Pharm Quiz 2 Flashcards

1
Q

Biomarker

A

The presence of a substance that indicates the presence of a specific phenomena.

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2
Q

What medications have decreased effects due to genes?

A

Warfarin, Clopidogrel, Isoniazid, some cancer meds

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3
Q

What medication has a different effect due to genes?

A

B-Blockers (tend to favor pts with European genes)

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4
Q

How does carbamazepine effect people differently?

A

Can cause a life-threatening skin condition to patients of Asian descent.

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5
Q

What HIV drug can be life threatening?

A

Abacavir (Ziagen)

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6
Q

How much does GFR increase in the third trimester?

A

It doubles

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7
Q

What percentage of genetic abnormalities are caused by drugs?

A

1%

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8
Q

Preimplantation/Presomite Period

A

Drugs work in an all or nothing fashion

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9
Q

Embryonic Period (1st Trimester)

A

Gross abnormalities are most likely

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10
Q

Fetal Period (2nd and 3rd Trimesters)

A

Disruption in function especially brain development

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11
Q

Organogenesis

A

Weeks 3-8: If drug taken during this time, 2 ultrasounds should be done.

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12
Q

What criteria must be met to prove that a drug is teratogenic?

A

It must affect specific structures.
It must happen during a specific time.
Increasing doses lead to worse effects.

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13
Q

Category Risk A:

A

Studies have been done and there is little risk to the fetus.

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14
Q

Category Risk B:

A

No studies have been done or harm to animals but not humans.

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15
Q

Category Risk C:

A

No controlled studies or risk showed in animals.

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16
Q

Category Risk D:

A

Studies do show risks but benefits might outweigh risks.

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17
Q

Category Risk X:

A

Risks do not outweigh benefits.

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18
Q

How should patients of reproductive age be educated?

A

50% of pregnancies are unintended, so if taking a teratogenic medication, at least 1 form of birth control should be used.

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19
Q

What guidelines should be followed when dosing a breast-feeding mother?

A

Take directly after breast feeding.
Do not use a long-acting medication.
Avoid medications with a long half-life.
Choose drugs that tend to be excluded by milk.

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20
Q

Pediatric Patient

A

Up to 16

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21
Q

Premature Infants

A

<36 weeks

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22
Q

Neonates

A

First 4 weeks of life

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23
Q

Infants

A

First year of life

24
Q

Absorption Infants and Neonates

A

Gastric emptying is delayed which leads to increased absorption in the stomach and decreased in the intestine. Gastric pH is also increased –> increased absorption.

25
Q

IM Neonates

A

Blood flow to limbs is decreased –> decreased absorption

26
Q

Transdermal Neonates

A

Thin skin –> increased absorption.

27
Q

Distribution Infants and Neonates

A

Less albumin –> more free drug –> increased effects.

28
Q

Metabolism Infants

A

Metabolism by the liver is significantly decreased in the first year and then increases rapidly.

29
Q

Excretion Infants

A

Kidney excretion is significantly decreased in the first year.

30
Q

Metabolism 2 years

A

Metabolism is significantly increased until puberty.

31
Q

What do Tetracyclines cause?

A

Yellowing of the teeth

32
Q

What do sulfonamides cause?

A

Kernicterus

33
Q

What do glucocorticoids cause?

A

Growth suppression with long-term use

34
Q

Dose calculation for children

A

BSA x Adult Dose / 1.73

35
Q

Pharmacokinetic Changes in the Elderly:

A

Everything decreases except pH

36
Q

Absorption Elderly

A

The extent is not usually decreased but the rate may be.

37
Q

Distribution Elderly

A

Increased fat –> more storage –>less free drug. Decreased water and albumin –> more free drug.

38
Q

Excretion Elderly

A

Creatinine Clearance must be measured rather than serum Creatinine bc muscle mass decreases in parallel with serum Creatinine.

39
Q

BEERS NSAIDs

A

Tylenol

40
Q

BEERS TCAs (1st Gen)

A

SSRI/SNRI

41
Q

BEERS Anti-histamines (1st Gen)

A

Anti-Histamines (2nd Gen)

42
Q

BEERS A-1 Blockers

A

Any other anti-htn

43
Q

BEERS Barbituates

A

Ambien, CBT

44
Q

BEERS Urge Incontinence Meds

A

Behavioral Therapy

45
Q

BEERS Muscle Relaxants

A

Anti-Spasmodics, Exercise Therapy

46
Q

BEERS PPIs

A

H2 Receptor antagonists

47
Q

Is non-adherence usually intentional or unintentional?

A

It is usually intentional because patients believe their medication is not necessary.

48
Q

First choice for EOL constipation?

A

Osmotic Laxatives

49
Q

Delirium in EOL?

A

Anti-psychotics or pain management

50
Q

Pain drug of choice for patients with hepatic and renal dysfunction?

A

Fentanyl

51
Q

Treatment for death rattle?

A

Glyccopyrolate

52
Q

1st Gen Amit-histamine Example

A

Diphenhydramine

53
Q

2nd Gen Anti-Histamine

A

Loratadine

54
Q

PPI example

A

Omeprazole

55
Q

H2 example

A

Famotidine