Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Spring Pharm > plz learn this > Flashcards

plz learn this Flashcards

1
Q

zofran dose

adults
kids

A

adults: 4-8 mg Iv over 2 minutes ->HA
kids: 0.05 to 0.15 mg/kg IV - careful

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

reglan dose

A

10-20 mg over 3-5 min -> abd cramping

peds T&A: 0.15 mg/kg slowly/ after

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

CV effects of reglan

A

increase HR
decrease BP

c/I with pheochromocytoma

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

omeprazole is given as a

A

pro-drug is protonated to active form

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

MOA of omeprazole

A

irreversibly inhibits H/K pump in gastric parietal cells, decreasing secretion of gastric acid and H+.
decreases gastric acid volume, increases gastric acid ph

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

bicitra is C/I in

A

pts taking aluminum salt ant acids
severe renal impairment
low sodium diet

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

antacids can result in increased rate of absorption of

A

salicylates
indomethacin.
naproxen

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

antacids with acid rebound

A

Na bicarb

calcium carbonate

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

H1 receptors are located at

A

bronchial smooth muscle (bronchoconstriction)
GI smooth muscle (Constriction)
vascular smooth muscle - (VASODILATION)
vascular endothelial cells (edema/permeability)
peripheral nerve endings - itching
Heart! AV node - SLOWS

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

H2 receptors are located at

A

proton pumps of gastric parietal cells - increase acid
heart -positive inotoropic and chronotropic effect
airway - bronchodilator

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

CV Side Effects of Benadryl

A

tachycardia

hypotension

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

Benadryl is C/I in

A

acute asthma?
CV disease r/t hypotension and tachycardia
increase IOP! (ach antagonism - mydriasis)

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

MOA H2 receptor antagonists:

A

block H2 receptor effects in gastric parietal cells, decrease cAMP, decrease H+ secretion, decrease gastric acid secretion.

does not change volume or pH of what is already in stomach.

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

least potent H2 antagonist

A

cimetidine

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

dose of cimetidine

A

300 mg IV over 15-30 minutes 1-2 hrs pre-op

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

cimetidine C/I in

A

asthma
caution in renal failure (excreted 75%)
caution in liver failure (transient increase in LFTs)

**INHIBITS CYP450
prolonged effect of WARFARIN, DIAZPEAM, LIDOCAINE, PROPANOLOL, MOPRHINE, CCB, TCAs, phenytoin

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

most potent H2 receptor antagonist

A

famotidine

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

dose of ranitidine

A

50 mg IV over 15-30 minutes, 1-2 hrs pre-op
give slowly.

50% excreted unchanged.
pulled r/t Ca risk

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

dose of famotidine

A

50 mg IV over 2 minutes, can give faster.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SE of H2 receptor antagonists

A

delayed awakening from anesthesia
decrease HBF, transient increase in LFTs,
HA, fatigue, dizziness, confusion
arrthymias
rapid administration - hypotension, bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q 
Dicyclomine - class 
uses:
A

dicyclomine is an anti-cholinergic,
used to decrease gastric acid secretion.

It has a poor therapeutic window, many interactions and is LESS effective than H2 antagonists and PPis

SE: Dry mouth, constipation, blurred vision, cardiac arrthymias , urinary retention

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

famotidine PK
onset:
DOA

A

famotidine
onset- 30 minutes (others are 1 hour)
DOA: 8 hours (others are 4 hours)

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

Sucralafate!

A

is a barrier drug

coats the gastric lining of the stomach to prevent further ulceration

does NOT change pH

SE
constipation, flatulence, little systemic absorption, drug interactions via binding to drugs

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

Colloidal Bismuth?

