Pharmacology Flashcards
Hydralazine (Apresoline®)
is a vasodilator used to treat hypertension.
The treatment of angular cheilitis involves the use of a combination of
antifungal and anti-inflammatory agents.
(nystatin and triamcinolone cream)
Internal bleaching for non-vital teeth options:
- carbamide peroxide
- sodium perborate
- hydrogen peroxide (not ideal, if hydrogen peroxide with heat is contraindicated can cause external root resorption)
what is methadone
it is synthetic opioid agonist can prevent withdrawal symtoms and relieveopioid cravings in those with substance use disorders.
bacteriocidal
cephalosporin, fluoroquinolones, metronidazole, penicillin, vancomycin
Tramadol (Ultram®)
is an opioid that functions as a serotonin and norepinephrine reuptake inhibitor
Potassium-sparing diuretics, such as spironolactone, are associated with
hyperkalemia.
symptoms of hypoglycemia
sweating,
pallor
dizzy
shakiness
agitation
hunger
lack of coordination
sleepiness
methemoglobinemia
It increases the rate of oxidation of hemoglobin to methemoglobin. Methemoglobin strongly binds to oxygen, impairing the ability to release oxygen to tissues. This can result in tissue hypoxia and end-organ damage.
All LA can cause in young patients bc enzyme that converts is found less in children
Antimalarials, such as hydroxychloroquine, can also be taken by patients to
treat muscle and joint pain, skin rashes, pericarditis, pleuritis, and other symptoms such as fatigue and fever
Grave’s disease
the body makes antibodies which mimic the function of TSH
Nifedipine MOA
block L-type calcium channel blocker, it belongs to the dihydropyridine class so does not affect cardiac contractility.
Percocet
Oxycodone +APAP
Risperidone (Risperdal®)
second-generation antipsychotic agent, for the treatment of bipolar disorder, is a risk factor for developing tardive dyskinesia (TD). TD is a medication-induced movement disorder associated with dopamine receptor-blocking agents such as first and second-generation antipsychotics, antiemetic drugs, and rarely lithium.
what is associated with liver damage
tetracycline
Both clopidogrel and aspirin affect platelet quantity (T/F)
False
Platelet function
the first drug of choice for Prosthetic joint prophylaxis
Keflex 2 g
fomatidine (pepcid) is for what
for managing GERD
MOA : H2 receptor antagonist
MOA of antiviral like Acyclovir used to treat Herpes simplex virus
inhibit the viral DNA polymerase.
What antibiotics are contraindicated for patients w liver disease/cirrhosis
erythromycin (bc excreted and detoxy by liver)
Vancomycin
synthetic
fentanyl and methadone
Steroid
Dexamethasone
Name esters and amides in local anesthetics
esters: Procaine, Chloroprocaine, Tetracaine, Benzocaine
Amides: Lidocaine Mepivacaine Prilocaine Bupivacaine Articaine ** (has ester group as well)
Esters do not have “i” before the “caine”
natural opioids
morphine and codeine
type 1and type 2 dose response curve
- Type I: dose vs. efficacy of the drug
- Type II: dose vs. response of patient
HbA1c measures glycated hemoglobin in what cells
red blood cells.
where does alpha-1 and 2, beta 1 and 2
alpha 1 and 2 = smooth muscles
beta 1 = heart
beta 2 = smooth muscles and skeletal muscles
beta-lactamase resistant
augmentin, methicillin, dicloxacillin
what is associated with allergic cholestatic hepatitis
erythromycin estolate
Two types of COPD
Chronic bronchitis and emphysema
contraindication of Bupropion
epilepsy
_______should be avoided in patients with asthma as they are known to cause bronchospasms and trigger asthma exacerbations.
Non-steroidal anti-inflammatory drugs (NSAIDs)
antiphychotic drug associated with tardive dyskinesia (TD).
Risperidone (Risperdal®)
anti-seizure medication with mood-stabilizing properties used to treat seizures, neuropathic pain (such as trigeminal neuralgia), and bipolar disorder
Carbamazepine (Tegretol®)
What to give patient with angina/chest pain
nitroglycerin
Initial: Nitroglycerin, oxygen and aspirin
moa of Denosumab
is a monoclonal antibody that binds to RANKL and prevents this interaction, which thereby blocks osteoclast maturation and reduces bone resorption. It is typically used to treat osteoporosis.
