Uworld Pharm

  1. Name absolute contraindications to thrombolytics (6)
    • Prior Intracranial hemorrhage
    • Structural cerebrovascular lesion (arteriovenous malformation, aneurysm) 
    • Ischemic stroke within 3 months (except within 3 hours)
    • Suspected aortic dissection
    • Active bleeding
    • Significant head trauma within 3 months
  2. What 3 things should a patient avoid when taking tetracyclines?
    • Iron supplements
    • Antacids
    • Dairy products
    • *they bind with the drug and decrease absorption*
  3. Why is codeine contraindicated with  COPD patients?
    It is both used as a analgesic and cough suppressant. Depressing the cough reflex can cause accumulation of secretions.
  4. Rifapentine is a TB med. How will it affect oral contraceptives?
    Reduces the efficacy by increasing their metabolism. Patients will need an alternate birth control plan
  5. Which anticoagulant therapy can be affected when vitamin K rich foods are taken?
  6. What are reversing agents for these anticoagulants:

    1. Warfarin
    2. Enoxaprin
    3. Heparin
    • 1. Vit. K
    • 2. Protamine
    • 3. Protamine
  7. What is the suffix for loop diuretic meds?
    • -ide
    • ex: Furosemide
  8. How should levothyroxines be taken?
    • Empty stomach
    • Preferably in the AM
    • Separate with other meds
    •  - Including antacids, calcium, and iron supplements.
  9. Why should a patient on carbamazepine for neuropathic pain report any s/s of fever or sore throat?
    It is associated with agranulocytosis
  10. When is Milrinone used to treat heart failure patients? Which kind of IV does it require?
    • Given for heart failure patients when other meds are unresponsive.
    • It is given through a central line d/t being vesicant
  11. How does grapefruit affect calcium channel blockers like Nifedipine?
    Can cause severe hypotension, and some statins may result in mypoathy
  12. What is the PPE required for measels?
    Airborne precautions: N95
  13. What kind of precatuion is needed for whooping cough?
  14. What are the three labs that can confirm presence of sickle cell crisis?
    • Elevated bilirubin and reticulocyte count
    • Hemoglobin <10 g/dL
  15. T or F: clients who have dentures will need to soak them in nystatin oral suspension as well as swish and spit for oral candidiasis
  16. The "death rattle" sound of a dying patient can be treated using this med: 

    B. This is a anticholinergic which used for this sound, or a transdermal scopolamin patch.
  17. Are bananas rich in Potassium or Vitamin K?
  18. What is the cardiovascular side effect of Amitriptyline (a tricyclic antidepressant) you must tell the patient to watch out for?
    Orthostatic Hypotension: get up slowly from the bed or a sitting position
  19. What is the indication of Dabigatran (Pradaxa)?
    Anticoagulant (Thrombin inhibitor): reduce risk of stroke / DVT / nonvalvular atrial fib -> stroke
  20. Match:

    You can mix regular insulin (Humalog) with ___ insulin.

  21. What labs should you monitor for when giving Enoxaparin?
    CBC: H&H, platelet count
  22. What labs should you monitor when giving Digoxin?
    • Dig levels
    • Potassium (Low K can potentiate dig toxicity
  23. Metoclopramide (Reglan) is used for both delayed gastric emptying, GERD, and as an antiemetic. What can long term use be associated with using it?
    Tardive Dyskinesia: uncontrollable movements around the face and cheeks, fingers or neck
  24. Why should Lithium and NSAIDS like ibuprofen not be taken together?
    Lithium is cleared renally, and NSAIDS and other drugs that decrease renal blood flow can cause lithium toxicity.
  25. What expected meds are given to moderate or severe asthma exacerbations with diminished VS?
    • O2
    • Albuterol
    • Ipratropium nebulizer
    • Systemic corticosteroids (Solu-Medrol)
  26. Why is a baseline TST (TB test) done before initiating TNF inhibitors (tumor necrosis factor) drugs?
    TNF drugs inhibit the inflammatory response and cause immuno - suppression. Latent TB patients must be treated with antitubercular agents or TB reactivation would occur.
  27. Should Methylphenidate (Ritalin) be taken in AM or HS?
    It should be given no later than 6pm as it can interfere with sleep.
  28. What's the number of hours peak time is regular insulin?
    2-5 hours subq
  29. What is the indication for IVIG in Kawasaki dz in kids?
    For prevention of coronary aneurysm and subsequenmt occlusion; given with aspirin therapy
  30. 1. When taking levothyroxine for hypothyroidism during pregnancy, symptom relief will begin approximately when?
    2. Can you take prenatal vitamin along with it?
    3. How should it be taken? In the AM or PM? With or without food?
    • 1. 3-4 weeks
    • 2. No. They can contain iron that affect absoprtion. 
    • 3. It should be taken in the AM on an empty stomach
  31. This drug requires good oral hygiene with a soft-bristle toothbrush and regular dentist visits. Otherwise gingival hyperplasia (overgrowth of gum tissues), especially in high doses can occur.

    Hint: it is used for seizure disorders
  32. When should a patient take his Simvastatin?

    A. Most effective in the evening or at HS
  33. What is the indication for Filgrastim with a patient who received Chemotherapy?
    Increase their neutrophil count.
  34. List conditions that can increase lithium levels in a patient that can lead to toxicity?`
    • Dehydration
    • Hyponatremia
    • Severe renal dysfunction
  35. T or F: Rifampin, TB drug, can cause red-orange discoloration of body fluids. It is not concerning
  36. T or F: A patient who experiences coughs when taking ACE inhibitors can take cough suppressants to relieve their symptom.
    False: cough supressants won't help with this kind of cough
  37. This type of abx can cause prolonged QT intervals, leading to Torsades.
    Macrolides (azithromycin for ex)
  38. List the therapeutic range of lithium
    • 0.6 - 1.2
    • >1.5 and/or presence of even mild symptoms must be reported
  39. Can ACE inhibitors increase or decrease potassium?
    Increase by decreasing urinary potassium excretion
  40. What test should be done prior to starting statin meds?
    Liver function tests
  41. Isotretonoin is for severe acne. Which vitamin supplement is contraindicated when taking this med?
    Vitamin A: the med is derived from Vitamin A, and taking supplements can lead to toxicity
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