Pharmacy Review Flashcards

1
Q

Who can prescribe prescription drugs

A

Require a written prescription by an accredited authorized

Prescriber provider.

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2
Q

What are controlled substance prescriptions written on

A

DD 1289

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3
Q

Define pharmacokinetic

A

the study of drug absorption, distribution, metabolism and excretion

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4
Q

What are factors that alter bioavailability?

A

Drug form, route, liver changes, GI mucosa, food and drugs, solubility

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5
Q

Where does metabolism occur?

A

Liver, kidneys, lungs, plasma, and intestinal mucosa

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6
Q

What factor can increase the half-life of a drug?

A

Liver disease and old age

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7
Q

What is a cumulative drug effect?

A

When the body has not fully metabolized a dose of a drug before the next dose is given.

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8
Q

What is an additive drug reaction?

A

When the combined effect of two drugs equal the sum of each drug given alone

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9
Q

What is synergism

A

When drugs produce an effect that is greater than the sum of their separate actions

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10
Q

What are the parenteral drug admin routes?

A

SubQ = between skin and muscle (slower than IM), IM = directly to the muscle, IV= directly into the blood (action is immediate), ID= first and second layer of the skin (sensitivity tests)

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11
Q

What can be applied to the skin causing a systemic effect?

A

transdermal

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12
Q

What route has a local effect on the lungs?

A

inhalation

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13
Q

In high doses, what drug has anticonvulsant properties?

A

Barbiturates

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14
Q

What is used as a short term antianxiety?

A

Benzodiazepines

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15
Q

What are some examples of benzodiazepines?

A

(END in PAM) Diazepam, Lorazepam, Alrazolam

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16
Q

What is used in the management of generalized tonic-clonic, status epilepticus and partial seizures?

A

Barbiturates

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17
Q

How do antidepressants work?

A

increase serotonin by inhibiting neuronal uptake to CNS

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18
Q

Who will not be prescribed MAOI?

A

CVA disease, CHF, Hypertension

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19
Q

How do antipsychotics work?

A

Block dopamine receptors in the brain

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20
Q

What is a contraindication of antipsychotics

A

Hypotension

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21
Q

What is an antipsychotic carried onboard

A

Haloperidol

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22
Q

What are CNS stimulants used for?

A

Treatment of ADHD and Narcolepsy

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23
Q

How do anticonvulsants work?

A

Reduction of excitability of the neurons in the brain

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24
Q

What are some examples of anticonvulsants?

A

(End in PAM) Diazepam, Lorazepam, Clonazepam

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25
Q

What is the adverse side effects of TCA’s?

A

Dry mouth, blurred vision, postural hypotension, urinary retention, constipation and orthostatic hypotension.

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26
Q

When used with a MAOI, what may result in a fatal reaction referred to as serotonin syndrome?

A

Setraline

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27
Q

What is the action of anti-emetics?

A

Primarily by inhibiting the chemoreceptor trigger zone or by depressing the sensitivity of the vestibular apparatus of the inner ear

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28
Q

Ondansetron block the effects of serotonin at what?

A

5-HT3 receptor sites

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29
Q

What are some examples of antiemetics and antivertigo?

A

(End in ZINE) Promethazine, meclizine

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30
Q

How does local anesthetics work?

A

inhibiting transport of ions across neuronal membranes

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31
Q

What is used in the relief of mild to moderate pain?

A

Non-salicylates

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32
Q

What is an example of non-salicylates?

A

Acetaminophen

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33
Q

What is the action of NSAIDS?

A
  • Inhibit the action of cox1 and cox2 which is responsible for prostaglandin synthesis
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34
Q

What is the difference between COX1 and COX2?

A

Non-selective and Selective

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35
Q

What is a possible adverse side effect of NSAIDS?

A

GI upset and may increase your risk of heart attack or stroke

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36
Q

Long term use of NSAIDS may result in what

A

GI bleeding, stop use if prolonged bleeding or dark stools occur

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37
Q

What medication is both a salicylate and an NSAID?

A

Aspirin

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38
Q

What is the action of Narcotic Analgesics?

A

Alteration to the perception of and response to pain

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39
Q

What is the Antagonist to Narcotics (Opioids)?

A

Naloxone

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40
Q

What can antihistamines also be used to treat?

A

Insomnia, motion sickness, or vertigo

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41
Q

What are H2 antihistamines used to treat?

A

Gastric Ulcers

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42
Q

How do decongestants work?

A

induces vasoconstriction of the blood vessels in the nose, throat and paranasal sinuses, which results in reduced swelling and mucus formation in these areas

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43
Q

What is the max amount of time you can take Oxymetazoline HCL for?

A

no more than 3 days, may result in rebound congestion

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44
Q

How do Beta2 agonists work?

A

Cause relaxation (dialation) of bronchioles

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45
Q

What is a contraindication of beta2 agonist?

A

Cardiac arrhythmias, narrow angle glaucoma. Also should not be used while taking a beta blocker as it may inhibit the effects of the beta2 agonist

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46
Q

What are the adverse effects of anticholinergics?

