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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
Chantix adrs
Nausea (take with food and WATER), insomnia, seizures, headache, constipation, psychiatric effects Possible rash/ SJS
26
Less know side effects of bupropion
Dry mouth
27
When to NEVER use cipro!
PNA! MGL!!!
28
Can you use 1st gen antihistamines with MAOI?
Apparently not
29
Antihistamine in lactation
No first gen- use second gen
30
Fexofenadine info
Take with water NOT juice | -no al or mg products
31
Chem 7 fishbone
Na CL BUN GLUCOSE K CO2 scr
32
Vincristine extravasation
Warm compress
33
Menthol age req
Don’t use in children less than 2
34
Glaucoma drugs MOA
``` PG analogs: increase outflow Carbonic anhydrase: produc? BB; production Cholinergic: outflow Rho kinase: outflow Alpha agonists: both ```
35
Cholinergic effect on pupils
Constriction (mitosis)
36
Weird lamotrigine ADR
Hair loss Give zinc or selenium
37
Levetiracetam ADR
Psychiatric reactions, rash, anemias Renal dose < 80
38
AEDs causing hyperammonium
Topiramate and valproate
39
Topiramate max and renal dose
Max: 400/ d | 50% for crcl < 70
40
Valproate vitamin supplementation
Carnitine for hyperammonium
41
Valproate DR to ER
Increase daily dose 8-20%
42
Carbamazepine level
4-12
43
AED IV: PO 1:1
Phenytoin, levetiracetam, lacosamide
44
When to stick with same manufacturer
AEDs, thyroid
45
PO acyclovir consideration
Take with water to avoid kidney stone
46
Acid base issues with diuretics and RASS inhibitors
Thiazides/loops: metabolic alkalosis K+ sparing: metabolic acidosis RASS: metabolic acidosis
47
Cardio selective beta blockers
AMEBBA + nebivolol (added Nitric oxide )
48
When are CCB CI
Acute MI (both DHP and Non-DHP) If BB use only non-DHP CI If HF both CI- if normal EF non-DHP ok
49
Clopidogrel dose
75 mg Qd
50
Preganancy BG goals
Fasting <95 | Post prandial <120-140
51
Should diabetes patients get live vaccine
No
52
Urine albumin:scr ratio in kidney dx
>30
53
Drugs that increase BG
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
54
DM drugs with CV benefit
GLP-1: liraglutide, semaglutide, exenatide SGLT-2: empagliflozin, canagliflozin
55
DM meds NOT to combine!
Insulin and SU/meglitinides GLP-1 and DPP-4
56
Metformin and contrast dye timing
Stop at time of or before Restart 48 hours after
57
Metformin + topiramate
Increase risk of metabolic acidosis
58
Metformin food?
Duh!
59
Older SU
Chlorpropamide, tolazamide, tolbutamide *not used d/t hypoglycemia
60
Micronase vs microzide
Micronase: glyburide Microzide: HCTZ
61
Can you use meglitinides or SU in T1DM?
No
62
TZDs less know risks
Risk of fractures Ovulation- use BC URTI
63
SGLT2 renal
Not recommended GFR<45 | CI: GFR<30
64
Canagliflozin electrolyte
Hyperkalemia
65
SGLT2 less known risk
Keto acidosis!!
66
DPP-4 risks
- Acute pancreatitis - HF (saxagliptan and alogliptan) - hepatotoxicity (alogliptan) - renal dose except linagliptan
67
Insulin dosing T2DM
Basal: 10 u/ day or 0.1-0.2 u/kg/d Prandial: 4 u/d or 10% basal
68
GLP-1 renal dosing
Exenatide: don’t use with crcl<30
69
Victoza dose
0.6 mg QD x 1 week then 1.2 mg QD Can increase to 1.8
70
Trulicity dose
Dulaglutide 0.75 mg Qwk Can increase to 1.5 mg
71
Byetta and adlyxin unique properties
No risk of thyroid CA Give with 60 min of meals (others no regard to meals)
72
Adlyxin
Lixisenatide Start with green pen and use all doses before moving to burgundy pen
73
Pramlintide facts
T1 and T2 DM Weight loss Must give with food!
