Brand/generic/ clinical pearls Flashcards
Metronidazole
Flagyl, Flagyl ER
-Anti-infective
-Anti-bacterial, Antiprotozoal
-Finish course as prescribed. Avoid alcohol during therapy and for 2 days after. May discolor urine reddish-brown
Fluconazole
Diflucan
-Finish course as prescribed. May cause headache and GI upset. CYP interactions: strongly inhibits 2C9, 2C19 (clopidogrel, warfarin, and phenytoin); moderately inhibits 3A4, may prolong QT interval
Ketoconazole
Nizoral
-Available topically or orally. Tablets should be taken with food. Drug is absorbed best in acidic conditions; avoid antacids, PPI’s and H2 blockers for 2 hours before and after administration. Major CYP3A4 drug interactions. Topical formulations are flammable. Potential for hepatotoxicity.
Nystatin
Mycostatin, Nystop
-Available in many different dosage forms (topical, oral, suspension, powder) and some combination products. Suspensions can be dosed as “swish and spit” for oral candidiasis or “swish and swallow” for esophageal candidiasis
Terbinafine
Lamisil
-Finish course as prescribed. Topical formulation available OTC and is most common use
Acyclovir
Zovirax
-Available topically and orally. Avoid intercourse during herpes outbreaks. Dose and duration depends on indication. CNS side effects especially in elderly and renal impairment. Interacts with herpes zoster vaccine. Stay well hydrated.
Valacyclovir
Valtrex
-Avoid intercourse during herpes outbreaks. Dose and duration depends on indication. CNS side effects especially in elderly and renal impairment/ Interacts with herpes zoster vaccine. Stay well hydrated.
Cephalexin
Keflex
-Finish course as prescribed. May cause GI upset. Hypersensitivity reactions may occur if allergic to penicillin and/or other cephalosporins. May decrease absorption of oral contraceptives.
Cefuroxime axetil
Ceftin
-Finish course as prescribed. May cause GI upset. Hypersensitivity reactions may occur if allergic to penicillin and or other cephalosporins. May decrease absorption of oral contraceptives
Cefdinir
Omnicef
-Finish course as prescribed. May cause GI upset. Hypersensitivity reactions may occur if allergic to penicillin or other cephalosporins. May decrease absorption of oral contraceptives
Ciprofloxacin
Cipro (XR)
-Finish course as prescribed. Monitor glucose. Do not take within 2 hours of consuming foods or other products containing di- or trivalent cations (milk, calcium antacids, multivitamins and supplements) May cause sun sensitivity and CNS side effects. FDA requires assessments of risk of QTc prolongation. BBW for tendonitis/ tendon rupture. Available orally and in opthalmic and otic suspensions
Levofloxacin
Levaquin
-Finish course as prescribed. Monitor glucose. Do not take within 2 hours of consuming foods or other products containing di- or trivalent cations (milk, calcium antacids, multivitamins and supplements) May cause sun sensitivity and CNS side effects. FDA requires assessments of risk of QTc prolongation. BBW for tendonitis/ tendon rupture. Available orally and in ophthalmic suspensions
Moxifloxacin
Avelox
-Finish course as prescribed. Monitor glucose. Do not take within 2 hours of consuming foods or other products containing di- or trivalent cations (milk, calcium antacids, multivitamins and supplements) May cause sun sensitivity and CNS side effects. FDA requires assessments of risk of QTc prolongation. BBW for tendonitis/ tendon rupture. Available orally and in ophthalmic suspensions (Vigamox, Moxeza)
Azithroycin
Zithromax, zmax, Azasite
-finish course as prescribed. No 3A4 inhibition. QT prolongation possible. Ophthalmic solution (Azasite) is refrigerated
Clarithromycin
Biaxin (XL)
-Finish course as prescribed. May impart metallic taste. Inhibits CYP 3A4. QT prolongation possible
Clindamycin
Cleocin, Cleocin T, Evoclin, Clindagel
-Available in many dosage forms (oral, topical, vaginal suppository, powder for suspension) and combination products. Oral therapy may cause C.diff associated severe diarrhea. Suspension has a horrible taste, little flavoring options available.
Nitrofurantoin
Macrobid, Macrodantin, Furadantin
-Take with food to enhance absorption. May cause peripheral neuropathy or pulmonary fibrosis. Shake suspension thoroughly.
Amoxicillin
Amoxil
-Finish course as prescribed. May cause GI upset; take with food. Hypersensitivity reaction possible. May decrease efficacy of oral contraceptives. Secondary vaginal yeast infection may develop. Shake suspension well and keep refrigerated
Amoxicillin + clavulanate
Augmentin, Augmentin XR
- Finish course as prescribed. May cause GI upset; take with food. More likely to have diarrhea bc of clavulanate- maintain hydration. Clavulanic acid doses vary among formulations; double-check if using alternate formulation to achieve prescribed dose. Shake susp well and keep refrigerated, note exp date
Penicillin V potassium
Veetids, Pen-Vee K
-Finish course as prescribed. May cause GI Upset; take with food. C. diff associated diarrhea may develop. Hypersensitivity reactions possible
Sulfamethoxazole + Trimethoprim
Bactrim, Bactrim DS, Septra, Spetra DS
-Finish course as prescribed. Take with plenty of water. Increase sensitivity to sunlight. Increased risk of hypoglycemia if taken with other sulfonylureas. Severe life-threatening skin reactions possible
Doxycycline
Vibramycin, Doryx, Adoxa, Monodox, Oracea, Periostat
-May increase sensitivity to sunlight. Do not take within 2 hours of consuming food or other products containing di- or trivalent cations (ex. milk, calcium antacids, multivitamins and supplements) Hyclate and monohydrate salts not interchangeable
Metronidazole (topical)
metrogel, metrogel-vaginal, metrocream, metrolotion
-use condoms during vaginal therapy. some drug is absorbed systemically; avoid alcohol consumption during therapy and for 2 days after. Also used topically on the face for rosacea.
Mupirocin
Bactroban
-Used most in hospital to reduce the risk of MRSA infection from carriers
Nystatin + triamcinolone
Mycolog II
-use sparing amount, avoid application around eyes
Chlorhexidine gluconate
Peridex, Periogard
-Tx for gingivitis/ periodontitis
-swish and spit 15 mls BID
Olsetamivir
Tamiflu
-BID dosing for Tx, QD dosing for prophylaxis, Tx within 24-48 hours of sx, rarely causes behavioral disturbances inc delirium, risk of anaphylaxis and allergic skin reactions
Emtricitabine + Tenofovir
Truvada
-Reverse Transcriptase inhibitor
-Adherence important to prevent resistance. May be taken without regard to food. May cause decrease in bone mineral density, fat redistribution, lactic acidosis, hepatomegaly, and renal toxicity. Recently approved for pre-exposure HIV prophylaxis for those whose partner has HIV; must have regular testing every 3 months
Zidovudine +lamivudine
Combivir
-Reverse transcriptase inhibitor
-Adherence important to prevent resistance. May be taken without regard to food. May cause fat redistribution, lactic acidosis, hepatomegaly, myopathy, and hematologic toxicity.
Enalapril
Vasotec
-Pregnancy category D. May cause dry cough, first-dose hypotension (especially in CHF and hypervolemia) and hyperkalemia (avoid salt substitutes) Angioedema is a serious reaction; discontinue immediately and medical intervention may be necessary. Drug has renoprotective properties, but may also cause acute renal failure; monitor serum creatinine and discontinue if >30% increase.
Ramipril
Altace
-Pregnancy category D. May cause dry cough, first-dose hypotension (especially in CHF and hypervolemia) and hyperkalemia (avoid salt substitutes) Angioedema is a serious reaction; discontinue immediately and medical intervention may be necessary. Drug has renoprotective properties, but may also cause acute renal failure; monitor serum creatinine and discontinue if >30% increase. May have greater benefit if dosed at bedtime
Quinapril
Accupril, Accuretic
-Pregnancy category D. May cause dry cough, first-dose hypotension (especially in CHF and hypervolemia) and hyperkalemia (avoid salt substitutes) Angioedema is a serious reaction; discontinue immediately and medical intervention may be necessary. Drug has renoprotective properties, but may also cause acute renal failure; monitor serum creatinine and discontinue if >30% increase.
