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Things to know > Naplex things to know > Flashcards

Naplex things to know Flashcards

1
Q

What is the acronym for Major Inducers?

A

PS PORCS

Phenytoin
Smoking
Phenobarbital
Oxcarbazepine
Rifampin
Carbamazepine
St. John's Wort
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2
Q

What do Major inducers do to drug levels?

A

Major inducers decrease drug levels

PS PORCS
Phenytoin
Smoking
Phenobarbital
Oxcarbazepine
Rifampin
Carbamazepine
St. John's Wort
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3
Q

What are the major inducers (7)?

A

PS PORCS

Phenytoin
Smoking
Phenobarbital
Oxcarbazepine
Rifampin
Carbamazepine
St. John's Wort
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4
Q

What is the acronym for Major Inhibitors?

A

G-PACMAN

Grapefruit
Protease Inhibitors (ritonavir)
Azoles
C- Cyclosporin, Cimetidine, cobistat 
Macrolides - BUT not azithromycin
Amiodarone
Non-DHP CCB (diltiazem and verapamil)
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5
Q

What do Major Inhibitors do to drug levels?

A

Major inhibitors increase levels – Then INHIBIT the metabolism to elimination.

G-PACMAN
Grapefruit
Protease Inhibitors (ritonavir)
Azoles
C- Cyclosporin, Cimetidine, cobistat 
Macrolides - BUT not azithromycin
Amiodarone
Non-DHP CCB (diltiazem and verapamil)
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6
Q

What are the major Inhibitors? (7-11)

A

G-PACMAN

Grapefruit
Protease Inhibitors (ritonavir)
Azoles
C- Cyclosporin, Cimetidine, cobistat 
Macrolides - BUT not azithromycin
Amiodarone
Non-DHP CCB (diltiazem and verapamil)
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7
Q

What is the preferred nasal steroid in pregnancy?

A

budesonide (Rhinocort) is the preferred nasal steroid in pregnancy

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8
Q

What are the preferred oral antihistamines in pregnancy?

A

Zyrtec and Claritin are the preferred oral antihistamines in pregnancy

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9
Q

Intranasal ipratropium bromide (Atrovent) is only good for decreasing rhinorrhea caused by?

A

Intranasal ipratropium bromide (Atrovent) is only good for decreasing rhinorrhea caused by nasal dryness

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10
Q

Which Intranasal must be used scheduled, not PRN?

A

Intranasal cromolyn (Nasalcrom) must be used scheduled, NOT PRN

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11
Q

What age group should you NOT use ceftriaxone in?

A

do NOT use ceftriaxone in neonates (<28days)

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12
Q

What should you use as malaria prophylaxis for preggos and children?

A

Chloroquine or mefloquine (Lariam) dosed WEEKLY

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13
Q

What is something that can decrease the absorption of allopurinol (Zyloprim)?

A

Antacids decrease allopurinol absorption

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14
Q

What is first line in CKD?

A

Phos binders –> calcium based (Tums, PhosLo) is first line due to price

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15
Q

What is the generic name of Renvela? What is it used for?

A

Sevelamer (Renvela) –> used for CKD, is non-calcium, non-aluminum, not systemically absorbed. Also lowers total cholesterol and LDL ~15-30%

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16
Q

In addition to CKD what does Sevelamer (Renvela) also do?

A

Sevelamer (Renvela) also lowers total cholesterol and LDL ~15-30%

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17
Q

When is erythropoietin (ESA) used in CKD?

A

ESA is only used when hemoglobin is <10 and discontinued if > 11

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18
Q

What forms of Hepatits are vaccines available for?

A

vaccines are available for Hep A and Hep B

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19
Q

What is fist line OTC for headache/pain in cirrhosis pts?

A

Tylenol is first line OTC for headache/pain in cirrhosis pts. it is safer than NSAIDS due to risk of GI bleed, blunting and diurectic response, and exacerbating renal dysfunction.

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20
Q

What vaccinations do you need if you have Asplenia?

A
  1. H. influenza type B
  2. Pneumococcal
  3. Meningococcal
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21
Q

What is the MOA of triptans?

A

5-HT1 agonist and cause vasoconstriction of cranial blood vessels

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22
Q

What is the starting dose for Viagra, Revatio?

A

Sildenafil (Viagra, Revatio) - starting dose is 50mg

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23
Q

What is the starting dose for Cialis, Adcirca?

