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Leik For FNP > Pharmacology > Flashcards

Pharmacology Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

patient with both HTN and osteoporosis receive extra benefit from

A

Thiazides

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2
Q

patients with serious sulfa allergies should avoid

A

loops and thiazide meds

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3
Q

Do not combine ACE & Arbs due to direct renin inhibitor to increase risk of

A

hyperkalemia

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4
Q

with severe renal disease all ACE and ARBS are contraindicated b/c of

A

high risk of hyperkalemia

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5
Q

spironolactone adverese effect is

A

gynecomastia

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6
Q

Fairly common side effect of Aces and Arbs is

A

dry cough

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7
Q

What happens when pt develops cough from Ace or Arbs

A

switch to another medication - if pt is diabetic switch to an ARB

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8
Q

ACE and ARBS are contraindicatd in

A

pregnancy, renal artery stenosis, angiodema, hyperkalemia

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9
Q

other meds that affect RAAS are

A

direct renin inhibitor (valsartan)

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10
Q

ACE/ARBS preferred drug in treatment of HTN in

A

Diabetics with mild/mo CKD

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11
Q

first line treatment for HF with left ventricular dysfunction

A

ACES

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12
Q

Should breastfeeding mom avoid Avoid Aces and ARBS

A

yes - can be exccreted in breast milk

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13
Q

catopril is associated with

A

agranulocytosis (neutropenia and leukopenia)

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14
Q

ACE and angioedema caused by inhibition of the metabolism

A

bradykinin sx

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15
Q

using diltiazem and verapamil should be avoided in pts with

A

heart failure

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16
Q

nifidipine and amlodopine can cause

A

pedal edema - should be given later in the day

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17
Q

what is the first line treatment for raynauds phenomenon

A

calcium channel blockers

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18
Q

do not mix verapamil with

A

erythromycin or clarithromyocin

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19
Q

beta blockers are the preferred treatment for

A

post MI and angina pectoris

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20
Q

contraindicated in beta blockers are

A

asthma
COPD
emphysema

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21
Q

alpha blockers do what

A

relax the smooth muscle in the bladder neck and prostate and improves symptoms of BPH

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22
Q

2 alpha blockers that can lower BP and BPH is

A

terazosin (hytrin) and doxazosin (cardura)

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23
Q

common side effects of alpha blockers are

A

dizziness and hypotension

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24
Q

do not use tetracycline during

A

pregnancy - neural defect and skeletal defects, cleft palage

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25
Q

tetracycline can cause permanent what if used in children under 8

A

discoloraton of teeth (yellow- grey - brown0

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26
Q

what is used for Rocky Mountain spotted fever

A

doxycycline

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27
Q

Tetracycline should avoid the

A

sun it causes photosenstivity

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28
Q

do not use tetracycline for _______ acne

A

mild acne - start with OTC topicals

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29
Q

for mild acne not responding to OTC drugs use

A

benzoyl peroxide and erythromycin or retinal - A

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30
Q

what is another tetracycline option

A

minocycline

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31
Q

minocycline can cause

A

vertigo

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32
Q

tetracycline is best taken

A

on an empty stomach one to two hrs before meals

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33
Q

tetracycline can decrease the effects of

A

oral contraceptives

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34
Q

macrolides (erythomyocin and azithromycin) are contraindicated in what disease

A

mysthenia gravis

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35
Q

what erythromycin side effects are common

A

GI, abdominal pain, diarrhea

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36
Q

what is the most tolerated macrolide

A

azithromyocin

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37
Q

what is the first line treatment for gonorrheal infections

A

certriaxone (rocephin)

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38
Q

avoid using amoxicillin in pts who have

A

mono - causes a rash

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39
Q

what is used for anthrax antibiotic

A

Cipro

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40
Q

what is a serious complication of quiniline therapy

A

achilles tendon rupture

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41
Q

travelers diarrhea is treated with

A

cipro 750 mg single dose or 500 mg 2 x day for 3 days

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42
Q

Cipro has the best activity against what

A

pseudomona aruginosa - due to CF

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43
Q

what is the adverse effect of CCB
Hyperkalemia
Hypertrigyceremia
hyperuricemia
constipation

A

constipation

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44
Q

after warfarin is stopped the anticoagulation effects last

A

2 to 5 days

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45
Q

aces all end in

A

Pril ( lisinopril, catopril)

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46
Q

Beta Blockers all end in

A

Lol ( metoprolol, atenolol)