Cells that are predominant in acute and chronic infection
Acute: Neutrophils
Chronic: Lymphocytes (e.g. T cell and B cells), monocytes
INR for hemophilia patients?
Normal INR
High cholestrol can lead to ?
weight gain, muscel weakness, fatigue and hyperglycemia. it if often referred as cushing’s syndrome
Zero-order kinetics of elimination of drug
A constant amount of drug is eliminated per unit
time (mg/hour)
– Less common
– Higher risk of drug accumulation
Protein binding is associated with the duration of action? How does pKa affect diffusion?
the lower the protein binding, the shorter the duration of action
Lower pKa increase diffusion means more rapid onset of action
Which LA is not safe to use in children
Bupivacaine
what is vasovagal reflex and what blocks it?
NE can activate baroreceptors
which stimulate vagal reflex to
reduce heart rate, leading to an
opposite response to what NE
usually does
* Atropine blocks this reflex
Nitrogen-containing bisphosphonates primarily work by
inhibiting abnormal osteoclast activity.
One effect is triggering apoptosis of osteoclasts and another is inhibition of osteoclast metabolism, which interferes with its ability to bind to bone
MOA of heparin
acts on activation of antithrombin; this binds to thrombin (that converts fibrinogen to fibrin) and inactivates it and inhibit the ability to clot.
pKa
lower pKa = stronger acid
faster onset of action
pka for mepivicaine 7.6
lidocaine, prilocaine, Articaine = 7.8
bupivacaine = 8.1
beta blockers to treat what?
- to treat hypertension.
-olol
Maximum dose of acetaminophen and ibuprofen
APAP: 4 g/day
ibuprofen 3.2 g/day
Selegiline?
Selegiline is a monoamine oxidase inhibitor, an enzyme that metabolizes dopamine. This medication increases the half-life of levodopa
Cyclosporine MOA
calcineurin inhibitor prescribed to prevent organ rejection in transplant patients. It is an immunosuppressant drug. By inhibiting calcineurin activity, the synthesis of various cytokines is prevented, leading to decreased T-cell activation and decreased immune response.
what is MOA for denosumab
RNAKL inhibitor - reduction in the number and activity of osteoclasts , thereby decreasing bone resorption and increasing bone density
When to do rescue breaths
when pulse present and breathing abnormal/impaired
1 breath every 3 sec = KID
1 breath every 5 sec = adult
what to prescribe for parkinson?
NOT DOPAMINE: it is unstable to cross the blood-brain barrier to target sites in CNS.
GIVE: levodopa, selegiline, benztropine
Which LA causes methemoglobinemia?
prilocaine
Long term exposure of nitrous
peripheral neuropathy
Why not prescribe Fluconazole in patients with congenital long QT
reported to cause QT interval prolongation which can lead to torsades de pointes in extreme situations
What’s parkinson disease?
deficiency of dopamine
interaction btw diazepam and clarithromycin
Increased sedation because of reduced metabolism of benzodiazepine
which are more potent bisphosphonates. In addition, they are administered intravenously, which is associated with higher rates of MRONJ than oral bisphosphonates.
Zoledronate (Zometa®) and pamidronate (Aredia®)
MOA of benzodiazepam
acts by binding to GAPA receptors that increase the FREQUENCY of chloride ion channel opening in CNS.
- sedating and anxiolytic effects
antifungal medication used for localized, superficial Candida infections of the oral cavity, skin, vagina, and esophagus. I
Nystatin
what is epinephrine reversal?
The vasoconstrictor effect of epinephrine is converted into a vasodilator effect in the presence of an α-blocker whereby the β2 vasodilator effect becomes the major vascular response
* Basically α-blocker cancels out epinephrine’s α activation effects and it only activates β receptors
serotonin syndrome caused by
combination of St. John’s Wort and tramadol (Ultram®)
medication for smoking cessation (given to pt w nicotine stomatitis)
varenicline (chantix)
what is drug-induced immune hemolytic anemia
is a rare presentation of anemia and has been found to be associated with penicillins like amoxicillin and cephalosporins.
