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Pharmacology > Exam 3 Drugs > Flashcards

Exam 3 Drugs Flashcards

1
Q

Prototype for loop diuretics

A

Furosemide (Lasix)

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2
Q

Mechanism of action of Furosemide

A

Acts on ascending loop of Henle to block reabsorption

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3
Q

Pharmacokinetics of furosemide

A

Rapid onset
PO: 60 min
IV: 5 min

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4
Q

Therapeutic uses of furosemide

A

Pulmonary edema
Edematous states
Hypertension

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5
Q

Adverse effects of furosemide

A

Hyponatremia, hypochloremia, dehydration
Hypotension - volume loss, relaxation of venous smooth
muscle
Hypokalemia
Ototoxicity
Hyperglycemia
Hyperuricemia

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6
Q

Can furosemide be used during pregnancy?

A

No, because it’s too risky when trying to balance fluid/electrolytes of both mom and baby

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7
Q

What do we have to pay particular attention to when giving furosemide? Why?

A

Potassium levels

We have to expect pt to lose potassium when giving furosemide, bc it’s pulling fluid out of the body

But it must stay in it’s normal range b/c if it gets too low or high, pt will have cardiac rhythm issues.

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8
Q

Drug interactions for furosemide

A

Digoxin
Ototoxic drugs
Potassium-sparing diuretics
Lithium
Antihypertensive agents
Nonsteroidal anti-inflammatory drugs

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9
Q

Administration of furosemide

A

Oral or parenteral

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10
Q

How should furosemide be given IV?

A

Must be given slowly, over at least 2 min
Giving fast can cause hearing loss

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11
Q

3 other types of loop diuretics

A

Ethacrynic acid (Edecrin)
Bumetanide (Bumex)
Torsemide (Demadex)

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12
Q

Another name for Thiazides and Related Diuretics

A

Benzothiadiazides

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13
Q

Effects of Thiazides and related diuretics

A

Similar to those of loop diuretics:
- Increase renal excretion of sodium, chloride, potassium, and water
- Elevate levels of uric acid and glucose

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14
Q

Differences between thiazides and loop diuretics

A

Diuresis is considerably lower than that produced by loop diuretics
Not effective when urine flow is scant (unlike loop diuretics)

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15
Q

Prototype Thiazide

A

Hydrochlorothiazide (HydroDIURIL)

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16
Q

Pharmacokinetics of hydrochlorothiazide

A

Peaks in 4-6 hrs

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17
Q

Therapeutic uses of hydrochlorothiazide

A

HTN
Edema
Diabetes insipidus (helps with hormonal issues from diabetes)

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18
Q

Adverse effects of hydrochlorothiazide

A

Hyponatremia, hypochloremia, and dehydration
Hypokalemia
Hyperglycemia
Hyperuricemia
Impact on lipids, calcium, and magnesium

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19
Q

Effect of hydrochlorothiazide on breast feeding

A

Enters breast milk

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20
Q

Drug interactions for hydrochlorothiazide

A

Digoxin
Augments effects of hypertensive meds
Can reduce renal excretion of lithium (leading to accumulation)
NSAIDs may blunt diuretic effect
(Can be combined with ototoxic agents without increased risk of hearing loss)

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21
Q

Prototype for potassium-sparing diuretics

A

Spironolactone (Aldactone)

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22
Q

Mechanism of action for Spironolactone

A

Blocks aldosterone in the distal nephron
Retention of potassium
Increased excretion of sodium

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23
Q

Therapeutic uses of spironolactone

A

HTN
Edematous states
Heart failure (decreased mortality in severe failure)
Primary hyperaldosteronism

Can be used for hormonal issues:
Premenstrual syndrome
Polycystic ovary syndrome
Acne in young women

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24
Q

Adverse effects of spironolactone

A

Hyperkalemia
Benign and malignant tumors
Endocrine effects

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25
Q

Drug interactions of spironolactone

A

Thiazide and loop diuretics
Agents that raise potassium levels

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26
Q

Two other potassium sparing diuretics

A

Triamterene (Dyrenium)
Amiloride (Midamor)

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27
Q

Prototype for osmotic diuretics

A

Mannitol (Osmitrol)

