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Pharm exam 5 chapters > misc highlights > Flashcards

misc highlights Flashcards

1
Q

average daily dietary intake sufficient to meet the nutrient deficiency of nearly all healthy indifiduals

A

RDA

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2
Q

average daily intake required to meet nutritional needs. (employed when experimental evidence is not enough to establish an RDA)

A

AI (adequate intake)

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3
Q

highest ave daily intake that can be consumed by nearly everyone without sig risk for adverse effect (not a recommended upper limit for intake)

A

UL (tolerable upper intake level)

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4
Q

level of intake that will meet nutrition requirements for 50% of the healthy individuals in any life stage or gender group

A

EAR (estimated average requirement)

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5
Q

range for macronutrients associated with optimal health

A

AMDR (acceptable macronutrient distribution range)

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6
Q

fat soluble vitamins

A

ADEK

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7
Q

water soluble

A

C and B complex

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8
Q

those on vegan diets may require what vitamins

A

A, B12, D and riboflavin

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9
Q

breastfed infants should be given

A

400IU of Vit D

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10
Q

women of childbearing age should receive

A

folic acid to prevent neural tube defects

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11
Q

People over 50 should be taking

A

vit B12

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12
Q

what vitamin may be beneficial for adults 65 and older

A

Vit D plus calcium

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13
Q

what vitamins recommended for postmenopausal women

A

vit D

calcium

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14
Q

what vitamin if taken in excess is linked to congenital deformities (pregnancy)

A

vit A

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15
Q

Prematurity increases risk for what vitamins

A

Vit A

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16
Q

Alcohol dependence increases risk for what vitamins

A 
Vit B1 (thiamine)
B3
B6
B7 (biotin)
B9 (folate)
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17
Q

older age increases risk for what vitamins

A

B1 (thiamine)

B12 (cobalamin)

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18
Q

HIV/AIDS increases risk for what vitamins

A

B1

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19
Q

Bariatric Surgery increases risk for what vitamins

A

B1

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20
Q

DM increases risk for what vitamins

A

B1

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21
Q

pregnancy and lactating

A

B2
B7
Vit C

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22
Q

vegan increases risk for what deficiencies

A

B2

B12

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23
Q

impaired renal function increased risk for what deficiencies

A

B6 (pyridoxine)

Vit C - those on dialysis

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24
Q

strict vegetarian increased risk for what deficencies

A

B12

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25
Q

smokers are at risk for what vit deficiency

A

Vit C

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26
Q

inadequate food sources puts you at risk for what vit def

A

Vit C

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27
Q

cancer puts you at risk for what vit def

A

Vit C

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28
Q

newborns get what vit at birth

A

Vit K

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29
Q

taking PPIs and H2 receptor agonists can put you at increased risk for what vit def

A

Vit B12 def

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30
Q

taking metformin puts you at increased risk for what vit def

A

Vit B12

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31
Q

pernicious anemia at risk for what vit def

A

vit B12

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32
Q

what vit may delay progression of age related macular degeneration

A

E

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33
Q

what vit used to prevent and treat scurvy

A

Vit C

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34
Q

symptoms of scurvy

A 
faulty bone and tooth development
loosening of teeth
gingivitis
bleeding gums
poor wound healing
hemorrhage into muscles and joints
ecchymoses
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35
Q

treat pellagra

A

nicotinamide

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36
Q

vit to reduce cholesterol

A

Vit B3 (niacin)

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37
Q

deficiency in this vit causes

sore throat
angular stomatitis (cracks at corners of mouth)
cheilosis (painful cracks in lips)
glossitis (tongue inflammation)
vascularization of cornea
itchy derm of scrotum or vulva
A

Riboflavin

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38
Q

wet beriberi

A 
severe thiamine deficiency 
causes fluid accumulation in legs
palpitations
ecg abnormalities
high output HF

responds rapidly to treatment

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39
Q

dry beriberi

A 
severe thiamine deficiency
neurologic and motor defects
anesthesia of feet 
ataxic gait
foot drop
wrist drop

responds slowly to treatment

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40
Q

serious disorder of the CNS- neuro and psych manifestations

nystagmus
diplopia
ataxia
inability to remember recent past
failure to correct -> irreversible brain damage
A

Wernicke-korsakoff

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41
Q

what should you do if you suspect Wernicke -Korsakoff

A

give parenteral thiamine immediately

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42
Q

what herb is a CYP inducer

A

St johns wort

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43
Q

what herbs suppress platelet aggregation and can increase risk for bleeding in pt receiving antiplatelet drugs

A

Ginkgo biloba
feverfew
garlic
cranberry juice

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44
Q

what herb can elevate BP and stimulate heart and CNS - therefore can intensify the effects of pressor agents, cardiac stimulants and CNS stim

A

Ma Huang (ephedra)

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45
Q

what herb should not be used to reduce hot flashes caused by tamoxifen and other SERMS

