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Ultimate Sadness > Study Gal Tips and Key Drugs > Flashcards

Study Gal Tips and Key Drugs Flashcards

1
Q

Capecitabine active metabolite

A

fluorouraciil

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2
Q

clopidogrel active metaolite

A

just know that it is metabolized into an active metabolite by CYP2C19 enzymes

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3
Q

codeine active metabolite

A

metabolized into morphine by CYP2D6

CYP2D6 ultra-rapid metabolizers change it into morphine too fast, tox risk

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4
Q

Colistimethate active metabolite

A

colistin

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5
Q

Cortisone active metabolite

A

cortisol

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6
Q

famciclovir active metabolite

A

penciclovir

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7
Q

fosphenytoin active metabolite

A

phenytoin

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8
Q

Isavuconazonium sulfate active metabolite

A

isavuconazole

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9
Q

levodopa active metabolite

A

dopamine

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10
Q

lisdexamfetamine active metabolite

A

dextroamphetamine

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11
Q

prednisone active metabolite

A

prednisolone

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12
Q

primidone active metabolite

A

phenobarbital

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13
Q

tramadol active metabolite

A

just know it has one

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14
Q

valacyclovir active metabolite

A

acyclovir

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15
Q

valganciclovir active metabolite

A

ganciclovir

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16
Q

Common CYP inducers involved in drug interactions

A

PS PORCS

  • phenytoin
  • smoking
  • phenobarbital
  • oxcarbazepine
  • rifampin (rifabutin, rifapentine)
  • carbazepime
  • st. john’s wort
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17
Q

Patches that can be applied twice a day

A

diclofenac

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18
Q

Patches that can be applied daily

A
  • Methylphenidate (Daytrana) - apply 2hr before school
  • Nicotine (NicoDerm CQ)
  • Rivastigmine (Exelon)
  • Rotigotine (Neupro)
  • Selegiline (Emsam)
  • Testosterone (Androderm) - apply HS, NOT to scrotum
  • Lidocaine - on for 12hr, off for 12hr PRN
  • Nitroglycerin - on for 12-14hr, off fr 10-12hr
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19
Q

Patches that can be applied Q72H

every 3 days

A
  • fentanyl (but if it wears off after 48hrrs can change to q48h)
  • scopolamine (Transderm Scop) - PRN
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20
Q

Patches that can be applied twice a week

A
  • Estradiol (Alora, Vivelle-Dot) - can applied twice a week continously or in cycles of 3 weeks on, 1 week off
  • Oxybutynin (Oxytrol)
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21
Q

Patches that can be applied weekly

A
  • Donepezil (Adlarity)
  • Buprenorphine (Butrans)
  • Clonidine (Catapress-TTS)
  • Estradiol (Climara) - can be applied continously or in cycles of 3 weeks on, 1 week off
  • Estradiol/Levonorgestrel
  • Ethinyl etradiol/norelgestromin (Xulane, Zafemy) - in cycles of 3 weeks on, 1 week off
  • Ethinyl estradiol/levonorgestrel (Twirla) - in cycles of 3 weeks on, 1 week off
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22
Q

Drugs that require non-PVC containers

A

LATTIN (Leach Asorbs To Take In Nutrients)

  • lorazpam
  • Amiodarone
  • Tacrolimus
  • Taxanes (exception: paclitaxel-albumin bound can do PVC)
  • Insulin
  • Nitroglycerin
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23
Q

Drugs to mix in saline only

A

ADIACEP (A DIAbetic Can’t Eat Pie)

  • ampicillin (much shorter stability in dextrose)
  • daptomycin
  • infliximab
  • amp/sul
  • caspofungin (Cancidas)
  • ertapenem (Invanz)
  • phenytoin (Dilantin)
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24
Q

Drugs to mix in dextrose only

A

OSA (Only Sugar Always)

  • oxalipltin
  • smx/tmp
  • amphotericin B (all)
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25
Q

what injectables should NOT be mixed with Ca

A
  • ceftriaxone
  • phosphate - if making TPN phosphate first, Ca last

remember that LR contains Ca, don’t do LR with CTX

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26
Q

Drugs that require filters

A

my GAL Is PAT who has a MaP
- Golimumab
- Amphotericin B (lipid formulations) - needs a 5 micron filter
- Isavuconazoium
- Phenytoin - filter only required for continuous infusion, NOT IV push
- Amiodarone
- Taxanes
- Mannitol >20%
- Parenteral nutrition - 1.2 micron filter

also
- abatacept
- select albumin products
- antithymocyte globulin
- infliximab

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27
Q

Injectable drugs that should NOT be refrigerated

A

Dear Sweet Pharmacist, Freezing Makes Me Edgy
- Dexmetodomidine
- Smx/tmp
- Phenytoin - crystallzies
- Furosemide - crystallizes
- Metronidazole
- Moxifloxacin
- Enoxaparin

also
- APAP
- acyclovir - crystallizes
- deferoxamine - precipitates
- levetiraceta
- pentaidine - crystallizes
- valproate

