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MPJE + NAPLEX 2023 PREP > mnemonics + GOOD TO KNOW > Flashcards

mnemonics + GOOD TO KNOW Flashcards

1
Q

Beta-selective BBs

A

AMEBBBA

atenolol
metoprolol
esmolol
bisoprolol
betaxolol
bystolic (nebivolol)
acebutolol

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2
Q

BB in IV Form

A

MAPLES

metoprolol
atenolol [D/C’ed in US]
propanolol
labetalol
esmolol
sotalol

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3
Q

Beta Blocker SEs

A

BLOCKERS

brady/broncho
lipid increase/decrease libido
orthostatic HTN (dizziness)
conduction abnormalities (AV block)
K(c)onstriction of peripheral vasculature (Raynaud’s)/potassium increase
exhaustion/emotional depression
reduced recognition of hypoglycemia (decreased ability to recognize tachycardia)

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4
Q

AV blockers

A

cause bradycardia/can treat afib (also capable of causing atrial fib) [CAN HELP W/ VENTRICULAR RATE]

amiodarone (dronedarone - multaq)
BB
CCBs/corlanor - ivabradine
digoxin

[for afib = first line = BB and non-DHP CCB]

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5
Q

displaces digoxin (increase digoxin concentration)

A

VAQC

verapamil
amiodarone
quinidine (SE: think ear ringing)
clarithromycin

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6
Q

ACEi adverse effects

A

CAPTOPRIL

cough (d/t increase in bradykinin)
angioedema
potassium
taste change (metallic, sweet, salty taste; occurs since ACEi chelates Zn)
orthostasis (hypotension)
pregnancy –> NO (1st trim = cat C // 2nd/3rd trim = cat D)
rash (contra w/ renal artery stenosis)
increase in potassium
leukocytosis (captopril)

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7
Q

BB in HF

A

the cardinal met the bishop

carvedilol (with food)
metoprolol succinate
bisoprolol

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8
Q

increase lipids

A

PASS on the BLT

protease inhibitors
antipsychotics
SGLT2i // STEROIDS

BB
loops
thiazides

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9
Q

cyp3a4 inhibitors

A

GPAC [ increases substrate concentrations]

grapefruit juice
protease inhibitors
azoles, amiodarone, androgen (specific) –> Danazol
CCB (verapamil, diltiazem, amlodipine), clarithromycin (also erythromycin)

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10
Q

cyp3a4 inducers

A

SR CuP

S = St. John’s Wort (OTC), Sustiva (efavirenz)
R = Rifampin (remember, turns you red)

C = Carbamazepine (also oxcarbazepine)
P = Phenytoin, Phenobarbital

*also garlic
*also goldenseal (induces 3A4 and 2D6)

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11
Q

warfarin colors

A

party like girls then bring peaches to your wedding

pink
lavender
green
tan
blue
peach
teal or blue green
YELLOW (7.5 mg)
WHITE (10 mg)

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12
Q

OTCs that increase bleed risk

A

NOT a mnemonic

NSAIDs
garlic
ginger
gingko biloba
vitamin E
fish oils –> can prolong bleeding time

additionally (rx) –> alcohol, SSRIs

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13
Q

anticholinergic SEs

A

hot as a hare (increase body temperature)
blind as a bat (mydriasis - dilated pupils)
dry as a bone (“anhidrosis”; dry mouth, dry eyes, decreased sweat)
red as a beat (flushed face)
mad as a hatter (delirium, altered mental status)
full as a flask (urinary retention)

also:
tachycardia
worsening of glaucoma
constipation
short term memory loss

random: urinary incontinence = LEAKING of urine

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14
Q

anticholinergic (adrenergic) impact

A

increased heart rate (+ chronotrope)
increased contractility (+ inotrope)
increased cardiac output
increased BP
bronchodilation
fat lipolysis/glycogenolysis (increase glucose)
uterus relaxation

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15
Q

what are the vitamin Bs

A

the rabbi needs prayer for comfort

thiamin B1
riboflavin B2
niacin B3
pyridoxine B6
folic acid B9
cyanocobalamin B12

