazole/ Diflucan

A

inhibits fungal membrane synthesis

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16
Q

anti-fungal that can be used as vaginal suppository for yeast vaginitis

A

Fluconazole/ Diflucan

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17
Q

Fluconazole/ Diflucan can inhibit

A

cytochrome enzyme systems responsible for metabolism of many drugs

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18
Q

side effects of Fluconazole/ Diflucan

A

nausea and vomiting with oral and IV doses

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19
Q

class of Amphotericin B/Amphocil

A

antimycotic

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20
Q

indication of Amphotericin B/Amphocil

A

systemic fungal infections such as systemic Candidadiasis, Histoplasmosis, Coccidiomycosis, Aspergillus and Blastomyces

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21
Q

MOA of Amphotericin B/Amphocil

A

binds to ergosterol molecules on the fungal cell membrane and disrupts membrane integrity, resulting in death of the fungal cell

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22
Q

Amphotericin B/Amphocil may for used via intrathecal route for

A

fungal meningitis or fungal brain abscess

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23
Q

side effects of Amphotericin B/Amphocil

A

Very severe side effect profile. Fevers and shaking chills are common. (“Ampho-terrible” and “shake and bake” are terms used to describe the severe side effects). Pre-treatment with Benadryl, NSAIDs or Prednisone often used to mitigate the fever and chills. Hypotension, renal impairment and severe anemia can occur.

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24
Q

Isoniazid (INH) / Nitrazid class

A

antibiotic

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25
Q

indication of Isoniazid (INH) / Nitrazid

A

tuberculosis

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26
Q

MOA of Isoniazid (INH) / Nitrazid

A

Isoniazid is a pro-drug and must be activated by bacterial catalase. The activated form of INH inhibits the synthesis of mycolic acid in the mycobacterial cell wall

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27
Q

lower doses of Isoniazid (INH) / Nitrazid should be given to patients with

A

chronic liver disease

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28
Q

side effects of Isoniazid (INH) / Nitrazid

A

rash, abnormal liver function tests, hepatitis, sideroblastic anemia, peripheral neuropathy and CNS effects. The possible hepatotoxicity of INH is best avoided by close clinical monitoring of the patient, specifically for signs of nausea, vomiting, and abdominal pain as well as monitoring liver function tests

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29
Q

Isoniazid competes with an enzyme that is needed to produce

A

pyridoxine

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30
Q

peripheral neuropathy is a common side effect when using ____ and is caused by

A

when using Isoniazid and is caused by INH induced pyridoxine deficiency

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31
Q

peripheral neuropathy caused by ___ may be reduced or avoided altogether by concurrent

A

caused by Isoniazid, avoided by supplementation with pyridoxine (vit B6 - 10to 50 mg/day)

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32
Q

class of Rifampin/ Rifadin

A

antibiotic

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33
Q

indication of Rifampin/ Rifadin

A

tuberculosis, Methicillin-resistant Staphylococcus aureus (MRSA) and prophylactic therapy against meningococcal infection from Neisseria meningitidis

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34
Q

MOA of Rifampin/ Rifadin

A

inhibits DNA-dependent RNA polymerase in bacterial cells thus preventing transcription of messenger RNA and subsequent translation to protein production

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35
Q

weird side effect of Rifampin/ Rifadin

A

can cause certain bodily fluids, such as urine and tears, to become orange-red in color. may permanently stain soft contain lenses

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36
Q

side effects of Rifampin/ Rifadin

A

fever, upset stomach, nausea, vomiting, rash. hepatotoxicity with liver damage and jaundice can occur. liver function tests must be followed.

