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NAPLEX BABY > THINGS I NEED TO KNOW & DONT > Flashcards

THINGS I NEED TO KNOW & DONT Flashcards

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1
Q

corrected Ca formula

A

-use when albumin is < 3.5

Ca + [(4-albumin) *0.8]

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2
Q

Phenytoin corrected formula

A

-use when albumin is < 3.5

(total phenytoin measured) / (0.2 * albumin) + 0.1

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3
Q

What 2 formulas are used to predict drug concentration?

A

C2 = C1 * e^-kt

Ke= ln (c1/c2) / time

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4
Q

ICR & correction factor formulas for regular insulin

A

ICR = 450/ TDD = grams of carbs covered by 1 unit of insulin

CF: 1500/TDD = correction factor

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5
Q

ICR & correction factor formulas for rapid-acting insulin

A

ICR: 500/TDD = g of carbs covered by 1 unit of rapid acting insulin

CF: 1800/TDD = correction factor

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6
Q

formula for calculating insulin correction dose

A

BG now - target BG / correction factor

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7
Q

Commonly used drugs for specific organisms: MSSA

A

gram + clusters

-Dicloxicillin, nafcillin, oxacillin (no renal dosing needed)

-Cefazolin (IV/IM), cephalexin (po-keflex)

-Amoxicillin/clavulanate (PO/IV), ampicillin/sulbactam (NS only)

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8
Q

Commonly used drugs for specific organisms: MRSA

A

gram + clusters

-Vancomycin: 1st line if MIC < 2, (ototoxicity, hepatotoxicity)

-Linezolid: no renal dose (myelosuppression, serotonin syndrome, optic neuropathy)

-Daptomycin: NO DEXTROSE, (myopathy, rhabdomyolysis- CPK weekly)

-SMX/TMP (Bactrim): CA-MRSA SSTI (sulfa allergy, SJS/TENS, TTP, hemolytic anemia)

-Doxycycline, minocycline

-Clindamycin: no renal dose, D-test on S. aureus

(others: ceftoroline, tigacycline, mupirocoin, delfoxacin)

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9
Q

Commonly used drugs for specific organisms: Vancomycin-resistant Enterococcus (VRE)

A

gram + pairs & chains

-Pen G (IM ONLY) & ampicilin –> E. faecalis only

-Linezolid: no renal dose (myelosuppression, serotonin syndrome, optic neuropathy)

-Daptomycin: NO DEXTROSE, (myopathy, rhabdomyolysis- CPK weekly)

–> Cystitis only: Nitorfuranton (renal imapir crcl < 60, hemolytic anemia), fosomycin, doxycycline

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10
Q

Commonly used drugs for specific organisms: Atypical organisms

A

chlamydia, legionella, myoplasma pneumoniae, myobacterium tuberculosis

-azithromycin, clarithromycin (QT, hepatotoxicity)

-doxycycline, minocycline

-Quinolones [levo, cipro, moxifloxacin] (tendon rupture, QT, psych disturbances, hypo/hyperglycemia, photosensitivity)

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11
Q

Commonly used drugs for specific organisms: HNPEK

A

gram -s: H. influenzae, Neisseria, Proteus micobilis, E.coli, Klepsiella

-beta lactams/betalactamase (penicillins)

-Cephalosporins: cefuroxine, ceftotetan, cefoxitin, cefdinir, ceftriaxone, cefotuxine, ceftazidine, cefepime, ceftaroline)

-Carbapenems (meropenem, enteropenem)

-aminoglycosides (genta, tobra, amikacin) –> nephrotoxicty

-Quinolones [levo, cipro, moxifloxacin] (tendon rupture, QT, psych disturbances, hypo/hyperglycemia, photosensitivity)

-SMX/TMP (Bactrim): CA-MRSA SSTI (sulfa allergy, SJS/TENS, TTP, hemolytic anemia)

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12
Q

Commonly used drugs for specific organisms: Psuedomonas aerginosa

A

gram - rod

-pip/tazo (zyson)
-cefepime (4th gen)
-ceftazidime (3rd gen)
-ceftolozane/tazobactam
-ceftazidine/avibactam
-meropenem
-azteronam
-tobramycin
-colistimethate, polymixin B

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13
Q

Commonly used drugs for specific organisms: CAPES

A

**gram -s: Citrobacter, Acinobacter, Providencia, Enterobacter, Serratia)

-pip/tazo (zyosn)
-cefepime
-carbepenems
-aminoglycosides (genta. tpbra, amikacin)
-colistimethate, polymixin B

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14
Q

Commonly used drugs for specific organisms: ESBL

A

gram - rods: E.coli, k. pneumoniae, P. mirabilis)

-carbepenems
-ceftazidime/avibactam
-ceftrolozane/tazobactam

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15
Q

Commonly used drugs for specific organisms: Carbepenem resistant gram - rods (CRE)

A

-ceftazidime/avibactam
-colistimethate, polymixin B
-meropenem/vaboractam
-imiperem/cilastitin/relebactam

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16
Q

Commonly used drugs for specific organisms: Gram - anaerobes (B. fagiilis)

A

-metronidazole. (disulfiram rxn with alcohol)
-beta lactams
-ceftetan (disulfiram rxn), cefoxitin
-carbapenems
-moxiflixacin

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17
Q

Commonly used drugs for specific organisms: C. difficile

A

-Vancomycin (PO)
-Fidaxomicin
-metronidazole (disulfiram rxn with alcohol)

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18
Q

Preferred HIV initial tx for t naive pts: 1 pill daily: Biktarvy

A

-Bictegravir - INSTI
-Emtricitabine -NRTI
-Tenofovir alfenamide (TAF) - NRTI

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19
Q

Preferred HIV initial tx for t naive pts: 1 pill daily: Triumeq

A

-Dolutegravir - INSTI
-Abacavir - NRTI- TEST for HLAB5701
-Lamivudine- NRTI

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20
Q

Preferred HIV initial tx for t naive pts: 1 pill daily: Dovato

A

-Dolutegravir - INSTI
-Lamivudine - NRTI

**do NOT use if:
- HIV RNA > 500,000
-HBV co infection or unknown
-HIV genotype unknown

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21
Q

Preferred HIV initial tx for t naive pts: 2 pills daily: Tivicay + Truvada

A

-Dolutegravir - INSTI
-Emtribitabine (NRTI)/tenofovir DF (NRTI)

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22
Q

Preferred HIV initial tx for t naive pts: 2 pills daily: Tivicay + Descovy

A

-Dolutegravir - INSTI
-Emtricitabine (NRTI)/tenofovir AF (NRTI)

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23
Q

ART in pregnancy

A

-may contin current ART regimen in most cases
-NEW START: Dolutegravir/boosted darunavir PLUS dual NRTI (emtricitabine/tenofovir)

–> perinatal transmission ppx:
-maternal admin of IV zidovudine pre delivery
-neonatal ART if needed

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24
Q

HIV: Stribild products

A

-Elvitegravir
-Cobicistat (tybost)
-Emtricitabine (Emtriva)
-Tenofovir DF (vibread)

***cannot use of crcl < 50

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25
HIV: Genvoya products
-Elvitegravir -Cobicistat (tybost) -Emtricitabine (Emtriva) -Tenofovir AF
26
HIV Cabanuva products
-Cabotegravir -Rilpivirine
27
HIV: Complera products
-Rilpivirine -Emtricitabine -Tenofovir DF
28
HIV: Odefsey products
-Rilpivirine -Emtricitabine -Tenofovir AF
29
HIV: Descovy Products
-Emtricitabine -TAF
30
HIV: Truvada Products
-Emtricitabine -TDF
31
PrEP for HIV
Indications: mult sex partners, men f men & IV drug use *must be HIV neg before starting --> Truvada (Emtricitabinr/TDF) --> Descovy (Emtricitabinir/TAF) --> IM cabotegravir (Apretude) monthly q 2 mon, then 1 2 months -screen for HIV q 3 month, only give 90 ds at a time
32
PEP treatment
EXPOSURE to body fluids, unprotected sex, IV drug use, needle stick -get baseline HIV, Scr and HBV tests **start rx ASAP (within 72 hrs) x 28 days --> Truvada (emitribicibine/TDF) if crcl > 60 + dolutegravir OR raltegravir
33
Common CYP INhibitors
Inhibitors = INCREASE Grapefruit PIs (ritanovir) Azole antifungals Cyclosporine, colbicstat Macrolides (eryhtromycin/clarithomycin) Amiodorine Non-DHP CCBs (verapamil. diltiazam)
34
Common CYP INDucers
inDucers= DECREASE Phenytoin Smoking Phenobarbital Oxacarbazepine Rifampin Carbamazepine St. johns wort
35
What drugs can cause an immune mediated hemolytic anemia and need a coombs test?
-penicillins -cephalorins -isoniazid -levodopa -methyldopa -quinidine -quinine -rifampin -sulfonamides -rasburicase
36
Self injectable meds that need to be in the fridge and how long are they able to be outside
-Glatiramer (Copaxone): up to 30d -Stanercept (Enbrel) up to 14 d -Adalimumab (Humira) up to 14d -Certolizuman (Cimzio): up to 7d -Golimumab (Simponi): up to 30 d -Teriparatide (Forteo) minimize -Abaloparatide (Tymlos): up to 30 d
37
Patches that are worn daily
-Methylphenidate (Daytrana) @ am 2 hrs before school, flush -Nicotine (NicoDerm) -Rivastigmine (Exelon) - parkin -Rotigotine (Neupro) -parkin *MRI -Selegiline (Emsam) - parkin & depress -Testosterone (Androderm) *MRI -Lidocaine (Lidoderm) 1-3 patches, on for 12, off for 12 -Nitroglycerin: on for 12-14 off for 10-12
38
Patches that are changed q 72 hrs
-Fentanyl (duragestic) - can cover, flush -Scopolamine (Transderm scop) behind the ear *MRI
39
Patches that are changed twice weekly
-Estradiol (Vivelle-Dot): lower abd, butt -Oxybutynin (Oxytrol)
40
Patches that are changed weekly
-Donepezil (Adlarity) - alz -Buprenorphine (Butrans) - can cover, flush -Clonidine (Catapress-TT) *MRI, own patch cover -Estradiol (Climara) -Xulane, Twirla (3 week on, 1 week off)
41
Drugs with Leaching/adsoprtion/issues with PVC containers
Leaches Absorbs To Take In Nutrients Lorazepam (ativan) Amiodaraone Taxines Tacrolimus Insulin Nitroglycerin
42
Drugs that are only compatible with SALINE
"A DIAbetic Cant Eat Pie" Ampicillin Daptomycin (Cubicin) Infliximab (Remicade) Ampicillin/sulbacta, (unasyn) Caspofungin (cancidas) Ertapenem (Invanz) Phenytoin (Dilantin)
43
Drugs that are only compatible in DEXTROSE
"Old Bakers Avoid Salt" Oxaloplatin Bactrim (SMX/TMP) Amphotericin B Synercid (quinupristine/Dalfopristin)
44
Common drugs that need a filter when given IV
"my GAL Is PAT who has a MaP" Golimumab (simponi) Amphotericin B (lipid formulation) Lipids (1.2) ISavuconazonium Phenytoin (continuous infusion) Amiodarone Taxanes (cqbazitaxel, paclitaxel) Manatol > 20% Parenteral nutrients (1.2)
45
DO NOT REFRIGERATE drugs
"Dear Sweet Pharmacist, Freezing Makes Me Edgy!" Dexmedetomidine (precedex) SMX/TMP Phenytoin- crystalizes Furosemide - crystalizes Moxifloxican Metronidazole Enoxaparin
46
Protect from sunlight during admin
"Protect Every New Man from Dick" Phytonasione (vit K) Epoprostenol Nitroprusside Micafungin (Mycamine) Doxycycline (monodox. Oracea)
47
What are the Odefsey components?
-emtricitabine - rilpivirine, -tenofovir alafenamide
48
Key drugs that are associated with photosensitivity
-amiodarone -diuretics (thiazide & loops) -methotrexate -oral and topical retinoids -Quinolones -St. John's Wort -sulfa drugs -tacrolimus -tetracycline -voriconazole
49
Key drugs associated with severe cutaneous AEs (SJS/TENS)
-allopurinol -amoxicillin -ampicillin -carbamazepine -ethosuximide -lamotrigine -nevirapine -phenytoin -sulfamethoxazole -sulfasalazine -vancomycin
50
Invanz
Ertapenem (also a beta lactam)
51
Testing: Abacavir (Ziagen) in combo drugs like Triumeq & Epzicom
-HLA-B*5701 --> if +, do not use *test ALL pts prior to use
52
