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x 6103 final > quick meds > Flashcards

quick meds Flashcards

1
Q

H2 receptor antagonists

A
  • TIDINE
  • Famotidine (Pepcid) ** most potent, fast, available OTC, IV in acute settings
  • Cimetidine (Tagamet)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)
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2
Q

PPIs

A
  • PRAZOLE
  • Omeprazole (Prilosec) (PO, IV) - OTC
  • Esomeprazole (Nexium) (PO, IV) - OTC
  • Lansoprazole (Prevacid) (PO, IV) - OTC
  • Pantoprazole (Protonix) (PO, IV)
  • Rabeprazole (AcipHex) (PO)
  • Dexlansoprazole (Dexilant) (PO)
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3
Q

Ca & PPI

A

increased incidence of fractures of used gt 1yr or high doses (possibly d/t - ↓ Ca absorption r/t ↓ acidity)

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4
Q

mucosal protective agents x3

A
  1. Sucralfate
  2. Misoprostol
  3. Bismuth
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5
Q

misoprostol class

A

prostaglandin E-1 analog

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6
Q

bismuth examples x2

A

peptobismol

kaopectate

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7
Q

prokinetic x1

A

metoclopramide

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8
Q

metoclopramide class

A

dopamine-2 receptor blocker

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9
Q

do not give to parkinsons patient

A

metoclopramide

phenothiazine/butyrophenone (Compazine, Phenergan)

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10
Q

types of laxatives x6

A
  • Bulk forming
  • Stool softeners
  • Emollients
  • Osmotic Laxatives
  • Stimulant Laxatives
  • Opioid receptor antagonists
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11
Q

bulk forming laxatives x2

A
  • Psyllium (Metamucil)

- Methylcellulose (Citrucel)

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12
Q

Stool softener x1

A

Docusate (Colace)

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13
Q

Emollients x2

A

Glycerin suppository

Mineral oil

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14
Q

Osmotic Laxatives

A
  • Milk of Magnesia
  • Sorbitol & Lactulose (good for ammonia as well)
  • Magnesium citrate
  • Polyethylene glycol (PEG)
  • (GoLYTELY) (MiraLax)
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15
Q

Stimulant Laxatives

A
  • Cascara
  • Senna
  • Biscodyl (Dulcolax)
  • Castor Oil
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16
Q

Opioid receptor antagonists x2

A
  • methylnaltrexone (Relistor)

- alvimopan (Entereg)

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17
Q

post-op ileus

A

alvimpan (Entereg)

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18
Q

opioid-induced constipation

A

methylnaltrexone (Relistor)

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19
Q

anti-diarrheals x3

A
  • Loperamide (Imodium) (OTC)
  • Diphenoxylate (Lomotil) (Rx)
  • Colloidal Bismuth Compound
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20
Q

GI opioid receptor agonists x3

A
  • Loperamide (Imodium) (OTC)
  • Diphenoxylate (Lomotil) (Rx)
  • Colloidal Bismuth Compound
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21
Q

anti-emetics

A
  • phenothiazines & butyrophenones
  • serotonin 5HT-3 antagonists
  • H1 receptor blockers & anticholinergics
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22
Q

GI: phenothiazines & butyrophenones

A

anti-emetic

  1. Prochlorperazine (Compazine)
  2. Promethazine (Phenergan)
  3. Droperidol (Inapsine)
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23
Q

GI: serotonin 5HT-3 antagonists

A

anti-emetic -TRON = gone!

  • Ondansetron (Zofran)
  • Granisetron (Kytril)
  • Dolasetron (Anzemet)
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24
Q

GI: H1 receptor blockers & anticholinergics

A

anti-emetic

  • Diphenhydramine (Benadryl)
  • Dimenhydrinate (Dramamine)
  • Meclizine (Antivert)
  • Hyoscine (Scopolamine)
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25
Q

significant vessel injury possible; dilute & give slowly via large bore vessel

A

promethazine

phenthiazine/butyrophenone anti-emetic

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26
Q

5HT3 anti-emetics only effective for what kind of vom?

A

vagal stimulation

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27
Q

Chemo induced anticipatory nausea and vomiting

A

benzodiazepines
cannabinoids
corticosteroids: dexamethasone (Decadron) & methylprednisolone (Solu-medrol)

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28
Q

most commonly used cannabinoid

A

dronabinol (Marinol)

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29
Q

octreotide class

A

synthetic somatostatin

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30
Q

synthetic somatostatin

A

octreotide (Sandostatin)

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31
Q

antacids x 3

A
  • sodium bicarbonate: alka-seltzer, baking soda
  • calcium carbonate: tums
  • magnesium hydroxide: milk of magnesia
  • aluminum hydroxide: amphogel
  • Ca/Mg: Rolaids
  • Mg/Al: Gaviscon, Maalox/Mylanta
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32
Q

anti-thyroid meds x3

A
  1. Thioamides
  2. Iodides
  3. Radioactive Iodide
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33
Q

thioamides

A

Propylthiouracil (PTU)

Methimazole (Tapazole)

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34
Q

preferred for thyrotoxicosis

A

Propylthiouracil (PTU)

Class: thioamide antithyroid

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35
Q

iodides

A
  • Lugol’s Solution (iodine and potassium iodide)

- Saturated solution of potassium iodide (SSKI)

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36
Q

radioactive iodine

A

131I-iodotope

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37
Q

absolutely no aspirin when?

