Brandname Flashcards
Kinrix
DTaP / IPV vaccine
Vimovo
Naproxen + esomeprazole
Giazo
Balsalazide
Mild UC tx
Tablet
Induction: Approved in males only 3.3 (3x1.1 g tablets) PO BID for up to 8 weeks
CI: Salicylate allergy
Warning: Gastric retention (due to pyloric stenosis) can delay release of the drug in the colon, acute intolerance syndrome, caution in patients with renal and hepatic impairment
SE: HA, abdominal pain, N/V/D
Monitoring: Renal fct, LFT, sx of IBD
Colazal capsules can be opened and sprinkled on applesauce, beads are not coated, so mixture can be chewed if needed , when used this way, it can cause staining of the teeth/tongue
Mevacor
Lovastatin
Hypercholesterolemia
20-80 mg with evening meal
CI: liver dx, pregnancy, breastfeeding, CYP3A4 inhibitor
Warning: rhabdomyolysis (higher with dose, age, renal impairment, inhibitor), hepatotoxicity, hyperglycemia
SE: muscle pain, diarrhea, cognitive impairment
Monitoring: LFT, lipid panel every 3 months then annually
Osmitrol
Mannitol
For hemorrhagic stroke
Deltasone
Prednisone
Steroid for the flare episodes in UC/CD tx
Tablet
5-60 mg QD
CI: Infections, live vaccines
SE: Short-term: ↑ appetite, weight gain, Fluid retention, Insomnia, Emotional instability, GI, ↑ BG and BP
Long-term: Adrenal suppression (Cushing’s syndrome), Immunosuppression, BG, BP, Cataracts, Osteoporosis
ADT (alternate day therapy) ↓ adrenal suppression
If > 2 weeks => taper to avoid withdrawal sx
If LT require => bone density, Vitamin D and Ca, Biphosphonate
Andexxa
Andexanet alpha
Antidote for Factor Xa inhibitors Eliquis and Xarelto
Bydureon
Exenatide ER GLP-1 agonist 2 mg SC once weekly Not in ESRD or CrCl < 30 BB: thyroid cancer CI in thyroid or endocrine cancer Warnings: pancreatitis, serious injection reaction, not recommended if severe GI disorder SE: nausea, weight loss
Veltassa
Patiromer
Non absorbed cation exchange resin used in hyperkalemia
Powder for oral suspension
8.4 g PO QD Max 25.2 g/day
Warnings: Can worsen GI motility, Hypomagnesemia, Bind other medication => 3h before or after
SE: N/V/C
Monitoring: K, Mg
Store powder in the fridge, max 3 months at room temp
Durlaza
Aspirin
Anti platelet aggregation
Caspule ER do not crush
Soltamox
Tamoxifen
SERM used in breast cancer
20 mg PO QD
BB: ↑ risk of uterine or endometrial cancers, ↑ risk of thromboembolic events such as VTE, PE, stroke
CI: Do not use with warfarin, hx of DVT/PE
SE: DVT/PE, menopausal symptoms, hot flashes, flushing, edema, weight gain, hypertension, mood changes, amenorrhea, vaginal bleeding/discharge
Not recommended in pregnancy and breast feeding
Bethkis
Tobramycin inhalation solution
Chronic pulmonary infection in CF
300 mg / 4 ml ampule single use
300 mg via nebulizer BID (28 days on/28 days off)
SE: Ototoxicity, tinnitus, voice alteration, mouth and throat pain, dizziness, bronchospasm
Do not mix with any other drugs in nebulizer
Pt at least 6 yo
Keep in the fridge / protect from light (pouch)/ room temp for max 28 days
Use with PARI LC Plus nebulizer or De Vilnius Pulmo-aide air compressor
Cafergot
Ergotamine 1 mg + caffeine 100 mg
Migraine
2nd line after triptan
2T at onset then 1 T every 30 min max 6T
BB: do not use with 3A4 inhibitors (life-threatening peripheral vasoconstriction)
CI: cardiac problems, uncontrolled hypertension, renal/ hepatic impairment, MAOI within 2 weeks, serotoninergic within 24hrs
Warnings: cardiovascular effects, cerebrovascular effects, ergotism (severe vasoconstriction with gangrene), severe drug interact
Infanrix
DTaP vaccine
Routine childhood vaccine for kids younger than 7 yo
5 doses: 2,4,6, 12-18 months and 4-6 yo
CI: Encephalopathy within 7 days
Warning: GBS within 6 weeks of previous DTaP vaccine, infantile spasms, uncontrolled seizure
TOBI podhaler
Tobramycin inhalation powder
Chronic pulmonary infection in CF (pseudomonas aeruginosa)
Jantoven
Warfarin
OAC
AFib, VTE Tx/Px, bioprosthetic and mechanical mitral valve, mechanical aortic valve, antiphospholipid syndrome (7 indications)
10 mg QD dor 2 days (after see INR) or 5 mg in specific conditions (elderly, malnourrished, interactions, liver dx, HF, ↑ risk for bleeding)
BB: Major or fatal bleeding
CI: Pregnancy (except with mechanical heart valves at high risk for thromboembolism), hemorrhagic tendencies, blood dyscrasias, uncontrolled HTN, noncompliance, recent or potential surgery of the eye or CNS, major regional lumbar block anesthesia or traumatic surgery resulting in large open surfaces, pericarditis or pericardial effusion, bacterial endocarditis, (pre-)eclampsia, threatened abortion
Warnings: Tissue necrosis/gangrene, HIT (CI as monotherapy in the initial tx of active HIT), systemic atheroemboli and cholesterol microemboli, presence of 2C9*2 or *3 alleles and/or polymorphism of VKORC1 gene may↑ bleeding risk (routine genetic testing is not currently recommended)
SE: Bleeding, skin necrosis, purple toe syndrome
Monitoring: INR: INR 2-3 (target 2.5) for most indications (DVT, Afib, bioprosthetic mitral valve, mechanical aortic valve, antiphospholipid syndrome), INR 2.5-3.5 for mechanical valve (mitral, 2 heart valves) / high risk indications, Measure INR after 2 or 3 initial doses, adjust to reach the goal, When stable and within the goal, monitor INR every 12 weeks (3 months) instead of every month
Hct, Hbg, signs of bleeding
Antidote = vitamin K, dental cleanings and single tooth extraction do not generally require a change in warfarin dosing, if INR is in therapeutic range
Activase
Alteplase
Fibrinolytic for ischemic stroke management
0.9 mg/kg (max 90 mg); give 10% of the dose as a bolus over 1 mon than infuse remainder over 60 min
Dosing différent for MI and PE
Fibrinolytic for STEMI when PCI not possible
100 mg IV (15 mg bolus + 50 mg over 30 min + 35 mg over 1h)
Humira
Adalimumab
Anti-TNF alpha (RA, UC, CD)
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Fragmin
Dalteparin
AC (parenteral)
Ascriptin
Aspirin
Anti platelet aggregation
Canasa
Mesalamine
Suppository
Mild UC tx
Induction: 1 g rectally QHS, retain for at least 1-3 hrs
CI: Hypersensitivity to salicylates or aminosalicylates
Warnings: Acute intolerance syndrome (cramping, acute abdominal pain, bloody diarrhea), caution in patient with renal or hepatic impairment, delayed gastric retention (due to pyloric stenosis), can delay release of oral products in the colon, hypersensitivity reactions (including myocarditis, pericarditis, nephritis, hematologic abnormalities and other internal organ damage), more likely with sulfasalazine than mesalamine, ↑ risk of blood dyscrasias in patients > 65 yo
Apriso contains phenylalanine, do not use in patients with PKU
Rowasa enema contains potassium bisulfite, a sulfite that may cause an allergic-type reaction
SE: Abdominal pain, nausea, HA, flatulence, eructation, pharyngitis
Monitoring: Renal fct, CBC, sx of IBD
Mesalamine is better tolerated than other aminosalicylates
Rectal mesalamine is more effective than oral mesalamine and rectal steroids for distal dx/proctitis in UC, can use oral and topical formulation together
Swallow capsules and tablets whole, do not crush, chew or break due to delayed-release coating
Apriso: do not use with antacids (dissolution pH-dependent)
Genvoya
Elvitegravir + cobicistat + emtricitabine + tenofovir alafenamide
NP thyroid
Thyroid desiccated USP
Aloprim
Allopurinol Gout (chronic urate lowering therapy) Tablet and injection 100 mg QD titrage slowly to UA 6mg/dL (>300 mg divided dose Renal adj Warnings: hypersensitivity (HLA-B*5801 asian), hepatotoxicity, myelosuppression SE: rash, N/V/D Monitor: CBC, LFT, renal fct
Truvada
Emtricitabine 200 mg + Tenofovir disoproxil fumarate 300 mg
Used in Preexposure Px
Nature-Thyroid
Thyroid desiccated
Maxalt
Rizatriptan
Zerit
Stavudine
HIV / NRTI
Capsule, Oral solution (30 days in fridge, Shake well)
≥ 60 kg: 40 mg PO BID, < 60 kg: 30 mg PO BID
Renal adj CrCl≤50
BB: Pancreatitis (sometimes fatal) has occurred during combination therapy with didanosine
Warnings: Neurologic Sx including motor weakness (mimic Guillain-barre syndrome) and hepatotoxicity
SE: HA, N/V/D, peripheral neuropathy (reversible), ↑ LFT, hyperbilirubinemia, lipoatrophy, pancreatitis, insulin resistance/diabetes, hyperlipidemia
Monitoring: LFT, renal fct, Sx peripheral neuropathy, lipids
Avoid stavudine / didanosine combination ↑ risk of peripheral neuropathy, pancreatitis, lactic acidosis
Do not combine with zidovudine, antagonist reaction as both are thymidine analogd: d4T and AZT
Lipoatrophy: stavudine > zidovudine > other NRTIs
Vytorin
Ezetimibe + simvastatin
10/10, 10/20, 10/40, 10/80
Take in the evening (with or without food)
CRCl< 60, do not use more than 20 mg of simvastatin
Adacel
Tdap vaccine
1 dose if no record of DTaP
+ no full program DTaP, pregnancy (each), child-care providers, healthcare provider
Sitavig
Acyclovir
Antiviral agent used in Herpes labialis
Buccal tablets 50 mg
Single dose (50 mg) apply on gum region
Warning: TTP/HUS (Thrombotic thrombocytopenic purpura / hemolytic uremic syndrome) in immunocompromised PTs, nephrotoxicity
SE: N/V/D, Seizure, neutropenia, rash, pruritus
Edurant
Rilpivirine
HIV / NNRTI
CI: Concurrent use of PPIs, rifampin, rifapentine, carbamazepine, oxcarbazepine, phenobarbital, phenytoin, St John’s wort, dexamethasone (more than a single dose)
Warning: QT prolongation, serious skin reaction, multiorgan hypersensitivity reaction (DRESS), depressive disorders, hepatotoxicity
SE: Depressive disorders, mood changes, insomnia, HA, rash
Monitoring: LFT, rash, lipids, CNS effects, QT
Higher rate of failure with viral load > 100,000 copies / ml and /or CD4+ counts < 200 cell/mm2 at tx initiation
Protein supplement drinks should not be substituted for normal to high calorie meal (does not ↑ rilpivirine absorption)
Cortifoam
Hydrocortisone react foam UC Tx (Flares)
Cayston
Aztreonam inhalation solution
Chronic pulmonary infection in CF (pseudomonas aeruginosa)
Remicade
Infliximab
Anti-TNF alpha (RA, UC, CD)
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Biktarvy
Bictegravir + emtricitabine + tenofovir alafenamide
HIV tx
Symdeko
Tezacaftor + Ivakaftor
Tezacaftor = CFTR Modulator - increase number of channels on cell surface
Ventavis
Iloprost
Prostacyclin analogue used in PAH
Dipentum
Olsalazine Mild UC tx Capsule Maintenance: 500 mg PO BID with food CI: Salicylate allergy SE: Diarrhea, abdominal pain Monitoring: CBC, LFT, renal fct, sx of IBD
Epivir
Lamivudine
HIV / NRTI
BB: Do not use Epivir-HBV (lower dose / 100 mg) => HIV resistance, Exacerbation of HBV when discontinue in HBV pt
SE: HA, N/V/D, Fatigue, Insomnia, Myalgia, ↑ LFT
Monitoring: LFTs, Renal function, HBV status
Savaysa
Edoxaban
OAC
Afib, VTE Tx (2 indications)
Quadracel
DTaP / IPV vaccine
Give IM
Store in fridge, shake before administration
Part of the série for DTaP (5 doses at 2,4,6,12-18 months, and 4-6 y) and IPV (4 doses at 2,4,6-18 months, and 4-6y)
Ecotrin
Aspirin
Anti platelet aggregation
Havrix
Hepatitis A vaccine
2 doses (12 months and 6-18 months later)
Routine childhood vaccination or adult with high risk
Krystexxa
Pegloticase Gout (chronic urate lowering therapy)
Gilenya
Fingolimod
Oral immunomodulator used in MS (Multiple sclerosis)
Capsule
Can cause bradycardia => pt must be monitored for at least 6h after the 1st dose (ECG required at baseline and at the end of initial observation period or if tx course is interrupted, CI in most patients with Hx of CVD or stroke, Caution with other drugs that ↓ HR
Other significant AE: macular edema (monitor with eye exam), hepatotoxicity (monitor LFT), myelosuppression (monitor CBC)
Tirosint
Levothyroxine 1.6 mcg/kg/day (IBW) for healthy adults Elderly: 20-25% less: < 1mcg/kg/day CAD: 12.5-25mcg/day BB: not for obesity CI: uncorrected adrenal insufficiency Warning: low dose in CAD, osteoporosis SE: none if euthyroid (hyper or hypo) Monitor: TSH, Sx, FT4 in pregnancy, central hypothyroidism
PredniSONE Intensol
Prednisone oral solution
For UC/CD Tx
Duzallo
Allopurinol + lesinurad
Gout, association of XOI and uricosuric (↑ uric acid elimination by ↓ its reabsorption in kidneys / always used in combination with XOI)
Emtriva
Emtricitabine
HIV / NRTI
200 mg PO QD (capsule)
240 mg PO QD (oral solution)
Renal adj: CrCl<50
Oral solution should be in the fridge or 3 months max at room temp
BB: exacerbation HepB when D/C, Truvada combination with tenofovir disoproxil fumarate used for Px => HIV test negative before start Tx and every 3 months confirmation
Pacerone
Amiodarone
Antiarrhythmic class III
VF, VT with/without pulse, ventricular arrhythmia, AFib (cardioversion/NSR)
BB: proarrhytmic, pulmonary toxicity, hepatotoxicity, LD in hospital
CI: iodine sensitivity, bradycardia, cardiogenic shock
Warning: thyroid, visual, neuropathy, blue skin, SKS/TEN
Monitor: cardio (HR, BP, ECG, electrolytes), thyroid, lungs, LFTs, eyes
Uceris
Budesonide tablet 6 mg (or rectal foam) UC tx (flares))
Ziagen
Abacavir
HIV / NRTI
300 mg BID or 600 mg QD
Renal adj CrCl <15
BB: hypersensitivity reactions (warning card), test HLA*B5701
CI: previous hypersensitivity, liver impairment
Warning: higher risk MI
Tivicay
Dolutegravir + emtricitabine
HIV / INSTI
25 mg
Lialda
Mesalamine
ER tablet
Mild UC tx
Induction: 2.4-4.8 g PO QD
Maintenance: 2.4 PO QD
CI: Hypersensitivity to salicylates or aminosalicylates
Warnings: Acute intolerance syndrome (cramping, acute abdominal pain, bloody diarrhea), caution in patient with renal or hepatic impairment, delayed gastric retention (due to pyloric stenosis), can delay release of oral products in the colon, hypersensitivity reactions (including myocarditis, pericarditis, nephritis, hematologic abnormalities and other internal organ damage), more likely with sulfasalazine than mesalamine, ↑ risk of blood dyscrasias in patients > 65 yo
Apriso contains phenylalanine, do not use in patients with PKU
Rowasa enema contains potassium bisulfite, a sulfite that may cause an allergic-type reaction
SE: Abdominal pain, nausea, HA, flatulence, eructation, pharyngitis
Monitoring: Renal fct, CBC, sx of IBD
Mesalamine is better tolerated than other aminosalicylates
Rectal mesalamine is more effective than oral mesalamine and rectal steroids for distal dx/proctitis in UC, can use oral and topical formulation together
Swallow capsules and tablets whole, do not crush, chew or break due to delayed-release coating
Apriso: do not use with antacids (dissolution pH-dependent)
Lexiva
Fosamprenavir
HIV /PI
Simponi
Golimumab
Anti-TNF alpha (RA, UC)
single-dose prefilled syringe or single-dose autoinjector
50 mg monthly SC
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Viramune
Nevirapine
HIV / NNRTI
Tablet , Oral suspension
200 mg QD 14 days then 200 mg BID (or 400 mg Viramune XR QD)
Require titration (lead-in period) 14 days to ↓ rash and hepatotoxicity / titrate again if stop for > 2 weeks
BB: Hepatotoxicity (liver failure, death) ↑ risk the 1st 6 weeks of therapy but may be seen out to 18 weeks (or more), more common in women and with higher CD4+ counts
Serious skin reaction (SJS/TEN) ↑ risk during the 1st 18 weeks of therapy and intensive monitoring is required
CI: Moderate-to-severe hepatic impairment, use in post exposure prophylaxis regimens
SE: Rash (SJS/TEN), nausea, diarrhea, ↑ LFT
Monitoring: CBC, LFT, Rash
Do not initiate therapy in women with CD4+ > 250 cells/mm3 or in men with CD4+ > 400 cells/mm3 due to ↑ risk of hepatotoxicity
Pentacel DT
DTaP / IPV / Hib vaccine
Xofluza
Baloxavir Influenza tx Viral replication inhibition 40-79 kg: 40 mg PO once From 80 kg: 80 mg PO once
Trulicity
Dulaglitide
GLP-1 agonist (diabetes type 2)
Start 0.75 mg SC once weekly, then ↑ 1.5 mg SC once weekly
Provided with needle in single-dose pen, 14 days at room temperature
BB: Thyroid cancer
CI: Thyroid or endocrine cancer
Warnings: Pancreatitis, serious injection reaction, not recommended in severe GI disorder (including gastroparesis)
SE: Nausea, weight loss
Monitoring: BG, A1C, Renal function
Cortenema
Hydrocortisone enema UC Tx (Flares)
Ozempic
Semaglutide GLP1 agonist BB: thyroid cancer CI: thyroid, endocrin cancer Warnings: pancreatitis, serious injection reaction, not recommended in GI dx
Denavir
Penciclovir
Topical Tx herpes labialis (Rx)
Cream
apply every 2 hours awake for 4 days
Frova
Frovatriptan
CI: cerebrovascular dx, uncontrolled hypertension, ischemic heart dx, within 24 hrs other Tristan or ergotamine product
Warning: BP higher, serotonin syndrome
SE: paresthesia, Triptan sensation
Rowasa
Mesalamine
Enema
Mild UC tx
Induction: 4 g rectally QHS, retain in the rectum overnight, approximately 8 hr
Maintenance: 2 g rectally QHS or 4 g QHS every 2-3 days
CI: Hypersensitivity to salicylates or aminosalicylates
Warnings: Acute intolerance syndrome (cramping, acute abdominal pain, bloody diarrhea), caution in patient with renal or hepatic impairment, delayed gastric retention (due to pyloric stenosis), can delay release of oral products in the colon, hypersensitivity reactions (including myocarditis, pericarditis, nephritis, hematologic abnormalities and other internal organ damage), more likely with sulfasalazine than mesalamine, ↑ risk of blood dyscrasias in patients > 65 yo
Apriso contains phenylalanine, do not use in patients with PKU
Rowasa enema contains potassium bisulfite, a sulfite that may cause an allergic-type reaction
SE: Abdominal pain, nausea, HA, flatulence, eructation, pharyngitis
Monitoring: Renal fct, CBC, sx of IBD
Mesalamine is better tolerated than other aminosalicylates
Rectal mesalamine is more effective than oral mesalamine and rectal steroids for distal dx/proctitis in UC, can use oral and topical formulation together
Swallow capsules and tablets whole, do not crush, chew or break due to delayed-release coating
Apriso: do not use with antacids (dissolution pH-dependent)
Intelence
Etravirine
HIV / NNRTI
Tablet
200 mg BID after meals
Tablets can be dispersed in water to ease administration
SE: Nausea, rash (including SJS/TEN), ↑ cholesterol, LDL, TG, hyperglycemia, ↑ LFT, peripheral neuropathy
Monitoring: LFT, lipids, BG
Typically used in pt who are tx-experienced and have resistance to 1st line ART regimen
Recombivax HB
Hepatitis B vaccination
3 doses (at birth, 1-2 months, 6-18 months)
Routine childhood vaccination, adult with risk
D.H.E. 45
Dihydroergotamine
Migraine
Injection (IV, IM, SC) 1 mg at onset then repeat hourly with max 2 mg / day for IV, 3 mg/day IM, SC and max 6 mg per week
2nd line after triptan
BB: do not use with 3A4 inhibitors (life-threatening peripheral vasoconstriction)
CI: cardiac problems, uncontrolled hypertension, renal/ hepatic impairment, MAOI within 2 weeks, serotoninergic within 24hrs
Warnings: cardiovascular effects, cerebrovascular effects, ergotism (severe vasoconstriction with gangrene), severe drug interact
Nexterone
Amiodarone
Antiarrhythmias class IIII
VF, VT with/without pulse, Ventricular arrhythmias, AFib (cardioversion/NSR)
BB: proarrhytmic, pulmonary toxicity, hepatotoxicity, LD in hospital
CI: iodine sensitivity, bradycardia, cardiogenic shock
Warning: thyroid, visual, neuropathy, blue skin, SKS/TEN
Monitor: cardio (HR, BP, ECG, electrolytes), thyroid, lungs, LFTs, eyes
Byetta
Exenatide GLP-1 agonist BB: thyroid cancer CI: thyroid, endocrin cancer Warnings: pancreatitis, serious injection reaction, not recommended in GI dx
Zurampic
Lesinurad Gout (chronic urate lowering therapy) Always with XOI 200 mg QD BB: acute renal failure if use alone CI: CrCl<30, ESRS, dialyse, kidney dx SE: HA, high SCr, renal failure, kidney stone Monitor: SCr, CrCl
Levalo
Pitavastatin
HMG-CoA resductase inhibitor for hypercholesterolemia
1-4 mg QD
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Arthrotec
Diclofenac + misoprostol
Abelcet
Amphotericin B lipid complex
Antifungal broad spectrum / empiric usage - injection only - bind to ergosterol
5 mg/kg/ day
BB: !!! Conventional, deoxycholate: 0.1-1.5 mg/kg/day do not confuse with liposomal
Kaletra
Lopinavir + ritonavir
HIV / PI
Tablet, oral solution (80 mg lopinavir + 20 mg ritonavir / ml)
Naïve pt: 800 mg lopinavir + 200 mg ritonavir QD (or 400 mg/100 mg BID)
Experienced pt: 400/100 mg BID
Tablet: without regard to meals, swallow whole, store at room temp
Oral solution: with food, refrigerate, stable for 2 months at room temp, contain 42% of alcohol
Warnings: Pancreatitis, hepatotoxicity, QT and / or PR prolongation, caution in patients with CVD due to ↑ risk or MI
SE: N/V/D, abdominal pain, hyperlipidemia (TG), hyperglycemia
Monitoring: LFT, BG, lipids, ECG in at-risk patients
