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What are the common side effects for opioids?
- Constipation
- Abdominal Pain
- Dizziness
- Drowsiness
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What do opioids act on?
Central Nervous System
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What are the laws for C IIs in NC?
- No refills
- No prescription expiration date
- Cannot be faxed to pharmacy
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Common C IIs
- Cocaine
- Hydromorphone
- Meperidine
- Methadone
- Oxycodone
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Common C IIIs
- Testosterone
- Anabolic Steroids
- Butalbital
- Chlorhexadol
- Hydrocodone
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C IVs
- Alprazolam
- Clonazepam
- Clorazepam
- Diazepam
- Phentermine
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Common C Vs
- Opium Preparations
- Some Codeine Products
- Diphenoxylate Products
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What is the difference between Lorcet and Lortab?
- Lortab= 500 mg APAP
- Lorcet= 650 mg APAP
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What is the maximum dose of APAP per day?
4 grams/ day
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What is the difference between bacteriostatic and bactericidal?
- Bacteriostatic prevents bacteria from dividing.
- Bactericidal kills the bacteria.
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Describe Penicillin Drugs:
- most commonly used
- Used for skin, teeth and UR infections
- Made from Mold
- Beta Lactam Antibiotic
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What are the common adverse effects with penicillins?
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What are the counseling points for penicillin?
- Take on empty stomach if possible.
- Take at even intervals.
- Finish full course of therapy.
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What is the point of adding clavulanic acid to penicillin drugs?
Protects the beta lactam ring from bacteria by inhibiting beta lactamase.
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Explain cephalosporins:
- Beta Lactam Antibiotic
- 4 generations (1st: narrow- 4th: broad)
- 1st: Keflex, Duricef
- 2nd: Ceftin, Cefzil
- 3rd: Omnicef
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What are the adverse effects of cephalosporins?
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What are the counseling points for cephalosporins?
- Take on empty stomach.
- Take at even intervals.
- Complete full course of therapy.
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Explain Quinolones:
- Broad Spectrum
- Very Expensive
- 4 Generations
- Well tolerated by patients
- Irreversible nerve damage can occur and spontaneous tendon damage
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What are the adverse effects of quinolones?
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What are the patient counseling points for quinolones?
- Complete full course of therapy
- Take with 8 oz. of water
- Skin sensitivity to sun may occur
- Do not take with antacids, multi-vitamins (separate by 2 hours)
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Explain Macrolides:
- Broad Spectrum Antibiotic
- Suspension forms and Tablet forms available
- Antacids slow the absorption
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What can macrolides be used for?
To treat upper and lower respiratory infections, skin infections, certain STDs
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What are some adverse effects with macrolides?
- Diarrhea can occur in almost 5%
- Can cause stomach upset
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What are some patient counseling points for macrolides?
Take with food to decrease GI upset.
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What type of infections are treated with tetracycline derivatives?
- Upper respiratory infections
- Acn
- Pneumonia
- Skin Infections
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What are patient counseling points for tetracycline derivatives?
- No dairy products, antacids, multivitamins, calcium (Take on empty stomach if possible)
- Causes yellowing of teeth (should not be used in children < 8 or pregnant women)
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What is doxycline used to treat?
- Rocky Mountain Spider Fever (red bumps/fever)
- Lyme Disease (bullseye rash)
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What is flagyl used to treat?
Anaerobic bacterial and protozoal infections (deep within the body)
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What are some adverse effects of flagyl?
May cause GI upset
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What are patient counseling points for flagyl?
- May be taken with food to reduce GI upset
- AVOID ALCOHOL (disulfiram like reaction may occur)
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What are Septra and Bctrim used to treat?
- UTI
- Chronic Bronchitis
- Traveler's Diarrhea
- Acne
- Bronchitis
- Otitis media
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Which component of Septra are dosages based?
Trimethoprim
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What are the patient counseling points for Septra?
Take with 8 ozs. of water
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What is the typical dosage for diflucan?
Can be used as a one time dose. May have a repeat dose.
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What is diflucan used for?
To treat yeast infections, thrush, and meningitis.
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What is the half life elimination of diflucan?
30 hours
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What drug is typically used in magic mouthwash?
Nystatin
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What age groups are recommended to use tamiflu?
Older than one year and adults
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How long can you show symptoms before taking Tamiflu?
No longer than 2 days
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Can infants < 1 year of age be treated for H1N1?
Yes, there are specific guidelines.
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What is valtrex used to treat?
- Herpes Virus:
- Genital
- Shingles
- Cold Sores
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is it safe to have sexual intercourse when taking valtrex?
NO!
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What are some adverse effects of bactoban?
- Stinging and pain at site
- Swelling
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How should bactroban be applied?
Covering the area with asmall film; do not rub in
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What forms can bactroban come in?
Ointment and nasal ointment
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What are the two main types of lipids?
Cholesterol and Triglycerides
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What is cholesterol?
- soft, fat-like, waxy
- Found in the blood stream and in all the body's cells
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Where is the majority of cholesterol produced in the body?
Liver and Intestines ( 80%)
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Can cholesterol be dissolved in the blood?
No
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How does cholesterol effect risk of heart disease?
Increases the blood pressure which can lead to heart disease and increased risk of other diseases.
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What cholesterol is considered "bad cholesterol"?
LDL
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In what direction does LDL carry cholesterol?
Towards the tissues-- forms plaque by building up on the inner walls of the arteries
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Define atherosclerosis
Clogged arteries that impedes blood flow to the brain, heart, kidneys, etc.
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What is your ideal level for LDL?
< 100 mg/dL
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What is HDL?
- "good cholesterol"
- high levels protect against heart attack
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What is the goal range for HDL?
Greater than 40 mg/dl
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What direction does HDL carry cholesterol?
Away from arteries to the liver.
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What is VLDL?
- Very low density lipoprotein
- Contains the highest amount of TG
- "bad"
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What are triglycerides?
- the chemical form of fat which exists in food and in the body
- If calories are not used immediately they will turn into triglycerides
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What is the goal level of TG?
< 150 mg/dL
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How do HMG-CoA reductase inhibitors work?
- Reduces intracellular cholesterol levels
- Increases the clearance of LDL from bloodstream
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Is it safe to give these drugs to a pregnant woman?
NO- should not be pregnant or plan on becoming pregnant while on these drugs
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Which two drugs have interactions with grapefruit?
Zocor and Vytorin
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What are common adverse effects of antihyperlipidemics?
Constipation and Muscle Pain
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How long should you conduct liver functions tests after starting a HMG CoA reductase inhibitor?
4-6 weeks for 15 months
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What is the range at which statin drugs reduce LDL?
30-55%
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What is the biggest adverse effect of Niaspan? How can it be prevented?
- Flushing
- Can take a bedtime with a snack and with a NSAID
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