Module 1 Flashcards
1
Q
Who has full prescriptive Authority?
A
MD or DO a.k.a. physicians
2
Q
What is prescriptive authority?
A
The legal right to prescribe drugs
3
Q
What are the two components of prescriptive authority?
A
Right to prescribe independently and right to prescribe without limitation
4
Q
What scheduled drug classes can PAs prescribe to?
A
Scheduled II-V
5
Q
In Texas, APRNs can prescribe what scheduled class of meds?
A
Scheduled III—V
6
Q
What are controlled substances?
A
Meds that require a prescription and not at risk for addiction
7
Q
What are scheduled drugs?
A
Drugs that are at risk for addiction
8
Q
Legend or controlled drugs are good for how much time from the date of the prescription?
How good are they after they have been turned into the pharmacy?
A
From the date the prescription is written it is good for one month.
From the date the prescription is written and has been turned into the pharmacy, it is good for one year from the date it was written
9
Q
Controlled drugs in class three through five are good for how long?
A
It is good for six months from the date it was written
But if not turned into the pharmacy, it will expire in 1 month.
10
Q
Class II schedule drugs Are good for how long from the date of it being issued?
A
It is good for seven days from the date it was issued
11
Q
What are the three primary reasons for a drug monitoring?
A
To determine therapeutic dosage, Evaluating medication adequacy, and identifying adverse effects
12
Q
What are the four Processes of pharmacokinetics?
A
Absorption, distribution, metabolism, excretion
13
Q
What is pharmacokinetics?
A
The study of drug movement throughout the body
14
Q
What is absorption?
A
The drugs movement from that site of administration to the blood
15
Q
What is distribution?
A
The drugs movement from the blood to the interstitial space of tissues and into cells
16
Q
What is another name for metabolism?
A
Bio transformation
17
Q
PGlycoprotein or PGP Is what?
A
It is a multi drug transporter proteins that transports a wide variety of drugs out of cells
18
Q
For a drug to directly penetrate a Membrane what kind of solubility would it need to be?
Direct penetration of the membrane is most common
A
A drug must be lipid soluble or lipophilic
19
Q
Can polar molecules and ions Dissolve in lipids?
A
No
Only non-ionized and non-polar can dissolve in liquids
20
Q
The ionization of the drug is?
A
PH dependent
21
Q
What is PH portioning also called ion trapping?
A
The process where a drug accumulates on the side of a membrane were the pH most favors it’s ionization
22
Q
Which side do acidic drugs accumulate on?
Acidic side or alkaline side
A
Alkaline side
23
Q
Basic drugs tend to accumulate on which side?
Acidic or alkaline
A
Acidic side
24
Q
The rate of absorption determines what?
A
How soon effects will begin
25
The amount of absorption helps determine what?
How intense effects will be
26
The rate of dissolution helps determines what?
The rate of absorption
27
In regards to absorption, when the surface area is larger, the absorption is what?
Faster
When the surface areas larger, the absorption is faster
28
In regards to absorption, the greater the concentration gradient has, will have what effect on absorption?
Absorption will be faster
29
Which drugs are absorbed faster: High lipid soluble drugs or low lipid soluble drugs?
High lipid soluble drugs
30
What is distribution?
Movement of drugs from systemic circulation or blood to the side of drug action
31
Name 3 factors determine distribution
Blood flow to the tissues, ability of the drug to exit the vascular system, Ability of the drug to enter cells
32
In regards to distribution, and exiting the vascular system drugs usually leave the blood how?
Drugs in the vascular system leave the blood at capillary beds
33
In regards to the blood brain barrier why are neonates at risk?
The blood brain barrier has tight junctions that prevent drug passages, this is not Fully developed At birth
34
How do you most drugs cross the placenta?
Most drugs possible center via simple diffusion
35
Drugs that are non-ionized and non-polar can do you what?
Pass through membranes more easily Because they are more lipid soluble friendly
36
Does IV Have any barriers to absorption?
No, there is no barriers to absorption
37
In regards to protein binding,
| Are drugs needing to be bound or free to be pharmacologically active?
Drugs need to be unbound or free to be pharmacologically active
38
Most drug metabolism that takes place in the liver is performed by hepatic microsomal enzyme system known as what?