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28
Q

Action of Mannitol

A

Promotes diuresis by creating osmotic force within lumen of the nephron

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29
Q

Pharmacokinetics of Mannitol

A

Must be given parenterally

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30
Q

Therapeutic uses of Mannitol

A

Prophylaxis of renal failure
Reduction of intracranial pressure
Reduction of intraocular pressure

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31
Q

Adverse effects of Mannitol

A

Edema
Headache
N & V
Fluid and electrolyte imbalance

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32
Q

Drug class of Digoxin (Lanoxin)

A

Cardiac (Digitalis) Glycosides

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33
Q

Effects of Digoxin (Lanoxin)

A

Positive inotropic action on the heart
Increases the force of ventricular contraction
Increases myocardial contractility

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34
Q

Hemodynamic benefits of Digoxin

A

Increased cardiac output:
- Decreased sympathetic tone
- Increased urine production
- Decreased renin release

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35
Q

Adverse effects of Digoxin (Lanoxin)

A

Cardiac dysrhythmias (predisposing factors= Hypokalemia elevated digoxin level, and heart disease)

Nausea
Vomiting
Anorexia
Fatigue
Visual impairments (seeing halos)

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36
Q

Therapeutic range of digoxin

A

0.5-0.8 ng/mL

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37
Q

When should digoxin be held?

A

If pt’s heart rate is <60, notify provider and hold drug

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38
Q

Drug interactions of digoxin (Lanoxin)

A

Diuretics
ACE inhibitors and ARBs
Sympathomimetics
Quinidine
Verapamil

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39
Q

Half life of Digoxin (Lanoxin)

A

About 1.5 days

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40
Q

Most effective group of drugs to lower LDL cholesterol

A

HMG-CoA Reductase inhibitors (Statins)

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41
Q

Which drug class does Lovastatin (Mevacor) belong to?

A

HMG-CoA Reductase Inhibitors

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42
Q

Therapeutic uses of Statins

A

Hypercholesterolemia
Primary and secondary prevention of CV events
Post-MI therapy
Diabetes

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43
Q

Common adverse effects of statins

A

Headache
Rash
GI disturbances

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44
Q

Rare adverse effects of statins

A

Myopathy/rhabdomyolysis
Hepatotoxicity

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45
Q

Drug interactions of statins

A

Most other lipid-lowering drugs (except bile acid sequestrants)
Drugs that inhibit CYP3A4
Use in pregnancy

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46
Q

Dosing of statins

A

Should be once daily, in the evening

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47
Q

Which class does Colesevelam (Welchol) belong to?

A

Bile-Acid Sequestrants

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48
Q

Benefits to Colesevelam (Welchol)

A

Newest and better-tolerated drug
Does not decrease uptake of fat-soluble vitamins
Does not significantly reduce the absorption of statins, warfarin, digoxin, and most other drugs

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49
Q

Use of Colesevelam (Welchol)

A

Reduces LDL cholesterol (with modified diet and exercise)

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50
Q

Adverse effects of Colesevelam (Welchol)

A

Constipation

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51
Q

Bile-Acid sequestrant with more serious side effects

A

Ezetimibe (Zetia)

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52
Q

Which class is Gemfibrozil (Lopid) in?

A

Fibric Acid Derivatives (Fibrates)

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53
Q

Actions of Gemfibrozil (Lopid)

A

Decrease plasma TG content
Decrease VLDL levels
Increase HDL cholesterol

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54
Q

Drug interactions of Gemfibrozil (Lopid)

A

Displaces warfarin from plasma albumin
(Must measure INR frequently)

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55
Q

Uses of Gemfibrozil (Lopid)

A

Reduces high levels of VLDLs (in pts who have not responded to diet modification)

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56
Q

Adverse effects of Gemfibrozil (Lopid)

A

Rashes
Myopathy
Gastrointestinal disturbances
Gallstones
Liver injury

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57
Q

3 families of antianginal agents

A

Organic nitrates
Beta blockers
Calcium channel blockers

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58
Q

Which class does nitroglycerin belong to?

A

Organic nitrates

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59
Q

Uses of nitroglycerin

A

Acute anginal therapy
Sustained anginal therapy
Perioperative control of BP
Treatment of heart failure with MI
Unstable angina
Uncontrolled exacerbations of chronic angina

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60
Q

Which drug class does isosorbide mononitrate (Imdur) belong to?

