EOR #7 pharm part 1

Question 1

Common indications of mirtazapine

Answer 1

Major depressive d/o

Question 2

MOA of mirtazapine

Answer 2

Increases release of serotonin and NE and potent antagonism of 5HT2 and 5HT3 serotonin receptors

Question 3

Common adverse effects of mirtazapine

Answer 3

Drowsiness
Dry mouth
Increased appetite
Constipation
Wt gain
Dizziness

Question 4

Renal or hepatic dose adjustments for mirtazapine

Answer 4

May need an increased dose in renal impairment

Question 5

BBW for mirtazapine

Answer 5

Increased suicidal thinking and behavior, especially in children and young adults

Question 6

Clinically sig drug interactions with mirtazapine

Answer 6

MAO inhibitors

May increase risk of upper GI bleed with ASA or NSAIDs

Question 7

Major counseling points of mirtazapine

Answer 7

Pay close attention and report sudden changes in mood, behavior, thought or feelings
May cause drowsiness
It takes 2 weeks before full effects are seen
Do not abruptly d/c this med

Question 8

Monitoring parameters of mirtazapine

Answer 8

Improvement of s/sx of depression
Unusual changes in behavior
Suicidality

Question 9

Common indications of Pen VK

Answer 9

Various infections

Question 10

MOA of Pen VK

Answer 10

Inhibits cell wall mucopeptide biosynthesis

Question 11

Common AEs of Pen VK

Answer 11

Black tongue
Diarrhea
Vomiting

Question 12

Renal or hepatic dose adjustments for Pen VK

Answer 12

Consider dose adjustments with either renal or liver failure

Question 13

Clinically sig drug interactions with Pen VK

Answer 13

May result in an increased INR when taken by a warfarin pt

Question 14

Major counseling points of Pen VK

Answer 14

Take till empty

May affect the effectiveness of contraceptives

Question 15

Monitoring parameters of Pen VK

Answer 15

Improvement in s/sx of infection, wbc

Question 16

Common indications of Macrobid

Answer 16

UTI

Question 17

MOA of Macrobid

Answer 17

inactivates bacterial ribosomal proteins and other large molecules resulting in inhibition of vital biochemical processes such as protein synthesis, aerobic energy metabolism, DNA synthesis, RNA synthesis, and cell wall synthesis

Question 18

Common AEs of Macrobid

Answer 18

Nausea
HAs
Hemolytic anemia

Question 19

Renal or dosage adjustments of Macrobid

Answer 19

Renal- CrCl <60: use is contraindicated

Question 20

Clinically sig drug interactions with Macrobid

Answer 20

Hepatic and pulmonary toxicity can result from concurrent use with fluconazole

Question 21

Major counseling points of Macrobid

Answer 21

May cause brown colored urine

Take this med with food

Question 22

Monitoring parameters of Macrobid

Answer 22

Improvement in s/sx of infection, wbc

Question 23

Common indications of donepezil

Answer 23

Alzheimers

Question 24

MOA of donepezil

Answer 24

reversibly and noncompetitively inhibits centrally-active acetylcholinesterase, results in increased concentrations of acetylcholine available for synaptic transmission in the central nervous system

