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NAPLEX Prep > Review in class > Flashcards

Review in class Flashcards

1
Q

How fast can you give potassium to someone?

What is the corrected calcium level equation?

Do you have to give calcium chloride through a central line?

A

40 mEq in life threatening through central. 10 is fastest peripheral and can give 20 in central if non life threatening.

(.8 X (normal albumin - patients albumin)) + serum Ca level

YES

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2
Q

When do you give k phos?

Do you have to give phosphate binders with food?

What is MCV normal range and difference between macro and micro?

A

Less than 4, if greater than 4 give sodium phosphate.

YES

80-96. B12 and folate deficiency cause MACROcyctic anemia. Low MCV means iron deficiency, anemia of chronic disease is normally normal MCV.

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3
Q

Will hypothyroidism have low FT4?

Will hyperthyroidism have high T3?

What are the common causes of seizures?

A

YES

YES

80% is unknown. Rest is VITAMINS(Vascular(stroke), infection, trauma, AV malformation, metabolic/toxic, idiopathic, neoplasm, psychiatric).

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4
Q

What drugs increase seizure risk?

What is the therapeutic range for phenytoin and what to know about it?

What to know about carbamazepine (tegretol)?

A

Bupropion(wellbutrin, zyban), meperidine (demerol), tramadol (ultram), tapentadol (nucynta), theophylline, cocaine, carbapenems/beta-lactams when not adjusted for renal impairment.

Dilantin is phenytoin, Cerebryx is fosphenytoin. 10-20 mcg/mL. Can give IM(Fosphenytoin). Adverse effects is nystagmus, drowsiness, ataxia, diplopia, hyperplasia, hirsutism, HLA-B 1502 mutation. Can only give phenytoin IV 50 mg/min, Fosphenytoin IV 150 mg PE/min.

Autoinducer, HLA-B 1502 high RASH. 4-12 concentration. Watch for blood disorders.

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5
Q

What’s the corrected phenytoin calculation?

What to know about Depakote?

What to know about phenobarbital?

A

Total phenytoin/ (0.2 x albumin) + 0.1))

Migraine prophylaxis and bipolar and seizures. Need to taper. AVoid in pregnancy, pancreatitis, liver disorder. Valproate doubles concentrations of carbapenems and lamotrigine. Watch for hair loss.

Used in neonatal seizure. Primidone metabolized to phenobarb (familial tremor).

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6
Q

What is used for absence seizures?

What is 1st drug choice in status epilepticus and what else to know about benzos?

What to know about Gabapentin?

A

Ethosuximide (Zarontin). Limited drug interaction potential and eliminated by liver.

IV Lorazepam. Diazepam rectal. Most sedating AED’s. Use versed (midalozam) in IV benzos drip.

Neurontin. Peripheral edema, somnolence, dizziness, weight gain, movement disorders, nystagmus, blurred vision. Can use for chronic pain and hot flashes and migraine prophylaxis. Gralise is once daily, Gabapentin encarbil Horizant.

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7
Q

What to know about Lamictal?

What to know about Topiramate?

What to know about Levetiracetam?

A

Lamotrigine, well tolerated, no other drug interactions, Most serious ADR is RASH, dipolopia, drowsiness, insomnia, headache, and tics.

Topamax, Dose adjust kidneys, inhibits carbonic anhydrase and can cause kidney stones and metabolic acidosis. Do not use with zonisamide and acetazolamide, can cause severe cognitive impairment, migraine prophylaxis and seizures. Qudexy and Trokendi XR are once daily formulations.

Keppra crazies. No significant drug interactions. ODT is spritam.

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8
Q

What to know about oxcarbazepine?

What can zonisamide cause?

When to use felbamate?

A

Used off label for bipolar and trigeminal neuralgia. Decreases bioavailability of oral contraceptives.

Metabolic acidosis and kidney stones (encourage hydration)

When all other are used, informed consent.

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9
Q

What to know about Lacosamide?

What to know about perampanel?

What to know about Rufinamide?

