Pharm II: Exam 1 review
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Questions and Answers

What is crucial for effective seizure management?

  • High dosage initial treatment
  • Regular, consistent dosing (correct)
  • Infrequent dosing of medications
  • Dosing at random times

Which medications can be used as the drug of choice for status epilepticus?

  • Diazepam or lorazepam (correct)
  • Carbamazepine
  • Methotrexate
  • Phenobarbital

What is a benefit of Phenobarbital?

  • Rapid onset requiring multiple daily doses
  • Long half-life allowing once-a-day dosing (correct)
  • Short half-life for frequent dosing
  • High potential for dependency

What happens with Carbamazepine therapy due to autoinduction?

<p>It results in lower-than-expected drug concentrations (B)</p> Signup and view all the answers

How is Methotrexate administered to reduce medication errors?

<p>Once weekly (C)</p> Signup and view all the answers

What is a known adverse effect of Methotrexate?

<p>Bone marrow suppression (A)</p> Signup and view all the answers

What should be avoided during AED therapy due to risk of severe sedation?

<p>Alcohol (C)</p> Signup and view all the answers

What is the administration route for Etanercept?

<p>Subcutaneous injection (B)</p> Signup and view all the answers

What is the primary use of Filgrastim?

<p>Increase neutrophils post-chemotherapy (C)</p> Signup and view all the answers

What should be monitored in adolescents taking Atomoxetine?

<p>Depression or suicidal thoughts (B)</p> Signup and view all the answers

What is the primary purpose of immunosuppressant medications in organ transplantation?

<p>To suppress T-lymphocyte activity (A)</p> Signup and view all the answers

What significant interaction should be monitored with cyclosporine?

<p>Grapefruit juice increases cyclosporine levels (B)</p> Signup and view all the answers

What symptom indicates capillary leak syndrome?

<p>Sudden weight gain (D)</p> Signup and view all the answers

When should colony-stimulating factor be administered after chemotherapy?

<p>24 hours after chemotherapy (A)</p> Signup and view all the answers

What is the therapeutic range for phenytoin (Dilantin)?

<p>10-20 mcg/mL (A)</p> Signup and view all the answers

Which adverse effect is commonly associated with filgrastim (Neupogen)?

<p>Bone pain (D)</p> Signup and view all the answers

What is a key characteristic of monoclonal antibodies in treatment?

<p>They target specific cells (D)</p> Signup and view all the answers

What safety measure is vital when administering intravenous phenytoin?

<p>It should be mixed with normal saline and administered slowly (C)</p> Signup and view all the answers

What action should be taken if a patient taking immunosuppressants experiences signs of organ rejection?

<p>Notify the healthcare provider for reassessment (D)</p> Signup and view all the answers

What mechanism of action does cyclosporine have in preventing organ rejection?

<p>Inhibits IL-2 production (A)</p> Signup and view all the answers

Immunosuppressant medications are used to enhance the immune system.

<p>False (B)</p> Signup and view all the answers

Which of the following drugs are commonly used as immunosuppressants? (Select all that apply)

<p>Cyclosporine (A), Azathioprine (C)</p> Signup and view all the answers

Cyclosporine Sandimmune is not interchangeable with cyclosporine-modified products.

<p>True (A)</p> Signup and view all the answers

Which immunosuppressant drug stimulates neutrophil production for immunocompromised patients?

<p>filgrastim (A)</p> Signup and view all the answers

What is a primary indicator for monitoring the effectiveness of Filgrastim (Neupogen)?

<p>Increased white blood cell count (B)</p> Signup and view all the answers

What is the purpose of Oprelvekin (Neumega)?

<p>Stimulates megakaryocytes in bone marrow to produce platelets (A)</p> Signup and view all the answers

What is Oprelvekin (Neumega) used to treat?

<p>Chemotherapy-induced low platelet counts (A)</p> Signup and view all the answers

What drug treatment causes Capillary Leak Syndrome?

<p>Interleukin therapy (B)</p> Signup and view all the answers

What is an adverse reaction associated with monoclonal antibodies, requiring premedication corticosteroids (e.g. methylprednisolone)?

<p>Cytokine release syndrome (A)</p> Signup and view all the answers

What are some uses of monoclonal antibodies? (Select all that apply)

<p>Treating cancer (A), inflammatory diseases (B), Transplant rejection (C), Rheumatoid arthritis (D)</p> Signup and view all the answers

What is a toxicity sign of Phenytoin (Dilantin)?

<p>Levels above 20 mcg/mL may cause CNS depression and lethargy. (B)</p> Signup and view all the answers

What should be monitored while a patient is on Methotrexate? (Select all that apply)

<p>Infection (A), Anemia (C), Bleeding tendencies (D)</p> Signup and view all the answers

Etanercept (Enbrel) requires rotating injection sites to minimize irritation.

<p>True (A)</p> Signup and view all the answers

Aldesleukin (IL-2) combined with antihypertensive medications may lead to which adverse effect?

<p>additive hypotension (B)</p> Signup and view all the answers

What is Adalimumab (Humira) used to treat? (Select all that apply)

<p>Rheumatoid arthritis (B), Crohn's disease (C), Ulcerative colitis (D)</p> Signup and view all the answers

What is the primary use of Atomoxetine (Strattera)?

<p>Attention-deficit/hyperactivity disorder (ADHD) (C)</p> Signup and view all the answers

What is Sumatriptan (Imitrex) used to treat?

<p>Acute migraine relief (B)</p> Signup and view all the answers

What adverse effect should be monitored when administering Sumatriptan (Imitrex)?

<p>Chest pain due to vasoconstriction (B)</p> Signup and view all the answers

Narrow therapeutic index (NTI) drugs are drugs where small differences in dose or blood concentration may lead to drug toxicity or therapeutic failure.

<p>True (A)</p> Signup and view all the answers

Which medication interferes with tumor necrosis factor?

<p>Etanercept (Enbrel) (A)</p> Signup and view all the answers

What is a common side effect to monitor for when using Cyclosporine?

<p>Hypertension (B)</p> Signup and view all the answers

Epoetin alfa (Epogen) is primarily classified as what type of medication?

<p>Hemopoietic agent (C)</p> Signup and view all the answers

What is Phentermine (Ionamin) used for?

<p>Appetite suppressant (B)</p> Signup and view all the answers

Modafinil (Provigil) is used to treat which of the following conditions?

<p>Narcolepsy (C)</p> Signup and view all the answers

Which of the following are contraindications or cautions for the use of immunosuppressant drugs? (Select all that apply)

<p>Pregnancy (A), Renal failure (C), Liver failure (B)</p> Signup and view all the answers

Which medication is typically dosed once a day?

<p>Phenobarbital (Luminal) (A)</p> Signup and view all the answers

What is included in the baseline assessment for methylphenidate (Ritalin)?

<p>Height and weight (A)</p> Signup and view all the answers

What side effect should we monitor for when using methylphenidate (Ritalin)?

<p>Hypertension (A)</p> Signup and view all the answers

What side effects should we monitor for when using triptan injectables? (Select all that apply)

<p>Increased blood pressure (B), Chest pain (A)</p> Signup and view all the answers

Which medication is used to treat respiratory depression in neonatal and postoperative patients?

<p>Doxapram (Dopram) (B)</p> Signup and view all the answers

Flashcards

Immunosuppressant Medication

A medication that suppresses the immune system to prevent the rejection of transplanted organs.

T-lymphocyte

A type of white blood cell that is involved in cell-mediated immunity, responsible for attacking foreign substances in the body.

Cyclosporine (Sandimmune)

A medication that inhibits the production of interleukin-2, a molecule important for T-cell activation, thus blocking organ rejection.

Filgrastim (Neupogen)

A medication that stimulates the production of neutrophils, a type of white blood cell that helps fight infections, in patients with suppressed immune systems caused by treatments like chemotherapy.

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Oprelvekin (Neumega)

A medication that stimulates the production of platelets, which are essential for blood clotting, in patients with low platelet counts.

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Capillary Leak Syndrome

A condition that causes sudden weight gain, often linked to interleukin therapy, indicating extreme fluid retention in the body.

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Monoclonal Antibody

A type of antibody that is specifically designed to target and bind to certain cells, used in treating cancers, transplant rejection, and inflammatory diseases.

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Phenytoin (Dilantin)

A medication used to treat seizures with a narrow therapeutic range, meaning there's a small difference between the effective dose and a toxic one.

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Phenytoin Toxicity

A serious condition caused by excessive phenytoin levels in the blood, characterized by CNS depression and lethargy.

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Colony-Stimulating Factor (CSF)

Colony-Stimulating Factors are drugs that stimulate the production of blood cells, often used in cancer treatment to help the body recover from the effects of chemotherapy.

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Consistent Dosing for Seizures

Regular and consistent dosing of antiepileptic drugs (AEDs) is crucial for effectively managing seizures and preventing withdrawal-induced seizures.

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Status Epilepticus Treatment

Diazepam (Valium) or lorazepam (Ativan) are the preferred medications for treating status epilepticus, a prolonged seizure.