Testing: Allopurinol (Zyloprim, aloprim)
-HLA-B*5801 --> if +, do not use, inc risk of SJS
53
Testing: Carbamazepine (Tegretol), Oxcarbazepine (Trileptral), Phenytoin (Dilantin), Fosphenytoin (Cerebyx)
-HLA-B*1502 --> if positive do not use -must test all Asians for carbamazepine
54
Testing: Clopidogrel (Plavix)
-CYP2C9 -if poor metabolizer, consider alt therapy
55
Testing: Codeine
-Cyp2D6 -if ultra-rapid metabolizer, do NOT use = dead babies (whites mainly)
56
Testing: Warfarin (Coumadin, Jantoven)
-CYP2C9*2 and *3, VKORC1 -risk of inc bleeding, consider lower doses
57
Testing: Trastuzumab (Herceptin)
-HER2 -if gene NOT present, drug will not be effective
58
Testing: Cetuximab (Erbitux)
-KRAS mutation -if + for mutation, do NOT use
59
Testing: Capecitabine (Xeloda), Fluorouracil
-DPD deficiency -f deficient, do NOT use
60
supplements that can cause liver toxicity (hepatoxicity)
-black cohosh -kava -chaparral, cornfry -green tea extract
61
supplements that increase bleeding risk
- 5G's: garlic, ginger, ginko, ginseng & glucosamine -fish oil -vitamin E -dong quai -willow bark (salicylate)
62
Supplements that increase cardiac toxicity
-Ephiedra -bitter orange -DMAA -yohimbe (vitamin E - excessive intake can lead to CVD)
63
Unfractionated heparin dosing
-via antithrombin -ppx of VTE: 5,000 u SC q 8-12H -tx of VTE: 80 units/kg IV, 18 u/kg/hr infusion -tx of ACS/STEMI: 60 u/kg bolus, 12 u/kg/hr infusion MONITOR: APTT, anti-Xa levels ANTIDOTE: protamine (1 mg reverses 100 units)
64
Enoxaparin (Lovanox) dosing
-via anthithrombin -ppx of VTE: 30 mg SC q12 or 40 mg sc qd -tx of VTE,UA,NSTEMI: 1 mg/kg sc q 12h. 1.5mg/kg sc q 12h -tx of STEMI: 30 mg IV bolus, 1 mg/kg SC q12 MONITOR: anti-xa (do it in pregnancy) ANTIDOTE: protamine
65
Apixaban (Eliquis) dosing
-factor xa direct inhibitor -stroke ppx: 5 mg po BID -tx of DVT/PE: 10 mg PO BID x 7 then 5 mg PO BID DEC DOSE IF pt has at least 2; age > 80, wt / 1.5 ANTIDOTE: andexant alpha (Andexxa)
66
Rivaroxiban (Xarelto) dosing
-factor xa direct inhibitor -stroke ppx: 20 mg po qd w/ evening meal -tx of DVT/PE: 15 mg BID x 21d, 20 mg qd w/ evening meal ANTIDOTE: andexant alpha (Andexxa)
67
Dabigatran (Pradaxa) PO, Argatraban, Bivalirubicin (Angiomax) IVs
-direct thrombin inhibitors Pradaxa SEs- dyspepsia, gastrisis like symptoms, bleeding (keep in original cont, discard after 4 mon) ANTIDOTE: Idarucizumab (Praxbind) (IV argatraban and bivalirubicin have no antidote and used for pts with hx of HITT)
68
Warfarin tablet colors
Please Let Greg Bring Big Peaches To Your Wife Pink: 1 mg Lavender: 2mg Green: 2.5 mg Brown/tan: 3 mg Blue: 4 mg Peach: 5 mg Teal: 6 mg Yellow: 7.5 mg White: 10 mg *test for CYP2C9 *2 & *3, VKORCI gene = inc bleeding ANTIDOTE: vitamin K (phytonadione), kcentra, novoseven RT
69
Drug interactions with Warfarin
-INR DEC with: carbamazepine, phenobarbital, phenytoin, rifampin, SJW = risk of clots -INR INC with: amiodarone, azoles, metronidazole & bactrim = risk of bleeding
70
Zestoretic
lisinopril/HCTZ
71
Hyzaar
losartan/HCTZ
72
Benicar HCT
olmesartan/HCTZ
73
Diovan HCT
valsartan/HCTZ
74
Lotrel
benazepril/amlodipine
75
Exforge
valsartan/amlodipine
76
Tenoretic
Atenolol/chlorthalidone
77
Ziac
Bisoprolol/HCTZ
78
Maxzide/Maxzide-25/Dyazide
Triamterene/HCTZ
79
Chemo man: neurotoxicity
-carmustine -lomustine
80
Chemo man: ototoxicity
-cisplatin --> limit dose to < 100mg / cycle --> give amifostine
81
Chemo man: pulmonary toxicity
-bleomycin (limit dose to 400 mg/life) -busulfan -carmustine
82
chemo man: cardiotoxicity
-doxorubicin --> limit dose to 450-550/lifetime --> give dexrazoxane
83
chemo man: GI tox
-capeciitabine -fluorouracil -Irinotecan (DIARRHEA, atropine and loperamide) -methotreaxte (leucovorin)
84
chemo man: nephrotoxicity
-cisplatin (give amifostine) -methotrexate (leucovorin)
85
chemo man: BMS
all BUT bleomycin, vincristine, asparaginase
86
chemo man: hemorrhagic cystitis
-cyclophosphamide -Ifosamide (give mesna)
87
chemo man: peripheral neuropathy
-vincristine (limit dose to 2 mg) -cisplatin, oxaplatin (limit cold exposure) -paclitaxel
88
LGI: Paliperadone
-Invega Hafyera: 6 mon -Invega Trinza: 3 mon -Invega sustenna: 1 mon
89
LGI: Aripiprazole
-apripiprazole lauroxin (Aristada): 4 weeks -abilify mantena: 4 weeks
90
LGI: Haloperidol
Haldol decanonate: 4 weeks
91
LGI: olanzapine
zyprexa relprevv: 2-4 weeks
92
LGI: risperidone
risperrdol consta: 2 weeks
93
LGI: fluphenazine
-fluphenazine deconate: 2 weeks
94

NAPLEX BABY (23 decks)

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