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Pharmacy foundations Flashcards

1
Q

Sentinel event

A

death or serious physical or psychological injury of a patient

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2
Q

Prospective Study

A

A prospective study watches for outcomes, such as the development of a disease, during the study period and relates this to other factors such as suspected risk or protection factor(s). The study usually involves taking a cohort of subjects and watching them over a long period. Prospective studies usually have fewer potential sources of bias and confounding than retrospective studies.

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3
Q

Retrospective Study

A

A retrospective study looks backwards and examines exposures to suspected risk or protection factors in relation to an outcome that is established at the start of the study. Most sources of error due to confounding and bias are more common in retrospective studies than in prospective studies.
-EX: case-control studies (but not exclusively)

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4
Q

Continuous

A

-measure continuous data
-weight, height, length, time, and temperature
-Infinite number of fractional values between any two values.

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5
Q

The Joint Commission (TJC)

A

independent, not for profit organization that accredits and certifies
-set national patient safety goals annually

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6
Q

high alert medications

A

Anesthetic inhaled or IV (propofol)
Antiarrhythmics IV (amiodarone)
Anticoagulants/antithrombotics (heparin, warfarin)
Chemotherapy
epidural/intrathecal drugs
hypertonic saline
immunosupressants
inotropics
insulins
mag sulfate
NMBA
opioids
oral hypoglycemic
PN
KCl/KPhos
SWi

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7
Q

5 rights of medication administration

A

right patient
right time and frequency
right dose
right route
right drug

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8
Q

type A reactions

A

dose-dependent related to known pharmacologic actions

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9
Q

type B reactions

A

not dose-dependent, unrelated to the pharmacologic actions
-allergies
-intolerances
-idiosyncratic reactions

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10
Q

Type 1 reactions

A

IgE-mediated and immediated within 60 min

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11
Q

Type 2 reactions

A

antibody-mediated occuring several days (5-8 days) after drug expsoure

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12
Q

Type 3 reactions

A

immune-complex reactions ocurring >1 week after drug exposure

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13
Q

Type 4 reactions

A

cell-mediated or delayed hypersensitivity reactions, occurring anytime from 48 hr to several weeks after drug exposure

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14
Q

medication guides

A

FDA-approved patient handouts that details a drug important adverse event

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15
Q

drugs associated with photosensitivity

A

amiodarone, diuretics, methotrexate, oral and topical retinoids, quinolones, st. johns wort, sulfa antibiotics, tacrolimus, tetracyclines, voriconazole

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16
Q

drugs associated with thrombotic thrombocytopenic purpura (TTP)

A

oral P2Y12 inhibitors
sulfamethoxazole

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17
Q

drugs commonly associated with severe skin reactions

A

abacavir, allopurinol, carbamazepine, ethosuximide, lamotrigine, modafinil, nevirapine, penicillins, phenytoin, sulfamethoxazole

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18
Q

Vd

A

amount of drug in body / concentration of drug in plasma

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19
Q

corrected calcium

A

= calcium + [(4.0 - albumin) x 0.8]

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20
Q

Cl

A

dose / AUC

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21
Q

elimination rate constant

A

ke = cl/ vd

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22
Q

t1/2

A

= 0.693 / ke

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23
Q

loading dose

A

= desired concentration x vd / F

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24
Q

HLA-B*5701

A

Abacavir (containing agents Triumeq, Epzicom)
-incr risk of hypersensitivity reactions
-fatal hypersensitivity reactions

