175-200 use to study Flashcards
Group: Triphasic oral Contraceptives
Brand: Ortho Tri-Cyclen, Tri-Sprintec, Trivora
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/Vomting Increased risk of blood clots Weight Changes; Fluid RetentionConsider various factors that may decrease effectiveness (abx, missed dose, time to onset, etc.)
Levofloxacin
Brand: Levaquin
MOA: Inhibits DNA-gyrase and promotes breakage of double-stranded DNA
Schedule: legend
Dosing: 500mg to 750mg once daily
Contraindication(s):
Hypersensitivity
BBW:
• Serious adverse reactions • Exacerbation of myasthenia gravis
Key Points:
May bind with certain cations. Avoid taking with certain multivitamins and minerals (calcium, aluminum, magnesium, etc.) QTC prolongation DysglycemiaDiarrhea (AAD & CDAD)
Levothyroxine
Brand: Levoxyl, Synthroid, Tirosint, Unithroid
MOA: Synthetic form of thyroxine (T4), which is converted to active thyroid hormone
Schedule: legend
Dosing: 25mcg to 300mcg once daily About 1.7mcg/kg/day
Contraindication(s):
Acute MI Untreated subclinical or overt thyrotoxicosis of any etiology uncorrected adrenal insufficiency
BBW: • Weight reduction
Key Points:
Empty stomach; may or may not be first thing in the morning
Symptoms of hyperthyroidism if dosed too aggresively
Chelates with numerous drugs, vitamins, and mineralsRemind patient to have labs checked if new rx or changing dose
Levothyroxine and Liothyronine
Brand: Thyrolar
MOA: Active (T3) and synthetic (T4) thyroid hormone
Schedule: legend
Dosing:
50mcg/12.5mcg to 100mcg/25mcg once daily
Contraindication(s):
Uncorrected adrenal insufficiency Untreated thyrotoxicosis
BBW:
• Weight reduction
Key Points:
Empty stomach; may or may not be first thing in the morning
Symptoms of hyperthyroidism if dosed too aggresively
Chelates with numerous drugs, vitamins, and mineralsRemind patient to have labs checked if new rx or changing dose
Liothyronine
Brand: Cytomel
MOA: Active (T3) thyroid hormone
Schedule: legend
Dosing: 25mcg to 75mcg once daily Max: 100mcg/day
Contraindication(s):
Uncorrected adrenal insufficiency
Untreated thyrotoxicosis
BBW: • Weight reduction
Key Points:
Empty stomach; may or may not be first thing in the morning Sxs of hyperthyroidism if dosed too aggresively Chelates with numerous drugs, vitamins, and mineralsRemind patient to have labs checked if new rx or changing dose
Medroxyprogesterone
Brand: Provera, Depo-Provera
MOA: Inhibits secretion of pituitary gonadotropins, which prevents follicular maturation and ovulation and causes endometrial thinning
Schedule: legend
Dosing: 5mg to 10 mg PO once daily
Depo-Provera: 150 mg IM every 3 months
Contraindication(s):
DVT or PE Active or history of thromboembolic disease breast cancer Pregnancy
BBW:
- Cardiovascular disorders (tablet)
- Breast cancer (tablet)
- Dementia (tablet)
- Long-term use (injection)
- Loss of bone mineral density (injection)
- Patient education (subcutaneous injection) • Risk vs benefits (tablet)
Key Points:
amenorrhea Weight gain Headache
Metronidazole
Brand: Flagyl, MetroGel, MetroCream, MetroLotion
MOA: Interacts with DNA to cause a loss of helical DNA structure and strand breakage resulting in inhibition of protein synthesis and cell death
Schedule: legend
Dosing:
500mg to 750mg BID to TID
Trichomoniasis: 250mg q 8 hours x 7 days OR 1gm BID x 1 day OR 2gm once as a single dose
Contraindication(s):
First trimester of pregnancy Use of alcohol within 3 days use of disulfiram within the past 2 weeks
BBW: • Carcinogenic (systemic)
Key Points: Avoid alcohol Metallic taste Headache, Nausea
Minocycline
Brand: Minocin, Solodyn
MOA: Inhibits protein synthesis by binding with the 30S ribosomal subunit
Schedule: legend
Dosing:
Acne Vulgaris: 50mg to 100mg BID
Infection: 200mg once daily x 1 dose, followed by 100mg BID
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Photosensitivity Avoid < 8 years old Adequate fluid intake otherwise esophagitisdiarrhea (AAD & CDAD)
