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Dec 6, 2023

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Davis McClendon Oct. 22, 2023 Adv. Pharmacology 8.1 Study Guide 1. Differentiate between low-dose and high-dose colchicine. a. Low: 1.2mg initially and 0.6mg one hour later – for acute gout attacks b. High: 0.6mg to 1.2mg q1-2hrs until symptoms are relieved. High dosing is reserved for refractory cases because of the high toxicity potential that may cause renal and hepatic dysfunction with GI side effects. DIC has also been reported. 2. What lab values should be monitored with gout? a. CBC, renal panel, hepatic, uric acid (serum), 3. What patient education should you provide when prescribing colchicine? a. Take it with food but avoid grapefruit juice (toxicity). Adverse side effects include fatigue, fever, and muscle weakness. Provider should be notified if the patient develops numbness/tingling in hands/feet. 4. What are the adverse effects of corticosteroids if administered for six months or more? a. Iatrogenic cushing’s disease (cushingoid) b. Weight gain, fluid retention, HTN, osteoporosis, psychosis, mood swings, thinning of skin layers. 5. Why is it important to taper the corticosteroid? a. Abrupt cessation instead of tapering could cause an Addisonion crisis. 6. What are the black box warnings on NSAIDs? a. Increased platelet aggregation and vasoconstriction (may lead to heart
Davis McClendon Oct. 22, 2023 Adv. Pharmacology attack or stroke). b. NSAIDs may also cause AKI/renal failure d/t decreased renal flow. c. Chronic NSAID use puts patients at high risk for gastric ulcers because of decreased gastric prostaglandins. 7. What are the recommendations for the treatment of pain? a. Assess for risk and compliance issues. b. Develop a plan with outcomes, functional goals, and adjunct therapy c. High-risk patients should be met with a contract between patient and provider. d. Patients should only get their pain medications from a single provider and only fill at one preferred pharmacy. 8. What is the mechanism of action of ibuprofen? a. Non-selectively inhibits cyclooxygenase (COX) to block prostaglandin synthesis. 9. What are the serious side effects associated with acetaminophen? a. Liver damage or liver failure due to hepatotoxicity b. Nephrotoxicity (increases BUN and creatinine) c. Blood disorders (anemia, leukopenia, neutropenia, or pancytopenia)
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