pharm 2 exam IV

Card Set Information

Author:
crazysupermedic
ID:
242170
Filename:
pharm 2 exam IV
Updated:
2013-11-02 19:47:46
Tags:
pharm exam IV
Folders:

Description:
pharm 2 exam IV
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user crazysupermedic on FreezingBlue Flashcards. What would you like to do?


  1. what is the agent used for treatment of Addison's dz and other adrenocortical insufficiencies (deficiencies of endogenous hormone cortisol)
    hydrocortisone
  2. what must be added to hydrocortisone when treating Addison's, in order to supplement the appropriate amount of salt-retaining
    fludrocortisone
  3. what is the diagnostic agent used in the diagnosis of Cushing syndrome
    dexamethasone
  4. what are the adverse effects of systemic corticosteroids
    short term (<2 weeks), high dose: facial flushing, appetite stimulation, GI irritation(peptic ulcer), HA, mood changes

    long term- daily chronic use: amenorrhea, aseptic necrosis of bone, cataracts, centripetal obesity (fat body with thin limbs), growth failure, hyperlipidemia, HTN, immunosuppression, mood disorders, muscle weakness, osteoporosis, seizures
  5. what are your short acting corticosteroids
    • cortisone
    • hydrocortisone (cortisol)
  6. what are your medium acting corticosteroids
    prednisone (deltasone): MOST prescribed oral medication for short tem therapy in inflammatory disorders

    prednisolone (prelone): IV

    methylprednisolone (Medrol): available for a 6 day pack therapy with a pt friendly taper

    methylprednisolone acetate (depo-medrol)

    methylprednisolone sodium succinate (solu-medrol): IV glucocorticoid most used for acute asthma attacks and allergic reactions
  7. what is the most used drug used in acute asthma attacks and allergic reactions
    methylprednisolone sodium succinate (solu-medrol)
  8. what is the name of the intermediate acting corticosteroids
    triamcinolone (kenalog)
  9. this is a mineralcorticoid that is used to replace aldosterone activity in primary and secondary adrenocortical insufficiency (ie, Addison dz)
    fludrocortisone (florinef)
  10. what are the names of the mineralcorticoid antagonists
    • spironolactone (aldactone)
    • eplerenone (inspira)
  11. which mineralcorticoid antagonist is used in the treatment of primary aldosteronism
    spironolactone (Aldactone)
  12. this is a glucocorticoid antagonist that is FDA approve as an antifungal but is used for the treatment of hyper-adrenocorticalism (unapproved use)
    ketoconazole (nizoral)
  13. this drugs MOA is that it is a potent and nonselective inhibitor of adrenal gonadal steroid synthesis (decreases the body's production of corticosteroids)
    ketoconazole (nizoral)
  14. what are the SE of ketoconazole (nizoral)
    • adrenal suppression
    • gynecomastia
    • hypocholesterolemia
    • hypothyroidism
  15. which anti-emetic has become a popular agent for N/V in pregnancy, esp now that it is generic
    ondansetron (Zofran)
  16. which stool softener can be given to a pregnant woman
    colace
  17. what anti-diarrheals should not be used in pregnancy
    • stimulant laxatives - bisacodyl (dulcolax), senna
    • enemas
  18. which GERD medication is considered safe in pregnancy
    sucralfate
  19. what is the recommended treatment for DM in pregnant women
    insulin
  20. what medications can be used in HTN diagnosed before conception or before 20th week of gestation
    • methyldopa
    • labetalol
    • CCB
  21. this medication to treat HTN in pregnancy is a centrally acting alpha agonist that reduces peripheral resistance without a decrease in cardiac output so blood flow to the vital organs is not reduced
    methyldopa
  22. this medication that treats HTN in pregnancy is a combined alpha-beta blocker, the IV formulation is recommended for acute therapy b/c it is effective, has a rapid onset of action (within 2 hours) and has a good safety profile
    labetalol
  23. for a pt with preeclampsia/eclampsia, what HTN meds can be used in pregnancy
    • methyldopa- mild hypertensive, slow onset of action, long-term safety profile for fetus
    • CCB- nifedipine- safely used in all trimesters
  24. what is the treatment of eclampsia
    • mag sulfate prophylaxis
    • IM and IV regimens
    • IV therapy is more common )4-6g IV loading followed by 2gm/hr)
  25. which medication that treats GERD may slow or stop labor late in pregnancy
    magnesium
  26. what are the barrier techniques used in contraceptives
    • condom
    • female condom
    • diaphragm
    • cervical cap
  27. what are the pharmacologic options for contraception
    • spermicides: cream, film, foam, gel, suppository, sponge and tablet
    • spermicide implanted barrier: sponge (lasts 24hrs regardless of intercourse frequency, leave in place 6 hours post intercourse NLT 30 hours)
    • hormonal contraception
  28. what are the 2 components of hormonal contraception
    • progestin
    • estrogen
  29. of hormonal contraceptions, what provides most of the contraceptive effect
    progestins
  30. what is the primary role of estrogen in contraceptions
    • stabilize the endometrial lining
    • provide cycle control
  31. what is the role of progestins in contraceptives
    • creates a hostile environment by:
    • thickened cervical mucus
    • slows tubal mobility
    • induces endometrial atrophy
    • inhibit ovulation by blocking LH surge
  32. how is oral hormonal contraceptions dose
    • combined (progestin and estrogen)
    • progestin only
  33. which progestins have less of a testosterone effect for contraceptives
    • drospirenone
    • desogestrel
    • norgestimate
  34. what are the names of your progestin contraceptives
    • drospirenone
    • desogestrel
    • norgestimate
    • ethynodiol diacetate
    • norethindrone
    • norethindrone acetate
    • noreethynodrel
    • norgestrel
    • levonorgestrel
    • norelgestromin (patch)
    • etonogestrel (ring)
  35. what are the names of your estrogen contraceptives
    • ethinyl estradiol
    • mestranol
  36. which hormonal contraceptives contributes to suppression of LH surge thru negative feedback on pituitary FSH release
    estrogen
  37. what is the most popular method for initiation of hormonal contraceptives
    • sunday start: first tab on the first sunday after the beginning of menstruation
    • use alternative method of contraceptive for first month
    • "period free weekend"
  38. which initiation method is mandatory for progestin only products
    first day start
