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Integrated Exam > P3 YEAR > Flashcards

P3 YEAR Flashcards

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1
Q

Legitimate Medical Purpose and Usual Course of Professional Practice

A

Acting in accordance with standard of medical practice generally recognized and accepted in the United States

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2
Q

Corresponding Responsibility

A

Pharmacists are legally responsible for the proper dispensing of controlled substances

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3
Q

Record Keeping Federal vs OK

A

Fed: 5 yrs for Prescription 2 yrs Nightly report
OK: 2 yrs patient records, invoices, inventory

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4
Q

Inventories, records, invoices, and purchase records of Schedules I and II must be kept separate from what?

A

Schedule III-V

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5
Q

In Oklahoma, CDS Inventory must be taken when?

A

Between May 1st and July 1st and a copy included with pharmacy license reneweal

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6
Q

When should a Controlled Substance Inventory must be performed according to OBNDD Federal standards?

A

2 years

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7
Q

What type of diabetes tends to have lower doses of insulin and why?

A

T1DM, because they do not have insulin resistance

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8
Q

What is the insulin requirement for total daily dosing?

A

0.2-0.1 unit/kg/day

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9
Q

When should Fixed Dosing be used in Diabetes?

A

If CHO is consistent with each meal or patient cannot count carbs

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10
Q

If NPH is used in Fixed Dosing, what should be done?

A

Split Dose 2/3 AM and 1/3 PM

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11
Q

Calculate I:CHO

A

500 divided by total daily dose

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12
Q

Calculate CF

A

Rapid = 1800/tdd
Regular = 1500/tdd

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13
Q

List indications to start insulin in T2DM?

A
  1. Hyperglycemia despite maximal doses of 2-3 oral agents
  2. GLP-1 agonist are not an option/patient is already on one
  3. Glucose Toxicity >300
  4. Pregnancy
  5. CI to oral agents
  6. Acute Hyperglycemia
  7. Hospital admission
  8. Cost
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14
Q

What happens to oral agents in T2DM when insulin is added on?

A
  1. Metformin is always maintained unless CI
  2. Oral agents often maintained when basal is added
  3. Once bolus is added, other orals are titrated off
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15
Q

Basal Insulin for T2DM

A

0.1-0.2 units/kg/day or 10-25 units

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16
Q

Bolus Insulin for T1DM

A

10% of basal or 4 units

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17
Q

Tighter vs Looser Ratio of CHO

A

Tight = decrease CHO
Loose = increase CHO

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18
Q

List the rapid acting insulins

A
  1. Humalog
  2. Admelog
  3. Novolog
  4. Fiasp
  5. Afrezza
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19
Q

What is the peak/duration of rapid acting insulin?

A

Peak = 2hrs
Duration = 3-5hrs

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20
Q

List the short acting insulins

A
  1. Humulin R
  2. Novolin R
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21
Q

What is the peak/duration of short acting insulin?

A

Peak = 2-3 hrs
Duration = 6-8 hrs

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22
Q

List the intermediate acting insulins

A
  1. Humulin NPH
  2. Novolin NPH
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23
Q

What is the peak/duration of intermediate acting insulin?

A

Peak = 4-6 hrs
Duration = 8-12 hrs

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24
Q

List the long acting insulins

A
  1. Lantus
  2. Levemir
  3. Toujeo
  4. Tresiba
  5. Basaglar
  6. Semglee
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25
Which long acting insulin is peak-less?
Lantus
26
Which long acting insulins have a duration of 24 hrs?
1. Lantus 2. Levemir 3. Semglee
27
Which long acting insulins have a duration of 30 hrs?
Basaglar
28
Which long acting insulins have a duration of 36 hrs?
Toujeo
29
Which long acting insulins have a duration of 42 hrs?
Tresiba
30
Which long acting insulins are biosimilar?
Basaglar and Semglee (glargine)
31
List the Biguanides
1. Glucophage 2. Glumetza
32
Metformin is CI with what?
eGFR <30
33
List the Sulfonylureas
1. Amaryl 2. Diabeta/Micronase 3. Glucotrol XL 4. Glucotrol
34
What are SU's CI'd with?
Sulfa Allergy and T1DM
35
List the Meglitinides
1. Prandin 2. Starlix
36
List the thiazolidinediones
1. Actos 2. Avandia
37
What is the contraindication for thiazolidinediones?
Class III or IV Heart Failure
38
List the DPP-4 Inhibitors
1. Januvia 2. Onglyza 3. Tradjenta 4. Nesina
39
List the SGLT-2 Inhibitiors
1. Invokana 2. Farxiga 3. Jardiance 4. Steglatro
40
What is the contraindication for SGLT-2 Inhibitors?
Dialysis
41
List the GLP-1 Agonists
1. Byetta 2. Victoza 3. Adlyxin 4. Trulicity 5. Ozempic 6. Rybelsus 7. Mounjaro
42
What are the MISC Oral diabetic agents?
1. Precose 2. Symlin
43
What drug has a contraindication of GI disorders and IBD?
Precose
44
What drug has a contraindication of Gastroparesis?
Symlin
45
Between Sulfonylureas and Meglitinides, which one is glucose independent?
Sulfonylureas meglitinides are dependent
46
Are DPP-4 Inhibitors and GLP-1 Agonists glucose independent or dependent?
Dependent
47
What are the AEs of Levothyroxine?
HF Angina MI Arrhythmias Anxiety Dyspnea
48
What is the dosing of an Uncomplicated Adult <60 for Levothyroxine?
1.6 mcg/kg day
49
What is the dosing of an Adult >60 without CHD for Levothyroxine?
25-50 mcg/day
50
What is the dosing for any age with CHD for Levothyroxine?
12.5-50 mcg/day
51
What is the dosing for Subclinical Hypothyroidism in adults <50 without CHD for Levothyroxine?
1.5 mcg/kg/day
52
What is the dosing for Subclinical Hypothyroidism in adults >50 or with CHD for Levothyroxine?
25-50 mcg/day
53
What is the dose titration for Levothyroxine?
12-25 mcg/day Every 3-6 wks
54
What are the 2 baseline labs you must get before starting hyperthyroidism thioamide therapy?
1. CBC 2. LFTs
55
MMI has less hepatotoxcity and is the preferred treatment in hyperthyroidism unless what?
PTU is preferred for 1. Pregnancy 1st trimester 2. Lactation 3. Thyroid Storm
56
Plavix MOA
Irreversible binding/ platelet ADP receptors
57
Effient MOA
Irreversible binding/ platelet ADP receptors
58
Brilinta MOA
Reversible binding/platelet ADP receptors
59
Coumadin MOA
Inhibits synthesis of vitamin K dependent clotting factors
60
Pradaxa MOA
Reversible direct thrombin inhibitor
61
Xarelto MOA
Reversible factor Xa inhibitor
62
Eliquis MOA
Reversible factor Xa inhibitor
63
Savaysa MOA
Reversible factor Xa inhibitor
64
List the 3 anti platelet drugs
1. Plavix 2. Effient 3. Brilinta
65
List the 5 anticoagulant drugs
1. Coumadin 2. Pradaxa 3. Xarelto 4. Eliquis 5. Savaysa
66
What are the 4 MAJOR Statin benefit groups?
1. Severe Hypercholesterolemia LDL >190 2. 40-75yrs with DM and LDL >70 3. 40-75yrs w/o DM and ASCVD risk >7.5% 4. Clinical ASCVD
67
What are the drug interactions for Coumadin?
1. NSAID 2. Antiplatelet 3. BAMIF 4. Fab5
68
What are the drug interactions for Pradaxa?
1. NSAID 2. Antiplatelet 3. Pgp Inhibitor 4. 3A4 Inhibitor
69
What are the drug interactions for Xarelto and Eliquis?
1. NSAID 2. Antiplatelet 3. 3A4 Inhibitor/Inducer
70
Limit the dose of Savaysa to 30 mg/day when using what?
1. Verapamil 2. Azithromycin 3. Clarithromycin 4. Erythromycin
71
What are the drug interactions for Plavix?
1. NSAID 2. ASA 3. Anticoagulant 4. Omeprazole/Esomeprazole 5. Fluoxetine 6. Grapefruit
72
What should be avoided when using Brilinta?
Lovastatin or Simvastatin >40 mg/day
73
What interacts with NSAIDs?
1. Warfarin 2. Anticoagulants 3. Probenecid 4. Lithium 5. Anti-HTN 6. Loops 7. ACEi 8. Methotrexate 9. Steroids (systemic) 10. ASA
74
What WIDENS the CI Width?
1. Increase % confidence 2. Increase standard error 3. Decrease sample size 4. Decrease alpha
75
What NARROWS the CI Width?
1. Decrease % confidence 2. Decrease standard error 3. Increase sample size 4. Increase alpha
76
Unstandardized (b)
1. Predictor variables 2. Cannot be compared
77
Standardized (B)
1. SD units 2. Direct comparison
78
Definition of Odds Ratio
The odds that an outcome will occur given a particular exposure (X), compared to the odds of the outcome occurring in the absence of that exposure
79
Define OR =1, <1, >1
=1: X dose not affect odds of Y >1: X is associated with higher odds of Y <1: X is associated with lower odds of Y
80
What is IBS-C?
Constipation with hard or lumpy stools >25% of the time
81
OTC Treatment of IBS-C
Bulk Forming Laxative 1. Psyllium/Metamucil 2. Polycarbophil/Fiber 3. Methylcellulose
82
Osmotic Laxatives Treatment of IBS-C
Draw water from GI 1. PEG/Miralax 2. Lactulose/Emulose Lactitol/Pizenxy
83
Stimulant Laxatives Treatment of IBS-C
1. Bisacodyl 2. Senna
84
5HT4 Receptor Agonist Treatment of IBS-C
1. Prucalopride/Motegrity 2. Tegaserod/Zelnorm WOMEN ONLY
85
Chloride-Channel Activator Treatment of IBS-C
1. Lubiprostone/Amitiza WOMEN ONLY
86
Guanylate Cyclase Agonist Treatment of IBS-C
1. Linaclotide/Linzess 2. Plecanatide/Trulance
87
What is IBS-D?
Diarrhea with loose or watery stools >25% of the time
88
OTC Treatment of IBS-D
1. Loperamide/Imodium 2. Peppermint Oil 3. Probiotics
89
Anti-Spasmodics Treatment of IBS-D
1. Dicyclomine/Bentyl 2. Hyoscyamine/Levsin
90
5HT3 Receptor Selective Antagonist Treatment of IBS-D
1. Alosetron/Lotronex WOMEN ONLY
91
Mu-Opioid Receptor Agonist Treatment of IBS-D
1. Eluxadoline/Viberzi
92
Peripherally Acting Opioid Antagonists Treatment of IBS-D
1. Naldemedine/Symproic
93
Non-Systemic Antibiotic Treatment of IBS-D
1. Rifaximin/Xifaxan
94
Administer vaccines before starting biologics, what vaccine in particular for JAK Inhibitors?
Shringrix

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