A

Flushed face, Blurred vision, Urinary retention, Confusion, hallucinations, increased heart rate/body temp and dry mouth.

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47
Q

What is used in the treatment of Asthma and COPD?

A

Leukotriene antagonist and mast cell stabilizers

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48
Q

How do antitussives work?

A

Depress cough center and anesthetize stretch receptors

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49
Q

How does expectorants work?

A

Expectorants reduces the viscosity, tenacious secretion by increasing respiratory tract fluid

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50
Q

What loosens and mobilizes thick mucus from respiratory system?

A

Mucolytic

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51
Q

What is used as an expectorant on board?

A

Guaifenesin

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52
Q

What do antiarrhythmic do?

A

decreases symptomatology while increasing hemodynamic performance

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53
Q

What do class 2 beta blockers do?

A

Block stimulation of the beta receptors of the heart

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54
Q

What class of beta blockers block potassium channels in the heart?

A

Class 3

55
Q

What class of beta blockers would you use for ventricular dysrhythmias and atrial fibrillation?

A

Class 3

56
Q

What is a decrease in oxygen supply to the heart muscle resulting in chest pain or pressure?

A

Angina

57
Q

What is used to treat angina?

A
  • Nitroglycerin
58
Q

When would you not give nitroglycerin?

A
  • Low blood pressure
59
Q

What is considered stage 1 hypertension?

A

Systolic 130-139 and/or diastolic 80-89

60
Q

If lifestyle changes do not help hypertension then what drug will you give?

A

Thiazide Diuretuc, ACE-I, ARB or CCB

61
Q

What is the lasix management of edema associated with CHF, renal diseas and acute pulmonary edema

A

Loop diuretics

62
Q

A dry hacking cough is associated with some patients taking this medication

A

ACE inhibitors

63
Q

What is the examples of ACE-inhibitors?

A

(End in PRIL) lisinopril

64
Q

What are examples of beta blockers?

A

(End in OLOL) - metoprolol

65
Q

How does thiazide diuretics work

A
  • inhibit reabsorption of sodium and chloride ions in the kidney
66
Q

What diuretic is one of the first line indication for managing hypertension in the absence of any contraindication?

A

Thiazide Diuretics (HCTZ Hydrochlorothiazide)

67
Q

What is 1st line indication in the treatment of hypertension in patients with diabetes mellitus?

A

ACE inhibitors and ARBS

68
Q

What are anti-hyperlipidemias used for?

A

reduction of blood lipids in an effort to reduce morbidity and mortality of cardiovascular disease and its sequelae

69
Q

What are examples of anti-hyperlipidemias?

A

(End in STATIN) atorvastatin and simvastatin

70
Q

What is the action of antacids?

A

Neutralize or reduce acidity of the stomach and duodenal contents by combining with hydrochloric acid and producing salt and water

71
Q

What is an example of a commonly used antacid?

A

Calcium carbonate

72
Q

What is the action of Proton pump inhibitors?

A

Supress gastric acid secretion by blocking the final step in the production of gastric acid be the gastric mucosa

73
Q

What do you use to treat ulcers with helicobacter pylori?

A

Proton pump inhibitors

74
Q

What is an example of a Proton pump inhibitor?

A

End in ZOLE) omeprazole

75
Q

How do antidiarrheal work?

A

Decrease intestinal peristalsis

76
Q

When would you not give an antidiarrheal?

A

When you cannot rule out infection as a cause

77
Q

What is an example of an antidiarrheal?

A
  • Loperamide
78
Q

What is the action of anti-flatulents?

A
  • Simethicone has a defoaming action that dispereses and prevents the formation of mucus-surrounded gas pockets in the intestines
79
Q

What can occur with bulk producing laxatives?

A

Obstruction of esophagus, stomach, small intestines, and colon

80
Q

When treating an underlying hemorrhoid condition are best achieved how?

A
  • Increasing consumption of fiber/fiber supplements, laxatives and applying warm sitz bath and invasive procedures
81
Q

What can happen when prolonged or excessive use of hemorrhoid medications?

A
  • may lead to atrophy of the affected tissues
82
Q

What is insulin used to control?

A

Type one diabetes mellitus

83
Q

When taking oral hypoglycemic agents what factors may result in hypoglycemia

A

Eats too little, Dose greater, Increased Physical activity, infection

84
Q

In order to take oral antidiabetics what needs to work?

A

Pancreas

85
Q

What hormone influences every organ and tissue in the body?

A

Thyroid Hormones

86
Q

What is an example of a thyroid medication?

A

Levothyroxine

87
Q

Why would you give male hormone replacement?

A

Replacement therapy for testosterone deficiency (Hypogonadism)

88
Q

What are contraceptives used for?

A

inhibit ovulation

89
Q

What is a severe adverse reaction of contraceptives?

A

Venous Thromboembolism

90
Q

Define bacteriostatic

A

Drugs that slow or retard the multiplication of bacteria

91
Q

Define Bactericidal

A

Drugs that kill bacteria

92
Q

What is a contraindication of Sulfonamides?

