76-100 Test 1 Flashcards
Olmesartan
Brand: Benicar
MOA: Antagonizes angiotensin receptors, blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II
Schedule: legend
Dosing: 20mg to 40mg once daily
Contraindication(s):
Concomitant use of aliskerin in patients with diabetes
BBW:
• Fetal toxicity
Key Points:
Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting
Lightheadedness, dizziness, orthostasis, hypotension
Olmesartan and Hydrochlorothiazide
Brand: Benicar HCT
MOA: See individual agents
Schedule: legend
Dosing: See Individual Agents
Contraindication(s):
Concomitant use of aliskerin in patients with diabetes
Anuria
BBW: • Fetal toxicity
Key Points:
See Individual Agents
Omega-3 fatty acids
Brand: Lovaza
MOA: Reduction in hepatic production of VLDL and a reduction in the hepatic synthesis of triglycerides
Schedule: legend
Dosing: 2g BID or 4g once daily
Contraindication(s):
Hypersensitivity
BBW: • None
Key Points:
Diarrhea
Nausea/Dyspepsia
Abdominal Pain
Ensure no seafood allergies
Omeprazole
Brand: Prilosec
MOA: Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell
Schedule: legend
Dosing: 20mg to 40mg once daily
Contraindication(s):
Hypersensitivity to other PPIs
BBW: • None
Key Points:
Headache
Diarrhea
Take 30 minutes before food.
May diminish effect of clopidogrel
Ondansetron
Brand: Zofran, Zuplenz
MOA: Selective 5-HT3-receptor antagonist Schedule: legend
Dosing:
8mg to 16mg po 30min to 1 hour before therapy
Contraindication(s):
Hypersensitivity
Use with apomorphine
BBW: • None
Key Points:
Headache
Malaise
Fatigue
Constipation
Pantoprazole
Brand: Protonix
MOA: Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell
Schedule: legend
Dosing: 40mg once daily or BID
Contraindication(s):
Hypersensitivity to other PPIs
BBW: • None
Key Points:
Headache
Diarrhea
Take 30 minutes before food.
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)
Impotence, Depression/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 risk
Take 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
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
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
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
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 edema, Lightheadedness, 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 products
Bleeding