- appear as cyanosis
First lne of tx of antibiotics for patients with liver disease/cirrhosis
Penicillin and its derivatives, cephalosporins, and fluoroquinolones
what can cause adrenal suppression?
Steroids taking: 20 mg for 2 weeks in the time frame of 2 years
Side effect of nitrous
nausea
Bacteriostatic antibiotics
clindamycin, tetracycline ,erythromycin, chloramphenicol, sulfamethoxazole.
Explain what happens when hemoglobin dissociation curve shift right and left
Mnemonic: “CADET, face Right”.
Causes of right shift:
Increased CO2
Increased Acid (decreased pH)
Increased 2,3-DPG (DPG is an allosteric effector found in red blood cells. Its function is to stabilize hemoglobin when it is in its low oxygen state. This causes oxygen to dissociate from hemoglobin and be released into target tissues.)
Increased Exercise
Increased Temperature
decrease hemoglobin saturation
Prilocaine, above the recommended maximum of 600 mg, puts the patient at risk of developing methemoglobinemia. what’s the treatment
Administer Oxygen, vitamin C and methylene blue
Safest in children
Lidocaine (xylocaine)
Example of anti coagulants
- warfarin
- dabigatran
Apixaban (eliquid) = Novel oral anticoagulant
How does aspirin effect as analgesic, anti-inflammatory and ant-pyretuic
Where in the brain is the temperature regulation center is for antipyretic MOA of aspirin?
Analgesic = inhibit COX 1 and 2 (PG synthesis)
* Anti-inflammatory = same
* Antipyretic = inhibit PG synthesis in temperature regulation center of hypothalamus
* Bleeding time = inhibit TXA2 synthesis thereby inhibiting platelet aggregation
MOA of carbamazepine
anticonvulsant, as well as an analgesic. It is a sodium channel blocker that binds to voltage-gated sodium channels in nerves and prevents the repetitive and sustained firing of an actional potential.
following a myocardial infarcation, after how many months emergency dental treatment can be provided under appropriate care.
6 months
HPV vaccines :
Under age 9
Under age 15
under age 9: 2 doses
Under age 15: 3 doses
What to prescribe to patients with severe fungal infection like mucormycosis
Iv Amphotericin B (Fungizone®)
MOA of fluconazole
inhibits fungal cytochrome P450, decreasing ergosterol synthesis, which results in decreased cell membrane formation
How is heparin overdose administered
Protamine sulfate
most common medical emergency in the dental chair and often occurs before, during, or after administration of local anesthetic.
Syncope
Which amide group has the longest duration for LA and which is the shortes?
Bupivacaine (Longest), Articaine (shortest)
Which LA is a vasoconstrictor?
Cocaine
Obesity can lead to cancer in what organs?
kidney and colon
which is associated with aplastic anemia.
chloramphenicol
symptoms of hypothyroidism
cold intolerance, alopecia, ad hair loss, a decreased sympathetic nervous system response.
which antibiotic category has the broadest antimicrobial spectrum
tetracyclines
cushing syndrome
too much cortisol
weight gain, fatty tissue deposits, red striae of abdomen, muscle weakness
explain metabolize of drug
lipi-soluble drug converts to water-solube drug by increasing drug polarity and increasing ts hydrosolubility: allowing decrease reabsorption of drug in kidney and thus promoting its excretion
addison’s disease
adrenal insufficiency
A loss of appetite
Fatigue
Low blood pressure
High heart rate
Sweating
Bronzing of the skin
what causes pseudomembranous colitis
Clindamycin
MOA of Hydrochlorothiazide (Microzide®)
is a diuretic that acts by blocking the Na+/Cl- transporter at the distal convoluted tubule.
antiretroviral medications are commonly used to prevent and treat HIV/AIDS.
