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From Flashcardlet > Pharm Fall Exam 2 > Flashcards

Pharm Fall Exam 2 Flashcards

1
Q

What is first line Tx for endometriosis

A

CHC or Progestin > 3 months

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2
Q

MOA of CHC

A

decreases menstrual flow, decreases endometrial implants by inducing anovulatory/hypoestrogenic state

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3
Q

MOA of Progestin

A

cause atrophy and decidualization of endometrial tissue

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4
Q

What is a GnRH agonist used in Tx of endometriosis?

A

Donazol

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5
Q

MOA of Donazol

A

synthetic steroid analogue of testosterone, induces anovulation, amenorrhea and endometrial atrophy by suppressing midcycle LH and FSH surge

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6
Q

SE of Donazol

A

weight gain, acne, hot flashes, hirsutism, increased LDL

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7
Q

When do physiologic changes occur during pregnancy?

A

begin in 1st trimester, peak in 2nd trimester

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8
Q

What are nonpharmocologic measures to Tx Nausea and vomiting in pregnancy?

A

Eat frequent, small, bland meals, avoid fatty foods, Acupressure point P6 on volar wrist

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9
Q

What are some medications used to help ease N/V in pregnancy?

A

Pyridoxine (Vitamin B6), Antihistamines (Doxylamine/Unisom), Zofran

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10
Q

What antacids can be used to Tx GERD associated with pregnancy?

A

aluminum, calcium, magnesium preparations, sucralfate

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11
Q

What H2 Antagonists can be used to Tx GERD associated with pregnancy?

A

ranitidine (zantac), cimetidine (tagamet)

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12
Q

What should be avoided in treated GERD in pregnancy?

A

sodium bicarb and Mag trisilicate

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13
Q

What oxmotic laxatives can be used if necessary to Tx pregnancy associated constipation?

A

polyethylene glycol, lactulose, sorbitol, magnesium/sodium salts

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14
Q

What should be avoided in Tx constipation in pregnancy?

A

castor and mineral oil

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15
Q

What is first line Tx for Gestational diabetes?

A

recombinant human insulin

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16
Q

What are 2 other options for Tx for gestational diabetes?

A

glyburide, metformin

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17
Q

Which one of glyburide or metformin crosses the placenta more?

A

metformin

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18
Q

What are 3 drugs that are safe to give for HTN in pregnancy?

A

Metyldopa, Labetalol, CCB

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19
Q

What supplement should be given to decrease the risk of HTN and pre-eclampsia in pregnancy?

A

Calcium 1-2 g/day

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20
Q

what is magnesium sulfate given for in pregnancy?

A

prevention of eclampsia and seizures

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21
Q

what anti-HTN meds should be avoided in pregnancy?

A

ACEI, ARBs, Renin Inhibitors, Diazepam, Phenytoin

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22
Q

What is preferred Tx for ppx of VTE in pregnancy?

A

Low molecular weight heparin (lovenox)

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23
Q

what anticoagulant should not be used in pregnancy?

A

warfarin - causes nasal hypoplasia, stippled epiphyses, limb hypoplasia, eye abnormalities, CNS anomalies

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24
Q

What are two medications to be given for UTI Tx while pregnant?

A

Cephalexin, Nitrofurantoin

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25
Q

When should Nitrofurantoin not be given in pregnancy?

A

after week 37 in patients with glc 6 phosphate dehydrogenase deficiency - risk for hemolytic anemia in newborn

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26
Q

What meds should be avoided for Tx of UTI in pregnancy?

A

sulfas, trimethoprim, fluoroquinolones, tetracycline

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27
Q

what is preferred Tx for allergic rhinitis in pregnancy?

A

intranasal corticosteroids: beclomethasone, budesonide

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28
Q

what else can be given for Tx of allergic rhinits in pregnancy?

A

nasal cromolyn, first generation antihistamines: chlorpheniramine, hydroxyzine

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29
Q

should oral decongestants (pseudoephedrine) be used chronically for allergic rhinitis?

A

no, give only once to reduce risk of gastroschisis

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30
Q

what are 4 tacolytic agents used to postpone delivery?

