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Pharmacology II > Exam 1 - Questions > Flashcards

Exam 1 - Questions Flashcards

(103 cards)

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1
Q

What is a hematologic effect of estrogen?

A

Increased tendency for clotting

Increases vitamin K levels

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2
Q

What are some effects estrogen has on the skin?

A

Dryness, increased thickness, increased pigmentation

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3
Q

Which organ dysfunction is contraindicated with estrogen?

A

Liver dysfunction or disease

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4
Q

Estrogen CI’s

A

DVT, PE, breast CA, thrombophilic disorders, pregnancy

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5
Q

Which drug inhibits the activity of progesterone?

A

Ketoconazole

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6
Q

Warnings for progestins

A

Increased risk of DVT, PE, AMI, CVA, dementia, invasive breast cancer, severe migraines

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7
Q

Which progestin’s also have androgenic effects?

A 
Second generation (Estranes)
Norethindrone, ethynodiol
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8
Q

What progestin requires monitoring of potassium levels?

A

Drospirenone

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9
Q

What specific ADR is associated with medroxyprogesterone acetate?

A

Bone loss

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10
Q

Estrogen MOA

A

Inhibits FSH release

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11
Q

Progestin MOA

A

Prevents LH surge, no ovum released

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12
Q

How much estrogen is contained in each contraceptive pill?

A

< 35 mcg per pill

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13
Q

At what age and what smoking specifications are OCPs contraindicated?

A

Age > 35 smoking more than half a pack per day

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14
Q

Which drugs reduce the efficacy of oral contraceptions?

A

Rifampin, phenytoin, carbemazepine, phenobarbital

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15
Q

Which antibiotics reduce ethinyl estradiol concentration?

A

Tetracyclines and PCNs

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16
Q

Which drug may interact with oral contraceptives to cause breakthrough bleeding?

A

Ampicillin

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17
Q

What adjustments should be made to an OCP pt with early cycle breakthrough bleeding?

A

Higher estrogen OCP

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18
Q

What adjustments should be made to an OCP pt with late cycle breakthrough bleeding?

A

Higher progestin OCP

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19
Q

What adjustments should be made to an OCP pt with dysmenorrhea or menorrhagia?

A

Lower estrogen OCP or

Higher progestin OCP

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20
Q

What adjustments should be made to an OCP pt with vasomotor symptoms, nervousness, or decreased libido?

A

Higher estrogen OCP

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21
Q

What adjustments should be made to an OCP pt with increased appetite, weight gain, bloating, constipation, irritability, fatigue or depression?

A

Lower Progestin OCP

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22
Q

When is backup contraception needed for misuse of the Ortho Evra Patch?

A

When patch has been off or partially off for more than 1 day, forgot to change patch for more than 2 days, forgot to change patch on week one., if there are more than 7 patch free days

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23
Q

How long does Depo-provera prevent ovulation?

