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Pharm Exam II
pharm exam 2
159
Pharmacology
Undergraduate 3
07/03/2012

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Term
antacids should not be taken with how many hours of other meds?
Definition
1-2 hours
Term
antacids decrease the absoprtion of other drugs, most importantly:
Definition
abx, digoxin, isoniazid, phenothiazine, quinidine, phentyoin
Term
antacids react with what to do what
Definition
react with gastric acid to produce neutral salts
Term
antacids with aluminum in them can cause
Definition
constipation. My pal al is constantly constipated.
Term
antacids with magnesium in them can cause
Definition
diaaarheaaa! maggy-rhea
Term
H2 blockers end in..
Definition
DINE.. no wine, just DINE!
Term
h2's prevent..
Definition
stress ulcers and reduce the occurrence of all uclers
Term
use caution with h2's in pts with..
Definition
renal or hepatic dysfunction
Term
food slows the absorption of..
Definition
h2s
Term
cimetidine passes the what and can cause what
Definition
blood brain barrier and cause cns side effects, confusion, agitation, psychosis
Term
with ranitidine, side effects are..
Definition
uncommon, and does not cross BBB, as with cimetidine
Term
do not take h2's at the same time as..
Definition
antacids, take them at least 1 hour before.
Term
you should take h2s at what time?
Definition
6 pm for better suppression of nocturnal acid secretion
Term
pts with acid problems should avoid..
Definition
caffeine, alcohol, harsh spices, chocolate and peppermint, stop smoking.. no ASA's or NSAIDS
Term
if pt is on cimetidine, and coumadin, dilatnin, lidociaine the pt should..
Definition
reduce the dosages of these meds
Term
prilosec can be administered via..
Definition
PO only
Term
ppi's are used to treat
Definition
acitve ulcer disease, erosive esophagitis and hypersecretory conditions
Term
side fx of ppi's
Definition
headache, diarrhea, abdominal pain, and nausea
Term
abx used for h. pylori tx
Definition
amox, clarithromycin, bismuth compounds, tetracycline, metranidzole, tinidazole
Term
do not give anti-d's for patients..
Definition
who are under 2, pregnant, elderly, and antibiotic associated colitis, or ulcerative colitis, or if pt has C. DIFF.- hep/ren disease, glaucoma, electrolyte imbalance
Term
zollinger ellison
Definition
increased production of gastrin
Term
side fx of anti-d's
Definition
drowsiness, dizziness, consipation, dry mouth, blurred vision, urinary retention
Term
for pt taking anti-d's you should assess
Definition
cause of diarrhea, monitor stools, bowel sounds, vitals, and electrolytes, and narcotic drug history
Term
for pt taking anti-d's you should educate the clien tto..
Definition
drink clear liquids, avoid OTC drugs and alcohol, notifiy provider if diarrhea persists longer than 2 days, high fever, BLOOD in stool, or acute abd pain
Term
difference between stimulant and emollient laxatives..
Definition
stim-increases persistalsis by directly effecting colonic smooth muscle
emollient- softens stools by increasing the water and fat penetration in intestines
Term
do not give laxatives to patients who are..
Definition
having fecal impactions, intesinal/biliary obstruction, nausea vomiting, acute hep/appendicitis
Term
stimulant laxatives may cause..
Definition
gastric irritation if taken with antacids, h2 blockers, and gastric proton pump inhibitors and milk
Term
emollient lax's may cause..
Definition
toxicity if taken with mineral oil
Term
laxatives are given to post op patients to..
Definition
help prevent "straining"
Term
emollients may take how long to take effect
Definition
three days
Term
for laxatives.. report if..
Definition
thirstiness, sxs of electrolyte imbalances
Term
antiem's work by..
Definition
acts centrally by blocking the chemoreceptor trigger zone, this in turn acts on the vomiting center
Term
antiem's decrease the effects of..
Definition
thiethylperazine- barbituates, antacids.
Term
antiem's increase the..
Definition
anticholinergic action- anticholingerics, antiparkison drugs and antidepressants
Term
antiemetics can cause..
