Pharm Exam 2

Question 1

Morphine and Oxycodone

Answer 1

PAIN

CNS Depressant
-sedation
-orthostatic hypotension
-bradycardia
Constipation and urinary retention
NV
Cough suppression
Pupil constriction

Toxicity
CNS depression -> severe respiratory depression (decreased rate of breathing)
CM
-coma
-respiratory depression
-pinpoint pupils

Question 2

Naloxone

Answer 2

OPIOID OVERDOSE ANTIDOTE

Reversal of analgesia
Increased BP
Tremors
Hyperventilation
Rapid pulse

Question 3

Aspirin, Ibuprofen, Naproxen

Answer 3

PAIN, FEVER, INFLAMMATION

GI irritation and ulceration/bleeding
-care, take with meals
-CI peptic ulcer, irritates stomach lining
Bleeding
-CI for bleeding disorder, thins blood
-withdraw 1 week before surgery/birth
Renal impairment (from reduced blood flow)
Reye’s Syndrome (brain dysfunction, liver damage)
Allergic reactions
-urticaria
-nasal polyps
-asthma
Pregnancy and lactation, birth defects, drug can leak into break milk

Toxicity (>12g)
“Salicylism”
-tinnitus
-hearing-loss
-hyperventilation
-NV
-acid-base imbalance
-dehydration

Question 4

Celecoxib

Answer 4

PAIN, FEVER, INFLAMMATION

Adverse CV effects = last choice therapy

Question 5

Acetaminophen

Answer 5

PAIN, FEVER (not inflammation)

Risk of renal or hepatic (liver) toxicity

Toxicity
-NV
-sweating, pallor
-hepatic damage

Question 6

Prednisolone

Answer 6

ANTI-INFLAMMATORY GLUCOCORTICORD

Susceptibility to adrenal suppression
Osteoporosis and muscle wasting
GI irritation, take with food
Electrolyte disturbances (hypernatremia, hypokalemia)
Increase in blood glucose
Susceptible to infections
Mood disturbances
Cushing’s Syndrome (too much sugar)

Question 7

Methotrexate

Answer 7

DMARD FOR RA

Hepatotoxic
NVD
Bone marrow suppression
CI in pregnancy

Question 8

Etanercept

Answer 8

DMARD FOR RA

Susceptibility to infection

Question 9

Colchicine

Answer 9

ACUTE GOUT

GI

Question 10

Sumatriptan

Answer 10

MIGRAINE

Nausea, weakness (from high amt of vasoconstriction)
Vasoconstriction
-numbness
-tingling
-CP, tightness
-heavy arms
-CI for patients with CV problems, such as angina, obesity, HTN, congestive heart failure
No smoking, no cold weather

Question 11

Ergotamine & Dihydroergotamine

Answer 11

MIGRAINE

Nausea, weakness (from high amt of vasoconstriction)
Vasoconstriction
-numbness
-tingling
-CP, tightness
-heavy arms
-CI for patients with CV problems, such as angina, obesity, HTN, congestive heart failure
No smoking, no cold weather
CNS excitation effects
Uterine cramping (spasms, can be used in post partum hemorrhages to constrict bleeding)

Toxicity: ergotism
-burning pain (vasoconstriction may cause vessels to close -> blood pools -> throbbing)
-hallucinations

Question 12

Cimetidine & Ranitidine

Answer 12

HYPERACIDITY, GERD, ULCERS

CNS effects (disorientation, confusion, changes in pH with elderly
Pneumonia
*caution if impaired renal or hepatic function
-inhibits liver metabolising enzyme -> care with patients taking phenytoin, warfarin
-less acid -> impairs absorption

Question 13

Omeprazole

Answer 13

(for hyperacidity, GERD, ulcers)

Side effects
-headache
-dry mouth
-diarrhea

Question 14

Sucralfate

Answer 14

(for hyperacidity, GERD, ulcers)

very few side effects

Question 15

Ondansetron

Answer 15

ANTIEMETIC

Side effects
-headache
-constipation
-diarrhea
CI: hx of allergic reactions

Question 16

Chlorpromazine

Answer 16

ANTIEMETIC

EPSE (movement)
Sedation
CI = Parkinson’s

Question 17

Nabilone

Answer 17

ANTIEMETIC

Side effects
-mental disturbances
-drowsiness
-abuse/dependence
CI: pt with psychiatric disorders

