Meds for Dyslipidemia
Food/drug interaction for HMG-COA reductase inhibitors (statins)
Grapefruit juice
What is the black box warning for all antidepressants?
Increased risk of suicidal behavior, especially in children and young adults
First line for acute bronchospasm?
First line for asthma prevention?
acute: inhaled beta agonist (albuterol)
prevention: inhaled corticosteroids
Which drug class needs to be taken on an empty stomach 20-30 min before breakfast? H2 antagonist or PPIs.
What is the prototype drug for your answer?
PPIs
Protoype: omeprazole
What is the antidote for benzodiazepine overdose?
flumazenil
Common adverse effect of niacin and how it can be reduced.
Intense flushing and hot flashes
- take ASA 30 min before
Which is the antidepressant that does not cause weight gain or sexual side effects?
bupropion
MOA and adverse effects of varenicline?
Adverse effects: common- N/V, constipation, vivid dreams. Serious- depression, risk for suicide, angioedema, MI, serious skin reactions
How does sucralfate work and what are the adverse effects?
MOA: creates a gel in the stomach that coats the injured area and protects it.
Side effects: constipation (most common), nausea, dyspepsia
Which anxiolytic has no abuse potential and is not a CNS depressant?
buspirone
MOA of fabric acid drugs and therapeutic use?
MOA: activates lipoprotein lipase which breakdown and eliminates triglycerides
Use: preferred drug for hypertriglyceridemia (often combined with a statin for greater reduction in triglycerides)
If a patient has been taking an SSRI for 1 week and doesn't feel relief what should they do?
keep taking it- it takes up to 4 weeks to see effects
Prototype, adverse effects and teaching of inhaled corticosteroids?
Prototype: beclomethasone
Adverse effects: hoarseness, sore throat, dry mouth, oral candidiasis. Long term use can cause decreased growth in kids and osteoporosis in adults.
Teaching: rinse mouth after using, take Calcium and vitamin D (adults). Need to take this daily for it to work
Serious adverse effects of alosetron?
colitis, bowel obstruction, and death
Which receptors do FGAs block and how is it different than SGAs?
FGAs- block dopamine receptors
SGAs- block serotonin receptors and minimal dopamine receptor blockade.
Prototype of bile acid sequestrates?
How long do you need to wait to give other meds
Cholestyramine
give other meds 1 hour before or 4-6 hours after cholestyramine
Name 2 side effects associated with anticholinergics and the teaching for each?
1. Dry mouth: hard candy, sips of water, dental hygiene
2. constipation: fluid, fiber, exercise
3. urinary retention: void before taking the dose
4. blurred vision: notify provider
MOA of intranasal decongestants and teaching needed?
MOA: activates alpha 1 receptors in the nose (vasoconstriction in the nose leads to shrinking of swollen mucus membranes)
teaching: discontinue after 3 to 5 days to avoid rebound congestion
Contraindications to laxative use?
1. symptoms of appendicitis, enteritis, diverticulitis, ulcerative colitis
2. acute abdominal sx
3. fecal impaction/bowel obstruction
4. habitual use
5. caution with pregnancy/lactation
What is akathisia and how can it be treated?
It is the inability to stay still or rest
Treatment: benzos or beta blockers
Common adverse effects of statins?
Severe adverse effects of statins and nursing considerations?
Common: GI effects (flatulence, abdominal pain, cramps, N/V, constipation)
Severe: liver failure (monitor LFTs), myopathy and rhabdomyolysis (monitor CK levels and discontinue if any muscle or joint pain)
Name 5 foods/beverages that someone on an MAOI needs to give up?
Cheese, smoked/pickled/fermented meats, lava beans, red wine, light and pale beer, distilled liquors, soy sauce, meat extracts, avocados, chocolate, some fruits (figs, raisins, grapes, pineapples, oranges) and sour cream/yogurt.
Drug class and common adverse effects of albuterol
class: SABA (short acting beta agonist)
adverse effects: tachycardia, palpitations, nervousness, tremors
Prototype for H2 antagonists and food/drug interactions
Prototype: famotidine
interactions: antacids (give an hr before or 2 hrs after) and cigarettes (smoking decreases effectiveness)
What is the therapeutic range for lithium levels and what adverse effects would you see when someone has a level of 3?
0.5 to 1.4
multi organ toxicity and significant risk of death (plus all the other adverse effects seen with lithium)