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Flashcards in Correlate Review Deck (207):
1

Sildenafil (viagra) and antibiotics

Viagra is metabolized by CYP450 so use the smallest dose possible when using with other 3A4 drugs (macrolides except azithro and azoles).

2

Step 4 Asthma Treatment

Medium Dose ICs and LABA or montelukast

3

Step 2 Asthma Treatment

Low Dose ICS or cromolyn or montelukast

4

H. Pylori Treatment

Clarithromycin (caution with statins). PPIs can cause false positives.

5

Betaxolol

Second Gen Beta-Blocker (Cardioselective)

6

First Gen Beta-Blocker (Non-Cardioselective) Side Effects

Bronchospasm, worsen CHF, exercise intolerance, depression, fatigue, raise lipids, imparied glucose tolerance, decreased libido. Avoid abrupt withdrawal.

7

Intermittent Asthma

less than or equal to 2 times a week. No nighttime awakenings.

8

Parkinson's and DA

Smooth movement. Substantia nigra to basal ganglia .

9

Furosemide and metoprolol and lisinopril

All lower BP (hypotension). Decreased renal blood flow with increase digoxin levels.

10

Stage 1 HTN

140-159/90-99

11

Fexofenadine (Allegra)

Second Generation H1 blocker. Longer lasting and non sedating. Approved for pilots.

12

Step 1 Asthma Treatment

SABA PRN

13

Prochlorperazine (compazine)

Anti-emetic. Has anticholinergic effects, CNS depression EPS.

14

Ranitidine (Zantac)

H2 blocker. Used as adjunct for uticaria.

15

Citalopram (celexa) Side Effects

Insomnia, somnolence, nausea, dry mouth, sexual dysfunction.

16

Velafaxine (Effexor) indications

SNRI. MDD, GAD, SAD, panic.

17

Aliskren (tekturna) Side Effects

Hyperkalemia, renal impairment, hypersensitivity. Contraindicated in pregnancy.

18

Diphenhydramine (Benadryl)

(Nytol, Sominex). First Generation H1 blocker.

19

African Americans and HTN

CCB or thiazide

20

Salmerterol/fluticasone

LABA + ICS. Control. Thrush and hoarseness.

21

Labetolol

Combined Alpha and Beta antagonist

22

Meclizine (Antivert)

First Generation H1 blocker.

23

Hydrocodone Schedule

Schedule II

24

IBD Treatment

Newly diagnosed cases should get a tapering dose of prednisone. adalimumab (humira), infliximab (remicade).

25

Drugs that potentiate Digoxin

Diuretics (except spironolactone), Propranolol, amiodarone, Antibiotics (erythromycin and tetracycline), IV calcium, CCB, quinidine, thyroid hormone.

26

Hyperthyroidism and HTN

BB

27

Norepinephrine in the cerebral cortex

Arousal and attention

28

Nociceptive Pain Treatment

NSAIDs, Tramadol, opiates, muslce relaxants, PT

29

Step 6 Asthma Treatment

Add oral Glucocorticoid.

30

Metoprolol

Second Gen Beta-Blocker (Cardioselective)

31

Spironolactone

potassium sparing diuretic and aldosterone antagonsit (decreases number of sodium channels).

32

Norepinephrine in the hypothalamus

Appetite. Increased NE suppresses appetite.

33

Stage C COPD Treatment

ICS + LABA or LAMA

34

Morphine Schedule

Schedule II

35

Acebutolol

Second Gen Beta-Blocker (Cardioselective)

36

Norepinephrine targets

Limbic lobe, Cerebral Cortex and hypothalamus.

37

Contraindicated in Depression

BB, central alpha blocker

38

Stage D COPD Treatment

ICS+ LABA + LAMA

39

Metoclopramide (reglan)

Prokinetic. Risk of EPS and tardive. SE: cramping and diarrhea.

40

Norepinephrine in the limbic lobe

Mood. Increased/decreased NE release is associated with bipolar disorder.

41

Prazosin ("-zosins") Side Effects

First dose phenomenon (postural hypotension). fatigue, weakness, nasal congestion and HA. Beneficiall effect on lipids and BPH.

42

Bisacodyl (dulcolac)

Stimulant laxative

43

Essential tremor and HTN

BB (nonselctive)

44

Timolol

First Gen Beta-Blocker. Non-Cardioselective.

45

Citalopram (celexa) Indications

SSRI. MDD only

46

CKD and HTN

ACEI/ARB

47

Clorpheniramine (Chlor-trimeton)

First Generation H1 blocker.

