Random Info (not AI generated) ✅ Flashcards by noelle wilson

What serum creatinine level should be monitored for in a pt taking ACEIs & ARBs?

increase > 30% or >2.5 mg/dL

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what to note about non-DHP CCBs?

slow AV conduction

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how can NSAIDs impact diuretcs?

can decrease their effect

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what toxicity can diuretics cause?

lithium toxicity (increased risk)

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what blocks secretion of diuretics?

probenecid

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what is the mechanism of action of digoxin?

Inhibits sodium potassium pump → increases intracellular Ca²⁺ → increased inotropy; decreased chronotropy.

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what is digoxin indicated for?

HF with reduced EF + persistent symptoms; AF control

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what is the half-life of digoxin?

36-48 hrs

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how long does it take for digoxin to reach steady state?

without a loading dose, steady state is achieved in about 1 week

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what are the signs of digoxin toxicity?

GI (N/V)
CNS (visual halos)
arrhythmias

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what to note about statins? (3)

first line
contraindicated in pregnancy
monitor LFTs

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what to note about bile acid sequestrates? (2)

safe in pregnancy
used for hyperlipidemia

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what does ezetimibe do?

inhibits intestinal cholesterol absorption

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what are PCSK9 inhibitors (alirocumab, evolocumab)?

monoclonal antibodies that dramatically lower low-density lipoprotein (LDL) cholesterol

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What impact do Fibrates (gemfibrozil, fenofibrate) have?

↓ TGs 30–50%, ↑ HDL

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when should lipid panel be checked?

4–6 weeks after dose change

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What do direct renin inhibitors like Aliskiren do?

blocks renin & decrease angiotensin I

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what are direct renin inhibitors indicated for?

HTN only

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what are ADRs of direct renin inhibitors?

hyperkalemia & renal dysfunction

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what should be monitored for a pt taking direct renin inhibitors?

Blood pressure
creatinine
potassium

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contraindications for direct renin inhibitors?

pregnancy
diabetics on ACEI/ARB

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what can happen with continuous use of nitrates like nitroglycerin?

tolerance: requires nitrate-free intervals

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what effect does hydralazine have?

direct arteriolar relaxation

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how is hydralazine metabolized?

by acetylation

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ADRs of hydralazine?

reflex tachycardia and lupus-like syndrome (monitor for arthralgia).

what effect does minoxidil have?

potent arteriolar dilator via K⁺ channel opening

ADRs of minoxidil?

fluid retention & hypertrichosis (excessive hair growth)

what should be used w minoxidil if ADRs occur?

diuretic and beta blocker

what should be monitored w pts taking minoxidil?

weight & HR

ADRs vs benefits of contraceptives?

VTE risk acne improvement bone density gain

what should be monitored in a pt taking testosterone?

DRE, PSA, lipids, LFTs, CBC

what are different antiandrogens? (3)

5α-reductase inhibitors (finasteride) GnRH modulators direct receptor antagonists (flutamide).

ADRs of estrogen?

VTE and HTN

ADRs of progesterones?

irregular bleeding & osteoporosis risk

what kind of actions do SERMs such as tamoxifen, raloxifene, and ospemifene have?

tissue-specific agonist/antagonist actions

what is used for medical abortion?

Mifepristone: progesterone antagonist

ADRs of Bisphosphonates?

osteonecrosis of the jaw & atypical fractures

instructions for Bisphosphonates?

take on empty stomach remain upright for 30 or more minutes

half life of Bisphosphonates?

up to years

monitoring for Bisphosphonates?

bone density 1-2 yrs renal function GI sx

what drugs are Teriparatide/abaloparatide?

intermittent PTH analogs

what are PTH analogs like Teriparatide & abaloparatide used for?

bone formation

how long can a pt be on Teriparatide or abaloparatide?

max 2 years

what should be monitored for a pt taking Teriparatide/abaloparatide?

calcium

what is Denosumab?

a RANKL inhibitor

what monitoring must be done for a pt taking Denosumab?

serum calcium every 6 months

ADR of Denosumab?

immunosuppression?

what is Romosozumab?

a sclerostin inhibitor

what monitoring is needed for a pt on Romosozumab?

monthly serum calcium

black box for Romosozumab?

CV event

what are Allopurinol & febuxostat?

xanthine oxidase inhibitors

what is the goal for pts taking Allopurinol & febuxostat?

target urate < 6 mg/dL

ADR of febuxostat?

increased CV risk

when is colchicine used?

acute flares of gout

what is important to note about colchicine?

CYP3A4 interactions

what does probenecid do?

increases uric acid excretion

what should probenecid be avoided in?

renal stones

tx for osteoarthitis?

acetaminophen, topical NSAIDs

what should pts with osteoarthritis avoid?

avoid long-term glucosamine

if a pt with RA is prescribed methotrexate, what supplement do they need?

folate

pts with RA taking hydroxychloroquine need what?

regular ocular screenings

what biologics could someone w RA be on?

TNF-α inhibitors

what must a pt be screened for before starting biologics?

TB and hepatitis

what is the cornerstone of osteoporosis prevention & what is important to note?

Calcium + vitamin D dietary sources preferred

what OUD drug is a full agonist? when?

Methadone: full agonist at withdrawal onset.

what OUD med is a partial agonist?

Buprenorphine

when should Buprenorphine be started?

8 hrs post opioid

what OUD med is an antagonist?

naltrexone

when should naltrexone be started?

7-10 days after last opioid

forms of naltrexone?

Daily oral pill OR extended release injection once a month.

contraindications for naltrexone?

liver disease active opioid use

what/when are adjunct txs used for OUD?

clonidine or lofexidine for withdrawal symptoms.

what is used for opioid overdose?

naloxone intranasal/IV until EMS arrival.

what can cause poor analgesia when taking hydrocodone?

hydrocodone + CYP2D6 inhibitors → poor analgesia

how to taper benzos?

switch to diazepam, then wean over 8–12 weeks

what is used in benzo overdose?

flumazenil (only in emergencies)

forms of NRT?

patch, gum, lozenge, nasal spray, inhaler

how long is NRT patch worn?

16-24 hrs

pt teaching for nicotine gum?

chew slowly and hold between cheek and gum

pt teaching for nicotine lozenge?

slow release in mouth

what to note about NRT inhaler?

needs prescription mimics act of smoking

what is the fastest acting NRT?

nasal spray

sx of nicotine withdrawal?

irritability, anxiety, insomnia, increased appetite.

what vaccines require boosters?

Inactivated: DTaP, IPV, Hib, Hep A/B, HPV, pneumococcal, meningococcal

schedule for MMR?

12–15 months & 4–6 years

contraindications of MMR/MMRV?

pregnancy immunocompromised

safety issues w MMR/MMRV?

febrile seizures possible reaction timeline travel-related early dosing

MMR international travel guidelines?

Infants 6 to 11 months old: Should receive one dose of MMR at least 2 weeks before travel. Children 12 months or older: Should have two doses of MMR administered at least 28 days apart before international

schedule for rotavirus vaccine?

RV1 at 2 & 4 months; RV5 at 2, 4, 6 months; finish by 32 weeks.

ADR of rotavirus vaccine?

intussusception risk within 31 days of dose.

immunoglobulins provide what?

passive immunity

when should immunoglobulins be avoided?

avoid within 3 months of live vaccines

when are PPD tests read? how are they interpreted?

PPD: read 48–72 hr; interpret by risk category.

list examples of both direct & indirect costs in healthcare

Direct costs: drug price, HCP time, diagnostics Indirect costs: lost wages, morbidity/mortality.

what does cost-effectiveness studies analyze?

cost per quality-adjusted life-year (QALY)

regarding pharmacoeconomics, what should be avoided?

avoid pure cost-benefit in dollars

what needs to be assessed for when a pt is on methadone?

Prolonged QT

what other meds can cause prolonged QT?

SSRI’s, antidepressants, anti-psychotics, some antibiotics (macrolides - erythromycin, fluoroquinolones - levofloxacin) and antifungals - fluconazole

aside from pain contracts what else should be used when a pt is provided controlled substances? (5)

urine drug screening pill counts single prescriber compliance agreement consequences for noncompliance.

What is cytokine release syndrome?

cytokine storm – T-cells in body overreact to infection/cancer

when does cytokine release syndrome occur?

occurs minutes up to 14 days post-monoclonal antibody infusion (e.g., rituximab)

Sx of cytokine release syndrome? (6)

fever hypotension chills rash tachycardia dyspnea

Management of cytokine release syndrome? (5)

stop infusion supportive care acetaminophen steroids tocilizumab **acute reaction requiring dose monitoring**

who is off-label prescribing esp common in?

pediatrics (also rare diseases)

Random Info (not AI generated) ✅ Flashcards

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