A

beta agonists (terbutaline, albuterol), Mg, CCB (Nifedipine), NSAIDS (Indomethacin)

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31
Q

Maternal SE of beta agonists

A

hyperkalemia, arrhythmias, hyperglycemia, hypotension, pulmonary edema

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32
Q

SE of Indomethacin when used in delivery

A

increased rate of constriction of ductus arteriosus in infants after 32 wks gestation

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33
Q

What drugs are used to increase fetal lung maturity?

A

antenatal corticosteroids: betamethasone, dexamethasone

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34
Q

when are antenatal corticosteroids given?

A

between 26-34 weeks gestation at risk for preterm delivery within next 7 days

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35
Q

how quickly will benefits of lung maturity be seen after giving antenatal corticosteroids?

A

within 24 hours

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36
Q

What are prostaglandin E1 analogs used to induce labor?

A

Misoprostol

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37
Q

What are prostaglandin E2 analogs used to induce labor?

A

Dinoprostone, Prepidil gel, Cervidil vaginal insert

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38
Q

when does a fetal heart rate monitor need to be applied when using dinoprostone?

A

during administration of and 15 minutes after removal

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39
Q

SE of misoprostol

A

uterine hyperstimulation, meconium stained amniotic fluid

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40
Q

SE of giving an epidural during labor?

A

hypotension, pruritis, inability to void, prolonged first and second stages of labor

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41
Q

Causes of mastitis

A

milk stasis, Staph aureus

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42
Q

Tx options for mastitis

A

Dicloxacillin, Oxacillin, Cephalexin

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43
Q

What can be given for analgesia with mastitis?

A

Acetaminophen if baby 6 months

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44
Q

What medication can be given to help with relactation?

A

Metoclopramide

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45
Q

What meds can be given to help with postpartum depression?

A

sertraline, paroxetine, nortriptyline

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46
Q

what meds can be given to help with syx of thyroiditis?

A

propranolol, labetalol

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47
Q

Give two Tx options for gonorrhea

A

Ceftriazone with Azithromycin or Doxycycline

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48
Q

What can be given for Tx of gonorrhea with cephalosporin allergy?

A

Azithromycin

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49
Q

What are 3 options for Tx for chlamydia

A

azithromycin, doxycycline, erythromycin

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50
Q

What is the Tx for syphilis?

A

Benzathine Pencillin G

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51
Q

What is the Tx for syphilis with PCN allergy?

A

Doxycyline

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52
Q

What are 3 Tx options for persistent urethritis/cervicitis?

A

metronidazole, tinidazole, azithromycin

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53
Q

Organism cause of PID

A

polymicrobial - N. gonorrhoeae, C. trachomatis

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54
Q

IP Tx options for PID

A

Cefotetan, Cefoxitin with Doxycycline, Clindamycin with Gentamycin

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55
Q

OP Tx options for PID

A

Ceftrixone with Doxycycline, Cefoxitin

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56
Q

Patient applied Tx for genital warts

A

Podofilox, Imiquimod, Sinecatechins

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57
Q

Provider given Tx for genital warts

A

Cryotherapy, Podophyllin resin, Trichloroacetic acid, surgical removal

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58
Q

What are 3 options for Tx of HSV

A

Acyclovir, Famciclovir, Valacyclovir

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59
Q

Give 2 Tx options for Trichomonas

A

Metronidazole, Tinidazole

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60
Q

what are two glycoproteins present on HIV surface

A

gp 160, gp120 which have affinity for CD4 R and T helper lymphocytes to infect cells

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61
Q

What are 3 laboratory tests that are done prior to HIV Tx?

A

CD4 T cell count, Plasma HIV RNA, Drug Resistance Testing

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62
Q

When is HLAB*5701 screening performed?

A

prior to starting patients on Abacavir to screen for mutation at risk for hypersensitivity

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63
Q

when is CoR tropism assays performed for HIV Tx?

A

prior to using a CCR5 Inhibitor to check for mutation that prevents drug from being effective

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64
Q

what is the general Tx for HIV and its goals of therapy?