  39. explain first day start for hormonal contraceptives
    • first tab on the first day of menses
    • avoids risk of early ovulation and the need for alternative methods of contraception for the first month
  40. explain quick start for hormonal contraceptives
    • first tab on the day of office visit
    • use alternate method of contraception for 7 days
    • more successful in getting women to start and continue OCPs
  41. what are the major adverse effects of combined hormonal contraceptives
    • thrombolytic event
    • MI
    • HTN
    • DM
    • carcinoma
  42. how is estrogen excess managed associated with nausea, breast tenderness, HAs, cyclic weight gain due to fluid retention
    • decrease estrogen content in combined hormonal contraceptives
    • consider progestin- only methods for use in IUD
  43. how is estrogen excess managed associated with dysmenorrhea, menorrhagia, and/or uterine fibroid growth
    • decrease estrogen content in combined hormonal contraceptives
    • consider extended cycle or continuous OC
    • consider progestin only methods or IUD
    • NSAIDS for dysmenorrhea
  44. how is estrogen deficiency managed associated with vasomotor symptoms, nervousness, or decreased libido
    increase estrogen content in combined hormonal contraceptives
  45. how is estrogen deficiency managed that is associated with an early-cycle (days 1-9) breakthrough bleeding and spotting
    increase estrogen content in combined hormonal contraceptives
  46. how is estrogen deficiency managed that is associated with the absence of withdrawl bleeding (amenorrhea)
    • exclude pregnancy
    • increase estrogen content in the combined hormonal contraceptive if menses is desired
    • continue current combined hormonal contraceptive if amenorrhea is acceptabe
  47. how is progestin excess that is associated with increased appetite, weight gain, bloating, and constipation managed
    decrease progestin content in combined hormonal contraceptive
  48. how is progestin excess that is associated with acne, oily skin, and hirsutism managed
    • decreased progestin content in combined hormonal contraceptive
    • choose less androgenic progestin in combined hormonal contraceptives
  49. how is progestin excess that is associated with depression, fatigue, and irritability managed
    decrease progestin content in combined hormonal contraceptive
  50. how is progestin deficiency associated with dysmenorrhea or menorrhagia managed
    • increase progestin content in combined hormonal contraceptive
    • consider extended-cycle or continuous regimen in OC
    • consider progestin-only methods or IUD, NSAIDS for dysmenorrhea
  51. how is progestin deficiency associated with late cycle (days 10-21) breakthrough bleeding and spotting
    increase progestin content in combined hormonal contraceptive
  52. what are the drug interaction associated with oral contraceptives
    • rifampin
    • anticonvulsants (phenobarb, carbamazepine, phenytoin)
    • broad spectrum abx, antifungals
  53. what is the name of the transdermal contraceptive that is both ethinyl estradiol and norelgestromin hormones, it is applied weekly for 3 weeks to abd, buttocks, upper torso, or upper arm. There is a higher estrogen exposure
    orthoevra patch
  54. what is the name of the contraceptive ring that contains ethinyl estradiol and etonorgestrel
    nuvaring
  55. what are the progestin only oral contraceptives
    • Nor-QD
    • micronor
    • camila
    • errin
    • jolivette
    • nora BE
  56. how are progestins dosed
    taken everyday (28 on with no placebo pills)
  57. which class of hormonal contraceptives does not affect milk production so it can be used after 6 wks postpartum
    progestin only OC
  58. which class of oral contraceptives has a higher risk of ectopic pregnancy
    progestin only
  59. what are the adverse effects of depot medroxyprogesterone products (Depo-Provera and depo- SUBQ- provera)
    • menstrual irregularity
    • weight gain
    • osteoporosis (boxed warning)
  60. which contraceptive is a good choice for women who are non-adherent or who are not planning on having children for at least 3 years, or those who have estrogen side effects
    subdermal progestin implants: nexplanon
  61. how long is fertility delayed once Depo-Provera is stopped
    a median of 10 months
  62. how long is fertility delayed when stopping nexplanon
    30 days post removal
  63. this IUD is associated with increased spotting during the first 6th months, has decreased blood flow overall, and lasts 5 years
    mirena (levonorgestrel 52mg)
  64. this IUD is hormone free, 99% effective, but may increase menstrual flow 35% and dysmenorrhea, and can be left in place for 10 years
    paragard
  65. this IUDs MOA is that the copper interferes with sperm transport or fertilization, and prevention of implantation
    paragard
  66. which IUD is not a good choice for a pt who already suffers from dysmenorrhea
    paragard
  67. what are the three things that will guide you to choose and OCP with your pt
    • pts age
    • pt exam/history
    • pt preference
  68. hormone therapy for menopause treatment should be based on which parameters
    • menopausal symptoms
    • osteoporosis risk
    • cardiovascular disease risk
    • breast cancer risk
    • thrombo-embolism risk
  69. what is the only estrogen replacement therapy in menopause
    estrogen
  70. what hormones are considered hormone replacement therapy in menopause
    estrogen with a progestin
  71. what are the FDA approved non-estrogen products approved for osteoporosis in menopause
    raloxifene and bisphosphonates
  72. which hormonal therapy for menopause diminishes hot flushes/flashes in most women
    estrogen
  73. when is the only time you would not give estrogen replacement therapy as a stand alone treatment
    in women without a uterus
  74. what type of hormone replacement therapy is used for women with an intact uterus
    estrogen combined with a progestin
  75. which estrogen replacement therapy is approved for short term use in menopause not osteoporosis
    synthetic conjugated estrogen (cenestin)
  76. which estrogen replacement therapy is approved for both menopause and osteoporosis
    estropipate (ogen)- it is a synthetic human estrogen
  77. what are the adverse reactions associated with estradiol transdermal
    • burning
    • erythema
    • irritation
    • pruritis
    • rash
  78. which hormonal therapy is less likely than oral estrogen to cause nausea and headache
    transdermal estradiol