Benazepril, Ben/HCTZ
Lotensin, Lotensin HCT
-Pregnancy category x. May cause dry cough, first-dose hypotension (especially in CHF and hypervolemia) and hyperkalemia (avoid salt substitutes) Angioedema is a serious reaction; discontinue immediately and medical intervention may be necessary. Drug has renoprotective properties, but may also cause acute renal failure; monitor serum creatinine and discontinue if >30% increase.
Lisinopril, Lis/HCTZ
Zestril or Prinivil, Zestoretic
-Pregnancy category D. May cause dry cough, first-dose hypotension (especially in CHF and hypervolemia) and hyperkalemia (avoid salt substitutes) Angioedema is a serious reaction; discontinue immediately and medical intervention may be necessary. Drug has renoprotective properties, but may also cause acute renal failure; monitor serum creatinine and discontinue if >30% increase.
Doxazosin Mesylate
Cardura, Cardura XL
*Alpha 1 blocker
-May cause postural hypotension/orthostasis after first dose or an increase in dose. Dizziness and headache commo
Terozosin
Hytrin
*Alpha 1 blocker
-May cause postural hypotension/ orthostasis after first dose or increase in dose. Dizziness and headache common
Clonidine
Catapres, Catapres TTS, Nexiclon XR, Kapvay ER
*Alpha II agonist
May cause drowsiness, dry mouth, or skin reactions. Rotate patch application sites and discard patches carefully. Do not discontinue abruptly.
Amiodarone
Cordarone
*Antiarrhythmic
Many drug interactions, complicated by extremely long half life of 40-50 days. Hepatic and pulmonary damage possible; notify MD if jaundice, dark urine or trouble breathing occur. May cause thyroid problems, hypotension, bradycardia, ocular disease and exacerbate arrhythmia. Have regular ophthalmic visits. May cause skin to turn bluish-grey in color.
Warfarin
Coumadin
*anticoagulant
-risk of bleeding, especially GI. Very narrow therapeutic index, INR must be monitored regularly and vitamin K intake should be uniform. Many drug interactions; always check with MD or RPh when taking a new medication
Fenofibrate
TRICOR, Trilipix
*Antihyperlipidemic
-Risk of myopathy; taking with statins increase risk. Discontinue immediately and report any signs (muscle pain, brown urine) to MD and/or RPh. Increases action of sulfonylureas; monitor for hypoglycemia. No good outcome data; FIELD and ACCORD Lipid were not positive. Safer to combine with a statin than gemfibrozil, but not evidence based. Many different “brand” formulations
Gemfibrozil
Lopid
-antihyperlipidemic
-Increases effects of statins and therefore myopathy risk; discontinue immediately and report any signs (muscle pain, brown urine to MD or RPh. Should be taken 30 minutes before breakfast and dinner. Increased risk of gallstones.
Niacin
Niaspan ER
*antihyperlipidemic
-Causes flushing in most individuals (>80%); take at bedtime with a low-fat snack and 325 mg aspirin to reduce effects. Doses higher than 2g/day may cause hepatotoxicity
Atorvastatin
Lipitor
*Antihyperlipidemic- HMG CoA reductase inhibitor
-Pregnancy category X. Myopathy is a serious reaction; discontinue immediately and report any signs (muscle pain, brown urine) to MD or RPh. May be taken at anytime of day. Avoid excessive alcohol and grapefruit juice. Some CYP3A4 interactions
Lovastatin
Mevacor, Altoprev ER
*HMG CoA reductase inhibitor
–Pregnancy category X. Myopathy is a serious reaction; discontinue immediately and report any signs (muscle pain, brown urine) to MD or RPh. Take in the evening. Avoid excessive alcohol and grapefruit juice. Some CYP3A4 interactions
Pravastatin
Pravachol
*HMG CoA reductase inhibitor
–Pregnancy category X. Myopathy is a serious reaction; discontinue immediately and report any signs (muscle pain, brown urine) to MD or RPh. Avoid excessive alcohol and grapefruit juice. Significantly fewer drug interactions compared to other statins (cleared by kidney rather than liver)
Rosuvastatin
Crestor
*HMG CoA reductase inhibitor
–Pregnancy category X. Myopathy is a serious reaction; discontinue immediately and report any signs (muscle pain, brown urine) to MD or RPh. May be taken at anytime of day. Avoid excessive alcohol and grapefruit juice.
Simvastatin/ Ezetimibe
Vytorin
*HMG CoA reductase inhibitor and cholesterol absorption inhibitor
–Pregnancy category X. Myopathy is a serious reaction; discontinue immediately and report any signs (muscle pain, brown urine) to MD or RPh. Take in the evening. Avoid excessive alcohol and grapefruit juice. Several CYP 3A4 interactions. Lacks data that combination is superior to simvastatin alone.
Simvastatin
Zocor
*HMG reductase inhibitor
–Pregnancy category X. Myopathy is a serious reaction; discontinue immediately and report any signs (muscle pain, brown urine) to MD or RPh. Take in the evening. Avoid excessive alcohol and grapefruit juice. Some CYP3A4 interactions
Aspirin
Ecotrin
*Antiplatelet
-Used for cardiovascular or cerebrovascular accident treatment/prophylaxis. 75-325 mg po daily. Risk/benefit important for prophylaxis decisions. Increased risk of bleeding. Be aware of hypersensitivity reactions especially in patients with allergic triad as a allergy, nasal polyps, and asthma, avoid in children due to risk of Reye Syndrome
Amlodipine + Valsartan
Exforge, Exforge HCT
*ARB + calcium channel blocker
Valsartan, Val/HCTZ
Diovan, Diovan HCT
*ARB
-BBW in pregnancy. May cause dizziness, hypotension, hyperkalemia (avoid salt substitutes, potassium sparing diuretics), and renal dysfunction (discontinue if serum creatinine increase >30%) NSAIDs reduce antihypertensive effect and increase risk of renal dysfunction. Taking with ACE inhibitor or renin inhibitor increases side effects with little benefit
Irbesartan, Irbesartan/ HCTZ
Avapro, Avalide
*ARB
-BBW in pregnancy. May cause dizziness, hypotension, hyperkalemia (avoid salt substitutes, potassium sparing diuretics), and renal dysfunction (discontinue if serum creatinine increase >30%) NSAIDs reduce antihypertensive effect and increase risk of renal dysfunction. Taking with ACE inhibitor or renin inhibitor increases side effects with little benefit
Candesartan, Can/HCTZ
Atacand, Atacand HCT
*ARB
-BBW in pregnancy. May cause dizziness, hypotension, hyperkalemia (avoid salt substitutes, potassium sparing diuretics), and renal dysfunction (discontinue if serum creatinine increase >30%) NSAIDs reduce antihypertensive effect and increase risk of renal dysfunction. Taking with ACE inhibitor or renin inhibitor increases side effects with little benefit
Olmesartan
Benicar, Benicar HCT
*ARB
-BBW in pregnancy. May cause dizziness, hypotension, hyperkalemia (avoid salt substitutes, potassium sparing diuretics), and renal dysfunction (discontinue if serum creatinine increase >30%) NSAIDs reduce antihypertensive effect and increase risk of renal dysfunction. Taking with ACE inhibitor or renin inhibitor increases side effects with little benefit
Losartan, Los/HCTZ
Cozaar, Hyzaar
*ARB
-BBW in pregnancy. May cause dizziness, hypotension, hyperkalemia (avoid salt substitutes, potassium sparing diuretics), and renal dysfunction (discontinue if serum creatinine increase >30%) NSAIDs reduce antihypertensive effect and increase risk of renal dysfunction. Taking with ACE inhibitor or renin inhibitor increases side effects with little benefit
Atenolol
Tenormin
*Beta Blocker, Beta 1 selective
-May cause drowsiness. Masks symptoms of hypoglycemia. Do not discontinue abruptly. Limited evidence/data
Metoprolol Succinate
Toprol XL
*Beta blocker, beta 1 selective
-may cause drowsiness. Masks symptoms of hypoglycemia. Do not discontinue abruptly. Succinate and tartrate salts are not interchangeable
Metoprolol tartrate
Lopressor
*Beta blocker, beta 1 selective
-may cause drowsiness. Masks symptoms of hypoglycemia
bisoprolol, bisoprolol + HCTZ
Zebeta, Ziac
*Beta blocker, beta 1 selective
-may cause drowsiness. Masks symptoms of hypoglycemia. Do not discontinue due to risk of tachycardia and hypertension. Bisoprolol has outcome data in heart failure; target dose of 10 mg/day
atenolol/chlorithalidone
Tenoretic
*beta blocker, beta 1 selective
Propranolol
Inderal, Inderal LA, Innopran, Innorpan XL
*Beta blocker, nonselective
-May cause drowsiness. Masks symptoms of hypoglycemia. Do not discontinue abruptly. LA and immediate release formulation are not mg-mg equivalent; dose may need to be increased up to 30% when converting from immediate release to LA
Carvedilol
Coreg
*Beta blocker, nonselective, alpha 1 blocker
-may cause drowsiness. masks symptoms of hypoglycemia. Do not discontinue abruptly. CR and immediate release are not mg-mg equivalent; CR 10 mg equivalent to 3.125 mg BID of immediate release.