A

3 months

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24
Q

Most common ADR of Depo-provera

A

Irregular menstrual bleeding

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25
ADR to watch for for Depo-provera
Depression --> 3 month injection (can't stop) | Decreased bone density (reversible)
26
Which contraceptive methods are less effective in obese women?
Ortho Evra Patch and implants
27
Major ADR of implants
Irregular bleeding
28
ADRs of implants
HA, abdominal pain, and vaginitis, weight gain
29
Leukocytosis with left shift will be seen in....
Patients with sepsis after taking Mifepristone
30
Which organ can be adversely affected by HRT estrogen?
Gallbladder
31
Golden rule of HRT
Never give unopposed estrogen to a woman with a uterus!
32
Absolute contraindication for HRT
Hx of breast cancer
33
What should be monitored in pts using Black Cohosh?
LFTs/Liver Damage
34
ADR to watch with wild yam
Vomiting
35
Hypoactive sexual desire disorder
Flibanserin
36
Contraindications to Flibanserin
Alcohol, P450 3A4 inhibitors, hepatic impairment
37
Organs that may be affected by Tamoxifen
Liver and eyes
38
ADRs of Ospemifene
Clots, muscle spasms, vaginal discharge, hyperhidrosis, hot flashes
39
Indicated for prevention of postmenopausal osteoporosis
Bazedoxifene
40
Breast Cancer Tx indicated for moderate to severe vasomotor symptoms
Bazedoxifene
41
Indicated first-line for adjuvant breast cancer tx in postmenopausal women
Anastrozole Letrozole Exemestane
42
How many patients fail PDE5 inhibitors?
30-40%
43
How long should a patient wait to take a PDE5 inhibitor after taking a nitrate?
24-48 hours
44
What medication should be specifically avoided with Vardenafil?
Antiarrhythmics --> can prolong QT
45
Organ of caution for Selective Alpha-1 Antagonists (Tamsulosin, Alfuzosin, Silodosin)
Liver
46
When is silodosin contraindicated in renal patients?
When CrCl < 30
47
How do fluconazole, verapamil, ,and diltiazem all interact with Silodosin?
Increase silodosin levels, leading to hypotension, tachycardia
48
Prevents conversion of testosterone to dihydrotestosterone
Finasteride, Dutasteride
49
How long is a BPH regimen with 5-Alpha Reductase Inhibitors?
6 months
50
Pregnancy Category X Medication for BPH
Alpha-5 Reductase Inhibitors | Finasteride, Dutasteride
51
What controlled substance ranking does testosterone have?
CIII
52
Contraindications for testosterone supplementation
Hx breast/prostate cancer, palpable prostate nodule, hematocrit above 50%, untreated sleep apnea, uncontrolled heart failure
53
How should hematocrit be monitored in testosterone supplementation patients?
Baseline, then q6 months x 18 months, then annually
54
How should risk of prostate cancer be monitored in testosterone supplementation patients?
Baseline PSA, at 3-6 mo, then annual PSA in men over 40 Baseline prostate exam Prostate related symptom assessment minimum every 6-12 mo
55
Concern for oral testosterone supplementation
Liver damage
56
Boxed warning for risk of serious pulmonary oil microembolism
Aveed Testosterone Injection | Acute cough after injection
57
What should you prostate cancer pts on ADT be monitored for?
Osteoporosis and anemia
58
This class of drugs is also used for enuresis in children
Anticholinergics
59
What drugs interact with anticholinergics?
Macrolides, ketoconazole, azoles
60
How long does it take for full efficacy of anticholinergics?
4 weeks
61
Which organ should you monitor in anticholinergic pts?
Liver (decreased elimination in cirrhosis) and kidneys | Liver and renal adjustment
62
What organ should be monitored with mirabegron (beta 3 agonist)?
Heart
63
First line for focal seizures
Carbamazepine
64
What is carbamazepine contraindicated for?
Hx of bone marrow suppression
65
What do Asian pts have an increased risk of with carbemazepine?
Stevens Johnson Syndrome
66
Why is carbemazepine a pregnancy category D medication?
Increased risk of spina bifida
67
Serious ADRs of Lamotrigine
SJS, DRESS, aseptic meningitis
68
What AED is associated with fatal liver toxicity?
Valproic Acid
69
Will valproic acid cause weight loss or weight gain?
Weight gain
70
Which AED is associated with hyperammonemia?
Valproic Acid
71
Which AED requires renal dose adjustments?
Levetiracetam, Topiramate
72
Which AED can be used in kids ages 2 and older?
Topiramate
73
Which AED is first line for absence seizures?
Ethosuximide
74
Which AED drug has osteomalacia, lymphadenopathy, and dermatitis as serious ADRs
Phenytoin
75
What's a contraindication for zonisamide?
Sulfonamide allergy
76
Which AED is associated with oligohidrosis and hyperthermia in peds?
Zonisamide
77
Which AED is associated with kidney stones?
Zonisamide
78
Which AEDs (2) are associated with metabolic acidosis?
Topiramate, Zonisamide
79
Which AEDS (2) are associated with blood dyscrasias?
Ethosuximide, Zoniosamide
80
Which AEDs (2) are both carbonic anhydrase inhibitors?
Topiramate, Zonisamide
81
Which AEDs (3) are associated with DRESS?
Lamotrigine, Lacosamide, Gabapentin
82
Which AED is associated with a long PR interval, Afib, and AFlutter?
Lacosamide
83
How does perampanel interact with OCPs and alcohol?
Reduces effects of OCPs | Additive effects of EtOH
84
How does perampanel interact with carbamazepine, oxcarbazepine, phenytoin, and rifampin?
Perampanel levels decreased
85
How does perampanel interact with carbamazepine, lamotrigine, valproic acid, and clobazam?
Decreased levels of carbamazepine, lamotrigine, valproic acid and clobazam
86
How does perampanel interact with oxcarbazepine?
Increased levels of oxcarbazepine
87
Which AED is associated with an ADR of hyperalgesia?
Phenobarbital
88
Drug interactions of phenobarbital:
anticoagulants, corticosteroids, griseofulvin, doxycycline, other AEDs, CNS depressants, MAOIs, OCPs
89
Which AEDs are associcated with treatment of Lennox-Gastaut syndrome?
Topiramate, Valproic Acid, Lamotrigine, Felbamate, Clobazam, Clonezepam, Phenobarbital
90
Which AEDs (3) have renal adjustments?
Levetiracetam, Gabapentin, Pregabalin
91
Black Box warning for Gabapentin
Pancreatic Cancer
92
Which AEDs (2) are associated with angioedema?
Oxcarbazepine, Pregabalin
93
Indicated for infantile spasms
Vigabatrin
94
Associated with progressive, permanent vision loss
Vigabatrin
95
Which AED is associated with blue skin/eye discoloration?
Ezogabine
96
Which AEDs (2) are associated with aplastic anemia?
Carbamazepine, Felbamate
97
AEDs (3) associated with weight loss
Topiramate, Zonisamide, Felbamate
98
AEDs (2) associated with ddiplopia, blurred vision, and visual distortion?
Carbamazepine, lamotrigine
99
Which AED is associated with cleft lip in pregnancy?
Topiramate
100
Best AEDs (2) for pregnancy
Lamotrigine | Levetiracetam
101
What pregnancy X medication can be found in the semen of men and should be avoided by childbearing age women?
Finasteride, Dutasteride
102
What AED medication is associated with pink-brown urine?
Ethosuximide
103
CIII Medications
Testosterone, Perampanel

Pharmacology II (6 decks)

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