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Flashcards in Pharm Deck (71):
1

clozapine gold standard for?

treatment-resistent schizophrenia

(must have failed at leas 2 trails of other antipsychotics)

2

major risk w/ clozapine?

agranulocytosis

3

HTN treatment options in pregnancy?

- Hydralazine
- Labetalol
- Methyldopa
- Nifedipine

*Most common above, but can use any Beta blockers or Ca blockers

4

dihydropyridine Ca channel blockers act on?

vascular smooth muscle

5

dihydropyridine Ca channel blockers (5)?

"-dipine"
- Amlodipine
- Clevidipine
- Nicardipine
- Nifedipine
- Nimodipine

6

non-dyhydropyridine Ca channel blockers act on?

heart

7

ex of non-dihydropyridine Ca Channel blockers?

- Diltiazem
- Verapamil

8

Ca channel blockers do what?

block voltage dependent Ca channels in heart and smooth m. --> dec m. contractility

9

what Ca channel blocker used for subarachnoid hemorrhage, and why?

Nimodipine, prevents cerebal vasospasm

10

Dihydropyridines (except nimodipine) used for? (3)

- HTN
- Angina (inc prinzmetal)
- Raynaud's

11

which Ca blocker used for HTN urgency adn emergency?

Clevidipine

12

What are non-dihydropyridine used for that dihydropyridine CCB aren't?

atrial fib and flutter

13

non-dihydropyridine CCB used for? (4)

- HTN
- Angina
- A fib
- A flutter

(prevention of nodal arrhythmias - ie SVT)

14

special toxicity that verapamil has?

hyperprolactinemia

15

non-dihydropyridine toxicity can -->?

AV block

16

CCB toxicity -->?

-peripheral edema
- flushing
- dizziness
- constipation
- gingival hyperplasia

*verapamil --> hyperprolactinemia
*non-D CCB --> AV block

17

meds that can cause drug induced lupus?

- Quinidine
- Procainamide
- Isoniazid
- Minocycline
- Hydralazine

18

Hydralazine is contraindicated when?

angina/CAD
b/c of compensatory tachycardia

19

hydralazine mainly dilates what and causes what?

vasodilates arterioles --> afterload reduction

(smooth m. relaxor)

20

wolff parkinson white syndrome, after advising agains phys activity what med for arrhythmias?

procainamide

21

sinus brady, what med use to inc heart rate?

atropine

22

definitive treatment of sinus brady?

pacemaker

23

AChE inhibitor toxicity antidote?

atropine +/- pralidoxime (must be shot time for it to be useful)

24

organophosphates toxicity antidote?

atropine +/- pralidoxime (must be shot time for it to be useful)

25

amphetamines toxicity antidote?

NH4Cl (to acidify the urine)

26

Antimuscarinic or anticholinergic agent toxicity (ie atropine) antidote?

Physostigmine & control hyperthermia

27

Benxodiazepines toxicity antidote?

Flumazenil

28

B-blocker toxicity antidote?

Glucagon

29

CO toxicity antidote?

100% O2, hyperbaric O2

30

Copper toxicity antidote?

Penicillamine

31

Arsenic toxicity antidote?

Penicillamine

32

Gold toxicity antidote?

Penicillamine

33

Penicillamine treats what toxicities? (3)

- Copper
- Arsenic
- Gold

34

Cyanide toxicity antidote?

Option 1) Nitrate + thiosulfate

Option 2) Hydroxocobalamine

35

Digtalis (digoxin) toxicity antidote?

Anti-dig Fab fragments (monoclonal Ab)

36

Heparin toxicity antidote?

Protamine sulfate
(bind heparin --> inactive complex)

37

Iron toxicity antidote?

- deFeroxamine
- deFerasirox

38

Lead toxicity antidote?

- mild (5-44): no treatment, test level in =70): Dimercaprol (BAL) + Ca disodium edetate (EDTA)

(venous lead level)

39

Mercury toxicity antidote?

- Dimercaprol (BAL)
- Succimer

40

Methanol or ethylene glycol (antifreeze) treatment?

- Fomepizole (if unavailable can do ethanol)
- dialysis

41

Methemoglobin toxicity antidote?

- Methylene blue
- Vit C

42

Opiod toxicity antidote?

- Naloxone
- naltrexone

43

Salicylate toxicity antidote?

Sodium Bicarb (to alkalinize urine)
- dialysis

44

TCAs toxicity antidote?

Sodium Bicarb (to alkalinize plasma)

45

tPA, stretokinase, urokinase toxicity antidote?

Aminocaproic acid

46

Warfarin toxicity antidote?

immediately: Fresh Frozen Plasma

- Vit K (delayed effect)

47

drug of choice in dx and abolishing supraventricular tachycardias (ie atrial/AV nodal based tachy cardias --> tachy + p wave anomalies w/ normal QRS)?

Adenosine

48

Torsades de points treat?

- Mg
- if unstable cardiovert

- correct hypokalemia or withdraw offending drugs

49

what gets immediate electrical defibrillation?

Ventricular Fibrillation

50

V tach treatment?

- unstable: cardiovert

- give antiarrhythmics (ie amiodarone, lidocaine, procainamide)

51

acetazolamide is a ?

carbonic anhydrase inhibitor

52

loop diuretics?

- furosemide
- ethacrynic acid (non-sulfa)
- bumetanide
- torsemide

53

side fx of loop diuretics?

"OHHH DANG"
- Ototoxicity
- HypoKalemia
- HypoCalcemia
- HypoMagnesemia

- Dehydration
- Allergy (sulfa)
- Nephritis (interstitial)
- Gout

54

Thiazide side fx?

- HypOkalemc metabolic alkalosis
- HypONatremia
- Sulfa allergy

"HyperGLUC"
- hyperGlycemia
- hyperLipidemia
- hyperUricemia
- hyperCalcemia

55

which diuretic looses Ca?

Loop diurects
"loops loose Ca"

[thiazides actually dec Ca excretion and can cause hyperCalcemia]

56

K sparing diuretics?

Competitive aldosterone receptor antagonists:
- Spironolactone
- Eplerenone

Block Na channels in collecting tubules:
- Triamterene
- Amiloride

57

what kind of meabolic derangement from acetazolamide?

hyperchloremic metabolic acidosis

58

side fx of ACE inhib?

CATCHH
- Cough
- Angioedema
- Teratogen
- Creatinine (inc)
- HyperKalemia
- Hypotension

59

ACE-inhibitor contraindicated for what congenital disease?

C1 esterase inhibitor deficiency

60

direct renin inhibitor?

Aliskiren

61

ARBs?

"-sartan"
- Losartan
- Candesartan
- Valsartan

62

digoxin use? (2)

- HF (inc contractility)
- A fib (dec conduction at AV node and depression of SA node)

63

digoxin toxicity?

- n/v/d
- blurry yellow vision
- AV block, arrhythmias
- HyperKalemia

64

don't use digoxin with what other 3 drugs as it wil dec digoxin clearance?

- verapamil
- amiodarone
- quinidine

65

Potassium channel blockers?

- Amiodarone
- Ibutilide
- Dofetilide
- Sotalol

66

Ventricular tachy can use what med?

- amiodarone
- sotalol

67

Amiodarone side fx?

- pulm fibrosis
- hepatotoxicity
- hypO/ERthyroid
- corneal deposits
- Blue/gray skin deposits
- neuro effects
- cardio effects (brady, heart block, HF)

68

Check what when using amiodarone?

PFTs
LFTs
Thyroid function
CXR

69

Which potassium channel blocker will not cause torsades?

amiodarone

70

chronic diarrhea w/ weight loss, anemia, elevated ESR, thrombocytosis, and positive stool occult for bld - waht type of diarrhea?

inflammatory diarrhea

71

lactose intolerance results in what type of diarrhea?

osmotic