Labetalol
Normodyne or Tradate
*Beta blocker, nonselective; alpha 1 blocker
-may cause drowsiness. masks symptoms of hypoglycemia. do not discontinue abruptly
digoxin
Lanoxin or Lanoxicap
*Cardiac glycoside: + inotropic, - chronotropic
-narrow therapeutic index, many drug interactions. Digoxin toxicity possible (anorexia, nausea, fatigue, vision disturbances, bradycardia, arrhythmias)
Amlodipine + olmesartan
Azor, tribenzor
amlodipine
Norvasc
*dihydro calcium channel blocker
-may cause drowsiness, risk of hypotension and orthostasis. Risk of peripheral edema that is not responsive to diuretics but may be relieved by ACEi or ARB
Nifedipine
Procardia, Procardia XL, Adalat
*Dihydro CCB
-may cause drowsiness. risk of peripheral edema that is not responsive to diuretics. ACEi or ARB used to reverse. Adalat and Procardia not equivalent, double-check when dispensing generics
Amlodipine + Benazepril
Lotrel
*Dihydro CCB + ACEi
Amlodipine +Atorvastatin
Caudet
*dihydroCCB + HMG-CoA reductase inhibitor
-titrate amlodipine to response over 1-2 weeks and atorvastatin in 6-8 weeks
Dabigatran
Pradaxa
*direct thrombin inhibitor
-Monitor for bleeding. May cause some GI upset. Store capsules in original container or blister pack; discard unused medication after 4 months. Do not crush, chew or open capsules. If a dose is missed, do not take a double dose if more than 6 hours have passed. Drug interaction with p-glycoprotein substrates (dronedarone, ketoconazole, rifampin). Dose should be adjusted for kidney function. discontinuation for surgery determined by creatinine clearance
potassium chloride
Klor-con
-May cause GI upset, take with food. monitor salt intake
Rivaroxaban
Xarelto
*Factor Xa inhibitor
-Monitor for bleeding. Doses of 15 mg or more must be taken with food. Compliance extremely important, but do not take a double dose if a dose is missed. discontinue at least 24 hours before surgeries. drug interactions with CYP 3A4 substrates, but benefit outweighs cost in some cases
apixaban
Eliquis
*Factor Xa inhibitor
-Monitor for bleeding. 5 mg orally twice daily. A dose of 2.5 mg twice daily is recommended for patients at least 80 years old, who weigh no more than 60 kg, or have serum creatinine of at least 1.5 mg/dL, as well as those receiving strong dual inhibitors of cytochrome P450 3A4 and P-glycoprotein. Boxed waring- increased risk of stroke if DC’d. Not indicated in patients with prosthetic heart valves
furosemide
Lasix
*loop diuretic
-May cause hypokalemia; monitor potassium levels and kidney function. Also watch salt intake. May be used as needed in congestive heart failure. Hypersensitivity reaction may occur in individuals with sulfa allergy. Lasix is short for “last six hours”
Enoxaparin
Lovenox
*Low molecular weight heparin
-Increased risk of bleeding. Counsel on injection technique. Often used when beginning warfarin to achieve goal INR more quickly. In community pharmacy, double-check to make sure proper package size and quantity are being dispensed/billed
Isosorbide Mononitrate
Imdur, ISMO
*Nitroglycerin antianginal/ vasodilator
-Frequently causes dizziness and/or headache. Dosed twice daily, but must be taken “asymmetrically” to prevent tolerance; take second dose 8 hours after first dose rather than every 12 hours
Nitroglycerin SL
Nitrostat
*Nitroglycerin antianginal/ vasodilator
-Frequently causes dizziness and/or headache. If chest pain persist after first dose, take second dose in 5 minutes. Call 911 if symptoms persist after second dose. Store in original container
Topical Nitroglycerin
Nitro-Dur
*Nitroglycerin antianginal/ vasodilator
-Finish course as prescribed. Apply patch for 12 hours and remove for 12 hours for nitrate-free period
Diltiazem
Cardizem, Cardizem SR, Cardizem CD, Cardizem LA, Tiazac
*Non-dihydro CCB
-May cause drowsiness/dizziness or headache. Do not discontinue therapy without discussing with MD. Many formulations that may not be equivalent; double-check when dispensing generics
Verapamil
Calan, Calan SR, Isoptin SR
*Non-dihydro Calcium Channel blocker
-may cause drowsiness/ dizziness, headache, or constipation. Do not discontinue therapy without discussing with MD
Clopidogrel
Plavix
*Platelet inhibitor
-Monitor for bleeding. Compliance extremely important. CYP 2C19 inhibitors such as omeprazole and esomeprazole greatly decrease efficacy. Check with MD or RPh before starting new medications or taking OTC medications
Triamterene +HCTZ
Dyazide capsule or Maxzide tablets
*Potassium sparing + thiazide
-Take in the early morning, monitor renal function, potassium levels, and salt intake; not to be used if renal function impaired. Risk of kidney stones; drink plenty of fluids to reduce risk. Double check patient profile when dispensing generics; patients should remain on tablets or capsules unless MD changes
Spironolactone, Spir/HCTZ
Aldactone, Aldactizide
*potassium sparing
-take early in the morning. monitor renal function, potassium levels, and salt intake. may cause gynecomastia in males, menstrual irregularities in females (antiandrogenic properties) Evidence based data for heart failure, post MI, and resistant hypertension. Aldactazide may cause hypersensitivity reactions in individuals with sulfa allergy.
Indapamide
Lozol
*thiazide
-take in the early morning. monitor renal function, potassium levels, and salt intake; not to be used in severe renal impairment, but may be used in minimally impaired renal function. Hypersensitivity reaction may occur in individuals with sulfa allergy.