A

Organic nitrates

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61
Q

Which drug class does isosorbide dinitrate (Isordil) belong to?

A

Organic nitrates

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62
Q

Which drug class does propanolol (inderal) belong to?

A

Beta blockers

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63
Q

Which drug class does metoprolol (Lopressor) belong to?

A

Beta blockers

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64
Q

Use of propranolol and metoprolol

A

Decrease cardiac oxygen demand

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65
Q

Adverse effects of propranolol and metoprolol

A

Bradycardia
Decreased AV conduction
Reduction of contractility
Asthmatic effects
(Use with caution in pts with diabetes)
Insomnia - bizarre dreams
Sexual dysfunction - depression

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66
Q

Which drug class does verapamil belong to?

A

Calcium channel blockers

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67
Q

Which drug class does diltiazem belong to?

A

Calcium channel blockers

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68
Q

Which drug class does nifedipine belong to?

A

Calcium channel blockers

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69
Q

Adverse effects of calcium channel blockers

A

Dilation of peripheral arterioles
Reflex tachycardia
Hypotension
Beta blockers
Bradycardia
Heart failure
AV block

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70
Q

Action of Heparin

A

Enhances antithrombin
Rapid-acting anticoagulant

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71
Q

Administration of unfractionated heparin

A

Injection only
IV (continuous and intermittent)
Deep subQ

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72
Q

Therapeutic uses of unfractionated heparin

A

Preferred anticoagulant during pregnancy
Pulmonary embolism
Stroke evolving
Massive DVT
Open heart surgery
Renal dialysis
Low-dose therapy postoperatively
Disseminated intravascular coagulation
Adjunct to thrombolytic therapy

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73
Q

Adverse effects of unfractionated heparin

A

Hemorrhage
Heparin-induced thrombocytopenia
Hypersensitivity reactions

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74
Q

When is unfractionated heparin contraindicated?

A

Thrombocytopenia
Uncontrollable bleeding
During and immediately after surgery of eye, brain, or spinal cord

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75
Q

Antidote for OD of heparin

A

Protamine sulfate

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76
Q

What should be measured to determine if a pt has enough unfractionated heparin?

A

Activated partial thromboplastin tine (aPTT)

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77
Q

Therapeutic uses of Low-Molecular-Weight Heparins

A

Prevention of DVT following surgery
Treatment of established DVT
Prevention of ischemic complications

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78
Q

Administration of Low-Molecular-Weight Heparins

A

SubQ
Dosage based on body weight

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79
Q

Adverse effects and interactions of Low-Molecular-Weight Heparins

A

Bleeding (but less than with unfractionated heparin)
Immune-mediated thrombocytopenia
Severe neurologic injury for pts undergoing spinal puncture of spinal epidural anesthesia

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80
Q

What drug group does Enoxaparin (lovenox) belong to?

A

Low-Molecular-Weight Heparins

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81
Q

Which drug class does Dalteparin (Fragmin) belong to?

A

Low-Molecular-Weight Heparins

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82
Q

Action of Warfarin (Coumadin)

A

Oral anticoagulant

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83
Q

Use of Warfarin (Coumadin)

A

Oral anticoagulant with delayed onset
Vitamin K antagonist
Blocks synthesis of factors VII, IX, and X and prothrombin

*Long-term prophylaxis of thrombosis
- associated with PE
- thromboembolism in pts with prosthetic heart valves
- thrombosis during atrial fibrillation

Not useful in emergencies

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84
Q

What is monitored when a pt is taking warfarin?

A

Prothrombin time (PT)
Internal normalized ration (INR)

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85
Q

Adverse effects of Warfarin

A

Hemorrhage
Fetal hemorrhage and teratogenesis during pregnancy

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86
Q

What should be given for toxicity of warfarin?

A

Vitamin K

87
Q

Drug interactions with warfarin

A

Drugs that increase anticoagulant effects
Drugs that promote bleeding
Drugs that decrease anticoagulant effects
Heparin
Aspirin
Acetaminophen

88
Q

Which drug class does etexilate (Pradaxa) belong to?

A

Direct thrombin inhibitors

89
Q

Which drug class does Bivalirudin (Angiomax) belong to?

