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CDM1 > Pharmacology 14 Drugs Review > Flashcards

Pharmacology 14 Drugs Review Flashcards

(72 cards)

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1
Q

Acetaminophen Classification/Indication

A

Analgesic/Antipyretic

Analgesia, Fever

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2
Q

Acetaminophen Dosing

A

IR: 325-650mg PO/PR q4h
ER: 1000mg PO Q6-8h

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3
Q

Acetaminophen MOA

A

Acts on the hypothalamus to produce antipyresis.
Peripherally works to block pain impulse generation
May inhibit prostaglandin synthesis in CNS

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4
Q

Acetaminophen ADE’s

A

Angioedema
Disorientation/dizziness
Pruritic, maculopapular rash

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5
Q

Acetaminophen Elimination

A

Hepatic Metabolism

Excreted in urine

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6
Q

Acetaminophen Clinical Pearls

A

Pregnancy Cat B

Avoid Doses >3250 mg daily

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7
Q

Amlodipine Classification/ Indication

A

Antihypertensive

Hypertension, Coronary Artery Disease, Angina

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8
Q

Amlodipine Dosing

A

5mg PO D; may increase q7-14d. NTE 10mg PO D

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9
Q

Amlodipine MOA

A

CCB; inhibits cardiac and vascular smooth muscle contraction. Leads to dilation of main coronary & systemic arteries

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10
Q

Amlodipine ADE

A

Edema/Pulmonary Edema
HA
Fatigue

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11
Q

Amlodipine Elimination

A

Hepatic metabolism

Excreted in urine

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12
Q

Amlodipine Clinical Pearls

A

Comes in combo w/ Benazepril, atorvastatin, olmesartan, Telmisartan, Valsartan.
Use w/caution in CHF
Titrate slowly in those w/severe hepatic impairment due to extensive liver metabolism

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13
Q

Aspirin Classification/Indication

A

NSAID, Antiplatelet

Pain, Fever
Acute Coronary Syndrome

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14
Q

Aspirin Dosing

A

P/F: 325-650mg PO/PR q4-6h PRN

ACS: 160-325 mg PO; chew non enteric coated tablet upon presentation. Maintanance dosing 81-325 mg D

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15
Q

Aspirin MOA

A

Inhibits synthesis of prostaglandins by blocking COX
Inhibits platelet aggregation
Has antipyretic/analgesic activity

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16
Q

Aspirin ADE

A

Angiodema, uticaria, rash
Bronchospasm
CNS alteration

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17
Q

Aspirin Elimination

A

Hepatic metabolism

Excreted mostly in urine, some in sweat, saliva, feces

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18
Q

Aspirin Clinical Pearls

A

Contraindicated: Bleeding, GI Ulcers, hemophelia, hemorrhoids, lactating mothers, nasal polyps.
Associated with asthma, sarcoidosis, throbocytopenia, UC
Avoid in pediatrics due to increased incidence of Reyes syndrome
May worsen CHF in pts due to increased NA/H2O retention due to prostaglandin inhibition

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19
Q

Atorvastatin Classification/Indication

A

Hypolipemic

Hyperlipidemia

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20
Q

Atorvastatin Dosing

A

10-80 mg PO D

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21
Q

Atorvastatin MOA

A

Inhibits rate limiting step in cholesterol biosynthesis by inhibiting HMG-CoA reductase

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22
Q

Atorvastatin ADE

A

N/D/dyspepsia
Nasopharyngitis
Arthralgia

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23
Q

Atorvastatin Elimination

A

Hepatic metabolism

Excreted mainly in bile

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24
Q

Atorvastatin Clinical Pearls

A

May cause elevations in LFTs

Risk of myopathy increased by coadmin of HIV protease inhibitors or azole antifungals

