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CSR > Pharm part 3 > Flashcards

Pharm part 3 Flashcards

1
Q

Common indications for Coumadin

A

Prophylaxis or tx of pulmonary embolism or venous thrombosis
Treatment of a fib with embolization
Adjunct in tx of coronary occlusion

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2
Q

MOA of Coumadin

A

Antagonizes synthesis of vit K dependent clotting factors II, VII, IX, and X, as well as proteins C and S

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3
Q

Adverse effects of Coumadin

A

Bleeding
Bruising
Nausea
Diarrhea

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4
Q

Renal or hepatic adjustments for Coumadin

A

No definitive adjustments- monitor INR closely in renal and hepatic impairment

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5
Q

BBW for Coumadin

A

May cause major or fatal bleeding

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6
Q

Drug interactions of Coumadin

A

Enhanced anticoag effects with alcohol, allopurinol, amiodarine, adrenocortical steroids, cimetidine, disulfiram, erythromycin, metronidazole, salicylates, Bactrim/Septra, and thyroid medications
Decreased anticoag effects with carbamazepine, cholesyramine, rifampin, and vit K

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7
Q

Counseling of Coumadin

A

Take only as directed
Avoid alcohol and aspirin-containing drugs
Do not begin or d/c other medications without first consulting your physician
Store in a cool dry place away from kids and sunlight
If dose is missed, take it as soon as possible
If it is closer to the time of your next dose, skip the missed dose and resume nl dosing schedule- do not double doses
Be consistent with the amount of green leafy vegetables eaten

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8
Q

Monitoring of Coumadin

A

INR
Bruising
S/sx of bleeding

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9
Q

Common indications for atenolol

A

HTN

Angina pectoris

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10
Q

MOA of atenolol

A

Cardioselective beta-1 adrenergic receptor blocker which results in decreased HR and CO

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11
Q

Common SEs of atenolol

A 
Drowsiness
Dizziness
Bradycardia
Hypotension
Fatigue
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12
Q

Renal or hepatic dosage adjustments for atenolol

A

Renal: CrCl 15-35: max dose 50 mg/day

CrCl <15: max dose 25 mg/day

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13
Q

BBW for atenolol

A

Withdrawn abruptly can cause acute tachycardia, HTN, and/or ischemia

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14
Q

Clinically significant drug interactions for atenolol

A

May decrease effect of clonidine

Verapamil increases toxicity effect of atenolol

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15
Q

Major counseling points of atenolol

A

May mask hypoglycemic sx in pt with DM.
Use caution while operating machinery or when mental alertness is required.
Rise slowly when standing up from sitting and lying position.
Do not abruptly d/c

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16
Q

Monitoring parameters of atenolol

A

BP

HR

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17
Q

Common indications for clonazepam

A 
Lennox-Gastaut syndrome
Akinetic and myoclonic seizures
Absence seizures with succinimide failure
Panic disorder
GAD
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18
Q

MOA of clonazepam

A

Binds to and enhances activity of GABA receptors

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19
Q

Common AEs of clonazepam

A

Drowsiness
Ataxia
Fatigue
Dizziness

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20
Q

Clinically significant drug interactions of clonazepam

A

Increased CNS depression with EtOH and other CNS depressants

Caution in pts taking opioids d/t increased risk of sedation and resp depression

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21
Q

Major counseling points of clonazepam

A

May cause drowsiness
Avoid EtOH while taking this medication
May be habit-forming
Do not stop taking this med abruptly
Store in a cool dry place away from kids and sunlight
If a dose is missed, take it ASAP
If it is closer to the time of your next dose, skip the missed dose and return to nl dosing schedule- do not double doses

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22
Q

Monitoring parameters of clonazepam

A

Improvement in sx of anxiety

Misuse, abuse, decreased seizure activity

23
Q

Common indications of penicillin

A

Various infections

24
Q

MOA of penicillin

A

Inhibits cell wall mucopeptide biosynthesis

25
Q

Common AEs of penicillin

A

Black tongue
Diarrhea
Vomiting

26
Q

Renal or hepatic dose adjustments for penicillin

A

Consider dose adjustments with either renal or liver failure

27
Q

Clinically sig drug interactions with penicillin

A

May result in an increased INR when taken by a warfarin pt

28
Q

Major counseling points for penicillin

A

Take till empty

May effect the effectiveness of contraceptives

29
Q

Monitoring parameters of penicillin

A

Improvement in S/Sx of infection, WBC

30
Q

Common indications of Augmentin

A

Tx of OM, sinusitis, and infections caused by susceptible organisms involving the lower resp tract, skin and skin structure, and urinary tract

