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Pharm 2 Test 3 Flashcards
Nova Orlando
135
Health Care
Graduate
04/10/2011

Additional Health Care Flashcards

 


 

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Term
used to treat and prevent DVT's, PE's, and other thromboembolic events, as well as in the tx of MI
Definition
Heparin
Term
reversal agent for heparin
Definition
protamine sulfate
Term
low molecular weight heparin (2)
Definition
enoxaprin and dalteparin
Term
advantages of LMWH
Definition
greater activity degrading activated Factor X. Longer DOA, less frequent dosing.
Term
used for chronic anticoagulation
Definition
warfarin
Term
SE of warfarin (3)
Definition
bleeding, skin changes, teratogen
Term
reversal agent for warfarin
Definition
Vitamin K or FFP
Term
drugs that inhibit warfarin metabolism therefor increasing it's effect
Definition
cimetidine, metronidazole, and TMP-SMX
Term
drugs that accelerate warfarin metabolism therefor lessening it's effects
Definition
barbituates, rifampin, cholestyramine
Term
used for pt's who need anticoagulation but are unable to take heparin
Definition
direct thrombin inhibitors
Term
what are the direct thrombin inhibitors (7)
Definition
hirudin, bivalirudin, lepirudin, desirudin, argatroban, melagatran, dabigatran
Term
used to tx ACS along with aspirin, to prevent CVA's, and in pts undergoing coronary stent placement to prevent thrombosis
Definition
clopidogrel
Term
drug acts to inhibit cyclic nucleotide phophodiesterase. Used in pharmacologic stress tests and as a secondary prevention of stroke.
Definition
dipryridamole
Term
used in the tx of ACS, adjunctive tx for prevention of thrombosis during PCI
Definition
abciximab (eptifivatide, tirofiban)
Term
antipyretic, analgesic, anti-inflammatory, anti-platelet
Definition
ASA
Term
toxic amounts of this drug lead to respiartory and metabolic acidosis
Definition
ASA
Term
SE of ASA (5)
Definition
bleeding in the GI tract, gastritis, gastric ulcers, reyes syndrome, tinnitus
Term
MOA = promotion of plasminogen to plasmin, which acts to degrade fibrin, and thus degrade a thrombus
Definition
fibrinolytic agents
Term
what are the fibrinolytic agents (5)
Definition
streptokinase, urokinase, antistreplase, alteplase, reteplase
Term
when is fibrinolytics therapy indicated?
Definition
massive PE, stroke, AMI
Term
when are fibrinolytics most effective?
Definition
when given early after symptom onset
Term
inhibits plasminogen activation, used in post-op bleeding and in the tx of hemophilia
Definition
aminocaproic acid
Term
SE of aminocaproic acid
Definition
thrombosis
Term
what drug is in the class of aminocaproic acid?
Definition
tranexamic acid
Term
used in the tx of anemia associated with chronic renal insufficiency, chemotherapy, or critical illness
Definition
synthetic erythropoietin
Term
what drugs are synthetic erythropoietins?
Definition
epoetin, darbepoetin
Term
SE fo synthetic erythropoietin (3)
Definition
cardiovascular events and thrombotic complications (Hbg > 13), teratogen, hypertension
Term
used in the treatment of non-insulin dependent DM2. MOA = prolong binding of insulin to target tissue receptors,reduce serum glucagon levels.
Definition
Sulfonyureas
Term
sulfonyurea contraindication
Definition
pregnancy
Term
sulfonyurea caution
Definition
renal or hepatic insufficiency
Term
sulfonyurea similar drugs
Definition
1st generation = chlorpropamide, tolbutamide, tolazamide.
2nd generation = glyburide, glipizide.
3rd generation = glimepiride
Term
use = non-insulin dependent DM.
SE = GI upset, lactic acidosis.
Definition
metformin
Term
metformin contraindication
Definition
renal insufficiency
Term
what class of drugs does metformin belong to?
