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Flashcards in Pharmacology Deck (138):
1

Which medication prevents neural tube defects?

Folic Acid

2

Which medication prevents neural tube defects?

Folic Acid

3

What do you want to r/o before starting someone on folic acid?

B12 deficiency

4

Which medication helps with N/V during pregnancy?

Doxyalamine and pyridoxine

5

Why type of medication is Doxyalamine?

antihistamine

6

What is pyridoxine?

Vitamin B6

7

What do you give someone with Trichomoniasis?

Metronidazole

8

What do you give someone with gonorrhea?

Ceftriaxone

9

What do you give someone with bacterial vaginosis?

Metronidazole

10

What do you give someone with chlamydia?

Azithromycin

11

What do you give someone with syphilis?

Benzathine Penicillin G

12

What do you give someone with HSV?

valcyclovir/acyclovir

13

What do you give someone with candidiasis?

Clotrimazole cream

14

What do you have to warn people about topical -azole medications?

weaken latex, diaphragm

15

What do you give an HIV neg person for HIV prophylaxis?

Truvada (Tenofovir/Emtricitabine)

16

What do you need to do before starting someone on truvada?

confirm HIV neg

17

How often do you want to test for HIV?

every 3 months

18

What type of PG HTN can you use methyldopa for?

chronic/pre-existing HTN

19

What is the other PG HTN medication that can be used in all types of HTN?

labetolol

20

What drug class is methyldopa?

CNS alpha-adgrenergic inhibitor

21

What drug class is labetalol?

nonselective alpha1, Beta1 and 2 blocker

22

What are common SE of methyldopa?

depression/anxiety, hemolytic anemia

23

What are contraindications for labetalol?

bradycardia and bronchial asthma

24

What medication can be given for premature labor/eclampsia?

magnesium sulfate

25

What is the MOA of magnesium sulfate?

decr ach in motor nerve terminals; slows rate SA node impulse formation; relaxation bronchial smooth muscle

26

What are contraindications for magnesium sulfate?

heart block, myocardial damage

27

what is the DOC for pain treatment in pregnancy?

acetaminophen

28

What drugs do you want to avoid to treat pain?

NSAIDs

29

What do you want to watch out for with antipyschotics in pregnancy?

potential risk for extrapyramadil signs and withdrawl sxs in neonate

30

What anti-depressant do you want to use in PG?

fluoxetine (more SSRIs are Cat C)

31

What SSRI is cat D?

paxil

32

Benefits of contraception

1. reduced risk endometrial CA
2. reduced risk ovarian CA
3. regulation of menstration, reduced dysmenorrhea
4. fever breast fibroadenomas, cysts
5. reduced risk PID
6. improved acne control

33

What is the biphasic COC?

Lo Loestrin Fe

34

What is the quadraphasic COC?

Natazia

35

What is the monophasic COC?

Loestrin Fe 1/20

36

What is the triphasic COC?

Triphasil

37

What is the progestin only OCP?

Ovrette

38

When is ovrette useful to take?

when patient can't take COC (tobacco, obesity, >35yo, HTN, lupus, migrain w/aura, etc.)

39

What are the 2 continuous/extended cycle COC?

1. Lybrel
2. Quartette

40

How long can you use continuous COC?

4 years

41

What are absolute contraindications to using COC?

hx thromboembolic d/o
hx CAD
hx breast CA
hx estrogen-dependent neoplasm
hx abnormal uterine bleeding
PG
>15cigs/day and >35yo
hx hepatic tumor
active liver disease
migraine w/aura

42

What are relative contraindications to using COC?

43

What are SE of COC?

bleeding
headache
GI

44

When should a headache cause you to stop COC and do a workup?

-start or more severe after starting COC
-associated with blurred vision or neuro deficit
-increased migraine frequency

45

What do you want to r/o before starting someone on folic acid?

B12 deficiency

46

Which medication helps with N/V during pregnancy?

Doxyalamine and pyridoxine

47

Why type of medication is Doxyalamine?

antihistamine

48

What is pyridoxine?

Vitamin B6

49

What do you give someone with Trichomoniasis?

Metronidazole

50

What do you give someone with gonorrhea?

Ceftriaxone

51

What do you give someone with bacterial vaginosis?

Metronidazole

52

What do you give someone with chlamydia?

