Exam 3 Flashcards
1
Q
class of Clotrimazole/ Lotrimin
A
antifungal
2
Q
indication of Clotrimazole/ Lotrimin
A
superficial mycoses such as tinea pedis, tinea cruris and ring worm as well as yeast vaginitis
3
Q
MOA of Clotrimazole/ Lotrimin
A
binds to ergosterol molecules on the fungal cell membrane and causes membrane leakage during cell division
4
Q
class of Nystatin/ Mycostatin
A
antifungal, may be used both topically and systemically
5
Q
indication of Nystatin/ Mycostatin
A
superficial mycoses such as ring worm, tinea pedis, tinea cruris and treatment of oral candidiasis (thrush) as well as esophageal and vaginal Candida Cryptococcus is also sensitive to Nystatin
6
Q
MOA of Nystatin/ Mycostatin
A
binds to ergosterol molecules on fungal cell membrane resulting in loss of membrane integrity death of the fungal cell
7
Q
Nystatin/ Mycostatin is used as prophylaxis in patients who are at risk for
A
fungal infections, such as AIDS patients with a low CD4+ count and patients receiving chemotherapy
8
Q
side effects of Nystatin/ Mycostatin
A
negligible oral absorption allows for diminished side effects. N/V possible. GI absorption also minimal and most orally administered Nystatin is passed unchanged in stool.
9
Q
current drug of choice for onychomycosis
A
Terbinafine/ Lamisil
10
Q
Terbinafine/ Lamisil is mainly effective on group of fungi known as
A
dermatophytes
11
Q
Terbinafine/ Lamisil treats onychomycosis of the toenail or fingernail due to
A
dermatophyte Tinea unguium
12
Q
common side effects of Terbinafine/ Lamisil
A
discomfort, diarrhea, and nausea as well as headache. Less commonly, elevated liver enzymes, hepatitis, liver damage and even liver failure have been reported
13
Q
class of Fluconazole/ Diflucan
A
antifungal, both topical and systemic
14
Q
indication of Fluconazole/ Diflucan
A
superficial mycoses such as yeast vaginitis as well as systemic or meningeal mycotic infections by fungi such as Cryptococcus or Histoplasmosis
15
Q
MOA of Fluconazole/ Diflucan
A
inhibits fungal membrane synthesis
16
Q
anti-fungal that can be used as vaginal suppository for yeast vaginitis
A
Fluconazole/ Diflucan
17
Q
Fluconazole/ Diflucan can inhibit
A
cytochrome enzyme systems responsible for metabolism of many drugs
18
Q
side effects of Fluconazole/ Diflucan
A
nausea and vomiting with oral and IV doses
19
Q
class of Amphotericin B/Amphocil
A
antimycotic
20
Q
indication of Amphotericin B/Amphocil
A
systemic fungal infections such as systemic Candidadiasis, Histoplasmosis, Coccidiomycosis, Aspergillus and Blastomyces
21
Q
MOA of Amphotericin B/Amphocil
A
binds to ergosterol molecules on the fungal cell membrane and disrupts membrane integrity, resulting in death of the fungal cell
22
Q
Amphotericin B/Amphocil may for used via intrathecal route for
A
fungal meningitis or fungal brain abscess
23
Q
side effects of Amphotericin B/Amphocil
A
Very severe side effect profile. Fevers and shaking chills are common. (“Ampho-terrible” and “shake and bake” are terms used to describe the severe side effects). Pre-treatment with Benadryl, NSAIDs or Prednisone often used to mitigate the fever and chills. Hypotension, renal impairment and severe anemia can occur.