A

Vimpat, Controlled substance (class V), causes PR prolongation.

Fycompa, dizziness, somnolence, psych issues is bad.

Banzel. Can shorten QT(don’t use with digoxin and mag). Used with Lennox gastaut

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10
Q

What to know about vigabatrin?

What is aptiom?

What is Briviact?

A

Sabril. Visual field loss problems.

Eslicarbazepine. Watch for heart rate Multi organ hypersensitivity syndrome.

Brivaracetam.

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11
Q

What to know about clopidogrel?

What is an absolute CI in prasugrel?

What are the big adverse effects of Ticagrelor?

A

Metabolized to active form. Delayed onset and reduced efficacy in CYP2C19 poor metabolizers. DI with PPI’s.

TIA/stroke previous, >75, <60 kgs.

Brilinta, Dyspnea, Bradycardia ADEs.

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12
Q

What to know about the G2b/3a receptor antagonists?

What is heparin dosing?

What is heparins reversal agent?

A

Tirofiban, Eptifibatide. Reversible inhibition. Thrombocytopenia.

5000 SQ every 8 hours for prophylaxis. Treatment is 80 units/kg IV followed by 18 units/kg/hr. Can give SC.

Protamine. 1 mg IV per 100 units of heparin.

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13
Q

What are your LMWH?

When are LMWH CI’d?

What do you change therapy to with HIT?

A

Dalteparin- Fragmin. Enoxaparin- Lovenox. Use anti-Xa assay.

Active bleeding, heparin hypersensitivity, thrombocytopenia, spinal hematoma.

Fondaparinux, bivalirudin/argatroban.

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14
Q

What is fondaparinux?

What to know about bivalirudin?

Are there liver things in argatroban?

A

Can use in heparin allergy. Arixtra. Renally cleared so if CrCl <30 can’t use.

Reduce dose to 1 mg/kg/hr with CrCl <30 mL/min.

Yes, if liver dysfunction must lower dose.

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15
Q

What factors do warfarin affect?

What are goal INR’s for warfarin?

What are your warfarin drug interactions?

A

2,7,9,10,Protein C and S.

2-3 for VTE/PE. 2.5-3.5 for mechanical valve or post- MI.

Bactrim, metronidazole, antifungals(fluconazole), analgesics, anticonvulsants(carbamazepine), antiarrhythmics(amiodarone), alcohol. Rifampin.

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16
Q

When is dabigatran (pradaxa) CI’d?

What reverses dabigatran?

What to know about Rivaroxaban (Xarelto)?

A

Active bleeding, mechanical valve, Renal failure CrCl <15 mL/min.

Idarucizumab. Oral capsule(can’t open it).

CrCl <50 mL./min needs to be 15 mg PO once daily. Treatment of chronic CAD/PAD is 2.5 mg twice daily in combination with 81 mg of aspirin daily.

17
Q

What do you need to know about edoxaban?

What therapy treats Acute Coronary Syndrome?

Do you give NSAIDS or Celecoxib to anyone with ACS?

A

Savaysa, if good kidney function (>95 mL/min), don’t recommend for AFIB.

MONA.

Heck naw

18
Q

When are patients on prasugrel (effient) stopping prior to surgery?

What’s the limit of ticagrelor while on aspirin?

Why should statins be given before a PCI?

A

7 days prior. Major bleeding can happen in patients >75, <60 kg, prior TIA/stroke.

Should not receive more than 81 mg. Reversible.

High intensity (atorvastatin 80 or rosuvastatin 40). Helps prevent periprocedural MI.

19
Q

What to know about Nitroglycerin?

When are beta blockers CI’d?

What are beta blocker AE’s?

A

PDE-5 inhibitors CI’d. Do not use in right sided infarcts.

Pheochromocytoma, hypersensitive, 2nd and 3rd degree heart block, severe sinus bradycardia.

Fatigue, erectile dysfunction, hypotension, etc.

20
Q

Can beta blockers affect glucose?

Do you avoid CCB’s in heart failure?

