Sys Pharm Final Pt 3

Front 1

Low molecular weight heparins are used for what? Example?

Back 1

prevention of deep vein thrombosis, unstable angina, or MI, or after joint replacement surgeries
ex: enoxaparin

Front 2

Aspirin/NSAID uses? admin?

Back 2

uses: aspirin reduces risk of AMI, stroke, and TIAs. Both used for anti-inflamm and analgesic
admin: taken orally, liver metabolism

Front 3

aspirin/NSAID ADEs? drug interactions?

Back 3

ADEs: GI ulceration, bleeding, stomach upset, blurred vision, reduce effects of anti-HTN
drug interactions: increase bleeding risk

Front 4

Clopidogrel use? Admin?

Back 4

use: reduction of thrombotic events after recent AMI or stroke. Peripheral arterial disease, unstable angina, non-Q-wave MI
admin: orally, is a prodrug

Front 5

clopidogrel ADEs? Drug interactions?

Back 5

GI ulceration, bleeding, stomach upset, cataracts and conjunctivits, conjunctival bleeding
drug inter: increased bleeding risk w/ other antithrombotic agents

Front 6

Commonly used NSAIDs? Which one can be given IV/IM (otherwise, topical) and can only be used for 5 days?

Back 6

Diclofenac, bromfenac, flurbiprofen, ketorolac, nepafenac

Ketorolac

Front 7

Colesevelam/Colestipol use? ADEs? interactions?

Back 7

use: elevated LDL cholesterol
ADEs: GI problems (gas, constipation, NV)
interactions: may decrease absorption of other drugs through drug:drug binding

Front 8

Gemfibrozil use? ADEs? interactions?

Back 8

use: hypertriglyceridemia
ADEs: increased risk of myopathy in patients w/ renal fxn impairment
interactions: increased risk of myopathy when given with statin drugs, can increase warfarin effects. Avoid use w/ repaglinide, itraconazole

Front 9

Niacin use? ADEs? interactions?

Back 9

use: hyperlipidemia
ADEs: headache, itch, flushing, may make glucose control more difficult
interactions: ethanol can increase headache/flushing. Caution with anticoagulants, antihypertensives, statins, vasoactive drugs

Front 10

fenofibrate use? ADEs? interactions?

Back 10

use: hypertriglyceridemia
ADEs: dose-related hepatotoxicity, rash/itching, myalgia
interactions: caution if used with statins, may increase effect of warfarin

Front 11

Ezetimibe use? ADEs? interactions?

Back 11

use: hyperlipidemia
ADEs: headache, myalgia, hepatic dysfunction, GI problems
interactions: caution if used with statins

Front 12

HMG-CoA reductase inhibitors (statins) use? ADEs? interactions?

Back 12

use: hyperlipidemia (#1 choice!!!)
ADEs: myalgia, diarrhea, rhabdomyolysis (breakdown of muscle tissue, release of toxins, can be fatal), headache, rash, GI upset, dizziness
interactions: increased risk of hepatotoxicity and rhabdomyolysis with other lipid lowering drugs

Front 13

Examples of statins?

Back 13

atorvastatin, fluvastatin, rosuvastatin, simvastatin

Front 14

3 statin combo meds? what makes up each?

Back 14

1. Advicor (niacin + lovastatin)
2. Caduet (amlodipine+atorvastatin)
3. Vytorin (simvastatin+ezetimibe)

Front 15

Drug of choice for acute angina?

Back 15

sublingual nitroglycerin

Front 16

Nitroglycerin use? ADEs? Interactions?

Back 16

use: acute angina, extended release and patches used for angina prophylaxis. IV form for unstable angina, heart failure, AMI
ADEs: headache, flushing, orthostatic hypotension, tachycardia, peripheral edema, dizziness, NV, blurred vision
interactions: hypotensive effects increased when taken with other meds that lower BP

Front 17

beta blocking agents use? ADEs? interactions?

Back 17

use: angina prophylaxis
ADEs: orthostatic hypotension, dizziness, can cause eye dryness or soreness
interactions: hypotensive effects can be increased when taken with other meds that lower BP

Front 18

calcium channel antagonists use? ADEs? interactions?

Back 18

use: angina prophylaxis
ADEs: orthostatic hypotension, dizziness, transient blindness (with nifedipine)
interactions: hypotensive effects increased when taken with other meds that lower BP

Front 19

Isosorbide mononitrate use? ADEs? interactions?

Back 19

use: angina prophylaxis
ADEs: headache, flushing, orthostatic hypotension, tachycardia, peripheral edema, dizziness, NV, blurred vision
interactions: hypotensive effects increased when taken with other meds that lower BP

Front 20

Digoxin is a? uses? ADEs?

Back 20

is a: Cardiac glycosides
uses: CHF, atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia
ADEs: NV, dizziness, lethargy, bradycardia, tachycardia, blurred or yellow vision*******

Front 21

atrial, atrial, atrial, CHF is a pnemonic for?

Back 21

digoxin uses

Front 22

carvedilol uses? special info?

Back 22

uses: maintenance therapy for CHF
special: must be d/c if heart fuction decompensates

Front 23

lisinopril uses?

Back 23

maintenance therapy for CHF

Front 24

phenylepherine's effect on alpha? peripheral vasoconstriction?

Back 24

alpha: +++
peripheral vasoconstriction: +++

Front 25

lidocaine use? ADRs? comments?

Back 25

use: ventricular arrhythmias
ADRs: CNS stimulation, paresthesias, disorientation, coma, diplopia and visual changes
comments: used parenterally as an IV push or as an IV drip

Front 26

Propafenone use? ADRs?

Back 26

use: atrial OR ventricular arrhythmias
ADRs: may worsen arrhythmias, blurred vision

Front 27

Metoprolol use?

Back 27

use: sinus tachycardia, atrial arrhythmias

Front 28

Amiodarone********* use? ADRs? Interactions?

Back 28

use: atrial fibrillation and ventricular arrhythmias
ADRs: corneal microdeposits (>90%), halo vision, optic neuritis
interactions: with several meds under OD SoP

Front 29

Sotalol use? ADRs?

Back 29

use: ventricular tachycardia
ADRs: arrhythmia, visual problems in 5% (blur)

Front 30

Adenosine use? ADRs? interactions?

Back 30

use: paroxysmal supra ventricular tachycardia
ADR: dyspnea, flushing, temporary asystole, chest pain
interactions: few, of short duration

Front 31

Analgesics used for?

Back 31

treatment of pain

Front 32

3 receptors types that mediate effects of opioid meds? What does each do?

Back 32

Mu, kappa, delta

Mu mediates analgesia, kappa mediates analgesia in the spinal cord and brain, delta mediates analgesic effects of endogenous and some exogenous opioids

Front 33

Morphine use? Drug of choice for what?

Back 33

use: relief of severe pain, sedation of patients with pain, acute pulmonary edema, and treatment of pain and anxiety of AMI
DoC for treatment of pain and anxiety in AMI

Front 34

morphine effects? side effects?

Back 34

effects: analgesia, narcosis
side effects: peripheral vasodilation (flushing, sweating, itching), nausea, constipation, CNS depression, miosis and blurred vision***. can develop tolerance and addiction

Front 35

Hydromorphone use? effects? side effects?

Back 35

use: alternative to morphine
effects: analgesia and narcosis
side effects: CNS depression, sedation, cardiac changes, dizziness, itching, constipation, nausea, urinary retention, blurred vision**, diplopia**, miosis**, nystaagmus********

Front 36

Oxycodone use? ADEs?

Back 36

use: moderate to severe pain
ADEs: CNS depression, sedation, cardiac changes, dizziness, itching, constipation, nausea, urinary retention, blurred vision**, diplopia**, miosis**, nystagmus**. Dependence

Front 37

Hydrocodone** use? Is it under our SoP? ADEs?

Back 37

ues: moderate pain. Perhaps for trauma to the eye if not helped by rxing a lens
SoP: Yes, it is under our SoP. Need a DEA license
ADEs: CNS depression, sedation, cardiac changes, dizziness, itching, constipation, nausea, urinary retention, blurred vision, diplopia, miosis, nystagmus. dependence

Front 38

Codeine (under our SoP) is a what? Use? ADEs?

Back 38

Is a: prodrug, 10% converted to morphine
Use: moderate pain, sometimes as an antitussive agent (cough suppressant)
ADEs: CNS depression, rash/itching, dizziness, constipation, nausea, blurry vision, diplopia. Dependence

Front 39

Fentanyl (and other -nil drugs) use? ADEs?

Back 39

use: more potent than morphine, severe pain management
ADEs: CNS depression, sedation, cardiac changes, dizziness, itching, constipation, nausea, urinary retention, blurred vision, diplopia, miosis, nystagmus. Dependence

Front 40

Tramadol use? MoA? ADEs? admin?

Back 40

use: moderate to severe chronic pain
MoA: bind to mu-opiate receptors in CNS and cause inhibition of ascending pain pathways
ADEs: dizziness, headache, constipation, sedation, itching.
admin: only available orally.. Must be adjusted for renal/hepatic

Front 41

Acetylsalicylic acid (ASA, Aspirin) use?

