BLOCK 3 FINALS REVIEW Flashcards
(198 cards)
1
Q
Which omega-3 fatty acids are used to treat severe hypertriglyceridemia?
A
DHA and EPA (docosahexaenoic acid and eicosapentaenoic acid).
2
Q
Which hormone analog is used to treat central diabetes insipidus?
A
Vasopressin or desmopressin.
3
Q
What antihypertensive is safe for use in pregnancy and acts centrally as an alpha-2 agonist?
A
Methyldopa.
4
Q
Why is captopril contraindicated in pregnancy?
A
ACE inhibitors like captopril can cause fetal renal damage and are teratogenic.
5
Q
Which diuretic is preferred for initial blood pressure management in a Black male?
A
Hydrochlorothiazide (HCTZ).
6
Q
Which alpha-1 blocker is used to treat BPH by relaxing prostatic smooth muscle?
A
Tamsulosin.
7
Q
Which alpha blocker may cause first-dose orthostatic hypotension and is used in PTSD-related nightmares?
A
Prazosin.
8
Q
Which alpha blocker is used for BPH and hypertension and has a longer half-life?
A
Terazosin.
9
Q
Which calcium channel blocker is used in vasospastic (Prinzmetal’s) angina?
A
Amlodipine.
10
Q
Which beta blocker is used off-label for essential tremor and migraine prophylaxis?
A
Propranolol.
11
Q
Which mixed alpha/beta blocker is indicated for heart failure?
A
Carvedilol.
12
Q
If nitroprusside fails to control hypertensive crisis, what can be given instead?
A
Labetalol.
13
Q
What antihypertensive is used in pregnancy but may reduce fetal growth?
A
Labetalol.
14
Q
Why are non-selective beta blockers avoided in COPD?
A
They may cause bronchoconstriction due to beta-2 blockade.
15
Q
What is the mechanism of action of beta blockers?
A
They antagonize epinephrine and norepinephrine at beta-adrenergic receptors.
16
Q
What is the mechanism of action of ACE inhibitors?
A
They block the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone.
17
Q
What is the mechanism of action of ARBs?
A
They block angiotensin II receptors, preventing vasoconstriction and aldosterone secretion.
18
Q
Why is lisinopril commonly prescribed for diabetic patients with hypertension?
A
It protects renal function by reducing intraglomerular pressure.
19
Q
Which loop diuretic is used for acute heart failure with pulmonary edema?
A
Furosemide.
20
Q
Why is spironolactone added to HCTZ therapy?
A
To prevent hypokalemia and enhance diuretic effect through aldosterone antagonism.
21
Q
Which class of diuretics is the most potent?
A
Loop diuretics.
22
Q
How do thiazide diuretics work?
A
They mildly inhibit sodium reabsorption in the distal convoluted tubule.
23
Q
Which osmotic diuretic is used for cerebral edema and acute renal failure?
A
Mannitol.
24
Q
What is the effect of alpha blockers on blood vessels?
A
They reduce vascular resistance by relaxing smooth muscle.
25
What is the effect of beta blockers on cardiac output?
They decrease heart rate and contractility, lowering cardiac output.
26
How do diuretics lower blood pressure?
By reducing blood volume through increased urinary sodium and water loss.
27
Which medication is used for atrial fibrillation with controlled hypertension and improves rate control?
Digoxin.
28
What EKG finding is associated with digoxin toxicity?
U waves and other arrhythmias.
29
What inotrope is used in decompensated heart failure to improve cardiac output?
Dobutamine.
30
How should adenosine be administered in supraventricular tachycardia?
Push IV rapidly over 1–3 seconds.
31
Which medication is used for intermittent claudication and inhibits platelet aggregation?
Cilostazol.
32
Which calcium channel blocker is used to control tachycardia from stimulant use?
Verapamil.
33
Why should nitroglycerin not be combined with phosphodiesterase-5 inhibitors (e.g., sildenafil)?
It can cause life-threatening hypotension.
34
Which beta blocker is also used to treat elevated intraocular pressure?