47
Q

SSRI’s citalopram can cause what

A

QT increaed interval

48
Q

asians may require lower doses of what med

A

warfarin

49
Q

thiazides reduce calcium excretion by the kidneys

A

stimulate osteoclasts to help build bone

50
Q

avoid potassium sparing diuretics in what severe

A

renal failure

51
Q

ace and arbs are preferred for which patient

A

diabetics

52
Q

alpha blockers are the first line treatment for

A

men and HTN and BPH

53
Q

in the US heart attacks occur during what time

A

6 am and 12 pm

54
Q

Most MI occur

A

on a monday in the winter

55
Q

pts who have UTI and are on coumadin should not be given what

A

TMP - SMX bacrtrim increases risk of bleeding

56
Q

pregnant women with UTI should be treated with

A

beta lactams nitrofurantoin and fosfomycin

57
Q

decongestants are contraindicated in

A

HTN and CAD

58
Q

alcohol may delay absorption of what

A

erythromycin

59
Q

Avoid ceftriaxone in ——- because it can cause kernicterus.

A

hyperbilirubinemia and preterm infants

60
Q

MRSA skin infections (boils, abscesses): Do not use ———- First-line therapy is trimethoprim–sulfamethoxazole (Bactrim DS) or clindamycin. Treat for at least 5 to 10 days.

A

cephalosporins.

61
Q

Anaphylaxis and angioedema are type what —– mediated reactions

A

IGE

62
Q

if pt is allergic to pencillin use what abx

A

macrolide

63
Q

what is used for peicillinase producing staph skin infections (mastitis and impetigo)

A

dicloxacillin

64
Q

Cephalexin is used for

A

uncomplicated skin or soft tissue infections, impetigo

65
Q

Cefuroxime
cefaclor
ceprozil is used for

A

CAP, chronic bronchitis, rinosinusitis, otitis media

66
Q

ceftriaxone (rocephin), Cefixime (suprax), cefdinir (omnicef) is sued for

A

gonorrhea, PID
pyelnoprhitis
acute otitis media
CAP

67
Q

PCN used for
amoxicillin
augmentin

A

strep throat
syphilis

68
Q

Ofloxacin (Floxin) BID use for

A

UTI, epididymtiis, prostatitis

69
Q

levofloxacin increases risk of

A

hypoglycemia

70
Q

Quinolones can cause

A

QT prolongation, torsades de pointes

71
Q

Quinolones adverse effects

A

Adverse Effects

Hypoglycemia (monitor blood glucose in type 1 diabetics)
CNS effects (headache, dizziness, insomnia, memory impairment, delirium, seizures)
QT prolongation, torsades de pointes
Peripheral neuropathy (can occur at any time, can last for months to years)
Phototoxicity (advise patients to avoid excessive sunlight or UV light)
Double vision
Tendinopathy, tendon rupture (higher risk if on steroids, >60 years, history of organ transplantation)
Hepatotoxicity (may cause mild elevations of AST/ALT)

72
Q

is a serious complication of quinolone therapy, and patients who are on steroids or >60 years are at higher risk.

A

achilles tendon rupture

73
Q

Do not use quinolones in children (<18 years) or women who are pregnant or breastfeeding because of

A

adverse effects on growing cartilage.

74
Q

For athletes or very physically active patients, if fluoroquinolone is needed, advise to reduce their training volume and intensity to reduce risk of Achilles tendon injury. Wait from 2 to 4 weeks after completion of fluoroquinolones before resumption of sport or activity.

A

educe their training volume and intensity to reduce risk of Achilles tendon injury. Wait from 2 to 4 weeks after completion of fluoroquinolones before resumption of sport or activity.

75
Q

Traveler’s diarrhea is treated with

A

Cipro 750 mg (single dose) or 500 mg twice a day × 3 days.

76
Q

sulfonamides are contraindicated in

A

glucose 6 dehydrogenase anemia

77
Q

Sulfonamides are contrainidciated in

A

Glucose-6-phosphate dehydrogenase (G6PD) anemia (a genetic hemolytic anemia) causes hemolysis.
Newborns and infants <2 months of age (risk of hyperbilirubinemia)
Pregnancy 32 weeks or later (increased risk of hyperbilirubinemia, kernicterus, hemolytic anemia in the infant)
Porphyria (genetic disease)
Hypersensitivity to sulfa drugs

78
Q

Bactrim is used to treat

A

MRSA cellulitis

79
Q

HIV patients are at high risk (25%–50%) for sulfa-related

A

Steven Johnson syndrome

80
Q

he second most frequent cause of allergic drug reactions (penicillins and cephalosporins are the first).

A

Sulfonamides

81
Q

what is the most common adverse reacton to clindaymycin

A

diarrhea

82
Q

alternative antibiotics for penicillin-allergic patients. A good alternative antibiotic for these patients with gram-positive bacterial infections are

A

macrolides such as azithromycin x 5 days (zpakco or clarithromycin (niacin) twice a day

83
Q

If a patient has both mono and strep throat, avoid using

A

amoxicillin or ampicillin.

