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Extra Tips Flashcards

1
Q

Weird long term metronidazole adr

A

Peripheral neuropathy

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2
Q

Hepatic encephalopathy

A
  1. lactulose
  2. Rifaxim
  3. Neomycin ( caution neuro tox)
  4. PO metronidazole
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3
Q

Lasix : spironolactone ratio

A

40:100

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4
Q

Weight and TCAs

A

Weight gain

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5
Q

Adjunctive antipsyches for depression

A

Abilify, symbyax, seroquel, brexpiprazole

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6
Q

Sodium oxybate reqs

A

REMs
Date rape drug
Narcolepsy with cataplexy

C3, xyrem

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7
Q

PAH tx

A

Positive Nitric oxide response
-CCB (no verapamil)

Negative: go to main drugs

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8
Q

PDE-5 inhibitor interactions

A

Cyp3A4 inhibitors!

Nitrates

Etoh!

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9
Q

Adempas info

A

Riociguat
PAH
REMs for pharmacy and Females
Monthly preganancy tests

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10
Q

Bosentan additional information

A

Male and female must enroll in REMs

I think more hepatotoxicity

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11
Q

Weird ADR of LTRAs

A

Neuropsychiatric events (mood and behavior )

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12
Q

Theophylline kinetics

A

Michaels-menton

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13
Q

Respimat

A

These are MDIs but don’t need to be shaken!

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14
Q

Exercise induced asthma

A

SABA

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15
Q

Albuterol Neb solution 0.083% vs 0.5%

A

0.5% must be diluted with 2.5 mL NS

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16
Q

Inhaler type of no suffix

A

MDI

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17
Q

Only DPI requiring priming

A

Flexhaler

Just before first use!

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18
Q

Ergots major interaction

A

CI with 3A4 inhibitors

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19
Q

Drugs to avoid if salicylate allergy

A

MESALAMINE, bismuth, sulfasalazine

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20
Q

MDIs that don’t need to be shaken

A

Respimat, Alvesco, Qvar redihaler, atrovent

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21
Q

CYP1A2 substrates

A

Caffeine, theophylline,

R-warfarin (less potent), fluvoxamine, olanzapine, clozapine

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22
Q

Minimum nicotine gum or lozenge to use

A

9 pc /day in first 6 wk

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23
Q

How to bupropion and Chantix work for smoking cessation

A

Both reduce cravings and withdrawal

Chantix is partial agonist and blocks reward affects associated with smoking

*no need to taper these

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24
Q

Is bupropion serotonergic?

A

Yes

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25
Q

Chantix adrs

A

Nausea (take with food and WATER), insomnia, seizures, headache, constipation, psychiatric effects

Possible rash/ SJS

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26
Q

Less know side effects of bupropion

A

Dry mouth

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27
Q

When to NEVER use cipro!

A

PNA!

MGL!!!

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28
Q

Can you use 1st gen antihistamines with MAOI?

A

Apparently not

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29
Q

Antihistamine in lactation

A

No first gen- use second gen

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30
Q

Fexofenadine info

A

Take with water NOT juice

-no al or mg products

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31
Q

Chem 7 fishbone

A

Na CL BUN
GLUCOSE
K CO2 scr

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32
Q

Vincristine extravasation

A

Warm compress

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33
Q

Menthol age req

A

Don’t use in children less than 2

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34
Q

Glaucoma drugs MOA

A 
PG analogs: increase outflow 
Carbonic anhydrase: produc?
BB; production
Cholinergic: outflow
Rho kinase: outflow
Alpha agonists: both
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35
Q

Cholinergic effect on pupils

A

Constriction (mitosis)

