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NAPLEX
| Question | Answer |
|---|---|
| Medications that interact with warfarin | "ACADEMIC FACS" Amiodarone Ciprofloxacin/levofloxacin Aspirin Dicloxacillin Erythromycin (Macrolides) Metronidazole (Azoles) Indomethacin Clofibrates Fibrates Allopurinol CYP 2C9 Inducers/inhibitors Statins |
| Amiodarone- drug interactions | -Digoxin -Warfain =decrease dose of digoxin or warfarin by 30-50% when starting amiodarone |
| Digoxin- drug interactions | -increase in levels: likely due to decreased renal function -toxicity more likely if potassium low -P-gp substrate, narrow therapeutic range -caution with drugs that lower INR: beta blockers, non-dhp CCBs, amiodarone, dexmedetonidine (Precidex), clonidine, opioids |
| Grapefruit juice- interactions | inhibits CYP3A4 -simvastatin -lovastatin -nifedepine -tacrolimus |
| Lamotrigine and Valproate- drug interaction | severe rash |
| MAOIS, Opioids- interactions | -avoid with serotonergic drugs- serotonin syndrome -parkinson's drugs -washout period for MAOIs: 14 days -tyramine metabolism decreased with MAOIs: selegiline, rasagiline -Serotonergic drugs: ephedrine, lithium, meperidine, levodopa, Dextromethorphan, cyclobenzaprine, triptans etc. |
| Tramadol- drug interactions | -2D6 metabolized to active form -diministed effect on 2D6 inhibitors (fluoxetine, paroxetine, or poor metabolizers of 2D6) |
| Codeine- drug interactions | partial prodrug metabolized by 2D6 -ultrametabolizers, extensive metabolizers- OD risk -2D6 inhibitors, poor metabolizers = diminished effect |
| CYP450 enzyme inhibitors "BIGFACES.COM" | "BIGFACES.COM" Bupropion Itraconazole/ketoconazole/fluoxetine Gemfibrozil Fluoxetine/fluvoxamine Amiodarone Ciprofloxacin Erythromycin/Clarithromycin Sulfamethoxazole-trimethoprim Clopidogrel Omeprazole/Esomeprazole Metronidazole |
| CYP450 enzyme inducers | "PS PORCS" Phenytoin Smoking Phenobarbitol Oxcarbazepine Rifampin Carbamazepine St. John's Work |
| CYP450 enzyme inhibitors "G PACMAN" | "G PACMAN" Grapefruit Protease Inhibitors (ritonavir) Azole antifungals Cyclosporine, Cimetedine, Cobicistat Macrolides (except azithromycin) Amiodarone Non-DHP CCBs |
| Calcineurin Inhibiots- drug interactions | CYP substrates: Systemic azoles macrolides rifampin -nephrotoxic- avoid with aminoglycosides |
| Fentanyl, Hydrocodone, Oxycodone, Methadone- drug interactions | CYP3A4 inhibitors = fatal respiratory depression |
| PDE-5 Inhibitors- drug interactions | C/I with nitrates = severe hypotension -decrease doses of alpha blockers with PDE5 inhibitors -caution with CYP3A4 inhbitors- PDE5 inhibitors are substrates |
| Quinolones, tetracyclines- drug interactions | Chelation risk, seperate from vitamins, electrolytes |
| Statins- drug interactions | increased levels = increased muscle toxicity -most are CYP3A4 metabolites: atorvastatin, simvastatin, lovastatin |
| 1 gallon | 4 quarts 3840 mL (approx) 3785 mL (exact) |
| 1 fluid oz | 30 mL (approx) 29.57 mL (exact) |
| 1 quart | 2 pints 960 mL (approx) 946 mL (exact) |
| 1 pint | 16 oz 480 mL (approx) 473 mL (exact) |
| 1 cup | 8 oz 240 mL (approx) 236.56 mL (exact) |
| Use IBW for these drugs | -aminophylline -theophylline -acyclovir |
| Use AdjBw (if obese) for these drugs | aminoglycosides |
| Use TBW (if obese) for these drugs | -LMWHs -UFH -Vancomycin |
| When calculating CrCl- which body weight to use? | Underweight: TBW Normal: IBW Overweight/obese: AdjBW |
| Calcium+ Phosphate total should not exceed | 45 MEQ/L (precipitates) |
| Hazard Ratio | Hazard rate in treatment group/ hazard rate in control group |
| Sensitivity | 1- type II error(false negative) |
| Specificity | 1- type I error (false positive) |
| Relative risk reduction | 1- RR or (%risk in control- % risk in treatment)/ % risk in control |