Definition
biguanides
Term
DM drug that doesn't cause hypoglycemia
Definition
metformin
Term
thiazolidinediones
Definition
rosglitazone, pioglitazone, troglitazone
Term
SE rosglitazone
Definition
hypoglycemia, edema
Term
SE a-glucosidase inhibitors
Definition
GI upset (flatulence, diarrhea)
Term
meglitinides
Definition
repaglinide, nateglinide
Term
DDP-4 inhibitors
Definition
sitagliptin, vildagliptin
Term
glucagon-like peptide-1 analog
Definition
exanatide
Term
meglitinides SE
Definition
weight gain, hypoglycemia
Term
DDP-4 inhibitors SE
Definition
nausea
Term
GLP-1 analog SE
Definition
pancreatitis, hypoglycemia
Term
MOA = inhibit HMG-CoA reductase. Increase concentration of LDL receptors
Definition
atorvastatin
Term
med used to decrease total cholesterol and LDL levels
Definition
atorvastatin
Term
SE of atorvastatin
Definition
myopathy, abnormal liver function tests, teratogen
Term
med that mainly results in lowering of LDLs
Definition
ezetimibe
Term
bile acid resins
Definition
cholestyramine, colestipol, colesevelam
Term
not nearly as efficacious in individuals who lack LDL recepto
Definition
Term
not nearly as efficacious in individuals who lack LDL receptors (homozygous for familial hypercholesterolemia)
Definition
bile acid resins and atorvastatin
Term
fibrates (4)
Definition
gemfibrozil, ciprofibrate, bezafibrate, fenofibrate
Term
class of drugs that act to decrease triglyceride levels
Definition
fibrates
Term
drug used primarily to increase HDL
Definition
niacin
Term
drug that acts to decrease lipolysis in adipose tissue
Definition
niacin
Term
drug used in prostate cancer
Definition
flutamide
Term
drug acts as a mild agonist of androgen and progesterone receptors
Definition
danazol
Term
drug used in the tx of endometriosis
Definition
danazol
Term
drug used in BPH and prostate cancer
Definition
finasteride
Term
drug acts to inhibit aromatase, used in the treatment of estrogen-receptor positive breast cancer
Definition
anastrozole
Term
drug that acts to decrease GnRH release, decreasing FSH and LH levels. Inhibits follicular development and results in absence of ovulation.
Definition
oral contraceptive pills
Term
other use of OCP aside from birth control
Definition
decrease the risk of ovarian and endometrial cancer
Term
OCP that contains only synthetic progestins
Definition
progestin-only pills
Term
OCP that contains high doses of synthetic progestin
Definition
emergency contraception pills, must be taken within 72 hrs
Term
steroid compound that acts as a competitive receptor antagonist at the progesterone receptor. In high doses it can act as an abortifacient.
Definition
mifepristone
Term
used for metastatic prostate cancer, leiomyomas
Definition
leuprolide
Term
administered in an intermittent fashion to treat infertility
Definition
leuprolide
Term
GnRH agonists (3)
Definition
leuprolide, nafarelin, goserlin
Term
partial agonist at the estrogen receptors in the pituitary, used to induce ovulation and treat infertility.
Definition
clomiphene
Term
used to treat osteoperosis by decresing osteoclastic bone resorption.
Definition
alendronate
Term
used to treat bone mets with associated hypercalcemia
Definition
alendronate
Term
inhibits thyroid peroxidase --> inhibition of thyroid hormone synthesis --> inhibiting peripheral conversion of T4 and T3.
Definition
Proprylthiouracil (PTU)
Term
used in the treatment of hyperthyroidism if pregnant
Definition
PTU
Term
drug used to treat hypothyroidism
Definition
levothyroxine
Term
SE of PTU
Definition
maculopapular rash, agranulocytosis, arthralgias
Term
gout agents (3)
Definition
colchicines, probenecid, allopurinol
Term
induce microtubular depolymerization
Definition
colchicines
Term
decreases resorption of uric acid
Definition
probenecid
Term
inhibits xanthine oxidase
Definition
allopurinol
Term
used in an acute gouty attack
Definition
colchecine
Term
used for prevention of further gouty attacks (2)
Definition
probenecid, allopurinol
Term
SE of colchicines
Definition
diarrhea
Term
synthetic corticosteroids (7)
Definition
prednisone, hydrocortisone, cortisone, prenisolone, methylprenisolone, betamethasone, dexamethasone
Term
used to treat adrenocortical insufficiency, allergic reactions, collagen-vascular disorders, IBD, MS, ITP, arthritis, asthma, spinal cord compression
Definition
synthetic corticosteroids
Term
SE of synthetic corticosteroids
Definition
cushing syndrome, osteoperosis, irritability, hyperglycemia, fat redistribution, impaired wound healing
Term
inhaled glucocorticoid that is used to treat chronic asthma
Definition
beclomethasone
Term
used in the treatement of a variety of endocrine disorders, ZE syndrome, and esophageal varices associated with cirrhosis-induced portal hypertension.
Definition
octreotide
Term
used in treatment of central DI, spetic shock, and cardiac arrest.
Definition
vasopressin
Term
SE of vasopressin
Definition
hyponatremia
Term
used to induce labor and stimulate breast milk letdown
Definition
oxytocin
Term
med that inhibits the pancreatic enzyme lipase
Definition
orlistat
Term
med that is a neurotransmitter (serotonin, norepinephrine, dopamine) reuptake inhibitor
Definition
sibutramine
Term
SE of orlistat
Definition
steatorrhea and fecal incontinence, decraesed absorption of fat-soluble vitamins (ADEK)
Term
SE of sibutramine
Definition
nausea, sexual dysfunction, hypertension, arrythmias
Term
antiobesity med that was withdrawn from the market
Definition
Fen-Phen
Term
anti-pyritic agent, analgesic, and anti-inflammatory
Definition
ibuprofen
Term
SE of ibuprofen
Definition
GI bleeding, allergic reactions, interstitial neprhitis, tinnitus, hepatitis
Term
drugs similar to ibuprofen
Definition
naproxen, indomethacin, diclofenac, sulindac, oxaprozin
Term
reversible inhibitor of Cox 1 & 2
Definition
indomethacin
Term
used in RA, OA, and other acute pain
Definition
celecoxib
Term
SE of celecoxib
Definition
GI upset, interstitial nephritis, increased risk of thrombosis
Term
irreversible blocker of Cox 1 & 2
Definition
ASA
Term
used as an antipyretic and analgesic. Se = fatal hepatotoxicity with overdose
Definition
acetominophen
Term
antidote for acetaminophen overdose
Definition
acetylcysteine
Term
acute onset of SOB. PMHx = dx of colon cancer x 3 months ago. Pt is hypoxic, tachypneic, tachycardic, and has elevated D-dimer levels. Order high resolution CT. Empiric tx with an anticoagulant drug that acts to accelerate the action of antithrombin III
Definition
Heparin
Term
palpitations x 2 hrs. denies previous episodes. PMHx = anterolatearl MI 4 months ago. HR 122, irregularaly, irregular. ECG = a-fib. You prepare to administer diltiazem to lower the HR and tell the pt he will likely need chronic anticoagulation with
Definition
warfarin
Term
right hip pain after a fall. PMHx = heparin induced thrombocytopenia. imaging confirms a fx hip. Pt scheduled for surgery. Given pt risk for developing DVT post op, you order prophylactic anticoagulation with a med that acts by directly inhibiting thrombin
Definition
direct thrombin inhibitors (hirudin, bivalirudin, lepirudin, desirudin, argatrudin
