Pharmacy and Medical Therapeutics Lecture Review

Comprehensive fill-in-the-blank practice flashcards covering diabetes, hypertension, dyslipidemia, heart failure, anticoagulation, and asthma management based on the lecture notes.

Major microvascular complications of diabetes include retinopathy, nephropathy, and __________.

neuropathy

Macrovascular complications of diabetes include coronary artery disease, __________, and peripheral vascular disease.

stroke

The fastest acting insulin listed is insulin __________, while the longest acting is insulin degludec.

glulisine

According to the notes, GLP-1 receptor agonists and __________ should NOT be used together.

DPP-4 inhibitors

The preferred medication for gestational diabetes is __________, although metformin and glyburide can also be used.

insulin

The brand name for insulin glargine $100\,u/mL$ is Lantus, and the concentrated $300\,u/mL$ version is called __________.

Toujeo

Ultra-Long Acting insulin degludec is known by the brand name __________.

Tresiba

All pens made by Sanofi, including Lantus and Toujeo, are known as __________ pens.

SoloStar

Regular insulin (Humulin R, Novolin R) should be injected SQ __________ minutes before meals.

$$30$$

NPH insulin (Humulin N, Novolin N) is typically given as a basal insulin __________ times per day.

$$2$$

The combination product Humulin $70/30$ consists of $70\%$ NPH and $30\%$ __________.

regular insulin

Insulin should be considered in Type 2 Diabetes patients if their A1c is greater than or equal to __________.

$$10\%$$

In a catabolic state such as __________, insulin therapy should be initiated immediately.

Diabetic Ketoacidosis (DKA)

The starting dose for basal insulin in Type 2 Diabetes is either $10\,u/day$ or __________ units/kg/day.

$$0.1-0.2$$

Basal insulin dosing should be titrated based on the patient's __________.

fasting glucose

When transitioning a patient from Toujeo to insulin glargine, you should use __________ of the Toujeo dose.

$$80\%$$

Regular insulin is the preferred form for __________ infusions or parenteral nutrition.

IV

When mixing insulin in a syringe, the provider should always draw up the __________ insulin before the cloudy insulin.

clear

NPH insulin is characterized by its __________ appearance compared to the clear appearance of regular insulin.

cloudy

A standard insulin pen contains $3\,mL$ of insulin, but the __________ pen also comes in a $1.5\,mL$ size.

Toujeo

According to the notes, when calculating insulin dispensing units, you must always __________ to the nearest whole pen or vial.

round up

Humulin R $U-500$ vials are stable at room temperature for __________ days.

$$40$$

The insulin pen with the longest room temperature stability ($56$ days) is __________.

Tresiba

Lantus, Basaglar, and Semeglee vials and pens are stable at room temperature for __________ days.

$$28$$

In the management of DKA, the first step is to administer $2000\,mL$ of __________.

fluids

During DKA treatment, when blood glucose reaches $250\,mg/dL$, the IV fluid should be changed to __________.

D5W

The obesity medication Qsymia is a combination of __________ and topiramate.

phentermine

Qsymia is contraindicated in pregnancy and requires a __________ program for dispensing.

REMS

Orlistat (Xenical/Alli) works as a __________ inhibitor to decrease fat absorption.

pancreatic lipase

A common and unpleasant side effect of Orlistat is __________, often described in the notes as 'oily diarrhea'.

steatorrhea

Naltrexone/bupropion, brand name __________, is contraindicated in patients with seizure disorders.

Contrave

The GLP-1 receptor agonist Saxenda (liraglutide) is titrated to a final daily dose of __________.

$$3\,mg$$

The dual GIP/GLP-1 receptor agonist __________ is marketed under the brand name Zepbound for weight loss.

tirzepatide

The statin conversion chart lists Pitavastatin at a dose of __________.

$$2\,mg$$

The statin conversion chart lists Rosuvastatin at a dose of __________.

$$5\,mg$$

In the statin conversion chart, $20\,mg$ of simvastatin is equivalent to __________ of atorwastatin.

$$10\,mg$$

In the statin conversion chart, both lovastatin and __________ have an equivalent dose of $40\,mg$.

pravastatin

Fluvastatin, noted as Lescol in the transcript, has a conversion dose of __________.

$$80\,mg$$

A high-intensity statin is required for primary prevention in patients with an LDL level of __________ or higher.

$$190\,mg/dL$$

For secondary prevention of clinical ASCVD, the recommended treatment is a __________ statin.

high intensity

Drugs that increase only triglycerides include IV lipid emulsions and the sedative __________.

propofol

Fish oils, with the exception of __________, can actually increase LDL levels while decreasing triglycerides.

Vascepa

Statin levels can be increased by 'G PACMAN' inhibitors, which stand for __________ inhibitors.

CYP3A4

Typical Blood Pressure goals for general hypertension are less than __________.

$$130/80\,mmHg$$

The first-line antihypertensive classes include ACE inhibitors, ARBs, CCBs, and __________ diuretics.

thiazide

In Black patients without CKD or diabetes, the preferred first-line HTN meds are thiazides or __________.

CCBs

ACE inhibitors or ARBs are the first-line choice for HTN patients with __________.

CKD

Common medications for hypertension in pregnancy include Labetalol, Nifedipine ER, and __________.