84
Q

Of patients with true penicillin allergy, a small percentage (0.17%–8.4%) will also react to a

A

cephalosporin

85
Q

GI upset (nausea and vomiting, abdominal pain) is a common side effect of

A

erytromycin

86
Q

If a patient who needs a macrolide is not allergic, what is a good choice

A

z pack

87
Q

Rhinitis medicamentosa is due to

A

chronic use of over 3 days of nasal decongestants (farina)

88
Q

avoid using benadryl in the

A

elderly

89
Q

what should be used in elderly because of lower incident of sedatoin

A

claritin

90
Q

what is potent and long acitng and very effective for acute and cnronic urticaria

A

zyrtec

91
Q

Nasal sprays are good for

A

allergic rhinitis, seasonal allergies

92
Q

Dextromethorphan increases risk of

A

serotonin syndrome

93
Q

Decongestants (stimulants) are contraindicated with

A

HTN andCAD

94
Q

NSAIDs should be avoided in

A

HF, severe heart disease, GI bleeding, and severe renal disease and during the last 3 months of pregnancy (blocks prostaglandins).

95
Q

Ketoroloac (toradol) should only be used for

A

up to 5 days

96
Q

Ketorolac should not be used before

A

surgery, with concurrent acety lsalicylic acid (ASA), pediatric patients, active or recent GI bleed, stroke, labor/delivery, and others.

97
Q

Avoid long-term use of NSAIDs if patient is on

A

aspirin prophylaxis (interferes with aspirin’s cardioprotective effect).

98
Q

Adults and children ≥12 years of age; maximum dose ranges from on tyelnol

A

3.000 to 4 g

99
Q

what is the first line tx for OA/DJD pain

A

tylenol

100
Q

Capsaicin cream can be used to treat pain in

A

trigeminal neuralgia and PHN

101
Q

The maximum dose for acetaminophen (Tylenol) ranges from

A

3 to 4 g/d

102
Q

Aspirin irreversibly suppresses platelet function for up to

A

4 days

103
Q

Discontinue ASA if patient complains of

A

tinnitus

104
Q

Oral corticosteroids are first-line treatment of

A

polymyalgia rheumatica (dramatic relief of symptoms) and temporal arteritis/giant cell arteritis.

105
Q

f uveitis (inflammation of the middle portion of the eye) is suspected, refer to

A

ED. Ideally it should be treated within 24 hours to reduce risk of blindness. It is a complication of autoimmune diseases such as rheumatoid arthritis, lupus, and polymyalgia rheumatica. Treated with topical steroid eye drops and/or systemic steroids.

106
Q

A severe case of poison ivy or poison oak rash may require

A

14 to 21 oral steroid to clear

107
Q

Avoid Abrupt Discontinuation: Withdrawal Symptoms*

A

Venlafaxine (Effexor) Sweating, agitation, dizziness, nausea, fatigue, tremor, restlessness
Paroxetine (Paxil) Nausea, vomiting, diarrhea, headaches, vivid dreams, insomnia
Gabapentin (Neurontin) Agitation, confusion, disorientation, sweating, insomnia, GI effects
Steriods (long term) Weakness, severe fatigue, nausea, vomiting, anorexia, diarrhea
Baclofen (Lioresal) Muscle cramps/spasms, rigidity, confusion, seizures, psychotic mania/paranoid states
Clonidine (Catapres) Acute rebound hypertension, sudden death
Propranolol (Inderal) Acute rebound hypertension, angina, MI, or sudden death
Benzodiazepines Seizures, anxiety, insomnia
Opioids Pain, anxiety, restlessness, diarrhea

108
Q

These drugs pose fetal risks that outweigh the medication’s benefits:

A

Finasteride (Proscar, Propecia): Reproductive-aged or pregnant women should not handle crushed/broken finasteride tablets
Isotretinoin (Accutane)
Warfarin sodium (Coumadin)
Misoprostol (Cytotec)
Androgenic hormones: Birth control pills, hormone replacement therapy (HRT), testosterone
Live virus vaccines (measles, mumps, rubella, varicella, rotavirus, FluMist)
Thalidomide, diethylstilbestrol (DES), methimazole, and so on

109
Q

Maximum number of refills for Schedule III to V drugs is

A

five refills (limit of 90 pills per refill).

110
Q

schedue 2 drugs have how many refils

A

zero

111
Q

max quantity of schedule two drugs is

A

30 days only

112
Q

schedule two drugs

A

It cannot be called in by phone. It has to be written on a traditional paper prescription pad (some states now accept electronic prescriptions). Prescription will automatically expire in 6 months.

113
Q

Schedule II drugs

A

Demerol, Dilaudid, OxyContin, cocaine, amphetamines, fentanyl)

Leik For FNP (2 decks)

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