Pharmacology - FNP Exam study test revision questions with correct answers
Macrolides (erythro, clarithro, pediazole), Antifungals (ketoconazole,
fluconazole), Cisapride (Propulsid) *Been pulled, Cimetidine (Tagament), Citalopram
(Celexa) - ANSCauses the most interactions
Cause or exacerbate CHF in some patient. Do not use in Class III or IV heart
failure; Stop Actos if c/o dyspnea, weight gain, cough (heart failure) -
ANSThiazolidinediones (TZDs) - Pioglitazone (Actos)
High risk of weight gain, metabolic syndrome, and type 2;
Monitor weight every 3 months, higher mortality in elderly patients
Monitor TSH, lipids, weight/BMI - ANSAtypical antipsychotics -
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quietipine (Seroquel)
Jaw pain (jaw necrosis), chest pain, difficulty swallowing, burning mid-back
(perforation).
Take alone upon awakening with 8 oz glass of water not juice before breakfast.
Do not lie down x 30 min. afterwards, do not mix with other meds. -
ANSBisposphonates-
Alendronate (Fosamax)
Risedronate (Actonel)
Do not mix with grapefruit juice
Drug induced hepatitis or rhabdomyolysis higher if mixed with azole antifungals
High dose Zocor (80mg) has highest risk for rhabdo (muscle pain, tenderness)
CK (creatine kinase) level goes up - ANSStatin-
Atorvastatin (Lipitor)
Lovastatin (Mevacor)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
High risk of C. diff associated diarrhea
Metronidazole (Flagyl) PO TID x 10-14 days
Probiotics daily - BID x few weeks - ANSLincosamides-
Clindamycin (Cleocin)
Treats a-fib
Overdose: anorexia, N/V, abd pain, arrhythmias, confusion, yellowish green tinged-
color vision, scotomas (paritial loss of vision or blind spot)
Treatment: Digibind
Labs: Potassium, Magnesium, Calcium, Creatinine, serial EKGs - ANSCardiac
Glycosides -
Digoxin (Lanoxin)
Hold warfarin for 1 to 2 doses , recheck INR every 2 to 3 days until it is stable
(btw 2.0-3.0)
OR
Hold warfarin and add a small dose of oral vit. K
, After stable recheck monthly - ANSINR between 5.0 and 9.0 (without bleeding)
green leafy vegetables, broccoli, brussel sprouts, cabbage (ALL GREEN)
Mayonnaise, canola oil, and soybean oil - ANSFoods high in Vitamin K
increases stroke 6-fold - ANSINR below 2.0
risk for hemorrhage in elderly (>70) - ANSINR high
First line for uncomplicated hypertension, heart failure, edema - ANSThiazide
diurectics -
Hydrochlorothiazide (HCTZ)
Chlorthalidone (longer acting and more potent than HCTZ)
Indapamide
Hyperglycemia
Elevated TG and LDL
Elevates uric acid
Hypokalemia - ANSThiazide diurectics adverse effects
Decrease calcium excretion by kidneys and stimulate osteoclast formation -
ANSThiazide diurectics benefits
serious sulfa allergy and use potassium-sparing diuretics (triamterene, amiloride)
- ANSAvoid Thiazide diurectics if
Hypertension
Alternative diuretic for pt with severe sulfa allergy - ANSPotassium-Sparing
Diuretics -
Triamterene (Dyrenium)
Amiloride (Midamor)
Hyperkalemia (fatal)
Higher risk for those with:
Renal impairment
Diabetes
Elderly
Severly ill
Diuretics may worsen urinary incontinence - ANSPotassium-Sparing Diuretics
adverse effects
Serum potassium (baseline, during, dose change, illness)
Do not mix with ACEI/ARBS - high risk for hyperkalemia
Avoid with severe renal disease - high risk for hyperkalemia - ANSWhile on
Potassium-Sparing Diuretics monitor
Macrolides (erythro, clarithro, pediazole), Antifungals (ketoconazole,
fluconazole), Cisapride (Propulsid) *Been pulled, Cimetidine (Tagament), Citalopram
(Celexa) - ANSCauses the most interactions
Cause or exacerbate CHF in some patient. Do not use in Class III or IV heart
failure; Stop Actos if c/o dyspnea, weight gain, cough (heart failure) -
ANSThiazolidinediones (TZDs) - Pioglitazone (Actos)
High risk of weight gain, metabolic syndrome, and type 2;
Monitor weight every 3 months, higher mortality in elderly patients
Monitor TSH, lipids, weight/BMI - ANSAtypical antipsychotics -
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quietipine (Seroquel)
Jaw pain (jaw necrosis), chest pain, difficulty swallowing, burning mid-back
(perforation).
Take alone upon awakening with 8 oz glass of water not juice before breakfast.
Do not lie down x 30 min. afterwards, do not mix with other meds. -
ANSBisposphonates-
Alendronate (Fosamax)
Risedronate (Actonel)
Do not mix with grapefruit juice
Drug induced hepatitis or rhabdomyolysis higher if mixed with azole antifungals
High dose Zocor (80mg) has highest risk for rhabdo (muscle pain, tenderness)
CK (creatine kinase) level goes up - ANSStatin-
Atorvastatin (Lipitor)
Lovastatin (Mevacor)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
High risk of C. diff associated diarrhea
Metronidazole (Flagyl) PO TID x 10-14 days
Probiotics daily - BID x few weeks - ANSLincosamides-
Clindamycin (Cleocin)
Treats a-fib
Overdose: anorexia, N/V, abd pain, arrhythmias, confusion, yellowish green tinged-
color vision, scotomas (paritial loss of vision or blind spot)
Treatment: Digibind
Labs: Potassium, Magnesium, Calcium, Creatinine, serial EKGs - ANSCardiac
Glycosides -
Digoxin (Lanoxin)
Hold warfarin for 1 to 2 doses , recheck INR every 2 to 3 days until it is stable
(btw 2.0-3.0)
OR
Hold warfarin and add a small dose of oral vit. K
, After stable recheck monthly - ANSINR between 5.0 and 9.0 (without bleeding)
green leafy vegetables, broccoli, brussel sprouts, cabbage (ALL GREEN)
Mayonnaise, canola oil, and soybean oil - ANSFoods high in Vitamin K
increases stroke 6-fold - ANSINR below 2.0
risk for hemorrhage in elderly (>70) - ANSINR high
First line for uncomplicated hypertension, heart failure, edema - ANSThiazide
diurectics -
Hydrochlorothiazide (HCTZ)
Chlorthalidone (longer acting and more potent than HCTZ)
Indapamide
Hyperglycemia
Elevated TG and LDL
Elevates uric acid
Hypokalemia - ANSThiazide diurectics adverse effects
Decrease calcium excretion by kidneys and stimulate osteoclast formation -
ANSThiazide diurectics benefits
serious sulfa allergy and use potassium-sparing diuretics (triamterene, amiloride)
- ANSAvoid Thiazide diurectics if
Hypertension
Alternative diuretic for pt with severe sulfa allergy - ANSPotassium-Sparing
Diuretics -
Triamterene (Dyrenium)
Amiloride (Midamor)
Hyperkalemia (fatal)
Higher risk for those with:
Renal impairment
Diabetes
Elderly
Severly ill
Diuretics may worsen urinary incontinence - ANSPotassium-Sparing Diuretics
adverse effects
Serum potassium (baseline, during, dose change, illness)
Do not mix with ACEI/ARBS - high risk for hyperkalemia
Avoid with severe renal disease - high risk for hyperkalemia - ANSWhile on
Potassium-Sparing Diuretics monitor
