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NPLEX II - Lynda > Pharmacology Group 2 > Flashcards

Pharmacology Group 2 Flashcards

1
Q

Which pharmaceutical should be used for the following conditions?
Hypertriglyceridemia and coronary heart disease risk

A

Gemfibrozil (similar agent is Fenofibrate)

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2
Q

Which pharmaceutical activates lipoprotein lipase which reduces triglycerides and VLDL cholesterol, modestly reduces LDL, and increases HDL cholesterol?

A

Gemfibrozil

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3
Q

What are 6 adverse effects associated with Gemfibrozil use?

A
  1. Drowsiness
  2. Dyspepsia
  3. Abdominal pain
  4. Diarrhea
  5. Fatigue
  6. Mildly decreased WBC, hematocrit, and hemoglobin levels
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4
Q

What is the pregnancy class of Gemfibrozil?

A

Preg C

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5
Q

What are 2 contradictions for use of Gemfibrozil?

A
  1. Cholelithiasis

2. Renal insufficiency

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6
Q

T/F: There is an increase in rhabdomyolysis with concomitant lovastatin use

A

True

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7
Q

There is an increase in toxicity with concomitant use of Gemfibrozil with which 2 other medications?

A
  1. Repaglinide

2. Thiazolidinedione

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8
Q

What are 3 monitoring parameters associated with Gemfibrozil use?

A
  1. Lipid levels (test every 3 months)
  2. CBC
  3. Liver panel
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9
Q

How is Gemfibrozil administered? Usual dose?

A

Oral; 300-600mg

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10
Q

Which pharmaceutical should be used for the following conditions?
Mild to severe heart failure, left ventricular dysfunction

A

Carvedilol

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11
Q

Which pharmaceutical is a non-selective beta-adrenoreceptor and has alpha-adrenergic blocking activity?

A

Carvedilol

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12
Q

What are 8 adverse effects associated with Carvedilol use?

A
  1. Hypotension
  2. Dizziness
  3. Fatigue
  4. Hyperglycemia
  5. Weight gain
  6. Diarrhea
  7. Weakness
  8. Bradycardia
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13
Q

What are 6 contraindications for use of Carvedilol?

A
  1. Bronchial asthma
  2. AV block
  3. Sick sinus syndrome
  4. Severe bradycardia
  5. Cardiogenic shock
  6. Severe hepatic impairment
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14
Q

What is the pregnancy class of Carvedilol?

A

Preg C

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15
Q

Which 5 drugs/drug types is Carvedilol inhibited by?

A
  1. Delavirdine
  2. Fluconazole
  3. Ketoconazole
  4. NSAIDS
  5. Sulfonamides
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16
Q

Serum levels of Carvedilol are increased by which 2 drugs?

A
  1. Clonidine

2. Cimetidine

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17
Q

What are 5 monitoring parameters associated with Carvedilol use?

A
  1. HR
  2. BP
  3. Renal studies
  4. BUN
  5. Liver function
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18
Q

How is Carvedilol administered?

A

Orally

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19
Q

Which pharmaceutical should be used for the following conditions?
CHF, A-fib/flutter

A

Digoxin

20
Q

Which pharmaceutical is a cardiac glycoside that inhibits cardiac Na+/K+-ATPase, it is positively inotropic (increases contractility), negatively chronotropic (decreases HR), and makes heart beat more efficiently (reduces O2 demand)?

A

Digoxin

21
Q

What are 8 adverse effects with use of Digoxin?

A
  1. Anorexia
  2. Fatigue
  3. Nausea/vomiting
  4. Yellow-green halo around objects (visual disturbances)
  5. Bradycardia
  6. Arrhythmias
  7. Gynecomastia
  8. Loss of libido
22
Q

T/F: Digoxin has a narrow therapeutic window

A

True: OD can be lethal and will recirculates in the enterohepatic cycle (toxicity cumulative)

23
Q

What are 2 antidotes for Digoxin?

A
  1. Potassium

2. Digoxin antibodies

24
Q

What are 6 contraindications associated with using Digoxin?

A
  1. Hypokalemia
  2. Hypo- or hypercalcemia
  3. Hypomagnesemia
  4. Ventricular arrhythmia
  5. Kidney failure (renal excretion)
  6. Severe carditis
25
Q

T/F: Digoxin can cause false positives on ECG

A

True

26
Q

Digoxin toxicity is potentiated by ___ and/or _____ depleting substances. Examples?