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37
Q

Standard treatment of TB

A

Rifampin/Rifadin, Isoniazid (INH)/Nitrazid, Pyrazinamide/Pyrazinamide, Ethambutol/Myambutol

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38
Q

drug that is a nicotinamide analog with an unknown mechanism of action

A

Pyrazinamide

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39
Q

MOA of Ethambutol

A

inhibits mycolic acid synthesis in the mycobacterial cell wall

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40
Q

the drugs utilized for M. tuberculosis can also be used for other mycobacterial diseases such as

A

leprosy

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41
Q

Multi-drug resistant tuberculosis (MDR-TB) is defined as TB that is resistant to at least

A

Isoniazid and Rifampin

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42
Q

Rick factors for MDR-TB include

A

exposure to patient with MDR-TB, HIV infection, previous incarceration, failure to respond to standard TB treatment, and relapse following standard TB treatment

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43
Q

acronym for CDC recommended empiric treatment of patient suspected of having MDR-TB

A

SHREZ MC

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44
Q

7 drugs that make up SHREZ MC are

A

Streptomycin + Hydrazine + Rifampin + Ethambutol + pyraZinamide + Moxifloxacin (a fluoroquinolone) and Cycloserine (a broad spectrum antibiotic)

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45
Q

Viruses that can be treated with anti-virals

A

URI viruses including influenza types A and B and respiratory syncytial virus (RSV)…herpesviruses, cytomegalovirus, HIV, viral hepatitis B and C

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46
Q

US Centers for Disease Control and Prevention recommends the use of what for treatment/prevention of swine flu virus

A

Tamiflu (Oseltamivir) or Relenza (Zanamivir)

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47
Q

class of Oseltamivir/ Tamiflu

A

anti-viral

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48
Q

indication of Oseltamivir/ Tamiflu

A

treatment (and prevention) of infections due to influenza A and B virus in adults and in children at least one year of age - when given within 48 hours of symptoms of infections. Tamiflu has also shown effectiveness for H5N1 known as avian flu.

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49
Q

how soon do you need to administer Oseltamivir/ Tamiflu for it to be effective

A

within 48 hours of symptoms

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50
Q

MOA of Oseltamivir/ Tamiflu

A

neuramidase inihbitiion, preventiing virus from budding off from cell. Oseltamivir/ Tamiflu was first orally active neuraminidase inhibitor to be commercially developed.

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51
Q

doses of Oseltamivir/ Tamiflu are decreased for children and patients with

A

renal impairment

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52
Q

side effects of Oseltamivir/ Tamiflu

A

abdominal pain nausea, vomiting and headache…concern about potential adverse effects including delirium, hallucinations, depression and increased suicidal ideation

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53
Q

Zanamivir/ Relenza is formulated as a

A

powder that is delivered via the respiratory tract by an oral inhaler

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54
Q

Zanamivir/ Relenza is not recommended in people with

A

history of asthma or COPD due to risk of serious bronchospasm

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55
Q

class of Zanamivir/ Relenza

A

anti-viral

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56
Q

indication of Zanamivir/ Relenza

A

influenza treaetment and/or prophylaxis

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57
Q

MOA of Zanamivir/ Relenza

A

neuramidase inhibitor

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58
Q

route of Zanamivir/ Relenza

A

inhaled route

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59
Q

side effects of Zanamivir/ Relenza

A

N/V. Post treatment diarrhea, vaginal candidiasis and thrush is negligible.

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60
Q

drug that is used as a treatment for the early stages of Parkinson’s disease

A

Amandatine/ Symmetrel…best used as short term therapy (6-12 months)…its an anti-viral that was recommended as prophylaxis for influenza

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61
Q

primary drug for herpesvirus infection

A

Acyclovir/Zovirax

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62
Q

class of Acyclovir/ Zovirax

A

anti-viral

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63
Q

indication of Acyclovir/ Zovirax

A

herpesvirus infections such as HSV-1, HSV-2 and Herpes zoster (chicken pox and shingles)

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64
Q

MOA of Acyclovir/ Zovirax

A

guanosine analog that is incorporated into the virus DNA and inhibits further viral synthesis

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65
Q

Acyclovir/ Zovirax only works against

A

viruses that are actively replicating and is ineffective against latent viruses

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66
Q

Does Acyclovir/ Zovirax actively cross the blood barrier?

A

Yes. It can be used to treat herpes meningitis and encephalitis.

