Pharm blessings! Flashcards
If these cards look funny it’s because brainscape is taking away my ability to do cool things unless I pay money
anyway
time to have FUN and learn about neurological drugs
i mean neurololical
because lol
what is non-pharm sprain treatment
RICE
just eat a shit ton of rice
also Rest Ice Compression Elevation
what is a good pharm treatment for a sprain
scheduled vicoden for 1 week then NSAIDs
what is the primary goal with pain management?
increase functionality and normality for patient
is codeine a prodrug
yes they call it PROdeine
no they don’t
which drug can cause baby death because it’s excreted in the breast milk
codeine
what drugs have the most evidence in treating muscle spasms?
scheduled NSAIDs x 3days
what is the max ibuprofen dose per day
2400 mg
what is the max dose of naproxen [aleve]?
400mg/day
what muscle relaxant from msk can you give for a muscle spasm?
cyclobenzaprine
what are the 2 DOC for diabetic neuropathy?
duloxetine [cymbalta]
anitriptyline [elavil]
what drug class works best for diabetic neuropathy?
antidepressants
TCA, SNRI
will treating diabetic neuropathy cure all the pain
nope
what is the DOC for MS?
glatiramer acetate [copaxone]
but in a different case tdubs also said dimethyl fumarate [tecfidera] which is new soo
by how much does dimethyl fumerate [tecfidera] decrease MS relapses?
75%
by how much does glatiramer acetate [copaxone] reduce MS relapses?
28% / 35%
choose your own adventure / answer
what can you give for an acute MS attack
prednisone x 3d
your pt has chronic pain from OA with no response to vicoden so what do you do
#1 drug test #2 prescribe percocet
what is tolerance
- when you have a really annoying friend and you just put up with them
- when you used to be hammered off of 3 drinks but now you’re an alcoholic so 3 drinks don’t even touch you
what is dependence
- when that really annoying friend is super clingy
2. when you psychologically and physiologically need a drug to function
WHAT IS A SIDE EFFECT OF OPIOIDS
CONSTIPATION DAMN IT
your pt has severe pain from a hip fracture. what do you rx?
IV morphine
do you need to dose adjust morphine for CKD?
yes
what thing causes no pain when it hits you?
music
bob marley/sublime reference
(look up the song trenchtown rock)
which drug swears at you when you take it?
ibuprofane
these jokes are pathetic, i know
but not as pathetic as the lack of efficacy of codeine in 10% of the Caucasian population AM I RIGHT
what does codeine metabolize to
morphine
what is the biggest concern with IV opioids?
overdose leading to respiratory depression
what drug is an opioid antagonist
naloxone [narcan]
what opioid is 4x more potent than morphine?
hydromorphone [dilaudid]
what opioid is the MOST potent?
fentanyl [duragesic]
what should you do about a pre-surgical person’s metformin or glipizide while admitted?
d/c that and give insulin until 48hours after surgery
why can’t you give the elderly tramadol?
decreases seizure threshold
CNS symptoms
what 2 drugs did we prescribe in class for tonic-clonic seizures?
valproic acid [depakote]
carbamazepine
(you can give others, too)
what seizure med can you use for all different types of seizures?
lamotrigine [lamictal]
what is the DOC for petit mal seizures?
ethosuximide [zarontin]
what do you give for status epilepticus?
#1 IV lorazepam [ativan] for immediate seizing #2 phenytoin [dilantin] in a different IV
should you give phenytoin fast or slow, and why?
slow
can cause tissue necrosis otherwise
what defines status epilepticus?
a tonic-clonic seizure lasting longer than 5 minutes
do seizures meds have a wide or narrow therapeutic range?
narrow
which anticonvulsant drug has a side effect of gingival hyperplasia?
phenytoin [dilantin]
what supplement should you give with phenytoin [dilantin] (and maybe other seizure meds? idk)
folic acid
what is a unique side effect of phenytoin [dilantin]
gingival hyperplasia like I just effing told you 2 cards ago
WORKIN’ THAT SHORT-TERM MEMORY BABY
what drug is ACTUALLY FDA approved as an anticonvulsant, but has a crazy short half-life?
valium [diazepam]
what is DOC for alzheimer’s disease?
donepezil [aricept]
DEMENTIA TEST #1
you are in a race. you run past the person in 2nd place. what place are you in?