Back 41

use: mild-moderate pain, reduces fever, reduces inflamm, reduces blood clotting, uricosuric agent

Front 42

Acetaminophen (APAP, tylenol) use? MoA? ADEs? admin?

Back 42

use: mild-moderate pain, reduces fever. NO ANTI-INFLAMM EFFECTS
MoA: inhibits syn of prostaglandins in the CNS and peripherally blocks pain impulse generation
ADEs: drug metabolized hepatically (watch how much you take), life threatening hepatotoxicity can occur
admin: PO, PR

Front 43

5-HT1 (serotonin) receptor agonists ("triptans") use? ADEs? comments? examples?

Back 43

use: migraine treatment
ADEs: increased BP, chest pain, palpitations, corony artery vasospasm, dizziness, drowsiness, abdominal pain
comments: caution in px w/ coronary artery disease
examples: sumatriptan, rizatriptan, etc

Front 44

Propionic acid derivative NSAIDs use? ADEs? 2 main examples?

Back 44

use: arthritis analgesia, antipyresis (reduce fever), inflammation, dysmenorrhea
ADEs: GI irritation, GI bleeding/ulcers, blood dyscrasias, visual disturbance
ex: ibuprofen, naproxen

Front 45

Ketorolac use? ADEs? Special considerations?

Back 45

use: analgesia
ADEs: GI irritation, GI bleed/ulcers, blood dyscrasias, renal failure, possibility of hepatic problems, vision abnormalities, corneal thinning and erosion with topical forms
special: used IV/IM after surgery, cant use more than 5 days

Front 46

Celecoxib use? ADEs? admin?

Back 46

use: arthritis pain and inflamm
ADEs: GI intolerance, question risk of cardiac complication such as CHF, blurred vision, cataracts, conjunctival hemorrhage, conjunctivits eye pain, increased IOP, vitreous floaters
admin: PO only

Front 47

glucocorticoid effect on protein metabolism?

Back 47

increase catabolism, decrease anabolism

Front 48

glucocorticoid effect on carb metabolism?

Back 48

decreases insulin binding to receptors, increases gluconeogensis

Front 49

glucocorticoid effect on immune system?

Back 49

Decreases inflamm reactions, antibody production, immunocompetent lymphocytes, antigen processing

Front 50

glucocorticoid effect on fat distribution?

Back 50

redistributes body fat to the trunk

Front 51

glucocorticoid on blood?

Back 51

increases neutrophils and erythropoesis

Front 52

glucocorticoid effect on electrolytes?

Back 52

decreases GI absorp of Ca++, increases Na+ retention, increases K+ excretion, can increase development of metabolic alkalosis

Front 53

glucocorticoid effect on brain?

Back 53

decreases electrical excitation threshhold

Front 54

glucocorticoid effect on GI tract?

Back 54

increases acid and pepsin secretion, thins mucous lining

Front 55

glucocorticoid effect on water?

Back 55

increases clearence of free water

Front 56

Missing info on short-term and long-term corticosteroid effects, get from andrea

Back 56

!!!

Front 57

Hydrocortisone, prednisone, methylprednisolone, dexamethasone are all?

Back 57

corticosteroids

Front 58

Hydrocortisone available in what forms?

Back 58

PO, IV, IM, topical

Front 59

Prednisone available in what form(s)? comments?

Back 59

PO only
Comments: useful in acute asthma attacks and in COPD maintenance therapy, taper doses when completing short term therapy

Front 60

methylprednisolone available in nwhat form(s)? Comments?

Back 60

PO, parenteral
Comments: useful in acute asthma attacks and in COPD maintenance therapy, taper doses when completing short term therapy

Front 61

Dexamethasone available in what form(s)?

Back 61

PO, parenteral, INH

Front 62

Corticosteroids general ADEs?

Back 62

cataracts, increase IOPs

Front 63

cyclobenzaprine use? ADEs?

Back 63

use: musculoskeletal pain
ADEs: drowsiness, dizziness, GI upset, blurred vision, not recommended for elderly. Can be very sedating

Front 64

Benzodiazepine use? ADEs?

Back 64

use: muscle relaxant, used in spasticity disorders. used as sedatives, anticonvulsants
ADEs: CNS depression, respiratory depression

Front 65

Metaxalone use? ADEs?

Back 65

use: musculoskeletal pain
ADEs: blood dyscrasias, several ADEs and interactions, check as needed

Front 66

tizanidine use? ADEs?

Back 66

use: spasticity related to MS, spinaal cord injury
ADEs: several CNS, GI, cardiac ADEs. Blurred vision. Several possible interactions, check as needed.