Term
| what are enoxaparin and delteparin? |
|
Definition
| LMWH - greater activity in degrading fac X. longer duration than heparin. |
|
|
Term
| when pt are unable to take heparin what should you give? |
|
Definition
Hirudin
Bivalirudin
lepirudin
Desirudin
these are some of the Direct thrombin Inhibitors |
|
|
Term
| what drug is used a vasodilator and anti-platelet? |
|
Definition
| Dipryridamole - also given in stress test. |
|
|
Term
| if pt is going under stent placement what drug would u administer? |
|
Definition
| clopidogrel with aspirin -also used for Cerebrovascular infarct, and if pt cant take aspirin then give just clopidogrel |
|
|
Term
| this drug is a monoclonal abs to tx acute coronary syndrome? |
|
Definition
|
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Term
| pt comes is OD and ABG revels resp and meta acidosis. -- what drug level should you check for? |
|
Definition
|
|
Term
| if this drug is given within 3 hrs of stroke or 6hrs of MI, it could make a big difference on mortality and morbidity? |
|
Definition
| Fibrinolytic agents : Streptokinase urokinase, alteplase, retelplase |
|
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Term
| this pt is bleeding excessively due to the surgery which Ryan performed. hep is off and other anticoag is off. but he is still bleeding. what could be last resort aft giving all the reversal for anti-coag? |
|
Definition
Aminocaproic Acid. inhibits tPA so no plasmin made to break fibrin.
also tx hemophilia |
|
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Term
| this drug SE are cardiovascular events and thrombotic complication in pt with RF. |
|
Definition
| Synthetic Erythropoietin. |
|
|
Term
| this drug (give atleast two names) SE is depletion of insulin in fetal pancreas if used during preg. |
|
Definition
| Sulfonyureas- gyburide, glipizide, glimepiride |
|
|
Term
| this drug impair absorption of B12 which is used for DM II. what is the other SE of this drug? |
|
Definition
Metformin - also cause lactic acidosis.
it does not cause hypoglycemia. |
|
|
Term
| this DM II drug should be stopped for radiology contrast is used for imaging studies. |
|
Definition
| Metformin- cause increase in level of metformin due to renal dysfunction caused by combo of contrast and metformin |
|
|
Term
| this drug inhibits breakdown of monosac* in Small intestine thus preventing its absorption. what is the name of the drug and what is the side effect? |
|
Definition
| a-Glucosidase inhibitor. SE: flatulence and diarrhea |
|
|
Term
| Avandia falls in which class and what is the generic name |
|
Definition
class thiazolidinediones
G. name: Rosiglitazone. |
|
|
Term
| give the name of the drug that increase insulin sec by activating K+ channels in pancreas |
|
Definition
|
|
Term
| what two drugs fall under DPP-4 |
|
Definition
| Sitagliptin and vildagliptin |
|
|
Term
|
Definition
inhibits HMG-CoA
inc LDL receptors on hepatocytes to pick up more LDL and VLDL |
|
|
Term
| what is the name of the drug that inhibits absoprtion of cholesterol in GI track? |
|
Definition
|
|
Term
| this drug side effect is myopathy. and should be taken at night. |
|
Definition
| Statins- cholesterol synth occur at night (PPT) |
|
|
Term
| this class of drug bind to bile acids in the intestine and prevent reabsorption back in to body. |
|
Definition
BAS-bile acid sequestrants
Cholestyramine |
|
|
Term
| Side effect of cholestyramine. |
|
Definition
dec absorption of fat soluble vitamin - A D E K and folic acid.