A

thyrotoxicosis

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38
Q

beta blocker + thyrotoxicosis

A

propranolol to decrease conversion of T4 to T3

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39
Q

thyroid replacement meds x4

A
  • Levothyroxine (Synthroid) (T4)
  • Desiccated Thyroid Gland Extracts (T3/T4)
  • Liothyronine (Cytomel) (T3)
  • Liotrix (Thyrolar) (T3/T4)
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40
Q

Desiccated Thyroid Gland Extracts

A

Armour
T3/T4
1:4

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41
Q

myxedema coma

A

levothyroxine (Synthroid)

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42
Q

progestin-only contraception method x4

A

Depo
Nexplanon
Progestin Only Pill
Novel progestin: Drospirenone, Yaz, Yazmin

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43
Q

novel progestin: examples x3, MOA, considerations

A

examples: drosperinone, Yaz, Yazmin

analogue of spironolactone/aldactone antagonist

  • mild diuretic
  • Counteracts E2-induced stimulation of renin-angiotensin system

GI upset = check K level

contraindicated: abnormal renal, adrenal or hepatic function

possibly increases estrogen thrombogenicity: doesn’t have real progestinic activity to block estrogen, which could mean more estrogen availability → clots

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44
Q

hormone IUDs x3 and what hormone?

A

Mirena, Liletta, Skyla

levonorgestrel

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45
Q

non-hormone IUD

A

ParaGard - Copper

46
Q

IUDs with metal

A

ParaGard - it’s all copper

Skyla - has a silver bead on it for US visualization

47
Q

emergency contraception

A
  • ellaONE® ulipristal acetate - Selective progesterone receptor modulator
  • Plan B® - 2 pills 12 hrs apart within 120 hrs of 75
  • Next Choice (generic Plan B)
  • Plan B One-Step® - 1 tablet of 1.5 mg LNG
48
Q

estrogens on the market

A

mestranol - Ortho-Novum 1/50
ethinyl estradiol (EE) ← will see most often in COCs
estradiol valerate - Natazia
estradiol cypionate - Lunelle (Europe/Mexico only)

49
Q

peanut allergy warning

A

prometrium (MRT)

50
Q

horse allergy warning

A

premarin (MRT from CEE)

51
Q

progestin replacement + horse allergy warning

A

micronized progesterone

52
Q

COC:EPRT

A

6:1

53
Q

CEE:EE

A

1:6 even if dose huge

54
Q

what causes breast cancer in MRT?

A

THE PROGESTERONE!

but if she has a uterus… can’t withhold it.

55
Q

SERM for GSM

A

ospemihene (Osphena)

56
Q

SERM stands for

A

selective estrogen receptor modulators

57
Q

SERMS

A

Duavee - bone loss

Brisdelle - it’s paroxetine (Paxil)

58
Q

the only natural AND bioidentical hormone

A

Premarin (CEE)

59
Q

non-hormone for VSM x2

A

Gabapentin, Pregabalin

Clonidine (alpha adrenergic, VSM only)

60
Q

how long does it take estrogen to work?

A

3-4 weeks

61
Q

target Vitamin D level for osteoporosis

A

target & maintain 30-50 ng/mL

if pt is not deficient - no > 4000 IU/day

62
Q

top 2 pharm management for osteoporosis

A 
1st alendronate (bisphosphonate)
2nd teriparatide (PTH)
63
Q

what is RANKL?

A

osteoclast inhibitor for osteoporisis

64
Q

creatinine clearance

+ cockroft gault

A

(Urine Vol x Urine Creat) / Serum Cr

[ (140 - age) x (IDBW kg) ] / 72(m) or 85(f) x Cr

110-120 normal

65
Q

methotrexate

A

DMARD: antifolate (stops DNA synthesis)

bone marrow suppression & hepatotoxicity (dose related)

avoid if CrCl lt 30

LFTs & CBCs monthly

contraindicated: pregnancy

66
Q

Cytoxan

A

DMARD: alkylates DNA, inhibits B cells

bone marrow suppression

carcinogenic metabolite - drink water!!!

