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Pharm part 3 Flashcards

(54 cards)

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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

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A

Improvement in sx of anxiety

Misuse, abuse, decreased seizure activity

23
Q

Common indications of penicillin

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A

Various infections

24
Q

MOA of penicillin

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A

Inhibits cell wall mucopeptide biosynthesis

25
Common AEs of penicillin
Black tongue Diarrhea Vomiting
26
Renal or hepatic dose adjustments for penicillin
Consider dose adjustments with either renal or liver failure
27
Clinically sig drug interactions with penicillin
May result in an increased INR when taken by a warfarin pt
28
Major counseling points for penicillin
Take till empty | May effect the effectiveness of contraceptives
29
Monitoring parameters of penicillin
Improvement in S/Sx of infection, WBC
30
Common indications of Augmentin
Tx of OM, sinusitis, and infections caused by susceptible organisms involving the lower resp tract, skin and skin structure, and urinary tract
31
Common AEs of Augmentin
Diarrhea GI upset Vomiting
32
Renal or hepatic dose adjustments for Augmentin
Renal- CrCl 10-30: dose every 12 hrs, CrCl <10: dose every 24 hrs. Do not use ER tablets in pts with hemodialysis
33
Major counseling points of Augmentin
``` Do not skip any doses Take with food Refrigerate suspension If a rash develops contact physician Ask for PCN allergy ```
34
Monitoring parameters of Augmentin
Improvement of S/sx of infection, WBC
35
Common indications of Bactrim
Susceptible infections
36
MOA of Bactrim
Trimethoprim blocks production of tetrahydrofolic acid by inhibiting dihydrofolate reductase Sulfamethoxazole inhibits bacterial synthesis of dihydrofolic acid by competitively antagonizing PABA
37
Common AEs of Bactrim
Increased sensitivity to sunlight, diarrhea, rash, GI upset, increased potassium
38
Renal or hepatic dose adjustments of Bactrim
CrCl 15-30 mL/min: administer 50% recommended dose | CrCl <15 mL/min: use not recommended
39
Clinically significant drug interactions with Bactrim
May increase effects of cyclosporine May increase serum levels of phenytoin May increase effects of oral anticoagulants and sulfonylureas
40
Major counseling points of Bactrim
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
Monitoring parameters of Bactrim
Improvement of S/Sx of infection, WBC
42
Common indications of Plavix
Reduction of atherosclerotic events in pt with h/o stroke, MI, established peripheral artery disease, or acute coronary syndrome
43
MOA of Plavix
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
Common AEs of Plavix
``` CP HA Flu-like sx Arthralgia Dizziness GI bleed ```
45
BBW for Plavix
Diminished effectiveness in poor CYP2C19 metabolizers
46
Clinically sig drug interactions with Plavix
Predisposition of occult blood loss with NSAIDs May interfere with metabolism of CYP2C9 substrates Omeprazole and esomeprazole may decrease effects of clopidogrel
47
Major counseling points of Plavix
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
Monitoring parameters of Plavix
Bruising/bleeding
49
Common indications of PPIs
``` Duodenal/gastric ulcer Erosive esophagitis GERD H. pylori infection Heartburn (hypersecretory conditions) ```
50
MOA of PPIs
Supresses H+/K ATPase (proton pump) at the gastric parietal cells decreasing production of acid
51
Common AEs of PPIs
Cough Constipation Rash Dizziness
52
Clinically sig drug interactions of PPIs
Increase gastric pH Inhibits activation of clopidogrel Increases levels of diazepam, phenytoin, and warfarin
53
Major counseling points of PPIs
Take 30 mins prior to a meal | Contents of capsule may be added to applesauce for administration
54
Monitoring parameters of PPIs
Improvement in GI sx | Mg if used long term

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