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28
Q

Injectable drugs that need to be protected from light

A

Protect Every Necessary Med from Daylight
- Phytonadine (VitK)
- Epoprosteol
- Nitroprusside
- Micafungin
- Doxycycline

also
- amohtericine B deoxycholate
- anthracyclines
- dacarbazine - if it extravasates, protect exposed tissues from light
- pentamidine

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29
Q

How to look for med problems in a pt case

A
  • untreated condition
  • meds without an indication
  • improper drug selecgion
  • improper dose
  • therapeutic duplication
  • lack of pt understanding
  • drug allergy
  • drug interaction
  • improper use of med
  • failure to receive med
  • adverse drug reaction
  • nonadherence
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30
Q

Aminophylline - theophylline dose conversion

A

aminophylline x 0.8 = theophylline

ATM (aminophylline to theophylline, multiply)

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31
Q

Calcium salts dose conversion

A
  • calcium carb = 40% elemental Ca
  • calcium citrate = 21% elemental Ca
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32
Q

iron salts dose conversion

A
  • Fe gluconate - 12% elemental Fe
  • Fe sulfate - 20%
  • Ferrous sulfate, dried (ER) - 30%
  • Ferrous fumarate - 33%
  • Carbonyl iron - 100%
  • Polysaccharide iron complex - 100%
  • Ferric maltol - 100%
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33
Q

loop diuretic dose converson

A

the following are PO equivalent doses

bumetaanide and ethacrynic acid have IV:PO 1:1, furosemide IV:PO = 1:2

  • furosemide 40mg
  • torsemide 20mg
  • bumetanide 1mg
  • ethacrynica acid 50mg
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34
Q

opioid dose conversioin

A

the following are equivalent:
- morphine: 10mg IV = 30mg PO
- hydromorhine: 1.5mg IV = 7.5mg PO
- oxycodone: NA IV = 20mg PO
- hydrocodone: NA IV = 30mg PO
- codeine: 130mg IV = 200mg PO
- fentanyl: 0.1mg IV = NA PO
- meperidine: 75mg IV = 300mg PO
- oxymorphone: 1mg IV = 10mg PO

to convert, calculate the 24 hr dosse and reduce dose by 25% for cross tolerance (if the exam does NOT specify to reduce, do NOT)

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35
Q

statin equivalent doses

A
  • pitavastatin 2mg
  • rosuvastatin 5mg
  • atorvastatin 10mg
  • simvastatin 20mg
  • lovastatin 40mg
  • pravstatin 40mg
  • fluvastatin 80mg
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36
Q

metoprolol IV:PO dose conversion

A

IV:PO 1:2.5

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37
Q

levothyroxine IV:PO dose conversion

A

IV:PO 0.75:1

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38
Q

ratio strength to percent strength

A

% strength = 100 / ratio strength

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39
Q

dissociation particles vs. valence

A
  • valence: outer electrons/bonds that can be made
  • dissociation particles: number of particles made by breaking something apart

  • NaCl: 1 bond therefore 1 valence; Na and Cl therefore 2 particles
  • CaCl2: 2 bonds therefore 2 valence; Ca and 2 Cl therefore 3 particles
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40
Q

carbs kcal/gram

A

4 kcal/gram

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41
Q

fat kcal/gram

A

9 kcal/gram

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42
Q

protein kcal/gram

A

4 kcal/gram

43
Q

dextrose monohydrate kcal/gram

A

3.4 kcal/gram

44
Q

glycerol/glycerin kcal/gram

A

4.3 kcal/gram

45
Q

injectable lipid emulsion (ILE) 10% kcal/mL

A

1.1 kcal/mL

46
Q

injectable lipid emulsion (ILE) 20% kcal/mL

47
Q

injectable lipid emulsion (30%) kcal/mL

48
Q

amino acid solutions kcal/gram

`

A

4 kcal/gram

49
Q

how to interpret ABG (acidosis vs alkalosis)

