Pharmacotherapy Flashcards
Monitoring on methotrexate
Hemoglobin
ALT/AST
Creatinine
Monitoring on hydroxychloroquine
Routine eye exams
SE to steroids
Adrenal insufficiency
Avascular necrosis
Osteoporosis
Edema
GI ulceration
Glaucoma
Cataract
Glucose intolerance
Muscle weakness
Insomnia
Increased BP
Weight Gain
Skin Thinning
Growth Impairment
Cushingoid Appearances
Menstrual Irregularities
Change in Mood
SE of acetylcholinesterase inhibitors
Nausea
Headache
Dizziness
Fatigue/Somnolence
Insomnia
Diarrhea/Vomiting
Weight Loss/Anorexia
Bradycardia/Syncope
Seizures
Urinary Incontinence
SE of anticholinergics
Dry Mouth
Dizziness
Constipation
Somnolence
Confusion
Blurred Vision
Nausea
Urinary Retention
Which meds are stimulating (can cause insomnia)
SSRIs
Levodopa
BB
Decongestants
NRT
What advice to give a pt about to get chemo?
No live vaccines, stop smoking
AP SE
EPSEs, wt gain, hyperprolactinemia, sedation, orthostatic hypotension, sexual dysfunction, anticholinergic SE
Neuropathic pain med classes
SSRIs, anticonvulsants, cannabinoids
SE of pregabalin
dizziness, sedation, wt gain, peripheral edema, ataxia
SE of nitrofurantoin
pulmonary toxicity, peripheral neuropathy, liver toxicity
Tool for determining drug toxicity cause
Naranjo Adverse Drug Reaction Probability Score
Types of EPSEs
acute dystonia, akathisia, pseudo parkinsonism, tardive dyskinesia
Which classes do you use for rhythm control in AFib?
Class 1/ sodium channel blockers (procainamide) + class 3 antiarrhythmics/ potassium channel blocks = amiodarone
Indications for antihistamines
rhinitis, conjunctivitis, urticaria
Which population should you not use antihistamines in?
Elderly
What to assess on hx for suitability of a pt for cannabinoids?
Pain hx, MH history, SU hx
Common mistakes w/ inhaler use
not loading device properly, not exhaling before use, lack of breath hold, breathing in too fast or slow
Which pt group is SGLT2i CI in?
T1DM
What to monitor while on spironolactone?
BP, K+, Cr
SE antihistamines
sedation, cognitive impairment, psychomotor impairment
What drug classes should be avoided w/ spironolactone?
NSAIDs, trimethoprim, K+ sparing diuretics
Meds causing gynaecomastia
ACEi, CCB, aldosterone receptor antagonists, 5 alpha reductase inhibitors
What acne med in pregnancy
azeliac acid
grades of hepatic encephalopathy + what criteria used to grade
West haven criteria
1 = changes in behaviour
2 = gross disorientation, confusion, asterixis
3 = incoherent, sleepy but rousable
4 = coma
Complication of hepatic enceopahlopathy + what is the treatment
cerebral edema - rx = transplant
lactulose, rifaxamin, PEG - PO or PR (can give enema)
complications of liver disease
SBP, hepatic encephalopathy, hepatorenal syndrome, varices
rx for SBP
abx, paracentesis, albumin
hepatorenal syndrome types
Type 1 = acute deterioration in kidney function
Type 2 = chronic
hepatorenal syndrome rx
minodrine, albumin, octreotide
alcoholic hepatitis Rx
abstain from alcohol, steroids for 1 month
Treatment of varices
treat with non selective BB (carvedilol, propranolol, nadalol)
Screen for hepatocellular carcinoma q6mo
acute hep c - whats the risk of it turning to chronic hep c?
30%