A

tadalafil (Cialis, Adcirca) - start dose is 10mg

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24
Q

What is the starting dose for Levitra, Staxyn ODT?

A

Vardenafil (Levitra, Staxyn ODT) - start dose is 10mg

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25
Q

What is the Start dose for Stendra?

A

Avanafil (Stendra) - start dose is 100mg

Use 50mg if pt >65 years, using a 3A4 inhibitor, using an alpha blocker, severe renal/liver impairment.

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26
Q

What is the generic of Kapvay?

A

Clonidine ER (Kapvay) this brand is used for ADHA

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27
Q

What is the generic of Intuniv?

A

guanfacine ER (Intuniv) used for ADHA

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28
Q

What are the main SE’s of Kapvay and Intuniva?

A

Clondidine ER (Kapvay) and guanfacine ER (Intuniv) are sedating and lower blood pressure.

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29
Q

What is the generic of Focalin?

A

Dexmethylphenidate

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30
Q

What is the generic of Concerta?

A

Methylphenidate (Concerta, Ritalin, Quillivant)

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31
Q

what is the generic of Ritalin

A

Methylphenidate (Concerta, Ritalin, Quillivant)

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32
Q

what is the generic of Quillivant

A

Methylphenidate (Concerta, Ritalin, Quillivant)

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33
Q

Which BZDs are preferred in elderly because they are metabolized to inactive compounds (glucuronides)

A

LOT (Lorazepam, oxazepam, temazepam)

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34
Q

What is Temazepam (Restoril) indicated for?

A

Temazepam (Restoril) is longer acting and NOT indicated for anxiety. It is used for sleep.

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35
Q

What is the main medication used for Alzheimer’s?

A

Aricept (Donepezil)

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36
Q

What medication is added to Donepezil in moderate to severe Alzheimer disease. What is the combonation called?

A

Memantine (Namenda), the combo pill is Namzaric

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37
Q

When do you take Donepezil (Aricept)?

A

take at night due to nausea. “sleep through” the nausea so during the day the nausea is not so bad. Other side effects include: insomnia, bradycardia, tremors.

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38
Q

What does the term comminution mean?

A

comminution means to reduce solids from an average particle size to a smaller average particle size.

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39
Q

Magnesium stearate is an example of a?

A

magnesium stearate is an example of glidant/lubricant = improves flowability of powder.

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40
Q

Sodium lauryl sulfate is and example of a?

A

sodium lauryl sulfate is and example of a Surfactant = neutralizes static charge and keeps powder from floating away.

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41
Q

Magnesium oxide, magnesium carbonate and kaolin are examples of ?

A

Magnesium oxide, magnesium carbonate and kaolin are examples of adsorbent = keeps powder dry

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42
Q

What does the term eutectic mean?

A

eutectic = two components, when mixed, will melt at a lower temperature than either individual melting point.

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43
Q

What 2 things are used as plasticizers - used to make capsules less brittle/more flexible?

A

glycerol, sorbitol

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44
Q

Between lotion, cream, ointment, which one contains the most water?

A

Lotion contains the most water.

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45
Q

Between lotion, cream, ointment, which one contains the most oil?

A

Ointment contains the most oil.

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46
Q

What is Pluronic lecithin organogel (PLO) used for?

A

Pluronic lecithin organogel (PLO) is used for transdermal drug delivery - gel = semisolid impenetrable by liquid.

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47
Q

What is an emulsion?

A

emulsion = liquid dispersed in liquid.

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48
Q

What is an emulsifier?

A

emulsifier = Surfactant that reduces surface tension between oil and water.

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49
Q

What is an suspension?

A

Suspension is a solid dispersed in liquid

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50
Q

What are wetting agent/levigating agent?

A

Wetting agent/levigating agent - Surfactant that helps incorporate insoluble drug into liquid.

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51
Q

Low HLB < 10 (lipophilic) are more ____ soluble and used for ______ emulsions

A

Low HLB < 10 (lipophilic) are more oil soluble and used for water-in-oil (w/o) emulsions

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52
Q

Low HLB > 10 (hydrophilic) are more _____ soluble and used for _____ emulsions

A

Low HLB > 10 (hydrophilic) are more water soluble and used for oil-in-water (o/w) emulsions

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53
Q

What is the BUD for non-aqueos formulations

A

The BUD for non-aqueous formulations = any API or 6 months

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54
Q

What is the BUD for water containing oral formulations in the fridge?