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67
Q

Bizarre possible form of Acyclovir/ Zovirax

A

topical ointment

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68
Q

side effects of Acyclovir/ Zovirax

A

Dependent upon route of administration. Headache, nausea and vomiting can occur with oral dose. Transient renal insufficiency can occur with higher IV doses and skin irritation can occur with topical doses.

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69
Q

current treatment for HIV infection consists of

A

Highly Active Antiretroviral Therapy or HAART

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70
Q

4 main categories of drugs used as treatment or prophylaxis against HIV

A

reverse transcriptase inhibitors (RTIs), protease inhibitors (PIs), fusion inhibitors, integrase inhibitors

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71
Q

standard HAART drug classes

A

two nucleoside reverse transcriptase inhibitors plus either a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI).

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72
Q

what do RTIs do

A

block enzymatic function of reverse transcriptase and prevent the completion of synthesis of double-stranded viral DNA thus preventing HIV from multiplying.

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73
Q

3 main forms of RTIs

A

Nucleoside reverse transcriptase inhibitors, Nucleotide reverse transcriptase inhibitors, Non-nucleoside reverse transcriptase inhibitors

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74
Q

primary Nucleoside reverse transcriptase inhibitor

A

Zidovudine (AZT)/ Retrovir

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75
Q

class of Zidovudine (AZT)/ Retrovir

A

anti-viral, nucleoside reverse transcriptase inhibitor

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76
Q

indication of Zidovudine (AZT)/ Retrovir

A

HIV

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77
Q

MOA of Zidovudine (AZT)/ Retrovir

A

pyrimidine analog that is incorporated into the viral DNA by reverse transcriptase. Incorporation into viral DNA terminates further replication

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78
Q

side effects of Zidovudine (AZT)/ Retrovir

A

Headaches are common. Potentially toxic to bone marrow with severe anemia and leukopenia in patients receiving high doses.

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79
Q

Unlike nucleoside RTIs, which bind at the enzyme’s active site, NNRTIs bind within

A

a pocket termed the NNRTI pocket

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80
Q

____ inhibitors are currently used to treat HIV and Hep C

A

protease inhibitors

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81
Q

primary protease inhibitor

A

Saquinavir/ Invirase

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82
Q

class of Saquinavir/ Invirase

A

anti-viral, protease inhibitor

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83
Q

indication of Saquinavir/ Invirase

A

HIV, Hep C

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84
Q

MOA of Saquinavir/ Invirase

A

Protease enzyme inhibition prevents viral protein molecules from being cleaved into smaller fragments, which prevents both the replication of the virus within the cell and the release of mature viral particles from an infected cell.

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85
Q

side effects of Saquinavir/ Invirase

A

Mostly G.I. i.e. abdominal discomfort, nausea, vomiting and diarrhea.

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86
Q

interferon alpha is for

A

Hep C

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87
Q

Interferon Beta is for

A

relapsing multiple sclerosis

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88
Q

interferon gamme is for

A

chronic granulomatous diseases

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89
Q

class of Interferon alpha

A

anti-viral

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90
Q

indication of Interferon alpha

A

chronic hep B and C, genital warts due to HPV, Kaposi’s sarcoma and hairy cell leukemia

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91
Q

MOA of Interferon alpha

A

Interferon is a naturally occurring glycoprotein that interferes with the ability of a virus to infect cells. Interferon appears to induce host cell enzymes that inhibit viral RNA translation and subsequent viral synthesis within the infected host cell.

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92
Q

Side effects of Interferon alpha

A

Arthralgias, myalgias, fever, lethargy, headache, dizziness, hair thinning and depression.

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93
Q

what is Pegylated interferon alpha

A

a form of interferon in which polyethylene glycol is added to make the interferon last longer in the body.