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16
Q

increased uric acid

A

ABCDET

asa, alcohol, ALSO abaloparatide - Tymlos (new PTH analog for osteo)
B3 (niacin), bempedoic acid
calcineurin inhibitors (tacrolimus, cyclosporine), chemo agents
diuretics (loops + thiazides)
ethambutol (“E” = effects the eyes), Empirozenimide (TB drug)
ticagrelor (brilinta), Teriparatide - Forteo (for osteo), tacrolimus

also pyrazinamide (the “P” in the TB “RIPES” mnemonic)

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17
Q

statin SEs

A

HMG-CoA reductase inhibitors

hepatotoxicity, HA
myopathy/rhabdo, memory
glucose increase, GI (flatulence, abdominal pain)
CPK (check only if myopathy is being considered)
ophthalmic (blurred vision)
alopecia

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18
Q

DKA treatment

A

DIABETES

dehydrated (hydrate w/ NS (6 - 8L)
insulin (regular): IV preferred 0.1 U/kg/hr
acidosis (this is just indicating the pt is in an acidotic state)
bicarbonate (this used to be given)
electrolytes (monitor): for every 1 U of insulin given –> 1 U of potassium pulled into the cell [if pt has low K+, giving insulin WON’T be effective]; checking electrolytes to not give TOO much
time
electrolyties
sugar (when glucose drops below 200 or 250..maybe give more)

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19
Q

GLP-1 agonist SEs

A

gall bladder disease, GI symptoms
weight Loss
pancreatitis
1 –> “T” –> thyroid tumors [US boxed warning]

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20
Q

DPP-4 SEs

A

pancreatitis
joint Pain

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21
Q

SGLT2i SEs

A

genital yeast infections
L x4: LDL increase, lowers weight, lowers bp, LABs (increases K, Mg, Phosphate)
bone fracTures

*all given once daily in the AM
*canagliflozin should be taken b4 first meal

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22
Q

hypercalcemia signs/symptoms

A

ways it can be increased: increase PTH, thiazide, lithium

stones (kidney)
bones (disease)
groans (abdominal)
PSYCH overtones (anxiety, depression)

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23
Q

metabolic acidosis causes

A

MUDPILES

methanol
uremia
DKA
paraldehyde
iron, INH (isoniazid)
lactic acidosis
ethylene glycol, etoh
salicylate // STARVATION

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24
Q

glucocorticoid equivalent doses

A

CUTE HOT PRETTY PHARMACISTS MAKE TRIPLE DIGITS BOOOOOM

25mg - Cortisone
20mg - Hydrocortisone
5mg - Prednisolone
5mg - Prednisone
4mg - Methylprednisolone
4mg - Triamcinolone
0.75mg - Dexamethasone
0.6 - 0.75mg - Betamethasone