A

Black cohosh

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46
Q

interactions with Butterbur can occur with what type of drugs

A

CYP inducers

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47
Q

CoQ10 may _____ the effects of warfarin

A

antagonize

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48
Q

cranberry juice and warfarin

A

increase risk of bleeding in pt taking warfarin

49
Q

allergic reaction to echinacea

A

can cause allergic reactions such as acute asthma, urticaria, angioedema, anaphylaxis

50
Q

who needs to avoid echinacea

A

autoimmune disease (short term may stimulate immune function and long term can suppress immune function)

51
Q 
what syndrome is characterized by
 nervousness
fatigue
insomnia
tension headache
joint pain
stiffness
A

postfeverfew syndrome

52
Q

feverfew can decrease

what precautions

A

platelet aggregation and should be d/c 2 weeks before surgery

53
Q

herb that has been shown decrease plasma levels of total cholesterol and LDL

A

Flaxseed

54
Q

Cranberry juice and urine

A

does not acidify the urine

55
Q

daily consumption of cranberry juice can

A

prevent UTI

56
Q

quadruple G - antiplatelet herbs

A

Garlic
ginger
Ginko
glucosamine

57
Q

uses for peppermint

A

decrease nausea

confirmed benefit for mgmt of IBS (RCTs)

therapy for small intestinal bacterial overgrowth (SIBO)
due to antibiotic properties

prevent nipple cracking and pain when breastfeeding

functional abd pain

tension headaches (apply to temples) - comparable to tylenol

58
Q

Peppermint is bactericidal against what bacteria

A

E.coli
H.Pylori
Salmonella enterididis

59
Q

how does peppermint help with pain

A

activates opioid receptors

TRPM8 receptors in GI

60
Q

Adverse effects peppermint

A

esophageal reflux
allergic reactions have been reported
excessive can cause renal problems
perianal burning in high doses

in standard doses - no serious side effects

61
Q

peppermint oil and antispasmotics

A

may have an additive effect when taken together (Bentyl)

62
Q

garlic and cardiovascular

A

may lower BP

may decrease rate of atherosclerosis

antiplatelet effects

63
Q

garlic can reduce levels of what 2 drugs

A

cyclosporine (immunosuppressant)

Saquinavir (protease inhibitor for HIV)

64
Q

ginger is used for

A

suppression of n/v for morning sickness (proven)

motion sickness, seasickness and gen anesthesia (inconclusive)

antiinflammatory for arthritis and other chronic inflammatory (not proven)

65
Q

Ginger interactions

A

antiplatelet

lower Blood sugar

66
Q

ginko biloba used for

A

improve memory

halt progression of dementia (not proven)

decrease intermittent claudication

treatment of ED

antiplatelet

67
Q

people eating raw or roasted ginko seeds can cause

A

seizures and fatalities

68
Q

who should not take ginko

A 
seizures
people on antiplatelet drugs
antipsychotics
antidepressants
cholinesterase inhibitors
decongestants
first gen antihistamines
systemic glucocorticoids
69
Q

glucosamine and chondroitin

A

usually given together

used to treat osteoarthritis (not proven for pain relief)
American college of rheum does not recommend

70
Q

who should not take glucosamine and chondroitin

A

shellfish allergy
can raise levels of glucose
antiplatelet

71
Q

what plant is green tea made from

A

camellia sinensis plant

72
Q

uses for green tea

A

lose weight
improve mental clarity
prevent and treat cancers of stomach, skin, bladder, breast

73
Q

interactions for green tea

A

small amount of Vit K so opposes warfarin anticoagulant effects

if you take nadolol - decreases absorption of nadolol

74
Q

3 types of bacteria in probiotics

A

lactobacilli
bifidobacteria

also
Saccharomyces boulardii

75
Q

adverse effect for probiotic

A

fungemia has occured when packets of S.boulardii (florastor) have been opened at the bedside in the ICU - contraindicated in pt with central lines

blood infection with lactobacilli and fungi after yogurt in severely ill

76
Q

Resveratrol

A

antioxidant

found in red wine 
purple grape juice
blueberries
cranberries
peanuts
77
Q

Probiotics should be taken no sooner than ___ hours after dosing with antibacterial or antifungals

A

2

78
Q

interactions for Saw Palmetto

A

antiplatelet effects

79
Q

soy taken to relieve

A

hot flashes and may slow the progression of osteoporosis in perimenopausal/postmenopausal women

80
Q

soy should not be combined with

A

tamoxifen and other drugs that block estrogen receptors

MAO inhibitors (because soy contains tyramine)

81
Q

St Johns equal to what type of antidepressant

A

Tricyclic antidepressants

82
Q

St johns and digoxin

A

greatly reduces levels of digoxin

83
Q

St johns with other antidepressants and stim

MAO inhibitors
SSRIs
Tricyclic agents (amitriptyline, clomipramine)
duloxetine
nefazodone
venlafaxine
A