A

also a barrier drug.

stimulation of mucosal bicarbonate and PGE2, inhibits h. pylori growth, protects stomach from further ulceration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Misoprostol
is a prostaglandin analogue. give to pts on NSAIDs to prevent NSAID induced ulcers
26
Aprepitant (Emend?)
Substance P antagonist. little to not affinity for serotonin, d dopamine, corticosteroid receptors. very effective! used in oncology and often with agents
27
Scopalamine dose
5 mcg/hr for 72 hr patch. | usually must be put-on 4 hours in advance for best results
28
scopolamine is C/I in
glaucoma, MG, tachycardia r/t CV issues GI/GU obstruction paralytic ileus
29
scopolamine decreases
effects of acetaminophen and levodopa
30
stats on statins | HDL/LDL/TG
statins: decrease LDL: 20-60% increase HDL: 10% decrease TG: 10-20%
31
Niacin + statin =
increased r/f myopathy | increased r/f hepatotoxicity
32
Gemfibrozil + statin =
increased r/f myopathy increased r/f hepatoxicity also! DECREASED TG
33
increased r/f myopathy with statins:
``` preexisting muscle condition >80 y/o female asian smaller body frame hypothyroid impaired renal function impaired hepatic function ETOH abuse High statin level ```
34
pravastatin differences
not highly PB and not highly metabolized by cYP450
35
CYP3A4 inhibits will increase concentration of...
prodrug statins!! simvastatin lovastatin CYP3A4 inhibits: grapefruit, verapamil, amiodarone, erythropoietin, clarithro, azole antifungals, coumadin, cyclosporine, protease inhibitors
36
Dabigatran +simva/lova =
high risk for bleeding. | now have reversal agent for dabigatrarin (prdxbind?)
37
cyclosporine increases
concentration of all statins
38
bile acid-binding, resin sequestrin stats
Decrease LDL increase HDL no effect on TG - get rid of more bile via GI - getting rid of cholesterol will also increased LDL receptors cholestyramine, colestipol, colesevlam
39
bild acid resins can interfere with
PO absorption of drugs ``` synthroid OC suflas phenytoin thiazides fat soluble vitamins ```
40
in small/young pts, cholecystramine can cause
hyperchloremic acidosis
41
resins + statins
further decrease in LDL
42
only pregnancy safe anti-cholesterol =
binding resins (cholecystryamine, colestipol, colesevalem)
43
Niacin MOA
acts on liver and adipose tissue to decrease TG, unsure why increase in HDL, does decrease LDL - not very effective
44
Niacin stats
minor decrease in LDL (10-20%) TG - decrease HDL increase but unsure why
45
niacin is best for pts
at risk of pancreatitis increases HDL more than any other drug does little to improve long term outcomes
46
Niacin SE
intense flushing - tx with ASA GI upset Hepatotoxicity - assess LFTs Hyperglycemia - without DM, increases r/f DM hyperuricemia - gout, increase fluid uptake, watch kidney function visual changes increased r/f myopathy and hepatotoxicity with statins
47
most effective drug to decrease TG:
fiber acid derivative - gemfibrozil
48
Gemfibrozil MOA
increase synthesis of LPL also decreases level of apolipoprotei that decrease LPL LPL breaks down TG
49
Gemfibrozil stats
``` decrease TG (best) also increase HDL!! (20%) does very little to decrease LDL ```
50
Gemfibrozil SE
Rahses/GI upset/ HA rhabdo myopathy with statins liver injury check LFTS - made worse with statins GALLSTONES - dc displaces warfarin - watch INR/ LFTs potentiates oral anti-hyperglycemias - monitor can increase serum level of statins
51
Ezetimibe (Zetia) MOA
Inhibits cholesterol absorption from brush border of SI
52
Ezetimibe is used to
decrease LDL
53
Ezetimibe SE:
``` diarrhea also gallstones -> D/C may increase bleeding of warfarin iS INCREASED BY CYCLOSPORINE absorption of this drug would be inhibited by resins ```
54
PCSK9 inhibitors MOA
block the enzyme that breaks down LDL receptors increase LDL receptor expression
55
PCSK9-i stats
PCSK9 inhibitor stats | DECREASE LDL significantly.
56
PCSK9-I are a good choice for
