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45 Cards in this Set
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What should one monitor with amiodarone?
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electrolyte disturbances (patients with hypokalemia or hypomagnesemia makes antiarrhythmic drugs ineffective)
thyroid function liver enzyme elevations/hepatic injury QT prolongation/ventricular dysfunction-heart stuff pulmonary abnormalities/GI abnormalities/dermatologic abnormalities common |
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What isn't a SE of amiodarone?
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Correct answer was GERD even though there is GI upset really commonly, such as dyspepsia.
Retinal deposits (eye abnormalities) and headaches (neurological abnormalities) are |
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NRT withdrawal-what is not a symptom?
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symptoms are: irritable, feeling tired/low energy, trouble sleeping, hunger, trouble concentrating, constipation (less stimulation), dizzy (more oxygen), coughing/chest soreness (lungs getting rid of tar)
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19 year old starting escitalopram-what to monitor for?
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behavioural/emotional changes/suicidal ideation, agitation-type adverse events (akathisia, depersonalization...etc)
increase risk of bleed, patients with hepatic impairment-1/2 life doubled mydriasis (can cause glaucoma) not neuropathy, or weight loss (mostly weight gain) |
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accidentally dispensed an arb instead of sulfonylurea. What to expect?
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decreased blood pressure via vasodilation and then heart rate will increase to try and compensate
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What can manifest from alcohol withdrawal?
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seizures, sweating, tremor, insomnia, hallucinations, agitation, anxiety, depression
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what is the main difference b/w alcohol and benzo withdrawal?
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same symptoms but alcohol is lethal.
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what to avoid in kids with lice and ragweed allergy?
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permethrin/butoxyl
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what is veracity?
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devotion to the truth, power of conveying the truth
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for orolabial herpes, how does topical therapy work?
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ointment acyclovir doesn't, cream does a little bite
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what can valacyclovir oral do for orolabial herpes and how?
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within 1 hour of onset, decrease pain duration by 1 day
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for healthy people with recurrent cold sores >6/year, what can be done?
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daily antivirals up to 4 months but benefits disappear after that
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what are the differences between famcyclovir, acyclovir, and valacyclovir?
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similar efficacy but famcyclovir and valacyclovir have a simpler regimen (varies with each type of infection) Genital is like 5 times daily vs tid or bid (respectively), herpes zoster valacyclovir is tid
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when is acyclovir recommended for chicken pox?
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within 24 hours in people at greater risk of severe cases ie >12 years old, cutaneous or pulmonary disorders, kids using short term puffers or long term salicylate treatment
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herpes zoster recommendations?
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oral antivirals /n 72 hours, topicals not so much
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what is the DOC for live in pregs?
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permethrin
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what is contraindicated for head lice in kids with ragweed, chrysanthemum allergy?
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pyrethrins/piperonyl butoxide (R&C shampoo)
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what are symptoms of antidepressant SSRI withdrawal symptoms? how do you mange?
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FINISH: flulike, insomnia, nausea, imbalance, sensory disturbance, hyperarousal
reinstatement of ssri, give fluoxetine and taper gradually answer key said give diazepam in hospital until symptoms improve |
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pinworms treatment guidelines?
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review PSC, pyrantel pamoate
what if it doesn't work? mebendazole |
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what are symptoms of overdosage for pyrantel pamoate?
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It is dosed by weight, overdose can cause autonomic dysfunction, muscle spasm/paralysis,
side effects are nausea, headache, insomnia |
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what can you recommend for hypertension to a patient with bilateral artery stenosis
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ACEI is contraindicated (also caution in patients with liver abnormalities and hyperkalemia)
recommend CCB instead (SEs of CCB are swelling, caution in CHF, CYP broken down, liver dysfunction may have prolonged half life) |
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what are weight neutral antidiabetics?
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metformin not associated with weight gain which is why often when patients start on insulin they are kept on metformin
sulfonylureas (gliclazide, glyburide), thiazolidinedions (pioglitazone, rosiglitazone), insulin get weight gain |
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severe asthmatic with ASA allergy, what could've caused her reaction?
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ibuprofen
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dialysis patient wants to use supplements-what to recommend?
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answer key says recommend DEAK (water soluble) and refer him as all vitamins renally excreted...
TC says avoid A and C but recommend D, low sodium diet, recommend potassium restriction, recommend some calcium unless hypercalcemia happens |
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what can urine dipsticks for protein be affected by?
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hydration status
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what causes gingival hyperplasia?
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nifedipine
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acute copd exacerbation, what is appropriate?
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purulent patients benefit from antibiotic, otherwise increase dose of current bronchodilator treatment (SABA and ipratropium)
amoxi, ceph, tmp, doxy, macros amoxi/clav or fluoroquinolone if complicated (ie. severe) |
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what is iv antibiotic appropriate for cellulitis?
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ampicillin
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sulfa allergy patient new diagnosed with glaucoma--concerns?
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carbonic anhydrate inhibitor (dorzolamide, brinzolamide-topical, acetazolamide, methazolamide-oral) can show cross reactivity in patients with sulfa allergies!
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severe asthma exacerbation-hospitalized, how to manage?
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after bronchodilators titrate to response q15-20min AND ipratropium bromide, start iv methylprednisolone or hydrocortisone or oral prednisone, use rehydration
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Heart failure symptoms after climbing a few stairs, what class is he?
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I: no sx w/ ordinary activity
II: symptoms occur with ordinary activity III: symptoms occur with less than ordinary activity IV: sx occurs at rest or with minimal activity probs II |
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What non pharm can you recommend to a heart failure patient?
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control risk factors: hypertension, obesity, diabetes, arrhythmia, dyslipidemia, CAD
avoid exaccerbating risk factors recommend moderate regular physical exercise no more than 1 alcoholic drink per day restrict sodium intake <2-3g/day restrict fluid intake <1.5-2L/day in pt w/ fluid retention influenza, pneumococcal vaccine daily weight |
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what can be expected with an ACEI initiation in patients with CHF?
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increased serum creatinine (but anything over 30% you need to rule out other causes of worsening renal function
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which BB are shown to be good for HF?
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bisoprolol, carvedilol, not metoprolol
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explain the use of diuretics in HF
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loop diuretics, usually furosemide used in everyone while thiazide diuretics more so for fluid retention
thiazides have poor efficacy in pts with renal dysfunction -note this stuff doesn't decrease mortality, it's for symptom control so once you have symptoms under control then that's when you want to up everything else to target. |
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Thiazide and loop diuretics deplete potassium and magnesiums. Maintain above >4mmol/L. What can hypokalemia result in?
What are the potassium sparing diuretics? |
fatal ventricular arrhythmias and digoxin toxicity
spironolactone eplerenone |
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What are ARBs associated with that ARBs aren't?
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renal dysfunction and hyperkalemia
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When should an aldosterone antagonist be used for HF?
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when patients remain symptomatic despite optimal use of ACE inhibitor, and BB
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Other than for rate control, what can digoxin be used in?
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Patients that don't respond to anything or can't tolerate BBs
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How should digoxin be dosed?
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individualize based on weight, age, renal function, concomitant drugs
range is 0.0625-0.25mg daily measure trough levels 8 hours after admin-maintain at 0.6-1nmmol/L |
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what must nitrates be administered with to decreased mortality?
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hydralazine
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When could an ACEI possibly be used with an ARB?
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in heart failure
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low HDL, high TG, on atorva 40mg-what do to?
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add a fibrate, niacin (unpleasant sied effects, ie hepatotoxic) is good with this but don't use with a statin
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Differentiate between the different lipid-lowering agent functions
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niacin, fibrates: increase HDL, decrease TG
statins: do everything but mostly lower LDL resins: bad for TG ezetimibe: more LDL lowering, less effects on HDL and TG |
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What to monitor on high dose prednisone?
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mental or mood disturbances associated w/ high dose therapy and is dose dependent
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