Summer 14 Final Flashcards
What is the lowest potency corticosteroid?
hydrocortisone 1% is lowest potency
What is the immune response modifier used for topically for basal cell carcinoma?
imiquimod
What is the topical treatment for skin cancer that is a pyrimidine antimetabolite?
5-fluorouracil
Which treatment for acne is keratolytic? Which is OTC? What is the level of acne it is used for?
benzoyl peroxide
benzoyl peroxide
mild or mod-severe w/ abx
What is used for severe acne? What type of drug is it? What is special about using it?
accutane and anti androgens (spironolactone)
retinoid
need to sign ipledge before taking
What type of drug is tazarotene? What is it used for?
retinoid
psoriasis and acne
Which abx are used in acne?
tetracycline (minocycline)
Which level severity are anti androgens used for in acne? Example of one?
severe- spironolactone
What type of drug that is used for psoriasis is a topical VitD3 analog?
calcipotriol
What is cyclosporine used for and what type of drug is it?
psoriasis
immunomodulator- calciurein inhibitor
What is etanercept used for and what type of drug is it?
psoriasis
BMR- TNF inhibitor
Which severity of psoriasis are topical agents used for?
mild to moderate
What bacteria do erysipilas and impetigo have in common?
strep pyogenes
How do you treat CA MRSA?
doxycycline, bactrim, or clindamycin
How can you treat folliculitis?
benzyl peroxide
How can you treat erysipelas?
erythromycin
What is muprocin used for? What does it cover? What is retapamulin used for? What does it cover?
impetigo
gram + and MRSA
only MSSA (staph a and strep pyogenes)
What causes gas gangrene? How do you treat?
clostridium spp.
clindamycin or penicillin
How do you treat cellulitis?
clindamycin
What is an OTC treatment for vulvovaginal candidiasis?
clotrimazole
What drug can you use for onychomycosis? Which drug has a narrow spectrum of action and high relapse rate?
terbinatine
griseofulvin
Which is the prodrug- valacyclovir or acyclovir?
valacyclovir
If the patient has vomiting and a migraine, what drug should you make sure to include?
antiemetic (metoclopramide, chlorpromazine, prochlorperazine)
What drug should you also use if you are using ergot for migraine?
anti-emetic d/t side effect of nausea—> use antemetic 15 min before ergot
When are ergots contraindicated?
MI pts, uncontrolled HTN
w/in 24 hours of triptans
When are triptans contraindicated?
ischeimc heart disease, uncontrolled HTN, cerebrovascular disease
with macrolides
Which drugs are used for prophylaxis treatment of migraines?
petasites, propanolol, and riboflavin
Which drug is used as prophylaxis for cluster headaches?
verapamil
Which drug is used for OD of opioids?
naloxone
What is one sx everyone on opioids experiences?
constipation
Which drugs that are used for seizures can auto induce?
carbamezapine, oxycarbamezapine
What is a common side effect with carbamezapine?
hyponatremia
What is a common side effect with lamotrigene?
rash
Which drug is for absence seizures?
Ethosuximide
Which drug is used is neonates for seizures?
phenobarbitals
Which drugs are ok to use in hepatic failure patients?
gabapentin and levetiracetam
Which drug is bad in hepatic failure patients?
phenytoin
Which drug is used in acute attacks of MS?
methylprednisone
Which is the preferred treatment for MS?
interferon B (improve mortality)
What is a side effect of interferon beta?
flu like symptoms
What is a side effect of glatiramer?
eosinophilia
Which is an oral drug for MS?
fingolimod
What is a side effect of leukoencephalopathy?
natalizumab
What is a side effect of mitoxatrone?
cardiotoxicit
Which is a drug for MS that is a GABA-B analog and is used for mm relaxation?x
baclofen
What drug can be used for neuropathic pain in MS?
gabapentin
Which drug for Parkinson’s can increase compulsions? What type of drug is it?
bromocriptine
ergot (DA agonist)
What effect do COX 2 inhibitors have on PGI2? What effect do they have on TXA2?
decrease PGI2
no effect on TXA2
What effect do COX 2 inhibitors have on GI and inflammation?
anti-inflammatory w/ minimal risk to GI
Which is cardioprotective- aspirin or ibuprofen?
aspirin is
What is a complication of subarachnoid hemorrhage? Which drug can prevent this?
DCI
nimodipine
What is the dosing for t-PA?
0.9 mg/kg over 1 hour with a 10% bolus in the first 1 min. (max dose is 90mg)
What are the absolute exclusion criteria for giving t-PA?
hx of intracerebral hemorrhage
improving symptoms
What are the relative exclusion criteria for giving t-PA?
age >80 years
taking oral anti-coags
hx of DMT2 and prior ischemic stroke
Which drug can you give if there is an aspirin allergy? if they have a-fib but no coumadin?
plavix (aggrenox has aspirin in it)
pradexa or rivoaroxaban or apixaban
When do you give statins?
all the time no matter the LDL level
What is the point of permissive HTN?
allow transient cerebral brain perfusion
When do you give SSRIs?
first line in late onset depression
What two drugs together can cause serotonin syndrome?
zoloft (any SSRI) and mirtazapine (tetracyclic)
but don’t discontinue mirtazapine if starting zoloft unless side effect that is dose dependent
Which anti-depressant is for neuropathic pain and sedation?
