14 Medications Flashcards
Acetaminophen
Tylenol
Amlodipine
Norvasc
Aspirin
Bayer Aspirin
Atorvastatin
Lipitor
Glyburide
Micronase
Hydrochlorothiazide
Hydrodiuril
Ibuprofen
Motrin
Levofloxacin
Levaquin
Lisinopril
Zestril
Losartan
Cozaar
Metformin
Glucophage
Metoprolol succinate
Toprol XL
Metoprolol tartrate
Lopressor
Simvastatin
Zocor
What is the classification of acetaminophen?
Analgesic/antipyretic
What is the classification of amlodipine?
Antihypertensive
What is the classification of aspirin?
NSAID/anti-platelet
What is the classification of atorvastatin?
Hypolipemic
What is the classification of glyburide?
Antidiabetic
What is the classification of hydrochlorothiazide?
Diuretic
What is the classification of ibuprofen?
NSAID
What is the classification of levofloxacin?
Antibiotic
What is the classification of lisinopril?
Antihypertensive
What is the classification of losartan?
Antihypertensive
What is the classification of metformin?
Antidiabetic
What is the classification of metoprolol succinate?
Beta-blocker (antihypertensive)
What is the classification of metoprolol tartate?
Beta-blocker (anti-hypertensive)
What is the classification of simvastatin?
Hypolipemic
What is the indication of acetaminophen?
analgesia, fever
What is the indication of amlodipine?
hypertension, coronary artery disease, angina
What is the indication of aspirin?
Pain, fever, acute coronary syndrome
What is the indication of atorvastatin?
hyperlipidemia
What is the indication of glyburide?
diabetes
What is the indication of hydrochlorothiazide?
hypertension, edema
What is the indication of ibuprofen?
pain relief, fever, headache
What is the indication of levofloxacin?
- 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)
- UTI (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.
What is the indication of lisinopril?
hypertension, CHF, acute MI
What is the indication of losartan?
hypertension, diabetic nephropathy
What is the indication of metformin?
diabetes mellitus, type 2
What is the indication of metoprolol succinate?
angina, heart failure, HTN, MI
What is the indication of metoprolol tartate?
angina, heart failure, HTN, MI
What is the indication of simvastatin?
Hyperlipidemia, prophylaxis for CVD event risk
What is the dose of acetaminophen?
IR: 325-650 PO/PR q4h
ER: 1000 mg PO q 6-8h
What is the dose of amlodipine?
5 mg PO daily; may increase q7-14 days
Do not exceed 10 mg PO daily
What is the dose of aspirin?
- Pain & fever: 325-650 mg PO/PR q4-6h
- ACS: 160-325 PO
- chew nonenteric-coated tablet upon presentation
- maintenance includes 81-325 mg/day
What is the dose of atorvastatin?
10-80mg PO Daily
What is the dose of glyburide?
1.25mg-20mg po daily, max 20 mg daily
What is the dose of hydrochlorothiazide?
Edema: 25-100 mg po daily in single or divided doses
HTN: initial 12.5-25mg po daily
What is the dose of ibuprofen?
200-400mg po q4-6h prn (max 1200 mg/day)
What is the dose of levofloxacin?
500-750 mg once daily
What is the dose of lisinopril?
5-10mg po daily
What is the dose of losartan?
50mg once daily
What is the dose of metformin?
500mg BID or 850mg QD
titrate in increments of 500mg weekly or 850mg every other week
What is the dose of metoprolol succinate?
25-100mg po daily
What is the dose of metoprolol tartate?
25-100mg po daily
What is the dose of simvastatin?
5-40mg po daily (dependent of intensity)
What is the MOA of acetaminophen?
- Acts on hypothalamus to produce antipyresis
- peripherally works to block pain impulse generation
- may inhibit prostaglandin synthesis in CNS
What is the MOA of amlodipine?
- calcium channel blocker
- inhibits cardiac and vascular sm. muscle contraction leading to dilation of main coronary and systemic arteries
What is the MOA of aspirin?
- inhibits synthesis of prostaglandins by blocking COX
- inhibits platelet aggregation
- has antipyretic and analgesic activity
What is the MOA of atorvastatin?
inhibits rate-limiting step of cholesterol biosynthesis by inhibiting HMG-CoA reductase
What is the MOA of glyburide?
- sulfonylurea enhance insulin secretion from pancreatic beta cells
- increase peripheral utilization of glucose
- suppress hepatic gluconeogenesis
- possibly increase sensitivity and/or number of peripheral insulin receptors
What is the MOA of hydrochlorothiazide?