Chlorithalidone
Thalidone, Hygroton
*thiazide
–take in the early morning. monitor renal function, potassium levels, and salt intake; not to be used if renal function impaired. Hypersensitivity reaction may occur in individuals with sulfa allergy. Chlorithalidone is twice as potent as HCTZ
Hydrochlorithiazide
Oretic, Microzide
*thiazide
-Take in the early morning. Monitor renal function, potassium levels and salt intake. Hypersensitivity reactions may occur in individuals with sulfa allergy
Metolazone
Zaroxolyn
*thiazide
-take in the early morning. monitor renal function, electrolytes (potassium and magnesium) and salt intake. hypersensitivity reaction may occur in individuals with sulfa allergy. Often used in diuretic-resistant patient in combination with loop diuretics
Ondansetron
Zofran, Zofran ODT
*5-HT3 antagonist; antiemetic
-may cause headache, fatigue, dissolve ODT under the tongue, store in original container until ready to use. QT prolongation possible
Donepezil
Aricept
*acetylcholinesterase inhibitor
-take in the evening. significant nausea, vomiting and diarrhea possible, as well as anorexia. May also cause bradycardia and fainting. Set realistic expectations for Alzheimer’s patients. Keep in mind positive statistical significance vs clinical significance
Rivastigmine
Exelon, Exelon Patch
*Acetylcholinesterase inhibitor
-Take capsule in the evening. rotate patch application sites. Significant nausea, vomiting and diarrhea possible, as well as anorexia. May also cause bradycardia and fainting. Set realistic expectations for Alzheimer’s patients
Butalbital + aspirin + caffeine (w or wo codeine)
Fiorinal, Fiorinal with codeine
*Analgesic combo for tension headache C-III
-may cause drowsiness or dizziness; avoid alcohol use during therapy. Caution against taking other products containing aspirin
Butalbital + acetaminophen + caffeine
Fioricet, Fioricet with codeine
*Analgesic combo for tension headaches, C-III
-May cause drowsiness or dizziness; avoid alcohol use during therapy. Do not exceed 4 g of APAP per day, 3g if frequent alcohol drinker, 2g if taking warfarin. New BBW with acetaminophen due to hepatotoxicity
Buspirone
Buspar
*Antianxiety- serotonin 5-HT1A receptor partial agonist
-may cause drowsiness or dizziness, slow onset, mildly effective, little potential for abuse
Scopolamine
Transderm-Scop
*Anticholinergic
-may cause drowsiness or dizziness. wash your hands after application as touching your eyes after application may result in blurred vision (dilation)
Mirtazapine
Remeron
*antidepressants
-may cause drowsiness or dizziness, dry mouth, constipation and weight gain. do not discontinue abruptly. open from blister and dissolve on the tongue
Trazodone
Desyrel
*Antidepressant/ sleep aid
-may cause dizziness/drowsiness/orthostasis, priapism risk
Bupropion
Wellbutrin (SR) (XL) or Zyban
*Antidepressant/ smoking cessation aid
-Take XL tabs in the AM to avoid insomnia, do not crush or chew SR or XL tabs, do not take doses too close or exceeding maximum doses because of seizure risk. Potential side effects inc nervousness, constipation, trouble sleeping, dry mouth, tremor
Carbamazepine
Tegretol (XR)
Antiepileptic
-Take with food, may cause drowsiness, avoid alcohol. Serious and sometimes fatal dermatologic reactions (including Stevens-Jonson syndrome and toxic epideral necrolysis) have been reported especially in patients with the inherited allelic variant HLA-B1502. Genetically at risk patients (IE those from Asia) should be screened prior.
Lamotrigine
Lamictal
*Antiepileptic
-Report hypersensitivity/rash to MD, may cause drowsiness, do not operate heavy machine
Levetiracetam
Keppra
*Antiepileptic
-May cause dizziness/drowsiness, do not operate heavy machinery, do not abruptly discontinue therapy
Oxcarbazepine
Trileptal
*Antiepileptic
-May cause dizziness/drowsiness, do not operate heavy machinery or abruptly discontinue therapy
Phenytoin Sodium
Dilantin Kapseals
*Antiepileptic
-May cause dizziness/drowsiness, do not operate heavy machinery. Emphasize good oral hygiene to reduce risk of gingival hyperplasia.
Divalproex
Depakote (ER)
*Antiepileptic, mood stabilizer
-Do not abruptly discontinue therapy, avoid alcohol use, may cause drowsiness
phenobarbital
phenobarbital
*Antiepileptic/hypnotic; C-IV
May cause drowsiness or dizziness, avoid alcohol use during therapy
Topiramate
Topamax
*Antiepileptic/ migraine prophylactic
-May cause drowsiness or dizziness, avoid alcohol use during therapy. Confusion (“Dopamax”) and it is now FDA approved in combination with phentermine in extended release- Qsymia (C-IV)
Gabapentin
Neurontin
*Antiepileptic/ neuropathic analgesic
-May cause drowsiness or dizziness, avoid alcohol use during therapy. Edema, weight gain and confusion common, as well as generally need to titrate slowly to higher doses as this agent has dose related kinetics
Hydroxyzine hydrochloride
Atarax
*Antihistamine
-May cause anticholinergic side effects
Hydoxyzine pamoate
Vistaril
*Antihistamine/ antianxiety
-may cause anticholinergic side effects
Eletriptan
Relpax
*Antimigraine, 5-HT1 agonist
-Take at onset of migraine. If headache is relieved but returns after 1st dose, repeat in 2 hours. Do not exceed 2 doses or 80 mg in a 24 hours period. If 1st dose does not relieve symptoms, reevaluate condition. Ischemic cardiovascular events possible. Drug interactions with CYP 3A4 substrates and ergot derivatives
Rizatriptan
Maxalt, Maxalt MLT
*Antimigraine, 5-HT1 agonist
-Take at onset of migraine. If headache is relieved but returns after 1st dose, repeat in 2 hours. Do not exceed 2 doses or 80 mg in a 24 hours period. If 1st dose does not relieve symptoms, reevaluate condition. Ischemic cardiovascular events possible. Drug interactions with ergot derivatives. Dissolve tablets contain phenylalanine
Sumatriptan
Imitrx
*Antimigraine, 5-HT1 agonist
-Take at onset of migraine. If headache is relieved but returns after 1st dose, repeat in 2 hours. Do not exceed 2 doses or 80 mg in a 24 hours period. If 1st dose does not relieve symptoms, reevaluate condition. Ischemic cardiovascular events possible. Drug interactions with ergot derivatives. Available in oral tablet, injection kit and nasal spray
Benztropine
Cogentin
*Antiparkinson agent
-May take with food to decrease GI Symptoms. Potential anticholinergic side effectd
Levodopa/Carbidopa
Sinemet (CR)
*Antiparkinson Agent
-Avoid products containing B6 as they reduce the effectiveness of levodopa, may be taken with food/milk if GI upset occurs
Pramipexole
Mirapex
*antiparkinson agent
-Hallucinations may occur, report any changes in vision to MD, may cause drowsiness and even sleep attacks (falling asleep without warning)
Ropinirole
Requip
*antiparkinson/ restless leg agent
-may cause drowsiness or dizziness, avoid alcohol use during therapy , orthostasis may occur. May also cause sleep attacks
Olanzapine
Zyprexa
*antipsychotic
-Initially may cause dizziness, use caution when operating heavy machinery due to drowsiness, may cause wt gain, DM and dyslipidemia
Quetiapine
Seroquel (XR)
*Antipsychotic
-Initially may cause dizziness, use caution when operating heavy machinery due to drowsiness
Risperdone
Risperdal
*Antipsychotic
-first dose may cause fainting, may impair judgment, avoid alcohol use
Ziprasidone
Geodon
*Antipsychotic
-May cause arrhythmias, do not discontinue use abruptly, take with food
Aripiprazole
Abilify
*Antipsychotic for bipolar, schizophrenia and major depressive disorder
-Avoid alcohol, D/I 3A4, QT prolongation, do not discontinue abruptly
Meclizine
Antivert
