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OTC > rxfiles notes part 2 > Flashcards

rxfiles notes part 2 Flashcards

1
Q

uncomplicated cystitis treatment duration for nitrofurantoin and septra

A

nitroFurantoin=Five, sulfamethoxazole Trimethoprim=Three

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2
Q

realisitic decrease (%) in chronic pain

A

30-50%

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3
Q

analgesics of choice in renal or hepatic failure

A

renal- hydromorph, oxy, fent, methadone. hepatic- morphine, hydromorph, oxy, fent, methadone

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4
Q

when should NSAIDs be avoided in renal dysfx

A

crcl less than 40 (unless dialysis)

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5
Q

best for GAD (SSRIs)

A

EPS- escit, parox, sert

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6
Q

lowest effective antiinflammatory dose for ibu and naprox

A

ibu- 400mg, naprox 375

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7
Q

what is the saturation point of uric acid

A

over 405umol/L. Target we want is less than 300-360. If asxatic, can be higher and no big deal may not treat (usually don’t)

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8
Q

do not start, stop or adjust allopurinol during acute gout attack- TF

A

T- first time, wait 1-2 weeks after inflammation/attack settles before starting as it may destabilize crystals

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9
Q

when can allopurinol be used not in gout attack

A

to proph while waiting for allopurinol to kick in- 0.6mg OD-BID for 3-6 months when starting allo

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10
Q

allopurinol should be taken AC- TF

A

F- preferred after food

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11
Q

MOA of ASA, how long does effect last?

A

irreversible platelet inhibition- lasts 7-10 days

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12
Q

which NSAID has the most CNS effects

A

indomethacin (CNS confusion esp in elderly). Dosed 25-50mg TID (max 200)

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13
Q

what is the equivalency between oral morphine and fentanyl

A

90MEq in about 25mg/day patch

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14
Q

what is the watchful dose for morphine and how long should you taper opioids over

A

200mg, taper over 2-16 weeks

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15
Q

how long does it take to lose tolerance to an opioid dose

A

as little as 1-2 weeks; careful when tapering off to caution patients not to abruptly go back to previous dose

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16
Q

dose of dimenhydrinate

A

50-100mg q6h prn

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17
Q

what automatically volumes you up a level on the CAROC scale for OP

A

pre if greater than or equal to 7.5 mg/day for over 3 months or frag fracture after age 40

18
Q

bisphosponates should not be used below a crcl of

A

30

19
Q

what is etidronate good for

A

weak antiresorptive; only for vertevral fracture in those at high risk (NOT hip or non vertebral) and must be 2 hours before food… sucks!

20
Q

what is raloxifine? who is it CI in?

A

SERM- SE hot flushes/flushing, leg cramps, VTE is rare but serious. CI in women of childbearing potential and active or past thromboembolic events. Only decreases risk of vertebral

21
Q

how does teriperatide work?

A

anabolic- only one that works on osteoblasts- it increases activity. SE- N, Dizzy, aching. For vertebral and non vertebral (ie not hip) in postmenopausal if severe OR glucocorticoid induced OR men. Given SC daily

22
Q

list foods that contain about 300mg calcium

A

1 cup milk or orange juice, 3/4 cup yogurt, 1/2 pack of cards sized serving of cheese

23
Q

what does Ca decrease the absorption of? what should it be taken with to increase absorption?

A

Decreases cipro, iron, PI, tetracyclines, thyroid meds. PPIs can decrease Ca absorption (citrate best in this situation). Usually give carbonate; if with meal it will increase its F (menopausal- 1200mg per day, age 19-50 1000mg daily)

24
Q

how much vitamin D in OP per day

A

800-2000IU per day

25
Q

who to treat for OP

A

always high (consider patient wants though), consider in moderate but retest q1-3 yrs if don’t, not usually in low and will retest in 5 years

26
Q

what kind of stiffness is classic of RA

A

morning for more than 30 minutes

27
Q

tx for RA

A

mild dx- HCQ or SSZ. If active DSX, MTX or Leflun or combo therapy (usually MTX+SSZ+HCQ or MTX + HCQ or a biologic with MTX or leflun)

28
Q

BB approved for migraine proph

A

MTP (migraine therapy prophylaxis)- metoprolol, timolol, propranolol. ISA activity ones may not be effective, but atenolol and nadolol may be but not first recommended.

29
Q

ergot vs non ergot derivative DA agonists for parkinsons

A

ergots are not recommended as fist line due to concerns with cardiac valve dsx ((pulmonary and cardiac fibrosis) bromocriptine, cabergoline) vs non ergot are first line (or start with levodopa) (pramipexole, ropinerole)

30
Q

interaction between DA agonists and SSRIs MAOIs

A

increased risk SS

31
Q

how often do you get the progestin injection for birth control? what drugs might change this?

A

q12w (3 months) (grace period of up to 14 weeks)- do q10w if on meds that decrease the elvel like carbamaz, griseofulvin, phenobarb, phenytoin, rifampin, st john’s wort, etc

32
Q

mean weight gain with all progestins

A

less than 2 kg

33
Q

drugs good for bipolar- mania or mixed

A

divalproex/valproate, lithium, atypical psych (esp for acute agitation), carbamazepine as an alternative

34
Q

how long is a good medication trial in bipolar

A

2 weeks

35
Q

what is the best (first line) for bipolar rapid cycling

A

divalproex/valproate. litium or carbamax as second line added on if necessary

36
Q

what happens when combining lamotrigine and divalproex

A

risk of life threatening rash increases

37
Q

which antidepressants are the worst in bipolar for rapid cycling

A

TCAs by far, then SSRI, then venla, then bupropion

38
Q

best for bipolar depression

A

mithium, lamotrigine, quetiapine. 2nd line olanzapine plus ssri

39
Q

when is carbamaz’s autoinduction phase complete

A

about 4 weeks

40
Q

how to switch from fluoxetine to another antidepressant

A

35 day washout for all except only 7 for another SSRI or bupropion. 8 week taper may even be required if it was high dose fluoxetine

41
Q

how to switch from MAOI irreversible (phenelzine, trancypromine) to another antidepressant

A

wait 10-14 days

OTC (21 decks)

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