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Pharmacology Flashcards

1
Q

Warfarin reversal

When?

How?

A

PO vitamin K (phytonidione) if > 10

Hemorrhage : IV vitamin K plus PCC

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2
Q

Warfarin adverse effects

A

Bleeding

Purple toe syndrome

Warfarin induced skin necrosis

Teratogenic

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3
Q

HIT type I

HIT type II

A

No clinical significance, transient decrease in platelets

Serious. Low plts while clotting

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4
Q

Why lovenox DVT prophylaxis over heparin??

A

Safer

Less likely to bleed

Less thrombocytopenia

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5
Q

When start statin for 10 yr calculated risk?

A

Greater than 7.5%

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6
Q

What other than statins can cause myalgias??

A

Vitamin D deficiency

Thyroid disease

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7
Q

What do you use if high high triglycerides?

A

Gemfibrozil –Careful use with statins!!!

Fenofibrates

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8
Q

Low K, low mag, and bradycardia is perfect set up for what?

A

Torsades

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9
Q

Amio problems

A 
CYP concerns
QT prolongation
Cardiac toxicity 
Pulmonary toxicity - hypersensitivity or subacute cough w patchy interstitial infiltrates 
Recurrent sun exposure --> blue skin
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10
Q

Digoxin toxicity

A

Nausea

PVCs

Yellow green blurred vision

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11
Q

Loop diuretic works how?

A

Blocks Na/K exchange in ascending segment of loop of henle by inhibiting Na/k ATP-ase

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12
Q

Thiazides work how?

A

Interferes with Na/K exchange in early distal convoluted tubule by inhibiting Na/k ATP-ase

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13
Q

Side effects of diuretics?

A

Low K

Orthostatic hypotension

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14
Q

How does spironolactone work?

A

Anti-aldosterone drug, not so much a diuretic actually

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15
Q

Side effects of spironolactone ?

A

Hyperkalemia

Painful gynocomastia

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16
Q

adverse effect of ACE-I

A

Cough
Hyperkalemia
Angioedema - bad

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17
Q

Drugs for BPH

A

Alpha adrenergic blockers

Prazosin, terazosin, doxazosin

Cause postural hypotension

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18
Q

Non beta1 selective beta blocker

A

Propranolol

Metoprolol

Atenolol

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19
Q

Beta blocker that also has alpha1 blocking activity

A

Carvedilol

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20
Q

What drugs cause gingival hyperplasia??

A

Calcium channel blockers

Phenytoin

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21
Q

Amlodipine is what class?

A

Dihydropuridines

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22
Q

Dihydropuridines have what MOA?

A

Vasodilation

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23
Q

Inhaled corticosteroids like fluticasone can cause what adverse effect?

A

Increased risk of osteoporosis

24
Q

What is an adverse effect of anticholinergics??

A

Urinary retention and increase Intra-ocular pressure.

Use with caution in pts with glaucoma and BPH

25
Q

Short acting beta2 agonist

26
Q

Rescue inhaler in asthma

27
Q

Maintenance inhaler

A

Long acting beta2 agonist

28
Q

Long acting beta 2 agonist

A

Salmeterol

Formoterol

29
Q

Rescue inhaler in COPD

A

Albuterol plus ipratropium

30
Q

Short acting inhaled anticholinergic

A

Ipratropium (used with albuterol)

31
Q

Long acting inhaled corticosteroid

A

Tiotropium

32
Q

NSAIDs not in pregnancy why?

A

Can close PDA early

33
Q

What h2 receptor blocker interacts with everything on the Cytochrome P450 list?

A

Cimetidine !

34
Q

DOC for Rheumatoid arthritis

A

Methotrexate

Second : hydroxychloroquin

Severe: TNF inhibitors

35
Q

Warfarin is metabolized by?

36
Q

Aspirin adverse effects

A

Dyspepsia

Reye’s syndrome

Associated with: Sensorineural hearing loss (ringing)

Bronchospasm in asthma pts
Asthma, aspirin, and nasal polyps

37
Q

Long term use of PPIs can cause what?

Now trying to reign in use

A

Anemia

Fractures

Associated with C. diff and infections

38
Q

Drug commonly used for migraine in the ER?

39
Q

What group avoid Phenergan with ?

A

Kids less than 2

Can cause respiratory suppression and death

40
Q

Post-op constipation only if really need it?

41
Q

2x increased risk in congenital heart defects and cleft palat when use this in pregnancy

A

Ondansetron !

Category B but only use when really need it.

42
Q

First line for allergic rhinitis

A

Intranasal steroid

43
Q

Treatment of hyperthyroid

A

First: methimazole to calm down

Then, radioactive iodide therapy

Unless pregnant: than PTU (propylthiouracil)

44
Q

MOA of bisphosphinates

A

Drug binds bone -> osteoclasts begin to resorb bone impregnated with bisphosphinate which promotes apoptosis and this leads to reduced bone resorption

45
Q

ADRs of bisphosphinates

Quit use after 5 yrs to avoid

A

Esophagitis or esophageal cancer - take on empty stomach and try to maximize absorption

Osteonecrosis of the jaw
Atypical femur fractures

46
Q

Priapism – what do you think of?

A

Drugs

Sickle cell

47
Q

Migraine treatment

A

-Triptan

Avoid in vasculopaths

48
Q

Alzheimer’s treatment

A

Donepezil

If benefit after 3 months continue, if not, discontinue

49
Q

Parkinson’s first line

A

Levodopa + carbidopa

50
Q

When use phenytoin?

A

Rare now

Maybe to prevent seizures in or with head trauma

Nystagmus–> toxic and risk of death

51
Q

Carbamazepine adverse effect need to remember

A

Rash–SJS

52
Q

Valproate use

A

Mania

Migraine prophylaxis

53
Q

Valproic acid adverse effect

A

Hepatotoxicity

Teratogen - don’t use in women of hold bearing age at all per FDA

54
Q

When use gabapentin

A

Restless legs

Post-herpetic neuralgia

55
Q

When use lamotrigine?

56
Q

When use topiramate

A

Migraine prophylaxis

57
Q

SSRI

A

Fluoxetine and paroxetine

Sertraline and citalopram

PANRE (21 decks)

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