Pharm II Exam 1
Terms
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- agents that protect the esophageal mucosa
-
alginic acid
sucralfate - prokinetic agents (inc esophageal and gastric clearance)
-
bethanechol
metoclopramide
cisapride
macrolides - T/F: Tagamet has more side effects and Zantac
- true
- T/F: Pepcid has more side effects than Axid
- false
- T/F: Zantac has more drug interactions than Tagamet
- false
- T/F: Axid has more drug interactions than Pepcid
- true
- H2 blocking agents
-
Tagamet
Zantac
Axid
Pepcid - T/F: You might have to double the doses of H2 blockers for them to be effective for GERD
- true
- T/F: To control sxs and healing, you may need to divide the doses of H2 blockers
- true
- PPI agents
-
Omeprazole (Prilosec)
Lansoprozole
Rabeprazole
Pantoprazole
Esomeprazole (Nexium) - PPIs will heal gastric ulcers up to 96% in ___ wks
- 4
- PPIs will heal duodenal ulcers up to 97% in ___ wks
- 8
- If you stumble upon Abx associated colitis...
-
-stop Abx, avoid antimotility agents
-Metronidazole or Vanco - Sns and Sxs of IBS
-
-diarrhea/ constipation
-abd pain
-mucous in stool
-inc'd flatus - T/F: Diagnosis of IBS is based upon laboratory tests
- False- based clincially
- Mgmt of constipation IBS
-
-inc fiber
-stool softeners
-psyllium
-avoid anticholinergics - Mgmt of diarrhea IBS
-
-eliminate sorbitol, lactose
-cholestyramine
-loperamide - Which agent is used for diarrhea IBS?
- Alosetron
- Which agent is used for constipation IBS
- Tegaserod
- Describe the pathway of Ascites
-
1. cirrhosis
2. portal htn
3. splanchnic vasodilation
4. inc splanchnic cap pressure
5. lump formation - What diuretics might you use to tx ascites?
-
-spironolactone
-furosemide
-amiloride - T/F: a combo of neomycin and kristalose will not be effective in a pt who failed to respond to either agent alone
- false- it may be effective
- What are the specific agents for sclerotherapy? (varices)
-
sodium tetradecyl sulfate
ethanolamine oleate - In which pt should you be careful if prescribing vasopressin?
- those with vascular disease or CAD
- T/F: Azulfidine is considered inferior to corticosteriods in the mgmt of Crohns bc it has a slower onset
- true
- What is the most useful purpose of Azulfidine?
- maintaining remission of IBD
- T/F: Rowasa is better tolerated than Azulfidine
- true
- Olsalzine for IBS is released when?
- when colonic bacteria acts on it (like Azulfidine)
- What are the corticosteriod therapies available for IBD?
-
cortenema
cortifoam
prednisone
entocort ec - When are IV corticosteriods indicated for IBD?
- for severe exacerbations
- What are the immunomodulatory agents for IBD?
-
imuran
6 mercaptopurine
methotrexate
neoral
infiximab
thalidomide - What are the risk factors for PUD?
-
age
institutionalization
crowded living conditions
family members with disease - What types of diseases is H pylori most associated with?
-
duodenal ulcer
gastric ulcer
type B antral gastritis
gastric ca - H2 blockers heal duodenal uclers up to 84% in __ wks
- 4
- H2 blockers heal gastric ulcers up to 82% in __ wks
- 8
- T/F: you are not required to tx a H pylori infx with abx. You can just tx with antisecretory drugs
- false- need abx
- Combo meds for H pylori
-
Helidac (tetracycline, metronidazole, bismuth)
Prevpac (amox, clarith, lansoprazole) - What causes spasticity?
- 1. UMN lesions dec inhibitory tone to LMN (they are left hyperexcitable)
- What is the aim of muscle relaxant therapy?
- -to inc inhibitory tone to the LMN and dec the excitability of the Ia fibers (to dec the firing)
- Valium happens to be the DOC for...
- status epilepticus
- T/F: Lioresal results in less sedation than Valium
- true
- If a pt has severe spasticity, where might you inject Lioresal?
- intrathecally
- T/F: Cardiac and smooth muscle are greatly effected by Dantrolene
- false
- other muscle relaxants for "acute spasm"
-
flexeril
norflex
parafon forte
robaxin
skelaxin
soma - tumor development is affected by...
