Pharm Exam 3 Flashcards
what kind of drug is contraindicated for an asthma patient?
bronchoconstrictors
Where does bicarb get secreted
epithelial cells of the stomach and duodenum
What type of drug is toradol
NSAID, nonopioid analgesic, inhibits prostaglandin. 5 day use only
Where does NSAIDs inhibit prostaglandins
periphery
This is a stool softener/lubcricant that increases water retention in the stool
emollient laxatives
This is a short acting potent antacid that is sytemically absorbed
- alka selzer (Sodium Bicarbonate)
- anti-ulcer agent
- admin PO or IV- for metabolic acidosis
- SE: cerebral hemorrhage, edema
Side effects of stimulant laxatives?
- hypokalemia
- tetany
- muscle weakness
What kind of drug is colchicine?
inhibits inflammation fo gout only, inhibits migration of leukocytes to the inflamed site.
What lab values do you need for antimalarial agents?
- Eye Exams due to retinal damage
- monitor CBC & platelet
Can rapid acting insulin be mixed with intermediate or long acting?
Yes
Name the onset, peak and duration for short acting insulin
- Onset 30 minutes
- Peak 2-4 hours
- duration-6-8 hours
What should a patient using opiods take caution with
- mao inhibitors
- additive cns depression with alcohol
- anti-depressants
- antihistamines
What is uric acid?
A by product of metabolic breakdown of purine (found in food and drinks)
How often do you adminterster intermidate acting insulin
Twice a day
What can aspirin do to a mother who is pregnant?
can cause premature closure of the ductus arteriosus
How do stimulant laxatives work?
increase peristalis by irritating sensory nerve endings in the intenstinal mucosa
Drug categories to treat motion sickness
- anticholinergic
- Antihistamines
- DO NOT ADMINISTER IF GLAUCOMA
Can short acting insulin be mixed with intermediate and long acting?
yes
Tell me about Imuran
- Its an immunosuppressant
- used for severe R.arthritis
- purine antagonist
-one drugs
glucocorticoids
What does mylanta and Maaxlox contain?
Magesium w/ Aluminum Hydroxide
If a patient is NON responsive what do you give for hypoglycemia
Glucagon or dextrose
Tell me about Colace
- Emollient Laxative/Stool softener
- do not take within 2 hours of other laxatives
What does intermediate acting insulin end in…humulun…
R its cloudy
Name the peak, onset, and duration for rapid acting insulin
(lispro, aspart)
- Onset- 10 min
- Peak- 30-60 min
- Duration-3-5 hours
What is the action for metformin
- decrease hepatic production of glucose
- reduce absorption in the gut
- safe for patients that skip meals
- DOES NOT RELEASE INSULIN
What do ergo derivaties do
suppress CCGRP
Amitriptyline is a tricylci antidepressants what does it do to prevent migraines?
allows more sertonin for 5ht receptors
What percent of dextrose do you use for a child
D10% (iv therapy)
This is a first line treatment for short term and long term use laxative
bulk laxatives
Name some bulk laxatives
- fiberCon
- Citrucel
- Metamucil
What is the drug of choice for type 2 diabetes?
metformin (glucophage)
-prazole drugs
proton pump inhibitors
Tell me about hydroxychloroquine?
- Its an antimalarial/antirheumatic (DMARD)
- severe rheumatoid/lupus
- inhibits protein synthesis
- Seizures
What do antimuscurainic drugs do?
inhibit the action of acetylcholine at site innervated by postganglionic cholinergic nerves
This is rebound hyperglycemia causing blood sugar to drop during the night
Somogyi Effect
What happens to Calcitonin Gene Related Peptide during a migraine?
Rise
How long can a prefilled syringe of insulin be kept in the refrigerator?
1-2 weeks, avoid direct sunlgiht
How long can you keep insulin at room tempearute
1 month, also less irritating to the skin
What do steroid drugs end in?
