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Emma Rheumatology > Random Pharm (Quizzes, Review Slides) > Flashcards

Random Pharm (Quizzes, Review Slides) Flashcards

1
Q

osteoporosis or cataracts

impaired glucose tolerance

A

systemic corticosteroids (prednisone)

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2
Q

Tramadol MOA

A

weak agonist of the mu-opioid receptor

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3
Q

___ inc risk of toxicity due to elevated levels of acetaminophen

A

enzyme inducers of the CYP450 system (eg, alcohol, carba- mazepine, phenytoin, rifampin)

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4
Q

acetaminophen OD antidote

A

N-acetylcysteine (glutathione precursor)

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5
Q

celecoxib

A

COX-2 selective

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6
Q

no ceiling effect

A

opioid analgesics

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7
Q

ceiling effect

A

NSAIDs

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8
Q

topical patch fentanyl onset of action

A

delayed

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9
Q

_____, a synthetic opioid, would generally be safe to use in someone with a history of hypersensitivity to a naturally derived opioid such as morphine.

A

fentanyl

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10
Q

opioid GI AE

A

nausea and loss of appetite due to a combined effect of stimulating the chemoreceptor trigger zone (CTZ) in the medulla and slowing gastric emptying in the GI tract (constipation)

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11
Q

to avoid GI AE, opioids are usually rx’d w/

A

laxatives and stool softeners

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12
Q

misoprostol

A

prostaglandin E analog

minimizes risk for NSAID-related GI ulceration

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13
Q

NSAIDs and body temperature

A

Due mainly to inhibition of fever-promoting prostaglandins, NSAIDs will LOWER body temperature if abnormally elevated.

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14
Q

T/F

An extended release formulation of NSAIDs mitigates risk of GI side effects

A

F

The risk for NSAID-related GI side effects is dose related.

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15
Q

synthetic opioids

A

methadone
meperidine
fentanyl

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16
Q

Cross-sensitivity will result if ____ is used in someone w/ hx of HS to codeine.

A

morphine

a metabolite of codeine

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17
Q

cyclophosphamide

A
  • an alkylating agent that stops cell growth

- reduces risk of renal failure in SLE

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18
Q

mycopenolate

A
  • depletes guanosine NTs in T and B lymphocytes and inhibits their proliferation
  • prevents transplant rejection, tx of choice for proliferative lupus nephritis
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19
Q

hydroxychloroquine

A

use in SLE, dec flares

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20
Q

biologics for SLE

A

belimumab

rituximab

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21
Q

epistaxis

A

NSAIDS

thromboxane inhibition

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22
Q

miosis

A

opioids

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23
Q

myoclonus

A

opioids

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24
Q

selective COX-2 inhibitor

A

celecoxib

25
Q

irreversible COX inhibitor

A

aspirin

26
Q

celecoxib

AE

A

MI

27
Q

QT interval prolongation

A

methadone

28
Q

long-acting opioid agonist

A

methadone

29
Q

opioid agonist with neurotoxicity

A

merperidine

30
Q

partial anti-depressants partial opioid

A

tramadol

31
Q

CYP3A4

alteration that would lead to morphine OD

A

inhibition

32
Q

CYP2D6

alteration that would lead to morphine OD

A

overexpression

33
Q

Cl of morphine

A

renal

34
Q

abatacept

A

T cell modulator

targets CD80/86 on APC to prevent attachment to CD28 on T cell

35
Q

Entanercept

A

anti-TNF

36
Q

hydrocholoroquine

A

DMARD

anti-malarial
poorly understood MOA

37
Q

methotrexate

use/MOA/AE

A

DMARD

use: 1st line for RA

MOA: folate inhibition (not likely MOA for arthritis suppression)

AE:

  • liver tox (EtOH abstinence)
  • BM suppression
  • teratogen (BIRTH CONTROL)
  • pneumonitis/pulm fibrosis
38
Q

DMARDs general principles

A
  • slow onset
  • immunosuppressive
  • no effect on wound healing
  • req reg f/u
  • TERATOGENIC
  • malignancy risk (lymphomas)
  • not curative
  • better in combo
39
Q

MTX administration

A

WEEKLY (daily is highly toxic)

admin w/ folic acid to lim AE

40
Q

leflunomide

use/MOA/AE

A

DMARD

use: 1st line for arthritis when MTX contraindicated

MOA: inhib pyrimidine synthesis by inhibiting dihydroorotate dehydrogenase

AE: sim to MTX (no EtOH)

41
Q

leflunomide administration

A

daily medication, no req for folic acid (unlike MTX)

42
Q

sulfasalazine

use/MOA/AE

A

DMARD

use: 1st line for arthritis when MTX contraindicated

MOA: unclear

AE: BM suppression, esp w/ G6PD deficiency

43
Q

sulfasalazine

administration

A

often used in combo w/ MTX and/or hydrochloroquine (triple therapy)

44
Q

hydroxycholoroquine

use/MOA/AE

A

DMARD

use: 1st line for SLE, often used for RA and other arthritides

MOA: poorly understood, originally an antimalarial

AE: mostly SAFE. Possible retinopathy (irreversible, “bull’s eye)

45
Q

hydroxycholoroquine administration

A
  • SAFE during pregnancy

- yearly retinal exams

46
Q

Azathioprine

use/MOA/AE

A

DMARD

use: 2nd line therapy for many non-life threat manifestations of SLE, vasculitides, others. Occasional RA.

MOA: antagonizes purine metab (inhib DNA synth)

AE:

  • BM suppression
  • infection risk
47
Q

Azathioprine administration

A

-SAFE during pregnancy

48
Q

biologics clearance

A

reticuloendothelial system

don’t need to worry about organ related damage

49
Q

biologics administration

A

-IM, subQ, or IV

50
Q

biologics general principles

A
  • newer DMARDs
  • parenteral admin
  • admin rxns
  • infections
  • cost
  • CHF (fluid retention)
  • neuro dz (MS)
  • malignancy
51
Q

etanercept

A

anti-TNF

52
Q

prednisone AE

A
  • infections
  • hypERglycemia
  • osteoporosis
  • weight gain
53
Q

T/F

Prednisone commonly causes bronchospasm.

A

F

relieves leukotrienes

54
Q

targets CD20

A

rituximab

55
Q

IL-6 inhibitor

A

tocilizumab

56
Q

JAK kinase inhibitor

A

tofacitinib

57
Q

duloxetine

A

SNRI

use: fibromyalgia

58
Q

tx of type III glomerulonephritis

A

mycophenolate or cyclophosphamide

59
Q

anticondulsants
gabapentin
pregabalin

used in…

A

fibromyalgia

can inhibit substance P and glutamate

Emma Rheumatology (8 decks)

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