25-50 Test 1 Flashcards
Pioglitazone
Brand: Actos
MOA: Selective PPARgamma agonist which improves target cell response to insulin
Schedule: legend
Dosing: 15mg to 45mg once daily
Contraindication(s):
NYHA Class III/IV Heart failure
BBW:
• Congestive heart failure
Key Points:
peripheral edema
worsening heart failure
weight gain takes weeks to show effects on BG
Pneumococcal conjugate vaccine
Brand: Prevnar 13, Synflorix
MOA: Promotes active immunization against invasive disease caused by S. pneumoniae
Schedule: legend
Dosing: Single 0.5mL IM dose
Contraindication(s):
Severe allergic reaction to any diphtheria toxoid-containing vaccine
BBW: • None
Key Points:
Chills
Skin Rash
Local Erythema Arthralgia
Pneumococcal Polysaccharide Vaccine
Brand: Pneumovax 23
MOA: Promotes active immunization against invasive disease caused by S. pneumoniae
Schedule: legend Dosing: Single 0.5mL IM dose
Contraindication(s):
Severe allergic reaction to pneumococcal vaccine
BBW: • None
Key Points:
Chills
Skin Rash
Local Erythema Arthralgia
Potassium Chloride
Brand: K-tab, Klor-Con, Micro-K
MOA: Provides potassium, the major intracellular cation, for various metabolic functions
Schedule: legend
Dosing: 20mEq to 100mEq daily in 1 to 4 evenly divided doses (Max single dose 20mEq to 25mEq)
Contraindication(s):
Hyperkalemia, renal failure, and conditions in which potassium retention is present
Structural, pathological, and/or pharmacologic cause for delay or arrest in passage through the GI tract
BBW: • None
Key Points:
Hyperkalemia
IV Form - phlebitis
Prednisone
Brand: Daltasone
MOA: Decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability
Schedule: legend
Dosing: 5mg to 60mg once daily
Contraindication(s):
Administration of live attenuated vaccines with immunosuppressive doses of predisone
Systemic fungal infections
BBW: • None
Key Points:
Increase in glucose
Poor wound healing
Edema Weight gain
Risedronate
Brand: Actonel
MOA: Inhibits bone resorption via actions on osteoclasts or on osteoclast precursors; decreases the rate of bone resorption, leading to an indirect increase in bone mineral density
Schedule: legend
Dosing:
Treatment or Prevention (females): 5mg once daily OR 35mg once weekly OR 150mg once monthly
Treatment (males): 35mg once weekly
Contraindication(s):
Hypocalcemia
Esophageal abnormalities
Inablility to sit or stand upright for 30 minutes
BBW: • None
Key Points:
Take on an empty stomach before breakfast with a full glass of water. Do not eat or drink, or take other meds for at least 30 mins post dose. Remain upright for 30 minutes after dose
Notify your dentist that you are taking this medicine (due to very rare osteonecrosis of the jaw)
Maintain calcium & Vit D supplementation if diet inadequateBone pain
Saxagiptin
Brand: Onglyza
MOA: Inhibits dipeptidyl peptidase IV (DPP-IV) enzyme resulting in prolonged active incretin levels
Schedule: legend
Dosing: 2.5mg to 5mg once daily
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
congestion, sore throat
unlikely, but symptoms of pancreatitis: severe stomach/upper abdominal pain, persistent N/V
Sitagliptin
Brand: Januvia
MOA: Inhibits dipeptidyl peptidase IV (DPP-IV) enzyme resulting in prolonged active incretin levels
Schedule: legend
Dosing: 100mg once daily
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
congestion, sore throat
unlikely, but symptoms of pancreatitis: severe stomach/upper abdominal pain, persistent N/V
Sitagliptin and Metformin
Brand: Janumet
MOA: See individual agents
Schedule: legend
Dosing: See Individual Agents
Contraindication(s):
Severe renal dysfunction (CrCl less than 30ml/min