Term
11 yo boy found unconscious in his bed at home. His parents tell you he's been feeling ill x 2-3 days and having "shaking chill" and muscle aches. Temp = 102, tried to treat with over-the counter meds. Lab tests = extremely elevated liver enzymes, you believe pt may be suffereing from Reye's syndrome
Definition
acetylsalacylic acid
Term
severe, crushing, substernal chest pain began while shoveling his driveway 6 hrs ago. He has had this pain in the past when exerting himself, usually dissipates with rest. ECG = ischemia, cardiac enzymes are normal. Dx = unstable angina pectoris. Cath = stenosis of left anterior descending coronary artery, stent placed. Med given to prevent thrombosis by inhibiting ADP pathway involved in platelet aggregation
Definition
clopidogrel
Term
cardiology follow up regarding recent cardiac stress test which showed ischemia to the lateral wall, likely blockage of LCX. During stent placement she is likely to recieve a med that acts to prevent thrombosis at the site of stent placement by nhibiting platelet aggregation through inhibition at the glycoprotein IIb/IIIa receptor present on platelets
Definition
abciximab
Term
heavy, substernal chest pain that radiates to left shoulder and jaw, began 2 hrs ago. Breathing heavy and sweating. ECG = ST elevation and T-wave inversion in leads 2,3 and aVF = inferior MI. No cath lab available, to minimize damage you give a med that might dissolve the coronary blockage.
Definition
fibrinolytic agents (stretokinase, urokinase, antistreplase, alteplase, reteplase)
Term
significant bleeding from the gums. Pt has hemophilia and had wisdom teeth extracted 1 day ago. In order to treat his bleeding you administer a drug that will inhibit plasminogen activation and thus control the bleeding and replace his deficient clotting factors.
Definition
aminocaproic acid (tranexamic acid)
Term
ESRD, requiring hemodialysis presents for follow up. Feeling more fatigued lately. PE = thin, pale, stable HR and BP. Lab = anemia with hematocrit of 29. Iron = anemia of chronic disease. GI bleed = negative. Start on a med to stimulate RBCs in his bone marrow
Definition
synthetic erythropoietin (epoetin, darbepoetin)
Term
woman presents to your endocrinology clinic for follow up of Type 2 DM. Difficulty achieving optimal control of her blood sugar. Currently takes metformin. A1C = 7.7. You decide to add another med to lower blood sugar by stimulating increased insulin release from B-cells of her pancreas.
Definition
sulfonylureas (1st, 2nd, and 3rd generation)
Term
PCP for annual check up. FHx type 2 DM. fasting BGL = 152. give him a med that will lower his blood sugar by inhibiting glucose production by the liver
Definition
metformin
Term
recent DM 2 dx. One drug in class causes significant liver damage but is no longer prescribed. Remainder of class have been shown to be safe.
Definition
thiazolidinediones (rosglitazone, piogliatzone, troglitazone)
Term
DM 2 med acts to decrease absorption of postprandial carbs in the GI tract, but warn that GI SE of the med are not minimal
Definition
alpha-glucosidase inhibitors (acarbose, miglitol)
Term
DM 2 follow up, not well contolled with metformin, glipizide, and rosglitazone. Asks about a drug that treats DM by mimicking glucagon-like peptide-1
Definition
GLP-1 analog = exanatide
Term
elevated cholesterol, recommend starting a med that lowers cholesterol by inhibiting the body's production of cholesterol. You also suggest he improves diet and exercise regimen.
Definition
atorvastatin
Term
pt with elevated LDL, normal HDL and triglycerides. started her on atorvastatin but she was unable to tolerate due to myalgias. You tried a different med to lower LDL, she complains of diarrhea and a terrible taste.