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94
Q

When treating hepatitis C, pegylated interferon is often administered with the drug

A

Ribavirin

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95
Q

what type of vaccine is most likely to confer life-long immunity

A

live/attenuated virus vaccinations

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96
Q

live vaccinations are typically not given to

A

people who are immunocompromised

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97
Q

name the two recombinant protein vaccinations

A

Hep B and HPV

98
Q

Live Attenuated Influenza Vaccine (LAIV) is delivered as

A

a nasal spray (FluMist)

99
Q

Gardasil and Cervarix protect against what two types of HPV

A

HPV 16 and 18

100
Q

Gardasil also protects against what two HPV types that cause genital warts

A

6 and 11

101
Q

Most commonly reported side effects of HPV vaccine

A

lightheadedness, pain and swelling at the injection site.

102
Q

what are adjuvants

A

substances added to boost the immune response to a vaccine

103
Q

examples of aluminum containing vaccines

A

Hep A, Hep B, and DTaP

104
Q

as of 2005 the only childhood vaccine in the US that still contained more than trace amounts of Thiomersal is

A

the influenza vaccine

105
Q

what are the two types of Influenza vaccination

A

LAIV and TIV (trivalent inactivated vaccine)

106
Q

what type of vaccine is Hib

A

conjugate

107
Q

what type of vaccine is Meningococcal

A

conjugate

108
Q

for people that are asplenic, revaccination at period intervals is recommended for what vaccine

A

pneumococcal vaccine…also recommended for nephrotic syndrome

109
Q

Psyllium/ Metamucil class

A

fiber laxative

110
Q

indication of Psyllium/ Metamucil

A

constipation, irritable bowel, reduction of colon cancer risk, reduction of cholesterol levels and heart disease risk

111
Q

MOA of Psyllium/ Metamucil

A

contains soluble and insoluble fiber. adds bulk to stool as well as absorbing fluid into the feces to soften the stool

112
Q

Side effects of Psyllium/ Metamucil

A

may cause diarrhea. avoid if any suspicion of intestinal obstruction. powder and capsules are gluten free, but wafers contain gluten

113
Q

class of Docusate/ Colace

A

stool softener

114
Q

indication of Docusate/ Colace

A

constipation, hemorrhoids. prophylaxis in patients who should no strain during bowel movement (i.e. after anorectal surgery, MI)

115
Q

MOA of Docusate/ Colace

A

anionic surfactant

116
Q

side effects of Docusate/ Colace

A

flatulence, bloating, abdominal cramping. may cause diarrhea. avoid oral use if suspicion of intestinal obstruction.

117
Q 
class of Magnesium Hydroxide/ 
Milk of Magnesia
A

osmotic laxative, antacid

118
Q

MOA of Magnesium Hydroxide/

Milk of Magnesia

A

magnesium salts are poorly absorbed by the GI tract and thus act as osmotic agents to draw water into the lumen of the GI tract

119
Q

indication of Magnesium Hydroxide/

Milk of Magnesia

A

constipation, indigestion

120
Q

side effects of Magnesium Hydroxide/

Milk of Magnesia

A

Diarrhea, cramping, abdominal pain. May precipitate or exacerbate electrolyte imbalances. Patients with severe chronic kidney disease are at greater risk for possible hypermagnesemia. Avoid use if any suspicion of intestinal obstruction.

121
Q

Bisacodyl/ Dulcolax class

A

stimulative laxative

122
Q

MOA of Bisacodyl/ Dulcolax

A

increases intestinal motility

123
Q

indication of Bisacodyl/ Dulcolax

A

constipation

124
Q

side effects of Bisacodyl/ Dulcolax

A

Diarrhea, abdominal cramping, sweating. Possible laxative dependence with prolonged use. Definitely avoid use if any suspicion of intestinal obstruction.

125
Q

class of Loperamide/ Imodium

A

antidiarrheal - analog of Meperidine

126
Q

MOA of Loperamide/ Imodium

A

diminished peristalsis due to activation of opiate receptors in GI tract. Loperamide is an opioid receptor agonist and acts on the u-opioid receptors in the myenteric plexus within the large intestines. It does not affect the central nervous system like other opioids. Dimished activity of the myenteric plexus decreases the motility of the circular and longitudinal smooth muscles of the intestinal wall. This increases the amount of time substances stay in the intestine, allowing for more water to be absorbed out of the fecal matter.