Definition
drowsiness
Term
colace..
Definition
emollient/surfactant
Term
biscodyl, lactulose
Definition
stimulant laxative
Term
ondansetron
Definition
anti-e
Term
hydroxyzine
Definition
anti-e
Term
loperamide
Definition
anti-diarrheal
Term
zofran was first invented for
Definition
chemo induced nausea
Term
aluminum hydroxide antacids may increase..
Definition
edema
Term
calcium carbonate antacids may..
Definition
constipate
Term
histamine can be found..
Definition
everywhere
Term
H1 receptor causes
Definition
vasodilation (pressure drop), increase cap perm, skin rash, bronchoconstriction, mucus secretion
Term
H2 receptor
Definition
secretion of gastric acid, act directly on parietal cells, to promote acid release
Term
histamine antagonists/antihistamines
Definition
act on h1 and h2,
Term
anaphylaxis causes
Definition
bronchoconstriction, hypotension, edema, of the glottis, feeling of impending doom, larynx will start to swell shut
Term
h1 antagonists
Definition
1st and 2nd generation- highly sedating, 2nd generation- non drowsy
Term
promathazine and dimenhydrinate (dramamine) is used for
Definition
motions sickness
Term
you shouldnt give benadry with other..
Definition
cns depressants
Term
know difference between 1st and 2nd generation antihistamines
Definition
Term
asthma drugs - 2 types
Definition
anti inflammatory (prednisone), bronchodilators (albuterol- beta 2 agonist)
Term
advantages of inhalation drug therapy
Definition
fewer systemic effects, effects enhanced, effects are faster
Term
three types of inhalers
Definition
metered dose inhalers (MDI), dry powder inhaler (DPI), nebulizers
Term
glucocorticoids side fx
Definition
minor effects when taken acutely, can be bad when used long term (adrenal suppression, osteoporis, hyperglycemia, and others
Term
bronchodilators provide
Definition
provide symptomatic relief but do not alter the underlying disease (albuterol, salmeterol, terbutaline) relieve acute bronchospasm
Term
theophyline
Definition
lots of side fx, narrow therapeutic index, toxicity is related to theophyline levels- plasma drug levels, 10-20 mcg
Term
glucocorticoid/LABA combinations
Definition
advair/symbicort, for long term maintenance
Term
subq 1:10,000, iv 1:1000 dosing for epinephrine
Definition
Term
look over tagamet adr
Definition
Term
levalbuterol is what compared to reg albuterol
Definition
kinder, gentler- so its used more frequently with pedi and geri
Term
how long should you wait between puffs?
Definition
at least one minute
Term
which should go first Bronchdilator or nebulizer treatments
Definition
bronchdi's so steroid gets into lungs better
Term
BETA B's and BRONCHO D's should..
Definition
not be used together bc they negate one another
Term
what does LABA stand for
Definition
long acting beta adrenergic agonist- salmeterol and advair
Term
salmeterol and advair shoud not be used..
Definition
IN AN EMERGENCY! hence the word long acting.
Term
what does theophyline do?
Definition
ORAL MED, long term control of asthma. causes relaxation of bronchial smooth muscle, which results in bronchodilation
Term
atrovent is a
Definition
inhaled anticholinergics
Term
flovent is..
Definition
glucocorticoids (steroids!)
Term
theophyline is a..
Definition
methylxanthines- oral - long term asthma control
Term
advair is a combo of
Definition
flovent and salmeterol..
Term
singular is a
Definition
(long term use) leukotriene modifier- suppressing inflamm by suppressing bronchoconstirction, airway edema, and mucus production
Term
guaifenesin works by..
Definition
increasing mucous secretion/cough production to decrease chest congestion by coughing out secretions.
Term
side fx of guaifenesin..
Definition
gi upset, drowsiness, allergic rash
Term
pt's taking expectorants should be advised to..
Definition
drink water to promote liquefying secretions
Term
1st gen anthists
Definition
benadryl, phenegran, dramamine
Term
antihists work by..