  79. which type of hormonal medications are for atrophic vaginitis
    estrogenic vaginal preparations
  80. what are your estrogenic vaginal preparations
    • premarin (conjugated estrogens)
    • ortho dienestrol (dienestrol)
    • ogen (estropipate)
  81. what are the names if the vaginal rings that provide continuous release of estrogen over 90 days that treats local symptoms only
    • estradiol acetate (Femring)
    • estradiol (estring)
  82. which vaginal ring is designed to achieve systemic concentrations of estrogen and is indicated for treatment of moderate to severe vasomotor systems
    estradiol acetate (Femring)
  83. this estrogenic vaginal preparation is a lotion that is applied to the thighs and calves once daily
    estrasorb
  84. this estrogenic vaginal preparation is a gel applied on one arm from the wrist to shoulder once daily
    estrogel
  85. what needs to be ruled out before prescribing estrogenic vaginal preparations
    endometrial hyperplasia
  86. which progestin is recommended for complete protection against estrogen-induced endometrial hyperplasia and is also indicated for amenorrhea
    medroxyprogesterone (provera)
  87. which progestin is found in several birth control pills and now is a combination HRT product
    norethindrone
  88. which combination HRT product causes less endometrial bleeding and breast pain but is not proven to cause less heart disease or breast cancer
    prempro 1.5
  89. which selective estrogen receptor modulator is used for osteoporosis and breast cancer
    raloxifene (evista)
  90. which selective estrogen receptor modulator treats breast cancer
    tamoxifen (nolvadex)
  91. this ovulation inducing agent mediates ovulation through increased output of pituitary gonadotropin and estrogens by inhibiting the action of stronger estrogens on the body's negative feedback system
    clomiphene (clomid)
  92. which ovulation induction agent is indicated for the treatment of ovulatory failure in women desiring pregnancy
    clomiphene (clomid)
  93. what are the adverse effects of clomipheme (clomid)
    • blurring spots or flashes in the eyes
    • vasomotor flushes
    • abd sxs
    • at high doses possible ovarian enlargement
    • ovarian cysts
    • possible increases risk of ovarian cancer with prolonged use
  94. what is your 1st generation selective estrogen receptor modulator
    tamoxifen (nolvadex)
  95. what is the recommended dose of iron for a women of child bearing age
    0.4mg/d from diet and possible supplementation
  96. what is the recommended dose for folic acid during pregnancy
    0.5-0.8 mg
  97. what is the recommended folic acid dose for previous NTD pregnancy
    4mg/d for the 1st month
  98. which estrogen receptor modulator works as an estrogen agonist to improve the lipid profile, decreases bone resorption, however there is an increased risk of thromboembolism and endometrial hyperplasia. This medication also works as an estrogen antagonist to reduce the chance of breast cancer but causes vasomotor hot flushes
    tamoxifen (nolvadex)
  99. which estrogen receptor modulator is approved for the treatment of breast cancer and the prevention of breast cancer in high risk women, this drug is not approved for osteoporosis
    tamoxifen (novaldex)
  100. what are the adverse effects of tamoxifen (nolvadex)
    • hot flashes
    • increased risk of endometrial hyperplasia venous thrombembolism
  101. what is the name of the 2nd generation selective estrogen receptor modulator
    raloxifene (evista)
  102. this estrogen receptor modulator is approved for prevention of postmenopausal osteoporosis, appears to not effect breast and endometrial receptors, improves lipid profile and prevents bone resorption, and has an increased risk of thromboembolisms;vasomotor hot flashes
    raloxifene (evista)
  103. which estrogen receptor modulator does not increase the risk of endometrial hyperplasia; may reduce the chance of breast cancer
    raloxifene (evista)
  104. which estrogen receptor modulator is FDA approved to lower the risk of invasive breast cancer in postmenopausal women with osteoporosis and postmenopausal women at high risk for invasive breast cancer
    raloxifene (evista)
  105. which estrogen receptor modulator is not indicated for premenopausal women, pregnancy (teratogen) or women with a history of thromboembolic events
    raloxifene (evista)
  106. which class of drugs is indicated for treatment of hormone responsive breast cancer (post-menopause)
    aromatase inhibitors
  107. what are the names of your aromatase inhibitors
    • letrozole (femara)
    • anastrozole (arimidex)
    • exemestane (aromasin)
  108. which aromatase inhibitor irreversibly inactivates aromatase
    exemestant (aromasin)
  109. which aromatase inhibitor is indicated for advanced breast cancer in postmenopausal women whose disease has progressed on tamoxifen therapy
    exemestane (aromasin)
  110. this progestin antagonist inhibits progesterone activity; also binds to glucocorticoid receptors, is primarily used to terminate early pregnancy
    mifepristone (mifeprex)
  111. this progestin antagonist is used to treat endometriosis and fibrocystic breast disease
    danazol (danocrine)
  112. this is a weak progestational, androgenic, and glucocorticoid activity. It is a synthetic androgen (weak) that suppresses the pituitary ovarian axis by inhibiting the output of pituitary gonadotropins
    danazol (danocrine)
  113. what are the treatments of endometriosis
    • danazol
    • gonadotropin-releasing hormones (GnRH) analogs
    • combination oral contraceptive without interruption
  114. how long do the medications that treat endometriosis inhibit ovulation for
    4-9 months
  115. what are the therapeutic uses for androgens
    • they effect males with inadequate androgen secretions
    • anabolic effects: in senile osteoporosis and severe burns
    • growth
    • endometrosis
    • can increase lean body mass and muscle strength (drug of abuse)
  116. this medication is indicated in males that need replacement therapy (hypogonadism); delayed puberty, and in females is used for metastatic breast cancer
    testosterone
  117. what are the adverse effects of testosterone
    • females: masculinization, acne, facial hair, deepening of voice, male pattern baldness, excessive muscle development
    • males: priapism, impotence, decreased spermatogenesis and gynecomastia
    • children: growth disturbances/abnormal sexual maturation
  118. what is used in the treatment of: benign prostatic hypertrophy, prostate CA, endometriosis, advanced breast CA
    antiandrogens
  119. what are the obstructive signs of obstructive BPH
    • hesitancy
    • decrease force
    • incomplete voiding
    • straining to urinate
  120. what are the symptoms of irritative BPH
    • urgency
    • frequency
    • nocturia
  121. what are the alpha1 blockers that are used for BPH and also lowers blood pressure
    terazosin (hytrin) and doxazosin (Cardura)
  122. what are the significant risks associated with alpha1 blockers that treat BPH and lowers the BP
    significant risk of snycope
  123. what are the alpha1 blockers that is used to treat BPH but does not have significant affect on BP
    alfuzosin (uroxatral) and tamsulosin (Flomax)
  124. this drugs MOA inhibits 5α reductase, the enzyme that converts testosterone into 5α dihydrotestosterone (DHT) the principle androgen responsible for prostatic growth
    finasteride (proscar 5mg tabs)
  125. this anti-androgen halts BPH progression and reduces prostate size and symptoms over time
    finasteride (proscar 5mg tabs)
  126. what are the side effects of finasteride (proscar)
    • decreased libido
    • erectile dysfunction
    • ejaculation dysfunction
  127. what medication is approved for androgenic alopecia (male pattern baldness)
    finasteride (propecia and proscar)
  128. these medications decrease the production of gonadotropins by interfering with the GnRH receptor in the pituitary
    GnRH analogs
  129. continuous dosing of what class of drugs leads to decrease LH and FSH
    GnRH
  130. which GnRH is indicated for prostate CA, endometriosis, and advanced breast CA
    goserelin (zoladex)- BCF for tx of prostate CA
  131. what class of medications prevent testosterone from binding to its receptor in target tissue (prostate, testes)
    androgen blockers
  132. what are the names of the androgen blockers
    • flutamide (eulexin)
    • bicalutimide (casodex)
    • nilutamide (nilandron)
  133. what class of medications are used in conjunction in the treatment of metastatic prostate cancer
    androgen blockers and GnRH analogs
  134. what class of medication is used for osteoporosis
    bisphosphonates or SERM
  135. what are the names of the bisphosphonates that are FDA approved for the treatment of osteoporosis
    • alendronate
    • risedronate
    • ibandronate
    • zoledronic acid
  136. this class of medication decreases bone resorption, increases bone density, and is shown to prevent fractures. They selectively bind to the antiresorptive surfaces of bone and may be incorporated into the bone
    bisphosphonates
  137. this bisphosphonate's place in therapy is an alternative to ERT/HRT for osteoporosis but no effect on vasomotor symptoms or genitourinary symptoms
    alendronate (Fosamax)
  138. which bisphosphonate is used in the prevention and treatment of osteoporosis
    alendronate (Fosamax)
  139. what are the CI and precautions associated with alendronate (Fosamax)
    • upper GI problems
    • esophageal irritation/GI ulceration
    • pt is required to sit/stand upright for 30 minutes after dosing and have nothing but water
    • easiest to comply when using the weekly products
    • hypocalcemia
    • renal insufficiency
    • * recently been associated with osteonecrosis of the jaw
  140. which bisphosphonate is used as an IV infusion once a year for osteoporosis
    zoledronic acid (zometa)
  141. which medication class is used in Paget's dz and hypercalcemia, and will block bone resorption by making the bone resistant to hydrolysis
    injectable bisphosphonates
  142. this medication may have analgesic effects in pts with acute fractures
    calcitonin salmon (miacalcin) (fortical rDNA origin) nasal spray
  143. this medication has a place in therapy for pts with high risk of fractures due to history of fractures or very low bone mineral density
    teriparatide (forteo)
  144. this is the first agent that stimulates new bone growth
    human parathyroid hormone (teriparatide; forteo)
  145. what is the adverse effect of teriparatide (forteo)
    may increase risk of bone cancer
  146. what are used as prerequisites for therapy with raloxifiene/bisphosphonates for osteoporosis
    calcium and vit D
  147. which medications are used in the prevention of osteoporosis
    raloxifiene and bisphosphonates
  148. which medication that is used in the prevention of osteoporosis is NOT to be used with thromboembolic disorders or in premenopausal women, is shown to increase spine BMD and decrease vertebral fractures but not hip fractures
    raloxifiene
  149. which medication that is used in the prevention of osteoporosis is NOT to be used in hypocalcemia, esophageal abnormalities, pts who can't sit or stand upstraight, low renal function, is shown to increase BMD the most and reductions in vertebral and hip fractures have been shown
    bisphosphonates
  150. which medication is approved for primary osteoporosis in men
    alendronate (Fosamax)
  151. what are the names of the medications that treat erectile dysfunction
    • sildenafil (Viagra)
    • vardenafil (Levitra)
    • tadalafil (Cialis)
  152. the MOA is these drugs are to increase blood flow to the corpus cavernosum (phosphodiesterase-5 inhibitor)
    drugs for erectile dysfunction
  153. what are the drug to drug interactions associated with erectile dysfunction drugs (PDE5 inhibitors)
    nitates- increase in vasodilatory effects resulting in a significant fall in blood pressure (can be life threatening)
  154. what are the cautions with starting an erectile dysfunction medication (PDE5 inhibitors) with the use of alpha blockers
    • must be stable on alpha blockers with no syncope
    • must have adequate intravascular volume
    • start at lowest dose of PDE5 inhibitor
    • even with above precautions, symptomatic HoTN can occur
  155. what are the adverse effects of PDE5 inhibitors
    • priapism
    • vision changes (blurring, color changes)
  156. this class of medications are competitive H1 antagonist, or an inverse agonist, of the early response of allergies. They exhibit anticholinergic and some alpha1-antagonist properties (1st generation) and may have some anti-inflammatory action
    antihistamines
  157. what are the negative outcomes associated with antihistamines
    • drowsiness
    • sedation
    • performance impairment
    • anticholinergic SE
  158. what are the adverse events associated with antihistamines
    1st gen: paradoxical excitement in children