48

Risks of PPIs

Malabsorption (ca, mg, iron, b12), osteoporosis, respiratory/enteric infections, CKD.

49

Serotonin in the cerebral cortex

Sensation and perception

50

SSRI/SNRI Black Box Warning

Incrased suicidal thinking in children and young adults (monitor closely during first 1-2 months). Trip a manic episode if underlying bipolar disorder. Must taper down gradually.

51

Dicyclomine

Anti-spasmodic used for IBS. Anticholinergic properties. Caution in elderly.

52

Combined Alpha and Beta antagonist Side effects

Orthostatic hypotension, bronchospasm. Really only used in HTN emergencies or after an MI.

53

NSAIDS and Renal Function

NSAIDS cause vasoconstriction of the afferent arterioles

54

Sertraline (Zoloft) Indications

SSRI. MDD, OCD, Panic, PTSD, SAD, nocturnal eating, PMDD

55

Norepinephrine production site

Brianstem

56

Propranolol

First Gen Beta-Blocker. Non-Cardioselective.

57

Contraindicated in gout

diuretics

58

Neuropathic Pain Treatment

Neurontin (gabapentin), Lyrica (pregabalin), Elavil (amitriptyline), Cymbalta (duloxetine), lidoderm patch, spinal cord stimulator, ESI.

59

Magnesium antacids Side effects

Diarrhea

60

Antihistamines and Breast Feeding

Loratadine (Claritin) and Cetirizine (Zyrtec)

61

Contraindicated in second or third degree block

BB, verampamil/diltiazem

62

Sodium-bicard Side effects

Fluid retention (caution in CHF)

63

Pre-HTN

120-139/80-89

64

Chronic Stable Angina

BB

65

Clonidine and Methyldopa MOA

Central acting alpha agonist (alpha2). Reduces SNS vasoconstriction and vascular resistance.

66

Statins and antibiotics

Risk of elevated transaminase levels, myopathy, rhabdomyolysis and ARF. Contraindicated with Erythromycin, itraconazole, niacin and gemfibrozil.

67

Desvenlafaxine (pristiq) Indications

SNRI. MDD only.

68

Stage 2 HTN

greater than 160/100

69

Fluoxetine (Prozac) Side Effects

Insomnia (take in am), HA, Nervousness, decreased libido, diarrhea, anorexia. Longest half life with the broadest effects, least specific for 5HT.

70

Oral Gluccocotricoids and asthma

Prednisone. Used for acute exacerbations. SE: anxiety, agitation, insomnia, increased appetite.

71

ARB ("-sartans") MOA

Blocks the effect of angiotensin II on the tissue.

72

Urticaria treatment

Second generation antihistamines with an H2 blocker as adjunct. Consider adding a tapering course of steroids.

73

Opiates and ESRD

DOC is fentanyl. Avoid morphine, demerol, vicodin, codeine.

74

Docusate (colace)

Stool Softener. Safe in pregnancy.

75

Nifedipine ("-pines") MOA

CCB. Dihydropyridines that cause arteriolar smooth muscle relaxation and decrease peripheral resistance. Potent vasodilators.

76

Olopatadine (patanol)

Antihistamine eye drops. Mast cell stabilizer.

77

A-Fib and HTN

BB, verapamil/diltiazem

78

Escitalopram (lesapro) Side Effects

Insomnia, somnolence, nausea, ejaculation disorders.

79

Buproprion (wellbutrin) Side Effects

Insomnia, HA, nausea, weight loss, dry mouth, tachycardia, dizziness. Less Sexual side effects compared to SSRIs. Avoid in patients with seizure disorder (lowers the seizure threshold) and anorexia.

80

ARB ("-sartans") Side Effects

hypotension and hyperkalemia. Contraindicated in pregnancy.

81

Aliskren (tekturna) MOA

Direct renin inhibitor. Decreases plasma renin activity.

82

Antihistamine Side Effects

Anticholinergic side effects (First generation more so than second). Sedation (First gen). Impotence, urinary hesitancy, sedation, confusion, weight gain, hypersensitivity, prolonged QT (arrhythmias).

83

Montelukast (singulair)

Leukotriene receptor antagonist. SE: URIs, HA, abdominal pain, mood changes.

84

Thiazide MOA

Block sodium reabsorption in the distal convoluted tubule via Na/Cl transporter.

85

Contraindicated in Liver Disease

Methyldopa

86

Levaquin Renal dosing (CAP)

Renal dosing is based on the creatinine clearance. Monitor serum levels of the drug.

