Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

TOP 300 drugs - NAPLEX > Pharmacy Foundations Part II > Flashcards

Pharmacy Foundations Part II Flashcards

1
Q

Errors of omission

A

Something was left out that is needed for safety (e.g. not using double-check systems)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

“Medication Safety” definition

A

Freedom from preventable harm from medication use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Errors of commission

A

Something was done incorrectly (E.g. prescribing bupropion in someone with a hx of seizures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which committees in the hospitals should be informed of the error?

A

P&T
Medication Safety Committee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MERP

A

Medication Errors Reporting Program
Voluntary, confidential reporting program that provides recommendations as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

FMEA

A

Failure Mode and Effects Analysis
Proactive method to reduce the frequency & consequences of errors Screen potential effects of a new system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Examples of CQI programs

A

Lean
Sig Sigma (DMAIC: define, measure, analyze, improve, control)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Common types of hospital-acquired (nosocomial) infections

A

UTIs from indwelling catheters
Bloodstream infections from IV lines (Central lines = highest risk) & catheters
Surgical site infections
Hepatitis
Decubitus ulcers
Hepatitis
C. diff
VAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When are airborne precautions recommended?

A

Varicella, TB, measles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ADRs: Type A

A

Predictable
Dose-dependent, based on pharmacologic properties
Most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ADRs: Type B

A

NOT dose-dependent & not related to pharmacology of drug
Can be immediate or delayed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Examples of Type B reactions

A

Drug allergies
Drug hypersensitivity rxns (HLA genes, vanc infusion)
Idiosyncratic reactions (G6PD deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Drug allergy: Type 1 reactions

A

Immediate
IgE-mediate ranging from minor local rxns to severe systemic rxns (anaphylaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Drug allergy: Type 2 reactions

A

Delayed
Antibody-mediated, usually occurring 5-8 days after exposure
Ex: hemolytic anemia, thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Drug allergy: Type 3 reactions

A

Delayed
Immune complex reactions, occurring ≥1 week after exposure
Ex: serum sickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drug Allergy: Type 4 reactions

A

Delayed
T Cell-mediated occurring 48 hrs to weeks after exposure
Ex: SJS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Drugs most associated with photosensitivity

A

Amiodarone
Diuretics
MTX
Oral & topical retinoids
Quinolones
St Johns Wort
Sulfa drugs
Tacrolimus
Tetracyclines
Voriconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Abacavir testing

A

HLA-B* 5701

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drugs most commonly associated with severe cutaneous adverse reactions

A

Allopurinol
Amoxicillin
Ampicillin
Carbamazepine
Ethosuximide
Lamotrigine
Nevirapine
Phenytoin
Bactrim
Sulfasalazine
Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In the NAPLEX you must avoid ALL beta-lactams if someone is allergic. What is a notable exception?

A
  1. AOM: 2-3rd gen cephalosporin in patients with non-severe cephalosporin allergy
  2. Aztreonam considered safe in patients with Immediate-type PCN allergy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Drugs to avoid if someone has a Sulfa Allergy:

A

Sulfasalazine
Sulfadiazine
Thiazides
Loops (except ethacrynic acid)
Sulfonylureas
Acetazolamide
Zonisamide
Darunavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Drugs to avoid in someone with peanuts or soy allergies

A

Propofol
Clevidipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is skin testing C/I for PCN allergies?

A

If the patient experienced SJS prior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Situation: A pregnant woman has an allergy to PCN and presents with syphillis?

A

Desensitization & PCN treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Naranjo Scale

A

Can help determine the likelihood that a drug caused the adverse reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

F calculation

A

(AUCextra/AUCintra) * (DOSEintra/DOSEextra)*100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Calcium corrected equation

A

Ca(reported) + ([4-albumin) * 0.8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Phenytoin corrected equation

A

(Total phenytoin measure/(0.2*albumin) + 0.1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Vd equation

A

Amt of drug in body (dose)/ Concentration in plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Clearance equation

A

Rate of elimination/Drug concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

AUC & Cl equation

A

F*Dose/AUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

0 order vs 1st order

A

0-order: Constant amount is removed per unit of time
1st order: Constant percentage is removed per unit of time

T1/2 is constant is 1st order and NOT in 0-order

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Common drugs that exhibit Michaelis-Menten kinetics

A

Phenytoin
Theophylline
Voriconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Elimination rate constant (Ke)

A

Cl/VD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Predicting drug concentrations

