Pharm Exam Finale Flashcards
1
Q
Fluticasone
A
- Rinse mouth after use
- Works best if used daily (bc it is a steroid)
- ## Usually, combined w. LABAs
- Weight gain
- Thrush
- Rare adrenal suppression
- Epistaxis (nose bleeds)
- Localized irritation
2
Q
Montelukast
A
- Not for rescue
- Oral pill (not inhaled)
- Class: leukotriene modifier
- ## Long term use of asthma
- Psychiatric
- Depression/suicidal thoughts
- Liver impairment
3
Q
Formoterol
A
- Bronchodilator
- LABA
- DON’T use in acute bronchospasm
- Long-term use
- ALWAYS/MUST BE combined w steroid (inc. risk
of death)
————————————————————————– - Tachycardia
- Angina
- Tremors
4
Q
Levalbuterol
A
- SABA
- Less Beta-1 agonist activation (not as tachycardic)
- ## Expensive (not given much)
- Tachycardia: less likely
- Angina
- Tremors
4
Q
Albuterol
A
- On it for life
- SABA
- Rescue inhaler/for acute bronchospasm
- Nebulizer has a higher dose vs. inhaler
- Commonly combined w. Atrovent to create
Duoneb
————————————————————————— - Tachycardia
- Angina
- Tremors
5
Q
Ipratropium
A
- Onset within 30 sec.
- Lasts 6hrs.
- Anticholinergic (monitor for s/s)
- Use: acute bronchospasms
***combined w. albuterol = Duoneb
————————————————————————— - Anticholinergic s/s
6
Q
Cetirizine
A
- 2nd gen antihistamine
- Use: allergies
- Doesn’t reduce nasal congestion; less drowsy than 1st gen.
- ## Most effective prophylactically (taken daily)
- Excitatory phase in pediatrics (same as Benadryl; sleepy then wired)
- Anticholinergic s/s (could result in catheterization)
7
Q
Codeine
A
- THE BEST antitussive (cough)
- Opiate pain med
- Monitor for resp. depression
- ## Give in small doses
- Resp. depression
- Opiate side effects (constipation, addiction,
slurred speech, etc.)
8
Q
Guaifenesin
A
- Expectorant
- More productive coughs (yay)
- Used for when pt. can’t get up thick secretions
(supportive treatment)
————————————————————————– - Renal based
9
Q
Benzonatate
A
- Assess neuro function
- Cough suppressant/antitussive
- DO NOT crush, let it sit in back of mouth so it
numbs the area
————————————————————————— - Numbness
- Drowsiness
- Constipation
- Insomnia
10
Q
Calcium Carbonate
A
- Direct neutralization of stomach acid
- ## Short-term effects
- Constipation
- Gas
- Can cause electrolyte abnormalities
10
Q
Famotidine
A
- Rapid absorption in small intestines
- Class: Histamine 2 (H-2)
- Suppresses gastric acid
- Can be taken at meal times
- ## 1st line treatment for prevention of ulcers in ICU patients
- Pneumonia
- CNS effects
- Refractory Acid Reflux
11
Q
Omeprazole/Pantoprazole
A
- Most effective in suppressing gastric acid secretion
- Well tolerated
- Treatment option for PUDs
- ## Take first think in morning (SOMETIMES before bed)
- Headaches,
- N/V/D
- High risk for C/ diff
- Hypomagnesium (long term use)
- DO NOT take with other meds
12
Q
Bismuth
A
- H pylori treatment
- ## Treats all GI symptoms (nausea, heartburn, indigestion, upset stomach, diarrhea)
- Dark stools
12
Q
Metoclopramide
A
- Use: N/V to promote gastric motility
- ## Major use: diabetic gastroparesis
- EPS s/s (ex. Tardive dyskinesia)
- Sedation
- Diarrhea
12
Q
Sucralfate
A
- Creates coating on stomach for PUD
- DO NOT give w. other meds
- Given at meal times
- ## Pill or drink (both are dissolved in water) -No serious AEs-
13
Q
Docusate
A
- Take w. full glass of water
- ## Inc. water in stool
- Diarrhea, abdominal cramping
14
Q
Magnesium Citrate
A
- Laxative (stool softener)
- Off label use: GI prep
- Very fast-acting
- Ensure hydration
- ## Patient takes the whole bottle to drink
- Not for renally impaired -> they will end up with very high mag levels
- Fluid and electrolyte imbalances
15
Q
Polyethylene glycol
A
- Ensure hydration
- Monitor food and electrolytes
- ## First-line constipation treatment (prophylactic)
- GI S/s
16
Q
Loperamide
A
- Most effective antidiarrheal (because its an opiate)
- Never use to treat diarrhea caused by infection
- ## Check allergies related to opiates
- Constipation
17
Q
Dicyclomine
A
- Use: IBS
- Stops cramps
- ## Antispasmotic
- Paralytic ileus (GI stops moving) treat with ambulation
18
Q
Scopolamine
A
- Sticker behind the ear (transdermal use)
- Good for hospice (makes em sleepy, dry mouth)
- Anticholinergic
- ## Watch for local skin reaction (particularly w the stickers)
- Anticholinergic s/s
19
Q
Meclizine
A
- ## Use: motion sickness (cruise ship drug)
- Drowsiness (bc its an antihistamine) - Anticholinergic s/s
20
Q
Ondansetron
A
- (Zofran)
- First-line treatment for nausea
- VERY well tolerated
- Can be given sublingually (ODT)
- ## Only helps if given before emesis (puking)
- QT prolongation**
- Headache
- GI symptoms
21
Vit D
- Pts. W deficiencies or fractures (supports bone health)
- Almost always given w. Calcium (not for cancer pts.)
