Pharm Flashcards
Most potent to least derm formulation
-ointment
-cream (most easily absorbed)
-lotion
-solutions
how many steroid classes
7
most potent steroid class
1- never Rx in primary
least potent steroid topical class
7- otc creams
what potency is not prescribed in primary care
3-4
bactroban treats what gm+ bacteria
staph aureus and strep pyogenes
who to avoid bactroban in
pregnant people who are breastfeeding (not enough evidence)
how soon to see improvement with bactroban
3-5 days
antivirals can be harsh on what organ
kidneys- can lead to aki
antifungal safety alert
they are teratogenic and increase risk of spont. abortion and heart defects
what to look out for in those with antifungal meds
liver toxicity
Selenium sulfide is both a
antifungal and antiinfective
what is selenium sulfide used for
tinea versicolor
tinea capitus
how to dose for pinworms
1 dose then another 2 weeks later
terbinafine (lamisil) used for
tinea capitis
onchomycosis
duration of terbinafine tx for tinea capitis
2-4 weeks
duration of terbinafine for treatment of onchomycosis
6-12w
griseofluvin used for
tinea capitis
treatment duration of griseofulvin
6-8 weeks
pt teaching with griseofulvin
take with fatty food
what to monitor while on terbinafine
liver
what is permethrin used for
lice and scabies
how does permethrin work
overexcites the bug’s nervous system killin em
dosing info for permethrin for scabies
-apply to entire body neck down for 12 hours then wash off
-repeat in one week
dosing info for permethrin for lice
-apply to scalp and wash out right after
-only kills active lice and not eggs
-need 2nd treatment and nit combing
go-to initial acne treatment
benzoyl peroxide which dries and peels skin causing vacteria to shed off
what is sodium valproate (valporic acid)(depakote) used for
treats and prevents seizures
normal valporic acid level
50-100mcg
valporic acid tox level
> 100
SE of valporic acid
-wt gain
-hair loss with long term use
-hepato tox
what to monitor closely with valporic acid
liver
can we use depakote in pregnancy
NO
Phenytoin (dilantin) use
generalized and complex partial seizures
what must you tell pts with phenytoin (dilantin)
will decrease effectiveness of OCP
SE with dilantin (phenytoin)
-gingival hyperplasia
-hirsutism
what lab to monitor for with phenytoin (dilantin)
-avoid with liver issues (hepato tox)
-monitor LFT
What is tegretol (carbamazepine) used for
-trigeminal neuralgia
-seizures
how does tegretol (carbamazepine) work in trigeminal neuralgia
lessens pain signals sent to brain
Labs with tegretol (carbamazepine)
important se with tegretol (carbamazepine)
-mildly anticholinergic
Gabapentin use for
-peripheral neuropathy
-post herpatic neuralgia
SE of gabapentin
-dependent possible
-sedating
how does gabapentin work
works in brain by altering electrical activity and neurotransmitters
Topiramate uses
-seizure prevention
-migrane prevention
common se of topiramate
-wt loss
Avoid topiramate in
-hepatic or renal issues
-May increase risk of kidney stones
Which antidepressants can be used for migrain prophylaxis
-TCA (amatryptaline, nortryptaline)
What is nice about triptans
they are not all equivalant, if one doesnt work try another
do NOT use triptans with
-uncontrolled HTN
-MAOI
-CAD
How to take triptans
-take asap at migrane start
-only use 2x per week (risk for rebount HA if used more)
How does levodopa-carbidopa work
increased dopamine in brain
What symptom is levodopa-carbidopa best on
bradykanesia
consern with levodopa-carbidopa
hypotension = falls
Dopamine agonist examples
-ropinirol (requip)
-Pramipexole
How do dopamine agonists work
mimic dopamine in brain
Why are dopamine agonists used
to delay levodopa initiationas long as possible
DE of dopamine agonists
-impulse control issues
-edema
-hypotension- common
What is meclizine (bonine)
-antiemetic
-bppv
-labyrinthitis
med onset and duration of meclizine
onset of 30min
lasts 8-24 hours
why is meclizine good for old folks
-only mildly anticholinergic or sedating
how long to treat with iron
3-6mo
why should parents give iron with a gtt
to prevent stainig of teeth
How to know if pt has pernicious anemia
neuro symptoms will be present
How to replace B12 in pernicious anemia
they lack intrensic factor so must be IM
first line HTN meds
-ACE/ARB
-thiazides
-CCBS
acei are great for
-new dx of HTN
-previous MI
-HF
-CKD
WHen to stop acei after starting on gfr
if it drops less than 30% from baseline
What are the two types of CCBS
-dihydropyridine
-non-dihydropyridine
What are examples of nondihydropyridine CCBS
-verapimil
-diltiazem
examples of dihydropyridine ccbs
“-dipines”
Amalodipine, nifidipne
SE of CCB
ankle edema
HA
avoid in gerd
Dont use tzd in gfr less than
30
avoid these Bp drugs if sulfa allergy
tzd
who are BB good for?