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36
Q

Weird lamotrigine ADR

A

Hair loss

Give zinc or selenium

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37
Q

Levetiracetam ADR

A

Psychiatric reactions, rash, anemias

Renal dose < 80

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38
Q

AEDs causing hyperammonium

A

Topiramate and valproate

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39
Q

Topiramate max and renal dose

A

Max: 400/ d

50% for crcl < 70

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40
Q

Valproate vitamin supplementation

A

Carnitine for hyperammonium

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41
Q

Valproate DR to ER

A

Increase daily dose 8-20%

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42
Q

Carbamazepine level

A

4-12

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43
Q

AED IV: PO 1:1

A

Phenytoin, levetiracetam, lacosamide

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44
Q

When to stick with same manufacturer

A

AEDs, thyroid

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45
Q

PO acyclovir consideration

A

Take with water to avoid kidney stone

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46
Q

Acid base issues with diuretics and RASS inhibitors

A

Thiazides/loops: metabolic alkalosis
K+ sparing: metabolic acidosis
RASS: metabolic acidosis

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47
Q

Cardio selective beta blockers

A

AMEBBA

+ nebivolol (added Nitric oxide )

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48
Q

When are CCB CI

A

Acute MI (both DHP and Non-DHP)

If BB use only non-DHP CI

If HF both CI- if normal EF non-DHP ok

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49
Q

Clopidogrel dose

A

75 mg Qd

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50
Q

Preganancy BG goals

A

Fasting <95

Post prandial <120-140

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51
Q

Should diabetes patients get live vaccine

A

No

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52
Q

Urine albumin:scr ratio in kidney dx

A

> 30

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53
Q

Drugs that increase BG

A

Cough syrup, thiazide/loop diuretics, transplant, niacin, protease inhibitors, FQ, atypicals, statins, steroids

Azoles, beta-agonists, diazoxide, interferon alpha,

BB, FQ, and octreotide can increase and decrease

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54
Q

DM drugs with CV benefit

A

GLP-1: liraglutide, semaglutide, exenatide

SGLT-2: empagliflozin, canagliflozin

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55
Q

DM meds NOT to combine!

A

Insulin and SU/meglitinides

GLP-1 and DPP-4

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56
Q

Metformin and contrast dye timing

A

Stop at time of or before

Restart 48 hours after

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57
Q

Metformin + topiramate

A

Increase risk of metabolic acidosis

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58
Q

Metformin food?

A

Duh!

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59
Q

Older SU

A

Chlorpropamide, tolazamide, tolbutamide

*not used d/t hypoglycemia

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60
Q

Micronase vs microzide

A

Micronase: glyburide

Microzide: HCTZ

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61
Q

Can you use meglitinides or SU in T1DM?

A

No

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62
Q

TZDs less know risks

A

Risk of fractures
Ovulation- use BC
URTI

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63
Q

SGLT2 renal

A

Not recommended GFR<45

CI: GFR<30

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64
Q

Canagliflozin electrolyte

A

Hyperkalemia

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65
Q

SGLT2 less known risk

A

Keto acidosis!!

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66
Q

DPP-4 risks

A
  • Acute pancreatitis
  • HF (saxagliptan and alogliptan)
  • hepatotoxicity (alogliptan)
  • renal dose except linagliptan
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67
Q

Insulin dosing T2DM

A

Basal: 10 u/ day or 0.1-0.2 u/kg/d

Prandial: 4 u/d or 10% basal

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68
Q

GLP-1 renal dosing

A

Exenatide: don’t use with crcl<30

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69
Q

Victoza dose

A

0.6 mg QD x 1 week then 1.2 mg QD

Can increase to 1.8

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70
Q

Trulicity dose

A

Dulaglutide

0.75 mg Qwk
Can increase to 1.5 mg

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71
Q

Byetta and adlyxin unique properties

A

No risk of thyroid CA

Give with 60 min of meals (others no regard to meals)

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72
Q

Adlyxin

A

Lixisenatide

Start with green pen and use all doses before moving to burgundy pen

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73
Q

Pramlintide facts

A

T1 and T2 DM
Weight loss
Must give with food!

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74
Q

Insulin timing

A

Rapid: 15 mins before meal
Short: 30 mins before meal
Long: bedtime

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75
Q

Humulin U-500 syringe

A

Each marking=5 units

No conversions necessary

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76
Q

Insulins available without RX

A

Regular, NPH, 70/30’s

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77
Q

Can you mix LA insulins with other insulins?

A

No!