A

Direct thrombin inhibitors

90
Q

Mechanism of action of Bivalirudin (Angiomax)

A

Facilitates the actions of antithrombin
Prevents conversion of fibrinogen to fibrin
Prevents activation of factor XIII

91
Q

Use of Bivalirudin (Angiomax)

A

Prevents clot formation (combined with aspirin) in pts with unstable angina who are undergoing coronary angioplasty

92
Q

Adverse effects of Bivalirudin (Angiomax)

A

Bleeding
Back pain
Nausea
Headache

93
Q

Which class of drugs does Lepirudin (Refludan) belong to?

A

Direct thrombin inhibitors

94
Q

What is Lepirudin (Refludan) used for?

A

Argatroban: IV anticoagulant
Direct inhibition of thrombin
Prophylaxis and treatment of thrombosis in pts with HIT

95
Q

Which drug class does Rivaroxanan (Xarelto) belong to?

A

Selective Factor Xa Inhibitors

96
Q

Uses of Rivaroxanan (Xarelto)

A

Binds directly with factor Xa to cause inactivation
Oral, prevention of DVT and PE after ortho surgery
Prevention of stroke in pts with atrial fibrillation

97
Q

Adverse effects of Rivaroxanan (Xarelto)

A

Bleeding (esp head bleeds)

98
Q

Which drug class does aspirin belong to?

A

Antiplatelet drugs

99
Q

Therapeutic uses of aspirin (ASA)

A

Ischemic stroke
Transient ischemic attack
Chronic stable angina
Unstable angina
Coronary stunting
Acute MI
Previous MI
Primary prevention of MI

100
Q

Adverse effects of aspirin

A

Bleeding
GI bleeding and hemorrhagic stroke

101
Q

Which drug class does Clopidogrel (Plavix) belong to?

A

Antiplatelet drugs

102
Q

Therapeutic uses of Clopidogrel (Plavix)

A

Prevents blockage of coronary artery stents
Reduce thrombotic events in pts with acute coronary syndromes

103
Q

Which drug class does Vorapaxar (Zontivity) belong to?

A

Antiplatelet drugs

104
Q

Which drug class does Tirofiban (Aggrastat) belong to?

A

Antiplatelet drugs (GP IIb/IIa receptor antagonists)

105
Q

Which group of drugs does Eptifibatide (Integrilin) belong to?

A

Antiplatelet drugs (GP IIb/IIa receptor antagonists)

106
Q

Action of Eptifibatide (Integrilin)

A

Causes reversible and highly selective inhibition of GP IIb/IIIa receptors

107
Q

Uses of Eptifibatide (Integrilin)

A

ACS
Patients undergoing PCI
Antiplatelet effects reverse within 4 hours of stopping infusion

108
Q

Which drug class does Alteplase (tPa) belong to?

A

Thrombolytic Fibrinolytic Drugs

109
Q

Therapeutic uses of Alteplase (tPa)

A

MI
Ischemic stroke
PE

110
Q

Major adverse effect of Alteplase

A

Bleeding (esp intracranial bleeding)
(Recent wounds, needle puncture sites, invasive procedure sites)

111
Q

All post MI patients should take:

A

Beta blocker
ACE inhibitor
Antiplatelet drug or anticoagulant

112
Q

Two groups of calcium channel blockers

A

Dihydropyridines
Non-Dihydropyridines

113
Q

Sites of action of dihydropyridines

A

Act primarily on arterioles

114
Q

Sites of action for non-dihydropyridines

A

Act on arterioles and on the heart

115
Q

2 drugs in non-dihydropyridines group of CCBs

A

Verapamil
Diltiazem (Cardizem)

116
Q

Action of Verapamil

A

Block calcium channels in blood vessels and act on vascular smooth muscle and the heart

117
Q

Hemodynamic effects of verapamil

A

Direct effects on the heart and blood vessels
Reflex effects

118
Q

5 direct hemodynamic effects of verapamil

A
  1. Reduces arterial pressure
  2. Increases coronary perfusion
  3. Reduces heart rate
  4. Decreases AV nodal conduction
  5. Decreases force of contraction
119
Q

Indirect hemodynamic effects of verapamil

A

Baroreceptor reflex

120
Q

Net effects of verapamil

A

Little or no effect on cardiac performance
*Vasodilation accompanied by reduced arterial pressure and increased coronary perfusion

121
Q

Therapeutic uses of verapamil

A

Angina pectoris (Vasospastic & angina of effort)
Essential hypertension (first line agent)
Cardiac dysrhythmias

122
Q

Adverse effects of verapamil

A

*Constipation (most common complaint)
* Dizziness, facial flushing, headache
Edema of ankles and feet
Gingival hyperplasia
Heart block

123
Q

How can a pt relieve constipation from taking verapamil

A

Increasing dietary fiber and fluids

124
Q

Drug interactions of verapamil

A

Digoxin
Beta-adrenergic blocking agents

125
Q

What occurs with toxicity of verapamil

A

Severe hypotension
Bradycardia and AV block
Ventricular Tachydysrhythmias

126
Q

Actions of Diltiazem

A

Blocks calcium channels in the heart and blood vessels
Lowers blood pressure
(Arteriolar dilation, direct suppressant/reflex cardiac stimulation = little net effect on the heart)

127
Q

Therapeutic uses of Diltiazem

A

Angina pectoris
HTN
Cardiac dysrhythmias

128
Q

Adverse effects of Diltiazem

A

Similar to verapamil (except less constipation)
Dizziness, flushing, headache
Edema of ankles and feet
Exacerbates *bradycardia, sick sinus syndrome, heart failure, and second-or third- degree heart block

129
Q

Drug interactions of Diltiazem

A

Digoxin
Beta-adrenergic blocking agents

130
Q

Which drug class does nifedipine belong to?

A

Dihydropyridines (CCBs)

131
Q

Action of Nifedipine (Procardia)

A

Vasodilation by blocking calcium channels
Blocks in vascular smooth muscle
Very little blockade of heart Ca channels

132
Q

What can Nifedipine (Procardia) not be used to treat?

A

Dysrhythmias

133
Q

Indirect effects of nifedipine

A

Lowered BP activates baroreceptor reflex

134
Q

Net effect of Nifedipine causing vasodilation by blocking calcium channels

A

Lowered BP
Increased HR
Increased contractile force

135
Q

Therapeutic uses of Nifedipine

A

Angina pectoris
HTN

136
Q

Adverse effects of Nifedipine

A

Flushing
Dizziness
Headache
Peripheral edema
Gingival hyperplasia
Chronic eczematous rash in older patients
*Reflex tachycardia = increased O2 demand, so can cause increased pain for angina patients

137
Q

What can Nifedipine be combined with to prevent reflex tachycardia?

A

Beta blocker

138
Q

Action of ACE inhibitors

A

Decrease levels of angiotensin II and can dilate vessels
Increase levels of bradykinin, dilation can cause cough

139
Q

Therapeutic uses of ACE inhibitors

A

Hypertension
Heart failure
MI
Diabetic and nondiabetic nephropathy
Prevention of MI, stroke, and death in pts at high cardiovascular risk

140
Q

Adverse effects of ACE inhibitors

A

First-dose hypotension
Cough
Angioedema
Hyperkalemia
Dysgeusia and rash
Renal failure
Neutropenia
Fetal harm

141
Q

Drug interactions of ACE inhibitors

A

Diuretics
Antihypertensive agents
Drugs that raise potassium levels
Lithium
Nonsteroidal anti-inflammatory drugs

142
Q

How are ACE inhibitors administered?

A

Orally, expect for Enalapril (Vasotec)

143
Q

Actions of ARBs

A

Block access of angiotensin II
Cause dilation of arterioles and veins
Prevent angiotensin II from inducing pathologic changes in cardiac structure
Reduce excretion of potassium
Decrease release of aldosterone
Increase renal excretion of sodium and water
Do not inhibit kinase II
Do not increase levels of bradykinin

144
Q

Therapeutic uses of ARBs

A

HTN
Heart failure
MI
Diabetic nephropathy

If unable to tolerate ACE inhibitors:
Protection against MI, stroke, and death from CV causes in high risk pts

145
Q

Adverse effects of ARBs

A

Angioedema
Fetal harm
Renal failure

146
Q

Which drug class does Captopril (Capoten) belong to?

A

ACE inhibitors

147
Q

Which drug class does Enalapril (Vasotec) belong to?

A

ACE inhibitors

148
Q

Which drug class does Lisinopril (Prinivil) belong to?

