Naplex things to know COPY Flashcards
1
Q
What is the acronym for Major Inducers?
A
PS PORCS
Phenytoin Smoking Phenobarbital Oxcarbazepine Rifampin Carbamazepine St. John's Wort
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
3
Q
What are the major inducers (7)?
A
PS PORCS
Phenytoin Smoking Phenobarbital Oxcarbazepine Rifampin Carbamazepine St. John's Wort
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)
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)
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)
7
Q
What is the preferred nasal steroid in pregnancy?
A
budesonide (Rhinocort) is the preferred nasal steroid in pregnancy
8
Q
What are the preferred oral antihistamines in pregnancy?
A
Zyrtec and Claritin are the preferred oral antihistamines in pregnancy
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
10
Q
Which Intranasal must be used scheduled, not PRN?
A
Intranasal cromolyn (Nasalcrom) must be used scheduled, NOT PRN
11
Q
What age group should you NOT use ceftriaxone in?
A
do NOT use ceftriaxone in neonates (<28days)
12
Q
What should you use as malaria prophylaxis for preggos and children?
A
Chloroquine or mefloquine (Lariam) dosed WEEKLY
13
Q
What is something that can decrease the absorption of allopurinol (Zyloprim)?
A
Antacids decrease allopurinol absorption
14
Q
What is first line in CKD?
A
Phos binders –> calcium based (Tums, PhosLo) is first line due to price
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%
16
Q
In addition to CKD what does Sevelamer (Renvela) also do?
A
Sevelamer (Renvela) also lowers total cholesterol and LDL ~15-30%
17
Q
When is erythropoietin (ESA) used in CKD?
A
ESA is only used when hemoglobin is <10 and discontinued if > 11
18
Q
What forms of Hepatits are vaccines available for?
A
vaccines are available for Hep A and Hep B
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.
20
Q
What vaccinations do you need if you have Asplenia?
A
- H. influenza type B
- Pneumococcal
- Meningococcal
21
Q
What is the MOA of triptans?
A
5-HT1 agonist and cause vasoconstriction of cranial blood vessels
22
Q
What is the starting dose for Viagra, Revatio?
A
Sildenafil (Viagra, Revatio) - starting dose is 50mg
23
Q
What is the starting dose for Cialis, Adcirca?
A
tadalafil (Cialis, Adcirca) - start dose is 10mg
24
Q
What is the starting dose for Levitra, Staxyn ODT?
A
Vardenafil (Levitra, Staxyn ODT) - start dose is 10mg
25
What is the Start dose for Stendra?
Avanafil (Stendra) - start dose is 100mg
| Use 50mg if pt >65 years, using a 3A4 inhibitor, using an alpha blocker, severe renal/liver impairment.
26
What is the generic of Kapvay?
Clonidine ER (Kapvay) this brand is used for ADHA
27
What is the generic of Intuniv?
guanfacine ER (Intuniv) used for ADHA
28
What are the main SE's of Kapvay and Intuniva?
Clondidine ER (Kapvay) and guanfacine ER (Intuniv) are sedating and lower blood pressure.
29
What is the generic of Focalin?
Dexmethylphenidate
30
What is the generic of Concerta?
Methylphenidate (Concerta, Ritalin, Quillivant)
31
what is the generic of Ritalin
Methylphenidate (Concerta, Ritalin, Quillivant)
32
what is the generic of Quillivant
Methylphenidate (Concerta, Ritalin, Quillivant)
33
Which BZDs are preferred in elderly because they are metabolized to inactive compounds (glucuronides)
LOT (Lorazepam, oxazepam, temazepam)
34
What is Temazepam (Restoril) indicated for?
Temazepam (Restoril) is longer acting and NOT indicated for anxiety. It is used for sleep.
35
What is the main medication used for Alzheimer's?
Aricept (Donepezil)
36
What medication is added to Donepezil in moderate to severe Alzheimer disease. What is the combonation called?
Memantine (Namenda), the combo pill is Namzaric
37
When do you take Donepezil (Aricept)?
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.
38
What does the term comminution mean?
comminution means to reduce solids from an average particle size to a smaller average particle size.
39
Magnesium stearate is an example of a?
magnesium stearate is an example of glidant/lubricant = improves flowability of powder.
40
Sodium lauryl sulfate is and example of a?
sodium lauryl sulfate is and example of a Surfactant = neutralizes static charge and keeps powder from floating away.
41
Magnesium oxide, magnesium carbonate and kaolin are examples of ?
Magnesium oxide, magnesium carbonate and kaolin are examples of adsorbent = keeps powder dry
42
What does the term eutectic mean?
eutectic = two components, when mixed, will melt at a lower temperature than either individual melting point.
43
What 2 things are used as plasticizers - used to make capsules less brittle/more flexible?
glycerol, sorbitol
44
Between lotion, cream, ointment, which one contains the most water?
Lotion contains the most water.
45
Between lotion, cream, ointment, which one contains the most oil?
Ointment contains the most oil.
46
What is Pluronic lecithin organogel (PLO) used for?
Pluronic lecithin organogel (PLO) is used for transdermal drug delivery - gel = semisolid impenetrable by liquid.
47
What is an emulsion?
emulsion = liquid dispersed in liquid.
48
What is an emulsifier?
emulsifier = Surfactant that reduces surface tension between oil and water.
49
What is an suspension?
Suspension is a solid dispersed in liquid
50
What are wetting agent/levigating agent?
Wetting agent/levigating agent - Surfactant that helps incorporate insoluble drug into liquid.
51
Low HLB < 10 (lipophilic) are more ____ soluble and used for ______ emulsions
Low HLB < 10 (lipophilic) are more oil soluble and used for water-in-oil (w/o) emulsions
52
High HLB > 10 (hydrophilic) are more _____ soluble and used for _____ emulsions
High HLB > 10 (hydrophilic) are more water soluble and used for oil-in-water (o/w) emulsions
53
What is the BUD for non-aqueos formulations
The BUD for non-aqueous formulations = any API or 6 months
54
What is the BUD for water containing oral formulations in the fridge?
14 days in the fridge
55
What is the BUD for water containing topical/dermal/mucosal liquid?
30 days
56
What is a Type 1 error?
Type 1 error = false-positive --> the nullhypothesis is rejected in error --> think there is a difference but there isnt one
57
what is a Type 2 error?
Type II error = false negative --> the null hypothesis is accepted in error --> think that there is no difference but there acutally is.
58
What is Sensitivity?
Sensitivity = true positive --> how well a test identifies that you actually do have the condition.
59
What is Specificity?
Specificity = true negative, how well a test identifies that you do NOT have a condition. --> you Specifically do NOT have the disease
60
What class = reasonable probability that use will cause serious adverse health consequences/death?
Class I recall = reasonable probability that use will cause serious adverse health consequences/death
61
What class = probability of temporary/reversible adverse health consequences are remote?
Class II recall = probability of temporary/reversible adverse health consequences are remote
62
What class = Not likely to cause adverse health consequences?
Class III recall = Not likely to cause adverse health consequences
63
What is the Independent variable?
The independent variable = the intervention (ie., the drug)
64
What are the 3 first line drugs for ADHD?
Concerta, Vyvanse, Adderall XR
65
What is used 2nd line, or if abuse risk for ADHD?
Strattera
66
When do you use the Student/Unpaired T-test?
When Numerical/continuous Data, normal distribution, with Two groups
67
When do you use the ANOVA (or F-test)?
When Numerical/continuous Data, normal distribution, with three groups
68
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
Cost Utility Analysis - Includes a quality of life component
69
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
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.
70
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
Cost Benefit Analysis - have both the benefits and costs expressed in terms of dollars and are adjusted to their present value.
71
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
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.
72
What is the dependent variable?
The dependent variable is what is affected by the independent variable. AKA the outcome of interest. change in BP, A1C, hemoglobin, ect.
73
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
Case-control - type of study compares pt with disease to those without disease. Retrospective
74
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
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
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
Cross-sectional survey - type of study estimates relationship between variables and outcomes at one particular time?
76
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
Case report and case series - type of study describes adverse reaction in a single patient or a few patients
77
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
```
Most reliable
Meta analysis
Randomized control
Cohort
Case control
Case reports
Expert opinion
```
78
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
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
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
Randomized control - type of study compares an experimental treatment to the current or placebo to determine which is better
80
Gram positive, stain purple, clusters would likely be what?
MRSA/MSSA
81
What color do Gram Negative stain?
Gram negative = pink/red
82
What three groups of antibiotics are Cmax:MIC (Concentration dependent)?
aminoglycosides, quinolones, daptomycin
83
What Three groups of antibiotics are AUC:MIC
Vanc, Macrolides, tetracyclines
84
What Three groups of antibiotics are TIme>MIC
Penicillins, cephalosporins, carbapenems.
85
What is the drug of choice for syphilis?
Penicillin G benzathine (Bicillin L-A) = drug of choice for syphilis (2.4 million units IM x1)
86
What medication do you use for PCN allergy?
Aztreonam (Azactam) - can be ued with PCN allergy --> Only treats gram negative
87
What is the treatment for a neonate with meningitis?
neonate = ampicillin + cefotaxime OR gentamicin
| Remember, no ceftriaxone in neonates < 28 days
88
What is the treatment for babies with meningitis?
Ceftriaxone + Vancomycin
89
What is the treatment for meningitis for normal people 2-50 years old?
Ceftriaxone + Vancomycin
90
what is the treatment for elderly or immunocompromised with meningitis?
Ceftriaxone + Vancomycin + ampicillin
91
What do you for Meningitis if the pt has a PCN allergy?
quinolone + vancomycin +/- Bactrim
92
Outpatient CAP: pt hasn't had abx in past 3 months and is previously healthy. what can you give?
Macrolide OR doxycycline
93
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?
1. Beta lactam + Macrolide
OR
2. Respiratory quinolone monotherapy (Moxifloxacin, gemifloxacin, or levofloxacin)
94
How should Opana ER (oxymorphone) be taken relative to food?
Opana ER should be taken on an empty stomach
95
What are the Five A's for smoking cessation?
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
When do you start with 21mg nicotine patch vs the 14mg patch?
If > 10 cigs/day, start with 21 mg patch
| If < 10, start with 14mg patch
97
What is a main SE of the nicotine patch?
Vivid dreams
98
When do you use 2mg nicotine gum vs the 4mg gum?
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
For weeks 1-6 how often do you take the nicotine gum?
weeks 1-6 use Q1-2 hours
100
For weeks 7-9 how often do you take the nicotine gum?
Weeks 7-9 use q2-4hours
101
For weeks 10-12 how often do you take the nicotine gum?
weeks 10-12 use Q4-8hours
102
When do you start bupropion/chantix relative to the quit date?
start bupropion/Chantix 1 week before the quit date.
103
What is the cystic fibrosis treatment order?
cystic fibrosis treatment order --> Bronchodilator (albuterol), hypertonic saline, dornase alfa, chest physiotherapy, inhaled antibiotics (Tobramycin, oral azithromycin)
104
Is Creon and Lip-Prot-Amyl interchangeable?
Pancreatic enzyme products are NOT interchangeable. SO NO
105
What is the most common cause of Hypothyroid disease?
Hashimoto's disease --> an autoimmune condition where pt antibodies attack their own thyroid gland
106
What will the FT4 and TSH labs show in Hypothyroidism?
Hypothyroidism will show low FT4 (Free thyroxine) and elevation in TSH(Thyroid stimulating hormone).
107
When should Levothyroxine be taken?
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
What is the most common cause of Hyperthyroid disease?
Graves disease --> antibodies stimulate thyroid to produce too much T4
109
How do you treat myxedema coma?
myxedema coma --> treat with IV levothyroxine
110
How do you treat Thyroid storm?
Thyroid strom --> treat with propylthiouracil (PTU) + Iodide (SKKI or Lugol's) + beta blocker (Propranolol) + systemic steroid + acetaminophen
111
What is the normal starting dose of levothyroxine?
normal pts start levothyroxine 1.6mcg/kg IBW
| Pts with known CAD start levothyroxine 12.5-25mcg
112
Which steroid is used for Addison's disease?
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
```
What is the steroid conversion?
Cortisone
Hydrocortisone
prednisone
Prednisolone
Methylprednisolone
Triamcinolone
Dexamethasone
Betamethasone
```
```
Cortisone - 25
Hydrocortisone - 20
prednisone - 5
Prednisolone - 5
Methylprednisolone - 4
Triamcinolone - 4
Dexamethasone - 0.75
Betamethasone - 0.6
```
114
what is the relation of Cushing's and Addison's disease to cortisol?
