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CSR > Pharm part 4 > Flashcards

Pharm part 4 Flashcards

1
Q

Common indications of H2 blockers

A

Short-term tx of active duodenal ulcer, GERD, erosive esophagitis, gastritis

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2
Q

MOA of H2 blockers

A

Competitively and reversibly inhibits histamine at H2 receptors on gastric cells

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3
Q

Common AEs of H2 blockers

A

Abd pain
Constipation
Diarrhea
HA

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4
Q

Clinically sig drug interactions of H2 blockers

A

May decrease warfarin clearance

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5
Q

Major counseling points of H2 blockers

A

May be taken with food if GI upset occurs

Prolonged tx greater than or equal to 2 yrs may lead to vitamin B12 malabsorption

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6
Q

Monitoring parameters of H2 blockers

A

Improvement in GI S/sx

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7
Q

Common indications for alpha blockers

A

HTN

BPH

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8
Q

MOA of alpha blockers

A

HTN: Competitively inhibits postsynaptic alpha-adrenergic receptors which results in vasodilation of veins and arterioles and a decrease in total peripheral resistance and blood pressure
BPH: Competitively inhibits postsynaptic alpha-adrenergic receptors in prostatic stromal and bladder neck tissues. This reduces the sympathetic tone-induced urethral stricture causing BPH sx

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9
Q

Common AEs of alpha blockers

A

Dizziness
Fatigue
Orthostatic hypotension
HA

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10
Q

Renal or hepatic dose adjustments for alpha blockers

A

Use with caution in mild-to-moderate hepatic dysfunction

Do not use with severe impairment

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11
Q

Clinically sig drug interactions with alpha blockers

A

PDE-5 inhibitors

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12
Q

Monitoring parameters of alpha blockers

A

Decrease in BP

Urinary retention

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13
Q

Common indications of duloxetine

A

MDD
Neuropathic pain associated with diabetic peripheral neuropathy
GAD

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14
Q

MOA of duloxetine

A

Inhibits neuronal reuptake of serotonin and norepinephrine primarily, and dopamine to a slight extent

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15
Q

Common AEs of duloxetine

A 
Nausea
Dry mouth
Constipation
Insomnia
Dizziness
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16
Q

Renal or hepatic dose adjustments of duloxetine

A

CrCl <30: use not recommended
Mild-mod renal impairment use low dosing
Not recommended in hepatic impairment

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17
Q

BBW for duloxetine

A

Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults with MDD and other psychiatric d/os

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18
Q

Clinically significant drug interactions of duloxetine

A

CI-ed with MAOIs, inhibitors of CYP1A2 and CYP2DC increase levels of duloxetine. Chronic use of NSAIDs increases risk of GI bleeds.

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19
Q

Major counseling points of duloxetine

A

Pay close attention to mood or behavioral changes- this drug may increase suicidal thoughts or actions.
Benefits may not be seen before 2 wks of continued drug therapy;
May cause drowsiness; Avoid alcohol while taking this medication
Do not abruptly d/c
Store in a cool, dry place…
If a dose is missed, skip it and return to nl dosing schedule

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20
Q

Monitoring parameters of duloxetine

A

Improvement in S/sx of anxiety/depression/pain

Abrupt changes in mood

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21
Q

Common indications for risperidone

A 
Bipolar mania
Bipolar I maintenance
Shizophrenia
PTSD
Tourette's syndrome
Agitation
22
Q

MOA of risperidone

A

Dopamine and serotonin antagonism

23
Q

Common AEs of risperidone

A 
EPS
Tachycardia
Priapism
Rash
Somnolence
Agitation/anxiety
24
Q

Renal or hepatic dose adjustments for risperidone

A

Recommended

25
Q

BBW for risperidone

A

Increased mortality in elderly pts with dementia-related psychosis

26
Q

Clinically significant drug interactions of risperidone

A

Fluoxetine, carbamazepine, and clozapine may increase risperidone

27
Q

Major counseling points of ripseridone

A

May cause fainting during initial doses,
May impair judgement
Avoid EtOH
Avoid excessive exposure to sunlight and heat during therapy

28
Q

Monitoring parameters of risperidone

A

Decrease of S/sx of bipolar, schizophrenia, PTSD and Tourette’s syndrome

29
Q

Common indications for bupropion

A

Depression
Anxiety
Aid in smoking cessation

30
Q

MOA of bupropion

A

Weak inhibitor of neuronal uptake or norepinephrine, serotonin, and dopamine

31
Q

Common AEs of bupropion

A

Tremor
Wt loss
Insomnia

32
Q

Renal or hepatic dose adjustments of bupropion

A

Hepatic/renal: consider reducing dose and frequency

33
Q

BBW for bupropion

A

Suicidality

34
Q

Clinically sig drug interactions of bupropion

A

EtOH may lower seizure threshold
Toxicity is increased by monoamine oxidase inhibitors
Chronic use with NSAIDs increases risk of GI bleeds

35
Q

Major counseling points of bupropion`

A

Swallow XL and SR tabs whole
Avoid EtOH
Wt loss or gain may be temporary
May need up to 2 wks to show noticeable improvement
Pay attention to sudden mood/thought change
Do not abruptly d/c

36
Q

Monitoring parameters for bupropion

A

Improvement in mood/smoking frequency

Unusual changes in behavior/suicidality

37
Q

Common indications for diazepam

A 
Acute EtOH withdrawal
Anticonvulsant
Anxiety
Muscle spasm
Sedation
Status epilepticus
38
Q

MOA of diazepam

A

Enhances the inhibitory effect of GABA

39
Q

Common AEs of diazepam

A 
Drowsiness
Ataxia
Fatigue
Sedation
Cognitive impairment
40
Q

Renal or hepatic dose adjustments for diazepam

A

Daily 50% reduction of dose for cirrhosis pts

41
Q

Clinically sig drug interactions with diazepam

A

Additive effect with other CNS depressants
Cimetidine delays clearance
Grapefruit juice may increase plasma level

42
Q

Major counseling points of diazepam

A

May cause drowsiness
May be habit forming
Avoid EtOH while taking this medication
Do not abruptly d/c

43
Q

Monitoring parameters for diazepam

A

Improvement in S/sx of anxiety
Muscle spasticity
Seizure control
Abuse, misuse

44
Q

Common indications for methylprednisolone

A

Allergic or inflammatory dz

MS

45
Q

MOA of methylprednisolone

A

Regulate gene expression subsequent to binding specific intracellular receptors and translocation into the nucleus
Modulate carbs, protein, and lipid metabolism and maintenance of fluid and electrolyte homeostasis
CV, immunologic, musculoskeletal, endocrine, and neurologic physiology are influenced
Decreases inflammation by suppression of PMN leukocytes and reversal of increased capillary permeability

46
Q

Common AEs of methylprednisolone

A 
Blurred vision
Upset stomach
Nausea
Vomiting
Fluid and electrolyte disturbances
Agitation
Insomnia
Long-term Cushings
Osteoporosis
47
Q

BBWs for methylprednisolone

A

Epidural corticosteroid injection may cause neurologic complications

48
Q

Clinically significant drug interactions with methylprednisolone

A

Anticholinesterase
Barbiturates
Estrogens
Ketoconazole

49
Q

Major counseling points of methylprednisolone

A

Take with or without food
Do not d/c on your own
DM pts could see an increase in BG readings

50
Q

Monitoring parameters of methylprednisolone

A

S/sx of inflammation

BG

CSR (5 decks)

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