WCU 180 PHARM MIDTERM WEEK 1-5 WOODS NOTES
UPDATED QUESTIONS AND CORRECT
ANSWERS
Question:
1. Drug Types
Answer:
OTC: Not automatically safe. Hidden ingredients (APAP, ASA). Max APAP = 4,000 mg/day. APAP ’
liver damage. ASA ’ GI + kidney damage.
Prescription: Requires provider order.
Controlled substances: Schedule 1 = highest abuse (heroin). Schedule 2 = opioids, fentanyl.
Question:
2. Pharmacokinetics (AMDE)
Answer:
Absorption ’ GI tract Metabolism ’ liver (first-pass effect) Distribution ’ bloodstream Excretion ’ kidneys
Important: IV = 100% bioavailability. Liver disease ’ lower dose. Kidney disease ’ lower dose. Half-life =
how long drug stays in body.
Question:
3. Pharmacodynamics
Answer:
Onset = when it starts working Peak = strongest effect Trough = lowest level Duration = how long it works
Therapeutic range = safe zone
If peak is too high ’ toxicity. If trough too low ’ ineffective.
Question:
4. Receptors
Answer:
Agonist = activates Antagonist = blocks
Selective = one receptor Nonselective = multiple receptors
Question:
5. Adrenergic vs Cholinergic
Answer:
Adrenergic (fight/flight): ‘ HR, ‘ BP, bronchodilation
Cholinergic (rest/digest): DUMBBELLS Diarrhea Urination Miosis Bronchospasm Emesis Lacrimation
Salivation Sweating
Question:
6. Antidotes (Core List)
Answer:
Opioids ’ Naloxone Benzodiazepines ’ Flumazenil Heparin ’ Protamine Warfarin ’ Vitamin K
Acetaminophen ’ Acetylcysteine Aspirin overdose Activated ’ charcoal
Anaphylaxis: O2 ’ Epinephrine IM ’ Diphenhydramine ’ Airway monitoring
,Question:
7. Hypothyroidism
Answer:
Levothyroxine: Empty stomach AM Lifelong Takes 4-8 weeks Hold if HR >110 Watch for hyperthyroid
symptoms (overdose)
Question:
8. Hyperthyroidism
Answer:
Methimazole: Fever + sore throat = STOP (agranulocytosis)
Radioactive Iodine: Pregnancy contraindicated Secretions radioactive 6 ft distance precautions
Post-thyroidectomy: IV calcium gluconate Trach tray
Question:
9. Diabetes Insipidus
Answer:
Desmopressin: Decreases urine output Monitor sodium Risk: water intoxication
Question:
10. Steroids (Glucocorticoids)
Answer:
Uses: Inflammation control
Big dangers: Adrenal suppression (taper) Hypokalemia Hyperglycemia Infection Osteoporosis GI bleeding
Never stop abruptly.
Question:
11. GI Disorders
Answer:
Peptic ulcers: Caused by H. pylori + NSAIDs.
PPIs: Strongest acid suppression Long-term ’ pneumonia, fractures
Sucralfate: Empty stomach Separate other meds by 2 hours
Misoprostol: Pregnancy category X
Question:
12. Laxatives
Answer:
Bulk (Psyllium) ’ water Stimulant ’ hypokalemia Osmotic ’ strongest
Question:
13. Antiemetics
Answer:
Ondansetron: QT prolongation.
Metoclopramide: Tardive dyskinesia risk.
Question:
14. Type 2 Diabetes Drugs
, Answer:
Metformin: No alcohol. Hold with contrast. Lactic acidosis risk.
Sulfonylureas: No alcohol. Hypoglycemia risk.
Question:
15. NSAIDs
Answer:
Ibuprofen: GI bleed risk. Kidney risk. Ketorolac: Max 5 days only.
Celecoxib: Sulfa allergy risk. MI risk.
Acetaminophen: Liver toxicity. Max 4,000 mg/day.
Question:
16. Opioids
Answer:
Common AE: Constipation. Sedation.
Severe AE: Respiratory depression. Hold if RR <12.
Naloxone: Short half-life ’ monitor 2 hours.
Opioid triad: Pinpoint pupils. Resp depression. Decreased LOC.
Question:
17. Migraine Drugs (-triptan)
Answer:
Sumatriptan: Take at first sign. No MI history. No ergotamine together.
Question:
18. Muscle Relaxants
Answer:
Baclofen: Must taper. Sedation.
Neuromuscular blockers (-ium): Paralysis only. Need sedation + analgesia. Reversal: Sugammadex.
Succinylcholine ’ malignant hyperthermia ’ Dantrolene.
Question:
19. DMARDs
Answer:
Methotrexate: No alcohol. Bone marrow suppression. Folic acid.
-mab drugs: Screen TB + Hep B.
Question:
20. Gout
Answer:
Colchicine: Acute only. Diarrhea = toxicity. No grapefruit. 3L fluids.
Allopurinol: Chronic prevention.