24
Q
Isoniazid (INH) / Nitrazid class
A
antibiotic
25
indication of Isoniazid (INH) / Nitrazid
tuberculosis
26
MOA of Isoniazid (INH) / Nitrazid
Isoniazid is a pro-drug and must be activated by bacterial catalase. The activated form of INH inhibits the synthesis of mycolic acid in the mycobacterial cell wall
27
lower doses of Isoniazid (INH) / Nitrazid should be given to patients with
chronic liver disease
28
side effects of Isoniazid (INH) / Nitrazid
rash, abnormal liver function tests, hepatitis, sideroblastic anemia, peripheral neuropathy and CNS effects. The possible hepatotoxicity of INH is best avoided by close clinical monitoring of the patient, specifically for signs of nausea, vomiting, and abdominal pain as well as monitoring liver function tests
29
Isoniazid competes with an enzyme that is needed to produce
pyridoxine
30
peripheral neuropathy is a common side effect when using ____ and is caused by
when using Isoniazid and is caused by INH induced pyridoxine deficiency
31
peripheral neuropathy caused by ___ may be reduced or avoided altogether by concurrent
caused by Isoniazid, avoided by supplementation with pyridoxine (vit B6 - 10to 50 mg/day)
32
class of Rifampin/ Rifadin
antibiotic
33
indication of Rifampin/ Rifadin
tuberculosis, Methicillin-resistant Staphylococcus aureus (MRSA) and prophylactic therapy against meningococcal infection from Neisseria meningitidis
34
MOA of Rifampin/ Rifadin
inhibits DNA-dependent RNA polymerase in bacterial cells thus preventing transcription of messenger RNA and subsequent translation to protein production
35
weird side effect of Rifampin/ Rifadin
can cause certain bodily fluids, such as urine and tears, to become orange-red in color. may permanently stain soft contain lenses
36
side effects of Rifampin/ Rifadin
fever, upset stomach, nausea, vomiting, rash. hepatotoxicity with liver damage and jaundice can occur. liver function tests must be followed.
37
Standard treatment of TB
Rifampin/Rifadin, Isoniazid (INH)/Nitrazid, Pyrazinamide/Pyrazinamide, Ethambutol/Myambutol
38
drug that is a nicotinamide analog with an unknown mechanism of action
Pyrazinamide
39
MOA of Ethambutol
inhibits mycolic acid synthesis in the mycobacterial cell wall
40
the drugs utilized for M. tuberculosis can also be used for other mycobacterial diseases such as
leprosy
41
Multi-drug resistant tuberculosis (MDR-TB) is defined as TB that is resistant to at least
Isoniazid and Rifampin
42
Rick factors for MDR-TB include
exposure to patient with MDR-TB, HIV infection, previous incarceration, failure to respond to standard TB treatment, and relapse following standard TB treatment
43
acronym for CDC recommended empiric treatment of patient suspected of having MDR-TB
SHREZ MC
44
7 drugs that make up SHREZ MC are
Streptomycin + Hydrazine + Rifampin + Ethambutol + pyraZinamide + Moxifloxacin (a fluoroquinolone) and Cycloserine (a broad spectrum antibiotic)
45
Viruses that can be treated with anti-virals
URI viruses including influenza types A and B and respiratory syncytial virus (RSV)...herpesviruses, cytomegalovirus, HIV, viral hepatitis B and C
46
US Centers for Disease Control and Prevention recommends the use of what for treatment/prevention of swine flu virus
Tamiflu (Oseltamivir) or Relenza (Zanamivir)
47
class of Oseltamivir/ Tamiflu
anti-viral
48
indication of Oseltamivir/ Tamiflu
treatment (and prevention) of infections due to influenza A and B virus in adults and in children at least one year of age - when given within 48 hours of symptoms of infections. Tamiflu has also shown effectiveness for H5N1 known as avian flu.
49
how soon do you need to administer Oseltamivir/ Tamiflu for it to be effective
within 48 hours of symptoms
50
MOA of Oseltamivir/ Tamiflu
neuramidase inihbitiion, preventiing virus from budding off from cell. Oseltamivir/ Tamiflu was first orally active neuraminidase inhibitor to be commercially developed.
51
doses of Oseltamivir/ Tamiflu are decreased for children and patients with
renal impairment
52
side effects of Oseltamivir/ Tamiflu
abdominal pain nausea, vomiting and headache...concern about potential adverse effects including delirium, hallucinations, depression and increased suicidal ideation
53
Zanamivir/ Relenza is formulated as a
powder that is delivered via the respiratory tract by an oral inhaler
54
Zanamivir/ Relenza is not recommended in people with
history of asthma or COPD due to risk of serious bronchospasm
55
class of Zanamivir/ Relenza
anti-viral
56
indication of Zanamivir/ Relenza
influenza treaetment and/or prophylaxis
57
MOA of Zanamivir/ Relenza
neuramidase inhibitor
58
route of Zanamivir/ Relenza
inhaled route
59
side effects of Zanamivir/ Relenza
N/V. Post treatment diarrhea, vaginal candidiasis and thrush is negligible.
60
drug that is used as a treatment for the early stages of Parkinson's disease
Amandatine/ Symmetrel...best used as short term therapy (6-12 months)...its an anti-viral that was recommended as prophylaxis for influenza
61
primary drug for herpesvirus infection
Acyclovir/Zovirax
62
class of Acyclovir/ Zovirax
anti-viral
63
indication of Acyclovir/ Zovirax
herpesvirus infections such as HSV-1, HSV-2 and Herpes zoster (chicken pox and shingles)
64
MOA of Acyclovir/ Zovirax
guanosine analog that is incorporated into the virus DNA and inhibits further viral synthesis
65
Acyclovir/ Zovirax only works against
viruses that are actively replicating and is ineffective against latent viruses
66
Does Acyclovir/ Zovirax actively cross the blood barrier?
Yes. It can be used to treat herpes meningitis and encephalitis.
67
Bizarre possible form of Acyclovir/ Zovirax
topical ointment
68
side effects of Acyclovir/ Zovirax
Dependent upon route of administration. Headache, nausea and vomiting can occur with oral dose. Transient renal insufficiency can occur with higher IV doses and skin irritation can occur with topical doses.
69
current treatment for HIV infection consists of
Highly Active Antiretroviral Therapy or HAART
70
4 main categories of drugs used as treatment or prophylaxis against HIV
reverse transcriptase inhibitors (RTIs), protease inhibitors (PIs), fusion inhibitors, integrase inhibitors
71
standard HAART drug classes
two nucleoside reverse transcriptase inhibitors plus either a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI).
72
what do RTIs do
block enzymatic function of reverse transcriptase and prevent the completion of synthesis of double-stranded viral DNA thus preventing HIV from multiplying.
73
3 main forms of RTIs
Nucleoside reverse transcriptase inhibitors, Nucleotide reverse transcriptase inhibitors, Non-nucleoside reverse transcriptase inhibitors
74
primary Nucleoside reverse transcriptase inhibitor
Zidovudine (AZT)/ Retrovir
75
class of Zidovudine (AZT)/ Retrovir
anti-viral, nucleoside reverse transcriptase inhibitor
76
indication of Zidovudine (AZT)/ Retrovir
HIV
77
MOA of Zidovudine (AZT)/ Retrovir
pyrimidine analog that is incorporated into the viral DNA by reverse transcriptase. Incorporation into viral DNA terminates further replication
78
side effects of Zidovudine (AZT)/ Retrovir
Headaches are common. Potentially toxic to bone marrow with severe anemia and leukopenia in patients receiving high doses.
79
Unlike nucleoside RTIs, which bind at the enzyme's active site, NNRTIs bind within
a pocket termed the NNRTI pocket
80
____ inhibitors are currently used to treat HIV and Hep C
protease inhibitors
81
primary protease inhibitor
Saquinavir/ Invirase
82
class of Saquinavir/ Invirase
anti-viral, protease inhibitor
83
indication of Saquinavir/ Invirase
HIV, Hep C
84
MOA of Saquinavir/ Invirase
Protease enzyme inhibition prevents viral protein molecules from being cleaved into smaller fragments, which prevents both the replication of the virus within the cell and the release of mature viral particles from an infected cell.
85
side effects of Saquinavir/ Invirase
Mostly G.I. i.e. abdominal discomfort, nausea, vomiting and diarrhea.
86
interferon alpha is for
Hep C
87
Interferon Beta is for
relapsing multiple sclerosis
88
interferon gamme is for
chronic granulomatous diseases
89
class of Interferon alpha
anti-viral
90
indication of Interferon alpha
chronic hep B and C, genital warts due to HPV, Kaposi's sarcoma and hairy cell leukemia
91
MOA of Interferon alpha
Interferon is a naturally occurring glycoprotein that interferes with the ability of a virus to infect cells. Interferon appears to induce host cell enzymes that inhibit viral RNA translation and subsequent viral synthesis within the infected host cell.
92
Side effects of Interferon alpha
Arthralgias, myalgias, fever, lethargy, headache, dizziness, hair thinning and depression.
93
what is Pegylated interferon alpha
a form of interferon in which polyethylene glycol is added to make the interferon last longer in the body.
94
When treating hepatitis C, pegylated interferon is often administered with the drug
Ribavirin
95
what type of vaccine is most likely to confer life-long immunity
live/attenuated virus vaccinations
96
live vaccinations are typically not given to
people who are immunocompromised
97
name the two recombinant protein vaccinations
Hep B and HPV
98
Live Attenuated Influenza Vaccine (LAIV) is delivered as
a nasal spray (FluMist)
99
Gardasil and Cervarix protect against what two types of HPV
HPV 16 and 18
100
Gardasil also protects against what two HPV types that cause genital warts
6 and 11
101
Most commonly reported side effects of HPV vaccine
lightheadedness, pain and swelling at the injection site.
102
what are adjuvants
substances added to boost the immune response to a vaccine
103
examples of aluminum containing vaccines
Hep A, Hep B, and DTaP
104
as of 2005 the only childhood vaccine in the US that still contained more than trace amounts of Thiomersal is
the influenza vaccine
105
what are the two types of Influenza vaccination
LAIV and TIV (trivalent inactivated vaccine)
106
what type of vaccine is Hib
conjugate
107
what type of vaccine is Meningococcal
conjugate
108
for people that are asplenic, revaccination at period intervals is recommended for what vaccine
pneumococcal vaccine...also recommended for nephrotic syndrome
109
Psyllium/ Metamucil class
fiber laxative
110
indication of Psyllium/ Metamucil
constipation, irritable bowel, reduction of colon cancer risk, reduction of cholesterol levels and heart disease risk
111
MOA of Psyllium/ Metamucil
contains soluble and insoluble fiber. adds bulk to stool as well as absorbing fluid into the feces to soften the stool
112
Side effects of Psyllium/ Metamucil
may cause diarrhea. avoid if any suspicion of intestinal obstruction. powder and capsules are gluten free, but wafers contain gluten
113
class of Docusate/ Colace
stool softener
114
indication of Docusate/ Colace
constipation, hemorrhoids. prophylaxis in patients who should no strain during bowel movement (i.e. after anorectal surgery, MI)
115
MOA of Docusate/ Colace
anionic surfactant
116
side effects of Docusate/ Colace
flatulence, bloating, abdominal cramping. may cause diarrhea. avoid oral use if suspicion of intestinal obstruction.
117
```
class of Magnesium Hydroxide/
Milk of Magnesia
```
osmotic laxative, antacid
118
MOA of Magnesium Hydroxide/
| Milk of Magnesia
magnesium salts are poorly absorbed by the GI tract and thus act as osmotic agents to draw water into the lumen of the GI tract
119
indication of Magnesium Hydroxide/
| Milk of Magnesia
constipation, indigestion
120
side effects of Magnesium Hydroxide/
| Milk of Magnesia
Diarrhea, cramping, abdominal pain. May precipitate or exacerbate electrolyte imbalances. Patients with severe chronic kidney disease are at greater risk for possible hypermagnesemia. Avoid use if any suspicion of intestinal obstruction.
121
Bisacodyl/ Dulcolax class
stimulative laxative
122
MOA of Bisacodyl/ Dulcolax
increases intestinal motility
123
indication of Bisacodyl/ Dulcolax
constipation
124
side effects of Bisacodyl/ Dulcolax
Diarrhea, abdominal cramping, sweating. Possible laxative dependence with prolonged use. Definitely avoid use if any suspicion of intestinal obstruction.
125
class of Loperamide/ Imodium
antidiarrheal - analog of Meperidine
126
MOA of Loperamide/ Imodium
diminished peristalsis due to activation of opiate receptors in GI tract. Loperamide is an opioid receptor agonist and acts on the u-opioid receptors in the myenteric plexus within the large intestines. It does not affect the central nervous system like other opioids. Dimished activity of the myenteric plexus decreases the motility of the circular and longitudinal smooth muscles of the intestinal wall. This increases the amount of time substances stay in the intestine, allowing for more water to be absorbed out of the fecal matter.
127
indication of Loperamide/ Imodium
acute diarrhea and the management of chronic diarrhea in patients with inflammatory bowel disease
128
side effects of Loperamide/ Imodium
Dizziness, headache. Generally, not to be used in parasitic or bacterial infections accompanied by fever. Not to be used in severe colitis due to risk of toxic megacolon.
129
```
class of Diphenoxylate with
Atropine/ Lomotil
```
antidiarrheal
130
MOA of Diphenoxylate with
| Atropine/ Lomotil
combination of morphine analog and acetylcholine inhibitor results in diminished peristalsis
131
indication of Diphenoxylate with
| Atropine/ Lomotil
acute diarrhea
132
what antidiarrheal is generally no indicated beyond 48 hours
Diphenoxylate with
| Atropine/ Lomotil
133
side effects of Diphenoxylate with
| Atropine/ Lomotil
Dry mouth is quite common urinary retention, possible abdominal pain, constipation, (atropine effects). Generally, avoid when diarrhea is accompanied by fever. Not to be used in diarrhea due to bacterial or parasitic infections. Contraindicated in patients with severe colitis due to risk of toxic megacolon.
134
What is the active ingredient in Kaopectate
Bismuth subsalicylate (same as Pepto-Bismol). It was formerly kaolin clay (kaolinite) and pectin.
135
mild nausea and vomiting may respond to
antihistamines
136
moderate to severe N/V may require more potent agents that block
the 5-HT3 receptor sites
137
Meclizine/ Antivert class
antiemetic
138
MOA of Meclizine/ Antivert
H1 Histamine blocker
139
indication of Meclizine/ Antivert
mild to moderate nausea such as in motion sickness or vertigo
140
side effects of Meclizine/ Antivert
drowsiness, dizziness, dry mouth, urinary retention
141
class of Metoclopramide/ Reglan
antiemetic/pro-kinetic
142
MOA of Metoclopramide/ Reglan
dopamine 2 blocker and mixed serotonin 3 antagonist/serotonin 4 agonist
143
indication of Metoclopramide/ Reglan
mild to moderate nausea, gastric stasis (i.e. after gastric surgery or diabetic gastroparesis). Also used in GERD.
144
side effects of Metoclopramide/ Reglan
Drowsiness, dizziness and headache. It should be used with caution in Parkinson's disease since, as a dopamine antagonist, it may worsen symptoms. Contraindicated in patients with suspected bowel obstruction.
145
what drug increases peristalsis of the jejunum and duodenum, increases tone and amplitude of gastric contractions, and relaxes the pyloric sphincter tone.
