Pharm exam 3 study guide

Metformin

Biguanide; increases insulin sensitivity and decreases hepatic glucose production; side effects: GI upset, lactic acidosis, metallic taste.

Glipizide / Glyburide

Sulfonylureas; stimulate pancreas to release insulin; side effects: hypoglycemia, weight gain.

Repaglinide / Nateglinide

Meglitinides; short-acting insulin secretagogues; side effects: hypoglycemia, weight gain.

Levothyroxine

Synthetic T4 thyroid hormone; increases metabolism; used for hypothyroidism; take on empty stomach; monitor TSH.

Calcitriol

Vitamin D analog; increases calcium absorption; used in hypocalcemia, CKD, hypoparathyroidism; monitor calcium levels.

Prednisone

Glucocorticoid; anti-inflammatory and immunosuppressant; side effects: hyperglycemia, weight gain, infection risk.

Insulin Lispro

Rapid-acting insulin; onset ~15 min; take with meals; risk of hypoglycemia.

Regular Insulin

Short-acting insulin; onset 30–60 min; IV form used for DKA; give before meals.

NPH Insulin

Intermediate-acting insulin; cloudy appearance; peaks at 4–12 hrs; often combined with regular insulin.

Glargine (Lantus)

Long-acting insulin; provides steady basal coverage; do not mix with other insulins.

Aspirin

Salicylate; irreversibly inhibits COX-1/COX-2; used for pain, inflammation, antiplatelet; watch for GI bleed and tinnitus.

Ibuprofen

NSAID; inhibits COX enzymes; reduces pain, fever, inflammation; side effects: GI upset, renal damage.

Celecoxib

COX-2 selective NSAID; less GI risk but increased cardiovascular risk.

Infliximab

Biologic DMARD; inhibits TNF-α; used in rheumatoid arthritis and Crohn’s; infection risk, infusion reactions.

Febuxostat

Antigout agent; xanthine oxidase inhibitor; reduces uric acid production; monitor for joint pain, liver function.

Acetaminophen

Non-opioid analgesic; reduces pain and fever (no anti-inflammatory effect); hepatotoxicity in overdose.

Morphine Sulfate

Opioid analgesic; binds to opioid receptors; side effects: respiratory depression, constipation, sedation.

Nalbuphine

Mixed opioid agonist-antagonist; used for moderate to severe pain; fewer respiratory effects than morphine.

Sumatriptan

Antimigraine (triptan); vasoconstricts cranial vessels; used to abort migraines; side effects: chest tightness, serotonin syndrome.

Doxycycline

Tetracycline antibiotic; inhibits bacterial protein synthesis; avoid in kids/pregnancy; side effects: photosensitivity, GI upset.

Gentamicin

Aminoglycoside antibiotic; inhibits protein synthesis; side effects: nephrotoxicity, ototoxicity; monitor drug levels.

Ciprofloxacin

Fluoroquinolone; inhibits DNA replication enzymes; used for UTIs and respiratory infections; risk of tendon rupture.

TMP-SMZ

Sulfonamide combo (Trimethoprim-Sulfamethoxazole); inhibits folic acid synthesis; used for uncomplicated UTI; side effects: rash, crystalluria, photosensitivity.

Biguanides

Metformin

Sulfonylureas

Glipizide, Glyburide

Meglitinides

Repaglinide, Nateglinide

Rapid-Acting Insulins

Insulin Lispro, Insulin Aspart

Short-Acting Insulins

Regular Insulin (Humulin R, Novolin R)

Intermediate-Acting Insulins

NPH Insulin

Long-Acting Insulins

Insulin Glargine (Lantus), Insulin Detemir (Levemir)

Salicylates

Aspirin (ASA)

NSAIDs

Ibuprofen, Celecoxib

Glucocorticoids

Prednisone, Hydrocortisone, Dexamethasone

Thyroid Hormones

Levothyroxine (T4), Liothyronine (T3)

Vitamin D Analog

Calcitriol

Biologic DMARDs

Infliximab

Antigout Drugs

Febuxostat, Allopurinol

Non-opioid Analgesics

Acetaminophen

Opioid Analgesics

Morphine Sulfate, Nalbuphine

Triptans (Antimigraine)

Sumatriptan

Tetracycline Antibiotics

Doxycycline

Aminoglycoside Antibiotics

Gentamicin

Fluoroquinolone Antibiotics

Ciprofloxacin

Sulfonamide Antibiotics

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

UTI meds

sulfonamides, fluoroquinolones(levoflaxinandciproflaxin),and phenazopyridine (not antibiotic)

Aspirin

Salicylate NSAID; inhibits COX-1 and COX-2; antiplatelet and anti-inflammatory.

Ibuprofen

First-generation NSAID; reversibly inhibits COX-1/COX-2; used for pain and fever.

Celecoxib

COX-2 selective NSAID; less GI upset, but higher cardiovascular risk.

Infliximab

Biologic DMARD that inhibits TNF-α; used for rheumatoid arthritis and Crohn's; increases infection risk.

Febuxostat

Antigout drug that inhibits xanthine oxidase, reducing uric acid levels.

Allopurinol

Similar to febuxostat; used for long-term gout prevention.

Colchicine

Used for acute gout attacks; reduces inflammation; GI upset is common.

NSAIDs for Gout

Used in acute attacks; avoid aspirin as it may worsen symptoms.

Nalbuphine

Mixed opioid agonist-antagonist; less respiratory depression than morphine.

Aspirin Therapeutic Range

15–30 mg/dL

Acetaminophen Therapeutic Range

10–20 mcg/mL

Migraine

Throbbing head pain often with aura and nausea; treated with triptans.

Cluster Headache

Sharp, one-sided pain behind the eye; treated with oxygen and triptans.

Adjuvant Therapy

Non-analgesic medications used to enhance pain relief (e.g., antidepressants).

Analgesic Titration

Gradually increasing pain meds to achieve effective relief with minimal side effects.

Doxycycline

Tetracycline antibiotic; avoid dairy/iron; photosensitivity risk; do not use in pregnancy/kids.

Gentamicin

Aminoglycoside antibiotic; risk of ototoxicity and nephrotoxicity; requires peak/trough monitoring.

Ototoxicity Signs

Ringing in ears, balance issues, hearing loss—common with aminoglycosides.

Nephrotoxicity Signs

Elevated BUN/creatinine, decreased urine output—monitor during aminoglycoside therapy.

Aminoglycoside Trough

Measured before next dose; ensures drug is not accumulating to toxic levels.

Aminoglycoside Peak

Measured 30–60 min after dose; confirms therapeutic level.

TMP-SMZ

Sulfonamide combo antibiotic; used for UTIs; side effects: rash, crystalluria, photosensitivity.

Sulfadiazine

Sulfonamide used for toxoplasmosis; similar side effects to TMP-SMZ.

Nitrofurantoin

Urinary antiseptic; used for lower UTIs only; turns urine brown; avoid in renal impairment.

Fosfomycin

Single-dose treatment for uncomplicated UTI in women.

Ciprofloxacin

Fluoroquinolone; used for complicated UTI and pyelonephritis; risk of tendon rupture.

Amoxicillin-clavulanate

Broad-spectrum penicillin; used for UTI, E. coli, and Klebsiella; risk of diarrhea and yeast infection.

Phenazopyridine

Urinary analgesic for UTI pain; turns urine orange; use short-term only.