All Common PUP drugs - Strength/Frequency/Indication/Counseling Tips Flashcards
Overall Notes for Anti-Infectives
- duration of therapy: generally 5-14 days
- finish entire therapy
- may cause upset stomach (nausea and/or abdominal pain)
- Signs of allergic rxn: itching, rash, swelling, difficulty breathing
doxycycline -
monohydrate or
hyclate forms (Vibramycin, Monodox, adoxa)
Strengths: 20, 50, 75, 100, 150mg
Freq: q12h
Ind: RTI, UTI, STI, Acne/Skin inf
CT: - sun sensitivity
- wf
- No: Ca, Fe, Mg, Zn food 2h before/after
- decrease OC effectiveness
Amoxicillin (amoxil)
Strengths: 250, 500, 875mg
Freq: q8h, q12h
Ind: RTI, UTI, STI, ENT/Skin inf
CT: - Decrease OC effectiveness
- contraindicated if penicillin allergy
Cephalexin (Keflex)
Strengths: 250, 500mg
Freq: q6h, q8h
Ind: RTI, UTI, ENT/Skin/Bone inf
CT: - no Zn++ 3hrs after cephalexin
- Contraindicated if cephalosporin allergy
- caution if penicillin allergy
Azithromycin (zithromax, z-pak, tri-pak)
Strengths: 250, 500mg
Freq: Z-pak: take two 250mg tabs po on day 1, then one tab days 2-5, q24h
Ind: RTI, STI, ENT/skin/eye inf
CT: - don’t take with an Al++ or Mg++ containing antacid
- QTc prolongation
- Contraindicated if macrolide allergy
Ciprofloxacin (Cipro, Ciloxan)
Strengths: 250, 500, 750mg
Freq: q12h
Ind: STI Prostatitis, Skin/bone inf, pneumonia, complicated UTI, RTI, abdominal inf
CT: - QTc prolongation
- no Ca++ or Fe++ 2h b/a
- Sun-sensitivity
- increase caffeine sensitity
- Contraindicated if fluoroquinolone allergy
Sulfamethoxazole/trimethoprim (SMZ-TMP)
(Bactrim DS)
Strengths: 800mg[S]/160mg[T]
Freq: q12h
Ind: RTI, UTI, HIV-associated inf
CT: - sun-sensitivity
- take with at least 8oz water
- Contraindicated if sulfa allergy
Nitrofurantoin (Macrobid, Macrodantin)
Strengths: 100mg
Freq: q12h
Ind: UTI
CT: - Orange or brown urine (ok)
- No food with Mg++ 2h b/a
- Take with food/milk to increase absorption
Metronidazole (Flagyl)
Strengths: 250, 500mg
Freq: q6h, q8h, q12h
Ind: Abscess, Vaginosis, GI tract inf, STI
CT: -Contraindicated: Alcohol use during or 3 days after last dose
- Metallic taste in mouth
- Headache common adverse effect
Fluconazole (Diflucan)
Strengths: 100, 150, 200mg
Freq: q24h, single dose for vaginitis
Ind: Fungal inf of: mouth(thrush), skin, vagina, HIV-assoc
CT: - QTc prolongation
- report any new skin rash to PCP
Valacyclovir (Valtrex)
Strengths: 500mg, 1g
Freq: q8h, q12h, q24h
Ind: Herpes viral inf of: Genitals, cold sores, shingles
CT: - headache common adverse effect
- does not prevent disease transmission
- drink lots of fluids to prevent accumulation in kidneys
All Contraceptives: Side effects
- Water retention
- Upset Stomach/nausea
- Headache
All Contraceptives: Non-FDA Uses
- Regulation of menstrual cycle
- Lessen menstrual flow
- Reduce painful menses
All Contraceptives: Miss a dose?
Take ASAP or with next days’ dose; e.g., miss Monday, take 2 on Tuesday. If you miss 2 or more days, refer to package directions
Contraceptives containing ethinyl estradiol:
- Increased cardiovascular risk (DVT, PE, MI).
- Not recommended for those: +35 years old, smoker, or history of strokes/ blood clots
All Contraceptives: Counseling Tips
- If OC not started day 1 of menses, use additional non-drug form of contraception first week of therapy
- Take same time each day for maximum effectiveness
- Some anti-convulsants [ex: divalproex, lamotrigine] may decrease effectiveness of hormonal contraceptives and/or increase chance of seizures
- None of the medications on this list protect against HIV/ AIDS/ STDs
Ethyinal Estradiol/Norgestimate (Orto Tri-cyclen, Tri-Sprintec, Tri-ViLibra
Strengths: 0.035mg/0.18mg, 0.035mg/0.215mg, 0.035mg/0.25mg
Freq: One first phase tab daily for 7d, one second phase tab daily for 7d, then one third phase tab for 7d, then one inactive tab for 7d
Ind: OC,
-Acne
(Tri-phasics mimic natural menstraul cycle)
CT: Look at Overall lists
Ethinyl estradiol/ norethindrone/ ferrous fumarate (loestrin Fe 1/20, Junel Fe, Microgestin Fe)
Strengths: 0.02mg/1mg/75mg
Freq: take one active tab for 21 days, then one FE tab for 7 days
Ind: OC
- Acne
(replaces iron lost during menses)
CT: Look at overall lists
ehtinyl estradiol/ drospirenone (Yaz, Loryna, Jasmiel)
Strengths: 0.02mg/3mg
Freq: active tab for 24 days then one inactive tab for 4 days
Ind: OC
- Acne
- Premenstrual Dysphoric Disorder
(Only 4 inactive days= shorter menstrual periods
CT: - Drospirenone lessens the water retention/weight gain side effects of estrogen
-Look at overall lists
Ethinyl estradiol/ norelgestromin (Xulane)
Strengths: 0.53mg/4.86mg
Freq: Apply one new patch each week for 3 weeks then week 4 is patch free
Ind: Contraception
CT: -same side effects as OC’s but more common
-adhesive may cause skin rash/ rotate sites
-Do not cut patch
- Apply to butt, upper torso, stomach, upper arm
ethinyl estradiol/ etonogestrel (NuvaRing)
Strengths: 0.015mg/0.12mg/ 24h ER
Freq: Insert one ring into vagina on or before day 5 of cycle and leave in for 3 weeks, remove/discard on week 4
Ind: Contraception
CT: If it falls out, rinse with cold water and re-insert within 3h
- don’t remove for intercourse
-Ring is drug delivery device, not a barrier
Medroxyprogesterone (Depo-Provera)
Strengths: 150mg/mL
Freq: 150mg deep intramuscular inj in gluteal or deltoid muscle every 3 months
Ind: - Contraception
- Endometriosis pain
- abnormal uterine bleeding
- amenorrhea
- (No Estrogen)
CT: - Nervousness
- Administration by healthcare professional
- Don’t use >2 years due to potential bone loss
- spotting or absent menses may result
Levonorgestrel(OTC)
(Plan B One-step, Econtra One-step)
Strengths: 1.5mg
Freq: t1t po asap within 72h of sex
Ind: Emergency post-coital contraception
CT: - same side effects as OC’s but more common
- fatigue
- no evidence of interaction with antibiotics
- will not terminate existing pregnancy
Clonazepam (Klonopin)
Strengths: 0.5, 1, 2mg
Freq: QD, BID, TID, QID
Ind: -Panic disorder
- seizure disorders
- (off label use: anxiety)
CT: - Drowsiness
- Fatigue
- Ataxia
- Behavioral problems