2nd
if you answered “first place,” start looking for a nursing home because you have dementia.
what type of drug does donezapil [aricept] interact with?
anticholinergics
what can you add to duloxetine [aricept] for alzheimer’s disease if it’s moderate to severe?
memantine [namenda]
what drug class is memantine [namenda]?
NMDA receptor antagonist
what imbalance causes seizures to happen?
excess glutamate (excitatory) less GABA (inhibitory)
lorazepam [ativan] increases the neurotransmitter ______
GABA
which anticonvulsant is most likely to cause the side effect of osteoporosis?
phenytoin [dilantin]
others do this, too
What is the DOC for parkinson’s disease?
levodopa/carbidopa
what dopamine agonist drug can you add to levodopa/carbidopa?
ropinorole [requip]
what COMT inhibitor drug (which decreases dopamine degradation) can you add to levodopa/carbidopa?
Entacapone [comtan]
DEMENTIA TEST #2
if a red house is made of red bricks, and a blue house is made of blue bricks, and a black house is made of black bricks, what is a green house made of?
you can’t grow wonderful gardens inside of a green brick building, dummy
greenhouses are made of glass
how do you treat constipation with drugs
colace + senna
how come some people don’t respond to codeine?
can’t metabolize CYP enzyme therefore can’t convert it to morphine
WHAT OTC DRUG DECREASES THE EFFECTIVENESS OF ACE-I’S LIKE LISINOPRIL
NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS NSAIDS
what is the “wearing off” phenomenon?
when drugs start to wear off after 5y of use
what do you prescribe for MS muscle spasms?
the muscle relaxant Baclofen
should you taper a patient off Baclofen
since this is even a flashcard, you better bet your sweet ass that the answer is yes
with what neurological disorder can you not prescribe baclofen?
seizures
does baclofen work in the CNS or PNS?
CNS
Does dantrolene [dantrium] work in the CNS or PNS?
PNS
what type of intolerance is a sign of MS?
heat intolerance
are these pharm cards boring?
I’M SORRY BUT IT’S A BORING UNIT OKAY
what do you call an epileptic in a pile of leaves?
Russell
what should you prescribe for a migraine with aura?
elitriptan [relpax] or sumatriptan [imitrex] ASAP
what can you rx for ppx of migraine?
how often must a person get migraines to get ppx treatment?
propanolol
must get migraines once per week
what happens when you prescribe benzos for alzheimer’s disease?
the patients turn lime green
+ confusion + agitation
what is the MC side effect of dimethyl fumerate [tecfidera]
flushing and GI side effects
what can you do to counteract flushing?
take ASA 30 mins before med
like niacin
what type of vaccines should you avoid with dimethyl fumerate [tecfidera]
live
what pg category is dimethyl fumerate [tecfidera]?
PG-13
lol jk Cat C: avoid
also shout out to bethany for making THE best pharm tables week after week
you da best
what am I eating right now?
raspberries
just a fun fact about the author
we are so close to the end and I’m stalling
these pesticides are giving me ADD
here we go here we go here we go
if you prescribe fingolimod [gilenya] for MS, what tests should you order when you start it?
PFTs
and you monitor a shit ton of stuff
if you’re on fingolimod [gilenya], how long do you have to wait before getting pregnant?
2 months
what s/e are common for fingolimod [gilenya]?
man b00bs
^decide for yourself whether or not that’s true
HA, nausea, diarrhea
what’s the rule for down-titrating morphine in the elderly
don’t
just keep it high and let them die
wow that was morbid
down titrate 5% every 2 weeks or something like that
look we’re done in only 83 cards :)
see how quickly i can do this when i don’t dick around?
anyway, what time is it?
wine time.
good luck lovies!
