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semester 3 > pharmacy test 1 > Flashcards

pharmacy test 1 Flashcards

1
Q

Medication Used to Treat Status Epilepticus

A

Diazepam. It works faster than Lorazepam

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2
Q

Phenytoin (Dilantin) Therapeutic Levels

A

10-20 μg/mL
Highly protein bound

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3
Q

Phenytoin (Dilantin) Administration

A

Administered with a very slow IV push. Very irritating to the vein because of fucking ANTIFREEZE
Large gauge (20) needle with a filter
May only be mixed with normal saline

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4
Q

Carbamazepine (tegretol) Adverse Effects

A

anemia, leukemia, and steven-johnsons syndrome. Interactions with warfarin and decreases effectiveness of contraceptives.

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5
Q

Do Antiepileptics Have a Black Box Warning?

A

Yes, for suicidal ideation

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6
Q

Levetiracetam (keppra)

A

mostly used for adjunct therapy for partial seizures with or without secondary generalization.

Mechanism unknown. No known drug interactions. Generally well tolerated but may have adverse CNS effects.

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7
Q

Pregabalin (lyrica)

A

schedule V controlled substance
Indication: adjust therapy for partial seizures, neuropathic pain, postherpetic neuralgia, and fibromyalgia.
Adverse reactions are CNS related but none were highlighted or stressed in lecture.

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8
Q

Valproic Acid (depakote)

A

Highly protein bound for treatment of seizures

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9
Q

Valproic Acid (depakote)

A

Highly protein bound for treatment of seizures

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10
Q

Phenytoin (Dilantin) Adverse Effects

A

GIGIVAL HYPOPLASIA, acne, hirsutism (excessive male pattern hair growth in women), Dilantin facies, and osteoporosis

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11
Q

Convulsions Vs Seizures

A

Seizures: nerves are too excited
Convulsions: spasmodic contractions

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12
Q

Amantadine (symmetrel)

A

Used early in the Parkinson’s disease process, ineffective after 6-12 months.
Common side effects: dizziness, insomnia and nausea. Interacts with anticholinergic drugs.

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13
Q

Benztropine (cogentin) and diphenhydramine (benadryl)

A

block the effects of acetylcholine (ACh) relaxing smooth muscle.

Not for patients with bradykinesia symptoms. Adjust therapy for anti-dyskinetic properties.

HIGH RISK FOR HYPERTHERMIA. Cause dry mouth, urinary retention, decrease GI motility also used to block EPS with antipsychotics.

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14
Q

Selegiline (eldepryl) and rasagiline (azilect)

A

avoid fermented foods.
are selective MAO-B inhibitors. Either given alone or in adjective therapy with levodopa. Cause an increase in levels of dopaminergic stimulation in the CNS. Watch out for the cheese effect. Do not use with meperidine (demerol).

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15
Q

cheese effect

A

An acute attack of hypertension that can occur in a person taking a monoamine oxidase inhibitor (MAOI) drug who eats cheese or other fermented foods.

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16
Q

Lovenox

A

Given in the abdomen. Lovenox in love handles.
pre filled syringe, give WITH the air bubble.

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17
Q

Low-molecular weight heparins contraindication

A

never give when a patient has an epidural because it can lead to epidural hematomas

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18
Q

unfractured heparin antidote

A

protamine sulfate

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19
Q

side effects of heparin

A

you’re bleeding everywhere.
hematuria, melena (blood in the stool), petechiae, ecchymoses, and gum or mucous membrane bleeding

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20
Q

side effects of heparin

A

you’re bleeding everywhere.
hematuria, melena (blood in the stool), petechiae, ecchymoses, and gum or mucous membrane bleeding

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21
Q

Dabigatran (Pradaxa)

A

thrombin inhibitor approved for stroke and thrombosis prevention.

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22
Q

Dabigatran (Pradaxa) Antidote

A

Idarucizumab (Praxbind).

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23
Q

seizure assessment

A

last occurrence, length, and description.
CBC and liver panel

24
Q

Gabapentin (neurontin)

A

chemical analogue of GABA, a neurotransmitter that inhibits brain activity. Treatment of partial seizures, but most often used for treatment of neuropathy. Do not give if the patient is allergic. Adverse effects include CNS and GI symptoms.

25
Q

Tolcapone (tasmar) and entacapone (comtan)

A

locks COMT, the enzyme that catalyzes the breakdown of the body’s catecholamines.
Prolongs duration of action of levodopa.
Can decrease the on/off effect

26
Q

Tolcapone (tasmar) and entacapone (comtan) adverse effects

A

Adverse effects: GI upset; urine discoloration; can worsen dyskinesia that may already be present. Tolcapone has been associated with cases of severe liver failure.