The P450 system also know as cytochrome P450
39
Most drug metabolism occurs where?
Takes place in the liver
40
P4 50 enzymes can be inhibited Or induced by drugs,Leading to what?
To the development of drug to drug interactions which can result in an adverse drug reactions and therapeutic failures
41
A drug that induces the P4 50 enzyme can affect another drugs rate of metabolism and its effectiveness in what way?
It can increase another drug’s rate of metabolism which decreases it concentration and reduces effectiveness
This requires increase dosage and can cause therapeutic failure
42
A drug that inhibits the P4 50 enzyme can affect the rate of metabolism and its effectiveness how?
A inhibiting drug can decrease another drugs rate of metabolism and prolong its effects.
This will require decreased Dosages and may lead to toxic drug levels
43
What is a pro drug?
Is a compound that is pharmacologically in active when administered but once Undergoing metabolism it becomes active
44
The liver does not develop its full capacity to metabolize drugs until how long after birth?
Until approximately one year after birth
45
Drugs that increase the rate of drug metabolism Are called what?
Inducers
46
Drugs that decrease the rate of metabolism are called what?
Inhibitors
47
What is the first pass effect?
The rapid inactivation of certain oral drugs Because they are Carrie directly to the liver before they enter systemic circulation
48
What is enterohepatic recirculation?
It is a repeating cycle and went to drug is transport deliver to the intestate and then back to the liver
Drugs can remain in the body much longer than they otherwise would
49
Name six methods drugs can exit their body through
```
Urine
Bile
Sweat
Saliva
Breast milk
Expired air
```
50
What are the three processes for excretion or elimination?
Glomerular filtration, passive tubular reabsorption, active tubular secretion
51
Can drugs that are polar, ionized, or a protein bound enter the breastmilk?
No
Only lipid soluble drugs have ready access to breastmilk
52
What is the minimum effective concentration (MEC)?
It is the plasma level less than which therapeutic effects will not occur
(Aka a drug must be present in concentrations at or greater than MEC)
53
What is toxic concentration?
The plasma level at which toxic effects begin
54
Drugs are having a narrow therapeutic range Should:
Be monitored for signs and symptoms of toxicity
55
What is a Drugs half-life defined as?
As the time required for the amount of the drug in the body to decrease by 50%
56
When a drug is administered repealing in the same dose, plateau will be reaching approximately how many half lives?
4-5 half lives
57
What is pharmacodynamics?
It is the study of a drug’s action on the body and how the drug produces it’s therapeutic effects
58
What is maximal efficacy? In relation to pharmacodynamics and that dose- response relationship
It is the largest effect that a drug can produce
59
What is relative potency?
Potency refers to the amount of drug we must give to elicit an effect
60
What is affinity?
It refers to the strength of the attraction between a drug and its receptor
61
Drugs with strong and high in affinity are...
Attracted to their receptors
Drugs with high affinity are effective in low doses and more potent
62
What is intrinsic activity?
It refers to the ability of a drug to activate the receptor after binding
Low intrinsic—low maximal efficacy
High intrinsic—maximal efficacy
63
Affinity an intrinsic activity are related to what pharmacodynamic theory?
Modified occupancy theory
64
What is an agonist?
A drug that mimics the body’s own regulatory molecule responses
Agonists=activate
Affinity allows binding and intrinsic activity allows the bound agonist to activate or turn on receptor function
65
Drugs a block the actions of an endogenous regulators are called what?
Antagonist
66
What are drugs that mimic the actions of endogenous regulatory molecules but they produce responses of intermediate intensity?
Partial Agonists
67
How do antagonist work?
They prevent receptor Activation by endogenous regulatory molecules and drugs
68
In regards to affinity And intrinsic activity, antagonists have what?
They have affinity for a receptor but No intrinsic activity
Affinity allows binding to a receptor but lack of intrinsic activity prevents receptor activation
69
In regards to affinity and intrinsic activity, Agonists have what?
Intrinsic activity Is high and affinity is high
70
What is the difference between non-competitive and competitive antagonist?
Non-competitive antagonists bind irreversibly
Competitive Antagonist bind reversibly to receptors
NI-non competitive irreversible
CR—competitive reversible
71
When continuously exposed to an agonist a cell can become...