High risk of hyperglycemia, insulin resistance/diabetes (idem for indinavir)
Avoid once daily dosing with carbamazepine, phenytoin, phenobarbital or in pregnant women
Common AE for PI: metabolic disorders (Hypercholesterolemia, hyperglycemia, lipohypertrophy) + N/V/D
Apriso
Mesalamine
ER capsules
Mild UC Tx
Maintenance: 1.5 g PO QD
CI: Hypersensitivity to salicylates or aminosalicylates
Warnings: Acute intolerance syndrome (cramping, acute abdominal pain, bloody diarrhea), caution in patient with renal or hepatic impairment, delayed gastric retention (due to pyloric stenosis), can delay release of oral products in the colon, hypersensitivity reactions (including myocarditis, pericarditis, nephritis, hematologic abnormalities and other internal organ damage), more likely with sulfasalazine than mesalamine, ↑ risk of blood dyscrasias in patients > 65 yo
Apriso contains phenylalanine, do not use in patients with PKU
Rowasa enema contains potassium bisulfite, a sulfite that may cause an allergic-type reaction
SE: Abdominal pain, nausea, HA, flatulence, eructation, pharyngitis
Monitoring: Renal fct, CBC, sx of IBD
Mesalamine is better tolerated than other aminosalicylates
Rectal mesalamine is more effective than oral mesalamine and rectal steroids for distal dx/proctitis in UC, can use oral and topical formulation together
Swallow capsules and tablets whole, do not crush, chew or break due to delayed-release coating
Apriso: do not use with antacids (dissolution pH-dependent)
Migergot
Ergotamine+ caffeine
Migraine 2nd line after triptan
1 suppo at onset then 1 hr after, Max 2 per attack
BB: do not use with 3A4 inhibitors (life-threatening peripheral vasoconstriction)
CI: cardiac problems, uncontrolled hypertension, renal/ hepatic impairment, MAOI within 2 weeks, serotoninergic within 24hrs
Warnings: cardiovascular effects, cerebrovascular effects, ergotism (severe vasoconstriction with gangrene), severe drug interact
Triostat
Liothyronine
Onzetra Xsail
Sumatriptan
Nasal powder
CI: cerebrovascular dx, uncontrolled hypertension, ischemic heart dx, within 24 hrs other Tristan or ergotamine product
Warning: BP higher, serotonin syndrome
SE: paresthesia, Triptan sensation
Rapivab
Peramivir
Influenza tx injection
Neuraminidase inhibitor
600 mg IV once (dose adj if CrCl<50)
Hospital setting only
Warning: confusion, skin reaction (SJS/TEN), anaphylaxis, hepatic/renal impairment
SE: hypertension, insomnia, hyperglycemia, diarrhea, constipation, neutropenia, higher AST/ALT
Sarafem
Fluoxetine Premenstrual dysphoric disorder 10-60 mg QD BB: suicidal behavior CI: MAOI, linezolid, IV methylene blue, pregnancy W: QT prolongation, bleeding
Treximet
Sumatriptan + naproxen
Migraine
Abreva
Docosanol
Topical tx Herpea labialis (OTC)
Cream
Apply 5X / day until healed
Crixivan
Indinavir
HIV / PI
Prevacid
lansoprazole
PPI for GERD, PUD
Capsule (OTC, Rx), ODT (OTC, Rx), Suspension (Rx)
15-30 MG QD before breakfast
Warnings: C.Diff, Osteoporosis, Hypomagnesemia, Vit B12 deficiency (LT > 2years), DILE
SE: HA, N/D
Prevacid Solutab (ODT) contains aspartame => not in Phenylketonuria (PKU)
Adlyxin
Lixisenatide GLP-1 agonist BB: thyroid cancer CI: thyroid, endocrin cancer Warnings: pancreatitis, serious injection reaction, not recommended in GI dx
Viread
Tenofovir disoproxil fumarate
HIV / NRTI
300 mg PO QD
Renal adj: CrCl<50
BB: exacerbate HepB when D/C in Pt with HepB
Warnings; renal tox with AKI, Falconi syndrome, osteomalacia, low bone mineral density
SE: renal impairment and low bone mineral density
Bydureon BCise
Exenatide ER GLP-1 agonist BB: thyroid cancer CI: thyroid, endocrin cancer Warnings: pancreatitis, serious injection reaction, not recommended in GI dx
Yosprala
Aspirin + omeprazole
Stroke Px
WP thyroid
Thyroid desiccated USP
Azulfidine
Sulfasalazine
Mild UC tx or RA (immunomodulator)
Tablet
UC:
RA: 500-1000 mg QD initially then 1000 mg BID (max 3g/day)
CI: Sulfa or salicylate allergy, GI obstruction, porphyria
Warnings: Blood dyscrasias, severe skin reaction (SJS/TEN), hepatic failure, pulmonary fibrosis, caution in G6PD deficiency
SE: HA, rash, anorexia, dyspepsia, N/V/D, oligospermia, folate deficiency, arthralgia, crystalluria
Monitoring: CBC, LFT (baseline, weekly/3months, monthly/3 months, every 3 months), renal function
Coloration yellow-orange of the skin/urine
Folate supplement 1mg/day
Zypitamag
Pitavastatin
HMG-CoA resductase inhibitor for hypercholesterolemia
1-4 mg QD
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Zenpep
Pancrelipase (PEP, PERT)
CF
Fuzeon
Enfuvirtide
HIV / fusion inhibitor
Digitek
Digoxin
AFib (0.8-2 ng/ml), HF (0.5-0.9 ng/ml)
Viokace
Pancrelipase
PEP, PERT used in CF
Initial doses: < 1yo: varies by product, 1-3 yo: lipase 1,000 units /kg/meal, ≥ 4 yo: lipase 500 units/kg/meal
Max all ages lipase ≤ 2,500 units/kg/meal or ≤ 10,000 units/kg/day, doses > 6,000 units/kg/meal are associated with colonic stricture
Warnings: Fibrosing colonopathy advancing to colonic stricture (rare, higher risk with doses > 10,000 units/kg/day, mucosal irritation, hyperuricemia
SE: Abdominal pain, flatulence, nausea, HA, neck pain
Monitor: Abdominal sx, nutritional intake, weight, height, stool, fecal fat
Praxbind
Idarucizumab
Victoza
Liraglutide
GLP-1 agonist
SC QD (start 0.6 mg for one week then 1.2 mg)
BB: thyroid cancer
CI: thyroid, endocrin cancer
Warnings: pancreatitis, serious injection reaction, not recommended in GI dx
Nimalize
Nimodipine
Hemorrhagic stroke
Capsule with oral solution
60 mg PO Q4H for 21 days 1h before or 2 hrs after meal
Start within 4 days of the SAH
BB: Do not administer IV or by other parenteral routes, death and serious life-threatening adverse events have occurred (including cardiac arrest, cardiovascular collapse, hypotension and bradycardia) when the contents of nimodipine capsule have been inadvertently injected parenterally
CI: ↑ risk of significant hypotension when used in combination with strong inhibitors of 3A4
SE: Hypotension, bradycardia, HA, nausea, edema
Monitoring: CPP, ICP, BP, HR, neurological checks
Only PO never parenteral!!!
If cannot be swallowed, transfer oral solution from capsule into ORAL syringe within the pharmacy and label properly (For oral use only, Not for IV use)
Lipophile CCB with good penetration in brain
ActHib
Hib vaccine 4 doses between 2-15 months
Routine childhood vaccination, immunocompromised, asplenia
Triumeq
Dolutegravir + abacavir + lamivudine
HIV tx
Kionex
Sodium polystyrene sulfonate
Hyperkalemia
Unithyroid
Levothyroxine Hypothyroid 1.6 mcg/kg/day (IBW) for healthy adults Elderly: 20-25% less: < 1mcg/kg/day CAD: 12.5-25mcg/day BB: not for obesity CI: uncorrected adrenal insufficiency Warning: low dose in CAD, osteoporosis SE: none if euthyroid (hyper or hypo) Monitor: TSH, Sx, FT4 in pregnancy, central hypothyroidism
SPS
Sodium Polystyrene sulfonate
Hyperkalemia
Levoxyl
Levothyroxine Hypothyroid 1.6 mcg/kg/day (IBW) for healthy adults Elderly: 20-25% less: < 1mcg/kg/day CAD: 12.5-25mcg/day BB: not for obesity CI: uncorrected adrenal insufficiency Warning: low dose in CAD, osteoporosis SE: none if euthyroid (hyper or hypo) Monitor: TSH, Sx, FT4 in pregnancy, central hypothyroidism
Tamiflu
Oseltamivir Influenza tx Neuraminidase inhibitor Tx from 12 yo: 75 mg BID for 5 days Px from 12 yo: 75 mg QD for 10 days 30, 45, 75 mg tablet 6 mg/ml suspension for Kids (2-12): dosage in mg/kg
Asacol HD
Mesalamine
ER tablet
Mild UC tx
Induction: 1.6 g PO TID
CI: Hypersensitivity to salicylates or aminosalicylates
Warnings: Acute intolerance syndrome (cramping, acute abdominal pain, bloody diarrhea), caution in patient with renal or hepatic impairment, delayed gastric retention (due to pyloric stenosis), can delay release of oral products in the colon, hypersensitivity reactions (including myocarditis, pericarditis, nephritis, hematologic abnormalities and other internal organ damage), more likely with sulfasalazine than mesalamine, ↑ risk of blood dyscrasias in patients > 65 yo
Apriso contains phenylalanine, do not use in patients with PKU
Rowasa enema contains potassium bisulfite, a sulfite that may cause an allergic-type reaction
SE: Abdominal pain, nausea, HA, flatulence, eructation, pharyngitis
Monitoring: Renal fct, CBC, sx of IBD
Mesalamine is better tolerated than other aminosalicylates
Rectal mesalamine is more effective than oral mesalamine and rectal steroids for distal dx/proctitis in UC, can use oral and topical formulation together
Swallow capsules and tablets whole, do not crush, chew or break due to delayed-release coating
Apriso: do not use with antacids (dissolution pH-dependent)
Cambia
Diclofenac
Migraine
Pediarix
DTaP / HepB / IPV vaccine
Famvir
Famciclovir
Antiviral agent used in Herpes labialis, genital herpes and shingles
Safety:
TTP/HUS in immunocompromised PTs
Nephrotoxic (> acyclovir)
Seizure, high LFTs, SCr, BUN, neutropenia
Pentasa
Mesalamine
ER capsules
Mild UC Tx
Induction: 1 g PO QID
Maintenance: 1 g PO QID
CI: Hypersensitivity to salicylates or aminosalicylates
Warnings: Acute intolerance syndrome (cramping, acute abdominal pain, bloody diarrhea), caution in patient with renal or hepatic impairment, delayed gastric retention (due to pyloric stenosis), can delay release of oral products in the colon, hypersensitivity reactions (including myocarditis, pericarditis, nephritis, hematologic abnormalities and other internal organ damage), more likely with sulfasalazine than mesalamine, ↑ risk of blood dyscrasias in patients > 65 yo
Apriso contains phenylalanine, do not use in patients with PKU
Rowasa enema contains potassium bisulfite, a sulfite that may cause an allergic-type reaction
SE: Abdominal pain, nausea, HA, flatulence, eructation, pharyngitis
Monitoring: Renal fct, CBC, sx of IBD
Mesalamine is better tolerated than other aminosalicylates
Rectal mesalamine is more effective than oral mesalamine and rectal steroids for distal dx/proctitis in UC, can use oral and topical formulation together
Swallow capsules and tablets whole, do not crush, chew or break due to delayed-release coating
Apriso: do not use with antacids (dissolution pH-dependent)
Requip
Ropinirole
PD - dopamine agonist
Isentress
Raltegravir
HIV / INSTI
TOBI
Tobramycin inhalation solution
Chronic pulmonary infection CF (pseudomonas aeruginosa)
Uloric
Febuxostat
Gout (chronic urate lowering therapy)
Aptivus
Tipranavir
HIV / PI
Capsule, Oral solution
500 mg +200 mg ritonavir BID
Swallow whole, always with ritonavir, capsule should be in the fridge, 60 days at room temp, discard 60 days after opening bottle
Solution can be stored at room temp, D/C 60 days after opening the bottle
BB; Clinical hepatitis and hepatic decompensation (sometimes fatal), intracranial hemorrhage
CI: Moderate or severe hepatic impairment
Warnings: Use caution in patient with sulfa allergy, intracranial hemorrhage (caution with bleeding risk)
SE: N/V/D, HA, ↑ CPK, hyperlipidemia (TG)
Monitoring: LFT, BG, lipids
Capsule contains 7% alcohol
Oral solution contains Vit E => additional vitamin supplement should be avoided
Colazal
Balsalazide
Mild UC tx
Capsule
Induction: 2.25 g (3x 750 mg capsules) PO TID for 8-12 weeks
CI: Salicylate allergy
Warning: Gastric retention (due to pyloric stenosis) can delay release of the drug in the colon, acute intolerance syndrome, caution in patients with renal and hepatic impairment
SE: HA, abdominal pain, N/V/D
Monitoring: Renal fct, LFT, sx of IBD
Colazal capsules can be opened and sprinkled on applesauce, beads are not coated, so mixture can be chewed if needed , when used this way, it can cause staining of the teeth/tongue
Kalydeco
Ivakaftor (CFTR Modulator)
CF - increase time channels are open
Viracept
Nelfinavir
HIV / PI
Thyrolar
Liotrix
T3 and T4 in ratio 1/4 for hypothyroidism
Tablet
Start 25 mcg/6.25 mcg QD, Usual dose 50-100 mcg/12.5-25 mcg QD
BB: Do not use to treat obesity
CI: Uncorrected adrenal insufficiency
Warnings: ↓ Dose in CAD, Osteoporosis
SE: Euthyroid pt: no SE, Too much => hyperthyroid Sx
Monitoring: TSH, Clinical Sx, FT4 in selected pt (central hypothyroidism, pregnancy)
Atelvia
Risedronic acid
BIisphosphonate used in osteoporosis
DR tablet
Px: 5 mg QD, 35 mg weekly, 75 mg 2x/month, 150 mg monthly / Tx: 35 mg weekly / steroid-induced: 5 mg QD
30 minutes after breakfast (need acidic pH for absorption => no stomach medication)
CI: Inability to stand upright for 30 min, Abnormalities of esophagus, Difficulty swallowing, Hypocalcemia
Warnings: Osteonecrosis of the Jaw (ONJ) (> Dental procedure, hygiene, cancer, chemotherapy, Steroids), Atypical femur fracture, Bone, joint, muscle pain, Esophagitis to esophageal perforation (instructions for administration), Hypocalcemia, Renal impairment (CrCl < 30 not recommended)
SE: Hypocalcemia, hypophosphatemia, Dyspepsia, heartburn, N/V, abdominal pain, Muscle pain, rash, hypertension, HA, UTI, infection
NeBupent
Pentamidine
Alternative option for OI Pneumocystis pneumonia in AIDS
Injection, inhalation
Mitigare
Colchicine
Gout tx
1.2 mg PO (2T) then 1T one hour after (Max 4T/ day)
Repeat 3 days after (not earlier) and if CrCl<30 wait 2 weeks
Safety: myelosuppression, myopathy, neuropathy, GI N/V/D, anorexi
Lokelma
Sodium zirconium cyclosilicate
Hyperkalemia (Non absorbed cation exchange resin)
Powder for oral suspension
10 g PO TID for up to 48h
Warnings: Can worsen GI motility, Edema, Na => monitor diet, Bind to other medications => 2h before or after
SE: Peripheral edema
Store at room temp
Retrovir
Zidovudine
HIV / NRTI
Descovy
Emtricitabine 200 mg + Tenofovir alafenamide 25 mg
HIV-1/NRTI
Tablets
Safety class effect NRTI: lactic acidosis
Prezista
Darunavir
HIV / PI
Lescol
Fluvastatin
HMG-CoA reductase inhibitor used in hypercholesterolemia
20-80 mg QPM
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Pepcid complete
Famotidine + Calcium + magnesium
Axert
Almotriptan
6.25-12.5 mg repeat after 2 hrs (Max 25 mg/day) >=12 yo
CI: cerebrovascular dx, uncontrolled hypertension, ischemic heart dx, within 24 hrs other Tristan or ergotamine product
Warning: BP higher, serotonin syndrome
SE: paresthesia, Triptan sensation
Relpax
Eletriptan
CI: cerebrovascular dx, uncontrolled hypertension, ischemic heart dx, within 24 hrs other Tristan or ergotamine product
Warning: BP higher, serotonin syndrome
SE: paresthesia, Triptan sensation
Trogarzo
Ibalizumab-ulyk
HIV / CD4-directed post attachment HIV-1 inhibitor (Block entry of HIV into host cells by binding to CD4 without immunosuppression, last line therapy when everything else failed)
Injection
LD: 200 mg BID IV once, MD: 800 mg / 250 ml NS IV every 2 weeks
Warning: Risk of immune reconstitution inflammatory syndrome (IRIS)
SE: Infusion-related reactions, diarrhea, dizziness, nausea, rash
Observed patient for infusion-related reaction for 1h after the 1st infusion
Symbyax
Fluoxetine + olanzapime
Resistant depression
Pexeva
Paroxetine
Depression
10-60 mg QD
BB: suicidal behavior
CI: MAOI, linezolid, IV methylene blue, pregnancy
Warnings: QT prolongation, bleeding, SIADH, hyponatremia (> elderly)
SE: Sexual side effects, Somnolence, dizziness, weakness, insomnia, nausea, headache (LT can help), dry mouth, diaphoresis (sweating), Restless leg syndrome (onset and Tx initiation), ↑ fall risk => caution in frail patients, osteopenia/osteoporosis, use of CNS depressants
Boostrix
Tdap vaccine
1 dose if no record of DTaP, incomplete DTaP, healthcare provider, child-care provider, pregnancy (each)
Rayos
Prednisone delayed-release tablet
For UC / CD Tx
Sustiva
Efavirenz
HIV / NNRTI
Capsule, tablet (Capsule content may be sprinkle onto 1-2 teaspoon of food)
600 mg QD
Warnings: Serious psychiatric syndrome (suicidal ideation, depression), CNS Sx (generally resolve in 2-4 weeks), convulsions, QT prolongation, hepatotoxicity, fetal toxicity
SE: CNS effects (impaired concentration, abnormal dreams, confusion, dizziness), rash, HA, N/V, fatigue, insomnia
Monitoring: Lipids, CNS and psychiatric effects, LFT, ECG
Package insert state to avoid in the 1st trimester, based on additional data, guidelines recommend no restriction on use in pregnancy
May cause false positive for cannabinoid and BZD on drug screening tests
Efavirenz should not be used with abacavir/lamivudine (or emtricitabine) in pt with pre-Tx HIV viral load > 100,000 copies/ml
Invirase
Saquinavir
HIV/PI
Tenivac
Td vaccine
Every 10 years if older than 7 yo or wound prophylaxis
Reyataz
Atazanavir
HIV / PI
Bufferin
Aspirin
Anti platelet aggregation
Entocort EC
Budesonide tablet 3 mg
CD tx
Vaqta
Hepatitis A vaccine
Hiberix
Hib vaccine
Mirapex
Pramipexole
PD - dopamine agonist
Ancobon
Flucytosine 5-FC
Antifungal use in association with amphotericin B for yeast infection (Cryptococcal meningitis or Candida infections)
Capsule (250 or 500 mg)
50-150 mg/kg/day PO divided into Q6H
(Renal adj CrCl<40)
BB: Use with extreme caution in renal dysfunction (monitor blood, kidney, liver)
SE: Myelosuppression, Nephrototoxicity, Hepatotoxicity
Istalol
Timolol
Aciphex
Rabeprazole
PPI
Tablet (Rx), Capsule sprinkle (Rx)
20 mg QD w/o regard a meal for tab, 30 minutes before meal for caps sprinkles
Warnings: C.diff, osteoporosis, hypomagnesemia, vit B12 deficiency (LT), DILE
SE: HA, N/D
Beers criteria: Max 8 weeks in elderly unless clear indication (high risk due to chronic use of NSAIDs)
Pylera
Bismuth subcitrate potassium + metronidazole + tetracycline
Sinemet
Carbidopa/ levodopa
Bevyxxa
Betrixaban
OAC
DVT PX (only one) inpatient only
Amerge
Naratriptan
Triptan used in migraine (5 HT1 agonist)
Tablet
1-2.5 mg can be repeated after 4 hrs, Max 5 mg / day
CI: cerebrovascular dx, uncontrolled hypertension, ischemic heart dx, within 24 hrs other Triptan or ergotamine product
Warning: BP higher, serotonin syndrome
SE: paresthesia, Triptan sensation
Zembrace Symtouch
Sumatriptan
Pen SC injection
Relenza
Zanamivir Influenza Tx and Px Neuraminidase inhibitor (Diskhaler) Tx from 7 yo: 10 mg BID for 5 days Px from 5 yo: 10 mg QD for 10 days (28 days community acquired)
Valtrex
Valacyclovir
Antiviral agent used in Herpes labialis, genital herpes and shingles
Safety:
TTP/HUS in immunocompromised PTs
Nephrotoxic (>acyclovir)
Seizure, high LFTs, SCr, BUN, neutropenia
Stribild
Elvitegravir + cobicistat + emtricitabine + tenofovir disoproxil fumarate
Cytomel
Liothyronine
Westhroid
Thyroid desiccated USP
Caduet
Atorvastatin + amlodipin
AmBisome
Liposomal amphotericin B
Antifungal broad spectrum / empiric usage - injection only - bind to ergosterol
3-6 mg/kg/ day
BB: !!! Conventional, deoxycholate: 0.1-1.5 mg/kg/day do not confuse with liposomal
SE: infusion-related reaction (=> prémédication with acetaminophen, diphenhydramine, hydrocortisone, meperidine, NS), electrolyte (low K, Mg), nephrotoxicity
Migranal
Dihydroergotamine
Migraine
Nadal spray: 1 spray (0.5 mg)into each nostril, may repeat after 15 minutes and that’s it (Max 2 mg)
Prime 4 sprays before use do not inhale deeply
2nd line after triptan
2T at onset then 1 T every 30 min max 6T
BB: do not use with 3A4 inhibitors (life-threatening peripheral vasoconstriction)
CI: cardiac problems, uncontrolled hypertension, renal/ hepatic impairment, MAOI within 2 weeks, serotoninergic within 24hrs
Warnings: cardiovascular effects, cerebrovascular effects, ergotism (severe vasoconstriction with gangrene), severe drug interact
Selzentry
Maraviroc
HIV / CCR5 antagonist
Daptacel
DTaP Vaccine
5 doses 2,4,6,12-18 months, 4-6 years
Routine childhood vaccination (less than 7 yo)
PedvaxHib
Hib vaccine
3 doses
Routine childhood vaccination, immunocompromised, asplenia
Engerix-B
Hepatitis B vaccination
Kayexalate
Sodium polystyrene sulfonate
Hyperkalemia
Orkambi
Lumacaftor + Ivakaftor Cystic fibrosis (CFTR modulator for homozygous F508del mutation only) Tablet Warnings: ↑ LFT, cataract in children Take with high fat meal Approved for ≥ 2 yo
Heplisav
Hepatitis-B vaccination
Bentyl
Dicyclomine
Antispasmodic for diarrhea
Brisdelle
Paroxetine
Depression
Colcrys
Colchicine
Acute tx of gout
1.2 mg PO (2T) then 0.6 mg one hour later (Max 4T/day) can be repeated 3 days after but not earlier (if CrCl<30: wait 2 weeks between sessions)
CI: do not use in combination with strong inhibitor 3A4, P-gp and renal/hepatic impairment
Warnings: myelosuppression, GI Sx, Rhabdomyolysis (do not use with cyclosporine, diltiazem, verapamil, gemfibrozil, statin
SE: diarrhea, nausea, neuropathy, myelosuppression, myopathy
Kitabis Pack
Tobramycin inhalation solution
Chronic pulmonary infection in CF (pseudomonas aeruginosa)
Videx
Didanosine
HIV / NRTI
>60 kg: 400 mg PO QD, <60 kg: 250 mg PO QD
Renal adj: CrCl<60
Oral solution 30 days in fridge