A
  1. low pH is acidosis, high pH is alkalosis
  2. if there is a change in CO2 it has a respiratory origin; if there is a change in HCO3 it has a etabolic origin
  3. if both CO2 and HCO3 are abnormal, see which abnormality matches the pH, the other value is compensatory (CO2 is acidic, HCO3is basic)
50
Q

rounding when calculating NNT and NNH

A
  • always round up for NNT: 1.2 -> 2
  • always round down for NNH: 1.2 -> 1
51
Q

what is covered in USP 795

A

nonsterile (hazardous and non hazardous)

52
Q

what is covered in USP 800

A

hazardous (sterile and nonsterile)

53
Q

what is covered in USP 797

A

sterile (hazardous and nonhazardous)

54
Q

torsion balances

A

Class III (Class A) torsion balances require outside wts to determine a wt >1 gram and has interal weights for < 1gram

has a sensitivity requirement that is typically 6mg -> based on a standard acceptable error of 5%, the minimal weighable quanitity is 120mg

55
Q

Ora-Plus vs. Ora-Sweet

A

Ora-Plus
- keeps drug particles susended, prevents them from settling
- bland taste, must be combined with Ora-Sweet

Ora-Sweet
- simple to simple syrup
- provides flavor
- available in sugar-free formulations

56
Q

HLB number

A
  • HLB scale ranges from 0 to 20
  • Surfactants with an HLB number < 10 are ore lipid soluble and used for water in oil emulsions
  • If > 10, more water solule and used for oil in water emulsions
57
Q

When compounding, what patient population should alcohol be avoided in?

A

children

alcohol is used as a solvent

58
Q

When compounding, what patient population should aspartame be avoided in?

A

aspartame containes phenylalanine, avoid in patients with phenylketonuria (PKU), they are uunable to metabolize the phenylalanine

aspartame is used as a sweetner

59
Q

When compounding, what patient population should gelatin be avoided in?

A

anyone who wishes to avoid animal products

can use hypromellose capsule shells which are made from cellulose and are therefore vegan

60
Q

When compounding, what patient population should gluten be avoided in?

A

patients with celiacs and those who wish to avoid gluten

gluten is used as a starch (filler) and is in wheat, barley and rye - may use corn or potato starch or tapioca

61
Q

When compounding, what patient population should lactose be avoided in?

A

lactose intolerance or allergy

lactose is used as a sweetner, to compress tablets, and as a filler/diluent

62
Q

When compounding, what patient population should preservatives be avoided in?

63
Q

When compounding, what patient population should sorbitol be avoided in?

A

IBS (sorbitol can cause GI stress)

sorbitol is used as a sweetner

64
Q

When compounding, what patient population should sucrose be avoided in?

A

diabetics (depending on the amount)

sucrose (table sugar) is used as a sweetner and in coatings

66
Q

When compounding, what patient population should xylitol be avoided in?

A
  • dogs (it can cause xylitol toxicosis - hypoglycemia and hepatotox)
  • humans with hx of GI upset with xylitol use

xylitol is used as a sweetner

67
Q

how to prepare a solution

A
  1. gather ingredients
  2. reduce particle size o fine powder
  3. dissolve solute in solvent
  4. Add any required excipients: buffer, preservative, flavors, sweetners, coloring
  5. package and apply BUD with apropriate auxiliary labets

dissolution rate can be increased if the particles are smaller, if the preparation is stirred or if heat is applied

68
Q

how to prepare a suspension

A
  1. gather ingredients
  2. reduce particle size to fine powder
  3. wet powder ad levigate to form paste
  4. continue to add in liquid in portions
  5. add in surfactant to keep suspension dispersed
  6. transfer to dispensing container and QS the volume
  7. add any required excipients: preservatives, flavor, sweetneres
  8. package and apply BUD - make sure to include a shake sticker
69
Q

how to prepare emulsions

dry gum method (continental method)

A
  1. levigate gum with oil
  2. add water all at once
  3. triturate by shaking in a bottle or ixing in a mortar until a cracking sound is heard and mixture is creamy white
  4. add other ingredients by dissolving them first in solution and QS with water up to final volume
  5. homogenize with a homogenizer machine
70
Q

how to prepare an emulsion

wet gum method (english method)