Question 25

Common AEs of donepezil

Answer 25

``` Insomnia Diarrhea Nausea Vomiting Anorexia ```

Question 26

Clinically sig drug interactions with donepezil

Answer 26

The metabolism of Aricept may be increased by phenytoin, carbamazepine, phenobarbital, rifampin, dexamethasone, or decreased by ketoconazole

Question 27

Major counseling points of donepezil

Answer 27

23 mg tablet should not be broken or crushed ODT should not be swallowed whole Take in the evening before bed

Question 28

Monitoring parameters of donepezil

Answer 28

Decreased or maintenances of s/sx of Alzheimers Wt loss Constipation

Question 29

Common indications of famotidine

Answer 29

GERD | Ulcer

Question 30

MOA of famotidine

Answer 30

Inhibits both the concentration and volume of gastric secretion

Question 31

Common AEs of famotidine

Answer 31

Constipation Diarrhea Dizziness HA

Question 32

Renal or hepatic dose adjustments for famotidine

Answer 32

Renal CrCl 30-60: give 50% of recommended dose | CrCl <30: give 25% of recommended dose

Question 33

Clinically sig drug interactions of famotidine

Answer 33

Can potentially lead to QT prolongation when taken along with escitalopram

Question 34

Major counseling points of famotidine

Answer 34

Take this medication at bedtime | May take it with antacids if needed

Question 35

Monitoring parameters of famotidine

Answer 35

Decrease in s/sx of GERD/peptic ulcers | Decreased GI sx

Question 36

Common indications of ezetimibe

Answer 36

HLD

Question 37

MOA of ezetimibe

Answer 37

Inhibits the uptake of cholesterol by the small intestine

Question 38

Common AEs of ezetimibe

Answer 38

Diarrhea Myalgia Respiratory infection

Question 39

Clinically significant drug interactions of ezetimibe

Answer 39

Use with gemfibrozil could lead to cholelithiasis

Question 40

Major counseling points of ezetimibe

Answer 40

May cause muscle pain similar to that of statins | Take at least 2 hrs before or 4 hrs after a bile acid sequestrant

Question 41

Monitoring parameters of ezetimibe

Answer 41

Cholesterol levels Algias Myalgias

Question 42

Common indications of glipizide

Answer 42

Type 2 diabetes

Question 43

MOA of glipizide

Answer 43

Stimulates insulin release from the pancreatic beta cells Reduces glucose output from the liver Insulin sensitivity is increased at peripheral target sites

Question 44

Common adverse effects of glipizide

Answer 44

Dizziness Diarrhea Mild hypoglycemia Flatulence

Question 45

Renal or hepatic adjustments of glipizide

Answer 45

Hepatic- initiate at 2.4 mg titrate from there

Question 46

Clinically sig drug interactions of glipizide

Answer 46

Fluconazole: may increase the serum concentration of sulfonylureas GLP-1 antagonist: may enhance the hypoglycemic effect of sulfonylureas- consider glipizide dose reduction

Question 47

Major counseling points of glipizide

Answer 47

``` Take 30 mins before a meal ER tabs given with breakfast Maintain compliance while taking this medication Avoid excessive alcohol Could potentially cause hypoglycemia ```

Question 48

Monitoring parameters of glipizide

Answer 48

Decrease in blood glucose/A1c | S/sx of hypoglycemia

Question 49

Common indications of glyburide

Answer 49

Adjunct to diet in tx of type II DM

Question 50

MOA of glyburide

Answer 50

Stimulates insulin synthesis and secretion from pancreatic beta cells

Question 51

Common AEs of glyburide

Answer 51

Dicumerol, chloramphenicol, alcohol, MAOIs, phenylbutazones, salicylates, sulfinpyrazone, and sulfonamides may increase effects Diazoxide, rifampin, and thiazide diuretics may decrease effects

Question 52

Major counseling points of glyburide

Answer 52

Store in a cool dry place away from kids and sunlight If you miss a dose, take it as soon as possible, if it is closer to the time for the next dose, skip the missed dose and return to normal dosing schedule – do not double doses Take with breakfast or the first main meal Compliance is necessary for optimal effect Follow prescribed diet only Avoid excess use of alcohol Be aware of signs of hypoglycemia – sweating, tremor, blurred vision, weakness, hunger and confusion – and have oral glucose available to resolve this side effect.

Question 53

Monitoring parameters of glyburide

Answer 53

Decrease in blood glucose/A1c | S/sx of hypoglycemia

Question 54

Common indications of clobetasol

Answer 54

Psoriasis

Question 55

MOA of clobetasol

Answer 55

Stimulates phospholipase A(2) inhibitory proteins and subsequently blocks the release of arachidonic acid, which is a common precursor to leukotrienes and prostaglandins

Question 56

Common AEs of clobetasol

Answer 56

Eczema Burning sensation Pruritis

Question 57

Major counseling points of clobetasol

Answer 57

Decrease in s/sx of psoriasis Redness Skin irritation Decrease in inflammation