Labetalol.
35
A patient develops a cyanotic toe while on heparin. What condition is this consistent with?
Heparin-induced thrombocytopenia type 2 (HIT type 2), which is immune-mediated and causes thrombosis.
36
What serious complication is associated with HIT type 2?
Pulmonary embolism or other thrombotic events.
37
What common food interaction can affect warfarin’s efficacy?
Leafy green vegetables due to high vitamin K content.
38
What are notable adverse effects of aspirin?
Reye’s syndrome in children, tinnitus (salicylate toxicity), and GI bleeding.
39
What is a contraindication for using clopidogrel?
History of hemorrhagic stroke.
40
What vasodilator can be used during cardiac stress testing?
Dipyridamole.
41
What should be done if a hospitalized patient on warfarin has an INR of 1.5?
Increase the warfarin dose.
42
A patient with a DVT is on heparin and has prolonged bleeding time but is stable. What should you do?
Hold the heparin and recheck PTT in 6 hours.
43
What is a common harmless side effect of oral iron supplementation?
Black stools.
44
What should be given to a patient not responding to oral iron despite vitamin C supplementation?
IV iron.
45
What is the mechanism of action of heparin?
It potentiates antithrombin III to prevent clot extension and formation.
46
Which form of heparin is most associated with HIT?
Unfractionated heparin.
47
How long does it take for warfarin to become therapeutic?
5–7 days.
48
What is a preferred outpatient therapy for DVT?
Apixaban, a direct oral anticoagulant.
49
What is alteplase used for?
Thrombolysis in acute ischemic stroke, PE, or STEMI.
50
What is tenecteplase used for?
Thrombolysis, primarily in acute myocardial infarction.
51
What medication reverses the effects of heparin?
Protamine sulfate.
52
What is Kcentra used for?
Rapid reversal of warfarin-associated bleeding; contains clotting factors II, VII, IX, and X.
53
What does epoetin alfa treat?
Anemia in chronic kidney disease by stimulating erythropoiesis.
54
What anticoagulant should be used in a patient with acute kidney injury and DVT?
Unfractionated heparin.
55
What medication reduces infection risk in neutropenic cancer patients?
Filgrastim (Neupogen), a G-CSF.
56
What is used to gradually reverse elevated INR from warfarin?
Vitamin K.
57
What supplement helps prevent neural tube defects in pregnancy?
Folic acid.
58
What vitamin is used to treat pernicious anemia?
Vitamin B12.
59
What drug is used for both sickle cell disease and polycythemia vera?
Hydroxyurea.
60
Which antibiotic chemotherapeutic is used for Ewing’s sarcoma?
Dactinomycin.
61
Which chemotherapeutic is known for its cardiotoxicity?
Doxorubicin.
62
Which estrogen receptor modulator is used in breast cancer therapy?
Tamoxifen.
63
What antimetabolite is used in ALL, Crohn’s disease, and ulcerative colitis?
6-mercaptopurine.
64
What pyrimidine analog is used topically, orally, or IV for skin and colorectal cancers?
5-fluorouracil.
65
Which vinca alkaloid is used in ALL and causes peripheral neuropathy?
Vincristine.
66
What platinum-based drug is used for advanced prostate cancer?
Cisplatin.
67
What GnRH agonist is used in prostate cancer therapy?
Goserelin.
68
What monoclonal antibody targets CD20 and is used for non-Hodgkin’s lymphoma?
Rituximab.
69
How does aspirin exert its antiplatelet effect?
It irreversibly inhibits COX-1 and COX-2, reducing thromboxane A2 production.
70
What is the inpatient anticoagulant of choice for DVT/PE prophylaxis in renal impairment?
Unfractionated heparin.
71
What thrombolytic is used by radiologists for direct clot lysis during interventional procedures?
Alteplase.
72
What drug is used for rheumatoid arthritis, psoriasis, and cancer as an antimetabolite?
Methotrexate.
73
What does dual antiplatelet therapy typically include?
Aspirin plus a P2Y12 inhibitor (e.g., clopidogrel).