Desensitized
72
Continuous exposure to antagonists causes the cell to become...
Hyper sensitive
73
What is ED 50?
It is defined as the average effective dose required to produce a therapeutic response in about half of the population
Can be considered the standard dose
74
What is LD50?
The average lethal dose in 50% of the population
75
Is a drug safe or unsafe if it has a large or wide therapeutic index
Relatively unsafe
76
Grapefruit juice raise his drug levels by inhibiting the CYP3A4 metabolism enzyme in which some meds will need to be changed how?
Dosage will need to be decreased
Grapefruit juice increases the drug levels
77
What are adverse drug reactions?
World health organization defines it as any noxious unintended and undesired effect that occurs at normal drug doses
78
What is a side effect?
Nearly unavoidable secondary drug affects produce a therapeutic doses
These are predictable, intensity is dose dependent
79
What is toxicity?
It is defined as the degree of detrimental physiological effects caused by excessive drug dosing
80
What is an allergic reaction?
An allergic reaction is an immune response
For an allergic reaction to occur, we exposure to a drug can trigger the response. There must be a prior sensitization of the immune system
81
What is an idiosyncratic effect?
An uncommon drug response resulting from a genetic predisposition
82
What is a paradoxical effect?
This is the opposite of the intended drug response
83
What is an Iatrogenic disease?
It is a disease that occurs as a result of medical care treatment with drugs
A.k.a. Drugs promote this disease
84
What is the QT interval?
It is the measure of time required for the ventricles to repolarize (relax) after contraction
85
When a QT interval is prolonged patients can develop what 2 heart rhythms?
They can develop torsades and Ventricular fibrillation
86
When is a med guide required?
The FDA makes it a requirement, when they determine that patient adherence to the directions for drug use is essential for efficacy and what they need to know about serious side effects
Created to minimize germ from potentially dangerous drugs
87
What is a black box warning?
It is the strongest safety warning still stay on the market
FDA requires this when serious or life-threatening risks related to the drug—this will alert providers for severe side effects
88
What is tolerance?
It is defined as a decrease responsiveness to a drug as a result of repeated drug administration
Will usually require higher doses
89
What is a reduction in a drug’s Responsiveness brought on by repeated dosing over a short time?
This can take days or longer to develop
Tachyphylaxis
90
What is bioavailability?
It refers to the amount of an active drug that reaches the systemic circulation (blood) from its site of admin
Think sustained release, enteric coating, extended or delayed release
Usually involves oral meds
91
What is precision medicine? And what is it related to?
Precision medicine refers to a more general approach to find it effective strategies for treatment of similar group of patients with specific genetic, lifestyle, and environmental factors
Pharmacogenomics
92
In the third trimester pregnancy Reno blood flow is doubled causing a large increase in the glomerular filtration rate what impact can this mean for a patient who is pregnant and taking medications?
Dosages of drugs may need to be increased due to the increase of drug elimination through the kidneys
This can also occur in the liver
93
For women who are pregnant tone and motility of the bowel are decreased which can have what effect on medications?
More time for drugs to be absorbed so a reduction in dosage might be needed
This goes for drugs that undergo enterohepatic recirculation
94
What are symptoms of a drug dependent infant?
Shrill cry, vomiting, and extremely irritability
95
What is Teratogenesis?
It is the production of congenital anomalies In the fetus
96
What time period Is the pre-implantation/presomite period ?
| What should you know in regards to teratogens?
It is from conception to week 2
Teratogens act in an all or nothing fashion—can result in death or they fully recover
97
What time frame is the embryonic period?
What’s important to know in regards to teratogens?
Week three through week eight
Gross Malformations are produced by exposure to teratogens at this time, Pregnant patients must take special care to avoid exposure
98
What time frame is the fetal period?
It is a week nine through term
Teratogens can disrupt function than gross anatomy
Developmental cognitive disabilities can occur if taking teratogens
99
What should be done if teratogen exposure occurs during the organogenesis week 3-8?
Determine the expected type of malformation And at least two ultrasound scan should be done to assess the extent of the injury
If severe termination of pregnancy should be considered
100
Delayed gastric emptying on pediatric patients can Have what effect on absorption?
It can enhance absorption
101
For IM drugs, Absorption in the neonate is what?