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25
Glyburide (Micronase) Classification/Indication
Antidiabetic | Diabetes
26
Glyburide Dosing
1.25-20mg PO D. MDD 20mg D
27
Glyburide MOA
Sulfonylurea enhances insulin secretion from pancreatic beta cells. Increase peripheral utilization of glucose Suppresses hepatic gluconeogenesis, and possibly increase sensitivity and/or # of peripheral insulin receptors
28
Glyburide ADE
Noctural enuresis Hypoglycemia, Nausea, myalgia, skin rash, heartburn Disulfiram reaction, hemolytic anemia
29
Glyburide Elimination
Renal elimination 50%
30
Glyburide Clinical Pearls
May have symptoms of hypoglycemia masked by beta blockers (except sweating) Monitor blood glucose 2-4x D Alcohol may cause disulfiram reaction Often add-on therapy w/metformin if A1C goals are not met
31
Hydrochlorothiazide (Hydrodiuril) Classification/Indication
Diuretic | Hypertension, edema
32
HCTZ Dosing
Edema 25-100mg PO D in single or divided doses | HTN: Initial 12.5-25mg PO D
33
HCTZ MOA
Thizides increase NA/CL excretion by interfering with their reabosorption in the cortical diluting segment of the nephron
34
HCTZ ADE
Hypotension, dizziness, HA Constipation, nausea, impotence Hyper-calcemia/glycemia/uricemia Hypo-kalemia/magnesemia/natremia
35
HCTZ Elimination
Excreted 50-70% unchanged in urine
36
HCTZ Clinical Pearls
Full hypotensive effect may require 2-3 weeks | Avoid Alcohol and other NSAIDs
37
Ibuprofen Classification/Indication
NSAID | Pain relief, fever, HA
38
Ibuprofen Dosing
200-400mg po q4-6h prn
39
Ibuprofen MOA
Nonselective COX inhibiter. Reversibly alters platelet functioning and prolongs bleeding time
40
Ibuprofen ADE
GI Distress/Bleeding | Edema, Itching
41
Ibuprofen Clinical Pearls
Use with caution in renal dysfunction. | NSAIDs associated w/increased risk of CV thrombotic events
42
Levofloxacin (Levoquin) Classification/Indication
Antibiotic Treatment of community-acquired pnemonia, including multidrug resistance strains of S. PNEMONIAE (MDRSP) nosocomial pnemonia, chronic bronchitus (acute bacterial exacerbaction) acute bacterial rhinosinusitis (ARBS) prostatitis (chronic bacterial) UTI (complication or un) acute pyelonephritis, skin infections, reduces incidence or disease progression of inhalational anthrax (post exposure)
43
Ibuprofen Elimination
Hepatic metabolism via. CYP2C19 | 45-80% renal elim?
44
Levofloxacin Dosing
500-750mg 1D
45
Levofloxacin MOA
The S- enantomer of the floroquinolone, ofloxacin, levofloxacin inhibits DNA-gyrase in susceptible organisms thereby inhibits relaxation of supercoiled DNA and promotes breakage of DNA strands. DNA topoisomerase (tygrase)II is an essential bacterial enzyme that maintains the superhelical structure of DNA and is required for DNA replication transcription, repair, recombination and transposition.
46
Levofloxacin ADE
Nausea HA Diarrhea
47
Levofloxacin Elimination
CrCl 20-50 reduce dose by 50% (RENALLY EMINIATED) | CrCL 5-19 ml/min extend interval by 48H
48
Levofloxacin Clinical Pearls
Not approved in children younger than 18 y/o. Oral and IV dosing is interchangeable. Increased risk of tendon rupter in >60y/o.
49
Losartan Classification/Indication
Antihypertension | Hypertension, diabetic nephropathy
50
Losartan Dosing
50mg 1D
51
Losartan MOA
Selective and competative Nonpeptide ATII receptor antagonist, blocks vasoconstrictor and aldosterone-secreting effects of ATII. Interacts reversibly at AT1 and AT2 receports of many tissues and has slow dissociation kinetics. Affinity for AT1r is 1000x grater than AT2r. Angiotension II receptor antagonists may induce a complete inhibition of renin-antagonists may induce more complete inhibition of RAAS system than ACE inhibitors, they do not affect the response to bradykinin, and are less likely to be associated with nonrenin-angiotensin effects. Losartan increases urinary flow rate and in addition to being natriuretic and kaliuretic increases excretion of chloride, magnesium, UA, calcium and phosphate.
52
Losartan ADE
HA Diarrhea Hyperkalemia
53
Losartan Elimination
GFR <30 ml/min/1.73m2: use not recommended! | Hepatic mild to moderate impairment: 25mg 1D
54
Losartan Clinical Pearls
ACEi induced cough
55
Metformin (Glucophage) Classification/Indication
Antidiabetic | DMII
56
Metformin Dosing
500mg BID or 850mg 1D; Titrate in increments of 500mg weekly or 850mg QOW
57
Metformin MOA
Decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization)
58
Metformin ADE
Diarrhea N&V Flatulence
59
Metformin Elimination
Renal elimination contraindicated in eGFR <30 eGFR 30 to 45 may consider 50% dosage reduction
60
Metformin Clinical Pearls
Does not cause hypoglycemia, need good renal function measured by GFR, not SCr anymore
61
Simvastatin (Zocor) Classification/Indication
Hypolipemic | Hyperlipidemia; prophylaxis for CVD event risk
62
Simvastatin Dosing
5-40mg PO D (dependent on intensity)
63
Simvastatin MOA
Hydrolyzed to beta-hydroxyacid (potent HMG-CoA reductase inhibitor) increases rate of removal of cholesterol from body and reduces production by inhibiting conversion of HMG-CoA to mevolanate (early and rate limiting step in biosynthesis of cholesterol)
64
Simvastatin ADE
Myalgia, rhabdomyolysis Abdominal pain Increased LFTs
65
Simvastatin Elimination
Extensive hepatic metabolism | Renal and fecal elimination
66
Simvastatin Clinical Pearls
Avoid during pregnancy SX's muscle pain/weakness Take in evening CYP3A4 DDinx limit to 20mg w/ amiodarone, amlodipine, ranolazine. Limit to 10 mg w/ verapamil, diltiazem, dronedarone. Do not initiate 80mg- restricted to pts who received that dose chronically for at least 12 months w/o evidence of muscle tox.
67
``` Metoprolol Succinate (Toprol XL) Metoprolol Tartrate (Lopressor) Classification/Indication ```
Betablocker (antihypertensive) | Angina, heart failure, HTN, MI
68
Succinate/Tartrate Dosing
25 mg po D
69
Succinate/Tartrate MOA
Selective inhibitor of beta1 adrenergic receptors; competatively blocks b-1 with little to no effect on b2 receptors at oral doses <100mg. Does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity
70
Succinate/Tartrate ADE
Dizziness, Fatigue, Hypotension
71
Succinate/Tartrate Elimination
Liver disease- use slow dose titration
72
Succinate/Tartrate Clinical Pearls
Avoid concomitant use of CCBs as use may significantly affect heart rate rhythms.

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