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78
Q

Humulin R and Novulin R
VS
Humulin 70/30 and novulin 70/30

A

R: regular

70/30: 70%NPH/30%regular

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79
Q

Starting basal bolus insulin reg for T1DM

A

0.5 u/kg/d

50% basal and 50% bolus (divide bolus by three)

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80
Q

Trulicity and adlyxin exp

A

14 D

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81
Q

Victoza, symlin, byetta exp

A

30 d

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82
Q

Drugs that can cause hypoglycemia

A

Belviq (lorcaserin), linezolid, pentamidine, beta blockers, FQ, octreotide, quinine

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83
Q

DKA v HHS

A

DKA: BG>250, ph<7.35, anion gap>12

HHS: BG>600, osmolarity>320,
Dehydrated, ph>7.3, bicarb >15

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84
Q

When to not use GLP-1

A

Gastroparesis

Slows gastric emptying

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85
Q

DM drugs avoid if crcl<30

A

Metformin, SGLT2, exenatide, glyburide

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86
Q

DM drugs hepatotoxicity

A

Alogliptan and TZDs

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87
Q

Which biologic DMARDS are anti-TNF

A
  1. Enbrel (enterecept)
  2. Humira (adalimumab)
  3. Simponi (golimumab)
  4. Remicade (infliximab)
  5. Cimzia (certolizumab)
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88
Q

Myxedema coma

A

Emergency of hypothyroidism

-IV levothyroxine

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89
Q

Liotrix

A

T3 + T4 (levothyroxine + liothyronine)

*thyrolar

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90
Q

Other levothyroxine interactions

A

BB decrease conversion of T4 to T4

Take bisphosphonates 30 minutes before levothyroxine

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91
Q

Major steroid ADRs

A
  1. Hyperglycemia
  2. Hypertension
  3. Glaucoma
  4. Psychiatric

*decreased BMD, fluid retention, increased appetite/wt gain

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92
Q

Prednisone and prednisolone relationship

A

Prednisone is a prodrug of prednisolone

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93
Q

Preferred initial tx of RA

A

MTX

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94
Q

MTX major ADR

A

Hepatotoxicity, myelosuppression, mucositis/bleed, pregnancy, pulmonary
*give folate to decrease ADRs-give NEXT day!
Immunocompromise

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95
Q

Sulfa drugs causing crystaluria

A

Sulfasalazine, bactrim

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96
Q

Does amiodarone prolong QTc

A

Yes—-dummy

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97
Q

Preferred sglt2s in HF

A

Dapagliflozin, empagliflozin

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98
Q

Which statin is renally dosed?

A

Rosuvastatin

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99
Q

Which non-bio DMARDs to avoid with biologics DMARDs?

A

Xeljanz (tofacitinib) and Olumiant (baricitinib)

Janus kinase inhibitors (JAK)

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100
Q

Biologic DMARD preganancy (TNF and Non-TNF)

A

Risk unknown- pregnancy registry

Unlike MTX and leflunamide- CI in pregnancy

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101
Q

Parenteral vs oral meds for MS

A

Parenteral: copaxone/glatopa (glatiramer acetate) and interferon beta, alemtuzumab (lemtrada), ocrevus, tysabri

Oral: teriflunamide (aubagio), gilenya (fingolamid), tecfidera (dinethyl funarate), simponimod (mayzent), cladrabine (mavenclad)

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102
Q

Which MS/ RA drug- no pregnancy x 2 yr- can do accelerated elimination

A

Leflunamide (arava)-RA

Teriflunamide (aubagio)- MS

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103
Q

Myasthenia gravis

A

Autoimmune- destroys ach receptors- muscle weakness

Tx: cholinesterase inhibitor

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104
Q

Cholinergics and asthma/COPD

A

Bad- bronchoconstriction

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105
Q

Lipophilic and hydrophobic ABX

A

Hydro: beta-lactams, aminoglycosides, daptomycin, gylcopeptides, polymyxins
*BAD GP

LIPo: macrolide, rifampin, linezolid, quinolones, tetracyclines

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106
Q

Hydrophilic v lipophilic ABX properties

A

Hydro: renal elimination, not active against atypical, small VD, NOT 1:1

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107
Q

Doripenem do not use

A

PNA

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108
Q

Moxifloxacin unique coverage

A

Anaerobes- GI infxns

No UTI!!

