Pharm exam 4

What is the drug polyethylene (GoLytely) and what are it's adverse effects?
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What is the drug polyethylene (GoLytely) and what are it's adverse effects?
Avoid powder form of Golytely or polyethylene glycol as it causes erosive and constipated adverse effects
what are the effects of mineral oil and risks when taken as a laxative?
Interferes with FAT soluble vitamin absorption.
What are the effects with stimulant laxative abuse?
Vitamin insufficiencies-poor absorption of vital vitamins.
What is the surfactant that is safe to prescribe for older adults?
DOCUSATE SODIUM is safe to administer from infants to the elderly
What is the the drug diphenoxylate and what is the use of the drug?
adjuvant treatment with atropine for diarrhea in patients... but use caution as atropine causes adverse effects on patients with underlying diseases
What is the drug Loperamide (Imodium) and when it is prescribed?
Travelers diarrhea
What are the adverse effects with metoclopramide (Reglan)?
causes unwanted adverse effects such as tardive dyskinesia
How do you prescribe metoclopramide in a patient with gastroparesis and low creatinine clearance?
Metoclopramide is excreted in the urine, clearance is affected by renal function. In patients
whose creatinine clearance is less than 40ml/min, the recommended dose should be cut in HALF.
What is the drug ondansetron (Zofran) and what are its uses?
Used in cancer patients, post op patients and chemotherapy patients to PREVENT NAUSEA
Which drug is safe to treat the older adult with a gastric ulcer?
AVOID Cimitidine
What are the possible effects of co-administration with clarithromycin and omeprazole?Co-administration may result in INCREASED PLASMA LEVELS of both drugs.What is the mechanism of action of omeprazole (Prilosec)?Omeprazole is a proton pump inhibitor which suppress gastric acid secretion.What is the concept for enteric coated drugs?enteric coated drugs dissolve in small intestine where it is alkaline and become an active drug. Like the drug "biscotal"What are the adverse effects of anticholinergics?Scopalamine (anticholinergic) effects open angle glaucoma, so should not be usedWhat are the uses for bismuth subsalicylate?Do not use for constipationWhat is the drug phentermine and it's precautions with prescribing?Tolerance. It is for short term use ONLY.What is the drug phenytoin (Dilantin) and what are it's uses?FIRST LINE drug because it has the least sedative effects. Used to treat partial tonic clonic seizuresWhat are the adverse effects and serious effects with phenytoin (Dilantin)?SERIOUS DERMATOLOGICAL reactions including Stevens Johnson Syndrome and toxic epidermal necrolysis may occurWhat is the mechanism of action for ethosuxmide (Zarontin)?Succinimide is used to treat ABSENCE seizures in children and adults by decreasing nerve impulses and transmission in the motor cortex. INCREASES SEIZURE THRESHOLD.Which labs are needed to monitor for patients on carbamazepine (Tegretol)?CBCWhat patient education is needed before prescribing levetiracetam (Keppra)?TAKE MEDICATION EXACTLY AS PRESCRIBED (missing doses may increase seizures)What is the drug lamotrigine (Lamictal) and the drug to drug interactions with oral contraceptives and how to dose medication?ORAL ESTROGEN-CONTAINING CONTRACEPTIVES DECREASE LAMOTRIGINE LEVELS BY 50%What is the drug gabapentin (Neurontin) and what do you do when patient is experiencing depression?MONITORED for WORSENING depressionWhat is the drug carbamazepine (Tegretol) and what is it's life threatening (BBW) warnings?DERMATOLOGICAL BBW like steven johnson syndromeWhat are the health conditions that require caution when prescribing amitriptyline?CONTRAINDICATED in CARDIOVASUCLAR disorders due to their alpha-adrenergic blocking effect and quinidine like effect on the myocardium. CARDIAC CONDUCTION DISORDERS-most at risk.What are the labs to order and assess prior to initiating treatment for clinical depression?TSH levelWhat is the antidepressants class of drugs that are least likely to produce sedative effects?Bupropion (Wellbutron)-has stimulative effectWhat are the tricylic antidepressants (TCAs) and their uses?Acute and chronic migraine preventionWhat is the drug amitriptyline and it's effects and diagnostics to assess before prescribing?Baseline ECG-antidepressants can prolong the QT intervalWhat is the drug Fluoxetine and when is it appropriate to prescribe (age, diagnosis..)?Perform Depression screening testWhat are the advantages and disadvantages between drug classes TCAs and SSRIs?SSRI's have SAFER profile than TCA's or MAO'sWhat patient teaching would you give when prescribing citalopram (Celexa) and when is it effective and alleviates symptoms?1-2 weeks see a change in appetite and concentration, where they have more energy. This is the time in which a staff member from the office MUST follow up with them because they are at HIGHEST RISK for suicide...because they feel better and have energy to commit suicide. He stressed the follow up is MOST IMPORTANTWhat is the anxiolytics least likely to cause harm to patients while consuming alcohol?BUSPIRONE=has the LEAST risk of dependence and fewest drug interactions. It is considered relatively safe even at high doses. Buspirone is a non-benzodiazepine GABA agonist that treats anxiety