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Pharmacology Exam 3* > Pharm Exam 3 > Flashcards

Pharm Exam 3 Flashcards

1
Q

What is the dose for colchicine?

A

1.2 mg (2 tablets) then 0.6 mg 1 hour later until symptoms subside

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2
Q

What is the biggest side effect with colchicine?

A

diarrhea

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3
Q

What lab values should be monitored with gout?

A

serum uric acid levels, CBC, renal and hepatic fx

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4
Q

allopurinol, febuxostat, and probenecid are __________ drugs for gout, not rescue meds

A

Maintenance

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5
Q

avoid _________ as it precipitates gout flares

A

alcohol

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6
Q

report any signs of _________ or _________ when taking colchicine

A

neuropathy or myopathy

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7
Q

What types of food should you avoid when taking colchicine?

A

oxalate rich foods; organ meats (liver, kidney), some fish such as sardines, trout
turkey, venison

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8
Q

What patient teaching will you provide when prescribing febuxostat (Uloric)

A

symptoms will get worse before they get better. Can take NSAIDs up to 6 months to help

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9
Q

These symptoms are all caused by what?
thinning of the skin, alopecia, acne, poor wound healing, myopathy, muscle wasting, osteoporosis, , skeletal fractures, peptic ulcer disease, HTN…

A

The use of corticosteroids for >6 months

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10
Q

What is steroid psychosis?

A

Caused by overuse of corticosteroids and causes: delirium, agitation, insomnia, mood swings, severe depression

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11
Q

Why is it important to taper the corticosteroid dose?

A

prevent adrenal insufficiency

avoid trigger of reoccurence of disease

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12
Q

What are the black box warnings for NSAIDs

A

increase risk for cardiovascular events (MI, stroke) and increased risk for GI adverse effects such as bleeding, ulceration, perforation

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13
Q

What are the recommendations in the treatment of pain?

A

First-choice: NSAIDs before opioids

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14
Q

What is the MOA of ibuprofen?

A

COX-2 inhibitor

decreases prostaglandin synthesis

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15
Q

What are the serious side effects associated with acetaminophen? /

A

acute toxicity –> liver failure

chronic toxicity –> renal failure

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16
Q

These symptoms describe what? decreased LOC, hunger, diaphoresis, weakness, dizziness, tachycardia

A

hypoglycemia

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17
Q

These symptoms describe what? Polyuria, polydipsia, polyphagia

A

Hyperglycemia

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18
Q

These symptoms describe what? Drowsiness, dim vision, Kussmaul’s respiration, cherry red lips, abdominal pain, ketone-odor breath

A

Ketoacidosis

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19
Q

What drug class is metformin?

A

Biguanide

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20
Q

How does metformin work?

A

It increase peripheral glucose uptake, decreases hepatic glucose production, and decreases intestinal absorption of glucose. it also decreases glycogenolysis by the liver.

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21
Q

What diagnostic testing is required before and throughout therapy with metformin?

A

renal function, liver function, CBC, serum electrolytes and ketones, BG

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22
Q

dipeptidyl peptidasase-4 inhibitors (DPP-4): “_____”

A

gliptins

sitagliptin, saxagliptin, linagliptin, alogliptin

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23
Q

How do gliptins work?

A

acts on the incretin hormone system to increase insulin production

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24
Q

Glucagon-like peptide (GLP-1) agonists (albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide) MOA:

A

directly binds to the GLP-1 receptor in the beta cell and acts as an incretin mimetic

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25
Q

when should exenatide be administered? (GLP-1 Agonist)

A

60 minutes before a meal. Do not administer after a meal.

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26
Q

What are the adverse effects of propylthiouracil?

A

agranulocytosis and possible aplastic anemia

can cause drug-induced hepatitis

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27
Q

what is the BBW for propylthiouracil?

A

liver failure

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28
Q

What two drugs are used to treat toxic goiter?

A

methimazole and propylthiouracil

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29
Q

What are the doses of the two drugs used to treat toxic goiter?

A

methimazole: 60 mg/day TID

propylthiouracil 600-900 mg/day TID

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30
Q

What signs should a patient report while taking propylthiouracil?

A

fever, sore throat, abnormal bleeding/bruising

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31
Q

What is the MOA for alpha-glucosidase inhibitors?

A

block carbohydrates

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32
Q

What is the dosage for alpha-glucosidase inhibitors?

(Acarbose, Miglitol) AND when should this be taken?

A

25 mg x4 weeks with first bite of meal

increased by 25 mg up to 75 mg/day

33
Q

If a patient is less than 60 kg, what dose of acarbose or miglitol should be prescribed?

A

50 mg TID

34
Q

Describe the pharmakodynamics of meglitinides

A

stimulate insulin secretion to lower postprandial BG levels

35
Q

what is the MOA of propylthiouracil?

A

blocks the conversion of T4 to T3 (INHIBITS THYROID HORMONES)

36
Q

What are the contraindications for taking alpha-glucosidase inhibitors?

A

bowel diseases such as IBS. These drugs produce gas.

37
Q

What patient education is important relative to the administration of levothyroxine?

A

should be taken 30 minutes before breakfast on an empty stomach. take in the morning to prevent insomnia.

38
Q

What is the BBW for the administration of thiazolidinediones (TZDs)

A

heart failure and bladder cancer

39
Q

What symptoms may indicate that a patient is taking too much thyroid replacement drug?

