FNP Pharm Review (Leik book) Flashcards
Name 7 narrow therapeutic index drugs
Warfarin Digoxin Theophylline Tegretol Dilantin Levothyroxine Lithium
What drug interferes with garlic, ginger, gingko, ginseng?
Warfarin
What glitazone causes or worsens CHF? Side effects of this med?
Pioglitazone (Actos)
edema, weight gain, cough
Name 3 atypical antipsychotics. What are risks or side effects with these meds?
Risperidone, Olanzapine (Zyprexa), Quetiapine.
weight gain, increased BMI, DM2, hyperlipidemia
How should biphosphonates be taken?
Take before meal, with water (no juice, no other drugs)
Side effects of statins?
drug induced hepatitis, rhabdomyolysis if mixed with -azoles
Name a common lincosamide, and its common side effect
Clindamycin- risk for C diff colitis (give Flagyl & probiotics)
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
What is the maximum time a pt can take Ketorolac?
5 days
Why shouldn’t you combine ACEI & ARBs with K-sparing diuretics?
risk of hyperkalemia
What is a side effect of Spironolactone?
Gynecomastia, galactorrhea
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
Patient is on coumadin, and INR is 5. What should he do with dosing?
INR 5= omit one dose, check INR
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.
Which diuretics contain sulfa?
Thiazide (HCTZ, Chlorthalidone, Indapamide) & loop (lasix, bumex).
If allergic to sulfa but needs a diuretic, what to prescribe?
K-sparing (triamterene or Amiloride)
Side effects of thiazide diuretics?
- Glucosuria, hyperuricemia, high cholesterol & LDL
- hypokalemia (arrythmias)
Antihypertensives that are ok to give in pregnancy?
methyldopa, beta blockers
What antihypertensives are NOT ok to give in pregnancy?
ACEI
ARBs
Contraindications for calcium channel blockers?
2nd & 3rd degree heart blocks, CHF, bradycardia
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