Moxifloxacin
Brand: Avelox, Moxeza, Vigamox
MOA: Inhibits DNA-gyrase and promotes breakage of double-stranded DNA
Schedule: legend
Dosing: 400mg PO or IV once daily
Contraindication(s):
Hypersensitivity to other quinolones
BBW: • Serious adverse reactions • 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)
Mupirocin
Brand: Bactroban
MOA: Binds to bacterial isoleucyl transfer-RNA synthetase resulting in the inhibition of protein synthesis
Schedule: legend
Dosing: AAA topically TID
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points: Localized burning or stinging sensation Rhinitis Respiratory congestion
Nitrofurantoin
Brand: Macrobid, Macrodantin
MOA: Inactivates or alters bacterial ribosomal proteins leading to inhibition of protein synthesis, aerobic energy metabolism, DNA, RNA, and cell wall synthesis
Schedule: legend
Dosing:
Macrobid: 100mg BID for 7 days
Macrodantin: 50mg to 100mg q 6 hours
Contraindication(s):
Anuria, oliguria, or impairment of renal function (CrCl less than 60ml/min)
History of cholestatic jaundice or hepatic dysfunction associated with prior use of nitrofurantoin
BBW: • None
Key Points:
GI Upset Do not use with poor renal function Pulmonary fibrosis with long term use
Norethindrone
Brand: Nor-QD, Camila, Heather, Errin
MOA: Suppresses ovulation, thickens cervical mucus (which inhibits sperm penetration), alters follicle-stimulating hormone (FSH) and luteinizing hormone (LH) concentrations, slows the movement of ovum through the fallopian tubes, and alters the endometrium
Schedule: legend
Dosing: 1 tablet once daily at the same time each day
Contraindication(s):
Hepatic impairment or disease Breast Cancer - known, suspected, or history of Pregnancy Undiagnosed abdominal genital bleeding
BBW: • None
Key Points:
Nausea and Vomting
Increased risk of blood clots
Weight Changes; Fluid RetentionSticter dosing parmeters than other BCs. Consider various factors that may decrease effectiveness (time of dose, abx, missed dose, time to onset, etc.)
Oseltamivir
Brand: Tamiflu
MOA: Inhibits influenza virus neuraminidase
Schedule: legend
Dosing: Influenza prophylaxis: 75mg once daily Influenza treatment: 75mg BID
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Headache Nausea/Vomiting Give within 48 hours of flu symptoms
Oxybutynin
Brand: Oxytrol, Ditropan
MOA: Direct antispasmodic effect on smooth muscle and inhibits the action of acetylcholine
Schedule: legend
Dosing:
ER: 5mg to 10mg po once daily (Max 30mg/day)
Contraindication(s):
Patients with or at risk for uncontrolled narrow-angle glaucoma, urinary retention, gastric retention, or conditions with severely decreased GI motility
BBW: • None
Key Points:
Anticholinergic AE (dry mouth, sedation, constipation,e tc.) dizziness vision disturbance
Penicillin g
Brand: Bicillin L-A
MOA: Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria
Schedule: legend
Dosing: 1.2 million to 2.4 million units IM x1
Contraindication(s):
Hypersensitivity
BBW: • Appropriate administration
Key Points:
Diarrhea Allergy Take entire course and contact provider if symptoms do not improve within a few days of starting
Penicillin v Potassium
Brand: Apo-pen VK, Novo-Pen VK, Nu-Pen VK
MOA: Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria
Schedule: legend
Dosing: 125mg to 500mg q 6 to 8 hours
Contraindication(s): Hypersensitivity
BBW: • None
Key Points:
Diarrhea Allergy Take entire course and contact provider if symptoms do not improve within a few days of starting
Phenazopyridine
Brand: Pyridium
MOA: Unknown - Local urinary tract anesthetic
Schedule: legend
Dosing: 200mg TID after meals
Contraindication(s): Hypersensitivity renal insufficiency
BBW: • None
Key Points: Do not exceed 48-72h Urine color change
Sildenafil
Brand: Viagra, Revatio
MOA: Inhibits phosphodiesterase type 5 (PDE-5), causing increased levels of cGMP, resulting in smooth muscle relaxation and increased blood flow
Schedule: legend