74
What is the treatment for gastrinoma and other hypersecretory GI conditions?
Proton pump inhibitors (PPIs).
75
Which PPI is used IV for GI bleed prophylaxis in ICU patients?
Pantoprazole.
76
What antiviral is used for hepatitis B and C and inhibits viral replication?
Interferon alpha.
77
What is the mechanism of TNF blockers used in inflammatory bowel disease?
They are monoclonal antibodies that bind and inactivate TNF-alpha.
78
What are the three main pancreatic enzymes supplemented in exocrine insufficiency?
Lipase, amylase, and protease.
79
Which drug is used to prevent progression of primary biliary cholangitis?
Ursodiol (ursodeoxycholic acid).
80
In what unit are pancreatic enzyme doses measured?
Units of lipase activity.
81
What acid-reducing drug should be avoided in patients with GERD and osteoporosis?
PPIs; consider H2 blockers instead.
82
How does ondansetron (Zofran) work?
It acts centrally and peripherally on serotonin (5-HT3) receptors.
83
Why is linaclotide contraindicated in pediatric constipation?
It can cause severe dehydration in young children.
84
Why is docusate recommended in bedridden, hospitalized patients?
To prevent constipation by softening stool.
85
Why is misoprostol contraindicated in women of childbearing age?
It is abortifacient and stimulates uterine contractions.
86
What immunomodulator is used for steroid-sparing in Crohn’s disease?
6-mercaptopurine (6-MP).
87
What medication is used to escalate Crohn’s disease therapy after steroids?
Adalimumab, a TNF inhibitor.
88
Which drug is one of the most potent gastric acid reducers?
Pantoprazole.
89
What anticholinergic is used for motion sickness prevention on cruises?
Scopolamine.
90
What hemorrhoid treatment is safe in pregnancy?
Hydrocortisone and pramoxine topical cream.
91
Lamivudine belongs to what class of antiviral drugs?
Nucleoside reverse transcriptase inhibitors (NRTIs).
92
What diet modifications help with excessive intestinal gas?
Avoid carbonated drinks, chewing gum, and FODMAPs.
93
What is the treatment for steatorrhea from pancreatic enzyme deficiency?
Increase pancreatic enzyme supplementation.
94
What type of medication is ondansetron and how does it act?
5-HT3 receptor antagonist acting on both CNS and GI tract.
95
Which H2 receptor antagonist reduces stomach acid?
Famotidine.
96
What two GI medications are on the BEERS criteria for older adults?
Metoclopramide and chlorpromazine.
97
What OTC weight loss drug can cause fat malabsorption and steatorrhea?
Orlistat.
98
What is used to control post-tonsillectomy nausea and vomiting?
IM prochlorperazine.
99
What treatment is used for acute constipation in a child?
Sodium phosphate enema.
100
What is the class of scopolamine?
Anticholinergic.
101
What GI side effect can occur with magnesium hydroxide overuse?
Diarrhea.
102
What electrolyte disturbance can occur with aluminum hydroxide use?
Hypophosphatemia.
103
What formulation is appropriate for distal ulcerative colitis limited to the rectum?
5-ASA (mesalamine) enema.
104
Why should pancreatic enzymes not be chewed?
They cause enteric mucositis.
105
What OTC antidiarrheal carries a cardiac risk?
Loperamide, especially at high doses.
106
What controlled drug is used for diarrhea and contains atropine to reduce abuse?
Diphenoxylate-atropine.
107
Which GI medication is not systemically absorbed and acts as a mucosal barrier?
Sucralfate.
108
What drug causes black discoloration of the tongue and stool?
Bismuth subsalicylate.
109
What two drug classes are used for upper GI bleed treatment?
PPIs and somatostatin analogs (e.g., octreotide).
110
What antibiotic is used in H. pylori treatment for PCN-allergic patients?
Metronidazole.
111
What drug treats VIPoma and carcinoid tumors?
Octreotide.
112
Which laxative activates guanylate cyclase for IBS-C?