NRTIs(nucleoside/nucleotide reverse transcriptase inhibitors)tx for ; zidovudine or stavudine and lamivudine
Receptors in ANS:
1. Cholinergic
2. Adrenergic
Where does it bind and how
Cholinergic= binds acetylcholine
– Nicotinic (nAChR)= also binds nicotine; ionotropic
– Muscarinic (mAChR)= also binds muscarine; metabotropic
Adrenergic= binds Epi/NE; metabotropic
what’s the effects of beta -2
vasodilation , bronchodilation
serotonin is ____ in anxiety and ____ in depression
increase in anxiety and decrease in depression
how is the dissociation constant related to affinity
The lower the dissociation constant (Kd) the higher
the affinity
interaction btw tetracyclines and oral antacids
reduced absorption of tetracyclines
Moderate pain:
Ibuprofen 400 mg q4h
Contraindication to NSAID, use Tylenol 2 or 3
what/s the purpose of epi in LA
vasoconstrictor:
1. prolong numbness
2. reduce toxicity
3. promote hemostasis
therapeutic and side effects of morphine
- Miosis
- Out of it
- Respiratory depression
- Pneumonia
- Hypotension
- Infrequency
- Nausea and vomiting
- Euphoria and dysphoria
semi-synthetic opioids
oxycodone and hydrocodone
gamma cells in pancreatic islet products q
pancreatic polypeptides
first line of analgesic for patient with liver failure
tylenol if its without alchohol consumption
Median rhomboid glossitis can be suspected when an erythematous zone is in the mid-dorsal tongue. tx?
No tx for asymptomatic
if symptomatic: antifungal to alleviate pain
Emphysema manifestations
PINK PUFFERs
- permanent enlargement and destruction of airspaces distal to terminal bronchiole
severe dyspnea, older and thin, quiet chest
which LA are more allergic (esters or amides)?
esthers
First line of tx for smoking cessation
bupropion
denosumab (prolia ) is for what
osteopororsis
Tylenol 1,2,3,4
300 mg APAP+ 8 mg codeine
tylenol 2; 300 mg APAP+ 15 mg codeine
tylenol 3; 300 mg APAP+ 30 mg codeine
tylenol 4; 300 mg APAP+ 60 mg codeine
Which LA is metabolized in both liver and blood plasma?
Articaine (septcaine)
selective serotonin reuptake inhibitor (SSRI)
- tine
Fluoxetine (Prozac®) : depression
Sertraline (Zoloft®) : depression
what stimulatory neurotransmitter associated with learning and memory.
glutamate
______ have been shown to significantly increase pulp chamber calcification when compared with patients who had not taken statins.
Statin drugs
describe interaction between nsaids in hemophilia pts
nsaids block Cox so can increase risk of bleeding, leading to inhibition of platelet aggregation and prolong bleeding time
Refractory asthma
is a condition where asthma symptoms or attacks persist even though the condition is being managed with medication
what other factor is affected by facot V leiden
factor X
Nucleoside reverse transcriptase inhibitor is used for
HIV infection
what test to assess intrinsic pathway
intrinsic pathway: factors 8,9, and 11 : PTT
half life of denosumab is
28 days so don’t need premeds if patient stopped taking a month ago
Drug Induced Lupus symptoms
phenytoin, hydralazine, isoniazid, and procainamide and can occur within several months to a year of drug use. Many of the symptoms of this reaction are similar to those of systemic lupus erythematosus and can also include a malar rash, purpura, and serositis.
Ideal time to receive HPV vaccine
11-12 years old
why not take fluconazole and warfarin together
This medication is a strong inhibitor of cytochrome P450, an enzyme that metabolizes warfarin (Coumadin®).
The mechanism of action of amlodipine (Norvasc®)
is to block L-type calcium channels.
Clotrimazole (Mycelex) is antifungal found in what form
MOA???
troche form and is prescribed when patient suffers from oral thrush
Like all Azoles: it inhibits the synthesis of sterols, such as ergosterol, which are necessary components of the fungal cell membrane.