*Antivertigo agent
-potential anticholinergic side effects
Alprazolam
Xanax (XR)
Benzodiazepine Antianxiety, C-IV
-Do not exceed prescribed dose, do not take with alcohol, may cause drowsiness/dizziness, do not operate heavy machinery, avoid abrupt discontinuation
Clonazepam
Klonopin
*Benzo
-Do not exceed prescribed dose, do not take with alcohol, may cause drowsiness/dizziness, do not operate heavy machinery
diazepam
Valium
*benzo
-Do not exceed prescribed dose, do not take with alcohol, may cause drowsiness/dizziness, do not operate heavy machinery
Lorazepam
Ativan
*Benzo
-Do not exceed prescribed dose, do not take with alcohol, may cause drowsiness/dizziness, do not operate heavy machinery
Temazepam
Restoril
*Benzo
-Do not exceed prescribed dose, do not take with alcohol, may cause drowsiness/dizziness, do not operate heavy machinery
Phentermine
Adipex-P
*CNS stimulant - obesity management, C-IV
-Cardiovascular risk caution, take in the morning
Methylphenidate
Concerta or Ritalin (ER) or Metadate CD
*CNS stimulant for ADD, C-II
-take as directed, don’t share your pills
Atomoxetine
Strattera
*CNS stimulant, used for ADD
may impair cognitive & motor function, use caution when operating machinery, not a drug of abuse
(Dex)/Amphetamine mixed salts
Adderall (XR)
*CNS stimulant, used for ADD; C-II
-take as directed, don’t share your pills
Lisdexamfetamine
Vyvanse
*CNS stimulant, used for ADHD; C-II
-take as directed, don’t share your pills
Modafinil
Provigil
*CNS stimulant, used for narcolepsy; C-IV
-Take in morning or 1 hour prior to work, avoid driving until deemed safe by MD
Dexmethylphenidate
Focalin (XR)
*CNS stimulant; C-II
-Take as directed, don’t share your pills
Zaleplon
Sonata
*hypnotic, nonbenzo; C-IV
-Take 30 mins prior to desired sleep, allocate at least 5 hours after dose to sleep (t1/2 ~1 hour)
Cyclobenzaprine
Flexeril
*Muscle relaxant
-may cause drowsiness or dizziness and other anticholinergic side-effects, avoid alcohol use during therapy
Metaxalone
Skelaxin
*Muscle relaxant
-Least drowsy muscle relaxant, requires frequent dosing
Carisoprodol
Soma
*Muscle relaxant; C-IV
-drug of abuse, may be schedules in some state, caution for drowsiness
Fentanyl
Duragesic
*Narcotic analgesic C_II
-Caution for respiratory depression, do not exceed prescribed dose. Avoid exposing patch on the skin to heat as it will increase the risk of toxicity, dispose of the used patch by folding over and flushing it, be careful when starting therapy and remember the patch is used for several days normally 72 hours but may see it unchanged every 48 hours in some patients. Caution in narcotic naive patients as it is 80-100 times more potent analgesic than morphine
Morphine Sulfate
MS Contin
*Narcotic
-Risk of CNS and respiratory depression, avoid alcohol, may cause drowsiness/dizziness, do not operate heavy machinery, constipation
Oxycodone
Oxycontin
*Narcotic
-CNS depression, avoid alcohol, may cause drowsiness/ dizziness, do not operate heavy machinery, constipation
Oxycodone/APAP
Percocet or Roxicet
*Narcotic
-CNS depression, avoid alcohol, may cause drowsiness/dizziness, do not operate heavy machinery, constipation . APAP combination dose will be reduced to no more than 325 mg per tablet. Consider the total daily dose of acetaminophen from all sources
Acetaminophen/ codeine
Tylenol with codeine
*narcotic
-CNS depression, avoid alcohol, may cause drowsiness/ dizziness, do not operate heavy machinery, constipation. Consider the total daily dose of acetaminophen from all sources
Hydrocodone/ chlorpheniramine Polistirex
Tussionex
*Narcotic
-CNS depression, avoid alcohol, may cause drowsiness/dizziness, do not operate heavy machinery, constipation, taking with food may decrease some GI upset, Max dose 5mls BID
Hydrocodone/ibuprofen
Vicoprofen
*Narcotic
-CNS depression, avoid alcohol, may cause drowsiness/dizziness, do not operate heavy machinery, constipation, taking with food may decrease some GI upset
Hydrocodone/APAP
Lortab or Vicodin or Lorect
*Narcotic
-CNS depression, avoid alcohol may cause drowsiness/dizziness, do not operate heavy machinery, avoid concomitant said drugs, constipation. Vicodin reformulated to contain only 300 mg of APAP per dose to avoid generic competition and to meet new FDA requirement
Pregabalin
Lyrica
*Neuropathic analgesic
-may cause drowsiness, do not discontinue therapy abruptly. weight gain, edema and confusion are potential side-effects
Varenicline tartrate
Chantix
*Nicotinic receptor agonist, smoking cessation
-Usually titrated upward. most effective smoking cessation agent to date ~44% at 12 weeks, also watch for nightmares and any changes in affect and/or behavior and report them to the prescriber. side effects may be dose related
Memantine
Namenda
*NMDA receptor antagonist; anti-alzheimer’s agent
-Take in the evening, potential N&D, dizziness and agitation possible. Set realistic expectations. Keep in mind positive statistical significance vs clinical significance. Take without regard to food
Enteric diclofenac sodium, diclofenac potassium (non-enteric coated formulation)
Voltaren, Cataflam
*NSAID
Take with food, monitor for s/sx of GI bleed, CV and renal risks. Enteric coated diclofenac sodium, slow onset not for PRN pain, greater risk of hepatotoxicity vs other NSAIDs, use the Cataflam-diclofenac potassium non-enteric coated formulation if for PRN use for pain
Etodolac
Lodine (XL)
*NSAID
Take with food, monitor for s/sx of GI bleed, CV and renal risks
Indomethacin
Indocin
*NSAID
-Take with food, monitor for s/sx of GI bleed. CV and renal risks. Most likely NSAID to cause headaches and CNS side effects
Ketorolac Tromethamine
Toradol
*NSAID
-Take with food, monitor for s/sx of GI bleed. Very high risk of GI bleeding limits this drug to 5 days max of therapy. CV and renal risk s
Meloxicam
Mobic
*NSAID
-Take with food, monitor for s/sx of GI bleed. CV and renal risks
Nabumetone
Relafen
*NSAID
-Take with food, monitor for s/sx of GI bleed. CV and renal risks
Naproxen and Naproxen sodium
Naprosyn, Anaprox/ Aleve
*NSAID
-Take with food, monitor for s/sx of GI bleed. CV and renal risks. Naproxen sodium Aleve/Anaprox fast onset sodium salt vs regular naproxen - Naprosyn which is slow onset and used for chronic Rx of OA and RA not acute pain relief
Piroxicam
Feldene
*NSAID
-Take with food, monitor for s/sx of GI bleed, CV and renal risks
Ibuprofen
Motrin or Advil
*NSAID
-take with food, monitor for s/sx of GI bleed, CV and renal risks. Motrin at low doses (IE OTC it is analgesic and antipyretic) but if you need anti-inflammatory effects then you need higher doses 2400 to 3200 mg/day
Celecoxib
Celebrex
*NSAID Cox-II selective
-Report s/sx of GI bleed, caution for CV risks like all NSAIDs, not safer for renal function but may be slightly safer for GI bleeding risks
Diclofenac/ Misoprostol
Arthrotec
*NSAID / prostaglandin combo
-Take with food. Misoprostol may decrease GI bleeding risks. CV and renal risks. Avoid in pregnancy. Diarrhea may be a common side effect of the prostaglandin component
Tramadol
Ultram, Ultram ER
*Opioid analgesic
-May cause drowsiness; avoid alcohol. Drug is scheduled in some states but not by the DEA. Some risk of dependence due to weak opioid receptor agonist activity. Drug also has some serotonin reuptake inhibitor properties; increased seizure risk, and drug interactions (especially with SSRIs, SNRIs, 5-HT1 agonists/triptans)
Tramadol + acetaminophen
Ultracet
*Opioid analgesic combo