A
  1. triturate the gum with water to form a mucilage (thick and sticky like mucus)
  2. add oil in slowly while shaking or mixing
  3. add other ingredients by dissolving them first in solution and QS with water up to final volume
  4. homogenize with a homogenizer machine
71
Q

how to prepare a molded tablet

A
  1. triturate the dry ingredients and mix by geometric dilution
  2. add alcohol and/or water to moisten the powder (should be a pasty consistency)
  3. mold the paste into a tablet using tablet mold and allow to dry
72
Q

how to prepare ointments

A
  1. triturate powders well using a levigation agent which is miscible with base
  2. powder then mixed into ointmet base using geometric dilution

certain ointments need heat (called fusion)

73
Q

methods to prepare suppositories

A
  • hand molding
  • fusion molding
  • compression method
74
Q

non sterile BUD dates
- aqueous nonpreserved
- aqueous preserved
- nonaqueous oral liquid
- nonaqueous other forms

A
  • aqueous nonpreserved: 14 days in fridge
  • aqueous preserved: 35 days
  • nonaqueous oral liquid: 90 days
  • nonaqueous other forms: 180 days

aqueus: Aw > 0.6
nonaqueous: Aw < 0.6

75
Q

master formulation record vs. compounding record

A
  • master formulation record: wht you should do
  • compounding record: what yu did
76
Q

CSP

A

compounded sterile product

77
Q

SVP

A

small volume pareteral (IV bag 100mL or less)

78
Q

LVP

A

large volume parenteral (>100mL)

79
Q

PPE

A

personal protective equipent

80
Q

PEC

A

primary engineering control - sterile hood that provides ISO 5 air

81
Q

LAFW

A

laminar airflow workbench

82
Q

SEC

A

ssecodary engineering control - room ontaining ISO 7 air where PEC is located (buffer room)

83
Q

SCA

A

segrated compounding area - contains a PEC but is not an SEC

84
Q

CAI

A

compounding aseptic isolator - a closed front PEC used for nonhazardous drugs

85
Q

RABS

A

restrited access barrier system - any closed front PEC, used for either hazardous or nonhazardous (CAI)

“glovebox”

86
Q

ISO air requirements

A
  • PEC: ISO 5
  • SEC: ISO 7
  • anteroom: ISO 7 or 8 - dt positive pressure, can have ISO 8 because the air is blowing out of the SEC into the anteroom (therefore anteroom can have dirtier air)

if being used to compound hazadous materials, the anteroom must be ISO 7

87
Q

Sterile product BUDs
- immediate use - made outside of PEC but with aseptic technique
- category 1 - made in a PEC located in an SCA
- category 2 - made in a PEC located in an SEC
- category 3 - made in a PEC located in an SEC with additional requirements

A
  • immediate use: 4 hours no matter how it is sstored
  • category 1: 12 hrs at room temp **/ ** 24 in fridge
  • category 2: up to 45 days at room temp / 60 in fridge / 90 if frozen
  • category 3: up to 90 days at room temp / 120 in fridge / 180 in freezer
88
Q

important 5 alpha-reductase inhibitors on the NIOSH list

A
  • dutasteride
  • finasteride
89
Q

important abortifacients on the NIOSH list

A
  • mifepristone
  • misoprostol
90
Q

important anticoag on the NIOSH list

91
Q

important antivirals on the NIOSH list

A
  • cidofovir
  • ganiciclvor
  • valganciclovir
92
Q

important antiseizure meds on the NIOSH list

A
  • CBZ
  • oxCBZ
  • foshenytoin
  • phenytoin
  • topiramate
  • valproate
93
Q

important benzos on the NIOSH list

A
  • clonazeam
  • temazepam
94
Q

important dyslipidemia meds on the NIOSH list

A

lomitapide

95
Q

important heart failure meds on the NIOSH list

A

spironolactone

96
Q

important hepatitis meds on the NIOSH list

97
Q

important pulmonary arterial HTN meds on the NIOSH list

A
  • ambrisentan
  • bosentan
  • macitentan
  • riociguat
98
Q

important retinoic acid deritvatives on the NIOSH list

99
Q

important SSRIs on the NIOSH list

A

paroxetine

100
Q

important thionamides on the NIOSH list

A
  • methimazole
  • propylthiouracil
101
Q

important transplant meds on the NIOSH list

A
  • cyclosporine
  • mycophenolate
  • tacrolimus
  • sirolimus
102
Q

important meds to treat autoimmune conditions on the NIOSH list

A
  • acitretin
  • azathioprine
  • fingolimod
  • leflunomide
  • teriflunomide
103
Q

important hormonal agents on the NIOSH list

A
  • androgens
  • estrogens
  • oxytocin
  • progestins
  • SERD/SERMS
  • ulipristal

Ultimate Sadness (9 decks)

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