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Pharmacy Practice V > Cumulative Final Exam Material > Flashcards

Cumulative Final Exam Material Flashcards

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1
Q

What electrolyte changes can occur with Loop Diuretics?

A

DECREASE Potassium and Magnesium
INCREASE Uric Acid

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2
Q

What electrolyte changes can occur with Thiazides?

A

DECREASE Potassium, Magnesium, and Sodium
INCREASE Calcium, Glucose

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3
Q

What electrolyte changes can occur with Potassium Sparing Diuretics?

A

INCREASE Potassium

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4
Q

What electrolyte changes can occur with Spironolactone?

A

INCREASE Uric Acid

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5
Q

Coumadin

A

Warfarin
1. AE: Bleeding
2. DDI: BAMIF
3. CI: Pregnancy

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6
Q

Pradaxa

A

Dabigatran
1. Store in original container
2. Swallow whole
3. AE: Dyspepsia
4. DDI: Pgp + 3A4 Inhibitors = increase concentrations

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7
Q

Xarelto

A

Rivaroxaban
1. 10 mg = take without regard to food
2. 15-20 mg = take with evening MEAL
3. AE: Bleeding
4. DDI: Pgp + 3A4 Inhibitors = increase concentrations

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8
Q

Eliquis

A

Apixaban
1. AE: Bleeding
2. DDI: Pgp + 3A4 Inhibitors = increase concentrations

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9
Q

Savaysa

A

Edoxaban
1. AE: Bleeding
2. DDI: Limit dosage to 30 mg/day when using specific pg inhibitors

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10
Q

HTN Therapy Options for Patients with CKD

A
  1. ACE
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11
Q

HTN Therapy Options for Patients with DM

A
  1. ACE
  2. ARB
  3. Thiazide
  4. CCB
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12
Q

HTN Therapy Options for Patients with CAD

A
  1. BB
  2. RAAS Inhibitor
  3. CCB
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13
Q

HTN Therapy Options for Patients with HF

A
  1. Loops
  2. BB
  3. ACE
  4. ARB
  5. ARA
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14
Q

HTN Therapy Options for Patients with CVB

A
  1. ACE
  2. ARB
  3. Thiazide
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15
Q

HTN Therapy Options for Patients with AFib

A
  1. CCB
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16
Q

What is first line therapy for Chronic Stable Angina?

A
  1. Short Acting Nitrates (Nitrostat) – ACUTE exacerbation ONLY
  2. Beta Blockers – only if they are uncomplicated
  3. CCB – AVOID Non-DP CCBs
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17
Q

What Beta Blockers can be used for Chronic Stable Angina?

A
  1. Propranolol
  2. Atenolol
  3. Metoprolol Succinate
  4. Metoprolol Tartrate
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18
Q

What CCBs CANNOT be used for Chronic Stable Angina?

A
  1. NON-DP CCBs
  2. Felodipine
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19
Q

What is second line therapy for Chronic Stable Angina?

A
  1. Long Acting Nitrates (Isorbide Dinitrate)
  2. Ranolazine
  3. Ivabridine
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20
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age <75 yrs
What is the recommended therapy?

A

High Intensity Statin

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21
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age <75 yrs
4. On maximal statin therapy
5. LDL >70
What is the recommended therapy?

A

Add Ezetimibe

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22
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD Not High Risk
3. Age >75 yrs
What is the recommended therapy?

A

Start Moderate to High Intensity Statin OR
Continue High Intensity Statin if reasonable

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23
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
What is the recommended therapy?

A

High Intensity Statin

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24
Q

For patients with CLINICAL ASCVD and:
1. Healthy Lifestyle
2. ASCVD High Risk
3. On maximal statin therapy
4. LDL >70
What is the recommended therapy?

