Medications Flashcards
What antihypertensive medications should not be use for CHF patients
Nondihydropyridine calcium channel blocker - negative ionotropic effects
Doxazosin
What diuretic use for renal impaired patients
Furosemide
Butenamide
Ethacrynic acid
Methalazone
What are the primary intervention that can lower blood pressure
Weight reduction
Sodium reduction
Adequate potassium and calcium
Limit Etoh
Not limiting caffein or yoga or relaxation technique.
What is the diagnostic criteria for Metabolic syndrome
3 or more of the following Obesity- men waist >40 in women > 35 in Blood pressure > 130/85 FBS > 110 TG> 150 HDL < 40 in men , 50 in women's
How do you treat HTN emergency. What is the goal
Reduce the blood pressure by 25% , mins to 1 hour if stable bp of 160/100-110 in the next 2-6 hours.
What kind of mess for HTN emergency is used. How about for ischemic stroke
Rapid onset short duration mess but not foe ischemic stroke
What mess are good to use for HTN emergency associated with an MI ,which to avoid
Esmolol,
Labetalol
Clevidipine
Nicardipine
Avoid iv enalapril and short acting nifedipine
After an MI what antihypertensive improved cardiovascular outcome
Beta blocker ,ace inhibitors , aldosterone receptor agonist,
What meds are used for chronic HTN in pregnancy
Methydopa
Labetalol’ nifedipine and Procardia
What meds should not be used in pregnant women
ACE inhibitor- cause intrauterine growth restriction and renal failure
Tenormin/atenolol- IUGR
Thiazides - especially with eclampsia
What meds are used with uncontrolled HTN during active delivery
IV labetalol and hydra lazing
What antibiotics treat MRSA cellulitis
, Doxycycline, Bactrim, linezolid, vancomycin , oritavancin and dalbavancin. others like daptomycin, ceftaroline if needed.
Clindamycin too much resistance
Green medication does not cause rebound headaches
Try cyclic medications, hydroxyzine, prochlorperazine
What medication helps with prevention of migraine headache
Try cyclic, propranolol, Topiramate,divalproex sodium
List the most rapid effect of pain meds to least
Fentanyl- 3-5 min
Meperidine- 5-7 min( least preferred due to interactions w/.meds
( MAO inhibitors, SSRI, Toxic metabolites that can cause agitation and seizures
Morphine-20 min
Hydromorphone- dilaudid15-30 min
What are the symptoms of SSRI discontinuation syndrome
Somatic symptoms: URI, Gastro symptoms
Disequilibrium , sensory ( parenthesis , electric shock sensation and sleep( lethargy, myalgia)
Psychological : anxiety, c activity, the personalization, decreased concentration confusion and memory loss
1) Which SSRI is least likely to cost discontinuity syndrome
2) which has the shortest half like there cause SDS
3) which has the most anti-cholinergic activity
4) which SSRI I has the least likely to have a drug drug interaction 450
1) Fluoxetine due to long half-life
2) paroxetine and fluvoxamine shortest half life
3) Paroxetine
4) Citalopram
1) Side effect of Mirtazapine
2) which meds has a box warning for hepatic failure.
Alpha adrenergic agonist- orthostatic hypotension, hypotension, sedation, weight gain, dizziness, increase triglyceride.
Good for people w/ decrease appetite and weight loss and insomnia.
2) nefazodone- Serzone
1) What are the symptoms of serotonin syndrome
2) which antibiotic causes birth defects the most
3) which medications are toxic and overdose and can cause QT. and QRS prolongation
1) Muscle rigidity, hyperreflexia, hypothermia, confusion, agitation
2) fluoxetine and paroxetine
3) Venlafaxine and duloxetine
1) what vitamins interfere with warfarin causing INR to go up
2) vitamins in excess can cause what
a) vitamin A
b) vitamin C
c) vitamin D
d) Zinc
1) Vitamin
a) alopecia ,ataxia, gloss it’s, hepatotoxic
b) n/ v diarrhea
c) hypercalcemia, hypercalciuria, myalgia, bone demineralization
d) nausea, loss of smell and taste depressed immune function
1) which supplements can cause pseudohyperalsosteronism
2) what meds does grapefruit does not affect
3) what supplement can affect migraine
4) useful for depression
5) for insomnia
6) pregnancy related nausea
1) Licorice
2) ASA
3) Feverfew
4) St. John’s wort
5) valerian root
6) pyridoxine, doxylamine
Which supplements can prolong bleeding time
Ginkgo , garlic, feverfew, vit E, fish oil
What are the side effects of testosterone
It can cause increased risk of prostate cancer, worsening symptoms of BPH, liver toxicity and tumor, worsening of sleep apnea and heart feel year, gynecomastia come and fertility and skin disease. It is not good for patients who want to have children
Treatment for polymyalgia rheumatica
Standard initial treatment
Oral prednisone: 15 mg per day for three weeks, then 12.5 mg per day for three weeks, then 10 mg per day for four to six weeks, then decrease by 1 mg every four to eight weeks
Expect one to two years of treatment
Alternate treatment
Intramuscular methylprednisolone (Depo-Medrol): depot formulation, 120 mg every three to four weeks; decrease by 20 mg every two to three months
note: For both polymyalgia rheumatica and giant cell arteritis, treatment must be tailored to patient’s symptoms and inflammatory markers followed; in giant cell arteritis, persistence of ESR/CRP elevation
Bone protection
Patients at high risk of fracture (≥ 65 years or prior fracture): bisphosphonate, calcium, and vitamin D
Polymyalgia rheumatica, low-dose corticosteroid without high fracture risk: calcium and vitamin D, DEXA scan at onset of treatment, bisphosphonate if T-score is –1.5 or lower
Follow-up visits
Which anti-depressant with less or most sexual dysfunction
Paxil highest rate
Bupropion the least