-May cause drowsiness; avoid alcohol. Drug is scheduled in some states but not by the DEA. Some risk of dependence due to weak opioid receptors agonist activity. Drug also has some serotonin syndrome, increased seizure risk, and drug interactions (especially with SSRIs, SNRIs, 5-HT1 agonists/ triptans) Do not exceed 4g of APAP per day, 3 g if frequent alcohol drinker, 2 g if taking warfarin. BBW with acetaminophen due to hepatotoxicity
Acetaminophen
Tylenol
*Pain, antipyretic
-Limit total daily dose <4g, 3 g in elderly or frequent ETOH, 2 g if taking warfarin, consider the total daily dose of acetaminophen from all sources. BBW with acetaminophen due to hepatotoxicity and warning related to angioedema
Eszopiclone
Lunesta
*sedative hypnotic
-Do not take with alcohol, take 30 min prior to bed. has long half life of ~6 hours and thus an increased risk of morning residual sedation ~40% of patients complain of a bitter taste the morning after, need to have at least 8 hours to sleep after a dose and all of these agents can cause complex sleep behaviors (walking, eating, driving) Do not put yourself in a position where impairment may lead to increased risk of an accident until you know how you respond to the medication
Zolpidem
Ambien (CR)
*sedative hypnotic ; C-IV
-Do not take with alcohol, take 30 min prior to bed. Same issues as Lunesta. Lower dosing guidelines for wome
Desvenlafaxine
Pristiq
*SNRI
-Avoid alcohol, do not discontinue abruptly, not added benefit over venlafaxine- recommend generic venlafaxine
Duloxetine
Cymbalta
*SNRI
-Do not abruptly discontinue therapy. report any changes in affect and or behavior as psychiatric side effects including suicidal ideation is possible
Venlafaxine
Effexor (XR)
*SNRI
-avoid alcohol, do not discontinue abruptly, monitor BP
Citalopram
Celexa
*SSRI
-may cause drowsiness, do not discontinue therapy abruptly. avoid in patients with CV disease as it has been shown to increase QT interval
Escitalopram
Lexapro
*SSRI
-may cause drowsiness, do not discontinue therapy abruptly
Fluoxetine
Prozac or Sarafem
*SSRI
-May cause drowsiness or dizziness, avoid alcohol use during therapy- prozac longest half life SSRI, most activating SSRI AM dosing not PM and a major inhibitor of CYP 2D6
Paroxetine
Paxil (CR)
*SSRI
-May cause drowsiness, do not discontinue therapy abruptly. Paxil most likely agent to cause discontinuation syndrome. Sedation, major CYP2D6. approved for hot flashes related to menopause
Sertraline
Zoloft
*SSRI antidepressant
-may cause drowsiness or dizziness, avoid alcohol use during therapy. Drug of choice for patients with CV disease and MDD
Lidocaine
Lidoderm Patches
*topical analgesic
-do not apply to broken skin, do not leave patches on for more than 12 hours in a 24 hour period
Amitriptyline
Elavil
*TCA
-may cause drowsiness or dizziness, avoid alcohol use during therapy. rarely used for depression and usually used in low doses for off label uses (headache, pain, neuropathy) as it is a side effect of this agent and it is not well tolerated secondary to anticholinergic effects, risk of overdose causing CV death and arrhythmias, caution for suicidal ideation
Imipramine
Tofranil (PM)
*TCA
-May cause drowsiness or dizziness, avoid alcohol use during therapy. Also has significant anticholinergic effects and risk of overdose like Elavil
Lithium Carbonate
Eskalith or Lithobid
*Mood stabilizer
-Do not exceed recommended doses, consume 2-3 quarts of water qday. monitor serum levels and watch out for drug interactions with thiazide diuretics which require a dosage reduction of lithium
Adapalene
Differin
*Topical acne product
Acne may worsen before it improves; using more than recommended increases risk of skin reactions. Use as little product as can cover the face or affected areas with a thin film. Caution against sun exposure and recommended sunscreen
Clindamycin/ Benzoyl Peroxide
Benzaclin
*Topical acne product
-may cause skin irritation, use a sparing amount. Topical acne products remind patients that their acne may get worse before it gets better and exceeding the recommended doses will increase the risk of severe adverse effects
Erythromycin/ Benzoyl peroxide
Benzamycin
*Topical acne product
-May cause skin irritation, use a sparing amount. Topical acne products remind patients that their acne may get worse before it gets better and exceeding the recommended doses will increase the risk of severe adverse effects
clobetasol
Clobex
*topical corticosteroid
-use a sparing amount, avoid application on face and around eyes
Mometasone
Elocon
*topical corticosteroid
-use sparing amount, avoid application around eyes
triamcinolone
Kenalog
*topical corticosteroid
-use a sparing amount, avoid application around eyes, available in ointment, cream and lotion
pimecrolimus
Elidel
*topical skin product
BBW due to skin cancer risk
Clotrimazole/ betamethasone diproprionate
Lotrisone
*topical antifungal/corticosteroid
-use sparing amount, avoid application
Fluocinonide topical
Lidex, Lidez-E vanos
*Topical corticosteroid
-Use a sparing amount, avoid application on face and around eyes
Finasteride
Propecia or Proscar
*5 alpha reductase inhibitor
-Pregnant women should not handle, will not regrow hair but will prevent additional hair loss, sexual dysfunction which may not be reversible in men, when used for BPH they are not rapidly effective and may take 6 plus months to shrink and enlarge prostate and produce a reduction in symptoms, probably best when used in combo with an alpha blocker to reduce symptoms and prevent or delay the need for surgical intervention
isotretinoin
Accutane or Claravis
*acne treatment
-Must follow REMS system for isotrentinoin dispensing and counseling. teratogenic category X, adverse lipid effects especially increased TG and psychiatric effects and as with topical products acne may get worse before it gets better
testosterone
Androgel
*androgen; C-III
-Use as directed to upper arm and shoulder and not to genitals. women and children should avoid contact with this medication; men with BPH may get worse
Metformin
Glucophage (XR), Fortamet
*antidiabetic- biguanide
-GI upset, diarrhea and best titration to minimize symptoms, may lead to B12 deficiency related neuropathy
Sitagliptin, Sit + Metformin
Januvia, Janumet (XR)
*Antidiabetic-dipeptidyl peptidase IV inhibitor
-Take without regard to food, risk of pancreatitis
Saxaglitptin
Onglyza
*antidiabetic- dipeptidyl peptiase IV inhibitor
-take without regard to food, risk of pancreatitis, concomitant use of CYP3A4 inh- use 2.5 mg instead of 5 mg QD
glimepiride
Amaryl
*antidiabetic- sulfonylurea
-take with breakfast, avoid alcohol use, counsel on hypoglycemic risk
glipizide
Glucotrol (XL)
*antidiabetic- sulfonylurea
-may cause hypoglycemia due to active metabolites
glyburide, glyburide/metformin
Micronase, Glucovance
*antidiabetic- sulfonylurea
-take with breakfast, avoid alcohol use. has an active metabolite which is renally eliminated and thus increased sick of hypoglycemia and weight gain as patients age, may also increase CV events and no longer a recommended agent by ADA
Pioglitazone
Actos
*antidiabetic - thiazolidinedione
-take without regard to meals, increased risk of fractures, macular edema, heart failure, weight gain and edema as well as bladder CA in men
Exenatide, Exenatide weekly
Byetta, Bydureon
*Antidiabetic- glucagon-like peptide 1 receptor agonist
-counsel on pen injection technique. nausea and vomiting tend to be dose related and transient start with 5 mcg daily dose and after a month increase to 10 mcg dose, watch for signs of pancreatitis and can be dosed 60 mins or less before meals twice a day
liraglutide
victoza