A

Add Ezetimibe

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25
For patients with CLINICAL ASCVD and: 1. Healthy Lifestyle 2. ASCVD High Risk 3. On maximal statin therapy 4. On maximal ezetimibe therapy 5. LDL >70 What is the recommended therapy?
Add PCSK9-Inhibitor
26
For patients with PRIMARY PREVENTION: 1. Age 40-75 yrs 2. LDL >70 3. NO Diabetes 4. ASCVD 5% What is the recommended therapy?
Lifestyle Modifications
27
For patients with PRIMARY PREVENTION: 1. Age 40-75 yrs 2. LDL >70 3. NO Diabetes 4. ASCVD 5-7.5% What is the recommended therapy?
Discussion, could start moderate intensity statin if needed
28
For patients with PRIMARY PREVENTION: 1. Age 40-75 yrs 2. LDL >70 3. NO Diabetes 4. ASCVD 7.5-20% What is the recommended therapy?
Start Moderate Intensity Statin
29
For patients with PRIMARY PREVENTION: 1. Age 40-75 yrs 2. LDL >70 3. NO Diabetes 4. ASCVD >20% What is the recommended therapy?
Start High Intensity Statin
30
For patients with PRIMARY PREVENTION: 1. LDL >190 What is the recommended therapy?
Start High Intensity Statin
31
For patients with PRIMARY PREVENTION: 1. Age 40-75 yrs 2. Diabetes What is the recommended therapy?
Start Moderate Intensity Statin
32
Moderate Intensity Statin should reduce LDL by what percentage?
30-49%
33
High Intensity Statin should reduce LDL by what percentage?
>50%
34
What is the amount of time needed to achieve maximal lowering of LDL?
4-5 weeks
35
For patients with ASCVD and TG 150-499 mg/dL 1. LDL > 100 2. Adherent to max tolerated statin therapy What is the recommended therapy?
Add on Ezetimibe
36
For patients with ASCVD and TG 150-499 mg/dL 1. LDL 70-99 2. Adherent to max tolerated statin therapy What is the recommended therapy?
LDL or TG lowering non statin therapy, discussion
37
For patients with ASCVD and TG 150-499 mg/dL 1. LDL <70 2. Adherent to max tolerated statin therapy What is the recommended therapy?
Start Icosapent Ethyl
38
For patients with DM and TG 140-499 mg/dL 1. Age <50 OR 2. Age >50 w/o ASCVD Risk Factors 3. Adherent to max tolerated statin therapy What is the recommended therapy?
Add Ezetimibe
39
For patients with DM and TG 140-499 mg/dL 1. Age >50 WITH >1 ASCVD Risk Factors 2. Adherent to max tolerated statin therapy What is the recommended therapy?
Start Icosapent Ethyl
40
For patients with DM and TG 140-499 mg/dL 1. TG 500-999 What is the recommended therapy?
1. Optimize statin therapy 2. Add on Fenofibrate
41
For patients with DM and TG 140-499 mg/dL 1. TG >1000 What is the recommended therapy?
Add on Fenofibrate (alternative: Iscosapent Ethyl or Omega-3-Acid Ethyl Esters)
42
What are the preferred agents for VTE?
DOACs
43
Pradaxa and Savaysa should be started how many days after parenteral?
5-10 days after
44
What are the first line therapy options for HTN?
1. ACEs 2. ARBs 3. CCBs 4. Thiazides
45
What drugs can be utilized in the treatment of AFib?
1. Amiodarone 2. Digoxin 3. Dofetilide 4. Metoprolol Tartrate 5. Flecainide
46
DOACs can also be utilized as therapy in what type of AFib?
Nonvalvular
47
Warfarin can also be utilized as therapy in what type of AFib?
Valvular
48
What drugs have Symptom Benefit in the treatment of HFrEF?
Loop Diuretics
49
What drugs have Hospitalization Benefit in the treatment of HFrEF?
1. Digoxin 2. Ivabradine
50
What drugs have Mortality Benefit in the treatment of HFrEF?
1. ACE 2. ARB 3. ARNI 4. BB 5. SGLT2 6. ARA 7. Isosorbide/Hydralazine
51
Humalog
Lispro - Rapid Acting Onset: 15-30 mins Peak: 2 hrs Duration: 3-5 hrs Dosing: Before you eat
