Pharmacotherapy Flashcards

1
Q

Monitoring on methotrexate

A

Hemoglobin
ALT/AST
Creatinine

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2
Q

Monitoring on hydroxychloroquine

A

Routine eye exams

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3
Q

SE to steroids

A

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

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4
Q

SE of acetylcholinesterase inhibitors

A

Nausea
Headache
Dizziness
Fatigue/Somnolence
Insomnia
Diarrhea/Vomiting
Weight Loss/Anorexia
Bradycardia/Syncope
Seizures
Urinary Incontinence

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5
Q

SE of anticholinergics

A

Dry Mouth
Dizziness
Constipation
Somnolence
Confusion
Blurred Vision
Nausea
Urinary Retention

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6
Q

Which meds are stimulating (can cause insomnia)

A

SSRIs
Levodopa
BB
Decongestants
NRT

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7
Q

What advice to give a pt about to get chemo?

A

No live vaccines, stop smoking

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8
Q

AP SE

A

EPSEs, wt gain, hyperprolactinemia, sedation, orthostatic hypotension, sexual dysfunction, anticholinergic SE

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9
Q

Neuropathic pain med classes

A

SSRIs, anticonvulsants, cannabinoids

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10
Q

SE of pregabalin

A

dizziness, sedation, wt gain, peripheral edema, ataxia

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11
Q

SE of nitrofurantoin

A

pulmonary toxicity, peripheral neuropathy, liver toxicity

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12
Q

Tool for determining drug toxicity cause

A

Naranjo Adverse Drug Reaction Probability Score

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13
Q

Types of EPSEs

A

acute dystonia, akathisia, pseudo parkinsonism, tardive dyskinesia

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14
Q

Which classes do you use for rhythm control in AFib?

A

Class 1/ sodium channel blockers (procainamide) + class 3 antiarrhythmics/ potassium channel blocks = amiodarone

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15
Q

Indications for antihistamines

A

rhinitis, conjunctivitis, urticaria

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16
Q

Which population should you not use antihistamines in?

A

Elderly

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17
Q

What to assess on hx for suitability of a pt for cannabinoids?

A

Pain hx, MH history, SU hx

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18
Q

Common mistakes w/ inhaler use

A

not loading device properly, not exhaling before use, lack of breath hold, breathing in too fast or slow

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19
Q

Which pt group is SGLT2i CI in?

A

T1DM

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20
Q

What to monitor while on spironolactone?

A

BP, K+, Cr

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21
Q

SE antihistamines

A

sedation, cognitive impairment, psychomotor impairment

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22
Q

What drug classes should be avoided w/ spironolactone?

A

NSAIDs, trimethoprim, K+ sparing diuretics

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23
Q

Meds causing gynaecomastia

A

ACEi, CCB, aldosterone receptor antagonists, 5 alpha reductase inhibitors

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24
Q

What acne med in pregnancy

A

azeliac acid

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25
Q

grades of hepatic encephalopathy + what criteria used to grade

A

West haven criteria
1 = changes in behaviour
2 = gross disorientation, confusion, asterixis
3 = incoherent, sleepy but rousable
4 = coma

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26
Q

Complication of hepatic enceopahlopathy + what is the treatment

A

cerebral edema - rx = transplant
lactulose, rifaxamin, PEG - PO or PR (can give enema)

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27
Q

complications of liver disease

A

SBP, hepatic encephalopathy, hepatorenal syndrome, varices

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28
Q

rx for SBP

A

abx, paracentesis, albumin

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29
Q

hepatorenal syndrome types

A

Type 1 = acute deterioration in kidney function
Type 2 = chronic

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30
Q

hepatorenal syndrome rx

A

minodrine, albumin, octreotide

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31
Q

alcoholic hepatitis Rx

A

abstain from alcohol, steroids for 1 month

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32
Q

Treatment of varices

A

treat with non selective BB (carvedilol, propranolol, nadalol)
Screen for hepatocellular carcinoma q6mo

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33
Q

acute hep c - whats the risk of it turning to chronic hep c?

A

30%

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34
Q

acute hep b - whats the risk of it turning to chronic hep b?

A

5%

35
Q

hep C rx

A

direct acting antivirals for 3mo (Epclusa)

36
Q

Autoimmune hepatitis ix

A

anti smooth muscle antibody and anti-liver kidney antibody

37
Q

Rx for OP

A

denosumab - rank ligand inhibitor - SC q6mo
forteo - recombinant parathyroid hormone
ralixifene - selective estrogen receptor modulator

38
Q

CI to wellbutrin

A

sz, ED, electrolyte disturbances

39
Q

Classes of antidepressants + names of each

A

noradrenergic specific serotinergic antidepressant (NASSA) - mirtazapine
norepinephrine dopamine rey-take inhibitor = wellbutrin
SARI - trazodone - can cause priapism

40
Q

What meds are stimulating

A

BB, statins, ACEi, SSRIs

41
Q

venous vs arterial ulcers appearance

A

venous are medial, swollen + discoloured, varicose veins, hx of leg swellings, hemosiderin staining

arterial are full thickness, punch out, smooth edges

42
Q

tamoxifen SE

A

vaginal dryness, hot flashes, irritability, endometrial cancer

43
Q

Aromatase inhibitor SE

A

OP, raised lipids, lymphedema

44
Q

after breast cancer management

A

mammogram q1y
monthly self breast
clinic breast exam q6mo x3yrs

45
Q

eGFR <30, what meds to adjust?

