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CDM 1 > 14 common drugs > Flashcards

14 common drugs Flashcards

1
Q

Acetaminophen/brand

A

Tylenol

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2
Q

Acetaminophen/classification

A

Analgesic/antipyretic

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3
Q

Acetaminophen/indication

A

Analgesia, fever

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4
Q

Acetaminophen/dose

A

IR: 325-650 mg PO/PR q4h
ER:1000 mg PO q6-8h

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5
Q

Acetaminophen/MOA

A

Acts on hypothalamus to produce antipyresis, peripherally works to block pain impulse generation, may inhibit prostaglandin synthesis in CNS

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6
Q

Acetaminophen/ADEs

A

Angioedema
Disorientation/dizziness
Pruritic, maculopapular rash

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7
Q

Acetaminophen/elimination

A

Hepatic metabolism

Excreted in urine

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8
Q

Acetaminophen/clinical pearls

A

Pregnancy Cat B

Avoid doses >3250 mg daily

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9
Q

Amlodipine/Brand

A

Norvasc

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10
Q

Amlodipine/classifcation

A

Antihypertensive

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11
Q

Amlodipine/indication

A

Hypertension, Coronary Artery Disease, Angina

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12
Q

Amlodipine/dose

A

5 mg PO daily; may increase q7-14 days

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13
Q

Amlodipine/MOA

A

Calcium channel blocker; inhibits cardiac & vascular smooth muscle contraction leading to dilation of main coronary & systemic arteries

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14
Q

Amlodipine/ADEs

A

Edema/Pulmonary edema
Headache
Fatigue

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15
Q

Amlodipine/elimination

A

Hepatic metabolism

Excreted in urine

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16
Q

Amlodipine/clinical pearls

A

Comes in combination w/ Benazepril, Atorvastatin, Olmesartan, Telmisartan, & Valsartan

Use w/ caution in CHF

Peripheral edema may take 2-3 weeks to develop

Titrate slowly in those w/ severe hepatic impairment due to extensive liver metabolism

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17
Q

Aspirin/brand

A

Bayer Aspirin

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18
Q

Aspirin/classification

A

Non-Steroidal Anti-inflammatory/

Anti-platelet

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19
Q

Aspirin/indication

A

Pain and fever

Acute Coronary Syndrome

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20
Q

Aspirin/dose

A

Pain & fever: 325-650 mg PO/PR q4-6hr PRN

ACS: 160-325 mg PO; chew nonenteric-coated tablet upon presentation; maintenance includes 81-325 mg/day

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21
Q

Aspirin/MOA

A

Inhibits synthesis of prostaglandins by blocking COX; inhibits platelet aggregation; has antipyretic & analgesic activity

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22
Q

Aspirin/ADEs

A

Angioedema, urticaria, rash
Bronchospasm
CNS alteration

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23
Q

Aspirin/elimination

A

Hepatic metabolism

Excreted mostly in urine, some in sweat, saliva and feces

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24
Q

Aspirin/clinical pearls

A

Contraindications: bleeding GI ulcers, hemophilia, hemorrhoids, lactating mothers, nasal polyps associated with asthma, sarcoidosis, thrombocytopenia, ulcerative colitis

Avoid using in pediatric pts due to increased incidence of Reyes syndrome

May worsen CHF in pts due to increased Na & H2O retention due to prostaglandin inhibition

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25
Q

Atorvastatin/brand

A

Lipitor

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26
Q

Atorvastatin/classification

A

Hypolipemic

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27
Q

Atorvastatin/indication

A

Hyperlipidemia

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28
Q

Atorvastatin/dose

A

10-80 mg PO daily

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29
Q

Atorvastatin/MOA

A

Inhibits rate-limiting step in cholesterol biosynthesis by inhibiting HMG-CoA reductase

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30
Q

Atorvastatin/ADEs

A

N/D/dyspepsia (discomfort in the upper abdomen)
Nasopharyngitis (inflammatory attack of the pharynx and nasal cavity)
Arthralgia (joint stiffness)

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31
Q

Atorvastatin/elimination

A

Hepatic metabolism

excreted mainly in the bile

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32
Q

Glyburide/brand

A

Micronase

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33
Q

Glyburide/classification

A

Antidiabetic

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34
Q

Glyburide/indication

A

Diabetes

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35
Q

Glyburide/dose

A

1.25-20 mg po daily, max 20 mg daily

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36
Q

Glyburide/MOA

A

Sulfonylurea enhance insulin secretion from pancreatic beta cells. Increase peripheral utilization of glucose, suppress hepatic gluconeogenesis, and possibly increase sensitivity and/or number of peripheral insulin receptors

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37
Q

Glyburide/ADEs

A

Nocturnal enuresis
Hypoglycemia, nausea, myalgia, skin rash, heartburn
Disulfiram reaction, hemolytic anemia

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38
Q

Glyburide/elimination

A

Renal elimination 50%

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39
Q

Glyburide/clinical pearls

A

May have symptoms of hypoglycemia masked by beta blockers (except sweating)