Slow and erratic
102
IM medication in early infancy (5-52 weeks) Has what affect on absorption?
It becomes more rapid in neonates than in adults
103
For transdermal absorption, Which population has a faster absorption rate?
More rapid in kids than an older adults
This risks them for increased toxicity
104
Complete maturation of the liver occurs at what age?
One year
105
Is altered Gastro intestinal absorption a major factor in drug sensitivity in older adults?
No it is not
106
In older adults what is the proper index of renal function?
Creatinine clearance
107
What Female hormone is primarily dominant in the follicular phase?
Estrogen
108
What is estrogens affect on the ovaries and endometrium?
They mature ovarian follicles and cars proliferation of the endometrium
109
The follicle-stimulating hormone affects what female hormone?
Estrogen
110
Mid cycle what hormone rises abruptly?
Luteinizing hormone
111
Lutenizing hormone secretes which female hormone?
Progesterone
112
What is the mechanism of action for estrogen and how?
Estrogen ask primarily through receptors in the cell nucleus Through diffusion
Emphasis that is not on the cell surface it is inside the cell in the nucleus!
113
Estrogen metabolically have what effect?
Have important roles in glucose homeostasis
114
What age does menopause typically start?
51 or 52 years old
115
What is female sexual interest-arousal disorder?
Decrease in libido or decrease arousal during sexual activity
116
Is estrogen FDA approved for gender affirmation therapy for transgendered women?
No it is not FDA approved for this purpose
It is an off label use
117
What is the most common adverse effects for estrogens?
It’s nausea, it diminishes with continued use
118
What are the Main risks for taking estrogens ?
Potential for Endometrial cancer, breast cancer, endometrial hyperplasia, and Cardiovascular thromboembolic events
119
What is Cholasma?
It is a patchy brown face discoloration usually caused by estrogen. It is not dangerous
120
Can you prescribe estrogen to a pregnant woman or a woman who has vaginal bleeding with no known cause?
No you cannot
It will be very important to find the cause of the leading prior to administration
121
Estrogen is a major substrates of the CYP1A2 or CYP3A4 which means what?
Inducer’s and inhibitors can affect drug levels
122
What affect can estrogens have on antidiabetic drugs and thyroid preparations?
They may decrease the effectiveness of those drugs
123
Intravaginal estrogen rings and creams can Do what?
Can treat vaginal and vulval atrophy.
| Helps control night sweats and hot flashes
124
For an estrogen transdermal emotion how would you apply at?
Apply the emulsion in the morning to the top of both thighs and in the back calves
125
How would you apply the transdermal gel?
Applied a gel once daily after showering to one arm (from shoulder to wrist)
126
How would you apply the transdermal spray?
Instruct the patient to spray 1-3 sprays Once daily to the inner forearm and let it dry for at least two minutes before dressing and at least 30 minutes before washing
127
How long can a intravaginal ring be good for?
Three months then replace
128
What are phytoestrogens?
They are plant-based compounds I have weak Estrogenic activity
129
What are selective estrogen receptor modulators?
They are drugs that activate estrogen receptors in some tissues and block them another’s
130
What are three benefits of serms?
Protect against osteoporosis, maintenance of urogenital tract, and reduce LDL
131
Tamoxifen has what affect on the breast?
It Can inhibit cell growth in the breast
132
What drug is approved only for prevention and treatment of osteoporosis and for prevention of breast cancer in high risk women?
Raloxifene
133
Bazedoxifene Has what action?
Combines an estrogen with an estrogen Agonist/antagonist (bazedoxifene)
134
Where are progesterone’s receptors located?
In the cells nucleus and it must diffuse across the membrane
135
In dysfunctional Uterine bleeding, progesterone levels are what?
They are insufficient or low
136
Administering a progestin for 10 to 14 days Can help with what?
Dysfunctional uterine bleeding
When spotted med, withdrawal bleeding takes place
137
Are you pre-cancerous condition can be surprise with progestin , What are the three treatment options for this?
Megesterol acetate oral, medroxyprogesterone acetate (depo-provera), and iud locally
138
Name some adverse effects of progesterone
Breast tenderness, headach, depression, arthralgias.
Decrease and amount of cervical mucus, involuted endometrial layer
139
Can you prescribe progestin to a female that has had a hysterectomy?
