Pharm Final Exam

Glipizide

Anti-diabetes

What are the main points of glipizide?

• contraindicated in type 1 diabetes

• can cause severe hypoglycemia

• avoid alcohol because it causes disulfrant reaction

• take same time everyday, 30 mins before meals

metformin

anti-diabetic

What are the main points of metformin?

• does not cause hypoglycemia

• risk of lactic acidosis

• used adjunct with diet and exercise

• can cause GI upset, N+V, diarrhea, weakness

Sitagliptan

anti-diabetes

What are the main points of sitagliptan?

• causes hypoglycemia

• can cause hypersensitivity (should stop taking)

• blisters, pancreatitis

• dose adjustment if kidney disease

Levothyroxine

thyroid medication

What are the main points of levothyroxine?

• synthetic t4 that maintains metabolism

• treats hypothyroidism

• take with water, empty stomach, before breakfast

• lifelong therapy

• not used for weight loss

• can cause cardiac dysthymias, hold if there are symptoms

Morphine

opiod

What are the key points of morphine?

• treats acute or chronic moderate to severe pain

• can cause respiratory depression, N+V, sedation, constipation, hypotension

• antidote: narcan

• should not be taken with other CNS depressants

• can be addictive

Hydromorphone

opiod

What are they key factors of hydromorphone?

• manages acute or chronic moderate to severe pain

• same as morphine but 5-7 times stronger

• can cause respiratory depression, hypotension, bradycardia, urinary retention

• avoid dosing errors

• antidote: narcan

• can cause addiction, abuse, misuse

Oxycodone

opiod

What are key factors of oxycodone?

• manages moderate to severe pain

• can cause respiratory depression, hypotension N+V, constipation

• dont combine with other CNS depressants

• can cause abuse, addiction, misuse

Narcan

opiod antagonist

What are key factors of narcan?

• reverses the symptoms of opioids

• pain comes back

• can cause tremors, increased HR, hypertension

• can cause agitation since pain is coming back

Ibuprofen

NSAID

What are main factors of Ibuprofen?

• blocks COX 1 and 2

• treats mild to moderate pain, fever, and inflammation

• can cause GI issues, constipation, N+V, headache, renal failure

• Steven Johnson syndrome: blisters on face

• not used after CABG

Aspirin

NSAID

What are key points of aspirin?

• treats mild to moderate pain, fever, inflammation and reduces risk of MI and stroke

• anticoagulant

• avoid in children 12 with flu because causes Reyes syndrome (vomiting, confusion)

• can cause GI irritation, tinnitus, and prolongs blood to clot

• allergy risk: swelling, hives, wheezing

Ketorolac

NSAID

What are the key factors of ketorolac?

• used for short term management of moderate to severe pain that requires opiod level

• 5 days max (almost like opiod)

• pain and inflammation relief

• can cause GI issues, drowsiness, headaches, Steven Johnson syndrome, renal failure

• stomach bleeding risk avoid if ulcers

Celecoxib

NSAID

What are the key factors of celecoxib?

• only blocks cox 2

• used to treat pain with arthritis, osteoarthritis

• can cause hypertension, edema

• harder on kidneys

• contraindicated if CABG

• serious risk of cardio events MI, stroke

Acetaminophen

Non-opiod

What are key factors of acetaminophen

• relief of mild to moderate pain and fever

• tylenol

• hard on liver (hepatic failure), monitor liver function

• max dose is 4000 mg, geriatric is 3000, alcoholics is 2000

Baclofen

Muscle Relaxant

What are key factors of baclofen?

• reduces nerve signals to relax muscles

• treats muscle spasms, pain and stiffness

• can cause drowsiness, dizziness, confusion, constipation and muscle weakness

• hallucinations and seizures can happen if you stop abruptly

sumatriptan

anti-migraine

What are the key factors of sumatriptan?

• treats/stops headache/migraine

• not for prevention

• take right when migraine symptom start

• can cause serotonin syndrome, vertigo, dizziness, N+V

• contraindicated in uncontrolled hypertension

gabapentin

anti-convulsant

What are the key factors of gabapentin?

• used for partial seizures and neuropathic pain

• increased risk of suicidal thoughts and behaviors

• monitor for depression

• can harm fetus

calcium carbonate

antacid

what are the key factors of calcium carbonate?