BB: pancreatitis
CI: association with allopurinol and ribavirin
Warnings: portal hypertension, eye toxicity
SE: N/V/D, peripheral neuropathy, high amylase, rash, pruritus
Avoid association with stavudine, tenofovir
Cimzia
Certolizumab
Anti-TNF alpha (RA, CD)
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Amitiza
Lubiprostone Constipation (CIC, OIC, IBS-C) chloride channel activation => more fluid in the gut OIC and CIC: 24 mcg PO BID IBS-C: 8 mcg PO BID CI: intestinal obstruction SE: diarrhea, nause, HA, hypokaliémies Take a/ food and water, do not crush Do not take with methadone
Delzicol
Mesalamine
ER capsules
Mild UC Tx
Induction: 800 mg PO TID
Maintenance: 1.6 PO in 2-4 divided doses
CI: Hypersensitivity to salicylates or aminosalicylates
Warnings: Acute intolerance syndrome (cramping, acute abdominal pain, bloody diarrhea), caution in patient with renal or hepatic impairment, delayed gastric retention (due to pyloric stenosis), can delay release of oral products in the colon, hypersensitivity reactions (including myocarditis, pericarditis, nephritis, hematologic abnormalities and other internal organ damage), more likely with sulfasalazine than mesalamine, ↑ risk of blood dyscrasias in patients > 65 yo
Apriso contains phenylalanine, do not use in patients with PKU
Rowasa enema contains potassium bisulfite, a sulfite that may cause an allergic-type reaction
SE: Abdominal pain, nausea, HA, flatulence, eructation, pharyngitis
Monitoring: Renal fct, CBC, sx of IBD
Mesalamine is better tolerated than other aminosalicylates
Rectal mesalamine is more effective than oral mesalamine and rectal steroids for distal dx/proctitis in UC, can use oral and topical formulation together
Swallow capsules and tablets whole, do not crush, chew or break due to delayed-release coating
Apriso: do not use with antacids (dissolution pH-dependent)
Linzess
Linaclotide
Constipation (CIC, IBS-C)
Guanylate cyclise C agonist
Trulance
Plecanatide
Guanylate cyclase C agonist used in constipation (CIC, IBS-C)
Tablet
BB: Not in children, dehydration can cause death
CI: < 6 yo, GI obstruction
SE: Diarrhea, HA, Abdominal distension, Flatulence
Entereg
Alvimopan
PAMORA
Inpatient b4 surgery to reduce risk bowel obstruction
Relistor
Methylnatrexone
PAMORA (OIC)
Injection, Tablet
12 mg SC QD or 450 mg PO QD
CrCl < 30: ↓ dose
CI: Bowel obstruction
Warnings: Risk of GI perforation (monitor for abdominal pain), Risk of opioid withdrawal
SE: Abdominal pain, N/D, flatulence
Relistor: stay close to toilets after injection
Discontinue all laxatives before initiating tx (reintroduce OTC laxatives if no improvement after 3 days)
Movantik: 3C4 inhibitors interaction => ↓ dose with moderate inhibitor and no strong inhibitor, grapefruit
Movantik
Naloxegol PAMORA, OIC Tablet 25 mg QD (morning/empty stomach) Renal adj: CrCl < 60: 12.5 mg CI: Bowel obstruction Warnings: Risk of GI perforation (monitor for abdominal pain), Risk of opioid withdrawal SE: Abdominal pain, N/D, flatulence
Symproic
Naldemedine PAMORA (OIC) Tablet 0.2 mg QD CI: Bowel obstruction Warnings: Risk of GI perforation (monitor for abdominal pain), Risk of opioid withdrawal SE: Abdominal pain, N/D, flatulence
Lovenox
Enoxapirin
Parenteral AC
VTE Tx / Px, UA/NSTEMI/STEMI
Fragmin
Dalteparin
Parenteral AC
VTE Px, UA, NSTEMI (3 indications)
Eliquis
Apixaban OAC factor Xa inhibitor Non valvular Afib (5 mg BID), VTE Tx (10mg BID) Px (2.5 mg BID) , recurrence (2.5 mg BID) no renal adj BB: neuraxial anesthesia, brutal D/C CO: bleeding pt Warning: not recommended in prosthetic heart valve, liver dx SE: bleeding, anemia Monitoring: Hb, Hct, SCr, LFT
Xarelto
Rivaroxaban OAC Non valvular AFib (20 mg QD), VTE TX (15 mg QD)/ PX (10 mg QD), Recurrence (5 mg QD) BB: neuraxial anesthesia, brutal D/C CI: bleeding pt Warning: not recommended in prosthetic heart valve, liver dx SE: bleeding, anemia Monitoring: Hb, Hct, SCr, LFT If >= 15 mg, with fat meal Do not use When CrCl<30
Arixtra
Fondaparinux
Parenteral AC
VTE TX (>100kg:10 mg SC QD /50-100 kg: 7.5 mg SC QD/ <50 kg: 5 mg SC QD
VTE PX (>= 50 kg: 2.5 mg SC QD/< 50: do not use)
BB: neuraxial anesthesia
CI: HIT, Bleeding, bacterial endocarditis, CrCl<30
SE: bleeding, anemia, thrombocytopenia, injection reaction, hypokalemia, hypotension
Norpace
Disopyramide
Antiarrhythmic class Ia
CI: heart block, cardiogenic shock, congenital QT syndrome
Warnings: proarrhythmic, HF, anticholinergic effects
Rythmol
Propafenone
Antiarrhythmic Class Ic
Multaq
Dronedarone Antiarrhythmic class III
Tikosyn
Dofetilide Antiarrhythmic class III
Betapace
Sotalol
Antiarrhythmic class III
BB: TdP => initiate in hospital with ECG and trained staff, renal adj when CrCl<60 (For some CI when CrCl <40)
CI: heart block, long QT syndrome, bradycardia, HF, cardiogenic shock, for some QTc > 450
SE: fatigue, bradycardia, bronchoconstriction
Sotylize
Sotalol
Antiarrhythmic class III
BB: TdP => initiate in hospital with ECG and trained staff, renal adj when CrCl<60 (For some CI when CrCl <40)
CI: heart block, long QT syndrome, bradycardia, HF, cardiogenic shock, for some QTc > 450
SE: fatigue, bradycardia, bronchoconstriction
Sorine
Sotalol
Antiarrhythmic class III
BB: TdP => initiate in hospital with ECG and trained staff, renal adj when CrCl<60 (For some CI when CrCl <40)
CI: heart block, long QT syndrome, bradycardia, HF, cardiogenic shock, for some QTc > 450
SE: fatigue, bradycardia, bronchoconstriction
Covert
Ibutilide Antiarrhythmic class III
Cresemba
Isavuconazonium
Azole Antifungal
Noxafil
Posaconazole
Azole antifungal
Yeast + aspergillus + zygomycetes (Mucor, Rhizopus)
Suspension: 200 mg TID or 400 mg BID
Tablet: 300 mg BID once then QD
Injection: 300 mg IV once then QD (not in CrCl<50, Nephrotoxic adjuvant)
CI: sirolimus (9x blood level), 3A4 substrates bcz higher risk of QT prolongation, ergotamine derivative (higher risk of ergotism
Warning: QT prolongation
SE: N/V/D, fever, HA
Monitor: LFT, renal fct, electrolytes, CBC
Cytovene
Ganciclovir injection
CMV
BB: Myelosuppression, Teratogen, Carcinogen
SE: Fever, N/V/D, Anorexia , Neutropenia, thromcytopenia, leukopenia, anemia , ↑ SCr, Retinal detachment (valganciclovir)
Monitoring: CBC, PLT, Retinal exam (with valganciclovir), SCr
Zirgan
Gangciclovir ophthalmic gel
CMV
Eraxis
Anidulafungin
Antifungal (Echinocandin) active against resistant candidas (krusei, glabrata) or in combination for aspergillus
Injection
Candidemia: 200 mg IV QD, Esophageal Candidiasis: 100 mg IV once then 50 mg IV QD
Warnings: Histamine-mediated symptoms / Allergic reactions (skin, anaphylaxis)
SE: ↑ LFTs, ↑ Scr, Hypotension, ↑ K, Mg, Fever, N/V/D, Hypoglycemia, Rash, severe skin reactions
Monitoring: LFTs
Valcyte
Valgancyclovir
CMV
Foscavir
Foscarnet injection
CMV
Intron A
Interferon-Alfa-2b
Cytokine uses in HepB tx
Pegasys
Pegylated interferon-alpha-2a
Cytokine used in HepB tx
Vemlidy
Tenofovir alafenamide
NRTI used in HepB tx
Tablet
25 mg PO QD (with food)
BB: Lactic acidosis and severe hepatomegaly with steatosis, which can be fatal
Exacerbation of HBV when stopped => monitor closely, Can cause HIV resistance in HBV patient with undiagnosed, untreated HIV, Adefovir: caution in renal dx, with nephrotoxic drugs
Warning: Tenofovir: renal toxicity with AKI, Fanconi syndrome, osteomalacia, and ↓ BMD
SE: HA, abdominal pain, fatigue, cough, nausea, ↑ LFT, < renal and bone toxicity vs TDF
Baraclude
Entecavir
NRTI used in HepB tx
Hepsera
Adefovir
NRTI used in HepB tx
Tablet
10 mg QD
BB: Lactic acidosis and severe hepatomegaly with steatosis, which can be fatal
Exacerbation of HBV when stopped => monitor closely, Can cause HIV resistance in HBV patient with undiagnosed, untreated HIV, Adefovir: caution in renal dx, with nephrotoxic drugs
SE: HA, weakness, abdominal pain, hematuria, rash, nephrotoxicity
Epivir HBV
Lamivudine
NRTI used in HepB tx (different dosage in HIV)
Harvoni
Sofosbuvir / ledipasvir
DAA used in HepC tx
BB: Reactivate HBV => test HBV before Tx
Warnings: Sofosbuvir: do not use with amiodarone (serious bradycardia), acid suppressive therapy should be avoided
SE: Well-tolerated
Monitoring: LFT, HCV-RNA
Epclusa
Sofosbuvir / velpatasvir
DAA used in HepC tx
BB: Reactivate HBV => test HBV before Tx
Warnings: Sofosbuvir: do not use with amiodarone (serious bradycardia), acid suppressive therapy should be avoided
SE: Well-tolerated
Monitoring: LFT, HCV-RNA
Vosevi
Sofosbuvir/ velpatasvir / voxilaprevir
DAA used in HepC tx
Mavyret
Glecaprevir/ pibrentasvir
DAA used in HepC tx
Technivie
Paritaprevir/ ritonavir/ ambitasvir
DAA used in HepC tx
CI: Hepatic dx, 3A4 substrate, inducers (contraceptive pills, patch, ring), lovastatin, simvastatin (ethinyl estradiol-containing medication must be stopped (COC, patches, rings, menopause products)
Hepatotoxic (call Dr if yellow skin, eyes, dark urine, light stool, bad stomach pain with nausea)
Veikira
Paritaprevir / ritonavir / ambitasvir / dasabuvir
DAA used in HepC
Zepatier
Elbasvir / Grazoprevir
DAA used in HepC
Viibryd
Vilazodone
SSRI and 5HT1A agonist used in depression
Trintellix
vortioxetine
SSRI + 5HT receptor antagonist + 5HT1A agonist used in depression
Fetzima
Levomilnacipran
SNRI used in depression
40-120 mg QD (start 20 mg QD for 2 days)
Do not use when CrCl < 15 ml/min
BB: Suicidal behavior
CI: MAOI and hypertensive crisis, Do not initiate in patients receiving linezolid, methylene blue IV
SE: See SSRIs, SE dur to ↑ NE: ↑ HR, dilated pupils (can lead to narrow angle glaucoma), dry mouth, excessive sweating and constipation
Can affect urethral resistance => caution in patients prone to obstructive urinary disorders, ↑ BP (> venlafaxine when > 150 mg/day) all have risk, especially at higher doses => ↓ dose, use antihypertensive or change therapy
Elavil
Amitriptyline
TCA used in depression, neuropathic pain, migraine
Khedezla
Desvenlafaxine
SNRI used in depression
50 mg QD (can ↑ to 400 mg/day but no benefit to > 50 mg)
BB: Suicidal behavior
CI: MAOI and hypertensive crisis, Do not initiate in patients receiving linezolid, methylene blue IV
SE: See SSRIs
SE dur to ↑ NE: ↑ HR, dilated pupils (can lead to narrow angle glaucoma), dry mouth, excessive sweating and constipation, Can affect urethral resistance => caution in patients prone to obstructive urinary disorders
↑ BP (> venlafaxine when > 150 mg/day) all have risk, especially at higher doses => ↓ dose, use antihypertensive or change therapy
↓ dose in renal impairment, do not use levomilnacipran CrCl < 15, or duloxetine CrCl < 30
Anafranil
Clomipramine
TCA used in depression
Tofranil
Imipramine
TCA used in depression
Surmontil
Trimipramine
TCA used in depression
Norpramin
Desipramine
TCA used in depression
Pamelor
Nortriptyline
TCA used in depression
Marplan
Isocarboxazid
MAOI used in depression
Nardil
Phenelzine
MAOI used in depression
Parnate
Trancylcypromine
MAOI used in depression
30 mg/day in divided dose (max 60 mg/day)
BB: Suicidal behavior
CI: Cardiovascular dx, Cerebrovascular Dx, HA history, Hepatic Dx, Pheochromocytoma, Concurrent use of sympathomimetics, CNS depressants
Warnings: Drug-drug, Drug-food interactions
SE: Anticholinergic, Orthostasis, Sedation, Sexual dysfunction
Emsam
Selegiline
MAOI used in depression
Wellbutrin
Bupropion
Dopamine and NE reuptake inhibitor used in depression
Wellbutrin XL
Bupropion
Dopamine and NE reuptake inhibitor used in seasonal affective disorder
Aplenzin
Bupropion
Dopamine and NE reuptake inhibitor used in affective seasonal disorder
Forvivo
Bupropion
Dopamine and NE reuptake inhibitor used in depression
Rytary
Carbidopa/Levodopa Dopamine replacement agents used in PD ER capsules 23.75/95 mg PO TID Take whole or sprinkles on applesauce CI: MAOI within 14 days, Glaucoma SE: Nausea, Dizziness, orthostasis, dyskinesia, Dry mouth, dystonia (sometimes painful), Confusion, hallucination, psychosis, Dark urine, saliva, sweat + discolor clothes, Hemolysis (positive Coombs test) => D/C, Sexual urges and priapism, ↑Uric acid, Rytary: suicidal ideation Duopa: GI complications Titrate cautiously LT use: fluctuation in response and dyskinesia Separate from Iron, separate from protein intake
Duopa
Levodopa/carbidopa
Dopamine replacement agent used in PD
Comtan
Entacapone
COMT inhibitor used in PD
Stalevo
Entacapone / carbidopa / levodopa
Association used in PD
Neupro
Rotigotine
Dopamine agonist used in PD
Apokyn
Apomorphine
Dopamine agonist used in PD rescue agent for off episode
0.2 ml (2 mg) SC PRN up to 5x a day titrage by 1 mg weekly to max 0.6 ml (6 mg) (start in medical office, dose in ml
Eldepryl
Selegiline
MAOI used in PD
Zelapar
Selegiline
MAOI used in PD
Azilect
Rasagiline
MAOI used in PD
Xadago
Safinamide
MAOI used in PD
Cogentin
Benztropine
Central acting anticholinergic used in PD
Northera
Droxidopa
Alpha/beta agonist used in PD
Rifadin
Rifampin
Active TB tx
Rifamate
Rifampin + INH
Active TB to
Rifater
Rifampin + INH + Pyrazinamide
Active TB TCA
Fosamax
Alendronate
Bisphosphonate for osteoporosis tx
Tablet or oral solution
Px: 5 mg QD or 35 mg weekly / Tx: 10 mg QD or 70 mg weekly / steroid-induced 5-10 mg QD
Before breakfast
CI: Inability to stand upright for 30 min, Abnormalities of esophagus, Difficulty swallowing, Hypocalcemia
Warnings: Osteonecrosis of the Jaw (ONJ) (> Dental procedure, hygiene, cancer, chemotherapy, Steroids), Atypical femur fracture, Bone, joint, muscle pain, Esophagitis to esophageal perforation (instructions for administration), Hypocalcemia, Renal impairment (CrCl < 35 not recommended)
SE: Hypocalcemia, hypophosphatemia, Dyspepsia, heartburn, N/V, abdominal pain, Muscle pain
Binosto
Alendronate
Bisphosphonate for osteoporosis tx
Effervescent tablet
Px: 5 mg QD or 35 mg weekly / Tx: 10 mg QD or 70 mg weekly / steroid-induced 5-10 mg QD
Before breakfast
CI: Inability to stand upright for 30 min, Abnormalities of esophagus, Difficulty swallowing, Hypocalcemia
Warnings: Osteonecrosis of the Jaw (ONJ) (> Dental procedure, hygiene, cancer, chemotherapy, Steroids), Atypical femur fracture, Bone, joint, muscle pain, Esophagitis to esophageal perforation (instructions for administration), Hypocalcemia, Renal impairment (CrCl < 35 not recommended)
SE: Hypocalcemia, hypophosphatemia, Dyspepsia, heartburn, N/V, abdominal pain, Muscle pain, rash, hypertension, HA, UTI, infection
Actonel
Risedronate
Bisphosphonate for osteoporosis tx
Px: 5 mg QD, 35 mg weekly, 75 mg 2x/month, 150 mg monthly / Tx: 35 mg weekly / steroid-induced: 5 mg QD
CI: Inability to stand upright for 30 min, Abnormalities of esophagus, Difficulty swallowing, Hypocalcemia
Warnings: Osteonecrosis of the Jaw (ONJ) (> Dental procedure, hygiene, cancer, chemotherapy, Steroids), Atypical femur fracture, Bone, joint, muscle pain, Esophagitis to esophageal perforation (instructions for administration), Hypocalcemia, Renal impairment (CrCl < 30 not recommended)
SE: Hypocalcemia, hypophosphatemia, Dyspepsia, heartburn, N/V, abdominal pain, Muscle pain, rash, hypertension, HA, UTI, infection
Boniva tablet
Ibandronate
Osteoporosis tx
Px: 150 mg monthly
CI: Inability to stand upright for 30 min, Abnormalities of esophagus, Difficulty swallowing, Hypocalcemia
Warnings: Osteonecrosis of the Jaw (ONJ) (> Dental procedure, hygiene, cancer, chemotherapy, Steroids), Atypical femur fracture, Bone, joint, muscle pain, Esophagitis to esophageal perforation (instructions for administration), Hypocalcemia, Renal impairment (CrCl < 30 not recommended)
SE: Hypocalcemia, hypophosphatemia, Dyspepsia, heartburn, N/V, abdominal pain, Muscle pain, rash, hypertension, HA, UTI, infection
Reclast
Zoledronic acid
Bisphosphonate for osteoporosis tx
Injection (Over ≥ 15 min)
Px: 5 mg IV every 2 years / Tx: 5 mg IV once yearly / steroid-induced: 5 mg IV once yearly
CI: Hypocalcemia, CrCl < 35 or AKI
Warnings: See oral bisphosphonates (except GI issues), Renal impairment => monitor SCr before each injection, caution in dehydrated pt, with comorbidities, taking other nephrotoxic medications, caution in aspirin-sensitive asthma (bronchoconstriction)
SE: See oral bisphosphonate (except esophageal SE)
Flu-like symptoms
Reclast
Zoledronic acid
Bisphosphonate for osteoporosis tx
Injection (Over ≥ 15 min)
Px: 5 mg IV every 2 years / Tx: 5 mg IV once yearly / steroid-induced: 5 mg IV once yearly
CI: Hypocalcemia, CrCl < 35 or AKI
Warnings: See oral bisphosphonates (except GI issues), Renal impairment => monitor SCr before each injection, caution in dehydrated pt, with comorbidities, taking other nephrotoxic medications, caution in aspirin-sensitive asthma (bronchoconstriction)
SE: See oral bisphosphonate (except esophageal SE)
Flu-like symptoms, edema, hypotension, fatigue, dehydration, ↓ electrolytes (PO4, Mg, K)
Amaryl
Glimepiride SU for diabetes tx (decrease A1C 1-2%) Start 1-2 mg QD Max 8 mg/day increment 1-2 mg every week CI: type 1, DKA, sulfa allergy Warnings: hypoglycemia, G6PD deficiency, anaphylactic reaction SE: weight gain, nausea Monitoring: BG, A1C With breakfast
Glucotrol
Glipizide
SU for diabetes tx (decrease A1C 1-2%)
Start 5 mg QD Max 40 mg/day (XL 20 mg/day) > 15 mg divided dose / increment 5 mg every week
CI: type 1, DKA, sulfa allergy
Warnings: hypoglycemia, G6PD deficiency, anaphylactic reaction
SE: weight gain, nausea
Monitoring: BG, A1C
IR: 30 min before meal - Other with breakfast
XL: ghost tablet
Glynase
Glyburide SU for diabetes tx (decrease A1C 1-2%) Start 1.5-3 mg QD Max 12 mg/day increment 1.5 mg every week CI: type 1, DKA, sulfa allergy, not with bosentan Warnings: hypoglycemia, G6PD deficiency SE: weight gain, nausea Monitoring: BG, A1C Renal clearance => not in CKD Take with breakfast
Starlix
Nateglinide
Meglitinide for diabetes tx
Prandin
Repaglinide
Meglitinide for diabetes Tx
Glucovance
Metformin + glyburide
Diabetes tx
ActosMet
Metformine + pioglitazone
Diabetes Tx
Kazano
Metformin + alogliptin
Diabetes Tx
Jentadueta
Metformin + linagliptin
Diabetes tx
Janumet
Metformin + sitagliptin
Diabetes tx
Kombiglyze
Metformin + Saxagliptin
Diabetes tx
Invokamet
Metformin + canagliflozin
Diabetes tx
Xigduo
Metformin + dapagliflozin
Diabetes tx
Synjardy
Metformin + empaglifozin
Diabetes tx
Segluromet
Metformin + ertugliflozin
Diabetes tx
PrandiMet
Metformin + repaglinide
Diabetes tx
Effient
Prasugrel
Prodrug (2C19)
Platelet antiaggregant - P2Y12 inhibitor
Plavix
Clopidogrel
Prodrug (2C19)
Platelet antiaggregant - P2Y12 inhibitor
Brilinta
Ticagrelor
Platelet antiaggregant - P2Y12 inhibitor
TNKase
Tenecteplase
Fibrinolytic
Abilify
Aripiprazole
SGA
Aristada
Aripiprazole
SGA
Saphris
Asenapine
SGA
Rexulti
Brexpiprazole
SGA
Vraylar
Cariprazine
SGA
Clozaril
Clozapine
SGA
FazaClo
Clozapine
SGA
Versacloz
Clozapine
SGA
Fanapt
Iloperidone
SGA
Latuda
Lurasidone
SGA
Zyprexa
Olanzapine
SGA
Also for CINV
Invega
Paliperidone
SGA
Sustenna
Paliperidone
SGA
Risperdal
Risperidone
SGA
Perseris
Risperidone
SGA
Seroquel
Quetiapine
SGA used in ICU for delirium
Geodon
Ziprasidone
SGA
Riomet
Metformin
UFH
Heparin
Anticoagulant/ antithrombin activation
Px VTE (5000 IU SC BID), Tx VTE (80 IU/kg IV bolus then 18 IU/kg/hr IV infusion or 5000 IU IV bolus then 1000 IU/hr), STEMI (60 IU/kg IV bolus then 12 IU/kg/hr IV infusion) use ABW
Angiomax
Bivalirudin
AC / direct thrombin inhibitor
Iprivask
Desirudin
AC / direct thrombin inhibitor
Duexis
Famotidine + ibuprofen
Pepcid
Famotidine Stomach pain (GERD/PUD) / H2RA Tablet, chewable, suspension, injection OTC: 10-20 mg BID PRN Rx: 20 mg BID Renal adj when CrCl< 50 Warnings: confusion, QT prolongation SE HA, agitation Take 30-60 min before food (onset: 1hr /duration: 4-10) Tachyphylaxis
Zantac
Ranitidine Stomach pain (GERD/PUD) / H2RA Tablet, chewable, suspension, injection OTC: 75-150 mg BID PRN Rx: 150 mg BID Renal adj when CrCl< 50 Warnings: confusion, high ALT SE HA, agitation Take 30-60 min before food (onset: 1hr /duration: 4-10) Tachyphylaxis
Aricept
Donepezil
Acetylcholinesterase inhibitor for Alzheimer Tx
Namzaric
Donepezil + Memantine
For Alzheimer Tx
Exelon
Rivastigmine
Acetylcholinesterase inhibitor for Alzheimer dx
Razadyne
Galantamine
Acetylcholinesterase inhibitor for Alzheimer Tx
Namenda
Memantine
NMDA receptor antagonist for Alzheimer Tx
Pepto-Bismol
Bismuth subsalicylate
Anti diarrheal chewable, solution
525 mg every 30 min (1050 mg every hr) PRN max 4200 mg/day max 2 days
CI: salicylate allergy, association w/ salicylate, ulcer, coagulopathy, black/bloody stool
SE: black tongue/stool, salicylate toxicity (tinnitus, N/V, diaphoresis)
Diamode
Loperamide
2T PO after 1st loose stool, 1T (2 mg) after max 8T/day (16mg) when Rx and 8 mg when OTC (max 2 days)