A

combination antiretroviral therapy - to decrease viral load <50-75, increase CD4 count to prevent opportunistic infections

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65
Q

At what CD4 count is ART strongly recommended to be given?

A

<350

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66
Q

give some examples of nucleoside reverse transcriptase inhibitors (NRTIs) used for HIV Tx

A

Emtricitabine/Emtriva, Lamivudine, Tenofovir (TDF) Stavudine, Didanosine, Abacavir (ABC), Zidovudine

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67
Q

What must happen to NRTIs so that they become active?

A

become phosphorylated to terminate DNA elongation

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68
Q

what needs to be checked before giving NRTIs

A

CrCl, renally cleared, avoid in renal insufficiency

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69
Q

SE of NRTIs

A

peripheral neuropathy, pancreatitis, myopathy, lactic acidosis

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70
Q

When should the use of Abacavir (ABC) be avoided?

A

patients with CVD, viral load >100,000, patients with HLA B*5701 mutation

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71
Q

Give some examples of nonnucleoside reverse transcriptase inhibitors given for HIV Tx (NNRTIs)

A

Efavirenz (EFV), Delavirdine (DLV), Nevirapine (NVP), Etravirine (ETR), Rilpivirine (RPV)

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72
Q

SE/risks of NNRTIs

A

risk of resistance, rash

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73
Q

SE of nevirapine (NVP)

A

hepatotoxicity (life threatening)

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74
Q

SE of efavirenz (EFV)

A

neuropsyche, dyslipidemia, neural tube defects if used in first trimester

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75
Q

CI for rilpivirine (RPV)

A

PPIs

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76
Q

give examples of protease inhibitors

A

Amprenavir (APV), fosamprenavir (FPV), atazanavir (ATV), darunavir (DRV), indinavir (IDV), lopinavir (LPV), nelfinavir (NFV), ritonavir (RTV), saquinavir (SQV), and tipranavir (TPV)

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77
Q

MOA of protease inhibitors

A

competitively inhibit viral maturation by blocking cleavage of the gag-pol polyprotein

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78
Q

what drug is given along with protease inhibitors to increase drug plasma concentrations?

A

Ritonavir (CYP3A inhibitor)

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79
Q

SE of protease inhibitors

A

DM development, dyslipidemia, hepatotoxicity, GI syx

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80
Q

SE of Indinavir (IDV)

A

nephrolithiasis

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81
Q

DI of atazanavir (ATV)

A

Omeprazole with dosage >20 mg

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82
Q

What is a fusion inhibitor used for Tx of HIV

A

Enfuvirtide

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83
Q

MOA of enfuvirtide

A

synthetic a.a. binds gp41 to block fusion of HIV to target cell

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84
Q

how is enfuvirtide administered?

A

IV, IM, SQ

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85
Q

SE of enfuvirtide

A

injection site rxns

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86
Q

what is a chemokine CCR5 antagonist used for Tx of HIV?

A

Maraviroc

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87
Q

What are 2 integrase inhibitors (InSTIs) used for Tx of HIV?

A

Raltegravir, Elvitegravir

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88
Q

MOA of integrase inhibitors

A

binds to HIV integrase to block integration of viral DNA into human genome

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89
Q

what can be given with elvitegravir to increase plasma concentration of drug?

A

ritonavir

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90
Q

what is the combination drug given for ART naive patient with this abbreviation: (EFV/TDF/FTC)

A

efavirenz/tenofovir/emtricitabine

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91
Q

what is the combination drug given for ART naive patient with this abbreviation: (ATV/r + TDF/FTC)

A

ritonavir-boosted atazanavir + tenofovir/emtricitabine

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92
Q

what is the combination drug given for ART naive patient with this abbreviation: (DRV/r + TDF/FTC)

A

ritonavir-boosted darunavir + tenofovir/emtricitabine

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93
Q

what is the combination drug given for ART naive patient with this abbreviation: (RAL + TDF/FTC)

A

raltegravir + tenofovir/emtricitabine

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94
Q

what should be given to patients with RNA viral load 70 mL/min

A

rilpivirine (RPV) based regimen

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95
Q

What is in the combo drug Stribild

A

elvitegravir + cobicistat + tenofovir + emtricitabine

96
Q

What is in the combo drug Atripla

A

efavirenz + tenofovir + emtricitabine

97
Q

What is in the combo drug Complera

A

rilpivirine + tenofovir + emtricitabine

98
Q

Organism cause of osteomyelitis

A

S. aureus

99
Q

What is the initial Tx for osteomyelitis?

