Study Guide Flashcards
(41 cards)
What condition can Warfarin cause?
Calciphylaxis
Calciphylaxis manifests as painful, itchy calcium deposits in the skin and can lead to skin necrosis.
What are the two classes of calcium channel blockers?
Name one side effect of non-dihydropyridines
Dihydropyridines and non-dihydropyridines
Non-dihydropyridines include verapamil and diltiazem.
-constipation
What effect do NSAIDs have on antihypertensives?
Decrease efficacy of most antihypertensives
This is especially true for ACE inhibitors, ARBs, and thiazides.
-cause afferent arteriole vasoconstriction and reduced blood flow… =RAAS and salt/water retention
How do NSAIDs affect renal blood flow?
Inhibit COX, decrease prostaglandin synthesis, cause vasoconstriction of afferent arteriole
This leads to reduced renal blood flow, sodium, and water retention.
What is the interaction between Omeprazole and Clopidogrel?
Omeprazole decreases Clopidogrel levels through CYP450 inhibition
Clopidogrel is a prodrug that requires activation by CYP450 enzymes.
What is a risk associated with many anti-seizure medications?
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)
This risk is especially notable with lamotrigine***, phenytoin, and carbamazepine.
What are the effects of Acetaminophen?
Analgesic and anti-pyretic effects through central COX inhibition
Acetaminophen is not an NSAID and has no anti-inflammatory effects.
What is NAPQI?
Hepatotoxic byproduct of Acetaminophen requiring glutathione for conjugation
In overdose situations, glutathione is depleted, leading to liver damage.
What is the treatment for Acetaminophen overdose?
N-acetylcysteine (Mucomyst)
It replenishes glutathione levels.
What risk is associated with St. John’s wort?
Risk of serotonin syndrome
This risk increases when combined with tramadol, SSRIs, and other medications.
What dietary restrictions are advised for patients on MAOIs?
Avoid tyramine-containing foods
Examples include aged cheeses, cured meats, fava beans, and certain alcoholic beverages.
What are the categories of insulin?
Rapid-acting, short-acting, intermediate-acting, long-acting
It is important to know which medications fall into each category.
What is the difference between ACE inhibitors and ARBs?
ARBs have a lower risk of cough and angioedema
ACE inhibitors block the conversion of Angiotensin I to Angiotensin II and increase bradykinin levels.
What side effect is associated with Phenytoin?
Gingival hyperplasia
What risk does Methadone pose?
QT prolongation
What is Buprenorphine’s mechanism of action?
Partial agonist of mu receptor with high receptor affinity, lower intrinsic activity
It is less effective at producing euphoria or respiratory depression compared to full agonists.
In what patients is Prasugrel contraindicated?
Is a P2Y12 inhibitor
Patients with a history of TIA or stroke
This is due to the increased risk of intracranial bleeding.
What constitutes high dose statin therapy?
Rosuvastatin 20-40 mg/day or Atorvastatin 40-80 mg/day
Indicated for high-risk patients, such as those with CAD or diabetes.
What should be monitored in patients on Lithium?
Renal and thyroid function (TSH, free T4)
What is the first-line treatment for hypothyroidism?
Levothyroxine (Synthroid)
What is the role of non-selective beta blockers in thyrotoxicosis treatment?
Symptom management and blocking peripheral conversion of T4 to T3
Propranolol is an example of a non-selective beta blocker.
What are the side effects of Statins?
Myalgia, rhabdomyolysis, hepatotoxicity
If myalgia occurs without CK or LFT elevation, hold the statin for 2-4 weeks, then restart.
What side effect is associated with Spironolactone?
Gynecomastia in men
What are the safe antihypertensives in pregnancy?
Labetalol and methyldopa