A

14 days in the fridge

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55
Q

What is the BUD for water containing topical/dermal/mucosal liquid?

A

30 days

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56
Q

What is a Type 1 error?

A

Type 1 error = false-positive –> the nullhypothesis is rejected in error –> think there is a difference but there isnt one

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57
Q

what is a Type 2 error?

A

Type II error = false negative –> the null hypothesis is accepted in error –> think that there is no difference but there acutally is.

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58
Q

What is Sensitivity?

A

Sensitivity = true positive –> how well a test identifies that you actually do have the condition.

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59
Q

What is Specificity?

A

Specificity = true negative, how well a test identifies that you do NOT have a condition. –> you Specifically do NOT have the disease

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60
Q

What class = reasonable probability that use will cause serious adverse health consequences/death?

A

Class I recall = reasonable probability that use will cause serious adverse health consequences/death

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61
Q

What class = probability of temporary/reversible adverse health consequences are remote?

A

Class II recall = probability of temporary/reversible adverse health consequences are remote

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62
Q

What class = Not likely to cause adverse health consequences?

A

Class III recall = Not likely to cause adverse health consequences

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63
Q

What is the Independent variable?

A

The independent variable = the intervention (ie., the drug)

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64
Q

What are the 3 first line drugs for ADHD?

A

Concerta, Vyvanse, Adderall XR

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65
Q

What is used 2nd line, or if abuse risk for ADHD?

A

Strattera

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66
Q

When do you use the Student/Unpaired T-test?

A

When Numerical/continuous Data, normal distribution, with Two groups

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67
Q

When do you use the ANOVA (or F-test)?

A

When Numerical/continuous Data, normal distribution, with three groups

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68
Q

Which Cost Analysis - Includes a quality of life (QALYs) component?

a. Cost minimization analysis (CMA)
b. Cost benefit Analysis (CBA)
c. Cost effectiveness Analysis
d. Cost Utility Analysis

A

Cost Utility Analysis - Includes a quality of life component

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69
Q

Which Cost Analysis - is used when two or more interventions have already demonstrated equivalency in outcomes and the costs of each intervention are being compared.

a. Cost minimization analysis (CMA)
b. Cost benefit Analysis (CBA)
c. Cost effectiveness Analysis
d. Cost Utility Analysis

A

Cost minimization analysis - is used when two or more interventions have already demonstrated equivalency in outcomes and the costs of each intervention are being compared.

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70
Q

Which Cost Analysis - have both the benefits and costs expressed in terms of dollars and are adjusted to their present value.

a. Cost minimization analysis (CMA)
b. Cost benefit Analysis (CBA)
c. Cost effectiveness Analysis
d. Cost Utility Analysis

A

Cost Benefit Analysis - have both the benefits and costs expressed in terms of dollars and are adjusted to their present value.

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71
Q

Which Cost Analysis - is defined as a series of analytical and mathematical procedures that aid in the selection of a course of action from various alternative approaches. Inputs are usually measured in dollars and outputs are usually measured in natural units.

a. Cost minimization analysis (CMA)
b. Cost benefit Analysis (CBA)
c. Cost effectiveness Analysis
d. Cost Utility Analysis

A

Cost effectiveness Analysis - is defined as a series of analytical and mathematical procedures that aid in the selection of a course of action from various alternative approaches. Inputs are usually measured in dollars and outputs are usually measured in natural units.

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72
Q

What is the dependent variable?

A

The dependent variable is what is affected by the independent variable. AKA the outcome of interest. change in BP, A1C, hemoglobin, ect.

73
Q

What type of study compares pt with disease to those without disease. Retrospective?

a. Case-control
b. Cohort study
c. Cross-sectional survey
d. Case report and case series
E. Meta analysis
F. Randomized control
G. Systemic review

A

Case-control - type of study compares pt with disease to those without disease. Retrospective

74
Q

What type of study compares outcomes of pt exposed to treatment and those not exposed to see if develop the outcome?

a. Case-control
b. Cohort study
c. Cross-sectional survey
d. Case report and case series
E. Meta analysis
F. Randomized control
G. Systemic review

A

Cohort study - type of study compares outcomes of pt exposed to treatment and those not exposed to see if develop the outcome. Prospective (more common) or retrospective

75
Q

What type of study estimates relationship between variables and outcomes at one particular time?

a. Case-control
b. Cohort study
c. Cross-sectional survey
d. Case report and case series
E. Meta analysis
F. Randomized control
G. Systemic review

A

Cross-sectional survey - type of study estimates relationship between variables and outcomes at one particular time?