disorders with minimal risk of dependence or side effects.What are the drugs that are first-line for treatment of mild to moderate migraines without N/V?Acetaminophen NSAIDSWhat is preventive therapy with migraines and the goal of treatment?Reducing migraine attacks by 50%=SUCCESSWhat is the mechanism of action for sumatriptan (Imitrex)?Cerebral vasoconstrictionWhat are the treatments for tension headaches?Non-pharmacological therapyWhat is the drug ergotamine (Wigraine) and what other medications may need to be prescribed with it to prevent adverse effects?PRETREATMENT with ANTIEMETICS decreases the SEVERE side effects of nausea and vomiting with ergotamine use.What are the treatments for cluster headaches?Acute: Oxygen therapy administered via 100% nonrebreather mask for 15-30 minutes often provides relief of cluster headache.What is the treatment to prevent migraines in children who are having regular migraines?Propanolol (3 month trial)What is the drug class Coxibs, drug diclofenac and patients you should not prescribe too?DO NOT prescribe with heart diseaseWhat is the mechanism of action of opioids?Act on central and peripheral pain receptors most notably the u and k receptors to INHIBIT the transmission and perception of pain impulses.Wat is the standard guideline for prescribing schedule 2 controlled substances?Write only 30 supply with NO refills. Office visit is required for a refill.What is the drug Fentanyl (Sublimaze) and what is it's adverse effects?URINARY RETENTIONWhat are the physical assessments to perform before prescribing opioids?Assess pain intensity, respiratory rate, and level of consciousnessDefine the term tolerance?EXPOSURE to a drug induces changes that result in a diminution (decline in drugs effects or reduction of drugs effects over time) of one or more of the drugs effects over time.What is the drug capsaicin (Salonpas) and what is it's use?topical and treats moderate painWhat is the drug pregabaline (Lyrica) and what is it's use?FibromialgiaWhat are the uses of drug classes: salicylates, acetaminophen, and NSAIDs?used to treat dental pain, arthritic pain, post-op painWhat is the drug tramadol (Ultram) and what is its mechanism of action?INHIBITS reuptake of serotonin and norepinephrine which provides dual-action pain relief. Sedation is produced at the k sites without the other side effects.Commercially available probiotics have shown some benefit for preventing infection with which pathogen?Clostridium difficileMetoclopramide improves gastrointestinal reflux disease symptoms byIncreasing lower esophageal toneBismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints, what should you know about this drug?Has antimicrobial effects against bacterial and viral pathogens. May lead to toxicity if taken with aspirin. Is contraindicated in children with flu-like illness.A 5-year-old patient with a virus is having nausea, vomiting, and diarrhea. The patient is unable to keep fluids down and has lost 4 pounds. Which medication beside IV fluids would most likely help in controlling their nausea?Ondansetron (Zofran)Which is the drug of choice to prevent traveler's diarrhea while in a country with water-borne pathogens?Bismuth subsalicylate with each meal and at bedtime.Methylnaltrexone is used to treat constipation in patients with which condition?opioid-associated constipationWhich of the following statements describes proton pump inhibitors?They may increase risk for development of acute gastroenteritis in pediatric patients.Treatment failure in patients with peptic ulcer disease associated with H. pylori may be because of what?antimicrobial resistanceLong-term use of proton pump inhibitors may lead to what?hip fractures in at-risk personsWhat is the universal prescribing alerts for gastrointestinal agents?serious hypersensitivity to a specific drug or component of the product/formulation selected warrants dosage adjustment.Opioid analgesics are contraindicated in patients with what?closed head injuryMigraines in pregnancy can safely be treated with what?Sumatriptan (Imitrex) Acetaminophen with codiene (Tylenol #3)What "onset of action" symptoms should be reviewed with patients who have been newly prescribed a selective serotonin reuptake inhibitor?They can experience nausea, but this resolves in a week.Secondary uses for anxiolytic medications may include what?ethanol withdrawalAn appropriate drug for the treatment of depression with anxiety would be what?Escitalopram (Lexapro)Which of the following describes the activity of naloxone?It may induce immediate withdrawal symptoms in chronic opiate users.A 19-year-old patient is started on risperidone. Monitoring for risperidone includes observing for common side effects, including what?Bradykinesia, akathisia, and agitationWhich is an important consideration when prescribing antidepressants?Seizures have been reported in some antidepressant trials.Which describes the mode of action of anorexiants agents?stimulates the release of norepinephrine and/or dopamine from storage sites in nerve terminals in the lateral hypothalamic center, thereby producing a decrease in appetite.A 3-year-old child who has a history of status epilepticus is currently on routine daily antiseizure medications. Which medication should be given to them when they have an episode of status epilepticus?Rectal diazepam (Diastat)