Linaclotide.
113
What medication is used for bladder spasms in elderly patients?
Hyoscyamine.
114
What type of laxative is recommended for short-term use only?
Stimulant laxatives like bisacodyl.
115
What class of laxative is used for bowel prep before colonoscopy?
Osmotic laxatives (e.g., polyethylene glycol).
116
What bulk-forming agent is used to promote regular bowel movements?
Psyllium.
117
After H. pylori treatment, how long should PPI therapy be continued?
Continue for 4 weeks post-antibiotic therapy.
118
How do PPIs reduce stomach acid?
They irreversibly inhibit the H⁺/K⁺ ATPase pump in gastric parietal cells.
119
What is bisacodyl’s mechanism of action?
It is a stimulant laxative that increases intestinal motility.
120
What is polyethylene glycol used for?
Osmotic laxative for bowel cleansing or chronic constipation.
121
What condition involves involuntary tongue movements from chronic dopamine antagonists?
Tardive dyskinesia.
122
Which medication treats PTSD, hypertension, and BPH?
Prazosin.
123
Which alpha blocker treats both hypertension and BPH?
Terazosin.
124
Which alpha blocker is selective for BPH only?
Tamsulosin.
125
Which medication should be stopped before taking a PDE5 inhibitor?
Doxazosin.
126
Which class of medications causes profound hypotension when combined with PDE5 inhibitors?
Alpha blockers.
127
Which diuretic should be discontinued in a patient with AKI and diarrhea?
Furosemide.
128
Which medication can cause GI irritation if taken with a potassium supplement?
Oxybutynin.
129
Which diuretic is contraindicated in Addison’s disease?
Spironolactone.
130
Which class of diuretics is the most potent?
Loop diuretics.
131
What is the best diuretic for treating bilateral lower extremity edema?
Furosemide.
132
Which class of cardiac medication reduces systemic vascular resistance?
Alpha blockers.
133
What is the most common side effect of anticholinergic drugs?
Dry mouth.
134
What medication is used to induce labor?
Oxytocin.
135
Which medication can cause gynecomastia as a side effect?
Spironolactone.
136
Which erectile dysfunction medication is injected?
Alprostadil.
137
Which PDE5 inhibitor has the longest duration of action?
Tadalafil.
138
How long does sildenafil typically last?
3 to 5 hours.
139
Which cardiac medication class reduces blood volume?
Diuretics.
140
Which medication is used to treat prostate cancer by suppressing LH and FSH?
Leuprolide.
141
What initial emotional side effect may occur with leuprolide?
Emotional lability or mood swings.
142
What patient education is needed for phenazopyridine (Azo)?
It can turn urine a red or orange color.
143
Which medication helps with urinary retention due to neurogenic bladder?
Bethanechol.
144
Which medication is used in urinary retention without obstruction?
Bethanechol.
145
Which drug is used for interstitial cystitis and acts like a LMWH?
Pentosan polysulfate (Elmiron).
146
Which diuretics help in patients with hypokalemia?
Triamterene or spironolactone.
147
What medication is used for women with chronic pelvic pain and dysuria?
Pentosan polysulfate.
148
Which diuretic has a BBW for orthostatic hypotension and electrolyte disturbances?
Furosemide.
149
Which diuretic is recommended as first-line in African American patients with hypertension?
Hydrochlorothiazide (HCTZ).
150
What must be done before starting phenazopyridine (Azo)?
Urinalysis and urine culture.
151
What serious risk is associated with oxytocin use?
Uterine rupture.
152
What medications are first-line for erectile dysfunction?
Sildenafil or tadalafil.
153
Which PDE5 inhibitor is also used for pulmonary hypertension in women?
Tadalafil.
154
Which antimuscarinic drug reduces detrusor muscle contractions?
Oxybutynin.
155
How do PDE5 inhibitors like sildenafil work?
They increase nitric oxide, enhancing cGMP and vasodilation.
156
What is a serious adverse effect of PDE5 inhibitors?
Priapism.