A

IV coverage with either Daptomycin, Nafcillin, or Vancomycin, then can switch to PO

100
Q

What organisms does Daptomycin cover?

A

MRSA, VRE

101
Q

What organisms does Nafcillin cover?

A

G+, G-, no MRSA

102
Q

What organisms does Vancomycin cover?

A

G+

103
Q

What is target trough level for Vancomycin?

A

15-20

104
Q

What are PO options for Tx of osteomyelitis?

A

Linezolid, Daptomycin, Fluoroquinolones

105
Q

SE of fluoroquinolones

A

tendonitis, QT prolongation, nerve damage

106
Q

what is rifampin used for in Tx of osteomyelitis?

A

prevent resistance, penetrate infection of prosthetic joints

107
Q

What is used to Tx newborns with osteomyelitis?

A

Nafcillin with Cefotaxime

108
Q

What is used to Tx peds <5 yrs old with osteomyelitis?

A

Nafcillin

109
Q

What is used to Tx adults with osteomyelitis?

A

Nafcillin, or Cefazolin

110
Q

What is used to Tx IV Drug users with osteomyelitis?

A

Ceftazidime with Tobramycin to cover Pseudomonas

111
Q

whats the most common organism as cause of septic arthritis?

A

Staph aureus

112
Q

what is the organism that commonly infects immunosuppressed individuals/un-immunized kids in septic arthritis?

A

H. influenzae type B

113
Q

What other organism can infect adults aged 18-30 with septic arthritis?

A

N. gonorrhoeae

114
Q

What is needed along with Abx therapy to Tx diabetic food ulcers?

A

debridement and wound care

115
Q

What Abx need to be used to Tx diabetic foot ulcers?

A

broad spectrum Abx that cover G+, G-, anaerobes - Zosyn

116
Q

Tx for PCN-allergic diabetic foot ulcer

A

Flagyl, Clindamycin

117
Q

What are 2 hemorrheologic agents used to help Tx claudication with diabetic foot ulcers?

A

Pentoxifylline/Trenta, Cilostazol

118
Q

MOA of Pentoxifylline/Trenta

A

inhibits platelet aggregation, inhibits PDE to increase RBC flexibility, thins blood

119
Q

Contraindication for use of Pentoxifylline/Trenta

A

recent retinal/cerebral hemorrhage

120
Q

D.I. for use of Pentoxifylline/Trenta

A

Warfarin

121
Q

MOA of Cilostazol

A

inhibits PDE III to inhibit platelet aggregation

122
Q

Contraindication for use of Cilostazol

A

CHF patients

123
Q

What is Becaplermin/Regranex used for in Tx of diabetic foot ulcers?

A

topical PDGF wound healing agent that helps skin surface to clot quickly

124
Q

Drug Interactions with Calcium

A

PPIs, Verapamil, Thiazide Diuretics, Fiber laxatives, Iron, Tetracycline, Quinolones, Phenytoin, Fluoride

125
Q

What is the preferred Tx for osteoporosis?

A

Bisphosphonates with Vitamin D and Calcium

126
Q

What are 4 examples of bisphosphonates?

A

alendronate, risedronate, zoledronic acid, ibandronate

127
Q

what is the only indication for use of ibandronate?

A

postmenopausal osteoporosis

128
Q

what are other bisphosphonates indicated for Tx of?

A

postmenopausal, male, gluco-corticoid induced osteoporosis

129
Q

MOA of bisphosphonates

A

mimics pyrophosphate which inhibits bone resorption

130
Q

When should bisphosphonates not be used?