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Phenobarbital for Seizures

Phenobarbital (Luminal) has a long half-life, allowing for once-a-day dosing, reducing the need for frequent administration.

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Carbamazepine Autoinduction

Carbamazepine (Tegretol) induces its own metabolism, leading to decreased drug levels over time, necessitating dosage adjustment within two months.

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Methotrexate Dosing

Methotrexate is administered once weekly to reduce medication errors and manage rheumatoid arthritis.

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Methotrexate Side Effect

Methotrexate can suppress bone marrow, leading to increased risk of infection, anemia, and bleeding. Monitoring is essential.

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Etanercept Administration

Etanercept (Enbrel) is administered subcutaneously and injection sites should be rotated to minimize irritation.

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Avoid Grapefruit Juice

Grapefruit juice can significantly increase drug levels, potentially leading to adverse effects, particularly with cyclosporine and other medications.

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Antihypertensive Interactions

Combining aldesleukin (IL-2) with antihypertensives can lead to additive hypotension, due to both drugs lowering blood pressure.

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AED and Alcohol

Alcohol consumption during AED therapy can increase sedation and toxicity, potentially leading to dangerous complications.

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Study Notes

Immunosuppressant Medications

  • Immunosuppressant medications suppress T-lymphocytes, crucial in organ transplantation to prevent rejection.
  • Cyclosporine prevents organ rejection by inhibiting the production of IL-2 and T-cell activation.
  • Grapefruit juice significantly increases cyclosporine levels (20-200%), increasing the risk of toxicity.
  • Cyclosporine is not interchangeable with other cyclosporine-modified products (e.g., Neoral).
  • Filgrastim (Neupogen) increases neutrophil production to combat infection in immunosuppressed patients.
  • Adverse effects of Filgrastim can include bone pain from marrow stimulation.
  • Oprelvekin (Neumega) stimulates platelet production from megakaryocytes, useful for chemotherapy-induced low platelet counts.
  • Administer colony-stimulating factors 24 hours after chemotherapy to avoid interference with treatment.
  • Capillary leak syndrome involves sudden weight gain (e.g., 15 pounds) and fluid retention, potentially linked to Interleukin therapy.
  • Monoclonal antibodies target specific cells to treat cancer, transplant rejection, rheumatoid arthritis, and inflammatory diseases.

Antiepileptic Drugs (AEDs)

  • Phenytoin (Dilantin) has a narrow therapeutic index (10-20 mcg/mL), a small difference between safe and toxic levels.
  • Phenytoin toxicity leads to CNS depression and lethargy at levels above 20 mcg/mL.
  • Intravenous phenytoin should be mixed with normal saline to prevent bradycardia.
  • Maintaining consistent drug dosing is essential in seizure management; inconsistent dosing can lead to withdrawal seizures.
  • Diazepam (Valium) or lorazepam (Ativan) are the drugs of choice for status epilepticus.
  • Phenobarbital (Luminal) has a long half-life, allowing for once-daily dosing.
  • Carbamazepine (Tegretol) autoinduces, resulting in lower than expected drug concentrations (requiring dosage adjustments in 2 months).

Rheumatoid Arthritis Treatments

  • Methotrexate is administered weekly to reduce medication errors and can have adverse effects like bone marrow suppression.
  • Monitoring for infection, anemia, and bleeding tendencies is necessary with methotrexate.
  • Etanercept (Enbrel) is administered subcutaneously, rotating injection sites to minimize irritation.
  • Avoid grapefruit juice when taking cyclosporine or other drugs that can be affected by this interaction.
  • Concomitant use of aldesleukin (IL-2) and antihypertensives can lead to significant hypotension.
  • Avoid alcohol during AED use to lessen severe sedation and related toxicity problems.

Special Drug Indications

  • Filgrastim (Neupogen) increases neutrophils, useful after chemotherapy to fight infection.
  • Adalimumab (Humira) is prescribed to treat rheumatoid arthritis, Crohn's disease, and ulcerative colitis.
  • Atomoxetine (Strattera) is indicated for attention-deficit/hyperactivity disorder (ADHD), with potential warnings for depression or suicidal thoughts in adolescents.
  • Sumatriptan (Imitrex) is used for acute migraine relief, but may cause chest pain due to vasoconstriction.

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Description

This quiz covers key concepts related to immunosuppressant medications, including their mechanisms, uses in organ transplantation, and interactions with substances like grapefruit juice. Additionally, it discusses the roles of drugs like Filgrastim and Oprelvekin in managing side effects of chemotherapy. Test your knowledge on these vital medications!

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