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joy's deck for FNP > pharmacology > Flashcards

pharmacology Flashcards

1
Q

warfarin interacts with which drug

A

sulfa drugs ( i.e. Bacrim (trimethoprim-sulfamethoxazole) by increases warfin=>INR=>bleeding

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2
Q

First pass metabolism

A

lowers the amt of active drug. ex: to bypass first pass metabolism, insulin must be given as in injection

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3
Q

half life

A

time it takes for drug concentration to decrease by 50%

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4
Q

area under the curve (AUC)

A

avg Amt of drug in the blood after dose is given

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5
Q

cyp450 drugs

A

inhibitors= increase amy of drug= risk for toxicity

macrolids
antifungals (ketoconazole, fluconazole)
cimedtidine (Tagamet)
citaprolam (celexa)

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6
Q

cimedtidine (Tagamet)

A

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.

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7
Q

black box TZD (thiazolidinediones)

black box

A

ie
rosiglitazone (Avandia)
pioglitazone (actos)
exacerbate HEART FAILURE

stop if c/o dypnea, weight gain, cough (heart failure)

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8
Q

atypical antipsychotics black box

A

Risperidone ( Risperadal)
Olanzapine (Zyprexa)
Quietipine ( Seroquel)

higher mortality in elderly

monitor BMI (weight gain), TSH, lipids

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9
Q

biphosphonates warning

A

alendronate ( Foxamax)
Risedronate (Actonel)

jaw pain (jaw necrosis)
take first thing in the morning before breakfast, no juice
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10
Q

statins warning

A

check CK (hepatitis)

hepatitis risk and rhabo if mixed with antifungals

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11
Q

lincosamides risk

clindamycin (cleocin)

A

high risk c-did

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12
Q

digoxin therapeuric range

A

.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

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13
Q

warfarin INR

A

2-3

INR

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14
Q

HCTZ adverse effects

A 
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

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15
Q

benefit of hctz

A

Good for osteoporosis

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16
Q

potassium sparing diuretics

black box

A

alternative to sulfa allergy

triamterene (Dyrenium)
Amiloride ( Midamor)

blackbox: hyPERkalemia
don’t give salt substitutes, ace/arbs

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17
Q

aldosterone antagonist adverse

A

glactorrhea and hyPERkalmia

black box: risk for cancer

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18
Q

Beta blocker warning

A

depression, fatigue
NO use in pulmonary pts
blunts hypoglycemic response

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19
Q

ace contraindications

A

avoid K+ sparing diuretics

avoid K+ supplements

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20
Q

arbs first line for ..

A

1st line for DM

1st line for Renal disease

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21
Q

ace-I black box

A

death/injury to fetus during 2nd and 3rd tri

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22
Q

Ca blocker warning

A

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

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23
Q

mono, don’t give which drug

A

amoxcillin due to druh rash

24
Q

COPD medications

A

1st line: anticholinergic (ipratropium bromide or atrovent)
1nd: short acting B2 agonist (albuteral)

all get pneumovax-p

25
tetracyline warning
teeth stain | skeletal defects during pregnancy and children
26
1st line for chlymadial infection (i.e. cervicitis, PID, atypical pneumonia)
doxy
27
macrolides interactions
erythromycin and clarithromycin are potent cyp450 inhibitors erythromycin- careful with myasthenia gravis azithromycin- warfarin clarithryo- qt prolongation
28
ketolide telithromycin (ketek) contraindication
type of macrolide | don't give with myasthenia gravis- liver failure
29
tetracyclines contraindication
minocycline- don't use with antacids, oral contraceptives
30
don't use Warfarin with which drugs
erythromycin, clarithromycin dt inR risk and bleeding
31
beta lactam family drugs
cephalosporings PCN bactericiadal
32
1st generation cephalosporin
keflex gram positive tx for UTI during pregnancy
33
2nd generation cephalosporin
gram negative cefuroxime (ceftin) cefproxil (cefzil) cefalclor (ceclor) tx for sinuisitis, otitis media,
34
3rd generation cephalosporin
ceftrixone (rocephin) Cefixime (suprax) cefdinir (omnicef) tx for gonorrhea
35
syphillis first line
PCN G
36
strep throat first line
PCN V
37
otitis media first line
amoxcillin (2nd line augmenten)
38
gonorrhea first line
rocephin (ceftriaxone) IM
39
mrsa first line
bactrim DS or clindaymycin
40
amoxicillin in women reaction
may cause yeast infection. recommend probiotic
41
fluroquinolones black box warning
achilles tendon rubpture. avoid strenuous exercise while on the drug. don't use if
42
qt prolongation drugs
amiodarone, macrolids, tca, antipsychotics, fluoroquinolonoes FATAM
43
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
44
rx for pregnant women with UTI
amoxicillin or cephalosporin
45
avoid nsaid in what type of patient
heart failure
46
s.s aspirin toxicity
ears ringing
47
side effects of glucocorticoids (steroids)
``` cushings disease (round face, dorsal hump) osteoporosis (advice exercise, vit D, calcium 1200mg, bisphosphonates) ```
48
schedule 1
illegal to prescribe (MDMA, ecstasy)
49
schedule 2
ie norco, demerol, cocaine, oxycontin original prescription needed with dr.'s signature
50
schedule 3
tylenol with codeine, anabolic steroids, testosterone
51
schedule 4
benzodiazepine, ambien. can be mailed to the patient
52
schedule 5
cough medicine (less than 200mg codeine). can be mailed to the pt
53
category x drugs
proscar, propecia- finasteride, accutane, warfarin, cytotic (misoprostol), bcp, hrt, testosterone, LIVE VIRUS; MMR, varicella, rotavirus, flumist
54
live virus
MMR, varicella, rotavirus, flumist
55
accutane protocol
2 reliable forms of bcp, negative pregnancy test 1 month before, during, and 1 month after accutane

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