Definition
block h1 receptors, suppress mucous secretions by their antcholinergic action
Term
remember that antihists have..
Definition
anticholinergic effects, cant spit, cant shit, cant pee(toxicity)
Term
antihists ADI's
Definition
cns depressants/alcohol cause additive cns depression
Term
spontaneous bacterial mutation
Definition
resistance to only one abx
Term
what is conjugation
Definition
bacteria trade dna and may cross bacterial species- esp gram negative
Term
tx for c diff
Definition
metronidazole, vancomycin and fluid replacement
Term
penicillins work by
Definition
weakening the cell wall, causing bacteria to take up extra water and rupture
Term
theres a correlation between pnc allergy and..
Definition
cephalosporin allergy
Term
example of a broad spectrum penicillin
Definition
amoxicillin
Term
amoxicillin side fx
Definition
diarrhea, rash- probiotics to decrease pooze
Term
pnc is still the first line for..
Definition
syphillis
Term
beta-lactamase inhibitors are a subclass of..
Definition
pnc
Term
pnc are never used alone, or at all with the tx of
Definition
streptococcal pneumonia
Term
rocephin is a..
Definition
cephalosporin
Term
rocephin can be given im/iv and may cause..
Definition
pain upon injection, can cause oral/vaginal candidis, and diarrhea
Term
what causes redman's syndrome from infusing too quickly?
Definition
Vancomycin
Term
tetracycline is the go to for..
Definition
the clap syph and gonorrhea!
Term
macrolide..
Definition
emycin, erythramycin ALL mycins (except genta)
Term
macrolides have numerous
Definition
DI's because of the cyp450 thing- aed's, warfarin, antifungals, hiv meds, verpamil, theophylline
Term
cardio side fx of emycin..
Definition
prolonged QT interval
Term
azithromycin is a ? and also known as ?
Definition
macrolide, Z PACK
Term
vancomycin and clindamycin have no..
Definition
class name
Term
clindamycin is used for..
Definition
serious strep infections, gangrene, MRSA- causes the most c dif colitis out of all abx
Term
linezolid is its own..
Definition
class of drug!- used to treat VRE, serious MRSA
Term
side fx of linezolid
Definition
headache, neuropathy, bone marrow suppresion(myelopathy) monitor CBC
Term
major aminogylcoside side fx
Definition
ototoxicity, nephrotoxicity
Term
sulfa drugs are used to treat
Definition
MRSA, uti's
Term
side fx of sulfa drugs
Definition
SJS, toxic epidermal necrosis (25% mortality rate), photosensitivity, hemolytic anemia- check the CBC
Term
sulfa drugs can cause what in urine
Definition
crystals in kidneys so PUSH FLUIDS
Term
you shouldnt give sulfa during what stage of pregnancy?
Definition
the last stage, or breastfeeding. can cause bilirubin deposits in baby's brain (kernicterus)
Term
the folate deficient shouldnt take..
Definition
sulfa drugs- megaloblastic anemia - alcoholic, pg, frail ppls
Term
nitrofurantoin..
Definition
macrobid- uti's- treat and prevent, turns urine brown
Term
in order to take nitrofurantoin/macrobid pt must
Definition
have creatine clearance, so contraindicated in elderly
Term
cipro works by..
Definition
inhibits DNA enzyme in susceptible microorganisms, interferring with replication
Term
cipro side fx..
Definition
remember how you felt?
Term
what to abx are highly contraindicated during pregnacny
Definition
the two QT's- quinolones and tetracycline
Term
amphotericin is a..
Definition
antifungal
Term
isoniazide (INH) is used to treat
Definition
TB
Term
rifampin is used to treat
Definition
TB
Term
you should monitor what with rifampin..
Definition
sxs of hepatoxicity
Term
rifampin has high di's with hiv meds which is bad because..
Definition
lots of hiv pts have TB
Term
ethambutol is used to treat
Definition
TB- can cause optic neuritis- blurred vision/color changes,
Term
PZA pyrazinamide is used to treat..
