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CDM1 > Pharmacology 14 Drugs Review > Flashcards

Pharmacology 14 Drugs Review Flashcards

1
Q

Acetaminophen Classification/Indication

A

Analgesic/Antipyretic

Analgesia, Fever

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2
Q

Acetaminophen Dosing

A

IR: 325-650mg PO/PR q4h
ER: 1000mg PO Q6-8h

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3
Q

Acetaminophen MOA

A

Acts on the hypothalamus to produce antipyresis.
Peripherally works to block pain impulse generation
May inhibit prostaglandin synthesis in CNS

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4
Q

Acetaminophen ADE’s

A

Angioedema
Disorientation/dizziness
Pruritic, maculopapular rash

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5
Q

Acetaminophen Elimination

A

Hepatic Metabolism

Excreted in urine

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6
Q

Acetaminophen Clinical Pearls

A

Pregnancy Cat B

Avoid Doses >3250 mg daily

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7
Q

Amlodipine Classification/ Indication

A

Antihypertensive

Hypertension, Coronary Artery Disease, Angina

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8
Q

Amlodipine Dosing

A

5mg PO D; may increase q7-14d. NTE 10mg PO D

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9
Q

Amlodipine MOA

A

CCB; inhibits cardiac and vascular smooth muscle contraction. Leads to dilation of main coronary & systemic arteries

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10
Q

Amlodipine ADE

A

Edema/Pulmonary Edema
HA
Fatigue

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11
Q

Amlodipine Elimination

A

Hepatic metabolism

Excreted in urine

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12
Q

Amlodipine Clinical Pearls

A

Comes in combo w/ Benazepril, atorvastatin, olmesartan, Telmisartan, Valsartan.
Use w/caution in CHF
Titrate slowly in those w/severe hepatic impairment due to extensive liver metabolism

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13
Q

Aspirin Classification/Indication

A

NSAID, Antiplatelet

Pain, Fever
Acute Coronary Syndrome

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14
Q

Aspirin Dosing

A

P/F: 325-650mg PO/PR q4-6h PRN

ACS: 160-325 mg PO; chew non enteric coated tablet upon presentation. Maintanance dosing 81-325 mg D

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15
Q

Aspirin MOA

A

Inhibits synthesis of prostaglandins by blocking COX
Inhibits platelet aggregation
Has antipyretic/analgesic activity

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16
Q

Aspirin ADE

A

Angiodema, uticaria, rash
Bronchospasm
CNS alteration

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17
Q

Aspirin Elimination

A

Hepatic metabolism

Excreted mostly in urine, some in sweat, saliva, feces

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18
Q

Aspirin Clinical Pearls

A

Contraindicated: Bleeding, GI Ulcers, hemophelia, hemorrhoids, lactating mothers, nasal polyps.
Associated with asthma, sarcoidosis, throbocytopenia, UC
Avoid in pediatrics due to increased incidence of Reyes syndrome
May worsen CHF in pts due to increased NA/H2O retention due to prostaglandin inhibition

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19
Q

Atorvastatin Classification/Indication

A

Hypolipemic

Hyperlipidemia

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20
Q

Atorvastatin Dosing

A

10-80 mg PO D

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21
Q

Atorvastatin MOA

A

Inhibits rate limiting step in cholesterol biosynthesis by inhibiting HMG-CoA reductase

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22
Q

Atorvastatin ADE

A

N/D/dyspepsia
Nasopharyngitis
Arthralgia

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23
Q

Atorvastatin Elimination

A

Hepatic metabolism

Excreted mainly in bile

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24
Q

Atorvastatin Clinical Pearls

A

May cause elevations in LFTs

Risk of myopathy increased by coadmin of HIV protease inhibitors or azole antifungals

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25
Q

Glyburide (Micronase) Classification/Indication

A

Antidiabetic

Diabetes

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26
Q

Glyburide Dosing

A

1.25-20mg PO D. MDD 20mg D

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27
Q

Glyburide MOA

A

Sulfonylurea enhances insulin secretion from pancreatic beta cells.
Increase peripheral utilization of glucose
Suppresses hepatic gluconeogenesis, and possibly increase sensitivity and/or # of peripheral insulin receptors

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28
Q

Glyburide ADE

A

Noctural enuresis
Hypoglycemia, Nausea, myalgia, skin rash, heartburn
Disulfiram reaction, hemolytic anemia

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29
Q

Glyburide Elimination

A

Renal elimination 50%

30
Q

Glyburide Clinical Pearls

A

May have symptoms of hypoglycemia masked by beta blockers (except sweating)
Monitor blood glucose 2-4x D
Alcohol may cause disulfiram reaction
Often add-on therapy w/metformin if A1C goals are not met

31
Q

Hydrochlorothiazide (Hydrodiuril) Classification/Indication

A

Diuretic

Hypertension, edema

32
Q

HCTZ Dosing

A

Edema 25-100mg PO D in single or divided doses

HTN: Initial 12.5-25mg PO D

33
Q

HCTZ MOA

A

Thizides increase NA/CL excretion by interfering with their reabosorption in the cortical diluting segment of the nephron

34
Q

HCTZ ADE

A

Hypotension, dizziness, HA
Constipation, nausea, impotence
Hyper-calcemia/glycemia/uricemia
Hypo-kalemia/magnesemia/natremia

35
Q

HCTZ Elimination

A

Excreted 50-70% unchanged in urine

36
Q

HCTZ Clinical Pearls

A

Full hypotensive effect may require 2-3 weeks

Avoid Alcohol and other NSAIDs

37
Q

Ibuprofen Classification/Indication

A

NSAID

Pain relief, fever, HA

38
Q

Ibuprofen Dosing

A

200-400mg po q4-6h prn

39
Q

Ibuprofen MOA

A

Nonselective COX inhibiter. Reversibly alters platelet functioning and prolongs bleeding time

40
Q

Ibuprofen ADE

A

GI Distress/Bleeding

Edema, Itching

41
Q

Ibuprofen Clinical Pearls

A

Use with caution in renal dysfunction.