52
Admelog
Lispro - Rapid Acting Onset: 5 mins Peak: 2 hrs Duration: 3-5 hrs Dosing: Before you eat
53
Novolog
Aspart - Rapid Acting Onset: 15-30 mins Peak: 2 hrs Duration: 3-5 hrs Dosing: Before you eat
54
Fiasp
Aspart - Rapid Acting Onset: 5 mins Peak: 2 hrs Duration: 3-5 hrs Dosing: Before you eat
55
Afrezza
Rapid Acting Onset: 10-15 mins Peak: 2 hrs Duration: 3-5 hrs Dosing: Before you eat
56
Which rapid acting insulin has a U-200 formulation?
Humalog
57
Humulin R
Short Acting Onset: 30-60 mins Peak: 2-3 hrs Duration: 6-8 hrs Dosing: Before you eat
58
Novolin R
Short Acting Onset: 30-60 min Peak: 2-3 hrs Duration: 6-8 hrs Dosing: Before you eat
59
What short acting insulin has a U-500 formulation?
Humulin R
60
Humulin NPH
Intermediate Acting Onset: 2-4 hrs Peak: 4-6 hrs Duration: 8-12 hrs Dosing: BID
61
Novolin NPH
Intermediate Acting Onset: 2-4 hrs Peak: 4-6 hrs Duration: 8-12 hrs Dosing: BID
62
Lantus
Glargine - Long Acting Onset: 2 hrs Peak: PEAKLESS Duration: 24 hrs Dosing: QD
63
Levemir
Detemir - Long Acting Onset: 2 hrs Peak: 6-8 hrs Duration: 24 hrs Dosing: QD
64
Toujeo
Glargine - Long Acting Onset: 2 hrs Peak: 6-8 hrs Duration: 36 hrs Dosing: QD
65
Tresiba
Degludec - Long Acting Onset: 2 hrs Peak: 6-8 hrs Duration: 42 hrs Dosing: QD
66
Basaglar
Glargine - Long Acting Onset: 2 hrs Peak: 6-8 hrs Duration: 30 hrs Dosing: QD
67
Semglee
Glargine - Long Acting Onset: 2 hrs Peak: 6-8 hrs Duration: 24 hrs Dosing: QD
68
Which TWO long acting insulins are considered bio similar?
1. Basaglar 2. Semglee
69
Which long acting insulin has a U-200 Formulation?
Tresiba
70
Which long acting insulin has a U-300 Formulation?
Toujeo
71
When should Humalog, Admelog, and Novolog be administered in relation to eating?
15 minutes prior to eating
72
When should Fiasp be administered in relation to eating?
15 minutes prior to eating or 20 minutes after
73
When should Afrezza be administered in relation to eating?
At the beginning of the meal BUT allow the cartridge to sit at room temp for 10 MINUTES before
74
When should Humulin R be administered in relation to eating?
30 minutes prior to eating
75
When should Humulin N be administered in relation to eating?
Administer once or twice daily
76
When should Lantus, Basaglar, Semglee, and Toujeo be administered?
In the evening or before bed
77
When should Levemir be administered?
QD or BID
78
When should Humalog Mix and Novolog Mix be administered in relation to food?
15 minutes prior to AM and PM meal
79
When should Humulin Mix be administered in relation to food?
30-45 minutes before AM and PM meal
80
Soliqua
Insulin Glargine + Lixeisenatide
81
Glucophage/Glumetza Pearls
CI = eGFR <30, do not initiate if eGFR 30-45 AE: Diarrhea, GI effects, DECREASED B12 Warning: Lactic Acidosis
82
Sulfonylureas Pearls
Amaryl, Diabeta/Micronase, Glucotrol CI: T1DM and Sulfa Allergy AE: Weight Gain, HYPOGLYCEMIA, GI Upset DDI: Beta Blockers can mask symptoms of hypoglycemia
83
When should Amaryl, Diabeta, Glucotrol be taken in relation to food?
QD WITH Breakfast
84
Are sulfonylureas independent or dependent of glucose?
INDEPENDENT
85
What drugs have the highest risk of HYPOglycemia?
1. Sulfonylureas 2. Insulin
86
Meglitinides Pearls
Prandin and Starlix CI: T1DM AE: Weight Gain, Hypoglycemia, GI Upset DDI: BB
87
When should Prandin and Starlix be administered in relation to food?
TID 30 minutes before a meal
88
Are Meglitinides independent or dependent of glucose?
DEPENDENT
89
Thiazolidinediones Pearls