A

pregnancy, CrCl<35 mL/min, GI esophageal stricture or achalasia

131
Q

SE of high dose bisphosphonates

A

osteonecrosis of jaw, subtrochanteric femoral Fx

132
Q

What is an estrogen agonist used in Tx of osteoporosis?

A

Raloxifene

133
Q

Indications for use of Raloxifene

A

prevention/Tx of postmenopausal osteoporosis, decrease risk of invasive breast cancer

134
Q

What effect does Raloxifene have on CV effects?

A

no reduction, but may decrease total and LDL cholesterol

135
Q

SE of Raloxifene

A

hot flashes, leg cramps, VTE, peripheral edema, cataracts, gallbladder disease, risk for stroke

136
Q

Contraindication for use of Raloxifene

A

women with a history of DVT or PE

137
Q

When can Calcitonin be used in Tx of osteoporosis

A

5 years after menopause, third line Tx

138
Q

Patients with what kind of allergy should avoid use of Calcitonin?

A

Salmon!

139
Q

What are the indications for Teriparatide?

A

postmenopausal women, men, patients on G.C. at high risk for Fx and osteoporosis

140
Q

MOA of Teriparatide

A

similar a.a. structure to PTH that increases bone formation, remodeling rate, osteoblast number and activity, increases bone mass

141
Q

SE of Teriparatide

A

transient hypercalcemia, increased risk for osteosarcoma in patients with Pagets, or elevated Alk Phos

142
Q

What are some non-biologics used in Tx of rheumatoid arthritis?

A

Methotrexate, Hydroxychloroquine, Sulfasalazin, Leflunomide

143
Q

MOA of Methotrexate

A

inhibits cytokine production, inhibits purine synthesis, increases release of adenosine

144
Q

What is a recommended supplementation to be given with Methotrexate?

A

folic acid

145
Q

SE of methotrexate

A

myelosuppression, hepatic fibrosis, cirrhosis, stomatitis, rash

146
Q

MOA of Leflunomide

A

inhibits pyrimidine synthesis to decrease WBC proliferation and inflammation

147
Q

SE of Leflunomide

A

liver toxicity, avoid if planning to become pregnant

148
Q

SE of hydroxychloroquine

A

Nausea, Vomiting, Diarrhea, ocular toxicity, rash, hemolysis

149
Q

What are some examples of biologics used to Tx rheumatoid arthritis?

A

Etanercept, Infliximab, Adalimumab, Certolizumab, Golimumab, Abatacept, Rituximab, Tocilizumab

150
Q

Contraindications to use of Biologics

A

CHF

151
Q

when is Abatacept used in Tx of RA

A

in moderate to severe disease after failure of Tx with DMARDs

152
Q

MOA of Abatacept

A

binds to CD80/CD86 R on APC to inhibit interaction with T cells, prevents inflammation

153
Q

when is rituximab used in Tx of RA

A

patients who have failed methotrexate/TNF inhibitors

154
Q

MOA of tocilizumab

A

attaches to IL-6 R to block IL-6 cytokine from binding to cells promoting inflammation

155
Q

How does Anakinra work?

A

IL-1R antagonist

156
Q

What is first choice for Tx of Osteoarthritis?

A

Acetaminophen

157
Q

SE of NSAIDS

A

GI bleed, Renal injury, Nausea, anorexia, diarrhea, abdominal pain

158
Q

What is a topical cream used for Tx of osteoarthritis obtained from hot peppers?

A

Capsaicin

159
Q

MOA of topical Capsaicin

A

Releases and depletes substance P from afferent nociceptive nerve fibers

160
Q

SE of Capsaicin

A

local effects of burning, stinging, erythema, coughing

161
Q

Risk factors for development of gout

A

age, Creat, BUN, male, high BP, body weight, alcohol intake, use of thiazides, high amounts of meat/fish in diet

162
Q

What management options are there for thiazide related gout?

A

increase hydration, switch thiazide within the class, or switch to another drug

163
Q

What should be done with heart failure patients on thiazides that develop gout?

