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PC707 Final Exam Ultimate Study Guide
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Latest 202 5 /2026 Version
lass of medication can cause tooth discoloration, deposits on bones, and bone growth restriction?
- ✔✔Tetracycline antibiotics What are the risks to a postpartum mother and newborn if the mother is an ultra-rapid metabolizer taking codeine? - ✔✔opioid toxicity *in ultrarapid metabolizers, there may be an increase in morphine from codeine, resulting in opioid toxicity. Combined oral contraceptives increase blood levels of , , , and. - ✔✔theophylline valium TCA's Lithium Grapefruit juice is a CYP450 , and leads to pharmacologic effect of drugs.
- ✔✔inhibitor increased What electrolyte do you need to monitor while a patient is taking Drospirenone (COC)? - ✔✔Potassium It also interacts with other K+ sparing drugs, causing hyperkalemia (ACEi, ARBs, K+ sparin diuretics, NSAIDs) Iron supplementation is contraindicated in whom? - ✔✔children <6 years overdose is fatal
What are the risks to a pregnant woman who takes an NSAID? (2 listed) - ✔✔Hypertension bleeding at delivery What are the risks to a fetus if the mother takes an NSAID? (2 listed) - ✔✔premature closure of DA may cause GI bleeds Probiotic use is contraindicated in whom? - ✔✔immunocompromised individuals What fatal rhythm is the risk when taking a medication that causes a QT prolongation? - ✔✔torsades T/F: A 30 - year old woman with hyperlipidemia can safely continue to take her statin when pregnant. - ✔✔False *Statins are teratogenic in pregnancy Excessive intake of what vitamin is teratogenic in pregnancy? - ✔✔Vitamin A/Retinoic Acid What is the black box warning for fluoroquinolones? - ✔✔tendon rupture fluoroquinolones should not be prescribed for patients with peripheral atherosclerotic vascular disease, HTN, Marfan's syndrome and the elderly d/t the increased risk of what? - ✔✔aortic aneurysm Clarithromycin (Biaxin) should not be taken with what two HMG-CoA reductase inhibitors (statins)? - ✔✔lovastatin simvastatin Live vaccines are contraindicated in , children < years old, and individuals. - ✔✔pregnancy children <12 years old immunocompromised
increased risk of hyperkalemia and sudden cardiac death (especially in elderly or pt's with kidney disease) Trimethoprim-sulfamethoxazole (TMP-SMX) use is associated with what electrolyte deficiency when used alone? - ✔✔Hypokalemia What class of antibiotics is associated with bilateral hearing loss that is reversible in 24 hours- 2 weeks? - ✔✔Sulfonamides Bismuth Subsalicylate (Pepto-Bismol) contains and is contraindicated in , , and. - ✔✔aspirin pregnancy, lactation, children <12 years *can cause Reye's Syndrome Cimetidine (Tagamet) can cause what two issues for men? - ✔✔gynecomastia impotence What is the black box warning for Metoclopramide (Reglan)? - ✔✔tardive dyskinesia with chronic use *do not use >12 weeks if possible Use of PPI's can cause deficiencies in what 3 vitamins? - ✔✔B calcium magnesium Chronic use of can increase the risk of fractures and cause hyperplasia of the stomach lining (pre-condition of gastric carcinoid). - ✔✔PPI's What is the black box warning for Promethazine (antiemetic)? - ✔✔fatal respiratory depression in children
Promethazine is contraindicated in whom? (2) - ✔✔children <2 years people with Parkinson's disease Angioedema can occur with what two classes of anti-hypertensives? - ✔✔ACEi ARBs What two beta blockers should not be used with lactation? - ✔✔atenolol acebutolol Calcium channel blockers are contraindicated in someone with what heart problem? - ✔✔2nd/3rd degree heart block bradycardia What class of drugs do you have to worry about rhabdomyolysis with? - ✔✔statins Thiazide diuretics are contraindicated in someone with an allergy to what class of antibiotic? - ✔✔sulfa *thiazide diuretics contain sulfa Name 3 side effects of thiazide diuretics. (5 listed) - ✔✔hyperglycemia hyperuricemia triglyceridemia hyponatremia hypokalemia