-sone
Name the onset, peak, and duration for Intermediate Acting insulin
- Onset- 1-2 hours
- Peak 6-12 hours
- Duration 18-24 hours
Tell me about Sodium phosphate
- osmotic laxative/min.electrolyte supplement/phosphate supplelement
- can cause cardiac arrest
- fluid retention
What are side effects of steroids
- effect metabolism
- influence electrolytes
- should be tapered
What drug can provide prophylaxis for a patient with high dose aspirin or NSAIDS?
Carafate
Name the drugs that can manage GERD?
Reglan, Carafate (off label)
What does short acting insulin end in…humulin/novolin
R- for ShoRt
Tell me about carafate
- Anti-ulcer/GI protectant
- mgmt duodenal ulcers
- reacts w/ gastric acid forms a thick paste
- could cause allergic rxt, dry mouth, hyperglycemia
This drug is used for pain and cough suppression it can be used with acetominophen
Hydrocodon (Lortab, Vicodin)
What are preventitive medications for migraines?
- Betablockers (Inderal)
- trycyclic Antidepressants
- Anticonvulsants
What is regular insulin?
short acting insulin, IV
Where does acetaminophen inhibit prostaglandins
only the cns
Tell me about imodium
- antidiarrheal
- increases fecal viscosity and bulk
- doesn’t cross blood brain barrier
- SE: drowsiness, constipation, avoid CNS depressants
How do you administer glucagon, how long does it take to work?
IV, 10 minutes (may vomit)
These drugs end in -mine
antihistamines
Tell me about acarbose
- Alpha Glucosidase Inhibitor/Antidiabetic
- MGMT type 2
- delays glucose absorption
- PO
- SE: ab distention
What do serotonon drugs end in?
ptans
Why should you NOT take metformin before a Ct scan?
- it has iodine
- can cause lactic acidosis 50% mortality rate
- renal insufficiency
Fight or flight
glucose level should be up
What are th drug categories for DMARDs x4
- gold drug therapy
- immunosuppressive agnets
- antimalarial agent
- immunomodulators
What are some drug/food interactions with aspirin
- should not take with anticoagulants
- oral antidiabetics
- gluccorticoids (g.ulcer risk)
Drug classes for antiarthritic drugs
- corticosteroids
- NSAIDs
- DMARDs
What is the name of long acting insulin?
Lantus…for lllong
Where is bicarb produced?
pancreas
What do you need to assess with NSAIDs? x5
- asthma
- rhinitis
- urticaria (rash)
- GI bleeding
- Renal Function
This happens to everyone and is due to hormones causing glucose levels to rise during the night
Dawn Phenomenon (wake up hyperglycemic)
How often should you give lantus and when should they take it
once a day, before bed (somogyieffect)
What do proton pump inhibitors end in?
-prazole
mineralcorticoids make you hold on to salt and water
What lab value to you want to get for gold drug therapy
monitor CBC & nephrotoxcity
Tell me about Tums (calcium carbonate)
- Mineral/Electrolyte replacement
- SE: constipation, dysrhythmias
What are side effects of Acarbose?
gas, cramps, abdominal distention. Not too significant
This drug binds chemicals in the GI tract for acute posioning following emesis
Activated Charcoal
Se: black tarry stools, upper GI bleed, constipation
How long can insulin be kept in the refridgerator?
3 months
What are side effets of Ergo Derivatives?
phys dependence, rebound headaches, cateogry X (caus u. contractions)
What lab values do you need for immunosuppressive agents?
- CBC
- renal
- hepatic
What is gout?
Caused by elevated uric acid in the blood. It crystallizes and deposits in the joints.
What insulin types are cloudy
Lispro, NPH (intermediate)
What disease can be caused by steroids due to adrenal insufficiency?