74
Insulin timing
Rapid: 15 mins before meal Short: 30 mins before meal Long: bedtime
75
Humulin U-500 syringe
Each marking=5 units No conversions necessary
76
Insulins available without RX
Regular, NPH, 70/30’s
77
Can you mix LA insulins with other insulins?
No!
78
Humulin R and Novulin R VS Humulin 70/30 and novulin 70/30
R: regular 70/30: 70%NPH/30%regular
79
Starting basal bolus insulin reg for T1DM
0.5 u/kg/d 50% basal and 50% bolus (divide bolus by three)
80
Trulicity and adlyxin exp
14 D
81
Victoza, symlin, byetta exp
30 d
82
Drugs that can cause hypoglycemia
Belviq (lorcaserin), linezolid, pentamidine, beta blockers, FQ, octreotide, quinine
83
DKA v HHS
DKA: BG>250, ph<7.35, anion gap>12 HHS: BG>600, osmolarity>320, Dehydrated, ph>7.3, bicarb >15
84
When to not use GLP-1
Gastroparesis Slows gastric emptying
85
DM drugs avoid if crcl<30
Metformin, SGLT2, exenatide, glyburide
86
DM drugs hepatotoxicity
Alogliptan and TZDs
87
Which biologic DMARDS are anti-TNF
1. Enbrel (enterecept) 2. Humira (adalimumab) 3. Simponi (golimumab) 4. Remicade (infliximab) 5. Cimzia (certolizumab)
88
Myxedema coma
Emergency of hypothyroidism | -IV levothyroxine
89
Liotrix
T3 + T4 (levothyroxine + liothyronine) *thyrolar
90
Other levothyroxine interactions
BB decrease conversion of T4 to T4 Take bisphosphonates 30 minutes before levothyroxine
91
Major steroid ADRs
1. Hyperglycemia 2. Hypertension 3. Glaucoma 4. Psychiatric *decreased BMD, fluid retention, increased appetite/wt gain
92
Prednisone and prednisolone relationship
Prednisone is a prodrug of prednisolone
93
Preferred initial tx of RA
MTX
94
MTX major ADR
Hepatotoxicity, myelosuppression, mucositis/bleed, pregnancy, pulmonary *give folate to decrease ADRs-give NEXT day! Immunocompromise
95
Sulfa drugs causing crystaluria
Sulfasalazine, bactrim
96
Does amiodarone prolong QTc
Yes—-dummy
97
Preferred sglt2s in HF
Dapagliflozin, empagliflozin
98
Which statin is renally dosed?
Rosuvastatin
99
Which non-bio DMARDs to avoid with biologics DMARDs?
Xeljanz (tofacitinib) and Olumiant (baricitinib) Janus kinase inhibitors (JAK)
100
Biologic DMARD preganancy (TNF and Non-TNF)
Risk unknown- pregnancy registry | Unlike MTX and leflunamide- CI in pregnancy
101
Parenteral vs oral meds for MS
Parenteral: copaxone/glatopa (glatiramer acetate) and interferon beta, alemtuzumab (lemtrada), ocrevus, tysabri Oral: teriflunamide (aubagio), gilenya (fingolamid), tecfidera (dinethyl funarate), simponimod (mayzent), cladrabine (mavenclad)
102
Which MS/ RA drug- no pregnancy x 2 yr- can do accelerated elimination
Leflunamide (arava)-RA Teriflunamide (aubagio)- MS
103
Myasthenia gravis
Autoimmune- destroys ach receptors- muscle weakness Tx: cholinesterase inhibitor
104
Cholinergics and asthma/COPD
Bad- bronchoconstriction
105
Lipophilic and hydrophobic ABX
Hydro: beta-lactams, aminoglycosides, daptomycin, gylcopeptides, polymyxins *BAD GP LIPo: macrolide, rifampin, linezolid, quinolones, tetracyclines
106
Hydrophilic v lipophilic ABX properties
Hydro: renal elimination, not active against atypical, small VD, NOT 1:1
107
Doripenem do not use
PNA
108
Moxifloxacin unique coverage
Anaerobes- GI infxns No UTI!!