A

Switch to another thiazide or add on allopurinol, cannot be taken off BP med

164
Q

Give some examples of drugs that act to increase uric acid levels

A

Diuretics, Nicotinic Acid/Niacin, Salicylates, Pyrazinamide, Levodopa, Ethambutol, Cytotoxic drugs, Cyclosporine

165
Q

What is used to Tx acute attacks of gout for pain relief?

A

Colchicine, NSAIDS

166
Q

When should Colchicine be given for maximum effect?

A

within 24 hours of symptom onset

167
Q

SE of Colchicine

A

GI upset (diarrhea, nausea, vomiting)

168
Q

When should NSAIDS be used for Tx of acute gout?

A

in patients without co-morbidities (HF, DV, DV disease)

169
Q

What should also be given with NSAIDS in Tx of acute gout to protect the stomach?

A

PPI, Misoprostol

170
Q

SE of Etodolac

A

GI irritation - avoid in patients with peptic ulcer disease and active GI bleed

171
Q

SE of Fenoprofen

A

Renal dysfunction, fluid retention, HTN, cautious use in CHF patients

172
Q

When are corticosteroids used in Tx of gout?

A

last resort, or IP

173
Q

What are two xanthine oxidase inhibitors used for preventative Tx of gout?

A

Allopurinol, Febuxostat (Uloric)

174
Q

MOA of xanthine oxidase inhibitors

A

lowers uric acid concentration by blocking the enzyme that converts precursors to uric acid

175
Q

Does Allopurinol or Febuxostat (Uloric) require renal dosage adjustment?

A

Allopurinol

176
Q

SE of xanthine oxidase inhibitors

A

Skin rash, leukopenia, GI, headache, urticaria

177
Q

What are two uricosuric drugs used in preventative Tx of gout?

A

Probenicid, Sulfinpyrazone

178
Q

MOA of uricosuric drugs

A

increase renal clearance of uric acid by inhibiting postsecretory renal proximal tubular reabsorption of uric acid

179
Q

SE of uricosuric drugs

A

GI irritation, rash/hypersensitivity, stone formation

180
Q

DI of uricosuric drugs

A

salicylates block its action

181
Q

CI of uricosuric drugs

A

CrCl <50, past hx of renal calculi

182
Q

What are the properties of an ideal anesthetic?

A

maintain unconsciousness, analgesia, short term amnesia, immobility, reduce emetogenic effects

183
Q

Do general anesthetics have high or low therapeutic indices?

A

low

184
Q

What effect does general anesthetics have on BP, Respiration, Temperature, and GI system?

A

induces hypotension, respiratory depression, hypothermia, activates vomiting center

185
Q

how is the potency of general anesthetics measured?

A

determining the concentration needed to prevent movement in response to surgical stimulation

186
Q

how is the potency of inhalation anesthetics measured?

A

in MAC units, minimum alveolar conc. that prevents movement in response to surgical stimulation in 50% of patients

187
Q

MOA of General Anesthetics

A

through GABA R, NMDA R, and K channels

188
Q

MOA of Nitrous Oxide and Ketamine?

A

inhibit NMDA R and activate K channels

189
Q

Which of Nitrous Oxide and Ketamine has stronger analgesic properties?

A

Ketamine

190
Q

What are the two stages of anesthesia?

A

induction and maintenance

191
Q

What general anesthetic is first line for patients without any risk factors?

A

Propofol

192
Q

Give 3 examples of barbiturates used for anesthesia

A

Thiopental, Thiamylal, Methohexital

193
Q

What will happen if barbiturates are mixed with drugs in acidic solutions?

A

Barbiturate will precipitate out as a free acid

194
Q

SE of barbiturates

A

suppresses EEG, reduces cerebral O2 consumption and blood pressure, respiratory depression

195
Q

What is Propofol used for in anesthesia

A

preferred for induction, also used for maintenance

196
Q

What is the only general anesthetic agent that does not induce nausea and vomiting?

A

Propofol

197
Q

Does Propofol provide an analgesic effect?

A

no

198
Q

How soon does Propofol need to be given after it is used?

A

within 4 hours, at risk for bacterial contamination

199
Q

In what patients does the dose of Propofol need to be lowered?