  159. which intranasal antihistamines are associated with a bitter taster and somnolence
    azelastine (astelin)= higher prevalence for bitter taste and somnolence

    olopatadine
  160. what are your oral 1st generation antihistamines
    • brompheniramine (dimetane)
    • chlorpheniramine (chlortrimeton)
    • diphenhydramine (Benadryl)
    • promethazine (Phenergan)
    • hydroxyzine (atarax)
    • meclizine (antivert)
    • cyproheptadine (periactin)
  161. which 1st gen antihistamine is used primarily for urticarial and itching
    hydroxyzine (atarax)
  162. which 1st gen antihistamine is used primarily for vertigo
    meclizine (antivert)
  163. which 1st gen antihistamine is used for serotonin syndrome
    cyproheptadine (periactin)
  164. which 1st gen antihistamine is used primarily for N/V
    promethazine (Phenergan)
  165. what are the names of the oral 2nd gen antihistamines
    • fexofenadine (allegra)
    • loratadine (Claritin)
    • desloratadine (clarinex)
    • cetirizine (zyrtec)
    • levocetirizine (xyzal)
  166. what are the names of your 2nd gen intranasal antihistamines
    • azelastine (astelin, astepro)
    • olopatadine (patanase)
  167. which 2nd gen intranasal antihistamine crosses the BBB
    azelastine (astelin, astepro)
  168. which 2nd generation intranasal antihistamine is relatively selective for the H1 receptor resulting in fewer side effects
    olopatadine (patanase)
  169. what is the decongestant of choice in pregnancy (2nd trimester or later)
    pseudoephedrine (Sudafed)
  170. which topical decongestant is short acting up to 4 hours
    phenylephrine (neo-synephrine)
  171. which topical decongestant is long acting, up to 12 hours
    oxymetazoline (afrin)
  172. this class of medications MOA is an anti-inflammatory agent that inhibits the mediators released in both the early and late phase reaction which inhibits mucosal edema and vasodilation
    intranasal steroids
  173. blocked nasal passages should be cleared how before administration of a intranasal steroid
    cleared with a decongestant or saline irrigation
  174. what can be used if the pt has severe debilitating allergic rhinitis
    short course of oral burst therapy (prednisone 40 mg daily x 5-7 days
  175. what are the adverse effects associated with intranasal steroids
    • drying and stinging of the nasal passage
    • epistaxis
    • growth suppression (beclomethasone only)
    • after taste
    • nasal septum perforation (rare)
  176. which intranasal steroid may exert greatest systemic effects and may decrease growth velocity
    beclomethasone (beconase AQ) NF
  177. which intranasal steroid is the preferred steroid if the pt is pregnant
    budesonide (rhinocort aqua) NF
  178. what are the most effective drugs for allergic rhinitis that relieves all four symptoms (rhinorrhea, itching, sneezing, congestion)
    intranasal corticosteroids
  179. this class of medication has an MOA that inhibits cysteinyl leukotriene, an inflammatory mediator released by the mast cell, on target cells
    leukotriene inhibitors
  180. what is the name of your leukotriene inhibitor
    montelukast (singulair)
  181. which class of drugs MOA results in a decrease of nasal mucous secretion
    anticholinergics
  182. what is the name of the anticholinergic used for allergic rhinitis
    ipratropium nasal (atrovent)
  183. the MOA of this class of drugs is that it is a mast cell stabilizer that inhibits cell mast degranulation, which prevents the release of histamine and leukotrienes after contact with an antigen
    mast cell stabilizers
  184. this class of medication is most effective if initiated 1-2 weeks prior to exposure to known allergens
    mast cell stabilizers
  185. what is the name of the mast cell stabilizers used in allergic rhinitis
    cromolyn sodium (nasalcrom)
  186. this class of medication has a MOA that irrigates and cleanses the nasal passages of mucous and allergens reducing inflammation
    normal saline
  187. what is the triad of allergic conjunctivitis
    • itching
    • conjunctival injection (redness)
    • chemosis (swelling) with or without tearing/watery discharge
  188. these drugs are H1 receptor antagonists that decrease itching and vasodilation (tearing and swelling)
    ocular antihistamines
  189. what are the adverse events associated with ocular antihistamines
    • sting/burning
    • may cause mydriasis causing vision disturbances and increased IOP (CI in angle-closure glaucoma)
    • dry eyes
    • bitter taste
    • H/A
  190. what are the names of the ocular antihistamines
    • azelastine (optivar)
    • levocabastine susp (livostin)
  191. these are alpha agonists that constricts conjunctival vessels thereby reducing redness and swelling
    ocular decongestants
  192. what are the adverse events associated with ocular decongestants
    • stinging/burning
    • dry eye feeling
    • rebound hyperemia (conjunctivitis medicamentosa; restrict use < 10 days)
    • mydriasis causing vision disturbances and increased IOP (CI in angle-closure glaucoma)
  193. what are the names of the ocular decongestants
    • naphazoline (vasocon)
    • oxymetazoline (visine LR)
    • tetrahydrozoline (visine original)
  194. which ocular decongestant is most potent (intermediate acting)
    naphazoline (vasocon)
  195. which ocular decongestant causes more rebound hyperemia (long acting)
    oxymetazoline (visine LR)
  196. what is the active component of visine A
    naphazoline
  197. what are the names of the ocular mast cell stabilizers
    • cromolyn (opticrom)
    • lodoxamide (alomide)
    • nedocromil (alocril)
  198. what are the names of the ocular antihistamine and mast cell stabilizers
    • ketotifen (zaditor)
    • olopatadine (patanol)
  199. these medications decrease prostaglandin production resulting in relief of pain, inflammation, and ocular itching
    ocular NSAIDS
  200. which class of ocular antihistamines may induce an asthma attack in pts with an ASA sensitivity
    ocular NSAIDS
  201. what are the names of the ocular NSAIDS
    ketorolac (acular, acular PF)
  202. this class of medications MOA is that it is an anti-inflammatory agent that is reserved for the more severe and chronic cases of allergic conjunctivitis
    ocular steroids
  203. what are the negative outcomes of ocular steroids
    risk for cataract formation and increased IOP increases with prolonged use (monitor IOP if > 10 days use)
  204. what is the name of the ocular steroids
    loteprednol susp (alrex)
