Pharmacology Flashcards
(118 cards)
1
Q
Area under the curve
A
-average amount of a drug in the blood after a dose is given –> bioavailability
2
Q
Drugs that commonly cause inhibition of CYP450 system
A
- Macrolides
- antifungals
- Cimetidine
- Citalopram
- grapefruit juice
3
Q
Antibiotic with highest risk of C.diff
A
Clindamycin (Cleocin)
Lincosamide class
4
Q
Digoxin therapeutic levels
A
-0.5-2
5
Q
Signs of digoxin toxicity
A
- GI: anorexia, N/V, abdominal pain
- scotoma, yellow-green tinge vision
6
Q
Labs for suspected digoxin toxicity
A
- digoxin level
- electrolytes
- creatinine
- EKGs
7
Q
Digoxin toxicity treatment
A
-Digibind
8
Q
Citalopram (Celexa) contraindications
A
QT prolongation
9
Q
Frequency of testing INR
A
every 2-4 weeks up to every 12 weeks
10
Q
What to do if INR <5 with no significant bleeding risk
A
- omit one dose and/or
- reduce maintenance dose slightly
- check INR
11
Q
What to do if warfarin dose missed
A
- take as soon as possible on the same day
- do NOT double dose next day
12
Q
After warfarin is discontinued, how long will the anticoagulant effects persist
A
2-5 days
13
Q
What medication should not be combined with diuretics
A
- Lithium
- risk of lithium toxicity
14
Q
Patients with HTN and osteoporosis have extra benefit from what medication
A
- thiazide diuretics
- reduce calcium excretion by kidneys and stimulate osteoblasts
15
Q
Spironolactone adverse effects
A
-gynecomastia and hyperkalemia
16
Q
BBW Spironolactone
A
-increased risk of benign and malignant tumors
17
Q
Loop diuretic should not be given to patients with what allergy
A
sulfa
18
Q
Loop diuretic adverse effects
A
- electrolyte imbalance
- hypovolemia
- hypotension
- pancreatitis, jaundice, rash
- ototoxicity
19
Q
Noncardioselective BB
A
- propranolol
- carvedilol (Coreg)
20
Q
Cardioselective BB
A
- blocks beta 1
- atenolol
- metoprolol
21
Q
BB contraindications
A
-asthma
COPD
-bradycarida
AV block 2nd-3rd
22
Q
BB adverse effects
A
- bronchospasm
- bradycardia
- depression, fatigue
- ED
- blunts hypoglycemic response
- HF
23
Q
ACE/ARB adverse effects
A
- hyperkalemia
- cough
- angioedema
24
Q
Direct renin inhibitor example
A
- Aliskerin (Tekturna)
- not recommended for initial treatment
25
When does ACE induced cough usually begin
- first few months of treatment
| - discontinue and switch to ARB
26
Which antihypertensive preferred for HTN in diabetics and patients with CKD
ACEI/ARBs
27
T/F ACEI/ARB excreted in breastmilk
true
| avoid
28
First line medication for Raynauds
CCB
29
Verapamil should not be mixed with
erythromycin
| clarithromycin
30
CCBs are contraindicated with
AV block
bradycardia
CHF
31
up to 25% of patients using verapamil develop ___
constipation
32
CCB adverse effects
- headache
- peripheral edema
- bradycardia
- HF and heart block
- hypotension
- QT prolongation
- constipation
33
Alpha-blockers are used when
-patients with BPH and HTN
34
alpha-blocker examples
- Terazosin (Hytrin)
| - Doxazosin (Cardura)
35
Alpha-blocker adverse effects
- orthostatic hypotension
- dizziness, syncope
- priapism
- do not give with cataract/glaucoma surgery
36
Tetracyclines can cause permanent teeth staining and skeletal defects in who
- children <9
- last half of pregnancy
- infancy
37
Tetracycline adverse reactions
- photosensitivity with minimal sunlight
| - esophageal ulcerations very rare
38
When are tetracyclines best taken at
-empty stomach
| take 1-2 hours before a meal
39
Tetracycline organism coverage
G- only
Atypicals
MRSA
40
Macrolide organism coverage
G+ (except enterococci)
Some G-
atypicals
41
Macrolide adverse effects
- GI distress
- ototoxicity
- QT prolongation
42
If patient can not tolerate erythromycin, switch to
Azithromycin or clarithromycin
43
Macrolide and warfarin
INR may be increased
44
First generation cephalosporin coverage
- G+ cocci
- not effective against MRSA
- poor anaerobic coverage
45
Cephalexin
Keflex
| 1st
46
Cefadroxil
Duricef
| 1st
47
What are 1st generation cephs good for
skin infections
48
Second generation cephalosporin coverage
G+
G-
proteus
49
Cefuroxime
Ceftin
| 2nd
50
Cefaclor
Ceclor
| 2nd
51
Cefprozil
Cefzil
| 2nd
52
Third generation cephalosporin coverage
weak G+
G-
beta-lactamase
53
Cefixime
Suprax
| 3rd gen
54
Extended spectrum 3rd gen coverage
G+
G-
beta lactamase
55
Ceftriaxone
Rocephin
| ES 3rd
56
Cefdinir
Omnicef
| ES 3rd
57
MRSA treatment
- Bactrim
- Doxycyline
- minocycline
58
PCN coverage
-G+
| G-
59
PCN adverse reactions
-diarrhea
C.diff
-vaginitis
-SJS
60
Patient with mono and strep throat
-use macrolide
61
Dicloxacillin indication
- penicillinase producing staph
| - mastititis and impetigo
62
Type 1 IgE mediated reactions
Anaphylaxis
| angioedema
63
Some women on which antibiotic will complain of candida vagnitis symptoms
- amoxicillin
| - recommend probiotics or eating yogurt
64
FQ coverage
-G-
-some atypicals
3rd gen: newer generations have G+ coverage
65
Ciprofloxacin
Cipro
2nd gen FQ
Gut and urinary infections
66
Levofloxacin
Levaquin
| 3rd gen respiratory FQ
67
Moxifloxacin
Avelox
| 4th gen resp FQ
68
FQ BBW
- increased risk of Achilles tendon rupture
- avoid strenuous exercise
- reserved for patients with no other choice of abx
69
Which abx used for anthrax infection and prophylaxis
Cipro
70
Which abx used for traveler's diarrhea
Cipro
71
Floxin otic drops indicated for
OM with perforated TM
72
FQ drug interactions
- FQs
- amiodraone
- macrolides
- TCAs
- antipsychotics
- electrolyte imbalances
- increased risk of arrhythmia
73
FQs not to be used with which people
- <18 years old
| - pregnant or breastfeeding women
74
Patient on FQ c/o difficulty walking plan
-Order US r/o tendon rupture or neuropathy
75
First line drug to treat pseudomonal PNA for cystic fibrosis
Cipro
76
Which antibiotic has best activity against Pseudomonas
Cipro
77
Other sulfa-type drugs
- diruretics
- sulfonylureas
- COX-2 inhibitors
- Dapsone
- sulfasalazine
- Nitrofurantoin
78
Pregnant women with UTI preferred abx
- amoxicillin
| - cephalosporin
79
HIV positive patients are at greatest risk for what with sulfa
-SJS
80
Short acting topical nasal decongestants
- Oxymetazoline (Afrin)
| - Phenylephrine (Neo-Synephrine)
81
Which antihistamine has lowest sedation
Loratidine (Claritin)
82
Which antihistamine is more potent and longer acting
Cetirizine (Zyrtec)
83
NSAID option for patients which high risk for GI bleed
Celecoxib
84
NSAIDs should not be used with ASA because
reduces ASA cardioprotective effects
85
NSAIDs may worsen ___ in patients who were previously well controlled
HTN
86
Max regular strength acetaminophen dose in >12
3250 mg/24 hours
87
Max extra strength tylenol /day
3000 mg /24 hours
88
Max extended release tylenol /day
3900 mg/day
89
Tylenol should not be used for more than ___
10 days
90
Antidote for tylenol
Acetylcysteine (MucoMyst)
91
Capsaicin cream can be used to treat what kind of pain
trigeminal neuralgia
| PHN
92
ASA should be discontinued if patient complains of what
tinnitus
| possible ASA toxicity
93
Side effects of chronic steroid use
- HPA suppression
- Cushing syndrome
- osteoporosis
- immunosuppression
- skin changes
94
Drugs that require eye exams
- Digoxin
- Linezolid
- Corticosteroids
- FQs
- Viagra, Cialis, Levitra
- Accutane
- Topamax
- Plaquenil
95
With which illegal substances will pupils constrict
- Miosis
- Prescription opioids
- meth
96
With which illegal substances will pupils dilate
- Mydriasis
- cannabis
- cocaine
97
Which illegal substance can cause severe dental caries
-meth
98
Category X drugs
- Finasteride
- Isotretinoin
- Warfarin
- Misoprostol
- Androgenic hormones
- Live virus vaccines
- Thalidomide, DES, methimazole
99
Information required on prescription pads
- name
- designation
- license number
- NPI number
- supervising physician name/ designation
- clinic address
100
Which schedule of drug can not be called in to the pharmacy
2
101
5 rights of prescribing
- right patient
- right dose
- right drug
- right time
- right route
102
Preferred method of drug prescriptions for Medicaid and Medicare
E-prescribing
103
Feverfew
migraine headache
104
Cinnamon
improve blood sugar and cholesterol
105
Glucosamine (with or without chondroitin)
osteoarthritis
106
Natural progesterone cream from wild yam root extract
-premenstrual symptoms (hot flashes)
107
Isoflavones (soy beans)
Estrogen like effects
108
Saw palmetto
urinary symptoms of BPH
109
Kava kava, valerian root
-anxiety and insomnia
110
St. John's wort
mild depression
111
Tumeric
Alzheimer's
arthritis
cancer
112
What should not be mixed with St.John's wort
-SSRIs
-sumatriptan
-HIV protease inhibitors
etc
113
Ayurveda
healing system from India
| -food, spices, herbs, yoga, lifestyle to prevent disease
114
Type1 reaction
IgE mediated
| anaphylaxis
115
Benzo with shortest half life
-Triazolam (Halcion)
| 2 hours
116
Benzo with longest half life
Clonazepam (Klonipin)
| 34 hours
117
Anticholinergic overdose
-mydriasis (dilation)
-flushing
-fever
-urinary retention
delirium/HA
118
Drug interactions with levothyroxin
- anticoagulants
- TCA
- antacids and calcium
- iron
- Multivitamin
- PPI
- estrogen
- statins
- metformin, etc
- space out several hours apart