BB: torsade de pointe and cardiac arrest (higher dose)
CI: kids<2yo, dysentery, bacterial colitis (C.diff), UC
SE: abdominal pain, constipation, QT prolongation
Anti-diarrheal
Loperamide
2T PO after 1st loose stool, 1T (2 mg) after max 8T/day (16mg) when Rx and 8 mg when OTC (max 2 days)
BB: torsade de pointe and cardiac arrest (higher dose)
CI: kids<2yo, dysentery, bacterial colitis (C.diff), UC
SE: abdominal pain, constipation, QT prolongation
Imodium
Lomotil
Diphenoxylate/atropine
Diarrhea Tx
Viberzil
Eluxadoline
Peripherally acting mu opioid receptor agonist (not PAMORA) for IBS-D Tx
C IV
Phoslyra
Calcium acetate
Phosphate binder for CKD-mineral bone disorder
PhosLo
Calcium acetate
Phosphate binder for CKD-mineral bone disorder
Velphora
Sucroferric Oxyhydroxide
Phosphate binder for CKF-mineral bone disorder
Auryxia
Ferric citrate
Phosphate binder for CKF-mineral bone disorder
Fosrenol
Lanthanum carbonate
Phosphate binder for CKF-mineral bone disorder
Renvela
Sevelamer carbonate
Phosphate binder for CKF-mineral bone disorder
Renagel
Sevelamer hydrochloride
Phosphate binder for CKF-mineral bone disorder
Equetro
Carbamazepine
For maintenance of bipolar manic episode in bipolar disorder
Qsymia
Phentermine/topiramate
Weight loss
Contrave
Natrexone/bupropion
Weight loss
Belviq
Lorcaserin
Weight loss
Adipex-P
Phentermine
Weight loss
Lomaira
Phentermine
Weight loss
Regimex
Benzphetamine
Weight loss
FeverAll
Acetaminophen
Analgesic suppo
Ofirmev
Acetaminophen injection
Analgesic
Norco
Acetaminophen + hydrocodone
Vicodin
Acetaminophen + hydrocodone
Loratab
Acetaminophen + hydrocodone
Endocet
Acetaminophen + Oxycodone
Percocet
Acetaminophen + oxycodone
Primlev
Acetaminophen + Oxycodone
Ultracet
Acetaminophen + tramadol
Fioricet
Acetaminophen + caffeine + butalbital
Ultram
Tramadol
Centrally acting analgesics
Conzip
Tramadol
Centrally acting analgesic
Nucynta
Tapentadol
Centrally acting analgesic
Adriamycin
Doxorubicin
Cancer anthracyclines
Doxyl
Doxorubicin liposomal
Cancer anthracyclines
Lipodox
Doxorubicin liposomal
Cancer anthracyclines
Vyxeos
Daunorubicin + cytarabine liposomal
Cancer anthracyclines
Ellence
Epirubicin
Cancer anthracyclines
Idamycin PFS
Idarubicin
Cancer anthracyclines
Valstar
Valrubicin
Cancer anthracyclines
Solu-Cortef
Hydrocortisone
Cortef
Hydrocortisone
Millipred
Prednisolone
Orapred ODT
Prednisolone
Veripred
Prednisolone
Otrexup
Methotrexate
Non biological DMARD used in RA
Single dose SC autoinjector
7.5-20 mg once weekly
BB: Hepatotoxicity, myelosuppression, mucositis/stomatitis pregnancy, acute renal failure, pneumonitis, GI toxicity, dermatological reactions, malignant lymphoma, potentially fatal opportunistic infections
CI: Pregnancy, breastfeeding, liver dx, alcoholism, immunodeficiency syndrome, blood dyscrasis
SE: N/V/D, ↑LFT, stomatitis, alopecia, photosensitivity, arthralgia, myalgia
Monitoring: CBC, LFT, TB test, HepB and C, chest X-Ray
Rasuvo
Methotrexate
Non biological DMARD used in RA
Single dose SC auto-innjector
7.5-20 mg once weekly
BB: Hepatotoxicity, myelosuppression, mucositis/stomatitis pregnancy, acute renal failure, pneumonitis, GI toxicity, dermatological reactions, malignant lymphoma, potentially fatal opportunistic infections
CI: Pregnancy, breastfeeding, liver dx, alcoholism, immunodeficiency syndrome, blood dyscrasis
SE: N/V/D, ↑LFT, stomatitis, alopecia, photosensitivity, arthralgia, myalgia
Monitoring: CBC, LFT, TB test, HepB and C, chest X-Ray
Trexall
Methotrexate
Non biological DMARD used in RA
Tablet
7.5-20 mg once weekly
BB: Hepatotoxicity, myelosuppression, mucositis/stomatitis pregnancy, acute renal failure, pneumonitis, GI toxicity, dermatological reactions, malignant lymphoma, potentially fatal opportunistic infections
CI: Pregnancy, breastfeeding, liver dx, alcoholism, immunodeficiency syndrome, blood dyscrasis
SE: N/V/D, ↑LFT, stomatitis, alopecia, photosensitivity, arthralgia, myalgia
Monitoring: CBC, LFT, TB test, HepB and C, chest X-Ray
Xatmep
Methotrexate
Non biological DMARD used in RA
Pediatric oral solution
7.5-20 mg once weekly
BB: Hepatotoxicity, myelosuppression, mucositis/stomatitis pregnancy, acute renal failure, pneumonitis, GI toxicity, dermatological reactions, malignant lymphoma, potentially fatal opportunistic infections
CI: Pregnancy, breastfeeding, liver dx, alcoholism, immunodeficiency syndrome, blood dyscrasis
SE: N/V/D, ↑LFT, stomatitis, alopecia, photosensitivity, arthralgia, myalgia
Monitoring: CBC, LFT, TB test, HepB and C, chest X-Ray
Plaquenil
Hydroxychloroquine
Non biological DMARD used in RA
Tablet
400 mg QD then 300 mg QD PO with food or milk
CI: Eye toxicity (irreversible retinopathy, ↓ visual acuity), neuromuscular weakness, cardiomyopathy, bone marrow suppression, hypoglycemia, caution in G6PD deficiency
SE: N/V/D, abdominal pain, pruritis, rash, HA, vision changes, pigmentation changes (skin, hairs)
Monitoring: CBC, LFT, eye exam and muscle strength at baseline and every 3 months
Less liver toxic than methotrexate then can be consider as an alternative
Monotherapy if low dx activity and Sx < 24 months
If no improvement after 6 months, consider alternative
Arava
Leflunomide
Non biological DMARD used in RA
Tablet
100 mg QD for 3 days the 20 mg QD (can ↓ 10 mg if 20 mg not tolerate) PO, Omit LD if higher risk of liver toxicity or immunosuppression
BB: Embryo-fetal toxicity => exclude pregnancy before starting Tx, Hepatotoxicity => do not start if liver enzyme 2x upper limit normal value (ULN)
CI: Pregnancy, severe hepatic dx, teriflunomide therapy
Warnings: Severe infections, severe skin reactions (SJS/TEN), peripheral neuropathy, lung dx, HTN
When D/C, use accelerate drug elimination to ↓ level of active metabolite, teriflunomide
SE: ↑ LFTs, nausea, diarrhea, respiratory infections, rash, HA
Monitoring: LFT, CBE: baseline / monthly for 6 months , BP, Screen TB and pregnancy before starting tx
Negative pregnancy before starting and 2 contraception methods during tx, Must wait 2 years after D/C for becoming pregnant or use accelerated elimination procedure
Xeljanz
Tofacitinib
Non biological DMARD used in RA
Tablet
5 mg BID, XR: 11 mg QD
BB: Infections => screen for TB, Malignancy, Baricitinib: VTE causing death
Warnings: GI perforation, LFT, avoid live vaccines
SE: URTI, UTI, diarrhea, HA, HTN, ↑ lipids
Monitoring: CBC, Lipids, LFT, abdominal pain, signs of infection
Do not take if Lymphocyte < 500 cells/mm3, Hemoglobin < 9 g/dL, ANC < 1000 cells/mm3
Caution in Asian, more for SE
Available through speciality pharmacy network
ProQuad
MMRV
Menactra
MCV4 (Meningococcal conjugated vaccine / quadrivalent)
Routine vaccination: 2 doses (11-12 yo, 16 yo)
Special population: travelers meningitis belt sub-Sahara Africa (requested by Saoudi Arabia on yellow card), lab worker with N.Meningitis exposition, student 1st year college in dorms (<21 yo)
Military recruit
Dose/timing depdt on Age/risk
Renew every 5 years of at risk
Olumiant
Baricitinib
Non biological DMARD used in RA
Tablet
2 mg QD
BB: Infections => screen for TB, Malignancy, Baricitinib: VTE causing death
Warnings: GI perforation, LFT, avoid live vaccines
SE: URTI, UTI, diarrhea, HA, HTN, ↑ lipids
Monitoring: CBC, Lipids, LFT, abdominal pain, signs of infection
Do not take if Lymphocyte < 500 cells/mm3, Hemoglobin < 8 g/dL, ANC < 1000 cells/mm3
Caution in Asian, more for SE
Available through speciality pharmacy network
Menveo
MCV4 (Meningococcal conjugated vaccine / quadrivalent)
Routine vaccination: 2 doses (11-12 yo, 16 yo)
Special population: travelers meningitis belt sub-Sahara Africa (requested by Saoudi Arabia on yellow card), lab worker with N.Meningitis exposition, student 1st year college in dorms (<21 yo)
Military recruit
Dose/timing depdt on Age/risk
Renew every 5 years of at risk
Bexsero
Meningococcal vaccine serogroup B 2 doses at 1 month apart for >= 10 yo Immunocompromised Lab worker with N. Meningitis exposition During outbreak In addition to MCV4
Trumenda
Meningococcal vaccine serogroup B 2 dose 6 months apart For >= 10 yo Immunocompromised Lab worker with N. Meningitis exposition Outbreak (3 dose month 0,2,6) On request 16-23 yo
In addition MCV4
IPOL
IPV (Inactivated Polyovirus Vaccine)
Varivax
Varicelle virus vaccine
Zostavax
Zoster Virus Vaccine
Shingrix
Zoster virus vaccine
Xopenex
Levalbuterol
SABA used in asthma as reliever (R-isomer)
1-2 inh Q4-6H PRN (45 mcg/inh)
Warning: CVD,diabetes, hyperthyroidism, seizure, glaucoma
SE: tremor, nervousness, hypokalemia, hyperglycemia, tachycardia, cough
Monitor: Use, Sx, pulmonary fct, BG, HR, K
Ventolin HFA
Albuterol 90 mcg/inh
SABA for asthma (reliever)
1-2 inh Q4-6H PRN
Warning: CVD,diabetes, hyperthyroidism, seizure, glaucoma
SE: tremor, nervousness, hypokalemia, hyperglycemia, tachycardia, cough
Monitor: Use, Sx, pulmonary fct, BG, HR, K
ProAir RespiClick
Albuterol
SABA for asthma (reliever)
1-2 inh Q4-6H PRN
BB: do not use if allergy to milk proteins
Warning: CVD,diabetes, hyperthyroidism, seizure, glaucoma
SE: tremor, nervousness, hypokalemia, hyperglycemia, tachycardia, cough
Monitor: Use, Sx, pulmonary fct, BG, HR, K
Serevent diskus
Salmeterol
LABA for asthma (controller)
1 INH BID (50 mcg/inh)
BB: higher risk of asthma related deaths
Warning: CVD,diabetes, hyperthyroidism, seizure, glaucoma
SE: tremor, nervousness, hypokalemia, hyperglycemia, tachycardia, cough
Monitor: Use, Sx, pulmonary fct, BG, HR, K
Nesina
Alogliptin
DDP4 inhibitor un diabetes type II
25 mg QD
Renal adjustments: CrCl<60(50%), CrCl<30(25%)
Warnings: pancreatitis, heart failure, arthralgia
SE: URTI, UTI, rash, peripheral edema
Monitoring: BG, A1C, renal function
Tradjenta
Linagliptin DDP4 inhibitor in disabetes type I 5 mg QD no renal adj Warnings: pancreatitis, heart failure (>alogliptin, Saxagliptin), arthralgia SE: URTI, UTI, rash, peripheral edema Monitoring: BG, A1C, renal function
Onglyza
Saxagliptin DPP4 inhibitor used in diabetes type II 2.5-5 mg QD Renal Adj: eGFR <45 ml/min/1.73m2 Warnings: pancreatitis, heart failure, arthralgia SE: URTI, UTI, rash, peripheral edema Monitoring: BG, A1C, renal function
Januvia
Sitagliptin
DPP4 inhibitor used in diabetes type II 100 mg QD
Renal adjustments: CrCl<60(50%), CrCl<30(25%)
Warnings: pancreatitis, heart failure (>alogliptin, Saxagliptin), arthralgia
SE: URTI, UTI, rash, peripheral edema
Monitoring: BG, A1C, renal function
Novolog
Insulin aspart
Rapid acting insulin
Fiasp
Insulin aspart
Rapid acting insulin
Apidra
Insulin glulisine
Rapid acting insulin
Humalog
Insulin lispro
Rapid acting insulin
Ademalog
Insulin lispro
Rapid acting insulin
Afrezza
Human rapid acting insulin
Powder for inhalation
TNKase
Tenecteplase
Fibrinolytic for ACS when PCI not available
Retavase
Reteplase
Fibrinolytic in ACS when PCI not possible
Kemgreal
Cangrelor
P2Y12 inhibitor for ACS when PCI
ReoPro
Abciximab
GIIb/GIIIa receptor antagonist in ACS
Integrilin
Eptifibatid
GIIb/GIIIa receptor antagonist in ACS
Aggrastat
Tirofiban
GIIb/GIIIa receptor antagonist in ACS
Simulect
Basiliximab
Interleukin-2 receptor antagonist for induction immunosuppression
ATGAM
Horse antithymocyte globulin for induction immunosuppression
Thymoglobulin
Rabbit antithymoglobulin for induction immunosuppression
Prograf
Tacrolimus
Calcineurin inhibitor for maintenance immunosuppression
Astagraf
Tacrolimus
Calcineurin inhibitor for maintenance immunosuppression
Envarsus
Tacrolimus
Calcineurin inhibitor for maintenance immunosuppression
Neoral
Cyclosporine
Calcineurin inhibitor for maintenance immunosuppression
Sandimmune
Cyclosporine
Calcineurin inhibitor for maintenance immunosuppression
Gengraf
Cyclosporine
Calcineurin inhibitor for maintenance immunosuppression
CellCept
Mycophenolate mofetil
Antiproliferative agent for maintenance immunosuppression
Myfortic
Mycophenolic acid
Antiproliferative agent for maintenance immunosuppression
Imuran
Azathioprine
Antiproliferative agent for maintenance immunosuppression
Azasan
Azathioprine
Antiproliferative agent for maintenance immunosuppression
Zortress
Everolimus
Antiproliferative agent for maintenance immunosuppression
Rapamune
Sirolimus
Antiproliferative agent for maintenance immunosuppression
Praluent
Alirocumab PCSK9 inhibitor for cholesterol (HeFH ASCV) Prefilled syringed, Pen-injector 75 mg/ml, 150 mg/ml Warnings: Allergic reactions SE: Injection site reaction, Nasopharyngitis, URTI, UTI, Influenza Monitoring: LDL at baseline and after 4-8 weeks to assess response
Questran
Cholestyramine
Bile acid séquestrant for cholesterol
Powder packet (4 grams )
Initial: 4 grams QD or BID, Maintenance: 4-8 grams BID with meals (max 24 grams/day)
CI: Cholestyramine: biliary obstruction, Colesevelam: bowel obstruction and TG>500
Warnings: Cholestyramine and colesevelam with phenylalanine (!!!phenylketonuria), Bleeding (vit K deficiency)
SE: Constipation, abdominal pain, bloating, cramping, gas, ↑ TG ,LFT, dyspepsia, nausea, esophageal obstruction
ACC/AHA do not recommend when TG ≥ 300 mg/dL
Colesevelam can be considered as an option in a pregnant patient
Repatha
Evolocumab
PCSK9 inhibitor for cholesterol (HeFH, ASCVD, HoFH)
Prefilled syringed, auto-injector, Prefilled cartridges
140 mg/ml, 420 mg/3.5 ml
Warnings: Allergic reactions
SE: Injection site reaction, Nasopharyngitis, URTI, UTI, Influenza
Monitoring: LDL at baseline and after 4-8 weeks to assess response
Prevalite
Cholestyramine
Bile acid sequestrant used for cholesterol
Powder packet (4 grams )
Initial: 4 grams QD or BID, Maintenance: 4-8 grams BID with meals (max 24 grams/day)
CI: Cholestyramine: biliary obstruction, Colesevelam: bowel obstruction and TG>500
Warnings: Cholestyramine and colesevelam with phenylalanine (!!!phenylketonuria), Bleeding (vit K deficiency)
SE: Constipation, abdominal pain, bloating, cramping, gas, ↑ TG ,LFT, dyspepsia, nausea, esophageal obstruction
ACC/AHA do not recommend when TG ≥ 300 mg/dL
Colesevelam can be considered as an option in a pregnant patient
Welchol
Colesevelam
Bile acid sequestrant for cholesterol
Tablet (625 mg), Granule packet (3.75 grams)
3.75 grams QD (divided doses option) w/ meal and liquid
CI: Cholestyramine: biliary obstruction, Colesevelam: bowel obstruction and TG>500
Warnings: Cholestyramine and colesevelam with phenylalanine (!!!phenylketonuria), Bleeding (vit K deficiency)
SE: Constipation, abdominal pain, bloating, cramping, gas, ↑ TG ,LFT, dyspepsia, nausea, esophageal obstruction
ACC/AHA do not recommend when TG ≥ 300 mg/dL
Colesevelam can be considered as an option in a pregnant patient
Colestid
Colestipol
Bile acid sequestrant for cholesterol
Tablet (1 gram), Powder Packet (5 grams), Granule packet (5 grams)
2 T PO QD/BID (max 16g/day), 5 grams pack QD/BID (max 30g/day)
CI: Cholestyramine: biliary obstruction, Colesevelam: bowel obstruction and TG>500
Warnings: Cholestyramine and colesevelam with phenylalanine (!!!phenylketonuria), Bleeding (vit K deficiency)
SE: Constipation, abdominal pain, bloating, cramping, gas, ↑ TG ,LFT, dyspepsia, nausea, esophageal obstruction
ACC/AHA do not recommend when TG ≥ 300 mg/dL
Colesevelam can be considered as an option in a pregnant patient
Antara
Fenofibrate
For cholesterol
30-90 mg QD
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Tricor
Fenofibrate
For cholesterol
48-145 mg QD
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Trilipix
Fenofibrate
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Fenoglide
Fenofibrate
For cholesterol
40-100 mg QD with meal
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Fibricor
Fenofibrate
For cholesterol
35-105 mg QD
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Lipofen
Fenofibrate
For cholesterol
50-150 mg QD with meal
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Triglide
Fenofibrate
For cholesterol
160 mg QD
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Ritalin
Methylphenidate IR
Tablet, chewable
Methylin
Methylphenidate IR
Oral solution
Lopid
Gemfibrozil
For cholesterol
600 mg BID 30 min before breakfast and diner
For cholesterol
45-135 mg QD
CI: Severe liver dx including primary biliary cirrhosis, Severe renal dx (CrCl<30), Gallbladder dx, Nursing mother: fenofibrate only, Concurrent use with repaglinide or simvastatin (gemfibrozil only)
Warnings: Myopathy ↑ when coadministration of statin, > in elderly, diabetes, renal failure, hypothyroidism
Cholelithiasis, Reversible ↑ SCr (>2 g/dl) clinical significance unknown
SE: ↑ LFT, abdominal pain, ↑ CPK, dyspepsia, URTI
Monitoring: LFT, renal function
↓ dose if CrCl 30-80 (fenofibrate)
Concerta
Methylphenidate ER
OROS tablet
Metadata ER
Methylphenidate ER
Tablet
Methylin ER
Methylphenidate ER
Tablet
Relexxii
Methylphenidate ER
Tablet
Ritalin SR
Methylphenidate ER
Tablet
Jornay PM
Methylphenidate ER
Capsule
QuilliChew ER
Methylphenidate XR
Chewable
Quillivant XR
Methylphenidate XR
Oral suspension
Cotempla XR ODT
Methylphenidate XR
ODT
Daytrana
Methylphenidate transdermal patch
Focalin
Dexmethylphenidate
Evekeo
Amphetamine
Tablet
Adzenys XR-ODT
Amphetamine
ODT
Dyanavel XR
Amphetamine
Suspension
Adzenys ER
Amphetamine
Suspension
Adderall
Dextrophetamine / amphetamine IR
Mydayis
Dextroamphetamine/amphetamine ER
Zenzedi
Dextroamphetamine
IR tablet
ProCentra
Dextroamphetamine
Oral solution
Dexedrine spansule
Dextroamphetamine ER capsule
Vyvanse
Lisdexamfetamine
Capsule, chewable
Desoxyn
Methamphetamine
Nuplazid
Pimavenserin
Antipsychotic for PD (does not act on dopamine receptor but in 5HT2
Vibativ
Telavancin
Lipoglycopeptide, AB for Gram+ infection
Orbactiv
Oritavancin
Lipoglycopeptide, AB for Gram+ infection
Dalvance
Dalbavancin
Lipoglycopeptide, AB for Gram+ infections
Cubicin
Daptomycin
AB for Gram+ infection (MRSA, VRE, E. Faecalis, E. Faecium)
Lamictal
Lamotrigine
AE broad spectrum
BB: Serious skin reaction (SJS/TEN) with dose in pediatric, starting dose and valproic acid
Warnings: Aseptic meningitis, Hemotoxic, DRESS reaction, Immune reaction that can be fatal
SE: N/V, Somnolence, Blurred vision, Alopecia
Monitoring: Rash
Spritam
Levetiracetam
AE broad spectrum
Warnings: Psychosis and suicidal behavior, Anaphylaxis and angioedema, Serious skin reaction (SJS/TEN), Anemia, BP ↑
SE: Irritability, Dizziness, Asthenia
= Keppra
Trokendi XR
Topiramate
AE broad spectrum
CI: Trokendi XR: alcohol within 6hrs before/after, Metabolic acidosis in pt taking metformin
Warnings: Metabolic acidosis, ↓Sweat (hypohidrosis => hyperthermia), Nephrolithiasis, Glaucoma, Fetal harm
SE: Somnolence, dizziness, ataxia, difficulty with memory, attention, concentration, Weight loss, anorexia
Monitoring: Electrolytes (bicarbonates), hydration, eye exam (pressure)
Qudexy XR
Topiramate
AE broad spectrum
CI: Trokendi XR: alcohol within 6hrs before/after, Metabolic acidosis in pt taking metformin
Warnings: Metabolic acidosis, ↓Sweat (hypohidrosis => hyperthermia), Nephrolithiasis, Glaucoma, Fetal harm
SE: Somnolence, dizziness, ataxia, difficulty with memory, attention, concentration, Weight loss, anorexia
Monitoring: Electrolytes (bicarbonates), hydration, eye exam (pressure)
Depacon
Valproic acid
AE broad spectrum
= Depakene
BB: Hepatic failure: usually during first 6 months of therapy, children < 2 yo and patients with mitochondrial disorders (mutation in mitochondrial DNA polymerase gamma gene (POLG)) are at higher risk, fetal harm (neural tube defects and ↓ IQ scores), pancreatitis
CI: Hepatic dx, urea cycle disorders, prophylaxis of migraine in pregnancy, known or suspected (<2yo) POLG-related disorder
Warnings: hyperammonia (treat with carnitine in symptomatic adults only), hypothermia, dose-related thrombocytopenia (↑ bleeding risk), multiorgan hypersensitivity (DRESS) reactions
SE: N/V, anorexia, abdominal pain, dizziness, somnolence, tremor, alopecia (supplement selenium and zinc), weight gain, edema, polycystic ovary syndrome, diplopia, blurred vision
Monitoring: LFT (baseline and frequently in the first 6 months), CBC with differential, platelets
Depakote
Divalproex
AE broad spectrum
BB: Hepatic failure: usually during first 6 months of therapy, children < 2 yo and patients with mitochondrial disorders (mutation in mitochondrial DNA polymerase gamma gene (POLG)) are at higher risk, fetal harm (neural tube defects and ↓ IQ scores), pancreatitis
CI: Hepatic dx, urea cycle disorders, prophylaxis of migraine in pregnancy, known or suspected (<2yo) POLG-related disorder
Warnings: hyperammonia (treat with carnitine in symptomatic adults only), hypothermia, dose-related thrombocytopenia (↑ bleeding risk), multiorgan hypersensitivity (DRESS) reactions
