176-200 Flashcards
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
Pravastatin
Brand: Pravachol MOA: Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase Schedule: legend Dosing: 40mg to 80mg once daily Contraindication(s): Active liver disease Unexplained persistent elevations of transaminases Pregnancy and breastfeeding BBW: • None Key Points: Diarrhea Muscle pain and weakness
Promethazine
Brand: Phenadoz, Phenergan, Promethegan MOA: Blocks postsynaptic mesolimbic dopaminergic receptors in the brain; exhibits a strong alpha-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones; competes with histamine for the H1-receptor Schedule: legend Dosing: Allergies, N/V: 12.5mg to 25mg po or PR q HS or q 4 to 6 hours PRN Motion sickness: 25mg po or PR 30min to 1 hour before departure Contraindication(s): Hypersensitivity treatment of lower respiratory tract symptoms, including asthma Children under 2 years old BBW: • Respiratory depression - Pediatrics • Severe tissue injury, including gangrene (injection) Key Points: Sedation Possible EKG changes
Propranolol
Brand: Inderal MOA: Nonselective beta-adrenergic blocker; competitively blocks response to beta1- and beta2-adrenergic receptors Schedule: legend Dosing: IR: 80mg to 240mg daily in 2 to 3 evenly divided doses ER: 80mg to 160mg once daily Contraindication(s): Uncompensated congestive heart failure Severe sinus bradycardia Heart block greater than 1st degree Bronchial asthma BBW: • Cardiac ischemia after abrupt discontinuation (Inderal LA, Inderal XL, Innopran XL) Key Points: Fatigue and Lethargy Bradycardia (or rebound tachycardia if stopped abruptly) ImpotenceDepression/vivid dreams
Rabeprazole
Brand: Aciphex MOA: Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell Schedule: legend Dosing: 20mg once daily H. pylori eradication: 20mg BID Contraindication(s): Hypersensitivity to other PPIs BBW: • None Key Points: Headache Diarrhea Take 30 minutes before food.
Ranitidine
Brand: Zantac MOA: Competitively inhibits histamine at H2 receptors of the gastric parietal cells, which inhibits gastric acid secretion Schedule: legend Dosing: 150mg BID or 300mg q HS Contraindication(s): Hypersensitivity BBW: • None Key Points: Headache Diarrhea
Rivaroxaban
Brand: Xarelto MOA: Inhibits platelet activation and fibrin clot formation via direct, selective and reversible inhibition of free and clot-bound factor Xa Schedule: legend Dosing: AF: 20mg once daily DVT Prophylaxis: 10mg once daily DVT Tx/Recurrent Prophylaxis: 20mg once daily Contraindication(s): Hypersensitivity active pathological bleeding BBW: • Premature discontinuation increases the risk of thrombotic events • Spinal/Epidural hematomas Key Points: No routine lab monitoring Signs/Symptoms bleeding/clotting Missing a single dose increases clotting riskTake with food for doses 15mg or higher
Rosuvastatin
Brand: Crestor MOA: Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase Schedule: legend Dosing: 10mg to 20mg once daily, may titrate to 40mg/day Contraindication(s): Active liver disease Unexplained persistent elevations of transaminases Pregnancy and breastfeeding BBW: • None Key Points: Diarrhea Muscle pain and weakness
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 DizzinessPriapism
Simvastatin
Brand: Zocor MOA: Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase Schedule: legend Dosing: 5mg to 40mg once daily Contraindication(s): Active liver disease Unexplained persistent elevations of transaminases Pregnancy and breastfeeding Concomitant use of strong CYP3A4 inhibitors BBW: • None Key Points: Diarrhea Muscle pain and weakness
Simvastatin and Ezetimibe
Brand: Vytorin MOA: See individual agents Schedule: legend Dosing: See Individual Agents Contraindication(s): Active liver disease Unexplained persistent elevations of transaminases Pregnancy and breastfeeding Concomitant use of strong CYP3A4 inhibitors BBW: • None Key Points: See Individual Agents
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
Spironolactone
Brand: Aldactone MOA: Competes with aldosterone for receptor sites in the distal renal tubules, increasing sodium chloride and water excretion while conserving potassium and hydrogen ions Blocks the effect of aldosterone on arteriolar smooth muscle Schedule: legend Dosing: 25mg to 100mg once daily HF: Max 50mg/day Contraindication(s): Anuria, or significant impairment of renal excretory function hyperkalemia Addison Disease Concomitant use with eplerenone BBW: • Tumorigenic Key Points: Hyperkalemia Gynecomastia
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 CHFErythrocytosis
Triamterene and hydrochlorothiazide (combination)
Brand: Dyazide, Maxzide MOA: Triamterene: Blocks epithelial sodium channels in the late distal convoluted tubule (DCT) and collecting duct which inhibits sodium reabsorption from the lumen, decreasing the function of Na+/K+ ATPase, leading to potassium retention and decreased calciu Hydrochlorothiazide: Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions Schedule: legend Dosing: 37.5mg/25mg to 75mg/50mg once daily Contraindication(s): Anuria Acute or chronic renal insufficiency or significant renal impairment Patients receiving other potassium sparing diuretics or potassium supplements Hyperkalemia BBW: • Hyperkalemia Key Points: Photosensitivity Hyperkalemia, monitor renal function
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
Valsartan and hydrochlorothiazide (combination)
Brand: Diovan HCT MOA: Valsartan: Antagonizes angiotensin receptors, blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II Hydrochlorothiazide: Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ions Schedule: legend Dosing: 160mg/12.5mg to 320mg/25mg once daily Contraindication(s): anuria concomitant use with aliskerin in patients with diabetes BBW: • Fetal toxicity Key Points: Hypotension Rarely angioedema Incr in SCr
Verapamil
Brand: Calan, Verelan MOA: Inhibits calcium ions from entering select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization Schedule: legend Dosing: IR: 80mg to 160mg TID ER: 240mg to 480mg daily in one dose or in two evenly divided doses Contraindication(s): Hypotension or cardiognic shock sick sinus syndrome second or thrid degree AV block Wolf-Parkinson-White syndrome BBW: • None Key Points: Bradycardia Constipation Peripheral edemaLightheadedness, dizziness, orthostasis, hypotension
Warfarin
Brand: Coumadin, Jantoven MOA: Inhibits subunit 1 of the multi-unit VKOR complex, leading to depletion of factors II, VII, IX, and X, as well as proteins C and S. Schedule: legend Dosing: 2mg to 10mg once daily Contraindication(s): Hemorrhagic tendencies Spinal puncture or recent CNS or eye surgery Patients with high potential for noncompliance Pregnancy BBW: • Bleeding risk Key Points: Monitor INR Diet should be consistent for Vitamin K intake Inform pharmacist or prescriber of new medications and herbal productsBleeding
