final exam meds

Question 1

Erythropoiesis Stimulating Agent

Answer 1

Prototype: epoetin alfa
MOA: mimics human erythropoietin
FDA approved to maintain RBC count in patients with:
CKD
HIV infection on drug therapy
Anemia 2 chemotherapy in certain cancers
Pre-operative in patients with anemia
ROUTE: SUBQ

Question 2

Iron therapy

Answer 2

Prototype: Ferrous Sulfate
Indication: iron deficiency and prevention
MOA: taken up by bone marrow cells to make hemoglobin
AE: GI disturbances and teeth staining
ANTACIDS REDUCE ABSORPTION

Question 3

Parenteral Iron (IM or IV)

Answer 3

Prototype: Iron Dextran
Indication: Clear diagnosis of iron deficiency, oral iron is intolerable/ineffective
AE: Black box warning: potentially fatal anaphylaxis
**Small test dose before each dose

Question 4

Vitamin B12

Answer 4

Prototype: Cyancobalmin
Indication: B12 deficiency
AE: Hypokalemia
USE CAUTION WITH FOLIC ACID

Question 5

Folic Acid

Answer 5

MOA: converts to the active form of folic acid after administration
Indication: treatment of folic acid deficiency, prophylaxis of folate deficiency, initial treatment of severe anemia from vitamin B12 deficiency
IT CAN MASK B12 DEFICIENCY

Question 6

Aluminum

Answer 6

BASAJEL
Class: antacid
MOA: neutralize acid in the stomach
Indication: heal PUD, treat GERD symptoms, stress ulcers
SE: CONSTIPATION

Question 7

Calcium

Answer 7

TUMS
Class: antacid
MOA: neutralize stomach acid
Indication: PUD, GERD treatment, stress ulcer
SE: CONSTIPATION

Question 8

Magnesium

Answer 8

Milk of magnesia
Class: antacid
MOA: neutralize the acid in the stomach
Indication: heal PUD, treat GERD symptoms, stress ulcers
SE: DIARRHEA

Question 9

Aluminum + Magnesium

Answer 9

MAALOX + MYLANTA
Class: antacid
MOA: neutralize stomach acid
Indication: PUD, GERD symptoms, stress ulcers

Question 10

Cimetidine

Answer 10

Class: Histamine type II receptor antagonist
MOA: blocks H2 receptors and reduces gastric secretion
Indication: GERD symptoms, PUD healing
SE: CNS in elders
** INHIBITS CYP450 ENZYMES

Question 11

Famotidine

Answer 11

Class: Histamine type II receptor Antagonist
MOA: blocks H2 receptors and reduces gastric secretion
Indication: GERD symptoms, healing PUD
SE: CNS in elderly

Question 12

Omeprazole

Answer 12

Class: Proton Pump Inhibitor
MOA: binds to protein pump and irreversibly inhibits secretion of HCl
Indication: SHORT TERM treatment of GERD and PUD
SE: Pneumonia and Hip Fracture and Anemia

Question 13

Pantoprazole

Answer 13

Class: Protein Pump Inhibitor
MOA: binds to protein pump and irreversibly inhibits secretion of Hal
Indication: SHORT TERM treatment of GERD and PUD
SE: Pneumonia and hip fracture and anemia

Question 14

Sucralfate

Answer 14

Class: protectant
MOA: alters when exposed to gastric acid
Indication: gastric and duodenal ulcer
** Decreased Drug Absorption
PO- tablet/suspension

Question 15

Metoclopramide

Answer 15

Class: Pro kinetic Antiemetic
MOA: Increase upper GI motility and decrease emesis
Indication: GERD, N/V, Post-op
SE: sedation, restlessness, extra pyramidal reaction
SHORT TERM

Question 16

Insulin Lispro

Answer 16

Class: Rapid- Acting Insulin
MOA: helps facilitate the uptake of glucose
Indication: Type 1 diabetes
Start: 15 min
Peak: 1 hours
Duration: 2-4 hours
SE: hypoglycemia, allergic reaction
NC: GIVE WITH MEALS
**Give in conjunction with intermediate or long lasting insulin

Question 17

Insulin Regular

Answer 17

Class: Short-Acting Insulin
MOA: helps facilitate the uptake of glucose
Indication: Type 1 diabetes
Onset: 30-60
Peak: 2-6 hrs
Duration: 3-8 hrs
NC: GIVE BEFORE MEALS

Question 18

NPH

Answer 18

Class: Intermediate Acting Insulin
MOA: binds to cells on surface of cells and promotes uptake of glucose
Indication: Type 1 diabetes
Onset: 2-4 hours
Peak: 4-10 hrs
Duration: 10-20 hrs
NC: Inject 2 daily with meals
**Clear before cloudy
**Roll cloudy insulin

Question 19

Insulin Aspart

Answer 19

Class: Rapid Acting Insulin
MOA: Allows insulin to be absorbed into the bloodstream quicker than regular human insulin
Indication: Type 1 diabetes
Onset: 15 mins
Peak: 60 mins
Duration: 2-4 hours
NC: Give before meals cover glucose rise that occurs after eating

Question 20

Insulin Glargine

Answer 20

Class: Long acting insulin
MOA: binds to insulin receptors on cells and stimulates glucose uptake
Indication: Type 1 diabetes
Onset: 70 mins
Duration: All day
NC: GIVE AT NIGHT! check sugars during meals and correct with rapid acting PRN
** NEVER MIX WITH OTHER INSULIN

