Rotation 3 pharm quiz part 2 Flashcards Preview

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Flashcards in Rotation 3 pharm quiz part 2 Deck (46):
1

Dosage forms of trazodone

Tablets: 50 mg, 100 mg, 150 mg, 300 mg

2

Average daily dosages of trazodone

150-400 mg daily

3

Common indications for trazodone

Depression
Insomnia

4

MOA of trazodone

Inhibits serotonin uptake in the brain

5

Common AE of trazodone

Drowsiness
Dry mouth
Hypotension
Dizziness
Fatigue
Confusion
Nightmares

6

BBW of trazodone

Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults with MDD or other psychiatric d/os

7

Clinically sig drug interactions

EtOH and other CNS depressants may potentiate drowsiness
May increase effectiveness of phenytoin
Grapefruit juice may increase plasma levels
CYP3A4 inhibitors may decrease metabolism of trazodone
Chronic use with NSAIDs and SSRIs/SNRIs increases risk of GI bleeds

8

Major counseling points of trazodone

Take with food to enhance absorption
May cause drowsiness- use caution when operating machinery/driving
Avoid EtOH while taking this medication
Stop taking this drug and seek immediate medical attention in the event of prolonged penile erection
Store in cool dry place away from kids and sunlight
If dose is missed, skip it and return to nl dosing schedule

9

Monitoring parameters for trazodone

Improvement of sleep/mood
Unusual mood changes or suicidal thought

10

Dosage forms of Bactrim

Tablets: 400 mg/80 mg, 800 mg/160 mg
Suspension: 200 mg/40 mg/5 mL
Infusion: 400 mg/80 mg/5 mL

11

Average daily dosages of Bactrim?

800 mg/160 mg every 12 hrs x 10-14 days

12

Common indications of Bactrim

Susceptible infections

13

MOA of Bactrim

Trimethoprim blocks production of tetrahydrofolic acid by inhibiting dihydrofolate reductase
Sulfamethoxazole inhibits bacterial synthesis of dihydrofolic acid by competitively antagonizing PABA

14

Common AEs of Bactrim

Increased sensitivity to sunlight, diarrhea, rash, GI upset, increased potassium

15

Renal or hepatic dose adjustments of Bactrim

CrCl 15-30 mL/min: administer 50% recommended dose
CrCl <15 mL/min: use not recommended

16

Clinically significant drug interactions with Bactrim

May increase effects of cyclosporine
May increase serum levels of phenytoin
May increase effects of oral anticoagulants and sulfonylureas

17

Major counseling points of Bactrim

Preferably taken on an empty stomach one hour before or two hours after meals with a full glass of water
Complete full course of therapy unless otherwise directed
Avoid prolonged exposure to sunlight
Shake suspension well before using
Store in a cool dry place away from kids and sunlight
If a dose is missed, take it ASAP

18

Monitoring parameters of Bactrim

Improvement of S/Sx of infection, WBC

19

Dosage forms of Plavix

Tablets: 75 mg, 300 mg

20

Average daily dosages of Plavix

75 mg

21

Common indications of Plavix

Reduction of atherosclerotic events in pt with h/o stroke, MI, established peripheral artery disease, or acute coronary syndrome

22

MOA of Plavix

Converted to active metabolite via CYP2C19, which irreversibly modifies platelet receptors, selectively inhibiting binding of ADP to the platelet receptors, thereby inhibiting platelet aggregation

23

Common AEs of Plavix

CP
HA
Flu-like sx
Arthralgia
Dizziness
GI bleed

24

BBW for Plavix

Diminished effectiveness in poor CYP2C19 metabolizers

25

Clinically sig drug interactions with Plavix

Predisposition of occult blood loss with NSAIDs
May interfere with metabolism of CYP2C9 substrates
Omeprazole and esomeprazole may decrease effects of clopidogrel

26

Major counseling points of Plavix

Contact physician if you notice any sign of infection
Can be taken with or without food
Do not take PPIs with this
Bleeding time will be increased while taking this
Tell physicians and dentists about therapy prior to surgery
Take only as prescribed
Store in cool dry place away from kids and sunlight
If dose is missed, take it ASAP
If it is closer to the time of the next dose, skip the missed dose and return to nl dosing schedule- do not double doses

27

Monitoring parameters of Plavix

Bruising/bleeding

28

Common indications of PPIs

Duodenal/gastric ulcer
Erosive esophagitis
GERD
H. pylori infection
Heartburn (hypersecretory conditions)

29

MOA of PPIs

Supresses H+/K ATPase (proton pump) at the gastric parietal cells decreasing production of acid

30

Common AEs of PPIs

Cough
Constipation
Rash
Dizziness

31

Clinically sig drug interactions of PPIs

Increase gastric pH
Inhibits activation of clopidogrel
Increases levels of diazepam, phenytoin, and warfarin

32

Major counseling points of PPIs

Take 30 mins prior to a meal
Contents of capsule may be added to applesauce for administration

33

Monitoring parameters of PPIs

Improvement in GI sx
Mg if used long term

34

Common indications of H2 blockers

Short-term tx of active duodenal ulcer, GERD, erosive esophagitis, gastritis

35

MOA of H2 blockers

Competitively and reversibly inhibits histamine at H2 receptors on gastric cells

36

Common AEs of H2 blockers

Abd pain
Constipation
Diarrhea
HA

37

Clinically sig drug interactions of H2 blockers

May decrease warfarin clearance

38

Major counseling points of H2 blockers

May be taken with food if GI upset occurs
Prolonged tx greater than or equal to 2 yrs may lead to vitamin B12 malabsorption

39

Monitoring parameters of H2 blockers

Improvement in GI S/sx

40

Common indications for alpha blockers

HTN
BPH

41

MOA of alpha blockers

HTN: Competitively inhibits postsynaptic alpha-adrenergic receptors which results in vasodilation of veins and arterioles and a decrease in total peripheral resistance and blood pressure
BPH: Competitively inhibtis postsynaptic alpha-adrenergic receptors in prostatic stromal and bladder neck tissues. This reduces the sympathetic tone-induced urethral stricture causing BPH sx

42

Common AEs of alpha blockers

Dizziness
Fatigue
Orthostatic hypotension
HA

43

Renal or hepatic dose adjustments for alpha blockers

Use with caution in mild-to-moderate hepatic dysfunction
Do not use with severe impairment

44

Clinically sig drug interactions with alpha blockers

PDE-5 inhibitors

45

Major counseling points of alpha blockers

May cause sudden drop in BP so watch for dizziness, light-headed, etc
Check BP when sitting or lying down
When awaking at night get up slowly
Do not drive until you feel the effectiveness of the medication
Avoid drinking alcohol if medications causes dizziness and increase nighttime urination if taken close to bedtime
Contact physician if you are taking cold/allergy meds and if painful erection occurs

46

Monitoring parameters of alpha blockers

Decrease in BP
Urinary retention