A

C2 = C1 X E^-kt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Half-life equation

A

0.693/Ke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Loading dose equation

A

(Desired concentration * VD)/F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Allopurinol: prior testing

A

HLA-B*5801

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Carbamazepine, Oxcarbazepine: prior testing

A

HLA-B*1502

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Clopidogrel: genetic testing

A

CYP2C19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Codeine: genetic testing

A

CYP2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Warfarin: genetic testing

A

CYP2C9*2 and VKORC1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Trastuzumab: genetic testing

A

HER2 (if negative, drug will not work)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Cetiximab: genetic testing

A

KRAS mutation (If positive, don’t use)
KRAS negative = wild type = should receive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Azathioprine: genetic testing

A

TPMT
Low/absent lvls risk of severe, life threatening myelosuppression
IF low/absent, use low dose or alternative treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Capecitabine/Fluorouracil: genetic testing

A

DPD deficiency (inc risk of severe toxicity). If DPD deficient, do not use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Folic acid requirements for women in child-bearing years

A

600 mcg DFE = 360 mcg of folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

St Johns Wort: drug interactions

A

Induces CYP450, 3A4, 2C19, 2C9, 1A2
Serotonergic
Photosensitivity
May lower seizure threshold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Supplements that increase bleeding risk

A

5 G’s: garlic, ginger, ginkgo, ginseng, glucosamine
Fish oil
Vitamin E
Dong quai
Willow bark (a salicylate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Supplements that can be hepatotoxic

A

Black cohosh (used for menopausal symptoms)
Kava (used for stress/anxiety)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Supplements with cardiotoxicity risk

A
  1. Ephedra (replaced by bitter orange or synerphrine): stimulants
  2. DMAA
  3. Yohimbe is used to inc. libido & for ED
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Supplements for anxiety

A

Valerian
Passionflower
Kava
St Johns Wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Supplements for ADHD

A

Omega-3-fatty acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Supplements for cold sores

A

L-lysine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Supplements for colds & flu

A

Echinacea
Zinc
Vit C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Supplements for memory

A

Ginkgo
Vitamin E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Supplements for depression

A

St. Johns Wort
SAMe
Valerian
5-HTP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Supplements for diabetes

A

Alpha lipoic acid
Chromium
Cassia cinnamon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Supplements for dyslipidemia

A

Red yeast rice
Fish oils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Supplements for dyspepsia

A

Ca
Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Supplements for energy/weight loss

A

Bitter orange
Caffeine
Guarana, green tea powder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Supplements for ED

A

Ginseng
L-arginine
Yohimbe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Supplements for hypertension

A

Fish oils
L-arginine
Co-Q-10
Garlic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Supplements for GI health

A

Fibers
Chamomile
Probiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Supplements for Heart health

A

Co-Q-10
Hawthorn
Fish oils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Supplements for inflammation

A

Fish oils
Flax seeds/oil
Turmeric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Supplements for insomnia

A

Valerian
Melatonin
Chamomile

65
Q

Melatonin dosing for jetlag

A

0.5-2mg preflight
5mg post-flight

66
Q

Supplements for liver disease

A

milk thistle

67
Q

Supplements for menopause

A

Black cohosh
Dong quai
Evening primrose oil
Soy, red clover

67
Q

Supplements for migraine ppx

A

FeverFew
Butterbur
Mg
Riboflavin (vit B2)
CoQ10

68
Q

Supplements for motion sickness

A

Ginger
Peppermint

69
Q

Supplements for osteoarhritis

A

Glucosamine
Chondroritin
SAMe
Turmeric

69
Q

Supplements for osteoporosis

A

Ca
Vit D
Soy

70
Q

Supplements for prostate health

A

Saw palmetto
Lycopene

71
Q

Supplements for skin conditions

A

Tea tree oil

72
Q

Supplements for UTis

A

Cranberry

72
Q

Safety issues with bitter orange

A

Stimulant

72
Q

Safety issues with 5-HTP

A

Serotonergic

73
Q

Safety issues with Feverfew

A

Mouth ulceration, inc. bleeding risk

74
Q

Safety issues with fibers

A

GI effects (e.g. bloating, cramping, flatulence)

75
Q

Safety issues with Hawthorn

A

Positive inotrope. Avoid concurrent use with digoxin (additive effect)

76
Q

Safety issues with L-arginine

A

Converts into nitric oxide

77
Q

Safety issues with passionflower

A

QT prolongation

78
Q

Safety issues with red yeast rice (natural form of lovastatin)

A

CYP450 inhibitors (e.g. amiodarone) will inc. red yeast rice level.

