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pharmacy foundations 1 Flashcards

1
Q

muscarinic action & agonist/antagonist

A

ACh
SLUDD - pilocarpine
anti SLUDD - atropine, oxybutynin

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2
Q

nicotinic action & agonist/antagonist

A

ACh
increase BP, HR - nicotine
NM blockade - NM blockers (rocuronium)

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3
Q

alpha 1 action & agonist/antagonist

A

Epi/NE - peripheral
increase BP/ smooth muscle vasoconstriction - PE, dopamine
decrease BP/ vasodilation - doxazosin, carvedilol, phentolamine

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4
Q

alpha 2 action & agonist/antagonist

A

Epi/NE - central
decrease BP, HR - clonidine, brimonidine
increase BP, HR - ergot alkaloids, yohimbe

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5
Q

beta 1 action & agonist/antagonist

A

Epi/NE - heart
increase contractility, HR, CO - dobutamine, isoproterenol, dopamine
decrease CO, HR - AMEBBA, propranolol, carvedilol

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6
Q

beta 2 action & agonist/antagonist

A

Epi - lungs
bronchodilation - albuterol, isoproterenol, terbutaline
bronchoconstriction - non selective BB

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7
Q

dopamine action & agonist/antagonist

A

renal, cardiac, CNS - levodopa, pramiprexole
renal, cardiac, CNS - FGA, metoclopramide

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8
Q

serotonin action & agonist/antagonist

A

platelet, GI, psych - triptans
platelet, GI, pysch - ondansetron, SGA

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9
Q

AChesterase drugs

A

donepezil, rivastigmine, galantamine

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10
Q

MAO inhibitors

A

phenelzine, tranylcypromine, isocarboxazid, selegiline, rasagiline, methylene blue, linezolid

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11
Q

what drugs should be separated from polyvalent ions

A

levothyroxine, tetracyclines, quinolones, bisphosphonates

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12
Q

which drugs are polyvalent cations and should be separated from certain drugs

A

antacids, MVI, sucralfate, bile acid resins, Al, Ca, Fe, Mg, Zn, phosphate binders

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13
Q

where do most PK drug interactions occur

A

liver

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14
Q

list of prodrugs and their active metabolites

A

colistimethate - colistin
cortisone - cortisol
famciclovir - penciclovir
isavuconazonium sulfate - isavuconazole
prednisone - prednisolone
primidone - phenobarbital
tramadol - active

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15
Q

CYP inhibitors

A

G <3 PACMAN
Grapefruit juice
Protease inhibitors (-avir)
Amiodarone
Cyclosporine, cobicistat
Macrolides (not azithromycin)
Azoles
Non DHP CCB

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16
Q

CYP inducers

A

PS PORCS
Phenytoin
Smoking
Phenobarbital/Primidone
Oxcarbazepine
Rifampin
Carbamazepine (auto inducer)
St john’s wort

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17
Q

Pgp substrates

A

anticoagulants
digoxin
non dhp ccb
cyclosporine/tacrolimus
colchicine
HCV drugs

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18
Q

Pgp inhibitors

A

PACMAN
Protease inhibitor (AND HCV drugs)
Azoles (itraconazole/posaconazole)
Cyclosporine/Cobicistat
Macrolides (clarithromycin)
Amiodarone
Nonn DHP CCB

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19
Q

Pgp inducers

A

P PRCS
Phenytoin
Phenobarbital
Rifampin
Carbamazepine
St John’s wort

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20
Q

common CV drug interactions

A

amiodarone (2C9 inhibitor) + warfarin - decrease warfarin 50%

amiodarone (Pgp inhibitor) + digoxin - decrease digoxin 50%

digoxin + loop - decreases K, Mg, Ca, Na (digoxin increases Ca)

statin (3A4 substrate) + inhibitor - use pitastatin, pravastatin, rosuvastatin

warfarin + 2C9 inhibitor/inducer - increase/decrease warfarin level AND INR

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21
Q

common inhibitor/substrate drug interactions

A

valproate + lamotrigine - increase lamictal (use lower starter kit)

MAO + antidepressants, antipsychotics, opioids, analgesics, ADHD drugs, lithium, st john’s wort, tyramine food