87

Step 3 Asthma Treatment

Medium Dose ICS

88

Sertraline (Zoloft) Side Effects

Insomnia, HA, Dizziness, fatigue, Decreased libido, somnolence, nausea, diarrhea, anorexia, dry mouth

89

Antiepileptics and antibiotics

such as phenytoin, carbamazepine and phenobarbital. Effects are ptentiated by inhibitors of CYP450: Macrolides (EXCEPT Azithromycin), and the azoles.

90

Serotonin in the hypothalamus

Appetite and sleep

91

Second Gen Beta-Blocker (Cardioselective) Side Effects

Less side effects than first generation. Still raise lipids. Avoid abrupt withdrawal (MI, rebound HTN, bronchoconstriction).

92

Infective Esophagitis

Fluconazole. Beware of interaction with statins (rhabdo and myopathy).

93

Codeine Schedule

Schedule II

94

Buproprion (wellbutrin) Indications

DA reuptake inhibitor. MDD, SAD and smoking cessation. Can be used in combination with SSRIs.

95

MDD treatment plan

Antidepressants (SSRIs are first line), +/- psychotherapy, follow up in 1-2 weeks (SE profile), instructions on when to contact provider, crisis line number, community resources. Refer if PHQ-9 is greater than 16.

96

Nadolol

First Gen Beta-Blocker. Non-Cardioselective.

97

Dopamine Production to Targets

Substantia nigra to basal ganglia Ventral tegmentum to nucleus accumbens/frontal cortex

98

SSRI/SNRI Patient Education

Takes 2-8 weeks to have effect. Side effects usually occur during the first few days and resolve in a week. Do not stop abruptly (need taper).

99

Severe asthma

Throughout the day. Night time awakenings weekly.

100

Ondansetron (zofran)

Anti-emetic. QT prolongation and risk of serotonin syndrome.

101

Misoprostol (cytotc)

Prevents ulceration induced by NSAIDs. Contraindicated in pregnancy.

102

Contraindicated in Renovascular Disease

ACEI/ARB, renin inhibitor

103

OCPs and antibiotics

Insufficient evidence but still encouraged to use an alternative form of birth control.

104

ACEI ("-prils") Side Effects

Dry cough, orthostatic hypotension, hyperkalemia, angioedema, elevated creatinine, rash. Contraindicated in Pregnancy.

105

Angina and HTN

BB or CCB

106

Desvenlafaxine (pristiq) Side Effects

Same as SSRIs with adrenergic effects. Insomnia, HA, nervousness, diaphoresis, constipation/diarrhea, dizziness, increased BP, ejaculation/orgasm difficulties.

107

Parozetine (Paxil) Side Effects

Most weight gain of all SSRIs (especially in combo with antipsychotic). Insomnia, HA, Dizziness, fatigue, Decreased libido, somnolence, nausea, diarrhea, anorexia, dry mouth

108

Mild Asthma

more than twice a week

109

Migraines and HTN

BB

110

Contraindicated in hyponatremia

thiazides

111

Stage A COPD Treatment

SABA or SAMA PRN

112

Mitrazapine (Remeron) Side Effects

Somnolence, increased appetite, weight gain, increased cholesterol, constipation, dry mouth. Less sexual side effects than SSRIs.

113

Dilitiazem MOA

Middle ground between the dipines and verapamil.

114

Tylenol with Codeine Schedule

Schedule III

115

Oxymorphone Schedule

Schedule II

116

Contraindicated in Pregnancy

ACEI/ARB, renin inhibitor

117

Verapamil and Diltiazem Indications

Arrhythmias, variant angina, long term angina and a-fib.

118

Famotidine (Pepcid)

H2 blocker. Used as adjunct for uticaria.

119

Promethazine (Phenergan)

First Generation H1 blocker.

120

ACEI ("-prils") MOA

Block the enzyme to stop the formation of angiotensin II. Causes venous dilation (decreases resistance and BP)

121

Anticholinergics and COPD

Relief. Long acting: Tiotripium (spiriva). Short acting: Ipatripium (atrovent). Dry mouth, cough, HA, nausea, blurred vision, dizziness.

122

Pindolol

First Gen Beta-Blocker. Non-Cardioselective.

123

ACEI/ARBs and Renal Function

Vasodilate the efferent arterioles. Increase the risk or hyperkalemia with renal failure.

124

Loops Side Effects

HYPOKALEMIA.

125

Duloxetine (cymbalta) Side Effects

Insomnia, somnolence HA, Dizziness, fatigue, nausea, anorexia, dry mouth, contstipation/diarrhea, sexual dysfunction. Doesn't increase BP like other SNRIs. Contraindicated in liver disease.