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25
steroid systemic SEs
PREDNISONE (w/ long term use) - oral, not inhaled PUD/Psychiatric: effects (at high PO doses) delirium, mania, depression, euphoria, mood swings Retention: of Na & H2O Eye: Cataracts, glaucoma Diabetes: increased glucose --> decreased wound healing Neurologic: CNS - HA, insomnia, seizure Immunosuppression: however, WBC count increases Swelling: Cushing's Syndrome Osteoporosis Nausea (used to treat - very effective) Electrolyte changes (decreased K, increased Na)
26
equivalent statin doses
Pharmacists Rock At Saving Lives and Prevent Fatty deposits 2- Pitavastatin 5- Rosuvastatin 10 - Atorvastatin 20 - Simvastatin 40 - Lovastatin 40 - Pravastatin 80 - Fluvastatin
27
divalproex sodium what to remember [PNN migraine chapter]
depakote [when you die (DIvalproex), you put your coat (depaKOTE) on] a = think alopecia, ammonia increase l = liver, check LFTs p = pancreatitis t (in brand name) = thrombocytopenia
28
mtx symptoms
METHOTREXATE m = myelosuppression // mucositis h = hepatotoxicity o = (make it a sun) photosensitivity r = rash // renal (keep urine alkaline w/ Na Bicarb) x = pregnancy cat X // chest x-ray ANTIDOTE = LEUCOVORIN
29
leflunomide (Arava) symptoms
L = LFT, looong half life of the active metabolite (monitor AST, ALT. Check ALT qmonth for 6 months) A = alopecia also a lot of nausea antidote = cholestyramine 8 g TID x11 days OR activated charcoal (50g in a suspension) x11 days
30
hydroxychloroquine (plaquenil) symptoms // monitoring
HYDROXYCHLOROQUINE monitoring: CBC/CNS, liver function, muscle strength o = ophthalmologic c = CBC // CNS o = tinnitus (decreased hearing acuity) l = liver function n = neuroMyopathy "PLAQ PLAQ PLAQ IN THE EYES" eye exam at baseline, annual screening beginning after 5 years of use
31
amiodarone (Pacerone) SEs
AMIODARONE BLUE = can turn pt blue a = alveoli (check CXR); AV blocker (monitor EKG) iod = IODine = check TSH (can cause hypo+hyperthyroidism) o = "eye" = check corneal micro deposits = check eyes d = DDI = inc warfarin/digoxin (would dec dose of war/dig) = INHIBITOR; 100% liver (CHECK LFTS; don't worry about renal system); long t1/2 [don't give w/ sofosbuvir or Harvoni (sofosbuvir + ledipasvir)] o = sun = PHOTOSENSITIVITY (must wear sunscreen) n = if waiting > 2 hr and need to make, use NON-PVC e = check EKG (HR) & BP; check electrolytes (inc K, inc Mg)
32
CHA2DS2-VASc
CHF = 1 pt HTN = 1 pt A2GE >/= 75 --> 2 pts DM = 1 pt S2TROKE // TIA = 2 pts VASCULAR DZ = 1pt AGE 65 - 74 = 1pt SEX = FEMALE = 1pt CHEST Men >/= 1; Women >/= 2 --> anticoagulate [at least 1 non-sex risk factor] AHA/ACC Men >/= 2; Women >/= 3 --> anticoagulate [at least 2 non-sex risk factors] Men 1; Women 2 --> MAY consider anticoagulate [at least 1 non-sex risk factor]
33
class I antiarrhythmics
Sodium channel blockers (I = QDP, II = PLM, III = PF) Ia = QDP [quinidine, disopyramide, procainamide] (atrial & ventricular arrhythmias) IIb = PLM [phenytoin, lidocaine, mexiletine] (ventricular arrhythmias) IIIc = PF [propafenone, flecainaide] (atrial & ventricular arrhythmias)
34
class II antiarrhythmics
Beta Blockers --> RATE CONTROL IN AFIB IV (acute) = metoprolol, esmolol (brevibloc; shortest half-life), propanalol (inderal) Oral (long-term rate control) = BBs are 1st line for pts w/ systolic HF & AF requiring rate control: carvedilol, metoprolol succinate or bisoprolol BB antidote = glucagon
35
class III antiarrhythmics
Potassium channel blockers IASDD ibutilide (Corvert = IV; chemical cardioversion) amiodarone (Pacerone = PO; Nexterone = IV) sotalol (Betapace, Betapace AF = PO/IV; contra <40 CrCl) dofetilide (Tikosyn = PO; D/C <20 CrCl; 125 - 500 mcg caps) dronedarone (Multaq = PO; amio deriv: no thyroid, lung, eye SE; SE = liver failure // HF)
