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Summer pharm exam 2 > Pharm review > Flashcards

Pharm review Flashcards

1
Q

If the patient experiences postural hypotension, hyponatremia, and hyperkalemia, what should you do to the fludrocortisone dose

A

INCREASe it!

It causes salt retention and edema

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2
Q

What mineralocorticoid has the most salt retaining ability

A

Fludrocortisone

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3
Q

What is first line in Addison’s (adrenal insufficiency) treatment

A

Hydrocortisone!
Prednisone is second line
dexamethasone is rarely used to treat

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4
Q

Which drugs cause hypoglycemia

A

Insulin
Sulfonylurea
Meglitinides

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5
Q

Which drugs cause weight gain

A

Insulin
Sulfonylurea
TZD
(meglitinides?)

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6
Q

Which drugs cause weight loss

A

GLP-1 agonist
SGLT-2 antagonist
+/- metformin

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7
Q

Which drugs are weight neutral

A

DPP4 inhibitors

Metformin

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8
Q

Which drugs are CV beneficial

A 
Liraglutide 
Empagliflozin 
Canagliflozin 
\+/- metformin  
Pioglitazone
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9
Q

Which drugs are renally benficial

A

Liraglutide
Empagliflozin
Canagliflozin

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10
Q

Which drugs are contraindicated in renal failure

A 
metformin 
canagliflozin 
dapagliflozin 
empagliflozin 
exenatide 
lixisenatide 
*Adjust DPP4 dose in renal failure
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11
Q

FDA BBW for diabetes meds

A

Pio/Rosi: CHF
GLP-1: Thyroid C-cell tumors
Canagliflozin: risk of amputation and bone Fx

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12
Q

FDA special warning on Tolbutamide (sulfonylurea)

A

increased risk of CV death

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13
Q

At what BMI do you initiate pharmacotherapy

A 
BMI 27 (25-29.9 is obese) 
Initiate metabolic surgery at BMI 30+ (obese)
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14
Q

What drug is aproved for short term Tx of obesity

A

Phentermine; only a few weeks

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15
Q

ADE of phentermine

A

HA, high BP, tachy, insomnia, dry mouth, constipation, anxiety, palpitations

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16
Q

Which drug is used for long term Tx of obesity

A

Orlistat

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17
Q

ADE of orlistat are

A 
abd pain 
oily stool
flatulence
malabsorption of ADEK 
potentiates warfarin
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18
Q

When do you use a statin in obesity

A

If they are <40 with ASCVD, or anytime over 40
High: Atorv (40-80), Rosuv (20-40)
Mod: Atorv (10-20) Rosuv (5-10)

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19
Q

What are ACE guidelines (more stringent)

A

A1c: <6.5%
FBG: <110
post-prandial <140

20
Q

What are ADA guidelines (less stringent)

A

A1c: <7%
FBG: 80-130
post-prandial: <180

21
Q

First line drug in T2DM

A

Metformin
Then GLP
then DPP4
(sulfonylurea not the best 2/2 weight gain and hypoglycemia)

22
Q

What drug family is metformin

A

biguianide

23
Q

How does metformin work

A

increase insulin sensitivity

decrease gluconeogenesis

24
Q

Metformin is indicated for

A

PCOS, DM2

25
Q

ADE of metformin are

A

Diarrhea

lactic acidosis

26
Q

How mich does metformin lower A1c

A

1-2%

27
Q

What suplement do you give with metformin

A

B12

28
Q

What option is good for older T2DM who eat constant meals

A

Basal bolus (NPH:short)

29
Q

What should we know about sliding scale

A

at BG 181-240, low dose scale is 4 units insulin, and 1 unit insulin lowers 30 BG points

30
Q

When is sliding scale good

A

in a situation where pt cant tell you their normal carb intake

31
Q

TDD is calculated using

A

lbs/4

kg*0.55

32
Q

If their A1c is >8 and not coming down, what do you do

A

ADD BOLUS

33
Q

what is correction factor

A

rule of 1800

1800/TDD= amount that 1 unit insulin will lower BG

34
Q

If no other medical conditions, what do you start women on (estrogen dose)

A

35 mcg

if adolescent, underweight, of >35, start at 20-25 to reduce risk of exposure

35
Q

KNow the changes in contraception times (pill to…)

A

pill: no change
ring: no change
patch: 1 day
implant: 4 days
shot: 1 week
hormonal IUD: 1 week
Cupper IUD: 5 days of coverage

36
Q

Women >45

A

Use: implant, or POP

Injections second line

37
Q

Smokers

A

<35: Any except CHC

>35: CHC stage 4

38
Q

HTN

A

Use: implant, LNG or Cu-IUD

>160/100: NO CHC

39
Q

Dyslipidemia

A

Use: Cu-IUD

DONT use: CHC

40
Q

Dm w/ microvascular complications, or >20 years

A

Use: Cu-IUD
3: injection (depo)
DONT use: CHC

41
Q

Migraines:

A

Add estrogen? Cycleesa

42
Q

Breast cancer

A

Use: Cu-IUD

No hormones

43
Q

DVT

A

Use: Cu-IUD

DONT use: CHC

44
Q

Obesity BMI >30

A

DONT use CHC

45
Q

Obesity >30 but <18 y/o

A

DONT use CHC or Depo

46
Q

Lupus

A

Use: Cu-IUD (unless w/ thrombocytopenia)

DONT use: CHC if w/ + ALA Abs

47
Q

Absolute NO’s

A

Distorted uterus: No IUD
Cervical cancer: no IUD
Cirrhosis: No CHC (can use Cu-IUD

Summer pharm exam 2 (6 decks)

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