Metoclopramide/Reglan
146
class of Ondansetron/ Zofran
antiemetic
147
MOA of Ondansetron/ Zofran
blockade of serotonin (5HT3) receptor sites results in significant anti-nausea effect
148
indication of Ondansetron/ Zofran
severe nausea
149
what is an effective agent for severe nausea due to various chemotherapeutic agents (given approx. 30 min prior)
Ondansetron/ Zofran
150
side effects of Ondansetron/ Zofran
dizziness, headache
151
Emetic/ Syrup of Ipecac class
emetic
152
MOA of Emetic/ Syrup of Ipecac
stimulation of medullary chemoreceptor trigger zone and local irritant of GI tract
153
indication of Emetic/ Syrup of Ipecac
induction of vomiting for drug overdose and certain poisonings
154
Emetic/ Syrup of Ipecac is not given with
charcoal, will absorb the drug
155
side effects of Emetic/ Syrup of Ipecac
abdominal muscle spasm (often lasting hours after stomach contents are emptied), dizziness and dehydration
156
class of Calcium carbonate/ Tums
antacid
157
MOA of Calcium carbonate/ Tums
neutralization of stomach acid, reducing mucosal irritation
158
indication of Calcium carbonate/ Tums
symptomatic relief of gastric acid irritation
159
side effects of Calcium carbonate/ Tums
Constipation. Drugs which alter the stomach or duodenal pH can alter the absorption of nutrients as well as the absorption other oral drugs. Increased pH may also inhibit protection against digested pathogens.
160
class of Ranitidine/ Zantac
H2 Histamine receptor antagonist
161
MOA of Ranitidine/ Zantac
blocks the action of histamine on parietal cells in the stomach, decreasing acid production by these cells
162
indication of Ranitidine/ Zantac
Gastritis, PUD, GERD
163
side effects of Ranitidine/ Zantac
Generally well tolerated. Greater side effect profile when given I.V. Headache, confusion, dizziness, rash. Drugs which alter the stomach or duodenal pH can alter the absorption of nutrients as well as the absorption other oral drugs. Increased pH may also inhibit protection against digested pathogens.
164
class of Omeprazole/ Prilosec
proton pump inhibitor
165
MOA of Omeprazole/ Prilosec
inhibits H+/K+ ATPase pump of parietal cells thus reducing acid secretion
166
indication of Omeprazole/ Prilosec
gastritis, PUD, GERD
167
side effects of Omeprazole/ Prilosec
Headaches, dizziness, diarrhea. Drugs which alter the stomach or duodenal pH can alter the absorption of nutrients as well as the absorption other oral drugs. Increased pH may also inhibit protection against digested pathogens.
168
Esomeprazole/ Nexium--what is it
single enantiomer form of Omeprazole that AstraZeneca made because they lost their patent
169
rank least to most potent drug classes for stomach acid
antacid, H2 blocker, PPI
170
therapy of choice for PUD
triple therapy for 7-14 days for PUD due to H Pylori
171
two forms of Triple Therapy for PUD
Proton Pump Inhibitor and Bismuth based
172
what is proton pump inhibitor based triple therapy
a PPI and 2 antibiotics for 1-2 weeks
173
what is Bismuth based triple therapy
Subsalicylate and 2 antibiotics for 1-2 weeks
174
how does Bismuth work for H Pylori
shown to damage the cell wall of H Pylori and other bacteria as well as reducing the bacterial adherence to mucosal cells
175
what increases risk of travelers diarrhea?
blocking stomach acid what do
176
what promotes mucosal healing
H2 histamine blockers to block acid production or PPIs to do so
177
why is monotherapy discouraged for H Pylori
Although the growth of H. pylori is readily suppressed by a single antibiotic, antimicrobial monotherapy is discouraged because it does not eradicate the organism and leads to increased risk for the selection of resistant strains.