```
Cushing's = too much cortisol
Addison's = not enough cortisol
```
115
Allopurinol increases azathioprine (Azasan) concentration, how much should the dose be reduced by?
Allopurinol increases azathioprine concentration. Reduce dose of azathioprine ~75%
116
What is the maximum dose of Calcium due to saturability?
Max calcium dose at one time is 600mg due to saturability. Split doses.
117
Increased COX-2 selectivity = lower GI risk
Place in order of least GI risk
Celebrex, Relafen, Lodine, Voltaren, Mobic
```
Lower GI RIsk =
Celecoxib (Celebrex)
Diclofenac (Voltaren)
Meloxicam (Mobic)
Etodolac (Lodine)
Nabumetone (Relafen)
```
118
What is preferred in a COPD, Asthma patient with glucoma?
Betaxolol (Betopic S) = preferred in COPD, asthma pt with glaucoma. Selective beta blocker.
119
What ANC value represents neutropenia?
neutropenia = ANC < 1000
120
What ANC value represents Severe neutropenia?
Severe neutropenia = ANC < 500
121
What ANC value represents Profound Neutropenia?
profound neutropenia = ANC < 100
122
What ANC value represents Profound Neutropenia?
profound neutropenia = ANC < 100
123
Why does Bleomycin have a max dose of 400 units?
Bleomycin = max dose 400 units = pulmonary toxicity
124
Why does doxorubicin have a max dose of 450-550 mg/m2?
doxorubicin = max dose 450-550 mg/m2 = cardiotoxicity
125
why does cisplatin have a max dose of 100mg/m2?
Cisplatin - dose per cycle NOT to exceed 100mg/m2 = nephrotoxicity
126
Why is vincristine's dose capped at 2mg?
Vincristine = single dose capped at 2mg = neuropathy
127
What is a common SE of fluorouracil?
fluorouracil = hand foot syndrome
128
what is a common SE of methotrexate?
stomatitis/mucositis
129
How is the MCV related to anemia?
Low MCV = microcytic
| High MCV = macrocytic
130
What is Macrocytic anemia caused by?
Macrocytic anemia is caused by b12 or folate deficiency
131
10 drugs/classes that can cause Hemolytic anemia?
beta-lactamase inhibitors, cephalosporins, isoniazid, levodopa, methyldopa, penicillins, platinum chemo drugs, quinidine, ribavirin, rifampin
132
what are 8 medications that are high risk with G6PD deficiency?
chloroquine, dapsone, methylene blue, nitrofurantoin, primaquine, probenecid, rasburicase, sulfonamides.
133
What is valbenazine (Ingrezza) approved for?
Valbenazine (Ingrezza) is approved for tardive dyskinesia
134
What is the common SE of Zyprexa?
olanzapine (zyprexa) = SE include metabolic abnormalities
135
What is the trough range for lithium?
lithium therapeutic range = 0.6-1.2 MEq/L (trough)
136
What are the three colors of the does for lamictal?
```
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
When should you call 911 for a seizure?
Call 911 if seizure lasts > 5 minutes
138
Focal vs generalized seizure?
Focal = starts on one side of the brain
| Generalized starts on BOTH sides of the brain.
139
define status epilepticus
Status epilepticus is a seizure lasting ? 5 minutes and can cause brain damage/fatality
140
5-20 minutes into a seizure what can you give?
5-20 minutes = give IM midazolam OR IV lorazepam OR Rectal diazepam
141
20 40 minutes into a seizure what can you give?
20-40 minutes = give regular AED option (IV fosphenytoin, valoprooic acid, keppra, phenobarb if others not available
142
40+ minutes into a seizure what can you give?
40+ minutes = shit out of luck
143
Why should all patients on Anticonvulsants be supplemented with calcium and vit D?
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
What does Depakote (Valproic acid) have a BBW for?
Depakote (valproic acid) = BBW for hepatotoxicity
145
How must phenytoin be given?
Phenytoin = normal saline only + filter needle
146
primidone (mysoline) is a prodrug of?
Primidone (mysoline) is a prodrug of phenobarbital
147
Which dhp CCB is more selective for cerebral arteries due to its increased lipophilicity and is PO ONLY?
nimodipine (Nymalize) = dhp CCB that is more selective for cerebral arteries due to its increased lipophilicity and is PO ONLY
148
What are the ONLY two IV PPIs?
only two IV PPIs = esomeprazole and pantoprazole
149
Which USP is used for Hazardous drugs?
USP 800. ASHP provides guidance for implementing these standards
150
What are the Three types of hazardous drugs (HD)?
Three type of hazardous drugs (HD) = Antineoplastic(Cancer drugs), non-antineoplastic (hormones, transplant), and drugs with reproductive risk.
151
What is an error of omission?
error of omission = something was left out that is needed for safety
152
What is an error of commission?
error of commission = something was done incorrectly
153
When should you use Soap and water instead of alcohol based rubs
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
What are Type A and Type B adverse drug reactions?
Adverse drug reactions = predictable (Type A) and unpredictable (Type B)
155
What is the Naranjo scale?
Naranjo scale (causality assessment scale) helps determine likelihood a drug caused an adverse reaction.
156
What is the name of the FDA's adverse drug reaction reporting program?
Side effects, adverse events, and allergies should be reported to FDA's MedWatch program = FDA adverse event reporting system (FAERS)
157
How do you treat a preggo pt with syphilis and penicillin allergy?
Preggo pt with syphilis and penicillin allergy should be desensitized and treated
158
The amount of drug removed per hour is the same - describes what kind of kinetics?
Zero order kinetics = amount of drug removed per hour is the same (eg., 300mg)
159
The percent of drug removed per hour is the same - describes what kind of kinetics
First order kinetics = percent of drug removed per hour is the same (eg.,15%)
160
Give 3 examples of drugs that follow non-linear/saturable /mixed/michaelis-menten kinetics
Voriconazole, phenytoin, theophylline
| = doubling the dose can more than double serum concentrations
161
How do you treat shock?
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
How many mcg of folic acid do preggo's need? How much do women of child bearing age need?
preggo women need 600mcg/day folic acid
| Women of child bearing age need 400mcg/day
163
How much calcium and vitamin D do Preggo's need?
preggo women need 1000mg/day of calcium and 600 IU/day of Vitamin D.
164
What 3 medications should you use for HTN in preggos?
Labetolol, methyldopa, nifedipine
165
How much do you need to increase the dose of levothyroxine during pregnancy?
Need to increase levothyroxine 30-50% during pregnancy
166
If drugs needed for hyperthyroidism in during pregnancy what do you use?
if drugs need for hyperthyroidism, use PTU in 1st trimester and methimazole in 2nd and 3rd trimester.
167
Babies receiving breast milk need how many IU of vitamin D until the are consuming 1 liter vitamin D fortified formula per day?
Babies receiving breast milk need 400IU of vitamin D until the are consuming 1 liter vitamin D fortified formula per day
168
How much Iron should babies receive during the first 4-6 months?
Breastfed babies also need 1mg/kg iron during months 4-6.
169
What can procainamide and quinidine cause?
Procainamide and quinidine can cause lupus
170
what are the Class I (NA blockers) used for arrhythmias?
1a. Disopyramide, quinidine, procainamide
1b. lidocaine, mexiletine
1c. Flecainide, propafenone
171
What are the Class II Anti arrhythmic drugs?
Beta blockers
172
What are the class III (K block) anti arrhythmic drugs
dronedarone, dofetilide, sotalol, ibutilide, amiodarone
173
What are the class IV Anti arrhythmic drugs
Verapamil, diltiazem
174
What is the VTE prophylaxis dose of Heparin?
VTE prophylaxis = 5000 units SQ Q8-12H
175
What is the VTE treatment dose of Heparin?
VTE treatment = 80units/kg IV bolus + 18units/kg/hr
176
What is heparin ACS/STEMI treatment dose?
ACS/STEMI treatment = 60units/kg IV bolus + 12 units/kg/hr
177
What is the antidote used for heparin toxicity?
Heparin antidote = protamine sulfate
178
When do take enoxaparin anti-Xa levels?
Enoxaparin anti-XA levels = take a peak level 4 hours post dose
179
drugs/classes that can raise blood sugar (12)
```
Azoles
Beta agoinst
Beta blockers
Diuretics
Tacrolimus/cyclosporine
niacin
protease inhibitors
quinolones
antipsychotics
statins
steroids
```
