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Pharmacy > G and G chapter ends > Flashcards

G and G chapter ends Flashcards

1
Q

Alosetron indication other than nausea

A

IBS-D

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2
Q

Zofran MOA

A

5HT-3 antagonist

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3
Q

Lorcaserin MOA

A

5HT-2c agonist

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4
Q

Lorcaserin indication

A

Weight loss

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5
Q

Scary side effect of lorcaserin at supraclinical doses

A

Hallucinations

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6
Q

Triptans MOA

A

5HT-1b and d agonist

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7
Q

Triptans contraindicated in what patients?

A

Ischemic heart disease and coronary artery vasospasm

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8
Q

Which Triptans have drug interactions with cyp 3a4 inhibitors?

A

Eletriptan and naratriptan

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9
Q

Can MAOI’s affect Triptans?

A

Yes, avoid

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10
Q

4 Most common side effects with triptans

A

Dizziness, sleepiness, neck and chest pain

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11
Q

Triptans safe in pregnancy?

A

No

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12
Q

Triptans safe in breastfeeding?

A

No

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13
Q

Can triptans be used concomitantly with SSRI’s/SNRI’s?

A

Not recommended due to serotonin syndrome

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14
Q

Methylergonovine MOA

A

Broad 5-HT action

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15
Q

Methylergonovine indication

A

Prevent post-partum hemorrhage

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16
Q

High dose Methylergonovine can cause what unpleasant side effect?

A

Sustained uterine contracture

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17
Q

Buspar MOA

A

Partial agonist 5-HT1a and D2

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18
Q

Flibanserin MOA

A

5-HT1a agonist and 5-HT2 antagonist

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19
Q

Flibanserin indication

A

Hypoactive sexual desire in premenopausal women

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20
Q

Cabergoline MOA and indication

A

Dopamine agonist, Parkinson’s and hyperprolactinemia

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21
Q

Bromocriptine MOA and indication

A

Dopamine agonist, Parkinson’s and hyperprolactinemia

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22
Q

Rotigotine moa

A

Dopamine agonist

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23
Q

Main reason cabergoline and bromocriptine are avoided

A

Cardiac issues (valvulopathies)

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24
Q

Side effect of dopamine agonists (mirapex, requip…) early in parkinson’s

A

Impulse control

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25
Q

What benefit from use of clozapine in terms of side effects?

A

Less EPS

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26
Q

Why vraylar or resulting for schizophrenia?

A

Improved side effect profile

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27
Q

Can adderall be used in patients that also have bipolar?

A

Not likely, can worsen psychosis

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28
Q

What side effects does vilazodone lack?

A

Sexual and weight gain

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29
Q

Milnacipran moa

A

SNRI

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30
Q

Duloxetine and milnacipran contraindicated in what?

A

Uncontrolled narrow angle glaucoma

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31
Q

Doxepin drug class

A

TCA

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32
Q

Desipramine drug class

A

TCA

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33
Q

How long to wait after taking MAOI to take TCA?

A

14 days

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34
Q

Blood pressure side effect of TCA’s

A

Orthostatic hypotension

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35
Q

3 indications of atypical antipsychotics

A

Depression, schizophrenia, and bipolar

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36
Q

Isocarboxazid drug class

A

MAOI

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37
Q

Tranylcypromine drug class

A

MAOI

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38
Q

MAOI’s can cause what side effect if tyramine containing foods/drinks eaten?

A

Hypertensive crisis

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39
Q

Trazodone and remeron moa

A

5-HT2 antagonist

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40
Q

Trazodone and remeron dose for successful sleep

A

Low dose

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41
Q

Why avoid nefazodone?

A

Risk of liver failure

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42
Q

Chlorpromazine drug class

A

1st gen antipsychotic

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43
Q

Chlorpromazine hits what 4 receptor types? What are side effects from each receptor type?

A

D2, muscarinic, histamine, and A1. EPS, anticholinergic, sedation, and hypotension

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44
Q

How can chlorpromazine effect the skin?