  205. what is the name of your short acting inhaled beta 2 agonists
    albuterol
  206. if a child is unable to use a inhaler, what is the next choice of treatment
    nebulizer
  207. what are the names of the other short acting beta agonists
    • levalbuterol (xopenex)
    • pirbuterol (maxair and maxair autoinhaler)
    • terbutaline (brethine)
  208. which short acting beta agonist is said to cause less nervousness and tremors and is given at lower doses
    levalbuterol (xopenex)
  209. which short acting beta agonist is an autoinhaler that is breath activated
    pirbuterol (maxair and maxair autoinhaler)
  210. which anti-cholinergic is only indicated as adjunctive therapy in acute severe asthma not completely responsive to B2 agonists alone because it does not improve outcomes in chronic asthma
    ipratropium bromide
  211. when a glucocorticoid is used for acute therapy in asthma, how should it be used
    burst therapy for 3-10 days
  212. what are the names of the glucocorticoids used in the acute treatment of asthma
    • oral: prednisone, prednisolone, methylprednisone
    • Inj: methylprednisone
  213. which IV glucocorticoid is most used for acute asthma attacks and allergic reactions
    methylprednisolone succinate (solu-medrol)
  214. for a pt that is 12 years or older, what is your 1st line choice of long-term controlled medication for asthma
    • low dose: beclomethasone
    • medium dose: beclomethasone
    • medium dose/LABA (long acting beta agonist): mometasone/formoterol
  215. which leukotriene medication can be used as an alternative for asthma
    montelukast (singulair)
  216. which glucocorticoid is produced in the adrenal cortex, has anti-inflammatory action that is beneficial in asthma, and inhibits lymphocytic, eosinophilic airway mucosal inflammation of asthmatic airways
    natural glucocorticoid (cortisol)
  217. which class of medications are the most effective anti-inflammatory agents for asthma
    glucocorticoids
  218. this class of medications MOA is to decrease and inhibit lymphocytes and macrophages and indirectly inhibits phospholipase A2
    glucocorticoids
  219. which class of medications blocks the release of arachidonic acid, the precursor to prostaglandins, and blocks leukotrienes from membrane bound phospholipids
    glucocorticoids
  220. what are the actions of glucocorticoids
    • increase the beta2 receptor density
    • reduce mucus production and hypersecretion
    • prevent and reverse airway remodeling
  221. what are the adverse effects associated with glucocorticoids
    • reduces body's ability to fight infections (impaired wound healing)
    • hyperglycemia (glucose intolerance)
    • osteoporosis
    • cataracts
    • increased BP
    • thin fragile skin
    • aggravates peptic ulcers
    • causes weight gain and fat redistribution
  222. what are the adverse effects specific to inhaled steroids
    • cough
    • dysphonia
    • oral candidiasis (thrush)

    *use of spacers and rinsing mouth after use will reduce these SE
  223. which inhaled glucocorticoid is a good starting drug by allowing providers to adjust therapy without increasing the number of puffs the pt has to use
    fluticasone (flovent)
  224. which inhaled glucocorticoid is a potent inhaler that is more convenient in pts requiring high dose steroids
    budesonide (pulmicort)
  225. what is the only corticosteroid available in suspension for oral inhalation (via nebulizer)
    pulmicort respules
  226. which inhaled glucocorticoid is a nasal spray used in allergic rhinitis
    rhinocort
  227. which inhaled glucocorticoid has a built in spacer and required TID or QID dosing or excessive puffs to handle most pts
    triamcinolone (azmacort)
  228. which inhaled glucocorticoid is a low potency inhaler and is preferred by many providers for children
    beclomethasone (QVAR)
  229. this inhaled glucocorticoid is not indicated for children <4 y/o, the cap is needed to prime the inhaler, requires QD or BID dosing in pts who receive oral steroids
    mometasone furoarte (azmanex twisthaler)
  230. when should mometasone furoate (azmanex twisthaler) be discarded
    after 45 days of opening pouch or when the dose counter reads 00
  231. why should oral glucocorticoids be tapered
    because systemic (oral) glucocorticoids can lead to hypothalamic-pituitary- adrenal (HPA) axis supression
  232. which oral glucocorticoid can be used to gain control of symptoms of asthma in adults
    prednisone 60mg/d for 3-10 days and can be given without a taper
  233. what are the names of the long acting beta 2 agonists
    • salmeterol (serevent)
    • formoterol (foradil)-- faster onset time
  234. this class of medications are added to corticosteroid therapy for long term control and prevention of symptoms in moderate to severe persistent asthma
    long acting beta 2 agonists (LABAs)
  235. this medication reduces the number of inhalers pts are required to use thereby increasing pt satisfaction and compliance
    advair diskus and advair HFA
  236. this medication is for pts not adequately controlled on other asthma controller medications (12 years and older)
    symbicort MDI
  237. this combination MDI is indicated for asthma treatment in pts 12 years and older
    formoterol and mometasone dulera
  238. which LABA may increase the risk of asthma related death
    formoterol and salmeterol
  239. this class of medications MOA inhibits the degranulation of mast cells that occurs after exposure to antigens
    mast cell stabilizers
  240. how long is the trial period for mast cell stabilizers
    4-6 weeks
  241. what are the names of the mast cell stabilizers
    • cromolyn (intal)
    • nedocromil (tilade)
  242. what are the side effects of mast cell stabilizers
    • bad taste
    • H/A
    • cough
  243. this class of medication is considered in allergic asthmatics on a seasonal basis or before acute exposure and is the second line drug (after a B2 agonist) in exercise induced asthma
    mast cell stabilizers
  244. this medication is indicated for children 1 years to adults with asthma and is now approved for seasonal allergic rhinitis
    montelukast (singulair)
  245. this medication is indicated for children 5 years to adults with asthma but inhibits CP450
    zafirlukast (accolate)
  246. this class of medications improves PFTs, decrease nocturnal awakenings and B2 agonist use
    anti-leukotriene agents
  247. what are the names of the anti-leukotriene agents
    • montelukast (singulair)
    • zafirlukast (accolade)
