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Pharm Step 2 CK Part 3

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eesohbel's version from 2016-08-15 16:39

misc

Question Answer
tx for primary hyperaldosteronismmedical therapy with aldosterone antagonists sprionolactone, eplerenone
drug eluting cardiac stent txaspirin plus P2y12 receptor blockers (clopidogrel)
moa statinsinhibit intracellular HMG-COA reductase and increases number of cell membrane LDL receptors aka inhibition of intracellular synthesis pathway
drug of choice for chemo induced vomitingserotonin antagonists (ondansetron)
drug of choice motion sicknessanticholinergic drugs like (scopolamine)
drug of choice refractory vomitingdopamine antagonists (metoclopramide)
drugs that cause IIHGH, tetracyclines, vitamin A
memorize

misc2

Question Answer
hypothermiatypical antipsychotics
tx for idiopathic intracranial hypertensionacetazolamide +/- furosemide
prophylaxis for toxoTMP-SMX
tx for toxosulfadizine and pyrimethamine
what is diclofenacNSAID
tx for pinworm (perianal pruritis especially at night)albendazole
tx for acute distoniaanticholinergics (benzotropine) or diphenhydramine
common side effects of erythropoietin therapyworsening of hypertension, headaches, flu-like syndrome, red cell aplasia
rituximabCD20 cell surface antigen CLL
imatinibBCR-ABL
memorize

misc

Question Answer
abortive migraine therapiestriptans, NSAIDS, acetaminophen, antiemetics, ergots
preventive mgiraine therapiestopiramate, TCAs, beta blockers
triptan cannot be combined w/Ergot causes severe prolonged vasoconstriction resulting in elevated BP, MI, and stroke
tx for post-nasal driporal antihistamine
medication to avoid in acute angle closure glaucomaatropine because it is a mydratic agent and can precipitate glaucoma
first line tx for acute anglle glaucomaIV mannitol
medications for posttransplant patientsproph w/TMP-SMX, ganciclovir or valganciclovir
memorize

teratogens

Question Answer
ACEIoligo, IUGR
alcoholFAS
androgensvirilization of female fetuses
carbamazepineNTD
cocainebowel atresias
DES:clear cell adeno of the vagina
leadincreased rate of SAB
lithiumebstein anomaly
phenytoinmicrocephaly
radiationmental retardation
streptomycinhearing loss CNVII damage
tetracyclineyellow brown discoloration of teeth
thalidomidbilateral limb deficiences
valproateNTD
vitamin Aincreased SAB rate
warfarinnasal hypoplasia
memorize

misc

Question Answer
benzo overdoseslurred speech, unsteady gait and drowsiness
phenytoin toxicityhorizontal nystagmus, cerebellar ataxia, and confusion
opioid intoxicationrespiratory depression and miosis
lithium toxtremor and hyperreflexia ataxia and seizures
how does sodium bicarb treat TCA overdosesodium load alleviates depressant action on myocardial sodium channels
tx for ALSriluzole, glutamate inhibitor
acute pulmonary edema in acute MIdiuretics avoid beta blockers
prolonged infusion of nitroprussidecyanide tox include headache, confusion, arrhythmias, flushing and respiratory depression
memorize

misc

Question Answer
medical tx options for AUBhigh dose IV estrogen, high dose OCPS, high dose progestin pills. tranexamic acid
daily tx of MGcholinesterase inhibitors
tx myasthenic crisisIVIG or plasmapheresis in addition to steroids
a/e primidoneprecipitates AIP which manifests as abdominal pain, neuro and psych abnormalities
moa of flushing of niacinprostaglandin induced peripheral vasodilation
tx for central precocious pubertyGnRH agonist
tx for impetigolimited skin (mupirocin), extensive skin (oral antibiotics-cephalexin)
memorize

alcohol tox

Question Answer
alcohol ketoacidosis cfslurred speech, unsteady gait, altered mentation
lab results alcohol ketoacidosisanion gap MA
methanol cfvisual blurring, afferent pupillary deffect altered mentation
lab results methanolanion gap MA
ethylene glycol clinical featuresflank pain, hematuria, oliguria, cranial nerve palsies, tetany
lab results ethylene glycolanion gap MA, calcium oxalate crystals in urine
tx for ethanol glycol poisiningfomepizole or ethanol and sodium bicarb
memorize

tocolytics

Question Answer
first lineindomethacin, nifedipine, terbutaline
a/e indomethacin in mothergastritis, platelet dysfunction
a/e nifedipine in mothertachycardia, nausea, flushing, headache
a/e terbutalinehyperglycemia, hypotension, pulmonary edema
memorize

lipid drugs

Question Answer
best for hypertriglyceridemiafibrates
LDLcholestyramine, statins
best for increasing HDLniacin
memorize

Parkinsonian Medications

Question Answer
A/E L-Dopa plus carbidopasomnolence, confusions, hallucinations (older), dyskinesia
benzotropine moaanticholinergic
a/e benzotropinedry mouth, blurred vision, constipation and urinary retention
a/e amantadineanke edema and livedo reticularis
bromocriptine moadopamine agonist
a/e bromocriptinesomnolence, hypotension, and confusion, hallucinations (older)
moa entacapone or tolcaponeCOMT inhibitor
moa selegilineMao B inhibitor
a/e selegilineinsomnia and confusion (elderly patients)
memorize