76
Q

What type of study describes adverse reaction in a single patient or a few patients?

a. Case-control
b. Cohort study
c. Cross-sectional survey
d. Case report and case series
E. Meta analysis
F. Randomized control
G. Systemic review

A

Case report and case series - type of study describes adverse reaction in a single patient or a few patients

77
Q

What order is the most reliable study?

a. Case-control
b. Cohort study
c. Cross-sectional survey
d. Case report and case series
E. Meta analysis
F. Randomized control
G. Systemic review

A 
Most reliable
Meta analysis
Randomized control
Cohort
Case control
Case reports
Expert opinion
78
Q

What type of study combines results from multiple studies in order to develop a conclusion that has greater statistical power than the individual studies

a. Case-control
b. Cohort study
c. Cross-sectional survey
d. Case report and case series
E. Meta analysis
F. Randomized control
G. Systemic review

A

Meta analysis - type of study combines results from multiple studies in order to develop a conclusion that has greater statistical power than the individual studies

79
Q

What type of study compares an experimental treatment to the current or placebo to determine which is better?

a. Case-control
b. Cohort study
c. Cross-sectional survey
d. Case report and case series
E. Meta analysis
F. Randomized control
G. Systemic review

A

Randomized control - type of study compares an experimental treatment to the current or placebo to determine which is better

80
Q

Gram positive, stain purple, clusters would likely be what?

A

MRSA/MSSA

81
Q

What color do Gram Negative stain?

A

Gram negative = pink/red

82
Q

What three groups of antibiotics are Cmax:MIC (Concentration dependent)?

A

aminoglycosides, quinolones, daptomycin

83
Q

What Three groups of antibiotics are AUC:MIC

A

Vanc, Macrolides, tetracyclines

84
Q

What Three groups of antibiotics are TIme>MIC

A

Penicillins, cephalosporins, carbapenems.

85
Q

What is the drug of choice for syphilis?

A

Penicillin G benzathine (Bicillin L-A) = drug of choice for syphilis (2.4 million units IM x1)

86
Q

What medication do you use for PCN allergy?

A

Aztreonam (Azactam) - can be ued with PCN allergy –> Only treats gram negative

87
Q

What is the treatment for a neonate with meningitis?

A

neonate = ampicillin + cefotaxime OR gentamicin

Remember, no ceftriaxone in neonates < 28 days

88
Q

What is the treatment for babies with meningitis?

A

Ceftriaxone + Vancomycin

89
Q

What is the treatment for normal people 2-50 years old?

A

Ceftriaxone + Vancomycin

90
Q

what is the treatment for elderly or immunocompromised with meningitis?

A

Ceftriaxone + Vancomycin + ampicillin

91
Q

What do you for Meningitis if the pt has a PCN allergy?

A

quinolone + vancomycin +/- Bactrim

92
Q

Outpatient CAP: pt hasn’t had abx in past 3 months and is previously healthy. what can you give?

A

Macrolide OR doxycycline

93
Q

Outpatient CAP: pt has risk for drug resistant Strep pneumo or abx use within 3 months or chronic disease or immunocompromised. What can you give?

A
  1. Beta lactam + Macrolide
    OR
  2. Respiratory quinolone monotherapy (Moxifloxacin, gemifloxacin, or levofloxacin)
94
Q

How should Opana ER (oxymorphone) be taken relative to food?

A

Opana ER should be taken on an empty stomach

95
Q

What are the Five A’s for smoking cessation?

A
  1. Ask about tobacco use
  2. Advise to quit
  3. Assess willingness to make an attempt
  4. assist in quit attempt
  5. Arrange follow up
96
Q

When do you start with 21mg nicotine patch vs the 14mg patch?

A

If > 10 cigs/day, start with 21 mg patch

If < 10, start with 14mg patch

97
Q

What is a main SE of the nicotine patch?

A

Vivid dreams

98
Q

When do you use 2mg nicotine gum vs the 4mg gum?