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109
Q

Erythromycin unique effect

A

Promotility

-GI upset

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110
Q

Daptomycin drug interaction

A

Statins- myopathy/rhabdo

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111
Q

Tigecycline does not cover

A

3 P’s

Pseudomonas, proteus, providencia

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112
Q

Metro and etoh separation

A

3 days

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113
Q

Which enterococcus does synercid not cover

A

Faecalis

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114
Q

What does no beta lactam cover?

A

Atypicals

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115
Q

Ribaverin v abacavir ADR

A

Ribaverin: hemolysis and pregnancy

Abacavir: hypersensitivity

*double check!

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116
Q

Genetic alleles for rash

A

5801- allopurinol
1502- anticonvulsants
5701- abacavir

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117
Q

Metoprolol iv:po

A

1:2.5

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Perfectly
118
Q

PPI ok in G-tube

A

Lansoprazole

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119
Q

Vilazodone food?

A

With food!

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120
Q

Which drugs (other than antipsyches) worsen PD?

A

Alzheimer’s meds

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121
Q

Which anticonvulsants cause weight loss?

A

Lamotrigine, keppra, Zonisamide, topiramate

122
Q

Tx bordetella (whooping cough)

A

Zpack, clarithromycin, or bactrim

123
Q

Is clindamycin renally dosed?

A

No

124
Q

Do cipro and levo cover anerobes?

A

Don’t this so, use moxifloxacin or add metro

125
Q

UTI ppx

A

> 3 /yr

  • bactrim SS QD or DS after sex
  • nitro 50 QD
126
Q

Bactrim and nitro pregnancy

A

Avoid both in 1st trimester

-avoid nitro in third trimester

127
Q

Bicillin LA or CR for syphilis

A

LA

  • don’t sub!
128
Q

Metronidazole pregnancy

A

CI in first trimester except for trichomoniasis

129
Q

Tick illnesses

A

Typhus, ehrlichiosis, tularemia,
Lyme, Ricky mountain

Almost always doxy.

Gent/tobra for tularemia

130
Q

Diflucan renal adjustment

A

<50 decrease by 50%

131
Q

Voriconazole / posaconazole renal impairment

A

Oral preferred bc IV vehicle (SBECD) accumulates

<50

132
Q

Zygomycetes

A

Posa or isavu NOT vori

133
Q

Which antifungal requires a filter

A

Isavuconazole

134
Q

What is famciclovir a prodrug of

A

Penciclovir (denavir)

135
Q

Acyclovir infusion time

A

At least 1 hour (prevent kidney damage)

136
Q

Shingles and tx

A

Cluster, fluid filled blisters in band

  • tx best within 72 hrs
  • tx duration: 7 d
  • acy 800 Po 5x/d
  • Val 1g tid
  • fam 500 tid
137
Q

Are cidofovir, ganciclovir and Valganciclovir hazardous

A

Yes

138
Q

Valcyte and cytovene suspension storage

A

Fridge

139
Q

Amo/ amp rash with EBV

A

Not an allergy!

-FYI no tx for ebv

140
Q

Immunosuppressed definition

A

20 mg prednisone equivalent or 2 mg/kg/d x 14 days!

141
Q

Does reglan require medguide

A

Yes

142
Q

Which antihistamine is a metabolite of hydroxyzine?

A

Cetirizine

143
Q

Hormones breast cancer

A

Both estrogens and progesterone can cause- I think

144
Q

Hormones uterine cancer

A

Estrogen increases risk

Progesterone decreases risk

145
Q

When can you use cephalosporin in PCN allergy

A

Acute otitis media: use second or third gen cephalosporin

146
Q

What is not considered a sulfa allergy?