• treats heartburn and indigestion

• can cause electrolyte imbalances (high calcium)

• dont give within 1-2 hours of other meds

famotidine

• short term treatment for GERD and ulcers

• can cause hepatic or renal toxicity

• give 15-20 mins before food

pantoprazole

PPI

What are the key factors of pantoprazole?

• short term treatment of GERD and ulcers

• can cause B-12 defiency

• osteoporsis

• monitor magnesium and zinc

Loperamide

anti-diarreal

What are the key factors of loperamide?

• decreases bowel motility and decreases the flow of fluid

• causes dehydration and decreased electrolytes

• can cause heart arrythmia if you take more than you should

• opiod like med so avoid alc and cns depressants

• dont take if there are already GI toxins or abdomen pain

Psyllium

fiber supplement laxative

What are the key factors of psyllium?

• bulk forming to make a passage for stool

• can cause bloating and cramping

• mix powder with 8oz H2O

• seperate from other meds for 2 hrs

• natural best for long term

Polyethylene glycol

Osmotic agent laxative

What are key factors of polyethylene glycol?

• softens stool and causes water to be retained

• need to stay hydrated and no more than 7 days

• loose watery stool

Bisacodyl

stimulant laxative

What are the key factors of bisacodyl?

• treats constipation and produces BM in 1 hour

• laxative dependence of you use regular

• cause contractions

• stool moves through colon

Ondansetron

antiemetic

What are key factors of ondansetron?

• prevents and treats severe N+V

• doesn’t work with everyone

• can cause seratonin syndrome

• can cause cardiac arrythmias so hold if symptoms

metaclopromido

antiemetic

what are key factors for metaclopromido?

• antimetic and prometic

• treats GERD too

• causes drowsiness

prochloraperzine

antiemetic

what are key factors of prochloraperzine?

• very strong works in mins/secs

• can cause dizziness or drowsiness

• caution in patients with heart and liver disease

Phenobarbital

Barbiturates CNS depressant

what are key factors of barbiturates (phenobarbitital)?

• used as an anti-convulsant

• sedation and pre-anesthesia agent

• potential for addiction

• deadly blood disorders

• suicidal thoughts

• respiratory depression

• sedation

• hypotension

• avoid alc and other cns depressants

• contraindicated in new borns and geriatirics.

Lorezepam

benzodizepines

What are key factors of benzodiazepines?

• can cause paradoxical reactions in kids

• treats anxiety pre op

• sedation

• use cautiously with elderly and liver dysfunction

• short term use (2-4 weeks max)

amitriptyline

Trycyclic (TCA)

What are key factors of amitriptyline?

• first generation antidepressants

• now more used for neuropathic pain and insomnia

• not with MAOIs

• causes sedation, hypotension, cardiotoxicity and anticholergic effects

Tranyleypromine

MAOI

What are the key factors of Tranyleypromine?

• first generation antidepressants (stronger)

• risk of serotonin syndrome

• hypertensive

• hyperglycemia (monitor glucose)

• risk with foods with tyramine

citalopram/fluoxetine

SSRI

What are key factors of citalopram/fluoxetine?

• 2nd generation antidepressant (less side effects)

• treats depression, anxiety, OCD, PTSD

• rashes, seizures,seratonin syndrome

• decreased appetite

• should no be used with MAOIs

• bleeding risk

• can take up to 12 weeks to work

Venlafaxine

SNRI

What are key factors of Venlafaxine?

• 2nd generation antidepressant

• treats major depression

• increased cholesterol and BP

• seratonin syndrome

• dont use with MAOIs

• can take 8 weeks to work

Furosemide

loop diuretic

What are the key factors of furosemide?

• gets rid of excess fluids

• used for heart failure, hypertension, edema, CKD

• can cause dehydration, hypokalemia, hypotension

• contraindicated in anuria

• should eat potassium rich foods

• give slowly because it can cause ototoxicity

• more potent (3 parts of kidney)

hydrochlorothiazide

thiazide diuretic

What are the key factors of hydrochlorothiazide?

• used for heart failure, edema, hypertension, CKD

• can cause hypokalemia and photosensitivity

• depletion of potassium

• do not give if gout or sulfa allergy

• 2 parts of kidney

spirnolactone

potassium sparing diuretic

what are the key factors of spirnolactone

• mild diuretic

• potassium sparing (retained)

• avoid potassium rich foods

• can cause hyperkalemia and hyperglycemia

• avoid salt substitutes

digoxin

cardiac glycoside

what are the key factors of digoxin?