A

Sulpha allergies, and use in caution with patients having G6PD

93
Q

What are sulfonamides used for?

A

Control UTI’s caused by e coli, staphloccus and silver sulfadiazine is topical used to treat burns

94
Q

What is an adverse reaction of Sulfonamides?

A

Use with caution in patients with G6PD as hemolysis may occur

95
Q

What is the action of Tetracyclines?

A
  • Inhibit bacterial protein synthesis, which is necessary for reproduction
96
Q

What is an example of tetracyclines?

A

Doxycycline

97
Q

What is the action of Fluoroquinolones

A

prevents cell reproduction leading to death of the bacteria (Bacteriocidal)

98
Q

What class of drugs inhibit viral replication?

A

antivirals

99
Q

What are some viral diseases?

A
  • HIV, Influenza A/B, Chronic Hep C treatment, and Herpes
100
Q

What are some examples of antivirals?

A
  • End in VIR, Acyclovir
101
Q

What is the action of anti-fungals?

A

May be fungicidal or fungistatic having an effect on the cell membrane of the fungus.

102
Q

What are the examples of anti-fungal?

A

End in ZOLE - Clotrimazole

metronizazole isnt antifungal its antibacterial

103
Q

What class of drugs is used to relieve acute painful musculoskeletal conditions?

A

muscle relaxers

104
Q

Why will you not stop corticosteroids abruptly?

A

A potentially life threating adrenal insufficiency can occur

105
Q

How do antimigraine medications work?

A

Acts on intracranial blood vessels and sensory nerves of trigeminal system; causes vasoconstriction and reduces neurogenic inflammation

106
Q

What are the examples of antimigraine medications?

A

End in TRIPTAN, sumatriptan, rizatriptin

107
Q

What class of drug inhibits sodium ion influx through nerve cell membrane channels in parasites resulting in delayed repolarization and thus paralysis and death of the pest?

A

Scabicide

108
Q

What is a scabicide?

A

Permethrin

109
Q

What is the action of topical corticosteroids?

A

Exert localized anti-inflammatory activity

110
Q

What treats otitis externa

A

Ciprofloxacin

111
Q

What do local anesthetics do?

A
  • inhibit the conduction of impulses of the sensory nerve fibers
112
Q

When should you make sure is not present before administering otic solutions?

A

Ensure there is no ear drum perforation.

113
Q

What are some nicotine replacement therapy?

A

Transdermal patch, gum, inhaler, nasal spray, lozenge

114
Q

Who has overall responsibility of controlled substances?

A

co

SMDR has custodial

115
Q

When will you change the combination code?

A

every 6 months

116
Q

who is required to be present when destroying medications

A

3 CSIB board members one being the senior member

117
Q

What form is used when theft of a controlled substance occurs?

A

DA 106

118
Q

How often is CSIB inventory conducted?

A

Quarterly, Monthly or as requested

119
Q

what is the action of stimulant laxatives

A

Increase peristalsis by direct action on the intestine.

120
Q

are antilipidemics diuretics?

A

no

121
Q

what is the examples of macrolides?

A

(a) Azithromycin: Zithromax
(b) Erythromycin (Alternate therapy and off label use for acne).
(c) Clarithromycin
(d) Teithromycin

122
Q

Examples of Fluoroquinolones

A

(a) Ciprofloxacin: Cipro

(b) Levofloxacin: Levaquin

123
Q

examples of Aminoglycosides

A

(a) Gentamicin

(b) Neomycin

124
Q

What is the action of Lincosamide

A

Exerts an extended post-antibiotic effect against some strain of bacteria.

125
Q

what are the examples of Lincosamide

A

a) Clindamycin

b) Lincomycin

126
Q

The effectiveness of individual antibiotics depends on these factors

A

(a) Location of the infection
(b) Ability of the antibiotic to reach the site of infection.
(c) Ability of the bacteria to resist or inactivate the antibiotic.

127
Q

what has the highest risk of dehydration

A

thermogenics

128
Q

What are anti-emetics/anti-nauseants used for?

A

Phenothiazines act to inhibit nausea and vomiting

129
Q

What is Furosemide (Lasix) used in the treatment of?

A

a. Edema due to CHF\
b. Cirrhosis of the liver
c. Acute pulmonary edema

130
Q

Remember

a. Antacids - reduce the acidity of the stomach
b. H2 antagonist- reduces the secretion of gastric acid
c. PPIs – suppress gastric acid secretions

A

Remember

a. Antacids - reduce the acidity of the stomach
b. H2 antagonist- reduces the secretion of gastric acid
c. PPIs – suppress gastric acid secretions

131
Q

How many safes are required?

A

2 with the exception of ddg1000, LCS, mcm, pc they only have one

132
Q

How often are the safe combinations changed?

A

Immediately upon turnover

b. Suspicion of compromise
c. Every six months

133
Q

What does nitric oxide enhance?

A

Oxygen and nutrient delivery to muscles