Definition
TB- hepatotoxic
Term
are antivirals for hsv hzv safe during pregnancy?
Definition
yes
Term
go to med for streptococcus pneumonia
Definition
penicillins
Term
penicillins are used for..(5)
Definition
tx of pneumonia, meningitis, endocarditis(viridans), and pharyngitis(pyrogenes) and syphylis
Term
ceph's treat..
Definition
uti's, postop infection, pelvic infections, and meningitis
Term
cephalosporins act how?
Definition
beta-lactam abx, destroy bacterial cell wall
Term
is alcohol ok while taking cephalosporins?
Definition
NO!
Term
vanco is first line for
Definition
MRSA and c. diff
Term
vanco adverse fx
Definition
otoxicity, infusion reactions, thrombophlebitis
Term
abx that act on bacterial cell wall
Definition
CILLINS, CEPHS, and VANCO
Term
tetracyclines work by..
Definition
preventing protein sythesis
Term
tetras treat..
Definition
chlamydias(westford), pneumonia(mycoplasma), lyme disease, ANTHRAX, h. pylori
Term
side fx of tetras
Definition
gi, tooth discoloration, sunburn more easily, suprainfection of the bowel- dizzy lightheaded with minocycline
Term
tetras interact with..
Definition
milk products, calcium, laxatives w/ Mg, and antacids.. decreases effectivnes off BIRTH CONTROL
Term
tetracycline should be taken..
Definition
on an empty stomach - with a full glass of water. Mono and doxy can be taken with food
Term
macrolide drugs..
Definition
erythromycin! azithromycin!
Term
macrolides are used for the tx of..
Definition
chlamydia pertussis, legionnaire's, diptheria, mycoplasma pneumonia
Term
macrolides can cause
Definition
prolonged QT intervals
Term
macrolides are highly contraindicated in pts with
Definition
pre-existing liver disease- antihistamines, asthma meds, AED, and anticoags (leads to toxicity of these drugs)
Term
gentamicin is the drug of choice against
Definition
e. coli
Term
gentamicin is a type of
Definition
aminoglycoside (amino-acts on dna synthesis)
Term
side fx of gentamicin
Definition
ototoxicity, nephrotoxicity,
Term
sulfa drugs work by..
Definition
preventing the synthesis of folic acid- which is essential for the production of dna, rna, and proteins
Term
side fx of sulfas
Definition
SJS- anemias- crystalluria- kernicturus- photsensitivity-
Term
sulfas can increase the effects of what drugs?
Definition
coumadin, dilantin, and sulfonyurea oral hypoglycemics
Term
fluoroquinoline drugs..
Definition
cipro and levofloxacin
Term
cipro is the med of choice for..
Definition
ANTHRAX
Term
side fx for fluoroquinolines/cipro
Definition
achilles tendon rupture, suprainfection(yeast)
Term
cipro shouldnt be given to..
Definition
people under the age of 18 because of tendon rupture risk- unless they're being treated for e. coli, uti, or anthrax
Term
cipro may increase drug levels with
Definition
coumadin, watch PT time
Term
metronidazole/flagyl is used to treat..
Definition
parasitic infections/c. diff
Term
isoniazid is used to treat
Definition
tb
Term
multiple med therapy is need for tb after..
Definition
the latent period is over (6-9 months) a minimum of six months of tx is needed to get rid of active TB
Term
side fx of isoniazid
Definition
peripheral neuropathy (b6 deficiency), hepatotoxicity,
Term
what is pyrazinamide used to treat?
Definition
TB
Term
rifampin is used to treat..
Definition
tb
Term
rifampin may cause..
Definition
discoloration of body fluids, hepatotoxicity, mild gi discomfort
Term
rifampin may decrease effectiveness of..
Definition
warfarin, contraceptives, and hiv meds(increase dosage of hiv meds)
Term
INH and pyrazinamide taken together increases risk for..
Definition
hepatotoxicity
Term
flagyl is used to..
Definition
treat protozoal infections, c. diff, and prophylaxis in pts post op.
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