109
Erythromycin unique effect
Promotility -GI upset
110
Daptomycin drug interaction
Statins- myopathy/rhabdo
111
Tigecycline does not cover
3 P’s Pseudomonas, proteus, providencia
112
Metro and etoh separation
3 days
113
Which enterococcus does synercid not cover
Faecalis
114
What does no beta lactam cover?
Atypicals
115
Ribaverin v abacavir ADR
Ribaverin: hemolysis and pregnancy Abacavir: hypersensitivity *double check!
116
Genetic alleles for rash
5801- allopurinol 1502- anticonvulsants 5701- abacavir
117
Metoprolol iv:po
1:2.5
118
PPI ok in G-tube
Lansoprazole
119
Vilazodone food?
With food!
120
Which drugs (other than antipsyches) worsen PD?
Alzheimer’s meds
121
Which anticonvulsants cause weight loss?
Lamotrigine, keppra, Zonisamide, topiramate
122
Tx bordetella (whooping cough)
Zpack, clarithromycin, or bactrim
123
Is clindamycin renally dosed?
No
124
Do cipro and levo cover anerobes?
Don’t this so, use moxifloxacin or add metro
125
UTI ppx
> 3 /yr - bactrim SS QD or DS after sex - nitro 50 QD
126
Bactrim and nitro pregnancy
Avoid both in 1st trimester -avoid nitro in third trimester
127
Bicillin LA or CR for syphilis
LA * don’t sub!
128
Metronidazole pregnancy
CI in first trimester except for trichomoniasis
129
Tick illnesses
Typhus, ehrlichiosis, tularemia, Lyme, Ricky mountain Almost always doxy. Gent/tobra for tularemia
130
Diflucan renal adjustment
<50 decrease by 50%
131
Voriconazole / posaconazole renal impairment
Oral preferred bc IV vehicle (SBECD) accumulates | *<50*
132
Zygomycetes
Posa or isavu NOT vori
133
Which antifungal requires a filter
Isavuconazole
134
What is famciclovir a prodrug of
Penciclovir (denavir)
135
Acyclovir infusion time
At least 1 hour (prevent kidney damage)
136
Shingles and tx
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
Are cidofovir, ganciclovir and Valganciclovir hazardous
Yes
138
Valcyte and cytovene suspension storage
Fridge
139
Amo/ amp rash with EBV
Not an allergy! -FYI no tx for ebv
140
Immunosuppressed definition
20 mg prednisone equivalent or 2 mg/kg/d x 14 days!
141
Does reglan require medguide
Yes
142
Which antihistamine is a metabolite of hydroxyzine?
Cetirizine
143
Hormones breast cancer
Both estrogens and progesterone can cause- I think
144
Hormones uterine cancer
Estrogen increases risk | Progesterone decreases risk
145
When can you use cephalosporin in PCN allergy
Acute otitis media: use second or third gen cephalosporin
146
What is not considered a sulfa allergy?
Sulfite and sulfate do NOT cross react with sulfonamides
147
Michaelis menton drugs
Phenytoin, theophylline, voriconazole
148
HLA-1502 drugs
Carbamazepine, oxcarbazepine, phenytoin, fosphenytoin *test all ASIAN patients before starting CARBAMAZEPINE *
149
Plavix gene- don’t use
Cyp2c19 *2 or *3 | Poor metabolizes
150
Genetic: avoid codeine
Cyp2D6 ultra rapid metabolizer
151
Genes to decrease warfarin dose
Cyp2c9 *2 or *3 VKORC1 G> A
152
Azathioprine gene
Low or absent TPMT increases risk of myelosuppression
153
Which drug requires genetic testing in all patient?
Abacavir!! 5701 Carb- asians Cetuximab (kras) Trasruzumab (her-2) Azathioprine (TPMT)
154
How long is phenytoin IV bag stable for ?