A

Sulfite and sulfate do NOT cross react with sulfonamides

147
Q

Michaelis menton drugs

A

Phenytoin, theophylline, voriconazole

148
Q

HLA-1502 drugs

A

Carbamazepine, oxcarbazepine, phenytoin, fosphenytoin

*test all ASIAN patients before starting CARBAMAZEPINE *

149
Q

Plavix gene- don’t use

A

Cyp2c19 *2 or *3

Poor metabolizes

150
Q

Genetic: avoid codeine

A

Cyp2D6 ultra rapid metabolizer

151
Q

Genes to decrease warfarin dose

A

Cyp2c9 *2 or *3

VKORC1 G> A

152
Q

Azathioprine gene

A

Low or absent TPMT increases risk of myelosuppression

153
Q

Which drug requires genetic testing in all patient?

A

Abacavir!! 5701

Carb- asians

Cetuximab (kras)
Trasruzumab (her-2)
Azathioprine (TPMT)

154
Q

How long is phenytoin IV bag stable for ?

A

4 hours

155
Q

FQ QTc

A

Moxi>levo>cipro

156
Q

FQ most potent inhibitor

A

Cipro

157
Q

Hepatotoxic supplements

A

Black cohosh, kava

158
Q

Anxiety herbals

A

Valerian, passionflower, kava, chamomile, st, johns

159
Q

Cold sore herbal

A

l-lysine

160
Q

Dementia herbal

A

Ginkgo, vitamin E

161
Q

Depression herbal

A

SAMe, St. John, valerian

162
Q

Diabetes herbal

A

Alpha lipoic, cinnamon, chromium

163
Q

Cholesterol herbals

A

Ref yeast rice, garlic, omega 3, plant sterol, fibers

164
Q

Energy/wt loss herbal

A

Bitter orange, caffeine, guarana, green tea powder

165
Q

HF herbal

A

Hawthorn, coQ10, omertà 3

166
Q

HTN herbal

A

Omega 3, l-arginine, coQ10, garlic

167
Q

Inflammation herbal

A

Flax seed, turmeric, omega 3

168
Q

Liver dx herbal

A

Milk thistle

169
Q

Motion sickness herbal

A

Ginger, peppermint

170
Q

Soy

A

Osteoporosis and menopause herbal

171
Q

Nutrient depletion

  1. MTX
  2. PPI
A
  1. Folate

2. Magnesium, B12

172
Q

NAc dose

A

Po: 140 mg/kg x1, 70 mg/kg q4 x17 h

IV: 150 mg/kg over 60 min, 50 mg/kg over 4g, 100 mg/kg over 16h

173
Q

Physostigmine

A

Acetylcholinesterase inhibitor- reverses anticholinergic OD

174
Q
  1. BB OD

2. CCB OD

A
  1. Glucagon

2. IV calcium

175
Q

Metal OD

A

Dimercaprol, penicillamine, succimer

176
Q

Pralidoxime

A

Acetylcholinesterase inhibitor OD (neostigmine, pyridostigmine)

177
Q

Fomepizole

A

Ethylene glycol, antifreeze, methanol toxicity

178
Q

Sodium bicarb heart effect

A

Use if widened QRS

179
Q

Levocarbitine

A

Use for valproate or topiramate induced hyperammonium

180
Q

Crofab

A

Snake bites

181
Q

Which diuretics are sulfa drugs

A

Loops and thiazides

182
Q

Corticosteroids potassium

A

Hypokalemia

183
Q

Do clonidine and precedex decrease HR?

A

Yes

184
Q

Cyp2D6 inhibitors

A

Fluoxetine, paroxetine, fluvoxamine,

Ciprofloxacin, , amiodarone

185
Q

FQ separation from chelators

*give FQ…

A

Cipro: 2h before, 6h after
Levo: 2h before, 2h after
Moxi: 4h before, 8h after

Doxy: 1-2 before, 4-6 after
*minocycline is fine

186
Q

Serotonergic drugs

A

Lithium, buspirone, amphetamines, fent/meth/tram/tapentadol, lorcaserin, reglan, triptans, St. John, mirtazapine, trazodone , dectromethorphan, DHE