*antidiabetic GLP1
-Counsel on pen injection technique. nausea and vomiting tend to be dose related and transient, watch for signs of pancreatitis. Box warning- risk of thyroid C-cell tumors
alendronate
Fosamax
*Bisphosphonate Osteoporosis agent
-Take on an empty stomach with a full glass of water, must sit or stand for 30 minutes following the dose. osteonecrosis of the jaw and atypical fractures
Ibandronate
Boniva
*Bisphosphonate Osteoporosis agent
-take on an empty stomach with a full glass of water, must sit or stand for 60 minutes following the dose, osteonecrosis of the jaw and atypical fractures
Risedronate, delayed release enteric coated risedonate
Actonel, Atelvia
*Bisphosphonate Osteoporosis agent
-take on an empty stomach with a full glass of water, must sit or stand for 30-60 minutes following the dose. Atelvia is enteric coated formulation which should be taken after breakfast but not available as generic, osteonecrosis of jaw and atypical fractures
Estrogen/ methyltestosterone
Estratest (HS)
*Combination hormone
-CV, thromboembolic caution
Estradiol/ norethindrone
Combipatch
*Estrogen and progestin combination
-stable at room temperature for 3 months
conjugated estrogens
Premarin
*estrogen hormone
-may take with food to decrease GI symptoms
Estradiol
Climara, Estrace
*Estrogen hormone
-CV, thromboembolic caution
Raloxifene
Evista
*Estrogen receptor modulator, post-menopausal osteoporosis
-CV risk and thromboembolic BBWs, may increase TGs, myalgia. may cause worsen hot flashes
Conjugated Estrogens with medroxyprogesterone
Prempro or Premphase
*Estrogen-progestin hormone combo
-increased risk of CV and DVT as well as dementia with long term therapy, report any abnormal vaginal bleeding
Colchicine
Colcrys
*Gout- inflammatory mediator
-long term therapy requires blood work, no more than 3 tablets for an acute attack with similar efficacy to 8 tablets but with much less risk of GI toxicity
Allopurinol
Zyloprim
*gout- xanthine oxidase inhibitor
-consume large amounts of fluids to prevent kidney stone formation. start with 100 mg QD after an acute gout attack has subsided and gradually increase the dose at no more than weekly interval to about 300 mg QD to reduce the risk of mobilization gout, may also add low dose colchicine 1-2 tabs per day for prevention of mobilization gout, D/C at first signs of a rash
Febuxostat
Uloric
*gout- xanthine oxidase inhibitor
-same as allopurinol but may be safe in patients with a history of adverse skin reactions to allopurinol
Medroxyprogesterone acetate
Provera
*Hormone/progestin
-may take with food to decrease GI symptoms, preg cat: X, may lead to uterine bleeding irregularities, long term use may decrease bone mineral density
Insulin- regular
Humulin R
*Insulin fast acting
-injection technique, hypoglycemia, take 15-30 mins prior to meal
Insulin- NPH
Humulin N
*Insulin intermediate acting
-counsel on injection technique and hypoglycemia
Insulin detemir
Levemir
*Insulin- intermediate-long acting
-cannot be mixed with another insulin
Insulin Glargine
Lantus
*insulin -long acting
-cannot be mixed with another insulin, may have an increase in injection site pain/rxn
Insulin aspart
Novolog
*insulin- rapid acting
-take immediately before meals, counsel on injection technique and hypoglycemia
Insulin lispro
Humalog
*Insulin- Rapid Acting
-Take immediately before meals, counsel on injection technique and hypoglycemia
Insulin Glulisine
Apridra
*Insulin- rapid acting
-take immediately before meals, counsel on injection technique and hypoglycemia
Ethinyl Estradiol/ drospirenone
Yasmin, Ocella, Yaz
*Oral contraceptive
-take everyday, counsel on missed dose protocol, caution with antibiotics, increased risk of VTEs especially in older women and those who smoke; risk of hyperkalemia
Ethinyl estradiol/ desogestrel
Kariva, ortho-cept, Mircette, Desogen or Apri
*Oral contraceptive
-Take everyday, counsel on missed dose protocol, caution with antibiotics, increased risk VTEs especially in older women and those who smoke; risk of hyperkalemia
Ethinyl estradiol / levonorgestrel
Aviane, Alesse
*oral contraceptive
-take everyday, counsel on missed dose protocol, caution with antibiotics. increased risk of VTEs especially in older women and those who smoke, risk of hyperkalemia
Norethindrone/ Ethinyl Estradiol, Fe+
Loestrin FE
*oral contraceptive
-take at the same time everyday, counsel on missed dose protocol. caution with antibiotics, smoking
norgestimate & ethinyl estradiol
TriNessa, Tri-Sprintec
*oral contraceptive
Norgestimate/ ethinyl estradiol
Ortho Tri-Cyclen (Lo)
*oral contraceptive
Insulin 70% NPH / 30% Regular
Novolin 70/30, Humulin 70/30
*Pre-mixed insulin
-injection technique and hypoglycemia. Intermediate:fast acting
Insulin 70% protamine/ 30% rapid acting
Novalog Mix 70/30, Humalog mix 70/30
*Premixed insulin
-Intermediate: rapid acting
medroxyprogesterone
Depa-Provera
*Progestin contraceptive
-may cause weight gain, pregnancy cat X, may lead to uterine bleeding irregularities, long term use may decrease bone mineral density
Prednisone
Deltasone
*steroid anti-inflammatory
-take with food, may cause agitation, insomnia
methylprednisolone
Medrol
*steroid anti-inflammatory/ allergy
-take with food, may cause agitation, insomnia
Desiccated thyroid
Armour thyroid
*Thyroid Hormone
-Take on an empty stomach in the morning
Levothyroxine
Synthroid or Levoxyl
*Thyroid hormone (synthetic T4)
-Take drug on an empty stomach in the morning with full glass of water at least 30 minutes prior to food ( not close to calcium) stay on specific brand or generic due to bioavailability issues, TSH monitoring adverse drug reactions early on often due to too high of dosing (med induced hyperthyroidism- heat intolerance and sweating, frequent bowel movements, restlessness, tachycardias, hair loss) Takes 4 weeks to reach new steady state levels and TSH may lag another 2-3 weeks
Estradiol
Vivelle- Dot, Estraderm
*topical estrogen patch
-counsel on twice weekly patch application
Ethinyl estradiol/ etonogestrel
NuvaRing
*Vaginal contraceptive
-Counsel on vaginal application, 3 weeks in, 1 week off
Estradiol
Vagifem
*Vaginal estrogen
-counsel on vaginal tablet use with vagifem
Dicyclomine
Bentyl
*Anticholinergic for cramping/ irritable bowel
-may cause dry mouth, dizziness. avoid alcohol use
Hyoscyamine
Levsin/Levbid/Levsinex
*anticholinergic for cramping/ irritable bowel
-take before meals. may experience dizziness, blurred vision, constipation
Loperamide
Imodium
*antidiarrheal
-may cause drowsiness, contact MD if diarrhea persists longer than 48 hours
Diphenoxylate/ atropine
Lomotil
*Antidiarrheal; C-V
-Do not exceed prescribed dose, anticholinergic side effects possible
Promethazine
Phenergan
*Antihistamine- N/V
-may cause anticholinergic side effects
Lubiprostone
Amitiza
*Chloride Channel Activator
-Take with food to decrease nausea
Famotidine
Pepcid
*H2 antihistamine
-Do not exceed 14 days of OTC therapy unless directed by MD, report severe abdominal pain/ discomfort to MD
Orlistat
Xenical
*Fat absorption inhibitor
-caution regarding uncontrollable oily bowel movements, especially after high fat meal, patient should take supplemental fat soluble vitamins at least 2 hours prior to orlistat dose
Ranitidine
Zantac
*H2 antihistamine
-Do not exceed 14 days of OTC therapy unless directed by MD, report severe abdominal pain/discomfort
Polyethylene Glycol
Miralax, Glycolax
*laxative
-safe for daily use
metoclopramide
Reglan
*Promotility -antiemetic
-take 30 minutes prior to meal, avoid use with alcohol, associated with extrapyramidal symptoms and depression, caution in elderly