Definition
cholestyramine = bile acid resin
Term
severe epigastric pain associated with N/V. Lab = elevated amylase and lipase --> acute pancreatitis. No dx of alcohol use or gallstone dz. Triglycerides = 1500. You immediately start a triglyceride-lowering agent
Definition
gemfibrozil = fibrates
Term
1 week hx of back pain after moving heavy boxes. Point tenderness at T12, L1. Imaging = fx of L1. Bone scan = osteoperosis. start a med that decreases osteoclastic bone resorption
Definition
alendronate (bisphosphonate)
Term
racing heart, experienced several times over last 6 months. 2-3 episodes of diarrhea/day and difficulty sleeping. PE = exopthalmos, and mildly enlarged thyroid gland. give a med to inhibit thyroid hormone synthesis.
Definition
propylthiouracil (PTU)
Term
severe pain on right big toe. Hx = non-hodgkin lymphoma being treated. Lab = elevated uric acid levels. begin tx with a med to decrease the migration of inflammatory cells to the affected joint and tell him he may be able to prevent similar attacks with a med that acts by inhibiting xanthine oxidase
Definition
gout agents.
decreased migration = colchicine.
inhibit xanthine oxidase = allopurinol
Term
weakness, fatigue over past month. Pe = hyperpigmentation over knuckles, knees, and elbows. Lab = hypoglycemia, hyperkalemia, and hyponatremia. condition = autoimmune process. Likely will need replacement of specific hormones
Definition
synthetic corticosteroids
Term
morbidly obese with a body mass index of 43. PMHx = hyperlipidemia, type 2 DM tx with insulin, HTN, OA of bilateral knees. oral med to tx obesity. Prescribe med that will help weight loss by inhibiting intestinal fat absorption but warn him of the SE = fecal incontinence.
Definition
antiobesity agent = orlistat
Term
difficulty urinating, trouble starting and stopping the stream of urine x 4 months. lost 10 lbs in the last 2 months. DRE = easily palpable, prostatic nodules that are firm, enlarged, and irregularly shpaed. Lab = elevated PSA. Bx = prostate cancer. tx with a med that acts as a competitive antagonist at androgen receptors.
Definition
flutamide
Term
increased frequency of urination with difficulty starting and stopping. DRE = diffusely enlarged prostate gland. Lab - increased PSA. Dx = BPH. tx = med to decraese productino of dihydrotestosterone and thus decrease the size of his prostate to help his urinary sxs.
Definition
finasteride
Term
oncology clinic for a consult regarding his mets prostate cancer. Several areas of bone mets. Tx = med which acts as a gonadotropin-releasing hormone agonist.
Definition
leuprolide
Term
21 yo female in monogomous relationship using condoms for protection. Interested in other protection. No personal or family hx of blood clots, and she doesn't smoke. You prescribe hormonal birth control to reduce her risk of developing endometrial and ovarian cancer.
Definition
OCPs
Term
large volumes of bloody vomit. PMHx = cirrhosis secondary to alcohol abuse. PE = HR 100, BP 90/60, some epigastric pain. endoscopy = esophageal varices. start pt on a synthetic analog of a naturally occuring pancreatic hormone which causes vasoconstriction of his esophageal varices
Definition
octreotide
Term
female with recurrent headaches, denies neuro sxs and no hx of migraines. very thirsty and urinating often lately. labs = normal glucose, increased serum osmolality, hypernatremia. You refer to endocinologist. In the mean time you start a med to cause an increase in permeability to water in the collecting duct of the kidney, thereby resulting in increased renal absorption of water.
Definition
vasopressin
Term
pain in right knee worse in the evening after a full day of activity. bony nodules on her DIP and PIP. you suspect OA and start tx with an OTC med that will reversibly inhibit COX 1 & 2
Definition
ibuprofen
Term
newly dx RA. Hx of gastric ulcers. You recommend an OTC anti-inflammatory with a low risk of developing gastric ulcers as compared to ibuprofen. You warn her this drug may cause an increased risk for stroke.
Definition
celecoxib
Term
headaches worse at the end of a stressful day, often associated with shoulder tightness. Dx = tension headaches. OTC med for tx = one that acts to inhibit cyclooxygenase in the nervous system
Definition
acetominophen
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