- tell pt's to report any aggression or anxiety, depression, hostility, or SI Singlair is approved for asthma patients months and older. For other uses, it is approved for patients ________ months and older. - ✔✔ 12 6 What is the most sedating 2nd generation antihistamine and, therefore, use should be avoided in pilots or those who operate heavy machinery? - ✔✔Cetirizine (Zyrtec) What is the black box warning for Carbamazepine and Lamictal? - ✔✔Steven Johnson Syndrome Lithium is pregnancy/breastfeeding category ---------- ✔✔D should be discontinued until postpartum What is the BBW for phenytoin? - ✔✔rapid IV administration can cause cardiac events Prozac is approved for children and older. - ✔✔ 8 What is the BBW for Prozac (an SSRI)? - ✔✔increased SI in adolescents and children started on SSRI's is the only SSRI approved for children 8 years and older; all others are approved for children years and older. - ✔✔Prozac 12 What class of anti-depressant is lethal in overdose? - ✔✔TCA's What class of antidepressant can increase TCA levels? - ✔✔SSRI's What is the BBW for Metformin? - ✔✔lactic acidosis
Metformin has a D2D interaction with what medication? - ✔✔Tagamet Metformin should be discontinued for how long after any contrast radiologic procedure? - ✔✔ 48 hours What vitamin level should be monitored while pt is on Metformin? - ✔✔B What is the BBW for Thiazolidinediones (aka Glitazones)? - ✔✔heart failure (may cause or exacerbate) Why are first-generation sulfonylureas contraindicated during pregnancy? - ✔✔may cause fetal hyperinsulinemia What are 3 GI impacts from a gastric bypass surgery? - ✔✔calcium absorption decreased B12 supplementation needed lifelong oral meds are not well absorbed What is the BBW for testosterone? (3 listed) - ✔✔secondary exposure to transdermal formulation may cause virilization in children pulmonary oil microembolism blood pressure increases What lab value should be monitored while pt is on testosterone therapy? - ✔✔PSA What is the BBW for Liraglutide (Saxenda, Victoza)? - ✔✔risk of medullary thyroid tumor Phentermine is a schedule drug. - ✔✔IV
(do not use in children/elderly) Metronidazole can cause what type of reaction with concurrent ETOH use? - ✔✔Disulfiram reaction *do not ingest alcohol for 48 - 72 hours of azole ingestion. What is the BBW for fluconazole? (3 listed) - ✔✔Miscarriage NS effects hepatotoxic Antihistamines are contraindicated in pt's with what eye disorder? - ✔✔glaucoma Type 1 allergic reaction is mediated. - ✔✔IgE What type of allergy occurs after re-exposure to a substance and includes symptoms such as angioedema and anaphylaxis? - ✔✔Type 1: IgE mediated *immediate hypersensitivity A type 4 allergic reaction is mediated. - ✔✔cell mediated *delayed hypersensitivity When does a Type 4 reaction typically occur? - ✔✔it is delayed, usually doesn't start until 48 - 72 hours after exposure A type 4, cell-mediated allergic reaction, is mediated by what cells? - ✔✔T cells A type II hypersensitivity reaction is and mediated and produces a reaction. - ✔✔IgG and IgM cytotoxic
A type III hypersensitivity reaction is and mediated and produces an reaction. - ✔✔IgG and IgM Immune complex What is the "all or nothing" period? - ✔✔preimplantation period (fertilization and transport to the uterus has occurred) - the teratogen will either cause a MC or resorption of the conceptus, or the conceptus will survive without damage When is the most critical period of high sensitivity and susceptibility to major congenital anomalies, MC, or when more mild but permanent defects can occur? - ✔✔organogenesis (when organs are forming; begins 5th week of gestation to the end of the 10th week) drugs that occupy receptors and activate them are called what? - ✔✔agonists drugs that occupy receptors but do not activate them are called what? - ✔✔antagonists What kind of metabolizer is considered 'normal'? - ✔✔Extensive metabolizer Would a 'poor metabolizer' need a decreased or increased medication dosage? - ✔✔decreased if someone is a poor metabolizer, this means that the active drug spends more or less area under the curve? - ✔✔more area under the curve *leads to more potential for side effects/build-up Would an 'ultra-rapid metabolizer' need a decreased or increased medication dosage? - ✔✔increased dose
Citalopram (SSRI) TCAs Name 1 anti-emetic that can prolong the QT interval. - ✔✔Ondansetron Name 1 antifungal that can prolong the QT interval. - ✔✔fluconazole Name 3 unclassified meds that can prolong the QT interval. (6 listed) - ✔✔Chloroquine Chlorpromazine Cilostazol Hydroxychloroquine Donepezil Methadone Sirturo What are 3 risk factors for the development of prolonged QT interval? (4 listed) - ✔✔female gender age >= 68 years K+ <3. pt on >= 2 QT prolonging drugs