-EF<40%
-post MI
-anxiety and hyperthyroid for rate control
BBs are not good in
-asthma
-copd
how long does furosemide last
6-8hrs
What if ferosemide doses are given too quickly
ototoxicity
When is spironolactone usually given
HF
what to monitor with spironolactone
-renal
-K+ levels
weird SE of spironolactone
-gynocomastia
when do we use digoxin
HF with a/fib
how does digoxin work
-slows heart allowing for full filling time
-increases contractility
When to hold digoxin
when HR less than 60
s/s of digoxin tox
-Green/yellow halos
-fatigue
-brady
-weakness
-V-fib, V-tach
dig toxicity level
> 2ng/ml
Why is hypokalemia significant with digoxin
low K+ can cause easier tox
antidote to digoxin
digibind
Nitrates used to treat
angina
What type of drug is amiodarone
antiarrhythmic
what is amiodarone used for
-a-fib
-ventricular arrythmias
long term SE of amiodarone
-thyroid (contins a lot of iodine, can cause hypo or hyper)
-Eyes (optic neuropathy, corneal deposits)
-Lungs (pulm tox, get baseline xray and PFT)
what med needs to be reduced with amiodarone
anticoags (incrase anticoag effectiveness so you have to drop dose)
what do statins do
-lower LDL and increase HDL
-Also lowers CRP levels
S/S of rhabdo
-elevated CK
-muscle pain
Drug induced hepatitis s/s
-dark urine
-jaundice
-fatigue
-abd pain
What do fibrates doq
-decrease triglycerides
-increase HDL
When to use fibrates
with triglycerides over 500
what doesnt fibrates do
lower ldl well
What does Niacin (nicotininc acid) do
-decreases triglycerides
-increase LDL
(little to no effect on LDL)
se of nicotinic acid (niacin)
-facial flushing 30-60mins after
(can be reduced with ASA coadmin)
pt teaching with niacin
dont take with warm water
bile acid sequestrants
cholestyramine
colestipol
what do bile acid sequestrants do
decrease LDL by binding to it
how to take bile acid sequestrants
take one hr before other meds
SE of bile acid sequestrants
sever GI stuff
-nausea
-constipation
improperly treated DVT =
PE in 45%
how long to keep pts on meds for DVT
x6mo
DVT apixaban (eliquis)
10mg bid x7 then 5mg
Dabigatran (pradaxa) for dvt
150mg bid 5-10d until lmwh
rivaroxaban (xarelto) for dvt
15mg bid x21d then 20mg qd
short term uses for wardfarin
-DVT
-PE
-Joint surgery
long term warfarin uses
-a-fib
-cardiomyopathy
lab for warfarin
pt/INR
goal of warfarin due to hear valve issues
2.5-3.5 (or 4)
How long to stop warfarin for surgery
5 days
What does warfarin interact with
-ASA
-Tylenol
-antacids
-abx
-antifungals
-antidepressants
what kind of food to limit with warfarin
green leafy veggies
When is enoxaparin used
-post op
-bridging to warfarin
BBW for exnoxaparin
dont give with spinal anesthesia!
Best anticoag in pregnancy
lovenox (warfarin causes 1st T defects)
Anticoags do
slow ability to make clots
antiplatelets
stop platelet aggrigation and stop clot formation
ASA is a
antiplatelet
how does ASA bind
irreversibliy for 10 days
What if our pt is allergic to asa
give plavix
When to stop ASA prior to sx
7-10days
what is ASA used in
CAD
Stroke
MI
RA/OA
what can amoxicillin be used for
-PNE
-acute otitis media if no abx in last 30
-group A strep
what can augmentin be used for
-sinusitis
-dog bites
-acute otitis media if abx in last 30
What is Pen G used for
syphilis
what can you treat mastitis with
-dicloxacillin
-keflex
-clinda (GI SE)
What are cephalosporins used for
-Post op wounds
-Otitis media if abx in last 30
-tx failure of sinusitis
-skin complaints
Good ages for cephalosporins
good for old, babes and pregnant women
Macrolides end in
“-mycin”
What are macrolides nortorious for?
GI side effects
Maccrolides are considered first line for
-PNE
-Group A strep
Can macrolides be used in pregnancy
YEA
Sulfonamides are good for
-uncomplicated UTI
-below the waste skin complaints
KILLS MRSA
What is a big risk of sulfonamides
Steven Johnsons
-eperdermal dealth and shedding which can be fatal
What are tetracyclines good for
-PNE
-Rocky Mt Fever
-Purulent cellulitis
-chlymydia
can you use tetracyclines in preg
NO
What are fluoroquinolones good for
-Pne
-UTI
-Travelers diarrhea
-divertic
-chronic prostatitis
BBW for floroquinolones
tendon rupture
can you use a fluroquinolones
cat C avoid
SE of metronidazole
-GI disturbances
-Metallic taste
Metronidazole treats
-Trichomoniasis
-BV
-Divertic
-Giardia
-Rosacia
When is clinamycin used
serious infections
purulent cellulitis
What is the pt at risk of when takin gclindamycin
-fatal colitis
-C. Diff
When is vanco indicated
-serious infections
-C.diff
-MRSA
risks of vanco
-ototox
-nephrotox
-red man (IV usually, 5-10 min after)
Rifampin used to treat
TB- long term use of 9-12mo
Serious SE of rifampin
-thromobytopenia
-liver tox
What drugs can tern secretions red
-rifampin
-pyridium