127
Q

indication of Loperamide/ Imodium

A

acute diarrhea and the management of chronic diarrhea in patients with inflammatory bowel disease

128
Q

side effects of Loperamide/ Imodium

A

Dizziness, headache. Generally, not to be used in parasitic or bacterial infections accompanied by fever. Not to be used in severe colitis due to risk of toxic megacolon.

129
Q 
class of Diphenoxylate with 
Atropine/ Lomotil
A

antidiarrheal

130
Q

MOA of Diphenoxylate with

Atropine/ Lomotil

A

combination of morphine analog and acetylcholine inhibitor results in diminished peristalsis

131
Q

indication of Diphenoxylate with

Atropine/ Lomotil

A

acute diarrhea

132
Q

what antidiarrheal is generally no indicated beyond 48 hours

A

Diphenoxylate with

Atropine/ Lomotil

133
Q

side effects of Diphenoxylate with

Atropine/ Lomotil

A

Dry mouth is quite common urinary retention, possible abdominal pain, constipation, (atropine effects). Generally, avoid when diarrhea is accompanied by fever. Not to be used in diarrhea due to bacterial or parasitic infections. Contraindicated in patients with severe colitis due to risk of toxic megacolon.

134
Q

What is the active ingredient in Kaopectate

A

Bismuth subsalicylate (same as Pepto-Bismol). It was formerly kaolin clay (kaolinite) and pectin.

135
Q

mild nausea and vomiting may respond to

A

antihistamines

136
Q

moderate to severe N/V may require more potent agents that block

A

the 5-HT3 receptor sites

137
Q

Meclizine/ Antivert class

A

antiemetic

138
Q

MOA of Meclizine/ Antivert

A

H1 Histamine blocker

139
Q

indication of Meclizine/ Antivert

A

mild to moderate nausea such as in motion sickness or vertigo

140
Q

side effects of Meclizine/ Antivert

A

drowsiness, dizziness, dry mouth, urinary retention

141
Q

class of Metoclopramide/ Reglan

A

antiemetic/pro-kinetic

142
Q

MOA of Metoclopramide/ Reglan

A

dopamine 2 blocker and mixed serotonin 3 antagonist/serotonin 4 agonist

143
Q

indication of Metoclopramide/ Reglan

A

mild to moderate nausea, gastric stasis (i.e. after gastric surgery or diabetic gastroparesis). Also used in GERD.

144
Q

side effects of Metoclopramide/ Reglan

A

Drowsiness, dizziness and headache. It should be used with caution in Parkinson’s disease since, as a dopamine antagonist, it may worsen symptoms. Contraindicated in patients with suspected bowel obstruction.

145
Q

what drug increases peristalsis of the jejunum and duodenum, increases tone and amplitude of gastric contractions, and relaxes the pyloric sphincter tone.

A

Metoclopramide/Reglan

146
Q

class of Ondansetron/ Zofran

A

antiemetic

147
Q

MOA of Ondansetron/ Zofran

A

blockade of serotonin (5HT3) receptor sites results in significant anti-nausea effect

148
Q

indication of Ondansetron/ Zofran

A

severe nausea

149
Q

what is an effective agent for severe nausea due to various chemotherapeutic agents (given approx. 30 min prior)

A

Ondansetron/ Zofran

150
Q

side effects of Ondansetron/ Zofran

A

dizziness, headache

151
Q

Emetic/ Syrup of Ipecac class

A

emetic

152
Q

MOA of Emetic/ Syrup of Ipecac

A

stimulation of medullary chemoreceptor trigger zone and local irritant of GI tract

153
Q

indication of Emetic/ Syrup of Ipecac

A

induction of vomiting for drug overdose and certain poisonings

154
Q

Emetic/ Syrup of Ipecac is not given with

A

charcoal, will absorb the drug

155
Q

side effects of Emetic/ Syrup of Ipecac

A

abdominal muscle spasm (often lasting hours after stomach contents are emptied), dizziness and dehydration

156
Q

class of Calcium carbonate/ Tums

A

antacid

157
Q

MOA of Calcium carbonate/ Tums

A

neutralization of stomach acid, reducing mucosal irritation

158
Q

indication of Calcium carbonate/ Tums

A

symptomatic relief of gastric acid irritation

159
Q

side effects of Calcium carbonate/ Tums

A

Constipation. Drugs which alter the stomach or duodenal pH can alter the absorption of nutrients as well as the absorption other oral drugs. Increased pH may also inhibit protection against digested pathogens.