-------------------------------------------------------------------
- No AE with the vitamin (its naturally occurring)
22
LMWH (low molecular
weight heparins)
- Inactivates factor Xa
- DVT prophylaxis
- Antidote is protamine sulfate
- BID Dosing – active
- Bruising
- Monitoring for bleeding
23
Heparin
- Does not matter if the kidneys suck
- DOC for pt with bad kidneys for DVT prophylaxis
- Antidote is protamine sulfate
- Heparin-induced
thrombocytopenia
(low platelets)
24
Warfarin
- Vitamin K antagonist so if diet has lots of vitamin K, gonna change warfarin
- Works slow
- Monitor PT/INR (clotting time) 2.0-3.0 normal is < 1
- Reverse overdose – FFP (fresh frozen plasma)
- If INR high skip a dose…
- Do not reverse if not bleeding!!
- Antidote VITAMIN K
- Hemorrhage
- Teratogenesis
25
Rivaroxaban
- Xa inhibitors
- Used for A fib and DVT
- Lower dose for renal
- Last for a long time
- Transition med: heparin
- Antidote: Kcentra
- Bleeding
- Interaction with
antibiotics
26
Apixaban
- Xa inhibitors
- Used for A fib and
DVT
- Lower dose for renal
- Last for long time
- Transition med:
heparin
Antidote: Kcentra
- Bleeding
- Interaction with
antibiotics
27
Aspirin
- 81 mg/day general coronary artery disease prevention
- Active problem – 325 mg
- Clot prevention
- NSAID
- Give enteric-coated
to not mess with
stomach pain
- Bleeding
- Hemorrhagic stroke
28
Clopidogrel
antiplatelets
- Paired with aspirin
for 12 months if you
have a heart attack
- Listen to recording
38:00
- Bleeding
- Hemorrhagic stroke
29
Alteplase (Tpa)
- Go to med for strokes previously, now to break up formed clots
- Used in MI, ischemic stroke, massive PE
- Given for heart attack when cath lab not available!!!
- Screen for bleeding
- Monitor patients closely
-bleeding
30
Kcentra
- Given when actively bleeding
- Provides many factors
- Heparin allergy can't take!!!
31
Epoetin Alfa
- Pt with low hemoglobin with no chance of it getting better on its own
- Monitor for thrombosis
- HTN (contraindicated with HgB of 11 due to
incr risk of A/E) , TIA, MI, thrombolic events
32
Ferrous sulfate
- Iron deficient
- Vitamin c enhances absorption
- Oral replacement isn’t as good
- Overdose tx: deferoxamine (deferral)
- Black stool
- Constipation
- N/V
- Brown stains on teeth
33
Baclofen
- Muscle relaxer
- Not used with stroke
- Sedation
- withdrawal
34
Alendronate
(Fosamax) - used for osteoporosis
- take with full glass of water in upright position for 30 mins to hour after taking, med can get stuck on esophagus and cause ulcer
- take 30 mins before first food, beverage, or med
- N/D
- Dyspepsia
- Flatulence/constipation
- Bone fractures
- Myalgia
35
Colchicine
(Colcrys)
- antigout medication
- only give for 2 days to help inflammatory process and reduce inflammation
- GI
- N/V/D
- Myopathy
36
Allopurinol
(Zyloprim)
- Reduce levels of uric acid over time
- Not effective for acute exacerbation
- Chronic gout, given everyday
- Dietary changes
- Hypersensitive syndrome
- GI effects
- Neuro effects
37
The management of H. Pylori
- Metronidazole (antibiotics as a whole)
- PPI or H2
- Pepto bismol
- Tx lasts for over a month
- Breath test or stool sample to test for H. Pylori
38
Know the management of HIT
- Stop heparin
39
the management of DVT
- Prevented with lovenox, heparin, pills
- Prophylaxis: compression socks, SCDs, meds ^
- Good kidneys: lovenox
- Bad kidneys: heparin
- If bleeding for prophylaxis, give socks/SCD (for example: HgB is 5 or actively bleeding)
- IVC filter: inferior vena cava filter to prevent clots
40
Bone cocktail:
calcium, vitamin D, once those levels are good…give alendronate!!!! If you don’t have enough vitamins to build bones, can’t build them