187
Q

Ototoxicity

A

Cisplatin

Amg,salicylates, ASA, loops, vanc

188
Q

Agranulocytosis meds

A

PTU, methimazole, procainamide, clozapine, carbamazepine, bactrim, isoniazid

189
Q

Procainamide level

A

4-10
Napa-15-25
Combine: 10-30

190
Q

Hazardous drugs USP

A

800

191
Q

Copaxone (glatiramer) room temp exp

A

30 d

192
Q

Cymzia room temp exp

A

7 d

193
Q

Simponi room temp exp

A

30 d

194
Q

Abalopartide (tymlos) and teriparatide (forteo) storage and exp

A
  1. 30 d room temp

2. Fridge at all times

195
Q

IV MTX color

A

Yellow

196
Q

Licorice

A

Increase BP, decrease k

197
Q

Thiazide and loop adr

A

Photosensitivity and rash
BG, TG, chol, uric acid
Met alkalosis

198
Q

Spironolactone pregnancy

A

No!

199
Q

BB less know ADRs

A

Fluid retention, dyslipidemia and wt gain, depression

200
Q

When are fibrinolytics contraindicated?

A

Pregnancy, HTN

201
Q

Lipid effects for lupus meds

A

Fish oil: decrease TG, inc LDL
Niacin: decrease TG/LDL inc HDL
Fibrates: decrease TG, inc LDL
Bile acid: decrease LDL, inc TG

202
Q

Riboflavin

A

B2

203
Q

Does ASA require medguide

A

No, don’t think so

204
Q

NSAID safe with lithium

A

Sulindac

205
Q

ASA separation from Motrin

A

Take ASA 1h before or 8h after

206
Q

Dig + milnacipran

A

Increase dig

207
Q

Triptans

A

Stroke, HTN, paresthesias, seratonin syndrome, chest sensation

208
Q

How soon must you take cochicine for acute gout attack

A

Within 36 hours

209
Q

Colchicine timing

A
  • start within 36h
  • restart ppx in 12h
  • no repeat tx dose for 3 d
210
Q

Can lesinurad be used without XOI

A

No

211
Q

Uricosuric (lesinurad and probenecid) counseling point

A

Hydration!!

212
Q

Pegloticase (krystexxa) major ADR

A

Hypersensitivity rxn
Premeditate
G6PD
*don’t combine with other four agents

213
Q

When can you use rectal steroids?

A

For UC only! Not chrones

214
Q

Which meds are NOT helpful for motion sickness

A

Reglan, 5HT3 blockers

Use cyclizine, dimenhydrinate, or meclizine…or Benadryl. Or scop

215
Q

Dramamine v Dramamine all day less drowsy

A
  1. Dimenhydrinate

2. Meclizine

216
Q

If you miss a dose of POP how long must you use back up?

A

Use for 48 h if 3 h late

217
Q

Why is estrogen given with progesterone

A

Protects from endometrial cancer in women with uterus!

nothing about menopause- unlike AIs (given post menopause or if no uterus)

218
Q

What types of cancer do estrogens cause

A

Endometrial (if no progesterone), breast, ovarian, liver

219
Q

Medroxyprogesterone IM ADRs

A

Decreases BDM, weight gain!!

220
Q

When to avoid patch birth control

A

> 198 pounds

221
Q

Technivie or viekira pak plus ethinyl estradiol

A

CI! Liver toxicity!!

222
Q

Protease inhibitors /ritonavir plus birth control

A

Use backup! Decrease it somehow! Even though they’re inhibitors

223
Q

How long to use backup if 2 missed COC? POP (3h late)

A

7 days

48h

224
Q

How long can vaginal ring fall out for

A

3h, if >3h backup required

225
Q

Nuvaring exp at room temp

A

4 months

226
Q

Annovera

A

Reusable vaginal ring (up to a year)

227
Q

Paragard

A

Copper IUD

-fun fact: also works as EC if placed within 5 days

228
Q

Other than day limit, when else may ella be better than plan B

A

Overweight: >165 pounds

229
Q

When should you treat asymptomatic bacturia

A

Pregnancy!

230
Q

Drugs that cause osteoporosis

A

Anticonvulsants, aromatase inhibitors, medroxyprogesterone, GnRH agonists, lithium, PPIs, steroids, thyroid hormones, loop diuretics, TZDs, SSRIs, heparin

231
Q

What do aromatase inhibitors do? What are they for?

A

Breast cancer treatment/ppx. They prevent conversion or other hormones to estrogen!