178
antibiotics used in Triple Therapy for PUD
Amoxicillin, Erythromycin, Clarithromycin (Biaxin), Tetracycline or Metronidazole (Flagyl)...NOT Zithromax
179
the active moiety of all the aminosalicylates used to treat inflammatory bowel disease is
5-aminosalicylic acid (5-ASA), also called Mesalamine
180
class of 5-ASA/ Mesalamine
aminosalicylates
181
indications of 5-ASA/ Mesalamine
IBD
182
MOA of 5-ASA/ Mesalamine
inhibition of leukotriene production, anti-prostaglandin and anti-oxidant effects
183
side effects of 5-ASA/ Mesalamine
N/V, diarrhea, and abdominal pain. Nephrotoxicity can occur
184
5-ASA/ Mesalamine is delivered as a ___ drug
pro-drug to allow for release of drug at ileum of beyond
185
5-ASA/ Mesalamine, is it more useful for Crohn's or UC
far more useful for UC
186
Who benefits more from antibiotics: Crohn's or UC?
Patients with Crohn's disease
187
two of the most commonly used antibiotics for treating Crohn's disease
Metronidazole/Flagyl and Ciprofloxacin/Ciprofloxin
188
Metronidazole should not be taken by
patient's consuming alcohol
189
Ciprofloxacin is notable for its affinity to
calcium and for increased risk for occurrence of tendon rupture in patients taking this drug
190
drug approved by the FDA for the treatment of traveler's diarrhea and hepatic encephalopathy
Rifaximin/Ixifaxin
191
Prednisone is a pro-drug that is converted in the liver into
prenisolone, which is the most active form of the drug
192
Prednisone/ Deltasone class
glucocorticoid/corticosteroid
193
indications of Prednisone/ Deltasone
preferred drug for reactive airways disease or moderate to severe allergic reaction. Important for leukemia reaction.
194
MOA of Prednisone/ Deltasone
affects gene transcription to either stimulate or repress protein production
195
side effects of Prednisone/ Deltasone
Side effects include reduced resistance to infections, hypertension, hyperglycemia and possible diabetes mellitus, severe bone loss, avascular necrosis, cataracts, myopathy, thinning of skin, diminished wound healing, easy bruising, insomnia and mental status changes and possible adrenal suppression.
Increased appetite is a commonly reported side effect as is weight gain from salt and water retention.
196
Budesonide/ Entocort is used to treat
mild to moderate Crohn's disease
197
what are immunomodulatory drugs often used for
weaning from prednisone and to maintain the length of remission
198
Azthioprine/ Immuran class
immunomodulator
199
indications of Azthioprine/ Immuran
IBD, rheumatoid arthritis and other auto-immune conditions, post-transplant cases (anti-rejection agent) and cancer chemotherapy
200
MOA of Azthioprine/ Immuran
inhibits purine synthesis, resulting in an anti-proliferative effect and induction of apoptosis of T-cells
201
Azathioprine/ Immuran is a ___ drug
pro-drug which is converted in the body to its active form called mercaptopurine (Purinethol)
202
side effects of Azathioprine/ Immuran
Side effects include nausea, fatigue, hair loss, and rash. Because Azthioprine suppresses the bone marrow, patients will be more susceptible to infection.
203
patients taking what drug are excluded from eligibility for blood donation
Azathioprine/ Immuran
204
Infliximib/ Remicade class
immunomodulator - TNF inhibitor
205
indications of Infliximib/ Remicade
IBD, rheumatoid arthritis, psoriasis and other auto-immune conditions
206
MOA of Infliximib/ Remicade
inhibits the pro-inflammatory cytokine, TNF-alpha
207
Infliximib/ Remicade is dosed every ___ or ___
every 2 weeks or every 4 weeks
208
side effects of Infliximib/ Remicade
Marked susceptibility to infection and sepsis, potential reactivation of hepatitis B, potential reactivation of tuberculosis, T-cell lymphoma and drug induced lupus
209
several medications are available to treat urge incontinence by
blocking acetylcholine action on the bladder and diminish detrusor muscle contraction
210
class of Oxybutynin/ Ditropan
anticholinergic med
211
indication of Oxybutynin/ Ditropan
used to relieve frequent urination and inability to control urination due to urge incontinence. also used for hyperhidrosis (hyper-active sweating)
212
MOA of Oxybutynin/ Ditropan
competitive antagonism of M3 subtype of the muscarinic acetylcholine receptor
213
side effects of Oxybutynin/ Ditropan
dry mouth, dry eyes, constipation, blurred vision, drowsiness dizziness and diminished sweating. Patients taking this medication should be instructed to use extra care not to become overheated during exercise to avoid the risk of heat stroke.