Acute or chronic metabolic acidosis
BBW: • Lactic acidosis
Key Points:
See Individual Agents
Timolol
Brand: Betimol, Timoptic
MOA: Blocks both beta1- and beta2-adrenergic receptors and reduces intraocular pressure by reducing aqueous humor production and possibly increases the outflow of aqueous humor
Schedule: legend
Dosing:
Gel: Instill 1 gtt into affected eye(s) once daily
Solution: Instill 1 drop into affected eye(s) BID, may decrease to once daily if well controlled
Contraindication(s):
Bronchial asthma or severe COPD
Sinus bradycardia
Second or third degree AV block
BBW: • None
Key Points:
Burning/stinging of eyes
rarely bradycardia
Travoprost
Brand: Travatan
MOA: Prostaglandin analog which increases the outflow of aqueous humor
Schedule: legend
Dosing:
1 gtt in affected eye(s) q PM
Contraindication(s):
None
BBW: • None
Key Points:
Ocular hyperemia
Increased growth of eyelashes
Burning/stinging/itching of eyes,
Decreased visual acuity
Varicella Vaccine
Brand: Varivax
MOA: Induced cell mediated and humoral immune responses
Schedule: legend
Dosing: Two 0.5mL doses separated by at least 4 weeks
Contraindication(s):
Hypersensitivity to the vaccine, neomycin, or gelatin
Immunosuppressed/deficient individuals
Active, untreated TB or other current febrile illness
Pregnancy
BBW:
• None
Key Points:
Injection site reaction
Fever
Zoster Vaccine
Brand: Zosavax
MOA: Stimulates active immunity to disease caused by the varicella-zoster virus
Schedule: legend
Dosing: Single 0.65mL SC dose
Contraindication(s):
Hypersensitivity to the vaccine, neomycin, or gelatin
Immunosuppressed/deficient individuals
Pregnancy
BBW: • None
Key Points:
Injection site reaction
Chicken pox-like rash may develop post administration (rare)
Amlodipine
Brand: Norvasc
MOA: Acts on vascular smooth muscle to produce peripheral arterial vasodilation by inhibiting calcium ions from entering select voltage-sensitive areas of vascular smooth muscle
Schedule: legend
Dosing: 5mg to 10mg once daily
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Peripheral edema
Flushing
Lightheadedness, dizziness, orthostasis, hypotension
Amlodipine and Benazepril
Brand: Lotrel
MOA: See individual agents
Schedule: legend
Dosing: See individual agents
Contraindication(s):
History of angioedema
Concurrent use of aliskiren
BBW: • Fetal toxicity
Key Points:
See Individual Agents
Apixaban
Brand: Eliquis
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: 5mg BID PE/DVT Tx: 10mg BID x 7 days followed by 5mg BID PE/DVT
Prophylaxis: 2.5mg BID
Contraindication(s):
Hypersensitivity
Active pathological bleeding
BBW:
- Discontinuation
- Spinal/Epidural hematoma
Key Points:
Risk of bleeding
Signs/Symptoms bleeding/clotting
No routine lab monitoring,
Missing a single dose increases clotting risk
Atenolol
Brand: Tenormin
MOA: Selectively blocks beta1-receptors
Schedule: legend
Dosing: 25mg to 50mg once daily, may increase to 100mg once daily BID doses are acceptable
Contraindication(s):
Sinus bradycardia
Heart block greater than 1st degree
Uncompensated cardiac failure
Cardiogenic shock
BBW:
• Cessation of therapy
Key Points:
Bradycardia (or rebound tachycardia if stopped abruptly)
Fatigue and Lethargy
Impotence
Hypotension
Atorvastatin
Brand: Lipitor
MOA: Inhibits 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase
Schedule: legend
Dosing: 10mg to 80mg once daily
Contraindication(s):
Active liver disease
Preganacy or wormen who may become pregnant
Breastfeeding
Unexplaned persistent elevations of serum transaminases
BBW: • None
Key Points:
Muscle pain and weakness
Diarrhea
Benazepril
Brand: Lotensin