TCA
Which drug is good for smoking cessation?
wellbutrin
Which drug is good for loss of appetite?
mitrazapine
Which drug causes a HTN crisis if eaten with tyramine rich foods?
MAO-I
Which drug is good fro agitation and positive psychotic symptoms?
quetiapine
Which drugs are first generations v second generations AP?
first: haloperidol and chlorpromazine
second: olazapine, risperidone, quetiapine, ziprasidone, clonzapine\
Which drugs cause hyperprolactinemia?
first generations, risperidone, (switch to aripiprazole or ziprasidone)
Which drugs cause a new onset DMT2?
olanzapine, clozapine, risperidone, quetiapine
Which drug causes neutropenia?
clonzapine
What do you need to keep an eye on with lithium for bipolar?
decreased thyroid hormone synthesis
What drug could increase lithium levels when combined?
NSAIDs
Which drugs decrease the risk for metabolic syndrome?
risperidone, ziprasidone, aripiprazole
What is the benzo MOA? Can they be used in seizure prevention?
increase GABA binding
yes
What are the safe benzos for liver failure?
Lorazepam, Oxazepam, Temazepam
Which benzos are short acting, intermediate acting, and long acting?
short: midazolam, tiazolom
intermediate: alprazolam, clonazepam, LOT
long: chlorodiazepoxide, diazepem, florazepam
long: chlorodiazepoxide, diazepem, florazepam
What is the MOA of amphetamines for ADHD?
increase catecholamines (DA, epi)
Which drug is for ADHD that is not a stimulant?
atomoxetine
How can you treat PTSD? Which drugs to avoid?
SSRI like sertraline or paroxetine
benzos
What is an OTC drug for insomnia?
melatonin
Which type of patients should you avoid using benzos in for sleep disorders? What is the time frame for using benzos?
pregnancy, sleep apnea
short term
Which is a prodrug for narcolepsy that has a faster onset of action and less chance for side effects?
lisdexamfetamine
What is a stimulant used for narcolepsy that treats EDS?
modafinil
What is A1C goal?
<7%
What is the goal for blood glucose on med floor? ICU? outpatient?
140
180
130
When would you prefer the use of insulin over oral therapy?
when blood glucose is over 500
What is the first choice drug for outpatient?
metformin
What is a side effect of that drug? MOA? When is it contraindicated?
GI discomfort
increase sensitivity to insulin
if serum creatinine is greater than 1.4 in females and 1.5 in males
What is a second line drug? Side effect? How much does it reduce A1C?
sulfonylureas
hypoglycemia, weight gain, hyponatremia
1.5-2%
What effect does insulin have on K? What are the side effects of insulin?
causes K to go into the cell
hypoglycemia, weight gain, lipodystrophy
Which drug worsens gastroparesis?
liraglutide
Which drugs can be used in type I diabetes?
pramlintide and insulin
What is the MOA of exenatide? What is its main side effect?
GLP-1 agonist—> increases insulin secretion
nausea
Which drug interferes with bactrim?
repaglinide and nateglinide
Which drug causes the retention of fluids (like in CHF you would want to avoid it)?
TZDs- pioglitazone and rosipglitazone
What is the MOA of TZDs?
PPAR gamma receptor
How much do TZDs lower A1C by?
1.5%
Which drug decreases triglycerides?
pioglitazone
What type of drug is sitagliptin?
DP4- Inhibitor
Which drug is not used much d/t flatulence?
alpha glucosidase inhibitors (acarbose and miglitol)
What are the side effects of dapagliflozan?
UTI, vulvovaginal mycotic infections, hypovolemia
What are the steps for therapy according to the guidelines?
first metformin then insulin then other orals if still not working 3-6 months later
What should you adjust if a patient notice morning hyperglycemia?
bedtime basal dose
Which insulin is the closest to physiologic insulin?
long acting
When is PTU the preferred therapy?
first trimester of pregnancy
What is different between PTU and MMI?
MMU is 10x more potent b.c not bound to protein
Which is the preferred therapy for Grave’s disease treatment?
radioactive iodine
When is RAI contraindicated?
pregnancy
What is the preferred treatment for hypothyroidism? What interaction do you need to be aware of?
levothyroxine (T4)
Ca
What is the ratio of prednisone to dexamethasone?
prednisone (5 mg) to dexamethasone (0.75 mg)
How many days do you have to be taking steroids before you need to taper doses?
> 5 days
Which drug is an anti-progesterone agent?
mifepristone
What drug would you use in the ICU (acutely) for decreasing steroids/cortisol?
etomidate
Which drug causes an increase in androgen? What are the side effects of that?
metyrapone
hirsutism and acne
Which drug is sedating and causes weight gain?
cryoproheptadine
Which drug is a GHR antagonist?
pegvisomat
What do you need to monitor with this drug?
LFTs
Which drug increases the risk of gallstones via inhibiting the release of CCK?
octreotide
Which drug is god for prolactinomas and GH?
cabergoline