SE: N/V, anorexia, abdominal pain, dizziness, somnolence, tremor, alopecia (supplement selenium and zinc), weight gain, edema, polycystic ovary syndrome, diplopia, blurred vision
Monitoring: LFT (baseline and frequently in the first 6 months), CBC with differential, platelets
Carbatrol
Carbamazepine
AE narrow spectrum
BB: Serious skin reactions, including SJS/TEN: patients of Asian descent should be tested for HLA-B1502 allele prior initiation, if +, do not use (unless benefit > risk), aplastic anemia and agranulocytosis, D/C if significant myelosuppression occurs
CI: Myelosuppression, hypersensitivity to TCAs, use of MAOI within 14 days, nefazodone, delaviridine and other NNRTIs
Warnings: Risk of developing hypersensitivity reactions can be ↑ in patients with variant HLA-A3101 allele, multiorgan hypersensitivity (DRESS) reactions, hyponatremia (SIADH), hypothyroidism, mild anticholinergic effects, cardiac conduction abnormalities, liver damage, fetal harm
SE: N/V, dry mouth, pruritus, photosensitivity, blurred vision, rash, ↑ LFT, alopecia
Monitoring: CBC with differential and platelets prior to and during therapy, LFT, rash, eye exam, thyroid fct, electrolytes (Na), renal fct, Monitor levels within 3-5 days of initiation and after 4 weeks due to autoinduction
Enzyme inducer, autoinducer, ↓ level of other drugs and itself
Epitol
Carbamazepine
AE narrow spectrum
BB: Serious skin reactions, including SJS/TEN: patients of Asian descent should be tested for HLA-B1502 allele prior initiation, if +, do not use (unless benefit > risk), aplastic anemia and agranulocytosis, D/C if significant myelosuppression occurs
CI: Myelosuppression, hypersensitivity to TCAs, use of MAOI within 14 days, nefazodone, delaviridine and other NNRTIs
Warnings: Risk of developing hypersensitivity reactions can be ↑ in patients with variant HLA-A3101 allele, multiorgan hypersensitivity (DRESS) reactions, hyponatremia (SIADH), hypothyroidism, mild anticholinergic effects, cardiac conduction abnormalities, liver damage, fetal harm
SE: N/V, dry mouth, pruritus, photosensitivity, blurred vision, rash, ↑ LFT, alopecia
Monitoring: CBC with differential and platelets prior to and during therapy, LFT, rash, eye exam, thyroid fct, electrolytes (Na), renal fct, Monitor levels within 3-5 days of initiation and after 4 weeks due to autoinduction
Enzyme inducer, autoinducer, ↓ level of other drugs and itself
Carnexiv
Carbamazepine
AE narrow spectrum
BB: Serious skin reactions, including SJS/TEN: patients of Asian descent should be tested for HLA-B1502 allele prior initiation, if +, do not use (unless benefit > risk), aplastic anemia and agranulocytosis, D/C if significant myelosuppression occurs
CI: Myelosuppression, hypersensitivity to TCAs, use of MAOI within 14 days, nefazodone, delaviridine and other NNRTIs
Warnings: Risk of developing hypersensitivity reactions can be ↑ in patients with variant HLA-A3101 allele, multiorgan hypersensitivity (DRESS) reactions, hyponatremia (SIADH), hypothyroidism, mild anticholinergic effects, cardiac conduction abnormalities, liver damage, fetal harm
SE: N/V, dry mouth, pruritus, photosensitivity, blurred vision, rash, ↑ LFT, alopecia
Monitoring: CBC with differential and platelets prior to and during therapy, LFT, rash, eye exam, thyroid fct, electrolytes (Na), renal fct, Monitor levels within 3-5 days of initiation and after 4 weeks due to autoinduction
Enzyme inducer, autoinducer, ↓ level of other drugs and itself
Vimpat
Lacosamide
AE narrow spectrum
Warnings: Prolong PR interval and ↑ risk of arrhythmias, obtain ECG prior to use and after titrated to steady state in patients with or at risk of cardiac conduction problems
Multiorgan hypersensitivity (DRESS) reactions, syncope, dizziness, ataxia
SE: N/V, HA, diplopia, blurred vision, ataxia, tremor, euphoria
Monitoring: ECG (baseline and steady state) in at-risk patients
Trileptal
Oxcarbazepine
AE narrow spectrum
CI: Hypersensitivity to eslicarbazepine
Warnings: ↑ risk of serious skin reactions (SJS/TEN), consider screening patients of Asian descent for HLA-B*1502 prior initiating therapy, multiorgan hypersensitivity (DRESS) reactions, hyponatremia, hypothyroidism, hypersensitivity reactions to carbamazepine have 25-30% cross-reactivity to oxcarbazepine, potential worsening of seizures
SE: Somnolence, dizziness, N/V, abdominal pain, diplopia, visual disturbances, ataxia, tremor
Monitoring:Serum Na levels especially during 1st 3 months of therapy, thyroid fct, CBC
Trileptal oral suspension muss be used within 7 weeks once original container is opened
XR tablets: take on empty stomach 1h before or 2h after meals
Oxtellar XR
Oxcarbazepine
AE narrow spectrum
CI: Hypersensitivity to eslicarbazepine
Warnings: ↑ risk of serious skin reactions (SJS/TEN), consider screening patients of Asian descent for HLA-B*1502 prior initiating therapy, multiorgan hypersensitivity (DRESS) reactions, hyponatremia, hypothyroidism, hypersensitivity reactions to carbamazepine have 25-30% cross-reactivity to oxcarbazepine, potential worsening of seizures
SE: Somnolence, dizziness, N/V, abdominal pain, diplopia, visual disturbances, ataxia, tremor
Monitoring:Serum Na levels especially during 1st 3 months of therapy, thyroid fct, CBC
Trileptal oral suspension muss be used within 7 weeks once original container is opened
XR tablets: take on empty stomach 1h before or 2h after meals
Phenytek
Phenytoin
AE narrow spectrum
= Dilantin
BB: Phenytoin IV administration rate should not exceed 50 mg/min and fosphenytoin IV should not exceed 150 mgPE/min or 2 mgPE/kg/min (use the slower rate), if given faster hypotension and cardiac arrhythmias can occur
CI: Previous hepatotoxicity due to phenytoin
Warnings: Extravasation (leading to Purple Glove Syndrome, characterized by edema, pain and bluish discoloration of the skin which can sometimes lead to tissue necrosis)
Bradycardia, ↑ risk of serious skin reactions (SJS/TEN), avoid phenytoin in patients with a positive HLA-B*1502 and in patients who have had a severe rash with carbamazepine, multiorgan hypersensitivity (DRESS) reactions, fetal harm, fraction of unbound (free) drug is higher with renal or hepatic failure or ↓ albumin, blood dyscrasias, caution in cardiac dx, hepatic and renal impairment, hypothyroidism
SE: Dose-related toxicity: nystagmus, ataxia, diplopia/blurred vision, slurred speech, dizziness, somnolence, lethargy, confusion
Chronic: skin thickening (children), gingival hyperplasia, hair growth, morbilliform rash (measle-like), rash, hepatotoxicity, peripheral neuropathy, ↑ BG, metallic taste, connective tissue changes, enlargement of facial features (lips)
Monitoring: LFT, CBC with differential
IV: continuous cardiac (ECG, BP, HR) and respiratory monitoring
RabAvert
Rabies vaccine
Imovax
Rabies vaccine
Cerebyx
Fosphenytoin
AE narrow spectrum
BB: Phenytoin IV administration rate should not exceed 50 mg/min and fosphenytoin IV should not exceed 150 mgPE/min or 2 mgPE/kg/min (use the slower rate), if given faster hypotension and cardiac arrhythmias can occur
CI: Previous hepatotoxicity due to phenytoin
Warnings: Extravasation (leading to Purple Glove Syndrome, characterized by edema, pain and bluish discoloration of the skin which can sometimes lead to tissue necrosis)
Bradycardia, ↑ risk of serious skin reactions (SJS/TEN), avoid phenytoin in patients with a positive HLA-B*1502 and in patients who have had a severe rash with carbamazepine, multiorgan hypersensitivity (DRESS) reactions, fetal harm, fraction of unbound (free) drug is higher with renal or hepatic failure or ↓ albumin, blood dyscrasias, caution in cardiac dx, hepatic and renal impairment, hypothyroidism
SE: Dose-related toxicity: nystagmus, ataxia, diplopia/blurred vision, slurred speech, dizziness, somnolence, lethargy, confusion
Chronic: skin thickening (children), gingival hyperplasia, hair growth, morbilliform rash (measle-like), rash, hepatotoxicity, peripheral neuropathy, ↑ BG, metallic taste, connective tissue changes, enlargement of facial features (lips)
Monitoring: LFT, CBC with differential
IV: continuous cardiac (ECG, BP, HR) and respiratory monitoring
Vaxchora
Cholera vaccine
Ixiaro
Japanese encephalitis vaccine
BCG
Tuberculosis Bacille Calmette Guerin vaccine
Vivotif
Typhoid fever vaccine
Typhym
Typhoid fever vaccine
YF-VAX
Yellow fever vaccine
Clinoril
Sulindac
NSAID for acute tu of gout
Caldolar
Ibuprofen
NSAID
Motrin, Advil
NeoProfen
Ibuprofen injection
Closure of PDA (Patent Ductus Arteriosus) in premature infant
Trivorbex
Indomethacin
NSAID
Indocin
Naprelan
Naproxen
NSAID
Aleve, Naprosyn
Toradol
Ketorolac
NSAID
Sprix
Ketorolac
NSAID
DST Plus Pak
Diclofenac
NSAID
EnovaRX
Diclofenac
NSAID
Flector
Diclofenac
NSAID
Klofensaid II
Diclofenac
NSAID
Pennsaid
Diclofenac
NSAID
Zorvolex
Diclofenac
NSAID
Zipsor
Diclofenac
NSAID
Xrylix
Diclofenac
NSAID
Vivlodex
Meloxicam
NSAID
Mobic
Lodine
Etodac
NSAID
Relafen
Nabumetone
NSAID
Doans
Salsalate
Salicylate NSAID
Zyvox
Linezolid
AB for gram+ infections (VRE, MRSA) and C.diff
600 mg BID
CI: MAOI within 2 weeks
Warnings: myelosuppression, optic neuropathy (>28 days), serotonin syndrome, hypoglycemia, hypertension
SE: low platelets, Hgb, WBC, HA, nausea/diarrhea, high LFTs
Monitoring: CBC, BP, BG, HR
Sivextro
Tedizolid Oxazolodinone AB for gram + infections (MRSA, VRE) same class than linezolid
Synercid
Quinupristin/dalfopristin
AB for gram+ infection (MRSA, VRE but not E. Faecalis)
Approved for SSTI
Not well tolerated
Tigacyl
Tigecycline
Broad coverage except 3 Ps
Use as last option
Ferate
Ferrous gluconate
Microcytic anemia
FeroSul
Ferrous sulfate
Microcytic anemia
Fer-in-Sol
Ferrous sulfate
Microcytic anemia
Slow Fe
Ferrous sulfate dried
Microcytic anemia
Slow Iron
Ferrous sulfate dried
Microcytic anemia
Ferretts
Ferrous fumarate
Microcytic anemia
Ferrimin 150
Ferrous fumarate
Microcytic anemia
Hemocyte
Ferrous fumarate
FerrPlus 90
Carbonyl iron
Microcytic anemia
Ferrate 90
Carbonyl iron
Microcytic anemia
Iron Chews
Carbonyl iron
Microcytic anemia
Ferrer 100
Polysaccharide iron complex
Microcytic anemia
INFeD
Iron dextran complex
injection
Microcytic anemia for specific pts
Ferrlecit
Sodium ferric gluconate
Injection
Microcytic anemia for specific pt
Venofer
Iron sucrose
Injection
Microcytic anemia for specific pt
Feraheme
Ferumoxytol
Injection
Microcytic anemia for specific pt
Injectafer
Ferric carboxymaltose
Injection
Microcytic anemia
Triferic
Ferric pyrophosphate citrate
Injection
Microcytic anemia for specific pt
Duragesic
Fentanyl patch
Opioid analgesic
Sublimaze
Fentanyl injection
Opioid analgesic
Actiq
Fentanyl lollipop
Opioid analgesic
Lazanda
Fentanyl nasal spray
Opioid analgesic
Fentora
Fentanyl buccal tab
Opioid analgesic
Abstral
Fentanyl tab SL
Opioid analgesic
Subsys
Fentanyl spray SL
Opioid analgesic
Onsolis
Fentanyl buccal film
Opioid analgesic
Dexilant
Dexlansoprazole PPI 30-60 mg QD with or without food Warnings: C.diff, osteoporosis, hypomagnesemia, vit B12 deficiency (LT), DILE SE: HA, N/D
Nexium
Esomeprazole
PPI
20-40 mg QD
Warnings: C.diff, osteoporosis, hypomagnesemia, vit B12 deficiency (LT), DILE
SE: HA, N/D, for IV: phlebitis, severe skin reaction (SJS, TEN)
Prevacid
Lansoprazole
PPI
15-30 mg QD
Warnings: C.diff, osteoporosis, hypomagnesemia, vit B12 deficiency (LT), DILE
SE: HA, N/D
Prevacid Solutab: not in PKU bcp aspartame
Prilosec
Omeprazole PPI 20 mg QD Warnings: C.diff, osteoporosis, hypomagnesemia, vit B12 deficiency (LT), DILE SE: HA, N/D
Protonix
Pantoprazole PPI 40 mg QD Warnings: C.diff, osteoporosis, hypomagnesemia, vit B12 deficiency (LT), DILE SE: HA, N/D
Talicia
Amoxicillin 1 g + rifabutin 50 mg + omeprazole 40 mg
Prepvac
Amoxicillin 1 g + clarithromycin 500 mg + Lansoprazole 30 mg
Azo
Phenazopyridin
Urinary Analgesic
Uristat
Phenazopyridine
Urinary analgesic
Pyridium
Phenazopyridine
Urinary analgesic
Hexalen
Altretamine
Alkylating agent
Bendeka
Bendamustine
Alkylating agent
Treanda
Bendamustine
Alkylating agent
Myleran
Busulfan
Alkylating agent
Busulfex
Busulfan
Alkylating agent
BiCNU
Carmustin
Alkylating agent
Gliadel Wafer
Carmustine
Alkylating agent
Cytoxan
Cyclophosphamide
Alkylating agent
Ifex
Ifosfamide
Alkylating agent
Gleostine
Lomustine
Alkylating agent
Maxipime
Cefepime
Cephalosporin 4th generation
IV/IM 1-2 g Q8H
Active against Pseudomonas
CAP with MDRO, HAP, VAP
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Fortaz
Ceftazidime
Cephalosporin 3rd generation groupe 2
IV/IM 1-2 g Q8H
Active against pseudomonas
CAP, HAP, VAP with MDRO
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Tazicef
Ceftazidime
Cephalosporin 3rd generation groupe 2
IV/IM 1-2 g Q8H
Active against pseudomonas
CAP, HAP, VAP with MDRO
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Primaxin
Imipenem/cilastatin
Carbapenem For MDRO
IV:250-1000 mg Q6-8H
Renl adj CrCl ≤70
CI: Anaphylactic reactions to beta-lactams
Warnings: CNS AE including confusion and seizures
Doripenem: do not use for the tx of pneumonia (including HAP, VAP)
Do not use in patients with PNC allergy (cross-reactivity reported to be as high as 50% but more recent studies show 10%
SE: Diarrhea, rash/ severe skin reactions (DRESS), seizures with higher doses and in patient with impaired renal fct (mainly imipenem), bone marrow suppression with prolonged use, ↑ LFT
Imipenem combined with cilastatin to prevent degradation by renal tubular dehydropeptidase
Azactam
Aztreonam Monobactam IV 500-2000 mg Q6H Active against MDRO but no gram+ or anaerobie activity Can be use if penicillin allergy
Copy-Mycin M
Colistimethate sodium
Polymyxin
IV/IM 2.5-5 mg/kg/day in 2-4 divided doses
For MDRO gram-
Mustargen
Mechloretamine
Alkylating agent
Azactam
Aztreonam Monobactam Active against Gram -MDRO but no gram+ or anaerobie activity, Can be use if penicillin allergy (≠ structure) IV 500-2000 mg Q6H SE: ~ PNC, including rash, N/V/D, ↑LFT
Valchlor
Mechloretamine
Topical gel
Alkylating agent
Alkeran
Mephalan
Alkylating agent
Evomela
Mephalan
Alkylating agent
Matulane
Procarbazine
Alkylating agent
Temodar
Temozolomide
Alkylating agent
Diuril
Chlorothiazide
Thiazide diuretic for HTN
500-2000 mg
CI: sulfa allergy, anuria
Warning: sulfa allergy, exacerbation liver dx, CKD, diabetes, gout, SLE
SE: hyponatremia, hypokalemia, hypomagnesemia, hypercalcemia, hyperuricemia, HDL, hyperglycemia, dizziness, photosensitivity, rash
Monitoring: BP, electrolytes, renal function, BG, fluids
Microzide
Hydrochlorothiazide
Thiazide diuretics for HTN
12.5-50 mg QD
CI: sulfa allergy, anuria
Warning: sulfa allergy, exacerbation liver dx, CKD, diabetes, gout, SLE
SE: hyponatremia, hypokalemia, hypomagnesemia, hypercalcemia, hyperuricemia, HDL, hyperglycemia, dizziness, photosensitivity, rash
Monitoring: BP, electrolytes, renal function, BG, fluids
Duetact
Glimepirirde/pioglitazone
Oseni
Alogliptin/pioglitazone
Glyxambi
Linagliptin/empagliflozin
Qtern
Saxagliptin/dapagliflozin
Steglujan
Sitagliptin/ertugliflozin
Xultophy
Liraglutide/insulin degludec Liraglutide BB: thyroid cancer CI: thyroid, endocrin cancer Warnings: pancreatitis, serious injection reaction, not recommended in GI dx
Soliqua
Lixisenatide/insulin glargine
Miacalcin
Calcitonin
Osteoporosis
Hypercalcemia of malignancy (in association with IV bisphosponate or denosumab)
Zometa
Zoledronic acid
Hypercalcemia of malignancy
Xgeva
Denosumab
RANKL inhibitor for osteoporosis or hypercalcemia of malignancy
Aredia
Pamidronate
Bisphophonate for hypercalcemia of malignancy
Anzemet
Dolasetron
5HT3R Antagonist for CINV
Sancuso
Granisetron
5HT3R antagonist for CINV
Sustol
Granisetron
5HT3R antagonist for CINV
Zofran
Ondansetron
5HT3R antagonist for CINV
Zuplenz film
Ondansetron
5HT3R antagonist for CINV
Aloxi
Palonosetron
5HT3R antagonist for CINV
Emend
Aprepitant
Fosaprepitant
Neurokin-1 receptor antagonist for CINV
Akinzeo
Netupitant + palonosetron
5HT3R AND Neurokin-1 receptor antagonist for CINV
Varubi
Rolapitant
Neurokin-1 receptor antagonist for CINV
Zithromax
Azithromycin
Macrolide antibiotic
Injection, Suspension, Tablets
250-500 mg IV QD
CI: Cholestatic jaundice / hepatic dx with prior use, Clarithromycin, erythromycin: do not use with lovastatin, simvastatin, pimozide, ergotamine, dihydroergotamine, Clarithromycin: do not use with colchicine in pt with renal/hepatic dx or pt with a Hx of QT prolongation
Warnings: QT prolongation (> erythromycin), Hepatotoxicity, Exacerbate myasthenia gravis
Clarithromycin: caution in pt with CAD (↑ mortality)
SE: GI, Taste perversion, Ototoxicity, Sever skin reaction (SJS/TEN)
Biaxin
Clarithromycin
Macrolide antibiotic
Tablet, Suspension
PO: 250-500 mg BID, XL: 1 G QD
Renal adj: CrCl < 30
CI: Cholestatic jaundice / hepatic dx with prior use, Clarithromycin, erythromycin: do not use with lovastatin, simvastatin, pimozide, ergotamine, dihydroergotamine, Clarithromycin: do not use with colchicine in pt with renal/hepatic dx or pt with a Hx of QT prolongation
Warnings: QT prolongation (> erythromycin), Hepatotoxicity, Exacerbate myasthenia gravis
Clarithromycin: caution in pt with CAD (↑ mortality)
SE: GI, Taste perversion, Ototoxicity, Sever skin reaction (SJS/TEN)
Erelzi
Etanercept
Biological DMARD for RA
Biosimilar for Enbrel
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Amjevita
Adalimumab
Biological DMRAD for RA
biosimilar for Humira
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
EES
Erythromycin
Macrolide antibiotic
CI: Cholestatic jaundice / hepatic dx with prior use, Clarithromycin, erythromycin: do not use with lovastatin, simvastatin, pimozide, ergotamine, dihydroergotamine, Clarithromycin: do not use with colchicine in pt with renal/hepatic dx or pt with a Hx of QT prolongation
Warnings: QT prolongation (> erythromycin), Hepatotoxicity, Exacerbate myasthenia gravis
Clarithromycin: caution in pt with CAD (↑ mortality)
SE: GI, Taste perversion, Ototoxicity, Sever skin reaction (SJS/TEN)
Cyltezo
Adalimumab
Biological DMARDS for RA
Biosimilar for Humira
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Renflexis
Infliximab
Biological DMARD anti-TNF for RA
Biosimilar for Remicade
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Inflectra
Infliximab
Biological DMARD anti-TNF for RA
Biosimilar for Remicade
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Ixifi
Infliximab
Biological DMARD anti-TNF for RA
Biosimilar for Remicade
BB: serious infection including TB, cancer
CI: active infection
Warnings: demyelination, seizure, HepB reactivation, hepatotoxicity, DILE, do not use with other DMARDS or live vaccines
Symtuza
Darunavir + cobicistat + emtricitabine + tenofovir adafenamide
Only PI- Based for HIV
Sandostatin
Octreotide
Splanchnique vasopressor for variceal bleeding
50 mcg IV bolus repeat 1 hr later if bleeding not controlled then 25-50 mcg/hr IV infusion for 2-5 days
Flolan
Epoprostenol
prostacyclin analogue for PAH
Veletri
Epoprostenol
prostacyclin analogue for PAH
Vasostrict
Vasopressin
Non-selective vasoconstrictor for variceal bleeding
IV infusion 0.2-0.4 units/min Max 24hrs
Also used in critical care
Vasopressor (not on adrenergic receptors, act on vasopressin receptors) used in ICU, anaphylactic shock
BB: Dopamine/ Norepinephrine: extravasation (treat with phentolamine)
Warnings: Use with MOAI can caused prolong hypertension
SE: Dopamine, epinephrine, vasopressin: arrhythmia, tachycardia
Phenylephrine: bradycardia
Epinephrine: hyperglycemia
Necrosis (gangrene), tachyphylaxis, peripheral and gut ischemia
Monitoring: Continuous monitoring of BP for infusion, HR, MAP, ECG, urine output, infusion site reaction (extravasation)
Solution should not be used if discolored
All vasopressors are vesicants (~ chemotherapy) = medical emergency, Use central line, Treat with phentolamine (𝛼”−1” blocker) or nitroglycerine ointment
Remodulin
Treprostinil
prostacyclin analogue for PAH
Injection
Tyvaso
Treprostinil
prostacyclin analogue for PAH
Inhalation
Orenitram
Treprostinil
prostacyclin analogue for PAH
Tablet
Uptravi
Selexipag
prostacyclin analogue for PAH
Tracleer
Bosentan
ERA for PAH
Letairis
Ambrisentan
ERA for PAH
Opsumit
Macitentan
ERA for PAH
Revatio
Sildenafil
PD-5 inhibitor for PAH
Adcirca
Tadalafil
PD-5 inhibitor for PAH
Adempas
Riociguat
Soluble guanylate cyclase stimulator for PAH
Decadron
Dexamethasone
Corticosteroid
Tablet
Compazine
Prochlorperazine
Dopamine receptor antagonist for CINV
Compro
Prochlorperazine
Dopamine receptor antagonist for CINV
Phenergan
Promethazine
Dopamine receptor antagonist for CINV
Phenadoz
Promethazine
Dopamine receptor antagonist for CINV
Promethegan
Promethazine
Dopamine receptor antagonist for CINV
Strattera
Atomoxetine
ADHD drug
Intuniv
Guanfacine ER
