Nr 565 Midterm
Assessing and addressing opioid use disorder (OUD) - ANSWER✅✅✅dx DSM 5,
medication assisted therapy, prescribing naloxone (concurrent benzo use) buprenorphine,
naltrexone, methadone. Asthma drugs to avoid and why - ANSWER✅✅✅B blockers
can promote bronchoconstriction Atherosclerotic cardiovascular disease risk score what
is it? - ANSWER✅✅✅it is the risk of people developing coronary artery disease over the
next 10 years. AV heart block drugs to avoid and why - ANSWER✅✅✅B blockers
labtealol verapamil and diltiazem suppress AV conduction and intensify AV block Beers
Criteria - ANSWER✅✅✅A list of medications that are generally considered
inappropriate when given to elderly people behaviors that predict controlled substance
addiction - ANSWER✅✅✅illegal drug use drug use for nonmedical reasons history of
substance use disorder or OD, mental health conditions or sleep disordered breathing
concurrent benzo use. black box warning - ANSWER✅✅✅A type of warning that
appears in a drug's prescribing information and is required by the U.S. Food and Drug
Administration (FDA) to alert prescribers of serious adverse events that have occurred with
the given drug. Black box warning for NSAIDS - ANSWER✅✅✅NSAIDs are associated
with an increased risk of adverse cardiovascular thrombotic events, including fatal MI and
stroke. GI ulcer and bleeding. Buprenorphine and naloxone benefit of combination -
ANSWER✅✅✅Buprenorphine is a opioid partial agonist should be started 6-12 hours
after the last dose of heroin or immediate release opioid prescribers must have a board
certification in addiction medication and complete special training to prescribe this.
Naloxone is a opioid antagonist-agonist it is taken to make the product less likely to be
abused by injection. CCB: Dihydropyridines MOA - ANSWER✅✅✅Cause vascular
smooth muscle relaxation resulting in decreased SVR and arterial BP act on the arterioles
CKD htn meds all except - ANSWER✅✅✅Diuetric and B blocker CCB AND
ALDOSTERONE ANTAGONIST Common fears with genetic testing - ANSWER✅✅✅Lack
of education - many health care providers do not possess the knowledge or comfort to
interpret the testing financial cost - many insurance plans do not cover this. cost can be
from $100-2000. discrimination from employers, insurance companies or providers.
Genetic information nondiscrimination act (GINA). contraindications for ranolazine -
ANSWER✅✅✅used for reduction of cardiac ischemia and associated pain can cause
torsades because of prolonged QT interval and raise BP with people who have severe renal
, impairment. avoid grapefruit juice, HIV protease inhibitors macrolide abx and azole
antifungals. Coronary artery disease drugs to avoid and why -
ANSWER✅✅✅hydralazine because it can precipitate an anginal attack through reflex
tachycardia COX 2 inhibitors and NSAIDS cause - ANSWER✅✅✅sedation dizziness
and ataxia Tricyclics and SNRI treats neuropathies pain contraindicated in severe cardiac
disease causes anticholinergic efffects. CYP450 inducers - ANSWER✅✅✅barbituates,
griseofulvin, carbamazepine, rifampin, st. john wart, chronic alcoholism, phenytoin (CRAP
GPS) CYP450 inducers function - ANSWER✅✅✅increase medication metabolism. act
on the liver to stimulate enzyme synthesis CYP450 inhibitors - ANSWER✅✅✅CRACK
AMIGOS Chloramphenicol Ritonavir (protease inhibitor) Amiodarone Ciprofloxacin
Ketocanazole (and other azoles) Acute alcohol use Valproate Isoniazid Grapefruit Juice
Sulfonamides CYP450 inhibitors function - ANSWER✅✅✅slow down the metabolic
activity of specific enzymes, causing a decrease in the rate/extent of metabolism of other
drugs that are substrates for those same enzymes this can cause drug toxicity. Depression
- ANSWER✅✅✅Reserpine can cause depression Determining whether to initiate
opioids for chronic pain - ANSWER✅✅✅establish treatment goals determine how
effectiveness will be evaluated outline a plan for discontinuation risks and benefits should
be considered and discussed strategies to improve patient safety use morphine milligram
equivalent calculation to inform dosage changes and reduce overdose risk. use extra
precautions when increasing to greater than or equal to 50 MME per day avoid or carefully
justify increasing dosage to greater than or equal to 90 MME/day. diabetes all HTN meds
except - ANSWER✅✅✅Aldosterone antagonist DM drugs to avoid and why -
ANSWER✅✅✅thiazides furosemide and B blockers, T & F promote hyperglycemia and
B blockers can mask signs of hypoglycemia Drug therapy for OA -
ANSWER✅✅✅NSAIDS provide rapid relief thats it. MOA 1st gen COX-1 and COX 2 risk
for GI ulcers because of inhibiting COX 1. aspirin ibuprofen meloxicam naproxen 2nd gen
only inhibit cox2 such as celecoxib inhibit prostaglandins that produce pain. During
pregnancy what category is ACE in and CCB requirements - ANSWER✅✅✅ACE is C
during first trimester and D during second and third.. CCB requires considerations during
pregnancy and breastfeeding. drug of choice is methyldopa and labetalol Dyslipidemia
drugs to avoid and why - ANSWER✅✅✅B blockers and diuretics because they can
exacerbate dyslipidemia Effects of cardiac glycosides (digoxin) - ANSWER✅✅✅effects
mechanical and electrical properties for dysthymias and HF monitor HR and monitor levels
second line for HF. Esetimibe (zetia) what is it - ANSWER✅✅✅non statin inhibits
dietary absorption of cholesterol from food. it would be used with statin or by itself.
