final safety exam part 2

Question 1

NSAIDs precautions

Answer 1

Post MI
stomach ulcers
asthma
kidney disease
liver disease

Question 2

BBW for loop diuretics

Answer 2

Diuresis and electrolyte depletion

Question 3

loop diuretic that can cause ototoxicity

Answer 3

furosemide (Lasix)

Question 4

BBW for spirinolactone

Answer 4

Tumors in rats

Question 5

ACE inhibitor safety (lisinopril)

Answer 5

Contraindicated in 2nd and 3rd trimesters d/t fetal injury
Angioedema
Increase bradykinins leading to cough

Question 6

BBW for ARBs (angiotensin-2 receptor blockers)

Losartan (cozaar)

Answer 6

Fetal injury - discontinue in 2nd and 3 trimester

Question 7

Is it okay to combine ARBs and ACEs

Answer 7

No!

Question 8

Safety for angiotensin-2 receptor blockers (ARBs)

Answer 8

renal failure, angioedema

Question 9

Antihypertensive used in pregnancy

Answer 9

beta blockers

Calcium Channel Blockers (Procardia)

Question 10

Do not use these antihypertensive drugs with CYP450 inhibitors

Answer 10

Calcium channel blockers (verapamil)

Question 11

BBW for beta blockers

Answer 11

Abrupt discontinuation can cause cardiac ischemia, increased risk of MI
Asthma
DM
Psych disorders/depression
Calcium channel blockers (do not combine)
can mask hypoglycemia

Question 12

Heart meds contraindicated in pregnancy

Answer 12

ACEs, ARBs, Statins, warfarin

Question 13

BBW for warfarin

Answer 13

Fatal bleeding

Question 14

BBW for heparin

Answer 14

Increased risk for spinal or epidural hematoma

Question 15

BBW for plavix

Answer 15

CV events in poor metabolizers like variant of CYP2C19
Get genetic test first

Plavix persists (irreversible effect for 7-10 days)

Question 16

safety with digoxin

Answer 16

toxicity, hypokalemia, dysrhythmias, bradycardia, lots of D2D interactions

Question 17

BBW for NSAIDs and aspirin

Answer 17

Risk of GI bleed

Question 18

Pain meds contraindicated in pregnancy

Answer 18

aspirin, NSAIDs (except Tylenol), Cox 1&2 inhibitors, ergot alkaloids (ergotamine)

Question 19

BBW for ergotamine

Answer 19

Risk of vasospasm, vasoconstriction. DO not use in CV patients

Question 20

Depakote BBW

Answer 20

Pancreatitis, hepatitis, Neural tube defects in fetus

Question 21

Increased risk for rhabdomyalsis
do not. use in pregnancy
Do not take with PGP inhibitors or CYP3A4 inhibitors

Answer 21

Colchicine

Question 22

Pain meds contraindicated in children under 18

Answer 22

codeine, tramadol

Question 23

opioid partial agonist (buprenorphine) safety

Answer 23

can cause withdrawal if given with opioid - wait until withdrawal has already begun

Question 24

Do not start until complete withdrawal of opioids has occured

Answer 24

Suboxone (buprenorphine and naloxone/narcan)

Question 25

BBW for naltrexone

Answer 25

Liver injury

Question 26

BBW for long-acting beta agonist (salmeterol, fomoterol)

Answer 26

do not use alone - increased risk of asthma-related death

Question 27

Safety consideration for Zyban (bupriopion)

Answer 27

Increased suicidality

Question 28

DMARD safety - disease modifying antirheumatic drugs

Infliximab/remicade, hydroxychloroquine

Answer 28

serious infections and malignancy

Question 29

BBW for methotrexate (DMARD)

Answer 29

bone marrow suppression, renal impairment, hepatotoxicity, malignancy, severe infections.
NO pregnancy, NO breastfeeding, NO alcohol

Question 30

Anti-rheumatoid drug that prolongs QT interval

Answer 30

Hydroxychloroquine (Plaquenil)