126

Scabies Antihistamine Choice

Hydroxyzine (Atarax) stops the itching and helps with sleep. Treatment also includes permethrin cream 5%.

127

Drugs that Cause Constipation

Anti-psychotics, aluminum hydroxide, dicyclomine (bentyl), antidepressants, CCBs, calcium, opiods.

128

Second Gen Beta-Blocker (Cardioselective) Indications

Good to treat HTN if previous MI, Stable CHF, angina or A-fib

129

Nociceptive Pain

Injury to tissues. Somatic or visceral.

130

Ketotifen (zatidor)

Antihistamine eye drops. Mast cell stabilizer.

131

Potassium sparing Diuretics Side Effects

Don't combine with ACEI/ARBs due to risk of hyperkalemia. Not great diuretics, may be combined with loops to balance potassium effects.

132

Albuterol

Short acting beta agonist. SE: tachycardia, tremor, nervousness, dizziness.

133

Triamterene

potassium sparing diuretic. Inhibits Na/K exchanger in the collecting tubule independent of aldosterone.

134

Magnesium Hydroxide

Osmotic Laxative

135

NSAIDS and ACEI/ARB and Diuretics

BAD NEWS. Increased risk of AKI.

136

H2 blockers Indications

Quick onset for on-demand relief. Most effective at decreasing night time acid production.

137

Azelastine (Optivar)

Antihistamine eye drops

138

Mitrazapine (Remeron) Indications

Presynaptic alpha 2 antagonist (enhances noradrenergic and serotonergic transmission). Often used in elderly patients with depression, sleep, and increased appetite.

139

Verapamil and Diltiazem Side Effects

Diarrhea (verapamil). Bradycardia, SA node dysfunction, heart block.

140

BPH and HTN

Alpha blocker (zosins)

141

Moderate asthma

Daily

142

Thiazide Side Effects

hypokalemia, hyperuricemia, hyponatremia, hypercalcemia, hypertriglyceridemia, hypercholesteremia.

143

Post MI and HTN

ACEI/ARB, BB, Adlo agonist

144

Bisoprolol

Second Gen Beta-Blocker (Cardioselective)

145

Loratadine (Claritin)

Second Generation H1 blocker. Longer lasting and non sedating. Approved for pilots and breast feeding (category B).

146

Cetririzine (Zyrtec)

Second Generation H1 blocker. Longer lasting and non sedating (Most sedation of second gen). Ok for breast feeding (category B).

147

Loop Diuretics

Furosemide, torsemide, bumetanide

148

Methadone Schedule

Schedule II

149

Serotonin in the Limbic Lobe

Mood. Decreased serotonin release is correlated to mood disorders and OCD

150

Acute COPD exacerbation treatment

Albuterol/ipratropium (duoned) SVN, intensify SABA +/- SAMA, Oral steroids, Antibiotics (macrolide or fluoroquinolone) if 2/3 of the cardinal symptoms (dyspnea, sputum volume, purulent sputum).

151

MDD Treatment length

at least 4-9 months after determining therapeutic dose. Risk of reoccurence should have 1-3 years of treatment. Multiple episodes or comorbid disorders will have indefinite treatment.

152

Carvediolol

Combined Alpha and Beta antagonist

153

Fluoxetine (Prozac) Indications

SSRI. MDD, OCD, Bulemia, panic, PMDD, depression with bipolar disorder (combined with olanzapine (zyprexa)).

154

Diluadid Schedule

Schedule II

155

Addiction pathaway

Pleasure and reward. DA from Ventral tegmentum to nucleus accumbens/frontal cortex.

156

Metformin and Renal Function

Contraindicated in ARF due to the high risk of lactic acidosis.

157

Clonidine and Methyldopa Side Effects

Orthostatic hypotension, sedation, drowsiness, avoid abrupt withdrawal (rebound HTN). Used only for refractory HTN.

158

Verapamil MOA

CCB. Diphenylalkylamines. Less vasodilation. Has negative ionotripic and chronotropic properties.

159

Azelastine + fluticasone (Dymista)

Antihistamine nasal spray

160

Antihistamine Contraindications

BPH and glaucoma (closed angle).

161

Serotonin Targets

Limbic Lobe, Hypothalamus, cerebral cortex.

162

Parozetine (Paxil) Indications

SSRI. MDD, Panic, OCD, GAD, PTSD, SAD, PMDD

163

Step 5 Asthma Treatment

High Dose ICS and LABA or montelukast

164

Thiazide Diuretics

HCTZ, Chlorothiazide, Metolazone. First line choice for african americans.