214
class of Tolterodine/ Detrol
anticholinergic med
215
indication of Tolterodine/ Detrol
used to relieve frequent urination and inability to control urination due to urge incontinence
216
MOA of Tolterodine/ Detrol
competitive antagonism of M2 and M3 subtypes of the muscarinic acetylcholine receptor
217
what antimuscarinic agent is marketed as having fewer side effects than other antimuscarinic agents
Tolterodine/ Detrol
218
Tolterodine/ Detrol and Oxybutynin/ Ditropan have potential interactions with
drugs metabolized by cytochrome P450
219
class of Imipramine/ Tofranil
tricyclic antidepressant, mainly used in the treatment of clinical depression but is also used in cases of urge incontinence and enuresis
220
MOA of Imipramine/ Tofranil
blocks reuptake of serotonin and norepinephrine and appears to diminish acetylcholine uptake in smooth muscle
221
side effects of Imipramine/ Tofranil
Dry mouth, blurred vision, constipation, insomnia, flushing, tremulousness and weight gain. Agitation, irritability, confusion, and delirium are also possible, particularly in the elderly.
222
2 very important things about Imipramine/ Tofranil
black box warning about increased risk for suicidal ideation and suicide. Overdose can be fatal due to a heart block.
223
drug used frequently for enuresis
Imipramine/ Tofranil
224
two main medication for management of BPH are
alpha blockers and 5alpha-reductase inhibitors
225
common side effects of alpha blockers include
orthostatic hypotension, fatigue, and nasal congestion
226
class of Tamsulosin/ Flomax
alpha 1 receptor antagonist
227
indication of Tamsulosin/ Flomax
BPH
228
MOA of Tamsulosin/ Flomax
smooth muscle relaxation via alpha adrenergic antagonism
229
side effects of Tamsulosin/ Flomax
possible retrograde ejaculation
230
class of Finasteride / Proscar
5 alpha-reductase inhibitor
231
indication of Finasteride / Proscar
BPH
232
MOA of Finasteride / Proscar
blocks conversion of testosterone to dihydrotestosterone
233
a lower dosage of Finasteride / Proscar is marketed for the treatment of
male pattern baldness. Drug is called Propecia.
234
side effects of Finasteride / Proscar (IMPORTANT)
Impotency. Women who are or who may become pregnant must not handle crushed or broken Finasteride tablets, because the medication could be absorbed through the skin. Category X.
235
the drug of choice for cystitis has been
TMP-Sulfa/Bactrim
236
drug that usually provides excellent coverage for UTI organisms
Ciprofloxin or other quinolones
237
avoid use of Ciprofloxin or other quinolones in
children and with pregnant or lactating women
238
indication of Phenazopyridine/ Pyridium
used to relieve symptoms such as pain, burning and the sensation of nedding to urinate urgently or frequently caused by irritation of the urinary tract lining
239
commonly used antibiotics to treat cystitis
TMP-Sulfa/Bactrim,
Quinolones - Ciprofloxin
Amoxicillin/Clavulanate – Augmentin, Nitrofurantoin – Macrodantin
240
drug that changes urine to distinct dark orange or reddish color
Phenazopyridine/ Pyridium
241
drug that has been known to permanently discolor contact lenses
Phenazopyridine/ Pyridium...infrequently can cause a yellowish discoloration in the skin or eyes
242
Metoclopramide/ Reglan should be used with caution in people with
Parkinson's disease because, as a dopamine antagonist, it may worsen the condition