MOA: Inhibits angiotensin converting enzyme, preventing the coversion of angiotensin I to angiotensin II
Schedule: legend
Dosing: 20mg to 80mg daily as a single dose or 2 evenly divided doses
Contraindication(s):
History of angioedema
Concurrent use of aliskiren in patients with diabetes
BBW:
• Fetal toxicity
Key Points:
May cause dry cough
Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting
Angioedema, Lightheadedness, dizziness, orthostasis, hypotension
Bisoprolol
Brand: Zebeta
MOA: Selective inhibitor of beta1-adrenergic receptors
Schedule: legend
Dosing:
5mg to 10mg once daily
Max 20mg/day
Contraindication(s):
Sinus bradycardia
Heart block greater than 1st degree
Cardiogenic shock
Overt cardiac failure
BBW: • None
Key Points:
Bradycardia (or rebound tachycardia if stopped abruptly)
Fatigue and Lethargy
Impotence, Hypotension
Carvedilol
Brand: Coreg
MOA: Nonselectively blocks beta-adrenoreceptors and alpha-adrenoreceptors
Schedule: legend
Dosing:
HTN: 6.25mg to 25mg BID (Max 25mg BID)
HF Target: 25mg BID (Max 50mg BID)
Contraindication(s):
Severe bradycardia
Severe hepatic impairment
Bronchial asthma or related bronchospastic conditions
Second or third degree AV block
BBW: • None
Key Points:
Bradycardia (or rebound tachycardia if stopped abruptly)
Fatigue and Lethargy
Impotence, Orthostatic hypotension
Clonidine
Brand: Catapres
MOA: Stimulates alpha2-adrenoceptors in the brain stem, thus activating an inhibitory neuron, resulting in reduced sympathetic outflow from the CNS
Schedule: legend
Dosing:
0.1mg BID Max 2.4mg/day
Contraindication(s):
Hypersensitivity
BBW:
•Epidural use
Key Points:
Dry mouth, dry eyes, constipation, urinary retention (anticholinergic)
Lightheadedness, dizziness, orthostasis, hypotension
Rebound hypertension if dc’ed abruptly
Na/Water retention
Clopidogrel
Brand: Plavix
MOA: Irreversibly blocks the P2Y12 component of ADP receptors on the platelet surface
Schedule: legend
Dosing: 75mg once daily 300mg to 600mg loading dose
Contraindication(s):
Hypersensitivity
Active pathological bleeding
BBW:
• Diminished antiplatelet effect in patients with two loss-of-function alleles of the CYP2C19 gene
Key Points:
Rash
Increased bleeding risk
Dabigatran
Brand: Pradaxa
MOA: Specific, reversible, direct thrombin inhibitor that inhibits both free and fibrin-bound thrombin
Schedule: legend
Dosing:
AF: 150mg BID PE/DVT
Tx and Prevention: 150mg BID (after 5-10 days parenteral anticoagulation)
Contraindication(s):
Hypersensitivity
Active pathological bleeding
Patients with mechanical prosthetic heart valves
BBW:
- Thrombotic events
- Spinal/Epidural hematoma
Key Points:
do NOT chew/crush/open capsule.
Must dispense in manufacturers bottle
Signs/Symptoms bleeding/clotting
No routine lab monitoring
Missing a single dose increases clotting risk
Dicylomine
Brand: Bentyl (anticholinergirc)
MOA: Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and the CNS
Schedule: legend
Dosing: 20mg to 40mg QID
Contraindication(s):
Obstructive diseases of the GI tract
Severe ulcerative colitis
Breastfeeding
Reflux esophagitis
BBW: • None
Key Points:
Dizziness
Blurred Vision
Xerostomia
Nausea
Digoxin
Brand: Digox, Digitek, Lanoxin
MOA: Inhibits the sodium/potassium ATPase pump in myocardial cells leading to increased contractility Directly suppresses AV node conduction to increase effective refractory period and decrease conduction velocity
Schedule: legend
Dosing: 0.125mg to 0.25mg once daily
Contraindication(s):
Hypersensitivity
Ventricular fibrilation
BBW: • None
Key Points:
Can cause bradycardia
Hyperkalemia
Toxicity: vision halos,
Nausea and Vomitting
Narrow therapuitic index. Monitor levels.
