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Flashcards in 15 Study Guide 2 Deck (69):
1

What is a general summary for DMARDS?

Disease modifying medication for RA. Slow onset, must bridge w/ NSAIDs if needed. Slow disease progression and joint erosions. Improve functional disability and decrease pain. Interfere with inflammatory process (does NOT treat inflammation)

2

What hormone is avoided in a female with NO uterus?

Progesterone

3

What combo of hormones is used in females going through menopause who still have a uterus?

Estrogen + Progesterone

4

Which DM med causes no weight gain?

Metformin. Januvia (Sitagliptan)

5

What are the common pathogens that cause Diabetic foot ulcer?

S. aureaus, B Hemolytic Strep

6

If you see a prescription for MTX 7.5mg PO QD what do you do?

Do not fill. Most regimens should be QW or 2xW

7

Which form of Fe (gluconate, fumarate, sulfate) has the least elemental iron?

Gluconate has the least

8

What is the rare side effect of Xolair?

Anaphylaxis. BBW: Bronchospasm, Hypotension, Syncope, Urticaria, and/or Angioedema or throat or tongue

9

Patient has SJS and you need a diuretic, what do you recommend?

Erytharcrynic acid (only non-sulfa). Safe to use: Amiloride, Eplerenone, Ethacrynic acid, Spironolactone, Triamterene

10

What do the results of the Asthma Control Test show?

Score of 20+ means asthma is controlled. < 20 not well controlled, < 15 very poorly controlled

11

How it ICS potency ranked for Asthma?

"Follow Busy Bee For Tulips, Mo": Fluticasone > Budesonide > Beclomethasone > Flunisolide > Triamcinolone > Mometasone

12

What is a contraindication for an ARB?

Pregnancy, Renal artery stenosis, volume depletion, renal/hepatic impairment

13

What is the treatment of Thyroiditis?

Propanolol reduce heart rate/tremors, steroids, etc

14

Which organism causes CAP?

Strep. pneumonia

15

Which organism can cause Pneumonia in an otherwise healthy person?

Mycoplasma pneumonia

16

What does SAR stand for?

Structure Activity Relationship

17

What is the MOA of GP IIb/IIIa inhibitors?

Directly block platelet GP IIb/IIIa receptor on the platelet membrane; inhibit binding of fibrinogen to the GPIIb/IIIa receptor thus inhibiting platelet aggregation

18

What is the best timing for tPA use with stroke?

Give tPA within 3 hours of stroke symptoms (if given after 3 hours, improvement in outcomes starts to decline). Best if < 90 minutes

19

Which statins have the least 3A4 inhibition?

Pravastatin < Rosuvastatin (2C9) < Fluvastatin (2C9)

20

What are the expected ADRs with Sominex (sleep aid) use?

Morning hangover, Constipation, Diarrhea. Sominex is the same as benadryl

21

How is COX-2 related to heart risk?

It increases heart risk

22

Which insulin replicates basal insulin the best?

Lantus - stimulates physiologic basal insulin

23

HPA axis suppression, which would most likely cause it (prednisone, steroid inhaler, etc.)?

Oral corticosteroids - LT prednisone, dexa or methylprednisone use

24

What are the IVIG infusion related ADRs?

HA, dizziness, N/V, flushing, arthralgia, etc.

25

Which antibiotics discolor urine?

Nitrofurantoin. Rifampin

26

Which Abx covers atypicals?

Cipro, Levo, Moxifloxacin. Macrolides (Clarithromycin, Azithromycin, Telithromycin)

27

What labs are consistent with UTI?

Leukocyte esterase (trace to large). White cell casts WBC > 5-10. Bacterial cell count (moderate to many). Those 3 are diagnostic.... nitrates, blood, protein are not

28

Which OTC for hot flashes?

Estroven (has black cohosh and soy)

29

What is some general information about Buspar?

20-30mg/d divided BID-TID. Start 7.5mg BID, not prn. Its a 5HT1A partial agonist so no sedative, anticonvulsant, muscle relaxant activity

30

Which type of DM oral drug should not be taken on empty stomach?