pts who cant tolerate high dose statins, use statin + PCSK9
57
mipomersen MOA
mipomersen MOA: decrease apoB protein and decrease risk of CV disease black box warning for fatty liver also flu like symptoms FDA approved for familial hyperlipidemia
58
Lopitamide MOA
triglyceride transfer protein inhibitor in ER, prevents assembly of apoB, inhibits synthesis of chylomicrons. 50% reduction in plasma LDL levels ****
59
bronchodilation and cAMP
activation of b2 receptors will INCREASE cAMP and lead to bronchodilation
60
inhaled corticosteroids
budesonide beclomethasone triamcinolone fluticasone
61
cromolyn MOA
Stablilizes mast cells | inhibits antigen induced release of mediators
62
cromolyn must be taken
PROPHYLACTICALLY must be taken 4 times daily safest of all drugs tho
63
Zileuton MOA:
Inhibits lipoxygenase, inhibits production of leukotrienes from arachidonic acid
64
Zileuton SE:
hepatotoxic 2-4% | neuropsych: anxiety, depression, suicidal ideation, hallucinations
65
zilueton is less effective than
inhaled corticosteroid and LABA onset = 1-2 hours, not useful in acute attack
66
montelukast mOA
cysLT1 receptor antagonist. | blocks the mechanism of bronchoconstriction and smooth muscle effects
67
montelukast is used
to tx in asthma in pts <1 y/o prevents exercise induced bronchospasm >15 y/o treat allergic rhinitis improves bronchial tone, pulmonary function, and asthma symptoms.
68
montelukast max effect =
max effect = 24hrs after 1st dose
69
omalizumab is used
in ALLERGY induced asthma when inhaled glucocorticoids have failed
70
SE of omalizumab
``` injection site rxn increased r/f viral infxn URI / sinusitis HA Pharyngitis increased CV complications, possible increased r/f CA ``` RARE adverse effect: triggering of an immune response (anaphylaxis) monitor 2 hours after 1st 3 doses monitor 30 minutes after all SQ doses
71
SE of beta 2 agonists
``` SE; minimized by inhalation delivery tremor increased HR vasodilation metabolic changes: hyperglycemia, hypokalemia, hypomagnesemia ```
72
terbutaline administer via SC resembles
epi response
73
terbutaline dosage
terbutaline dosage for child: 0.1 mg/kg terbutaline dosage for adult: 0.25 mg q 15 minutes each dose is 200 mcg max dose = 16-20 puffs/day
74
Long acting B2 agonists differ in that
they have a lipophilic side chain that allows them to bind more tightly to B2 DOA: 12-24 hours these are not for prevention, these work prophylactically
75
long acting B2 agonists
salmeterol and formoterol
76
black box warning for LABA
may increase the risk of fatal or near fatal asthma attack. now they are paired with steroids. No clear reason why this is better.
77
methylxanthines MOA
Unclear. Also called phosphodiesterase inhibitors maybe prevent cAMP degradation in smooth muscle as well as in inflammatory cells dRUG EFFECT: Airway relaxation and bronchodilation
78
clinical indication for methylxanthines
COPD | ASTHMA
79
SE of methylxanthines
multiple SE and a narrow therapeutic index therapuetic index: 10-20 mcg/mL toxic at >20mg/mL wide 1/2 life variation in different patients, especially in smokers who metabolize 50% faster ``` SE: Cardiac arrhthymias n/V Irritability insomnia seizures brain damage hyperglycemia hypokalemia hypotension dEATH FROM CV COLLAPSE ```
80
Drug interactions with methylxanthines
metabolized by cYP450: cimetidine, cipro, antifungals: cyp450 inhibitors - can INCREASE levels phenobarbitals and phenytoin: can DECREASE levels smoking can increase levels caffeine can increase levels and promote CNS/CV toxicity
81
Anticholinergics are used
to tx COPD | secondary line of tx for asthma in patients resistant to beta agonist or who have significant cardiac disease
82
ipatropium bromide
is an anti-cholinergic agent is a quartenary ammonium derivative of atropine - can't cross BBB SLOW onset 30-90 minutes duration of action 4-6 hours NOT significantly absorbed compared to atropine, so less SE, can have inadvertent oral absorption - GI upset, dry mouth
