3Final Exam Overview
● The final exam is cumulative, covering all material from the semester.
● Ensure you understand key concepts, medication mechanisms, and therapeutic
guidelines.
●
Cardiovascular Pharmacology (Weeks 2-3)
● Electrolytes with Digoxin: Monitor potassium, calcium, and magnesium.
● Statins: Avoid grapefruit juice with atorvastatin, lovastatin, and simvastatin.
● Hypertensive Crisis: Know medications used, such as nitroprusside.
● Diuretics: Distinguish between loop, thiazide, and potassium-sparing diuretics. Use loop
diuretics for fluid overload with symptoms like crackles and pitting edema.
● Renin Inhibitors: Aliskiren is the only one available.
● Antiarrhythmic Drugs: Review procainamide.
What to know from week 2-3
1. Know which electrolytes you've got to watch when patient on digoxin
2. Pt on Statins and they like to drink grapefruit juice, switch them to orange juice (all
except rosuvastatin & pravastatin)
3. Know about muscle injury with statins (not really seen with rosuvastatin)
4. Know what drugs use for HTN crisis
5. Kow the difference between loop & thiazide & potassium sparing
6. If you listen to a patient's lungs & hear crackles and they have pitting edema, they need
a loop diuretic
7. Aliskiren renin inhibitor used for HTN
8. Anytrhymtitic drugs, old one, procainmide, review this med
9. Know the dash diet
Gastrointestinal Pharmacology (Week 4)
● Constipation: Bulk-forming laxatives are safest for chronic use, especially in the elderly.
○ Methylcellulose is safest for elderly individuals chronic use
○ Safe in pregnancy, breastfeeding women (bulk forming)
● Stool Softeners: Docusate works slowly, taking about 3 days.
○ Less effective than bulk forming laxatives
● Mucosal Protectants: Sucralfate (Carafate) coats the lining of the esophagus and
stomach.
○ Decrease effects of gastric acid
● PPIs: Dose away from meals and know their interactions.
○ Know how to dose
○ EC give away with meals
○ Know thei interaction with drugs
, ● If you have hepatotoxic drugs, get baseline lfts
● Evaluate patient with abdominal pain before giving them meds
Musculoskeletal Pharmacology (Week 5)
● Pain Meds and Alcohol: Be aware of potentiation effects.
○ What kind of interaction do you see
● Acute Gout: Treat with NSAIDs or colchicine, not allopurinol during an acute attack.
○ Probenecid used for prophylaxis after acute attack
● Local anesthetics can cause heart block
Infectious Disease Pharmacology (Week 6)
● Gram-Positive Bacteria: Know the infections they cause.
○ Be aware of which infections it can cause
○ What antibiotics are used to treat gram + cocci infections → erythromycin,
penicillin, vancomycin, & cephalosporins
● UTIs in Pregnancy: Treat with amoxicillin; avoid sulfa drugs.
○ First trimester use amoxicillin, if resistant use nitrofurantin
○ Ampicillin, amoxicillin, cephalosporin, erythromycin, clindamycin, nitrofurantoin
○ Can not use Fluoroquinolones, tetracyclines, and sulfa drugs like bactirm
● 1st generation cephalosporin is the choice in preop
○ Cefazolin
● Acute otiis media
○ High dose amoxicillin or amoxicillin/clav
○ 4m baby with AOM, educate parents on oral syringe medication
● Upper Respiratory Infections in Children: Use rest, fluids, and nasal saline spray;
avoid systemic antibiotics unless there is a fever.
○ Systemic decongestant & nasal corticosteroids
● Beta-Lactam Antibiotics: Inhibit cell wall synthesis.
○ How do they work?
● How do tetracyclines work
○ Inhibit bacterial cellular protein activity
● Child in daycare the parent develops sinusitis
○ Amoxicillin/clav
● If ampicillin causes a rash, d/c drug could be allrgic
● Strep pharyngitis
○ Ampicillin, amoxicillin,amoxicillin/clav, azithromycin, not erythromycin because
it is not effective
● All stages of syphilis is treated with injected PCN, could use cephalosporin if they are
allergic or clindamycin
● Gonorrhea & chlamydia check @ 3-6 months to make sure they are clear
● Chancroid treatment in pregnant women → ceftriaxone 1 gram IM
○ Take oral azithromycin for 5 days or oral cipro for 10 days
● Suspected gonorrhea
, ○ 250 mg im ceftriaxone
● Linelozind side effects - whatever it causes it should be d/c and changed
● How is C diff treated → oral vanco, iv doesnt work.