79
Q

Safety issues with SAMe

A

Serotonergic
Inc. bleeding risk
Do not use in bipolar disorder

80
Q

Safety issues with Soy, red clover

A

Soy might inc. breast cancer risk in postmenopausal women

81
Q

Safety issues with valerian

A

Sedation, CNS depressant

82
Q

Safety issues with Vit C

A

Nephrolithiasis with high doses

82
Q

Safety issues with Vit E

A

Bleeding risk, CVD Risk
Do not exceed 400 IU daily

83
Q

Safety issues with Yohimbe

A

Inc. BP, Inc. HR, seizure risk

84
Q

Safety issues with Zinc

A

Nasal products can cause loss of smell

85
Q

Vitamin A

A

Retinol

86
Q

Vitamin B1

A

Thiamine

86
Q

Vitamin B2

A

Riboflavin

87
Q

Vitamin B3

A

Niacin

88
Q

Vitamin B6

A

Pyridoxine

89
Q

Vitamin B9

A

Folic acid

90
Q

Vitamin B12

A

Cobalamin

91
Q

Vitamin C

A

Ascorbic acid

92
Q

Vitamin D3

A

Cholecalciferol

93
Q

Vitamin D2

A

Ergocalciferol

94
Q

Vitamin E

A

Alpha-tocopherol

95
Q

Folic acid requirements (women)

A

400mcg/day = All women of child bearing age
600 mcg/day = during pregnancy

96
Q

How much folate is in prescription prenatal vitamins?

A

1 mg

97
Q

AAP iron recommendations

A

4-6 months: formulas contain adequate iron. However, breastfed babies need 1mg/kg/day from 4-6 months and until consuming iron-rich foods.

98
Q

Nutritions depleted with acetazolamide

A

Ca
K

99
Q

Nutritions depleted with antiepileptics

A

Ca

100
Q

Nutritions depleted with amphotericin B

A

Mg
K

101
Q

Nutritions depleted with isoniazid

A

Vitamin B6

102
Q

Nutritions depleted with loops

A

K+

103
Q

Nutritions depleted with metformin

A

vitamin B12

104
Q

Nutritions depleted with MTX

A

Folate

105
Q

Nutritions depleted with Orlistat

A

Beta-carotene
Fat-soluble vitamins

106
Q

Nutritions depleted with PPIs

A

Mg
Vitamin B12

107
Q

Nutritions depleted with SXT-TMP

A

folate

108
Q

Supplements recommended with AUD

A

Vitamin B1
Folate

108
Q

Supplements recommended with macrocytic anemia

A

vitamin b12
folate

109
Q

Supplements recommended with microcytic anemia

A

iron

110
Q

Supplements recommended with pregnancy

A

Folate
Ca++
Vit D
Pyridoxine

111
Q

Supplements recommended with CKD

A

Vit D

112
Q

Poison control center phone #

A

1-800-222-1222

113
Q

Initial management: topical exposure

A

remove contaminated clothing
wash skin with soap & water for 10 minutes

114
Q

Initial managment: ocular exposure

A

remove contact lenses
rinse eyes with a gentle stream of water for at least 15 minutes

115
Q

Ipecac syrup

A

No longer recommended

116
Q

When is activated charcoal most useful?

A

within 1 hr

117
Q

Activated charcoal: dose

A

1g/kg

118
Q

what is recommended to do prior to administering activated charcoal?

A

Airway protected to prevent aspiration
Hydrocarbons can inc. risk of aspiration

119
Q

When is activated charcoal contraindicated?

A

A. When airway is unprotected, including:
1. is unconscious
2. cannot clear their throat
3. cannot hold their head upright
B. With intestinal obstruction
C. When the GI tract is not intact or when there is dec. peristalsis

119
Q

Acetaminophen overdose: phase 1 (1-24 hrs)

A

Common asymptomatic or nonspecific symptoms (N/V)

120
Q

Acetaminophen overdose: phase 2 (24-48 hrs)

A

INR elevation, Inc. AST/ALT

121
Q

Acetaminophen overdose: phase 3 (48-96 hrs)

A

fulminant hepatic failure (e.g. jaundice, coagulopathy, renal failure, and/or death)

122
Q

Acetaminophen overdose: phase 4 (> 96 hrs)

A

recovers or receives liver transplant

123
Q

How does NAC work?