For ADHD
Kapvay
Clonidine ER
For ADHD
Remeron
Mirtazapine
For depression
Tiazac
Diltiazem
Arrhythmia and rate control
Cardura
Doxazosin
Non-specific alpha-blocker for BPH
IR: 1 mg QHS XL: 4 mg with breakfast
Warnings: orthostatic hypotension, intraoperative iris floppy syndrome
SE: dizziness, fatigue, HA, abnormal ejaculation
Flomax
Tamsulosine
Alpha1A-blocker for BPH
0.4 mg QD 30 min after same meal
Warnings: orthostatic hypotension, intraoperative iris floppy syndrome
SE: dizziness, fatigue, HA, abnormal ejaculation
Uroxatral
Afluzosin
Alpha1A-blocker for BPH
10 mg QD after same meal
Warnings: orthostatic hypotension, intraoperative iris floppy syndrome
SE: dizziness, fatigue, HA, abnormal ejaculation
Rapaflo
Silidosin
Alpha1A-blocker for BPH
8 mg with same meal QD
Warnings: orthostatic hypotension, intraoperative iris floppy syndrome
SE: dizziness, fatigue, HA, abnormal ejaculation
Proscar
Finasteride 5-alpha reductase inhibitor for BPH 5 mg QD CI: pregnant or potential, kids SE: impotence, less libido, ejaculation issues, breast enlargement and tenderness
Avodart
Dutasteride 5-alpha reductase inhibitor for BPH 0.5 mg QD CI: pregnant or potential, kids SE: impotence, less libido, ejaculation issues, breast enlargement and tenderness
Jalyn
Tamsulosine + dutasteride
For BPH
Cialis
Tadalafil
Phosphodiesterase-5 inhibitor for BPH
5 mg QD at the same time with or without food
CI: nitrates, riociguat
Warnings: color discoloration, hearing loss, vision loss, hypotension, priapism, MI
SE: HA, flushing, dizziness, dyspepsia, back pain
EpiPen
Epinephrine
Auto-injector, injection (0.01% for IV, 0.1% for IM or SC)
Vasopressor used in ICU, anaphylactic shock
Act on both alpha and beta adrenergic receptors
BB: Dopamine/ Norepinephrine: extravasation (treat with phentolamine)
Warnings: Use with MOAI can caused prolong hypertension
SE: Dopamine, epinephrine, vasopressin: arrhythmia, tachycardia
Phenylephrine: bradycardia
Epinephrine: hyperglycemia
Necrosis (gangrene), tachyphylaxis, peripheral and gut ischemia
Monitoring: Continuous monitoring of BP for infusion, HR, MAP, ECG, urine output, infusion site reaction (extravasation)
Solution should not be used if discolored
All vasopressors are vesicants (~ chemotherapy) = medical emergency, Use central line, Treat with phentolamine (𝛼”−1” blocker) or nitroglycerine ointment
Levophed
Norepinephrine
Vasopressor used in ICU, anaphylactic shock
Act on both alpha and beta adrenergic receptors (alpha > beta)
BB: Dopamine/ Norepinephrine: extravasation (treat with phentolamine)
Warnings: Use with MOAI can caused prolong hypertension
SE: Dopamine, epinephrine, vasopressin: arrhythmia, tachycardia
Phenylephrine: bradycardia
Epinephrine: hyperglycemia
Necrosis (gangrene), tachyphylaxis, peripheral and gut ischemia
Monitoring: Continuous monitoring of BP for infusion, HR, MAP, ECG, urine output, infusion site reaction (extravasation)
Solution should not be used if discolored
All vasopressors are vesicants (~ chemotherapy) = medical emergency, Use central line, Treat with phentolamine (𝛼”−1” blocker) or nitroglycerine ointment
Vazculep
Phenylephrine
Vasopressor used in ICU, anaphylactic shock
Selective for alpha receptors => no inotrope effect
BB: Dopamine/ Norepinephrine: extravasation (treat with phentolamine)
Warnings: Use with MOAI can caused prolong hypertension
SE: Dopamine, epinephrine, vasopressin: arrhythmia, tachycardia
Phenylephrine: bradycardia
Epinephrine: hyperglycemia
Necrosis (gangrene), tachyphylaxis, peripheral and gut ischemia
Monitoring: Continuous monitoring of BP for infusion, HR, MAP, ECG, urine output, infusion site reaction (extravasation)
Solution should not be used if discolored
All vasopressors are vesicants (~ chemotherapy) = medical emergency, Use central line, Treat with phentolamine (𝛼”−1” blocker) or nitroglycerine ointment
Neo -synephrin
Phenylephrine
Vasopressor used in ICU, anaphylactic shock
BB: Dopamine/ Norepinephrine: extravasation (treat with phentolamine)
Warnings: Use with MOAI can caused prolong hypertension
SE: Dopamine, epinephrine, vasopressin: arrhythmia, tachycardia
Phenylephrine: bradycardia
Epinephrine: hyperglycemia
Necrosis (gangrene), tachyphylaxis, peripheral and gut ischemia
Monitoring: Continuous monitoring of BP for infusion, HR, MAP, ECG, urine output, infusion site reaction (extravasation)
Solution should not be used if discolored
All vasopressors are vesicants (~ chemotherapy) = medical emergency, Use central line, Treat with phentolamine (𝛼”−1” blocker) or nitroglycerine ointment
Vibramycin
Doxycyclin
Minocin
Minocycline
Giapreza
Angiotensin II analog
Vasopressor used in ICU, anaphylactic shock
BB: Dopamine/ Norepinephrine: extravasation (treat with phentolamine)
Warnings: Use with MOAI can caused prolong hypertension
SE: Dopamine, epinephrine, vasopressin: arrhythmia, tachycardia
Phenylephrine: bradycardia
Epinephrine: hyperglycemia
Necrosis (gangrene), tachyphylaxis, peripheral and gut ischemia
Monitoring: Continuous monitoring of BP for infusion, HR, MAP, ECG, urine output, infusion site reaction (extravasation)
Solution should not be used if discolored
All vasopressors are vesicants (~ chemotherapy) = medical emergency, Use central line, Treat with phentolamine (𝛼”−1” blocker) or nitroglycerine ointment
Solodyn
Minocycline
Camptosar
Irinotecan
Topoisomerase I inhibitor (cell cycle specific cytotoxic agent)
Hycamtin
Topotecan
Topoisomerase I inhibitor (cell cycle specific agent)
Revlimid
Lenalidomide
Cytotoxic agent immunomodulator, used in multiple myeloma
Pomalyst
Pomalidomide
Cytotoxic agent immunomodulator, used in multiple myeloma
Thalomid
Thalidomide
Cytotoxic agent immunomodulator, used in multiple myeloma
Vaprisol
Conivaptan
Arginine vasopressin receptor antagonist used in SIADH (euvolemic/hypervolemic hyponatremia)
Injection, Max 4 days and do not use if CrCl <30
CI: Hypovolemic hyponatremia, anuria, 3A4 inhibitors
Warnings: Overly rapid correction
SE: Orthostatic hypotension, fever, hypokalemia, infusion site reaction (> 60%)
Monitoring: Na, BP, Volume, urine output
Lorcet
Hydrocodone + acetaminophen
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Samsca
Tolvaptan
Arginine vasopressin receptor antagonist used in SIADH (euvolemic/hypervolemic hyponatremia)
Tablet, Max 30 days and do not use if CrCl <10
BB: Initiate in hospital where monitoring Na
Overly rapid correction (consider slower correction in malnutrition, alcoholism, liver dx)
CI: Hypovolemic hyponatremia, anuria, 3A4 inhibitors
Pt unable to sense thirst, urgent need to raise Na
Warnings: Hepatotoxicity (max 30 days)
SE:Thirst, nausea, dry mouth, polyuria, weakness, hyperglycemia, hypernatremia
Monitoring: Rate of Na ↑, BP, volume, urine output, signs hepatotxicity
Lortab
Hydrocodone + acetaminophen
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Verdrocet
Hydrocodone + acetaminophen
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Xodol
Hydrocodone + acetaminophen
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Tussionex
Hydrocodone + chlorpheniramine
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Pennkinetic ER
Hydrocodone + chlorpheniramine
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
TussiCaps
Hydrocodone + chlorpheniramine
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Tussignon
Hydrocodone + homatropine
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Vicoprofen
Hydrocodone + ibuprofen
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Ibudone
Hydrocodone + ibuprofen
opioid used in pain management
BB: 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Warning: Respiratory and CNS depression, constipation, hypotension, skin reactions, caution in liver dx and 2D6 poor metabolizer, avoid alcohol
SE: N/V, dizziness, lightheadedness, SE related to acetaminophen
Hydrocodone containing cough and cold preparation are no longer indicated in patients < 18 yo – do not use
Zohydro
Hydrocodone ER
Opioid used in pain management
BB: Initiation of 3A4 inhibitors (or cessation of 3A4 inducers) can cause fatal overdose
Major substrate for 3A4 and minor substrate for 2D6
Preferably avoid use in breastfeeding
Abuse-deterrent formulation
Hysingla: QT prolongation has occurred at doses > 160 mg/day
Hysingla ER
Hydrocodone ER
Opioid used in pain management
BB: Initiation of 3A4 inhibitors (or cessation of 3A4 inducers) can cause fatal overdose
Major substrate for 3A4 and minor substrate for 2D6
Preferably avoid use in breastfeeding
Abuse-deterrent formulation
Hysingla: QT prolongation has occurred at doses > 160 mg/day
Ventrela
Hydrocodone ER
Opioid used in pain management
BB: Initiation of 3A4 inhibitors (or cessation of 3A4 inducers) can cause fatal overdose
Major substrate for 3A4 and minor substrate for 2D6
Preferably avoid use in breastfeeding
Abuse-deterrent formulation
Hysingla: QT prolongation has occurred at doses > 160 mg/day
Dilaudid
Hydromorphone
Opioid used in pain management
Tablet, Injection, Solution
Initial (naïve patient): Oral: 2-4 mg Q4-6H PRN, IV: 0.2-1 mg Q2-3H PRN
BB: Risk of medication error with high potency injection (used in opioid-tolerant patient only)
Potent, start low, convert carefully, high risk for overdose
Caution with 3A4 inhibitors, use lower doses initially
Commonly used in PCA and epidurals
Less nausea and pruritus
Dilaudid HP (10 mg/ml) higher potency than Dilaudid (1 mg/ml)
Exalgo: abuse-deterrent formulation (crush and extraction resistant) CI in opioid-naïve patient, 2 weeks wash out period between Exalgo and MAOI
Exalgo
Hydromorphone
Opioid used in pain management
ER tablet
Exalgo: abuse-deterrent formulation (crush and extraction resistant) CI in opioid-naïve patient, 2 weeks wash out period between Exalgo and MAOI
Dolophine
Methadone
Tablet
Initial 2.5-10 mg Q8-12H
BB: Life-threatening QT prolongation and serious arrhythmia (torsade de pointe)(> large, multiple daily dose) should be prescribed by professionals who known requirements for safe use
Initiation of CYP inhibitors (or stopping inducers) can cause fatal overdose
Warnings: Combination with serotoninergic drugs and MAOI can ↑ risk of serotoninergic syndrome
Also block reuptake of norepinephrine
Due to variable half life, difficult to dose safely
Can ↓ testosterone and contribute to sexual dysfunction
Major 3A4 substrate => avoid inhibitors or lower methadone dose
Demerol
Meperidine
Demerol
Meperidine
Opioid used in pain management
Tablet, Solution, Injection
Warnings: Renal impairment / elderly at risk of CNS toxicity, avoid use with or within 2 weeks of MAOI
SE: Lightheadedness, dizziness, somnolence, N/V, sweating
No longer recommended as analgesic (> elderly and renal impairment)
Avoid for chronic pain and even short term in elderly
Acceptable for short term acute or single use (eg suture in ER) and use off-label for post-operative rigors (shivering)
Short duration of action (pain controlled for max 3h)
Normepiridine = metabolite is renally cleared and can accumulate and cause CNS toxicity including seizures
Serotoninergic => ↑ risk of serotoninergic syndrome if use in combination with other drugs
MS Contin
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Kadian
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Roxanol
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
MorphaBond
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Arymo ER
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Duramorph
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Astramorph
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Infumorph
Morphine
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Embeda
Morphine + naltrexone
Opioid used in pain managemet
BB: Medication errors with oral solution
Appropriate staff and equipment needed for intrathecal/epidural administration
SE: N/V (anti-emetic), dizziness, changes in mood, confusion, delirium, flushing, pruritus, diaphoresis (anti-histamine)
Do not use MSO4 or MS abbreviations for morphine or magnesium
Do not crush, chew ER products, Kadian can be opened and sprinkle on applesauce or soft food
If renal impaired, start at low dose or avoid morphine due to accumulation of parent drug or active metabolite
Xartemis XR
Oxycodone + acetaminophen
Opioid used in pain managemet
BB: Initiation of 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Caution between oxycodone oral solution and oral concentrate (confusion between ml, mg and different concentration)
Obando, OxyContin, Targiniq ER, Troxyca ER and Xtampza ER: abuse-deterrent formulation
Xtampza ER capsules can be opened and mix with soft food or administered by NG tube
Avoid high fat meal with higher doses (except re-formulated OxyContin)
If renal impairment, start low doses or avoid oxycodone due to parent drug / active metabolite accumulation
Oxaydo
Oxycodone
Opioid used in pain managemet
BB: Initiation of 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Caution between oxycodone oral solution and oral concentrate (confusion between ml, mg and different concentration)
Obando, OxyContin, Targiniq ER, Troxyca ER and Xtampza ER: abuse-deterrent formulation
Xtampza ER capsules can be opened and mix with soft food or administered by NG tube
Avoid high fat meal with higher doses (except re-formulated OxyContin)
If renal impairment, start low doses or avoid oxycodone due to parent drug / active metabolite accumulation
Roxicodone
Oxycodone
Opioid used in pain managemet
BB: Initiation of 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Caution between oxycodone oral solution and oral concentrate (confusion between ml, mg and different concentration)
Obando, OxyContin, Targiniq ER, Troxyca ER and Xtampza ER: abuse-deterrent formulation
Xtampza ER capsules can be opened and mix with soft food or administered by NG tube
Avoid high fat meal with higher doses (except re-formulated OxyContin)
If renal impairment, start low doses or avoid oxycodone due to parent drug / active metabolite accumulation
OxyContin
Oxycodone
Opioid used in pain managemet
BB: Initiation of 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Caution between oxycodone oral solution and oral concentrate (confusion between ml, mg and different concentration)
Obando, OxyContin, Targiniq ER, Troxyca ER and Xtampza ER: abuse-deterrent formulation
Xtampza ER capsules can be opened and mix with soft food or administered by NG tube
Avoid high fat meal with higher doses (except re-formulated OxyContin)
If renal impairment, start low doses or avoid oxycodone due to parent drug / active metabolite accumulation
Xtampza
Oxycodone
Opioid used in pain managemet
BB: Initiation of 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Caution between oxycodone oral solution and oral concentrate (confusion between ml, mg and different concentration)
Obando, OxyContin, Targiniq ER, Troxyca ER and Xtampza ER: abuse-deterrent formulation
Xtampza ER capsules can be opened and mix with soft food or administered by NG tube
Avoid high fat meal with higher doses (except re-formulated OxyContin)
If renal impairment, start low doses or avoid oxycodone due to parent drug / active metabolite accumulation
Troxyca
Oxycodone + naltrexone
Opioid used in pain management
BB: Initiation of 3A4 inhibitors (or stopping 3A4 inducers) can cause fatal overdose
Caution between oxycodone oral solution and oral concentrate (confusion between ml, mg and different concentration)
Obando, OxyContin, Targiniq ER, Troxyca ER and Xtampza ER: abuse-deterrent formulation
Xtampza ER capsules can be opened and mix with soft food or administered by NG tube
Avoid high fat meal with higher doses (except re-formulated OxyContin)
If renal impairment, start low doses or avoid oxycodone due to parent drug / active metabolite accumulation
Opana
Oxymorphone
Opioid used in pain management
Do not use with moderate-to-severe liver impairment
Use low dose in elderly, renal impaired or liver impaired patients
Take on empty stomach
Narcan
Naloxone Opioid abuse agent Nasal spray acute withdrawal Sx (pain, anxiety, ↑RR) Low BA => use PO for OIC (off-label)
Evzio
Naloxone Injection (auto-injector) Opioid abuse agent acute withdrawal Sx (pain, anxiety, ↑RR) Low BA => use PO for OIC (off-label)
Buprenex
Buprenorphine
Opioid abuse agent
Injection
BB: Belbuca, Butrans: Risk of addiction, abuse and misuse, Risk of serious fatal respiratory depression
Life-threatening neonatal opioid withdrawal if prolonged used during pregnancy
Accidental ingestion (children) can be fatal
Warnings: CNS depression, QT prolongation
SE:sedation, dizziness, HA, confusion, mental and physical impairment, diaphoresis, QT prolongation, respiratory depression
Patch: nausea, HA, application site rash, dizziness, constipation, somnolence, vomiting, dry mouth
Do not expose patch to heat
Apply patch upper outer arm, upper chest, side of chest, upper back once weekly, do not use same site for 3 weeks
Fold and flush in the toilet or disposed in special container that came with the drug
If prescribe for opioid dependence, prescriber needs a drug addiction treatment act (DATA 2000) waiver, unique identification number delivered by DEA that starts with X
Sublocade
Buprenorphine
Opioid abuse agent
Injection (monthly)
BB: Belbuca, Butrans: Risk of addiction, abuse and misuse, Risk of serious fatal respiratory depression
Life-threatening neonatal opioid withdrawal if prolonged used during pregnancy
Accidental ingestion (children) can be fatal
Warnings: CNS depression, QT prolongation
SE:sedation, dizziness, HA, confusion, mental and physical impairment, diaphoresis, QT prolongation, respiratory depression
Patch: nausea, HA, application site rash, dizziness, constipation, somnolence, vomiting, dry mouth
Do not expose patch to heat
Apply patch upper outer arm, upper chest, side of chest, upper back once weekly, do not use same site for 3 weeks
Fold and flush in the toilet or disposed in special container that came with the drug
If prescribe for opioid dependence, prescriber needs a drug addiction treatment act (DATA 2000) waiver, unique identification number delivered by DEA that starts with X
Butrans
Buprenorphine
Opioid abuse agent
Patch
BB: Belbuca, Butrans: Risk of addiction, abuse and misuse, Risk of serious fatal respiratory depression
Life-threatening neonatal opioid withdrawal if prolonged used during pregnancy
Accidental ingestion (children) can be fatal
Warnings: CNS depression, QT prolongation
SE:sedation, dizziness, HA, confusion, mental and physical impairment, diaphoresis, QT prolongation, respiratory depression
Patch: nausea, HA, application site rash, dizziness, constipation, somnolence, vomiting, dry mouth
Do not expose patch to heat
Apply patch upper outer arm, upper chest, side of chest, upper back once weekly, do not use same site for 3 weeks
Fold and flush in the toilet or disposed in special container that came with the drug
If prescribe for opioid dependence, prescriber needs a drug addiction treatment act (DATA 2000) waiver, unique identification number delivered by DEA that starts with X
Belbuca
Buprenorphine
Opioid abuse agent
Buccal film
BB: Belbuca, Butrans: Risk of addiction, abuse and misuse, Risk of serious fatal respiratory depression
Life-threatening neonatal opioid withdrawal if prolonged used during pregnancy
Accidental ingestion (children) can be fatal
Warnings: CNS depression, QT prolongation
SE:sedation, dizziness, HA, confusion, mental and physical impairment, diaphoresis, QT prolongation, respiratory depression
Patch: nausea, HA, application site rash, dizziness, constipation, somnolence, vomiting, dry mouth
Do not expose patch to heat
Apply patch upper outer arm, upper chest, side of chest, upper back once weekly, do not use same site for 3 weeks
Fold and flush in the toilet or disposed in special container that came with the drug
If prescribe for opioid dependence, prescriber needs a drug addiction treatment act (DATA 2000) waiver, unique identification number delivered by DEA that starts with X
Bunavail
Buprenorphine +naloxone
Opioid abuse agent
Buccal film
BB: Belbuca, Butrans: Risk of addiction, abuse and misuse, Risk of serious fatal respiratory depression
Life-threatening neonatal opioid withdrawal if prolonged used during pregnancy
Accidental ingestion (children) can be fatal
Warnings: CNS depression, QT prolongation
SE:sedation, dizziness, HA, confusion, mental and physical impairment, diaphoresis, QT prolongation, respiratory depression
Patch: nausea, HA, application site rash, dizziness, constipation, somnolence, vomiting, dry mouth
Do not expose patch to heat