and impaired absorption of certain drugs |
|
|
Term
| this class of cholestrol drug is not good for familial dyslipidemia |
|
Definition
|
|
Term
give names
dec total cholestrol and ldl level
most effective in dec triglycerides
most effective to inc HDL |
|
Definition
give names
dec total cholestrol and ldl level: statins
most effective in dec triglycerides: Fibrates - Gemfibrozil
most effective to inc HDL: Niacin |
|
|
Term
used for prostate cancer
used for endometriosis and firbocystic breast disease. |
|
Definition
prostate cancer - Flutamide
Danazol - tx endometriosis... |
|
|
Term
| this durg is mainly used for hair loss. but it could also stop growth of BPH and prostate cancer. |
|
Definition
| Finasteride- in saving hair and prostate you co Fina -ncially broke |
|
|
Term
| what is the use of Anastrozole? |
|
Definition
block converting process of androgen to estrogen
for breast cancer |
|
|
Term
| what is the benefit of progestrone only pill? |
|
Definition
| can be given in breast feeding and pt who has hx of thromboembolism |
|
|
Term
| Emergency contraception - ingredient? |
|
Definition
|
|
Term
| this drug is given some times with MTX as abortifacient which causes break down of endometrial lining and cervical dilation.? the is the time limit |
|
Definition
| Mifepristone - progesterone receptor antagonist - within 49 days |
|
|
Term
| this drug is given quite often for infertility and to induce ovulation. it is a partial estrogen receptor agonist in pituitary |
|
Definition
|
|
Term
| all the drugs that end with -onate are? their SE? |
|
Definition
| bisphosphonate--alendronate. A-fib, jaw necrosis, GI upset |
|
|
Term
| this drug is drug inhibits thyroid peroxidase - thus inbibits conversion of t4 to t3. |
|
Definition
|
|
Term
this gout drug binds to tubulin - thus dec migration of leukocytes to the affected side.
this drug inhibits xanthine oxidase |
|
Definition
Colchicine - Acute gout attack
Allopurinol - prevent further gout attack |
|
|
Term
| name the drug that inhibits reabsorption of uric acid at PCT. |
|
Definition
| Probenecide --- P and P and P - probenecide works on PCT- and penicillin retainer. |
|
|
Term
| this drug inhibits lipase thus inhibiting fat absorption. |
|
Definition
| Orlistat - steatorrhea and fecal incontinence. lack fat soluble vitamin - ADEK |
|
|
Term
|
Definition
| obesity --NT reuptake inhibitor. |
|
|
Term
| how ibuprofen works in its action of antipyretic? |
|
Definition
| inhibits production of PGE2-thus dec sensation of pain and dec set-point at the hypothalamic thermoregulatory center. |
|
|
Term
| what drug is labor suppressant? (not turbutiline) |
|
Definition
Indomethacin - also used for gout and OA.
also used for--to close PDA |
|
|
Term
| this drug causes interstitial nephritis- papillary necrosis which cause sloughed paillae in the urine. |
|
Definition
| NSAIDS - also cause GI bleeding |
|
|
Term
| this is a good drug for pain with less SE but cause CV toxicity- inc risk of thrombosis -stroke and MI. |
|
Definition
| Celecoxib - also cause interstitial nephritis |
|
|
Term
| this drug reduce colonic polyps in pt with familial adematous polyposis. |
|
Definition
|
|
Term
| what is the max dose for Tylenol? |
|
Definition
|
|
Term
| what is the antidote for tylenol |
|
Definition
|
|
Term
| what is the antidote for tylenol |
|
Definition
|
|
Term
give me some short- medium acting glucocorticoids
intermediate
long acting |
|
Definition
short-medium acting: hydrocortisone, prednisone, methylprednisolone
intermediate : triamcinolone
long acting- betamethasone and dexamethasone |
|
|
Term
| pt has been on this drug for several weeks now and family has noticed depression, mania, insomnia and euphoria. he has gain weight and has dec visual acuity. |
|
Definition
SE of Glucocorticoids
o Behavioral changes: high doses can cause depression, mania, insomnia & euphoria
o Pituitary suppression resulting in less release of ACTH, GH, SH, LH
o Peptic ulcers
o Fat redistribution (increased visceral, facial, nuchal & supraclavicular fat)
o Antagonize the effect of vitamin D on calcium absorption (osteoporosis)
o Increase WBC count, platelets & RBCs
o Cushing’s Syndrome
o Impaired wound healing
o Myopathy
o Cataracts
o Fluid retention – hypokalemic, hypochloremic, alkalosis, hypertension, edema & heart failure
o Adrenal suppression with long-term therapy
o Disease exacerbation may occur with acute withdrawal |
|
|
Term
| contraindication of Steroids |
|
Definition
PUD
Heart Disease
DM
Glaucoma