160
Q

class of Ranitidine/ Zantac

A

H2 Histamine receptor antagonist

161
Q

MOA of Ranitidine/ Zantac

A

blocks the action of histamine on parietal cells in the stomach, decreasing acid production by these cells

162
Q

indication of Ranitidine/ Zantac

A

Gastritis, PUD, GERD

163
Q

side effects of Ranitidine/ Zantac

A

Generally well tolerated. Greater side effect profile when given I.V. Headache, confusion, dizziness, rash. Drugs which alter the stomach or duodenal pH can alter the absorption of nutrients as well as the absorption other oral drugs. Increased pH may also inhibit protection against digested pathogens.

164
Q

class of Omeprazole/ Prilosec

A

proton pump inhibitor

165
Q

MOA of Omeprazole/ Prilosec

A

inhibits H+/K+ ATPase pump of parietal cells thus reducing acid secretion

166
Q

indication of Omeprazole/ Prilosec

A

gastritis, PUD, GERD

167
Q

side effects of Omeprazole/ Prilosec

A

Headaches, dizziness, diarrhea. Drugs which alter the stomach or duodenal pH can alter the absorption of nutrients as well as the absorption other oral drugs. Increased pH may also inhibit protection against digested pathogens.

168
Q

Esomeprazole/ Nexium–what is it

A

single enantiomer form of Omeprazole that AstraZeneca made because they lost their patent

169
Q

rank least to most potent drug classes for stomach acid

A

antacid, H2 blocker, PPI

170
Q

therapy of choice for PUD

A

triple therapy for 7-14 days for PUD due to H Pylori

171
Q

two forms of Triple Therapy for PUD

A

Proton Pump Inhibitor and Bismuth based

172
Q

what is proton pump inhibitor based triple therapy

A

a PPI and 2 antibiotics for 1-2 weeks

173
Q

what is Bismuth based triple therapy

A

Subsalicylate and 2 antibiotics for 1-2 weeks

174
Q

how does Bismuth work for H Pylori

A

shown to damage the cell wall of H Pylori and other bacteria as well as reducing the bacterial adherence to mucosal cells

175
Q

what increases risk of travelers diarrhea?

A

blocking stomach acid what do

176
Q

what promotes mucosal healing

A

H2 histamine blockers to block acid production or PPIs to do so

177
Q

why is monotherapy discouraged for H Pylori

A

Although the growth of H. pylori is readily suppressed by a single antibiotic, antimicrobial monotherapy is discouraged because it does not eradicate the organism and leads to increased risk for the selection of resistant strains.

178
Q

antibiotics used in Triple Therapy for PUD

A

Amoxicillin, Erythromycin, Clarithromycin (Biaxin), Tetracycline or Metronidazole (Flagyl)…NOT Zithromax

179
Q

the active moiety of all the aminosalicylates used to treat inflammatory bowel disease is

A

5-aminosalicylic acid (5-ASA), also called Mesalamine

180
Q

class of 5-ASA/ Mesalamine

A

aminosalicylates

181
Q

indications of 5-ASA/ Mesalamine

A

IBD

182
Q

MOA of 5-ASA/ Mesalamine

A

inhibition of leukotriene production, anti-prostaglandin and anti-oxidant effects

183
Q

side effects of 5-ASA/ Mesalamine

A

N/V, diarrhea, and abdominal pain. Nephrotoxicity can occur

184
Q

5-ASA/ Mesalamine is delivered as a ___ drug

A

pro-drug to allow for release of drug at ileum of beyond

185
Q

5-ASA/ Mesalamine, is it more useful for Crohn’s or UC

A

far more useful for UC

186
Q

Who benefits more from antibiotics: Crohn’s or UC?