  248. what is the first biologic approved for allergy-related asthma
    omalizumab (xolair)
  249. this medication has an MOA that blocks IgE preventing allergens from causing inflammation
    omalizumab (xolair)
  250. which medication is indicated for pts 12 years and older with moderate to severe asthma triggered by allergic reaction when inhaled steroids do not provide adequate relief
    omalizumab (xolair)
  251. what is the side effect of omalizymab (xolair)
    anaphylaxis
  252. this medication may work by directly relaxing the bronchiolar smooth muscle and pulmonary blood vessels, also stimulates the CNS, induces diuresis, increases gastric acid secretion, reduces LESZ pressure and inhibits uterine contractions
    theophylline (xanthines)
  253. when would you use IV aminophylline
    reserved IV use for impending respiratory failure
  254. what is the primary pharmacologic therapy in management of COPD
    brochodilators
  255. what will work in COP for acute symptoms especially in pts who have underlying asthma as well as COPD
    SABA: albuterol, levalbuterol, pirbuterol
  256. which short acting anti-cholinergic/muscarinic antagonists are used in the treatment of COPD
    • ipratropium bromide (atrovent)
    • combivent (ipratropium and albuterol)
  257. what are the long acting anticholinergic/muscarinic antagonists that are used in the treatment of COPD
    tiotropium bromide (Spiriva)
  258. which short acting anti-cholinergic/muscarinic antagonist has a side effect of a metallic taste and muse be avoided in pts with peanut allergies
    ipratropium bromide (atrovent)
  259. this long acting anti-cholinergic/muscarinic agent improves lung function, dyspnea, exacerbation frequency, and health-related quality of life in COPD pts
    tiotropium (Spiriva)
  260. these medications can be used to reduce nocturnal symptoms and improve quality of life in pts with COPD
    • salmeterol
    • formoterol
  261. this drugs MOA reduces inflammation by inhibiting the breakdown of intracellular cyclic AMP
    daliaresp (roflumilast)
  262. this medication reduces moderate to severe exacerbations in pts with sever COPD associated with chronic bronchitis and a history of exacerbations
    daliaresp (roflumilast)
  263. what are the SE of daliaresp (roflumilast)
    • reduced appetite
    • abd pain
    • sleep disturbances
  264. if a pt has mild/mod acute bacterial exacerbations of chronic bronchitis, what antibiotics can be used to tx it
    • amox
    • doxy
    • oral ceph
  265. if a pt has severe acute bacterial exacerbations of chronic bronchitis, what antibiotics can be used to tx it
    • augmentin
    • Z-pack
    • clarithomycin
  266. this medication loosens and thins lower respiratory tract secretions and makes a minimally productive cough more productive
    guaifenesin
  267. this antitussive anesthetizes stretch receptors and reduces cough reflex
    benzonatate (tessalon perles)
  268. what is the only antihistamine that has antitussive indication
    diphenhydramine (Benadryl)
  269. which type of delivery system for derm agents, provides evaporative cooling and causes vasoconstriction. This type of delivery system is used for acutely inflamed, oozing lesions and ulcers
    wet dressings (ie: normal saline, acetic acid, domeboro)
  270. which type of delivery system for derm agents, is used for drying and cooling, absorbs moisture and creates more surface area for evaporation
    powders
  271. which type of delivery system for derm agents is a suspension of a powder in a water vehicle, is used for drying and cooling
    lotions
  272. this type of delivery system for derm agents is the most common vehicle; most are oil in water emulsions. They should be rubbed in until the vanish, are not very occlusive and are best suited for non-irritable dermatoses
    creams
  273. this type of delivery system for derm agents are water in oil emulsions, they relieve dryness, brittleness and protect fissures and are occlusive. They are not designed for hair covered areas and are good for damaged skin to provide occlusion
    ointments
  274. this type of delivery system for derm agents are clear, non-greasy, nonstaining, nonocclusive and quick drying semisolid emulsions. They contain propylene glycol, and are good for hair covered areas or the face where the pts want to avoid the greasy look after application
    gels
  275. this type of delivery system for derm agents are more expensive and less efficient that other topical methods, the advantage of this delivery system is that application does not require contact
    aerosol
  276. this type of delivery system for derm agents is a concentrated suspension of powder in an ointment base, is thick and dry, but not applied to weeping lesions or hairy areas
    pastes
  277. this type of delivery system for derm agents are alcoholic or hydro-alcoholic solutions, and the vehicle evaporates quickly
    tinctures
  278. which agents are DOC for all inflammatory and pruritic eruptions (allergic contact dermatitis, atopic eczema, seborrheic dermatitis)
    topical corticosteroid agents
  279. what are the CI's for the use of topical corticosteroid agents
    • acne vulgaris
    • warts
    • fungal infx
    • ulcers
  280. what are the adverse reactions/SE associated with topical corticosteroid agents
    • derm atrophy
    • fine hair growth
    • bruising
    • striae
  281. which type of derm vehicle are better for dry skin
    ointments
  282. which type of derm vehicles are better for oily skin
    creams
  283. what are the names of the low potency topical corticosteroid agents
    • hydrocortisone acetate 1% ointment, cream or lotion
    • desonide 0.05% ointment and cream (tridesilon)
  284. what is a good low potency front line agent topical corticosteroid
    hydrocortisone acetate 1%
  285. which low potency topical corticosteroid may be used on the face or body folds
    desonide 0.05% (tridesilon)
  286. these dermatologic agents are usually effective for treating thin acute inflammatory skin lesions, are preferred in infants and the eldery and are the safest for long term use or large surface areas
    low potency topical corticosteroids
  287. what are the names of the medium potency topical corticosteroids
    • hydrocortisone valerate 0.2% (westcort)
    • triamcinolone acetonide 0.1% (aristocort, kenalog)
  288. this dermatologic topical corticosteroid is a popular medium potency agent used for eczema, psoriasis, or dermatitis
    triamcinolone acetonide (aristocort, Kenalog)