3A4, pgp inhibitors + CNI or mTOR - increases drug concentration

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22
Q

common inducer/substrate drug interactions

A

AED + contraceptives, other AEDs (use higher lamictal kit)

smoking + antipsychotics, antidepressants, hypnotics, caffeine, theophylline, warfarin

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23
Q

drugs with additive serotonergic activity

A

antidepressants
MAO inhibitors
opioids
triptans
St. john’s wort, L tryptophan
buspirone, lithium, dextromethorphan

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24
Q

drugs with additive bleeding risk

A

anticoagulants
antiplatelets
NSAID
5 Gs, vitamin E, dong quai, willow bark, fish oil
SSRI/SNRI

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25
Q

drugs with additive hyperkalemia risk & hypokalemia

A

RAAS inhibitors (ACEi, ARB, ARNI, aliskiren, aldosterone antagonists)
potassium sparing (triamterene, amiloride)
KCl
CNI
SMX/TMP
canagliflozin
drosperinone

hypokalemia - diuretics, beta2 agonists, insulin

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26
Q

drugs with additive QT prolongation risk

A

antipsychotics
antidepressants
antiarrhythmics
anti-infectives - macrolides, quinolones, azoles, antimalarials
antiemetics
ADT
TKI
oxaliplatin
methadone
loperamide
hydroxyzine

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27
Q

drugs with additive ototoxicity risk

A

vancomycin
aminoglycosides
cisplatin
salicylates
loops

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28
Q

drugs with additive nephrotoxicity

A

ampB
vancomycin
cisplatin
aminoglycosides
CNI
loop
NSAIDs
contrast dye

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29
Q

drugs with anticholinergic toxicity

A

antidepressants/antipsychotics
sedating antihistamines
muscle relaxants - baclofen, carisoprodol, cyclobenzaprine
antimuscarinics
atropine, dicyclomine

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30
Q

drugs with additive hypotension risk

A

PDE5 inhibitors +
3A4 inhibitors OR nitrates OR alpha 1 blockers

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31
Q

CYP3A4 substrates

A

opioids (fentanyl, hydrocodone, oxy, methadone, tramadol)
statins
warfarin, Xa inhibitors
amiodarone
amlodipine
Non DHP CCB
CNI, sirolimus
NNRTIs
PDE5 inhibitors
EE

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32
Q

CYP1A2 substrates

A

theophylline
R-warfarin

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33
Q

CYP1A2 inhibitors

A

ciprofloxacin
fluvoxamine

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34
Q

CYP2C9 subtrate

A

S-warfarin

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35
Q

CYP2C9 inhibitors

A

amiodarone
fluconazole
metronidazole
SMX/TMP

36
Q

CYP2D6 substrates

A

codeine, meperidine, tramadol
tamoxifen

37
Q

CYP2D6 inhibitors

A

amiodarone
duloxetine
fluoxetine
paroxetine

38
Q

drugs that affect Ca

A

increase - thiazide, vit D, digoxin
decrease - loop, heparin, bisphosphonate, cinacalcet, steroids

39
Q

drugs that affect Mg

A

decrease - PPI, diuretics, ampB

40
Q

drugs that affect Na

A

increase - tolvaptan, saline
decrease - diuretics, SSRI, tegretol, trileptal

41
Q

what drug decreases bicarbonate

A

topiramate

42
Q

drugs that increase SCr

A

aminoglycosides, ampB, vancomycin, CNI, loops, colistin, NSAIDs, cisplatin

43
Q

drugs that decrease folate

A

phenytoin, phenobarbital, methotrexate, SMX/TMP

44
Q

drugs that cause hemolytic anemia

A

penicillins/cephalosporins, dapsone, isoniazid, levodopa, methyldopa, methylene blue, nitrofurantoin, pegloticase, primaquine, quinidine, quinine, rasburicase, rifampin, sulfonamides, fava beans

45
Q

what drugs can lead to a false PT/INR and aPPT reading

A

daptomycin, oritavancin, televancin

46
Q

drugs that cause pancreatitis (increased amylase, lipase)