Actos and Avandia CI: Class 3 or 4 Heart Failure and T1DM AE: EDEMA, weight gain Warning: risk for bladder cancer and hepatic dysfunction
90
When should Actos and Avandia be taken in relation to food?
Once DAILY
91
DPP-4 Inhibitor Pearls
Januvia, Onglyza, Tradjenta, Nesina AE: HA, Arthralgia, Pharyngitis Warning: Pancreatitis
92
When should Januvia, Onglyza, Tradjenta, and Nesina be taken in relation to food?
Once DAILY
93
Are DPP-4 Inhibitors independent or dependent on glucose?
DEPENDENT
94
When should you dose adjust Januvia and Onglyza?
eGFR <45
95
When should you dose adjust Nesina?
eGFR <60
96
SGLT-2 Inhibitor Pearls
Invokana, Farxiga, Jardiance, and Steglatro CI: Dialysis AE: Increased Urination, UTI, Genital fungal infections Warning: lower limb amputations
97
When should you administer Invokana, Farxiga, Jardiance, and Steglatro in relation to food?
Once DAILY
98
When should you AVOID Invokana and Jardiance?
eGFR <30
99
When should you AVOID Farxiga and Steglatro?
eGFR <45
100
GLP-1 Agonist Pearls
Byetta, Victoza, Adlyxin, Trulicity, Ozempic, Rybelsus, Mounjaro AE: Nausea, Diarrhea, and HA Warning: Pancreatitis
101
When should you administer Byetta in relation to food?
SQ BID
102
When should you administer Victoza and Adlyxin in relation to food?
SQ QD
103
When should you administer Trulicity, Ozempic, and Mounjaro in relation to food?
SQ WEEKLY
104
When should you administer Rybelsus in relation to food?
PO 30 Minutes prior to FIRST food
105
Are GLP-1 Agonists independent or dependent of glucose?
DEPENDENT
106
Precose Pearls
CI: GI Disorders and IBD AE: Flatulence and Diarrhea Warning: Increased LFTs
107
When should you administer Precose in relation to food?
TID PO with FIRST BITE of food SKIP dose if you SKIP a meal
108
Symlin Pearls
CI: Gastroparesis AE: Nausea Counsel: Admin in thigh or abdomen
109
When should you administer Smylin in relation to food?
TID SQ with MEALS
110
How do you calculate the Total Daily Dose TDD?
0.5 units/kg/day
111
How do you calculate the Rapid Acting Correction Factor CF?
1800/TDD "give 1 unit for every CF over target"
112
How do you calculate the Regular Correction Factor CF?
1500/TDD "give 1 unit for every CF over target"
113
How do you calculate the Insulin-to-Carbohydrate Ratio?
500/TDD = Insulin to Carb Ratio "give 1 unit for every __ grams of carbs"
114
What is the MOA of Biguanides?
Decrease hepatic glucose production, improved insulin sensitivity, decreased GI carb/glucose absorption
115
What is the MOA of Sulfonylureas?
Increased insulin secretion by beta cells, glucose INDEPENDENT, insulin secretagogue
116
What is the MOA of Meglitinides?
Increased insulin secretion by beta cells, glucose DEPENDENT, insulin secretagogue
117
What is the MOA of TZDs?
Decreased hepatic glucose production, improved insulin sensitivity
118
What is the MOA of DPP4 Inhibitors?
Increased insulin secretion by beta cells, decreased glucagon secretion, increases activity go GLP1 and GIP
119
What is the MOA of SGLT2 Inhibitors?
Decreased reabsorption of filtered glucose to increase excretion
120
What is the MOA of GLP1 Agonists?
Increased insulin secretion by beta cells, decreased glucagon secretion, delayed gastric emptying, increased satiety
121
What is the MOA of Precose?
Decreased GI carb/glucose absorption
122
What is the MOA of Symlin?
Delayed gastric emptying, decreased postprandial glucagon secretion, decreased appetite
123
Bentyl Pearls
Dicyclomine- Anticholinergic CI: Glaucoma, Urinary/GI Obstruction, Severe UC, MI, or CVD
