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NPLEX II - Lynda > Pharmacology Group 2 > Flashcards

Pharmacology Group 2 Flashcards

(46 cards)

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1
Q

Which pharmaceutical should be used for the following conditions?
Hypertriglyceridemia and coronary heart disease risk

A

Gemfibrozil (similar agent is Fenofibrate)

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2
Q

Which pharmaceutical activates lipoprotein lipase which reduces triglycerides and VLDL cholesterol, modestly reduces LDL, and increases HDL cholesterol?

A

Gemfibrozil

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3
Q

What are 6 adverse effects associated with Gemfibrozil use?

A
  1. Drowsiness
  2. Dyspepsia
  3. Abdominal pain
  4. Diarrhea
  5. Fatigue
  6. Mildly decreased WBC, hematocrit, and hemoglobin levels
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4
Q

What is the pregnancy class of Gemfibrozil?

A

Preg C

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5
Q

What are 2 contradictions for use of Gemfibrozil?

A
  1. Cholelithiasis

2. Renal insufficiency

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6
Q

T/F: There is an increase in rhabdomyolysis with concomitant lovastatin use

A

True

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7
Q

There is an increase in toxicity with concomitant use of Gemfibrozil with which 2 other medications?

A
  1. Repaglinide

2. Thiazolidinedione

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8
Q

What are 3 monitoring parameters associated with Gemfibrozil use?

A
  1. Lipid levels (test every 3 months)
  2. CBC
  3. Liver panel
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9
Q

How is Gemfibrozil administered? Usual dose?

A

Oral; 300-600mg

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10
Q

Which pharmaceutical should be used for the following conditions?
Mild to severe heart failure, left ventricular dysfunction

A

Carvedilol

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11
Q

Which pharmaceutical is a non-selective beta-adrenoreceptor and has alpha-adrenergic blocking activity?

A

Carvedilol

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12
Q

What are 8 adverse effects associated with Carvedilol use?

A
  1. Hypotension
  2. Dizziness
  3. Fatigue
  4. Hyperglycemia
  5. Weight gain
  6. Diarrhea
  7. Weakness
  8. Bradycardia
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13
Q

What are 6 contraindications for use of Carvedilol?

A
  1. Bronchial asthma
  2. AV block
  3. Sick sinus syndrome
  4. Severe bradycardia
  5. Cardiogenic shock
  6. Severe hepatic impairment
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14
Q

What is the pregnancy class of Carvedilol?

A

Preg C

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15
Q

Which 5 drugs/drug types is Carvedilol inhibited by?

A
  1. Delavirdine
  2. Fluconazole
  3. Ketoconazole
  4. NSAIDS
  5. Sulfonamides
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16
Q

Serum levels of Carvedilol are increased by which 2 drugs?

A
  1. Clonidine

2. Cimetidine

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17
Q

What are 5 monitoring parameters associated with Carvedilol use?

A
  1. HR
  2. BP
  3. Renal studies
  4. BUN
  5. Liver function
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18
Q

How is Carvedilol administered?

A

Orally

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19
Q

Which pharmaceutical should be used for the following conditions?
CHF, A-fib/flutter

20
Q

Which pharmaceutical is a cardiac glycoside that inhibits cardiac Na+/K+-ATPase, it is positively inotropic (increases contractility), negatively chronotropic (decreases HR), and makes heart beat more efficiently (reduces O2 demand)?

21
Q

What are 8 adverse effects with use of Digoxin?

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A
  1. Anorexia
  2. Fatigue
  3. Nausea/vomiting
  4. Yellow-green halo around objects (visual disturbances)
  5. Bradycardia
  6. Arrhythmias
  7. Gynecomastia
  8. Loss of libido
22
Q

T/F: Digoxin has a narrow therapeutic window

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A

True: OD can be lethal and will recirculates in the enterohepatic cycle (toxicity cumulative)

23
Q

What are 2 antidotes for Digoxin?

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A
  1. Potassium

2. Digoxin antibodies

24
Q

What are 6 contraindications associated with using Digoxin?