A

ACE inhibitors

149
Q

Which drug class does Losartan (Cozaar) belong to?

A

ARBs

150
Q

Which drug class does Valsartan (Diovan) belong to?

A

ARBs

151
Q

Which drug class does Telmisartan (Micardia) belong to?

A

ARBs

152
Q

Which drug class does Aliskiren (Tekturna) belong to?

A

Direct renin inhibitors

153
Q

Action of Aliskiren (Tekturna)

A

Binds tightly with renin and prevents division of angiotensinogen to angiotensin I

154
Q

Adverse effects of Aliskiren (Tekturna)

A

Angioedema
Cough
GI effects
Hyperkalemia
Fetal injury

155
Q

Which drug class does Eplerenone (Inspra) belong to?

A

Aldosterone antagonists

156
Q

Mechanism of action of Eplerenone (Inspra)

A

Selective blockade of aldosterone receptors

157
Q

Therapeutic uses of Eplerenone (Inspra)

A

HTN
Heart failure

158
Q

Adverse effects of Eplerenone (Inspra)

A

Hyperkalemia

159
Q

Drug interactions of Eplerenone (Inspra)

A

Inhibitors of CYP3A4
Drugs that raise potassium levels
Use with caution when combined with lithium

160
Q

Which drug class does spironolactone (Aldactone) belong to?

A

Aldosterone antagonists

161
Q

Mechanism of action of spironolactone (Aldactone)

A

Blocks aldosterone receptors
Binds with receptors for other steroid hormones

162
Q

Therapeutic uses of spironolactone (Aldactone)

A

HTN
Heart failure

163
Q

Adverse effects of spironolactone (Aldactone)

A

Hyperkalemia
Gynecomastia
Menstural irregularities
Impotence
Hirsutism
Deepening of the voice

164
Q

Which drug class does Hydralazine (Apresoline) belong to?

A

Vasodilators

165
Q

Action of Hydralazine (Apresoline)

A

Selective dilation of arterioles
(Postural hypotension is minimal)

166
Q

Therapeutic uses of Hydralazine (Apresoline)

A

Essential hypertension
Hypertensive crisis
Heart failure

167
Q

Adverse effects of Hydralazine (Apresoline)

A

Reflex tachycardia
Increased blood volume
Systemic lupus erythematous-like syndrome
Headache
Dizziness
Weakness
Fatigue

168
Q

Drug interactions of Hydralazine (Apresoline)

A

Other antihypertensive agents
Avoid excessive hypotension
Combined with beta blocker to protect against reflex tachycardia and diuretics to prevent sodium and water retention and expansion of blood volume

169
Q

Which drug class does Minoxidil (Loniten) belong to?

A

Vasodilators

170
Q

Action of Minoxidil (Loniten)

A

Selective dilation of arterioles
More intense dilation than Hydralazine but causes more adverse reactions

171
Q

Use of Minoxidil (Loniten)

A

Severe HTN that is unresponsive to safer drugs

172
Q

Adverse effects of Minoxidil (Loniten)

A

Reflex tachycardia
Sodium and water retention
Hypertrichosis (hair growth)
Pericardial effusion

173
Q

Drug class of sodium nitroprusside (Nitropress)

A

Vasodilator

174
Q

Action of sodium nitroprusside (Nitropress)

A

Fastest-acting antihypertensive agent
Causes venous and arteriolar dilation

175
Q

Administration and onset of sodium nitroprusside (Nitropress)

A

IV infusion (CCU)
Immediate onset (BP returns to pretreatment level in minutes when stopped)

176
Q

Use of sodium nitroprusside (Nitropress)

A

Hypertensive emergencies

177
Q

Adverse effects of sodium nitroprusside (Nitropress)

A

Excessive hypotension
Cyanide poisoning
Thiocyanate toxicity

178
Q

What is Levothyroxine?

A

Synthetic T4

179
Q

Treatment of a thyrotoxic crisis (thyroid storm)

A

Potassium iodide
Methimazole
Beta blocker

Sedation
Cooling
Glucocorticoids
IV fluids

180
Q

Drug of choice for hypothyroidism

A

Levothyroxine (Synthroid)

181
Q

Half life of Levothyroxine (Synthroid)

A

7 days

182
Q

When should Levothyroxine be administered?

