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Review > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Area under the curve

A

-average amount of a drug in the blood after a dose is given –> bioavailability

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2
Q

Drugs that commonly cause inhibition of CYP450 system

A
  • Macrolides
  • antifungals
  • Cimetidine
  • Citalopram
  • grapefruit juice
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3
Q

Antibiotic with highest risk of C.diff

A

Clindamycin (Cleocin)

Lincosamide class

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4
Q

Digoxin therapeutic levels

A

-0.5-2

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5
Q

Signs of digoxin toxicity

A
  • GI: anorexia, N/V, abdominal pain

- scotoma, yellow-green tinge vision

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6
Q

Labs for suspected digoxin toxicity

A
  • digoxin level
  • electrolytes
  • creatinine
  • EKGs
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7
Q

Digoxin toxicity treatment

A

-Digibind

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8
Q

Citalopram (Celexa) contraindications

A

QT prolongation

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9
Q

Frequency of testing INR

A

every 2-4 weeks up to every 12 weeks

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10
Q

What to do if INR <5 with no significant bleeding risk

A
  • omit one dose and/or
  • reduce maintenance dose slightly
  • check INR
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11
Q

What to do if warfarin dose missed

A
  • take as soon as possible on the same day

- do NOT double dose next day

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12
Q

After warfarin is discontinued, how long will the anticoagulant effects persist

A

2-5 days

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13
Q

What medication should not be combined with diuretics

A
  • Lithium

- risk of lithium toxicity

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14
Q

Patients with HTN and osteoporosis have extra benefit from what medication

A
  • thiazide diuretics

- reduce calcium excretion by kidneys and stimulate osteoblasts

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15
Q

Spironolactone adverse effects

A

-gynecomastia and hyperkalemia

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16
Q

BBW Spironolactone

A

-increased risk of benign and malignant tumors

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17
Q

Loop diuretic should not be given to patients with what allergy

A

sulfa

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18
Q

Loop diuretic adverse effects

A
  • electrolyte imbalance
  • hypovolemia
  • hypotension
  • pancreatitis, jaundice, rash
  • ototoxicity
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19
Q

Noncardioselective BB

A
  • propranolol

- carvedilol (Coreg)

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20
Q

Cardioselective BB

A
  • blocks beta 1
  • atenolol
  • metoprolol
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21
Q

BB contraindications

A

-asthma
COPD
-bradycarida
AV block 2nd-3rd

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22
Q

BB adverse effects

A
  • bronchospasm
  • bradycardia
  • depression, fatigue
  • ED
  • blunts hypoglycemic response
  • HF
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23
Q

ACE/ARB adverse effects

A
  • hyperkalemia
  • cough
  • angioedema
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24
Q

Direct renin inhibitor example

A
  • Aliskerin (Tekturna)

- not recommended for initial treatment

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25
Q

When does ACE induced cough usually begin

A
  • first few months of treatment

- discontinue and switch to ARB

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26
Q

Which antihypertensive preferred for HTN in diabetics and patients with CKD

A

ACEI/ARBs

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27
Q

T/F ACEI/ARB excreted in breastmilk

A

true

avoid

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28
Q

First line medication for Raynauds

A

CCB

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29
Q

Verapamil should not be mixed with

A

erythromycin

clarithromycin

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30
Q

CCBs are contraindicated with

A

AV block
bradycardia
CHF

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31
Q

up to 25% of patients using verapamil develop ___

A

constipation

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32
Q

CCB adverse effects

A
  • headache
  • peripheral edema
  • bradycardia
  • HF and heart block
  • hypotension
  • QT prolongation
  • constipation
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33
Q

Alpha-blockers are used when

A

-patients with BPH and HTN

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34
Q

alpha-blocker examples

A
  • Terazosin (Hytrin)

- Doxazosin (Cardura)

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35
Q

Alpha-blocker adverse effects

A
  • orthostatic hypotension
  • dizziness, syncope
  • priapism
  • do not give with cataract/glaucoma surgery
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36
Q

Tetracyclines can cause permanent teeth staining and skeletal defects in who

A
  • children <9
  • last half of pregnancy
  • infancy
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37
Q

