Pharmacology Flashcards
1
Q
patient with both HTN and osteoporosis receive extra benefit from
A
Thiazides
2
Q
patients with serious sulfa allergies should avoid
A
loops and thiazide meds
3
Q
Do not combine ACE & Arbs due to direct renin inhibitor to increase risk of
A
hyperkalemia
4
Q
with severe renal disease all ACE and ARBS are contraindicated b/c of
A
high risk of hyperkalemia
5
Q
spironolactone adverese effect is
A
gynecomastia
6
Q
Fairly common side effect of Aces and Arbs is
A
dry cough
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
8
Q
ACE and ARBS are contraindicatd in
A
pregnancy, renal artery stenosis, angiodema, hyperkalemia
9
Q
other meds that affect RAAS are
A
direct renin inhibitor (valsartan)
10
Q
ACE/ARBS preferred drug in treatment of HTN in
A
Diabetics with mild/mo CKD
11
Q
first line treatment for HF with left ventricular dysfunction
A
ACES
12
Q
Should breastfeeding mom avoid Avoid Aces and ARBS
A
yes - can be exccreted in breast milk
13
Q
catopril is associated with
A
agranulocytosis (neutropenia and leukopenia)
14
Q
ACE and angioedema caused by inhibition of the metabolism
A
bradykinin sx
15
Q
using diltiazem and verapamil should be avoided in pts with
A
heart failure
16
Q
nifidipine and amlodopine can cause
A
pedal edema - should be given later in the day
17
Q
what is the first line treatment for raynauds phenomenon
A
calcium channel blockers
18
Q
do not mix verapamil with
A
erythromycin or clarithromyocin
19
Q
beta blockers are the preferred treatment for
A
post MI and angina pectoris
20
Q
contraindicated in beta blockers are
A
asthma
COPD
emphysema
21
Q
alpha blockers do what
A
relax the smooth muscle in the bladder neck and prostate and improves symptoms of BPH
22
Q
2 alpha blockers that can lower BP and BPH is
A
terazosin (hytrin) and doxazosin (cardura)
23
Q
common side effects of alpha blockers are
A
dizziness and hypotension
24
Q
do not use tetracycline during
A
pregnancy - neural defect and skeletal defects, cleft palage
25
tetracycline can cause permanent what if used in children under 8
discoloraton of teeth (yellow- grey - brown0
26
what is used for Rocky Mountain spotted fever
doxycycline
27
Tetracycline should avoid the
sun it causes photosenstivity
28
do not use tetracycline for _______ acne
mild acne - start with OTC topicals
29
for mild acne not responding to OTC drugs use
benzoyl peroxide and erythromycin or retinal - A
30
what is another tetracycline option
minocycline
31
minocycline can cause
vertigo
32
tetracycline is best taken
on an empty stomach one to two hrs before meals
33
tetracycline can decrease the effects of
oral contraceptives
34
macrolides (erythomyocin and azithromycin) are contraindicated in what disease
mysthenia gravis
35
what erythromycin side effects are common
GI, abdominal pain, diarrhea
36
what is the most tolerated macrolide
azithromyocin
37
what is the first line treatment for gonorrheal infections
certriaxone (rocephin)
38
avoid using amoxicillin in pts who have
mono - causes a rash
39
what is used for anthrax antibiotic
Cipro
40
what is a serious complication of quiniline therapy
achilles tendon rupture
41
travelers diarrhea is treated with
cipro 750 mg single dose or 500 mg 2 x day for 3 days
42
Cipro has the best activity against what
pseudomona aruginosa - due to CF
43
what is the adverse effect of CCB
Hyperkalemia
Hypertrigyceremia
hyperuricemia
constipation
constipation
44
after warfarin is stopped the anticoagulation effects last
2 to 5 days
45
aces all end in
Pril ( lisinopril, catopril)
46
Beta Blockers all end in
Lol ( metoprolol, atenolol)
47
SSRI's citalopram can cause what
QT increaed interval
48
asians may require lower doses of what med
warfarin
49
thiazides reduce calcium excretion by the kidneys
stimulate osteoclasts to help build bone
50
avoid potassium sparing diuretics in what severe
renal failure
51
ace and arbs are preferred for which patient
diabetics
52
alpha blockers are the first line treatment for
men and HTN and BPH
53
in the US heart attacks occur during what time
6 am and 12 pm
54
Most MI occur
on a monday in the winter
55
pts who have UTI and are on coumadin should not be given what
TMP - SMX bacrtrim increases risk of bleeding
56
pregnant women with UTI should be treated with
beta lactams nitrofurantoin and fosfomycin
57
decongestants are contraindicated in
HTN and CAD
58
alcohol may delay absorption of what
erythromycin
59
Avoid ceftriaxone in ------- because it can cause kernicterus.
hyperbilirubinemia and preterm infants
60
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.
cephalosporins.
