Pharm Core Comp

Front 1

Mode of action: Direct-acting Cholinomimetrics

Back 1

Bind to and activate muscarinic M2 and M3 receptors

Front 2

Mode of action: Indirect-acting Cholinomimetrics

Back 2

Inhibit acetylcholinesterase

Front 3

Basics treatment of acute narrow angle glaucoma

Back 3

1. Decrease pressure by re-constricting pupil
2. Re-openning the angle

Front 4

Drug treatment for acute narrow angle glaucoma

Back 4

muscarinic agonists plus anticholinesterase
- both cause ciliary muscle contraction
carbonic anhydrase inhibitor - decrease fluid production

Front 5

Surgical treatment of acute narrow angle glaucoma

Back 5

Laser peripheral iridotomy = permanent cure

Front 6

Drug Class: Pilocarpine (Pilopine) drops

Back 6

Muscarinic Agonist

Front 7

Drug Class: Carbochol (Isopto-carbachol) drops

Back 7

Muscarinic Agonist

Front 8

Drug Class: Physostigmine ophth ointment

Back 8

Anticholinesterase

Front 9

Drug Class: Demecarium (Humorsol drops)

Back 9

Anticholinesterase

Front 10

Longterm treatment for Chronic Open Angle Glaucoma

Back 10

Alpha-agonists and Beta-blockers and Carbonic Anhydrase Inhibitors and Prostaglandins

Front 11

Actions of Cholinomimetrics in Chronic Open Angle Glaucoma

Back 11

enhance drainage by causing ciliary muscle contration and thereby strectching the trabeculae

Front 12

Actions of Carbonic Anhydrase Inhibtors in Chronic Open Angle Glaucoma

Back 12

decrease aqueous humor production

Front 13

Drug Class: Acetazolamide (Diamox)

Back 13

Carbonic Anhydrase Inhibitor

Front 14

Drug Class: Brinzolamide (Azopt)

Back 14

Carbonic Anhydrase Inhibitor

Front 15

Actions of Prostaglandins in Chronic Open Angle Glaucoma

Back 15

Increase drainage

Front 16

Mode of action: Direct-acting Cholinomimetrics

Back 16

Bind to and activate muscarinic M2 and M3 receptors

Front 17

Mode of action: Indirect-acting Cholinomimetrics

Back 17

Inhibit acetylcholinesterase

Front 18

Basics treatment of acute narrow angle glaucoma

Back 18

1. Decrease pressure by re-constricting pupil
2. Re-openning the angle

Front 19

Drug treatment for acute narrow angle glaucoma

Back 19

muscarinic agonists plus anticholinesterase
- both cause ciliary muscle contraction
carbonic anhydrase inhibitor - decrease fluid production

Front 20

Surgical treatment of acute narrow angle glaucoma

Back 20

Laser peripheral iridotomy = permanent cure

Front 21

Drug Class: Pilocarpine (Pilopine) drops

Back 21

Muscarinic Agonist for Acute Angle Glaucoma

Front 22

Drug Class: Carbochol (Isopto-carbachol) drops

Back 22

Muscarinic Agonist - Acute Angle Glaucoma

Front 23

Drug Class: Physostigmine ophth ointment

Back 23

Anticholinesterase - Acute Angle Glaucoma

Front 24

Drug Class: Demecarium (Humorsol drops)

Back 24

Anticholinesterase - Acute Angle Glaucoma

Front 25

Longterm treatment for Chronic Open Angle Glaucoma

Back 25

Alpha-agonists and Beta-blockers and Carbonic Anhydrase Inhibitors and Prostaglandins

Front 26

Actions of Cholinomimetrics in Chronic Open Angle Glaucoma

Back 26

enhance drainage by causing ciliary muscle contration and thereby strectching the trabeculae

Front 27

Actions of Carbonic Anhydrase Inhibtors in Chronic Open Angle Glaucoma

Back 27

decrease aqueous humor production

Front 28

Drug Class: Acetazolamide (Diamox)

Back 28

Carbonic Anhydrase Inhibitor - Chronic Open Angle Glaucoma

Front 29

Drug Class: Brinzolamide (Azopt)

Back 29

Carbonic Anhydrase Inhibitor - Chronic Open Angle Glaucoma

Front 30

Actions of Prostaglandins in Chronic Open Angle Glaucoma

Back 30

Increase drainage

Front 31

Drug Class: Bimatoprost (Lumigan)

Back 31

Prostaglandin - Chronic Open Angle Glaucoma

Front 32

Actions of Nonselective Alpha-Agonists in Chornic Open Angle Gluacoma

Back 32

Increase drainage

Front 33

Drug class: Dipivefrin (Propine)

Back 33

Nonselective Alpha Agonist - Chronic Open Angle Glaucoma

Front 34

Actions of Alpha-2 Agonists in Chornic Open Angle Glaucoma

Back 34

Decease humor production

Front 35

Drug class: Aproclonidine (Iopidine)

Back 35

Alpha-2 Agonist - Chronic Open Angle GLaucoma

Front 36

Action of Beta-Blockers in Chronic Open Angle Gluacoma

Back 36

Decrease humor production

Front 37

Drug Class: Betaxolol (Betoptic)

Back 37

Beta-Blocker for Chornic Open Angle Glaucoma

Front 38

Use of Cholinomimetrics in GI and Urinary Tracts

Back 38

Used in conditions in which smooth muscle activity is depressed in the absence of obstruction: Post-Op Ileus, Urinary Retention and Reflux Esophagitis

Front 39

Drug Class: Bethanechol (Urecholine)

Back 39

Muscarinic Agonist - GI and Urinary Tract

Front 40

Drug Class: Neostigmine (Prostigmin)

Back 40

Anticholinesterase - GI and Urinary Tract

Front 41

Most popular remedies for GERD

Back 41

H2 blockers and PPIs

Front 42

Drug used to diagnose Myasthenia Gravis and assess the level of longterm treatment

Back 42

Edrophonium (Tensilon)

Front 43

Give Tensilon and patient's weakness (fatiguability) does not improve

Back 43

Patient is over-medicated

Front 44

Given Tensilon and patient's weakness does improve

Back 44

Patient is under-medicated

Front 45

Drug Class: Succinylcholine

Back 45

Depolarizing Agent - Neuromuscular Blockade

Front 46

Drug Class: Atracurium

Back 46

Non-Depolarizing Agent - Neuromuscular Blockade

Front 47

Action of Anticholinergic in Neuromuscular Blockade

Back 47

Block the nicotinic NM receptors on the muscle fibers by competing with Ach thereby preventing depolarization of the muscle fiber membrane

Front 48

Remove neuromuscular blockade

Back 48

Reversed by injecting an anticholinesterase that will increase the amount Ach and its half-life at the motor endplate

Front 49

Drug Class: Neostigmine (Prostigmin)

Back 49

Anticholinesterase - removing neuromuscular blockade

Front 50

Drug Class: Pyridostigmine (Mestinon)

Back 50

Anticholinesterase - remove neuromuscular blockade

Front 51

Action of Insecticides

Back 51

Orhanophosphates that kill via irreversible anticholinesterase activity - cause excessive parasympathetic vetative manifestations

Front 52

DUMBLES

Back 52

Diarrhea, Urination, Miosis, Bronchorrhea, Bronchospasm, Bradycardia, Excitation, Lacrimation, Salivation

Front 53

Antidote for Insecticide

Back 53

Atropine (hyoscyamine) - blocks all muscarinic receptors

Front 54

Action of Antimuscarinic

Back 54

Block transmission between the parasympathetic postganglionic fiber and the target organ

Front 55

Drug Class: Dicyclomine (Bentyl)

Back 55

Semisynthetic tetiary ammonium analgue of Atropine

Front 56

Drug Class: Tropicamide (Mydriacil)

Back 56

Semisynthetic tetiary ammonium analgue of Atropine

Front 57

Drug Class: Dimenhydrinate (Dramamine)

Back 57

Antihistamine

Front 58

Drug Class: Diphenhydramine (Benadryl)

Back 58

Antihistamine

Front 59

Drug Class: Amitriptyline (Elavil)

Back 59

Tricyclic Antidepressant

Front 60

Drug Class: Haloperidol (Haldol)

Back 60

Antipsychotic

Front 61

Drug Class: Chlorpromazine (Thorazine)

Back 61

Antipsychotic

Front 62

Action of Antimuscarinic in Fundoscopic Exam

Back 62

Cause pupillary dilation and paralyze the ciliary body

Front 63

Drug Class: Tropicamide (Mydriacil)

Back 63

Antimuscarinic - Fundoscopic Exam

Front 64

Drug Class: Cyclopentolate (Cyclogil)

Back 64

Antimuscarinic - Fundoscopic Exam

Front 65

Action of Antimuscarinic in IBS

Back 65

Reduce vagal-muscarinically-induced gastric acid secretion

Front 66

Drug Class: Glycopyrrolate (Robinul)

Back 66

Antimuscarinic - IBS

Front 67

Drug Class: Dicyclomine (Bentyl)

Back 67

Antimuscarinic - IBS

Front 68

Drug Class: Atropine + Diphenoxylate (Lomotil)

Back 68

Antimuscarinic - Traveler's Diarrhea and GI Hypermotility

Front 69

Drug Class: Loperamide (Imodium A-D)

Back 69

Antimuscarinic - Traveler's Diarrhea and GI Hypermotility
- need to be sure the patient does not have C. diff Colitis

Front 70

Drug Class: Oxybutynin

Back 70

Antimuscarinic - Overactive bladder and Urge Incontinence

Front 71

Action of Antimuscarinic in Asthma and COPD

Back 71

Permit bronchodilation and facilitate breathing. Inhalent forms limit systemic antimsucarinic side effects

Front 72

Drug Class: Ipratropium (Atrovent)

Back 72

Antimuscarinic - Asthma and COPD

Front 73

Drug Class: Tiotropium (Spiriva)

Back 73

Antimuscarinic - Asthma and COPD

Front 74

Combivent is a combination of what two drugs

Back 74

Ipratropium and Albuterol

Front 75

Action of Antimuscarinic in Motion Sickness

Back 75

Prevent nausea and vomiting

Front 76

Drug Class: Scopolamine (Transderm Scop)

Back 76

Antimuscarinic - Motion Sickness

Front 77

Drug Class: Dimenhydrinate (Dramamine)

Back 77

Antihistamine with antimuscarinic effects - Motion Sickness

Front 78

Drug Class: Meclizine (Antivent)

Back 78

Antihistamine with antimuscarinic effects - Motion Sickness

Front 79

Pathophysiology of Alzheimer's

Back 79

Loss of cholinergic neurons in the nucleus blasalis of Mayner

Front 80

Pathophysiology of Parkinson's

Back 80

Loss of dopaminergic neurons in the substantia nigra

Front 81

Pathophysiology of Huntington's

Back 81

Degeneration of the frontal lobes, and of the caudate and putamen (of the basal ganglia)

Front 82

Pathophysiology of Amyotrophic Lateral Sclerosis

Back 82

Degeneration of the upper motor neurons (corticospinal tract) and lower motor neurons (alpha motor neurons)

Front 83

Causes of Secondary Parkinson's

Back 83

Antipsychotic drugs ("neuroleptics") block dopamine receptors leading to dyskinesias called extrapyramidal symptoms

Front 84

Strategy in Treatment of Parkinson's

Back 84

Restore dopaminergic transmission and/or antagonize the cholinergic overbalance

Front 85

Drug Class: Levodopa

Back 85

Precursor of dopamine that crosses the blood brain barrier

Front 86

Drug Class: Carbidopa

Back 86

Dopa-decarboxyalse inhibitor - used to prevent levopada from being decarboxylated in the tissues

Front 87

Drug Class: Sinemet

Back 87

Levodopa + Carbidopa

Front 88

Action of Selegiline

Back 88

Inhibits MAO-B. Increases dopamine levels in the brain, enchances the effects of levodopa and decreases the required dose of levodopa

Front 89

Action of MAO-A inhibtors

Back 89

Used as antidepressants because they increase norepinephrine and serotonin

Front 90

Drug Class: Phenelzine (Nardil)

Back 90

MAOI

Front 91

Drug Class: Tranylcypromine (Parnate)

Back 91

MAO-A Inhibitor

Front 92

If you combine MAO-A inhibitor and an SSRI or TCA what happens?

Back 92

Hypertensive Crisis

Front 93

Action of Catecholamine-O-methyltransferase (COMT) inhibitor

Back 93

Prevents Levodopa from being metabolized by COMT into 3-O-methyldopa which competes with the levodopa for transport into the brain

Front 94

Drug Class: Entacapone

Back 94

COMT Inhibitor - prevents the "wearing off" phenomenon of the benefit of levodopa

Front 95

Action of ergotamine dopamine receptor agonist in Parkinson's

Back 95

Improve Parkinson symptoms also cause vasoconstrictuion which can exacerbate peripheral vascular disease

Front 96

Drug Class: Bromocriptine

Back 96

Erogatime Dopamine Receptor Agonist - Parkinsons

Front 97

Drug Class: Pergolide

Back 97

Erogatime Dopamine Receptor Agonist - Parkinsons

Front 98

Action of Non-ergotamine dopamine receptor agonist

Back 98

Improve Parkinson symptoms, but are not vasoconstrictors

Front 99

Drug Class: Ropinirole

Back 99

Non-ergotatime dopamine receptor agonist - Parkinsons

Front 100

Drug Class: Pramipexole

Back 100

Non-ergotamine dopamine receptor agonist - Parksinsons

Front 101

Off-label use of Ropinrole

Back 101

Restless-leg syndrome

Front 102

Action of Antimuscarinic in Parkinsons

Back 102

Eliminate the cholinergic overbalance

Front 103

Side effects of Anticholinergics

Back 103

Dry mouth, Blurred vision, Constipation, Urinary retention, Mydriasis

Front 104

Action of Acetylcholinesterase Inhibitors in Alzheimer's

Back 104

Prolongs the action of Ach thereby increases brain cholinergic function in the form of thinking, memory, and the ability to recognize one's own spouce

Front 105

Drug Class: Donepizil (Aricept)

Back 105

Acetylcholinesterase Inhibitors

Front 106

Drug Class: Rivastigmine (Exelon)

Back 106

Acetylcholinesterase Inhibitor

Front 107

Side effects of Acetylcholinesterase Inhibitors

Back 107

Nausea, Vomiting, Diarrhea

Front 108

Location of Alpha 1A receptors

Back 108

Prostate Smooth Muscle

Front 109

Antagonist of Alpha 1A receptors causes

Back 109

Increased Urinary Stream

Front 110

Drug Class: Tamsulosin (Flomax)

Back 110

Alpha 1A Antagonist

Front 111

Location of Alpha 1B Receptors

Back 111

Arterioles & Veins

Front 112

Antagonist of Alpha 1B Receptors causes

Back 112

Vasodilation

Front 113

Drug Class: Doxazosin (Cardura)

Back 113

Alpha 1B Antagonist

Front 114

Agonist of Alpha 1B Receptors causes

Back 114

Vasoconstriction

Front 115

Drug Classes: Epinephrine/Norepinephrine

Back 115

Alpha 1B Agonist, Beta 1 Agonist, Beta 2 Agonist

Front 116

Location of Alpha 2 Receptors

Back 116

Medullary Vasomotor Center

Front 117

Agonism of Alpha 2 Receptrors causes

Back 117

Decreased Sympathetic Tone

Front 118

Drug Class: Clonidine (Catapres)

Back 118

Alpha 2 Agonist

Front 119

Locations of Beta 1 Receptors

Back 119

Heart and Kidney

Front 120

Antagonist of Beta 1 Heart Receptors Causes

Back 120

Decreased heart rate and Decreased Contractitily

Front 121

Antagonist of Beta 1 Kidney Receptors causes

Back 121

Decreased Renin produce leads to Decreased blood pressure

Front 122

Drug Class: Propranolol (Indera)

Back 122

Beta 1 Antagonist

Front 123

Agonist of Beta 1 Heart Receptors causes

Back 123

Increased heart rate and Increased contractility

Front 124

Agonist of Beta 1 Kidney Receptors causes

Back 124

Increased Renin

Front 125

Locations of Beta 2 Receptors

Back 125

Airways and Arterioles

Front 126

Agonist of Beta 2 Airway Receptors causes

Back 126

Bronchodilation

Front 127

Agonist of Beta 2 Arteriole Receptors causes

Back 127

Increased vasodilation

Front 128

Drug Class: Albuterol

Back 128

Beta 2 Agonist

Front 129

Side Effect of Flomax (Alpha 1A Blocker)

Back 129

Postural Hypotension - blocks Alpha 1B reptors as well

Front 130

Side Effects of Doxazosin (Alpha 1B Blocker) - three

Back 130

Increased Urinary stream in BPH (blocks alpha 1A)
Postural Hypotension and Nasal Congestion(blocks arteriolar alpha 1B)

Front 131

Side Effects of Decongestants - Three

Back 131

Nasal Decongestion and Increased Blood Pressure (agonist arteriolar alpha 1b)
Palpitations (agonize beta 1 in heart)

Front 132

Side Effects of Propranolol (Beta 1 Blocker)

Back 132

Shortness of Breath (blocks beta 2)

Front 133

Side Effects of Albuterol (Beta 2 Agonist)

Back 133

Palpitations (agonize Beta 1)

Front 134

Non-selective Beta Blocker

Back 134

Propranolol

Front 135

Selective Beta Blocker (2)

Back 135

Atenolol & Metoprolol

Front 136

Combined alpha 1 blocker and non-selective beta blocker (2)

Back 136

Labetalol & Carvedilol

Front 137

Actions of Beta Blockers lead to

Back 137

Decreased Cardiac work & O2 Consumption leading to Decreased BP

Front 138

Uses of Beta Blockers (4)

Back 138

Chronic Angina, Status Post-MI, Migraine prophylaxis, Hyperthyroid symptoms

Front 139

Drug Class: Timolol

Back 139

Beta Blocker for Open Angle Glaucoma to decrease aqueous humor secretion

Front 140

How Beta Blockers control Hypertension

Back 140

Block the beta receptors in the juxtaglomerular apparatus leading to decreased renin leading to decreased angiotensin II and decreased aldosterone

Front 141

Do not give non-selective beta blockers to which patients

Back 141

Asthma and Emphysema Patients

Front 142

Why not give beta blockers to diabetic patients

Back 142

Mask the sympathetic warning signs (tremor and tachycardia) of hypoglycemia

Front 143

Do not discontinue beta blocker abruptly.. why?

Back 143

Preciptate dysrhythmia

Front 144

Adverse effects of Beta blockers

Back 144

Increased Triglycerides & Decreased HDL
Erectile dysfunction
Exercise intolerance

Front 145

Labetalol indicated for

Back 145

hypertension of pregnancy and hypertensive emergency

Front 146

Uses of Diuretics (5)

Back 146

Heart Failure
Hepatic Ascites
Nephrotic Syndrome
Hypertension
Diabetes Insipidus

Front 147

Why Thiazide Diuretics are called Ceiling Diuretics?

Back 147

Maximal diuretic or anti-hypertensive effects at reletively low doses - no extra effect at higher doses

Front 148

Drug Class: Hydrochlorothiazide

Back 148

Thiazide Diuretic

Front 149

Drug Class: Chlorothalidone

Back 149

Thiazide Diuretic

Front 150

Action of Thiazide Diuretics

Back 150

Decrease Na reabsorption in the distal convoluted tubule

Front 151

When are Thiazide Diuretics not effective?

Back 151

GFR <30 ml/min
Creatine Clearance <50 ml/min

Front 152

Uses of Thiazide Diuretics

Back 152

Treatment of Hypertension and Congestive Heart Failure

Front 153

Side Effects of Thiazide Diuretics

Back 153

Increased K excretion leading to hypokalemia
Increased Hydrogen excretion leading to metabolic alkemia
Decreased uric acid secretion leading to gout

Front 154

Drug Class: Furosemide (Lasix)

Back 154

Loop Diuretic

Front 155

Drug Class: Bumetanide

Back 155

Loop Diuretic

Front 156

Action of Loop Diuretic

Back 156

Decrease Na reabsorption in the thick ascending limb of Loop of Henle
Decrease renal vascular resistance & Increase renal blood flow

Front 157

Patient with severe renal impairment would need a _____ diuretic

Back 157

Loop Diuretic

Front 158

Drug of choice for pulmonary edema of heart failure

Back 158

Loop Diuretic

Front 159

Diuretic useful in treating hypercalcemia and hyperkalemia

Back 159

Loop Diuretic - Increase Ca and K excretion

Front 160

Side Effects of Loop Diuretics (2)

Back 160

Ototoxicity - especially when given with aminoglycoside
Shock

Front 161

Loop diuretic most likely to cause ototoxicity

Back 161

Ethacrynic acid

Front 162

Drug Class: Triamterene

Back 162

K-Sparing Diuretic

Front 163

Drug Class: Amiloridine

Back 163

K-Sparing Diuretic

Front 164

Drug Class: Spironolactone

Back 164

K-Sparing Diuretic

Front 165

Side effect of K-Sparing Diuretic

Back 165

Hyperkalemia

Front 166

K-Sparing resemble sex-steroids and may be lead to ...

Back 166

Gynecomastia and Menstrual Abnormalities

Front 167

Drug Class: Mannitol

Back 167

Osmotic Diuretic

Front 168

Action of Osmotic Diuretic

Back 168

Holds water in the tubular fluid leading to increase urine

Front 169

Mannitol must be given by what route

Back 169

IV

Front 170

Common Uses for Mannitol (3)

Back 170

Maintain tubular fluid flow after ingestion of toxic substances
Prevent acute renal failure due to circulatory shock
Treat (lower) Increased intracranial pressure

Front 171

Three ways to lower blood pressure

Back 171

Dump some fluid
Dilate vessels
Decrease HR and Contractility

Front 172

Common drug that interferes with renal Na retension and interferes with good effects of many anti-hypertensive drugs

Back 172

NSAIDS

Front 173

Treatment for mild HTN

Back 173

Thiazide diuretic

Front 174

Treatment for HTN not controlled with thiazide

Back 174

switch to beta blocker

Front 175

Treatment of HTN not controlled by beta blocker

Back 175

add a thiazide

Front 176

Treatment of HTN not controlled by thiazide and beta blocker

Back 176

Vasodilator

Front 177

African Americans with HTN respond best to

Back 177

Thiazide and Calcium Channel Blockers

Front 178

Elderly with HTN respond best to

Back 178

Thiazides, Calcium Channel Blockers and ACE Inhibitors

Front 179

Young White with HTN respond best to

Back 179

ACE Inhibitors

Front 180

Drug Class: Captopril

Back 180

ACE Inhibitor

Front 181

Drug Class: Enalapril

Back 181

ACE Inhibitor

Front 182

Action of ACE Inhibitors

Back 182

Block production of Angiotensin II therefore causes Vasodilation, decreased aldosterone and decreased circulating fluid volume

Front 183

Drug of choice for diabetic patients with HTN

Back 183

ACE Inhibitors - renal protective by decreasing glomerular pressure

Front 184

Side Effects of ACE Inhibitors

Back 184

Dry cough and angioedema from increased bradykinin
Hyperkalemis

Front 185

Why are ARBs better than ACEs

Back 185

Less chance of angioedema & dry cough

Front 186

Drug Class: Nidefipine

Back 186

Dihydropyridine Calcium Channel Blocker

Front 187

Drug Class: Amlodipine

Back 187

Dihydropyridine Calcium Channel Blocker

Front 188

Drug Class: Verapamil

Back 188

Non-dihydropyridine Calcium Channel Blocker

Front 189

Drug Class: Diltiazem

Back 189

Non-dihydropyridine Calcium Channel Blocker

Front 190

Action of Calcium Channel Blocker

Back 190

Selective for vascular smooth muscle
Hypertension
Peripheral Vascular Disease
Raynauds

Front 191

Drug that dilates coronary vessels and used to treat angina

Back 191

Calcium Channel Blockers

Front 192

Used to treat Supraventricular Tachycardia

Back 192

Calcium Channel Blockers

Front 193

Side Effects of Calcium Channel Blockers

Back 193

Peripheral Edema
Flushing
Headache
Constipation

Front 194

Side Effects of 1st Generatoin Antihistamines

Back 194

Sedative Effects - cross the blood brain barrier
Dry mouth & eyes, blurred vision
Urinary retention & constipation
Anti-emetic
Relieve Itch

Front 195

Drug Class: Diphendydramine (Benedryl)

Back 195

1st Generation Antihistamine

Front 196

Drug Class: Promethazine (Phenergan)

Back 196

Antihistamine with anti-emetic activity

Front 197

Drug Class: Meclizine (Antivert)

Back 197

Antihistmaine with anti-emtic and anti-vertigo activity

Front 198

Drug Class: Bentropine (Cogentin)

Back 198

Antihistamine used to treat EPS

Front 199

3 Classes of Anti-emetics

Back 199

Antihistamines/Anticholinergics
Dopamine Antagonist
Serotonin Antagonist

Front 200

Used to Treat nausea due to chemo or radtion therapy

Back 200

Anti-emtic Dopamine Antagonist and Anti-Emtic 5-HT3 Antagonist

Front 201

Drug Class: Prochlorperazine (Compazine)

Back 201

Anti-Emetic Dopamine Antagonist

Front 202

Drug Class: Trimethobenzamide (Tigan)

Back 202

Anti-Emetic Dopamine Antagonist

Front 203

Drug Class: Ondansetron (Zofran)

Back 203

Anti-emetic 5-HT3 Antagonist

Front 204

Drug Class: Lorazepam (Ativan)

Back 204

Anti-emetic for Anticipatory Nausea

Front 205

Advantages of 2nd Generation Antihistamines

Back 205

Do not have peripheral anticholinergic effect
Do not have sedative or anti-emetic effects

Front 206

Drug Class: Desloratadine (Clarinex)

Back 206

2nd Generation Antihistamine

Front 207

Drug Class: Cetirizine (Zyrtec)

Back 207

2nd Generation Antihistamine

Front 208

Use of Zonalon (Dexepin)

Back 208

Pruritis due to atopic dermatitis

Front 209

Use of Acular (Ketorolac) ophth. solution

Back 209

NSAID for ocular itch of allergic conjunctivitis

Front 210

Use of Patanol ophth. solution

Back 210

Antihistamine + mast cell stabilizer for ocular itch of allergic conjunctivitis

Front 211

Use of Astelin (Azelastine)

Back 211

1st Generation antihistamine nasal spray for nose itch of allergic rhinitis

Front 212

Only oral decongestant not combined with something else

Back 212

Sudafed (pseudoephedrine)

Front 213

Never give an antihistamine to whom

Back 213

Patient with sinusitis...can lead to mucus brick

Front 214

Why never give a person with a productive cough an antitussive

Back 214

increased chance bronchitis will become pneumonia

Front 215

Drug Class: Flonase (Fluticasone)

Back 215

Nasal steroid

Front 216

Drug Class: Nasonex (Mometasone)

Back 216

Nasal Steroid

Front 217

Uses of Muscle Relaxants

Back 217

"The aching back"
Unexplained localized muscle spasm
Generalized spasticity cause by stroke, cerebral palsy, or MS

Front 218

Action of Valium

Back 218

Facilitates the membrane-stabilizing effects of the inhibitory transmitter GABA

Front 219

Drug of choice for status epilecticus

Back 219

Valium (Diazepam)

Front 220

Drug Class: Valium (Diazepam)

Back 220

Anxiolytic - sedative for general anxiety
Centrally Acting Muscle Relaxant

Front 221

Drug Class: Lioresal (Baclofen)

Back 221

Centrally Acting Muscle Relaxant

Front 222

Drug Class: Dantrium (Dantrolene)

Back 222

Non-centrally acting muscle relaxant

Front 223

Action of Dantrolene

Back 223

Inhibits excitation-contraction coupling

Front 224

Drug of Choice for Malignant Hyperthermia

Back 224

Dantrolene

Front 225

Use of Flexeril

Back 225

Recommended for "acute muscle spasm"

Front 226

Drug Class: Flexeril (Cyclobenzaprine)

Back 226

Muscle Relaxant

Front 227

Three classes of Penicillins

Back 227

Pencillins, Extended spectrum penicillins (aminopenicillins), and antistaphylcoccal penicillins

Front 228

Action of Penicillins

Back 228

Inhibit bacteria cell wall synthesis thereby inhibiting bacterial growth

Front 229

Penicillin and Ampicillin are active against what organism, and ineffective against what

Back 229

Active against Streptococcus pyogenes, ineffective against Staphylcoccus aureus

Front 230

What penicillin is stable against penicillinase?

Back 230

Nafcillin

Front 231

Most common side effects of Penicllin

Back 231

Hypersensitivity reaction
-skin rash is the most common manifestation, anaphylaxis is rare

Front 232

If patient has experienced an anaphylactic reaction to penicillin they should only receive ...

Back 232

Non-beta-lactam antibiotics

Front 233

Penicillin antibiotic indicated for Enterococcus and Streptococcus

Back 233

Ampicillin

Front 234

Effective against beta-lactase-producing Staphylococcus

Back 234

Nafcillin

Front 235

Effective against all stages of syphillis

Back 235

Penicillin G
Tetracycline or Doxycline in penicillin allergic

Front 236

Carbapenems (Imipenem) is reserved for what type of infections

Back 236

Highly resistant organisms, septicemia, bone and joint infections

Front 237

Potential serious side effect of Carbapenems

Back 237

Seizure

Front 238

Beta-Lactam Inhibitors are effective against what organisms

Back 238

anaerobes and Pseudomonas aeruginosa

Front 239

Augmentin is made of

Back 239

amoxicillin + clavulante

Front 240

Timentin is made of

Back 240

Ticarcillin + clavulante

Front 241

Second generation cephalosporins are effective against what?

Back 241

Gram-negatives

Front 242

Mainstay of therapy for bacterial meningitis

Back 242

Third generation cephalosporins

Front 243

Most common adverse effect of cephalosporins

Back 243

Hypersensitivity reactions such as skin rashes and hemolytic anemia

Front 244

Patients with a history of anaphylaxis to penicillin should not receive what other antibiotic

Back 244

Cephalosporins

Front 245

Cefepime is a 4th generation cephalosporin effective against what organism?

Back 245

Pseudomonas aeruginosa

Front 246

Antibiotics for the management of respiratory tract infections

Back 246

Macrolides

Front 247

Macrolides are effective against what organisms (5)

Back 247

Streptococcus pneumonia, Streptococcus pyogenes, Legionella pneumophila, Mycoplasma pneumonia and Chlamydia pneumonia

Front 248

Drug of choice for Whooping Cough

Back 248

Erythromycin

Front 249

Drug Class: Clarithromycin

Back 249

Macrolide

Front 250

Drug Class: Azithryomycin

Back 250

Macrolide

Front 251

Primary cause of non-gonococcal urethritis

Back 251

Chlamydia trachomatis - followed by Ureaplasma urealyticum

Front 252

Drug of choice for non-gonoccal urethritis

Back 252

Tetracycline - Doxycycline

Front 253

Adverse effect of Tetracyclines

Back 253

Photosensitivity - avoid prolonged exposure to sunlight

Front 254

Drug of choice for Lyme Disease

Back 254

Doxycycline - also kills Ehrlichiosis

Front 255

Side Effects of Tetracycline in children <8

Back 255

Discolor teeth and inhibit bone growth

Front 256

Complicated UTIs

Back 256

UTIs in men, elderly individuals, pregnant women, patients with in dwelling catheters

Front 257

Agents for Uncomplicated UTIs

Back 257

TMP-SMX, fluroquinolones and nitrofurantoin

Front 258

Used for treatment in Traveler's diarrhea

Back 258

Ciprofloxacin (Cipro)

Front 259

Antibiotic not safe during pregnancy

Back 259

Fluroquinolones

Front 260

Drug Class: Levofloxacin

Back 260

Fluroquinolone

Front 261

Drug of choice for Pneumocystis carinii

Back 261

Bactrim

Front 262

Used in the treatment of infections due to enteric gram-negative bacteria

Back 262

Aminoglycosides

Front 263

Side effects of Aminoglycosides

Back 263

Ototoxicty and Nephrotoxicity

Front 264

Presentation of Ototoxicity

Back 264

Tinnitus, high-frequency hearing loss, vertigo and ataxia

Front 265

Presention of Nephrotoxicity

Back 265

Increase in serum creatinine or Decreased Creatinine clearance

Front 266

Tobramycin and Gentamicin are effective against what

Back 266

Pseudomonas

Front 267

Most common cause of catheter-induced infections

Back 267

Coagulase-negative staphylococcus - Staph. epidermis
other cause include Staph aureus and Candida albicans

Front 268

Side Effects of Vancomycin

Back 268

"Red man" Syndrome, Phlebitis and Ototoxicity combined with known ototoxic agent

Front 269

Effective against MRSA and MRSE

Back 269

Vancomycin

Front 270

Indications for Vancomycin

Back 270

IV for sepsis and endocarditis due to MRSA
PO for C. difficile colitis

Front 271

Agents used in the treatment of intra-abdominal infections

Back 271

Metronidazole and Clindamycin

Front 272

Metronidazole has activity against what organisms

Back 272

Gram-negative anaerobes

Front 273

Clindamycin has activity against what organisms

Back 273

Gram positive and Gram-negative anaerobes

Front 274

Treatment of choice for amoebiasis, giardiasis and trichomoniasis

Back 274

Metronidazole

Front 275

Side effect of Metronidazole

Back 275

Disulfiram-like reaction when consumed with alcohol

Front 276

Side Effect of CLindamycin

Back 276

Antibiotic associated colitis

Front 277

Drug of choice for antibiotic-associated colitis

Back 277

Metronidazole

Front 278

Four antiviral agents for Influenza

Back 278

Amatadine, Rimantadine, Zanamivir, and Oseltamivir

Front 279

When should antiviral for Influenza be started

Back 279

Within 2 days of onset of symptoms

Front 280

Antivirals effective against only Influenza A

Back 280

Amatadine and Rimantadine

Front 281

Antiviral effective against Influenza type A and B

Back 281

Zanamivir and Oseltamivir

Front 282

Antivirals for Herpes Type 1 and 2 (3)

Back 282

Acyclovir (Zovirax)
Famciclovir (Famvir)
Valacyclovir (Valtrex)

Front 283

Antiviral for Cytomegalovirus

Back 283

Ganciclovir (Cytovene)

Front 284

Risk for invasive candidal infection

Back 284

Immunocompromised or diabetic, prolonged hospitalization, use of indwelling catheters, parentral nutrition and antibiotics

Front 285

Drug Class: Ketoconazole

Back 285

Systemic Azole antifungal

Front 286

Drug Class: Fluconazole

Back 286

Systemic Azole antifungal

Front 287

Drug Class: Iatroconazole

Back 287

Systemic azole antifungal

Front 288

Two topical azole antifungals

Back 288

Miconazole and Clotrimazole

Front 289

Adverse Effects of Amphotericin B

Back 289

Infusion-related reaction and adverse effects on kidneys

Front 290

Patients on Amphotericin B shoulde be premedicated with what

Back 290

Diphenhydramine and ASAP or NSAIDS

Front 291

Three organisms that cause Tuberculosis

Back 291

Mycobacterium bovis, Mycobacterium africanum and M. tuberculosis (most common)

Front 292

Four agents used in MTB (Mycobacterium tuberculosis)

Back 292

Isoniazid, Rifampin, Pyrazinamide and Ethambutol

Front 293

Side effect of TB drugs

Back 293

Hepatotoxicity - particularly Isoniazid and Rifampin

Front 294

Side effect of Isoniazid

Back 294

Peripheral neuropathy

Front 295

Side effect of Ethambutol

Back 295

Optic neuritis

Front 296

Prediposes patients to Digoxin Toxicity

Back 296

Electrolyte imbalance

Front 297

Common signs of Digoxin Toxicity

Back 297

Nausea, vomiting, anorexia, arrhthmias, confusion, hallucinations and visual disturbances

Front 298

Treatment of mild digoxin toxicty

Back 298

Stop digoxin and treatment of hypokalemia

Front 299

Treatment of severe digoxin toxicity

Back 299

Digoxin immune Fab (Digiband)

Front 300

Mechanism of action of Nitrates

Back 300

Decrease preload and myocardial oxygen demand

Front 301

Drug of choice for relieving angina

Back 301

Nitrates

Front 302

Preparation of choice for quick relief of exertional angina

Back 302

Short-acting nitrates in sublingual tabs or translingual sprays

Front 303

Drug Class: Isosorbide dinitrate and Isosorbide mononitrate

Back 303

Long-acting nitrates

Front 304

Long-acting nitrates indicated when:

Back 304

Number, severity, and duration of attacks increases

Front 305

How to prevent tolerance of nitrates

Back 305

10-12 hour nitrate-free interval

Front 306

Combining Nitrates with Viagra can lead to:

Back 306

Hypotension

Front 307

Complications of Unfractionated Heparin

Back 307

Osteoporosis, Heparin-induced Thombocytopenia

Front 308

Unfractionated Heparin requires monitoring of what lab

Back 308

aPTT

Front 309

Drug Class: Enoxaparin

Back 309

Low-Molecular Weight Heparin

Front 310

Drug Class: Dalteparin

Back 310

Low-Molecular Weight Heparin

Front 311

Advantage of LMWH

Back 311

Involve less monitoring, and rarely cause thrombocytopenia

Front 312

Length of time Warfarin needs to take effect

Back 312

4-5 days

Front 313

Treatment of "supratherapeutic" INR >9 caused by Warfarin

Back 313

low dose of Vitamin K

Front 314

Anticoagulant contraindicated in pregnancy

Back 314

Warfarin

Front 315

Aspirin is contraindicated when:

Back 315

Clopidogrel or Ticlopidine being used

Front 316

Anitplatelet shown to decrease overall mortality of the treatment of ACS

Back 316

Aspirin

Front 317

Two GpIIb/IIIa Inhibitors

Back 317

Tirofiban and Abciximab

Front 318

Drug of choice for Osteoarthritis (pain)

Back 318

Acetominophen

Front 319

Indication for NSAIDS in pain

Back 319

Those not provided adequate pain control on Acetominophen

Front 320

Indication for COX-2 Inhibitors in pain

Back 320

Risk for adverse GI effects from NSAIDS

Front 321

Less potent Opioids used for mild to moderate pain (3)

Back 321

Codeine, Hydrocodone, and Prooxyphene

Front 322

Opioids for Moderate to Severe Pain (5)

Back 322

Morphine, Methadone, Hydromorphone, Meperidine and Fentanyl

Front 323

Side Effect of Opioids

Back 323

Somnolence and Constipation
Myoclonus with high doses
Respiratory distress - most dangerous advers effect

Front 324

Opioid Antagonists

Back 324

Naloxone and Naltrexone

Front 325

Antidepressant used in treatment of neuropathic pain

Back 325

Amitriptyline (Elavil)

Front 326

Anticonvulsant used to treat neuropathic pain (2)

Back 326

Carbamazepine (Tegretol) and Gabapentin (Neurontin)

Front 327

Long-acting Opioids (3)

Back 327

Sustained-released Oxycodone and Morphone, and Transdermal fentanyl

Front 328

Benefits of Transdermal fentanyl over morphine

Back 328

Improved sleep quality, Reduced constipation and emesis, Long-term pain relief

Front 329

Treatment for Tension Headache

Back 329

Analgesics - Acetaminophen or NSAIDS (ibuprofen or naproxen)

Front 330

Agent most commonly used for headache prophylaxis

Back 330

Amitriptyline

Front 331

Cause of Migraine headaches

Back 331

Vasodilation of blood vessels

Front 332

Drug class in treatment for migraine headaches

Back 332

Serotonin Agonists

Front 333

Used in treatment of moderate to severe migraines (2)

Back 333

Ergotamine and Dihydroergotamine

Front 334

Associated symptoms of Migraine

Back 334

Nausea and gastric stasis

Front 335

Drug Class: Zolitriptan

Back 335

Serotonin Agonist

Front 336

Drug Class: Naratriptan

Back 336

Serotonin Agonist

Front 337

Drug Class: Rizatriptan

Back 337

Serotonin Agonist

Front 338

Drug Class: Almotriptan

Back 338

Serotonin Agonist

Front 339

Drug Class: Frovatriptan

Back 339

Serotonin Agonist

Front 340

Action of Serotonin Agonist

Back 340

Vasoconstriction

Front 341

Contraindication for use of ~triptans

Back 341

HTN and angina

Front 342

Migraine Prophylaxis

Back 342

Amitripytline, Beta-blockers and Ca-channel blockers

Front 343

Anitconsulvant known to cause hypersensitivity reaction

Back 343

Phenytoin

Front 344

Potential fatal reactions to anticonvulsants

Back 344

Erythema multiforme, Exfoliative dermatitis, Toxic epidermal necrolysis

Front 345

Treatment for status epilepticus

Back 345

IV Valium
IV Phenytoin
IV Phenobarbital
No response than general anesthesia

Front 346

Drug of choice for absence seizures

Back 346

Zarontin (Ethosuximide)

Front 347

Drug of choice for Partial Seizures

Back 347

Tegretol (Carbamazepine)

Front 348

Anticonvulsant used in the treatment of Trigeminal neuralgia

Back 348

Tegretol (Carbamazepine)

Front 349

First-line agent for Diabetes after lifestyle modifications

Back 349

Metformin

Front 350

Advantages of Metformin

Back 350

Does not cause hypoglycemia when used alone
Does not cause weight gain

Front 351

Action of Metformin

Back 351

Decreases hepatic glucose output

Front 352

Action of Sulfonylureas

Back 352

Are insulin secretagoues causing insulin secretion

Front 353

Adverse Effects of Sulfonylureas

Back 353

Hypoglycemia and Weight Gain

Front 354

Signs and Symptoms of Hypoglycemia

Back 354

Anxiety, sweating, tremor, fatigue, confusion, blurred vision and coma

Front 355

Drug Class: Glipizide (Glucotrol)

Back 355

Insulin secretagogue (Sulfonylurea)

Front 356

Drug Class: Repaglinide (Prandin)

Back 356

Insulin secretagogue

Front 357

Mechanism of Rosiglitazone (Avandia)

Back 357

Decreases insulin resistance

Front 358

Actions of Insulin

Back 358

Promotes the cellular uptake of glucose into fat and skeletal muscle and inhibits hepatic glucose output

Front 359

What is the "basal/bolus" concept?

Back 359

Basal insulin secretion is about 50% of the body's total daily insulin requirement and prandial insulin approximately 40% to 60% (10% to 20% at each meal)

Front 360

Use of rapid and short-acting insulins

Back 360

Prandial insulin replacement

Front 361

Use of Intermediate and Long-acting insulins

Back 361

Basal insulin replacement

Front 362

Drug Class: Lispro

Back 362

Rapid acting insulin

Front 363

Drug Class: Aspart

Back 363

Rapid acting insulin

Front 364

Drug Class: Regular Insulin

Back 364

Short-acting insulin

Front 365

Drug Class: NPH

Back 365

Intermediate acting insulin

Front 366

Drug Class: Lente

Back 366

Intermediate acting insulin

Front 367

Drug Class: Ultralente

Back 367

Long acting insulin

Front 368

Drug Class: Glargine

Back 368

Long acting insulin

Front 369

Treatment for DKA

Back 369

Regular insulin IV

Front 370

Where is cholesterol found in the body?

Back 370

Used to form cell membranes
Precursor to bile acids and steroid hormones

Front 371

How is CHD related to levels of HDL?

Back 371

Inverse related

Front 372

A lipid profile should be taken when:

Back 372

9-12 hours after a fast

Front 373

Four Classes of Lipid-Lowering Medications

Back 373

HMG-CoA Reductase Inhibitors (Statins), Bile Acid Sequestrants, Nicotinic Acid, and Fibric Acid

Front 374

Mechanism of Statins

Back 374

Decrease Cholesterol synthesis

Front 375

Adverse Effects of Statins

Back 375

Myopathy/Rhabdomyolysis
Increased LFTs
Headache

Front 376

Drug Class: Atrovastatin

Back 376

Statin

Front 377

Mechanism of Fibric Acids

Back 377

Increased VLDL Catabolism

Front 378

Adverse Effects of Fibric Acids

Back 378

Myopathy
Increased LFTs

Front 379

Drug Class: Gemfibrozil

Back 379

Fibric Acid

Front 380

Mechanism of Nicotinic Acid

Back 380

Decreased VLDL Secretion

Front 381

Adverse Effects of Nictonic Acid

Back 381

Flushing
Increased LFTs

Front 382

Drug Class: Niacin

Back 382

Nicotinic Acid

Front 383

Mechanism of Bile Acid Sequestrants

Back 383

Bind bile cholesterol in the gut

Front 384

Adverse Effects of Bile Acid Sequestrants

Back 384

Bloating

Front 385

Drug Class: Cholestyramine

Back 385

Bile Acid Sequestrant

Front 386

Agent for Hyperlipidemia that causes the greatest increase in HDL

Back 386

Niacin

Front 387

How to prevent flushing caused by niacin

Back 387

Take an aspirin or other NSAID 30 minutes before

Front 388

Agent for Hyperlipidemia used to lower very high TGs

Back 388

Fibric acid

Front 389

Treatment options for Hyperthyroidism

Back 389

Partial or complete thyroidectomy, radioactive iodine (RAI) treatment, thioamide therapy

Front 390

Action of Thioamides

Back 390

Inhibit thyroid hormone synthesis - does not affect thyroid hormone stores

Front 391

Agents used for short-term symptomatic relief in hyperthyroidism

Back 391

Beta-blockers and iodides

Front 392

Duration of Thioamide treatment

Back 392

12 months or longer

Front 393

Drug Class: Methimazole (Tapezole)

Back 393

Thioamide

Front 394

Drug Class: Propylthiouracil (PTU)

Back 394

Thioamide

Front 395

Agent used to treat Hypothyroidism

Back 395

Levothyroxine (Synthroid)

Front 396

Quick-relief asthma medications

Back 396

Inhaled B2-agonist
Systemic Corticosteroids

Front 397

Long-term control asthma medications taken on a daily basis

Back 397

Anti-inflammatory agents (inhaled corticosteroids, mast cell stabilizers), long acting B2-agonist, methylxanthines, Leukotriene modifiers

Front 398

Indications for long-term asthma medication

Back 398

Patient experiences symptoms more than twice weekly

Front 399

Local reactions of inhaled corticosteroids

Back 399

Dysphonia (hoarseness) and oral candidiasis - minimized by using a space and rinsing

Front 400

Drug Class: Albuterol (Proventil)

Back 400

Short-acting Beta2 Agonist - Asthma

Front 401

Drug Class: Pirbuterol (Maxair)

Back 401

Short-acting Beta 2 Agonist - Asthma

Front 402

Drug Class: Triamcinolone (Azmacort)

Back 402

Steroid Inhaler - Asthma

Front 403

Drug Class: Budesonide (Pulmicort)

Back 403

Steroid Inhaler - Asthma

Front 404

Drug Class: Salmeterol (Serevent)

Back 404

Long-acting Beta 2 Agonist - Asthma

Front 405

Drug Class: Formoterol (Foradil)

Back 405

Long-acting Beta 2 Agonist - Asthma

Front 406

Drug Class: Montelukast (Singulair)

Back 406

Leukotriene Modifier

Front 407

Drug Class: Nedcromil (Tilade)

Back 407

Mast cell Stabilizer

Front 408

Treatment for Status Asthmaticus

Back 408

Oral Prednisone
IV Methylprednisolone

Front 409

Only drug show to decrease morbidity of COPD

Back 409

Oxygen

Front 410

Symptoms of Acute Exacerbation of COPD

Back 410

Worsening dyspnea, production of purulent sputum, and acute respiratory distress

Front 411

Agents effective for acute exacerbation of COPD

Back 411

Inhaled B2-Agonist (Albuterol) and Anticholinergic Agents (Ipratropium)

Front 412

Agent used in asthma not appropriate for use in COPD

Back 412

Inhaled corticosteroids

Front 413

Drug Class: Tioptropium (Spiriva)

Back 413

Long acting anticholinergic inhibitor

Front 414

Leading cause of chronic liver disease in the US

Back 414

Hepatitis C

Front 415

Leading cause of cirrhosis

Back 415

Hepatitis C

Front 416

Transmision of Hepatitis C

Back 416

Exposure to infected blood

Front 417

Goal of therapy in chronic HCV

Back 417

Prevent progression of the disease to cirrhosis

Front 418

FDA-approved drugs for Hepatitis C

Back 418

Interferon-alpha
Intergeron-alpha plus oral Ribavirin

Front 419

Indications of progestin-only contraceptives

Back 419

Contraindications to estrogens
Experience intolerable side effects

Front 420

Reasons Progeston-only pills are not preferred treatment

Back 420

less effective than COC pills
Associated with greater incidence of dysmenorrhea, amenorrhea, irregular menses and break-through bleeding

Front 421

Drug Class: Depo-Provera

Back 421

Intramuscular injectable contraception

Front 422

Drug Class: Norplant

Back 422

Surgically placed subdermal implant contraception

Front 423

Advantages of COC use

Back 423

Decrease risk of endometrial and ovarian cancer

Front 424

Uses of Hormone Replacement Therapy in Menopause

Back 424

Reduce symptoms of hot flashes, insomnia, irritability, vaginal atrophy and vagina dryness

Front 425

Women with an intact uterus on HRT require:

Back 425

Combination of estrogen and progesterone to reduce risk of hyperplasia and endometrial cancer

Front 426

Contraindications to Hormone Replacement Therapy

Back 426

Pre-existing cardiovascular disease

Front 427

Short term use of HRT causes

Back 427

Increased risk for cardiovascular events due to thrombogenesis

Front 428

Long term use of HRT causes

Back 428

Decreases the risk of hip fracture

Front 429

Four ways to reduce risk of vertebral and nonvertebral fracture

Back 429

Use of daily Vitamin D and elemental calcium
Selective estrogen receptor modulators (SERMs such as raloxifene)
Bisphosphonates
Calcitonin

Front 430

Action of Bisphosphonates

Back 430

Inhibit bone resorption by inhibiting osteoclast activity

Front 431

Drug Class: Alendronate

Back 431

Bisphosphonate

Front 432

Drug Class: Risidronate

Back 432

Bisphosphonate

Front 433

Stage I GERD

Back 433

Intermittent heartburn - typically resolve with lifestyl modication, antacids, or OTC H2-receptor antagonists

Front 434

Stage II GERD

Back 434

Unrelieved by antacids or H2-blockers
Requires proton-pump inhibitors

Front 435

Drug Class: Metoclopramide (Reglan)

Back 435

Promotility agent = Prokinetic agents

Front 436

Stage III GERD

Back 436

Involves erosive GERD characterized by dysphagia and odynophagia
Requires long-term therapy with PPI

Front 437

Drug of choice for Stage II or III GERD

Back 437

PPIs

Front 438

Action of promotility agents in GERD

Back 438

Facilitate gastric emptying by increasing LES pressure and decrease the chance of regurgitation

Front 439

Bacteria found in 90% of patient with duodenal ulcers and 70% of gastric ulcers

Back 439

Helicobacter pylori

Front 440

Treatment of H. pylor positive dyspepsia

Back 440

Treatment aimed at eradicating bacteria and alleviating symptoms: Antisecretory agents and combination antibiotics (Amoxicillin, Clarithromycin, Metronidazole, Tetracycline and Bismuth subsalicylate)

Front 441

Treatment of H. pylor negative dyspepsia

Back 441

Empiric antisecretory drugs or prokinetic agents

Front 442

Drug Class: Cimetidine (Tagemet)

Back 442

H2-Blocker

Front 443

Drug Class: Famotidine (Pepcid)

Back 443

H2-Blocker

Front 444

Drug Class: Esomeprazole (Nexium)

Back 444

PPI

Front 445

Definition of Inflammatory Bowel Disease

Back 445

Ulcerative colitis (UC) and Crohn's disease
Chronic with periods of exacerbations and remissions

Front 446

Location of Ulcerative Colitis

Back 446

Colon and rectum

Front 447

Location of Crohn's disease

Back 447

Throughout the gastrointestinal tract

Front 448

Fissure, Strictures and Abdominal masses are asscoiated with what inflammatory bowel disease?

Back 448

Crohn's disease

Front 449

Symptoms of Ulcerative Colitis

Back 449

Chronic diarrhea and rectal bleeding

Front 450

Treatment of Ulcerative Colitis

Back 450

Anti-inflammatory medications, corticosteroids and sulfasalazine

Front 451

Treatment for severe Ulcerative Colitis

Back 451

Parenteral corticosteroids

Front 452

Topical steroids in Inflammatory Bowel Disease

Back 452

Limited to distal colon or rectum

Front 453

Anyone on oral steorids for weeks or months requires:

Back 453

bisphosphonate to prevent steroid-induced osteoporosis

Front 454

Used to maintain remission of IBD

Back 454

Aminosalicylates

Front 455

Drug Class: Mesalmine

Back 455

Aminosalicylate

Front 456

Drug Class: Sulfasalazine

Back 456

Aminosalicylate

Front 457

Options for treating acute gout attacks

Back 457

NSAIDs, Colchicine and Corticosteroids

Front 458

Drug of choice for Acute Gout

Back 458

NSAIDs - Indomethacin, Naproxen, Ibuprofen
Colchicine is less efficacy to resolve the gouty pain unless used within 24 hrs

Front 459

Drug Class: Indomethacin

Back 459

NSAID - Gout

Front 460

Indication for Colchicine

Back 460

Patient with gout who cannot tolerate NSAIDS

Front 461

Side effects of Colchicine

Back 461

Severe diarrhea

Front 462

Indications for Corticosteroids in Gout

Back 462

Patient cannot tolerate NSAIDs or Colchicine

Front 463

Side effects of Corticosteroids

Back 463

Glucose intolerance, HTN, electrolyte shifts, increased risk of infection

Front 464

Prophylaxis of Gout

Back 464

Uric acid-lowering agents, but should not be started until the acute attack resolves

Front 465

Drug Class: Allopurinol

Back 465

Uric acid lowering agent

Front 466

Drug Class: Probenecid

Back 466

Uric acid lowering agent

Front 467

Mechanism of Uric Acid-Lowering Agents

Back 467

Cause mobilization of urate crystals - can prolong an acute attack

Front 468

Two drugs contraindicated for patients with a history of gout

Back 468

Hydroclorothiazide and Loop Diuretics as they decrease the clearance of uric acid

Front 469

Drug of choice for over producers of uric acid

Back 469

Allopurinol

Front 470

Foundation of Rheumatoid Arthritis Treatment

Back 470

NSAIDs as they reduce joint swelling and pain

Front 471

Indications for DMARDs

Back 471

Patient has signficiant morning-stiffness or fatigue, persistent elevated ESR or CRP

Front 472

Advantages of DMARDs

Back 472

Potential to reduce or prevent joint damage

Front 473

Drug Class: Methotrexate (Rheumatrex)

Back 473

DMARD

Front 474

Drug Class: Azathioprine (Imuran)

Back 474

DMARD

Front 475

Drug Class: Hydroxychloroquine (Plaquenil)

Back 475

DMARD

Front 476

Adverse Effect of Hydroxychloroquine

Back 476

Possible Retinal Toxicity therefore need routine eye exams