36
class IV antiarrhythmics
non-DHP Ca channel blockers verapamil and diltiazem
37
major 2D6 inhibitor
fluoxetine, paroxetine, quinidine, sertraline - zoloft (weak/moderate inhibitor), duloxetine - cymbalta, bupropion - wellbutrin + Zyban, mirabegron - myrbetriq these inhibitors will decrease effectiveness of the following: -tamoxifen: for breast cancer --> needs to be converted to active form using 2D6 -codeine (prodrug of morphine)
38
major 1A2 inhibitors
fluvoxamine, ciprofloxacin, cimetidine (tagamet), isoniazid, viloxazine (Qelbree, non-stimulant that only increases norepi, similar to Strattera) [drugs can decrease concentration of warfarin and theophylline]
39
general antipsychotic SEs [from PNN schizophrenia chapter]
EPSE (dystonic reaction, akathisia, pseudoparkinsonism) tardive dyskinesia (TD) - repetitive, involuntary movements neuroleptic malignant syndrome (NMS) sedation: (w/ aripiprazole and cariprazine: sedation) anticholinergic effects (most with clozapine; rare w/ ziprasidone, aripiprazole, paliperidone, asenapine, lurasidone) orthostasis: dizziness (most w/ clozapine, iloperidone; rare w/ aripiprazole, brexipiprazole, cariprazine, asenapine, lurasidone) hyperprolactinemia: elevated prolactin levels (think risperidone AND paliperidone; aripiprazole has NOT been shown to increase this) weight gain (think clozapine and olanzapine) *all typical antipsychotics (block dopamine) have these SEs but w/ newer meds, some have less of these SEs
40
antipsychotic SE mnemonic [from PNN schizophrenia chapter]
WASH MEN weight gain - block histamine *H1* receptors anticholinergic - block cholinergic receptors sedation - block histamine receptors hypotension - BLOCK alpha-adrenergic movement disorders EPSE - extrapyramidal symptoms i.e., movement dysfunction neuroleptic malignant syndrome (NMS) i.e., life-threatening mental status change
41
another anticholinergic mnemonic [from PNN schizophrenia chapter]
ANTI - SLUDGE ANTI- Salivation Lacrimation Urination Defecation / Diaphoresis (excessive sweating) GI motility Excretion / Emesis
42
ATYPICALS // TYPICALS for rapid tranquilization mnemonic
HZZ rapid IM for ACUTE agitation: Haloperidal (Haldol) Ziprasidone (Geodon) Zyprexa (Olanzapine) --> watch for severe orthostatic hypotension
43
LONG ACTING INJECTABLE ANTIPSYCHOTICS for pts who are noncompliant ADD DETAIL? P432 IN PNN
decanoate means can last for long periods of time (e.g., weeks, months, etc) Haldol decanoate [typical] -oral monthly Fluphenazine decanoate [typical] -every 2 to 4 weeks Risperidone (Risperdal = Consta) -IM every 2 weeks Risperidone (Perseris) -subQ monthly Paliperidone palmitate -invega sustenna = IM every month -invega TRInza = IM every 3 months Aripiprazole (Abilify Maintena) -IM once monthly Aripiprazole lauroil (Aristada) -IM every 4 to 6 weeks Aripiprazole lauroil (Aristada initio) -IM is only to be used as a single dose to initiate Aristada "booster" Olanzapine pamoate (Zyprexa Relprevv)(olanzapine ER) -every 2 weeks or once a month
44
loss of dopamine results in [mnemonic; from PNN parkinsons]
TRAMPP tremor: "resting tremor", bilateral (initially unilateral), absent during sleep rigidity: stiff "cog wheel rigidity" akinesia: initiation of movement is difficult. Bradykinesia = slowed movement mask face: can't smile or make facial expressions d/t the stiffness of facial muscles pill rolling with fingers postural instability later in the disease state
45
contra // caution to anticholinergics [from PNN parkinsons]
BPH narrow-angle glaucoma bladder neck obstruction myasthenia gravis
46
meds with anticholinergic effects
atropine scopolamine TCAs dicyclomine (bentyl) hyoscyamine
47
BZDs for elderly mnemonic
LOT lorazepam (ativan) oxazepam temazepam (RESToril) = insomnia only (BZDs also insomnia only: estazolam - ProSom, triazolam - Halcion)
