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Advanced Pharmacology > Mid Term Review > Flashcards

Mid Term Review Flashcards

1
Q

What is pharmacokinetics?

A

What body does to drug.

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2
Q

What is pharmacodynamics?

A

What drug does to body.

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3
Q

What is the first pass effect?

A

The concentration of a drug is greatly reduced before reaching systemic circulation

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4
Q

What is a prodrug?

A

A biologically inactive compound that can be metabolized in the body to produce a drug.

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5
Q

What are drug isomers?

A

Two or more different substances with same molecular formula.

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6
Q

What is bioavailability?

A

The extent a substance or drug becomes completley available to it’s intended biological destination

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7
Q

What is bioequivalence?

A

When two drugs prodouce the same effect, or two fromulations do.

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8
Q

What role does the cytochrome P450 enzyme system play in drug metabolism?

A

Poor metabolizers: toxic levels or poor effect

Rapid metabolizers: subtherapuetic levels

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9
Q

What do inducers do?

What do inhibitors do?

A

Inducers: inrease metabolism, decreaase effect
Inhibitors: decrease metabolism, increase effect

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10
Q

What is the primary site of drug elimination in the body?

A

Kidneys

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11
Q

What is the best measure of renal function to use when dosing medications?

A

GFR

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12
Q

What are the restrictions for schedule 2 medications?

A

No fax/phone.
90 days only.
No refills.

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13
Q

Who is at greatest risk for drug reactions and adverse effects?

A

Children and elderly.

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14
Q

What population does the Beers criteria apply to?

A

Those of 65

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15
Q

What is most common reasons a medication appears on Beer’s list?

A

causing falls/CNS sx

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16
Q

MOA for thiazide diuretics

A

inhibition of Na/Cl cotransporter in the renal distal tubule

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17
Q

Side effects of thiazide diuretics

A 
dizziness
blurred vision
loss of appetite
headache
weakness
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18
Q

Monitoring parameters for thiazide diuretics

A

potassium

Cr Cl

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19
Q

MOA for Ace Inhibitors

A

inhibits conversation of angiotensin to renin

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20
Q

Side effects for Ace Inhibitors

A 
cough
hyperkalemia
fatigue
hypotension
headache
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21
Q

Monitoring parameters for Ace Inhibitors

A

creatinine and potassium

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22
Q

MOA for ARBs

A

blocking receptors that AT 1 works on, heart, blood vessels, kidneys

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23
Q

Side effects of ARBs

A

less cough
less angioedema
Can’t use if pregnant

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24
Q

Monitoring parameters for ARBs

A

creatinine/K+

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25
Q

MOA for calcium channel blockers:
Dihydro
Non-Dihydro

A

Dihydro: more peripherally

Non-dihydro: mostly in heart

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26
Q

Side effects of CA channel blockers

A

avoid non-dihydro in low EF/HF

CYP inhibitors and drug reactions common in non-dihydro

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27
Q

Monitoring parameters for CA channel blockers

A

Ca

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28
Q

What class of medication can be used for treatment of nightmares and PTSD?

A

Alpha Blockers

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29
Q

Aldosterone antagonists spare what electrolyte?

A

Potassium

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30
Q

What are some unique adverse effects of aldosterone antagonists?

A

Diarrhea

High K+

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31
Q

Which drugs are high intensity statins?

A

Atorvastatin

Rosuvastatin

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32
Q

What is the most common side effect of statins?

A

Myalgias

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33
Q

What medication is preferred when treating hypertriglycerides and dyslipidemia?

A

Fenofibrate

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34
Q

Lovasa is used more as it is _____ purified and ____ likely to increase LDL.

A

More, less

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35
Q

Zetia can be used as ______ to statins.

A

Adjunct

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36
Q

What drug is now considered first line for CHF with reduced EF?

A

sacubitril/valsartan (Entresto)

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37
Q

Amniodarone has a side effect that is concerning:

A

pulmonary toxicity

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38
Q

Dronedarone

A

Less likely to cause pulmonary toxicity

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39
Q

Which antiarrythmic can only be given inpatient due to risk of QT prolongation?

A

Dofetilide (Ticasyn)

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40
Q

Match the insulins with their duration of action:

  1. Regular
  2. Glargine
  3. Lispro
  4. Degludec
  5. NPH
A. Rapid
B. Short Acting
C. Intermediate.
D. Long Acting
E. Ultra Long Acting
A
  1. B
  2. D
  3. A
  4. E
  5. C
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41
Q

MOA of metformin

A

Inhibition of hepatic glucose production

42
Q

Side effects of metformin

A

GI symptoms

43
Q

Monitoring parameters for metformin.

A

AIC

44
Q

MOA for DPP4 inhibitors

A

Glucose dependent increase in insulin secretion.

Glucose dependent inhibition of glucagon secretion.

45
Q

Side effects of DPP4 inhibitors

A

Minimal side effects, not very potent.