Question 21

Glipizide

Answer 21

Class: sulfonyureas
MOA: binding and closing K-ATP channels in the pancreatic beta cells thereby STIMULATING the secretion of insulin
Indication: Type 2 diabetes
SE: hypoglycemia
NC: DO NOT TAKE WHILE PREGNANT
caution with taking with alcohol, NSAIDS, cimetidine

Question 22

Glyburide

Answer 22

Class: sulfonureas
MOA: binding and closing the K-ATP channels in the pancreatic beta cells thereby STIMULATING the secretion of insulin
Indication: Type 2 diabetes
SE: hypoglycemia
NC: DO NOT TAKE WHILE PREGNANT
caution while taking with alcohol, NSAIDS, cimetidine can lead to worsening SE

Question 23

Metformin

Answer 23

Class: biguanides
MOA: decrease blood glucose by decreasing the production of glucose in the liver
Indication: Type 2 diabetes
ONSET: several days
PEAK: 2-4 weeks
SE: abdominal bloating, N/V/D, LACTIC ACID, GI Problems
NC: monitor serum blood glucose, give 30 minutes before meals
**DO NOT USE in pt with increased ALT levels
** DO NOT USE in pt. with kidney disease, liver disease, alcoholism
**MUST BE HELD 48 hrs post IV contrast

Question 24

Dulaglutide

Answer 24

Class: GLP-1 Receptor Agonist
MOA: enhances glucose dependent insulin secretion
Indication: Type 2 diabetes
Peak: 2 hours
Half life: 2 1/2 hours
SE: N/V/D, headache, URIs
NC: DO NOT USE with those who have pancreatitis, ESRD, or renal disease
**GILA monster
BOX WARNING THYROID C-CELLS

Question 25

Semaglutide

Answer 25

Class: GLP-1 Agonist MOA: enhances glucose dependent insulin secretion Indication: Type 2 diabetes Peak: 2 hrs Half-life: 2 1/2 hours SE: N/V/D, headache, URI, decreased GI NC: DO NOT use with those who have pancreatitis, ESRD, or severe renal disease **GILA monster BOX WARNING THYROID C-CELLS

Question 26

Linagliptin

Answer 26

Class: DPP4 inhibitors MOA: inhibits DPP4 an enzyme that inactivates the incretin hormone (increases insulin, decreases glucagon) Indication: hyperglycemia SE: GI issues, skin, flu symptoms

Question 27

Sazagliptin

Answer 27

Class: DPP4 inhibitors MOA: inhibits DPP4 enzyme that inactivates the incretin hormone (increase insulin, decrease glucagon) Indication: hyperglycemia SE: GI problems, flu, skin, pancreatitis

Question 28

Empagliflozin

Answer 28

Class: SLGT-2 inhibitors MOA: prevents kidneys from reabsorbing glucose Indication: type 2 diabetes SE: increase risk of UTIs NC: Don't give with ESRD, kidney disease

Question 29

Dapagliflozin

Answer 29

Class: SLGT-2 inhibitors MOA: prevents kidneys from reabsorbing glucose Indication: type 2 diabetes SE: increase risk of UTIs NC: Do not give with those who have ESRD and kidney disease

Question 30

Glucagon

Answer 30

Class: anti-hypoglycemic agent MOA: activates hepatic glucagon receptors, gluconeogenesis and glucose Indication: hypoglycemia SHORT DURATION *check finger stick 15 minutes

Question 31

Finasteride

Answer 31

Class: 5 alpha reductant inhibitor MOA: blocks conversion of testosterone to DHT (ALPHA 1 RECEPTORS) decrease epithelial tissue in prostate Indication: mechanical obstruction of urethra SE: impotence, decreased libido, gynecomastia NC: DECREASED PSA levels used for male pattern baldness

Question 32

Dutasteride

Answer 32

Class: 5 alpha reductase inhibitor MOA: blocks the conversion of testosterone to DHT(alpha 1 and 2 receptors) decrease the epithelial tissue in the prostate Indication: mechanical obstruction of urethra

Question 33

Tamulosin

Answer 33

Class: Alpha 1 Adrenergic Antagonist MOA: relaxes smooth muscle cells selective for alpha receptors in prostate Indication: dynamic obstruction of urethra SE: well tolerated, abnormal ejaculation

Question 34

Dutasteride and tamsulosin

Answer 34

superior to either agent alone FDA approved

Question 35

Sildenafil

Answer 35

Class: PDE 5 inhibitor MOA: inhibits PDE 5, increases and preserves cGMP levels, only enhances the normal response to sexual stimuli Indication: relief of ED, pulmonary arterial hypertension, BPH SE: Hypothalyamic annorea, flushing, and dyspepsia NC: caution with preexisting CV disease and if on nitrate and hypotension ONSET: 30-60 minutes PRIAPISM: medical emergency

Question 36

Levodopa

Answer 36

Class: Levodopa MOA:converts to dopamine in the brain and activates dopamine receptors Carbidopa MOA: blocks the destruction of levodopa Indication: Parkinson's disease SE: N/V, dyskinesia, postural hypotension, dysrhythmias, psychosis, hallucinations, nightmares, paranoia **Most effective drug for Parkinson's ** Does not work long term

Question 37

Riuzole

Answer 37

Class: Glutamate inhibitor MOA: glutamate antagonist, reduces damage to motor neurons Indication: ALS SE: dizziness, GI, hepatotoxicity ** delays need for trach, vent, and increases life expectancy by 2-3 months

Question 38

Neostigmine

Answer 38

Class: cholinesterase inhibitor MOA: prevent inactivation of acetylcholine by cholinesterase Indication: Myasthenia gravis SE: increase secretions, increased GI motility, urinary urgency, bradycardia, bronchial constriction, miosis, NC: