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1. First-Pass Effect 1. CYP450 metabolizes the
drug in the liver to re-
1. What cytochrome metabolizes a medication drug lease the drug to the body
during the FIRST-PASS Effect? where it can be used.
2. CYP450 enzyme is the most . 2. Active
3. It can either be induced or inhibited (T/F) 3. True
2. Pharmacokinetics 1. Increase in fat-to-wa-
ter ratio, decrease in liver
1. What are age-related changes? function, decrease in GFR
(Distribution, Metabolism, Excretion)?
3. Pharmacology: Cardiac Glycosides 1. Second and Third
2. N/V, Hyperkalemia,
1. What order of line of treatment is Digoxin? Confusion, visual color
2. Signs of Digoxin Overdose changes
3. Laboratory tests 3. Digoxin level, CMP,
4. Treatment EKG
4. Digoxin-specific anti-
bodies
4. Pharmacology: Warfarin (Coumadin) 1. X
2. 2.0-3.0, 2.5-3.5
1. Category for pregnancy. 3. Cardiologist or antico-
2. Target INR for patients without mitral prosthetic agulation clinic
valves? With prosthetic valves? 4. Check every 2-4 weeks
3. Referral to for initiation and stabilization of up to 12 weeks.
warfarin dose. less than 5
4. How often do you check for consistently stable INR? with no
5. How often do you check for single out-of-range significant
bleeding risk?
INR?
6. What do you educate the patient to do if the INR
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5. Continue warfarin dose, retest INR in 1-2 weeks.
6. Omit one dose, recheck INR.
7. Take the dose as soon
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7. If one dose is missed, what do you do? as possible. Do not double
8. What kind of foods to avoid messing up the INR? dose.
8. Vitamin K foods
5. Pharmacology: Direct Oran Anticoagulants (DOAC) 1. Less monitoring and
less side ettects
1. Why are DOACs better than Warfarin? 2. Apixaban (Eliquis)
2. Example of DOACs? 3. 10 days
3. How long does it take for platelet function to return
to normal after a patient stops taking Plavix?
6. Pharmacology: Thiazide Diuretics 1. HCTZ, Chlorthalidone
2. Sulfa allergy
1. Examples 3. Hykpokalemia, increas-
2. Contraindication es uric acid and increases
3. Adverse effects LDL
4. Patients with osteoporosis receive an extra benefit 4. Calcium, True
from thiazide diuretics by reducing excre-
tion (T/F)
7. Pharmacology: Potassium-Sparing Diuretics 1. Triamterene, Amiloride
2. Hyperkalemia
1. Examples 3. Elevates K+ levels
2. Contraindication 4. ACEIs and ARBs
3. Adverse effects
4. Do not combine with which cardiac drugs to prevent
hyperkalemia?
8. Pharmacology: Loop Diuretics 1. Furosemide
2. Sulfa Allergy
1. Examples 3. Hypokalemia, Hy-
2. Contraindication/Allergy ponatremia, hypomagne-
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3. Adverse effects semia
4. Which toxicity with loop diuretics can occur? 4. Ototoxicity
9. Pharmacology: ACEIs and ARBs 1. Lisinopril, Losartan
2. Pregnancy
1. Examples 3. Dry cough, Hyper-
2. Black Box Warning/Contraindications kalemia, Angioedema
3. Adverse Effects 4. Heart Failure w/
4. ACEIs are first-line therapy for left ventricular dysfinction
5. ACEIs and ARBs protect the kidneys. But if severe (HFrEF)
CKD, should you continue ACEIs and ARBs? Why? 5. No, because severe CKD
and ACEIs and ARBs will
lead to increased risk of
hyperkalemia.
10. Pharmacology: CCBs 1. Dihydropyridines: Am-
lodipine, Nifedipine
1. Two types and Examples of both types Nondihydropyridines: Ve-
2. Cardiac contraindications for Nondihydropyridines rapamil, Diltiazem
3. Why does pedal edema occur with dihydropy- 2. Heart block and Heart
ridines? Failure
3. Vasodilation
11. Pharmacology: BBs 1. Asthma, COPD
2. Bronchospasm
1. Contraindications
2. Adverse Effets
12. Pharmacology: Tetracyclines 1. Doxycycline
2. Permanent Discol-
1. Examples: oration
2. Avoid use during pregnancy and breastfeeding due 3. Photosensitivity