67
Q

cyclosporine

A

DMARD: inhibits T cells

MULTIPLE INTERACTIONS esp Cyp450

hepatic, neuro, nephro toxic: frequent blood levels

68
Q

Imuran

A

DMARD: purine, T cells

hepatitis

69
Q

hydroxychloroquine

A

antimalarial = hemolysis risk with G6PD deficiency

3-6 mo to be effective

70
Q

Arava

A

DMARD: pyrimidine

slows progression, improves joint function

diarrhea common

hepatotoxicity risk

71
Q

sulfasalazine (Azulfidine)

A

DMARD: inhibits COX, PGE
- prevents joint erosion

antimalarial = hemolysis risk with G6PD deficiency

72
Q

antimalarials

A

sulfasalazine & hydroxychloroquine

DMARDs

73
Q

Etanercept (Enbrel)

A

DMARD: TNF alpha & beta inhibitor

high risk infection, lymphoma

74
Q

TNF alpha inhibitors

A

Enbrel, Remicade, Humira, Cimzia, Simponi

75
Q

monoclonal antibodies

A

DMARD: biologic agents!
Orencia, Actemra, Rituxan, anakinra

ONE AT A TIME NEVER COMBINE

76
Q

anakinra

A

DMARD: biologic agent: IL-1 receptor antagonist

least effective

77
Q

Xeljanz

A

DMARD, PO only

78
Q

Ridaura

A

DMARD: gold salts

last resort

proteinura, LFTs

79
Q

off label use for Cozaar & Tricor

A

gout: increases uric acid peeing

80
Q

NSAID for gout

A

indomethacin - most used but any NSAID works

EXCEPT ASPIRIN (causes reabsorption of uric acid)

81
Q

aspirin + gout

A

no. uric acid reabsorption

82
Q

colchicine

A

gout: myotoxin - acute gout

rapid pain/inflammation relief

renal problems

SHORT TERM USE

83
Q

gout maintenance drugs x4

A

xanthine oxidase inhibitors:
allopurinol
Uloric

uricosuric agents:
probenecid
sulfinpyrazone

84
Q

allopurinol

A

gout maintenance

xanthine oxidase inhibitor: prevents xanthine to uric acid
decreases tophi size

renal dose

GI upset, worsens acute attacks

85
Q

Uloric

A

gout maintenance

xanthine oxidase inhibitor: prevents xanthine to uric acid
decreases tophi size

more selective than allopurinol, no renal dose

GI upset

86
Q

probenecid

sulfinpyrazone

A

uricosuric agents
pee out that uric acid

DRINK WATER LIKE CRAZY

stone risk, pcn reabsorption

usually effective if added to inhibitor, monotherapy if can’t tolerate anything else

87
Q

gout maintenance meds consideration

A

make acute attacks worse, avoid for 1-2 weeks after

88
Q

calcineurin inhibitors

A

calcineurin inhibitor

tacrolimus (Protopic)
pimecrolimus (Elidel)

atopic dermatitis

89
Q

bronchodilators

A

ephedrine
isoproterenol (Isuprel)
Epinephrine (L isomer)
racemic epinephrine

90
Q

ephedrine

A

bronchodilator

less potent than epinephrine

91
Q

isoproterenol (Isuprel)

A

bronchodilator

potent beta 1 - beta 2

dangerous

92
Q

Epinephrine (L isomer)

A

bronchodilator

equal beta 1 - beta 2

emergencies & refractory

93
Q

racemic epinephrine

A

bronchodilator

ex: asthmanefrin (OTC) - very weak

stimulates A & B in upper airways: for stridor

lighter

monitor 2-4 hours after admin (to make sure sx don’t return)

94
Q

SABAs

A

albuterol - first line
terbutaline - 2nd/3rd
levalbuterol (Xopenex)

95
Q

albuterol

A

SABA 1st line rescue drug

96
Q

terbutaline

A

SABA - 2nd/3rd line

significant B effects - also treats pre-term labor

97
Q

levalbuterol (Xopenex)

A

R enantiomer only

more expensive

98
Q

LABAs

A 
Salmeterol (Serevent)
Indacaterol (Arcapta)
formoterol (Foradil)
Oladaterol (Striverdi)
Aformoterol (Brovana)
99
Q

anticholinergics

A

Atrovent, Spiriva

asthma/COPD management

100
Q

theophylline

A

methylxanthines

improve strength of diaphragm contractions (Ca inflow)

  • inhibits PDE = bronchodilation
  • dec histamine from mast cells

narrow 5-15 range

nicotine is an inducer (Cyp450 = subtherapeutic dosages)

101
Q

magnesium

A

smooth muscle relaxer for refractory COPD or asthma

beware rapid admin

102
Q

Cromolyn (Intal)

A

mast cell stabilizer

103
Q

prophylactic meds

A

mast cell stabilizers
leukotriene inhibitors
corticosteroids
anti-IgE mab

104
Q

montelukast (Singulair)

A

leukotriene receptor antagonist

105
Q

Zileuton (Zyflo)

A

Leukotriene Synthesis inhibitor

106
Q

inhaled corticosteroids

A 
Qvar
Pulmicort
Azmacort
AeroBid
Flovent
Asmanex
107
Q

nasal corticosteroids are for

A

allergic rhinitis

108
Q

anti-IgE mab

A

Omalizumab (Xolair)

109
Q

mean corpuscular volume

A

hct x 10 / RBC
80 - 100
average size RBC
cytic

110
Q

mean corpuscular hemoglobin volume

A

hgb x 10 / hct
32 - 36
avg concentration hgb per rbc
chromic

x 6103 final (4 decks)

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