A

K+ and/or Mg2+

Examples: Diuretics, steroids, Glycyrrhiza

27
Q

What are 10 drug/drug types that INCREASE Digoxin effects/toxicity?

A
  1. Alprazolam
  2. Antibiotics
  3. Anticholinergics
  4. Benzodiazepines
  5. Calcium channel blockers
  6. Ibuprofen
  7. Indomethacin
  8. Omeprazole
  9. Quinine
  10. Quinidine
28
Q

What are 12 drug/drug types that DECREASE Digoxin effects/toxicity?

A
  1. Aminoglycosides
  2. Antacids
  3. Antihistamines
  4. Barbituates
  5. Chemotherapy drugs
  6. Cholestyramine
  7. Dietary fiber
  8. Oral hypoglycemics
  9. Penicillamine
  10. Phenytoin
  11. Rifampin
  12. Sucralfate
29
Q

What are 4 monitoring parameters associated with Digoxin use?

A
  1. Monitor serum levels of drug
  2. Monitor electrolytes
  3. Renal function
  4. ECG
30
Q

How is Digoxin administered? What consideration should be taken for elderly?

A

Oral or IV

Must use lower doses for elderly

31
Q

Digoxin doses need to be adjusted to reflect metabolism, how does the dose need to be adjusted for hypo- hyperthyroidism or high fever?

A

Hypothyroidism: Decrease dose

Hyperthyroidism or high fever: Increase dose

32
Q

Which pharmaceutical should be used for the following conditions?
Bradycardia, iridocyclitis, heart block (Mobitz type 1 second-degree and third-degree), hyperhidrosis, organophosphate poisoning, PUD

A

Atropine

33
Q

Which pharmaceutical is antimuscarinic (anticholinergic) and increases AV and SA node activity?

A

Atropine

34
Q

What are 9 adverse effects associated with use of Atropine?

A
  1. Dry mouth
  2. Dry eyes
  3. Blurred vision
  4. Mydriasis
  5. Photophobia
  6. Confusion
  7. Hallucinations
  8. Tachycardia
  9. V-fib
35
Q

What are 2 antidotes for Atropine?

A
  1. Physostigmine

2. Pilocarpine

36
Q

What are 2 contraindication for use of Atropine? In which population should caution be used?

A
  1. Narrow-angle glaucoma
  2. Ischemic heart block
    Use caution in elderly
37
Q

T/F: Atropine has synergistic toxicity with other anticholinergic drugs

A

True

38
Q

T/F: Atropine potentiates the effects of bradycardia drugs (e.g. beta-blockers)

A

FALSE: Atropine counteracts effects of bradycardia drugs

39
Q

What are 3 routs of administration of Atropine?

A
  1. Oral
  2. IV
  3. IM
40
Q

Which pharmaceutical should be used for the following conditions?
Serious ventricular arrhythmias, chemical cardioversion of A-fib, NOT a first-line antiarrhythmic because of significant (potentially fatal) toxicity

A

Amiodarone

41
Q

Which pharmaceutical is a class III antiarrhythmic agent and is a sodium channel blocker w/ affinity for inactivated channels, in contrast to quinidine?

A

Amiodarone

42
Q

What are 10 adverse effects associated with use of Amiodarone? Which populations should caution be used when administering this medication?

A
  1. Hypotension
  2. Neurological adverse events
  3. Nausea/Vomiting
  4. CHF
  5. Arrhythmias
  6. Fever
  7. Fatigue
  8. Photosensitivity
  9. Involuntary movement
  10. Muscle weakness
    Use caution in surgical patients and elderly
43
Q

What are 5 contraindications for use of Amiodarone?

A
  1. Serious sinus-node dysfunction
  2. Second or Third degree AV block
  3. Bradycardia causing syncope
  4. Pregnancy
  5. Breast-feeding
    Note: Safety in pediatric patients is not established
44
Q

There are many interactions with use of Amiodarone and they tend to be quite serious. Why does it take more >1 week for drug interactions to show up with this medication?

A

Long half-life

45
Q

What are 6 monitoring parameters associated with use of Amiodarone?

A
  1. Monitor thyroid levels closely
  2. HR
  3. ECG
  4. Lethargy
  5. Edema
  6. Pulmonary function tests
46
Q

What is the oral Amiodarone used to manage? When is this medication switched to IV treatment and prophylaxis?

A

Life-threatening V-fib and V-tach; recurring V-fib and unstable V-tach use when oral treatment is indicated but not tolerated

NPLEX II - Lynda (29 decks)

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