A

Patients with Crohn’s disease

187
Q

two of the most commonly used antibiotics for treating Crohn’s disease

A

Metronidazole/Flagyl and Ciprofloxacin/Ciprofloxin

188
Q

Metronidazole should not be taken by

A

patient’s consuming alcohol

189
Q

Ciprofloxacin is notable for its affinity to

A

calcium and for increased risk for occurrence of tendon rupture in patients taking this drug

190
Q

drug approved by the FDA for the treatment of traveler’s diarrhea and hepatic encephalopathy

A

Rifaximin/Ixifaxin

191
Q

Prednisone is a pro-drug that is converted in the liver into

A

prenisolone, which is the most active form of the drug

192
Q

Prednisone/ Deltasone class

A

glucocorticoid/corticosteroid

193
Q

indications of Prednisone/ Deltasone

A

preferred drug for reactive airways disease or moderate to severe allergic reaction. Important for leukemia reaction.

194
Q

MOA of Prednisone/ Deltasone

A

affects gene transcription to either stimulate or repress protein production

195
Q

side effects of Prednisone/ Deltasone

A

Side effects include reduced resistance to infections, hypertension, hyperglycemia and possible diabetes mellitus, severe bone loss, avascular necrosis, cataracts, myopathy, thinning of skin, diminished wound healing, easy bruising, insomnia and mental status changes and possible adrenal suppression.
Increased appetite is a commonly reported side effect as is weight gain from salt and water retention.

196
Q

Budesonide/ Entocort is used to treat

A

mild to moderate Crohn’s disease

197
Q

what are immunomodulatory drugs often used for

A

weaning from prednisone and to maintain the length of remission

198
Q

Azthioprine/ Immuran class

A

immunomodulator

199
Q

indications of Azthioprine/ Immuran

A

IBD, rheumatoid arthritis and other auto-immune conditions, post-transplant cases (anti-rejection agent) and cancer chemotherapy

200
Q

MOA of Azthioprine/ Immuran

A

inhibits purine synthesis, resulting in an anti-proliferative effect and induction of apoptosis of T-cells

201
Q

Azathioprine/ Immuran is a ___ drug

A

pro-drug which is converted in the body to its active form called mercaptopurine (Purinethol)

202
Q

side effects of Azathioprine/ Immuran

A

Side effects include nausea, fatigue, hair loss, and rash. Because Azthioprine suppresses the bone marrow, patients will be more susceptible to infection.

203
Q

patients taking what drug are excluded from eligibility for blood donation

A

Azathioprine/ Immuran

204
Q

Infliximib/ Remicade class

A

immunomodulator - TNF inhibitor

205
Q

indications of Infliximib/ Remicade

A

IBD, rheumatoid arthritis, psoriasis and other auto-immune conditions

206
Q

MOA of Infliximib/ Remicade

A

inhibits the pro-inflammatory cytokine, TNF-alpha

207
Q

Infliximib/ Remicade is dosed every ___ or ___

A

every 2 weeks or every 4 weeks

208
Q

side effects of Infliximib/ Remicade

A

Marked susceptibility to infection and sepsis, potential reactivation of hepatitis B, potential reactivation of tuberculosis, T-cell lymphoma and drug induced lupus

209
Q

several medications are available to treat urge incontinence by

A

blocking acetylcholine action on the bladder and diminish detrusor muscle contraction

210
Q

class of Oxybutynin/ Ditropan

A

anticholinergic med

211
Q

indication of Oxybutynin/ Ditropan

A

used to relieve frequent urination and inability to control urination due to urge incontinence. also used for hyperhidrosis (hyper-active sweating)

212
Q

MOA of Oxybutynin/ Ditropan

A

competitive antagonism of M3 subtype of the muscarinic acetylcholine receptor

213
Q

side effects of Oxybutynin/ Ditropan

A

dry mouth, dry eyes, constipation, blurred vision, drowsiness dizziness and diminished sweating. Patients taking this medication should be instructed to use extra care not to become overheated during exercise to avoid the risk of heat stroke.

