Pharmacology Group 1 Flashcards
For which 5 conditions should be Nitroglycerin be used?
- Acute/chronic angina
- Acute MI
- CHF
- Hypertensive crisis (IV)
- Raynaud’s syndrome (topical)?
Which pharmaceutical’s action is releasing nitrous oxide in smooth muscle causing relaxation?
Nitroglycerin
What are 5 adverse effects of using nitroglycerin?
- Headache
- Postural hypotension
- Loses efficacy over time
- Reactive tachycardia
- Increased O2 consumption via cardiac sinus stimulation
T/F: After 24 hours of continuous use, nitroglycerin activity continues to efficacy for another 24
FALSE!! 24 hours of continuous use abolishes activity 100%, even at huge doses
Which 2 responses should cause one to discontinue use of nitroglycerin?
- Blurred vision
2. Dry mouth
T/F: Overdosing on nitroglycerin can be fatal
True
What pregnancy class is nitroglycerin?
Preg C
What are 5 contraindications for use of nitroglycerin?
- Severe anemia
- Glaucoma
- Head trauma
- Hypotension (IV)
- Hypertrophic cardiomyopathy
What happens when nitroglycerin is combined with ethanol?
Severe hypotension/CV collapse
What is nitroglycerin potentiated by?
Aspirin
What happens when nitroglycerin is used with calcium channel blockers and sildenafil?
Hypotension
What is the interaction between nitroglycerin and ergotamine?
It is unpredictable
T/F: Nitroglycerin interferes with heparin
True
_________________ helps reduce or reverse nitrate tolerance.
N-acetylcysteine
What are 2 monitoring parameters when using nitroglycerin?
- BP
2. HR
What are 5 modes of administration of nitroglycerin?
- Sublingual
- Oral
- Transdermal patch
- IV
- Ointment
T/F: Nitroglycerin should be withdrawn quickly to avoid rebound angina
FALSE!! Nitroglycerin should be withdrawn GRADUALLY to avoid rebound angina
Which pharmaceutical should be used for the following conditions?
Intermittent claudication, vascular dementia, Peyronie’s Dz, alcoholic and nonalcoholic fatty liver dz, sickle cell anemia
Pentoxifylline
Which pharmaceutical is a non-selective phosphodiesterase inhibitor, redox modulator, and inflammation modulator (inhibits TNF-alpha, leukotriene synthesis)?
Pentoxifylline
T/F: Adverse effects with use of Pentoxifylline are very rare
True
What pregnancy class is Pentoxifylline?
Preg C
What are the contraindications or interactions associated with use of Pentoxifylline?
None determined
What is the mode of administration of Pentoxifylline?
Oral
Which pharmaceutical should be used for the following conditions?
Hypercholesterolemia type IIa and b, hyperlipidemias, atherosclerosis (Decreases CAD mortality)
Atorvastatin
Lovastatin is a similar agent
Which pharmaceutical is a HMG-CoA reductase inhibitor (inhibiting the synthesis of cholesterol); mostly lowers LDL levels, variable effect on HDL levels; now largely believed to act by reducing inflammation and possibly as vitamin D receptor agonists?
Atorvastatin
What are 12 adverse effects seen with use of Atorvastatin?
- Inhibits CoQ10 formation (may worsen CV dz)
- Elevated liver enzymes
- Pruritis
- Myalgia
- Headache
- Hepatitis (2%)
- Myositis (0.5%)
- Cataracts
- Insomnia (Not seen with Pravastatin)
- Peptic ulceration
- Carcinogenic in animals
- Photosensitivity
What are 6 contraindication for use of Atorvastatin?
- Liver dz
- Kidney dz
- Cataracts
- PUD
- Lactation
- Undiagnosed secondary hyperlipidemia (i.e. hyperlipidemia due to poorly controlled DM)
What pregnancy class is Atorvastatin?
Preg X
T/F: Atorvastatin is highly protein bound
True - Pravastatin is not
T/F: Atorvastatin works synergistically with niacin
True
Which 5 pharmaceuticals increase Atorvastatin toxicity?
- Itraconazole
- Cyclosporine
- Erythromycin
- Gemfibrozil
- Sustained-release niacin
What pharmaceutical interferes with the function of Atorvastatin?
Rifampin
T/F: Atorvastatin reduces the levels of OCPs
FALSE! It INCREASES OCP levels
T/F: Atorvastatin works synergistically well with Propranolol, Cholestyramine, and Colestipol
FALSE! Atorvastatin is INTERFERED with by propranolol
T/F: Atorvastatin potentiates digoxin and warfarin
True
What are 3 monitoring parameters for Atorvastatin use?
- Monitor serum liver enzymes (baseline before therapy and again at 6-12 weeks)
- Administer periodic slit lamp exams
- Check CPK levels if myalgia occurs
How is Atorvastatin administered? When should it be taken? And why?
Oral; at night (highest cholesterol production is between midnight and 5am)
What is the indication for use of Isotretinoin?
Severe nodular acne not responsive to other treatments
What is the action of Isotretinoin?
Synthetic retinoid; reduce sebum production from sebaceous glands
What is the pregnancy class of Isotretinoin? What does this class mean?
Pregnancy X - must use birth control while taking
T/F: Alcohol should be avoided when using Isotretinoin
True
T/F: There is increased bioavailability of Isotretinoin with food or milk
True
T/F: There is decreased toxicity of Isotretinoin with corticosteroids
FALSE! Toxicity is INCREASED
T/F: Isotretinoin reduces contraceptive effectiveness with microdose progesterone preparations
True
What are 4 monitoring parameters associated with Isotretinoin use?
- CBC w/ diff
- Platelet count
- ESR
- CPK
What is the route of administration of Isotretinoin? With or without food?
Oral: capsule
Should be taken WITH food
What are 5 uses for Clindamycin?
- Acne (topical w/ benzoyl peroxide)
- Aerobic Gram-positive INFXN (Staph, MRSA, Strep w/TSS - NOT Enterococci)
- Unusual anaerobic Gram-negative INFXN
- BV (intravaginal)
- Falciparum malaria (w/quinine or chloroquine)
What is the action of Clindamycin?
Bacteriostatic protein synthesis (incl. toxin synthesis) inhibitor
What are 7 adverse effects associated with Clindamycin use?
- Diarrhea
- Pseudomembranous colitis
- Nausea/Vomiting
- Rash
- Dysgeusia
- GERD (stay upright after taking it to avoid this)
- Hepatotoxicity (rare)
What is the pregnancy class for Clindamycin?
Preg B
Clindamycin combined with macrolides or chloramphenicol will have which 2 interactions?
- Antagonism
2. Cross-resistance
T/F: Neuromuscular-blocking drugs potentiate Clindamycin
True
What is the route of administration for Clindamycin?
Oral, topical
What are 2 related drugs to Latanoprost?
- Bimatoprost
2. Travoprost
What is the indication for Latanoprost?
Primary open-angle glaucoma
What are the actions of Latanoprost?
Reduces intraocular pressure by increase aqueous fluid outflow; prostaglandin F2a analog
What are 5 adverse effects associated with Latanoprost?
- Hyperemia of eyes
- Blurry vision
- Thick darkened eyelashes
- Eye discomfort
- Browning of iris
Which condition should Latanoprost be used with caution?
Keratoconus
What is a monitoring parameters for use with Latanoprost?
Regular ocular pressure checks
What is the route of administration of Latanoprost?
Topical