  289. how long should the medium potency dermatologic topical corticosteroids be limited to
    limit to 3 months
  290. what are the names of the high potency dermatologic topical corticosteroid agents
    fluocinonide (lidex)
  291. which dermatologic topical corticosteroid is used for lesions resistant to medium potency steroids
    fluocinonide (lidex)
  292. what is the name of the ultra high potency dermatologic topical corticosteroid agents
    clobetasol (temovate)
  293. how long are the ultra-high potency dermatologic topical corticosteroids limited to
    2-3 weeks unless it is a very small lesion
  294. what are the names of the dermatologic topical immunomodulators
    • pimecrolimus cream (elidel)
    • tacrolimus ointment (protopic)
  295. which dermatologic agents are indicated for atopic dermatitis and chronic inflammatory skin disease
    • pimecrolimus cream (elidel)
    • tacrolimus ointment (protopic)
  296. what are the side effects associated with the topical immunomodulators (elidel, protopic)
    • skin burning/warmth
    • avoid sun exposure

    *oral tacrolimus (prograf) can cause lymphoma
  297. what is the black box warning associated with topical immunomodulators
    association with a rare case of malignancy so their use should be limited to short term or intermittent use only
  298. these medications should be considered a first line steroid sparing agent for atopic dermatitis in pts who can not tolerate topical steroids
    topical immunomodulators (elidel, protopic)
  299. what is the treatment for acute stage contact dermatitis
    • wet dressings w/astringents or drying agents
    • - aluminum acetate (domeboro, burrows solution)- astringent
    • - witch hazel- astringent
    • - calamine- drying
    • - zin oxide- drying
  300. which dermatologic vehicles are suitable options for contact dermatitis
    creams or gels
  301. what is the topical antibiotic of choice for impetigo
    mupirocin (bactroban)
  302. which acne drug therapy is used for normalizing follicular keratinization
    • retinoids
    • azelaic acid
    • benzoyl peroxide
  303. which acne drug medications decrease sebum production
    • retinoids
    • isotretinoin
    • hormone manipulation
  304. which acne drug medications are good at suppressing bacteria
    • antibiotics
    • benzyl peroxide
    • azelaic acid
    • retinoids
    • isotretinoin
  305. which acne drug medications are used for preventing inflammatory response
    • antibiotics
    • retinoids
  306. what is the most effective acne treatment that is an antibacterial and it unblocks pores by causing mild kerationolysis
    benzoyl peroxide (desquam, Clearasil)
  307. what are the names of the topical antibiotics used for the treatment of acne
    • clindamycin (cleocin-T)
    • erythromycin (T-stat)
    • combination: clinda and benzoyl peroxide (benzaclin) and erythromycin and benzoyl peroxide (benzamycin)
  308. what systemic antibiotics are used in the treatment of acne
    • macrolides (erythromycin or Zithromax)
    • tetracyclines (minocycline)
  309. which antibiotics are used in pts who are unresponsive to topicals (acne treatment)
    TMP/SMX and metronidazole
  310. this class for treating acne inhibits neutrophils and monocyte chemotaxis which reduces the production of sebum
    retinoids
  311. what are the names of the retinoid medications used in the treatment of acne
    • tretinoin (renti-A)
    • adapalene (differin)
    • tazarotene (avage, tazorac)
  312. what are the adverse events associated with retinoids
    will cause drying, redness, and peeling skin (made worse by the sun, only apply at night)
  313. what are the side effects of retinoids
    • can darken skin
    • dry skin
    • photosensitivity
  314. what do you want to tell your pts as you are prescribing them retinoids
    acne may appear worse for the first few weeks because the preclinical lesions become visible
  315. this retinoid is the only effective agent in severe cystic acne
    isotretinoin (Accutane)
  316. which systemic acne medication requires the provider, patient, and pharmacy to register to get the product
    isotretinoin (Accutane)
  317. what are the adverse effects associated with isotrentinoin (Accutane)
    • darken skin
    • dry skin
    • photosensitivity
    • dry mouth, lips, nose, eyes
    • alopecia
    • nail fragility
  318. this acne medication has an advantage over conventional acne regimens because it has minimal toxicity particularly in pts intolerant or unresponsive to topical or oral therapy, with antibiotics or benzoyl peroxide
    azelaic acid (azelex)
  319. what are the adverse effects associated with azelaic acid (azelex)
    • hypopigmentation in pts with a dark complexion
    • possible pruritis, burning, stinging and tingling in all pts
  320. which formulation of azelaic acid (azelex) is used for acne vulgaris and which one is used for acne rosacea
    • azelex: acne vulgaris
    • finacea: acne rosacea
  321. what is the topical  agent of choice in the treatment of acne rosacea
    metronidazole.e 0.75% gel or 1% cream
  322. what is the treatment for head lice
    • permethrin:
    • - nix 1% cream rinse
    • - elimite cream 5% for scabies and refractory head lice
    • rid
    • ovide: flammable
    • step 2 (not a pediculice): used after one of the above agents to loosen the bond that holds eggs to hair
  323. what is the treatment for pubic lice
    lindane (Kwell, G well)
  324. what is the black box warning associated with lindane
    can penetrate human skin and cause CNS toxicity (seizures) and neurotoxicity
  325. what are the keratolytic agents used to handle warts
    • salicylic acid (expect improvement in 1-2 weeks and resolution in 4-6 weeks)
    • duofilm, compound W
    • mediplast (patches)
  326. what is used to treat anogenital warts
    • podophyllum resin- clinic use only
    • podofilox (condylox)- outpt use
    • imiquimod (aldara)- more effective in women than men and safer in pregnancy
  327. which vaccine is used to prevent cervical CA and genital warts. Covers HPV 6,16,11, and 18
    gardasil
  328. this medication is a soap free cleaner that is used in pts sensitive to drying soap
    cetaphil (cetyl alcohol)
  329. what is used to treat acute weeping lesions
    • aluminum subacetate (domeboro tabs)- drying agent
    • colloidal oatmeal (aveeno)- soothing agent
  330. which systemic oral histamine is used in the treatment of atopic dermatitis
    hydroxyzine (atarax)

What would you like to do?

Home > Flashcards > Print Preview