Addison’s Disease
Name antimuscarinic drugs
- glycopyrrolate
- propantheline
- scopolamine
increase heart rate, decrease GI motility
Name some side effective of bulk laxatives
- bronchospasms
- decreased absoprtion of other drugs
- esophageal intestinal obstruction
- can solidify in the GI
Tell me about Rolaids (Calcium Cav w/ Mag Hydroxide)
- min electrolyte replacement
- heartburn, dyspepsia, flatulence
- requires Vitamin D to be absorbed in the GI
- SE:constipation
What does rapid acting insulin end in
-log
How do antihistamines work in preventing motion sickness?
decrease excitability of the middl ear and depress conduction in pathways
SE: dry mouth
What lab values do you want for immunomodulators?
Monitor CBC
Tell me about Aluminum Hydroxide
- Antiulcer agent/antacid/phosphate binder
- Binds phophate in the GI tract
- SE: constipation
Tell me about auranofin
- Gold Therapy Drug
- antirheumatic
- arrest the progression, prevent deformities
- response is slow
- caution for GI bleeding, diarrhea, anorexia, stomatitis
What is the most effective drug for gastric acid secretions?
proton pump inhibitors
can cause bloody stools, diarrhea, fever
What does anticholinergics inhibit?
- acetylcholine
- anti muscarinic
Other than respiratory depression, what else can opiods cause?
constipation, urinary retention, orthostatic hypotension
What does allopurinol inhibit?
uric acid
What are side effects for colchine
nausea, vomiting, diarrhea, ab pain
Tell me about Lactulose
- Osmotic Laxative
- Treatment of chronic constipation
- lower pH of colon
- pulls ammonia into the bowel
- good for liver disease
What is a side effect of Triptans?
coronary vaospasma, heavy arms, and chest pressure
Tell me about Surfak (docusate calcium)
emollient laxative/stool softener, incorporates water into the stool
Tell me about magnesium hydroxide
- osmoic laxative
- draw water into the lumen causing peristalsis
- monitor renal function
Tell me about Remicade
- Antirheumatic/Gastrointestinal/Anti-inflammatory
- Moderate to severe R.Arthritis w/ Methotrexate
- prevents TNF-alpha
- decreased pain, decreased rate of joint destruction
- can cause infections (reactivate TB)
What are some things a patient with GERD can do to improve lifestyle
dont eat meals before bed, quit smoking, cut back on caffeine
Tell me about indocin
- approved for arthritis and gout
- can be given IV to preterm infants to promote closure of the ductus arteriosus
What antihistamines are used to treat motion sickness x2?
- dimenhydrinate
- meclizine
What does Cox 2 inhibitor do?
- reduces pain
- reduces fever
- supresses inflammation
What do prostaglandin secrete?
mucu and bicarb (antacid)
What is the drug category for aspirin?
- antipyretic
- nonopiod analgesic
- salicylates
Tell me about Reglan
- Antiemetic
- chemotherapy induced emesis
- blocks dopamin receptors in CNS
- stimulates motility of the upper GI tract
- accelerates gastric emptying
- NMS (fever, muscular rigidity, altered mental status, and autonomic dysfunction)
What does Cox 1 inhibitors do?
- affects stomach lining which can lead to ulcers
- prevent blood clotting
What are side effects of Cox 2
- Peripheral edema
- headache dizziness
- (maintains renal function)
What happens to Serotonin 5-HT during a migraine?
falls
What are treatments for aborting a headache?
- aspirin/acetominophen
- sertonin Agonists (triptans)
- Ergo Alkaloids
What is the drug of choice for rheumatoid arthritis?
aspirin
What type of laxatives can be abused?
Stimulant Laxatives
(Ex Lax, Dulcolax, Castor Oil)
How does exercise support diabetic patients
- Need less insulin
- use insulin more effeciently
- Lower A1c
- Muscle take up glucose and use for energy wheter insulin is avaliable or not
What is the antidote for Acetominophen
Mucomyst
If you give patient steroids, glucose level with go up or down?
up
Name the onset, peak and duration for long acting insulin
- Onset 1 hour
- Peak- None
- Duration-24 hours
This drug is an opiod but does not have the abuse potential that other opiods have?
Codein Schedule II and III
more likely to cause constipation