Metformin

31

What is Climara used for?

Normal vasomotor menopause symptoms. Climara Pro (w/ progesterone) used for surgical (hysterectomy) vasomotor menopause symptoms

32

What does Ginseng do to Warfarin?

Decreases its effect

33

Which insulin can be given IV?

Only Regular Insulin

34

W patient is on Medrol Dosepak, what are important things to counsel on?

Take with food. May cause insomnia

35

Patient on Climara, what do you counsel her on?

Apply to a clean dry area. A women with a uterus should also be on progestin

36

What is the site of action of Furosemide (Lasix)?

Na-K-Cl pump at the ascending loop of henle

37

When should you tell the patient to take Lispro?

Rapid-acting insulin, Inject 15 minutes before meals or immediately after meals

38

What are the symptoms of IVIG?

Renal toxicity and HA

39

Patient on pernicious anemia what are recommendations for meds?

Take 3 months for symptoms to resolve AND must take meds indefinitely

40

Which demonstrates proper knowledge of Varenicline?

This medicine causes nausea

41

Which CCBs cause additive bradycardia w/ propranolol?

Verapamil. Diltiazem

42

What are the symptoms of GERD?

Chronic cough. Symptoms of asthma. Atypical chest pain

43

What is needed for Time-Dependent Killing?

Constant infusion, Multiple daily doses

44

How can Buspirone NOT be taken?

PRN like Diazepam

45

What disease states can increase the risk for osteoporosis?

Hyperthyroidism. DM Type 2. Cushings Syndrome

46

What is a common and severe ADR of Linezolid requiring discontinuation?

Myelosuppression: Monitor CBC weekly, esp if > 2 week of therapy, pre-existing myelosuppression, other myelosuppressive drugs, or chronic infection treated with other antibiotics. Consider stopping if myelosuppression occurs or worsens

47

What are the benefits of Activella (estrogen/northindone for menopause)?

Decrease in fracture risk, decrease risk of colorectal cancer

48

What are some of the encapsulated bacteria?

H. influenzae type B (Hib). S. pneumoniae (pneumococcus). N. meningitides. Group B Strep (GBS). Klebsiella pneumoniae. Salmonella

49

What clinical characteristics are important in determining antiviral regimen for Hep C?

Weight. HCV genotype

50

Why would Elavil likely worsen opioid-induced constipation?

Its an anticholinergic

51

Which opioid is least constipating?

Transdermal Fentanyl patch

52

What class of drug is Sumatriptan?

Selective Serotonin Agonist

53

Which COMT Inhibitor has reports of fatal liver toxicity?

Tolcapone

54

What has the least effect on efficacy of Oral Contraceptives?

Lamotrigine. Gabapentin

55

What are the effects in relation to weight gain of Valproic acid and Topiramate (anticonvulsants)?

Valproic acid increases weight. Topiramate decreases weight

56

How are TCAs and Carbamazepine related?

If someone has a hypersensitivity reaction to TCA, carbamazepine is contraindicated

57

Which anticonvulsants are renally eliminated and require dose adjustment?

Gabapentin. Topiramate

58

Whats an important note for Topiramate?

Precipitate kidney stone, drink plenty of fluid

59

What is the BBW with valproic acid?

Pancreatitis

60

How is Diastat administered?

Rectally

61

What formulations is Phenytoin available in?

Liquid, Chewable tablet, IV formulation

62

Why must patient be aware of importance of good oral hygiene with Phenytoin?

May cause gum and mouth sores

63

What is used to reverse opioid overdose?

Naloxone

64

What is morphine metabolized by?

Hepatic Glucuronidation. NOT CYP 450

65

Phenytoin is effective for all types of seizures except what?

Absence

66

What are the ADRs with Levodopa?

GI, involuntary movement, efficacy decreases in 3-5 years

67

What is a common ADR with lithium?

Polyuria. Lithium induced intentional tremor

68

What are the 1st line therapy options for mood stabilization in patients diagnosed with Bipolar?

Lithium and Depakote

69

What are common ADRs of Fluoxetine?

Insomnia, GI upset, HA