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Pharmacology > Exam 2: Step 3 Name that Drug (Toxicities, Special Features) > Flashcards

Exam 2: Step 3 Name that Drug (Toxicities, Special Features) Flashcards

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1
Q

what drug has high efficacy against psychosis but NOT first line because of risk of agranulocytosis?

A

clozapine

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2
Q

what drug has moderate efficacy against psychosis without risk of agranulocytosis, but highest risk of metabolic side effects?

A

olanzapine

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3
Q

which atypical antipsychotic is useful for elderly patients because it is non-sedating?

A

risperidone

“rise” and shine

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4
Q

which atypical antipsychotic has risk of QT prolongation?

which opioid has risk of QT prolongation?

A

ziprasidone

methadone

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5
Q

What are the extrapyramidal side effects that can be caused by D2 antagonists?

A

“muscle, rustle, hustle”

acute dystonia - 4 hours
akisthesia - 4 days
akinesia - 4 weeks

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6
Q

What is the late side effect of D2 antagonists?

A

tardive dyskinesia

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7
Q

What is the drug of choice for absence seizures?

A

ethosuximide

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8
Q

what would you give a depressed patient for migraine ppx?

A

amytryptaline (a TCA)

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9
Q

would would you give a hypertensive patient for migraine ppx, as long as they don’t have asthma?

A

propranolol

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10
Q

what combination of drugs could cause serotonin syndrome?

A

SSRI + MAOI
SSRI/SNRI + St. John’s Wort
SSRI + promethazine

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11
Q

which benzodiazepine is approved as a short term sleep aid?

A

triazolam

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12
Q

which benzodiazepine is used to induce anesthesia?

A

midazolam

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13
Q

which benzodiazepines are also useful as anticonvulsants because of their long half life?

A

diazepam, clonazepam

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14
Q

what two drugs bind directly to the alpha-1 subunit of GABA to cause sedation?

A

zolpidem

eszopicline

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15
Q

what can be used for maintenance treatment of generalized anxiety d/o without causing sedation?

A

buspirone

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16
Q

Besides lithium, name 3 drugs approved for treatment of bipolar disorder.

A

valproic acid
lamotrigine
olanzapine

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17
Q

what antidepressant can you prescribe to a 10 year old?

A

fluoxetine

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18
Q

what antidepressant(s) can you prescribe to a 14 year old?

A

fluoxetine or escitalopram

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19
Q

which anxiolytic cannot be taken with MAOI due to risk of serotonin syndrome?

A

buspirone

increases serotonin

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20
Q

which anticonvulsant can treat bipolar disorder and trigeminal neuralgia?

A

carbamazepine

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21
Q

Name two drugs that can treat HIT.

A

fondiparinux

argatroban

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22
Q

which anticonvulsant can cause Toxic Epidermal Necrolysis, especially in Han Chinese and South Asians with a genetic mutation?

A

carbamazepine

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23
Q

what is the antidote for heparin?

A

protamine sulfate

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24
Q

what drug can treat acute dystonic side effect of an antipsychotic (D2 blocker)?

