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vvn's ANCC FNP > Pharmacology > Flashcards

Pharmacology Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

Drugs to monitor

A

Warfarin (INR)
Digoxin (digoxin level, EKG, electrolytes)
Theophylline (blood levels)
Carbamazepine and phenytoin (blood levels)
Levothyroxine (TSH)
Lithium (blood levels, TSH => risk of hypothyroidism)

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2
Q

Safety–PPI’s

Specifically, omeprazole

A

Increased risk of fractures (postmenopausal women), pneumonia, Cdiff, hypomagnesemia, B12 and iron malabsorption, atrophic gastritis, kidney disease

Interacts with warfarin, diazepam, carbamazepine, phenytoin, ketoconazole

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3
Q

Safety–warfarin

A

Interacts with “G” herbs–garlic, ginger, gingko, and ginseng, as well as feverfew, green tea, and fish oil
DC 7 days before surgery

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4
Q

Safety–TZD’s

Specifically, pioglitazone (Actos)

A

Cause or exacerbate CHF; do NOT use in NYHA Class III or IV HF

DC if causes dyspnea, weight gain, cough (HF)

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5
Q

Safety–atypical antipsychotics

Specifically, risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel)

A

High risk of weight gain, metabolic syndrome, and type 2 DM; monitor weight Q3 months

Monitor TSH, lipids, weight/BMI

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6
Q

Safety–bisphosphonates

Specifically, alendronate (Fosamax), risedronate (Actonel)

A

Erosive esophagitis, abdominal pain, stop immediately if symptoms of esophagitis or jaw pain (osteonecrosis); take FIRST thing in the morning alone before breakfast

Contraindications: Active GI disease, CKD, esophageal stricture/varices

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7
Q

Safety–statins

Specifically, atorvastatin (Lipitor), lovastatin (Mevacor), rosuvastatin (Crestor), simvastatin (Zocor)

A

Do NOT mix with grapefruit juice
If mixed with azole antifungals, drug-induced hepatitis or rhabdomyolysis

High-dose Zocor (80mg) has highest risk of rhabdomyolysis
Chinese descent: higher risk myopathy when taking Zocor 40mg or higher with niacin
Creatine kinase level goes up

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8
Q

Safety–Lincosamides

Specifically, clindamycin

A

Increased risk of Cdiff

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9
Q

S/sx digoxin overdose

A

Anorexia, N/V/abd pain, arrhythmias, confusion, visual changes (yellowish green tinged-color vision, scotomas

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10
Q

Labs to order if digoxin overdose suspected

A

Digoxin level, electrolytes, creatinine, serial EKGs

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11
Q

Avoid ____ with ACEI/ARBs

A

Potassium supplements; careful with potassium-sparing diuretics

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12
Q

Avoid ____ with potassium-sparing diuretics

A

ACEI, ARBs (hyperkalemia), high potassium diet, salt substitutes, chronic NSAIDs

Gynecomastia may occur

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13
Q

Beta blockers contraindicated if

A

Patient has chronic lung disease

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14
Q

Do not mix PDE5 inhibitors (Viagra) with

A

Nitrates and some alpha-blockers

Do not give within 3-6 months of MI, stroke

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15
Q

Celexa max dose adult, and elderly

A

Adult: 40 mg/d (can prolong QT interval)

>60 years: 20 mg/day

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16
Q

Sources of vitamin K besides dark greens

A

Mayonnaise, canola oil, soybean oil

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17
Q

Thiazide adverse effects

A

Hyperglycemia, increases cholesterol/LDL, increases uric acid, hypokalemia

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18
Q

Loop diuretic adverse effects

A

Low potassium, sodium, magnesium, chlorine; hypovolemia and hypotension; pancreatitis, jaundice, and rash; ototoxicity

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19
Q

Beta blocker adverse effects

A

Bronchospasm, bradycardia, depression, fatigue, erectile dysfunction, blunts hypoglycemic response, HF

20
Q

CCB adverse effects

A

Headache, peripheral edema, bradycardia, HF and heart block, hypotension, QT prolongation, constipation

21
Q

Alpha-blockers adverse effects

A

Orthostatic hypotension (why it’s taken at night), dizziness, syncope, priapism

DO NOT GIVE DURING CATARACT/GLAUCOMA SURGERY

22
Q

Expired tetracycline pills need to be thrown away bc

A

They degenerate and can cause nephropathy or Fanconi syndrome (disorder of kidney tubule)

23
Q

Macrolide contraindications/drug interactions

A

Myasthenia gravis (respiratory depression)

Warfarin, antacid, CCBs, amiodarone, benzos, salmeterol, theophylline, anticonvulsants, ergotamine, statins

24
Q

1st generation cephalosporin

Keflex PO QID

A

Pregnancy: UTI
Skin: cellulitis, impetigo

25
Q

2nd generation cephalosporin

Cefuroxime (Ceftin) PO BID

A

ENT: Rhinosinusitis, otitis media

26
Q

2nd generation cephalosporin

Cefzil PO BID

A

Lungs: CAP, exacerbation chronic bronchitis

27
Q

3rd generation cephalosporin

Ceftriaxone IM

A

STDs: Gonorrhea, PID
Renal: Pyelonephritis

28
Q

3rd generation cephalosporin

Cefixime daily to BID

A

ENT: AOM in children, acute rhinosinusitis

29
Q

3rd generation cephalosporin

Cefdinir daily to BID

A

GU: Pyelonephritis
Lungs: CAP

30
Q

Benzathine penicillin G IM first line for…

A

Syphilis

31
Q

Dicloxacillin PO QID

A

Cellulitis, impetigo, erysipelas

32
Q

Avoid amoxicillin in ___ bc it causes rash
Use ____ instead
If allergy, use ____

A

Mono
Pencillin VK
Macrolide

33
Q

Quinolone drug interactions

A

QT-prolonging drugs (amiodarone, macrolids, TCAs, antipsychotics)
Do no co-administrate with minerals or antacids (drastically reduces effectiveness of quinolones)

34
Q

Quinolone adverse effects

A 
HYPOglycemia
CNS effects
QT prolongation
peripheral neuropathy
Phototoxicity
Double vision
Tendon rupture, tendinitis
35
Q

___ patients are at high risk (25-50%) for sulfa-related Stevens-Johnson syndrome

A

HIV

36
Q

PCN-allergic tx for Strep

A

Clarithromycin or azithromycin
Also, clinda (but C diff)
If >18, Levaquin and gatifloxacin are options

37
Q

Drugs that require eye exam

A 
digoxin
ehtmabutol and linezolid
steroids
fluoroquinolones
PDE-5 inhibitors
Accutane
Topamax
Plaquenil
38
Q

CAM treatments

Feverfew

A

Migraine HA

39
Q

CAM treatments

Cinnamon

A

Blood sugar and cholesterol

40
Q

CAM treatments

Glucosamine

A

Osteoarthritis

41
Q

CAM treatments

Natural progesterone cream (wild yam root extract)

A

Hot flashes

42
Q

CAM treatments

Isoflavones

A

Estrogen-like effects

43
Q

CAM treatments

Saw palmetto

A

BPH

44
Q

CAM treatments

Kava kava, valerian root

A

Anxiety, insomnia

45
Q

CAM treatments

St. John’s wort

A

Depression

Do NOT use with SSRIs, sumatriptan, HIV protease inhibitors

46
Q

CAM treatments

Tumeric

A

Alzheimer’s, arthritis, cancer

vvn's ANCC FNP (3 decks)

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