A

If the 1st cig > 30 min after waking up, use 2mg gum/lozenge

If 1st cig < 30 min after waking up, use 4mg gum/lozenge

99
Q

For weeks 1-6 how often do you take the nicotine gum?

A

weeks 1-6 use Q1-2 hours

100
Q

For weeks 7-9 how often do you take the nicotine gum?

A

Weeks 7-9 use q2-4hours

101
Q

For weeks 10-12 how often do you take the nicotine gum?

A

weeks 10-12 use Q4-8hours

102
Q

When do you start bupropion/chantix relative to the quit date?

A

start bupropion/Chantix 1 week before the quit date.

103
Q

What is the cystic fibrosis treatment order?

A

cystic fibrosis treatment order –> Bronchodilator (albuterol), hypertonic saline, dornase alfa, chest physiotherapy, inhaled antibiotics (Tobramycin, oral azithromycin)

104
Q

Is Creon and Lip-Prot-Amyl interchangeable?

A

Pancreatic enzyme products are NOT interchangeable. SO NO

105
Q

What is the most common cause of Hypothyroid disease?

A

Hashimoto’s disease –> an autoimmune condition where pt antibodies attack their own thyroid gland

106
Q

What will the FT4 and TSH labs show in Hypothyroidism?

A

Hypothyroidism will show low FT4 (Free thyroxine) and elevation in TSH(Thyroid stimulating hormone).

107
Q

When should Levothyroxine be taken?

A

Levothyroxine should be taken with water consistently at least 60 minutes beofre breakfast or at bed time (at least 3 hours after the last meal).

108
Q

What is the most common cause of Hyperthyroid disease?

A

Graves disease –> antibodies stimulate thyroid to produce too much T4

109
Q

How do you treat myxedema coma?

A

myxedema coma –> treat with IV levothyroxine

110
Q

How do you treat Thyroid storm?

A

Thyroid strom –> treat with propylthiouracil (PTU) + Iodide (SKKI or Lugol’s) + beta blocker (Propranolol) + systemic steroid + acetaminophen

111
Q

What is the normal starting dose of levothyroxine?

A

normal pts start levothyroxine 1.6mcg/kg IBW

Pts with known CAD start levothyroxine 12.5-25mcg

112
Q

Which steroid is used for Addison’s disease?

A

Fludrocortisone mimics aldosterone due to its mineralcorticoid activity that balances water and electrolytes. FDA approved for Addison’s disease. Used off-label for orthostasis.

113
Q 
What is the steroid conversion?
Cortisone
Hydrocortisone
prednisone
Prednisolone
Methylprednisolone
Triamcinolone
Dexamethasone
Betamethasone
A 
Cortisone - 25
Hydrocortisone - 20
prednisone - 5
Prednisolone - 5
Methylprednisolone - 4
Triamcinolone - 4 
Dexamethasone - 0.75
Betamethasone - 0.6
114
Q

what is the relation of Cushing’s and Addison’s disease to cortisol?

A 
Cushing's = too much cortisol
Addison's = not enough cortisol
115
Q

Allopurinol increases azathioprine (Azasan) concentration, how much should the dose be reduced by?

A

Allopurinol increases azathioprine concentration. Reduce dose of azathioprine ~75%

116
Q

What is the maximum dose of Calcium due to saturability?

A

Max calcium dose at one time is 600mg due to saturability. Split doses.

117
Q

Increased COX-2 selectivity = lower GI risk
Place in order of least GI risk
Celebrex, Relafen, Lodine, Voltaren, Mobic

A 
Lower GI RIsk =
Celecoxib (Celebrex)
Diclofenac (Voltaren)
Meloxicam (Mobic)
Etodolac (Lodine)
Nabumetone (Relafen)
118
Q

What is preferred in a COPD, Asthma patient with glucoma?

A

Betaxolol (Betopic S) = preferred in COPD, asthma pt with glaucoma. Selective beta blocker.

119
Q

What ANC value represents neutropenia?

A

neutropenia = ANC < 1000

120
Q

What ANC value represents Severe neutropenia?

A

Severe neutropenia = ANC < 500

121
Q

What ANC value represents Profound Neutropenia?

A

profound neutropenia = ANC < 100

122
Q

What ANC value represents Profound Neutropenia?

A

profound neutropenia = ANC < 100

123
Q

Why does Bleomycin have a max dose of 400 units?