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25
HLA-B*5801
allopurinol (Zyloprim, Aloprim) -incr risk of SJS
26
HLA-B*1502
Carbamezapine, oxcarbazepine, phenytoin, fosphenytoin -incr riskf of SJS and TEN -most common in asian patients
27
CYP2C19
clopidogrel -poor emtabolizers (*2 or *3) have incr risk of cardiovascular events
28
CYP2D6
codeine -ultra rapid metbaolizers have incr risk of OD -infant deaths when nursing mothers who were URM took codeine for pain
29
CYP2C9*2 and *3 and VORKC1
warfarin -increased bleeding
30
HER2
trastuzumab (herceptin)
31
KRAS
Cetuximab (Erbitux)
32
DPD deficiency
Capecitabine (Xeloda) Flurouracil
33
drugs that require pharmacogenomic testing
abacavir azathiopurine carbamazepine cetuximab and other EGFR inhibitors trastuzumab and other HER2 inhibitors
34
supplements that increase bleeding risk
garlic, ginger, ginkgo, ginseng, and glucosamine fish oils vitamin E dong quai willow bark
35
supplements with risk of liver toxicity
black cohosh kava chaparral
36
supplements with cardiac toxicity
ephedra (bitter orange - citrus aurantium or synephrine) DMAA Licorice Yohimbe
37
Tylenol poisoning
N-acetylcysteine: free radical scavenger and precursor to glutathione --> converting NAPQI to mercapturic acid which is really cleared
38
opioids
naloxone
39
anticholinergics
physostigmine
40
antipsychotics
benztropine
41
BZD
flumazenil
42
BB
glucagon
43
CCB
calcium chloride/gluconate
44
cyanide
hydroxocobalamin (cyanokit)
45
digoxin
digoxin immune fab (Digifab)
46
ethanol
thiamine
47
heavy metals
dimercaprol: arsenic, gold, mercury penicillamine: copper
48
hydrocarbons (petroleum products)
do not induce vomitting NPO
49
isoniazid
pyridoxine (vitamin B6)
50
iron
deferoxamine
51
organophosphate (insecticides)
-SLUDD symptoms (Salvation, lacrimations, urination, diarrhea, defecation) -atropine: blocks the effects of acetylcholine -pralidoxime (protopam): reactivates cholinesterase
52
methotrexate
leucovorin
53
methemoglobinemia
methylene blue (do not use in G6PD deficiency)
54
neostigmine, pyridostigmine
pralidoxime
55
salicylates
sodium bicarb
56
toxic alcohols
fomepizole
57
TCA
sodium bicarbs
58
valproic acid or topiramate induced hyperammonemia
levocartinine
59
animal bites
rabies vaccine + human rabies immune globulin
60
black widow
antivenin
61
scorpion stings
antivenin
62
snake bites
crotalidae polyvalent iune FAB for copper head and rattlesnake
63
G <3 PACMAN (CYP inhibitors)
Grapefruit Protease inhibitors (PI) Azole antifungals Cyclosporine, cobicistat Macrolides (not azithromycin) Amiodarone Non-DHP CCBs
64
CYP inhibitors effect on substrates
-decreased metabolism -increased serum levels and clinical effects -INhibitors = INcreased effects/levels/ADRs/toxicities
65
CYP inhibitor's effects on prodrugs
decreased conversion to the active drug
66
PS PORCS (CYP inducers)
Phenytoin Smoking Phenobarbital Oxcarbazepine Rifampin (and rifabutin, rifapentine) Carbamazepine St. Johns wart
67
CYP inducers effects on substrates
-incr metabolism -decreased serum levels and clinical effects -inDucers = Decreased effects/levels
68
CYP inducers effects on prodrugs
increased conversion to the active drug (incr serum levels and clinical effects)
69
P-gp substrates
-anticogaulants: apixaban, edoxaban, dabigatran, rivaroxaban -CV drugs: digoxin, diltiazem, carvedilol, ranolazine, verapamil -immunosuppressants: cyclosporine, sirolimus, tacrolimus -HCV drugs: dasabuvir, ombitasvir, paritaprevir, sofosbuvir -others: atazanavir, colchicine, dolutegravir, posaconazole, raltegravir, saxagliptin
70
P-gp inducers
carbamazepine, dexamethasone, phenobarbital, phenytoin, rifampin, st. johns wort
71
P-gp inhibitors
-ID: clarithromycin, itraconazole, posaconazole -CV: amiodarone, crvedilol, conivaptan, diltiazem, dronedarone, quinidine, verapamil -HIV drugs: ledipasvir, paritaprevir others: cyclosporine
72
orange book
approved drugs that can be interchanged with generics based on therapeutic equivalence
73
pink book
epidemiology and vaccine-preventable disease
74
pink sheet
news report on regulatory, legislative, legal, and buisness
75
purple book
list of biological drug products, including biosimilars
76
red book
drug pricing information
77
red book pediatrics
pediatric infectious diseases, antimicrobial tx and vaccinations
78
yellow book
international travel, required vaccines and ppx meds
79
green book
animal drug products
80
drugs with absorption or leaching issues with PVC: Leach Absorbs To Take In Nutrients
lorazepam, amiodarone, tacrolimus, taxanes, insulin, nitroglycerin
81
drugs that can only be diluted with saline: A DIAbetic Cant Eat Pie
Ampicillin Daptomycin Infliximab Ampicillin/sulbactam Caspofungin Ertapenem Phenytoin
82
drugs that can only be diluted with dextrose: Outrageous Bakers Avoid Salt
Oxaliplatin Bactrim Amphotericin B Synercid
83
drugs with filter requirements: GAL PLAT
Goliumab Amiodarone Lorazepam Phenytoin Lipids - 1.2 micron Amphotericin B (lipid formulations) Taxanes except docetaxel
84
drugs that should not be refrigerated: Dear Sweat Pharmacist Freezing Makes Me Edgy
Dexmedetomidine Sulfamethoxazole/Trimethoprim Phenytoin Furosemide Metronidazole moxifloxacin Enoxaprin
85
Drugs that should be protected from light: Protect Every Necessary Med from Daylight
Phytonadione Epoprostenol Nitroprusside Micafungin Doxycycline

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