What antibiotic class can cause ototoxicity? - ✔✔Aminoglycosides (Gentamicin)
- usually irreversible toxicity Macrolides Examples: erythromycin, clarithromycin, biaxin, zithromax What 2 classes of antibiotics can cause renal failure or nephrotoxicity? - ✔✔Aminoglycosides (Gentamicin) Sulfonomides What antibiotics/antibiotic classes are considered SAFE during pregnancy? (6 listed) - ✔✔PCN Cephalosporins Gentamycin Vancomycin Sulfonamides in 2nd trimester (not in 1st or 3rd) Nitrofurantoin what medication used for TB interferes with absorption of oral contraceptives, therefore putting pt at risk for an unplanned pregnancy? - ✔✔Rifampin (Rifadin) What class of antibiotic may decrease the effectiveness of oral contraceptives? - ✔✔tetracyclines
hepatotoxicity What is the boxed warning for warfarin (Coumadin)? - ✔✔major/fatal bleeding What is the boxed warning for Spironolactone? - ✔✔tumorigenic in rats with chronic use What is the boxed warning for Heparin? - ✔✔risk of spinal or epidural hematoma if on and undergoing spinal puncture or spinal/epidural anesthesia What is the BBW for Clopidogrel (Plavix)? - ✔✔· Do not use in poor metabolizers, as those with variant CYP2C19 gene cannot reliably convert this drug to its active form, which can lead to cardiovascular events What generation of NSAIDs are associated with increased risk for GI bleed and cardiovascular events? - ✔✔first generation What is the BBW for opioids (fentanyl, hydromorphone, codeine, tramadol, etc)? - ✔✔life-threatening respiratory depression risk for addiction as well What is the BBW for Ergotamine? - ✔✔life-threatening peripheral ischemia with coadministrationof caffeine and macrolide abx What is the BBW for Botulinum Toxin? - ✔✔may spread from area of injection to produce symptoms c/w botulinum toxin effects. What are 2 BBW's for NSAIDs? - ✔✔cardiovascular thrombotic events GI bleeding, ulceration, and perforation Tramadol can increase a pt's risk for what? - ✔✔seizures
What is the BBW for Long-Acting Beta- 2 Agonists (LABAs)? - ✔✔LABA's as monotherapy (without ICS's) increase the risk of asthma-related death. LABA's: Salmeterol What is the BBW for Bupropion SR (Zyban)? - ✔✔increased risk of suicidal thoughts and behavior in children, adolescents, and young adults what is the boxed warning for Omalizumab (Xolair)? a monoclonal antibody used for maintenance therapy for asthma - ✔✔Anaphylaxis § Observe pt's 2 hours after first 3 injections and 30 minutes after subsequent injections § Symptoms can occur 24 hours or more after administration What foods should pt's avoid while taking a MAOI? - ✔✔foods with tyramine (aged cheese, cured meats, smoked/processed foods, pickled meats, tofu, sour cream, yogurt, wine, soybeans) If you want to switch a patient from a MAOI to another antidepressant, what needs to be done? - ✔✔A 2 - week wash out period What are 3 side/adverse effects of Tetracyclines? - ✔✔anticholinergic effects cardiac dysrhythmias sedation weight gain orthostatic hypotension
hepatotoxicity pneumonitis GI toxicity secondary malignancy dermatological toxicity infections embryo-fetal toxicity What is the BBW for Contrave (naltrexone/bupropion)? - ✔✔increased risk of suicidal thoughts and behavior in children, adolescents, and young adults What is the boxed warning for tumor necrosis factor (TNF) inhibitors? (rheumatologic medication) - ✔✔serious infections malignancies What is the boxed warning for hormone replacement therapy? (4 listed) - ✔✔endometrial cancer cardiovascular disease breast cancer dementia What is the boxed warning for Levothyroxine? - ✔✔do not use for treatment of obesity or weight loss
What is the boxed warning for inhaled insulin? - ✔✔acute bronchospasms in pt's with asthma and COPD What is the boxed warning for Thiazolidinediones ("Glitazones")? - ✔✔CHF (can cause/exacerbate) What is the boxed warning for GLP1 Agonists (Byetta)? - ✔✔risk of thyroid c-cell tumors What is the boxed warning for Leflunomide (rheumatologic medication)? (2 listed) - ✔✔embryofetal toxicity hepatotoxicity What are 3 risks of using topical corticosteroids long-term? (7 listed) - ✔✔skin atrophy ecchymosis striae telangiectasia acne hypertrichosis cataract formation or glaucoma with prolonged use around eyes What acne medications are considered teratogenic or are contraindicated in pregnancy? - ✔✔Tretinoins (Isotretinoin, Retin-A, Tazarotene, adapalene) Retinoids
