Summer 14 Final Flashcards by Brianna Smith

What is the lowest potency corticosteroid?

hydrocortisone 1% is lowest potency

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What is the immune response modifier used for topically for basal cell carcinoma?

imiquimod

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What is the topical treatment for skin cancer that is a pyrimidine antimetabolite?

5-fluorouracil

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Which treatment for acne is keratolytic? Which is OTC? What is the level of acne it is used for?

benzoyl peroxide
benzoyl peroxide
mild or mod-severe w/ abx

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What is used for severe acne? What type of drug is it? What is special about using it?

accutane and anti androgens (spironolactone)
retinoid
need to sign ipledge before taking

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What type of drug is tazarotene? What is it used for?

retinoid

psoriasis and acne

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Which abx are used in acne?

tetracycline (minocycline)

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Which level severity are anti androgens used for in acne? Example of one?

severe- spironolactone

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What type of drug that is used for psoriasis is a topical VitD3 analog?

calcipotriol

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What is cyclosporine used for and what type of drug is it?

psoriasis

immunomodulator- calciurein inhibitor

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What is etanercept used for and what type of drug is it?

psoriasis

BMR- TNF inhibitor

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Which severity of psoriasis are topical agents used for?

mild to moderate

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What bacteria do erysipilas and impetigo have in common?

strep pyogenes

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How do you treat CA MRSA?

doxycycline, bactrim, or clindamycin

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How can you treat folliculitis?

benzyl peroxide

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How can you treat erysipelas?

erythromycin

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What is muprocin used for? What does it cover? What is retapamulin used for? What does it cover?

impetigo
gram + and MRSA
only MSSA (staph a and strep pyogenes)

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What causes gas gangrene? How do you treat?

clostridium spp.

clindamycin or penicillin

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How do you treat cellulitis?

clindamycin

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What is an OTC treatment for vulvovaginal candidiasis?

clotrimazole

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What drug can you use for onychomycosis? Which drug has a narrow spectrum of action and high relapse rate?

terbinatine

griseofulvin

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Which is the prodrug- valacyclovir or acyclovir?

valacyclovir

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If the patient has vomiting and a migraine, what drug should you make sure to include?

antiemetic (metoclopramide, chlorpromazine, prochlorperazine)

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What drug should you also use if you are using ergot for migraine?

anti-emetic d/t side effect of nausea—> use antemetic 15 min before ergot

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When are ergots contraindicated?

MI pts, uncontrolled HTN | w/in 24 hours of triptans

When are triptans contraindicated?

ischeimc heart disease, uncontrolled HTN, cerebrovascular disease with macrolides

Which drugs are used for prophylaxis treatment of migraines?

petasites, propanolol, and riboflavin

Which drug is used as prophylaxis for cluster headaches?

verapamil

Which drug is used for OD of opioids?

naloxone

What is one sx everyone on opioids experiences?

constipation

Which drugs that are used for seizures can auto induce?

carbamezapine, oxycarbamezapine

What is a common side effect with carbamezapine?

hyponatremia

What is a common side effect with lamotrigene?

rash

Which drug is for absence seizures?

Ethosuximide

Which drug is used is neonates for seizures?

phenobarbitals

Which drugs are ok to use in hepatic failure patients?

gabapentin and levetiracetam

Which drug is bad in hepatic failure patients?

phenytoin

Which drug is used in acute attacks of MS?

methylprednisone

Which is the preferred treatment for MS?

interferon B (improve mortality)

What is a side effect of interferon beta?

flu like symptoms

What is a side effect of glatiramer?

eosinophilia

Which is an oral drug for MS?

fingolimod

What is a side effect of leukoencephalopathy?

natalizumab

What is a side effect of mitoxatrone?

cardiotoxicit

Which is a drug for MS that is a GABA-B analog and is used for mm relaxation?x

baclofen

What drug can be used for neuropathic pain in MS?

gabapentin

Which drug for Parkinson’s can increase compulsions? What type of drug is it?

bromocriptine | ergot (DA agonist)

What effect do COX 2 inhibitors have on PGI2? What effect do they have on TXA2?

decrease PGI2 | no effect on TXA2

What effect do COX 2 inhibitors have on GI and inflammation?

anti-inflammatory w/ minimal risk to GI

Which is cardioprotective- aspirin or ibuprofen?

aspirin is

What is a complication of subarachnoid hemorrhage? Which drug can prevent this?

DCI | nimodipine

What is the dosing for t-PA?

0.9 mg/kg over 1 hour with a 10% bolus in the first 1 min. (max dose is 90mg)

What are the absolute exclusion criteria for giving t-PA?

hx of intracerebral hemorrhage | improving symptoms

What are the relative exclusion criteria for giving t-PA?

age >80 years taking oral anti-coags hx of DMT2 and prior ischemic stroke

Which drug can you give if there is an aspirin allergy? if they have a-fib but no coumadin?

plavix (aggrenox has aspirin in it) | pradexa or rivoaroxaban or apixaban

When do you give statins?

all the time no matter the LDL level

What is the point of permissive HTN?

allow transient cerebral brain perfusion

When do you give SSRIs?

first line in late onset depression

What two drugs together can cause serotonin syndrome?

zoloft (any SSRI) and mirtazapine (tetracyclic) | but don’t discontinue mirtazapine if starting zoloft unless side effect that is dose dependent

Which anti-depressant is for neuropathic pain and sedation?