- balance of oncogene expression and tumor suppressor gene expression
- oncogenes aka...
- accelerators
- tumor suppressor genes aka...
- brakes
- Cancer's seven warning signs
-
change in bowel/bladder
a sore that doesn't heal
unusual bleeding or discharge
thickening or lump in breast
indigestion or dysphagia
obvious change in mole
nagging cough/hoarseness - radiation
-
tx tumor locally
SE: skin and GI - Sensitive Chemo
-
ALL
AML
testicular
lymphoma
neuroblastoma
Ewings - Intermediate chemo
-
breast
colorectal
sarcoma
bladder
chronic leukemia
multiple myeloma
prostate
head/neck
cervical
gastric
SCLC - Resistant chemo
-
melanoma
NSCLC
pancreatic
thyroid
hepatocellular
renal - partial response
- > 50% reduction in all tumors
- stable disease
- <50% reduction or <25% inc in tumors
- progression
- >25% inc of tumors
- median overall survival
- time from enrollment until the death of 50% of pts
- time to progression
- time of enrollment to disease progression
- disease-free survival
- time of documented complete response until disease progression or death
- T/F: resistance in a cancer cell can only be inherited not acquired
- false- can be inherited and acquired
- NCI = 0
- no toxicity
- NCI= 4
- life-threatening toxicity
- T/F: NCI grade 0-1, chemo is considered tolerated
- true
- T/F: chemo is dosed based on cancer stage
- false- based on BSA
- nociceptive pain
- unpleasant sensory and emotional experience associated with tissue damage
- neuropathic pain
-
-occurs after main injury has healed (all nociceptive pain is gone)
-nerve fibers generating APs without stimulus - examples of neuropathic pain
-
phantom limb pain
PHN
small fiber disease in DM
post-mastectomy pain, etc - referred pain
-
projected pain
NOT neuropathic - types of nociceptive pain
-
somatic (bone, skin, tissue)
viceral (abd) - Step 3 of the ladder of analgesia
-
mod-severe pain
use high potency opioid - Step 2 of the ladder of analgesia
-
mod pain
use low potency opioid and a non-opioid - Step 1 of the ladder of analgesia
-
mild pain
NSAIDs or APAP - Salicylates/NSAIDs
-
ASA
Trilisate
Dolobid
Doan's
Disalcid - Nonselective NSAIDs
-
Naproxen
ibuprofen
toradol - max daily dose of Ibuprofen
- 3200mg
- max daily dose of naproxen
- 1000mg
- max daily dose of toradol
-
120mg IV
40mg PO - max daily dose of APAP
- 4-8g
- T/F: APAP should be used with caution in ETOHics and those with liver dysfunction
- true
- Non-opioid analgesics
-
ASA
Choline Salicylates
Diflunisal
APAP
Etodolac
Diclofenac
Ibuprofen
Fenoprofen
Celebrex - mixed agonist/antagonist opioids
-
butorphanol
pentazocine
nalbuphine
dezocine - T/F: mixed agonist/antagonist opioids can be used with cancer pain
- false
- T/F: mixed angonist/antagonist opioids can be used in combo with pure opioids
- false
- T/F: Codeine has more side effects than morphine
- true
- morphine agents
-
mscontin
oramorph
avinza
kadian
roxanol - max therapeutic level of transdermal fentanyl
- 2-3 days
- T/F: Methadone can be used with renal and hepatic dysfunction
- true-it has no active metabolites
- to prevent constipation with opioids
-
senna + docusate
bisacoydl - to manage opioid induced nausea
-
prochlorperazine
promethazine
droperidol
dronabinol - to manage opioid induced pruritis
- 2nd gen antihistamines
- to manage opioid induced sedation
-
methylphenidate
dextroamphetamine
modafinil
caffeine - nerve pain
- burning, stinging, lacinating pain, numbness, follows nerve tracks
- TCAs
-
amitryptiline
nortriptyline
impramine
desipramine
clomipramine
doxepin - What is duloxetine?
-
SSNRI
-used for PDN - Anticonvulsants
-
gabapentine
carbamazepine
phenytoin
lamotrigine
oxcarbazepine
topiramate - lidocaine patch
- worth a try
- capsaicin meta-analysis
- cheap and worth a try
- addiction
- drug-seeking behavior
- tolerance
- physical dependence