| Odds ratio | (disease present, exposed to treatment)(disease absent, unexposed to treatment)/ (disease absent, exposed to treatment)(disease present, unexposed to treatment) |
| Number needed to treat | 1/(risk in control-risk in treatment group) or 1/ARR |
| absolute risk reduction | %risk in control - % risk in treatment group |
| Risk | # of subjects with unfavorable events in arm/ total # of subjects in arm |
| Risk ratio | risk in treatment group/ risk in control group |
| Anion gap | Na- Cl- HCO3 |
| Calcium conversions | Carbonate: 40% elemental calcium Citrate: 21% elemental calcium |
| % ionization of weak base | 100/1 + 10^(pH-pKa) |
| % ionization of a weak acid | 100/1 + 10^(pKa-pH) |
| ANC | WBC X (%segs + %bands/100) |
| Corrected calcium | Calcium reported (serum) + [(4-albumin)(0.8)] |
| Vd Equation | amount of drug in body/ concentration of drug in plasma |
| Cl Renal equals | Cl GFR + Cl secretion- Cl reabsorption |
| Cl renal > Cl GFR | filtration + net secretion |
| Cl GFR > Cl Renal | filtration + net reabsoprtion |
| Cl renal = Cl GFR | filtration only |
| Loading dose equation | desired concentration x Vd/F |
| Ke equation | Cl/Vd |
| Peak serum concentration equation | LD/Vd |
| Clearance equation (extravascular) | absolute bioavailability x dose/ AUC |
| steady state concentration equation | DR/Cl |
| half-life equation | 0.693/Ke |
| Clearance equation (IV) | dose/AUC |
| clearance equation | rate of elimination/ concentration |
| acute bioavailability equation | 100 X [(AUC extravascular)/(AUC intravascular)]x{(dose IV)/(dose extravascular)] |
| Codeine- pharmacogenomics | consider testing CYP450 2D6 -ultrametablizers = toxicity risk |
| Clopidogrel- pharmacogenomics | consider testing CYP2C19 genotype -*1 allelle = fully functional *2 and *3 = loss of function of alleles |
| Trastuzumab- pharmacogenomics | HER2 protein overexpression- required for use |
| Carbamazepine- pharmacogenomics | HLA-*1502 -test in Asian populations- increased risk of serious skin reactions |
| Abacavir- pharmacogenomics | HLA-B*571 -if positive, increased risk of hypersensitivity |
| Allopurinol- pharmacogenomics | consider testing HLA-B*5801 if positive, do not use- increased risk of SJS |
| Phenytoin- pharmacogenomics | consider testing HLA-B*1502 in all Asain populations-incrased risk of SJS and TEN |
| Azathioprine- pharmacogenomics | TPMT- low/absent activity = increased risk of myelosuppression |
| Capecitabine- pharmacogenomics | consider testing DPD deficiency- increased toxicity risk |
| Cetuximab- pharmacogenomics | KRAS- if positive, drug will not work |
| Warfarin- pharmacogenomics | Consider testing CYP450 2C9*2/*3 -VKORC1 = increased bleed risk |
| Thyroid function tests needed for these drugs | levothyroxine, armour thyroid, amiodarone, lithium, statins |
| Drugs that cause severe skin reactions | allopurinol, lamotrigine, penicillins, phenytoin, piroxicam, sulfamethoxazole |
| drugs that cause photosensitivity | carbamazepine, diruetics, methotrexate, retinoids, quinolones, st. john's wort, sulfa abx, tacrolimus, tetracyclines, voriconazole |
| drugs that cause TTP | clopidogrel, ticlopidine |
| avoid these drugs with peanut and soy allergies | progesterone (peanut), Clevidipine, propofol (Soy and eggs) |
| hyperkalemia risk with these drugs | -aldosterone blockers- avoid NSAIDS -ACEIs, ARBS, aliskerin, amiloride, triamterene, calcinuerin inhibitors, bactrim, cangliflozin, pentamadine |
| ototoxicity risk with these drugs | salicylates, vancomycin, aminoglycosides, cisplatin, loop diuretics |
| avoid these with drugs that have increased bleed risk | NSAIDs, SSRIs/SNRIs, ginko biloba, garlic, ginger, glucosamine, ginseng |
Created by:
Bmiller01
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