pharm final Flashcards

Question

Daunorubicin

Answer 1

cytotoxic antibiotic heart failure, liver toxicity

Answer 2

cytotoxic antibiotic pulmonary toxicity/fibrosis

Answer 3

inhibits angiogenesis – blocks the blood supply to the tumor.

Answer 4

antimetabolite – squamous cell carcinoma and some leukemias. Lots of adverse effects. Nephrotoxicity, edema, pulmonary fibrosis.

Answer 5

chronic myeloid leukemia. Not a monoclonal antibody. Can cause many severe reactions as well. Be careful when combining with other drugs metabolized by the liver.

Answer 6

adrenal cancer. Cytotoxic. Given orally. CNS depression

Answer 7

opposing hormones block tumor growth

Answer 8

for breast cancer is used to starve estrogen dependent tumors induces menopause symptoms

Answer 9

FDA approved to prevent CA in BRCA + (broca? Gene) Also used post breast CA treatment with surgery, radiation and chemo

Answer 10

Acts as an agonist to endometrial tissue Report abnormal uterine bleeding; annual GYN Generally use limited to 5 yrs .or < Contraindicated with DVT, PE, coumadin

Answer 11

Fluid retention Cushing’s symptoms Osteoporosis Mood Swings Masks infections, raises BG

Answer 12

Prednisone, Dexamethasone

Answer 13

Double flushing of bodily fluids in the commode Special hampers for disposal of all objects that contact the patient’s body fluids Personal protective equipment (mask, gown, booties, gloves) Special concerns if chemotherapy liquid spills (spill kit) Pregnant nurses handling & exposure

Answer 14

Cytoprotective drug that is used to reduce renal toxicity associated with cisplatin

Answer 15

is used to reduce hyperuricemia Contraindicated if patient on cyclosporine (an immunosuppressant); increases toxicity

Answer 16

Infections - *fever* Pulmonary toxicity Allergic reactions – rash, hives, fever, etc Mucositis/Stomatitis with severe ulcerations Bleeding Metabolic aberrations Bowel irritability with diarrhea Renal, liver - (labs), cardiac toxicity – edema, EKG changes, HR changes, poor cardiac output. Monitor EKGs and Echos

Answer 17

good oral hygiene, assess for gingivitis, pain, ulcers

Answer 18

Aspirin Diflunisal (Dolobid) Salsalate (Salistab) Choline salicylate (Arthropan)

Answer 19

Inhibits platelet aggregation Antithrombotic effect: used in the treatment of MI and other thromboembolic disorders

Answer 20

topical salicylate

Answer 21

good for patients who take daily aspirin as it is coated and will protect their GI

Answer 22

Shown to reduce cardiac death after myocardial infarction (MI) Should be administered at the first sign of MI If not given before arriving in the emergency department, aspirin is one of the first drugs given if there are no contraindications. ~~chew it~~

Answer 23

for daily aspirin it is best to go with the lower dose of 81 mg over the 325 mg, however it is not unheard of

Answer 24

Acute and potentially life-threatening condition involving progressive neurologic deficits that can lead to coma and may also involve liver damage. Triggered by viral illnesses such as influenza as well as by salicylate therapy itself in the presence of a viral illness. Survivors of this condition may or may not have permanent neurologic damage.

Answer 25

Salicylate toxicity can be from short term high doses, or long term low doses Increased heart rate Tinnitus, hearing loss, dimness of vision, headache, dizziness, mental confusion, drowsiness Nausea, vomiting, diarrhea Sweating, thirst, hyperventilation, hypoglycemia or hyperglycemia associated with methyl salicylate - oil of wintergreen

Answer 26

diclofenac sodium (Voltaren) indomethacin (Indocin) sulindac (Clinoril) tolmetin (Tolectin) etodolac (Lodine) ** ketorolac (Toradol) ** meclofenamate (generic only) mefenamic acid (Ponstel)

Answer 27

acetic acid derivative Analgesic, antiinflammatory, antirheumatic, and antipyretic properties Uses: RA, OA, acute bursitis or tendonitis, ankylosing spondylitis, acute gouty arthritis, pericarditis, PDA (patent ductus arteriosus), and treatment of preterm labor Oral, rectal, intravenous use May cause nausea, vomiting

Answer 28

acetic acid derivative Some antiinflammatory activity Used primarily for analgesic effects Indication: short-term use (up to 5 days) to manage moderate to severe acute pain **post op pain**

Answer 29

Adverse effects: **renal impairment**, edema, GI pain, GI bleed, dyspepsia, and nausea

Answer 30

COX-2 Inhibitor (1st and last one standing) Indicated for OA, RA, acute pain symptoms, ankylosing spondylitis, and primary dysmenorrhea Little effect on platelet function

Answer 31

Adverse effects include headache, sinus irritation, diarrhea, fatigue, dizziness, lower extremity edema, and hypertension Theoretically less rick for GI upset than NSAIDs but the risk is still there ** not for patients with known sulfa allergy**

Answer 32

fenoprofen (Nalfon) flurbiprofen (Ansaid) **ibuprofen (Motrin, Advil, others)** ketoprofen (Orudis KT) **naproxen (Naprosyn, Aleve)** oxaprozin (Daypro)

Answer 33

Propionic Acid Derivative Most commonly used NSAID Uses: analgesic effects in the management of RA, OA, primary dysmenorrhea, gout, dental pain, musculoskeletal disorders, antipyretic actions

Answer 34

Second most commonly used NSAID Somewhat better adverse effect profile than ibuprofen Fewer drug interactions with ACE inhibitors given for hypertension

Answer 35

**COX-1: has a role in maintaining the gastrointestinal (GI) mucosa** COX-2: going to have the beneficial effects on inflammation with little effects on GI

Answer 36

Irreversible inhibitor of COX-1 receptors within the platelets themselves Reduced formation of thromboxane A2, a substance that normally promotes platelet aggregation other NSAIDs lack these antiplatelet effects

Answer 37

**aspirin allergy must not receive any other NSAIDs** (because of bleeding risk:) Vitamin K deficiency Peptic ulcer disease Renal disease. NSAIDs can cause renal problems and damage

Answer 38

GI: heartburn to severe GI bleeding **Acute renal failure** Noncardiogenic pulmonary edema Increased risk of MI and stroke – not aspirin though Altered hemostasis Hepatotoxicity Skin eruption, sensitivity reaction Tinnitus, hearing loss

Answer 39

prevents GI bleed Synthetic prostaglandin E1 analogue: inhibits gastric acid secretion and has a cytoprotective component Mechanism of action: unclear Prophylactic use - not a treatment. IN OB: to ripen the cervix

Answer 40

Use of NSAIDs can compromise existing renal function. Renal toxicity can occur in patients with dehydration, heart failure, liver dysfunction, or use of diuretics or angiotensin-converting enzyme (ACE) inhibitors.

Answer 41

All NSAIDs (except aspirin) share a black box warning regarding an increased risk of adverse cardiovascular thrombotic events, including fatal MI and stroke. NSAIDs may counteract the cardioprotective effects of aspirin.

Answer 42

Dyspepsia, heartburn, epigastric distress, nausea GI bleeding* (tell pt to stop drinking) Mucosal lesions* (erosions or ulcerations) *Misoprostol (Cytotec) can be used to reduce these dangerous effects.

Answer 43

Renal -Reductions in creatinine clearance -Acute tubular necrosis with renal failure Cardiovascular -Noncardiogenic pulmonary edema

Answer 44

Anticoagulants – can increase bleeding Aspirin – increased risk of GI problems Corticosteroids and other ulcerogenic drugs – increased ulcerogenic effects Protein bound drugs – effects absorption Diuretics and ACE inhibitors – decrease hypotensive effects and decrease diuretic effects

Answer 45

**NOT FOR CHILDREN** - Reyes Syndrome take with food or milk to prevent GI upset Therapeutic effect may take 3-4 weeks

Answer 46

Herbal Products used to treat the pain of OA Adverse effects -GI discomfort -Drowsiness, headache, skin reactions (glucosamine) Drug interactions -Enhances effects of warfarin -May increase insulin resistance (glucosamine)

Answer 47

condition that results from inappropriate uric acid metabolism (make too much or cant get rid of it) Uric acid crystals are deposited in tissues and joints, resulting in pain Hyperuricemia (elevated uric acid levels, a blood test, not a urine test) - often in feet, you will see BIG toes -

Answer 48

first line therapy is NSAIDs, these are secondary allopurinol (Zyloprim) febuxostat (Uloric) colchicine (Colcyrs) probenecid (Benemid) sulfinpyrazone (Anturane)

Answer 49

Used to prevent uric acid production and to prevent acute tumor lysis syndrome Exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis **monitor uric acid levels**

Answer 50

Inhibits the reabsorption of uric acid in the kidneys and thus increases the excretion of uric acid: less uric acid in the blood, more in the urine

Answer 51

Nonpurine selective inhibitor of xanthine oxidase More selective for xanthine oxidase than allopurinol May pose a greater risk of cardiovascular events than allopurinol

Answer 52

Reduces inflammatory response to the deposits of urate crystals in joint tissue Used for short-term management or prevention of gout May cause short-term leukopenia and bleeding into the GI or urinary tracts Have the patient report any blood in urine Empty stomach Increase fluid intake – important to stay hydrated joint pain should decrease

Answer 53

mycophenolate mofetil (CellCept) daclizumab (Zenapax)* -BBW: lymphoproliferative (can initiate that word and hypersensitivity reactions) basiliximab (Simulect)* sirolimus (Rapamune) *give prednisone to prevent anaphylactic response

Answer 54

only drug for long term IV maintenance

Answer 55

Cytokine release syndrome can lead to anaphylaxis. Patients are often pre-medicated with corticosteroids to avoid or alleviate that problem. solumedrol often used

Answer 56

Used as an adjunct medication to prevent rejection of kidney transplants Also used in the treatment of rheumatoid arthritis Expected reactions include leukopenia, thrombocytopenia, hepatotoxicity. monitor CBC – can induce leukopenia. Also liver function tests.

Answer 57

Primary drug used in the prevention of kidney, liver, heart, and bone marrow transplant rejection; other autoimmune disorders (refractory RA, plaque psoriasis)

Answer 58

Oral tabs: when possible to avoid skin penetration;* same time QD Oral liquids; mix with juice, choc milk, etc. No Styrofoam cups IV: no bolus dosing; use a pump; reactions in first 30 minutes; serum levels monitored

Answer 59

Often combined with a corticosteroid; oral antifungal Co administration of allopurinol ↑ action of cyclosporine, but also toxicity! * Grapefruit juice will ↑serum levels, ↑ toxicities

Answer 60

CV: moderate hypertension in 50% of cases!* CNS: neurotoxicity/tremors 20% of patients Liver: hepatotoxicity with cholestasis, ↑bilirubin Renal: toxic and often dose limiting – BBW Other: hypersensitivity, gingival hyperplasia, hirsutism

Answer 61

Prevention of liver, kidney, heart transplant rejection IV and PO formula’s available; IV 1st 2-3 days post transplant Switch to PO and maintain may also be used for severe psoriasis, Crohn’s, nephritis, atopic dermatitis

Answer 62

Side effects: predominately renal (albuminuria, dysuria, ARF & CNS (agitation dconfusion, neuropathy)

Answer 63

cyclosporine

Answer 64

The only immunosuppressant drug used for the treatment of multiple sclerosis (MS) Used to reduce the frequency of MS relapses (exacerbations) in relapsing-remitting multiple sclerosis (RRMS)

Answer 65

watch for signs of infection **WATCH FOR MILD SYMPTOMS** Renal, liver, and cardiovascular function studies, CBC Take with food Oral given to avoid IV/IM related infections

Answer 66

must be mixed in a glass container, Styrofoam fucks it up

pharm final Flashcards

(90 cards)