150-175 use to study Flashcards
Trazodone
Brand: Desyrel
MOA: Inhibits reuptake of serotonin, causes adrenoreceptor subsensitivity, and significantly blocks histamine (H1) and alpha1-adrenergic receptors
Schedule: legend
Dosing:
IR: 50mg to 100mg po BID to TID (Max 400mg/day)
Contraindication(s):
MAOI use within 14 days
Use with linezolid
BBW: • Suicidality and antidepressant drugs
Key Points:
Drowsiness and sedation Avoid alcohol or other sedating agents Risk of serotonin syndrome if used with serotonergic agents
Valproic acid and derivatives
Brand: Depacon, Depakote, Depakene
MOA: Causes increased availability of gamma-aminobutyric acid (GABA) to brain neurons
Schedule: legend
Dosing: 15mg/kg/day
Max: 60mg/kg/day
Contraindication(s):
Hepatic disease or significant impairment
Pregnamt women for the prevention of migraine Known mitochondrial disorders
BBW:
- Hepatotoxicity
- Patients with mitochondrial disease
- Fetal risk
- Pancreatitis
Key Points:
Acute pancreatitis Liver Failure Thrombocytopenia, Weight Gain
Vareniciline
Brand: Chantix
MOA: Partial neuronal α4 β2 nicotinic receptor agonist; prevents nicotine stimulation of mesolimbic dopamine system associated with nicotine addiction
Schedule: legend
Dosing: 0.5mg once daily for 3 days, then 0.5mg BID for 4 days, then 1mg BID for 11 weeks
Contraindication(s): Hypersensitivity
BBW: • None
Key Points:
Headache, Nausea, Vomitting Insomnia abnormal dreams Suicidal ideation
Venlafaxine
Brand: Effexor
MOA: Selectively inhibits the reuptake of serotonin and norepinephrine
Schedule: legend
Dosing:
IR: 75mg to 225mg daily in 2 to 3 evenly divided doses
ER: 75mg to 225mg once daily
Contraindication(s):
MAOI use within 14 days Use with linezolid
BBW:
• Suicidality and antidepressant drugs
Key Points: Seizures Insomnia HyperhidrosisXerostomia
Zolpidem
Brand: Ambien
MOA: Enhances activity of GABA via selective agonism at the benzodiazepine-1 (BZ1) receptor
Schedule: IV
Dosing:
IR: 5mg (female) or 5mg to 10 mg (male) q HS
ER: 6.25mg (female) or 6.25mg to 12.5mg (male) q HS
Contraindication(s): Hypersensitivity
BBW: • None
Key Points:
Drowsiness/Sedation Lethargy Memory Impairment
Acyclovir
Brand: Zovirax
MOA: Inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA
Schedule: legend
Dosing: 200mg - 800mg 3 to 5 times daily
Contraindication(s): Hypersensitivity
BBW: • None
Key Points:
Can crystalize in kidney and cause AKI Nausea and Vomitting Malaise
Amoxicillin
Brand: Moxatag
MOA: Binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis
Schedule: legend
Dosing: 500mg q 8 hours or 875mg q 12 hours
Contraindication(s):
Serious hypersensitivity to amoxicillin
BBW: • None
Key Points:
Diarrhea (AAD & CDAD)
Allergy
Take entire course and contact provider if symptoms do not improve within a few days of startingN/V, take with food to avoid upset stomach if needed
Amoxicillin and Clavulanic acid
Brand: Augmentin
MOA:
Amoxicillin binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis
Clavulanic acid binds and inhibits beta-lactamases that inactivate amoxicillin
Schedule: legend
Dosing: 500mg q 8 hours or 875mg q 12 hours Dosing based on amoxicillin component
Contraindication(s):
Serious hypersensitivity to amoxicillin or clavulanate
History of cholestatic jaundice or hepatic dysfunction with Augmentin
Augmentin XR: Severe renal impairment (CrCl less than 30ml/min
BBW: • None
Key Points:
Diarrhea (AAD & CDAD) Allergy
Take entire course and contact provider if symptoms do not improve within a few days of startingN/V, take with food to avoid upset stomach if needed
Azithromycin
Brand: Z-pak, Zithromax, Zmax, Azasite
MOA: Inhibits RNA-dependent protein synthesis by binding to the 50S ribosomal subunit
Schedule: legend
Dosing:
CAP: 500mg once, then 250mg daily on days 2 to 5
STI: 1g as a single dose
Contraindication(s):
Hypersensitivity History of cholestatic jaundice or hepatic dysfunction with prior azithromycin use
BBW: • None
Key Points:
Diarrhea (AAD & CDAD) Nausea and Vomitting
QTc prolongationMay bind with certain cations. Avoid taking with certain multivitamins and minerals (calcium, aluminum, magnesium, etc.)
