Pharm Flashcards

1
Q

clozapine gold standard for?

A

treatment-resistent schizophrenia

must have failed at leas 2 trails of other antipsychotics

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2
Q

major risk w/ clozapine?

A

agranulocytosis

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3
Q

HTN treatment options in pregnancy?

A
  • Hydralazine
  • Labetalol
  • Methyldopa
  • Nifedipine

*Most common above, but can use any Beta blockers or Ca blockers

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4
Q

dihydropyridine Ca channel blockers act on?

A

vascular smooth muscle

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5
Q

dihydropyridine Ca channel blockers (5)?

A

“-dipine”

  • Amlodipine
  • Clevidipine
  • Nicardipine
  • Nifedipine
  • Nimodipine
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6
Q

non-dyhydropyridine Ca channel blockers act on?

A

heart

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7
Q

ex of non-dihydropyridine Ca Channel blockers?

A
  • Diltiazem

- Verapamil

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8
Q

Ca channel blockers do what?

A

block voltage dependent Ca channels in heart and smooth m. –> dec m. contractility

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9
Q

what Ca channel blocker used for subarachnoid hemorrhage, and why?

A

Nimodipine, prevents cerebal vasospasm

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10
Q

Dihydropyridines (except nimodipine) used for? (3)

A
  • HTN
  • Angina (inc prinzmetal)
  • Raynaud’s
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11
Q

which Ca blocker used for HTN urgency adn emergency?

A

Clevidipine

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12
Q

What are non-dihydropyridine used for that dihydropyridine CCB aren’t?

A

atrial fib and flutter

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13
Q

non-dihydropyridine CCB used for? (4)

A
  • HTN
  • Angina
  • A fib
  • A flutter

(prevention of nodal arrhythmias - ie SVT)

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14
Q

special toxicity that verapamil has?

A

hyperprolactinemia

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15
Q

non-dihydropyridine toxicity can –>?

A

AV block

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16
Q

CCB toxicity –>?

A
  • peripheral edema
  • flushing
  • dizziness
  • constipation
  • gingival hyperplasia
  • verapamil –> hyperprolactinemia
  • non-D CCB –> AV block
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17
Q

meds that can cause drug induced lupus?

A
  • Quinidine
  • Procainamide
  • Isoniazid
  • Minocycline
  • Hydralazine
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18
Q

Hydralazine is contraindicated when?

A

angina/CAD

b/c of compensatory tachycardia

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19
Q

hydralazine mainly dilates what and causes what?

A

vasodilates arterioles –> afterload reduction

smooth m. relaxor

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20
Q

wolff parkinson white syndrome, after advising agains phys activity what med for arrhythmias?

A

procainamide

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21
Q

sinus brady, what med use to inc heart rate?

A

atropine

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22
Q

definitive treatment of sinus brady?

A

pacemaker

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23
Q

AChE inhibitor toxicity antidote?

A

atropine +/- pralidoxime (must be shot time for it to be useful)

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24
Q

organophosphates toxicity antidote?

A

atropine +/- pralidoxime (must be shot time for it to be useful)

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25
Q

amphetamines toxicity antidote?

A

NH4Cl (to acidify the urine)

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26
Q

Antimuscarinic or anticholinergic agent toxicity (ie atropine) antidote?

A

Physostigmine & control hyperthermia

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27
Q

Benxodiazepines toxicity antidote?

A

Flumazenil

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28
Q

B-blocker toxicity antidote?

A

Glucagon

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29
Q

CO toxicity antidote?

A

100% O2, hyperbaric O2

30
Q

Copper toxicity antidote?

A

Penicillamine

31
Q

Arsenic toxicity antidote?

A

Penicillamine

32
Q

Gold toxicity antidote?

A

Penicillamine

33
Q

Penicillamine treats what toxicities? (3)

A
  • Copper
  • Arsenic
  • Gold
34
Q

Cyanide toxicity antidote?

A

Option 1) Nitrate + thiosulfate

Option 2) Hydroxocobalamine

35
Q

Digtalis (digoxin) toxicity antidote?

A

Anti-dig Fab fragments (monoclonal Ab)

36
Q

Heparin toxicity antidote?

A

Protamine sulfate

bind heparin –> inactive complex

37
Q

Iron toxicity antidote?

A
  • deFeroxamine

- deFerasirox

38
Q

Lead toxicity antidote?

A
  • mild (5-44): no treatment, test level in =70): Dimercaprol (BAL) + Ca disodium edetate (EDTA)

(venous lead level)

39
Q

Mercury toxicity antidote?