Monitor blood glucose 2-4 times per day

Alcohol may cause disulfiram reaction

Often add-on in therapy with metformin if A1c goals are not met

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40
Q

Hydrochlorothiazide/brand

A

Hydrodiuril

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41
Q

Hydrochlorothiazide/classification

A

Diuretic

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42
Q

Hydrochlorothiazide/indication

A

Hypertension, edema

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43
Q

Hydrochlorothiazide/dose

A

Edema: 25-100 mg PO daily in single or divided doses
HTN: initial 12.5-25 mg PO daily

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44
Q

Hydrochlorothiazide/MOA

A

Thiazides increase sodium and chloride excretion by interfering with their reabsorption in the cortical diluting segment of the nephron

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45
Q

Hydrochlorothiazide/ADEs

A

Hypotension, dizziness, headache
Constipation, nausea, impotence
Hypercalcemia, hyperglycemia, hyperuricemia, hypokalemia, hypomagnesemia, hypoatremia

46
Q

Hydrochlorothiazide/elimination

A

Eliminated 50-70% unchanged in urine

47
Q

Hydrochlorothiazde/clinical pearls

A

Full hypotensive effect may require 2-3 weeks

Avoid alcohol and using NSAIDs

48
Q

Ibuprofen/brand

49
Q

Ibuprofen/classification

A

Non-Steroidal Anti-inflammatory

50
Q

Ibuprofen/indication

A

Pain relief, fever, headache

51
Q

Ibuprofen/dose

A

200-400 mg PO q4-6h prn (max 1200 mg/day)

52
Q

Ibuprofen/MOA

A

Nonselective inhibitor of COX-1 and COX-2 and reversibily alters platelet function and prolongs bleeding time

53
Q

Ibuprofen/ADEs

A

GI distress
Edema, itching
GI bleeding

54
Q

Ibuprofen/elimination

A

Hepatic metabolism via CYP2C19

45-80% renal

55
Q

Ibuprofen/clinical pearls

A

Use with caution in renal dysfunction

NSAIDs associated with increased risk of CV thrombotic events

56
Q

Levofloxacin/brand

57
Q

Levofloxacin/classification

A

Antibiotic

58
Q

Levofloxacin/indication

A

Treatment of community-acquired pneumonia, including multidrug resistant strains of S. pneumoniae (MDRSP); nosocomial pneumonia; chronic bronchitis (acute bacterial exacerbation); acute bacterial rhinosinusitis (ABRS); prostatitis (chronic bacterial), urinary tract infection (uncomplicated or complicated); acute pyelonephritis; skin or skin structure infections (uncomplicated or complicated); reduce incidence or disease progression of inhalational anthrax (postexposure); prophylaxis and treatment of plague (pneumonic and septicemic) due to Y. pestis

59
Q

Levofloxacin/dose

A

500-750mg once daily

60
Q

Levofloxacin/MOA

A

As the S(-) enantiomer of the fluoroquinolone, ofloxacin, levofloxacin, inhibits DNA-gyrase in susceptible organisms thereby inhibits relaxation of supercoiled DNA and promotes breakage of DNA strands. DNA gyrase (topoisomerase II), is an essential bacterial enzyme that maintains the superhelical structure of DNA and is required for DNA replication and transcription, DNA repair, recombination, and transposition.

61
Q

Levofloxacin/ADEs

A

nausea
headache
diarrhea

62
Q

Levofloxacin/elimination

A

CrCl 20-50, reduce dose by 50%

CrCl 5-19 mL/min, extend interval by 48h

63
Q

Levofloxacin/clinical pearls

A

Not approved in children younger than age of 18. Oral and IV dosing is interchangeable. Increased risk of tendon rupture in >60yr

64
Q

Lisinopril/brand

65
Q

Lisinopril/classification

A

Antihypertensive

66
Q

Lisinopril/indication

A

Hypertension, CHF, acute MI

67
Q

Lisinopril/dose

A

5-10mg PO daily

68
Q

Lisinopril/MOA

A

Competitive inhibitor of angiotensin-converting enzyme (ACE); prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor; results in lower levels of angiotensin II which causes an increase in plasma renin activity and a reduction in aldosterone secretion; a CNS mechanism may also be involved in hypotensive effect as angiotensin II increases adrenergic outflow from CNS; vasoactive kallikreins may be decreased in conversion to active hormones by ACE inhibitors, thus reducing blood pressure

69
Q

Lisinopril/ADEs

A

dizziness
hypotension
hyperkalemia

70
Q

Lisinopril/elimination

A

Renal: CrCl 10 to 30 mL/minute: Initial: 5 mg once daily, CrCl <10 mL/minute: Initial: 2.5 mg once daily

71
Q

Lisinopril/clinical pearls

A

ACEI induced cough

72
Q

Losartan/brand

73
Q

Losartan/classification

A

Antihypertensive

74
Q

Losartan/indication

A

Hypertension

Diabetic nephropathy

75
Q

Losartan/dose

A

50 mg once daily

76
Q

Losartan/MOA

A

As a selective and competitive, nonpeptide angiotensin II receptor antagonist, losartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II; losartan interacts reversibly at the AT1 and AT2 receptors of many tissues and has slow dissociation kinetics; its affinity for the AT1 receptor is 1000 times greater than the AT2 receptor. Angiotensin II receptor antagonists may induce a more complete inhibition of the renin-angiotensin system than ACE inhibitors, they do not affect the response to bradykinin, and are less likely to be associated with nonrenin-angiotensin effects (eg, cough and angioedema). Losartan increases urinary flow rate and in addition to being natriuretic and kaliuretic, increases excretion of chloride, magnesium, uric acid, calcium, and phosphate.

77
Q

Losartan/ADEs

A

Headache
Diarrhea
Hyperkalemia

78
Q

Losartan/elimination

A

Renal: GFR <30 mL/minute/1.73 m2: Use is not recommended.

Hepatic: Mild to moderate hepatic impairment: Initial: 25 mg once daily

79
Q

Metformin/brand

A

Glucophage

80
Q

Metformin/classification

A

Antidiabetic

81
Q

Metformin/indication

A

Diabetes mellitus, type 2

82
Q

Metformin/dose

A

500 mg twice daily or 850 mg once daily; titrate in increments of 500 mg weekly or 850 mg every other week

83
Q

Metformin/MOA

A

Decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization)

84
Q

Metformin/ADEs

A

Diarrhea
N&V
Flatulence

85
Q

Metformin/elimination

A

Renal: contraindicated in eGFR <30; eGFR 30 to 45 may consider 50% dosage reduction

86
Q

Metformin/clinical pearls

A

Does not cause hypoglycemia, need good renal function measured by GFR, not SCr anymore

87
Q

Metoprolol Succinate/brand

88
Q

Metoprolol Succinate/classification

A

Beta-blacker (antihypertensive)

89
Q

Metoprolol Succinate/indication

A

Angina, heart failure, HTN, MI

90
Q

Metoprolol Succinate/dose

A

25-100 mg PO daily

91
Q

Metoprolol Succinate/MOA

A

Selective inhibitor of beta1-adrenergic receptors; competitively blocks beta1-receptors, with little or no effect on beta2-receptors at oral doses <100 mg (in adults); does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity

92
Q

Metoprolol Succinate/ADEs

A

Dizziness
Fatigue
Hypotension

93
Q

Metoprolol Succinate/elimination

A

Liver disease-use slow titration

94
Q

Metoprolol Succinate/clinical pearls

A

Avoid concomitant use of CCBs as use may significantly affect heart rate rhythm

95
Q

Metoprolol Tartrate/brand

96
Q

Metoprolol Tartrate/classification

A

beta-blocker (antihypertensive)

97
Q

Metoprolol Tartrate/indication

A

Angina, heart failure, HTN, MI

98
Q

Metoprolol Tartrate/dose

A

25-100 mg PO daily

99
Q

Metoprolol Tartrate/MOA

A

Selective inhibitor of beta1-adrenergic receptors; competitively blocks beta1-receptors, with little or no effect on beta2-receptors at oral doses <100 mg (in adults); does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity

100
Q

Metoprolol Tartrate/ADEs

A

Dizziness
Fatigue
Hypotension

101
Q

Metoprolol Tartrate/elimination

A

Liver disease-use slow dose titration

102
Q

Metoprolol Tartrate/clinical pearls

A

Avoid concomitant use of CCBs as use may significantly affect heart rate rhythm

103
Q

Simvastatin/brand

104
Q

Simvastatin/classification

A

Hypolipemic

105
Q

Simvastatin/indication

A

hyperlipidemia, prophylaxis for CVD event risk

106
Q

Simvastatin/dose

A

5-40mg PO daily (dependent on intensity)

107
Q

Simvastatin/MOA

A

Hydrolyzed to beta-hydroxyacid (potent HMG-CoA reductase inhibitor) –> increases rate of removal of cholesterol from body and reduces production by inhibiting conversion of HMG-CoA to mevalonate (early and rate limiting step in biosynthesis of cholesterol)

108
Q

Simvastatin/ADEs

A

Myalgia, rhabdomyolysis
Abdominal pain
Increased LFTs

109
Q

SImvastatin/elimination

A

Extensive hepatic metabolism

Renal and fecal elimination

110
Q

Simvastatin/clinical pearls

A

AVOID during pregnancy

Report sxs of muscle pain/weakness

Take in the evening

CYP3A4 drug interactions: limit to 20mg w/ amiodarone, amlodipine, ranolazine, limit to 10mg w/ verapamil, diltiazem, dronedarone

Do not initiate 80mg - restricted to pts who received that dose chronically for at least 12 months w/o evidence of muscle toxicity”

CDM 1 (15 decks)

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