TCA

Which drug is good for smoking cessation?

wellbutrin

Which drug is good for loss of appetite?

mitrazapine

Which drug causes a HTN crisis if eaten with tyramine rich foods?

MAO-I

Which drug is good fro agitation and positive psychotic symptoms?

quetiapine

Which drugs are first generations v second generations AP?

first: haloperidol and chlorpromazine second: olazapine, risperidone, quetiapine, ziprasidone, clonzapine\

Which drugs cause hyperprolactinemia?

first generations, risperidone, (switch to aripiprazole or ziprasidone)

Which drugs cause a new onset DMT2?

olanzapine, clozapine, risperidone, quetiapine

Which drug causes neutropenia?

clonzapine

What do you need to keep an eye on with lithium for bipolar?

decreased thyroid hormone synthesis

What drug could increase lithium levels when combined?

NSAIDs

Which drugs decrease the risk for metabolic syndrome?

risperidone, ziprasidone, aripiprazole

What is the benzo MOA? Can they be used in seizure prevention?

increase GABA binding | yes

What are the safe benzos for liver failure?

Lorazepam, Oxazepam, Temazepam

Which benzos are short acting, intermediate acting, and long acting?

short: midazolam, tiazolom intermediate: alprazolam, clonazepam, LOT long: chlorodiazepoxide, diazepem, florazepam

long: chlorodiazepoxide, diazepem, florazepam | What is the MOA of amphetamines for ADHD?

increase catecholamines (DA, epi)

Which drug is for ADHD that is not a stimulant?

atomoxetine

How can you treat PTSD? Which drugs to avoid?

SSRI like sertraline or paroxetine | benzos

What is an OTC drug for insomnia?

melatonin

Which type of patients should you avoid using benzos in for sleep disorders? What is the time frame for using benzos?

pregnancy, sleep apnea | short term

Which is a prodrug for narcolepsy that has a faster onset of action and less chance for side effects?

lisdexamfetamine

What is a stimulant used for narcolepsy that treats EDS?

modafinil

What is A1C goal?

<7%

What is the goal for blood glucose on med floor? ICU? outpatient?

140 180 130

When would you prefer the use of insulin over oral therapy?

when blood glucose is over 500

What is the first choice drug for outpatient?

metformin

What is a side effect of that drug? MOA? When is it contraindicated?

GI discomfort increase sensitivity to insulin if serum creatinine is greater than 1.4 in females and 1.5 in males

What is a second line drug? Side effect? How much does it reduce A1C?

sulfonylureas hypoglycemia, weight gain, hyponatremia 1.5-2%

What effect does insulin have on K? What are the side effects of insulin?

causes K to go into the cell | hypoglycemia, weight gain, lipodystrophy

Which drug worsens gastroparesis?

liraglutide

Which drugs can be used in type I diabetes?

pramlintide and insulin

What is the MOA of exenatide? What is its main side effect?

GLP-1 agonist—> increases insulin secretion | nausea

Which drug interferes with bactrim?

repaglinide and nateglinide

Which drug causes the retention of fluids (like in CHF you would want to avoid it)?

TZDs- pioglitazone and rosipglitazone

What is the MOA of TZDs?

PPAR gamma receptor

How much do TZDs lower A1C by?

1.5%

Which drug decreases triglycerides?

pioglitazone

What type of drug is sitagliptin?

DP4- Inhibitor

Which drug is not used much d/t flatulence?

alpha glucosidase inhibitors (acarbose and miglitol)

What are the side effects of dapagliflozan?

UTI, vulvovaginal mycotic infections, hypovolemia

What are the steps for therapy according to the guidelines?

first metformin then insulin then other orals if still not working 3-6 months later

What should you adjust if a patient notice morning hyperglycemia?

bedtime basal dose

Which insulin is the closest to physiologic insulin?

long acting

When is PTU the preferred therapy?

first trimester of pregnancy

What is different between PTU and MMI?

MMU is 10x more potent b.c not bound to protein

Which is the preferred therapy for Grave’s disease treatment?

radioactive iodine

When is RAI contraindicated?

pregnancy

What is the preferred treatment for hypothyroidism? What interaction do you need to be aware of?

levothyroxine (T4) | Ca

What is the ratio of prednisone to dexamethasone?

prednisone (5 mg) to dexamethasone (0.75 mg)

How many days do you have to be taking steroids before you need to taper doses?

>5 days

Which drug is an anti-progesterone agent?

mifepristone

What drug would you use in the ICU (acutely) for decreasing steroids/cortisol?

etomidate

Which drug causes an increase in androgen? What are the side effects of that?

metyrapone | hirsutism and acne

Which drug is sedating and causes weight gain?

cryoproheptadine

Which drug is a GHR antagonist?

pegvisomat

What do you need to monitor with this drug?

LFTs

Which drug increases the risk of gallstones via inhibiting the release of CCK?

octreotide

Which drug is god for prolactinomas and GH?

cabergoline

Summer 14 Final Flashcards

(117 cards)