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Medications Flashcards

1
Q

Sinemet

A

Levodopa/Carbidopa

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2
Q

Start dose for Sinemet

A

100/25mg

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3
Q

Side effects of Sinemet

A

Common: hallucinations, nightmares, nausea, increased libido
BAD: hypotension, dyskinesia, psychosis, arrhythmia, NMS, decreased impulse control

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4
Q

CI to Levodopa/Carbidopa use

A

MAOI, caution in psychosis history, glaucoma

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5
Q

Treating hypotension in patients on Sinemet

A

inc. water, salt, Midodrine (2.5-5mg BID-TID), domperidone

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6
Q

Prolopa

A

Levodopa/benserazide

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7
Q

Stalevo

A

carbidopa/levodopa/entacapone

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8
Q

COMT inhibitor (decreases GI metabolism of levodopa to prolong the half-life)

A

Entacapone

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9
Q

Pramipexole

A

Mirapex

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10
Q

Mirapex side effects

A

nausea, vomiting, confusion, dyskinesia (less so than levodopa), hallucinations, hypotension, ankle edema, MI, gambling, stroke, seizures
Other side effects worse than in Levodopa

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11
Q

Dopamine agonists

A

Pramipexole, Ropinirole

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12
Q

Ropinirole

A

Requip

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13
Q

Benztropine

A

Cogentin

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14
Q

Cogentin use

A

PD tremor

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15
Q

Anticholinergic side effects

A

Cogentin
- confusion, drowsiness, headache, slow memory, dry mouth, blurred vision, elevated HR
(anticholinergic)

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16
Q

CHADS2VASc

A

CHF, hypertension, diabetes, vascular disease, age >65, female sex

2 points for age >75, previous stroke

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17
Q

Oral anticoagulation options for a.fib

A

Warfarin, apixaban, dabigatran, rivaroxaban

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18
Q

CHADSVASc versus CHADS2

A

CHA2DS2-VASc score is better at categorizing low- or intermediate-risk individuals

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19
Q

Coumadin

A

Warfarin

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20
Q

Apixaban

A

Eliquis

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21
Q

Dabigatran

A

Pradax

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22
Q

Rivaroxaban

A

Xeralto

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23
Q

When is warfarin preferred over other OACs

A

Valvular heart disease, advanced liver/renal dysfunciton, increased risk of dyspepsia and GI bleed, well-controlled INRs
Concerns re: cost

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24
Q

Dabigatran dosing

A

110mg - noninferior (use for 80, or 75 + 1 bld risk)

versus warfarin for prevention of stroke (RELY)

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25
Q

Dabigatran side effects

A

Bleed, pain, diarrhea, dyspepsia, nausea, major bleed, ICH

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26
Q

RELY study

A

Both doses of dabigatran have decreased hemorrhagic strokes and IC bleeds
150mg BID had - more GI bleeds compared to warfarin and dabigatran
110 BID similar to warfarin for stroke and systemic embolism but less major bleeding than warfarin

27
Q

Pradax CI

A 
Prosthetic valves (RE-ALIGN) - because of increased thrombosis and bleeds
Renal impairment (CrCl<30), active bleed
28
Q

Rivaroxaban

29
Q

Xarelto dosing

A

20mg daily with food
CrCl 30-50 15mg with food
CrCl <30 not recommended

30
Q

Xarelto side effects

A

Bleeding, pruritis

Major bleed, hematoma, syncope, ICH

31
Q

ROCKET-AF

A

Afib - warfarin versus rivaroxaban

  • less hemorrhagic strokes, systemic embolism and bleeding versus warfarin
  • More GI bleeds, transfusions
32
Q

Apixaban

33
Q

Apixaban dosing

A

5mg po BID

34
Q

Apixaban ARISTOTLE

A

Apixaban versus warfarin for stroke

  • superior to warfarin for stroke and systemic embolism
  • Dec stroke, hemorrhagic stroke, mortality, major bleeds
35
Q