A

Photosensitivity

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45
Q

Haldol has higher rates of which 3 side effects?

A

EPS, akathisia, and hyperprolactinemia

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46
Q

Hyperprolactinemia manifestations

A

Infertility, decrease BMD in women, and erectile dysfunction and gynecomastia in men

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47
Q

Haldol causes less of which 4 side effects?

A

Anticholinergic, sedation, weight gain, hypotension

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48
Q

2 mg Haldol is equivalent to ___ mg chlorpromazine

A

100

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49
Q

Thiothixene drug class

A

1st gen antipsychotic

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50
Q

Perphenazine drug class

A

1st gen antipsychotic

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51
Q

Loxapine drug class

A

1st gen antipsychotic

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52
Q

Which 2 1st gen antipsychotics have the least EPS and akathisia?

A

Perphenazine and loxapine

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53
Q

Asenapine

A

Saphris

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54
Q

Can saphris ODT be swallowed?

A

No, will be dismantled by liver

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55
Q

Saphris counseling point when administering

A

Avoid water for 10 minutes after taking

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56
Q

How much effect does asenapine have on weight gain?

A

Minimal

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57
Q

What 2 GI and oral side effects does clozapine have?

A

Constipation and drooling

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58
Q

Iloperidone drug class

A

Atypical antipsychotic

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59
Q

4 common side effects of atypical antipsychotics

A

Anticholinergic, sedation, weight gain, and hypotension

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60
Q

Counseling point on Latuda administration

A

Take with 350 cal food

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61
Q

Olanzapine has dose dependent ___ effects

A

Anticholinergic

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62
Q

Invega has high rates of which side effect?

A

Hyperprolactinemia

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63
Q

Which 3 side effects are most common with Quetiapine?

A

Weight gain, sedation, and hypotension

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64
Q

Which 2 atypical antipsychotics have high rates of hyperprolactinemia?

A

Risperidone and paliperidone

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65
Q

Ziprasidone administration counseling point

A

Take with 500 cal food

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66
Q

Ziprasidone has improved tolerability if you need to start at high starting dose of ___ mg per day how?

A

With food

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67
Q

Abilify has low risk of which 2 side effects?

A

Weight gain and hyperprolactinemia (actually lowers prolactin)

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68
Q

Nuplazid

A

Pimavanserin

69
Q

Nuplazid moa and indication

A

Parkinson’s disease psychosis. 5-HT2a inverse agonist without D2 affect

70
Q

With Cyp3a4 inhibitors, do what to Nuplazid dose?

A

Decrease by 50% to avoid overdose

71
Q

Clinical effects of Nuplazid take how long to be seen?

A

4-6 weeks

72
Q

Monitor what 3 labs with lithium?

A

TSH, lithium level, and renal function

73
Q

Therapeutic serum level for lithium in acute mania

A

1-1.5 meq/ml

74
Q

Maintenance therapeutic serum level for lithium

A

0.6-1 meq/ml

75
Q

Lithium may cause what 2 physical side effects?

A

Tremor, hair loss

76
Q

What 3 labs are monitored with divalproex?

A

Divalproex level, CBC, and liver function

77
Q

Avoid rapid dose escalation for carbamazepine to avoid ___ and ___

A

Sedation and ataxia

78
Q

Why slow dose increase for lamotrigine?

A

To avoid SJS

79
Q

What to do if patient on lamotrigine and divalproex?

A

Reduce lamotrigine dose by 50%

80
Q

How does phenytoin affect cyp3a4?

A

Induction

81
Q

2 Common phenytoin side effects

A

Gingival hyperplasia and facial coarsening

82
Q

5 common side effects of carbamazepine

A

Drowsiness, vertigo, ataxia, blurred vision, increased seizure frequency

83
Q

Which anti seizure meds reduce half life of lamotrigine?

A

Phenytoin, carbamazepine, and phenobarbital

84
Q

Why did they make oxcarbazepine?

A

Less side effects and cyp induction

85
Q

Lacosamide moa and indication

A

Sodium channel modulator, epilepsy

86
Q

Ethosuximide moa and indication

A

Calcium channel blocker, epilepsy

87
Q

6 common side effects of ethosuximide

A

GI, sleepiness, lethargy, dizziness, headache, hypersensitivity

88
Q

Zonisamide 4 common side effects

A

Sleepy, ataxia, anorexia, fatigue

89
Q

Zonisamide moa

A

Calcium channel blocker

90
Q

Abrupt withdrawal of benzos can facilitate what symptom?

A

Seizures

91
Q

Infinite levels can be increased in cyp___ poor metabolizers

A

2c19

92
Q

Phenobarbital 2 common side effects in children:

A

Irritability and hyperactivity

93
Q

Phenobarbital 2 common side effects in elderly

A

Agitation and confusion

94
Q

Primidone moa

A

GABA enhancer

95
Q

Primidone is a cyp 3a4 ___

A

Inducer

96
Q

Fycompa

A

Perampanel

97
Q

Perampanel

A

Fycompa

98
Q

Fycompa 6 common side effects

A

Anxiety, confusion, imbalance, vision problems, aggression, suicidal thoughts

99
Q

Fycompa moa

A

Glutamate receptor antagonist

100
Q

Keppra 5 common side effects

A

Sleepy, weakness, ataxia, dizziness, mood changes

101
Q

3 common topiramate side effects

A

Sleepy, fatigue, brain fog

102
Q

Why did they make rytary?

A

Mixed immediate and extended release sinemet to prevent wearing off effect

103
Q

3 Most common side effects of dopamine agonists (requip, mirapex…)

A

Sleepy, impulse control disorder, psychosis

104
Q

Apomorphine drug class and indication

A

Dopamine agonist, Parkinson’s rescue for off episodes

105
Q

Apomorphine must be used concurrently with what?

A

Nausea meds

106
Q

Apomorphine is contraindicated with which drug class?

A

Zofran (5-ht3 antagonists)

107
Q

Neupro

A

Rotigotine

108
Q

Rotigotine

A

Neupro

109
Q

Why are COMT inhibitors used in Parkinson’s?

A

To reduce peripheral metabolism of levodopa, increasing efficacy and half life

110
Q

Entacapone drug class

A

COMT inhibitor

111
Q

Why would rasagiline or selegeline be used in Parkinson’s?

A

As MAOI’s, they increase dopamine levels.

112
Q

Max efficacious dose of selegiline in Parkinson’s: ___mg

A

40 mg

113
Q

Amantadine effective at treating levodopa induced:

A

Dyskinesias

114
Q

Rivastigmine moa and indication

A

Acetylcholinesterase inhibitor, dementia (Parkinson’s and alzheimer’s)

115
Q

What is main dose limiting side effect of aricept?

A

GI symptoms (NVD)

116
Q

Exelon patches have less of what side effect?

A

GI (NVD)

117
Q

Memantine moa

A

NMDA antagonist (reduces glutamate excitation which leads to damage)

118
Q

Tetrabenazine moa and indication

A

Depletes pre-synaptic catecholamines, treats tics (Huntington’s chorea)

119
Q

2 main side effects tetrabenazine

A

Hypotension and suicidal depression

120
Q

Baclofen moa

A

GABA receptor agonist

121
Q

Which 4 benzos have the indication for alcohol withdrawal?

A

Chlordiazepoxide, valium, Ativan, and oxazepam

122
Q

Flumenazil indication

A

Benzo ovedose

123
Q

Belsomra moa

A

Orexin antagonist

124
Q

Ballpark phenobarbital half life

A

Long

125
Q

Levorphanol 2 unique Side effects

A

Delirium and hallucinations

126
Q

As an opioid, why is loperamide sold OTC?