Esomeprazole
Nexium
*PPI
-Take 30-60 mins prior to a significant meal. pro-drug: need to be absorbed in that state and are activated within the parietal cell when the patient stimulates the to secrete acid by eating. They also have a short half life of 1-2 hours. Risk include C. diff, pneumonia, fractures and low serum magnesium levels in addition to b12 deficiency
Lansoprazole
Prevacid
*PPI
-Take 30-60 mins prior to a significant meal. pro-drug: need to be absorbed in that state and are activated within the parietal cell when the patient stimulates the to secrete acid by eating. They also have a short half life of 1-2 hours. Risk include C. diff, pneumonia, fractures and low serum magnesium levels in addition to b12 deficiency
Omeprazole
Prilosec
*PPI
- Take 30-60 mins prior to a significant meal. pro-drug: need to be absorbed in that state and are activated within the parietal cell when the patient stimulates the to secrete acid by eating. They also have a short half life of 1-2 hours. Risk include C. diff, pneumonia, fractures and low serum magnesium levels in addition to b12 deficiency
Pantoprazole
Protonix
*PPI
-Take 30-60 mins prior to a significant meal. pro-drug: need to be absorbed in that state and are activated within the parietal cell when the patient stimulates the to secrete acid by eating. They also have a short half life of 1-2 hours. Risk include C. diff, pneumonia, fractures and low serum magnesium levels in addition to b12 deficiency
Rabeprazole
Aciphex
*PPI
-Take 30-60 mins prior to a significant meal. pro-drug: need to be absorbed in that state and are activated within the parietal cell when the patient stimulates the to secrete acid by eating. They also have a short half life of 1-2 hours. Risk include C. diff, pneumonia, fractures and low serum magnesium levels in addition to b12 deficiency
Omeprazole/ sodium bicarbonate
Zegerid
*PPI/ antacid combo
- Take 30-60 mins prior to a significant meal. pro-drug: need to be absorbed in that state and are activated within the parietal cell when the patient stimulates the to secrete acid by eating. They also have a short half life of 1-2 hours. Risk include C. diff, pneumonia, fractures and low serum magnesium levels in addition to b12 deficiency
Dutasteride
Avodart
*BPH - 5 alpha reductase inhibitor
-Capsules should not be handled by women, takes time for shrinkage of prostate and symptom relief
Tamsulosin
Flomax
*BPH - selective alpha blocker
-Take 30 minutes after the same meal every day. May cause dizziness
Alfuzosin
Uroxatral
*BPH- selective alpha blocker
-Take prior to bedtime to avoid orthostatic hypotensive effects
Vardenafil
Levitra
*Erectile dysfunction- vasodilator
-Report erections lasting longer than 4 hours to the ER, avoid nitroglycerin use
sildenafil
Viagra
*Erectile dysfunction -vasodilator
-Report erections lasting longer than 4 hours to the ER, avoid nitroglycerin use
Tadalafil
Cialis
*Erectile dysfunction - vasodilator
-Report erections lasting longer than 4 hours to the ER, avoid nitroglycerin use
Oxybutynin
Ditropan (XL)
*Urinary incontinence- anticholinergic
*May cause dry mouth, dizziness. avoid alcohol use
Tolterodine
Detrol (LA)
*Urinary incontinence - anticholinergic
- May cause dry mouth, dizziness. Avoid alcohol use.
Darifenacin
Enablex
*Urinary incontinence- anticholinergic
-May cause dry mouth, dizziness. avoid alcohol use
phenazopyridine
Pyridium
*Urinary Tract Analgesic
-urine will change to orange-red color, used for symptom relief only
cholecalciferol
calcitriol
*vitamin D supplement
-take with food to decrease GI problems
Brimonidine
Alphagan P
*Agent for Glaucoma
-Refer to eye-drop technique handout.
Lantanaprost
Xalatan
*Agent for glaucoma
-Refer to eye-drop technique handout. Stable at room temperature for 6 weeks
Timolol
Timoptic (XE)
*Agent for glaucoma
-Refer to eye-drop technique handout.
Travoprost
Travatan
*Agent for glaucoma
-Refer to eye-drop technique handout
Brimonidine/ Timolol
Combigan
*Alpha II agonist/ beta blocker/ antiglaucoma
-Refer to eye-drop technique handout
Olopatadine
Pataday or Patanol
*Antiallergy
-Refer to eye-drop technique handout
Tobramycin/ Dexamethasone
Tobradex
*Antibiotic/anti-inflammatory
-Refer to eye-drop technique handout
Moxifloxacin
Vigamox
*Antibiotic/ opthalmic
-refer to eye drop technique handout
Cyclosporine
Restasis
*Calcineurin inhibitor
-Invert vial several times prior to use to create uniform emulsion. Used every 12 hours
Dorzolamide/ timolol
Cosopt
*Carbonic anhydrase inhibitor/ beta blocker/ antiglaucoma
gatifloxacin
Zymar
*Fluoroquinolone
-eye drop
Bimatoprost
Lumigan
*prostaglandin analog for glaucoma treatment
-eye drop
Neomycin/polymyxin/ hydrocortisone
Cortisporin Otic
*Otic antibiotic
-ear drop
Ciprofloxacin/ dexamethasone, ciprofloxacin/ hydrocortisone
Ciprodex, Cipro HC
*Otic antibiotic/ corticosteroid
-ear drop
Azelastine
Astelin
*Allergic Rhinitis - Topical H1 antagonist
-prime 4x upon assembly, 2x if left unused for 3 days or more
Budesonide Nasal Spray
Rhinocort Aqua
*Allergic rhinitis- nasal steroid
-may cause taste distortion, effects seen after several days of therapy, may cause nasal irritation, bleeding
Fluticasone
Flonase
*Allergic rhinitis- nasal steroid
-may cause taste distortion, effects seen after several days of therapy, may cause nasal irritation, bleeding
Mometasone
Nasonex
*Allergic rhinitis- nasal steroid
-may cause taste distortion, effects seen after several days of therapy, may cause nasal irritation, bleeding
Montelukast
Singulair
*Anti-asthmatic - leukotriene inhibitor
-Chewable tablet contains phenylalanine
Albuterol
Proair HFA or Ventolin HFA or Proventil HFA
*Anti-asthmatic - short acting beta 2 agonist
-available in both MDI and nebulizer soln. Counsel on appropriate device use and prn rescue dosing. May also be use for prophylaxis for exercise-induce asthma. May cause jitteriness, nervousness, tachycardia and decrease effectiveness of beta blockers
Budesonide inhalation suspension
Pulmicort Respules, Flexhaler
*Anti-asthmatic- steroid
- some effects seen after 2 days of therapy, max effect seen within 2 weeks, not for rescue
Levalbuterol
Xopenex (HFA)
*Anti-asthmatic- short acting beta 2 agonist
-counsel on appropriate MDI use and prn rescue dosing
Fluticasone/ salmeterol
Advair
*Anti-asthmatic -steroid / LA B2 agonist/ controller
- diskus; do not shake after activating, not for rescue
Fluticasone
Flovent
*Antiasthmatic - steroid
-not for rescue
Albuterol/ Ipratropium
Respimat or Duoneb
*Antiasthmatic / COPD combo, Bronchodilator/ anticholinergic
Ipratropium Bromide
Atrovent
-Anticholinergic antibronchospasm and antisecretory
Tiotropium
Spiriva HandiHaler
*Anticholinergic bronchodilator for COPD
Cetirizine
Zyrtec
*Antihistamine 2nd generation H1
-may cause drowsiness, dizziness or dry mouth
Desloratadine
Clarinex
*Antihistamine, 2nd generation H1
-may cause drowsiness, dizziness or dry mouth
Loratidine
Caritin
*Antihistamine 2nd generation H1
-may cause drowsiness, dizziness or dry mouth
Fexofenadine (PSE)
Allegra (D)
*Antihistamine 2nd generation H1 (+decongestant)
-may cause drowsiness, do not take with fruit juices. take D products in AM
Guaifenesin
Mucinex (D, DM)
*expectorant (+/- decongestant, antitussive)
-take with a large glass of water, BID dosing, PSE may cause insomnia, PSE contraindicated in patients with CV risk, hypertension, DM drug interactions
Guaifenesin & codeine
Cheratussin AC
*Expectorant/ Antitussive combo- CV
-take with water, codeine side effects possible
