Term
| What does colchicine treat and how is it taken initially? |
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Definition
| It treats acute gout - Initial dose is 1-2 tabs every 1-2 hours until symptoms subside (no > 4-8 grams). |
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Term
| Within about how many hours should an acute gout attack be resolved after initiation of colchicine therapy? |
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Definition
| 24 hours - any more & the practitioner needs to worry about toxicity. |
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Term
| What side effect of colchicine can leave pts volume depleted? |
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Definition
|
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Term
| Is Colchicine tx appropriate for frail 80 y.o. patients? |
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Definition
| No - after volume depletion, their risk for a syncopal event increases. |
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Term
| How effective is allopurinol tx for acute gout attacks? |
|
Definition
| It's not. Allopurinol can exacerbate symptoms if given during an acute gout attack. |
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Term
| How many acute gout attacks per year would indicate to the practitioner that daily allopurinol tx is appropriate? |
|
Definition
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Term
| Is Indocin (indomethacin) for acute gout attacks, or for maintenance therapy? |
|
Definition
| It's indicated for acute gout attack. |
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Term
| Can steroid burst therapy be used in an acute gout attack? |
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Definition
|
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Term
| What antibiotic class can have cross-reactive allergies with Sulfinpyrazone (for gout)? |
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Definition
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Term
| What is the mechanism of action of probenecid? |
|
Definition
| Probenecid inhibits renal tubular urate resorption (note: it also inhibits tubular PCN secretion and can be an adjunct to penicillin treatment). |
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Term
| What is the most potent antiinflammatory available? |
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Definition
|
|
Term
| What is the primary glucocorticoid? |
|
Definition
|
|
Term
| What is the primary mineralcorticoid? |
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Definition
|
|
Term
| What electrolyte abnormality should the practitioner be wary of when using exogenous aldosterol? |
|
Definition
| Na+ retention and K+ wasting. |
|
|
Term
| What is the biggest short term problem of systemic corticosteroid use? |
|
Definition
| hypopituitary suppression. |
|
|
Term
| After how many days of systemic steroid therapy do patients need to be weaned off? |
|
Definition
|
|
Term
| What are some of the long-term adverse effects of systemic corticosteroid use? |
|
Definition
| muscle wasting, thinning of skin, osteoporosis, hyperglycemia. |
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|
Term
| NSAIDs reversibly bind to what component of the inflammatory system? |
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Definition
|
|
Term
| How does NSAID use effect aspirin efficacy? |
|
Definition
| It decreases ASA efficacy. |
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|
Term
| All NSAIDs promote retention of what electrolyte? |
|
Definition
|
|
Term
| The retention of Na+ by NSAID use should be kept in mind when treating what type of patients? |
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Definition
| Hypertensive, heart failure or renal failure patients - give high risk pts tylenol. |
|
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Term
| What is a common symptom of aspirin toxicity? |
|
Definition
| Tinnitus (also renal damage). |
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Term
| When charting about opiate therapy, always include what? (Hint: the 4 A's) |
|
Definition
| Analgesia, activity, adverse effects, aberrant behavior. |
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Term
| What lifestyle factor should always be addressed when prescribing patients muscle relaxants? |
|
Definition
| Alcohol use/substance abuse |
|
|
Term
| When initiating flexeril for an acute injury/spasm issue, how should it be scheduled for the first 3 days? |
|
Definition
|
|
Term
| What's the problem with using NSAIDs chronically for headaches? |
|
Definition
| Increased risk for developing rebound headaches. |
|
|
Term
| How does initiating triptans (serotonin receptor agonists) affect the respiratory tract? |
|
Definition
| Triptans can cause a tightness in the htraot - the first dose does not need to be monitored in healthy patients, though. |
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Term
| What kind of medical problems would be contraindicated for triptan therapy? |
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Definition
| Cardiac problems - ask about CAD hx before giving something that can vasoconstrict them. |
|
|
Term
| What drug class is used to treat Paget's disease (osteitis deformans)? |
|
Definition
| bisphosphonates (biophosphonates) or calcitonin. |
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|
Term
| What can Fosamax (alendronate) cause necessitating special instruction on administration? |
|
Definition
|
|
Term
| How should alendronate (Fosamax) be taken? |
|
Definition
| Fosamax should be taken first thing in the morning with a full glass of water (plain, not mineral), and remain sitting upright for 30 minutes afterwards (& no food or drink for those 30 minutes). |
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