Trials looking at rate versus rhythm control

A

RACE, AFFIRM

36
Q

Goal HR in management of A.fib

A

110 (RACE II)

Canadian Cardiovascular society recommends <100 (majority of patients in RACE II had this target)

37
Q

Options for rate control in afib

A

beta blockers, CCB and digoxin

38
Q

BB of choice for A.fib

A

Bisoprolol 2.5-10mg daily

Metoprolol 25-200mg BID

39
Q

BB side effects

A 
lowers HR (no change in exercise capacity)
hypotension, fatigue, dizziness, insomnia, vivid dreams, sexual dysfunction, PAD, cold extremities, hypoglycemia, fluid retention
40
Q

BB contraindications

A

severe/poorly controlled asthma, 2nd-3rd degree heart block (w/o pacemaker), PR>0.24sec, symptomatic bradycardia, SBP <85, decompensated HF

41
Q

Antidote for apixaban and rivaroxaban OD

A

PCC (octaplex), recombinant factor VIIa

42
Q

Pediatric Asthma mngt continuum (6-11 yo)

A 
Salbutamol -->
ICS at lowest effective dose -->
Increase ICS dose -->
Add LABA or LTRA -->
Prednisone
43
Q

Adult asthma mnagt continuum (>12)

A

Salbutamol –>
ICS –>
Add LABA, LTRA or increase ICS –>
Prednisone

44
Q

Inhaled corticosteroids names

A 
Beclomethasone dipropionate
Budesonide
Fluticasone propionate
Ciclesonide 
Mometasone
45
Q

Beclomethasone dipropionate

46
Q

ICS side effects

A

growth (children), adrenal insufficiency, oral thrush, dysphonia

47
Q

QVAR dosing

A

Approved for >5y
50-100ug MDI ii puffs BID (usual dose)

Dose range 100-800ug/day

48
Q

Pulmicort

A

Budesonide

49
Q

Pulmicort dosing

A

Approved for > 6y
Turbuhaler 100, 200, 400 ug ii pufts BID
[dose range 400-2400ug]

50
Q

Fluticasone propionate

A

Flovent HFA or Diskus

51
Q

Flovent dosing

A

> 1y (MDI 50, 125, 250ug) ii puffs BID

>5y (Diskus 50, 100, 250, 500ug) inhaled BID

52
Q

Salbutamol

53
Q

Ventolin dosing

A

MDI 100ug (ages >4) i-ii prn
Diskus 200ug inhaled prn
Ventolin neb 2.5, 5mg/2.5ml prn

54
Q

Ventolin SE

A

tremor, nervousness, elevated HR, inc QT, headache, hypokalemia, increased insulin seretion

55
Q

LABA +ICS

A

Formoterol + Budesonide
Salmeterol + Fluticasone
Formoterol + Mometasone

56
Q

Symbicort

A

Formoterol + Budesonide

57
Q

Formoterol + Mometasone

58
Q

Salmeterol + Fluticasone

59
Q

Advair

A

Diskus (>4yo) 50ug/(100, 250, 500) - 1 BID

MDI (>12yo) 25/125; 25/250 - 1-2 inh BID

60
Q

Symbicort

A

Age >12yo

6/100ug; 6/200ug (1-4 puffs BID)

61
Q

LTRA Singulair

A

dMontelukast (4 &5mg tabs) - 10mg qhs (standard)

62
Q

LTRA side effects

A

Side effects include rare eosinophilic vasculitis, neuropsychiatric events (agitation, aggression, suicidal ideation, many others - this is not a black box warning)

63
Q

Long acting LABA use

A

in COPD ONLY

DO NOT USE IN ASTHMA WITHOUT ICS ON BOARD!

64
Q

Adenosine use

A

SVT - to abort

6mg –> 12mg dose

Medicine (5 decks)

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