Thiazides increase sodium and chloride excretion by interfering with their reabsorption in the cortical diluting segment of the nephron
What is the MOA of ibuprofen?
- Nonselective inhibitor of COX-1 and COX-2
- reversibly alters platelet function
- prolongs bleeding time
What is the MOA of levofloxacin?
As the S(-) enantiomer of the fluoroquinolone, ofloxacin, it 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 struction of DNA and is required for DNA replication and transcription , DNA repair, recombination, and transposition
What is the MOA of lisinopril?
- 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 (increase in plasma renin activity and reduction in aldosterone secretion)
- CNS mechanism may also be involved in hypotensive effect as angiotensin II increases adrenergic outflow from CNS
- vasoactive kallikreins may be decrease in conversion to active hormones by ACE inhibitors, thus reducing blood pressure
What is the MOA of losartan?
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.
What is the MOA of metformin?
Decreases hepatic glucose production, decreasing intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization)
What is the MOA of metoprolol succinate?
- Selective inhibitor of beta1-adrenergic receptors
- competitively blocks beta1-receptors, little/no-effect on beta2-receptors at oral doses <100mg (in adults
- does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity
What is the MOA of metoprolol tartrate?
- Selective inhibitor of beta1-adrenergic receptors
- competitively blocks beta1-receptors, little/no-effect on beta2-receptors at oral doses <100mg (in adults
- does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity
What is the MOA of simvastatin?
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)
What are 3 ADEs for acetaminophen?
- angioedema
- disorientation/dizziness
- pruritic, maculopapular rash
What are 3 ADEs for amlodipine?
- edema/pulmonary edema
- headache
- fatigue
What are 3 ADEs for aspirin?
- angioedema, urticaria, rash
- bronchospasm
- CNS alteration
What are 3 ADEs for atorvastatin?
- N/D/dyspepsia
- Nasopharyngitis
- arthralgia
What are 3 ADEs for glyburide?
- noctural enuresis
- hypoglycemia, nausea, myalgia, skin rash, heartburn
- disulfiram reaction, hemolytic anemia
What are 3 ADEs for hydrochlorothiazide?
- hypotension, dizziness, headache
- constipation, nausea, impotence
- hypercalcemia, hyperglycemia, hyperuricemia, hypokalemia, hypomagnesemia, hyponatremia
What are 3 ADEs for ibuprofen?
- GI distress
- Edema, itching
- GI bleeding
What are 3 ADEs for levofloxacin?
- nausea
- headache
- diarrhea
What are 3 ADEs for lisinopril?
- dizziness
- hypotension
- hyperkalemia
What are 3 ADEs for losartan?
- headache
- diarrhea
- hyperkalemia
What are 3 ADEs for metformin?
- diarrhea
- N&V
- flatulence
What are 3 ADEs for metoprolol succinate?
- dizziness
- fatigue
- hypotension
What are 3 ADEs for metoprolol tartrate?
- dizziness
- fatigue
- hypotension
What are 3 ADEs for simvastatin?
- myalgia, rhabdomyolysis
- abdominal pain
- increased LFTs
Elimination of acetaminophen
hepatic metabolism, excreted in urine
Elimination of amlodipine
hepatic metabolism, excreted in urine
Elimination of aspirin
hepatic metabolism, excreted mostly in urine,
some in sweat, saliva, and feces
Elimination of atorvastatin
hepatic metabolism, excreted mainly in bile
Elimination of glyburide
Renal elimination 50%
Elimination of hydrochlorothiazide
Eliminated 50-70% unchanged in urine
Elimination of ibuprofen
hepatic metabolism via CYP2C19, 45-80% renal
Elimination of levofloxacin
CrCl 20-50, reduce dose by 50%
CrCl 5-19 mL/min, extend interval by 48h
Elimination of lisinopril
Renal - CrCl 10 to 30mL/min Initial: 5mg once daily - CrCl <10mL/min Initial: 2.5mg once daily
Elimination of losartan
Renal - GFR <30mL/minute/1.73 m2: use is not recommended Hepatic - mild to moderate hepatic impairment initial: 25mg once daily
Elimination of metformin
Renal
- contraindicated in eGFR <30
- eGFR 30 to 45 may consider 50% dosage reduction
Elimination of metoprolol succinate
Liver disease - use slow dose titration
Elimination of metoprolol tartrate
Liver disease - use slow dose titration
Elimination of simvastatin
Extensive hepatic metabolism
Renal and fecal elimination