Azithromycin

53

What do you give someone with syphilis?

Benzathine Penicillin G

54

What do you give someone with HSV?

valcyclovir/acyclovir

55

What do you give someone with candidiasis?

Clotrimazole cream

56

What do you have to warn people about topical -azole medications?

weaken latex, diaphragm

57

What do you give an HIV neg person for HIV prophylaxis?

Truvada (Tenofovir/Emtricitabine)

58

What do you need to do before starting someone on truvada?

confirm HIV neg

59

How often do you want to test for HIV?

every 3 months

60

What type of PG HTN can you use methyldopa for?

chronic/pre-existing HTN

61

What is the other PG HTN medication that can be used in all types of HTN?

labetolol

62

What drug class is methyldopa?

CNS alpha-adgrenergic inhibitor

63

What drug class is labetalol?

nonselective alpha1, Beta1 and 2 blocker

64

What are common SE of methyldopa?

depression/anxiety, hemolytic anemia

65

What are contraindications for labetalol?

bradycardia and bronchial asthma

66

What medication can be given for premature labor/eclampsia?

magnesium sulfate

67

What is the MOA of magnesium sulfate?

decr ach in motor nerve terminals; slows rate SA node impulse formation; relaxation bronchial smooth muscle

68

What are contraindications for magnesium sulfate?

heart block, myocardial damage

69

what is the DOC for pain treatment in pregnancy?

acetaminophen

70

What drugs do you want to avoid to treat pain?

NSAIDs

71

What do you want to watch out for with antipyschotics in pregnancy?

potential risk for extrapyramadil signs and withdrawl sxs in neonate

72

What anti-depressant do you want to use in PG?

fluoxetine (more SSRIs are Cat C)

73

What SSRI is cat D?

paxil

74

Benefits of contraception

1. reduced risk endometrial CA
2. reduced risk ovarian CA
3. regulation of menstration, reduced dysmenorrhea
4. fever breast fibroadenomas, cysts
5. reduced risk PID
6. improved acne control

75

What is the biphasic COC?

Lo Loestrin Fe

76

What is the quadraphasic COC?

Natazia

77

What is the monophasic COC?

Loestrin Fe 1/20

78

What is the triphasic COC?

Triphasil

79

What is the progestin only OCP?

Ovrette

80

When is ovrette useful to take?

when patient can't take COC (tobacco, obesity, >35yo, HTN, lupus, migrain w/aura, etc.)

81

What are the 2 continuous/extended cycle COC?

1. Lybrel
2. Quartette

82

How long can you use continuous COC?

4 years

83

What are absolute contraindications to using COC?

hx thromboembolic d/o
hx CAD
hx breast CA
hx estrogen-dependent neoplasm
hx abnormal uterine bleeding
PG
>15cigs/day and >35yo
hx hepatic tumor
active liver disease
migraine w/aura

84

What are relative contraindications to using COC?

85

What are SE of COC?

bleeding
headache
GI

86

When should a headache cause you to stop COC and do a workup?

-start or more severe after starting COC
-associated with blurred vision or neuro deficit
-increased migraine frequency

87

What are estrogen-based SE of COC?

N/V

88

What are progestin-based SE of COC?

constipation, bloating, distention

89

How soon do GI SE usually resolve after starting COC?

1-3 months

90

What are other SE of progestin in COC?

1. decreased libido
2. depression
3. dyslipidemia

91

What are other SE of estrogen in COC?

1. mastalgia
2. weight gain

92

What does estrogen excess cause?

1. bloating
2. migraine headache
3. decreased libido
4. weight gain

93

What does estrogen deficiency cause?

1. spotting
2. amenorrhea
3. vaginal dryness

94

What does progestin excess cause?

1. acne
2. increased appetite
3. fatigue
4. depression
5. hirsutism

95

What does progestin deficiency cause?

amenorrhea

96

Why do a lot of medications decrease estrogen effectiveness?

It is a CYP3A4 substrate

97

What are benefits to progestin only OCP?

1. less risk thromboembolic events
2. minimize menses after 6-9 cycles
3. continuous use

98

What are down sides of progestin only OCP?

1. sometimes spotting
2. need to take consistently same time each day

99

What are down sides to the ortho-evra patch?

1. higher failure rates in women> 90kg (200#)
2. possible increase rate VTE problems compared to COC

100

What are SE for depo?

1. weight gain
2. potential for amenorrhea/infertility for 12-18 months after discontinue

101

What is the MOA of COC?

Suppression of FSH/LH with suppression of ovulation and reduced implantation; thickening cervical mucus, decr tubal motility

102

What is the progesterone agonist-antagonist emergency contraceptive?

Ella

103

How soon do you need to take an emergency contraceptive after intercourse?

120 hours

104

Can emergency contraceptives be used in women with most contraindications to OC?

YES!

105

What are goals of therapy of treating amenorrhea?

1. preserve bone density
2. restore ovulation/fertility

106

What can be used in primary and secondary amenorrhea?

1. estrogen and progestin therapy (CEE, ethinyl estradiol, COC)

107

What do you use to treat hyperprolactinemia?

Bromocriptine (dopamine agonist)

108

What do you use to treat polycycstic ovarian syndrome?

Metformine and TZD

109

What do you use to treat secondary amenorrhea?

DEPA (MPA)

110

How can you treat menorrheagia?

1. NSAIDs (20-50%)
2. COC (50%)
3. Mirena IUD (most effective, 90%)

111

What can you use to treat dysmenorrhea?

1. NSAIDs
2. OCP
3. Depa
5. Mirena IUD (ok in nuliparous woman)

112

What causes anovulatory bleeding?

unopposed estrogen

113

How do you treat anovulatory bleeding caused by PCOS?

1. COC (increases SHGB-- increased androgen binding)
2. MPA (oral or depo)
3. metformin or TZD

114

What are some contraindications to hormone therapy?

1. CHD
2. hx breast CA
3. PG
4. liver disase
5. undiagnosed vaginal bleeding

115

What are alternative treatments for menopause other than estrogen?

1. SSRIs (low dose paxil, clonidine)
2. CAM

116

What are black box warning for estrogen (premarin)?

1. CVD
2. dementia
3. malignancies

117

What do you use estrogen for?

1. mod-severe vasomotor sxs
2. vaginal mucosal atrophy
3. hypogonadism

118

What drug do you use for dyspareunia?

Ospemifine

119

What drug do you use for hypoactive sexual desire in females?

Flibanserin

120

What disorder do you want to inhibit PDE5 enzyme?

ED

121

What receptors do you want to inhibit in BPH?

alpha 1 and 5-alpha reductase

122

What drugs can cause ED?

1. B-blockers
2. thiazides
3. spironolactone
4. alpha-blockers
5. 5alpha-reductase inhibitors

123

What are contraindications of PDE5 inhibitors?

1. high risk CV
2. nitrates
3. azole antifungals
4. erythromycin
5. >170/100,

124

What is the MOA of viagra?

inhibits PDE5 to increase [NO] leading to corpus cavernosum relaxation and inflow of blood to cause erection

125

What are SE of viagra?

1. headache
2. flushing
3. color vision changes
4. angina
5. hypotension

126

What are SE of testosterone?

1. prostate hypertrophy
2. emotional changes
3. altered libido
4. aggression
5. acne

127

What is the MOA of alpha-adrenergic antagonists in BPH?

relax bladder neck, prostatic, urethral smooth muscle

128

What is the MOA of 5alpha-reducate inhibtors in BPH?

decrease prostatic tissue growth sec to inhibiting conversion testosterone to dihydrotestosterone

129

What is the drug class for finasteride?

5 alpha-reducase inhibitor

130

What is the drug class for tamsulosin?

alpha-adrenergic antagonist

131

Which medication is used as an anti-neoplastic agent for palliative treatment of prostate CA, endometriosis?

Leuprolide

132

Which medication is used for metastatic prostate CA w/ LHRH agonist?

Flutamide

133

What is impramine used for?

depression, offlabel for Urinary incontinence

134

What is the drug class of impramine?

tricyclic antidepressant

135

What is oxybutinin used for?

1. overative bladder
2. urge incontinence

136

What is the drug class of oxybutinin and tolterodine?

anticholinergic agent

137

What is Mirabegron used for?

overactive bladder with sxs of urianry frequency, urgency or urge incontinence

138

What is the drug class for Mirabegron?

Beta2-agonist