Pharmacotherapy Flashcards
Antibiotics, specific medications and ADRs of interest.
Which medications cause acne?
I, Cause, Large, Pustules, Too
Isoniazid, Corticosteroids, Lithium, Phenytoin, Trimethadone
What are some Low, Intermediate, High and very High Potency Topical Corticosteroids?
How, To, Freaking, Climb (Low to High)
Hydrocortisone 1%
Triamcinalone Acetonide 0.1%
Fluocinonide 0.05%
Clobetasol propionate 0.05%
Classify Scheduled 1 drug in terms of abuse potential, legality, refills, and requirement for DEA number.
High abuse. No Therapeutic use. Can only get illegally and through the U.S. DEA.
Classify Scheduled 2 drug in terms of abuse potential, legality, refills, and requirement for DEA number.
Medical use accepted, but high abuse potential. Cannot be refilled. DEA number required.
Classify Scheduled 3 drug in terms of abuse potential, legality, refills, and requirement for DEA number.
Potential for abuse. Can refill five times in six months.DEA number required.
Classify Scheduled 4 drug in terms of abuse potential, legality, refills, and requirement for DEA number.
Low potential for abuse. Accepted medical use. Can refill five times in six months. DEA number required.
Classify Scheduled 5 drug in terms of abuse potential, legality, refills, and requirement for DEA number.
Least potential for abuse. Accepted medical use. Can refill five times in six months. DEA number required.
Clobetasol propionate 0.05%, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication class: Topical Corticosteroid. (very high potency)
Mechanism of Action: Anti-inflammatory.
Indications: Dermatitis.
Adverse Effects: Prolonged use of fluorinated corticosteroids and high-potency corticosteroids applied to the face may cause atrophy of the tissue or trigger steroidal rosacea. With prolonged use, ecchymoses may develop on the arms of the elderly. Epidermal atrophy, manifested by stria; shiny, thin skin: or telangiectases, can occur with prolonged use or a hypersensitivity reaction may occur, usually in response to the vehicle in which the medication is delivered. Topical corticosteroids can potentiate or cause cataract formation or glaucoma when used around the eyes for prolonged periods.
Contraindications: Avoid if there are bacterial, viral, or fungal skin infections and they are not to be prophylactically.
Special Considerations: Applying to moist skin and covering with occlusive dressing increase efficacy except with very-high potency topical corticosteroids. Can cause or intensify cataracts or glaucoma if used near eyes. Use lowest potency on thin/atrophic skin and children. Pregnancy category C.
Monitoring: Visual examination of affected parts. Patient to return for follow up evaluation within two or three days of starting therapy.
Patient Education: How to use correctly and how to avoid causative substance. How to make occlusive dressings. How to use emollients properly. Proper bathing.
Fluocinonide 0.05%, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication class: Topical Corticosteroid. (very high potency)
Mechanism of Action: Anti-inflammatory.
Indications: Dermatitis.
Adverse Effects: Prolonged use of fluorinated corticosteroids and high-potency corticosteroids applied to the face may cause atrophy of the tissue or trigger steroidal rosacea. With prolonged use, ecchymoses may develop on the arms of the elderly. Epidermal atrophy, manifested by stria; shiny, thin skin: or telangiectases, can occur with prolonged use or a hypersensitivity reaction may occur, usually in response to the vehicle in which the medication is delivered. Topical corticosteroids can potentiate or cause cataract formation or glaucoma when used around the eyes for prolonged periods.
Contraindications: Avoid if there are bacterial, viral, or fungal skin infections and they are not to be prophylactically.
Special Considerations: Applying to moist skin and covering with occlusive dressing increase efficacy except with very-high potency topical corticosteroids. Can cause or intensify cataracts or glaucoma if used near eyes. Use lowest potency on thin/atrophic skin and children. Pregnancy category C.
Monitoring: Visual examination of affected parts. Patient to return for follow up evaluation within two or three days of starting therapy.
Patient Education: How to use correctly and how to avoid causative substance. How to make occlusive dressings. How to use emollients properly. Proper bathing.
Triamcinolone acetonide 0.1%, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication class: Topical Corticosteroid. (very high potency)
Mechanism of Action: Anti-inflammatory.
Indications: Dermatitis.
Adverse Effects: Prolonged use of fluorinated corticosteroids and high-potency corticosteroids applied to the face may cause atrophy of the tissue or trigger steroidal rosacea. With prolonged use, ecchymoses may develop on the arms of the elderly. Epidermal atrophy, manifested by stria; shiny, thin skin: or telangiectases, can occur with prolonged use or a hypersensitivity reaction may occur, usually in response to the vehicle in which the medication is delivered. Topical corticosteroids can potentiate or cause cataract formation or glaucoma when used around the eyes for prolonged periods.
