Pharmacotherapeutic Principles
A drug that binds very tightly to a receptor is described as having this property.
What is affinity?
This agency determines whether a drug is approved for specific indications and regulates labeling.
What is the FDA?
This class of antibiotics is associated with photosensitivity and should be used with sun protection.
What are tetracyclines?
This class of antibiotics works by inhibiting bacterial cell wall synthesis and includes medications like penicillin and cephalosporins.
What are beta-lactams?
These ear drops are avoided if the tympanic membrane is not intact due to risk of hearing damage.
What are aminoglycosides?
This class of medications reduces inflammation but increases infection risk when used long-term.
What are corticosteroids?
A medication reaches its maximum therapeutic effect, and increasing the dose does not increase the response. This reflects this pharmacologic property.
What is efficacy?
A provider prescribes a medication for a non-FDA-approved use that is supported by evidence. This is known as this.
What is off-label prescribing?
A patient receiving chemotherapy develops alopecia and neutropenia. These effects are due to this mechanism of action.
What is targeting rapidly dividing cells?
A patient taking metronidazole develops severe nausea and vomiting after drinking alcohol. This reaction is known as this.
What is a disulfiram-like reaction?
A patient is started on latanoprost for glaucoma. This medication works by improving this process in the eye to reduce intraocular pressure.
What is increasing aqueous humor outflow?
These medications target specific immune pathways, such as TNF inhibitors.
What are biologics?
A medication with a half-life of 8 hours is started. Approximately how long will it take to reach steady state?
What is about 40 hours?
A patient with chronic liver disease is taking phenytoin and develops signs of toxicity despite no dose change. This is most likely due to decreased albumin levels leading to an increase in this portion of the drug.
What is the free (unbound) drug?
A breast cancer patient is prescribed trastuzumab. You order an echocardiogram before starting therapy to monitor for this specific toxicity.
What is cardiotoxicity (heart failure risk)?
A patient prescribed ciprofloxacin is advised to avoid taking it with calcium supplements or antacids. This is because these substances reduce the drug’s effectiveness through this mechanism.
What is decreased absorption due to chelation?
A patient has purulent ear drainage and the tympanic membrane cannot be visualized. What is the safest prescribing approach?
What is avoid ototoxic drops?
A patient abruptly stops long-term corticosteroids and develops hypotension and fatigue. This condition is called this.
What is adrenal insufficiency (or adrenal crisis)?
A patient reports no improvement despite increasing doses of a medication. The drug is known to have low maximal effect. The issue is most likely related to this property.
What is low efficacy?
A patient taking simvastatin develops muscle pain after starting clarithromycin. This is due to inhibition of this metabolic system.
What is the CYP450 system?
What is disruption of normal gut flora?
A patient is prescribed amoxicillin for a bacterial infection but reports no improvement after several days. This may be due to bacteria producing this enzyme, which inactivates the drug.
What is beta-lactamase?
A 70-year-old patient with a history of asthma is prescribed timolol eye drops for glaucoma. Shortly after starting therapy, the patient develops shortness of breath. This adverse effect is best explained by this mechanism.
What is systemic absorption of a beta blocker causing bronchospasm?
A patient receiving a TNF inhibitor for an autoimmune condition develops a persistent cough and weight loss. This raises concern for reactivation of this type of infection due to impaired immune function.
What is latent tuberculosis?
A patient is switched from IV to oral therapy. The provider decreases the dose due to high oral bioavailability. This pharmacokinetic concept explains the adjustment.
What is bioavailability?
A patient with chronic back pain calls requesting an early refill of their oxycodone prescription, stating their pain has worsened. Upon review, you note the medication is classified as a Schedule II controlled substance. What is the most appropriate response regarding prescribing this medication?
What is a new prescription must be issued and refills are not permitted for Schedule II medications?
A patient receiving cyclophosphamide develops hematuria during treatment. This adverse effect is most closely associated with this complication of therapy.
What is hemorrhagic cystitis?
A patient is prescribed a broad-spectrum antibiotic and later develops severe diarrhea with suspected Clostridioides difficile infection. This complication is most closely related to this effect of antimicrobial therapy.
What is disruption of normal gut flora?
A patient with glaucoma and a history of asthma is being started on treatment. Which medication class should be avoided due to risk of worsening respiratory symptoms?
What are beta blockers (e.g., timolol)?
A patient with psoriasis is well controlled on a biologic therapy but develops recurrent sinus infections. This side effect occurs because biologics work by blocking these immune system signals.
What are cytokines (e.g., TNF, interleukins)?