FNP Pharm Review (Leik book) Flashcards by Kathryn Richards

Name 7 narrow therapeutic index drugs

Warfarin
Digoxin
Theophylline
Tegretol 
Dilantin
Levothyroxine
Lithium

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What drug interferes with garlic, ginger, gingko, ginseng?

Warfarin

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What glitazone causes or worsens CHF? Side effects of this med?

Pioglitazone (Actos)

edema, weight gain, cough

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Name 3 atypical antipsychotics. What are risks or side effects with these meds?

Risperidone, Olanzapine (Zyprexa), Quetiapine.

weight gain, increased BMI, DM2, hyperlipidemia

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How should biphosphonates be taken?

Take before meal, with water (no juice, no other drugs)

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Side effects of statins?

drug induced hepatitis, rhabdomyolysis if mixed with -azoles

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Name a common lincosamide, and its common side effect

Clindamycin- risk for C diff colitis (give Flagyl & probiotics)

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Why is digoxin given?

Sx of overdose?

SV arrythmias, heart failure, LV systolic dysfunction.

OD= n/v/abd pain, arrythmias, confusion, vision change (yellow-green), scotomas

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What is the maximum time a pt can take Ketorolac?

5 days

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Why shouldn’t you combine ACEI & ARBs with K-sparing diuretics?

risk of hyperkalemia

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What is a side effect of Spironolactone?

Gynecomastia, galactorrhea

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Name some phosphodiesterase inhibitors.

What should NOT be taken with these drugs?

Sildenafil (viagra),; Tadalafil (Cialis), Vardenafil (Levitra)

do not mix w/ nitrates, some alpha blockers
if erection sustained >4 hours, go to ED
don’t give within 3-6 months of MI or stroke

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Patient is on coumadin, and INR is 5. What should he do with dosing?

INR 5= omit one dose, check INR

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What are foods w/ Vitamin K? What do they do to the INR with pt on coumadin?

green leafy veggies (kale, spinach, collard greens, broccoli). These reduce warfarin’s effect, and decrease INR.

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Which diuretics contain sulfa?

Thiazide (HCTZ, Chlorthalidone, Indapamide) & loop (lasix, bumex).

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If allergic to sulfa but needs a diuretic, what to prescribe?

K-sparing (triamterene or Amiloride)

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Side effects of thiazide diuretics?

Glucosuria, hyperuricemia, high cholesterol & LDL

- hypokalemia (arrythmias)

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Antihypertensives that are ok to give in pregnancy?

methyldopa, beta blockers

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What antihypertensives are NOT ok to give in pregnancy?

ACEI

ARBs

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Contraindications for calcium channel blockers?

2nd & 3rd degree heart blocks, CHF, bradycardia

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Contraindications for tetracyclines? Side effects?

Contraindications: Children <9; pregnancy; infancy

Side effects: permanent teeth discoloration, skeletal defects (if taken during pregnancy, infancy). Photosensitivity.

Name an indication for Tetracyclilne.

Moderate acne, rosacea (if topicals do not work)

Name 2 indications for Doxycyline

Chlamydial infections (PID, cervicitis, atypical PNA)
Nongonococcal urethritis.

What bacteria do macrolides typically cover?

Gram positive
Staph aureus
Strep pyogenes
Atypical bacteria

Which macrolides should be avoided in pregnancy?

Clarithromycin, Telithromycin (Category C)

What antibiotic to give to a pregnant woman with UTI?

Augmentin, Amoxicillin, cephalexin or fosfomycin Avoid nitrofurantoin & sulfas during lats trimester (they increase bilirubin which can cause hemolysis if G6PD anemia)

Name a first generation cephalosporin. | What is it used for?

Cephalexin | UTI in pregnancy, cellulitis, impetigo

First line antibiotics for: - Strep throat? - Otitis media? - Rhinosinusitis? - Syphillis? - Erysipelas, cellulitis?

Strep- PCN VK OM- Amoxicillin Rhinosinusitis- Amoxicillin Syphillis- Benzathine PCN G Erysipelas/cellulitis- Dicloxacillin

What to use if pt has penicillin allergy (ex., has strep throat but can't use PCN)?

macrolide (e.g., biaxin, azithromycin)

What are contraindications for fluoroquinolones?

Children <18 Myasthenia gravis Pregnant, breastfeeding

Antibiotic for anthrax infection and prophylaxis, and traveler's diarrhea

Ciprofloxacin | Also give anthrax vaccine (3 dose series)

Pt has cystic fibrosis and pneumonia, what antibiotic to give?

Ciprofloxacin

What is levaquin used for?

CAP, pyelonephritis, epididymitis, prostatitis

Adverse effects of quinolones

``` hypoglycemia CNS effects QT prolongation peripheral neuropathy phototoxicity achilles tendon rupture ```

Name some sulfonamides

Trimethoprim-Sulfamethoxazole | Erythromycin-sulfisoxazole

What are contraindications for sulfa drugs?

G6PD anemia newborns, infants pregnancy in 3rd trimester (increased risk of bili) UTI on warfarin (bactrim increases bleeding risk)

What are common uses for Bactrim

pneumocystis jirovecci prophylaxis/treatment MRSA cellulitis UTI, pyelonephritis

Who should not use decongestants (e.g., sudafed, phenylephrine)

HTN, CAD, MI, angina

What are NSAIDs that can be prescribed for pts at high risk of bleeding?

Cox-2 inhibitors | Celecoxib (celebrex

What is capsaicin topical used for?

``` Muscle & joint pain neuropathic pain (postherpetic neuralgia, trigeminal neuralgia) ```

What type of prevention is this: | giving a post-MI patient aspirin

Secondary prevention

What drugs require regular eye exams?

``` digoxin ethambutol linezolid corticosteroids fluoroquinolone viagra, cialis, levitra accutane (cataracts, decreased night vision) Topamax (glaucoma, increased ICP) plaquenil ```

Name schedule I drugs

illegal to prescribe | heroin, ecstasy, MDMA, PCP

Name schedule II drugs

Demerol, dilaudid, oxycontin, cocaine, amphetamines

schedule III drugs

tylenol w/ codeine, vicodin, anabolic steroids

schedule IV drugs

benzos, ambien, lunesta, soma

schedule v drugs

cough meds w/ less than 200 mg codeine; lomotil; lyrica

What is feverfew used for?

migraines

What is saw palmetto used for?

BPH sx

What is st. johns wort used for?

depression (dont use w/ SSRI, imitrex)

What is cinnamon used for?

diabetes, cholesterol

What is turmeric used for?

alzheimers, arthritis, cancer