A

Poor BBB penetration, great for diarrhea

127
Q

Why is diphenoxylate formulated with atropine?

A

Atropine side effects of weakness and nausea discourage abuse of the opioid component

128
Q

What syndrome does delsym increase risk for?

A

Serotonin syndrome

129
Q

Naltrexone boxed warning:

A

Contraindicated in liver failure and hepatitis due to dose dependent liver injury

130
Q

Precedex should be used only up to ___ duration sedation

A

24 hours

131
Q

Dexmedetomidine moa

A

A2 agonist

132
Q

How long to apply lidocaine/prilocaine for onset of action?

A

30 minutesd

133
Q

Do not use Emla cream where topically?

A

Mucous membranes and open wound

134
Q

Acamprosate indication

A

Alcoholism

135
Q

Diuretic used for altitude sickness

A

Acetazolamide

136
Q

Fomepizole indication

A

Methanol poisoning

137
Q

Ethacrynic acid moa

A

Loop diuretic

138
Q

Risk of otoxicity highest with which loop diuretic?

A

ETHACRYNIC ACID

139
Q

Metolazone drug class

A

Thiazide diuretic

140
Q

Thiazide diuretics have what effect on blood sugar and LDL?

A

Elevate

141
Q

amiloride drug class

A

Potassium sparing diuretic

142
Q

Best diuretic in PCOS

A

Aldactone

143
Q

Drug of choice for central diabetes insipidus

A

Desmopressin

144
Q

Major ADR with desmopressin

A

Water intoxication

145
Q

Inhibition of conversion of angiotensin 1 to 2 causes blood pressure to lower how?

A

Lowers arteriolar resistance

146
Q

Ace inhibitors contraindicated in renal artery ___

A

Stenosis

147
Q

How does RAAS contribute to hypertension?

A

Volume overload, so body releases renin, which elevates angiotensin and aldosterone, leading to arteriolar contraction and elevated blood pressure.

148
Q

Aliskiren moa

A

Direct renin inhibitor

149
Q

With nitrates, need drug free interval of how long?

A

8 hours

150
Q

2 indications for calcium channel blockers

A

Angina and HTN

151
Q

Which formulation of calcium channel blocker preferred for angina?

A

Long acting or XR

152
Q

Odd potential nifedipine side effect

A

Tachycardia

153
Q

Common gi side effect with diltiazem and verapamil:

A

Constipation

154
Q

4 unique and common side effects of beta blockers

A

Bronchospasm, peripheral vasoconstriction, depression, and worsening psoriasis

155
Q

Ranolazine indication

A

Angina

156
Q

Ivabradine moa

A

Decreases heart rate by inhibiting SA node firing

157
Q

Ivabradine 2 indications

A

Heart failure and angina

158
Q

Ivabradine visual side effect

A

Phosphene (perception of light when none entering eye)

159
Q

Ivabradine contraindicated with what drugs?

A

Diltiazem or verapamil

160
Q

Heparin moa

A

Thrombin and factor Xa inhibitor

161
Q

Thiazides lose efficacy at what eGFR? 2 Exceptions:

A

<40, indapamide and metolazone

162
Q

Which 3 beta blockers indicated for heart failure?

A

Nebivolol, metoprolol, and bisoprolol

163
Q

2 Beta blockers of choice in peripheral artery disease

A

Coreg and labetalol

164
Q

Isosorbide dinitrate and Hydralazine combo indication

A

Heart failure in African americans

165
Q

3 digoxin common side effects

A

Nausea, diarrhea, visual disturbances

166
Q

When is Ivabradine used in heart failure?

A

Not tolerating beta blockers or HR over 75 on a beta blocker

167
Q

Quinidine indication

A

Prevent AF, VT, and VF

168
Q

3 common side effects with quinidine

A

Diarrhea, QT prolongation, cinchonism: (tinnitus, blurred vision, flushing, dizziness, diarrhea)

169
Q
A

Pharmacy (20 decks)

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