A
  • Dimercaprol (BAL)

- Succimer

40
Q

Methanol or ethylene glycol (antifreeze) treatment?

A
  • Fomepizole (if unavailable can do ethanol)

- dialysis

41
Q

Methemoglobin toxicity antidote?

A
  • Methylene blue

- Vit C

42
Q

Opiod toxicity antidote?

A
  • Naloxone

- naltrexone

43
Q

Salicylate toxicity antidote?

A
Sodium Bicarb (to alkalinize urine)
- dialysis
44
Q

TCAs toxicity antidote?

A

Sodium Bicarb (to alkalinize plasma)

45
Q

tPA, stretokinase, urokinase toxicity antidote?

A

Aminocaproic acid

46
Q

Warfarin toxicity antidote?

A

immediately: Fresh Frozen Plasma

- Vit K (delayed effect)

47
Q

drug of choice in dx and abolishing supraventricular tachycardias (ie atrial/AV nodal based tachy cardias –> tachy + p wave anomalies w/ normal QRS)?

A

Adenosine

48
Q

Torsades de points treat?

A
  • Mg
  • if unstable cardiovert
  • correct hypokalemia or withdraw offending drugs
49
Q

what gets immediate electrical defibrillation?

A

Ventricular Fibrillation

50
Q

V tach treatment?

A
  • unstable: cardiovert

- give antiarrhythmics (ie amiodarone, lidocaine, procainamide)

51
Q

acetazolamide is a ?

A

carbonic anhydrase inhibitor

52
Q

loop diuretics?

A
  • furosemide
  • ethacrynic acid (non-sulfa)
  • bumetanide
  • torsemide
53
Q

side fx of loop diuretics?

A

“OHHH DANG”

  • Ototoxicity
  • HypoKalemia
  • HypoCalcemia
  • HypoMagnesemia
  • Dehydration
  • Allergy (sulfa)
  • Nephritis (interstitial)
  • Gout
54
Q

Thiazide side fx?

A
  • HypOkalemc metabolic alkalosis
  • HypONatremia
  • Sulfa allergy

“HyperGLUC”

  • hyperGlycemia
  • hyperLipidemia
  • hyperUricemia
  • hyperCalcemia
55
Q

which diuretic looses Ca?

A

Loop diurects
“loops loose Ca”

[thiazides actually dec Ca excretion and can cause hyperCalcemia]

56
Q

K sparing diuretics?

A

Competitive aldosterone receptor antagonists:

  • Spironolactone
  • Eplerenone

Block Na channels in collecting tubules:

  • Triamterene
  • Amiloride
57
Q

what kind of meabolic derangement from acetazolamide?

A

hyperchloremic metabolic acidosis

58
Q

side fx of ACE inhib?

A

CATCHH

  • Cough
  • Angioedema
  • Teratogen
  • Creatinine (inc)
  • HyperKalemia
  • Hypotension
59
Q

ACE-inhibitor contraindicated for what congenital disease?

A

C1 esterase inhibitor deficiency

60
Q

direct renin inhibitor?

A

Aliskiren

61
Q

ARBs?

A

“-sartan”

  • Losartan
  • Candesartan
  • Valsartan
62
Q

digoxin use? (2)

A
  • HF (inc contractility)

- A fib (dec conduction at AV node and depression of SA node)

63
Q

digoxin toxicity?

A
  • n/v/d
  • blurry yellow vision
  • AV block, arrhythmias
  • HyperKalemia
64
Q

don’t use digoxin with what other 3 drugs as it wil dec digoxin clearance?

A
  • verapamil
  • amiodarone
  • quinidine
65
Q

Potassium channel blockers?

A
  • Amiodarone
  • Ibutilide
  • Dofetilide
  • Sotalol
66
Q

Ventricular tachy can use what med?

A
  • amiodarone

- sotalol

67
Q

Amiodarone side fx?

A
  • pulm fibrosis
  • hepatotoxicity
  • hypO/ERthyroid
  • corneal deposits
  • Blue/gray skin deposits
  • neuro effects
  • cardio effects (brady, heart block, HF)
68
Q

Check what when using amiodarone?

A

PFTs
LFTs
Thyroid function
CXR

69
Q

Which potassium channel blocker will not cause torsades?

A

amiodarone

70
Q

chronic diarrhea w/ weight loss, anemia, elevated ESR, thrombocytosis, and positive stool occult for bld - waht type of diarrhea?

A

inflammatory diarrhea

71
Q

lactose intolerance results in what type of diarrhea?

A

osmotic