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NAPLEX STUDY > Pharmacy foundations > Flashcards

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
Q

HLA-B*5801

A

allopurinol (Zyloprim, Aloprim)
-incr risk of SJS

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26
Q

HLA-B*1502

A

Carbamezapine, oxcarbazepine, phenytoin, fosphenytoin
-incr riskf of SJS and TEN
-most common in asian patients

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27
Q

CYP2C19

A

clopidogrel
-poor emtabolizers (*2 or *3) have incr risk of cardiovascular events

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28
Q

CYP2D6

A

codeine
-ultra rapid metbaolizers have incr risk of OD
-infant deaths when nursing mothers who were URM took codeine for pain

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29
Q

CYP2C9*2 and *3 and VORKC1

A

warfarin
-increased bleeding

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30
Q

HER2

A

trastuzumab (herceptin)

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31
Q

KRAS

A

Cetuximab (Erbitux)

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32
Q

DPD deficiency

A

Capecitabine (Xeloda)
Flurouracil

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33
Q

drugs that require pharmacogenomic testing

A

abacavir
azathiopurine
carbamazepine
cetuximab and other EGFR inhibitors
trastuzumab and other HER2 inhibitors

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34
Q

supplements that increase bleeding risk

A

garlic, ginger, ginkgo, ginseng, and glucosamine
fish oils
vitamin E
dong quai
willow bark

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35
Q

supplements with risk of liver toxicity

A

black cohosh
kava
chaparral

36
Q

supplements with cardiac toxicity

A

ephedra (bitter orange - citrus aurantium or synephrine)
DMAA
Licorice
Yohimbe

37
Q

Tylenol poisoning

A

N-acetylcysteine: free radical scavenger and precursor to glutathione –> converting NAPQI to mercapturic acid which is really cleared

38
Q

opioids

A

naloxone

39
Q

anticholinergics

A

physostigmine

40
Q

antipsychotics

A

benztropine

41
Q

BZD

A

flumazenil

42
Q

BB

A

glucagon

43
Q

CCB

A

calcium chloride/gluconate

44
Q

cyanide

A

hydroxocobalamin (cyanokit)

45
Q

digoxin

A

digoxin immune fab (Digifab)

46
Q

ethanol

A

thiamine

47
Q

heavy metals

A

dimercaprol: arsenic, gold, mercury
penicillamine: copper

48
Q

hydrocarbons (petroleum products)

A

do not induce vomitting NPO

49
Q

isoniazid

A

pyridoxine (vitamin B6)

50
Q

iron

A

deferoxamine

51
Q

organophosphate (insecticides)

A

-SLUDD symptoms (Salvation, lacrimations, urination, diarrhea, defecation)
-atropine: blocks the effects of acetylcholine
-pralidoxime (protopam): reactivates cholinesterase

52
Q

methotrexate

A

leucovorin

53
Q

methemoglobinemia

A

methylene blue (do not use in G6PD deficiency)

54
Q

neostigmine, pyridostigmine

A

pralidoxime

55
Q

salicylates

A

sodium bicarb

56
Q

toxic alcohols

A

fomepizole

57
Q

TCA

A

sodium bicarbs

58
Q

valproic acid or topiramate induced hyperammonemia

A

levocartinine

59
Q

animal bites

A

rabies vaccine + human rabies immune globulin

60
Q

black widow

A

antivenin

61
Q

scorpion stings

A

antivenin

62
Q

snake bites

A

crotalidae polyvalent iune FAB for copper head and rattlesnake

63
Q

G <3 PACMAN (CYP inhibitors)

A

Grapefruit
Protease inhibitors (PI)
Azole antifungals
Cyclosporine, cobicistat
Macrolides (not azithromycin)
Amiodarone
Non-DHP CCBs

64
Q

CYP inhibitors effect on substrates

A

-decreased metabolism
-increased serum levels and clinical effects
-INhibitors = INcreased effects/levels/ADRs/toxicities

65
Q

CYP inhibitor’s effects on prodrugs

A

decreased conversion to the active drug

66
Q

PS PORCS (CYP inducers)

A

Phenytoin
Smoking
Phenobarbital
Oxcarbazepine
Rifampin (and rifabutin, rifapentine)
Carbamazepine
St. Johns wart

67
Q

CYP inducers effects on substrates

A

-incr metabolism
-decreased serum levels and clinical effects
-inDucers = Decreased effects/levels

68
Q

CYP inducers effects on prodrugs

A

increased conversion to the active drug (incr serum levels and clinical effects)

69
Q

P-gp substrates

A

-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
Q

P-gp inducers

A

carbamazepine, dexamethasone, phenobarbital, phenytoin, rifampin, st. johns wort

71
Q

P-gp inhibitors

A

-ID: clarithromycin, itraconazole, posaconazole
-CV: amiodarone, crvedilol, conivaptan, diltiazem, dronedarone, quinidine, verapamil
-HIV drugs: ledipasvir, paritaprevir
others: cyclosporine

72
Q

orange book

A

approved drugs that can be interchanged with generics based on therapeutic equivalence

73
Q

pink book

A

epidemiology and vaccine-preventable disease

74
Q

pink sheet

A

news report on regulatory, legislative, legal, and buisness

75
Q

purple book

A

list of biological drug products, including biosimilars

76
Q

red book

A

drug pricing information

77
Q

red book pediatrics

A

pediatric infectious diseases, antimicrobial tx and vaccinations

78
Q

yellow book

A

international travel, required vaccines and ppx meds

79
Q

green book

A

animal drug products

80
Q

drugs with absorption or leaching issues with PVC: Leach Absorbs To Take In Nutrients

A

lorazepam, amiodarone, tacrolimus, taxanes, insulin, nitroglycerin

81
Q

drugs that can only be diluted with saline: A DIAbetic Cant Eat Pie

A

Ampicillin
Daptomycin
Infliximab
Ampicillin/sulbactam
Caspofungin
Ertapenem
Phenytoin

82
Q

drugs that can only be diluted with dextrose: Outrageous Bakers Avoid Salt

A

Oxaliplatin
Bactrim
Amphotericin B
Synercid

83
Q

drugs with filter requirements:
GAL PLAT

A

Goliumab
Amiodarone
Lorazepam

Phenytoin
Lipids - 1.2 micron
Amphotericin B (lipid formulations)
Taxanes except docetaxel

84
Q

drugs that should not be refrigerated:
Dear Sweat Pharmacist Freezing Makes Me Edgy

A

Dexmedetomidine
Sulfamethoxazole/Trimethoprim
Phenytoin
Furosemide
Metronidazole
moxifloxacin
Enoxaprin

85
Q

Drugs that should be protected from light:
Protect Every Necessary Med from Daylight

A

Phytonadione
Epoprostenol
Nitroprusside
Micafungin
Doxycycline

NAPLEX STUDY (25 decks)

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