A

symptoms of hyperthyroidism
tachycardia, arrhthmias, angina, tremors, insomnia, irratabillity, V/D, Weight loss, menstrual irregularities, heat intolerance

40
Q

What is the MOA of metformin?

A

increases insulin sensitivity, decreases hepatic glucose production, and decreases intestinal absorption of glucose

41
Q

What lab values will be used to monitor a patient who is on levothyroxine?

A

TSH and free T4

42
Q

Two rapid acting insulins:

A

aspart and glulisine

43
Q

two short-acting insulins

A

regular insulin and R U-500

44
Q

What is the intermediate insulin?

A

NPH

45
Q

Name three long-acting insulins

A

glargine, detemir, degludec

46
Q

When changing from NPH insulin, how will you adjust the patient’s dose?

A

Add total daily dose then decrease by 20% and make adjustments by the patient’s response

47
Q

What are the side effects of insulin therapy?

A

hypoglycemia, hypokalemia, weight gain

48
Q

What assessment should be made before prescribing anti-hypertensive agents?

A

baseline BP and pulse, diet, sodium intake, electrolytes (especially potassium d/t diuretic therapy)
weight and other fluid status indicators

49
Q

What should you monitor when prescribing ACE-I, ARBs, and DRI (direct rennin inhibitors)

A

RENAL FUNCTION and potassium levels

50
Q

Why are ACE inhibitors the drug of choice in a diabetic patients with HTN?

A

They delay progression of diabetic neuropathy

51
Q

What is the MOA for ACE-I

A

decreased production of both angiotensin II and aldosterone

52
Q

What is the most common adverse effect of an ACE inhibitor?

A

dry, hacking cough

53
Q

What is the MOA for ARBS

A

block angiotensin II receptors

do not produce dry, hacking cough

54
Q

What is the MOA for CCB?

A

Block calcium channels resulting in decrease in trans-membrane calcium and prolonged vascular smooth muscle relaxation

55
Q

What are the two types of CCBs?

A

dihydropyridine type “PINE” or non-dihydropyridine type (verapamil)

56
Q

side effects of CCB?

A

dizziness, hypotension, tachycardia, increase proteinuria which causes edema

57
Q

What are the adverse effects of statins?

A

risk of myopathy and the resulting rhabdomyolysis

58
Q

What patient education will you provide for patients taking statins?

A

report any muscle weakness
avoid alcohol
do not take if pregnant

59
Q

What lipid disorders do fibric acid derivatives treat?

A

hypertriglyceridemia

60
Q

What disorders do bile acid sequestrants treat?

A

hyperlipidemia

61
Q

What is the MOA for fibric acid derivatives?

A

promotes secretion of LDL which is then cleared by a receptor-mediated mechanism (so lower overall LDL)

62
Q

What is the MOA for bile acid sequestrants?

A

reduce plasma low-density lipoprotein (LDL) by interrupting the enterohepatic circulation of bile acids, with consequent diversion of hepatic cholesterol toward the synthesis of new bile acids

63
Q

What would you recommend to a patient who is experiencing flushing while taking niacin?

A

gradually increase the dose over a few weeks

pre-treat with ASA 30 minutes before, and take the extended release form (Niaspan)

64
Q

What type of drug is amlodipine?

A

dihydropyridine CCB

65
Q

How is amlodipine metabolized?

A

CYP3A4 system in the liver

avoid grapefruit

66
Q

What are the side effects of amlodipine?

A

dizziness, hypotensin, edema (which can exacerbate HF)

67
Q

What patient teaching will you provide when taking amiodorone?

A

take as prescribed. Don’t double doses, it has a very long half life. Abrupt withdrawal can cause life-threatening arrythmias, MI, or stroke. Can also cause pulmonary toxicity. Change positions slowly d/t hypotension

68
Q

What are the drug interactions with digoxin?

A

any drug that cause hypokalemia, hypercalcemia, or hypomagnesemia

69
Q

What is the purpose of a thyroid panel while taking amiodarone?

A

amiodarone (structurally similar to thyoxine) inhibits the thyroid gland and results in inflammation causing either hyperthyroidiism or hypothyroidism

70
Q

What is nitrate intolerance?

A

continuous exposure to nitates cause them to lose effect. Need to be free for 10-12 hours before regaining their effects.

71
Q

What are the contraindications to warfarin?

A

any type of bleeding issues or pregnancy

72
Q

What classes of medication are used in the treatment of HF?

A

ACE inhibitors are the first-line of treatment

73
Q

What are the adverse effects of procanimide (anti-arrhythmic agent) and what patient teaching will you provide?

A

hypotension–change positions slowly
take caution while driving d/t sedative effects
report fever, chills, sore throat, or unusual bleeding (agranulocytosis)

74
Q

What lab monitoring will be completed for a patient taking statins?

A

cholesterol, liver fx

75
Q

3 contraindications for ACE-I and ARBs?

A

bilateral renal artery stenosis
angioedema
pregnancy

76
Q

What patient education will be provided when taking thiazolidiediones (TZDs)

A

don’t use with patients with bladder CA or HF

may need to increase BC dose or choose alternative treatment for BC

77
Q

What is the daily maximum dose of APAP?

A

4 gm/day

78
Q

Can schedule 2 drugs be refilled?

A

NO

79
Q

Can schedule 3 drugs be refilled?

A

prescription must be rewritten after 6 months or 5 refills (narcotics with codeine, stimulants, depressants

Pharmacology Exam 3* (1 decks)

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