124
Levsin/Levbid Pearls
Hyoscyamine- Anticholinergic CI: Glaucoma, Urinary/GI Obstruction, Severe UC, MI, or CVD DDI: Antacids and Alcohol
125
Lomotil Pearls
Diphenoxylate/Atropine- Opioid Agonist+Anticholinergic Short term use within 10 DAYS
126
Bentyl, Levsin/Levbid, and Lomotil are anticholinergics used for what?
IBS-D
127
Lotronex
Alosetron- 5HT3 Antagonist AE: Constipation Warning: Ischemic Colitis -- REMS FEMALES ONLY
128
Lotronex is for WOMEN ONLY and used for what?
IBS-D
129
Viberzi
Eluxadoline- Mu-Opioid Receptor Agonist DDI: OATP1B1 Inhibitors Warning: Pancreatitis and Severe Constipation
130
Viberzi has a pancreatitis risk but it is used for what?
IBS-D
131
Imodium
Loperamide- Peripheral Mu-Opoid Receptor Agonist CI: Diarrhea secondary to infection Warning: CNS infection
132
Imodium is OTC and can be used for what?
IBS-D
133
Miralex
PEG- Osmotic Laxative May take 48-96 hours for effect
134
CoLyte
PEG+Electrolytes- Osmotic Laxative
135
Chronulac
Lactulose- Osmotic Laxative AE: Gas or Abdominal Discomfort May take 24-48 hours for effect
136
How do you titrate Chronulac?
Titrate to 2-3 stools/day
137
Miralax, CoLyte, and Chronulac are Osmotive Laxatives that draw water into the intestine to hydrate and soften stool, what are they used for?
IBS-C
138
Senokot
Senna- Stimulant Laxatives QD at HS Administer 2hrs before or after other meds Onset within 6-24 hrs
139
Senokot is used for what?
IBS-C
140
Colace
Docusate- Stool Softener DDI: Do NOT COMBINE with Mineral Oil May take 12-72 hrs for effect
141
Colace is a prevention method used for what?
IBS-C
142
Amitiza
Lubiprostone- Pro-Secretory Agent CI: GI Obstruction AE: NAUSEA, diarrhea, abdominal pain, and HA TAKE WITH FOOD FEMALES >18 yrs ONLY
143
Amitiza is used in females ONLY for what?
IBS-C
144
Linzess
Linaclotide- Pro-Secretrory Agent CI: GI obstruction and use in pediatrics <6 yrs AE: Diarrhea, abdominal pain Take on EMPTY stomach
145
Linzess is CI'd in children less than 6 yrs, but used in what?
IBS-C
146
Relistor
Methylnaltrexone- PAMORA Warning: Risk of GI perforation NEVER use in GI Obstruction or Impaired Integrity
147
Prucalopride
Motegrity- Selective 5-HT Agonist AE: Suicidal Ideation
148
Relistor (PAMORA) and Prucalopride (Selective 5-HT Agonist) are both used in what?
IBS-C
149
For Opioid Induced Constipation, what is first line?
Laxatives
150
Combination of at least 2 types of Laxatives such as osmotic + stimulant or stimulant + stool softener is recommended before what?
Escalating Therapy
151
In Opioid-Induced Constipation, what is recommend for administration and escalation?
SCHEDULED USE Escalate to mu-opioid antagonist
152
Compazine
Prochlorperazine CI: Movement disorders AE: Drowsy/Dizzy/Blurred Vision/EPS
153
Phenergan
Promethazine CI: IM/IV/SQ AVOIDED due to risk of tissue injury AE: Drowsy, Anticholinergic, EPS
154
Zofran
Ondansetron AE: QT Prolongation
155
Reglan
Metoclopramide CI: GI obstruction, EPS AE: QT Prolongation
156
What is the limit of use for Reglan?
12 weeks
157
What are the ALARM symptoms for GERD?
1. Trouble or Pain swallowing food 2. Vomiting with blood, or bloody/black stools 3. Unintentional weight loss 4. Choking
158
Warfarin has an interaction with what CYP2C9?
Celecoxib
159
Aspirin has an interaction with what drug that causes decreased cardio protection?
Ibuprofen
160
Aspirin has an interaction with what drug that causes increased GI bleed risk?
Celecoxib

Pharmacy Practice V (19 decks)

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