48
BZDs that don't have many DDIs (i.e., not a substrate) mnemonic
LOT lorazepam (ativan) oxazepam temazepam (RESToril) = insomnia only (BZDs also insomnia only: estazolam - ProSom, triazolam - Halcion) [CONFIRM ESTAZOLAM AND TRIAZOLAM CAN ALSO BE USED FOR SLEEP]
49
DSM-5 diagnostic criteria mnemonic
five or more symptoms present nearly every day, for 2 weeks. at least one of the symptoms is (1) depressed mood or (2) loss of interest/pleasure SIG E CAPS: sleep changes interest (loss) guilt (worthless) energy (lack): fatigue cognition/concentration appetite (wt loss or wt gain) psychomotor agitation (anxiety) or retardation (lethargic) suicidal thoughts or suicide attempt
50
SSRIs SE mnemonic
HOWS G H = hypotension, HA, hyponatremia O = bOne (increased risk of fractures), ocular effects W = wt gain S = suicidal thinking, sexual dysfunction, serotonin syndrome caution G = GI (can exacerbate loose stools) // GI Bleed
51
lithium SEs mnemonic [from PNN anxiety, depression, bipolar disorder]
LITHIUM L = Li levels 0.6 - 1 mEq/L (mainten.), leukocytosis (inc WBC) I = increase urination (polyuria // polydipsia; concern for nephrogenic diabetes insipidus --> check electrolytes) T = tremor, TSH (concern for hypothyroidism - low T3 & T4) H = hypercalcemia, hyperparathyroidism I = increase CNS // dermatologic (acne, alopecia) bUn and scr = lithium is excreted renally M = monitor WEB (Weight // EKG // Electrolytes // Beta-hCG)
52
2C19 inhibitors
omeprazole and esomeprazole [can increase phenytoin and R-warfarin; can decrease impact of plavix]
53
TB Drugs mnemonic
RIPES [all drugs are bactericidal except for ethambutol] Rifampin (rifadin) - empty stomach Isoniazid (INH) - empty stomach Pyrazinamide Ethambutol (Myambutol) - bacteriostatic Streptomycin bedaquiline (Sirturo) combinations: -rifamate (isoniazid + rifampin) - empty stomach -rifater (isoniazid + rifampin + pyrazinamide) - empty stomach
54
2C9 inhibitors
isoniazid, erythromycin
55
rifampin an inducer of
3A4, 1A2 and 2C9 decreases efficacy of oral contraceptives, decreases INR w/ warfarin. avoid using with protease inhibitors d/t increased risk of hepatotoxicity
56
NRTIs mnemonic
ZALES DT zidovudine (AZT,ZDV)(retrovir) abacavir (ABC)(Ziagen) lamivudine (3TC)(Epivir, Epivir-HBV) emtricitabine (FTC)(Emtriva) stavudine (d4T)(Zerit) didanosine (ddI)(Videx, Videx EC) tenofovir
57
NNRTIs mnemonic
RNEEDD rilpivirine (RPV)(Edurant) nevirapine (NVP)(Viramune) efavirenz (EFV)(Sustiva) etravirine (ETR)(Intelence) doravirine (Pifeltro) delavirdine (DLV)(Rescriptor)
58
Integrase inhibitors mnemonic
RBED raltegravir (RAL)(Isentress - PO) bictegravir (+ emtricitabine + TAF = Biktarvy) elvitegravir (+ cobicistat + TDF + emtricitabine = Stribild; + cobicistat + emtricitabine + TAF = Genvoya)(PO) dolutegravir (DTG)(Tivicay)(PO) cabotegravir (Apretude - IM; PrEP; Vocabria - PO; + rilpivirine = Cabenuva - IM)
59
protease inhibitors mnemonic
LAND FIRST lopinavir/ritonavir (RTV)(Kaletra) atazanavir (ATZ)(Reyataz) w/ cobicistat (Evotaz) nelfinavir (NFV)(Viracept) darunavir (DRV)(Prezista) w/ cobicistat (Prezcobix) fosamprenavir (FPV)(Lexiva) indinavir (IDV)(Crixivan) ritonavir (RTV)(Norvir) Saquinavir (SQV)(Invirase) tipranavir (TPV)(Aptivus)
60
barbiturates SE mnemonic
ex: phenobarbital, pentobarbital, primidone BARB bone disease, bone marrow suppression ataxia (loss of full control of body movements) rash, respiratory depression behavior changes, bradycardia
61
seizure med levels
phenobarbital -infants + children: 15 - 40 mcg/mL -adult: 20 - 40 mcg/mL primidone: 5 - 12 mcg/mL fosphenytoin // phenytoin: 10 - 20 mg/L or mcg/mL valproic acid (divalproex sodium): 50 - 100 mcg/mL carbamazepine: 4 - 12 mcg/mL oxcarbazepine: 12 - 30 mcg/mL ethosuximide: 40 - 100 mcg/mL
62