A

DOACs, warfarin, ACEi, diuretics, metformin, abx, NSAIDs, statins, BB

46
Q

physical exam findings for HTN

A

fundoscopy, assess for bruits, peripheral pulse exam

47
Q

NAFLD + NASH rx

A

semaglutide

48
Q

Score for pancreatitis mortality + components

A

Bisaps score:
BUN
AMS
>2 SIRS criteria
Age >60
Pleural effusions present

49
Q

New meds for IBS

A

Constella (guanaclase inhibitors)
Ibsrela
Vibrerzi - stomach opioid antagonist - good for diarrhoea predominant IBS

50
Q

SE of levodopa

A

‘on’ effects (chorea), ‘off’ effects (hypokinetic)

51
Q

Peripheral neuropathy causes (poly + mono)

A

Polyneuropathies:
vasculitis (mononeuritis multiplex)
Thiamine deficiency
heavy metal exposure
Guillan barree syndrome
DM
Neoplastic
Chemo induced
Charcot marie tooth

mononeuropathies:
carpal tunnel syndrome
bells palsy
cubital tunnel syndrome
piriformis syndrome

52
Q

Parkinsonism sx

A

TRAP - tremor, rigidity, akathisia, postural instability

53
Q

Causes of parkinsonism

A

haldol, maxeran, progressive supranuclear palsy, ecstasy OD, vascular, shy drager

54
Q

When do you use Dopamine agonists in Parkinsonism, and whats the name?

A

Young pts - ropinirole, pramipexole

55
Q

Alternative meds + treatment for PD

A

Anticholinergic - trihexyphenolil - weekly med for PD

Catecholamine o methyltransferase inhibitors -

MAOi - risegiline

Amantadine - used for terminal dyskinesias

Apo-morphine injectors - IM
Deep brain stimulation

56
Q

MS drugs + classes

A

anti-CD20 (Ocrivus) biologics
thingolamid (anti-sphingosine agent)
Methylfumarate
clabradine + terryflunoamide (anti metabolite)
glatiramir, beta interferons (avanex)

57
Q

New med for dyslipidemia

A

Incliseran - small interfering RNA

58
Q

Caroc score for OP components

A

BMD (lowest T-score of hip and lumbar spine), age, gender, fracture history and steroid use

59
Q

Young healthy person with normal exam with ED?

A

MS

60
Q

Post arrest care

A

ensure they remain afebrile, bloodwork, support BP with pressors, establish definitive airway, discuss goals of care with family, NG for decompression, CXR to r/o pneumothorax, ?splenic laceration or liver lac

61
Q

What labs to order if you are transfusing lots of blood?

A

calcium and coags

62
Q

Entresto class + use

A

ARNI - naprilosyn inhibitors + valsartan in CHF

63
Q

Ivabradine class

A

F type channel inhibitor

64
Q

Bug causing gas in gangrene?

A

C diff

65
Q

Bilateral erythema in legs causes

A

Stasis dermatitis, venous insufficiency, eczema, DVT, fungal infection

66
Q

Cephalosporin 1st gen
Cephalosporin 2nd gen
Cephalosporin 3rd gen

A

Cephalosporin 1st gen
cephalexin

Cephalosporin 2nd gen
Cefuroxime

Cephalosporin 3rd gen
Ceftriaxone

67
Q

CKD diagnosis based on ACR + what ACR level to refer to nephro?

A

ACR >2 = CKD
ACR >6 or eGFR <30 = refer to nephro

68
Q

Optic neuritis in MS sx

A

painful, loss of colour saturation, loss of vision - episodes lasting days/ weeks

69
Q

MIBI - what is it + indications

A

Myocardial perfusion imaging / nuclear stress test
SOBOE or chest pain w/ activity

70
Q

Non stress test parameters

A

Considered reassuring if the fetal heart rate increases at least 15 beats per minute over the baseline (between 120 and 160 beats per minute), lasting at least 15 seconds, within a 20-minute timeframe§

71
Q

Canadas food guide

A

½ veggies + fruit
¼ protein
¼ whole grain

72
Q

Acute dissection score

A

High risk conditions (Marfans, aortic valve dz)
High risk pain features (chest, back, abdo, abrupt, severe, tearing)
High risk exam features (pulse deficit, focal neuro deficit, new aortic murmur, hypotension)

73
Q

Apgar score

A

Activity (tone)
Pulse
Grimace (reflexes)
Appearance (color)
Respiration

74
Q

Epi dose for peds + adults in CPR

A

Peds = 0.01mg/kg
Adults = 1mg

75
Q

Naloxone dose for peds + adults

A

Peds = 0.1mg/kg
Adults = 0.4mg

76
Q

Lorazepam dose for peds + adults (seizure)

A

Peds = 0.1mg/kg
Adults = 4mg
IV/IO

77
Q

Midazolam dose for peds + adults (seizure)

A

Peds = 0.2mg/kg
Adults = 10mg

78
Q

Keppra dose for peds + adults (seizure)

A

Peds = 60mg/kg
Adults = 4500mg

79
Q

Amiodarone dose for peds + adults (ACLS)

A

Peds = 5mg/kg
Adults = 300mg then 150mg

80
Q

Lidocaine dose for peds + adults (ACLS)

A

Peds = 1mg/kg
Adults = 1mg/kg

81
Q

Atropine dose for peds + adults (ACLS)

A

Peds = 0.02mg/kg
Adults = 1mg

82
Q

TXA dose for peds + adults (ACLS)

A

Peds = 15mg/kg
Adults = 1g

83
Q

Dose of Mg for eclampsia

A

4g IV