A

Bleomycin = max dose 400 units = pulmonary toxicity

124
Q

Why does doxorubicin have a max dose of 450-550 mg/m2?

A

doxorubicin = max dose 450-550 mg/m2 = cardiotoxicity

125
Q

why does cisplatin have a max dose of 100mg/m2?

A

Cisplatin - dose per cycle NOT to exceed 100mg/m2 = nephrotoxicity

126
Q

Why is vincristine’s dose capped at 2mg?

A

Vincristine = single dose capped at 2mg = neuropathy

127
Q

What is a common SE of fluorouracil?

A

fluorouracil = hand foot syndrome

128
Q

what is a common SE of methotrexate?

A

stomatitis/mucositis

129
Q

How is the MCV related to anemia?

A

Low MCV = microcytic

High MCV = macrocytic

130
Q

What is Macrocytic anemia caused by?

A

Macrocytic anemia is caused by b12 or folate deficiency

131
Q

10 drugs/classes that can cause Hemolytic anemia?

A

beta-lactamase inhibitors, cephalosporins, isoniazid, levodopa, methyldopa, penicillins, platinum chemo drugs, quinidine, ribavirin, rifampin

132
Q

what are 8 medications that are high risk with G6PD deficiency?

A

chloroquine, dapsone, methylene blue, nitrofurantoin, primaquine, probenecid, rasburicase, sulfonamides.

133
Q

What is valbenazine (Ingrezza) approved for?

A

Valbenazine (Ingrezza) is approved for tardive dyskinesia

134
Q

What is the common SE of Zyprexa?

A

olanzapine (zyprexa) = SE include metabolic abnormalities

135
Q

What is the trough range for lithium?

A

lithium therapeutic range = 0.6-1.2 MEq/L (trough)

136
Q

What are the three colors of the does for lamictal?

A 
orange = standard starting dose
Blue = lower starting dose = use if taking valproic acid
green = higher starting dose = used if taking other enzyme inducer and NOT taking valproic acid
137
Q

When should you call 911 for a seizure?

A

Call 911 if seizure lasts > 5 minutes

138
Q

Focal vs generalized seizure?

A

Focal = starts on one side of the brain

Generalized starts on BOTH sides of the brain.

139
Q

define status epilepticus

A

Status epilepticus is a seizure lasting ? 5 minutes and can cause brain damage/fatality

140
Q

5-20 minutes into a seizure what can you give?

A

5-20 minutes = give IM midazolam OR IV lorazepam OR Rectal diazepam

141
Q

20 40 minutes into a seizure what can you give?

A

20-40 minutes = give regular AED option (IV fosphenytoin, valoprooic acid, keppra, phenobarb if others not available

142
Q

40+ minutes into a seizure what can you give?

A

40+ minutes = shit out of luck

143
Q

Why should all patients on Anticonvulsants be supplemented with calcium and vit D?

A

Anticonvulsants depress electrical activity in the brain, cause BONE loss and increased Fracture risk. All pts should be supplemented with calcium and vit D.

144
Q

What does Depakote (Valproic acid) have a BBW for?

A

Depakote (valproic acid) = BBW for hepatotoxicity

145
Q

How must phenytoin be given?

A

Phenytoin = normal saline only + filter needle

146
Q

primidone (mysoline) is a prodrug of?

A

Primidone (mysoline) is a prodrug of phenobarbital

147
Q

Which dhp CCB is more selective for cerebral arteries due to its increased lipophilicity and is PO ONLY?

A

nimodipine (Nymalize) = dhp CCB that is more selective for cerebral arteries due to its increased lipophilicity and is PO ONLY

148
Q

What are the ONLY two IV PPIs?

A

only two IV PPIs = esomeprazole and pantoprazole

149
Q

Which USP is used for Hazardous drugs?

A

USP 800. ASHP provides guidance for implementing these standards

150
Q

What are the Three types of hazardous drugs (HD)?

A

Three type of hazardous drugs (HD) = Antineoplastic(Cancer drugs), non-antineoplastic (hormones, transplant), and drugs with reproductive risk.

151
Q

What is an error of omission?

A

error of omission = something was left out that is needed for safety

152
Q

What is an error of commission?

A

error of commission = something was done incorrectly

153
Q

When should you use Soap and water instead of alcohol based rubs

A
  1. Before eating
  2. After using the restroom
  3. anytime there is visible soil
  4. After caring for a C. diff patient
  5. before caring for a pt with food allergies
154
Q

What are Type A and Type B adverse drug reactions?