what enhances GABA (4)
-benzodiazepines -propofol (diprivan) -ethanol -phenobarbital Purpose of GABA: -inhibitory -agonize = calming effect -reduce stress // anxiety -improve sleep
63
how will alcohol impact phenytoin // warfarin (INR)
acute alcohol intake = increase phenytoin levels // increase INR chronic alcohol intake = decrease phenytoin levels // decrease INR
64
valproic acid and lamictal
weak inhibitor of 2C9, 2D6, 3A4 increases blood levels of lamotrigine
65
_______ serotonin ________ sodium
increase; decrease
66
adverse effects of COCs: progestational androgenic estrogenic
progestational: -breast tenderness, HA, HTN, acne, oily skin, hirsutism, decreased libido -progestins have chemical structure similar to testosterone thus have some androgenic activity androgenic: -acne, oily skin, INCREASED APPETITE, WT GAIN, DEPRESSION, fatigue, lethargy estrogenic: -nausea, edema, fluid retention, HA, wt gain, increased breast size, THROMBO-EMBOLIC EVENTS (PE, DVT, CVA), skin pigment changes [ESTROGEN THICKENS BLOOD]
67
ABSOLUTE CONTRAINDICATIONS FOR COCs
thromboembolic disorder or hx (DVT, CVA) hx of breast / uterus or any estrogen-dependent neoplasia (abnormal growth of cells) undiagnosed vaginal bleeding liver issues (jaundice, general hepatic disease) pregnancy World Health Organization (WHO) Contraindications: -lactation < 6 weeks postpartum (had a baby --> female is in a hypercoagulable state) -age > 35 & smoke > 15 cigs/day -HTN -migraines (IF HAVING AURAS) -DM w/ end organ disease -chest pain [IF BREAST CANCER = NO ESTROGEN]
68
If on COC, contact MD if [mnemonic]
ACHES abdominal pain (severe) chest pain, cough, SOB --> concern for PE headache, dizziness, numbness --> concern for stroke eye problems (vision loss/burning) severe leg pain (calf or thigh) --> concern for DVT SEs will decrease w/ consistent use after 3 months
69
concerning DDIs w/ COC
antibiotics / antifungal -griseofulvin cyp3A4 inducers -rifampin -anticonvulsants (phenytoin, phenobarbital, carbamazepine, oxcarbamazepine) if taking these meds, should not use hormonal contraception (EXCEPT depo-provera / IUD). If must use COC, some clinicians may recommend COC with 50 mcg of estrogen
70
NORETHINEDRONE // PROGESTERONE ONLY (MINI PILL) + counseling points
-Micronor -Nor-QD -Aygestin -Camila -Errin -Jolivette -Nora-BE ^norethindrone: 0.35 mg TAKE SAME TIME EVERY DAY INITIATE ON FIRST DAY OF MENSES or on first Sunday after menses begins USE BACK-UP FOR 2 DAYS IF > 3 HOURS LATE ON DOSE [progesterone has short half-life --> result --> lining can thin and allow sperm penetration] EVERY PILL IS THE SAME
71
good candidates for progestin only birth control
indicated for contraception / endometriosis contraception of >1 year duration is desired pts in whom estrogens should be avoided non-compliant w/ COC (forgetful) when breastfeeding is desired pts w/ a hx of seizures when amenorrhea is desired when considered w/ DDIs [progesterone is sedating // relaxing - estrogen is excitatory]
72
AVOID progesterone in pts w/
hx of depression or HAs
73
how to choose the right form of birth control: acne wt gain
74
how to choose the right form of birth control: dysmenorrhea (menstrual cramps) or PMS (premenstrual syndrome) bloating menstrual migraine
75
how to choose the right form of birth control: women w/ coexisting medical condition women w/ DM women w/ hx of DVT / PE, CAD, CHF, or CVA women w/ migraines & depression
76
FLibAnSeriN (Addyi) info
mixed serotonin agonist / antagonist for premenopausal women w/ hypoactive (decrease in physical or behavioral activity) sexual desire -dose = SQ 45 min before sexual activity -is a major 3A4 substrate --> CONTRA w/ 3A4 inhibitors -SEs: hypotension, syncope FLibAnSeriN L = liver A = alcohol contraindication S = serotonin, syncope, substrate: CYP3A4 (CONTRA w/ inhibitors) N = take it at Night (QHS)
