Term
Aspirin:
MOA
ADRs (besides bleeding) |
|
Definition
MOA: COX inhibit that causes irreversible anti-platelet effect
ADR:
Reyes syndrome when used in kids w/ virus
SNHL (ringing)
bronchospasm in asthmatics |
|
|
Term
Clopidogrel
MOA
May interact w/ what drug class? |
|
Definition
Irreversible platelet binding
May interact w/ some PPIs. Protonix is preferred PPI in pts on Plavix |
|
|
Term
Warfarin:
1) MOA
1) reversal agent
2) most important drug interaction to know
3) contraindication |
|
Definition
1) MOA: basically inhibits vit K
1) Vit K
2) CYP enzymes (lots of abx). if question is asking about CYP interaction, the answer is probably warfarin
3) Pregnancy- teratogenic |
|
|
Term
Unfractionated heparin:
1) MOA
2) reversal agent
3) When to use over Lovenox
4) life-threatening ADR when body creates an antibody directed at heparin platelet factor 4 complex and causes thrombocytopenia |
|
Definition
1) MOA: indirect thrombin inhibitor
2) Protamine
3) Use in elderly and CKD
4) HIT |
|
|
Term
| Does low or high INR infer bleeding risk? |
|
Definition
|
|
Term
| When should you give vit K to reverse warfarin? |
|
Definition
|
|
Term
Lovenox (enoxaparin)
1) MOA
2) reversal agent
3) ADRs |
|
Definition
BEST ANTICOAGULANT TO USE IN PREGNANCY
1) MOA: factor Xa inhibitor --> EnoXAparin inhibits factor Xa
2) Reversal: protamine
3) ADRs: same as heparin but less so |
|
|
Term
| Other anticoagulants: 1) a NOAC drug that works as a direct thrombin inhibitor. can be reversed wtih idarucizumab 2) NOAC drugs (2) that are oral direct factor Xa inhibitors. Are irriversible for now. both approved for what two conditions? |
|
Definition
1) dabigatran (pradaxa) 2) Rivaroxaban (xarelto) and apixaban (eliquis) - both have Xa in the name!
Approved for afib and DVT |
|
|
Term
Statins:
1) MOA
2) monitoring
3) important interactions
4) ADRs
5) contraindication |
|
Definition
MOA: HMG-CoA reductase inhibitors
Monitor: LFTs at baseline. can check CK if myalgias.
Interactions: grapefruit (CYP3A4 inhibitor). Niacin and fibrates can increase risk for myopathy and hepatotoxicity
ADR: myalgia, hepatotoxicity, increased glucose
Contraindication: Pregnancy |
|
|
Term
| What QT prolongers are most important to know (4) |
|
Definition
Macrolides
Fluoroquinolones
Diflucan
Antiarrythmics |
|
|
Term
Triglyceride questions
1) first line treatment
2) Pt with trigs >500 and at risk for pancreatitis? |
|
Definition
always pick diet changes as first line
use fibrate (gemfibrozil or fenofibrate) or niacin if pt high risk only |
|
|
Term
Anti-arrhythmics: what to know for test
1) All can cause what potentially fatal ADR?
2) All can cause what other ADR?
3) general classifications |
|
Definition
1) all can cause arrhythmia (such as torsades)
2) all can cause QT prolongation
3) classifications:
Class I: don't need to know
Class II: B-blockers
class III: K+ channel blockers - AMIODARONE
class IV: calcium channel blockers
Other: dig |
|
|
Term
Class III antiarrhythmics: Amiodarone
5 important ADRs to know |
|
Definition
photosensitivity
QT prolongation
digoxin interaction
pulmonary toxicity
thyroid toxicity
**If a question mentions amiodarone, they're probably looking for it as the cause of a symptom/ADR |
|
|
Term
Digoxin:
1) MOA
2) ADR
3) indications |
|
Definition
MOA: Inhibits NA/K ATPase pump
ADRs: rhythm disturbance, vision disturbance (yellow)
Indications: rate control in A fib or increase contractility in HF
Does NOT reduce mortality rate.
Generally will not be the drug they want you to choose on test |
|
|
Term
Diuretics:
1) indicates for Loops vs thiazides
2) ADRs (4) |
|
Definition
Loop: edema, acute hypercalcemia
Thiazide: HTN
ADRs:
orthostatic hypotension
Electrolyte disturbances (hypokalemia esp)
Hyperuricemia
Glucose intolerance |
|
|
Term
| What drug class is nephroprotective by dilating efferent arterioles and thereby decreasing glomerular pressure? |
|
Definition
|
|
Term
| Why are ACE inhibitors generally not favored in african americans? |
|
Definition
|
|
Term
ACE inhibitors:
1) Never use in combination with?