Tetracycline adverse reactions

A
  • photosensitivity with minimal sunlight

- esophageal ulcerations very rare

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38
Q

When are tetracyclines best taken at

A

-empty stomach

take 1-2 hours before a meal

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39
Q

Tetracycline organism coverage

A

G- only
Atypicals
MRSA

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40
Q

Macrolide organism coverage

A

G+ (except enterococci)
Some G-
atypicals

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41
Q

Macrolide adverse effects

A
  • GI distress
  • ototoxicity
  • QT prolongation
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42
Q

If patient can not tolerate erythromycin, switch to

A

Azithromycin or clarithromycin

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43
Q

Macrolide and warfarin

A

INR may be increased

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44
Q

First generation cephalosporin coverage

A
  • G+ cocci
  • not effective against MRSA
  • poor anaerobic coverage
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45
Q

Cephalexin

A

Keflex

1st

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46
Q

Cefadroxil

A

Duricef

1st

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47
Q

What are 1st generation cephs good for

A

skin infections

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48
Q

Second generation cephalosporin coverage

A

G+
G-
proteus

49
Q

Cefuroxime

A

Ceftin

2nd

50
Q

Cefaclor

A

Ceclor

2nd

51
Q

Cefprozil

A

Cefzil

2nd

52
Q

Third generation cephalosporin coverage

A

weak G+
G-
beta-lactamase

53
Q

Cefixime

A

Suprax

3rd gen

54
Q

Extended spectrum 3rd gen coverage

A

G+
G-
beta lactamase

55
Q

Ceftriaxone

A

Rocephin

ES 3rd

56
Q

Cefdinir

A

Omnicef

ES 3rd

57
Q

MRSA treatment

A
  • Bactrim
  • Doxycyline
  • minocycline
58
Q

PCN coverage

A

-G+

G-

59
Q

PCN adverse reactions

A

-diarrhea
C.diff
-vaginitis
-SJS

60
Q

Patient with mono and strep throat

A

-use macrolide

61
Q

Dicloxacillin indication

A
  • penicillinase producing staph

- mastititis and impetigo

62
Q

Type 1 IgE mediated reactions

A

Anaphylaxis

angioedema

63
Q

Some women on which antibiotic will complain of candida vagnitis symptoms

A
  • amoxicillin

- recommend probiotics or eating yogurt

64
Q

FQ coverage

A

-G-
-some atypicals
3rd gen: newer generations have G+ coverage

65
Q

Ciprofloxacin

A

Cipro
2nd gen FQ
Gut and urinary infections

66
Q

Levofloxacin

A

Levaquin

3rd gen respiratory FQ

67
Q

Moxifloxacin

A

Avelox

4th gen resp FQ

68
Q

FQ BBW

A
  • increased risk of Achilles tendon rupture
  • avoid strenuous exercise
  • reserved for patients with no other choice of abx
69
Q

Which abx used for anthrax infection and prophylaxis

A

Cipro

70
Q

Which abx used for traveler’s diarrhea

A

Cipro

71
Q

Floxin otic drops indicated for

A

OM with perforated TM

72
Q

FQ drug interactions

A
  • FQs
  • amiodraone
  • macrolides
  • TCAs
  • antipsychotics
  • electrolyte imbalances
  • increased risk of arrhythmia
73
Q

FQs not to be used with which people

A
  • <18 years old

- pregnant or breastfeeding women

74
Q

Patient on FQ c/o difficulty walking plan

A

-Order US r/o tendon rupture or neuropathy

75
Q

First line drug to treat pseudomonal PNA for cystic fibrosis

A

Cipro

76
Q

Which antibiotic has best activity against Pseudomonas

A

Cipro

77
Q

Other sulfa-type drugs

A
  • diruretics
  • sulfonylureas
  • COX-2 inhibitors
  • Dapsone
  • sulfasalazine
  • Nitrofurantoin
78
Q

Pregnant women with UTI preferred abx

A
  • amoxicillin

- cephalosporin

79
Q

HIV positive patients are at greatest risk for what with sulfa

A

-SJS

80
Q

Short acting topical nasal decongestants

A
  • Oxymetazoline (Afrin)