A

In the morning at least 30-60 mins before breakfast

183
Q

First line drug for hyperthyroidism

A

Methimazole (Tapazole)

184
Q

Which class does Methimazole (Tapazole) belong to?

A

Thionamides

185
Q

How long does Methimazole (Tapazole) take to fully work?

A

3-12 weeks

186
Q

Uses of Methimazole (Tapazole)

A

Used alone for grave’s disease
Or with radiation therapy
Or before thyroid gland surgery

187
Q

Class for Propylthiouracil (PTU)

A

Thionamides

188
Q

Action of PTU

A

Inhibits thyroid hormone synthesis

189
Q

Half life of PTU

A

90 mins

190
Q

How long before full effects of PTU?

A

6-12 months

191
Q

Uses of PTU

A

Grave’s disease
With radiation therapy
Before thyroid surgery
Thyrotoxic crisis

192
Q

Adverse effects of PTU

A

Agranulocytosis (most serious)
Hypothyroidism
Pregnancy and lactation
*Severe liver damage

193
Q

Use of radioactive iodine

A

Hyperthyroidism
(Grave’s disease)

194
Q

Half life of radioactive iodine

A

8 days

195
Q

How long until full effects of radioactive iodine?

A

2-3 months

196
Q

Use of Lugol’s solution

A

Suppress thyroid function in preparation for thyroidectomy

197
Q

Use of beta blockers for Grave’s disease

A

Can suppress tachycardia and other symptoms

198
Q

Glucose for prediabetes pts

A

Impaired fasting glucose between 100-125 mg/dL
Impaired glucose tolerance test

(Pt is at increased risk for developing type 2 diabetes)

199
Q

Common target values of blood glucose for diabetic patients

A

80-130 mg/dL before meals
<180 mg/dL 1-2 hours after meals

200
Q

Goal for A1C for diabetic patients

A

Below 7%

201
Q

Type of insulin, onset, and duration:
Insulin lispro (Humalog)

A

Short-duration, rapid-acting
Onset: 15-30 mins
Peak: .5-2.5 hours
Duration: 3-6 hours

202
Q

Type of insulin, onset, peak, and duration:
Insulin aspart (NovoLog)

A

Short-duration, rapid-acting
Onset: 10-20 mins
Peak: 1-3 hours
Duration: 3-5 hours

203
Q

Type of insulin, onset, peak, and duration:
Insulin glulisine (Apidra)

A

Short duration, rapid acting
Onset: 10-15 mins
Peak: 1-1.5 hours
Duration: 3-5 hours

204
Q

Type of insulin, onset, peak, and duration:
Regular insulin (Humulin R, Novolin R)

A

Short duration, short acting
Onset: 30-60 mins
Peak: 1-5 hours
Duration: 10 hours

205
Q

Type of insulin, onset, peak, and duration:
NPH insulin (Humulin N, Novolin N)

A

Intermediate duration
Onset: 60-120 mins
Peak: 6-14 hours
Duration: 16-20 hours

206
Q

Type of insulin, onset, peak, and duration:
Insulin glargine (Lantus)

A

Long duration
Onset: 70 mins
Duration 18-24 hours

207
Q

Type of insulin, onset, peak, and duration:
Insulin detemir (Levemir)

A

Long duration
Onset: 60-120 mins
Duration: 12-24 hours

208
Q

Type of insulin, onset, peak, and duration:
Insulin glargine (Toujeo)

A

Ultra long duration: 24 hours

209
Q

Which insulins can you mix?

A

NPH with short acting insulins
(Draw short-acting insulin up first)

210
Q

Adverse effects of insulin treatment

A

Hypoglycemia
Hypokalemia
Lipohypertrophy
Allergic reactions

211
Q

Class for Metformin (Glucophage)

A

Biguanides

212
Q

Use of metformin (Glucophage)

A

Drug of choice for prevention of T2DM
Gestational diabetes
PCOS

213
Q

Side effects of metformin (Glucophage)

A

GI disturbances
Lactic acidosis (potentially fatal, rare)

214
Q

Characteristics of diabetic ketoacidosis

A

Hyperglycemia
Ketoacids
Hemoconcentration
Acidosis
Coma

Pharmacology (16 decks)

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