General Flashcards
Reye’s syndrome
Associated with use of salicylates in children(aspirin) under 16yrs
Symptoms— liver damage, encephalopathy (confusion, brain swelling)
Mostly seen after viral exposure
Tachyphylaxis
When the body no longer responds to drugs which is due repeated exposure eg drugs acting on nervous system
This is either by phosphorylation or similar event often requiring higher doses
Inunction
Improve absorption through skin by suspending drug in oily vehicle and rubbing it into skin
Specific gravity
(Same as density but no units)
Ratio of density of substance to density of water
Used for IV meds mostly and interpreting urinalysis
Note: density of water is 1
If SG is greater that 1, it’s heavier than water
If less, water is heavier
D penicillamine
Sulfahydryl group chelates metals
Similar to dimercaprol
EDTA
Carboxylic group chelates lots of metal
ACEI
The enzymes posses zinc metal which is the active sight for inhibitors
Captopril (thiol pharmacophore)
Lisinopril (carboxylic group)
Tetracycline
1carbonyl, 3 hydroxyl groups can chelates metals wc is a side effect
Ciprofloxacin
Can also chelates metal due to 1,3 dicarbonyl group
Milk thistle
Silymarin from Silybum marianum
Hepatoprotection
Narcolepsy
Excessive uncontrollable sleepiness in the day time
Treated with amphetamines(also ADHD)
Adrenochrome
A red colored byproduct of epinephrine after oxidation (hydroxyl groups) which can polymerize to form black compounds
Chlordiazepoxide
A benzodiazepine that undergoes light catalyzed reaction to form inactive compound
Phototoxic drugs
Can absorb light so lead to side effects such as sun burn, skin reaction, erythema, extreme sensitivity
Eg of drugs TCNs, FQs, certain TCA, NSAIDS of propionic acid class and amiodarone
Use sunscreen, avoid sun or discontinue
Linoleic acid
omega 3 FA prevents essential FA deficiency
Elongated to arachidonic acid, EPA and DHA
Lowers CV dxs
DHEA
Fountain of youth
Dehydroepiandrosterone-endogenous product of cholesterol metabolism act as precursor of testosterone and estradiol which begins to decline in3rd decade used for depression, arthritis, cancer and performance enhancer
Containdicated in hormone responsive cancer
SE acne, hirtusism, voice deepening, menstrual irregularities, gunaecomastia, wt gain , insomnia
CoQ 10
Ubiquinone(and cholesterol product of mevalonate)
Product of mevalonate pathway (used with HMGCoA wch inhibits the pathway)
Used cancer, diabetes,CV dxs (angina, heart failure)
Increase PT time or INR (should be monitored)
Omega 3 FA
And fish oil
Precursor of EPA and DHA (can use dietary supplements)
Remove fish skin and fat which can accumulate polychlorinated biphenyls(PCB)
Mercury in flesh of shark, king mackerel, swordfish or tilefish
SE anti thrombotic effects especially in 3g/day dose
Melatonin
Induce sleep
Used widely for minimising and preventing jet lag
Improve sleep latency but not efficiency and length
Exogenous derived from bovine
SE drowsiness, nausea, disorientation and decrease sperm count and motility in male
Melatonin
Induce sleep
Used widely for minimising and preventing jet lag
Improve sleep latency but not efficiency and length
Exogenous derived from bovine
SE drowsiness, nausea, disorientation and decrease sperm count and motility in male
Drug shortages and other info.
By APhA and ASHSP (American Society of Health System Pharmacist)
Biologics
Vaccines, blood and blood components, allergenic, somatic cells, gene therapy, tissues and recombinant therapeutic proteins
Information found in Purple book
(Product exclusivity, biosimilarity and interchangeability evaluations)
CDSS
Clinical decision support system in pharmacy
CPOE
Computerized physician order entry at the Doctors to reduce errors
AMP
The actual transaction price received by manufacturers
Manufacturer must report to DHHRS of Medicaid or Medicare to determine rebates paid by manufacturer for being part of Medicare Medicaid market
PBM
CVS Caremark, Optum Rx and express script
Are intermediaries bwn health plans or employers and pharmacy
Reimburse pharmacies
Negotiate rebates with manufacturers
Create formularies, pharmacy network and review drug use
Albumin
It is basic and bind to acidic or neutral drugs
Large and stays within plasma
Warfarin, phenytoin, aspirin, diazepam, ibuprofen, furosemide, valproic acid, tolbutamide, and verapamil
Drug-drug interaction can occur
Alpha 1 acid glycoprotein
AKA orosomucoid, AAG
Binds to basic and neutral drugs
Propranolol, lidocaine, imipramine, chlorpromazine, quinidine, alprenolol, disopyramide, methadone, fentanyl
Erythromycin formulation
Lactobionate, sugar as the counter ion which enhance water solubility used as parenteral
The ethyl succinate- lipophilic so used to mask taste and improve compliance esp in children suspension
8 chloro théophylline salt
Of diphenhydramine and dimenhydramine reduces sedative effet since theophylline is a stimulant
Basic drug
Such as morphine or antihistamine used for motion sickness can have delayed onset because they are ionized in the stomach so minimally absorbed until emptied in the small intestine where it will unionized
Forced acid diuresis
Acidification of urine when overdose of basic drugs eg flurazepam in order to enhance excretion
Use vitamin C , ammonium chloride
Forced alkaline diuresis
Alkalinization of urine using sodium bicarbonate in order to enhance excretion of acidic drugs eg phenobarbital
REMS
2010
Risk evaluation and mitigation strategies
Medication possession ratio
Used for calculating adherence
It is sum of days supply in a fill divide by number of days in the time period
CPICg
Clinical Pharmacogenetics Implementation Consortium guidelines
—therapeutic recommendations based on pharmacogenetic results
Can also be found FDA
PCR
2 primers, thermostable DNA, neucleotides and buffer cationic solution.
Emphysematous lungs
Hyperresonant or boom like sound
Healthy lung
Resonant or hollow sound
Pulse
60-100bpm
Respiratory rate
12-20 adults
20-40 children
30-60 newborns
Temperature
97.6 99.4 F or 36.5 - 37.5
Orthopnea
Difficulty breathing when in supine position
Goodpasture syndrome
Rare autoimmune dxs that attacks the basement membrane in kidneys and lungs leading to bleeding from lungs and kidney failure
Hypokalamia
Diuretics and amphotericin B
Acidosis, alkalosis, insulin, glucose and B2 agonist can change serum K without affecting total.
Hyperkalamia (and false)
ACEI, heparin, trimethoprim and K sparing diuretics can cause hyper
Hemolysis — false increase
CQI
Continuous quality improvement
plan do study act circle
FMEA
Another CQI program
Failure mode effect analysis
To identify failures within a system
Establish severity, occurrence score, detection score
Using them determine RPN(used to establish priorities for action plan)
Hypokalamia by Dextrose in water
Insulin released cause K to shift intracellularly cause hypokalalaemia
VIS
Vaccine information statements
Thimerosal
Mercury containing preservative contained in some vaccines that is thought to cause autism but no evidence