77
allergies to be aware of: cleviprex diprivan prometrium paclitaxel LMWH Hyalgan Calcitonin Pramlintide
clevidipine --> soy & egg propofol --> soy & egg progesterone --> peanut paclitaxel --> Cremophor EL (polyoxyethylated castor oil) LMWH (enoxaparin, dalteparin) --> pork allergy Hyaluronate --> eggs, avian protein, feathers Miacalcin --> salmon Symlin --> Metacresol
78
cigarette smoking and drug interactions: CYP enzyme of concern what drugs concerned about what do when quit smoking
cigarette smoking induces CYP1A2 substrates theophylline (Theo-Dur), olanzapine (Zyprexa), clozapine (Clozaril), & fluvoxamine (Luvox) [may need higher dose of these drugs in pts who smoke] when quit smoking, may need to reduce the dose of CYP1A2 substrates and caffeine [caffeine levels increase when a pt quits smoking; counsel them to reduce their caffeine intake after they quit]
79
how reduce nephrotoxicity w/ cisplatin and carboplatin
ALL B4 CHEMO AGENTS hydrate 2-3L NS mannitol 25-50 g IV amifostine (ethyl) [cisplatin ONLY; carboplatin less nephrotoxic than cisplatin]
80
how premedicate: BuSulfan
premedicate w/ prophylactic anticonvulsants (phenytoin, levetiracetam, BZDs, or valproate)
81
how premedicate: cyclophosphamide and ifosfamide
hydrating AND MESNA which binds to acrolein (this is responsible for hemorrhagic cystitis)
82
MTX antidote
Leucovorin (folinic acid)
83
how improve effect of fluorouracil (5-FU)
ADD leucovorin
84
precursors of: Fluorouracil (5-FU) and Mercaptopurine (6-MP)
Capecitabine (Xeloda) is PRO-DRUG of Fluorouracil (5-FU) Azathioprine turns into Mercaptopurine (6-MP)
85
Azathioprine // Mercaptopurine (6-MP) major DDI
allopurinol // febuxostat are xanthine oxidase inhibitors which increase the concentration of Azathioprine and Mercaptopurine (6-MP) solution = decrease dose of Azathioprine and Mercaptopurine (6-MP) if need to give together
86
life time doses of: Bleomycin Doxorubicin Daunorubicin
400 units 550 mg/m2 550 mg/m2
87
how premedicate: Doxorubicin and Daunorubicin
Dexrazoxane IV (Zinecard: iron chelator) protects against cardiotoxicity
88
how premedicate: docetaxel (Taxotere)
corticosteroids: dexamethasone 8 mg BID x3-5 days, start 1 day prior
89
how premedicate: paclitaxel (Taxol)
d/t hypersensitivity premedicate before starting taxol w/ dexamethasone, IV diphenhydramine, and IV histamine H2 antagonists (cimetidine, ranitidine or famotidine)
90
how treat diarrhea and dehydration: irinotecan // topotecan
early form --> atropine late form --> loperamide (no MAX dose HERE) also replenish fluids and electrolytes
91
tacrolimus SEs
tacrolimus mnemonic t - tremor a - alopecia, acne c - cardiovascular (HTN, QT increase) r - renal o - oncology (skin cancer; avoid sun & UV light exposure) l - liver (CYP3A4 substrate) i - infection, immunosuppression, increase in K, IDDM (insulin dependent DM) m - monitor levels, malignancy u - uric acid increase s - seizures (neurotoxicity)
92
elemental iron values
93
mnemonic for MAOi
MAO Takes Pride In Shanghai T --> tranylcypromine (Parnate) P --> phenelzine (Nardil) I --> isocarboxazid (Marplan) S --> selegiline (Emsam; Zelapar)(MAO-B > MAO-A at low doses i.e., 10 mg or less) *MAO-A degrades: serotonin, dopamine, norepi, epi, tyramine, other chemicals *MAO-B degrades: dopamine, other chemicals [ only MAOi w/ preferential inhibition (ONLY at low doses) is selegiline; other 3 inhibit MAO-A and MAO-B EQUALLY ]
94
opportunistic infection prophylaxis: PCP Toxoplasmosis MAC
95
Abx w/ NMTT side chain [MNEMONIC]
man met operator 4 tea cefamandole cefmetazole cefoperazone cefotetan
96
PPI Side Effects
all PPIs cause a reduction in calcium absorption

MPJE + NAPLEX 2023 PREP (16 decks)

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