Random Pharm (Quizzes, Review Slides) Flashcards
osteoporosis or cataracts
impaired glucose tolerance
systemic corticosteroids (prednisone)
Tramadol MOA
weak agonist of the mu-opioid receptor
___ inc risk of toxicity due to elevated levels of acetaminophen
enzyme inducers of the CYP450 system (eg, alcohol, carba- mazepine, phenytoin, rifampin)
acetaminophen OD antidote
N-acetylcysteine (glutathione precursor)
celecoxib
COX-2 selective
no ceiling effect
opioid analgesics
ceiling effect
NSAIDs
topical patch fentanyl onset of action
delayed
_____, a synthetic opioid, would generally be safe to use in someone with a history of hypersensitivity to a naturally derived opioid such as morphine.
fentanyl
opioid GI AE
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)
to avoid GI AE, opioids are usually rx’d w/
laxatives and stool softeners
misoprostol
prostaglandin E analog
minimizes risk for NSAID-related GI ulceration
NSAIDs and body temperature
Due mainly to inhibition of fever-promoting prostaglandins, NSAIDs will LOWER body temperature if abnormally elevated.
T/F
An extended release formulation of NSAIDs mitigates risk of GI side effects
F
The risk for NSAID-related GI side effects is dose related.
synthetic opioids
methadone
meperidine
fentanyl
Cross-sensitivity will result if ____ is used in someone w/ hx of HS to codeine.
morphine
a metabolite of codeine
cyclophosphamide
- an alkylating agent that stops cell growth
- reduces risk of renal failure in SLE
mycopenolate
- depletes guanosine NTs in T and B lymphocytes and inhibits their proliferation
- prevents transplant rejection, tx of choice for proliferative lupus nephritis
hydroxychloroquine
use in SLE, dec flares
biologics for SLE
belimumab
rituximab
epistaxis
NSAIDS
thromboxane inhibition
miosis
opioids
myoclonus
opioids
selective COX-2 inhibitor
celecoxib
irreversible COX inhibitor
aspirin
celecoxib
AE
MI
QT interval prolongation
methadone
long-acting opioid agonist
methadone
opioid agonist with neurotoxicity
merperidine
partial anti-depressants partial opioid
tramadol
CYP3A4
alteration that would lead to morphine OD
inhibition
CYP2D6
alteration that would lead to morphine OD
overexpression
Cl of morphine
renal
abatacept
T cell modulator
targets CD80/86 on APC to prevent attachment to CD28 on T cell
Entanercept
anti-TNF
hydrocholoroquine
DMARD
anti-malarial
poorly understood MOA
methotrexate
use/MOA/AE
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
DMARDs general principles
- slow onset
- immunosuppressive
- no effect on wound healing
- req reg f/u
- TERATOGENIC
- malignancy risk (lymphomas)
- not curative
- better in combo
MTX administration
WEEKLY (daily is highly toxic)
admin w/ folic acid to lim AE
leflunomide
use/MOA/AE
DMARD
use: 1st line for arthritis when MTX contraindicated
MOA: inhib pyrimidine synthesis by inhibiting dihydroorotate dehydrogenase
AE: sim to MTX (no EtOH)
leflunomide administration
daily medication, no req for folic acid (unlike MTX)
sulfasalazine
use/MOA/AE
DMARD
use: 1st line for arthritis when MTX contraindicated
MOA: unclear
AE: BM suppression, esp w/ G6PD deficiency
sulfasalazine
administration
often used in combo w/ MTX and/or hydrochloroquine (triple therapy)
hydroxycholoroquine
use/MOA/AE
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)
hydroxycholoroquine administration
- SAFE during pregnancy
- yearly retinal exams
Azathioprine
use/MOA/AE
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
Azathioprine administration
-SAFE during pregnancy
biologics clearance
reticuloendothelial system
don’t need to worry about organ related damage
biologics administration
-IM, subQ, or IV
biologics general principles
- newer DMARDs
- parenteral admin
- admin rxns
- infections
- cost
- CHF (fluid retention)
- neuro dz (MS)
- malignancy
etanercept
anti-TNF
prednisone AE
- infections
- hypERglycemia
- osteoporosis
- weight gain
T/F
Prednisone commonly causes bronchospasm.
F
relieves leukotrienes
targets CD20
rituximab
IL-6 inhibitor
tocilizumab
JAK kinase inhibitor
tofacitinib
duloxetine
SNRI
use: fibromyalgia
tx of type III glomerulonephritis
mycophenolate or cyclophosphamide