A

neonates, elderly, patients with hepatic impairment

200
Q

SE of Propofol

A

suppresses EEG, decreases CMRO2 cerebral blood flow ICP and intaocular pressures, respiratory depression, anaphylactoid reactions

201
Q

In what patients should Propofol not be used?

A

patients at risk of respiratory depression and hypotension

202
Q

When is Etomidate used for anesthesia?

A

Induction when patients are at risk for hypotension (provides cardiovascular stability)

203
Q

Does Etomidate provide analgesia with anesthesia?

A

no

204
Q

What reactions can be seen with administration of Etomidate?

A

pain with injection, myoclonic movements

205
Q

What can be given with Etomidate to avoid pain and myoclonic movements?

A

Lidocaine, premedication with Benzos or opiates

206
Q

When is Ketamine used for anesthesia?

A

induction for patients at risk for hypotension, bronchospasm, and pediatrics

207
Q

Does Ketamine provide analgesic properties with anesthesia?

A

Yes

208
Q

How is Ketamine administered?

A

IM, PO, Rectal

209
Q

SE of Ketamine

A

HTN, increased heart rate and CO, hallucinations, emergent delirium

210
Q

What is the only general anesthetic that provides analgesic properties?

A

Ketamine

211
Q

What is the max dose for Acetaminophen?

A

4000 mg

212
Q

What is the max dose for Ibuprofen

A

3200 mg

213
Q

What is the max dose for Naproxen?

A

1000 mg

214
Q

What is the max dose for Ketorolac (IV)

A

30-60

215
Q

What is the max dose for Celecoxib (Celebrex)

A

400 mg

216
Q

How far apart should Acetaminphen and Ibuprofen be given?

A

Separate by 2 hours and alternate what’s being given

217
Q

What are some examples of non-specific COX Inhibitors?

A

Ibuprofen, Naproxen, Ketorolac

218
Q

Which NSAID has the lowest CV risk?

A

Naproxen

219
Q

What is an examples of a COX 2 specific inhibitor?

A

Celebrex

220
Q

SE of non-specific COX inhibitors

A

GI distress

221
Q

SE of COX 2 specific inhibitors

A

promote platelet aggregation, increased risk for clots (DVT, MI)

222
Q

What opioid is used for Tx of heroin

A

Methadone

223
Q

What can be given in the case of an opioid OD?

A

Naloxone

224
Q

What opioid should not be given in patients with a risk of seizures and renal failure?

A

Meperidine

225
Q

When giving Methadone what do patients need to be monitored for?

A

respiratory depression, highly sedating effect

226
Q

What patient populations need decreased dosage of Tramadol?

A

renal impairment, elderly

227
Q

What are some pain meds given for patients with a pain rating 1-3?

A

NSAIDS, Acetaminophen

228
Q

What are some pain meds given for patients with a pain rating of 4-6?

A

Vicoden, Tramadol

229
Q

What are some pain meds given for patients with a pain rating of 7-10?

A

Morphine, Oxycodone, Fentanyl

230
Q

What’s first line pain Tx for patients with chronic low back pain?

A

Acetaminophen, Tramadol/opioids in selective patients

231
Q

What’s first line pain Tx for patients with Fibromyalgia?

A

Acetaminophen, TCAs, AEDs, SNRIs

232
Q

What is first line pain Tx for patients with neuropathic pain?

A

TCAs, SNRIs, AEDs, 5% lidocaine patch

233
Q

Patients with a mutated CYP2D6 will be unable to metabolize which opioids to active metabolites and produce an effect?

A

Codeine and Hydrocodone

234
Q

What liver enzyme is responsible for metabolism of Methadone, Fentanyl, and Oxycodone?

A

CYP3A4

235
Q

What will happen to the effect of opioids if a patients takes a CYP3A4 inhibitor or substrate along with their opioid?

A

increases opioid conc. prolonging their effects and increasing the potential for SE

236
Q

What type of drug class is Tramadol?

A

SNRI, doesn’t produce an opioid euphoric effect

237
Q

If a patient takes an MAOI with Tramadol, what are they at risk for?

A

Serotonin Syndrome

From Flashcardlet (30 decks)

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