2) Absolute contraindication
3) most common adr |
|
Definition
1) never use w/ ARB
2) Pregnancy
3) cough |
|
|
Term
Alpha blockers:
1) include what drugs?
2) 2 indications
3) Most common side effect |
|
Definition
1) -zosin drugs (prazosin, terazosin, doxazosin)
2) HTN and BPH --> on test will only be answer for BPH, not HTN
3) postural Hypotension- must titrate up the drug |
|
|
Term
| COPD or asthma patient presents wtih CHF. They need a beta blocker. which one would you choose? |
|
Definition
metoprolol SUCCINATE (not tartrate)
most cardio-selective |
|
|
Term
| Generally on the test, what are the two indications that they'll want you to pick a beta blocker for? |
|
Definition
Migraine
CHF
NOT HTN
More likely they'll want you to know when not to use it: Asthmatics, bradycardia, etc |
|
|
Term
CCBs:
1) 3 clinical uses
2) ADRs
3) Generally, they'll want you to pick which CCB? |
|
Definition
1) HTN, angina, raynaud's (or any vasospasm)
2) HA, lightheadedness, gingival hyperplasia, edema, reflex tachycardia
3) usually choose amlodipine EXCEPT in women of childbearing potential, then choose nifedipine |
|
|
Term
Inhaled drugs:
1) _____: class used as "rescue" agents in asthma/COPD
2) ____: used as maintenance agents in asthma/COPD but can NEVER be used alone. always must use w/ ICS.
3) ____: short acting anticholinergic used in asthma/COPD. often used in hospital settings for bronchospasm.
4) ______: Long active anticholinergic. mostly used for COPD |
|
Definition
1) SABA - albuterol
2) LABA
3) SAMA - ipratroprium. usually marketed in combination w/ albuterol (combivent, duoneb)
4) LAMA - tiotropium (Spiriva) |
|
|
Term
| Most common ADRs (3) with inhaled anticholinergics (LAMAs and SAMAs such as ipratroprium and tiotroprium) |
|
Definition
xerostomia
urinary retention - use w/ caution in BPH
increased IOP - use w/ caution in glaucoma |
|
|
Term
| First line maintenance drug for persistent asthma |
|
Definition
| ICS - fluticasone, budesonide |
|
|
Term
| Never choose ____ (asthma/copd drug) as a test answer, it's always a distractor |
|
Definition
|
|
Term
NSAIDs
1) MOA
2) ADRs
3) 2 lowest risk NSAIDs
4) drug interactions
5) Contraindications |
|
Definition
MOA: COX inhibition (1&2). reversible antiplatelet effect.
2) ADRs: GI issues, neprhotoxicity
3) ibuprofen and naproxen - lowest risk
4) Interactions: warfarin, Aspirin (interferes w/ antiplatelet effect
5) Contraindications:
-CKD
-pregnancy
-PUD
-asthma
-cardiac patients (CHF, hx of MI) |
|
|
Term
| Never use what opioid in kids? |
|
Definition
|
|
Term
|
Definition
|
|
Term
Antacids:
1) For PUD questions, answer is ?