Methyldopa

Thiazide diuretics should be monitored for the side effects of hypokalemia and __________.

hyponatremia

Thiazide diuretics are generally not effective if the patient's CrCl is less than __________.

$$30\,mL/min$$

The only thiazide-type diuretic that remains effective with a CrCl below $30$ is __________.

metolazone

Spironolactone is a potassium-sparing diuretic that can cause __________, or breast tissue enlargement in men.

gynecomastia

Mineralocorticoid receptor antagonists (MRAs) like spironolactone can increase the toxicity of the psychiatric drug __________.

lithium

The MRA __________ is a major substrate of CYP3A4 and should not be used with strong inhibitors.

eplerenone

Non-dihydropyridine CCBs, like diltiazem and verapamil, should be avoided in patients with __________.

HFrEF

A common side effect of verapamil mentioned in the notes is __________.

constipation

Gingival hyperplasia is a potential side effect associated with the use of __________.

Calcium Channel Blockers (CCBs)

Dihydropyridine CCBs are known for causing dose-related __________.

peripheral edema

CCBs like amlodipine and nifedipine ER are used for the treatment of __________ Disease, characterized by cold-induced vasospasm.

Raynaud's

The most common side effect specific to ACE inhibitors, which often leads to switching to an ARB, is a __________.

dry cough

ACE inhibitors should never be used concurrently with the heart failure medication __________.

Entresto

Beta-blockers should be used with caution in diabetes because they can __________.

mask hypoglycemia

Propranolol is useful for migraine prophylaxis and essential tremor because it has high __________ and crosses the blood-brain barrier.

lipid solubility

Coreg (carvedilol) is a non-selective beta-blocker that also blocks __________ receptors.

alpha-1

Stopping centrally acting alpha-2 agonists like clonidine abruptly can result in __________ hypertension.

rebound

A unique side effect of methyldopa and high-dose hydralazine is drug-induced __________.

lupus

Hypertensive emergency is defined by a BP of $180/120\,mmHg$ with evidence of __________.

target organ damage

The treatment goal for hypertensive emergency is to reduce MAP by __________ within the first hour.

$$25\%$$

In HFrEF, there should be a __________ hour washout period when switching from an ACE inhibitor to an ARNI.

$$36$$

SGLT2 inhibitors like empagliflozin and __________ are part of the 'treatment backbone' for heart failure.

dapagliflozin

To initiate an MRA in heart failure, the patient's potassium must be less than or equal to __________.

$$5\,mEq/L$$

To initiate an MRA in heart failure, the patient's eGFR must be greater than __________.

$$30\,mL/min/1.73m^2$$

Unfractionated Heparin (UFH) works by binding to __________ to inactivate Factors IIa and Xa.

antithrombin

The antidote for heparin and low molecular weight heparin (LMWH) is __________.

protamine

Lovenox syringes should not have the __________ removed before administration.

air bubble

If a patient experiences HIT (Heparin-Induced Thrombocytopenia), they should be switched to a non-heparin anticoagulant like __________.

argatroban

Eliquis (apixaban) is dosed at $2.5\,mg$ BID for Nonvalvular Atrial Fibrillation if the patient meets two of three criteria: Age > 80, Weight < 60kg, or __________.

SCr > 1.5

Doses of Xarelto should be taken with the __________ when higher than $15\,mg$.

evening meal

If a patient on Xarelto $15\,mg$ BID misses a dose, they should take __________ immediately to ensure they receive $30\,mg$ for the day.

two tablets

Savaysa (edoxaban) should not be used for stroke prevention if the patient's CrCl is greater than __________.

$$95\,mL/min$$

Dabigatran (Pradaxa) must be kept in its __________ and discarded 4 months after opening.

original container

The specific antidote for dabigatran is __________.

idarucizumab

Warfarin works by inhibiting the enzyme Vitamin K epoxide reductase (VKORC1) and affects Factors II, VII, IX, and __________.

$$10$$

One of the serious side effects of warfarin is __________ syndrome.

purple toe

Natural medicines that increase bleeding risk when taken with warfarin include the '5 G's': Garlic, Ginger, Ginseng, Glucosamine, and __________.

Ginkgo

For a warfarin patient with an INR > 10 and NO bleeding, the recommendation is to give __________ Vitamin K.

oral

Urgent reversal of warfarin-induced major bleeding requires Vitamin K and __________.

Kcentra (PCC)

Warfarin should generally be stopped __________ days before major surgery.

$$5$$

The __________ score is used to determine if a patient with Atrial Fibrillation requires oral anticoagulation.

CHA2DS2-VASc

In Atrial Fibrillation, if the score is greater than or equal to $2$ in males or __________ in females, anticoagulation is recommended.

$$3$$

The term 'MART' in asthma therapy stands for __________.

Maintenance And Reliever Therapy

In Track 1 of the GINA guidelines, the preferred reliever for asthma is a low-dose __________ combination.

ICS-formoterol

Budesonide is the only ICS available as a __________ solution, making it useful for children.

nebulized

After using an inhaled corticosteroid, patients must __________ to prevent oral thrush.

rinse their mouth

Montelukast carries a Black Box Warning for serious __________ events.

neuropsychiatric

The therapeutic range for theophylline is __________.

$$5-15\,mcg/mL$$

Theophylline can decrease the levels of the psychiatric medication __________.

lithium

Omalizumab is an injectable monoclonal antibody used for severe allergic asthma that targets __________.

IgE

Mepolizumab and reslizumab are monoclonal antibodies that target __________ for severe eosinophilic asthma.

IL-5

The medication __________ is a dual GLP-1/GIP agonist used for both diabetes (Mounjaro) and weight loss (Zepbound).

tirzepatide