Pharm Final

Diuretics

100

What is the most powerful Diuretics? Give an example and its indication. 

Loop Diuretics

ex: Furosemide: used for CHF, pulmonary edema and hypercalcemia

200

What is a contraindication of Thiazides? 

Thiazides cannot be used on patients with any renal issues. They specifically cannot be used is the patients creatinine clearance is less than 30-50 ml/min. 

300

What diuretics group typically has drugs that end in -ide?

Loop Diuretics: 

-Furosemide, Bumetanide, Torsemide

400

What are some common concerns the nurse must be aware of while administering any diuretic drug? Try thinking of the odd ones too. 

HYPOkalemia

HYPERglycemia

Dizziness

Hypotension 

Hyperuricemia (gout)

Impotence

500

Your patient comes in showing signs of severe pulmonary edema. You look at his chart and see that he has h/o CHF, HTN, and high cholesterol. He has a DNR and is allergic to penicillin and Bactrim. You see that the patient is ordered furosemide. Why is this a concern?

The patient is allergic to Bactrim which is a sulfonamide. Furosemide has a similar structure as sulfa- drugs so you should be mindful that this drug could cause a possible allergy. 

Antibiotics

100

Name the two types of Beta lactams.

Penecillin 

Cephalosporin 

200

This antibiotic class is highly concentrated in urine so it is typically used for UTI. 

Sulfonamides 

300

Majority of antibiotics have GI side effect and should be taken with food. However, this antibiotic class has better absorption on an empty stomach. What is it?

Macrolides

400

Explain the evolution of Beta Lactam rings and what we added to combat the issue. 

Originally the beta lactic rings were bactericidal and killed the bacteria. Overtime the bacteria because resistant and formed an enzyme that destroys the rings called beta lactase. So, to combat this enzyme Beta Lactams are now paired with a Beta lactase inhibitor. 

500

Cephalasporins are used based on a spectrum. Which generation of cephalosporins treat gram-negative? Gram positive?

Gram Positive: 1st Generation 

Gram Negative: 3rd Generation 

Analgesics

100

What is the main difference between opioids and non-opioids? 

Non-opioids have a ceiling effect whereas opioids do not. 

200

Name the analgesic that can lead to hepatotoxicity. Which one leads to renal toxicity?

Liver Tox: acetaminophen 

Renal Tox: Ibuprofen 

300

Explain how opioid agonist-antagonist work? How do they differ from other opioids? 

Opioid agonist-antagonists bind to the receptor fo the brain that reduces pain sensation but in lower amounts than regular opioids.  They are different from other opines because they have a ceiling effect. These are typically used for patients who are addicts or obstetrical patients because they are not as sedating. 

400

Name all 6 side effects of opioids. 

Depressed Respirations

Dizziness

Decreased GI motility and urine output 

Drug Dependence 

Drowsiness 

Decreased Blood Pressure 

500

This is a non-depolarizing NMBD drugs. It is long acting and used for prolonged paralyzation? What is this drug and what must you remember to do prior to administration.

The drug is Vecuronium. Prior to administering the drug you must remember to sedate the patient. You will also need to mechanically ventilate them.

Diabetes Drugs

100

When drawing up NPH and short acting insulin into the same syringe, which do you draw up first?

You must draw the short-acting insulin first.

(Remember clear before cloudy)

200

How do Biguanides (Metformin) work to treat diabetes. 

-Decrease production of glucose by the liver 

-Decreased intestinal absorption of glucose 

-Increase uptake of glucose by tissue

300

This diabetes drug is also used to improve survival for heart failure patients. 

SGLT-2 Inhibitors 

**empagliflozin 

400

What oral diabetic drug does the patient need to pay extra close attention to their perineal hygiene?

SGLT2 Inhibitors: an adverse effect of SGLT2 Inhibitors is Fournier gangrene which is infection and tissue death of the genitalia 

500

This drug excretes glucose and sodium through the urine. What is it?

SGLT-2 Inhibitor (empagliflozin) 

Cardiovascular

100

What drug group is responsible for: 

-Decreased BP 

-Decreased HR 

-Decreased AV node conduction 

-Reduce Myocardial oxygen consumption 

Beta Blockers 

200

What is Adenosine and what is it used for?

Adenosine is an anti-arrhythmic that shuts off the AV node and restarts it. It us used to treat PSVT (Paroxysmal supraventricular tachycardia). 

300

ACE Inhibitors work by lowering the blood pressure, increasing vascular function and can increase survival in patients with HF. However, it does come along with some annoying side effects. What are the side effects and which CV drug is the same but has reduced side effects. 

Side Effects: COUGH, angioedemia, hyperkalemia

**ARBs (-SARTANS) are safer than ACE Inhibitor and DO NOT cause a cough 

400

Name the 2 Fancy Beta blockers. What are there Indication and MOA. 

1. Coreg

-Indication: CHF and HTN 

-MOA: Beta_1,  Beta_{2 ,} and Alpha₁ Blocker 

2. Labetalol

-Indication: HTN 

-MOA: Alpha₁ blocker with some b1 and b2

500

Amiodarone is a anti-arrhythmic drug that enhances the effects of two other drugs. Which two drugs are they?

Warfarin and Digoxin