• treats heart failure

• increases cardiac output and lowers HR

• digoxin toxicity can be life threatening

• bradycardia, N+V, visual issues (halos)

• measure atrial heart rate for 60 secs

Nitroglycerin

Nitrate

What are key components of nitroglycerin?

• treats angina (chest pain because not enough blood to heart)

• increases the blood flow to heart

• can cause hypotension, palpitations, headaches, weakness and sweating

• sit while taking the medication

• check BP before giving

• do not take if pregnant, severe anemia or circulatory failure

Metaprolol

Beta blocker

What are the key factors of metaprolol?

• decreases HR and BP

• treats hypertension and tachycardia and early MI intervention

• masks blood gluclose levels so check them

• can cause worsening heart failure

• fatigue, dizziness, insomnia, depression

• taper gradually because if too fast can cause MI or stroke

• hold if HR is less than 60

lisinopril/captopril

ACE inhibitor

What are the key factors of lisinopril?

• Angioedema

• Cough

• Hyperkalemia

• Cardiac arrythmia

• lowers BP (treats hypertension and heart failure)

• hypotension

• blocks conversion of angiotension 1 to 2

• don’t take in pregnancy

Losartan

ARBs

What are the key factors of losartan?

• no cough

• angioedema

• hyperkalemia

• hypotension

• can cause renal impairment

• usually taken when can’t take ACE inhibitor

• don’t take in pregnancy

Ditiazam

Calcium Channel Blocker

What are the key factors of ditiazam?

• used for hypertension, chest pain, and arrythmia

• relaxes the heart muscle and decreases workload

• increases oxygen to heart

• avoid grapefruit juice

• can cause bradycardia, dizziness, edema

• don’t use if hypotension, acute MI or arrythmia

atorvastatin

Statin

What are the key factors of atorvastatin?

• used to lower cholesterol (hyperlipidemia)

• can cause rhabdomyolis (muscle pain, dark urine)

• hepatotoxicity (monitor liver)

• avoid if hepatic disease or pregnancy

ezetimibe

cholesterol absorption inhibitor

What are the key factors of ezetimibe?

• treats lipidemia and high cholesterol

• typically used adjunct with statins

• almost no side effects alone

Heparin

blood coagulation

What are the key factors of heparin?

• inhibits the clotting sequence

• does not break down existing clots prevents new ones

• treats DVT

• high risk of bleeding and HIT or HITT

• antidote is protamide sulfate

• avoid if allergy to pork or history of HITT

• monitor aPTT testing

enoxaparin

Anticoagulant

What are the key factors of enoxaparin?

• prevents and treats DVT

• epidural/spinal hematoma happens and can cause paralysis

• bleeding risk

• no routine labs

• caution in kidney disease

• HIT/HITT

• sub q in abdomen only

• don’t expel the air bubbles

Warfarin

oral anticoagulant

What are the key factors of warfarin?

• prevents and treats DVT

• prevents thrombitic complications

• bleeding risk (major/fatal)

• vitamin k is antidote

• caution in liver disease

• monitor PT/INR

• watch diet and avoid grapefruit juice

• avoid in pregnancy or hemorrhage in past

Rivaroxoban

oral anticoagulant

What are the key factors of rivaroxoban?

• prevents and treats DVT

• combined with aspirin can lower the risk of MI and cardiac events

• risk of bleeding

• epidural/spinal hematoma can cause paralysis

• don’t use if liver disease (assess liver function)

• no routine labs

• take with food

Clopidogrel

Antiplatelet

What are the key factors of clopidogrel?

• inhibits platelet aggression

• Aspirin: reduces rate MI and stroke

• risk of bleeding

• reduced effect for poor metabolizers

• give with food and avoid NSAIDs

• 7-10 days to work

penicillin

antibiotic

What are the key factors of penicillin?

• bacterialcidal

• risk of superinfection

• potential to disrupt hormonal contraceptives

• check allergy history

• don’t take grapefruit/citric juice

penicillin with beta lactamase inhibitors

antibiotic

What are key factors of penicillin with beta lactase?

• treats infections that have resistant organisms

• nephrotoxicity in renal patients

• increased allergy risk to cephalosporins

• check allergies

• lower dose in renal patients

cephalosporin

antibiotic