○ What drug is the number one cause of it
● Fluoroquinolones: Be aware of black box warnings, especially tendon rupture.
○ Also how they are dosed-empty stomach
○ If given with warfarin or theophylline many drug interactions
■ Get daily INRs
● Swam in poor water, risk of infection, go right to Fluoroquinolones
● Adolescent with uti can use nitrofurantoin
● Uncomplicated UTI on a child, if you give abx and they are better within 48hrs then that
is an example of antimicrobial efficacy
Respiratory Pharmacology (Week 7)
● Asthma: Know the stages and treatment protocols, including short-acting beta agonists
(SABAs) and long-acting beta agonists (LABAs).
○ short-acting beta agonists (SABAs) —> PRN & steop 1
○ long-acting beta agonists (LABAs).
■ Salmeterol
○ Ipratropium & tiotropium
■ Antimuscarinic agents, mast cell stabilizers
● Seasonal perennial rhinitis→ know how to treat
● 2nd generation histamine blockers are usually non sedating
○ Fexofenadine, loratadine
● adult with URI for 3-5 days can use topical afrin spray
● Azlastyn intranasal & non sedan g antihistamine
● Fluticasone prop→effective in allergic & seasonal rhinitis
● COPD: Use selective beta-1 blockers if a beta-blocker is needed.
○ Do not use propranolol
● Nicotine Effects: Causes tachycardia, vasoconstriction, and reduced gastric acid
secretion.
Neurology Pharmacology (Week 9)
● Carbamazepine: Monitor complete blood counts.
● None of the anti seizure meds are safe in pregancy, benefits need to outweigh risk, use
Levetiracetam→ has chemical structure if you stop abruptly can cause
seizures
● Side effects of topimax
○ Raise temp, inhibit sweating
● Benzo antagonist→ flumazinil
● Migraine Therapy: Goals include relieving headaches, avoiding medication overuse,
and improving quality of life.
, ● Cluster Headaches: Treat with 100% oxygen for 15-30 minutes.
○ Cluster in several weeks or months, patient may go in months without headache
○ Verapamil, lithium, valproic acid
■ Prevention of cluster headaches
● Medication overuse- when the medication wears off quicker b/c using more
● Guanfacine-alpha 2 antagonist used for HTN & ADHD
● Anticholinergic drugs→ which ones are used in alzheimers
○ Memantine is not anticholinergic not cholinerstrase inhibitor
○ Aricpt donepizil, longer duration of activity
● Stress reduction biofeedback, regular sleep, prophylaxis of migraines
Mental Health Pharmacology (Week 10)
● 10 yr old child with MDD→ fluoxetine
● SSRIs: Know their side effects and that fluoxetine (Prozac) has a long half-life (7 days
can just stop no taper).
○ Need full 4-6 week of therapy before saying it doesnt work
○ Metabolized differently in men and women→ different doses
○ Sertraline short half life, need to taper down, if stopped quickly can have seizure
● Check thyroid before starting antidepressant
● Panic Attacks: Class of choice for treatment.
● Know which drugs are MAOI
● Know what aa drug holiday is
● Lithium Monitoring: Includes serum sodium, thyroid function, and renal function.
Dermatology Pharmacology (Week 11)
● Tinea Capitis: Treat with oral griseofulvin for 6-8 weeks.
● Head Lice: Treat all household contacts.
● Mild Acne: First-line treatment is benzoyl peroxide.
○ Add topical clinda if benzoyl peroxide
○ May worsen but improve over time
○ Se: irritation ,redness, drying peeling→ reduce $ of applications per day
● Ipledge why is important in istretoin
● Trotoin –. Used on wrinkles but not good on coarse wrinkles or sun damaged skin
● Diaper dermatitis: 1% hydrocortisone OTC
● Know calcipotrium why is it different than other agents?
● Colcabero 2% for atopic dermatitis, 2x a day, can cause burning and stinging at site,
● Impetigo- caused by staph aureus, treated with mupirocin
● Localized skin infection, narrow spectrum topical abx
Women's Health Pharmacology (Week 12)
● Oral Contraceptives: Know interactions that decrease efficacy and use backup
methods.
