1
NR565 Advanced Pharmacology
Fundamentals
-Arises from connective tissue, muscle, bone and skin.
m
-Sharp and localized or dull and non-localized
.co
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local anesthetics,
ail
ice, massage - ANSWER Acute Somatic Pain
gm
-blocks calcium channels in the heart and blood vessels;
r@
-lower blood pressure through arteriolar dilation;
he
-used for angina pectoris, essential hypertension, and cardiac dysrhythmias - ANSWER
hig
Diltiazem Actions and Uses
ing
-Caution if CrCl 15-29; caution if severe hepatic impairment; caution if cardiovascular
fly
disease
-Patients should receive prophylactic NSAIDs or colchicine for up to 6 months after
starting treatment. - ANSWER Febuxostat Prescribing Consideration
, 2
-Digoxin; increase risk of AV block and raises plasma digoxin levels when combined:
-β-adrenergic blocking agents due to similar effects of decrease heart rate, AV
conduction, and contractility - ANSWER Verapamil/Diltiazem Drug Contraindication
m
.co
-Dihydropyridine;
ail
-blocks calcium channels in VSM of arteriole; promotes vasodilation;
gm
-produces very little blockade of calcium channels in the heart - ANSWER Nifedipine
r@
-DMARD of first choice owing to its efficacy, relative safety, low cost, and extensive use
he
in RA
hig
-Benefits appear to be the result of immunosuppression secondary to reducing the
activity of B and T lymphocytes. - ANSWER Methotrexate MOA
ing
fly
-Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
, 3
-Original drug is not pharmacologically active but one metabolite remains active -
ANSWER Three possible outcomes of phase 1 drug metabolism.
-increases the risk for hepatotoxicity when other drugs that contribute to liver injury
(including alcohol) are taken;
m
-greatly increases the risk for serious myelosuppression when it is prescribed for patients
.co
taking other drugs that can decrease bone marrow function. - ANSWER Methotrexate
ail
Drug Interaction
gm
-Major toxicities are hepatic fibrosis, bone marrow suppression, GI ulceration, and
r@
pneumonitis.
he
hig
-Can cause numerous and potentially fatal toxicities of the bone marrow, liver, lungs, and
kidneys. Other fatalities have occurred associated with skin reactions and due to
ing
hemorrhagic enteritis and gastrointestinal perforation. - ANSWER Methotrexate AE
fly
-myopathy, rhabdomyolysis, hepatitis, pancreatitis, and thrombocytopenia; - ANSWER
Ezetimibe Adverse Effects
, 4
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to
medication-disease or medication-syndrome interactions that may exacerbate the disease
or syndrome
-medications to be used cautiously in older adults
m
-clinically significant drug interactions that should be avoided in older adults
.co
-medications to be avoided or dosage decreased in the presence of impaired kidney
ail
function in older adults - ANSWER Beers Criteria
gm
-Promotes relaxation of peripheral arterioles resulting in a decreased afterload which
r@
reduces cardiac oxygen demand.
he
hig
-Blocks calcium channels in the heart and vascular smooth muscle;
ing
-dihydropyridines, for which nifedipine is the prototype.
fly
-nondihydropyridines, includes the drugs: verapamil and diltiazem. - ANSWER
Calcium Channel Blockers
NR565 Advanced Pharmacology
Fundamentals
-Arises from connective tissue, muscle, bone and skin.
m
-Sharp and localized or dull and non-localized
.co
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local anesthetics,
ail
ice, massage - ANSWER Acute Somatic Pain
gm
-blocks calcium channels in the heart and blood vessels;
r@
-lower blood pressure through arteriolar dilation;
he
-used for angina pectoris, essential hypertension, and cardiac dysrhythmias - ANSWER
hig
Diltiazem Actions and Uses
ing
-Caution if CrCl 15-29; caution if severe hepatic impairment; caution if cardiovascular
fly
disease
-Patients should receive prophylactic NSAIDs or colchicine for up to 6 months after
starting treatment. - ANSWER Febuxostat Prescribing Consideration
, 2
-Digoxin; increase risk of AV block and raises plasma digoxin levels when combined:
-β-adrenergic blocking agents due to similar effects of decrease heart rate, AV
conduction, and contractility - ANSWER Verapamil/Diltiazem Drug Contraindication
m
.co
-Dihydropyridine;
ail
-blocks calcium channels in VSM of arteriole; promotes vasodilation;
gm
-produces very little blockade of calcium channels in the heart - ANSWER Nifedipine
r@
-DMARD of first choice owing to its efficacy, relative safety, low cost, and extensive use
he
in RA
hig
-Benefits appear to be the result of immunosuppression secondary to reducing the
activity of B and T lymphocytes. - ANSWER Methotrexate MOA
ing
fly
-Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
, 3
-Original drug is not pharmacologically active but one metabolite remains active -
ANSWER Three possible outcomes of phase 1 drug metabolism.
-increases the risk for hepatotoxicity when other drugs that contribute to liver injury
(including alcohol) are taken;
m
-greatly increases the risk for serious myelosuppression when it is prescribed for patients
.co
taking other drugs that can decrease bone marrow function. - ANSWER Methotrexate
ail
Drug Interaction
gm
-Major toxicities are hepatic fibrosis, bone marrow suppression, GI ulceration, and
r@
pneumonitis.
he
hig
-Can cause numerous and potentially fatal toxicities of the bone marrow, liver, lungs, and
kidneys. Other fatalities have occurred associated with skin reactions and due to
ing
hemorrhagic enteritis and gastrointestinal perforation. - ANSWER Methotrexate AE
fly
-myopathy, rhabdomyolysis, hepatitis, pancreatitis, and thrombocytopenia; - ANSWER
Ezetimibe Adverse Effects
, 4
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to
medication-disease or medication-syndrome interactions that may exacerbate the disease
or syndrome
-medications to be used cautiously in older adults
m
-clinically significant drug interactions that should be avoided in older adults
.co
-medications to be avoided or dosage decreased in the presence of impaired kidney
ail
function in older adults - ANSWER Beers Criteria
gm
-Promotes relaxation of peripheral arterioles resulting in a decreased afterload which
r@
reduces cardiac oxygen demand.
he
hig
-Blocks calcium channels in the heart and vascular smooth muscle;
ing
-dihydropyridines, for which nifedipine is the prototype.
fly
-nondihydropyridines, includes the drugs: verapamil and diltiazem. - ANSWER
Calcium Channel Blockers