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A
  1. Hypokalemia
  2. Hypo- or hypercalcemia
  3. Hypomagnesemia
  4. Ventricular arrhythmia
  5. Kidney failure (renal excretion)
  6. Severe carditis
25
T/F: Digoxin can cause false positives on ECG
True
26
Digoxin toxicity is potentiated by ___ and/or _____ depleting substances. Examples?
K+ and/or Mg2+ | Examples: Diuretics, steroids, Glycyrrhiza
27
What are 10 drug/drug types that INCREASE Digoxin effects/toxicity?
1. Alprazolam 2. Antibiotics 3. Anticholinergics 4. Benzodiazepines 5. Calcium channel blockers 6. Ibuprofen 7. Indomethacin 8. Omeprazole 9. Quinine 10. Quinidine
28
What are 12 drug/drug types that DECREASE Digoxin effects/toxicity?
1. Aminoglycosides 2. Antacids 3. Antihistamines 4. Barbituates 5. Chemotherapy drugs 6. Cholestyramine 7. Dietary fiber 8. Oral hypoglycemics 9. Penicillamine 10. Phenytoin 11. Rifampin 12. Sucralfate
29
What are 4 monitoring parameters associated with Digoxin use?
1. Monitor serum levels of drug 2. Monitor electrolytes 3. Renal function 4. ECG
30
How is Digoxin administered? What consideration should be taken for elderly?
Oral or IV | Must use lower doses for elderly
31
Digoxin doses need to be adjusted to reflect metabolism, how does the dose need to be adjusted for hypo- hyperthyroidism or high fever?
Hypothyroidism: Decrease dose | Hyperthyroidism or high fever: Increase dose
32
Which pharmaceutical should be used for the following conditions? Bradycardia, iridocyclitis, heart block (Mobitz type 1 second-degree and third-degree), hyperhidrosis, organophosphate poisoning, PUD
Atropine
33
Which pharmaceutical is antimuscarinic (anticholinergic) and increases AV and SA node activity?
Atropine
34
What are 9 adverse effects associated with use of Atropine?
1. Dry mouth 2. Dry eyes 3. Blurred vision 4. Mydriasis 5. Photophobia 6. Confusion 7. Hallucinations 8. Tachycardia 9. V-fib
35
What are 2 antidotes for Atropine?
1. Physostigmine | 2. Pilocarpine
36
What are 2 contraindication for use of Atropine? In which population should caution be used?
1. Narrow-angle glaucoma 2. Ischemic heart block Use caution in elderly
37
T/F: Atropine has synergistic toxicity with other anticholinergic drugs
True
38
T/F: Atropine potentiates the effects of bradycardia drugs (e.g. beta-blockers)
FALSE: Atropine counteracts effects of bradycardia drugs
39
What are 3 routs of administration of Atropine?
1. Oral 2. IV 3. IM
40
Which pharmaceutical should be used for the following conditions? Serious ventricular arrhythmias, chemical cardioversion of A-fib, NOT a first-line antiarrhythmic because of significant (potentially fatal) toxicity
Amiodarone
41
Which pharmaceutical is a class III antiarrhythmic agent and is a sodium channel blocker w/ affinity for inactivated channels, in contrast to quinidine?
Amiodarone
42
What are 10 adverse effects associated with use of Amiodarone? Which populations should caution be used when administering this medication?
1. Hypotension 2. Neurological adverse events 3. Nausea/Vomiting 4. CHF 5. Arrhythmias 6. Fever 7. Fatigue 8. Photosensitivity 9. Involuntary movement 10. Muscle weakness Use caution in surgical patients and elderly
43
What are 5 contraindications for use of Amiodarone?
1. Serious sinus-node dysfunction 2. Second or Third degree AV block 3. Bradycardia causing syncope 4. Pregnancy 5. Breast-feeding Note: Safety in pediatric patients is not established
44
There are many interactions with use of Amiodarone and they tend to be quite serious. Why does it take more >1 week for drug interactions to show up with this medication?
Long half-life
45
What are 6 monitoring parameters associated with use of Amiodarone?
1. Monitor thyroid levels closely 2. HR 3. ECG 4. Lethargy 5. Edema 6. Pulmonary function tests
46
What is the oral Amiodarone used to manage? When is this medication switched to IV treatment and prophylaxis?
Life-threatening V-fib and V-tach; recurring V-fib and unstable V-tach use when oral treatment is indicated but not tolerated

NPLEX II - Lynda (29 decks)

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