Post menopausal!

232
Q

Tamoxifen bone effect

A

Increased BMD- (unlike AIs)

233
Q

Osteoporosis ppx vs tx

A

Ppx: bisphosphonates (except IV ibandronate), raloxifene, duavee

Tx: bisphosphonates, denosumab, PTH analogs, (teriparatide),, calcitonin

234
Q

Bisphosphonates or v IV

A

Oral: alendronate (daily/weekly), risendronate (daily/weekly/monthly) or ibandronate (monthly!!)

IV: zolendronate (reclast)- 5 yearly
Zometa (hyerpK) - 4 mg
Ibandronate Q3 months!

*boniva is monthly if oral and quarterly if IV

235
Q

Bisphosphonates ADRs

A

Osteonecrosis of jaw (check vit D and calcium lvls before), GI!!!, esophagitis/erosions, hypocalcemia, atypical femur fractures, heartburn/dyspepsia, separate from divalent cations/antacids, renal

*IV- no esophagitis or GI but does have acute phase rxn

236
Q

Teriparatide (forteo) and tymlos (abaliparatide) safety considerations

A

Max 2 years! (Osteosarcoma)

hyPERcalcemia

237
Q

Estrogen cancer risks

A

Endometrial AND breast!

238
Q

Testosterone ADRs

A

Clotting risk, prostate growth (don’t give if BPH), baldness, acne, gynecomastia, liver toxicity

239
Q

Who can take flibanserin (addyi)

A

Premenopausal only!

240
Q

Testosterone and BPH

A

Test increases prostate growth

-5- alpha reductase inhibitors prevents formation of test (may cause ED though )

241
Q

Fosrenol adr

And sevelemer

A

Lanthanum

N/V/D, constipation- chew thoroughly!!

Sevelemer- same and can also decrease cholesterol

Chelation!

242
Q

Bupropion enzymes

A

2D6 inhibitor

243
Q

Which MAOi doesn’t require no tyramine rich food

A

Selegiline patch (emsam)

244
Q

Antipsych potency trick

A

Low: thioridozine (mellaril) and chlirpromazine (Thorazine)

Mid: loxapine (loxitane/adasuve) abd perphenazine

*all others are high!

245
Q

Fast acting INj antipsyches

A

Haldol, fluphenazine, zyprexa, ziprasidone

246
Q

Smoking and Antiopsyces

A

Reduces olanzapine and clozapine

247
Q

Antipsyches with ODT

A

Abilify, fazaclo, risperdal M-tab, zydis

*asenapine is SL

248
Q

Risperdal oral solution

A

Cannot mix with cola or tea

249
Q

Bipolar drugs ok in pregnancy

A

Lamotrigine, lurasidone

250
Q

Lithium risk neurotoxicity (other drugs)

A

Verapamil, diltiazem, phenytoin, carbamazepine

251
Q

Kapvay- don’t get confused…

A

ER, NOT IR

252
Q

BZD differences

A

Diazepam: lipophillic- fast onset and long half life

Alprazolam: fast onset

Etoh: diazepam, Ativan, chlordiazepoxide

253
Q

Less known effect if Z-drugs

A

Pins and needles

253
Q

Less known effect if Z-drugs

A

Pins and needles

253
Q

Less known effect if Z-drugs

A

Pins and needles

254
Q

What other drugs can help narcolepsy

A

Solriamfetol (sunosi)

Amphetamines/stimulants

255
Q

Hep C DAA major issue

A

Interactions- watch for 3A4 inducers

256
Q

No monotherapy Hep c

A

Ribaverin!!