No you cannot, only estrogen
140
Are estrogens on the beers criteria?
Yes because they identify as potentially inappropriate for you some geriatric patients
141
High dose therapy of progestin In pregnant women during the first four months of pregnancy has been associated with what?
Increase incident of birth defects
| Limb reductions, heat defects
142
For a woman breast-feeding while on progestins they should know that it can cause what in babies?
Progressions may contribute to neonatal jaundice
143
What is Flibanserin?
Also called addyi
It is the first improvement to manage FSIAD
Not indicated for treatment of women who are postmenopausal
Will take several weeks before benefits are seen
144
What are the side effects of flibanserin?
Cns depression, hypotension with or without syncope
145
What is the mechanism of action for bremelanotide?
It activates melanocortin receptors and the MOA for improving sexual desire is unknown
146
What are specifics that you need to know bremelanotide?
It is administered subQ, At least 45 minutes before sexual activity.
Dosing is limited to one dose per 24 hours
A rise in bp can occur for up to 12 hours after taking med
147
What is the most widely used reversible form of contraception?
Oral contraceptive pills
148
What is the most common nonreversible birth control method?
Sterilization
149
What are the most effective methods for birth control?
Nexplanon (etonogestrel implant), IUD, and sterilization
150
Name the for least reliable methods in regards to birth control?
Barrier methods, periodic abstinence, spermicides, and withdrawal
151
What is the female sterilization surgery and what is the male sterilization surgery?
Female sterilization surgery is a tubal ligation. A male sterilization surgery is a vasectomy
152
Name three factors to consider when a method of birth control is being chosen
Effectiveness, safety and personal preference
153
What does coitus mean?
Sex
154
Can spermicide and barrier methods offer protection against STDs?
Yes it can also provide contraception
This method would be used If sexual activity is limited
155
What are three possible alternatives For women with Cardiovascular disorders that are over the age of 35 and smoke?
Diaphragm, progesterone only pill, and an IUD
156
What hormone do mini pills have?
Progesterone only
157
What is the mechanism of action for estrogen?
It suppresses the release of the follicle-stimulating hormone, it inhibits follicular maturation
158
What is progesterone’s mechanism of action in combination oral contraceptives?
It suppresses the mid cycles lutenizing hormone surge Which prevents ovulation
Normally LH surge triggers ovulation
159
Is a pelvic exam needed to prescribe oral contraceptives?
No
160
When prescribing oral birth control what should be done from the provider’s standpoint before prescribing?
Take thorough medical history and blood pressure should be taken
161
These two progesterones:
| Drospirenone and desogestrel appear to have what?
The greatest risk for thrombotic events
These should be avoided
162
When should oral contraceptives be discontinued before surgery to prevent post operative thrombosis?
At least four weeks before surgery
163
Women with a history of thrombosis should avoid combination oral contraceptives but can still do what?
They can take progestin only method mini pill, depo provers, IUD, and nexplanon
164
What is the black box warning for oral contraceptives?
Cigarette smoking increases the risk of cardiovascular side effects
165
Oral contraceptives protect against which two forms of cancer?
Ovarian and endometrial cancer
166
In relation to breast cancer estrogens would have what effect?
It would promote the growth of existing breast carcinoma
167
Oral contraceptives raise blood pressure by increasing what 2 compounds in the blood?
It increases angiotensin and aldosterone
168
What is the effect do oral contraceptives have on the breast during early stages of lactation?
It can enter breastmilk, and reduce milk production in the early stages of lactation
Once milk supply is more established with solids it to the infants diet use of oral contraceptives may resume
169
What is an alternative to combination oral contraceptives in the early stages of lactation?
Progestin only contraception
170
How can a patient manage nausea related to estrogen in an oral contraceptive?
It can be managed by dosing at bedtime or switching to an oral contraceptive with less estrogen
Using less estrogen can reduce breast discomfort
171
When is changing birth control a good time?
Changing birth-control is best made at the beginning of a new cycle
172
Name some side effects of excess estrogen
Nausea, breast tenderness, edema, bloating, hypertension, migraine
173
Early or mid cycle breakthrough bleeding or increase spotting is a deficiency in what hormone?
Estrogen
174
Name some side effects of excess progestin
Increase appetite, weight gain, depression, fatigue, breast regression, acne, oily scalp, hair loss, hirsutism
175
Late breakthrough bleeding, amenorrhea and hypermenorrhea Is a deficiency in what hormone?
Progestin
176
Which hormone an oral contraceptives can elevate glucose levels?
Progestin
177
Products that induce Hepatic cytochrome P3A4 can accelerate OC metabolism which can
Reduce the oral contraceptives affect making the need for increased dosage necessary
178
What effect does oral contraceptives have on warfarin and hypoglycemic agents?
It can decrease the effectiveness of those meds which may require increased dosage for those meds
179
Theophylline, tricyclics antidepressants, diazepam, and chlordiazepoxide Are affected by oral contraceptives how?
Oral contraceptives can impair hepatic metabolism and which accumulation of these drugs may result in toxic levels
Dosages may need to be reduced
180
In women who normally experience heavier prolong menstrual bleeding What medication would be good for them?
Natazia
181
If one or more pills are missed and the first week of a 28 day cycle pack what should you do?
Take one pill as soon as possible and continue with the pack. Also use an additional form of birth control for seven days
182
If one or two pills are missed and the second or third week of a 28 day cycle pack what should you do?
Take one pill as soon as possible and then continue with active pills in the pack. Go ahead and skip the placebo pills and Go straight into a new pack once all the active pills have been taken
183
If three or more pills are missed during the second or third week of a 28 day cycle pack, what should you do?
Take one pill as soon as possible and continue taking the active pills in the pack and skip the in active pills and go straight into a new pack. Also use an additional form of contraception
184
If you miss taking a progesterone only contraceptive even if for just three hours late what do you need to do?
Use back up protection or emergency contraception if unproductive sex occurs
185
For progesterone only contraceptives, if one or more doses is missed or taken after 3 hours, What should you do?
Take the pill ASAP and use back up contraception for two days
186
For a progesterone only contraceptives, if two pills are missed in the regimen what should you do?
The regimen should be restarted,
| And back up contraception should be used for at least two days
187
And progesterone only contraception, if two pills or more amidst and there is no menstrual bleeding what should you do?
Take a pregnancy test
188
For women switching from oral contraceptives to the transdermal patch when should the first patch be applied?
The first day of withdrawal bleeding
189
If the patch is off more than 24 hours what should you do?
A new cycle has started so apply a new patch and backup contraception for the first 7 days
190
Which causes more Venousthromboembolism in women: The patch or oral contraceptives?
The patch because they are more exposed to estrogen
191
What are the patient instructions for the vaginal contraceptive ring?
One ring is inserted each month, Left in place for three weeks and then removed. A new ring is inserted after seven days
192
Where is the Nexplanon inserted?
It is inserted sub-dermal in the groove between the bicep and triceps in the non-dominant arm
193
How long is the Nexplanon good for?
FDA approves it good for three years but studies show they can be effective for five years
194
When the Nexplanon is removed, how long does it take for the medicine to be undetectable in the body?
5 to 7 days
195
For Depo-Provera, when injections or just continued return of fertility is delayed by how many months?
Nine months
196
The Depo-Provera shot protects against pregnancy for how many months?
For three months
It is given by injection or subQ
197
What is the black box warning for Depo-Provera?
This drug should not be used for more than two years
198
What does Depo-Provera pose a risk for?
Reversible bone loss
Usually returns after discontinuation within 30 months
199
What is the most reliable reversible form of birth control?
Intrauterine devices
200
When should emergency contraception be taken?
Within 72 hours of unprotected intercourse
I can still be effective up to five days after intercourse
201
How should you take next choice emergency contraception?
First how that should be taken within 72 hours of unprotected sex and in the next 12 hours the second tab it should be taken
If vomiting occurs within two hours after dosing a repeat dose may be required
202
What are some patient education info for phosphodiesterase five inhibitors?
Can be taken with or without food although a high fat meal will delay absorption except in tadalafil
All meds should be taking one hour before sex except for Avanafil it should be taken 15-30 minutes
If lightheadedness or chest pain occurs refrain from sexual activity and notify provider
Seek medical attention if erections us more than four hours
203
You should avoid grapefruit juice in phosphodiesterase five inhibitors because it will what?
Can raise PDE-5 inhibitors levels
204
How many hours should you avoid nitrates when taking of Avanafil?
Think ASVT in time order
12 hours
205
How many hours should you avoid nitrates when Taking sildenafil (viagra) or vardenafil?
24 hours
206
How many hours should you avoid nitrates after tadalafil?
48 hours
207
What is revatio’s generic name and what is it used for?
It is sildenafil (viagra)
It is used to treat pulmonary hypertension
208
Which PDE-5 inhibitor causes prolonged QT interval?
Vardenafil (Levitra)
209
When taking CYP3A4 inhibitor, what should be done for patients taking PDE-5 inhibitors?
Reduce dosage of PDE-5 inhibitors
210
What is Viagra’s (sildenafil) mechanism of action?
It increases and preserves cGMP levels making the erection last longer and harder
211
Are PDE-5 inhibitors approved for women?
No
212
Severe hypotension Can occur as an adverse effect when taking PDE-5 inhibitors and what 2 other Drugs?
Nitrates or alpha adrenergic blockers
213
If sudden hearing loss occurs Do men stop taking sildenafil for ED and pulmonary artery hypertension?
They should stop taking it for ED. They should continue taking it for pulmonary artery hypertension
214
Non-arteric ischemic optic neuropathy (NAION) Is what?
It is an adverse effect from taking Viagra (sildenafil). It causes blockage of blood flow to the optic nerve
215
Which PDE5 inhibitor can last for 36 hours?
Tadalafil
216
Which PDE5 inhibitor has the fastest onset of action?
Avanafil
217
What drug class does Tamsulosin belong to?
Alpha adrenergic antagonist or blocker
When used with Viagra this can cause symptomatic postural hypotension
218
What is the generic name for Levitra and Staxyn?
Vardenafil
219
What is the generic name for Cialis?
Tadalafil
220
Tadalafil is used to treat what three medical problems
Erectile dysfunction, benign prostate hyperplasia, and pulmonary artery hypertension
221
Can tadalafil (cialis) be take daily ?
Yes but only in men who anticipate sexual activity at least twice a week
This medication can persist for about 36 hours
222
What is the generic name for Stendra?
Avanafil
223
Are there any FDA approved meds for premature ejaculation?
No there are drugs prescribed off label
224
What two drug classes treat benign prosthetic hyperplasia?
Five alpha reductase inhibitors and alpha one adrenergic antagonist/blockers
225
Five alpha reductase inhibitors treat men with what kind of prostate and what kind of obstruction?
They are most appropriate for men with large prostate that have mechanical obstruction
Think LME
226
Alpha one adrenergic antagonist/blockers are most appropriate for men with what kind of protests and what kind of obstruction?
They are treated for men with relatively small prostates that have dynamic obstruction
Think ASMD
227
Finasteride and dutasteride Belong to what class of medications?
Five alpha reductase inhibitors
228
Five alpha reductase inhibitors do want to the prostate?
They reduce the prostate size over several months
About 6 to 12 months
229
Proscar is the brand name for what med?
Finasteride
230
Women should not handle the tablets that have been broken or crushed in what med?
Finasteride (proscar)
The med is teratogenic to the male fetus
231
Should men donate blood on finasteride (proscar)?
Men should not donate blood while taking this med. They should wait at least one month after stopping the drug to avoid the risk of having a pregnant woman as a blood recipient.
232
If prostate specific antigen does not decrease in men while taking this med what should happen?
They should be evaluated for cancer
233
What is important to know about dutasteride (avodart)?
This man has an extremely long half life about five weeks. It can take months to clear the drug after stopping. It is teratogenic, should not donate blood for 6 months after stopping. This man can increased likelihood of high-grade prostate tumors but reduce low grade prostate tumors
234
When used in combination alpha one blocker and five alpha reductase inhibitor what are there actions?
Five alpha reductase inhibitors shrink the prostate.
Alpha one blockers provide relief by relaxing prostate smooth muscle
235
Do you alpha one adrenergic antagonist reduce prostate size?
No they do not
They improve urinary flow
236
```
Alfuzosin, terazosin, fox’s Zoe in, sildosin, and tamsulosin
Belong to what class medications?
```
Alpha one adrenergic antagonist/blockers
