Test 1 -- Things to Drill

things I don't know as well as I should for Test 1

What do Nitrates Treat?

Angina (drug dialates the blood vessels)

Do not combine Nitrates with?

Sildenafil, tadalafil, or vardenafil

Nitrates most common side effect?

headache

clopidogrel — what does it need to become active

it’s a prodrug - needs to be activated in liver enzymes (CYP2C19 & CYP34)

Drug Groups that make clopidogrel (Plaxis) less effective

PPI (proton pump inhibitors) — block liver enzymes and make this medication less effective

What should you do when taking Vitamin D2 (ergocalciferol)?

Take w/ a fat containing meal

cyancobalamin — what needs injection or high dose oral?

if deficiency is from pernicious anemia or gastiric surgery since the deficiency is an absorption problem and not an intake issue

What lowers B12 (cyancobalamin) levels?

Long-term metformin & PPI

What helps iron absorption?

Vitamin C or orange juice & empty stomach

What reduces iron absorption?

anatacids, PPIs or H2 blockers, calcium supplements, dairy, coffee, tea, high fiber foods, eggs, taking with food

Drug groups where absorption blocked by iron OR calcium

tetracyclines, flouroquinolones, levothyroxine (NTI), bisphosphonates

Ferrous gluconate elemental iron content

12% elemental iron (325mg gives 39mg elemental iron)F

Ferrous sulfate elemental iron content

20% elemental iron (325mg gives 65mg elemental iron)

levothyroxine

NTI drug, needs to be taken on empty stomach

Injecting a suspension risks what?

embolism (clotting)

Splitting Extended Release tablet can be fatal in what groups?

calcium channel blocker or opiod

apixaban - premature discontinuation risks what?

Increased risk of thromboembolism events. Increases stroke & clot risks (spinal hematoma risk)
FLAG MISSED REFILLS

amlodipine (Norvasc) & Lotrel have this common, not dangerous, side effect

peripheral edema — swelling of ankles and lower legs; most common reason patients stop taking these drugs

Cardiovascular drug (not a statin) grapefruit effects?

amlodipine (Norvasc) & also Lotrel

What is used as a 1st line hypertension treatment?

thiazide and thiazide-like diuretics (hydrochlorotthiazide [Microzide]) & chlorthalidone [Hygroto])

What allergy is a risk with thiazide & thiazide like diuretics (also the combo drugs)?

sulfa allergy

what time of the day should thiazide & thiazide like diuretics be taken?

morning dose

things thiazide and thiazide-like diuretics raise

hyperglycemia (glucose) & hyperuricemia (uric acid)

drug group that may trigger gout

thiazide & thiazide-like diuretics

electrolytes that thiazide and thiazide-like drugs impact

sodium & magnesium (lower), uric acid (raise)

drug classes that have photosensitivity

thiazide & thiazide-like diuretics (hydrochlorothiazide/Microzide; chlorthalidone/Hygroto) & loop diuretics (-semide; furosemide/Lasix)

triamterene/Dyrenium (potassium sparing diuretic) unique side effects

can turn urine blue

adverse effects from too much potassium

cardiac rhythm changes

spironolactone/Aldactone unique side effect

gynecomastia — breast tissue enlargement in men (hormones)

furosemide/Lasix (Loop diuretic) unique adverse effect

ototoxicity — rapid IV admin or high doses can cause hearing loss or tinitus

ezetimibe/Zetia mechanism

blocks cholesterol absorption in the intestine; usually added to a statin

beta blocker (metoprolol) adverse effect of stopping abruptly

worsen angina, hypertension, heart attack or rhythm change (tachycardia)

beta blocker (metoprolol) can mask what?

fatigue, dizziness, slow HR can mask warning signs of low blood sugar in diabetics

carvedilol unique risk

carries more bronchospasm risk than metoprolol in patients with asthma or COPD