What are ACEI side effects?

A

Yes.

Yes.

Cough, Renal insufficiency, hypotension, hyperkalemia, angioedema.

21
Q

What are the names of diltiazem?

What are the names of verapamil?

What drugs can cause gout?

A

Cardizem, Dilacor, Tiazac.

Isoptin, Calan, Covera, Verelan.

Thiazide diuretics, niacin, pyrazinamide, cyclosporine, tacrolimus, ethanol, ethambutol, cytotoxic drugs, levodopa. salicylates (<2 g/day)

22
Q

What’s the pediatric dose of acetaminophen?

What to know about meperidine?

Does methadone prolong the QT?

A

10/15 mg/kg/dose every 4 to 6 hours.

Pancreatitis, Allergies, drug-or blood product induced rigors, postanesthesia shivering is where it thrives.

Yes

23
Q

Can you drive at night while taking ivabradine?

What is the CD4 cut off for AIDS?

What are the principles of HIV therapy?

A

No

<200 or develop AIDS defining illness indicates AIDS

Week 25 need <50 copies per mL. CD4 should increase 150 cells/mL in first year. Failure is >200 copies/mL, <25-50 cells/mL, occurrence/recurrence of HIV related event.

24
Q

What are your naive HIV patient treatments?

What are the classwide side effects of NRTI’s?

What are the CrCl cut offs for Tenofovir?

A

PI-based with Darunavir + Ritonavir + TDF. INSTI is Genvoya, Stribild, Raltegrativr + TDF or TAF and emtricitabine, Dolutegravir + abacavir/lamivudine or TDF/emtricitabine or TAF/emtricitabine

Lactic acidosis, hepatic steatosis, lipodystrophy, hyperlipidemia

TAF has less nephrotoxicity and less bone mineral density. TAF is <30 CrCl, TDF is <60.

25
Q

What is emtricitabine unique side effect?

What drug do you use to decrease HIV transmission during birth?

What to know about HLAB-5701 drug testing?

A

Hyperpigmentation of palms/soles of hands and feet.

IV Zidovudine.

You MUST test this with Abacavir. Only NRTI that doesn’t need renal dose adjustment.

26
Q

What to know about Abacavir?

What are the classwide side effects of the NNRTI’s?

What are Efavirenz’s side effects?

A

Epzicom is combination, Only NRTI that doesn’t need renal dose adjustment, Need HLAB-5701 testing.

RASH, DI’s with 3A4 inducers/inhibitors.substrates.

CNS toxicity so watch out when using Atripla.

27
Q

What to know about Nevirapine?

Do you need to eat Rilpivirine with a full meal and what drugs are CI’d with it?

What is Complera?

A

Do not use in women with CD4 count >250 or men with CD4 > 400 due to increased risk of hepatotoxicity.

Yes. CI’d with PPI.

TDF/Emtricitabine/Rilpivirine. HAVE to give with a meal and no PPI.

28
Q

What are class wide SE of PI’s?

What to know about Atazanavir?

Can you use dolutegravir with dofetilide?

A

Hyperlipidemia, Hyperglycemia, lots of CYP P450 3A4 inhibition.

Reyataz, can’t take more than 20 of PPI and take with food.

NO

29
Q

Can you give dofetilide with cimetidine?

What is ANC calculation?

What are the white count and ANC cut offs?

A

NO

WBC x (segmented neutrophils + band neutrophils)

WBC >3000 or ANC >1500 and platelet >100,000

30
Q

Does cholestyramine help with diarrhea?

What are the side effects of sulfonylureas?

How do you treat hypoglycemia on alpha-glucosidase inhibitors?

A

YES, use with dumping syndrome.

Weight gain and hypoglycemia, Renal CL–> watch for necessary adjustments.

Gel, can’t use normal glucose

31
Q

What are 1st generation cephalosporins coverage?

What organisms are resistant to cephalosporins?

A

Staph, Strep, PEK.

Enterococci, Listeria, and Chlamydia.

NAPLEX Prep (74 decks)

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