2) For dyspepsia questions, answer is ? |
|
Definition
PUD- PPI
dyspepsia- H2 blocker |
|
|
Term
Promethazine (phenergan) and Prochlorperazine (compazine)
1) Clinical uses
2) ADRs (3) |
|
Definition
antiemetic in >2 y/o
pain management adjunct (ex: migraine)
ADRs:
QT prolongation, extrapyramidal symptoms, dry mouth
Dopamine receptor antagonists |
|
|
Term
Metoclopramide (Reglan)
1) indications
2) black box warning |
|
Definition
inidcations: prevention and treatment of chemo induced emesis & PONV
BBW: acute dystonia
is a DOPAMINE receptor antagonist |
|
|
Term
ondansetron
1) indications
2) ADR
3) MOA |
|
Definition
indications: PONV, chemo emesis, radition induced emesis
ADR: generally none, some concern w/ other QT prolongers
MOA: serotonin antagonist |
|
|
Term
| first line for allergic rhinitis |
|
Definition
|
|
Term
Metformin:
1) Class
2) ADR
3) Contraindication
4) MOA |
|
Definition
Class: Biguanide
MOA: decreases hepatic glucose production. needs insulin to work, so cant be used in T1DM
ADR: lactic acidosis (esp after surgery or in CKD), metallic taste, GI upset
Contraindication: CKD, hepatic failure
ALL T2DM SHOULD BE ON METFORMIN UNLESS CONTRAINDICATION |
|
|
Term
| 2 drugs that can cause a disulfuram reaction |
|
Definition
|
|
Term
Sulfonylureas:
1) include what drugs (3)
2) MOA
3) ADRs |
|
Definition
glimepiride, glipizide, glyburide
MOA: bind to K+ channels in pancreatic beta cells to INCREASE INSULIN SECRETION
ADR: weight gain, hypoglycemia, disulfuram reaction w/ glyburide |
|
|
Term
| In DM questions, generally don't choose what class of drugs? |
|
Definition
| thiazolidinediones (end in -glitazone) |
|
|
Term
Thyroid:
1) For thyroid questions, never choose what drug?
2) average therapeutic synthroid dose for adults and geriatrics
3) check TFTs how often?
4) major adr to thyroid medicines |
|
Definition
1) armour thyroid- lots of ADRs
2) Adults: 1.6 mcg/kg/d
Geriatrics: 0.5 mcg/kg/d
3) Check TFTs 4-6 wks after initiation then q6-12 months
4) osteoporosis |
|
|
Term
| 1st line treatment for BPH and one common side effect? |
|
Definition
tamsulosin
retrograde ejaculation |
|
|
Term
ED drugs -
1) class and names
2) What else can they be used for?
3) use is contraindicated with what other drug?
4) ADRs (4) |
|
Definition
phosphodiesterase inhibitors - sildenafil, tadalafil
2) can also be used for PAH
3) nitrates (hypotension)
4) HA, facial flushing, priapism, blue-ish vision (why all viagra commercials are blue) |
|
|
Term
| class of drugs that includes donepezil, rivastigmine. used for Alzheimers/dementia. are well tolerated but don't work well. |
|
Definition
| 1) Cholinesterase inhibitors |
|
|
Term
Antiseizure meds:
1) levels have to be monitored. historic choice for prevention of seizures following heady trauma or neurosurgery. can cause fetal abnormalities
2) Used for many seizure types, bipolar, chronic pain syndromes. teratogenic. can cause rash, anywhere from mild to SJS
3) used for migraine and mania associated w/ bipolar disorder. interacts w/ lots of other drugs. MOST TERATOGENIC |
|
Definition
1) phenytoin
2) Carbamazepine
3) valproic acid |
|
|
Term
SSRIs:
1) Include what drugs? (5)
2) May interact with what HTN drug?
3) ADRs (5) |
|
Definition
1) fluoxetine, paroxetine, sertraline, citalopram, escitalopram
2) Metoprolol
ADRs:
sexual dysfunction
prolonged QT
Suicidal ideation
serotonin syndrome (agitation, AMS< fever, resting tremor, changes in muscle tone)
Discontinuation syndrome "FINISH" syndrome: Flu-like symptoms, INsomnia, Imbalance, Sensory disturbance, Hyperarousal) --> why you must always taper off SSRIs |
|
|
Term
TCAs:
1) 2 big drugs to know
2) indications (4) |
|
Definition
1) amytriptiline, nortryptiline
2) depression (if refractory to SSRI and SNRI), Migraines, neuropathic pain, nocturnal enuresis in kids (imipramine) |
|
|
Term
| what is one OTC herbal therapy that interacts w/ lots of psych drugs? |
|
Definition
|
|
Term
Haloperiodol
Chlorpromazine
Risperidone
Olanzapine
Quetiapine
Ziprasidone
Aripiprazole
All are what kind of drug?
4 big ADRs to know |
|
Definition
antipsychotics
ADRs:
Suidical ideation
Increased mortality in dementai-related psychosis
Extrapyramidal symptoms
Neuroleptic malignant syndrome |
|
|
Term
Isotretinoin:
1) brand name
2) MOA
3) Monitoring |
|
Definition
Accutane
MOA: Vitamin A analogue
Monitoring: need to be on a registry, 2 forms of contraception
2 negative pregnancy tests prior to beginning, then monthly pregnancy tests while taking and 1 month after discontinuation. |
|
|