Apply patch upper outer arm, upper chest, side of chest, upper back once weekly, do not use same site for 3 weeks
Fold and flush in the toilet or disposed in special container that came with the drug
If prescribe for opioid dependence, prescriber needs a drug addiction treatment act (DATA 2000) waiver, unique identification number delivered by DEA that starts with X
Suboxone
Buprenorphine + naloxone
Opioid abuse agent
Sublingual film
BB: Belbuca, Butrans: Risk of addiction, abuse and misuse, Risk of serious fatal respiratory depression
Life-threatening neonatal opioid withdrawal if prolonged used during pregnancy
Accidental ingestion (children) can be fatal
Warnings: CNS depression, QT prolongation
SE:sedation, dizziness, HA, confusion, mental and physical impairment, diaphoresis, QT prolongation, respiratory depression
Patch: nausea, HA, application site rash, dizziness, constipation, somnolence, vomiting, dry mouth
Do not expose patch to heat
Apply patch upper outer arm, upper chest, side of chest, upper back once weekly, do not use same site for 3 weeks
Fold and flush in the toilet or disposed in special container that came with the drug
If prescribe for opioid dependence, prescriber needs a drug addiction treatment act (DATA 2000) waiver, unique identification number delivered by DEA that starts with X
Zubsolv
Buprenorphine + naloxone
Opioid abuse agent
Sublingual tablet
BB: Belbuca, Butrans: Risk of addiction, abuse and misuse, Risk of serious fatal respiratory depression
Life-threatening neonatal opioid withdrawal if prolonged used during pregnancy
Accidental ingestion (children) can be fatal
Warnings: CNS depression, QT prolongation
SE:sedation, dizziness, HA, confusion, mental and physical impairment, diaphoresis, QT prolongation, respiratory depression
Patch: nausea, HA, application site rash, dizziness, constipation, somnolence, vomiting, dry mouth
Do not expose patch to heat
Apply patch upper outer arm, upper chest, side of chest, upper back once weekly, do not use same site for 3 weeks
Fold and flush in the toilet or disposed in special container that came with the drug
If prescribe for opioid dependence, prescriber needs a drug addiction treatment act (DATA 2000) waiver, unique identification number delivered by DEA that starts with X
Tegretol
Carbamazepine
Adjuvant for pain management
Carnevix
Carbamazepine
Adjuvant for pain management
Lucemyra
Lofexidine
Opioid abuse agent
Warnings: Risk of hypotension, bradycardia, syncope, QT prolongation, ↑ CNS depression, ↑ risk of opioid overdose after D/C, risk of withdrawal Sx => must taper over 2-4 days
SE: Orthostatic hypotension, dizziness, dry mouth
↓ efficacy of oral naltrexone (OIC)
Paroxetine and other 2D6 inhibitors ↑ risk of hypotension and bradycardia
Neurontin
Gabapentin
Adjuvant for pain management
Capsule, Tablet, Solution
Initial: 300 mg TID (max 3,600 mg/day)
CrCl<60: ↓ dose or extend interval
Warnings: Angioedema, anaphylaxis, multiorgan hypersensitivity (DRESS) reactions, suicidal thoughts, ↑ seizure frequency if rapidly D/C in pt with seizure, CNS effect
SE: Somnolence, ataxia, peripheral edema, weight gain, dizziness, diplopia, blurred vision, dry mouth
Commonly used of-label for fibromyalgia, neuropathic pain, drug abuse, OH withdrawal
Take ER formulation with food
IR, ER and gabapentin enacarbil (Horizant) are not interchangeable
Fanatrex
Gabapentin
Adjuvant for pain management
Oral suspension (RapidPak oral supension / reconstitution valid for 8 weeks room temp)
Initial: 300 mg TID (max 3,600 mg/day)
CrCl<60: ↓ dose or extend interval
Warnings: Angioedema, anaphylaxis, multiorgan hypersensitivity (DRESS) reactions, suicidal thoughts, ↑ seizure frequency if rapidly D/C in pt with seizure, CNS effect
SE: Somnolence, ataxia, peripheral edema, weight gain, dizziness, diplopia, blurred vision, dry mouth
Commonly used of-label for fibromyalgia, neuropathic pain, drug abuse, OH withdrawal
Take ER formulation with food
IR, ER and gabapentin enacarbil (Horizant) are not interchangeable
Gralise
Gabapentin
Adjuvant for pain management, indicated for PHN (post herpetic neuropathy)
Initial: 300 mg TID (max 3,600 mg/day)
CrCl<60: ↓ dose or extend interval
Warnings: Angioedema, anaphylaxis, multiorgan hypersensitivity (DRESS) reactions, suicidal thoughts, ↑ seizure frequency if rapidly D/C in pt with seizure, CNS effect
SE: Somnolence, ataxia, peripheral edema, weight gain, dizziness, diplopia, blurred vision, dry mouth
Commonly used of-label for fibromyalgia, neuropathic pain, drug abuse, OH withdrawal
Take ER formulation with food
IR, ER and gabapentin enacarbil (Horizant) are not interchangeable
Horizant
Gabapentin enacarbil
Adjuvant for pain management (post-herpetic neuralgia)
Also used in RLS
ER formulation more expensive than IR
Initial: 300 mg TID (max 3,600 mg/day)
CrCl<60: ↓ dose or extend interval
Warnings: Angioedema, anaphylaxis, multiorgan hypersensitivity (DRESS) reactions, suicidal thoughts, ↑ seizure frequency if rapidly D/C in pt with seizure, CNS effect
SE: Somnolence, ataxia, peripheral edema, weight gain, dizziness, diplopia, blurred vision, dry mouth
Commonly used of-label for fibromyalgia, neuropathic pain, drug abuse, OH withdrawal
Take ER formulation with food
IR, ER and gabapentin enacarbil (Horizant) are not interchangeable
Marinol
Dronabinol
Cannabinoid used in CINV
C-III
Syndros
Dronabinol
Cannabinoid used in CINV
C-III
Lyrica
Pregabalin (C V)
Adjuvant for pain management
Capsule, Solution
Initial: 75 mg BID or 50 mg TID, Max 450 mg/day
CrCl<60: ↓ dose or extend interval
Warnings: Angioedema, multiorgan hypersensitivity (DRESS) reactions, suicidal thoughts, ↑ seizure frequency if rapidly D/C in pt with seizure, CNS effect
SE: Somnolence, mild euphoria, ataxia, peripheral edema, weight gain, dizziness, diplopia, blurred vision, dry mouth
Approved for fibromyalgia, PHN, neuropathic pain associated with diabetes and spinal cord injury
Cesamet
Nabilone
Cannabinoid used in CINV
C-II
Copaxone
Glatiramer acetate
Use in MS
Pre-filled syringes
20 mg SC daily or 40 mg SC 3x per week (at least 48h apart) , If ↑ dose to 40 mg, start at least 48h after the 20 mg dose
Warnings: Immediate post-injection reaction, chest pain, lipoatrophy
SE: Injection site reaction (inflammation, erythema, pain, pruritus, residual mass), infection, pain, flushing, diaphoresis, dyspnea, weakness, anxiety, rash, nausea, nasopharyngitis, vasodilation, antibody development
Preferred agent if tx is necessary during pregnancy
Check solution for discoloration and discard if present
Can be kept at room temp for up to one month, or in the fridge (preferred), if cold, let it stand at room temp for 20 min before injection
Glatopa
Gatiramer acetate
Used in MS
Pre-filled syringes
20 mg SC daily or 40 mg SC 3x per week (at least 48h apart) , If ↑ dose to 40 mg, start at least 48h after the 20 mg dose
Warnings: Immediate post-injection reaction, chest pain, lipoatrophy
SE: Injection site reaction (inflammation, erythema, pain, pruritus, residual mass), infection, pain, flushing, diaphoresis, dyspnea, weakness, anxiety, rash, nausea, nasopharyngitis, vasodilation, antibody development
Preferred agent if tx is necessary during pregnancy
Check solution for discoloration and discard if present
Can be kept at room temp for up to one month, or in the fridge (preferred), if cold, let it stand at room temp for 20 min before injectio
Avonex
Interferon beta-1a
Used in MS
Pre-filled syringe, Powder for reconstitution
30 mcg IM weekly
Warnings: Psychiatric disorders (depression/suicide), injection site necrosis, myelosuppression, ↑ LFT, thyroid dysfunction (hyper/hypo), infections, anaphylaxis, worsening cardiovascular dx, seizure risk
SE: Flu-like sx following administration (lasting min to hours), ↓ with continued tx, can use acetaminophen or NSAID prior injection or start with lower dose and titrate up weekly to target dose
Visual disturbance, fatigue, depression, pain, urinary tract infections, HA
Monitoring: LFT, CBC (at 1, 3, and 6 months then periodically), thyroid function every 6 months (in pt with thyroid dysfunction or as clinical necessary)
Refrigerate all except Betaseron and Extavia (which can be stored at room temp)
If refrigerate, let stand at room temp before injection, do not expel the small air bubble in pre-filled syringe due to loss of dose
Do not shake Avonex, Betaseron, Extavia
Some formulations contain albumin which can ↑ the risk of Creutzfeldt-Jakob dx transmission, avoid in albumin sensitive pt
Rebif
Interferon beta-1a
Used in MS
Pre-filled syringe, Powder for reconstitution
22 mcg or 44 mcg SC 3x/week (at least 48h apart)
Warnings: Psychiatric disorders (depression/suicide), injection site necrosis, myelosuppression, ↑ LFT, thyroid dysfunction (hyper/hypo), infections, anaphylaxis, worsening cardiovascular dx, seizure risk
SE: Flu-like sx following administration (lasting min to hours), ↓ with continued tx, can use acetaminophen or NSAID prior injection or start with lower dose and titrate up weekly to target dose
Visual disturbance, fatigue, depression, pain, urinary tract infections, HA
Monitoring: LFT, CBC (at 1, 3, and 6 months then periodically), thyroid function every 6 months (in pt with thyroid dysfunction or as clinical necessary)
Refrigerate all except Betaseron and Extavia (which can be stored at room temp)
If refrigerate, let stand at room temp before injection, do not expel the small air bubble in pre-filled syringe due to loss of dose
Do not shake Avonex, Betaseron, Extavia
Some formulations contain albumin which can ↑ the risk of Creutzfeldt-Jakob dx transmission, avoid in albumin sensitive pt
Betaseron
Interferon beta-1b
Used in MS
Powder for reconstitution, Auto-injector
SC: 0.25 mg every other day (use within 3h of reconstitution)
Warnings: Psychiatric disorders (depression/suicide), injection site necrosis, myelosuppression, ↑ LFT, thyroid dysfunction (hyper/hypo), infections, anaphylaxis, worsening cardiovascular dx, seizure risk
SE: Flu-like sx following administration (lasting min to hours), ↓ with continued tx, can use acetaminophen or NSAID prior injection or start with lower dose and titrate up weekly to target dose
Visual disturbance, fatigue, depression, pain, urinary tract infections, HA
Monitoring: LFT, CBC (at 1, 3, and 6 months then periodically), thyroid function every 6 months (in pt with thyroid dysfunction or as clinical necessary)
Refrigerate all except Betaseron and Extavia (which can be stored at room temp)
If refrigerate, let stand at room temp before injection, do not expel the small air bubble in pre-filled syringe due to loss of dose
Do not shake Avonex, Betaseron, Extavia
Some formulations contain albumin which can ↑ the risk of Creutzfeldt-Jakob dx transmission, avoid in albumin sensitive pt
Extavia
Interferon beta-1b
Used in MS
Powder for reconstitution, Auto-injector
SC: 0.25 mg every other day (use within 3h of reconstitution)
Warnings: Psychiatric disorders (depression/suicide), injection site necrosis, myelosuppression, ↑ LFT, thyroid dysfunction (hyper/hypo), infections, anaphylaxis, worsening cardiovascular dx, seizure risk
SE: Flu-like sx following administration (lasting min to hours), ↓ with continued tx, can use acetaminophen or NSAID prior injection or start with lower dose and titrate up weekly to target dose
Visual disturbance, fatigue, depression, pain, urinary tract infections, HA
Monitoring: LFT, CBC (at 1, 3, and 6 months then periodically), thyroid function every 6 months (in pt with thyroid dysfunction or as clinical necessary)
Refrigerate all except Betaseron and Extavia (which can be stored at room temp)
If refrigerate, let stand at room temp before injection, do not expel the small air bubble in pre-filled syringe due to loss of dose
Do not shake Avonex, Betaseron, Extavia
Some formulations contain albumin which can ↑ the risk of Creutzfeldt-Jakob dx transmission, avoid in albumin sensitive pt
Plegridy
Peginterferon beta-1a
Used in MS
Prefilled syringe and pen
SC: 63 mcg on day 1, 94 mcg on day 15, then 125mcg every 14 days starting on day 29
Warnings: Psychiatric disorders (depression/suicide), injection site necrosis, myelosuppression, ↑ LFT, thyroid dysfunction (hyper/hypo), infections, anaphylaxis, worsening cardiovascular dx, seizure risk
SE: Flu-like sx following administration (lasting min to hours), ↓ with continued tx, can use acetaminophen or NSAID prior injection or start with lower dose and titrate up weekly to target dose
Visual disturbance, fatigue, depression, pain, urinary tract infections, HA
Monitoring: LFT, CBC (at 1, 3, and 6 months then periodically), thyroid function every 6 months (in pt with thyroid dysfunction or as clinical necessary)
Refrigerate all except Betaseron and Extavia (which can be stored at room temp)
If refrigerate, let stand at room temp before injection, do not expel the small air bubble in pre-filled syringe due to loss of dose
Do not shake Avonex, Betaseron, Extavia
Some formulations contain albumin which can ↑ the risk of Creutzfeldt-Jakob dx transmission, avoid in albumin sensitive pt
Tysabri
Natalizumab
Monoclonal antibody used in MS or IBD
Injection IV
Lemtrada
Alemtuzumab
Recombinant human monoclonal antibody used in MS
Injection IV
BB: Alemtuzumab: serious, sometimes fatal autoimmune conditions, infusion reactions, malignancies, REMS program required
CI: Alemtuzumab: HIV (caused prolonged ↓ in CD4+)
Ocrelizumab: active HepB infection
Indicated when there is an inadequate response to ≥ 2 MS drugs
Complete all vaccinations 6 weeks before tx
Premedicate with a steroid, an antihistamine and/or acetaminophen (varies by drug)
Ocrelizumab requires a 0.22 micron in-line filter
Ocrelizumab has similar safety issues as other drugs that target the CD20 (eg rituximab)
Aubagio
Teriflunomide
Oral Immunomodulator used in MS
Tecfidera
Dimethyl fumarate
Oral immunomodulator used in MS
Capsules
NrF2 activator
Hepatotoxicity (monitor LFT), neutropenia (reversible, but monitor CBC)
Can cause flushing (prevent with aspirin 30 min before to dose and administer with food)
Do not crush, chew, or sprinkle capsule contents on food
Aubagio
Teriflunomide
Oral Immunomodulator used in MS
Tablets
Active metabolite of leflunomide
Severe hepatotoxicity and teratogenicity => CI in pregnancy and with severe hepatic Dx
Can use accelerated elimination to remove drug (like leflunomide)
Accelerated elimination procedures (2 options)
Cholestyramine 8 mg PO TID for 11 days
Activated charcoal suspension 50 g PO Q12H for 11 days
Atrovent HFA
Ipratropium bromide
SAMA
MDI used in COPD
17 mcg/inhalation
Combivent Respimat
Ipratropium bromide + albuterol
SAMA + SABA
MDI used in COPD
20/100 mcg per inhalation
Ampyra
Dalfampridine
K channel blocker used in MS to improve signal nerve conduction and walking, most pt do not respond
Tablet
CI in pt with Hx of seizure
Takes up to 6 weeks to show efficacy, most pt do not respond
Tudorza Pressair
Aclidinium
LAMA used in COPD
400 mcg/inhalation
Seebri Neohaler
Glycopyrrolate
LAMA used in COPD
DPI 15.6 mcg/inhalation
L’inhalation Magnair
Glycopyrrolate
LAMA used in COPD
Nebulizer 25 mcg/inhalation
Spiriva HandiHaler
Tiotropium
LAMA used in COPD
DPI 18 mcg/caps
Spiriva Respimat
Tiotropium
LAMA used in COPD
MDI 2.5 mcg/inhalation
Incruse Ellipta
Umeclidinium
LAMA used in COPD
DPI 62.5 mcg/inhalation
Serevent Diskus
Salmeterol
LABA used in COPD
DPI 50 mcg/inhalation
Perforomist
Formoterol
LABA used in COPD
Nebulizer 20 mcg/2 ml
Brovana
Artformoterol
LABA used in COPD
Nebulizer 15 mcg/2 ml
Arcapta Neohaler
Indacaterol
LABA used in COPD
DPI 75 mcg /caps
Striverdi Respimat
Olodaterol
LABA used in COPD
MDI 2.5 mcg/inhalation
Daliresp
Roflumilast
PDE-4 inhibitor for severe COPD always in combination with bronchodilator
Nulojix
Belatacept
Maintenance immunosuppression
Pen VK
Penicillin V potassium
Antibiotic (natural penicillin) used in strep throat (pharyngitis) or non-purulent skin infections
Tablet, Suspension
125-500 mg Q6-12H on empty stomach
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Pfizerpen-G
Penicillin G aqueous
Antibiotic (natural penicillin) used in neurosyphilis
Injection
IV: 2-4 millions units Q4-6H
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Bicillin L-A
Penicillin G benzathine
Antibiotic (natural penicillin) used in syphilis
Injection
IM: 1.2-2.4 million units (variable frequency)
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Bicillin CR
Penicillin G benzathine + penicillin G procaine
Injection
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Moxatag
Amoxicillin
Aminopenicillin
Tablet, Capsule, Chewable, Suspension
24h ER = once daily
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Augmentin
Amoxicillin/ clavulanate
Aminopenicillin + Beta-Lactamase inhibitor
Tablet, Chewable, Suspension
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Unasyn
Ampicillin/ sulbactam
Aminopenicillin
Injection
IV:1.5-3 g Q6H
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Zosyn
Piperacillin/tazobactam
Extended spectrum penicillin active against pseudomonas
Injection
IV: 3.375 g Q6H or 4.5 g Q6-8H
BB: Penicillin G benzathine: not for IV use, can cause cardiorespiratory arrest and death
CI: Augmentin/Unasyn: Hx of cholestatic jaundice or hepatic dysfunction associated with previous use
Severe renal impairment (CrCl<30): do not used extended-released oral forms of amoxicillin (Moxatag) and amoxicillin/clavunate (Augmentin XR) or 875 mg strength of amoxicillin/ clavunate
SE: Seizures (with accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reactions, hemolytic anemia, renal failure, myelosuppression with prolonged use, ↑ LFT
Monitoring: Renal fct, Sx of anaphylaxis with 1st dose, CBC and LFT with prolonged use
Keflex
Cephalexin
Cephalosporin 1st generation
250 mg – 2 grams PO Q6-12H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Daxbia
Cephalexin
Cephalosporin 1st generation
250 mg – 2 grams PO Q6-12H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Ceftin
Cefuroxime
Cephalosporin 2nd generation
PO / IV / IM
250 mg – 1.5 g Q8-12H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Cefotan
Cefotetan
Cephalosporin 2nd generation
IV / IM
1-2 g Q12H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Omnicef
Cefdinir
Cephalosporin 3rd generation group 1
300 mg Q12H or 600 mg QD PO
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Spectracet
Cefditoren
Cephalosporin 3rd generation group 1
200-400 mg PO Q12H w/ food
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Suprax
Cefixime
Cephalosporin 3rd generation group 1
400 mg PO divided Q12-24H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Avycaz
Ceftazidime/ avibactam
Cephalosporin 3rd generation group 2
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Zerbaxa
Ceftolozam/ tazobactam
Cephalosporin 3rd generation group 2
1.5 g IV Q8H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Teflaro
Ceftaroline fosamil
Cephalosporin 5th generation
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Invanz
Ertapenem
Carbapenem, For MDRO including ESBL
1 g QD
Renal adj CrCl ≤30
CI: Anaphylactic reactions to beta-lactams
Warnings: CNS AE including confusion and seizures
Doripenem: do not use for the tx of pneumonia (including HAP, VAP)
Do not use in patients with PNC allergy (cross-reactivity reported to be as high as 50% but more recent studies show 10%
SE: Diarrhea, rash/ severe skin reactions (DRESS), seizures with higher doses and in patient with impaired renal fct (mainly imipenem), bone marrow suppression with prolonged use, ↑ LFT
Ertapenem: no coverage for pseudomonas, Acinetobacter, or enterococcus (PEA) / common use: diabetic foot infection / stable in NS only
Anoro Ellipta
Umeclidinium
LAMA used in COPD
Breo Ellipta
Fluticasone furoate + vilanterol
ICS + LABA used in COPD
Doribax
Doripenem
Carbapenem
IV 500 mg Q8H
CI: Anaphylactic reactions to beta-lactams
Warnings: CNS AE including confusion and seizures
Doripenem: do not use for the tx of pneumonia (including HAP, VAP)
Do not use in patients with PNC allergy (cross-reactivity reported to be as high as 50% but more recent studies show 10%
SE: Diarrhea, rash/ severe skin reactions (DRESS), seizures with higher doses and in patient with impaired renal fct (mainly imipenem), bone marrow suppression with prolonged use, ↑ LFT
Arnuity Ellipta
Fluticasone furoate
ICS used in asthma
Trelegy Ellipta
Fluticasone furoate + umeclidinium + vilanterol
ICS+LAMA+LABA used in COPD
Duoneb
Ipratropium + albuterol
SAMA+SABA used in COPD (nebulizer)
Stiolto Respimat
Tiotropium + Olodaterol
