D116 OA Summary Review Pharmacology and Treatment Strategies for
Common Diseases and Conditions
1. What crosses BBB?: lipid soluble (nicotine, alc, heroin), anesthetics, sedatives, antidepressants, antipsy- chotics, catteine,
acetaminophen, NSAIDs
2. What is the generic name for Glucophage?: Metformin
3. What class of medication is Metformin?: Biguanide
4. What is the primary use of Metformin?: First-line treatment for Type 2 Diabetes (T2D) Also for
Gestational Diabetes and PCOS (ott-label)
Ettective glycemic control
5. What is one mechanism of action of Metformin?: 1-Decreases amt of glucose the liver produces
2-Blocks glucose absorption from food 3-
Increases insulin sensitivity
Does NOT stimulate insulin release= less risk of hypoglycemia Not
metabolized; excreted unchanged via kidneys
6. What is a potential risk of Metformin in patients with renal impairment?: Toxic
accumulation
Black Box Warning: Lactic Acidosis
Teach SX - Hyperventilation, myalgia, malaise, drowsiness
7. What are common side effects of Metformin?: GI issues: Nausea, diarrhea, decreased appetite
Take with Meals
,8. What is a major contraindication for Metformin?: Renal impairment Cimetidine: Can
increase the risk for lactic acidosis; another H2 blocker should be used if indicated
9. Is Metformin safe during pregnancy?: Yes, it is safe in pregnancy also
prescribed for
Polycystic Ovary Syndrome (PCOS) by increasing insulin sensitivity, decreasing insulin and androgen levels, and improving ovulation and
pregnancy rates
10. What is the interaction between alcohol and Metformin?: Increases risk of lactic
acidosis
11. What should be done with Metformin before iodinated contrast use?: Stop
Metformin 1-2 days before; restart 48 hrs after
12. What is the dosing for immediate-release Metformin?: Once/twice daily, up to
2.55g/day
13. What drugs are not given in Kidney Failure?: Thiazide Diuretics - HCTZ(for essential htn)
Metformin
ACE-I
14. What are characteristics of Acetylcysteine?: Mucamist- Rotten Egg Smell
Mucolytic agent breaks up thick mucous with chronic lung issues (COPD, Pna, Cystic Fibrosis, Chronic Bronchitis) also for Tylenol
overdose
15. Gonorrhea treatment and prevention: Ceftriaxone IM
150 kg - 1 dose 500mg Over
150kg -1 gm
Add 1g Azithromycin unless Chlamydia ruled out as these 2 go hand in hand.
, Sexual partners from last 60 days tested and treated Expedited Partner
therapy - provider treats without test
Abstinence x7 days or more (until all partners treated and symptoms resolve) Pharyngeal
Gonorrhea test to confirm cure 7-14 days post treat.
Prevention : abstinence only 100% condoms, monogamy, high risk (gay men, trans women) may give doxycycline after sex to prevent
gonorrhea Chlamydia and syphilis - provider to determine risk.
And regular testing
16. Best Source of Calcium: dairy low fat yogurt best, part skim ricotta, and fortified milk
17. Beta 2 antagonists actions vs Lungs: Propanolol -nonselective 1st gen. B2 blocKer
constriction in lungs
Not given with asthma
Instead give Metorolol- cardio selective (2nd gen)B2 (without lung constriction)
18. SSRI 1st Line Medications: Selective Serotonin Reuptake Inhibitors
• Fluoxetine, Paroxetine, Sertraline, Citalopram (influences the activity in the receptors and it target cells). 1st line for panic
attacks also
• Sexual dysfunction likely (70%)
• Avoid MAOIs- they increase risk for serotonin syndrome- must stop 2 weeks before starting SSRI
DoNOTcause sedation Monitor
Sodium levels
19. Chron's Disease treatment: Antibiotics
Anti-inflammatory medications
Common Diseases and Conditions
1. What crosses BBB?: lipid soluble (nicotine, alc, heroin), anesthetics, sedatives, antidepressants, antipsy- chotics, catteine,
acetaminophen, NSAIDs
2. What is the generic name for Glucophage?: Metformin
3. What class of medication is Metformin?: Biguanide
4. What is the primary use of Metformin?: First-line treatment for Type 2 Diabetes (T2D) Also for
Gestational Diabetes and PCOS (ott-label)
Ettective glycemic control
5. What is one mechanism of action of Metformin?: 1-Decreases amt of glucose the liver produces
2-Blocks glucose absorption from food 3-
Increases insulin sensitivity
Does NOT stimulate insulin release= less risk of hypoglycemia Not
metabolized; excreted unchanged via kidneys
6. What is a potential risk of Metformin in patients with renal impairment?: Toxic
accumulation
Black Box Warning: Lactic Acidosis
Teach SX - Hyperventilation, myalgia, malaise, drowsiness
7. What are common side effects of Metformin?: GI issues: Nausea, diarrhea, decreased appetite
Take with Meals
,8. What is a major contraindication for Metformin?: Renal impairment Cimetidine: Can
increase the risk for lactic acidosis; another H2 blocker should be used if indicated
9. Is Metformin safe during pregnancy?: Yes, it is safe in pregnancy also
prescribed for
Polycystic Ovary Syndrome (PCOS) by increasing insulin sensitivity, decreasing insulin and androgen levels, and improving ovulation and
pregnancy rates
10. What is the interaction between alcohol and Metformin?: Increases risk of lactic
acidosis
11. What should be done with Metformin before iodinated contrast use?: Stop
Metformin 1-2 days before; restart 48 hrs after
12. What is the dosing for immediate-release Metformin?: Once/twice daily, up to
2.55g/day
13. What drugs are not given in Kidney Failure?: Thiazide Diuretics - HCTZ(for essential htn)
Metformin
ACE-I
14. What are characteristics of Acetylcysteine?: Mucamist- Rotten Egg Smell
Mucolytic agent breaks up thick mucous with chronic lung issues (COPD, Pna, Cystic Fibrosis, Chronic Bronchitis) also for Tylenol
overdose
15. Gonorrhea treatment and prevention: Ceftriaxone IM
150 kg - 1 dose 500mg Over
150kg -1 gm
Add 1g Azithromycin unless Chlamydia ruled out as these 2 go hand in hand.
, Sexual partners from last 60 days tested and treated Expedited Partner
therapy - provider treats without test
Abstinence x7 days or more (until all partners treated and symptoms resolve) Pharyngeal
Gonorrhea test to confirm cure 7-14 days post treat.
Prevention : abstinence only 100% condoms, monogamy, high risk (gay men, trans women) may give doxycycline after sex to prevent
gonorrhea Chlamydia and syphilis - provider to determine risk.
And regular testing
16. Best Source of Calcium: dairy low fat yogurt best, part skim ricotta, and fortified milk
17. Beta 2 antagonists actions vs Lungs: Propanolol -nonselective 1st gen. B2 blocKer
constriction in lungs
Not given with asthma
Instead give Metorolol- cardio selective (2nd gen)B2 (without lung constriction)
18. SSRI 1st Line Medications: Selective Serotonin Reuptake Inhibitors
• Fluoxetine, Paroxetine, Sertraline, Citalopram (influences the activity in the receptors and it target cells). 1st line for panic
attacks also
• Sexual dysfunction likely (70%)
• Avoid MAOIs- they increase risk for serotonin syndrome- must stop 2 weeks before starting SSRI
DoNOTcause sedation Monitor
Sodium levels
19. Chron's Disease treatment: Antibiotics
Anti-inflammatory medications