Dosing:
ED: 25mg to 100mg PRN 1 hour prior to actvivity (Max 100 mg once daily)
Pulmonary HTN: 5mg to 20mg TID
Contraindication(s):
Concurrent use of organic nitrates or riociguat
BBW: • None
Key Points:
Headache Flushing Dizziness Priapism
Sofosbuvir and Ledipasvir
Brand: Harvoni
MOA: Ledipasvir inhibits the HCV NS5A protein necessary for viral replication sofosbuvir inhibits NS5B RNA-dependent RNA polymerase
Schedule: legend
Dosing: 400mg/90mg once daily
Contraindication(s): None
BBW: • Hepatitis B virus reactivation
Key Points:
Hyperkalemia Gynecomastia Monitor renal function regularly
Solifenacin
Brand: Vesicare
MOA: Inhibits muscarinic receptors resulting in decreased urinary bladder contraction, increased residual urine volume, and decreased detrusor muscle pressure
Schedule: legend
Dosing:
5mg once daily, may increase to 10mg/day
Contraindication(s):
Urinary retention gastric retention uncontrolled narrow-angle glaucoma
BBW: • None
Key Points:
Don’t crush/chew Dry mouth, dry eyes, constipation, urinary retention (anticholinergic) drink plenty of water to avoid crystaluria
Sulfamethoxazole and Trimethoprim
Brand: Bactrim, Sulfatrim
MOA: Sulfamethoxazole interferes with bacterial folic acid synthesis trimethoprim inhibits bacterial folic acid metabolism
Schedule: legend
Dosing: 800mg/160mg q 12 to 24 hours
Contraindication(s):
History of drug induced immun thrombocytopenia with sulfonamides
megaloblastic anemia due to folate deficiency
Marked hepatic damage or severe renal disease Cocomitant use with dofetilide
BBW: • None
Key Points:
Steven Johnson Syndrome Rash Diarrhea (AAD & CDAD) Photosensitivitydrink plenty of water to avoid crystaluria
Tadalafil
Brand: Cialis, Adcirca
MOA: Inhibits phosphodiesterase type 5 (PDE-5), causing increased levels of cGMP, resulting in smooth muscle relaxation and increased blood flow
Schedule: legend
Dosing:
ED: 2.5mg to 5mg once daily or 10mg to 20mg once daily PRN 30 min prior activity
BPH: 5mg once daily
Contraindication(s): Concurrent use of organic nitrates or riociguat
BBW: • None
Key Points:
Headache Flushing DizzinessPriapism
Tamsulosin
Brand: Flomax
MOA: Antagonist of alpha1A-adrenoreceptors leading to relaxation of smooth muscle in the bladder and prostate
Schedule: legend
Dosing: 0.4mg once daily
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Don’t crush/chew Take on empty stomach Tiredness
Tenofovir alafenamide and emtricitabine
Brand: Descovy
MOA: Each drug interferes with HIV viral RNA dependent DNA polymerase activities resulting in inhibition of viral replication
Schedule: legend
Dosing: 1 tablet once daily
Contraindication(s): None
BBW: • Hepatitis B coinfection
Key Points:
nausea Bone weakness Hypercholesterolemia
Terazosin
Brand: Hytrin
MOA: Competitively inhibits postsynaptic alpha1-adrenergic receptors leading to smooth muscle relaxation
Schedule: legend
Dosing: 1mg to 10mg q HS (Max 20mg/day)
Contraindication(s): Hypersensitivity
BBW: • None
Key Points:
Dizziness Orthostatic hypotension at bedtime
Testosterone
Brand: Androderm, Androgel, Axiron, Testim
MOA: Principle endogenous androgen responsible for growth and development of male sex organs and maintaining secondary sex characteristics
Schedule: III
Dosing:
Gel: 50mg q AM (Max 100mg/day)
Patch: 1 patch once daily
INJ: 50mg to 400mg IM q 2 to 4 weeks
Contraindication(s):
Breast or prostate cancer
Pregnant women or women who may become pregnant
Breastfeeding
BBW:
- Secondary exposure (transdermal gel, transdermal solution)
- Pulmonary oil microembolism (testosterone undecanoate)
Key Points:
Edema Hypertension CHF
Erythrocytosis
Valacyclovir
Brand: Valtrex
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:
Genital HSV (Initial Episode):1000mg q 12 hours; (Suppression): 1000mg once daily
Cold Sores (Episode): 2000mg q 12 hours x 1 day
Shingles: 1000mg q 8 hours
Contraindication(s): Hypersensitivity
BBW: • None
Key Points:
Nausea and Vomiting Headache
