Cpje Clinical Study Guide-with 100% verified solutions 2024-2025-tutor verified.docx, Exams of Nursing

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Cpje Clinical Study Guide-with 100% verified solutions

2024-2025-tutor verified

Rotigotine Neupro patch: do not heat/ use during MRI HLA b Test in Asians. Rash for carbamazepine (tegretol), phenytoin (Dilantin), fos phenytoin (cerebyx) Trastuzumab Herceptin, her/Neu- ado-trastuzunab (kadcyla), lapatinib (tykerb) pertuzumab (perjeta) Hla- b 5701 Don't give abacavir (ziagen), epzicom, trizivir Not cross reactive a/ opioid allergy Fentanyl, meperidine (Demerol), methadone (dolophine), tramadol (ultram), tapentadol (nucynta) Inducers Ps porcs (phenytoin, smoking, phenobarbital, oxcarbazepine, rifampin, carbamazepine, St. John's wort) Inhibitors Gpacman (grapefruit, pi's, azoles, cimetidine/cyclosporine, macrolides- erytho/clarithro, amiodarone, non dihydro (dilt, verapamil)

If on amiodarone, decrease these drugs by 30-50% Digoxin, warfarin, quinidine, procainanide, statins Statins with high risk of inhibition Las (lova, atorva, simva) Entecavir Baraclude. Empty stomach for hep B that fail lamivudime and adefovir- se: peripheral edema, nephrotoxic Ribavirin Copegus. W/ food bid for hep c, hepatotoxic, hemolytic anemia, preg x, psych disorders, ci: renal disfxn Glipizide Glucotrol 30 min before break & dinner Glimeprimide Amaryl 1-2 mg qd w/ 1st meal Glyburide Diabeta, + metformin = glucovance, do not use w/ renal failure 2.5-5mg qd Rosiglitazone Avandia 4-8mg qd (tzd, exacerbate hf, liver damage, increases hdl, decreases tg/total cholesterol) similar: pioglitazone (actos) Repaglinide

Prandin 0.5-2mg TID 15-30 min before a meal, hypoglycemia- do not take with su's Nateglinide Starlix injection- 15-30 min before meals Acarbose Precose- w/ 1st bite of meal and water Miglitol Glyset w/ 1st bite of meal and water Linagliptan Tradjenta- 5 mg qd in morning with or without food, no renal adjustment Saxagliptin OnglyZa 2.5-5mg qd Canaglifozin Invokana 100mg qd before first meal of day for DM. Se: female genital mycotic infxn, increased urination, hyperkalemia, can increase dig levels, ci: renal dx Exenatide Byetta 30-60 min before am & pm meals,medguide, pancreatitis, thyroid c-cell carcinoma xr= bydureon Liraglutide Victoza QD thyroid c-cell carcinoma, more weight loss, less pancreatitis

Pramlintide Symlin - injection, skip if no meals, weight loss Insulin aspart Novolog rapid Insulin glulisine Apidra rapid Insulin lispro Humalog rapid Detemir Levemir long acting Insulin glargine Lantus long acting Ibandronate Boniva 150 monthly

Zolendrenic acid Reclast iv - pretreat w/nsaids Teriparatide Forteo SC daily: osteosarcoma, kidney stones, orthostatic hypotension, hypocalcemia- must take ca starting 2 weeks before time- fridge after each dose, sit while giving Lotensin Benazepril Indapamide Lozol 1.25-5mg- thiazide diuretic Aerobid Budesonide inhaler Invirase Saquinavir tabs (fortivase=soft gels)- BID with food & norvir, pi= lipodystrophy, hepatotox Budesonide Plumicort inhaler/ rhinocort

Triamcinolone Azmacort inhaler, nasacort nasal Selegiline Eldepryl 5-10mg qd,Mao-I for Parkinson's, requires medguide or ensam patch for depression Dalteparin Fragmin (lmwh) ci: pork allergy, no antidote, affects anti-xa Metolazone Zaroloxyn, diuretic, allows for use of other thiazides in renal impairment Captopril Capoten (acei) 25 bid-TID 1 hour before meals- taste disturbances, preg x Mevacor Lovastatin Pindolol Visken

Fosamprenavir Lexiva bid-TID, sulfa drug, susp= empty stomach for adults, kids with food Emtricitabine & tenofovir Truvada - pigmentation, fanconi, problem absorbing electrolytes Zidovudine/ lamivudine Combivir bid- pigment, pancreatitis Tiprinavir Aptivus- bid w/ food, sulfa, separate from antacida Ticlopidine Ticlid, p2y12 inhib like clopidegrel- se: sjs, ttp (thrombocytopenic purpurea) Moexipril Univasc ace Perindopril Aceon

Ramipril Altace Trandopril Mavik Fosinopril Monopril Eprosartan Teveten Azilsartan Edarbi Atazanavir Reyataz qd, nephrolithiasis (take with water), separate from ppi's/h2ra's Didanosine Videx qd (empty stomach), pancreatitis