A

benztropine

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25
which antidepressant has a risk of seizures?
bupropion
26
which class of antidepressants has the highest risk of death by overdose and should not be given to patients with suicidal ideation?
TCA
27
Name 2 antipsychotics with the highest risk of weight gain & diabetes.
olanzapine | clozapine
28
which antipsychotic has the lowest side effect profile?
aripirazole
29
which antidepressant does not have a risk of sexual side effects?
buproprion
30
your patient has depression with insomnia and anorexia, what might you prescribe?
mirtazapine
31
what drugs could you try for a patient that needs long term treatment of insomnia?
ramelteon - best for falling asleep zolpidem eszopiclone - best for staying asleep
32
which benzodiazepine is useful for acute panic attack because of its short half life?
midazolam | alprazolam
33
what drug treats benzodiazepine or barbiturate overdose?
flumazenil
34
which anticonvulsant/antimigraine has side effects of weight loss and cognitive impairment?
topiramate
35
This therapy is approved for treatment of migraine in someone with 15 or more headaches per month. Treatment is repeated every 12 weeks.
onabotulinum toxin injection
36
what are 3 common adjuvant therapies for migraine?
caffeine metoclopramide NSAID
37
_________ must be given right at the start of a migraine, where as ________ is effective even if taken later and has fewer side effects.
ergots triptans
38
which drug for migraines is effective in 80% of patients but has a high rebound rate?
triptans
39
``` which antidepressant class can have the following cardiac toxicities: arrhythmia tachycardia palpitations orthostatic hypotension conduction block ```
TCAs
40
Treatment of arrhythmia secondary to TCA overdose is ______.
lidocaine
41
Which TCA (of the two we learned) is a secondary amine and has fewer side effects and a higher TI?
desipramine
42
If a patient eats tyramine while taking an _________ (class of antidepressant), he is at risk for acute hypertensive crisis.
MAOI
43
If MAOIs are taken with _________ or _________ (both opioids) the patient may experience severe serotonin syndrome.
meperidine | dextromethorphan
44
If MAOIs are taken with ___________ drugs, the patient may have headache and increased BP.
sympathomimetics | L-DOPA, bupropion, amphetamines, pseudoephedrine
45
Due to risk of serotonin syndrome, we must allow 2-5 weeks after discontinuing _______ before starting ___________.
MAOI SSRI, SNRI, or TCA
46
Which antidepressant is useful for smoking cessation?
bupropion
47
You do not want to give an antihypertensive that causes increased sodium excretion to a patient who is taking __________.
Lithium
48
What drugs are useful for treating an acute manic emergency?
antipsychotics (haloperidol) benzodiazepines IV valproate (not as rapid as the above)
49
Because its adverse affects include agitation, anxiety, insomnia and seizures, ___________ is not a good antidepressant for someone with anxiety.
bupropion
50
Which anticonvulsant has significant anti depressive activity but carries a risk of Stevens Johnson Syndrome?
lamotrigine
51
This drug commonly causes tremor, polydipsia and polyuria, or nephrogenic diabetes insipidus as a side effect.
lithium
52
Which drug has a black box warning for thrombosis, HTN, and atherogenesis?
celecoxib
53
Which drugs have a black box warning for hematoma after spinal anesthesia/puncture?
enoxaparin fondaparinux rivaroxaban dabigatran
54
Chronic high dose intake of NSAIDS is associated with analgesic ____________>
nephropathy
55
What drug can be given with NSAIDS to prevent GI toxicity?
misoprostol
56
At toxic levels, which drug causes tinnitus and acidosis?
aspirin
57
If coadministered, which drug will decrease the cardio protective effect of aspirin?
ibuprofen
58
Which drug causes potentially fatal hepatotoxicity at doses >15 grams?
acetaminophen
59
Alcohol induces CYP2E1, which increases toxicity of ___________.
acetaminophen
60
An acetaminophen overdose is treated with _______________.
N-acetylcysteine (Mucomyst)
61
Monitor _________ for patients on heparin (but not enoxaparin or fondiparinux).
PTT
62
Monitor _________ for patients on warfarin.
PT/INR why? highly variable person-to-person pharmacokinetics!
63
What is the antidote for warfarin?
vitamin K
64
Which anticoagulants are safe in pregnancy?
enoxaparin fondaparinux (heparin has something in the preservative)
65
Which drug has a BBW for risk of MI/stroke/death in those who are CYP2C19 poor metabolizers with acute coronary syndrome or PCI?
Clopidogrel
66
Which drug has a BBW for severe bleeding in people <60 kilograms?
Prasugrel
67
Which drug has a BBW for intracranial hemorrhage in people >75 years old?
Prasugrel
68
Which drug has a BBW for thrombosis/MI/death in patients likely to undergo CABG?
Prasugrel
69
Most serious complication of alteplase is______.
hemorrhagic stroke (1-2%)
70
What drug(s) chelate iron?
deferoxamine (SQ or IV) deferasirox (oral)
71
FDA released a warning of next-morning impairment with use of which drug?
zolpidem
72
This drug class should not be mixed with alcohol or given to a pt with respiratory disease.
benzodiazepines
73
Which benzodiazepines are associated with higher abuse?
alprazolam & diazepam | due to fast absorption and high rate of entry into CNS
74
Don't give triptans to someone with ________
CAD. | Don't give w/ MAOIs
75
Which migraine tx has worse side effect profile and a risk of dependence?
ergotamine
76
Which opioid - does not depress myocardium does not release histamine can be given epidural
fentanyl
77
Which opioid has HIGH first pass metabolism and needs dose adjustment for patients with renal failure?
morphine
78
Which opioid is going to be ineffective as an analgesic in people with CYP2D6 polymorphism?
codeine
79
Which two opioids are not analgesics?
dextromethorphan (antitussive) loperamide (antidiarrheal) also codeine if you have the CYP polymorphism!
80
Which two opioids cannot be combined with an MAOI or SSRI due to risk of serotonin syndrome?
meperidine tramadol
81
Which opioid is thought to have lower dependence/abuse since MOA is on the kappa opioid receptor instead of MOR?
pentazocine
82
What opioids have seizures as a potential adverse effect?
codeine meperidine tramadol
83
Which opioid is INACTIVATED by CYP2D6, therefore those with a polymorphism are at risk of overdose?
methadone
84
Which opioid does NOT cause miosis (pinpoint pupils)?
meperidine causes mydriasis (dilated pupils)
85
``` Salivation Lacrimation Urination Defecation GI distress Emesis [SLUDGE] are symptoms of _________. ```
sarin poisoning
86
A fast acting drug in this class is used to diagnose myasthenia gravis.
Anticholinesterase | the drug is edrophonium, not on our list
87
Treatment for sarin poisoning is two step: 1) ASAP injection of____________. 2) ______________.
1) atropine | 2) pralidoxime
88
If you want to reverse the skeletal muscle block of vecuronium, you can give __________.
neostigmine
89
This muscle blocker can produce malignant hyperthermia, hyperkalemia, cardiac arrhythmia, etc.
succinylcholine "succ sucks" use for emergency intubation only
90
#1 complaint from patients on _______ (drug class) is constipation.
opioids oral iron
91
This anticoagulant is metabolized (inactivated) by CYP3A4 and transported by P-gp, making drug-drug interactions common.
Rivaroxaban
92
This drug, given to assist with smoking cessation, has a BBW for neuropsychiatric symptoms including suicidal ideations.
Varenicline
93
Acetaminophen is formulated hydrocodone (Vicodin) or oxycodone (Percocet), increasing the risk of _____________.
liver toxicity
94
Opioid overdose is treated with __________.
Naloxone

Pharmacology (6 decks)

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