Pharm 2 Flashcards
when NOT to give tocolytics? how to tx preecl?
braxton hicks w/o cvx change. IV hydralazine or labetalol, PO nifedipine + FHR monitor + Mgso4 (cerebral vasodil & inc prostacyclin)
benefits vs risks of HRT
reverse menopause sxs, colon reduction in combined HRT, inc HDL/dec LDL vs endometrial ca if only estrogen, brca if use >3-5yrs, gallstones b/c more chol, DVT/PE/TE
general meds for menopausal osteoporosis
calc/vit D, HRT (estrogen promotes blasts), SERM (bone agonist), bisphosphonates (inhib osteoclast)
absolute CI to estrogen? HRT
undxed vag bleed, TE, active/recent stroke/MI, active liver dz, estrogen dep malig
causes of thyrotox
Graves, toxic multinodular goitere, malig, iatro, factitious ingest, dec Iodine, pit adenoma
sx vs tx myxedema coma
decompensated hypothyroid -> altered mental status, fluid/electrolyte imbal, poor thermoreg vs ICU -> fluid/electrolytes -> glucocorticoids -> T4 IV -> T3 IV
CI levo
thyrotox, diffuse goiter w/ low tsh, uncorrected adrenal insuff
tx of choice for DKA or HHS, T1DM, or exhausted T2DM. inhaled insulin can cause what?
(IV reg for DKA) insulin. acute bronchospasm -> caution in asthma/COPD
which meds can cause hyperglycemia? hypoglycemia?
glucocorticoids, HIV protease inhibitors, calcineurin inhibitors, valproic acid/phenytoin, 2nd gen antipsych like olanza/quetiapine, corticosteroids, FLQ. BB, FLQ
dawn vs somogyi effect. how to tx?
morning hyperglycemia w/o carb intake (maybe from hep gluconeo) vs nocturnal hypoglycemia to morning hyperglycemia. basal insulin
how to tx conscious vs unconscious hypoglycemia?
PO OJ, hard candy, table sugar, glu tablets vs inject glucagon. 15g carb -> rechk 15min for blood glu
AE of glucagon. when to give?
transient HTN, N/V, hyperemia. unconscious or altered mental status hypoglycemia
pramlintide
recombo amylin -> inc insulin, dec glucagon & gastric emptying. AE N/V, severe hypoglycemia (BBW). DI dec drug absorption