Question 18

Scopolamine & Diphenhydramine

Answer 18

ANTIEMETIC

Dry mouth

Question 19

Polycarbophil & Methylcellulose

Answer 19

SLOW-ACTING LAXATIVE

Side effects
-least harmful
-mix with fluid

Question 20

Docusate

Answer 20

SLOW-ACTING LAXATIVE

Side effects
-mild abdominal cramping (from all the peristalsis)

Question 21

Bisacodyl & Senna

Answer 21

INTERMEDIATE-ACTING LAXATIVE

Cramping (from all the movement)
Laxative abuse (bowel becomes dependence and losing own intrinsic factor)

Question 22

Laxative salts

Answer 22

INTERMEDIATE-ACTING LAXATIVE

Cramping

Question 23

Penicillin G, Amoxicillin, Oxacillin, Amox + Clavulanate, Ceftriaxone, Ceftaroline

Answer 23

BETA-LACTAM (CELL WALL)

Allergic reactions
-rashes
-urticaria
-anaphylaxis
-guidelines (be careful, skin tests)
GI distress
-take with food
-divide dose
-use probiotics
-water after

Question 24

Tetracyclines & Minocycline

Answer 24

PREVENT BACTERIAL PROTEIN SYNTHESIS

GI disturbances
Superinfection
*May stain teeth in children under 8, not to be given
Photosensitivity
Hepatotoxicity
Food and drug interactions (avoid antacids, milk/dairy, no mineral supplements)

Question 25

Chloramphenicol

Answer 25

PREVENT BACTERIAL PROTEIN SYNTHESIS

GI upset
Superinfection

Question 26

Erythromycin & Clarithromycin

Answer 26

PREVENT BACTERIAL PROTEIN SYNTHESIS

GI disturbances
Superinfections
Ototoxicity: erythromycin
Kidney and liver damage

Question 27

Clindamycin

Answer 27

PREVENT BACTERIAL PROTEIN SYNTHESIS

GI disturbances
Superinfection
-AAPMC
Rashes
Anaerobic infections
Watery, bloody stools

Question 28

Gentamicin

Answer 28

PREVENT BACTERIAL PROTEIN SYNTHESIS

Triad:
-Nephrotoxicity (kidney, renal failure; 3L of water a day)
-Ototoxicity (toxic to ear/cranial nerve 8)
-Neuromuscular blockade (problems breathing, muscle impairment, watch for pt with Parkinson’s)
Headache, confusion, tremors
Blood dyscrasias (blood count is off)

Question 29

Ciprofloxacin

Answer 29

INHIBIT DNA REPLICATION

Triad:
-GI: NVD
-CNS: dizziness, headache, tinnitus, insomnia
-cartilage and tendon damage (do not give to children, interferes with growth cartilage)
Allergies: rash, urticaria, photosensitivity
Superinfections

Question 30

Metronidazole

Answer 30

ANTIBIOTIC FOR ANAEROBIC INFECTIONS

GI: NVD
Metallic taste in mouth
Abdominal cramps
May discolor urine
CNS: dizziness, headache
Damages DNA in pregnancy
Violent reaction with alcohol (flushing, nausea, headaches, cramps)

Question 31

Vancomycin

Answer 31

ANTIBODIES FOR NOSOCOMIAL INFECTIONS

Triad:
-IV infusion = nausea, flushing, itching
-histamine release -> “red neck”
-nephrotoxicity (most common, decreased kidney function -> drink more water)
Ototoxicity

Question 32

Daptomycin

Answer 32

ANTIBODIES FOR NOSOCOMIAL INFECTIONS

GI
CNS
Myopathy (muscle pain)

Question 33

Linezolid

Answer 33

ANTIBODIES FOR NOSOCOMIAL INFECTIONS

GI