76-100

Question 1

Pregabalin

Answer 1

Brand: Lyrica MOA: Binds to alpha2-delta subunit of voltage-gated calcium channels within the CNS and modulates calcium influx at the nerve terminals, thereby inhibiting excitatory neurotransmitter release Schedule: V Dosing: 150mg to 300mg BID or TID Contraindication(s):  Hypersensitivity BBW: • None Key Points:  Weight gain  Drowsiness  DizzinessEdema

Question 2

Quetiapine

Answer 2

Brand: Seroquel MOA: Antagonist of dopamine and seratonin type two receptor sites Schedule: legend Dosing: IR and ER: 300mg to 800 mg once daily Contraindication(s):  Hypersensitivity BBW: • Increased mortality in elderly patients with dementia-related psychosis • Suicidal thoughts and behavior Key Points:  Weight gain  Increased glucose  drowsinessIncreased prolactin levels

Question 3

Risedronate

Answer 3

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

Question 4

Risperidone

Answer 4

Brand: Risperdal MOA: Antagonist of dopamine and seratonin type two receptor sites Schedule: legend Dosing: Schizophrenia: 1mg BID, may titrate to 18mg/day Bipolar I Disorder: 2mg to 3mg once daily, may titrate 6mg/day Contraindication(s):  Hypersensitivity BBW: • Increased mortality in elderly patients with dementia-related psychosis Key Points:  Weight gain  Increased glucose  drowsinessIncreased prolactin levels

Question 5

Saxagiptin

Answer 5

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

Question 6

Sertraline

Answer 6

Brand: Zoloft MOA: Selectively inhibits serotonin reuptake in the presynaptic neurons Schedule: legend Dosing: 50mg to 200mg once daily Contraindication(s):  MAOI use within 14 days BBW: • Suicidality and antidepressant drugs Key Points:  Drowsiness and insomnia  Dry mouth  Decreaed Libido/Ejaculatory disordersQTc prolongation

Question 7

Sitagliptin

Answer 7

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

Question 8

Sitagliptin and Metformin

Answer 8

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

Question 9

Sumatriptan

Answer 9

Brand: Imitrex, Sumavel MOA: Selective agonist for serotonin on intracranial blood vessels and sensory nerves of the trigeminal system Schedule: legend Dosing: 25mg to 100mg single dose at onset Contraindication(s):  Ischemic heart disease, uncotrolled hypertension, PVD, or cerebrovascular syndromes  MAOI use within 14 days  Use of ergotamine derivatives within 24 hours  Severe hepatic impairment BBW: • None Key Points:  Paresthesia  Dizziness  FlushingRisk of serotonin syndrome if used with serotonergic agents

Question 10

Temazepam

Answer 10

Brand: Restoril MOA: Enhances the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to chloride ions Schedule: IV Dosing: 15mg to 30mg q HS Contraindication(s):  Pregnancy BBW: • Risks from concomitant use with opioids Key Points:  Drowsiness and sedation  Avoid alcohol or other sedating agents

Question 11

Timolol

Answer 11

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

Question 12

Topiramate

Answer 12

Brand: Topamax MOA: Blocks neuronal voltage-dependent sodium channels, enhances GABA(A) activity, antagonizes AMPA/kainate glutamate receptors, and weakly inhibits carbonic anhydrase Schedule: legend Dosing: Epilepsy: 25mg to 200mg BID Migraine Prophylaxis: 25mg to 50mg once daily or BID Contraindication(s):  XR Formulation: Recent alcohol use (within 6 hours before or after administration) BBW: • None Key Points:  Confusion, mental slowing, difficulty with speech  Weight loss  Kidney stones

Question 13

Tramadol

Answer 13

Brand: Ultram MOA: Binds to μ-opiate receptors in the CNS causing inhibition of ascending pain pathways, altering the perception of and response to pain; also inhibits the reuptake of norepinephrine and serotonin Schedule: IV Dosing: IR tab, ODT tab: 50mg to 100mg q 4 to 6 hours ER: 100mg once daily (Max 300mg/day) Contraindication(s):  Significant respiratory depression  Acute or severe asthma  GI obstruction, including paralytic ileus (known or suspected)  MAOI use within 14 days BBW: • Addiction, abuse, and misuse • Life-threatening respiratory depression • Accidental ingestion • Neonatal opioid withdrawal syndrome • Cytochrome P450 interaction • Risks from concomitant use with benzodiazepines or other CNS depressants Key Points:  Dose adjust in renal impairment/elderly  Seizure risk

Question 14

Travoprost

Answer 14

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

Question 15

Trazodone

Answer 15

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

Question 16

Valproic acid and derivatives

Answer 16

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

Question 17

Vareniciline

Answer 17

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 dreamsSuicidal ideation

Question 18

Varicella Vaccine

Answer 18

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

Question 19

Venlafaxine

Answer 19

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

Question 20

Zolpidem

Answer 20

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

Question 21

Zoster Vaccine

Answer 21

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)

Question 22

Acyclovir

Answer 22

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

Question 23

Amlodipine

Answer 23

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

Question 24

Amlodipine and Benazepril

Answer 24

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

Question 25

Amoxicillin

Answer 25

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