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39 Cards in this Set

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DOC for RA?
ASA
DOC for osteo?
tylenol
tx for ASA toxicity?
to increase urine pH:
IV fluids
dialysis
correct acid/base/electrolyte disturbances
DOC for trigeminal neuralgias?
gabapentin
regimen for p with diabetic peripheral neuropathy?
gabapentin 15mg q PM
p is taking ibuprophen for minor pain. pain then persists to step 2 "mild to moderate". what drug will you add?
codeine
what is the reccommended dose for calcitonin?
50-100 IU sc/im.
give with calcium
your patient has been on calcitonin 100 IU x 6 months. what is the next step?
D/C calcitonin after 6 months and try a biphosphanate (fosamax)
MOA of calcitonin?
inhibit osteoclastic bone reabsorption
MOA of biphosphanates?
inhibit osteoclastic bone resorption
loss of bony tissue resulting in bones that are brittle and liable to fracture?
osteoporosis
what is the MC treatment for osteoporosis?
biphosphanates
what is the MC fracture?
hip
when do you start osteoporosis treatment?
>40 c H/O fractures
post menopausal
<65 with risk factors
thromboxanes, leukotrienes and prostaglandins are all synthesized from?
arachidonic acid
what converts arachidonic acid to prostaglandins and thromboxane?
the enzyme cyclooxygenase
where in the inflammation pathway do NSAIDS work?
prostaglandins
where does ASA work?
on COX 1: inhibits TXa2
what are the 3 main functions of ASA?
anti inflammatory
analgesic
antipyretic
at toxic/high levels of ASA what effects will it cause in relation to respiration?
hyperventilation and respiratory alkalosis
how do you correct ASA overdose?
hCO3
what are the adverse effects of ASA?
GI bleed
prolongs bleeding time
hypersensitivity rxn due to inhibition of leukotrienes
examples of non-opiote treatments?
ASA
ibuprophen
naproxen
what is the DOC in a gouty arthritis attack?
indomethicin
what are the adverse effects of indomethacin?
GI
acute pancreatitis
neutropenia
thrombocytopenia
allergic reactions
what drug is used to close PDA to avoid surgery in neonates?
indomethacin
where is indomethacin metabolized?
in the liver, excreted in urine and bile
patients who have a true ASA allergy are also not able to tolerate???
KEtoralac (toradol)
what drug is very similar to ASA, has equal anti-inflammatory potency and has the same ADE's as ASA?
ibuprofen: motrin , advil, nuprin
this drug is indicated in patients with severe acute pain and is the only IV NSAID but is contraindicated in the elderly?
toradol
what is the max dose for toradol?
40mg PO qd
120mg IV QD
if you are allergic to aspirin then technically you are also allergic to???
toradol
what is the only COX 2 inhibitor available?
celebrex 200mg
what is celebrex used for?
anti-inflamm
analgesic
antipyretic
what are the indicated uses for celebrex
Osteoarthritis
RA
what are the adverse effects of cox2 inhibitors?
GI: n/v/d
edema
what is your alternative treatment for a patient who is allergic to NSAIDS and has liver failure?
ultram with a low dose of APAP (tylenol) if necessary
your patient is currently taking the max dose of tylenol of 4g QD. his cardiologist just informed you that he will be starting to take coumadin. what is your next step?
cut tylenol dose in half since both meds are metabolized by the liver.
what are the indicated uses for tylenol?
reduce pain and fever, headache, reduce fever in viral infections
inhibits PG in the CNS