214
Q

class of Tolterodine/ Detrol

A

anticholinergic med

215
Q

indication of Tolterodine/ Detrol

A

used to relieve frequent urination and inability to control urination due to urge incontinence

216
Q

MOA of Tolterodine/ Detrol

A

competitive antagonism of M2 and M3 subtypes of the muscarinic acetylcholine receptor

217
Q

what antimuscarinic agent is marketed as having fewer side effects than other antimuscarinic agents

A

Tolterodine/ Detrol

218
Q

Tolterodine/ Detrol and Oxybutynin/ Ditropan have potential interactions with

A

drugs metabolized by cytochrome P450

219
Q

class of Imipramine/ Tofranil

A

tricyclic antidepressant, mainly used in the treatment of clinical depression but is also used in cases of urge incontinence and enuresis

220
Q

MOA of Imipramine/ Tofranil

A

blocks reuptake of serotonin and norepinephrine and appears to diminish acetylcholine uptake in smooth muscle

221
Q

side effects of Imipramine/ Tofranil

A

Dry mouth, blurred vision, constipation, insomnia, flushing, tremulousness and weight gain. Agitation, irritability, confusion, and delirium are also possible, particularly in the elderly.

222
Q

2 very important things about Imipramine/ Tofranil

A

black box warning about increased risk for suicidal ideation and suicide. Overdose can be fatal due to a heart block.

223
Q

drug used frequently for enuresis

A

Imipramine/ Tofranil

224
Q

two main medication for management of BPH are

A

alpha blockers and 5alpha-reductase inhibitors

225
Q

common side effects of alpha blockers include

A

orthostatic hypotension, fatigue, and nasal congestion

226
Q

class of Tamsulosin/ Flomax

A

alpha 1 receptor antagonist

227
Q

indication of Tamsulosin/ Flomax

A

BPH

228
Q

MOA of Tamsulosin/ Flomax

A

smooth muscle relaxation via alpha adrenergic antagonism

229
Q

side effects of Tamsulosin/ Flomax

A

possible retrograde ejaculation

230
Q

class of Finasteride / Proscar

A

5 alpha-reductase inhibitor

231
Q

indication of Finasteride / Proscar

A

BPH

232
Q

MOA of Finasteride / Proscar

A

blocks conversion of testosterone to dihydrotestosterone

233
Q

a lower dosage of Finasteride / Proscar is marketed for the treatment of

A

male pattern baldness. Drug is called Propecia.

234
Q

side effects of Finasteride / Proscar (IMPORTANT)

A

Impotency. Women who are or who may become pregnant must not handle crushed or broken Finasteride tablets, because the medication could be absorbed through the skin. Category X.

235
Q

the drug of choice for cystitis has been

A

TMP-Sulfa/Bactrim

236
Q

drug that usually provides excellent coverage for UTI organisms

A

Ciprofloxin or other quinolones

237
Q

avoid use of Ciprofloxin or other quinolones in

A

children and with pregnant or lactating women

238
Q

indication of Phenazopyridine/ Pyridium

A

used to relieve symptoms such as pain, burning and the sensation of nedding to urinate urgently or frequently caused by irritation of the urinary tract lining

239
Q

commonly used antibiotics to treat cystitis

A

TMP-Sulfa/Bactrim,
Quinolones - Ciprofloxin
Amoxicillin/Clavulanate – Augmentin, Nitrofurantoin – Macrodantin

240
Q

drug that changes urine to distinct dark orange or reddish color

A

Phenazopyridine/ Pyridium

241
Q

drug that has been known to permanently discolor contact lenses

A

Phenazopyridine/ Pyridium…infrequently can cause a yellowish discoloration in the skin or eyes

242
Q

Metoclopramide/ Reglan should be used with caution in people with

A

Parkinson’s disease because, as a dopamine antagonist, it may worsen the condition

Pharm 1 Jack (8 decks)

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