- Phenylephrine (Neo-Synephrine)

81
Q

Which antihistamine has lowest sedation

A

Loratidine (Claritin)

82
Q

Which antihistamine is more potent and longer acting

A

Cetirizine (Zyrtec)

83
Q

NSAID option for patients which high risk for GI bleed

A

Celecoxib

84
Q

NSAIDs should not be used with ASA because

A

reduces ASA cardioprotective effects

85
Q

NSAIDs may worsen ___ in patients who were previously well controlled

A

HTN

86
Q

Max regular strength acetaminophen dose in >12

A

3250 mg/24 hours

87
Q

Max extra strength tylenol /day

A

3000 mg /24 hours

88
Q

Max extended release tylenol /day

A

3900 mg/day

89
Q

Tylenol should not be used for more than ___

A

10 days

90
Q

Antidote for tylenol

A

Acetylcysteine (MucoMyst)

91
Q

Capsaicin cream can be used to treat what kind of pain

A

trigeminal neuralgia

PHN

92
Q

ASA should be discontinued if patient complains of what

A

tinnitus

possible ASA toxicity

93
Q

Side effects of chronic steroid use

A
  • HPA suppression
  • Cushing syndrome
  • osteoporosis
  • immunosuppression
  • skin changes
94
Q

Drugs that require eye exams

A
  • Digoxin
  • Linezolid
  • Corticosteroids
  • FQs
  • Viagra, Cialis, Levitra
  • Accutane
  • Topamax
  • Plaquenil
95
Q

With which illegal substances will pupils constrict

A
  • Miosis
  • Prescription opioids
  • meth
96
Q

With which illegal substances will pupils dilate

A
  • Mydriasis
  • cannabis
  • cocaine
97
Q

Which illegal substance can cause severe dental caries

A

-meth

98
Q

Category X drugs

A
  • Finasteride
  • Isotretinoin
  • Warfarin
  • Misoprostol
  • Androgenic hormones
  • Live virus vaccines
  • Thalidomide, DES, methimazole
99
Q

Information required on prescription pads

A
  • name
  • designation
  • license number
  • NPI number
  • supervising physician name/ designation
  • clinic address
100
Q

Which schedule of drug can not be called in to the pharmacy

A

2

101
Q

5 rights of prescribing

A
  • right patient
  • right dose
  • right drug
  • right time
  • right route
102
Q

Preferred method of drug prescriptions for Medicaid and Medicare

A

E-prescribing

103
Q

Feverfew

A

migraine headache

104
Q

Cinnamon

A

improve blood sugar and cholesterol

105
Q

Glucosamine (with or without chondroitin)

A

osteoarthritis

106
Q

Natural progesterone cream from wild yam root extract

A

-premenstrual symptoms (hot flashes)

107
Q

Isoflavones (soy beans)

A

Estrogen like effects

108
Q

Saw palmetto

A

urinary symptoms of BPH

109
Q

Kava kava, valerian root

A

-anxiety and insomnia

110
Q

St. John’s wort

A

mild depression

111
Q

Tumeric

A

Alzheimer’s
arthritis
cancer

112
Q

What should not be mixed with St.John’s wort

A

-SSRIs
-sumatriptan
-HIV protease inhibitors
etc

113
Q

Ayurveda

A

healing system from India

-food, spices, herbs, yoga, lifestyle to prevent disease

114
Q

Type1 reaction

A

IgE mediated

anaphylaxis

115
Q

Benzo with shortest half life

A

-Triazolam (Halcion)

2 hours

116
Q

Benzo with longest half life

A

Clonazepam (Klonipin)

34 hours

117
Q

Anticholinergic overdose

A

-mydriasis (dilation)
-flushing
-fever
-urinary retention
delirium/HA

118
Q

Drug interactions with levothyroxin

A
  • anticoagulants
  • TCA
  • antacids and calcium
  • iron
  • Multivitamin
  • PPI
  • estrogen
  • statins
  • metformin, etc
  • space out several hours apart

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