A

GLP1 agonists, DPP4 inhibitors, didanosine, valproic acid

47
Q

drugs that increase CPK

A

statins, INSTI, TDF/TAF, daptomycin

48
Q

drugs that increase uric acid

A

diuretics, CNI, aspirin, niacin, pyrazinamide, pancreatic enzymes

49
Q

drugs that cause DILE

A

hydralazine
anti TNF
isoniazid
methimazole/PTU
methyldopa
minocycline
procainamide
quinidine
terbinafine

50
Q

drugs that increase lactic acid

A

NRTI, metformin

51
Q

therapeutic level for carbamazepine

52
Q

therapeutic level for digoxin

A

0.5-0.9 for HF
0.8-2 for AF

53
Q

therapeutic level for aminoglycosides

A

peak 5-10
trough <2

54
Q

therapeutic level for lithium

55
Q

therapeutic level for phenytoin

56
Q

therapeutic level for procainamide

A

4-10
15-25 for NAPA
10-30 for combined

57
Q

therapeutic level for theophylline

58
Q

therapeutic level for valproic acid

59
Q

therapeutic level for vancomycin

A

15-20 for serious infection
10-15 for others

60
Q

therapeutic level for warfarin

A

2-3
2.5-3.5 for mechanical valve

61
Q

references for ADR

A

ASHP
FDAble
MedWatch

62
Q

references for compounding

A

Allens
ASHP
Excipients
SDS
Merck Index
Remington
Trissels
USP

63
Q

references for drug interactions

A

Hansten and Horns

64
Q

reference for drug pricing

65
Q

references for drug shortages

66
Q

references for immunizations

A

ACIP
MMWR
pink book
immunization action coalition

67
Q

references for international drug information

A

index nominum
martindale
USAN

68
Q

references for IV drug compatability and stability

A

ASHP handbook on injectable drugs
king guide
trissels

69
Q

references for drug safety

A

MedWatch
ISMP
NIOSH

70
Q

references for pediatrics

A

NeoFax
red book
harriet lane
AAP

71
Q

references for pharmacology

A

goodman and gilman

72
Q

references for pregnancy and lactation

A

briggs
micromedex
lactmed
hales
CDC

73
Q

references for regulatory and business development

A

CDER
pink sheet

74
Q

references for therapeutics and disease management

A

DiPiro
handbook of nonprescription drugs
koda kimble
merck manual
up to date

75
Q

which injectable medications are NOT refrigerated

A

methotrexate
lovenox
fondaparinux
imitrex

76
Q

which patches should be applied twice weekly

A

alora, vivelle-dot
oxytrol

77
Q

which patch should be applied twice daily

A

diclofenac

78
Q

which patches should be applied weekly

A

butrans
catapress
climara
xulane

79
Q

which patches should be removed during an MRI

A

catapres
neupro
transderm
andoderm

80
Q

what drugs have sorption or leaching issues with PVC containers

A

Leach Absorbs To Take In Nutrients
Lorazepam
Amiodarone
Tacrolimus
Taxanes
Insulin
Nitroglycerin

81
Q

what drugs must be diluted in SALINE ONLY

A

A DIAbetic Can’t Eat Pie
Ampicillin
Daptomycin
Infliximab
Ampicillin/sulbactam
Caspofungin
Ertapenem
Phenytoin

82
Q

what drugs must be diluted in DEXTROSE ONLY

A

Outrageous Bakers Avoid Salt
Oxaliplatin
Bactrim
AmpB
Synercid

83
Q

what IV drugs require filtration

A

GAL PLAT
Golimumab
Amiodarone
Lorazepam
Phenytoin
Lipids - 1.2 micron
AmpB - 5 micron
Taxanes, except docetaxel

84
Q

what IV drugs should NOT be refrigerated

A

Dear Sweet Pharmacist, Freezing Makes Me Edgy
Dexmedetomidine
SMX/TMP
Phenytoin
Furosemide
Metronidazole
Moxifloxacin
Enoxaparin

85
Q

what IV drugs should be protected from the light

A

Protect Every Necessary Med from Daylight
Phytonadione
Epoprostenol
Nitroprusside
Micafungin
Doxycycline

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