● The final exam is cumulative, covering all material from the semester.
● Ensure you understand key concepts, medication mechanisms, and therapeutic
guidelines.
●
Cardiovascular Pharmacology (Weeks 2-3)
● Electrolytes with Digoxin: Monitor potassium, calcium, and magnesium.
● Statins: Avoid grapefruit juice with atorvastatin, lovastatin, and simvastatin.
● Hypertensive Crisis: Know medications used, such as nitroprusside.
● Diuretics: Distinguish between loop, thiazide, and potassium-sparing diuretics. Use loop
diuretics for fluid overload with symptoms like crackles and pitting edema.
● Renin Inhibitors: Aliskiren is the only one available.
● Antiarrhythmic Drugs: Review procainamide.
What to know from week 2-3
1. Know which electrolytes you've got to watch when patient on digoxin
2. Pt on Statins and they like to drink grapefruit juice, switch them to orange juice (all
except rosuvastatin & pravastatin)
3. Know about muscle injury with statins (not really seen with rosuvastatin)
4. Know what drugs use for HTN crisis
5. Kow the difference between loop & thiazide & potassium sparing
6. If you listen to a patient's lungs & hear crackles and they have pitting edema, they need
a loop diuretic
7. Aliskiren renin inhibitor used for HTN
8. Anytrhymtitic drugs, old one, procainmide, review this med
9. Know the dash diet
Gastrointestinal Pharmacology (Week 4)
● Constipation: Bulk-forming laxatives are safest for chronic use, especially in the elderly.
○ Methylcellulose is safest for elderly individuals chronic use
○ Safe in pregnancy, breastfeeding women (bulk forming)
● Stool Softeners: Docusate works slowly, taking about 3 days.
○ Less effective than bulk forming laxatives
● Mucosal Protectants: Sucralfate (Carafate) coats the lining of the esophagus and
stomach.
○ Decrease effects of gastric acid
● PPIs: Dose away from meals and know their interactions.
○ Know how to dose
○ EC give away with meals
○ Know thei interaction with drugs
, ● If you have hepatotoxic drugs, get baseline lfts
● Evaluate patient with abdominal pain before giving them meds
Musculoskeletal Pharmacology (Week 5)
● Pain Meds and Alcohol: Be aware of potentiation effects.
○ What kind of interaction do you see
● Acute Gout: Treat with NSAIDs or colchicine, not allopurinol during an acute attack.
○ Probenecid used for prophylaxis after acute attack
● Local anesthetics can cause heart block
Infectious Disease Pharmacology (Week 6)
● Gram-Positive Bacteria: Know the infections they cause.
○ Be aware of which infections it can cause
○ What antibiotics are used to treat gram + cocci infections → erythromycin,
penicillin, vancomycin, & cephalosporins
● UTIs in Pregnancy: Treat with amoxicillin; avoid sulfa drugs.
○ First trimester use amoxicillin, if resistant use nitrofurantin
○ Ampicillin, amoxicillin, cephalosporin, erythromycin, clindamycin, nitrofurantoin
○ Can not use Fluoroquinolones, tetracyclines, and sulfa drugs like bactirm
● 1st generation cephalosporin is the choice in preop
○ Cefazolin
● Acute otiis media
○ High dose amoxicillin or amoxicillin/clav
○ 4m baby with AOM, educate parents on oral syringe medication
● Upper Respiratory Infections in Children: Use rest, fluids, and nasal saline spray;
avoid systemic antibiotics unless there is a fever.
○ Systemic decongestant & nasal corticosteroids
● Beta-Lactam Antibiotics: Inhibit cell wall synthesis.
○ How do they work?
● How do tetracyclines work
○ Inhibit bacterial cellular protein activity
● Child in daycare the parent develops sinusitis
○ Amoxicillin/clav
● If ampicillin causes a rash, d/c drug could be allrgic
● Strep pharyngitis
○ Ampicillin, amoxicillin,amoxicillin/clav, azithromycin, not erythromycin because
it is not effective
● All stages of syphilis is treated with injected PCN, could use cephalosporin if they are
allergic or clindamycin
● Gonorrhea & chlamydia check @ 3-6 months to make sure they are clear
● Chancroid treatment in pregnant women → ceftriaxone 1 gram IM
○ Take oral azithromycin for 5 days or oral cipro for 10 days
● Suspected gonorrhea
, ○ 250 mg im ceftriaxone
● Linelozind side effects - whatever it causes it should be d/c and changed
● How is C diff treated → oral vanco, iv doesnt work.