Question:
21. Osteoporosis
UPDATED QUESTIONS AND CORRECT
ANSWERS
Question:
1. Drug Types
Answer:
OTC: Not automatically safe. Hidden ingredients (APAP, ASA). Max APAP = 4,000 mg/day. APAP ’
liver damage. ASA ’ GI + kidney damage.
Prescription: Requires provider order.
Controlled substances: Schedule 1 = highest abuse (heroin). Schedule 2 = opioids, fentanyl.
Question:
2. Pharmacokinetics (AMDE)
Answer:
Absorption ’ GI tract Metabolism ’ liver (first-pass effect) Distribution ’ bloodstream Excretion ’ kidneys
Important: IV = 100% bioavailability. Liver disease ’ lower dose. Kidney disease ’ lower dose. Half-life =
how long drug stays in body.
Question:
3. Pharmacodynamics
Answer:
Onset = when it starts working Peak = strongest effect Trough = lowest level Duration = how long it works
Therapeutic range = safe zone
If peak is too high ’ toxicity. If trough too low ’ ineffective.
Question:
4. Receptors
Answer:
Agonist = activates Antagonist = blocks
Selective = one receptor Nonselective = multiple receptors
Question:
5. Adrenergic vs Cholinergic
Answer:
Adrenergic (fight/flight): ‘ HR, ‘ BP, bronchodilation
Cholinergic (rest/digest): DUMBBELLS Diarrhea Urination Miosis Bronchospasm Emesis Lacrimation
Salivation Sweating
Question:
6. Antidotes (Core List)
Answer:
Opioids ’ Naloxone Benzodiazepines ’ Flumazenil Heparin ’ Protamine Warfarin ’ Vitamin K
Acetaminophen ’ Acetylcysteine Aspirin overdose Activated ’ charcoal
Anaphylaxis: O2 ’ Epinephrine IM ’ Diphenhydramine ’ Airway monitoring
,Question:
7. Hypothyroidism
Answer:
Levothyroxine: Empty stomach AM Lifelong Takes 4-8 weeks Hold if HR >110 Watch for hyperthyroid
symptoms (overdose)
Question:
8. Hyperthyroidism
Answer:
Methimazole: Fever + sore throat = STOP (agranulocytosis)
Radioactive Iodine: Pregnancy contraindicated Secretions radioactive 6 ft distance precautions
Post-thyroidectomy: IV calcium gluconate Trach tray
Question:
9. Diabetes Insipidus
Answer:
Desmopressin: Decreases urine output Monitor sodium Risk: water intoxication
Question:
10. Steroids (Glucocorticoids)
Answer:
Uses: Inflammation control
Big dangers: Adrenal suppression (taper) Hypokalemia Hyperglycemia Infection Osteoporosis GI bleeding
Never stop abruptly.
Question:
11. GI Disorders
Answer:
Peptic ulcers: Caused by H. pylori + NSAIDs.
PPIs: Strongest acid suppression Long-term ’ pneumonia, fractures
Sucralfate: Empty stomach Separate other meds by 2 hours
Misoprostol: Pregnancy category X
Question:
12. Laxatives
Answer:
Bulk (Psyllium) ’ water Stimulant ’ hypokalemia Osmotic ’ strongest
Question:
13. Antiemetics
Answer:
Ondansetron: QT prolongation.
Metoclopramide: Tardive dyskinesia risk.
Question:
14. Type 2 Diabetes Drugs
, Answer:
Metformin: No alcohol. Hold with contrast. Lactic acidosis risk.
Sulfonylureas: No alcohol. Hypoglycemia risk.
Question:
15. NSAIDs
Answer:
Ibuprofen: GI bleed risk. Kidney risk. Ketorolac: Max 5 days only.
Celecoxib: Sulfa allergy risk. MI risk.
Acetaminophen: Liver toxicity. Max 4,000 mg/day.
Question:
16. Opioids
Answer:
Common AE: Constipation. Sedation.
Severe AE: Respiratory depression. Hold if RR <12.
Naloxone: Short half-life ’ monitor 2 hours.
Opioid triad: Pinpoint pupils. Resp depression. Decreased LOC.
Question:
17. Migraine Drugs (-triptan)
Answer:
Sumatriptan: Take at first sign. No MI history. No ergotamine together.
Question:
18. Muscle Relaxants
Answer:
Baclofen: Must taper. Sedation.
Neuromuscular blockers (-ium): Paralysis only. Need sedation + analgesia. Reversal: Sugammadex.
Succinylcholine ’ malignant hyperthermia ’ Dantrolene.
Question:
19. DMARDs
Answer:
Methotrexate: No alcohol. Bone marrow suppression. Folic acid.
-mab drugs: Screen TB + Hep B.
Question:
20. Gout
Answer:
Colchicine: Acute only. Diarrhea = toxicity. No grapefruit. 3L fluids.
Allopurinol: Chronic prevention.
Question:
21. Osteoporosis