A

Adverse drug reactions = predictable (Type A) and unpredictable (Type B)

155
Q

What is the Naranjo scale?

A

Naranjo scale (causality assessment scale) helps determine likelihood a drug caused an adverse reaction.

156
Q

What is the name of the FDA’s adverse drug reaction reporting program?

A

Side effects, adverse events, and allergies should be reported to FDA’s MedWatch program = FDA adverse event reporting system (FAERS)

157
Q

How do you treat a preggo pt with syphilis and penicillin allergy?

A

Preggo pt with syphilis and penicillin allergy should be desensitized and treated

158
Q

The amount of drug removed per hour is the same - describes what kind of kinetics?

A

Zero order kinetics = amount of drug removed per hour is the same (eg., 300mg)

159
Q

The percent of drug removed per hour is the same - describes what kind of kinetics

A

First order kinetics = percent of drug removed per hour is the same (eg.,15%)

160
Q

Give 3 examples of drugs that follow non-linear/saturable /mixed/michaelis-menten kinetics

A

Voriconazole, phenytoin, theophylline

= doubling the dose can more than double serum concentrations

161
Q

How do you treat shock?

A
  1. Fill the tank (Optimize preload with IV crystalloid bolus)
  2. Squeeze the pipes (peripheral vasoconstrictor with alpha-1 agonist(phenylephrine) to increase SVR))
  3. Kick the pump (beta-1 agonist to increase myocardial contractility and CO)
162
Q

How many mcg of folic acid do preggo’s need? How much do women of child bearing age need?

A

preggo women need 600mcg/day folic acid

Women of child bearing age need 400mcg/day

163
Q

How much calcium and vitamin D do Preggo’s need?

A

preggo women need 1000mg/day of calcium and 600 IU/day of Vitamin D.

164
Q

What 3 medications should you use for HTN in preggos?

A

Labetolol, methyldopa, nifedipine

165
Q

How much do you need to increase the dose of levothyroxine during pregnancy?

A

Need to increase levothyroxine 30-50% during pregnancy

166
Q

If drugs needed for hyperthyroidism in during pregnancy what do you use?

A

if drugs need for hyperthyroidism, use PTU in 1st trimester and methimazole in 2nd and 3rd trimester.

167
Q

Babies receiving breast milk need how many IU of vitamin D until the are consuming 1 liter vitamin D fortified formula per day?

A

Babies receiving breast milk need 400IU of vitamin D until the are consuming 1 liter vitamin D fortified formula per day

168
Q

How much Iron should babies receive during the first 4-6 months?

A

Breastfed babies also need 1mg/kg iron during months 4-6.

169
Q

What can procainamide and quinidine cause?

A

Procainamide and quinidine can cause lupus

170
Q

what are the Class I (NA blockers) used for arrhythmias?

A

1a. Disopyramide, quinidine, procainamide
1b. lidocaine, mexiletine
1c. Flecainide, propafenone

171
Q

What are the Class II Anti arrhythmic drugs?

A

Beta blockers

172
Q

What are the class III (K block) anti arrhythmic drugs

A

dronedarone, dofetilide, sotalol, ibutilide, amiodarone

173
Q

What are the class IV Anti arrhythmic drugs

A

Verapamil, diltiazem

174
Q

What is the VTE prophylaxis dose of Heparin?

A

VTE prophylaxis = 5000 units SQ Q8-12H

175
Q

What is the VTE treatment dose of Heparin?

A

VTE treatment = 80units/kg IV bolus + 18units/kg/hr

176
Q

What is heparin ACS/STEMI treatment dose?

A

ACS/STEMI treatment = 60units/kg IV bolus + 12 units/kg/hr

177
Q

What is the antidote used for heparin toxicity?

A

Heparin antidote = protamine sulfate

178
Q

When do take enoxaparin anti-Xa levels?

A

Enoxaparin anti-XA levels = take a peak level 4 hours post dose

179
Q

drugs/classes that can raise blood sugar (12)

A 
Azoles
Beta agoinst
Beta blockers
Diuretics
Tacrolimus/cyclosporine
niacin
protease inhibitors 
quinolones 
antipsychotics
statins 
steroids

Things to know (34 decks)

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