Examples of pure opioid agonists - ANSWER✅✅✅agonist that binds to the receptor
Assessing and addressing opioid use disorder (OUD) - ANSWER✅✅✅dx DSM 5,
medication assisted therapy, prescribing naloxone (concurrent benzo use) buprenorphine,
naltrexone, methadone. Asthma drugs to avoid and why - ANSWER✅✅✅B blockers
can promote bronchoconstriction Atherosclerotic cardiovascular disease risk score what
is it? - ANSWER✅✅✅it is the risk of people developing coronary artery disease over the
next 10 years. AV heart block drugs to avoid and why - ANSWER✅✅✅B blockers
labtealol verapamil and diltiazem suppress AV conduction and intensify AV block Beers
Criteria - ANSWER✅✅✅A list of medications that are generally considered
inappropriate when given to elderly people behaviors that predict controlled substance
addiction - ANSWER✅✅✅illegal drug use drug use for nonmedical reasons history of
substance use disorder or OD, mental health conditions or sleep disordered breathing
concurrent benzo use. black box warning - ANSWER✅✅✅A type of warning that
appears in a drug's prescribing information and is required by the U.S. Food and Drug
Administration (FDA) to alert prescribers of serious adverse events that have occurred with
the given drug. Black box warning for NSAIDS - ANSWER✅✅✅NSAIDs are associated
with an increased risk of adverse cardiovascular thrombotic events, including fatal MI and
stroke. GI ulcer and bleeding. Buprenorphine and naloxone benefit of combination -
ANSWER✅✅✅Buprenorphine is a opioid partial agonist should be started 6-12 hours
after the last dose of heroin or immediate release opioid prescribers must have a board
certification in addiction medication and complete special training to prescribe this.
Naloxone is a opioid antagonist-agonist it is taken to make the product less likely to be
abused by injection. CCB: Dihydropyridines MOA - ANSWER✅✅✅Cause vascular
smooth muscle relaxation resulting in decreased SVR and arterial BP act on the arterioles
CKD htn meds all except - ANSWER✅✅✅Diuetric and B blocker CCB AND
ALDOSTERONE ANTAGONIST Common fears with genetic testing - ANSWER✅✅✅Lack
of education - many health care providers do not possess the knowledge or comfort to
interpret the testing financial cost - many insurance plans do not cover this. cost can be
from $100-2000. discrimination from employers, insurance companies or providers.
Genetic information nondiscrimination act (GINA). contraindications for ranolazine -
ANSWER✅✅✅used for reduction of cardiac ischemia and associated pain can cause
torsades because of prolonged QT interval and raise BP with people who have severe renal
, impairment. avoid grapefruit juice, HIV protease inhibitors macrolide abx and azole
antifungals. Coronary artery disease drugs to avoid and why -
ANSWER✅✅✅hydralazine because it can precipitate an anginal attack through reflex
tachycardia COX 2 inhibitors and NSAIDS cause - ANSWER✅✅✅sedation dizziness
and ataxia Tricyclics and SNRI treats neuropathies pain contraindicated in severe cardiac
disease causes anticholinergic efffects. CYP450 inducers - ANSWER✅✅✅barbituates,
griseofulvin, carbamazepine, rifampin, st. john wart, chronic alcoholism, phenytoin (CRAP
GPS) CYP450 inducers function - ANSWER✅✅✅increase medication metabolism. act
on the liver to stimulate enzyme synthesis CYP450 inhibitors - ANSWER✅✅✅CRACK
AMIGOS Chloramphenicol Ritonavir (protease inhibitor) Amiodarone Ciprofloxacin
Ketocanazole (and other azoles) Acute alcohol use Valproate Isoniazid Grapefruit Juice
Sulfonamides CYP450 inhibitors function - ANSWER✅✅✅slow down the metabolic
activity of specific enzymes, causing a decrease in the rate/extent of metabolism of other
drugs that are substrates for those same enzymes this can cause drug toxicity. Depression
- ANSWER✅✅✅Reserpine can cause depression Determining whether to initiate
opioids for chronic pain - ANSWER✅✅✅establish treatment goals determine how
effectiveness will be evaluated outline a plan for discontinuation risks and benefits should
be considered and discussed strategies to improve patient safety use morphine milligram
equivalent calculation to inform dosage changes and reduce overdose risk. use extra
precautions when increasing to greater than or equal to 50 MME per day avoid or carefully
justify increasing dosage to greater than or equal to 90 MME/day. diabetes all HTN meds
except - ANSWER✅✅✅Aldosterone antagonist DM drugs to avoid and why -
ANSWER✅✅✅thiazides furosemide and B blockers, T & F promote hyperglycemia and
B blockers can mask signs of hypoglycemia Drug therapy for OA -
ANSWER✅✅✅NSAIDS provide rapid relief thats it. MOA 1st gen COX-1 and COX 2 risk
for GI ulcers because of inhibiting COX 1. aspirin ibuprofen meloxicam naproxen 2nd gen
only inhibit cox2 such as celecoxib inhibit prostaglandins that produce pain. During
pregnancy what category is ACE in and CCB requirements - ANSWER✅✅✅ACE is C
during first trimester and D during second and third.. CCB requires considerations during
pregnancy and breastfeeding. drug of choice is methyldopa and labetalol Dyslipidemia
drugs to avoid and why - ANSWER✅✅✅B blockers and diuretics because they can
exacerbate dyslipidemia Effects of cardiac glycosides (digoxin) - ANSWER✅✅✅effects
mechanical and electrical properties for dysthymias and HF monitor HR and monitor levels
second line for HF. Esetimibe (zetia) what is it - ANSWER✅✅✅non statin inhibits
dietary absorption of cholesterol from food. it would be used with statin or by itself.
Examples of pure opioid agonists - ANSWER✅✅✅agonist that binds to the receptor