Psychoses
current infection
HTN |
|
|
Term
| what is the glucocorticoid prototype. what is it used for...impt reason.. |
|
Definition
| there are many uses but highlighted is Replacement tx for adrenal cortical insufficiency |
|
|
Term
| what is the major glucocorticoid in human body? |
|
Definition
|
|
Term
| as SE of Glucocorticoid is hypokalemia by retaining water, it is given for hyperkalemia in pt. if this doesnt work what should your second choice be? |
|
Definition
| Fludrocortisone - mineralcorticoid. it is just like aldosterone. retain H2O to inc BP and secrets K+ |
|
|
Term
| what happens in primary adrenal insufficiency? and secondary insufficiency? |
|
Definition
Types of Adrenal Insufficiency
• Two types:
o Primary (Addison's disease)
Lack of both cortisol & aldosterone in most cases
May be a deficiency in cortisol alone
o Secondary (AKA “central”)
Defect is in the hypothalamic-pituitary area due to ACTH deficiency
Usually associated with other pituitary hormone deficiencies if due to pituitary disease but can be found alone |
|
|
Term
| give 4 Hs of adrenal insufficiency. |
|
Definition
Clinical presentation
CV: reduced CO, decreased vascular tone
Hypovolemia leads to secretion of vasopressin, which leads to water retention & hyponatremia
Hyperpigmentation
Hyperkalemia
Hyponatremia |
|
|
Term
| what drug is given to test for addison's disease? |
|
Definition
| Cortrosyn stimulation test |
|
|
Term
| what happens in Metyrapone test? |
|
Definition
it is for addison' disease
it block conversion of 11-deoxy to cortisol. hence drop in cortisol stimulate ACTH production. |
|
|
Term
tx for primary addison's disease
tx for secondary addison's disease |
|
Definition
Hydrocortisone and Fludrocortisone
secondary just hydrocortisone (renin is still working) |
|
|
Term
| what is mandatory for all the diagnosed pts with addison's disease? |
|
Definition
Mandatory for all diagnosed pts
ID bracelet
Wallet card
Education
Injectable form of glucocorticoid kept at home for emergency use
o Usually dexamethasone |
|
|
Term
Hyperaldosteronism treatment (lot of water retainer )
SEA (with lot of water) |
|
Definition
Spironolactone
Eplerenone - selective aldosterone receptor antagonist
Amiloride - black box warning for hyperkalemia |
|
|
Term
| what are the 7ps of pheochromocytoma? |
|
Definition
• Produces dopamine, norepi & epinephrine
• Paroxysms – “spells”
• Pressure – sudden increase in BP
• Pain – abrupt throbbing headache, chest, abd pain
• Perspiration – generalized diffuse diaphoresis
• Palpitations – tachycardia with panic or anxiety
• Pallor – from vasoconstriction
• Pheochromocytoma S/Sx |
|
|
Term
| this pt was given ketoconazole and mifepristone -- what did he get treated for? |
|
Definition
Cushing's
Ketoconazole - inhibits adrenal and gonadal steroid synth - monitor for hepatictoxicity
Mifepristone - glucocorticoid receptor antagonist |
|
|
Term
| 3 indication of estrogen and progestin use |
|
Definition
1. primary hypogonadism--surgical removal of balls or ovaries
2. HRT - postmenopausal tx
3. Contraception -- dysmennorhea and acne vulgaris |
|
|
Term
|
Definition
| HTN, thromboembolism, Gallbladder disease, Dementia, Stroke, hypercalcemia, endometrial carcinoma |
|
|
Term
| what is a nonsteroidal estrogen? |
|
Definition
| DES - diethylstilbestrol - tx of inoperable breast or prostate cancer (leuprolide also used) |
|
|
Term
| to suppress ovarian function what hormone would u give |
|
Definition
progesterone -
Indications
• Suppress ovarian function
o Dysmenorrhea, Endometriosis, Uterine bleeding
• Hormone Replacement Therapy
o Given with estrogen to prevent endometrial CA
o Lessen estrogen-induced irregular bleeding
• Synthetic Progestins |
|
|
Term
| what is the estrogen receptor modulator for osteoporosis and breast cancer? |
|
Definition
|
|
Term
| what is given to gain weight after surgery or infec or trauma? or bone pain from osteoparosis. |
|
Definition
| Fluoxymesterone and oxandrolone |
|
|
Term
| what is used for chemical castration? |
|
Definition
|
|
Term
| flutamide - indicated for |
|
Definition
| inoperable prostate CA and female hirsutism |
|
|
Term
| if a girl misses to take a pill in the first week...what do u tell her |
|
Definition
| take 1 active pill asap and use back up method. |
|
|
Term
| if the girl misses 2 pills in week 3 ---then |
|
Definition
| tell her to take 1 active pill and continue active pill as usual but skip placebo pills and start new pack |
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