Serotonin syndrome

84
Q

Valarian root works on

A

GABA agonist

85
Q

harmful supplements to avoid

A

comfrey - severe liver damage

kava - severe liver damage

Ephedra - stroke, MI, death

86
Q

intermediate acting insulin

A

NPH (Humulin N, Novolin N)

87
Q

Long acting insulins

A 
INsulin glargine (lantus)
Insulin detemir (levemir)
88
Q

Ultralong insulins

A 
Insulin glargine (U-300) (Toujeo)
INsulin degludec (TResiba)
89
Q

difference in methotrexate and entanercept

A

methotrexate is a traditional dmard

etanercept (enbrel) is a biologic dmard - no live vaccines, TB and Hep B testing prior to start, close monitoring of CBC

90
Q

bisphosphonate used to prevent and treat osteoporosis in postmenopausal women

A

Alendronate (Fosamax)

91
Q

education important for Alendronate (Fosamax)

A

Esophagitis is the primary concern
take with full glass of water and sit/stand for 30 min

rarely musculoskeletal pain
atypical femur fractures

92
Q

while a pt is on Cromolyn for allergic conjunctivitis

what can you prescribe while that begins to work?

A

2+ weeks to become max effective

antihistamines (H1 receptor antagonists)
-azelastine and olopatadine

NSAID - Ketorolac / glucocorticoid (loteprednol)

ocular decongestants - naphazoline and phenylephrine

93
Q

congenital hypothyroidism can cause

A

developmental problems

94
Q

when is the fetal thyroid fully functional

A

second trimester - at this point the fetus can supply their own thyroid hormones

95
Q

when women taking thyroid supplements become pregnant how does their dosage change

A

by as much as 50%

need increased between weeks 4-8 of gestation and levels off by week 16 and stays teady until partuition

96
Q

hypothyroid in newborn. how long to continue meds before trial

how long is trial

If TSH is high what does that mean

A

3 years

4 weeks off

test TSH and T4

if TSH is high - then they are hypothyroid, continue meds

if TSH is normal - d/c meds, it was transient

97
Q

if TSH is low, hypo or hyper thyroid

A

Hyperthyroid

98
Q 
hyperthermia (105 or higher)
severe tachycardia
restlessness
agitation
tremor

after surgery or sepsis

A

Thyrotoxic crisis (thyroid storm)

unconsciousness
coma
hypotension
heart failure may ensue

99
Q

what do you give for thyroid storm

A

high doses of potassium iodide or strong iodine solution

b blocker for heart rate

sedation, cooling, giving glucocorticoids
iv fluids

100
Q

pregnant with thyroid storm

A

PTU

101
Q

levothyroxine and warfarin

A

levothyroxine accelerates the degradation of vit K dependent clotting factors - > effects of warfarin are enhanced - warfarin needs to be reduced

102
Q

if someone needs to switch synthroids what is important to know

A

once you start you don’t want to switch because bioavailability can be different

monitor closely

103
Q

if someone on synthroid when do you re-evaluate levels

A

1 month to reach plateau
6-8 weeks after starting treatment
check at least once a year after dosing is established

104
Q

increased TSH means

A

hypothyroid

105
Q

how often should a diabetic taking insulin check their blood glucose

A

6-7 xs a day

106
Q

step 1 for treating type 2 DM

A

lifestyle changes and metformin

107
Q

at diagnosis for t2DM, when do you skip to step 2 for treatment

A

A1c of 9% or greater at time of diagnosis

108
Q

what opioid has the lowest risk for abuse

A

Petazocine (Talwin)

109
Q

most common adverse effect of bisphosphonates

A

esophagitis
muscle pain rair
osteonecrosis of jaw rare

110
Q

QT prolongation meds

A

methadone
Butrans
Hydroxychloroquine

111
Q

first line for RA treatment

A

methotrexate - takes 3-6 weeks to work

NSAIDS in the mean time
still doesnt work
glucocorticoid -

112
Q

someone on methotrexate needs what nutritional supplement

A

folic acid

113
Q

what NSAID is a second gen approved for RA that will only inhibit cox 2 - easier on stomach

A

Celebrex

114
Q

triptans and SSRI

A

cannot take together - serotonin syndrome

if need the SSRI (Fluoxetine - Prozac), wait 24 hours and start on Ergo (Elavil)

115
Q

taking Elavil and now has cold hands, feet with nausea

A

erotism -stop the ergo

116
Q

Boniva (ibandronate) is given for

what organ do you need to be careful with this one

what route and how often

A

postmenopausal osteoporosis - only for this

renal function checked before each dose

PO once a month - must sit up for 60 min after taking
or
IV every 3 months

117
Q

older than 60 on steroids long time, what are measures to prevent osteoporosis

A

check baseline vit d

give vit d and calcium

118
Q

as kids grow what happens with synthroid dose

A

increase as they grow, monitor TSH

Pharm exam 5 chapters (15 decks)

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