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155 Cards in this Set
- Front
- Back
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What is polistirex? What is its duration of action?
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Polistirex is a long-acing resin. It extends duration of action to 12 hours.
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What is the schedule for codeine by itself?
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Codeine by itself is a C-II.
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What can be done for patients taking Kadian or Avinza who have difficulty swallowing?
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The contents of the capsules can be sprinkled on food that doesn’t have to be chewed (like apple sauce) for patients who can’t swallow the capsule. Chewing would cause dose dumping.
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What must patients taking Kadian or Avinza avoid?
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Patients must avoid all alcohol, which speeds morphine release from the extended-release beads.
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Who couldn't take Percodan and Combunox?
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Patients with aspirin allergy
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In regard to meals, how should Opana be taken?
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Opana must be taken on an empty stomach because food results in extremely high blood levels of oxymorphone.
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How does methadone treat heroin addiction?
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It treats heroin dependence by minimizing heroin withdrawal symptoms. It switches the patient’s addiction from heroin to methadone. Methadone is then tapered off.
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What is naloxone and what is it used for?
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The naloxone is an opioid antagonist, which means it blocks opioid receptor sites. It would block the action of pentazocine, but it is not effective orally. It is effective if injected though. This was added to stop people from abusing pentazocine by dissolving the tablets and injecting themselves.
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What is the difference between Darvon and Darvon N?
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There is no real difference between Darvon and Darvon N; just the salts differ.
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How does Relistor work?
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Relistore blocks opioid receptors in the intestine so GI motility is not decrease, but methyl groups prevent entry into the CNS, thus allowing for pain relief.
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What is the maximum 24 hour dose of Ultram?
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Maximum 24-hour dose is 400 mg.
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What schedule is Ultram?
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C-IV
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What is a serious side effect of Ultram and how can it be minimized?
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One side effect can be seizures. These are not caused by an overdose. You can minimize seizure risk by starting with a low dose and titrating up.
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What is the maximum 24 hour dose of Ultram ER?
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Maximum 24-hour dose is 300 mg.
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Name all the drugs that can decrease the effectiveness of contraceptives? Which is the worst?
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barbiturates (phenobarbital, Mebaral)
hydantoins (Dilantin, Peganone, Cerebyx) carbamazepine Trileptal Mysoline Topamax Priftin (worst) |
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How do certain drugs decrease the effectiveness of contraceptives?
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by inducing liver enzymes that increase the metabolism of the contraceptive and lower blood serum level
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What is an adverse effect of the sulfonamide class? What can this lead to?
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Sulfonamides can cause oligohydrosis, which is decreased sweating. This can lead to hyperthermia.
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What is the Black Box Warning for carbamazepine?
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Black Box Warning is for agranulocytosis, which is a decrease in white blood cells.
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What percent of patients allergic to carbamazepine will also be allergic to oxcarbazepine?
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30%
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What are the Black Box Warnings for Felbatol? What else is special about it?
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Black Box Warnings include agranulocytosis and liver failure. It is for these reasons that it is never a first line drug. It is considered a drug of last resort. Patients must sign an informed consent form to obtain a prescription.
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What is postherpetic neuralgia?
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Postherpatic neuralgia is persistent pain in the area of shingles that persists after blisters have healed.
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What is diabetic peripheral neuropathy?
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Diabetic peripheral neuropathy is pain in the extremities of diabetic patients.
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What is the Black Box Warning for Lamictal?
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Black Box Warning is that it may cause serious rashes that may be permanently disfiguring
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What is the generic name and therapeutic class for Kaletra?
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Kaletra is composed of lopinavir and ritonavir, which are both protease inhibitors.
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What is a SALAD drug for Keppra?
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Keppra has a SALAD drug in Kaletra, which is indicated for HIV.
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What is an adverse effect of Topamax?
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Topamax can cause oligohydrosis (decreased sweating).
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What are the Black Box Warnings for Depakote?
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Black Box Warnings include hepatotoxicity, pancreatitis, and teratogenic effect (causes birth defects). A teratogen is anything that causes a birth defect.
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What is an adverse effect of Anafranil?
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It has an adverse effect in about 5% of patients that causes an inadvertent orgasm while yawning.
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What is different about Anafranil?
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Anafranil is NOT indicated for depression despite being listed under antidepressants. It is indicated for OCD.
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What is PMDD?
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PMDD is a severe from of PMS characterized by severe depression one week before menses.
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Why was Sarafem introduced?
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This drug was introduced because Prozac had a negative stigma, but fluoxetine was still marketable as an agent to fight PMDD.
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What are the 2 forms of paroxetine? Can they be substituted?
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paroxetine HCl and paroxetine mesylate; they cannot be substituted
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What does Celexa consist of?
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Celexa is a racemic mixture containing the R and S isomers. S is the active isomer.
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What does Lexapro consist of?
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Escitalopram is the purified form of citalopram and contains only the active S isomer.
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What does Pristiq consist of?
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Desvenlafaxine is the active metabolite of venlafaxine (Effexor).
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Bupropion is claimed to have another effect other than for depression. What is it?
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Bupropion is also claimed to increase sexual drive in women, though this is not an approved use.
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What is the Black Box Warning for nefazodone?
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Black Box Warning is that it can cause life-threatening hepatic failure
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What is paliperidone?
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Paliperidone is the active metabolite of risperdone.
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What is the Black Box Warning for Clozaril?
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Black Box Warning is for agranulocytosis.
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What is a new indication for Abilify that is unique among the antipsychotics?
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A new indication is for depression. Abilify is the only antipsychotics indicated for depression.
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What is Zyrtec composed of?
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Zyrtec is the active metabolite of hydoxyzine (both R and S isomers).
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What is Xyzal composed of?
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Xyzal is the R isomer of cetirizine.
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What is special about Niravam?
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The orally disintegrating tablet has a quick onset and can be used for quick relief of a panic attack.
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What is the SALAD drug for Klonopin?
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Klonopin has a SALAD drug in clonidine, the generic for Catapres.
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What is onset and duration of action of Ambien?
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Has an onset of 30 minutes and a duration of 8 hours.
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What is an adverse effect of Ambien, Sonata, and all benzodiazepines?
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somnambulence (sleep-walking)
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How is Ambien CR different from Ambien?
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Ambien CR keeps you asleep better because some drug is released immediately and the rest is released 3 hours later.
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What is the onset and duration of action of Sonata?
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Has an onset of 15 minutes and a duration of 4 hours.
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What is the onset and duration of action of Lunesta?
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Has an onset of 1 hour and a duration of 8 hours.
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What is bad about Lunesta?
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it has a bitter aftertaste
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How are Lunesta and Rozerem different from Ambien and Sonata?
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They are approved for long-term (6 months) use.
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What is the onset and duration of action of Rozerem?
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Has an onset of 30 minutes and a duration of 8 hours.
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What schedule is Soma?
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This is a C-IV in Arkansas.
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With regard to meals, how should Diflucan be taken?
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Diflucan can be taken without regard to food, unlike some fluoroquinolones.
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How must Diflucan be stored?
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Diflucan may be stored at room temperature or in the refrigerator.
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With regard to meals, how should Vfend be taken?
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Vfend should be taken on an empty stomach.
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With regard to meals, how should Noxafil be taken?
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With regard to meals, how should Vfend be taken?
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With regard to meals, how should Nizoral be taken?
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Nizoral should be taken with food.
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With regard to meals, how should griseofulvin be taken?
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Griseofulvin gets better absorption with food.
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What is the SALAD drug for Lamisil?
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Lamisil has a SALAD drug that is Lamictal.
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With regard to meals, how should Lamisil be taken?
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Lamisil can be taken with no regard to meals.
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How is Famvir used to treat cold sores?
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Famvir has a single dose treatment for cold sores, which is 1500 mg one time. This must be taken within one hour of first symptom.
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How is Valtrex used to treat cold sores?
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Valtrex has a one-day treatment for cold sores. The patient takes 2 grams in the morning and 2 grams in the evening.
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What is the relationship between Zovirax and Valtrex?
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If the patient is allergic to Zovirax, they can’t take Valtrex because valacyclovir is converted to acyclovir in the body.
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How is Penlac Nail Lacquer used? What is its effectiveness?
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Penlac is expensive, not covered by insurance, and doesn’t work very often. After one year, only 12% of patients show any improvement. The patient must paint the affected nail once a day at bedtime and paint over existing coat for 7 days.
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With regard to meals, how should penicillin be taken?
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Penicillin’s absorption is decreased with food.
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With regard to meals, how should amoxicillin be taken?
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Amoxicillin is not affected by food.
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With regard to meals, how should azithromycin tablets and Zithromax powder be taken?
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Azithromycin tablet can be taken with or without food. Zithromax powder can also be taken with or without food.
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With regard to meals, how should Zmax be taken?
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Extended-release microspheres for oral suspension (Zmax) come in a 2-gram single dose bottle that must be taken on an empty stomach.
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How must the patient store Zmax?
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The patient can reconstitute with 60 mL of water, but it must be administered in 12 hours after reconstitution.
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How should Zithromax suspension be stored?
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Zithromax suspension should not be refrigerated because this increases its viscosity.
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How must AzaSite be stored?
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This must be refrigerated in the pharmacy, but the patient may store at room temperature for 14 days.
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With regard to meals, how must Carafate be taken? How does it work? What should not be taken with Carafate?
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Carafate binds to an ulcer and forms a barrier. Food would prevent sucralfate from binding to the ulcer. Antacids shouldn’t be taken with Carafate either because they coat the stomach making Carafate unable to bind.
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What is the conversion factor for Vitamin D?
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70 mcg of cholecalciferol is equivalent to 2800 units of Vitamin D, and 140 mcg is equivalent to 5600 units of Vitamin D.
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How does Vitamin D work?
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Vitamin D is needed for calcium absorption. Vitamin D deficiency causes increased osteoclast production, which leads to increased resorption and calcium leaving the bone.
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How does Forteo work?
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Forteo is a parenteral indicated for osteoporosis, but it is not a bisphosphonate. It stimulates osteoblasts to produce more bone.
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How must Forteo be stored? With regard to meals, how must it be taken?
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It must be refrigerated and can be taken with no regard to meals.
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What are protease and reverse transcriptase?
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Protease and reverse transcriptase are enzymes HIV needs to replicate.
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What does Accolate work is asthma?
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Asthma is an inflammatory condition. Leukotrienes cause this inflammation. Blocking leukotriene receptors reduces the inflammation.
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With regard to meals, how must Accolate be taken?
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On an empty stomach, food decreases the absorption of Accolate.
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With regard to meals, how must Singulair be taken?
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Singulair can be taken without regard to food, unlike Accolate.
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How does Periostat work?
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Periostat inhibits collagenase, which causes the inflammation.
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Is Periostat antibacterial?
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20 mg of doxycycline is not strong enough to be antibacterial.
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How must Cipro be stored?
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Cipro can be stored at room temperature or in the refrigerator.
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Why wouldn't you used fluoroquinolones in children under 18?
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It can lead to joint damage, especially in the Achilles’ tendon. Patients should also be careful while exercising if they are taking a fluoroquinolone.
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What reaction can cefdinir cause in children? How does this occur?
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Cefdinir can cuase red stool in children. Only the oral suspension causes this. It is a reaction with the iron in the diet.
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How must Omnicef be stored?
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Omnicef must be stored at room temperature because its viscosity increases when it is cold.
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What adverse effect is associated with sulfonamides? How can this be minimized?
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Sulfonamides have a tendency to crystallize in urine. This is called crystalluria. Good hydration minimizes the risk of crystalluria.
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What adverse reaction is associated with phenazopyridine?
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Phenazopyridine always turns the urine red to red-brown. It is actually a redish dye that exerts a local anesthetic effect on the urinary tract mucosa.
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What is important for the patient to do when taking phenazopyridine?
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It must reach its site of action to work, so staying well hydrated will facilitate its action.
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How are Pyridium and Azo-Standard available?
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Pyridium is prescription only. Azo-Standard is available over the counter.
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How does benzonatate work?
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Benzonatate numbs the mouth and throat if not taken with plenty of water. It works as an antitussive by anesthesizing the stretch receptors in the lungs.
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What adverse effect is associated with Cytoxan? How can this be minimized?
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Cytoxan cause hemorrhagic cystitis, which is blood and painful urination, in as little as 4 hours. Its metabolites are irritating to the bladder mucosa. If the patient is well-hydrated these metabolites will be flushed out quickly. This should be taken in the morning and the patient should void frequently.
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What is an adverse effect of nitrofurantoin?
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Nitrofurantoin turns the urine a brown, rusty color.
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What is an adverse effect of rifampin.
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This colors all secretions orange for anyone who takes it.
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What is the relationship between rifampin and rifaximin?
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Patients shouldn't take rifaximin if they are allergic to rifampin.
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Xifaxan is used for Traveler's diarrhea. What drug is more commonly used for this? Is it an approved usage?
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Doxycycline is more commonly used for Traveler’s diarrhea caused by E. coli, but this is an unapproved use.
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What is special about Edecrin as opposed to the other loop or thiazide diuretics?
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This is the only loop or thiazide diuretic that can be given to patients allergic to sulfonamides without worry.
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What is Dyrenium mostly used for?
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occasional bloating
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How does sodium polystyrene sulfonate work?
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It is a cation-exchange resin that exchanges Na+ ions for K+ ions in the body. The K+ ions are then secreted with the resin, lowering potassium serum levels.
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What is the reaction most commonly seen in patients taking Flagyl?
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Disulfiram is the reaction between Flagyl and alcohol. This reaction causes vomiting in 10-15% of the patients who take drink alcohol while taking Flagyl.
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What is disulfiram used for?
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Disulfiram is used for enforced sobriety as it causes vomiting in patients who drink alcohol regularly.
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What is a SALAD drug for acetohexamide?
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acetazolamide, which is used for glaucoma
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How do incretin mimetics work?
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Incretin mimetics imitate incretin hormones. They must be administered one hour before breakfast and supper. They mimic incretin and stimulate insulin release from the pancreas. It is usually used in combination with another anti-diabetic. It doesn’t work with Type 1 diabetics because they produce no insulin to begin with.
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How must Byetta be stored?
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It must be stored in the refrigerator at the pharmacy but the patient can store it at room temperature for 6 days.
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What is neuramidase?
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Neuramidase is an enzyme necessary for viral replication.
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In patients over 13, what is the dose of Tamiflu?
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75 mg
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With regard to meals, how should Tamiflu be taken?
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Tamiflu is very nauseating, therefore it should be taken with food.
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How should amoxicillin be stored?
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Amoxicillin is good for 14 days at room temperature, but it tastes better when it is cold.
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What are the two adverse effects of opioids? How do opioids cause these?
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They cause sedation and constipation as adverse effects. Constipation occurs due to them slowing intestinal motility, which causes stool to harden.
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What are the 2 main types of seizures?
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partial and generalized
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What happens in generalized seizures?
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they affect both hemispheres and impair consciousness
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What are the 2 types of generalized seizures?
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tonic-clonic and absence
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What are tonic-clonic seizures?
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full-blown seizures with convulsions
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What are absence seizures?
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they are just seen as a brief delay in the person affected
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What happens in partial seizures?
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they affect only one hemisphere and may or may not affect consciousness
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What could happen if an anticonvulsant were to be suddenly discontinued?
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status epilepticus could occur, which is a continuous tonic-clonic seizure with no return to consciousness; anticonvulsants must be tapered off
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In what case in Mysoline contraindicated?
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in patients allergic to phenobarbital, because Mysoline is metabolized to phenobarbital
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What do antidepressants do? What is the usual onset for antidepressants?
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they elevate the mood, they have a delayed onset of about 3 to 4 weeks
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What are antipsychotics known as?
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neuroleptics
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What other term are typical antipsychotics known as?
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conventional antipsychotics
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What other term are atyipcal antipsychotics known as?
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novel antipsychotics
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What are the 3 main problems associated with atypical antipsychotics?
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weight gain, increased risk of diabetes, and increased risk of hyperlipidemia
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Which atypical antipsychotics show the highest incidence of adverse effects? lowest? intermediate?
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highest - clozapine, olanzapine
lowest - Geodon, Abilify intermediate - Risperdal, Invega |
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What are antihistamines?
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H-1 antagonists, they block H-1 receptors so histamine can't bind
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What are antihistamines indicated for?
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seasonal and perennial allergic rhinitis and chronic idiopathic urticaria (hives from an unknown cause)
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What is the clinical term for itching?
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pruritis
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Which class of antihistamines causes the most drowsiness? Why?
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first generation antihistamines because they bind to both central and peripheral H-1 receptors, second generation bind mostly to peripheral H-1 receptors
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What is the clinical term for something that reduces anxiety?
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anxiolytic
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What 3 things are antifungals most often used for?
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tinea corporis (ring worm)
tinea pedis (Athlete's foot) tinea cruris (jock itch) |
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What are the 2 terms for a fungal infection of the fingernails or toenails?
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tinea unguium
onychomycosis these usually need an oral antifungal to be cured |
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With regard to meals, how should Lamisil be taken?
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it can be taken with no regard to meals
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What is osteoporosis?
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a decrease in bone density caused by bone resorption (resorption means less of a substance)
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What happens in osteoporosis and how do bisphosphonates fight it?
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Osteoblasts and osteoclasts work in balance to continually remodel bone. Osteoblasts reform bone and osteoclasts cause bone resoprtion. Osteoclasts always function, but osteoblast function decreases as you get older. Bisphosphonates becomes part of the bone structure and make it resistant to resorption.
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What 2 things should patients taking bisphonates be sure to do?
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Bisphosphonates must be taken on an empty stomach in the morning 30 minutes before breakfast because food decreases absorption. They must be taken with a full glass of water. They irritate the esophagus and water makes them pass through the esophagus. The patient should also remain upright for 30 minutes to minimize esophageal burns.
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Iron preparations also include what?
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Iron preparations also include pre-natal vitamins.
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What is chelation and what does it cause?
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Some Antibiotics form complexes with divalent and trivalent cations. This is called chelation and decreases absorption.
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What is periostat indicated for?
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Periostat is indicated for periodontitis, which is inflammation around the tissue of teeth.
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What is a negative effect of diuretics?
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Diuretics can deplete potassium and lead to hypokalemia.
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What is the normal serum level of potassium?
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The normal serum level of potassium is 3.5 – 5 mEq/liter.
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What can hypokalemia lead to?
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Hypokalemia leads to leg cramps and weakness.
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Loop and thiazide diuretics should be prescribed cautiously to patients allergic to what? What is one exception?
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Loop diuretics and thiazide diuretics should be prescribed cautiously to patients allergic to sulfonamides (with the exception of Edecrin)
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If a patient is taking a potassium-sparing diuretic, what should you not advise them to do? Why?
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Don’t advise patients to eat a banana or drink a glass of orange juice with potassium-sparing diuretics like you would for loop and thiazide diuretics. Both of those have a fair amount of potassium in them and could lead to hyperkalemia.
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At what level are patients considered safe from hyperkalemia? What could hyperkalemia lead to?
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Hyperkalemia could lead to arrhythmias and death. Patients are fine at any level below 5.5 mEq/L.
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How do sulfonylureas work? What can happen with an overdose? What else could make this happen?
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Sulfonylureas stimulate insulin release from the pancreas and make tissue more responsive to insulin. Overdosing on sulfonylureas or any anti-diabetic that stimulates insulin release can cause life-threatening hypoglycemia. Drinking alcohol with sulfonylureas can also cause hypoglycemia.
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How do thiazolidinediones work?
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Thiazolidinediones increase tissue sensitivity to insulin, but they don’t stimulate insulin release from the pancreas. Therefore, an overdose doesn’t cause hypoglycemia.
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How do biguanides work?
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Biguanides increase tissue sensitivity to insulin, but they don’t stimulate insulin release from the pancreas. Therefore, an overdose doesn’t cause hypoglycemia.
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How do meglitinides work?
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Meglitinides stimulate insulin release from the pancreas. Overdose can lead to hypoglycemia.
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How do alpha-glucosidase inhibitors work? What are 2 adverse effects?
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Alpha-Glucosidase Inhibitors delay digestion of ingested carbohydrates, causing a smaller rise in blood glucose levels after meals. Patients take a dose at the first bite of each main meal. Adverse effects include diarrhea and flatulence.
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How do dipeptidyl peptidase-4 inhibitors work?
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Dipeptidyl Peptidase-4 Inhibitors inhibits DPP-4, which is an enzyme that metabolizes incretin hormones. Incretin hormones are released in the intestine in response to glucose (from a meal). They stimulate insulin release from the pancreas. DPP-4 metabolizes incretin hormones. DPP-4 inhibitors inhibit this, prolonging the effects of incretin hormones, keeping more insulin in the body.
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What are the 2 types of photosensitivity reactions?
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Photoallergic
Phototoxic |
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What happens in photoallergic reactions?
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Photoallergic reactions are rare. They occur when UV light chemically changes the drug in the skin. The changed drug becomes an allergen. This leads to urticaria (hives) on the next administration. This requires only a small amount of sunlight. These are usually caused by sunscreens
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What happens in phototoxic reactions?
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Phototoxic reactions are more common. They also require more sunlight. UV light activates the drug, giving it energy to emit electrons into the skin.
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What 3 drugs show the highest incidence of phototoxicity?
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Cipro, Floxin, and Levaquin
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What is the therapeutic category of amiodarone?
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Antiarrhythmic
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