46
Q

MOA for GLP-1

A

Glucose dependent insulin secretion
Glucose dependent decrease in glucagon secretion
decreased gastric emptying
increased satiety

47
Q

Side effects for GLP-1

A

N/V

Weight Loss

48
Q

Monitoring for GLP-1

A

Pancreatitis

Renal fct

49
Q

MOA for SGLT

A

Reduces reabsorption of filtered glucose and lowers renal threshold for glucose, increased urinary glucose secretion (lowers plasma levels)

50
Q

Side effects for SGLT

A

GU infections

51
Q

Monitoring for SGLT

A

Renal fct

52
Q

How do sulfonureas work?

A

Increasing secretion of insulin from pancreas

53
Q

What are common side effects of sulfonureas?

A

hypoglycemia

weight gain

54
Q

Which is the drug of choice for hypothyroidism?

A

Levothyroxine

55
Q

What are administration needs for levothyroxine?

A

Morning: 30-60 min before breakfast

56
Q

Methimazole is preferred for hypothyroidism because:

A

more potent
less toxicity
(not for pregnancy)

57
Q

SABA: Albuterol

Max puffs per day

A

12

58
Q

What med shoulc a patient using a SABA also be on?

A

ICS

59
Q

LABA use in asthma.

A

Must be coupled with ICS.

60
Q

What are adverse effects of ICS?

A

Thrush, hoarseness, impaired growth in children.

61
Q

Montelukast, a leukotriene modifier, can be used in very young children, but poses what risk?

A

Neuropsychiatric symptoms

62
Q

Name a couple of LAMAs

A

Spiriva
Ellipta
Tudorza

63
Q

MOA of LAMA

A

anticholinergic

64
Q

SE of LAMAs

A

dry mouth, dizziness

65
Q

Oral option for COPD.

A

Roflumilast/Daliresp

Not a bronchodilator

66
Q

What abx is sometimes used for COPD tx?

A

Azithromycin

67
Q

_______ for productive cough.

________ for non productive cough.

A

Expectorant

Suppressant

68
Q

Should you treat cough in patients under 6?

A

No

69
Q

Which type of heparin is used more outpatient?

A

LMWH

70
Q

What is the reversal agent for heparin?

A

Protamine Sulfate

71
Q

What is the MOA for Warfarin?

A

Vit K antagonist

72
Q

What monitoring is needed for coumadin?

A

INR

73
Q

Does warfarin have many or few drug and food interactions?

A

Many

74
Q

If INR is greater than 10….

A

Consider Vitamin K (phytoin)

75
Q

Factor 10a inhibitors all have an ___ and ____ in their names.

A

X A

76
Q

What are the two classes of DOACs?

A

Direct thrombin inhbitors

Factor Xa

77
Q

What monitoring is required with DOACs?

A

Renal fct

78
Q

Why is clopidegrel now preferred over ASA?

A

Lower risk of bleeding

79
Q

What is the dose needed for daily ASA?

A

81 mg

80
Q

Why is the metabolism of clopidegrel and important consideration?

A

Can by affected by CYP polymorphisms. Lowers efficacy.

81
Q

What are some adverse effects of oral iron?

A

Darkened stools
Constipation
N/V

82
Q

What are the administration routes for B12?

A

Oral, IM, SQ

83
Q

What is the first line of treatment for GERD?

A

Lifestyle modifications

84
Q

What are some adverse effects of antacids?

A 
Chalky taste
Blood sugar increase
Renal dsyfct
Constipation (aluminum)
Diarrhea (magnesium)
85
Q

What are some issues with using PPI long term?

A

decreased calcium

86
Q

What is the primary concern with promotility agents?

A

Extrapyramidal side effects, especially TD

87
Q

What is the most common cause of PUD?

A

H. Pylori

88
Q

What is the most common cause of diarrhea?

A

Antibiotics

89
Q

Which antidepressant is also approved for quitting smoking?

A

Bupropion

90
Q

What are some limitations for rx remeron?

A

weight gain

sedation

91
Q

Should you d/c an antidepressant abruptly?

A

No

92
Q

What medication commonly paired with an SSRI can cause seratonin syndrome?

A

Trazadone

93
Q

Are benzos thought to work quickly or long term?

A

Quickly

94
Q

What populations should avoid the use of benzos?

A

Elderly

Hx of substance misuse

95
Q

How long is it recommended to taper benzos?

A

more than a year: 3-4 mos

less than a year: 2-3 weeks

96
Q

What are the drugs for sleep?

A

Z drugs

97
Q

Beta 1 action primarily occurs in the:

A

heart

98
Q

Beta 2 action occurs in the

A

lungs

One heart, two lungs

99
Q

Alpha 1 acts on vascular smooth muscle, and…

A

genital smooth muscle

100
Q

Alpha 2 acts on vascular smooth muscle and

A

platelet aggregation.

Advanced Pharmacology (9 decks)

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