How does competitive or noncompetitive antagonist shift the curve
Competitive antagonist shifts agonist curve RIGHT
* Noncompetitive antagonist shifts agonist curve DOWN
non-productive cough in ace inhibitors is because of
increase in bradykinin levels results in bronchoconstriction, airway inflammation, and a dry, non-productive cough.
which one is only cox 2 blocker
Celecoxib and meloxicam
cells that function mainly in allergic reactions and parasitic infections
eosinophilis
Calculate max dose LA formula
max dose mg/kg X weight (kg)/10 X 1/Concentration(%) = max mL
Carisoprodol (Soma®) is a
muscle relaxant, also called an antispasmodic, used to treat muscle spasms.
interaction btw aspirin with anticoagulants, probenecid, and methotrexate
aspirin and anticoagulants: Increased bleeding tendency
Aspirin and Probenecid Decreased effect of probenecid
Aspirin and Methotrexate Increased methotrexate toxicity
MOA of furosemide
diuretic that acts by blocking the Na+/K+/2Cl- transporter at the thick ascending loop of Henle.
Vicodin
Hydrocodone +APAP
Factor V Leiden
Side effects of SSRIs like citalopram
sexual dysfunction, prolonged QT, diarrhea, and xerostomia.
patients with Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS) may have higher levels of
glutamate
Benzodiazepam
Short-acting
Intermediate
long-acting
Short: Midazolam, triazolam
Intermediate: Lorazepam
Long: diazepam
delta cells in pancreatic islet products q
somatostatin
Nitroglycerin for what?
Antihypertensive medication acts by nitric oxide release
- cause vasodilation and reduce blood pressure
Fluconazole for what
antifungal to treat candidiasis,
are side effect of corticosteroid therapy, such as prednisone (Deltasone®) is
Psychiatric disturbances like stress, mood chnage, sleep issues, mania.
which penicillin drug has best/broad gram-negative spectrum
ampicillin
Mild Pain
Acetaminophen 500 – 1,000 mg q4h
St. John’s Wort
St. John’s Wort is a yellow flowering plant prescribed for depression. Similar to other antidepressants, St. John’s Wort increases the availability of serotonin by decreasing serotonin reuptake into nerve terminals
what test to assess warfarin
extrinsic pathway: INR
which penicillin ab used against pseudomonas
carbenicillin
which NSAIDs is irreversible
Aspirin COX 1and 2
side effects of antidiabetic medication like metformin
vitamin B12 deficiency, gastrointestinal upset, and a metallic taste in the patient’s mouth.
Not to prescribe pt with kidney /renal failure as it causes lactic acidosis
Flumazenil
effective in reversing drug activity
will act as a competitive antagonist that displaces benzodiazepine
why not stop antibiotic course
Stopping treatment early may also allow some more resistant bacteria to survive, providing them the opportunity to increase in the future
Gabapentin
Anticonulsant for treating serizures and nerve pain
treat post-herpetic neuralgia
inhibits alpha 2 delta subunit f voltage-gated calcium chennels
Hyperthyroidism have increase levels of what hormones
increase of T3 and T4
but low levels of TSH
Name all med cause gingival hyperplasia
Ca2+ channel blockers: verapamil, nifedipine
anti-convulsant: phenytoin, lamotrigine
Cyclosporin
MOA of warfarin
inhibition of epoxide reductase that reduces vitamin K to its active form
alpha cells in pancreatic islet produces
glucagon
drug holiday for bisphosphonates is for how long
bone remodeling period - 3-6 months
help prevent osteonecrosis following extractions.
Oral triazolam used for wht pre-medication
short-acting benzodiazepine with a rapid onset of action with effects taking place within 20-40 minutes after administration. Due to its short half-life of 2-5 hours, oral triazolam is quickly absorbed and eliminated, making it safe and effective as premedication for an anxious adult for a 1 hour appointmen
sexual dysfunction is side effect of
SSRIs
trigeminal neuralgia pain:
sudden and severe facial pain, often characterized as a sharp, shooting pain or similar to an electric shock. short, unpredictable attacks that can last from a few seconds to about 2 minutes. The condition is treated with carbamazepine,
side effects of ACE inhibitors
cough, angioedema, selling.
orthostatic hypotension, hyperkalemia,
MOA of bisphosphonates
alendronate (Fosamax®), act by inducing apoptosis of osteoclasts. Without functioning osteoclasts, there is a disruption of bone resorption and an increase in bone density.
how is acetaminophen overdose corrected?
n-acetylcysteine and activated charcoal
what is alternative to ace inhibitor if patient experiencing cough
prescribe ARBs : angiotensin receptor blocker - like losartan
antifungal medication used to treat nail and skin infections.