Daclatasvir, sofosbuvir

257
Q

Crcl to reduce NRTIs

A 
<50
Except TAF (vemlidy) <15
258
Q

Octreotide adrs

A

Hypo/hyperglycemia, bradycardia, cholethiasis/biliary sludge

259
Q

Selegiline adr

A

Activating

260
Q

Measles

A

Koplik spots (small white ) in mouth,maculopapular rash, fever , malaise , cough, rhinitis, conjunctivitis

261
Q

Mumps

A

Swollen and tender salivary glands under ears

HA, Fever, fatigue, loss of appetite

262
Q

Rubella

A

Fine pink rash that begins on face and spreads to rest of body

263
Q

Polio

A

Nerve damage, weakness and cognitive issues later in life

Fever, sore throat, fatigue , nausea, HA, abd pain

264
Q

Pertussis

A

Whooping cough

TDAP

265
Q

Rotavirus

A

Diarrhea , fever, vomiting

266
Q

Chicken pox

A

Itchy rash, crops of sores that turn to blisters then burst then form crusts

267
Q

Anticoagulation monitoring

A

IVs (argat, bival, UFH): aPTT

SubQ: (Fonda, LMWH): anti-XA

Most things: Hgb/hct, plt, scr

Orals: no efficacy monitoring
Doacs: LFTs

268
Q

Amlodipine + statin

A

Simvastatin max: 20/d

Lovastatin max: 20-40/ d

269
Q

Additional fintate interaction

A

Increase effects of SU and warf

Zetia, statins, colchicine

270
Q

Niacin other tox

A

Bleeding, increase INR, N/V/D

Liver, BG, UA, flushing

271
Q

Women age: for taking tymlos forteo

A

At least 5 yr post-menopausal

272
Q

PPI equal doses

A

20: omeprazole, esomeprazole
Raber

40: pantop

30 lanso, dexlan

273
Q

P ovale

A

Dandruff yeast

274
Q

Diltiazem and verapamil iv to po

A

NOT 1:1

275
Q

GpIIBIIIA and Tpa adr and CI

A

CI: hx recent stroke

ADR: hypotension

GpIIbIIIA: throbocytopenia

276
Q

Azithromycin and clarithromycin food

A

Azithromycin ER susp- empty stomach

Clarithromycin XL- with food!

277
Q

Vanco max concentration and rate

A

Conc: 5mg/ml

Rate: 15 mg/ min

278
Q

Hydralazine v nitrates

A

Hydralazine: arterial dilator (afterload)

Nitrates: venous dilator (preload)

279
Q

Heparin weird adr

A

Osteoporosis

*less with LMWH

280
Q

Only fibrinolytic allowed for stroke

A

Alteplase

4.5 hr symptom onset

1 hr of hospital arrival

0.9 mg/kg (max 90 mg)

281
Q

Tpa BP req

A

Start: <185/110

Keep: <180/105

282
Q

When is anti-Xa lvl obtain for lmwh

A

4 hours post dose! (6h for aPTT)

Extremes body wt, pregnancy, extremes age, renal insufficiency

(3h if for fondaparinux)

283
Q

DOAC ok to double up for missed dose

A

BID dosing if Xarelto

284
Q

Xarelto food

A

With evening meal! If > 15 mg

285
Q

Edoxaban limitatjkn

A

After 5-10d parenteral AC (same with dabigatran)

Crcl <50: 30 mg

286
Q

Vit k ADR

A

Anaphylaxis

Dilute in 50 mL

287
Q

ER iron

A

Not initially!!

288
Q

Iron OD tx

A

Desferal (deferoxamine )

289
Q

Schillings

A

Pernicious anemia

290
Q

When is glipizide taken

A

30 mins before meals

Other SU with breakfast

291
Q

Sglt2 other adrs

A

Increased LDL, fractures

292
Q

DPP-4 less know adr

A

Arthralgia (joint pain)

Heart failure (esp saxa and alo)
URTIs
293
Q

Nafcillin

A

Vesicant- use cold packs

294
Q

Bismuth + tetracycline

A

Chelation

295
Q

Which drugs falsely increase PT/INR

A

Dapto!, televancin, oritavancin, dalbavancin

296
Q

Which suspension should not be shaken?

A

Linezolid

297
Q

Shingles tx

A

Tx within 72 h and rx for 7 days
Acy 800 5x
Val 1g tid
Fam 500 tid

298
Q

Phenazopyridine

A

Hemolysis if G6PD deficiency

Take with water or food

298
Q

Phenazopyridine

A

Hemolysis if G6PD deficiency

Take with water or food

299
Q

Peak flow meter

A

Morning before using inhalers

  • compare to personal best
  • record highest value

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