165

Duloxetine (cymbalta) Indications

SNRI. MDD. neuropathic pain (DM) and fibrimyalgia.

166

Anaphylaxis Treatment

Epinephrine! Diphenhydramine (benadryl). IM glucocorticoid (dexamethasone). Famotidine (pepcid).

167

Amiloride

potassium sparing diuretic. Inhibits Na/K exchanger in the collecting tubule independent of aldosterone.

168

Osteoporosis and HTN

Thiazides

169

Serotonin Production Site

Brainstem

170

Contraindicated in Angioedema

ACEI

171

Cimetidine

H2 blocker. CYP450 and antiandrogen effects.

172

Escitalopram (lesapro) Indications

SSRI. MDD and GAD.

173

HTN Treatment Goals

140/90 unless older than 60 (without CKD or DM) then 150-90.

174

Ceftriaxone renal dosing (CAP)

No adjustment needed

175

Nifedipine ("-pines") Side Effects

reflex tachycardia, HA, flushing (short term). Edema. Less affect on contractility.

176

Systolic Failure and HTN

ACEI/ARB, BB, Diuretic, aldosterone agonists.

177

Stage B COPD Treatment

LAMA or LABA

178

Atenolol

Second Gen Beta-Blocker (Cardioselective)

179

PPI indications

Reflex esophagitus. Takes 3-4 days to work. Take every morning before breakfast. Caution of rebound effect.

180

Ocycodone Schedule

ScheduleII

181

PUD Treatment

PPI, amoxicillin and clarithromycin. Can add bismuth subsalicylate.

182

Fentanyl Schedule

Schedule II

183

Azelastine (Astelin)

Antihistamine nasal spray

184

Digoxin and metoprolol interaction

Both cause bradycardia which can lead to an AV block

185

Digoxin and Furosemide Interaction

Loop diuretics can cause hypokalemia which increases digoxin toxicity.

186

Velafaxine (Effexor) Side Effects

Same as SSRIs with adrenergic effects. Insomnia, HA, nervousness, diaphoresis, constipation/diarrhea, dizziness, increased BP, ejaculation/orgasm difficulties. Take with food. Must be tapered (impending sense of doom).

187

Contraindicated in hyperkalemia

Aldo antagonists, ACEI/ARB, renin inhibitor

188

DOC for Reflux esophagitus

PPIs (prazoles).

189

Vasospastic Angina DOC

CCB

190

Contraindicated in Bronchospastic Disease

BB

191

Naphazoling (naphcon A)

Antihistamine eye drops

192

Fluticasone (flovent)

low dose ICS

193

Promethazine (phenergan)

Anti-emetic. SE: Sedation, CNS/Respiratory depression. Contraindicated in children less than 2 due to respiratory depression.

194

Soma Schedule

Schedule IV

195

MDD Screening

PHQ-9. 5-9 (minor), 10-14 (moderate), 15-19 (mod-severe), 20 or more (severe).

196

Warfarin and Antibiotics

Ciprofloxacin, macrolides (erythromycin, azithromycin), metronidazole, bactrim are contraindicated. Almost all antibiotics can potentiate warfarin but inhibiting the intestinal flora that produces vitamin K.

197

Azithromycin Renal dosing (CAP)

No adjustment needed

198

Dimenhydrinate (Dramamine)

First Generation H1 blocker.

199

Loop MOA

Blocks Na/K/2Cl transporters in the thick ascending limb.

200

Fluoroquinolones (floxacins)

Don't combine with cations (ca, mg, al, iron). Will reduce the absorption of fluoroquinolones. At least take 2-4 hours apart.

201

MDD DSM-V Criteria

Five or more symptoms (SIGECAPS) for at least 2 weeks. At least one symptom must be depressed mood or lost of interest/pleasure.

202

MDD Presentation

SIGECAPS. Sleep, Interest (lack), Guilt, Energy (decreased), Concentration (indecisiveness), Appetite, Psychomotor (agitation or retardation), Suicidal ideation.

203

Poison Ivy Treatment

Steroid cream (triamcinolone) and Second gen antihistamine (zyrtec). Steroid taper if not improving.

204

Raynaud's and HTN

CCB (dipines)

205

Penbutolol

First Gen Beta-Blocker. Non-Cardioselective.

206

Prazosin ("-zosins") MOA

Alpha antagonist. Reduces NE constriction leading to vasodialtion.

207

Hydroxyzine (Atarax)

(vistaril) First Generation H1 blocker. Extremely sedating.