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NAPLEX BABY > THINGS I NEED TO KNOW & DONT > Flashcards

THINGS I NEED TO KNOW & DONT Flashcards

1
Q

corrected Ca formula

A

-use when albumin is < 3.5

Ca + [(4-albumin) *0.8]

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2
Q

Phenytoin corrected formula

A

-use when albumin is < 3.5

(total phenytoin measured) / (0.2 * albumin) + 0.1

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3
Q

What 2 formulas are used to predict drug concentration?

A

C2 = C1 * e^-kt

Ke= ln (c1/c2) / time

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4
Q

ICR & correction factor formulas for regular insulin

A

ICR = 450/ TDD = grams of carbs covered by 1 unit of insulin

CF: 1500/TDD = correction factor

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5
Q

ICR & correction factor formulas for rapid-acting insulin

A

ICR: 500/TDD = g of carbs covered by 1 unit of rapid acting insulin

CF: 1800/TDD = correction factor

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6
Q

formula for calculating insulin correction dose

A

BG now - target BG / correction factor

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7
Q

Commonly used drugs for specific organisms: MSSA

A

gram + clusters

-Dicloxicillin, nafcillin, oxacillin (no renal dosing needed)

-Cefazolin (IV/IM), cephalexin (po-keflex)

-Amoxicillin/clavulanate (PO/IV), ampicillin/sulbactam (NS only)

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8
Q

Commonly used drugs for specific organisms: MRSA

A

gram + clusters

-Vancomycin: 1st line if MIC < 2, (ototoxicity, hepatotoxicity)

-Linezolid: no renal dose (myelosuppression, serotonin syndrome, optic neuropathy)

-Daptomycin: NO DEXTROSE, (myopathy, rhabdomyolysis- CPK weekly)

-SMX/TMP (Bactrim): CA-MRSA SSTI (sulfa allergy, SJS/TENS, TTP, hemolytic anemia)

-Doxycycline, minocycline

-Clindamycin: no renal dose, D-test on S. aureus

(others: ceftoroline, tigacycline, mupirocoin, delfoxacin)

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9
Q

Commonly used drugs for specific organisms: Vancomycin-resistant Enterococcus (VRE)

A

gram + pairs & chains

-Pen G (IM ONLY) & ampicilin –> E. faecalis only

-Linezolid: no renal dose (myelosuppression, serotonin syndrome, optic neuropathy)

-Daptomycin: NO DEXTROSE, (myopathy, rhabdomyolysis- CPK weekly)

–> Cystitis only: Nitorfuranton (renal imapir crcl < 60, hemolytic anemia), fosomycin, doxycycline

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10
Q

Commonly used drugs for specific organisms: Atypical organisms

A

chlamydia, legionella, myoplasma pneumoniae, myobacterium tuberculosis

-azithromycin, clarithromycin (QT, hepatotoxicity)

-doxycycline, minocycline

-Quinolones [levo, cipro, moxifloxacin] (tendon rupture, QT, psych disturbances, hypo/hyperglycemia, photosensitivity)

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11
Q

Commonly used drugs for specific organisms: HNPEK

A

gram -s: H. influenzae, Neisseria, Proteus micobilis, E.coli, Klepsiella

-beta lactams/betalactamase (penicillins)

-Cephalosporins: cefuroxine, ceftotetan, cefoxitin, cefdinir, ceftriaxone, cefotuxine, ceftazidine, cefepime, ceftaroline)

-Carbapenems (meropenem, enteropenem)

-aminoglycosides (genta, tobra, amikacin) –> nephrotoxicty

-Quinolones [levo, cipro, moxifloxacin] (tendon rupture, QT, psych disturbances, hypo/hyperglycemia, photosensitivity)

-SMX/TMP (Bactrim): CA-MRSA SSTI (sulfa allergy, SJS/TENS, TTP, hemolytic anemia)

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12
Q

Commonly used drugs for specific organisms: Psuedomonas aerginosa

A

gram - rod

-pip/tazo (zyson)
-cefepime (4th gen)
-ceftazidime (3rd gen)
-ceftolozane/tazobactam
-ceftazidine/avibactam
-meropenem
-azteronam
-tobramycin
-colistimethate, polymixin B

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13
Q

Commonly used drugs for specific organisms: CAPES

A

**gram -s: Citrobacter, Acinobacter, Providencia, Enterobacter, Serratia)

-pip/tazo (zyosn)
-cefepime
-carbepenems
-aminoglycosides (genta. tpbra, amikacin)
-colistimethate, polymixin B

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14
Q

Commonly used drugs for specific organisms: ESBL

A

gram - rods: E.coli, k. pneumoniae, P. mirabilis)

-carbepenems
-ceftazidime/avibactam
-ceftrolozane/tazobactam

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15
Q

Commonly used drugs for specific organisms: Carbepenem resistant gram - rods (CRE)

A

-ceftazidime/avibactam
-colistimethate, polymixin B
-meropenem/vaboractam
-imiperem/cilastitin/relebactam

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16
Q

Commonly used drugs for specific organisms: Gram - anaerobes (B. fagiilis)

A

-metronidazole. (disulfiram rxn with alcohol)
-beta lactams
-ceftetan (disulfiram rxn), cefoxitin
-carbapenems
-moxiflixacin

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17
Q

Commonly used drugs for specific organisms: C. difficile

A

-Vancomycin (PO)
-Fidaxomicin
-metronidazole (disulfiram rxn with alcohol)

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18
Q

Preferred HIV initial tx for t naive pts: 1 pill daily: Biktarvy

A

-Bictegravir - INSTI
-Emtricitabine -NRTI
-Tenofovir alfenamide (TAF) - NRTI

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19
Q

Preferred HIV initial tx for t naive pts: 1 pill daily: Triumeq

A

-Dolutegravir - INSTI
-Abacavir - NRTI- TEST for HLAB5701
-Lamivudine- NRTI

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20
Q

Preferred HIV initial tx for t naive pts: 1 pill daily: Dovato

A

-Dolutegravir - INSTI
-Lamivudine - NRTI

**do NOT use if:
- HIV RNA > 500,000
-HBV co infection or unknown
-HIV genotype unknown

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21
Q

Preferred HIV initial tx for t naive pts: 2 pills daily: Tivicay + Truvada

A

-Dolutegravir - INSTI
-Emtribitabine (NRTI)/tenofovir DF (NRTI)

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22
Q

Preferred HIV initial tx for t naive pts: 2 pills daily: Tivicay + Descovy

A

-Dolutegravir - INSTI
-Emtricitabine (NRTI)/tenofovir AF (NRTI)

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23
Q

ART in pregnancy

A

-may contin current ART regimen in most cases
-NEW START: Dolutegravir/boosted darunavir PLUS dual NRTI (emtricitabine/tenofovir)

–> perinatal transmission ppx:
-maternal admin of IV zidovudine pre delivery
-neonatal ART if needed

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24
Q

HIV: Stribild products

A

-Elvitegravir
-Cobicistat (tybost)
-Emtricitabine (Emtriva)
-Tenofovir DF (vibread)

***cannot use of crcl < 50

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25
Q

HIV: Genvoya products

A

-Elvitegravir
-Cobicistat (tybost)
-Emtricitabine (Emtriva)
-Tenofovir AF

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26
Q

HIV Cabanuva products

A

-Cabotegravir
-Rilpivirine

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27
Q

HIV: Complera products

A

-Rilpivirine
-Emtricitabine
-Tenofovir DF

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28
Q

HIV: Odefsey products

A

-Rilpivirine
-Emtricitabine
-Tenofovir AF

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29
Q

HIV: Descovy Products

A

-Emtricitabine
-TAF

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30
Q

HIV: Truvada Products

A

-Emtricitabine
-TDF

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31
Q

PrEP for HIV

A

Indications: mult sex partners, men f men & IV drug use
*must be HIV neg before starting
–> Truvada (Emtricitabinr/TDF)
–> Descovy (Emtricitabinir/TAF)
–> IM cabotegravir (Apretude) monthly q 2 mon, then 1 2 months

-screen for HIV q 3 month, only give 90 ds at a time

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32
Q

PEP treatment

A

EXPOSURE to body fluids, unprotected sex, IV drug use, needle stick
-get baseline HIV, Scr and HBV tests

**start rx ASAP (within 72 hrs) x 28 days

–> Truvada (emitribicibine/TDF) if crcl > 60 + dolutegravir OR raltegravir

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33
Q

Common CYP INhibitors

A

Inhibitors = INCREASE
Grapefruit
PIs (ritanovir)
Azole antifungals
Cyclosporine, colbicstat
Macrolides (eryhtromycin/clarithomycin)
Amiodorine
Non-DHP CCBs (verapamil. diltiazam)

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34
Q

Common CYP INDucers

A

inDucers= DECREASE
Phenytoin
Smoking
Phenobarbital
Oxacarbazepine
Rifampin
Carbamazepine
St. johns wort

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35
Q

What drugs can cause an immune mediated hemolytic anemia and need a coombs test?

A

-penicillins
-cephalorins
-isoniazid
-levodopa
-methyldopa
-quinidine
-quinine
-rifampin
-sulfonamides
-rasburicase

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36
Q

Self injectable meds that need to be in the fridge and how long are they able to be outside

A

-Glatiramer (Copaxone): up to 30d
-Stanercept (Enbrel) up to 14 d
-Adalimumab (Humira) up to 14d
-Certolizuman (Cimzio): up to 7d
-Golimumab (Simponi): up to 30 d
-Teriparatide (Forteo) minimize
-Abaloparatide (Tymlos): up to 30 d

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37
Q

Patches that are worn daily

A

-Methylphenidate (Daytrana) @ am 2 hrs before school, flush
-Nicotine (NicoDerm)
-Rivastigmine (Exelon) - parkin
-Rotigotine (Neupro) -parkin *MRI

-Selegiline (Emsam) - parkin & depress
-Testosterone (Androderm) *MRI

-Lidocaine (Lidoderm) 1-3 patches, on for 12, off for 12
-Nitroglycerin: on for 12-14 off for 10-12

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38
Q

Patches that are changed q 72 hrs

A

-Fentanyl (duragestic) - can cover, flush
-Scopolamine (Transderm scop) behind the ear *MRI

39
Q

Patches that are changed twice weekly

A

-Estradiol (Vivelle-Dot): lower abd, butt
-Oxybutynin (Oxytrol)

40
Q

Patches that are changed weekly

A

-Donepezil (Adlarity) - alz
-Buprenorphine (Butrans) - can cover, flush
-Clonidine (Catapress-TT) *MRI, own patch cover
-Estradiol (Climara)
-Xulane, Twirla (3 week on, 1 week off)

41
Q

Drugs with Leaching/adsoprtion/issues with PVC containers

A

Leaches Absorbs To Take In Nutrients

Lorazepam (ativan)
Amiodaraone
Taxines
Tacrolimus
Insulin
Nitroglycerin

42
Q

Drugs that are only compatible with SALINE

A

“A DIAbetic Cant Eat Pie”

Ampicillin
Daptomycin (Cubicin)
Infliximab (Remicade)
Ampicillin/sulbacta, (unasyn)
Caspofungin (cancidas)
Ertapenem (Invanz)
Phenytoin (Dilantin)

43
Q

Drugs that are only compatible in DEXTROSE

A

“Old Bakers Avoid Salt”
Oxaloplatin
Bactrim (SMX/TMP)
Amphotericin B
Synercid (quinupristine/Dalfopristin)

44
Q

Common drugs that need a filter when given IV

A

“my GAL Is PAT who has a MaP”
Golimumab (simponi)
Amphotericin B (lipid formulation)
Lipids (1.2)
ISavuconazonium
Phenytoin (continuous infusion)
Amiodarone
Taxanes (cqbazitaxel, paclitaxel)
Manatol > 20%
Parenteral nutrients (1.2)

45
Q

DO NOT REFRIGERATE drugs

A

“Dear Sweet Pharmacist, Freezing Makes Me Edgy!”
Dexmedetomidine (precedex)
SMX/TMP
Phenytoin- crystalizes
Furosemide - crystalizes
Moxifloxican
Metronidazole
Enoxaparin

46
Q

Protect from sunlight during admin

A

“Protect Every New Man from Dick”

Phytonasione (vit K)
Epoprostenol
Nitroprusside
Micafungin (Mycamine)
Doxycycline (monodox. Oracea)

47
Q

What are the Odefsey components?

A

-emtricitabine
- rilpivirine,
-tenofovir alafenamide

48
Q

Key drugs that are associated with photosensitivity

A

-amiodarone
-diuretics (thiazide & loops)
-methotrexate
-oral and topical retinoids
-Quinolones
-St. John’s Wort
-sulfa drugs
-tacrolimus
-tetracycline
-voriconazole

49
Q

Key drugs associated with severe cutaneous AEs (SJS/TENS)

A

-allopurinol
-amoxicillin
-ampicillin
-carbamazepine
-ethosuximide
-lamotrigine
-nevirapine
-phenytoin
-sulfamethoxazole
-sulfasalazine
-vancomycin

50
Q

Invanz

A

Ertapenem (also a beta lactam)

51
Q

Testing: Abacavir (Ziagen) in combo drugs like Triumeq & Epzicom

A

-HLA-B*5701

–> if +, do not use
*test ALL pts prior to use

52
Q

Testing: Allopurinol (Zyloprim, aloprim)

A

-HLA-B*5801

–> if +, do not use, inc risk of SJS

53
Q

Testing: Carbamazepine (Tegretol), Oxcarbazepine (Trileptral), Phenytoin (Dilantin), Fosphenytoin (Cerebyx)

A

-HLA-B*1502

–> if positive do not use
-must test all Asians for carbamazepine

54
Q

Testing: Clopidogrel (Plavix)

A

-CYP2C9

-if poor metabolizer, consider alt therapy

55
Q

Testing: Codeine

A

-Cyp2D6

-if ultra-rapid metabolizer, do NOT use = dead babies (whites mainly)

56
Q

Testing: Warfarin (Coumadin, Jantoven)

A

-CYP2C9*2 and *3, VKORC1

-risk of inc bleeding, consider lower doses

57
Q

Testing: Trastuzumab (Herceptin)

A

-HER2

-if gene NOT present, drug will not be effective

58
Q

Testing: Cetuximab (Erbitux)

A

-KRAS mutation

-if + for mutation, do NOT use

59
Q

Testing: Capecitabine (Xeloda), Fluorouracil

A

-DPD deficiency

-f deficient, do NOT use

60
Q

supplements that can cause liver toxicity (hepatoxicity)

A

-black cohosh
-kava
-chaparral, cornfry
-green tea extract

61
Q

supplements that increase bleeding risk

A
  • 5G’s: garlic, ginger, ginko, ginseng & glucosamine
    -fish oil
    -vitamin E
    -dong quai
    -willow bark (salicylate)
62
Q

Supplements that increase cardiac toxicity

A

-Ephiedra
-bitter orange
-DMAA
-yohimbe
(vitamin E - excessive intake can lead to CVD)

63
Q

Unfractionated heparin dosing

A

-via antithrombin

-ppx of VTE: 5,000 u SC q 8-12H
-tx of VTE: 80 units/kg IV, 18 u/kg/hr infusion
-tx of ACS/STEMI: 60 u/kg bolus, 12 u/kg/hr infusion

MONITOR: APTT, anti-Xa levels
ANTIDOTE: protamine (1 mg reverses 100 units)

64
Q

Enoxaparin (Lovanox) dosing

A

-via anthithrombin

-ppx of VTE: 30 mg SC q12 or 40 mg sc qd
-tx of VTE,UA,NSTEMI: 1 mg/kg sc q 12h. 1.5mg/kg sc q 12h
-tx of STEMI: 30 mg IV bolus, 1 mg/kg SC q12

MONITOR: anti-xa (do it in pregnancy)
ANTIDOTE: protamine

65
Q

Apixaban (Eliquis) dosing

A

-factor xa direct inhibitor

-stroke ppx: 5 mg po BID
-tx of DVT/PE: 10 mg PO BID x 7 then 5 mg PO BID

DEC DOSE IF pt has at least 2; age > 80, wt </ 60 kg, Scr >/ 1.5

ANTIDOTE: andexant alpha (Andexxa)

66
Q

Rivaroxiban (Xarelto) dosing

A

-factor xa direct inhibitor

-stroke ppx: 20 mg po qd w/ evening meal
-tx of DVT/PE: 15 mg BID x 21d, 20 mg qd w/ evening meal

ANTIDOTE: andexant alpha (Andexxa)

67
Q

Dabigatran (Pradaxa) PO, Argatraban, Bivalirubicin (Angiomax) IVs

A

-direct thrombin inhibitors

Pradaxa SEs- dyspepsia, gastrisis like symptoms, bleeding (keep in original cont, discard after 4 mon)

ANTIDOTE: Idarucizumab (Praxbind)

(IV argatraban and bivalirubicin have no antidote and used for pts with hx of HITT)

68
Q

Warfarin tablet colors

A

Please Let Greg Bring Big Peaches To Your Wife

Pink: 1 mg
Lavender: 2mg
Green: 2.5 mg
Brown/tan: 3 mg
Blue: 4 mg
Peach: 5 mg
Teal: 6 mg
Yellow: 7.5 mg
White: 10 mg

*test for CYP2C9 *2 & *3, VKORCI gene = inc bleeding

ANTIDOTE: vitamin K (phytonadione), kcentra, novoseven RT

69
Q

Drug interactions with Warfarin

A

-INR DEC with: carbamazepine, phenobarbital, phenytoin, rifampin, SJW = risk of clots

-INR INC with: amiodarone, azoles, metronidazole & bactrim = risk of bleeding

70
Q

Zestoretic

A

lisinopril/HCTZ

71
Q

Hyzaar

A

losartan/HCTZ

72
Q

Benicar HCT

A

olmesartan/HCTZ

73
Q

Diovan HCT

A

valsartan/HCTZ

74
Q

Lotrel

A

benazepril/amlodipine

75
Q

Exforge

A

valsartan/amlodipine

76
Q

Tenoretic

A

Atenolol/chlorthalidone

77
Q

Ziac

A

Bisoprolol/HCTZ

78
Q

Maxzide/Maxzide-25/Dyazide

A

Triamterene/HCTZ

79
Q

Chemo man: neurotoxicity

A

-carmustine
-lomustine

80
Q

Chemo man: ototoxicity

A

-cisplatin
–> limit dose to < 100mg / cycle
–> give amifostine

81
Q

Chemo man: pulmonary toxicity

A

-bleomycin (limit dose to 400 mg/life)
-busulfan
-carmustine

82
Q

chemo man: cardiotoxicity

A

-doxorubicin
–> limit dose to 450-550/lifetime
–> give dexrazoxane

83
Q

chemo man: GI tox

A

-capeciitabine
-fluorouracil
-Irinotecan (DIARRHEA, atropine and loperamide)
-methotreaxte (leucovorin)

84
Q

chemo man: nephrotoxicity

A

-cisplatin (give amifostine)
-methotrexate (leucovorin)

85
Q

chemo man: BMS

A

all BUT bleomycin, vincristine, asparaginase

86
Q

chemo man: hemorrhagic cystitis

A

-cyclophosphamide
-Ifosamide (give mesna)

87
Q

chemo man: peripheral neuropathy

A

-vincristine (limit dose to 2 mg)
-cisplatin, oxaplatin (limit cold exposure)
-paclitaxel

88
Q

LGI: Paliperadone

A

-Invega Hafyera: 6 mon
-Invega Trinza: 3 mon
-Invega sustenna: 1 mon

89
Q

LGI: Aripiprazole

A

-apripiprazole lauroxin (Aristada): 4 weeks
-abilify mantena: 4 weeks

90
Q

LGI: Haloperidol

A

Haldol decanonate: 4 weeks

91
Q

LGI: olanzapine

A

zyprexa relprevv: 2-4 weeks

92
Q

LGI: risperidone

A

risperrdol consta: 2 weeks

93
Q

LGI: fluphenazine

A

-fluphenazine deconate: 2 weeks

94
Q
A

NAPLEX BABY (23 decks)

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