83
Tiotropium
anti cholinergic quaternary ammonium salt not significantly absorbed approved by FDA for COPD
84
tiotropium/ipatropium is used in COPD as
maintenance and rescue therapy! | only used in asthma or ACUTE exacerbation
85
SE of cromolyn
Safest of all anesthesia drugs. ``` infrequent SEs are cough / bronchospasm laryngeal edema angio edema urticaria anaphylaxis ```
86
protamine sulfate dosing
1 mg protamine sulfate per 100 units heparin give slowly, can cause drop in BP
87
dabigatran is given as a
pro-drug | that is rapidly converted by plasma esterases into active form
88
fondaparinux MOA
Is a LMW heparin, has a 5 sugar base, binds to anti-thrombin 3 and then binds to only Xa. No thrombin effect. good in HIT, can cause thrombocytopenia more effective than other LMW heparin, so greater bleeding risk but less than heparin
89
dabigatran MOA
DIRECT thrombin inhibitor. pro drugs. binds to free and bound thrombin.
90
dabigatran pk
``` dabigatran onset; RAPID e1/2life ; 13 hours pb: low primarily cleared by kidneys, encourage PO uptake ```
91
drug interactions with dabigatran
Dabiagatran DDI: 1. p-glycopreotein inhibitors will iNCREASE drug levels (amino, verapamil, ketoconazole, quinine), 2. with simvastatin/lovastatin - major bleed, need reversal
92
Surgical considerations for dabigatran
stop 48 hours before surgery with normal renal function. stop 72-96 hours before surgery with impaired renal function. stop 5 days before surgery if high risk for bleed during surgery
93
reversal agent for rivaroxaban
andexxa
94
surgical considerations for rivaroxaban
hold 48 hours pre-op | hold 5 days if high risk for bleeds
95
dypridamole is used often
following heart valve replacement
96
dypridamole + ASA =
stroke prevention | "aggrenox"
97
dypridamole requires
BID dosing
98
Dypridamole SE
``` HA, hypotension - vasodilation bronchospasm, dyspnea MI arrthymias nausea, dizziness rash/flushing ```
99
abciximab used for
unstable angina, acute MI | PCI
100
tpa + ACE-i
increased risk for angio edema
101
anti-plt drugs are not recommended for patients with
severe hepatic disease or patients with GI ulcers
102
ADP receptor antagonists act for
the LIFE of the plt. 7-10 days exception: Ticagrelor
103
bare metal stents and drug eluding stents require
6 weeks and 6 months for seeding, post pone elective surgery until after this period
104
if no stent and pt on plavix and HIGH risk
dc 5 days before. placid washout, resume 24 hrs post - op use ASA in between
105
no stent, on plavix, LOW risk
dc 7-10 days prior | resume 24 hrs post -op
106
TXA dose
1 gm in 100 mL Ns given over 10 minutes [loading] | followed by 1 gm in 100 ml NS over 8 hours
107
pk of TXA
95% excreted, decease dose in renal failure
108
SE of TXA
seizures vision changes ureteral obstruction and bleeding renal toxicity
109
opioid that is always combined with something else
HYDROcodone ASA, ibuprofen, anti-histamine, acetaminophen
110
diphenyl derivative =
methadone
111
MOA of acetaminophen
unclear NMDA receptor antagonist in CNS substance P ANTAGONIST in spinal cord
112
NSAIDs displace
highly PB drugs ``` warfarin phenytoin sulfonylureas sulfonamides digoxin ```
113
NSAIDs decrease effectiveness of
diuretics beta blockers ace I INCREASElithium levels
114
Celecoxbin dosing
<200 mg/day
115
ketorolac dosing
30 mg IV or Im x 1 q 6 hours max - 120 mg cut doses by 50% in elderly do not exceed 5 days of use
116
hydrochlorothiazide clearance
100% in urine
117
dose of hydrochlorothiazide
25 mg - 100 mg / day max: 200 mg day low ceiling effect
118
hydrochlorothiazide is synergistic with
ACE-I or BB | NSAIDs DECREASE efficacy
119
Hydrochlorothiazide is C/I in
renal failure , Anura decrease dose in elderly, anti-arrthymic agents that prolong QTI
120
dose of mannitol
0.25 to 1 g/kg IV | over 30-60 minutes

Spring Pharm (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions