Pharmacology Flashcards
Morphine is a metabolite of what anti-tussive agent?
Codeine
Oxazepam is a metabolite of what drug?
Diazepam
What is the drug of choice to treat tachycardia caused by Wolff-Parkinson-White syndrome?
Procainamide
What is infliximab?
A TNF-alpha inhibitor, used in the treatment of rheumatoid arthritis. Patients are at increased risk of infections while taking this drug
What procedures should metformin be discontinued 48 hours prior to and restarted 48 hours after?
Since even a temporary reduction in renal function, such as occurs after pyelography or angiography, can cause lactic acidosis in patients taking metformin, the drug should be discontinued 48 hours before such procedures and restarted 48 hours after the procedure if renal function is normal.
What SSRI is contraindicated in pregnancy?
Paroxetine (category D, possible cardiac malformations. The other SSRIs, such as fluoxetine, have been shown to be safe.
What are the indications for use of teriparatide (Forteo)?
Teriparatide is indicated for the treatment of severe osteoporosis, for patients with multiple osteoporosis risk factors, or for patients with failure of bisphosphonate therapy. Therapy with teriparatide is currently limited to 2 years and is contraindicated in patients with a history of bone malignancy, Paget disease, hypercalcemia, or previous treatment with skeletal radiation. Its route of administration (subcutaneous) and high cost should be considered when prescribing teriparatide therapy.
What drug can be used to treat essential tremor in patients intolerant to beta-blockers?
Primidone
What NSAID is on the Beer’s list because it causes some central nervous system effects?
Indomethacin
What is the recommended starting dose of warfarin in elderly patients?
The American College of Chest Physicians recommends a starting warfarin dosage of ≤5 mg/day in elderly patients, or in patients who have conditions such as heart failure, liver disease, or a history of recent surgery.
What are some differences between men and women when it comes to drug metabolism and absorption?
Gastrointestinal transit times are slower in women than in men, which can diminish the absorption of medications such as metoprolol, theophylline, and verapamil. In addition, women should wait longer after eating before taking medications that should be administered on an empty stomach, such as ampicillin, captopril, levothyroxine, loratadine, and tetracycline.
Women also secrete less gastric acid than men, so they may need to drink an acidic beverage to aid in absorption of medications that require an acidic environment, such as ketoconazole. Women usually have lower BMIs than men, and may need smaller loading or bolus dosages of medications to avoid unnecessary adverse reactions. Women typically have higher fat stores than men, so lipophilic drugs such as benzodiazepines and neuromuscular blockers have a longer duration of action. Women also have lower glomerular filtration rates than men, resulting in slower clearance of medications that are eliminated renally, such as digoxin and methotrexate.
What cough medicine may cause serotonin syndrome?
Dextromethorphan
What herbal supplement should be used with caution in patients taking aspirin or other blood thinners?
Ginkgo biloba has been associated with serious intracerebral bleeding. In most of these patients, concurrent anticoagulant drugs were being used. Ginkgo has been shown in vitro to inhibit platelet aggregation and has been associated with case reports of spontaneous bleeding.
In patients with severe pain, what is the maximum safe dose of morphine sulphate that can be given in 24 hrs.
No limit - Because there is no therapeutic ceiling for morphine, extremely large dosages can be used safely and effectively if the drug is titrated properly.
What are good medications for treating orthostatic hypotension?
Fludrocortisone, midodrine, and physostigmine