Tenofovir Viread qd fanconi syndrome, treats hep b Almotriptan Axert Eletriptan Relpax Frovatriptan Frova Naratriptan Emerge Peglioticase Krystexxa (iv refractory only for gout), anaphylaxis during infusion require premed w/ antihistamines Bp goal <140/90 unless dm or ckd then <130/

Chlorthiazide Diuril- thiazide, hyperglycemia, hyperlipidemia, sulfa Ethacrynic acid Edecrin- most ototox, sulfa, gout, photosensitive Triamterene Dyrenium Amiloride Midamor k sparing Eplerenone Inspra- good for class 3 & 4 heart failure Aliskerin Tekturna - preg x, renin- inhib for htn Metoprolol tartrate Lopressor w/ food

Acebutolol Sectral Bisoprolol Zebeta Nebivolol Bystolic: nitric acid dilation properties, hypertriglyceride, decrease hdl Nadolol Corgard Labetalol Trandate Verapamil Calan, covera- don't use w/ b- blocker, arrhythmias, gingival hyperplasia, no grapefruit, decrease hr/contraction Felodipine Plendil- reflex tachycardia, headache

Nifedipine Adalat, procardia Nicardipine Cardene Clevidipine Cleviprex, iv ccb, do not use in soy/peanut allergy Guanfacine Tenex 0.5-2mg qd, alpha 2 agonist, do not stop abruptly Methyldopa Aldomet- 250 bid-TID, se: hsr, hep, myocarditis, lupus, anemia Prazosin Minipress- orthostatic hypotension, priapism, floppy iris syndrome Lotrel Amlod/benaze Amlodipine/valsartan

Exforge Amlodipine/olmesartan Azor Irbesartan/hctz Avalide Losartan/hctz Hyzaar Amiloride/hctz Moduretic Fluvastatin Lescol B blocker for hf Metoprolol er, bisoprolol (zebeta), carvedolol (coreg) Bidil Isosorbide dinitrate/ hydralazine- good for AA for HF

Electrolyte imbalances increasing dig tox Hypokalemia/magnesium/thyroid and hypercalcemia Argatroban Used in HIT, & renal impairment, increases iNr, monitor aptt, reduce in hepatic impairment, direct thromb inh Dalteparin Fragmin 2500-5000u sc daily, txt: 120u/kg bid Darbigatran Pradaxa- more gi ulceration/ bleeds, reduce if renal dx, discard after container is open >4 months, d/c 1-2 days before surgery- direct thrombin inh Bivalrudin Angiomax: reduce in renal failure, direct thrombin inh Fondaparinox Atrixtra- sc weight based, inhibits factor xa Rivaroxan

Xarelto 10-20mg qd, d/c warf if iNr <3, take w/meals, ci: liver/renal dx, 3a4 substrate Apixaban Eliquis 2.5-5mg qd, d/c if liver/ renal failure, lots of di's, d/c warfarin when < 4 factor prothrombin complex Kcentra: for iNr >10 or bleeds, refridgerate, protect from light Ranolazine Ranexa- 500mg bid for chest pain, ci: strong inducers, se: qt prolongation, no effect on hr/bp Prasugrel Effient- p2y12 inhib, ttp, 60mg then 10 qd Ticagrelor Brilinta (180mg, then 90mg BID) p2y12 inhib, 100mg Asa decreases effect Esmolol Brevibloc

Dronedarone Multaq 400 bid medguide, with food, related to amiodarone- liver/renal/pulmonary/blood discrasias Amiodarone Cordarone 0.22 filter, d5w, non PVC, flush with saline, pulm tox, liver tox, corneal microdeposits, blue skin discoloration, decrease dig, warfarin, statins Sotolol Betapace 80 mg bid, non selective, must initiate in hospital, torsades Dofetilide Tykosyn 500mcg bid, reduce renal, Rems- must start in hospital *3 days, medguide Sildenafil for PAD 20mg TID - ci: inhibitors, vision/hearing loss Tadalafil for PAH Adcirca 40mg qd Levalbuterol Xopenex

Pirbuterol Maxair- short acting b2 agonist Salmeterol Serevent- must be taken w/ steroid Formoterol Foradil bid- fridge, room temp for 4 months, requires steroid Fluticasone / salmeterol Advair Formoterol/ budesonide Symbicort Beclomethasone Qvar/qnasl or beconase aq Ciclesonide Alvesco inhaler/omnaris/zetonna nasal spray

Flunisolide Aero span inhaler/nasalide Mometasone Asmanex inh/ nasonex Mometasone + formeterol Dulera Zafirlukast Accolate 20mg bid on empty stomach- ci: active liver disease, se: neuropysch, URTI's Zileutin Zyflo (leukotriene modifier) 600mg QID, psych se, upper resp infxns Omalizumab Xolair- sc q2-4 weeks, anaphylaxis- must give in office, arthralgias, dermatitis, bone fracture Ipratropium Atrovent inhaler anticholinergic