Cefdinir
Brand: Omicef
MOA: Binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis
Schedule: legend
Dosing: 300mg q 12 hours
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Diarrhea (AAD & CDAD) Allergy
Liquid suspension: Do not refrigerate, keep at room temperature.Take 2 hrs before or after antacids or iron supplements; If taking iron supplement, may pass red colored stools
Cefuroxime
Brand: Ceftin, Zinacef
MOA: Binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis
Schedule: legend
Dosing: 250mg to 500mg q 12 hours
Contraindication(s):
Hypersensitivity to cefuroxime or other beta-lactam drugs
BBW: • None
Key Points:
Diarrhea (AAD & CDAD)
Allergy
Take entire course and contact provider if symptoms do not improve within a few days of startingNausea and Vomitting, take with food to avoid upset stomach if needed
Cephalexin
Brand: Keflex
MOA: Binds to penicillin-binding proteins (PBPs) which inhibits peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis
Schedule: legend
Dosing:
250mg q 6 hours or 500mg q 12 hours
Streptococcal Skin Infxns: 500mg q 6 hours
Contraindication(s): Hypersensitivty
BBW: • None
Key Points:
Diarrhea (AAD & CDAD) Allergy
Take entire course and contact provider if symptoms do not improve within a few days of startingN/V, take with food to avoid upset stomach if needed
Ciprofloxacin
Brand: Cipro, Ciloxa, Otiptrio
MOA: Inhibits DNA-gyrase and promotes breakage of double-stranded DNA
Schedule: legend
Dosing:
500mg to 750mg q 12 hours
Contraindication(s):
Hypersensitivity to other quinolones Concurrent use of tizanidine
BBW:
• Serious adverse reactions (tendinitis and tendon rupture, peripheral neuropathy, and CNS effects) • Exacerbation of myasthenia gravis
Key Points:
May bind with certain cations. Avoid taking with certain multivitamins and minerals (calcium, aluminum, magnesium, etc.)
QTc prolongation Dysglycemia, Diarrhea (AAD & CDAD)
Clarithromycin
Brand: Biaxin
MOA: Binds to 50S ribosomal subunit resulting in inhibition of protein synthesis
Schedule: legend
Dosing: 250mg to 500mg q 12 hours
Contraindication(s):
History of cholestatic jaundice/hepatic dysfunction associated with prior use of clarithromycin Use with drugs extensively metabolized by CYP3A4 Use with colchicine in patients with renal or hepatic impairment
BBW: • None
Key Points:
Diarrhea (AAD & CDAD) Nausea and Vomitting
qtc prolongation, Take entire course and contact provider if symptoms do not improve within a few days of starting
Clindamycin
Brand: Cleocin, Evoclin, Clindesse
MOA: Binds to 50S ribosomal subunit resulting in inhibition of protein synthesis
Schedule: legend
Dosing: 300mg to 450mg q 6 hours
Contraindication(s): Hypersensitivity
BBW: • Colitis
Key Points:
Diarrhea (AAD & CDAD) Rash
Nausea and Vomitting, take with food to avoid upset stomach if neededTake entire course and contact provider if symptoms do not improve within a few days of starting
Conjugated Estrogens
Brand: Premarin
MOA: Modulates the pituitary secretion of gonadotropins, luteinizing hormone, and follicle-stimulating hormone through a negative feedback system, thereby reducing elevated levels of these hormones in postmenopausal women
Schedule: legend
Dosing:
Oral: 0.3mg to 0.625mg once daily
Topical: 0.5g/day, 21 days on, 7 days off
Contraindication(s):
Angioedema or anaphylactic reaction to estrogens
Current history of PE or DVT or other known thrombophilic disorders
Undiagnosed abnormal genital bleeding
Pregnancy
BBW:
- Endometrial cancer
- Cardiovascular disease
- Breast cancer
- Dementia • Risk vs benefit
Key Points:
cream: dispense with applicators; insert amount & frequency directed by physician at bedtime
Tablet: progestin required for intact uterus tablet: signs & symptoms of thrombosis (VTE & stroke)tablet: lowest effective dose, shortest duration
Darunavir
Brand: Prezista
MOA: Binds to the site of HIV-1 protease activity and inhibits cleavage of viral Gag-Pol polyprotein precursors into individual functional proteins required for infectious HIV
Schedule: legend
Dosing: 800mg once daily
Contraindication(s):
Coadministration with drugs highly dependent on CYP3A4 for clearence
BBW: • None
Key Points:
Increased LDL Skin Rash Diarrhea
Doxycycline
Brand: Adoxa, Monodox, Oradea, Vibramycin, Doryx
MOA: Inhibits protein synthesis by binding with the 30S ribosomal subunit
Schedule: legend
Dosing: 100mg q 12 hours
Contraindication(s):
Hypersensitivity to tetracyclines
BBW: • None
Key Points:
Photosensitivity
Avoid < 8 years old
Adequate fluid intake otherwise esophagitisdiarrhea (AAD & CDAD)
Dutasteride
Brand: Avodart
MOA: Selectively inhibits 5α-reductase, resulting in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppressed serum dihydrotestosterone levels
Schedule: legend
Dosing: 0.5mg once daily
Contraindication(s):
Clinically significant hypersensitivity to other 5-alpa-reductase inhibitors
Use in pediatric patients, women of childbearing potential, or pregnancy
BBW: • None
Key Points:
Dicreased Libido Impotence Gynecomastia
Emtricitabine, Tenofovir, and Efavirenz
Brand: Atripla
MOA: Efavirenz: Non-nucleoside reverse transcriptase inhibitor of HIV-1, thereby blocking the RNA-dependent and DNA-dependent DNA polymerase resulting in inhibition of viral replication Emtricitabine: Nucleoside reverse transcriptase inhibitor, which interferes with HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication Tenofovir: Nucleotide reverse transcriptase inhibitor, interferes with the HIV viral RNA dependent DNA polymerase resulting in inhibition of viral replication
Schedule: legend
Dosing: 1 tablet once daily
Contraindication(s):
Clinically significant hypersensitivity
Coadministration with voriconazole
BBW: • Hepatitis B coinfection
Key Points:
Hypercholesterolemia Abnormal dreams HyperglycemiaDiarrhea
Ethinyl Estradiol and Etonogestrol
Brand: Nuvaring
MOA: Combination hormonal contraceptives inhibit ovulation via a negative feedback mechanism on the hypothalamus, which alters the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitar
Schedule: legend
Dosing:
Insert 1 ring for 3 weeks then remove for 7 days
Contraindication(s):
Breast cancer or other estrogen/progestin sensitive cancer
hepatic tumors or hepatic disease
Use in women at high risk of thrombotic disease Undiagnosed abdominal uterine bleeding
BBW: • Cigarette smoke and serious cardiovascular events
Key Points:
Weight Gain
Increased risk of blood clots
Nausea and Vomting, Consider various factors that may decrease effectiveness (abx, missed dose, time to onset, etc.)
Finasteride
Brand: Proscar, Propecia
MOA: Selectively inhibits 5α-reductase, resulting in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppressed serum dihydrotestosterone levels
Schedule: legend
Dosing:
BPH: 5mg once daily
Contraindication(s):
Pregnancy or women of childbearing potential BBW: • None
Key Points:
Decreased libido Pregnancy category X
Fluconazole
Brand: Diflucan
MOA: Interferes with fungal cytochrome P450 activity (lanosterol 14-α-demethylase), and decreases ergosterol synthesis which inhibits cell membrane formation
Schedule: legend
Dosing:
Vaginal Candidiasis: 150mg once
Candidemia: 800mg on day 1, then 400mg once daily thereafter
Contraindication(s):
Coadministration with CYP3A4 substrates which may lead to QTc prolongation
BBW: • None
Key Points:
Headache Nausea, vomiting, and Diarrhea Hepatitis & jaundice, Take entire course and contact provider if symptoms do not improve within a few days of starting
Group: Biphasic Oral Contraceptives
Brand: Kariva, Mircette, Ortho Novum 10/12
MOA: Combination hormonal contraceptives inhibit ovulation via a negative feedback mechanism on the hypothalamus, which alters the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitar
Schedule: legend
Dosing:
1 tablet once daily
Contraindication(s):
Breast cancer or other estrogen/progestin sensitive cancer Use in women at high risk of thrombotic disease
BBW:
• Cigarette smoke and serious cardiovascular events
Key Points:
Nausea and Vomting
Increased risk of blood clots
Weight Changes; Fluid Retention, Consider various factors that may decrease effectiveness (abx, missed dose, time to onset, etc.)
Group: Monophasic Oral Contraceptives
Brand: Avaine, Loestrin, Tasmin, Yaz, Oral
MOA: Combination hormonal contraceptives inhibit ovulation via a negative feedback mechanism on the hypothalamus, which alters the normal pattern of gonadotropin secretion of a follicle-stimulating hormone (FSH) and luteinizing hormone by the anterior pituitar
Schedule: legend
Dosing: 1 tablet once daily
Contraindication(s):
Breast cancer or other estrogen/progestin sensitive cancer
Use in women at high risk of thrombotic disease
BBW:
• Cigarette smoke and serious cardiovascular events
Key Points:
Nausea and Vomting Increased risk of blood clots Weight Changes; Fluid RetentionConsider various factors that may decrease effectiveness (abx, missed dose, time to onset, etc.)