Terbinafine
MOA of sulfonamides?
Folate synthesis inhibito (competes with PABA), bacteriostatic.
sulfadiazine, sulfamethoxazole
common side effects of 0.12% chlorhexidine gluconate (Peridex®)
extrinsic staining, altered taste, and calculus buildup.
Side effects of hydrochlorothiazide may include
dizziness, headaches, xerostomia, arrhythmias, and hypokalemia, increase urination, hypercalcemia, loss of appetite
Naloxone (narcan)
Mu-opioid receptor antagonist
- used to reverse effects of opioid overdose mainly that of respiratory depression
Gout
is a common inflammatory disorder characterized by sudden attacks of severe pain, swelling, redness, and tenderness in one or more joints. Gout most often affects the joints in the toes. It is caused by a build-up of uric acid crystals
MOA of NOACs
inhibit factor Xa
factor 8 deficiency what disease?
hemophilia
Barbiturates MOA
gamma-aminobutyric acid (GABA) receptors which increase the DURATION of chloride ion channel opening in the cns.
Lisinopril is an ACE inhibitor cause what
ACE inhibitor elevates substance P and bradykinin causing dry cough
MOA of 5-fluorocytosine
antifungal agent that competes with uracil and inhibits fungal RNA synthesis
-primarily used as a combination treatment with amphotericin B to treat meningitis caused by Cryptococcus neoformans
How is bupropion different from other antidepressants
not same side effects; it can cause increase risk of seizures
what is contraindicated in patients with bleeding problems or stomach ulcers, and what to give instead
non-selective NSAIDs
Clopidogrel is antiplatelet or anticoagulant
antiplatelet
what is a drug of choice in children with fever? and why?
APAP as aspirin can cause Reye’s syndrome
taking oral bisphosphonates for an extended period of time______ puts the patient at an increased risk of MRONJ.
> 3 years
Harmful to what organs:
Aspirin
Ibuprofen
APAP
Aspirin: GI
Ibuprofen: Kidney
APAP: Liver
which is most likely to cause superinfection
broad spectrum antibiotics
MOA of narcotics/ opioids
mu-opioid receptor agonists
moa of Allopurinol
used to treat gout and acts by inhibiting xanthine oxidase, an important enzyme in the production of uric acid.
MOA of sulfonylureas
acting on pancreatic beta cells
what’s contraindicated in patients with AIP because they enhance porphyrin synthesis.
Barbiturates
Kids who can’t take oral antibiotic
- ampicillin
if penicillin allergy: cefazolin or ceftriaxone
Chronic bronchitis patient’s manifestation
overweight and cyanotic and will have peripheral edema
BLUE BLOATERS
Amphotericin B (Fungizone®), MOA
action of binding to ergosterol and forming pores in the fungal cell membrane.
First-order kinetics of elimination of drug
Constant fraction of drug is eliminated per unit
time (%/hour)
– More common
What to use for IV sedation
Midazolam
Nitrous:
Sensation before onset
tingling
Omeprazol
Protein pump inhibitor taken for GERD
MOA: irreversible inactivating the H+/K+ ATPase of gastric parietal cells to prevent the transport of acid into the stomach lumen.
Omeprazole is formulated as a pro-drug and is only converted to its active form in the presence of an acid, which is conveniently located at the site of action (the parietal cell).
what position to avoid for patients with COPD
supine position: can experience orthopnea, shortness of breath when lying
Organophosphate poisoning
irreversibly inhibits cholinesterase, poisoning can be treated
with Pralidoxime
Drug induced hepatitis
inflammatio nin liver caused by advere medications like analgesics, anabolic steroids, oral contraceptives, antibiotics, statins,
what;s acute intermittent porphyria (AIP).
rare metabolic condition involving a deficiency in the hydroxymethylbilane synthase enzyme. This enzyme plays a role in the pathway converting toxic porphyrin precursors into the iron-containing porphyrin known as heme, which is the red pigment of human blood.
which bisphosphonate will have higher risk for MRONJ
IV bisphosphonates like zoledronate (Reclast®)
What analgesic to prescribe in patients with kidney failure/ renal disease.
Acetaminophen
potencies of all
bisphosphonates
(Least to most potent)
Etidronate<Pamidronate<
Alendronate<Risedronate
<Zoledronate
how does lipid solubility effect the pharmacokinetics of the drug
more lipid solubility, more potent and longer duration of action
Which medication is safe to prescribe with digoxin ,or patient with heart failure medication
doxycycline
moa of adalimumab
Adalimumab is a monoclonal antibody that binds to TNF-alpha, which is an inflammatory cytokine that contributes to joint inflammation and pain. Therefore, by targeting TNF-alpha, the medication inhibits the cytokine and reduces inflammation, pain, and damage to the joints.
convulsion
seizures: supine position
if repeated then given midazolan (versed)
MOA of opioids
mu, delta and kappa
primarily Mu
Isoniazid (Tubizid®) rifampin (RIF), ethambutol (EMB), and pyrazinamide (PZA
Tuberculosis
People taking warfarin what is acceptable INR value
2-3
if more then 3 reschedue
MOA of albuterol
beta 2 agonist : causes smooth muscle relaxation , bronchodilation
moa of benzodiazepines and barbiturate
Increasing GABA binding to its receptors
Methotrexate for what?
Chemotherapy and immunosuppressive drug. Used for cancer but also for RA ad psoriasis
MOA of fluoroquinolones
Bactericidal, DNA synthesis inhibitor
Ciprofloxacin, levofloxacin
Severe pain
Bupivacaine for long duration of LA
Ibuprofen 600 mg q4h
1000 mg acetaminophen + 400 mg ibuprofen q4h
Tylenol 3, 1 - 2 pills q4h
why is Dexamethasone used in IV sedation
it is corticosteroid used to prevent post-op nausea and vomiting.
beta cells makes up about 75% of the cells of the pancreatic islet and produces
insulin
MOA of digoxin
inhibits Na+/K+ ATPase : increase calcium ion influx in cardiac muscles and promotes positive inotropy
Antiarrhythmic and blood pressure support
Cocaine affects what transporter in CNS
dopamine transporter. It binds and blocks reuptake of monoamines: dopamne, norepinephrne, epi and serotonin. However, cocaine has a very direct effect on dopamine signaling and binds specifically to dopamine transporters in the central nervous system (CNS).
Is antibiotic considered for patients undergoing chemotherapy?
If not what is important
Patients undergoing chemotherapy are not considered for antibiotic prophylaxis unless they are receiving surgical dental treatment and their neutrophil count is less than 1000/mm3.
Give Nystatin to prevent from opportunistic infections
what category of patients can’t take azithryomycin
Azithromycin is associated with a risk for QT prolongation in patients, which can cause arrhythmias, especially in those on vasoconstrictors.
At what diastolic BP consult is required
> 109 mmHg
Benztropine
anticholinergic: for reducing tremor symptoms
moa of Anti-angiogenic tyrosine kinase inhibitors (e.g. sunitinib)
prevent signaling processes necessary for angiogenesis and are used in certain types of cancer therapies.
MOA of onabotulinumtoxinA (Botox®)
blocks the release of Ach.
when Ach binds to receptors on the cell membrane it causes deporlarization and leds to muscle contraction so botox inhibits and cause muscle paralysis
factor V leiden
causes patients to be in a hypercoagulable state.
What causes GI upset and pseudomonas colitis
clindamycin
which is the least potent of all bisphosphonates and is the least likely to interfere with bone remodeling and cause MRONJ.
etidronate
what can happen if NSAIDs taken with ace inhibitors
kidney damage, nsaids reduce the effectivness of ace inhibitors
all side effects associated with methylphenidate (Ritalin®) use (For ADHD)
Nervousness, weight loss, and sweating
Bupropion
inhibits norepinephrine and dopamine reuptake, which increases the concentration of both neurotransmitters. It can be used to treat various conditions such as major depressive disorder and to aid in smoking cessation.
