pharmacology Flashcards
warfarin interacts with which drug
sulfa drugs ( i.e. Bacrim (trimethoprim-sulfamethoxazole) by increases warfin=>INR=>bleeding
First pass metabolism
lowers the amt of active drug. ex: to bypass first pass metabolism, insulin must be given as in injection
half life
time it takes for drug concentration to decrease by 50%
area under the curve (AUC)
avg Amt of drug in the blood after dose is given
cyp450 drugs
inhibitors= increase amy of drug= risk for toxicity
macrolids
antifungals (ketoconazole, fluconazole)
cimedtidine (Tagamet)
citaprolam (celexa)
cimedtidine (Tagamet)
histamine H2-blocker
cyp450 inhibitor
Treats duodenal ulcer, gastric ulcer, gastroesophageal reflux disease (GERD), and other disorders of the stomach. Also treats or prevents heartburn.
black box TZD (thiazolidinediones)
black box
ie
rosiglitazone (Avandia)
pioglitazone (actos)
exacerbate HEART FAILURE
stop if c/o dypnea, weight gain, cough (heart failure)
atypical antipsychotics black box
Risperidone ( Risperadal)
Olanzapine (Zyprexa)
Quietipine ( Seroquel)
higher mortality in elderly
monitor BMI (weight gain), TSH, lipids
biphosphonates warning
alendronate ( Foxamax)
Risedronate (Actonel)
jaw pain (jaw necrosis) take first thing in the morning before breakfast, no juice
statins warning
check CK (hepatitis)
hepatitis risk and rhabo if mixed with antifungals
lincosamides risk
clindamycin (cleocin)
high risk c-did
digoxin therapeuric range
.5-2.0
dig overdose s/s: visual change (green/yellow), GI, confusion Sever toxicity tx with Digibind.
Check dig level, K, Mag, Ca, creatinine, ekg
warfarin INR
2-3
INR
HCTZ adverse effects
hyperglycemia ( watch out with DM)! sulfa allergy- dont' give elevates triglcerids, LDL elevates uric acid hypokalemia
G: glucose, Hyperglycemia
Uric acid ( gout)
Muscle weakness (HyPOkalemia)
S: sulfa allergy
first line for HN, heart failture
benefit of hctz
Good for osteoporosis
potassium sparing diuretics
black box
alternative to sulfa allergy
triamterene (Dyrenium)
Amiloride ( Midamor)
blackbox: hyPERkalemia
don’t give salt substitutes, ace/arbs
aldosterone antagonist adverse
glactorrhea and hyPERkalmia
black box: risk for cancer
Beta blocker warning
depression, fatigue
NO use in pulmonary pts
blunts hypoglycemic response
ace contraindications
avoid K+ sparing diuretics
avoid K+ supplements
arbs first line for ..
1st line for DM
1st line for Renal disease
ace-I black box
death/injury to fetus during 2nd and 3rd tri
Ca blocker warning
tx for HTN;
amlodipine ( norvasc)
dilt (cardezem)
nifedipine ( procardia)
verapamil ( Calan)- do not mix with erythromycin, clarithromycin
contraindicatiosn:
NO with HEART FAILURE
brady, CHF. avoid grapefruit
mono, don’t give which drug
amoxcillin due to druh rash
COPD medications
1st line: anticholinergic (ipratropium bromide or atrovent)
1nd: short acting B2 agonist (albuteral)
all get pneumovax-p
tetracyline warning
teeth stain
skeletal defects during pregnancy and children
1st line for chlymadial infection (i.e. cervicitis, PID, atypical pneumonia)
doxy
macrolides interactions
erythromycin and clarithromycin are potent cyp450 inhibitors
erythromycin- careful with myasthenia gravis
azithromycin- warfarin
clarithryo- qt prolongation
ketolide telithromycin (ketek) contraindication
type of macrolide
don’t give with myasthenia gravis- liver failure
tetracyclines contraindication
minocycline- don’t use with antacids, oral contraceptives
don’t use Warfarin with which drugs
erythromycin, clarithromycin dt inR risk and bleeding
beta lactam family drugs
cephalosporings
PCN
bactericiadal
1st generation cephalosporin
keflex
gram positive
tx for UTI during pregnancy
2nd generation cephalosporin
gram negative
cefuroxime (ceftin)
cefproxil (cefzil)
cefalclor (ceclor)
tx for sinuisitis, otitis media,
3rd generation cephalosporin
ceftrixone (rocephin)
Cefixime (suprax)
cefdinir (omnicef)
tx for gonorrhea
syphillis first line
PCN G
strep throat first line
PCN V
otitis media first line
amoxcillin (2nd line augmenten)
gonorrhea first line
rocephin (ceftriaxone) IM
mrsa first line
bactrim DS or clindaymycin
amoxicillin in women reaction
may cause yeast infection. recommend probiotic
fluroquinolones black box warning
achilles tendon rubpture. avoid strenuous exercise while on the drug.
don’t use if
qt prolongation drugs
amiodarone, macrolids, tca, antipsychotics, fluoroquinolonoes
FATAM
sulfa risk
increases INR (warfarin) patients with UTI and wafarin don't give septa pregnant women treat UTI with amoxcillin or cephalosporin
ie
trimethoprim-siulfa (TMP
rx for pregnant women with UTI
amoxicillin or cephalosporin
avoid nsaid in what type of patient
heart failure
s.s aspirin toxicity
ears ringing
side effects of glucocorticoids (steroids)
cushings disease (round face, dorsal hump) osteoporosis (advice exercise, vit D, calcium 1200mg, bisphosphonates)
schedule 1
illegal to prescribe (MDMA, ecstasy)
schedule 2
ie norco, demerol, cocaine, oxycontin
original prescription needed with dr.’s signature
schedule 3
tylenol with codeine, anabolic steroids, testosterone
schedule 4
benzodiazepine, ambien. can be mailed to the patient
schedule 5
cough medicine (less than 200mg codeine). can be mailed to the pt
category x drugs
proscar, propecia- finasteride, accutane, warfarin, cytotic (misoprostol), bcp, hrt, testosterone,
LIVE VIRUS; MMR, varicella, rotavirus, flumist
live virus
MMR, varicella, rotavirus, flumist
accutane protocol
2 reliable forms of bcp, negative pregnancy test 1 month before, during, and 1 month after accutane
