MSK Pharm (Exam 4)

Question 1

alendronate: Class

Answer 1

Biphosphate

Question 2

alendronate: MOA

Answer 2

Binds permanently to the surface of the bones to inhibit osteoclast activity

Question 3

alendronate: Indications

Answer 3

Osteoporosis (First line)

Reduces fractures by 50%

Question 4

alendronate: Adverse Effects

Answer 4

GI (N/V/D)

Esophageal Ulcerations (Do not lie down)

Question 5

alendronate: NSG consideration

Answer 5

Take with water (one sip in morning) (stay standing)

Do not lie down for 30 minutes after taking (esophageal ulcerations)

Do not take with food, other drinks, CALCIUM or vitamins for 2 hours (very low bioavailability)

Question 6

raloxifene: Class

Answer 6

Selective Estrogen Receptor Modulators (SERMS)

Question 7

raloxifene: MOA

Answer 7

Mimics estrogen by increasing bone density; inhibits bone resorption (osteoclasts)

Question 8

raloxifene: Indication

Answer 8

Used to TREAT and PREVENT post-menopausal osteoporosis.

Reduce spinal fracture by 50%

Question 9

raloxifene: Adverse Reaction

Answer 9

Hot flashes

Leg Cramping

Question 10

raloxifene: NSG consideration

Answer 10

Must take adequate calcium and vitamin D replacement to work

BBW: Stroke

Discontinue at least 72 hours before:
1: planned procedures.
2: Any prolonged immobilization periods

DO NOT DRINK OR SMOKE OR GET PREGNANT

Question 11

What drug do you want to discontinue at least 72 hours before planned procedure

Answer 11

raloxifene

Increase risk of clotting because it messes with estrogen

And there is decrease mobility

Question 12

Calcitonin-Salmon: MOA

Answer 12

Inhibits Bone removal by osteoclasts

ONLY TREATMENT

Question 13

Calcitonin-Salmon: Indication

Answer 13

Osteoporosis treatment only (not prevention)

Not long term

Question 14

Calcitonin-Salmon: NSG consideration

Answer 14

Give via nasal spray

Takes 5 YEARS to see long term benefit

Reduce pain in fractures

Question 15

methotrexate: Class

Answer 15

DMARD

Antineoplastic and anti-rheumatic

Question 16

methotrexate: MOA

Answer 16

Immonspurressive

Question 17

methotrexate: Indication

Answer 17

RA

Question 18

methotrexate: Adverse Reactions

Answer 18

GI

Bone Marrow Suppression (chemo drug)

Shortened life expectancy

Question 19

Methotrexate: NSG consideration

Answer 19

Only give weekly

11 BBW

Patient needs folic acid supplementation

NO alcohol (Liver involvement)

Teratogenic: (Two forms of birth control)

High risk of infection

Aplastic anemia risk when using NSAIDS (kidneys)

Question 20

hydroxychloroquine: Class

Answer 20

DMARD

antimalarial - anti-rheumatic

Question 21

hydroxychloroquine: MOA

Answer 21

Anti-inflammatory

Slow progression of RA when used in combination with other DMARDS

Question 22

hydroxychloroquine: Indicaiton

Answer 22

RA

Question 23

hydroxychloroquine: Adverse Effects

Answer 23

Vision Problems (1% Retinopathy)

Well tolerated compared to methotrexate

Question 24

Biologic Agents: Class

Answer 24

New gen DMARD

Response modifiers

Question 25

Biologic Agents: MOA

Answer 25

Target parts of the immune system that trigger inflammation that cause joint and tissue damage Target body own immune system

Question 26

Biologic Agents: Indicaiton

Answer 26

RA

Question 27

Biologic Agents: Adverse Effects

Answer 27

Skin or lung infection Skin cancer Serous allergic reactions

Question 28

Biologic Agents: NSG Consideration

Answer 28

Very expensive because of creation of biosimilars

Question 29

allopurinol: MOA

Answer 29

Inhibits the xanthine oxidase enzyme, which prevents uric acid production

Question 30

allopurinol: Indication

Answer 30

Patients whose gout is related to EXCESS uric acid production (hyperuricemia) PROPHYLACTIC DRUG ONLY

Question 31

allopurinol: Adverse Effects

Answer 31

Rash Aplastic anemia Skin (SJS/TENS)

Question 32

allopurinol: NSG consideration

Answer 32

Takes effects in 2-6 weeks and continue to take to prevent flares in the future allopurinol can increase effects of anti diabetes medications

Question 33

colchicine: MOA

Answer 33

Reduces inflammatory response to the deposits or urate crystals in joint tissues Powerful inhibitor of cell mitosis and can cause short-term leukopenia

Question 34

colchicine: Adverse Reactions

Answer 34

GI bleeding and Urinary Bleeding Stomach flu = Stop leukopenia and bone marrow suppression

Question 35

colchicine: Indication

Answer 35

Gout flares

Question 36

colchicine: NSG consideration

Answer 36

If patient has stomach flu symptoms (STOP THE DRUG ASAP) Contraindicated: Any person with severe renal, gastrointestinal, hepatic or cardiac disorders, or bleeding disorders

Question 37

probenecid: Class

Answer 37

Uricosuric Agent

Question 38

probenecid: MOA

Answer 38

Inhibits reabsorption of uric acid in kidney, promoting excretion Helps with hyperuricemia

Question 39

probenecid: Indication

Answer 39

Treat hyperuricemia with GOUT

Question 40

probenecid: Adverse Reaction

Answer 40

GI upset Dizziness or Headache Kidney/Liver impairment Lots of drug interactions

Question 41

Osteoporosis Pharmacotherapy GOAL and Primary prevention

Answer 41

Reduce fractures Primary prevention: Calcium and Vitamin D supplementation

Question 42

Osteomyelitis Pharmacotherapy

Answer 42

Obtain cultures Start broad spectrum antibiotics: -Nafcillin -Cefazolin -Vancomycin Switch to bacteria specific therapy when cultures come back

Question 43

What is the steroid of use in RA

Answer 43

Prednisone and used only when symptoms not controlled with NSAIDS