NSAIDs associated w/increased risk of CV thrombotic events

42
Q

Levofloxacin (Levoquin) Classification/Indication

A

Antibiotic
Treatment of community-acquired pnemonia, including multidrug resistance strains of S. PNEMONIAE (MDRSP) nosocomial pnemonia, chronic bronchitus (acute bacterial exacerbaction) acute bacterial rhinosinusitis (ARBS) prostatitis (chronic bacterial) UTI (complication or un) acute pyelonephritis, skin infections, reduces incidence or disease progression of inhalational anthrax (post exposure)

43
Q

Ibuprofen Elimination

A

Hepatic metabolism via. CYP2C19

45-80% renal elim?

44
Q

Levofloxacin Dosing

A

500-750mg 1D

45
Q

Levofloxacin MOA

A

The S- enantomer of the floroquinolone, ofloxacin, levofloxacin inhibits DNA-gyrase in susceptible organisms thereby inhibits relaxation of supercoiled DNA and promotes breakage of DNA strands. DNA topoisomerase (tygrase)II is an essential bacterial enzyme that maintains the superhelical structure of DNA and is required for DNA replication transcription, repair, recombination and transposition.

46
Q

Levofloxacin ADE

A

Nausea
HA
Diarrhea

47
Q

Levofloxacin Elimination

A

CrCl 20-50 reduce dose by 50% (RENALLY EMINIATED)

CrCL 5-19 ml/min extend interval by 48H

48
Q

Levofloxacin Clinical Pearls

A

Not approved in children younger than 18 y/o. Oral and IV dosing is interchangeable. Increased risk of tendon rupter in >60y/o.

49
Q

Losartan Classification/Indication

A

Antihypertension

Hypertension, diabetic nephropathy

50
Q

Losartan Dosing

51
Q

Losartan MOA

A

Selective and competative Nonpeptide ATII receptor antagonist, blocks vasoconstrictor and aldosterone-secreting effects of ATII.
Interacts reversibly at AT1 and AT2 receports of many tissues and has slow dissociation kinetics. Affinity for AT1r is 1000x grater than AT2r. Angiotension II receptor antagonists may induce a complete inhibition of renin-antagonists may induce more complete inhibition of RAAS system than ACE inhibitors, they do not affect the response to bradykinin, and are less likely to be associated with nonrenin-angiotensin effects.

Losartan increases urinary flow rate and in addition to being natriuretic and kaliuretic increases excretion of chloride, magnesium, UA, calcium and phosphate.

52
Q

Losartan ADE

A

HA
Diarrhea
Hyperkalemia

53
Q

Losartan Elimination

A

GFR <30 ml/min/1.73m2: use not recommended!

Hepatic mild to moderate impairment: 25mg 1D

54
Q

Losartan Clinical Pearls

A

ACEi induced cough

55
Q

Metformin (Glucophage) Classification/Indication

A

Antidiabetic

DMII

56
Q

Metformin Dosing

A

500mg BID or 850mg 1D; Titrate in increments of 500mg weekly or 850mg QOW

57
Q

Metformin MOA

A

Decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization)

58
Q

Metformin ADE

A

Diarrhea
N&V
Flatulence

59
Q

Metformin Elimination

A

Renal elimination
contraindicated in eGFR <30
eGFR 30 to 45 may consider 50% dosage reduction

60
Q

Metformin Clinical Pearls

A

Does not cause hypoglycemia, need good renal function measured by GFR, not SCr anymore

61
Q

Simvastatin (Zocor) Classification/Indication

A

Hypolipemic

Hyperlipidemia; prophylaxis for CVD event risk

62
Q

Simvastatin Dosing

A

5-40mg PO D (dependent on intensity)

63
Q

Simvastatin MOA

A

Hydrolyzed to beta-hydroxyacid (potent HMG-CoA reductase inhibitor) increases rate of removal of cholesterol from body and reduces production by inhibiting conversion of HMG-CoA to mevolanate (early and rate limiting step in biosynthesis of cholesterol)

64
Q

Simvastatin ADE

A

Myalgia, rhabdomyolysis
Abdominal pain
Increased LFTs

65
Q

Simvastatin Elimination

A

Extensive hepatic metabolism

Renal and fecal elimination

66
Q

Simvastatin Clinical Pearls

A

Avoid during pregnancy
SX’s muscle pain/weakness
Take in evening
CYP3A4 DDinx limit to 20mg w/ amiodarone, amlodipine, ranolazine. Limit to 10 mg w/ verapamil, diltiazem, dronedarone.
Do not initiate 80mg- restricted to pts who received that dose chronically for at least 12 months w/o evidence of muscle tox.

67
Q 
Metoprolol Succinate (Toprol XL) 
Metoprolol Tartrate (Lopressor)
Classification/Indication
A

Betablocker (antihypertensive)

Angina, heart failure, HTN, MI

68
Q

Succinate/Tartrate Dosing

A

25 mg po D

69
Q

Succinate/Tartrate MOA

A

Selective inhibitor of beta1 adrenergic receptors; competatively blocks b-1 with little to no effect on b2 receptors at oral doses <100mg. Does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity

70
Q

Succinate/Tartrate ADE

A

Dizziness, Fatigue, Hypotension

71
Q

Succinate/Tartrate Elimination

A

Liver disease- use slow dose titration

72
Q

Succinate/Tartrate Clinical Pearls

A

Avoid concomitant use of CCBs as use may significantly affect heart rate rhythms.

CDM1 (5 decks)

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