157
What is the first-line medication for chronic gout treatment?
Allopurinol.
158
What is the most commonly prescribed DMARD for rheumatoid arthritis?
Methotrexate.
159
What medication is used for pain and fever during pregnancy?
Acetaminophen.
160
Which OTC pain reliever is appropriate for a patient with a history of alcohol use and a headache?
Ibuprofen.
161
What muscle relaxant is used for acute back spasm?
Cyclobenzaprine.
162
Which spasmolytic is used in cerebral palsy with minimal sedation?
Baclofen.
163
What medication reduces alcohol cravings in patients with alcohol use disorder?
Naltrexone.
164
How does Suboxone (buprenorphine/naloxone) work?
Naloxone is inert orally but deters IV abuse by causing withdrawal.
165
A patient using street drugs has withdrawal symptoms. What is the likely condition?
Opioid abstinence.
166
A newborn experiencing symptoms of withdrawal was exposed to opioids in utero. What is the term?
Physical dependence.
167
Which analgesic is only partially reversed by naloxone?
Tramadol.
168
Why should you not combine a partial and full opioid agonist?
It can cause opioid abstinence syndrome.
169
What is an alternative first-line treatment for acute gout if steroids are not tolerated?
Indomethacin.
170
What is the first-line therapy for moderate-to-severe RA to prevent joint damage?
Methotrexate.
171
Which medication combo is correct for RA management?
Methotrexate and infliximab.
172
What should be prescribed if codeine-acetaminophen fails for pain?
Hydromorphone.
173
What is the WHO analgesic ladder?
Start with ibuprofen → tramadol → codeine or hydrocodone.
174
Which benzodiazepine binds GABA and causes sedation while treating spasms?
Diazepam.
175
Why can’t you safely discharge a sedated patient given flumazenil?
Flumazenil’s half-life is shorter than the sedative’s.
176
What should be added when starting urate-lowering therapy for gout?
A prophylactic NSAID like indomethacin.
177
Which NSAID is restricted due to GI and renal risks?
Ketorolac.
178
Which NSAID is contraindicated for therapy over 5 days?
Ketorolac.
179
A patient responded to naloxone but relapsed. What next?
Repeat naloxone.
180
What evaluation must be done before starting ibandronate?
Dental exam (risk of jaw osteonecrosis).
181
Which injectable medication is used for osteoporosis in patients who forget oral bisphosphonates?
Denosumab.
182
What is the MOA of bisphosphonates?
Inhibit osteoclast-mediated bone resorption.
183
What is the MOA of colchicine?
Inhibits leukocyte migration and phagocytosis.
184
Why is aspirin different from other NSAIDs?
It irreversibly binds COX enzymes.
185
What gout medication is used after allergy to probenecid and xanthine oxidase inhibitors?
Pegloticase.
186
What gout medication is used if the patient is allergic to xanthine oxidase inhibitors?
Probenecid.
187
What medication is appropriate for a first-time gout flare?
Corticosteroids.
188
If NSAID A is less COX-2 selective than NSAID B, what is the risk?
Greater GI side effects with NSAID A.
189
Which NSAID should be avoided in patients with aspirin sensitivity and nasal polyps?
Ibuprofen.
190
Which NSAID is more COX-2 selective and may have fewer GI effects?
Meloxicam.
191
Which opioid should be avoided in children who are ultra-rapid metabolizers?
Codeine.
192
What is required to prescribe schedule II controlled substances?
Federal DEA and state DHEC registration.
193
What is true of schedule II drugs?
They have high abuse potential but accepted medical use.
194
Which opioid is available as a transdermal patch?
Fentanyl.
195
What is the mechanism of NSAIDs?
They inhibit COX enzymes, reducing prostaglandin synthesis.
196
What is the BBW on all NSAIDs?
Risk of GI bleeding and cardiovascular events.
197
What OTC pain med is safest for a patient with cirrhosis?
Naproxen or ibuprofen with caution (avoid acetaminophen in excess).
198
Which OTC opioid treats diarrhea?
Loperamide.
