14 PRE- ADE/Clinical Pearls

Question 1

Acetaminophen ADE

Answer 1

Angioedema
Disorientation/dizziness
Pruritic, maculopapular rash

Question 2

Acetaminophen Clinical Pearls

Answer 2

Pregnancy Cat B

Avoid Doses >3250mg D

Question 3

Amlodipine ADE

Answer 3

Edema/Pulmonary Edema
HA
Fatigue

Question 4

Amlodipine Clinical Pearls

Answer 4

Comes in combo w/ Benazepril, Atorvastatin, Olmesartan, Telmesartan & Valsartan

Use w/caution on CHF

Peripheral edema may take 2-3 weeks to develop

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

Question 5

Aspirin ADE

Answer 5

Angioedema, Urticaria, Rash
Bronchospasm
CNS alteration

Question 6

Aspirin Clinical Pearls

Answer 6

Contraindicated: Bleeding, GI ulcers, hemophilia, hemorrhoids, lactating mothers, nasal polyps associated with asthma, sarcoidosis, thrombocytopenia, UC

Avoid in peds. due to increased incidences of Reyes syndrome

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

Question 7

Atorvastatin ADE

Answer 7

N/D/Dyspepsia
Nasopharyngitis
Arthralgia

Question 8

Atorvastatin Clinical Pearls

Answer 8

May cause elevations in LFTs

Risk of myopathy increased by coadmin of HIV protease inhibitors or azole antifungals

Question 9

Glyburide ADE

Answer 9

Noctural enuresis
Hypoglycemia, N, myalgia, skinrash, heartburn
Disulfram reaction, hemolytic anemia

Question 10

Glyburide Clinical Pearls

Answer 10

May have symptoms of hypoglycemia masked by beta blockers (except sweating)
Monitor blood glucose 2-4xD
Alcohol may cause disulfram like reaction
Often add-on therapy w/metformin when A1C goals are not met

Question 11

HCTZ ADE

Answer 11

Hypotension dizziness HA
Constipation, nausea, impotence
HYPER-calcemia, glyceria, uricemia
HYPO- kalemia, magnesemia, natremia

Question 12

HCTZ Clinical Pearls

Answer 12

Full hypotensive effect may require 2-3 weeks

Avoid alcohol and using NSAIDs

Question 13

Ibuprofen ADE

Answer 13

GI Bleeding/Distresss

Edema, Itching

Question 14

Ibuprofen Clinical Pearls

Answer 14

Use with caution in renal dysfunction

NSAIDs associated with incresed risk of CV thromobotic events

Question 15

Levofloxacin ADE

Answer 15

N, HA, Diarrhea

Question 16

Levofloxacin Clinical Pearls

Answer 16

Not approved in children younger than 18. Oral and IV dosing is interchangable. Increased risk of tendon rupture in >60y/o

Question 17

Lisinopril ADE

Answer 17

Dizziness, hypotension, hyperkalemia

Question 18

Lisinopril Clincial Pearls

Answer 18

ACEi induced cough

Question 19

Losartan ADE

Answer 19

HA, Diarrhea, Hyperkalemia

Question 20

Metformin ADE

Answer 20

Diarrhea, NV, flatulence

Question 21

Metformin Clinical Pearls

Answer 21

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

Question 22

Metoprolol succinate/Tartrate ADE

Answer 22

Dizziness, Fatigue, hypotension

Question 23

Metop. Succ/Tart Clinical Pearls

Answer 23

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

Question 24

Simvastatin ADE

Answer 24

Myalgia, rhabdomyolysis
Abdominal pain
Increased LFTs

Question 25

Simvastatin Clinical Pearls

Answer 25

Avoid during pregnancy
Report sxs of muscle pain/weekness
Take in the evenin
CYP3A4 DDinx limit to 20mg 2/amiodarone, amlodipine, ranolazine
Limit to 10mg w/verapamin, diltiazem, dronedarone

Do not initate 80mg- restricted to pts who recived that dose chronically for at least 12 m w/o evidence of muscle tox.