Ipratropium / albuterol Combivent respule: 1 puff QID , duoneb Aclidiniun Tudorza pressair bid, long acting anticholinergic Tiotropium Spiriva- 1 cap bid, long acting anticholinergic, wash once per month Clemastine Tavist 1.34-2.68 q8-12h. 1st gen antihistamine Promethazine Phenergan- 12.5-25mg q4-6h, resp failure in children, hypotension, dystonic rxns, parkinsonism, qt risk, tardive dyskinesia Azelastine/fluticasone Dymista Olapatadine Patanase- nasal antihistamine

Dornase Alfa Pumozyme via nebulizer daily. Ci: allergy to Chinese hamster ovary, se: uri, store in fridge, protect from light Pancreolipase Creon, viokase (must give w/ppi), zen pep (porcine derived), medguide, take prior to snacks and meals, more with high fat dose Epoetin Alfa Epogen 40000u once weekly: arms, abs, butt, thighs, if hgb>1g/dl over 2 weeks, decrease dose by 20% Darbepoetin Aranesp 300-500 mcg q2-3 weeks, arms, abs, butt, thighs, if hgb>1g/dl over 2 weeks, decrease dose by 20% Filgrastim/pegfilgrastim Neupogen/ neulasta: after chemo for neutropenia anc <1000- arthralgias & enlarged spleen Prochlorperazine Compro 5-10mg q6h- eps, seizures, qt prolongation, hypotension Chlorpromazine

Thorazine 10-25mg q4-6h, eps, seizures, qt prolong Aprepitant Emend 125mg 1 hr before. 80 mg qd x 2 days, se: hiccups Doxorubicin Adriamycin: cardiotoxic, extravasion, hyperpigmentation Mitoxantrone Novantrone: blue urine Capecitabine Xeloda: oral form of 5fu, cardiotoxic, hand/foot syndrome, neurotox, increases iNr Bicalutamide Casodex- 50mg qd, antiandrogen for prostate cancer, visual disturbances Leuprolide Lupron- antiandrogen/antiestrogen- decrease bone density, dyslipidenia, tumor flare, qt prolongation Anastrazole

Arimidex - 1mg qd, aromatase inhib- breast cancer, decrease bone, cv events, hepatotoxic, menopause sx Letrozole Femara 2.5mg qd, aromatase inhib- breast cancer, decrease bone, cv events, hepatotoxic, menopause sx Exemestane Aromasin 25mg qd, aromatase inhib- breast cancer, decrease bone, cv events, hepatotoxic, menopause sx Tamoxifen Soltamox- serm, preventative in pre and post menopause, DVT, weight gain, htn, endometrial cancer Raloxifene Evista: serm, can be preventative, post menopause, DVT, weight gain, htn Nasocobal B12 nasal spray, ci: cobalt allergy Hydroxyurea Droxia- for sickle cell, se: hyper pigmentation, scaling, skin/nail atrophy

Leaching- no PVC or dehp Tic tac toe craving delicious irresistible pho (cancer drugs) + amiodarone Propofol Diprivan- ci: egg/soy allergy, se: hypertriglyceride, green urine, pancreatitis, >5 micron filter, discard after 12 hours Warning: paralyzing agent Atracurium, cisatracurium (nimbex), pancuronium, rocuronium (zemuron), vecuronium- mechanical ventilation Vilazodone Viibryd- with food, less sexual se then ssri/SNRI Vortioxetine Brintellex- 10-20mg qd, ssri + 5ht antagonist Desvenlafaxine Pristiq: dilated pupils, dry mouth, sweating, constipation, htn Clomipramine Anafranil Tca: Anticholinergic effects and qt prolongation, weight gain

Imipramine Tofranil Tca: Anticholinergic effects and qt prolongation, weight gain Nortriptyline Pamelor, Tca: Anticholinergic effects and qt prolongation, weight gain Isocarboxazid Marplan- Mao-I, anticholinergic, weight gain, sexual dysfxn, htn crisis Phenilzine Nardil - Mao-I, anticholinergic, weight gain, sexual dysfxn, htn crisis Tranylcypromine Parnate - Mao-I, anticholinergic, weight gain, sexual dysfxn, htn crisis Selegiline patch Emsam- Mao-I, anticholinergic, weight gain, sexual dysfxn, htn crisis Bupropion Wellbutrin, ci: seizures, eating disorder, bipolar, se: weight loss, seizures, htn- no sexual se

Trazadone Desryl- othrostasis, priapism Milnacipran Savella, SNRI, anticholinergic se Triptan sensations Hot / cold sensations, chest pain, pressure in chest/neck 1st gen antipsychotics Chlorpromazine, thioridazine, loxapine, perphenazine, fluphenazine, haldol, thiothixene (navane)- eps se- txt w/ benztropine, qt prolongation Paliperidone Invega- 3-9mg qd, 2nd gen antipsychotics, lipid/glucose abnormalities, high prolactin- lactation/ gyneco/ sexual dysfxn Olanzapine Zyprexa- most weight/lipid/glucose gain, qt prolong, zydis odt, relprevv injxn Quetiapine Seroquel- least risk of eps se