31
Q

Common AEs of Augmentin

A

Diarrhea
GI upset
Vomiting

32
Q

Renal or hepatic dose adjustments for Augmentin

A

Renal- CrCl 10-30: dose every 12 hrs, CrCl <10: dose every 24 hrs.
Do not use ER tablets in pts with hemodialysis

33
Q

Major counseling points of Augmentin

A 
Do not skip any doses
Take with food
Refrigerate suspension
If a rash develops contact physician
Ask for PCN allergy
34
Q

Monitoring parameters of Augmentin

A

Improvement of S/sx of infection, WBC

35
Q

Common indications of Bactrim

A

Susceptible infections

36
Q

MOA of Bactrim

A

Trimethoprim blocks production of tetrahydrofolic acid by inhibiting dihydrofolate reductase
Sulfamethoxazole inhibits bacterial synthesis of dihydrofolic acid by competitively antagonizing PABA

37
Q

Common AEs of Bactrim

A

Increased sensitivity to sunlight, diarrhea, rash, GI upset, increased potassium

38
Q

Renal or hepatic dose adjustments of Bactrim

A

CrCl 15-30 mL/min: administer 50% recommended dose

CrCl <15 mL/min: use not recommended

39
Q

Clinically significant drug interactions with Bactrim

A

May increase effects of cyclosporine
May increase serum levels of phenytoin
May increase effects of oral anticoagulants and sulfonylureas

40
Q

Major counseling points of Bactrim

A

Preferably taken on an empty stomach one hour before or two hours after meals with a full glass of water
Complete full course of therapy unless otherwise directed
Avoid prolonged exposure to sunlight
Shake suspension well before using
Store in a cool dry place away from kids and sunlight
If a dose is missed, take it ASAP

41
Q

Monitoring parameters of Bactrim

A

Improvement of S/Sx of infection, WBC

42
Q

Common indications of Plavix

A

Reduction of atherosclerotic events in pt with h/o stroke, MI, established peripheral artery disease, or acute coronary syndrome

43
Q

MOA of Plavix

A

Converted to active metabolite via CYP2C19, which irreversibly modifies platelet receptors, selectively inhibiting binding of ADP to the platelet receptors, thereby inhibiting platelet aggregation

44
Q

Common AEs of Plavix

A 
CP
HA
Flu-like sx
Arthralgia
Dizziness
GI bleed
45
Q

BBW for Plavix

A

Diminished effectiveness in poor CYP2C19 metabolizers

46
Q

Clinically sig drug interactions with Plavix

A

Predisposition of occult blood loss with NSAIDs
May interfere with metabolism of CYP2C9 substrates
Omeprazole and esomeprazole may decrease effects of clopidogrel

47
Q

Major counseling points of Plavix

A

Contact physician if you notice any sign of infection
Can be taken with or without food
Do not take PPIs with this
Bleeding time will be increased while taking this
Tell physicians and dentists about therapy prior to surgery
Take only as prescribed
Store in cool dry place away from kids and sunlight
If dose is missed, take it ASAP
If it is closer to the time of the next dose, skip the missed dose and return to nl dosing schedule- do not double doses

48
Q

Monitoring parameters of Plavix

A

Bruising/bleeding

49
Q

Common indications of PPIs

A 
Duodenal/gastric ulcer
Erosive esophagitis
GERD
H. pylori infection
Heartburn (hypersecretory conditions)
50
Q

MOA of PPIs

A

Supresses H+/K ATPase (proton pump) at the gastric parietal cells decreasing production of acid

51
Q

Common AEs of PPIs

A

Cough
Constipation
Rash
Dizziness

52
Q

Clinically sig drug interactions of PPIs

A

Increase gastric pH
Inhibits activation of clopidogrel
Increases levels of diazepam, phenytoin, and warfarin

53
Q

Major counseling points of PPIs

A

Take 30 mins prior to a meal

Contents of capsule may be added to applesauce for administration

54
Q

Monitoring parameters of PPIs

A

Improvement in GI sx

Mg if used long term

CSR (5 decks)

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