DMARDS

Question Answer
a/e methotrexatehepatotox, stomatitis, cytopenias
a/e lefluonmidehepatox, cytopenias
a/e hydrochloroquineretinopathy
a/e sulfasalazinehepatotox, stomatitis, hemolytic anemia
a/e TNF inhibitorsinfection, demyelination, CHF, malignancy
memorize

HY drug side effects

Question Answer
ACEIScough, rash, angioedema
amantadineataxia, livedo reticularis
aminoglycosidesototox, nephrotox (ATN)
amiodaronepulmonary fibrosis, bluish disocoloration in chornea
amphotericinrigors, neprotox, bone marrow suppression, anemia
AZTmegaloblastic anemia, thrombocytopenia
carbamazepineagranulocytosis
CCBperipheral edema
chloramphenicolgray baby syndrome
cisplatinnephrotox, acoustic nerve damage
clonidinedry mouth; severe rebound headache and hypertension
clozapineagranulocytosis
cyclophosamidehemorrhagic cystitis
digoxinGI disturbance, yellow visual changes, arrythmias, neuro
doxorubicincardiotox
fluroquinolonescartillage damage in children; achilles tendon rupture in adults
furosemidehypokalemia, gout
halothanemalignant hyperthermia
hydralazinedrug induced lupus
hydroxychloroquineretinopathy
INHperipheral neuropathy (prevent w/pyridozxine, B6)
MAOIShypertensie tyramine, serotonin
methanolblindness, anion gap metaolic acidosis
methotrexatehepatic fibroisis
methyldopadrug induced lupus
metrodisulfram, metallic taste
niacincutaneous flushing
phenytoingingival hyperplasia
prazosinfirst dose hypotension
rifampinorange body secretions
succinycholinemalignant hyperthermia
TCASQRS prolongation
tetracyclinestooth discoloration, photosensitivity
valprosateNTD
vancomycinred man syndrome
vinblastinesevere myelosuppression
vincrisitneperipheral neuropathy, paralytic ileus
memorize

Water soluble vitamin deficiencies

Question Answer
B1 (thiamine)beriberi (peripehral neuropathy, HF), Wernicke-Korsakoff
B2 (riboflavin)angular cheilosis, stomatitis glossitis, normocytic anemia, sebhorreic dermatitis
B3 (niacin)pellagra (dermaitits, diarrhea, dementia, glossitis)
B6 (pyridoxine)chelliosis, stomatitis, glossitis
B9 (folate)megaloblastic anemia, NTD (fetus)
B12 (cobalamin)megaloblastic anemia, neuro deficits
C (ascorbic acid)scurvy
memorize

misc

Question Answer
triple therapy for H.PyloriPPI, amoxicillin and clarithromycin
quadruple therapyPPi, bismuth, metro and tetracycline
using a drug for preeclampsiaIV hydralazine, IV labetalol (dont use if there is bradycardia), nifedipine PO (dont use if there is emesis)
doesn't penetrate eschar and can cause leukopeniasilver sulfadiazine
doesn't penetrate eschar and causes hypoK and hypoNasilver nitrate
tx atrophic vaginitislow dose vaginal estrogen
tx lichen sclerosishigh dose vaginal steroids
memorize

meningitis tx

Question Answer
age 2-50vanco plus ceftriaxone
greater than 50vanco plus ampicillin plus third gen cephalosporin
neurosurgeryvanco plus cefepime
immunocompvanco plus ampicllin plus cefepime
penetrating trauma to skullvanco plus cefepime
memorize

Section

Question Answer
first line treatment for c. diff colitismetro
if patient resistant to metro (vancomycin oral)
treatment for migrainesNSAIDS, DHE, sumatriptan
contraindication to sumatripanother serotongeric agonists
first line prophylaxis for migrainesamitriptyline and propanolol
tx for uncomplicated diverticulitisbowel rest (NPO), NG tube placement and broad spectrum antibiotics (metro and fluroquinolone or cephalospirn)
diverticulitis perforationimmediate surgical resection
treatment for mild acute pancreatitisbowel rest (NPO), IV fluids, pain control
treatment for severe pancreatitisparenteral nutrition and potentially antibioitics (imipenem)
symptomatic treatment for RANSAIDS or steroids
first line agents for RADMARDS. best is methotrexate
side effects of methotrexatebone marrow suppression (give folinic acid), pulmonary fibrosis, liver injury
alternative to methotrexate for RAhydroxychloroquine (eye exams every 6 months)
if methotrexate not fully contain RAadd anti-TNF
treatment for acute goutNSAIDS indomethacin 1st, colchicine, steroids
gout prophylaxisuricosuric durgs (probenecid, sufinpyrazone) increase renal excretion. for overproduction give allopurinol
treatment for hypercalcemiaIV fluids first step, calcitonin, bisphosphonates
treatment for lupusNSAIDS, steroids, hydroxychloroquine, cyclophosamide (renal biopsy)
memorize

leilas

Question Answer
vareniclinepartial nicotinic agonist for smoking cessation
tx for diabetic gastroparesis (delayed gastric emptying)metroclopramide
memorize

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