1. when you have a really annoying friend and you just put up with them 2. when you used to be hammered off of 3 drinks but now you're an alcoholic so 3 drinks don't even touch you

1. when that really annoying friend is super clingy 2. when you psychologically and physiologically need a drug to function

Pharm blessings! Flashcards by Paige LaPointe

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

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what is non-pharm sprain treatment

RICE
just eat a shit ton of rice
also Rest Ice Compression Elevation

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what is a good pharm treatment for a sprain

scheduled vicoden for 1 week then NSAIDs

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what is the primary goal with pain management?

increase functionality and normality for patient

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is codeine a prodrug

yes they call it PROdeine

no they don’t

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which drug can cause baby death because it’s excreted in the breast milk

codeine

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what drugs have the most evidence in treating muscle spasms?

scheduled NSAIDs x 3days

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what is the max ibuprofen dose per day

2400 mg

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what is the max dose of naproxen [aleve]?

400mg/day

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what muscle relaxant from msk can you give for a muscle spasm?

cyclobenzaprine

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what are the 2 DOC for diabetic neuropathy?

duloxetine [cymbalta]

anitriptyline [elavil]

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what drug class works best for diabetic neuropathy?

antidepressants

TCA, SNRI

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will treating diabetic neuropathy cure all the pain

nope

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what is the DOC for MS?

glatiramer acetate [copaxone]

but in a different case tdubs also said dimethyl fumarate [tecfidera] which is new soo

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by how much does dimethyl fumerate [tecfidera] decrease MS relapses?

75%

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by how much does glatiramer acetate [copaxone] reduce MS relapses?

28% / 35%

choose your own adventure / answer

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what can you give for an acute MS attack

prednisone x 3d

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your pt has chronic pain from OA with no response to vicoden so what do you do

#1 drug test
#2 prescribe percocet

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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

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what is dependence

when that really annoying friend is super clingy

2. when you psychologically and physiologically need a drug to function

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WHAT IS A SIDE EFFECT OF OPIOIDS

CONSTIPATION DAMN IT

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your pt has severe pain from a hip fracture. what do you rx?

IV morphine

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do you need to dose adjust morphine for CKD?

yes

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what thing causes no pain when it hits you?

music

bob marley/sublime reference
(look up the song trenchtown rock)

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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!