61
Anaphylaxis and angioedema are type what ----- mediated reactions
IGE
62
if pt is allergic to pencillin use what abx
macrolide
63
what is used for peicillinase producing staph skin infections (mastitis and impetigo)
dicloxacillin
64
Cephalexin is used for
uncomplicated skin or soft tissue infections, impetigo
65
Cefuroxime
cefaclor
ceprozil is used for
CAP, chronic bronchitis, rinosinusitis, otitis media
66
ceftriaxone (rocephin), Cefixime (suprax), cefdinir (omnicef) is sued for
gonorrhea, PID
pyelnoprhitis
acute otitis media
CAP
67
PCN used for
amoxicillin
augmentin
strep throat
syphilis
68
Ofloxacin (Floxin) BID use for
UTI, epididymtiis, prostatitis
69
levofloxacin increases risk of
hypoglycemia
70
Quinolones can cause
QT prolongation, torsades de pointes
71
Quinolones adverse effects
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
is a serious complication of quinolone therapy, and patients who are on steroids or >60 years are at higher risk.
achilles tendon rupture
73
Do not use quinolones in children (<18 years) or women who are pregnant or breastfeeding because of
adverse effects on growing cartilage.
74
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.
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
Traveler’s diarrhea is treated with
Cipro 750 mg (single dose) or 500 mg twice a day × 3 days.
76
sulfonamides are contraindicated in
glucose 6 dehydrogenase anemia
77
Sulfonamides are contrainidciated in
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
Bactrim is used to treat
MRSA cellulitis
79
HIV patients are at high risk (25%–50%) for sulfa-related
Steven Johnson syndrome
80
he second most frequent cause of allergic drug reactions (penicillins and cephalosporins are the first).
Sulfonamides
81
what is the most common adverse reacton to clindaymycin
diarrhea
82
alternative antibiotics for penicillin-allergic patients. A good alternative antibiotic for these patients with gram-positive bacterial infections are
macrolides such as azithromycin x 5 days (zpakco or clarithromycin (niacin) twice a day
83
If a patient has both mono and strep throat, avoid using
amoxicillin or ampicillin.
84
Of patients with true penicillin allergy, a small percentage (0.17%–8.4%) will also react to a
cephalosporin
85
GI upset (nausea and vomiting, abdominal pain) is a common side effect of
erytromycin
86
If a patient who needs a macrolide is not allergic, what is a good choice
z pack
87
Rhinitis medicamentosa is due to
chronic use of over 3 days of nasal decongestants (farina)
88
avoid using benadryl in the
elderly
89
what should be used in elderly because of lower incident of sedatoin
claritin
90
what is potent and long acitng and very effective for acute and cnronic urticaria
zyrtec
91
Nasal sprays are good for
allergic rhinitis, seasonal allergies
92
Dextromethorphan increases risk of
serotonin syndrome
93
Decongestants (stimulants) are contraindicated with
HTN andCAD
94
NSAIDs should be avoided in
HF, severe heart disease, GI bleeding, and severe renal disease and during the last 3 months of pregnancy (blocks prostaglandins).
95
Ketoroloac (toradol) should only be used for
up to 5 days
96
Ketorolac should not be used before
surgery, with concurrent acety lsalicylic acid (ASA), pediatric patients, active or recent GI bleed, stroke, labor/delivery, and others.
97
Avoid long-term use of NSAIDs if patient is on
aspirin prophylaxis (interferes with aspirin’s cardioprotective effect).
98
Adults and children ≥12 years of age; maximum dose ranges from on tyelnol
3.000 to 4 g
99
what is the first line tx for OA/DJD pain
tylenol
100
Capsaicin cream can be used to treat pain in
trigeminal neuralgia and PHN
101
The maximum dose for acetaminophen (Tylenol) ranges from
3 to 4 g/d
102
Aspirin irreversibly suppresses platelet function for up to
4 days
103
Discontinue ASA if patient complains of
tinnitus
104
Oral corticosteroids are first-line treatment of
polymyalgia rheumatica (dramatic relief of symptoms) and temporal arteritis/giant cell arteritis.
105
f uveitis (inflammation of the middle portion of the eye) is suspected, refer to
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
A severe case of poison ivy or poison oak rash may require
14 to 21 oral steroid to clear
107
Avoid Abrupt Discontinuation: Withdrawal Symptoms*
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
These drugs pose fetal risks that outweigh the medication’s benefits:
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
Maximum number of refills for Schedule III to V drugs is
five refills (limit of 90 pills per refill).
110
schedue 2 drugs have how many refils
zero
111
max quantity of schedule two drugs is
30 days only
112
schedule two drugs
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
Schedule II drugs
Demerol, Dilaudid, OxyContin, cocaine, amphetamines, fentanyl)
