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Pharm II Exam 2
Terms in this set (120)
decrease metabolism; toxicity
what is the acronym for inducers?
inducers (CRAP GPS)
VICKS FACE All OVER GQ
acronym for inhibitor drugs
inhibitor drugs (VICKS FACE All OVER GQ)
CYP 1A2 Subtype
Fluconazole will decrease the metabolism of the omeprazole.
A patient is taking Omeprazole (a substrate of the CYP-enzymes) and the physician adds fluconazole (an inhibitor for the same CYP-enzyme) for a fungal infection, what will occur between these 2 medications?
Alcohol is an inducer to the CYP-40 enzyme inducer, therefore will increase the metabolism of the Grisofulvin. An increased dose may be needed, or the patient should limit or cease drinking alcohol while taking this medication.
A patient who drinks alcohol on a regular basis is taking Grisofluvin (CYP-enzyme). What interaction will occur?
where is the vomit center?
OTC tx for N/V
Motion Sickness Medication
prescribed meds to tx N/V
benadryl, scopolamine, & dramamine are what?
what is the ideal timing for antiemetics?
can be drying
cause hypotension if given too fast IV
most commonly used for motion sickness (give BEFORE travel)
benzodiazepines (lorazepam) can be used to treat... ?
N/V (schedule 2 drugs)
cannabinoids can be used to treat what?
N/V (should only be used short term)
corticosteroids can be used to treat what?
S/E of corticosteroids
primarily given prior to chemo
antiemetic primarily used prior to chemo
antiemetic that can cause some EPS and TD (can also be constipating and drying)
antiemetic used for brain tumors/increased ICP
diphenoxylate with atropine (lamotil)
antidiarrheal that can cause CNS depression (schedule V)
antidiarrheal that can be obtained OTC @ low dose & Rx @ high dose
diarrhea caused by infection w/ toxin producing organisms or poisoning
when should you not give antidiarrheal medications?
fiber, increase water intake, increase activity
how do you treat constipation
cathartics (used for GI prep)
magnesium hydroxide (MoM)
polyethelene glycol (miralax)
what are the types of osmotic (saline) constipation meds?
stimulant medication for constipation
irritate mucose and promote peristalsis (dumb & dumber)
constipation meds that dont cross BBB (can have pain relief)
surfactant stool softener
constipation med that doesnt make you go, but makes it easier to go
surfactant stool softener med
bulk-forming constipation med that has fiber
herbal constipation medications
drugs used to treat IBS-Const (decreases bloating and constipation by increasing H2O in gut)
initial therapy for IBS-Diarrhea
first line of defense to tx IBD (inflammatory bowel disease)
-cant give if sulfa drug allergy
-may impair male fertility while taking
-can be hepatoxic
-dont give if dehydrated
-can cause HYPOglycemia
second line of defense for IBD
3rd line of defense for IBD
what is the most common cause of peptic ulcer disease outside of H. pylori?
-Primary cause of peptic ulcers
-Gram-negative bacillus linked with the development of peptic ulcers
what drug regimen is needed to tx H. pylori?
amoxicillin or metronidazole, omeprazole or lansoprazole, and clarithromycin
what drugs should be chosen to tx h. pylori?
-avoid tobacco and alcohol
-avoid hot, spicy, and greasy foods
non-pharm measures to tx GERD
-neutralize hydrochoric acid - act fast! (10 - 15 min), but only last 2 hrs
-reduce pepsin activity
Sodium Bicarbonate (alka-seltzer)
- systemic anti-ulcer medication
-too many s/e
calcium carbonate (tums)
-systemic anti-ulcer med
-may cause acid rebound
-may result in hypercalcemia
lifestyle changes & pharmacotherapy
what is the best treatment for PUD & GERD
histamine 2 blockers
Block H2 receptors of parietal cells in the stomach, reducing acid secretion and concentration
-rapidly absorbed (1-3 hours)
-ulcer healing in 4 weeks
HA, dizzy, anemia, constipation, decreased libido, impotence
s/e of H2 blockers
Proton Pump Inhibitors
suppresses gastric acid secretion (end in azole)
onset: 2 hrs
peak: 1.5-3 hrs
may increase liver enzymes (AST/ALT)
covers ulcers and protects it from acid and pepsin
pepsin inhibitor medication that is non-absorbable & the dose = 1gm QID before meals & bedtime
what will happen if stools dont have enough pancreatic enzymes?
pancreatic enzymes taken right before or with meals
increase uric acid levels at high doses
S/e of pancreatic enzymes
islets of langerhans
clusters of cells
-acts as a bridge that carries glucose into cell
-tells liver to store glucose as glycogen
-inhibits breakdown of glycogen into glucose
release of fatty acids from liver --> production of glucose from fats/proteins
types of rapid insulins
onset of rapid insulins
peak time for rapid insulin
types of short (regular) insulins
onset of short (regular) insulins
peak of short (regular) insulins
types of intermediate insulins
onset of intermediate insulins
peak of intermediate insulins
intermediate insulins last __ hours?
types of long acting insulins
insulin that has no peak and lasts 42 hours
onset of long acting insulins
minimal lasts 24 hours
glargine and levemir duration times
first clear, then cloudy
how do you draw up insulins?
can happen after a stroke or head trauma (pituitary issues)
high urine output (clear large volumes w/ low gravity)
clinical findings of DI
what is the treatment for DI?
-given IV or intranasal
-andtidiuretic hormone (stop pee)
-can be given for hemophilia A or nocturnal uresis
Desmopressin can cause what as a side effect?
graves disease = hypo or hyper thyroidism?
bulging eyes (exophthalmos)
what is a tell tell sign of graves disease?
symptoms of graves disease
addisons or secondary adrenal insufficiency
what can happen with long term steroid use?
how do you discontinue corticosteroids?
if ill or stressed, what should you do with dose of corticosteroids?
how long before you worry about secondary adrenal insufficiency while on steroids?
-hump on neck
S/E of corticosteroids
drug preferred for hyperthyroidism in pregnancy and breast feeding
drug used for hypothyroidism
-take same time everyday
-take without food
-dont change brands
what should you do if you're taking synthroid?
lowers K+ levels
what happens to your K+ levels when on hydrocortisone?
give K+ supplementation
what should you do if patient is on hydrocortisone and lasix?
secreted by kidneys with decreased perfusion
-stimulates stem cells to produce erythrocytes
-increased risk for DVT, strokes, MI
contraindication for epoetin alfa
Stimulated by liver to produce megakaryocytes in the bone marrow.....they shed packets that enter the bloodstream and become platelets
given to STIMULATE production of thrombopoietin and megakaryocytes
how long do platelet counts remain elevated after giving last dose of oprelvekin
how is oprelvekin given?
S/E of oprelvekin
-decreased erythrocyte production
what are the causes of anemias?
iron deficient anemia
low transferrin saturation
treatment for iron deficient anemia
nausea, heartburn, constipation, diarrhea, dark stools, hypotension
s/e of ferrous sulfate
normal or low Hgb
normal or low Hct
low Vit B12
treatment for pernicious anemia
can cause sodium retention (use with caution in cardiac patients)
side effects of cyanocobalamin (nascobal)
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