MISC
the highest concentration of a drug in the patient's bloodstream
What is the Peak Level
what is the role of NSAIDS?
Reduce inflammation
Common ADRs of Tdap vaccine?
**Injection site reactions- most common!
Low-grade fever, chills, malaise, aches
Hgb: 9.1 g/dl Hct: 28% MCV: 67 fL MCHC: 32 g/dl MCH: 24 pg Platelets: 550,000/mL
*What additional labs might you want to get to obtain your diagnosis?*
Serum Iron
Name 5 SSRI medications
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
the lowest concentration in the patient's bloodstream. Specimen should be collected just prior to administration of the drug
What is the trough level
Antidote for opioid overdose?
Naloxone (Narcan)
ADRs of HPV vaccine?
**Injection site reaction- most common!
Fatigue, headache, myalgias
Syncope
Hgb: 7.5 g/dl Hct: 22.5% MCV: 91 fL MCHC: 34 g/dl MCH: 29 pg P
Anemia of Chronic Disease
Best use for benzodiazepines
Short acting; short-term or intermittent treatment of anxiety
the amount of a drug being absorbed is the same amount that's being cleared from the body when the drug is given continuously or repeatedly.
What is Steady State
Pain contracts are appropriate for what patient populations?
Any patient requiring long term management with opioids!
Who is a candidate for RhoGAM?
Any unsensitized woman who is RhD negative and who may be carrying or who delivers an RhD positive baby is a candidate for Rhogam
Weakness, Glossitis, Parasthesias, Palpitations, Dizziness, Loss of fine motor control
Pernicious Anemia
Name 3 common adverse effects of SSRIs
diarrhea
dizziness
nervousness
sexual dysfunction
sleep disturbances
nervousness
Process for weaning off an SSRI medication?
Taper off over several weeks; Risk of relapse is highest in the first 2 months post discontinuation.
Reduce the dose by 50% for 3 – 4 days. (May consider longer)
3 Examples of pain medications that are best utilized to treated neuropathic pain
Gabapentin (Neurontin)
Pregabalin (Lyrica)
Duloxetine (Cymbalta)
Typical dosing schedule for MMR?
CDC recommends all children get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.
What body system is responsible for red blood cell production? How does this process occur?
•The kidneys play a CRITICAL ROLE in red blood cell production.
•When the kidney senses hypoxia, it releases the hormone ERYTHROPOIETIN
•Erythropoietin is the chemical messenger that tells the BONE MAROW to produce more red cells BECAUSE THE BODY IS STARVING FOR OXYGEN
Name 6 side effect of anticholinergic medications
Name 5 medications that should be avoided or used in caution in the elderly
TCA's
NSAIDS
First generation antihistamines (Benadryl)
Sleep aids (ambien, Lunesta)
Benzos
***DOUBLE JEOPARDY!***
Name the types and describe the characteristics of acute pain
Somatic- skin, joints, bone, muscle, connective tissue; generally localized; throbbing, squeezing, aching, stinging.
Neuropathic- felt along dermatomes and can originate in central/peripheral nerves. Burning, shock-like, tingling sensations!
Visceral- arises from organs; dull, aching, cramping sensation!
Referred- can be perceived at a more distant site (example- shoulder pain associated with gallbladder)
TdaP guidelines in pregnancy?
Give during 3rd trimester for EVERY pregnancy!
Dosing for Vitamin B12 deficiency related to pernicious anemia?
Injection regimen:
•1000 mcg/day IM for five days, then
•1000 mcg/week IM for one month, then
•1000 mcg/month IM
Oral Regimen for maintenance:
•1000 mcg/day
You have a patient presenting with severe anxiety, depression and a history of suicidal attempts. What is your best option for prescribing a medication?
Aim to consider a safer medication in overdose; SSRI