○ What drug is the number one cause of it
● Fluoroquinolones: Be aware of black box warnings, especially tendon rupture.
○ Also how they are dosed-empty stomach
○ If given with warfarin or theophylline many drug interactions
■ Get daily INRs
● Swam in poor water, risk of infection, go right to Fluoroquinolones
● Adolescent with uti can use nitrofurantoin
● Uncomplicated UTI on a child, if you give abx and they are better within 48hrs then that
is an example of antimicrobial efficacy
Respiratory Pharmacology (Week 7)
● Asthma: Know the stages and treatment protocols, including short-acting beta agonists
(SABAs) and long-acting beta agonists (LABAs).
○ short-acting beta agonists (SABAs) —> PRN & steop 1
○ long-acting beta agonists (LABAs).
■ Salmeterol
○ Ipratropium & tiotropium
■ Antimuscarinic agents, mast cell stabilizers
● Seasonal perennial rhinitis→ know how to treat
● 2nd generation histamine blockers are usually non sedating
○ Fexofenadine, loratadine
● adult with URI for 3-5 days can use topical afrin spray
● Azlastyn intranasal & non sedan g antihistamine
● Fluticasone prop→effective in allergic & seasonal rhinitis
● COPD: Use selective beta-1 blockers if a beta-blocker is needed.
○ Do not use propranolol
● Nicotine Effects: Causes tachycardia, vasoconstriction, and reduced gastric acid
secretion.
Neurology Pharmacology (Week 9)
● Carbamazepine: Monitor complete blood counts.
● None of the anti seizure meds are safe in pregancy, benefits need to outweigh risk, use
Levetiracetam→ has chemical structure if you stop abruptly can cause
seizures
● Side effects of topimax
○ Raise temp, inhibit sweating
● Benzo antagonist→ flumazinil
● Migraine Therapy: Goals include relieving headaches, avoiding medication overuse,
and improving quality of life.
, ● Cluster Headaches: Treat with 100% oxygen for 15-30 minutes.
○ Cluster in several weeks or months, patient may go in months without headache
○ Verapamil, lithium, valproic acid
■ Prevention of cluster headaches
● Medication overuse- when the medication wears off quicker b/c using more
● Guanfacine-alpha 2 antagonist used for HTN & ADHD
● Anticholinergic drugs→ which ones are used in alzheimers
○ Memantine is not anticholinergic not cholinerstrase inhibitor
○ Aricpt donepizil, longer duration of activity
● Stress reduction biofeedback, regular sleep, prophylaxis of migraines
Mental Health Pharmacology (Week 10)
● 10 yr old child with MDD→ fluoxetine
● SSRIs: Know their side effects and that fluoxetine (Prozac) has a long half-life (7 days
can just stop no taper).
○ Need full 4-6 week of therapy before saying it doesnt work
○ Metabolized differently in men and women→ different doses
○ Sertraline short half life, need to taper down, if stopped quickly can have seizure
● Check thyroid before starting antidepressant
● Panic Attacks: Class of choice for treatment.
● Know which drugs are MAOI
● Know what aa drug holiday is
● Lithium Monitoring: Includes serum sodium, thyroid function, and renal function.
Dermatology Pharmacology (Week 11)
● Tinea Capitis: Treat with oral griseofulvin for 6-8 weeks.
● Head Lice: Treat all household contacts.
● Mild Acne: First-line treatment is benzoyl peroxide.
○ Add topical clinda if benzoyl peroxide
○ May worsen but improve over time
○ Se: irritation ,redness, drying peeling→ reduce $ of applications per day
● Ipledge why is important in istretoin
● Trotoin –. Used on wrinkles but not good on coarse wrinkles or sun damaged skin
● Diaper dermatitis: 1% hydrocortisone OTC
● Know calcipotrium why is it different than other agents?
● Colcabero 2% for atopic dermatitis, 2x a day, can cause burning and stinging at site,
● Impetigo- caused by staph aureus, treated with mupirocin
● Localized skin infection, narrow spectrum topical abx
Women's Health Pharmacology (Week 12)
● Oral Contraceptives: Know interactions that decrease efficacy and use backup
methods.