Contraindications: Avoid if there are bacterial, viral, or fungal skin infections and they are not to be prophylactically.
Special Considerations: Applying to moist skin and covering with occlusive dressing increase efficacy except with very-high potency topical corticosteroids. Can cause or intensify cataracts or glaucoma if used near eyes. Use lowest potency on thin/atrophic skin and children. Pregnancy category C.
Monitoring: Visual examination of affected parts. Patient to return for follow up evaluation within two or three days of starting therapy.
Patient Education: How to use correctly and how to avoid causative substance. How to make occlusive dressings. How to use emollients properly. Proper bathing.
Hydrocortisone 1%, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication class: Topical Corticosteroid. (very high potency)
Mechanism of Action: Anti-inflammatory.
Indications: Dermatitis.
Adverse Effects: Prolonged use of fluorinated corticosteroids and high-potency corticosteroids applied to the face may cause atrophy of the tissue or trigger steroidal rosacea. With prolonged use, ecchymoses may develop on the arms of the elderly. Epidermal atrophy, manifested by stria; shiny, thin skin: or telangiectases, can occur with prolonged use or a hypersensitivity reaction may occur, usually in response to the vehicle in which the medication is delivered. Topical corticosteroids can potentiate or cause cataract formation or glaucoma when used around the eyes for prolonged periods.
Contraindications: Avoid if there are bacterial, viral, or fungal skin infections and they are not to be prophylactically.
Special Considerations: Applying to moist skin and covering with occlusive dressing increase efficacy except with very-high potency topical corticosteroids. Can cause or intensify cataracts or glaucoma if used near eyes. Use lowest potency on thin/atrophic skin and children. Pregnancy category C.
Monitoring: Visual examination of affected parts. Patient to return for follow up evaluation within two or three days of starting therapy.
Patient Education: How to use correctly and how to avoid causative substance. How to make occlusive dressings. How to use emollients properly. Proper bathing.
Prednisone, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication Class: Systemic Corticosteroid.
Mechanism of Action: Inhibit cytokine and mediator release, attenuate mucus secretion, upregulate beta-adrenergic receptors, inhibit IgE synthesis, decrease microvascular permeability, and suppress the influx of inflammatory cells and the inflammatory process.
Indications: Use for dermatitis if resistant to topical corticosteroids.
Adverse Effects: These mask infection, may cause GI upset (short-term use), cause mood changes, sleep disturbances.
Contraindications: Not used for patients with systemic mycoses and patients receiving vaccination.
Special Considerations: Tapering doses for these. Can increase dose during flares but taper after flare.
Monitoring: Visual examination of affected parts. Patient to return for follow up evaluation within two or three days of starting therapy.
Patient Education: Discuss avoidance of causative substances.
Clotrimazole topical, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication Class: Topical Antifungal
Mechanism of Action: Impair the synthesis of ergosterol, the main sterol of fungal cell membranes, increasing their permeability and leakage of cellular components and results in cell death.
Indications: Tinea corporis, tinea cruris and tinea pedis and cutaneous candidiasis.
Adverse Effects: Erythema, irritation, stinging and pruritus.
Contraindications: Pregnancy or lactation. Use cautiously in patients with hepatocellular failure.
Special Considerations: Can be bought OTC.
Monitoring: Revaluate in two weeks. Follow-up every month for long-term care to monitor liver function. HIV and diabetes mellitus should be ruled out in patients who have recurring problems with candidiasis.
Patient Education: Discuss effects on liver.
Terbinafine, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication Class: Topical Antifungal
Mechanism of Action: Impair the synthesis of ergosterol, the main sterol of fungal cell membranes, increasing their permeability and leakage of cellular components and results in cell death.
Indications: Tinea corporis, tinea cruris and tinea pedis and cutaneous candidiasis.
Adverse Effects: Burning, irritation, skin exfoliation, dryness. Diarrhea, GI upset, rash, increase LFTs and headache.
Contraindications: Liver and kidney disease patients.
Special Considerations: Not recommended for children and avoid occlusive dressings.
Monitoring: Reevaluated in two weeks. Follow-up every month for long-term care to monitor liver function. HIV and diabetes mellitus should be ruled out in patients who have recurring problems with candidiasis.
Patient Education: Discuss effects on liver.
Acyclovir topical, what is the medication class, mechanism of action, indications, adverse effects, contraindications, special considerations, monitoring and patient education?
Medication Class: Topical Antiviral.
Mechanism of Action: Inhibiting viral DNA synthesis.
Indications: Use for herpes infections.
Adverse Effects: Pruritis, pain on application.
Contraindications: Do not use on mucous membranes.
Special Considerations: Must use glove or finger cot for application.
Monitoring: Patients should understand the importance of follow up beyond the initial wart removal because the virus may remain.
Patient Education: Information that viral warts may recur.