27
Q

Direct-Acting Dopamine Receptor Agonists

A

Pramipexole, ropinirole, and bromocriptine
Used in early and later stages of parkinson’s. Stimulates receptors to increase dopamine.
Better in younger patients who can tolerate drowsiness and postural hypotension. Also used for restless leg syndrome

28
Q

On-Off Phenomenon

A

Rapid swings in response to levodopa can occur. PD worsens when too little dopamine is present. Dyskinesia occurs when too much dopamine is present.

29
Q

Carbidopa-Levodopa (Sinemet)

A

Sinemet CR can increase the “on” time and decrease “off” time. Best taken on an empty stomach to minimize GI upset.
Most effective PD drug

30
Q

Carbidopa (Lodosyn)

A

Best taken on an empty stomach to minimize GI upset. Carbidopa is often given with levodopa because it does not cross the blood brain barrier and somehow promotes more levodopa to get across. The most effective drug available.

31
Q

Benztropine (cogentin) and diphenhydramine (benadryl)

A

block the effects of acetylcholine (ACh) relaxing smooth muscle. Not for patients with bradykinesia symptoms. Can cause dry mouth, urinary retention, decrease GI motility also used to block EPS with antipsychotics.

32
Q

Levodopa

A

is the biologic precursor of dopamine and works presynaptically to increase brain levels of dopamine. It is able to cross the blood brain barrier to be converted to dopamine in the brain. It is generally only effective for 5-10 years. Must be given orally. Effectiveness decreases after the first 1-2 years of treatment.

Adverse effects include confusion, involuntary movements, GI distress, etc

33
Q

Anticoagulants

A

also known as antithrombotic drugs. Do not affect clots that are already formed, can only prevent further clotting. Used prophylactically.

34
Q

Low-molecular weight heparins order

A

DVT prophylaxis order is typically 5000 units SQ given 2-3 times daily

35
Q

Lovenox and Fragmin

A

low molecular weight heparins

36
Q

Unfractured heparin therapeutic route

A

IV. must monitor with aPTT

37
Q

Heparin induced thrombocytopenia

A

can lead to thrombosis, which can be fatal
Can be treated with thrombin inhibitors lepirudin and argatroban.

38
Q

Warfarin (coumadin) antidote

A

Vitamin K
Kcentra and Profiline

39
Q

Warfarin (coumadin) therapeutic level

A

2-3.5

40
Q

Factor Xa drugs

A

Fondaparinux (Arixtra), Apixaban (Eliquis), Edoxaban (Savaysa), Betrixaban (Bevyxxa),

Rivaroxaban (Xarelto) - used for prevention of strokes in patients with a-fib

41
Q

Direct Thrombin Inhibitors

A

Human antithrombin III (Thrombate), Lepirudin (Refludan), Argatroban (Argatroban), Bivalirudin (Angiomax), Dabigatran (Pradaxa)

42
Q

Dabigatran (Pradaxa) antidote

A

Idarucizumab (Praxbind)

43
Q

Aspirin contraindications

A

for flu-like symptoms in children and teenagers (Reye’s Syndrome)

44
Q

most common prescription for aspirin

A

81 mg
Do not take on an empty stomach, recommend enteric coated version to protect the stomach lining.

45
Q

Clopidrogrel (Plavix)

A

is the most widely used ADP inhibitor

46
Q

Eptifibatide (Integrilin)

A

is a GP lib/IIIa inhibitor. Given IV (typically in an ICU or cardiac unit).

47
Q

Alteplase (activase)

A

fibrin specific so it does not produce a systemic lytic state.
Typical order: 0.9 mg/kg IV over 60 minutes, not to exceed 90 mg.

48
Q

drugs to treat systemic fungal infections

A

-zoles and -ins
caspofungin, voriconazole, Amphotericin B

fluconazole, flucytosine, griseofulvin, itraconazole, ketoconazole, micafungin, nystatin, terbinafine, posaconazole, anidulafungin

49
Q

drug of choice for Aspergillus for patients not tolerant to other drugs

A

Caspofungin

50
Q

warfarin blood test

A

pt/INR
prothrombin time
also called bleeding time

51
Q

heparin blood test

A

aPTT
Activated Partial Thromboplastin Clotting Time

52
Q

Fluconazole special skill

A

passes through the blood brain barrier

53
Q

the b in Amphotericin B stands for bitch because

A

To reduce the severity of the infusion-related reactions, pretreatment with an antipyretic (acetaminophen), antihistamines, antiemetics, and corticosteroids may be given.

54
Q

the b in Amphotericin B stands for bitch because

A

To reduce the severity of the infusion-related reactions, pretreatment with an antipyretic (acetaminophen), antihistamines, antiemetics, and corticosteroids may be given.

55
Q

Mupirocin (Bactroban) is no longer effective against

A

MRSA

56
Q

topical drugs for lice and scabies

A

spinosad (Natroba)
Ivermectin – you do not need to comb out the knits
lindane (Kwell)
malathion (Ovide)
crotamiton (Eurax)
benzyl alcohol 5% (Ulesfia)

semester 3 (9 decks)

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