4 hours
155
FQ QTc
Moxi>levo>cipro
156
FQ most potent inhibitor
Cipro
157
Hepatotoxic supplements
Black cohosh, kava
158
Anxiety herbals
Valerian, passionflower, kava, chamomile, st, johns
159
Cold sore herbal
l-lysine
160
Dementia herbal
Ginkgo, vitamin E
161
Depression herbal
SAMe, St. John, valerian
162
Diabetes herbal
Alpha lipoic, cinnamon, chromium
163
Cholesterol herbals
Ref yeast rice, garlic, omega 3, plant sterol, fibers
164
Energy/wt loss herbal
Bitter orange, caffeine, guarana, green tea powder
165
HF herbal
Hawthorn, coQ10, omertà 3
166
HTN herbal
Omega 3, l-arginine, coQ10, garlic
167
Inflammation herbal
Flax seed, turmeric, omega 3
168
Liver dx herbal
Milk thistle
169
Motion sickness herbal
Ginger, peppermint
170
Soy
Osteoporosis and menopause herbal
171
Nutrient depletion 1. MTX 2. PPI
1. Folate | 2. Magnesium, B12
172
NAc dose
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
Physostigmine
Acetylcholinesterase inhibitor- reverses anticholinergic OD
174
1. BB OD | 2. CCB OD
1. Glucagon | 2. IV calcium
175
Metal OD
Dimercaprol, penicillamine, succimer
176
Pralidoxime
Acetylcholinesterase inhibitor OD (neostigmine, pyridostigmine)
177
Fomepizole
Ethylene glycol, antifreeze, methanol toxicity
178
Sodium bicarb heart effect
Use if widened QRS
179
Levocarbitine
Use for valproate or topiramate induced hyperammonium
180
Crofab
Snake bites
181
Which diuretics are sulfa drugs
Loops and thiazides
182
Corticosteroids potassium
Hypokalemia
183
Do clonidine and precedex decrease HR?
Yes
184
Cyp2D6 inhibitors
Fluoxetine, paroxetine, fluvoxamine, Ciprofloxacin, , amiodarone
185
FQ separation from chelators | *give FQ…
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
Serotonergic drugs
Lithium, buspirone, amphetamines, fent/meth/tram/tapentadol, lorcaserin, reglan, triptans, St. John, mirtazapine, trazodone , dectromethorphan, DHE
187
Ototoxicity
Cisplatin Amg,salicylates, ASA, loops, vanc
188
Agranulocytosis meds
PTU, methimazole, procainamide, clozapine, carbamazepine, bactrim, isoniazid
189
Procainamide level
4-10 Napa-15-25 Combine: 10-30
190
Hazardous drugs USP
800
191
Copaxone (glatiramer) room temp exp
30 d
192
Cymzia room temp exp
7 d
193
Simponi room temp exp
30 d
194
Abalopartide (tymlos) and teriparatide (forteo) storage and exp
1. 30 d room temp | 2. Fridge at all times
195
IV MTX color
Yellow
196
Licorice
Increase BP, decrease k
197
Thiazide and loop adr
Photosensitivity and rash BG, TG, chol, uric acid Met alkalosis
198
Spironolactone pregnancy
No!
199
BB less know ADRs
Fluid retention, dyslipidemia and wt gain, depression
200
When are fibrinolytics contraindicated?
Pregnancy, HTN
201
Lipid effects for lupus meds
Fish oil: decrease TG, inc LDL Niacin: decrease TG/LDL inc HDL Fibrates: decrease TG, inc LDL Bile acid: decrease LDL, inc TG
202
Riboflavin
B2
203
Does ASA require medguide
No, don’t think so
204
NSAID safe with lithium
Sulindac
205
ASA separation from Motrin
Take ASA 1h before or 8h after
206
Dig + milnacipran
Increase dig
207
Triptans
Stroke, HTN, paresthesias, seratonin syndrome, chest sensation
208
How soon must you take cochicine for acute gout attack
Within 36 hours
209
Colchicine timing
- start within 36h - restart ppx in 12h - no repeat tx dose for 3 d
210
Can lesinurad be used without XOI
No
211
Uricosuric (lesinurad and probenecid) counseling point
Hydration!!
212
Pegloticase (krystexxa) major ADR
Hypersensitivity rxn Premeditate G6PD *don’t combine with other four agents
213
When can you use rectal steroids?
For UC only! Not chrones
214
Which meds are NOT helpful for motion sickness
Reglan, 5HT3 blockers Use cyclizine, dimenhydrinate, or meclizine…or Benadryl. Or scop
215
Dramamine v Dramamine all day less drowsy
1. Dimenhydrinate | 2. Meclizine
216
If you miss a dose of POP how long must you use back up?
Use for 48 h if 3 h late
217
Why is estrogen given with progesterone
Protects from endometrial cancer in women with uterus! *nothing about menopause- unlike AIs (given post menopause or if no uterus)*
218
What types of cancer do estrogens cause
Endometrial (if no progesterone), breast, ovarian, liver
219
Medroxyprogesterone IM ADRs
Decreases BDM, weight gain!!
220
When to avoid patch birth control
>198 pounds
221
Technivie or viekira pak plus ethinyl estradiol
CI! Liver toxicity!!
222
Protease inhibitors /ritonavir plus birth control
Use backup! Decrease it somehow! Even though they’re inhibitors
223
How long to use backup if 2 missed COC? POP (3h late)
7 days | 48h
224
How long can vaginal ring fall out for
3h, if >3h backup required
225
Nuvaring exp at room temp
4 months
226
Annovera
Reusable vaginal ring (up to a year)
227
Paragard
Copper IUD | -fun fact: also works as EC if placed within 5 days
228
Other than day limit, when else may ella be better than plan B
Overweight: >165 pounds
229
When should you treat asymptomatic bacturia
Pregnancy!
230
Drugs that cause osteoporosis
Anticonvulsants, aromatase inhibitors, medroxyprogesterone, GnRH agonists, lithium, PPIs, steroids, thyroid hormones, loop diuretics, TZDs, SSRIs, heparin
231
What do aromatase inhibitors do? What are they for?
Breast cancer treatment/ppx. They prevent conversion or other hormones to estrogen! Post menopausal!
232
Tamoxifen bone effect
Increased BMD- (unlike AIs)
233
Osteoporosis ppx vs tx
Ppx: bisphosphonates (except IV ibandronate), raloxifene, duavee Tx: bisphosphonates, denosumab, PTH analogs, (teriparatide),, calcitonin
234
Bisphosphonates or v IV
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
Bisphosphonates ADRs
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
Teriparatide (forteo) and tymlos (abaliparatide) safety considerations
Max 2 years! (Osteosarcoma) | **hyPERcalcemia**
237
Estrogen cancer risks
Endometrial AND breast!
238
Testosterone ADRs
Clotting risk, prostate growth (don’t give if BPH), baldness, acne, gynecomastia, liver toxicity
239
Who can take flibanserin (addyi)
Premenopausal only!
240
Testosterone and BPH
Test increases prostate growth | -5- alpha reductase inhibitors prevents formation of test (may cause ED though )
241
Fosrenol adr | And sevelemer
Lanthanum N/V/D, constipation- chew thoroughly!! Sevelemer- same and can also decrease cholesterol Chelation!
242
Bupropion enzymes
2D6 inhibitor
243
Which MAOi doesn’t require no tyramine rich food
Selegiline patch (emsam)
244
Antipsych potency trick
Low: thioridozine (mellaril) and chlirpromazine (Thorazine) Mid: loxapine (loxitane/adasuve) abd perphenazine *all others are high!
245
Fast acting INj antipsyches
Haldol, fluphenazine, zyprexa, ziprasidone
246
Smoking and Antiopsyces
Reduces olanzapine and clozapine
247
Antipsyches with ODT
Abilify, fazaclo, risperdal M-tab, zydis *asenapine is SL
248
Risperdal oral solution
Cannot mix with cola or tea
249
Bipolar drugs ok in pregnancy
Lamotrigine, lurasidone
250
Lithium risk neurotoxicity (other drugs)
Verapamil, diltiazem, phenytoin, carbamazepine
251
Kapvay- don’t get confused…
ER, NOT IR
252
BZD differences
Diazepam: lipophillic- fast onset and long half life Alprazolam: fast onset Etoh: diazepam, Ativan, chlordiazepoxide
253
Less known effect if Z-drugs
Pins and needles
253
Less known effect if Z-drugs
Pins and needles
253
Less known effect if Z-drugs
Pins and needles
254
What other drugs can help narcolepsy
Solriamfetol (sunosi) | Amphetamines/stimulants
255
Hep C DAA major issue
Interactions- watch for 3A4 inducers
256
No monotherapy Hep c
Ribaverin!! Daclatasvir, sofosbuvir
257
Crcl to reduce NRTIs
``` <50 Except TAF (vemlidy) <15 ```
258
Octreotide adrs
Hypo/hyperglycemia, bradycardia, cholethiasis/biliary sludge
259
Selegiline adr
Activating
260
Measles
Koplik spots (small white ) in mouth,maculopapular rash, fever , malaise , cough, rhinitis, conjunctivitis
261
Mumps
Swollen and tender salivary glands under ears HA, Fever, fatigue, loss of appetite
262
Rubella
Fine pink rash that begins on face and spreads to rest of body
263
Polio
Nerve damage, weakness and cognitive issues later in life Fever, sore throat, fatigue , nausea, HA, abd pain
264
Pertussis
Whooping cough | TDAP
265
Rotavirus
Diarrhea , fever, vomiting
266
Chicken pox
Itchy rash, crops of sores that turn to blisters then burst then form crusts
267
Anticoagulation monitoring
IVs (argat, bival, UFH): aPTT SubQ: (Fonda, LMWH): anti-XA Most things: Hgb/hct, plt, scr Orals: no efficacy monitoring Doacs: LFTs
268
Amlodipine + statin
Simvastatin max: 20/d | Lovastatin max: 20-40/ d
269
Additional fintate interaction
Increase effects of SU and warf Zetia, statins, colchicine
270
Niacin other tox
Bleeding, increase INR, N/V/D Liver, BG, UA, flushing
271
Women age: for taking tymlos forteo
At least 5 yr post-menopausal
272
PPI equal doses
20: omeprazole, esomeprazole Raber 40: pantop 30 lanso, dexlan
273
P ovale
Dandruff yeast
274
Diltiazem and verapamil iv to po
NOT 1:1
275
GpIIBIIIA and Tpa adr and CI
CI: hx recent stroke ADR: hypotension GpIIbIIIA: throbocytopenia
276
Azithromycin and clarithromycin food
Azithromycin ER susp- empty stomach Clarithromycin XL- with food!
277
Vanco max concentration and rate
Conc: 5mg/ml Rate: 15 mg/ min
278
Hydralazine v nitrates
Hydralazine: arterial dilator (afterload) Nitrates: venous dilator (preload)
279
Heparin weird adr
Osteoporosis | *less with LMWH
280
Only fibrinolytic allowed for stroke
Alteplase | 0.9 mg/kg (max 90 mg) 4.5 hr symptom onset 1 hr of hospital arrival
281
Tpa BP req
Start: <185/110 Keep: <180/105
282
When is anti-Xa lvl obtain for lmwh
4 hours post dose! (6h for aPTT) Extremes body wt, pregnancy, extremes age, renal insufficiency (3h if for fondaparinux)
283
DOAC ok to double up for missed dose
BID dosing if Xarelto
284
Xarelto food
With evening meal! If > 15 mg
285
Edoxaban limitatjkn
After 5-10d parenteral AC (same with dabigatran) Crcl <50: 30 mg
286
Vit k ADR
Anaphylaxis Dilute in 50 mL
287
ER iron
Not initially!!
288
Iron OD tx
Desferal (deferoxamine )
289
Schillings
Pernicious anemia
290
When is glipizide taken
30 mins before meals Other SU with breakfast
291
Sglt2 other adrs
Increased LDL, fractures
292
DPP-4 less know adr
Arthralgia (joint pain) ``` Heart failure (esp saxa and alo) URTIs ```
293
Nafcillin
Vesicant- use cold packs
294
Bismuth + tetracycline
Chelation
295
Which drugs falsely increase PT/INR
Dapto!, televancin, oritavancin, dalbavancin
296
Which suspension should not be shaken?
Linezolid
297
Shingles tx
Tx within 72 h and rx for 7 days Acy 800 5x Val 1g tid Fam 500 tid
298
Phenazopyridine
Hemolysis if G6PD deficiency Take with water or food
298
Phenazopyridine
Hemolysis if G6PD deficiency Take with water or food
299
Peak flow meter
Morning before using inhalers - compare to personal best - record highest value

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