A

acts as a glutathione precursor, resulting in non-toxic metabolites

124
Q

Anticholinergic overdose: symptoms + treatment

A

Symptoms: flushing, dry skin, mydriasis with blurry vision, AMS, fever
Treatment: supportive care, physostigmine (inhibits enzyme that breaks down ACh)

125
Q

Apixaban, Rivaroxaban overdose: treatment

A

Andexanet alfa (Andexxa)

126
Q

Dabigatran overdose: treatment

A

Idarucizumab (Praxbind)

127
Q

Warfarin overdose: treatment

A

Phytonadione (vitamin K)

128
Q

Heparin, LMWH overdose: treatment

A

Protamine

129
Q

Warfarin, Factor Xa inhibitor overdose: treatment

A

Prothrombin complex concentrate (Kcentra)

130
Q

Antipsychotics overdose treatment:

A

Primarily supportive care
Benztropine for dystonias

131
Q

Benzodiazepines overdose treatment:

A

Flumazenil (can cause seizures) if used in pts taking benzos chronically

132
Q

Beta-blockers overdose treatment:

A

Glucagon (if unresponsive to symptomatic treatment)

133
Q

CCB overdose treatment:

A

Same as BB plus Calcium (IV)

134
Q

Cyanide (smoke inhalation, nitroprusside in high doses/duration/renal impairment) overdose treatment:

A

Hydroxocobalamin (Cyanokit)
Sodium thiosulfate + sodium nitrite (Nithiodote)

135
Q

Digoxin overdose treatment:

A

Digoxin immune fab (DigiFab)

136
Q

Ethanol overdose treatment:

A

Thiamine to prevent wernicke’s
Can cause inc. anion gap

137
Q

Heavy metals (arsenic, copper, gold, etc) overdose treatment:

A

Dimercaprol
Succimer (for lead)
Penicillamine (for copper)

138
Q

Hydrocarbons: petroleum products overdose treatment:

A

Do not induce vomiting. Keep pts NPO d/t aspiration risk.

139
Q

Insulin or other hypoglycemic overdose treatment:

A

Dextrose: don’t administer if unconscious
Glucagon

140
Q

Isoniazid overdose treatment:

A

Pyridoxine (vitamin B6): IV for acute neurotoxicity

141
Q

Iron and aluminum overdose treatment:

A

Deferoxamine (Desferal)

142
Q

Organophosphates (including industrial insecticides) overdose treatment & symptoms:

A

Symptoms: SLUDD symptoms d/t acetylcholinesterase blockade
Treatment: Atropine, Pralidoxime (reactivates cholinesterase) **Combo can be used **

143
Q

MTX overdose treatment:

A

Leucovorin (Folinic acid)
Levoleucovorin (Fusilev)
Glucarpidase (Voraxaze)

144
Q

Methemoglobinemia overdose treatment:

A

Methylene blue C/I in G6PD deficiency

145
Q

Neostigmine, pyridostigmine overdose treatment:

A

Pralidoxime +/- atropine

146
Q

Nicotine overdose treatment + symptoms:

A

Symptoms: abdominal pain, nausea
Treatment: supportive care, atropine (for symptomatic bradycardia), benzos (for seizures)

147
Q

Salicylates overdose treatment:

A

Sodium bicarbonate

148
Q

Stimulant overdose treatment:

A

Benzos

149
Q

Toxic alcohols: ethylene glycol (antifreeze), methanol overdose treatment:

A

Fomepizole

150
Q

TCAs overdose treatment:

A

Overdose can quickly cause fatal arrhythmia
Treatment: sodium bicarb to dec a widened QRS complex

151
Q

Valproic acid or topiramate induced hyperammonemia overdose treatment:

A

Levocarnitine (Carnitor)

152
Q

Animal bites antidotes

A

Rabies vaccine (RabAvert, Imovax Rabies) + Human rabies Immune immunoglobin

153
Q

Black widow spider bites antidotes

A

Antivenin for Latrodectus mactans

154
Q

Scorpion stings antidotes

A

Antivenin immune FAB for centruoides (Anascorp)

155
Q

Snake bites antidotes

A

Crotalidae polyvalent immune FAB (CroFab) for copperhead and rattlesnake bites

TOP 300 drugs - NAPLEX (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions