Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm supplement > Weak 12: resp, immuno, GI > Flashcards

Weak 12: resp, immuno, GI Flashcards

1
Q

Contraindications/nursing considerations with 1st gen H1 antagonists

A

Sedation more prevalant in first generation, means they should not be used concurrently with other CNS depressants and alcohol. Educate to use only as directed, many ODs because people see as “safe” and are more lax about dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Uses of H1 antagonists

A

mild allergy
adjunt to severe allergy
Motion sickness (some have antagonizing pathways to vestibular apparatus in inner ear responsible for motion sickness)
Insomnia (1st gen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Caution/contraindications of theophylline

A

Slow IV admin to avoid fatal CV events
highly variable metabolism (CYP450), requires plasma monitoring
Caffeine (also a methylxanthine) – increase AE, compete for metabolizing enzymes
tobacco/marijuana – induces CYP450
CYP450 induces – subtherapeutic lvls
CYP450 inhibitors – supratherapeutic (even toxic levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Monoclonal antibody types

A

IgE antibody antagonist: omalizumab
IL-5 receptor antagonists
IL-4 receptor alpha antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does omalizumab work?

A

forms complex with IgE that prevents it binding to Mast cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AE of omalizumab

A

viral infection, injection site reaction, hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Considerations of omalizumab

A

Long half life, after stops, takes about a yr to get back to pre-treatment levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do IL-5 receptor antagonists work?

A

inhibit IL-5, causing decreased eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

AE of IL-5 receptor antagonists

A

HA, pharyngitis, fatigue, hypersensitivity rxns,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do IL-4 receptor alpha antagonists work?

A

decreased cytokine-induced inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

AE of IL-4 receptor alpha antagonists?

A

injexn site rxns, oral herpes, conjunctivitis, antibody development against the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Montelukast is the most commonly prescribed leukotriene receptor blocker. In comparing its adverse effects with the other two leukotriene receptor blockers, why do you think it’s more highly prescribed?

A

Minimal side effects, no CYP450 inhibition or liver injury, only rare neuropsych effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the purpose and mechanism of action of drugs to treat allergic rhinitis

A

Intranasal glucocorticoids: suppress immune response to allergens, prevention and treatment (not PRN)
Antihistamines: block histamine, less effective than intranasal glucocorticoids, can relieve some symptoms, but not nasal congestion
Sympathomimetics: cause local vasoconstriction, so less fluid can leak out to become snot, a1 agonism, only to relieve congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List three drugs used for cough (antitussives). Which can cause CNS depression? Which have abuse potential?

A

Codeine – small abuse potential when with something to deter abuse, CNS depression
Hydrocodone – CNS depression, small abuse potential when formulated with other drugs to deter abuse
Dextromethorphan – CNS actions, high doses can cause euphoria, thus abuse potential exists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do all glaucoma drugs except prostaglandin analogs work?

A

decreased production of aqueous humor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AE of Beta blockers for glaucoma

A

systemic beta blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

AE of Prostaglandin analogs for glaucoma
A2 agonists: dry mouth, ocular hyperemia

A

ocular hyperemia (enlarged vessels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

AE of A2 agonists for glaucoma

A

dry mouth, ocular hyperemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pt education for antibiotic treatment of H. Pylori

A

important to take all types and complete entire 10-14 days course, they should be taken 2-3 times a day and combined with an antisecretory agent (H2RA, PPI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

For each class of antiemetics, describe a patient you would NOT administer the drug to

A

Serotonin receptor antagonists: pt w/ a prolonged QT or on SSRIs
SubP/NK receptor antagonists: pt on warfarin, or on oral BC not using another method of contraception
Haloperidol: prolonged QT
Cannabinoids: psychiatric disease
Scopolamine: an elderly person who is particularly prone to disorientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Discuss opioid use in diarrhea: how do they work? What drug category are they? Why are they not schedule II like many of the other opioids?

A

Loperamide, and other similar drugs agonize Opioid receptors, which decreases bowel motility, they are either schedule IV or unscheduled because they are poorly absorbed (no euphoria) and they are formulated with drugs (atropine) which create unpleasant side effects if the dose is increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does sulfasalazine work?

A

Sulfasalazine is metabolized by intestinal bacteria, and converted into 2 substances, one of which (5-ASA) suppresses prostaglandin synthesis and local inflammation, the other is sulfapyridine and causes the AE associated with the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Alosteron used for

A

IBS-D in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

AE of alosteron

A

well-tolerated to severe, including death d/t ischemic colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the differences in H1 and H2 receptor agonism? What drugs do we use for each?

A

H1 receptor agonism causes:
Vasodilation, increased vascular permeability,
Hypotension, reflex tachy
Bronchoconstriction
itching/pain (stim of nerves)
CNS: cognition, memory, sleep/wake
Drugs: diphenhydramine (benadryl), promethazine (phenergan)
H2: gastric secretion
Drugs H2RAs: cimetidine, famotidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pt education for immunosuppressants

A

Toxic: nephrotoxicity, hepatotoxicity
AE: bone marrow suppression, infection, depression, flu-like symptoms, injection site reactions, decrease vaccine effectiveness
Don’t use with other immunosuppressants
Encourage family members to get vaccinated, avoid live vaccinations
Avoid with other nephrotoxic drugs, metabolized by CYP450 – be careful with inducers and inhibitors
mTOR inhibitors with high fat foods → increased absorption and possible toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Indication of Calcineurin inhibitors

A

prevent transplant rejection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Considerations for Calcineurin inhibitors

A

Unpredictable PO: must monitor plasma levels
hepatic metabolism: avoid CYP450 inducers and inhibitors
avoid with other nephrotoxic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Cyclosporine vs tacrolimus

A

tacrolimus is more effective but has a smaller TI

30
Q

Indication for mTOR inhibitors

A

prevent renal transplant rejection

31
Q

Cautions with mTOR inhibitors

A

avoid CYP450 inducers and inhibitors
high fat food cause increased absorption which can lead to toxicity

32
Q

List a short, medium, and long acting glucocorticoids

A

Short: cortisone, hydrocortisone
Medium: prednisone
Long: dexamethasone

33
Q

Uses of glucocorticoids

A

rheumatoid arthritis
SLE
IBD
asthma
bursistis/tenitis/synovitis/osteoarthritis
allergic rxns
neoplasms (for some types of cancers)
suppression of allograft rejection

34
Q

Class of Cyclophosphamide

A

cytotoxic drug

35
Q

What is similar about Azathioprine and
Methotrexate

A

they are both cytotoxic drugs that interfere with folate metabolism

36
Q

What are two long acting B2 agonists

A

formoterol and Salmeterol

37
Q

Indication for LABAs

A

preferred in COPD
fixed dose scheduling (not PRN)
when used alone in asthma increased mortality (USE W/ GLUCOCORTICOID)

38
Q

Indication of PO terbutaline and albuterol

A

long term control, not first line, dosing is 3-4x/day

39
Q

Indications for cromolyn

A

asthma, exercise induced asthma (neb), allergic rhinitis (intranasal)

40
Q

Indications for roflumilast

A

severe bronchitis primary COPD (not first line)

41
Q

CI roflumilast

A

pregnancy
psych rxns possible

42
Q

Indication of glucocorticoid + LABA

A

Symbicort and advair are used for asthma

43
Q

Indication B2 antagonist + anticholinergic

A

Combivent is used in COPD

44
Q

AE of sympathomimetics for allergic rhinitis

A

CNS stim
CV effects in high doses
rebound congestion
Pseudoephedrine is associated with abuse bc can be turned into meth

45
Q

AE of sympathomimetics for allergic rhinitis

A

CNS stim
CV effects in high doses
rebound congestion
Pseudoephedrine is associated with abuse bc can be turned into meth

46
Q

Drugs for allergic conjunctivitis

A

H1 receptor blockers: azelastine (prevents mast cell activation)
ocular decongestants: phenylephrine

47
Q

consideration with phenylephrine for ocular decongestion

A

use for max 2 weeks bc can cause rebound conjunctivitis

48
Q

Consideration with oitments

A

highest medication absorption (of topicals)
good for thickened, inflamed skin (eczema)
not good for moist, weeping skin (burns)

49
Q

AE of topical glucocorticoids

A

local reactions
thinning of skin with long term use

50
Q

AE of Keratolytics

A

toxicity with long term high dose use (rare)

51
Q

topical antibiotics:
-drug
-indication
-AE

A

benzoyl peroxide as first line for acne, AE peeling and drying

52
Q

Retinoids
-drug
- mechanism of action
-AE

A

tretinoin, hyperproliferation of epithelial cells
AE: peeling, drying

53
Q

Kerolytics
- drug
-mechanism of action
- AE

A

azelaic acid
supresses P. acnes (strain of bacteria causing acne)
AE: itching, burning, pigment reduction

54
Q

Drugs for psoriasis

A

Methotrexate: systemic, caution: teratogenisis
Topical: Coal tar: supresses DNA synthesis, inhibits keratinocytes

55
Q

Indication and AE for Topical tacrolimus

A

immunosuppressant, 2nd line for ezcema
AE: erythema, pruitis

56
Q

Indication, possible mechanism of action, AE of topical minoxidil

A

alopecia/male pattern bladness, possibly works thru direct vasodilation, AE: local allergic rxns

57
Q

Interactions of Cimetidine

A

H2RAs are CYP450 inhibitors (toxic doses of other meds metabolized by CYP450)
antacids can decrease the absorption of Cimetidine (give 1hr apart)

58
Q

Drug interactions of PPIs

A

increased pH causing decreased absorption of some HIV drugs and antifungals

59
Q

Who are antacids contraindicated for?

A

All antacids contain lots of Na+, so caution with HTN, HF, or renal d. (careful electrolyte balancing)

60
Q

Compare and contrast the two drugs used to increase defensive factors in the treatment of PUD

A

Misoprostol and sucralfate have different mechanisms of action (see 31). Misoprostol cannot be given to pregnant women, can cause dose-related diarrhea, abdominal pain, and spotting/dysmenorrhea. Sucralfate, on the other hand, has minimal side effects (some experience constipation), but can increase the absorption of some other drugs, so it should be given at least 2 hrs apart from other meds.

61
Q

How can Senna and Bisacodyl be give

A

PO or PR (per rectum faster)

62
Q

What type of laxative are magnesium compounds

A

osmotic laxatives

63
Q

AE of osmotic laxatives

A

dehydration, bloating, cramping, flatulance

64
Q

Indication, drug class, mechansim of action for methylnaltrexone

A

constipation, selective mu antagonist, blocks mu receptors on GI tract –> increased peristalsis

65
Q

Which med can be used in diarrhea caused by IBD

A

budesonide (for initiation of remission, not long term management)

66
Q

AE of dexamethasone for nausea

A

transient blood sugar increase

67
Q

Indication and potential MOA for Cannabinoids

A

likely antagonize canabinoid receptors in the CTZ, indicated for nausea and appetite stimulation in AIDs

68
Q

AE of Cannabinoids

A

in theory same as marijuana (psych disorders)
tachy, hypotension, drowsiness
abuse potential (schedule 4 d/t slow onset

69
Q

Class and MAO of meclizine

A

antihistamine, M and H block in neuronal pathway from inner ear to vomiting center

70
Q

AE of metoclopramide

A

in high doses, sedation, diarrhea, long teem EPS

Pharm supplement (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions