Pharm part 5

Question 1

Common indications for paroxetine

Answer 1

Depression
Panic d/o
OCD
GAD

Question 2

MOA of paroxetine

Answer 2

SSRI, clinically unrelated to tricyclic, tetracyclic, or other antidepressants
Presumably, the inhibition of serotonin reuptake from brain synapse stimulated serotonin activity in the brain

Question 3

Common AEs of paroxetine

Answer 3

Nausea
Somnolence
HA
Sexual dysfunction
Dizziness
Asthenia
Wt gain

Question 4

Renal or hepatic dose adjustments for paroxetine

Answer 4

CrCl <30 mL/min: adjustment needed

Severe hepatic impairment: adjustment needed

Question 5

BBW for paroxetine

Answer 5

Increased suicidal thinking and behavior

Question 6

Clinically sig drug interactions for paroxetine

Answer 6

MAOIs

Chronic use with NSAIDs increases risk of GI bleed

Question 7

Major counseling points for paroxetine

Answer 7

May cause drowsiness.
Avoid EtOH while taking this med
Therapy may take up to 2 wks to see improvement
Do not abruptly d/c
Pay close attention to any changes in mood, thought, or feelings such as suicidality

Question 8

Monitoring parameters of paroxetine

Answer 8

Improvement of S/sx of depression/panic/GAD/OCD
Unusual changes in mood
Suicidality

Question 9

Common indications of clonidine

Answer 9

HTN
Opioid detox
Impulse control/ADHD

Question 10

MOA of clonidine

Answer 10

Central pre-synaptic alpha 2 receptor antagonist

Reduces the brain’s adrenergic outflow to decrease BP

Question 11

Common AEs of clonidine

Answer 11

Drowsiness
Xerostomia
HA
Bradycardia
Rash (transdermal patch)
Dizziness 
Somnolence

Question 12

Clinically sig drug interactions of clonidine

Answer 12

TCAs may cause severe hypotension

Avoid CNS depressants

Question 13

Major counseling points of clonidine

Answer 13

Do not d/c abruptly d/t rebound HTN
Patches are applied on a weekly basis
Patch site must be rotated on a weekly basis

Question 14

Monitoring parameters of clonidine

Answer 14

Decrease in BP

Improvement of S/sx of ADHD/impulse control

Question 15

Common indications for promethazine

Answer 15

Nausea
Motion sickness
Cough

Question 16

MOA of promethazine

Answer 16

Competitively inhibits histamine at the H1 receptor sites, causing spasmolytic and decongestant effects

Question 17

Common adverse effects of promethazine

Answer 17

Drowsiness
Rash
Nausea
Vomiting
Blurred vision
Dry mouth
Dizziness

Question 18

BBW of promethazine

Answer 18

Do not use in patients younger than 2 years of age – potential for fatal respiratory depression; injection: tissue irritation and damage due to perivascular extravasation

Question 19

Clinically significant drug interactions of promethazine

Answer 19

Anticholinergics may decrease effects
CNS depression with EtOH or other CNS depressants
Use with metrizamide may decrease seizure threshold
Barbiturate may decrease actions

Question 20

Major counseling points of promethazine

Answer 20

May be taken with food or milk if GI upset occurs
May cause drowsiness
Avoid EtOH while taking this medication
Store in a cool dry place…
If dose is missed, skip it and return to nl dosing schedule- do not double doses
Drink plenty of water

Question 21

Monitoring parameters of promethazine

Answer 21

Decrease in N/V

Decreased cough

Question 22

Common indications for alendronate

Answer 22

Osteoporosis
Secondary osteoporosis due to glucocorticoids
Pagets disease

Question 23

MOA of alendronate

Answer 23

Inhibits bone resorption via actions on osteoclasts or on osteoclast precursors; decreases the rate of bone resorption, leading to an indirect increase in bone mineral density

Question 24

Common adverse effects of alendronate

Answer 24

Hypocalcemia
Hypophosphatemia
Abdominal pain
Diarrhea
Vomiting

Question 25

Renal or hepatic dose adjustments of alendronate

Answer 25

Renal: CrCl <35: use not recommended

Question 26

Clinically significant drug interactions of alendronate

Answer 26

Antacids must be given 30 minutes after taking alendronate or its serum concentration decreases

Question 27

Major counseling point of alendronate

Answer 27

Administer first thing in the morning and ≥30 minutes before the first food, beverage (except plain water), or other medication(s) of the day. Do not take with mineral water or with other beverages. Patients should be instructed to stay upright (not to lie down) for at least 30 minutes and until after first food of the day (to reduce esophageal irritation), Tablets and oral solution must be taken with a minimum of 6 ounces of plain water, Do not crush or chew tablet.

Question 28

Monitoring parameters of alendronate

Answer 28

Increase in bone density | Serum calcium/phosphorous

Question 29

Common indications for allopurinol

Answer 29

Gout Recurrent calcium oxalate stones Prevention of uric acid nephropathy associated with chemo

Question 30

MOA of allopurinol

Answer 30

Competitive inhibition of xanthine oxidase preventing the conversion of hypoxanthine to xanthine to uric acid

Question 31

Common adverse effects of allopurinol

Answer 31

Rash Drowsiness Abdominal pain N/V/D

Question 32

Renal or hepatic dose adjustments for allopurinol

Answer 32

Renal- CrCl 10-20: 200 mg/day CrCl 3-10: 100 mg/day CrCl <3: 100 mg/48 hrs

Question 33

Clinically significant drug interactions of allopurinol

Answer 33

Increases the effects and toxicity of mercaptopurine and azathioprine

Question 34

Major counseling points of allopurinol

Answer 34

May take 1-2 wks to reach maximum effectiveness Avoid EtOH while taking this med Take with lots of fluids

Question 35

Monitoring parameters of allopurinol

Answer 35

Decrease in serum acid levels Frequency of gouty attacks Pain relief

Question 36

Common indications for enalapril

Answer 36

Asymptomatic left ventricular dysfunction Heart failure Hypertension

Question 37

MOA of enalapril

Answer 37

ACEI

Question 38

Common adverse effects of enalapril

Answer 38

``` Cough Hyperkalemia Angioedema Hypotension Dizziness Acute renal insufficiency ```

Question 39

Renal or hepatic dosage adjustments for enalapril

Answer 39

Renal CrCl<30: initiate at 2.5 mg/day, max dose 40mg/day

Question 40

BBW for enalapril

Answer 40

Fetal toxicity

Question 41

Drug interactions with enalapril

Answer 41

Aliskiren

Question 42

Major counseling points for enalapril

Answer 42

Avoid salt substitutes containing potassium. Report any sign of angioedema If planning on becoming pregnant immediately inform your physician If a dose is missed, take it as soon as possible. If it is closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.

Question 43

Monitoring of enalapril

Answer 43

Decrease in BP Decrease in S/sx of heart failure Potassium SCr