Pharm

Question 1

Highest rate of upper G.I. bleeding in new oral anticoagulants. How can this risk be mitigated

Answer 1

Xarelto higher than eliquis

Adding PPI can reduce risk in all pts

Question 2

Some medications that are associated with elevated triglycerides.

Answer 2

Estrogen, Accutane, beta blockers, thiazide diuretics, atypical antipsychotics, steroids

Question 3

Starting dose of straterra.

Answer 3

<154 lbs start 0.5 mg/kg up to 1.4 mg/kg

>154 lbs is 40 mg, max is 100 mg daily

Question 4

best way to take iron

Answer 4

before bed, with 100-200 mg vitamin C on an empty stomach

Question 5

Key points to get a patient approved for Repatha

Answer 5

1- most recent lab results
2- ICD 10 diagnosis code
3 - current or past drug therapies. Patient has tried.

Question 6

Potential problem with topamax

Answer 6

Can increase chance of cleft palate

Question 7

Medications that can increase seizures or cause seizures

Answer 7

Wellbutrin above 150, ultram and benadryl

Question 8

supplement that can raise prolactin?

Answer 8

Biotin

Question 9

How dose chantix (varenicline) work?

Answer 9

partial agonist at Alpha 4- Beta 2 nicotine receptor. Blocks reward of nicotine.

Question 10

To increase cessation rates by 36% compared to chantix alone do what??

Answer 10

Use chantix with NRT.

Question 11

Morphine Equivalent of dilaudid? difference in PO and IV dilaudid?

Answer 11

1 mg of IV hydromorphone is equal to about 15-20 mg or oral morphine.
1 mg of IV dilaudid is equal to 2.5 mg of PO

Question 12

Fiber requires what to be effective in treating constipation?

Answer 12

Lots of water intake. Otherwise it can contribute to more constipation.

Question 13

How dose docusate work?
How dose Senna work?
How about Bisacodyl?

Answer 13

Osmotic agent, breaks down surface tension allowing water to mix and soften stools,
Senna is motility agent increases peristaltic motion of colon
Bisacodyl is also a stimulant laxative but stronger than Senna

Question 14

what is concern for SSRI and IBU?

Answer 14

x3 fold increase risk for GI bleeding

Question 15

Concern for adding Cox 2 drugs to CVD

Answer 15

COX 2 can increase risk of adverse outcomes in pt with CVD or at high risk for CVD. Use Short courses for short time//

Question 16

Pearls regarding tramadol

Answer 16

Less abuse potential, Effects serotonin so there is a risk for Serotonin syndrome

Question 17

Potential side effects of mirabegron?

Answer 17

Mirabegron can increase blood pressure, however, and should not be used in patients with uncontrolled hypertension. Other adverse effects of mirabegron include nausea, diarrhea, constipation, dizziness, and headache

Question 18

how do α-Adrenergic agonists, such as pseudoephedrine and phenylephrine effect urethra?

Answer 18

α-Adrenergic agonists, such as pseudoephedrine and phenylephrine, cause urethral constriction but are not indicated for the treatment of urge incontinence

Question 19

Some facts about DMPA birth control. Ways to administer? Safe window of effectiveness?

Answer 19

Window of admin is 12-15 wks. Can be given at home SC same as in clinic IM shot. Bone density decreases but comes back to baseline when stopped. wt gain 2kg in 12 mo but similar to other hormonal forms.