LAMA+LABA
used in COPD
Utibron NeoHaler
Glycopyrrolate + indacaterol
LAMA+LABA used in COPD
Bevespi Aerosphere
Glycopyrrolate + Formoterol
LAMA+LABA used in COPD
Monurol
Fosfomycin
AB used in UTI
3g once
Tybost
Cobicistat
Booster for HIV PI atazanavir and darunavir
Claforan
Cefotaxime
Cephalosporin 3rd generation group 1 used in meningitis
1-2 g IV/IM Q4-12H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Zontivity
Vorapaxar
PAR-1 antagonist used in MI patient inhibit platelet aggregation
Tenormin
Atenolol
Beta-1 sélective blocker used in HTN
Brevibloc
Esmolol
Beta-1 selective blocker
Injection
Lopressor
Metoprolol tartrate
Beta-1 selective blocker in HTN
Toprol XL
Metoprolol succinate
Beta-1 selective blocker used in HTN and HF
Brystolic
Nebivolol
Beta-1 selective blocker with nitric oxide-dependent vasodilation
Corgard
Nadolol
Non-selective bêta-blocker
Coreg
Carvedilol
Non-selective beta-blocker + alpha-1 blocker
Ciloxin
Ciprofloxacin
Fluoroquinolone antibiotics
Eye drops
Cetraxal
Cephalosporin
Fluoroquinolone antibiotics
Ear drop
Cipro
Ciprofloxacin
Fluoroquinolone antibiotics
Tablet, Suspension, Injection
PO: 250-750 mg Q12H, IV: 200-400 mg Q8-12H
Renal adj: CrCl<30: Q18-24H
BB: Tendon inflammation/rupture (often Achille tendon) within hours/days of starting or up to several months after completion of tx (↑ risk if concurrent use of systemic steroids, organ transplant patient, age > 60) => D/C immediately if Sx occur
Peripheral neuropathy, can last months to years after the drug D/C and may become permanent =>D/C immediately if Sx occur, CNS effects (seizure, tremor, restlessness, confusion, hallucination, depression and suicidal thoughts, paranoia, nightmares, insomnia, ↑ intracranial pressure including pseudotumor cerebri) => use with caution in CNS disorder or drugs cause seizures, Avoid in patients with myasthenia gravis (↑ muscle weakness), Last line only for acute bacterial sinusitis, acute exacerbation of chronic bronchitis, uncomplicated UTI
CI: Ciprofloxacine: concurrent association of tizanidine
Warnings: QT prolongation (> moxifloxacin) => avoid in pt with known QT prolongation, or hypokalemia, other drugs with QT prolongation including class Ia and III antiarrhythmic, Hypo and hyperglycemia, Psychiatric disturbance: agitation, disorientation, lack of attention, nervousness, memory impairment, delirium, Avoid systemic quinolones in children, risk of musculoskeletal toxicity (except for anthrax where the benefit > risk), Photosensitivity / phototoxicity, hepatotoxicity, crystalluria (drink to stay hydrated)
SE: N/D, HA, dizziness, serious skin reaction (SJS/TEN)
Otiprio
Ciprofloxacin
Fluoroquinolone antibiotics
Ear drops
Zymaxid
Gatifloxacin
Fluoroquinolone antibiotics
Eye drops
Baxdela
Delafloxacin
Fluoroquinolone antibiotics (active against MRSA)
Tablet, Injection
PO: 450 mg Q12H, IV: 300 mg Q12H
Renal adj: CrCl 15-29 IV only with ↓ dose, CrCl<15 not recommended
BB: Tendon inflammation/rupture (often Achille tendon) within hours/days of starting or up to several months after completion of tx (↑ risk if concurrent use of systemic steroids, organ transplant patient, age > 60) => D/C immediately if Sx occur
Peripheral neuropathy, can last months to years after the drug D/C and may become permanent =>D/C immediately if Sx occur, CNS effects (seizure, tremor, restlessness, confusion, hallucination, depression and suicidal thoughts, paranoia, nightmares, insomnia, ↑ intracranial pressure including pseudotumor cerebri) => use with caution in CNS disorder or drugs cause seizures, Avoid in patients with myasthenia gravis (↑ muscle weakness), Last line only for acute bacterial sinusitis, acute exacerbation of chronic bronchitis, uncomplicated UTI
CI: Ciprofloxacine: concurrent association of tizanidine
Warnings: QT prolongation (> moxifloxacin) => avoid in pt with known QT prolongation, or hypokalemia, other drugs with QT prolongation including class Ia and III antiarrhythmic, Hypo and hyperglycemia, Psychiatric disturbance: agitation, disorientation, lack of attention, nervousness, memory impairment, delirium, Avoid systemic quinolones in children, risk of musculoskeletal toxicity (except for anthrax where the benefit > risk), Photosensitivity / phototoxicity, hepatotoxicity, crystalluria (drink to stay hydrated)
SE: N/D, HA, dizziness, serious skin reaction (SJS/TEN)
Factive
Gemifloxacin
Fluoroquinolone antibiotics
Tablet
PO: 320 mg QD
Reanl adj: CrCl≤40
BB: Tendon inflammation/rupture (often Achille tendon) within hours/days of starting or up to several months after completion of tx (↑ risk if concurrent use of systemic steroids, organ transplant patient, age > 60) => D/C immediately if Sx occur
Peripheral neuropathy, can last months to years after the drug D/C and may become permanent =>D/C immediately if Sx occur, CNS effects (seizure, tremor, restlessness, confusion, hallucination, depression and suicidal thoughts, paranoia, nightmares, insomnia, ↑ intracranial pressure including pseudotumor cerebri) => use with caution in CNS disorder or drugs cause seizures, Avoid in patients with myasthenia gravis (↑ muscle weakness), Last line only for acute bacterial sinusitis, acute exacerbation of chronic bronchitis, uncomplicated UTI
CI: Ciprofloxacine: concurrent association of tizanidine
Warnings: QT prolongation (> moxifloxacin) => avoid in pt with known QT prolongation, or hypokalemia, other drugs with QT prolongation including class Ia and III antiarrhythmic, Hypo and hyperglycemia, Psychiatric disturbance: agitation, disorientation, lack of attention, nervousness, memory impairment, delirium, Avoid systemic quinolones in children, risk of musculoskeletal toxicity (except for anthrax where the benefit > risk), Photosensitivity / phototoxicity, hepatotoxicity, crystalluria (drink to stay hydrated)
SE: N/D, HA, dizziness, serious skin reaction (SJS/TEN)
Levaquin
Levofloxacine
Fluoroquinolone antibiotics
Tablet, Suspension, Injection, Eye drop
PO/IV: 250-750 mg QD
reanl adj: CrCl<50 Q48H and ↓ dose according to indication and renal fct
BB: Tendon inflammation/rupture (often Achille tendon) within hours/days of starting or up to several months after completion of tx (↑ risk if concurrent use of systemic steroids, organ transplant patient, age > 60) => D/C immediately if Sx occur
Peripheral neuropathy, can last months to years after the drug D/C and may become permanent =>D/C immediately if Sx occur, CNS effects (seizure, tremor, restlessness, confusion, hallucination, depression and suicidal thoughts, paranoia, nightmares, insomnia, ↑ intracranial pressure including pseudotumor cerebri) => use with caution in CNS disorder or drugs cause seizures, Avoid in patients with myasthenia gravis (↑ muscle weakness), Last line only for acute bacterial sinusitis, acute exacerbation of chronic bronchitis, uncomplicated UTI
CI: Ciprofloxacine: concurrent association of tizanidine
Warnings: QT prolongation (> moxifloxacin) => avoid in pt with known QT prolongation, or hypokalemia, other drugs with QT prolongation including class Ia and III antiarrhythmic, Hypo and hyperglycemia, Psychiatric disturbance: agitation, disorientation, lack of attention, nervousness, memory impairment, delirium, Avoid systemic quinolones in children, risk of musculoskeletal toxicity (except for anthrax where the benefit > risk), Photosensitivity / phototoxicity, hepatotoxicity, crystalluria (drink to stay hydrated)
SE: N/D, HA, dizziness, serious skin reaction (SJS/TEN)
Moxega
Moxifloxacin
Fluoroquinolone antibiotics
Eye drops
Vigamox
Moxifloxacin
Fluoroquinolone antibiotics
Eye drops
Avelox
Moxifloxacin
Fluoroquinolone antibiotics
Tablet, Injection
PO/IV: 400 mg QD
No renal adj
BB: Tendon inflammation/rupture (often Achille tendon) within hours/days of starting or up to several months after completion of tx (↑ risk if concurrent use of systemic steroids, organ transplant patient, age > 60) => D/C immediately if Sx occur
Peripheral neuropathy, can last months to years after the drug D/C and may become permanent =>D/C immediately if Sx occur, CNS effects (seizure, tremor, restlessness, confusion, hallucination, depression and suicidal thoughts, paranoia, nightmares, insomnia, ↑ intracranial pressure including pseudotumor cerebri) => use with caution in CNS disorder or drugs cause seizures, Avoid in patients with myasthenia gravis (↑ muscle weakness), Last line only for acute bacterial sinusitis, acute exacerbation of chronic bronchitis, uncomplicated UTI
CI: Ciprofloxacine: concurrent association of tizanidine
Warnings: QT prolongation (> moxifloxacin) => avoid in pt with known QT prolongation, or hypokalemia, other drugs with QT prolongation including class Ia and III antiarrhythmic, Hypo and hyperglycemia, Psychiatric disturbance: agitation, disorientation, lack of attention, nervousness, memory impairment, delirium, Avoid systemic quinolones in children, risk of musculoskeletal toxicity (except for anthrax where the benefit > risk), Photosensitivity / phototoxicity, hepatotoxicity, crystalluria (drink to stay hydrated)
SE: N/D, HA, dizziness, serious skin reaction (SJS/TEN)
Ocuflox
Ocuflox
Fluoroquinolone antibiotics
Eye drop
Klonopin
Clonazepam
BZD for short term anxiety
Tranxene-T
Clorazepam
BZD for anxiety
Vistaril
Hydroxyzine
Antihistamine for anxiety
Lunesta
Eszopiclone
Non-BZD for sleep disorder
C-IV
Ativan
Lorazepam
BZD for anxiety (elderly LOT)
Also used as agitation/sedation agent in ICU
BB: Used with opioid can result in sedation, respiratory depression, coma, and death
CI: Acute narrow angle glaucoma, sleep apnea, severe respiratory insufficiency, severe liver dx (clonazepam, diazepam), myasthenia gravis (diazepam), not for use in infants < 6 months (diazepam oral), premature infants (lorazepam parenteral products)
Warnings: Physiological dependence and tolerance develop with chronic use => do not D/C abruptly (taper slowly)
CNS depression, retrograde amnesia, potential for abuse, safety risks in patients ≥ 65 yo (impaired cognition, delirium, falls/fractures), extravasation with IV use, paradoxical reaction, severe renal and hepatic impairment
Pregnancy: cross placenta and cause birth defects and neonatal withdrawal syndrome
SE: Somnolence, dizziness, ataxia, weakness, lightheadedness
Injection formulated in propylene glycol => 1 mg/kg/day can cause propylene glycol toxicity (AKI and metabolic acidosis)
Monitor BP, HR, RR, sedation scale, Sx propylene glycol toxicity (BUN, SCr, lactate, anion gap) if receiving continuous infusion, limit use for delirium
C IV
Diazepam: lipophilic, fast onset, long t1/2, high abuse potential
Alprazolam: fast onset, often abuse due to quick action
Commonly used for alcohol withdrawal syndrome: lorazepam, diazepam, chlordiazepoxide
Antidote = flumazenil
Sonata
Zaleplon
Non-BZD for sleep disorder
C-IV
Ambien
Zolpidem
Non-BZD for sleep disorder
C-IV
Zolpimist
Zolpidem
Non-BZD for sleep disorder
Spray
C-IV
Edluar
Zolpidem
Non-BZD for sleep disorder
C-IV
Intermetzzo
Zolpidem
Non-BZD for sleep disorder
C-IV
Belsomra
Suvorexant
Orexin receptor antagonist
C-IV
Rozerem
Ramelteon
Melatonin receptor antagonist for sleep disorder
Silenor
Doxepin
Antidepressant used in sleep disorder
Restoril
Temazepam
BZD for sleep disorder
C-IV
Doral
Quazepam
BZD for sleep disorder
C-IV
Halcion
Triazolam
BZD for sleep disorder
C-IV
Benadryl
Diphenhydramine
Antihistamine for sleep disorder
Sleep Aid
Doxylamine
Antihistamine for sleep disorder
Provigil
Modafinil
Stimulant used in narcolepsy
C-IV
Nuvigil
Armodafinil
Stimulant used in narcolepsy
C-IV
Xyrem
Sodium oxybate
Derived from GABA used in narcolepsy with cataplexy
C-III
HyperSal
Hypertonic saline solution
Use in nebulizer for CF
PulmoSal
Hypertonic saline solution
Used in nebulizer for CF
Pulmozyme
Dornase alfa
Used in CF to thin the mucus
Toposar
Etoposide IV
Topoisomerase II inhibitor
Poor solubility (Max 0.4 mg/ml)
Etopophos
Etoposide phosphate
Topoisomerase II inhibitor
For concentration above 0.4 mg/ml
VePesid
Etoposide capsules
Topoisomerase II inhibitor
IV:PO ratio 1:2
Store in the fridge
Adrucil
Fluorouracil (5-FU)
Pyrimidine analog antimetabolite
DPD (dihydropyrimidine dehydrogenase) deficiency increases toxicity
Xeloda
Capecitabine
Oral prodrug of fluorouracil
Pyrimidine analog antimetabolite
DPD (dihydropyrimidine dehydrogenase) deficiency increases toxicity
DepoCyt
Cytarabine liposomal
Pyrimidine analog antimetabolite
Gemzar
Gemcitabine
Pyrimidine analog antimetabolite
Alimata
Pemetrexed
Folate antimetabolite
Folotyn
PRALAtrexate
Folate antimetabolite
Absorica
Isotretinoin
Vitamin A derivative use in severe acne
Amnesteem
Isotretinoin
Vitamin A derivative used for severe acne
Claravis
Isotretinoin
Vitamin A derivative used for severe acne
Myorisan
Isotretinoin
Vitamin A derivative used for severe acne
Vincasar PFS
Vincristin
Vinka alkaloid agent used in chemotherapy
IV administration only (intrathecal = fatal)
Marqibo
Vincristine liposomal
Vinca alkaloid used in chemotherapy
IV administration only (intrathecal = fatal)
Gardasil 9
HPV vaccine
Cervical, vaginal, oropharyngeal cancer, genital warts
2 doses before 15 yo (0; 6-12 months later) and 3 doses after 15 yo (0; 1-2; 6 months later)
Navelbine
Vinorelbine
Vinka alkaloid for chemotherapy
IV administration only (intrathecal = fatal)
Lioresal
Baclofen
Myorelaxant (antispasmodic with analgesic effect)
Tablet, injection
5-20 mg TID PRN
BB: abrupt withdrawal, intratechal administration (organ failure and death)
SE: excessive sedation, dizziness, confusion
Felxmid
Cyclobenzaprine Myorelaxant (antispasmodic with analgesic effect) Tablet IR 5-10 mg TID PRN SE: dry mouth
Amrix ER
Cyclobenzaprine Myorelaxant (antispasmodic with analgesic effect) Capsule ER 15-30 mg once daily SE: dry mouth
Flexeril
Cyclobenzaprine Myorelaxant (antispasmodic with analgesic effect) Tablet IR 5-10 mg TID PRN SE: dry mouth
Soma
Carisoprodol
Myorelaxant (antispasmodic with sedative activity)
C-IV
250-350 mg QID PRN
Metabolize by 2C19 / active metabolite = meprobamate
Skelaxin
Metaxalone
Myorelaxant (antispasmodic with sedative effects)
800 mg TID PRN
SE: Hepatotoxic
Zanaflex
Tizanidine Myorelaxant (antispasmodic with analgesic effect) Tablet, capsule 2-4 mg TID PRN SE: hypotension, dry mouth, weakness
Robaxin
Methocarbamol
Myorelaxant (antispasmodic with sedative effects)
1500-2000 mg QID PRN
SE: hypotension
Nitropress
Nitroprusside
Used in acute care for uncontrolled hypertension, mixed venous and arterial vasodilation
Do not use in acute MI, coronary steal (↓ blood fow in coronary arteries)
BB: degradation in cyanide, excessive hypotension, must be diluted before injection (preferably in D5W)
Warning: ↑ ICP
SE: HA, tachycardia, thiocyanate/cyanide toxicity (> renal/hepatic impairment)
Monitoring: BP (continuous), HR, renal/hepatic function, urine output , thiocyanate/ cyanide toxicity, acid-base status, venous oxygen concentration
Protect from light during administration
Use only clear solution, if discolored blue (cyanide degradation), do not use
Nitroprusside degradation in cyanide/thiocyanate
- Cyanide toxicity antidote: sodium thiosulfate
- Thiocyanate toxicity antidote: hyrdroxocobalamine
Faslodex
Fluvestrant
SERM used in breast cancer
500 mg IM day1, day15, day29 then monthly
SE: DVT/PE, menopausal symptoms, hot flashes, flushing, edema, weight gain, hypertension, mood changes, amenorrhea, vaginal bleeding/discharge
Not recommended in pregnancy and breast feeding
Fareston
Toremifene
SERM used in breast cancer
60 mg PO QD
BB: QT prolongation
CI: QT prolongation, hypokalemia, hypomagnesemia
SE: DVT/PE, menopausal symptoms, hot flashes, flushing, edema, weight gain, hypertension, mood changes, amenorrhea, vaginal bleeding/discharge
Not recommended in pregnancy and breast feeding
Toremifene offers an alternative if slow 2D6 metabolizer or drug interactions
Nipride
Nitroprusside
Used in acute care for uncontrolled hypertension, mixed venous and arterial vasodilation, not in acute MI because coronary steal (↓ blood flow in coronary arteries)
BB: Metabolism produce cyanide, excessive hypotension (BP monitoring)
Must be diluted before injection (preferably in D5W)
Warning: ↑ ICP
SE: HA, tachycardia, thiocyanate/cyanide toxicity (> renal/ hepatic impairment)
Monitoring: BP (continuous), HR, renal/hepatic function, urine output , thiocyanate/ cyanide toxicity, acid-base status, venous oxygen concentration
Protect from light during administration, use only clear solution, if discolored blue (cyanide degradation), do not use
Nitroprusside degradation in cyanide/thiocyanate
- Cyanide toxicity antidote: sodium thiosulfate
- Thiocyanate toxicity antidote: hyrdroxocobalamine
Estrace
17-Beta-estradiol
Topical hormone therapies or Systemic Hormone Therapies
Vaginal cream or Oral tablet micronized
Evista
Raloxifene
SERM used for prophylaxis of breast cancer, not tx / used in Ox and Tx of postmenopausal women with osteoporosis
60 mg PO QD
BB: ↑ risk of thromboembolic events such as VTE, PE, stroke
CI: hx of DVT/PE, pregnancy and breast feeding
SE: DVT/PE, menopausal symptoms, hot flashes, flushing, edema, weight gain, hypertension, mood changes, amenorrhea, vaginal bleeding/discharge, Muscle spams / cramps, Arthralgia, Flu Sx, Infections
Not recommended in pregnancy and breast feeding
Separate raloxifene and levothyroxine by several hours
Discontinue 72 hours prior to and during prolonged immobilization
Estring
17-Beta-estradiol
Topical hormone therapies
Vaginal ring
Vagifem
17-Beta-estradiol
Topical hormone therapies
Vaginal tablet
Imvexxy
17-Beta-estradiol
Topical hormone therapies
Vaginal insert
Premarin
Conjugated equine estrogens
Topical hormone therapies or Systemic Hormone Therapies
Vaginal cream / Oral tablet / Injection
Elestrin
Estradiol
Systemic Hormone Therapies
Topical gel
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Alora
Estradiol
Systemic Hormone Therapies
Transdermal patch
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression, Nausea, abdominal pain
Climara
Estradiol
Systemic Hormone Therapies
Transdermal patch
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Vivelle-Dot
Estradiol
Systemic Hormone Therapies
Transdermal patch applied twice weekly
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Menostar
Estradiol
Systemic Hormone Therapies
Transdermal patch
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression, Nausea, abdominal pain
Minivelle
Estradiol
Systemic Hormone Therapies
Transdermal patch
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Femring
Estradiol
Systemic Hormone Therapies
Vaginal ring
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Prempro
Conjugated equine estrogens + medroxyprogesterone
Systemic Hormone Therapies
Oral tablet
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Premphase
Conjugated equine estrogens + medroxyprogesterone
Systemic Hormone Therapies
Oral tablet
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Provera
Medroxyprogesterone
Systemic Hormone Therapies
Oral tablet
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Prometrium
Micronized progesterone
Systemic Hormone Therapies
Oral tablet
BB: Endometrial cancer, Dementia, VTE, Breast cancer
CI: Breast cancer, VTE or coagulopathy dx, Uterine bleeding, Hepatic impairment, Pregnancy
Warnings: Breast cancer, ovarian cancer, Retinal vascular thrombosis, Lipid effect (↑ HDL, TG, ↓LDL)
SE: Edema, Hypertension, HA, Weight gain, depression
Nausea, abdominal pain
Boniva injection
Ibandronic acid Bisphosphonate used in osteoporosis Injection (over 15-30 sec) Tx: 3 mg IV every 3 months CI: Hypocalcemia Warnings: See oral bisphosphonates (except GI issues), Renal impairment => monitor SCr before each injection, caution in dehydrated pt, with comorbidities, taking other nephrotoxic medications, not in CrCl < 30 SE: See oral bisphosphonate (except esophageal SE) Flu-like symptoms
Miacalcin
Calcitonin
For osteoporosis last line therapy
Nasal spray: 1 spray (200 U) in one nostril QD (alternate nostril)
Injection: SC/IM: 100 U QD
CI: Allergy to calcitonin salmon
Warnings: Hypocalcemia with tetany and seizure, Anaphylactic reaction with angioedema, Cancer with LT use, Nasal reaction => nasal exam recommended
SE: Backpain, myalgia, Nausea, dizziness, Injection reaction, nose bleeding (epistaxis)
Keep refrigerated (injection and unopened nasal spray)
Forteo
Teriparatide
PTH analogue for osteoporosis
Injection
SC 20 mg QD
BB: Bone cancer (bone cancer) with LT use (rats studies)
CI: Bone cancer or bone metabolic dx
Warnings: Hypercalcemia, use carefully when urolithiasis, Orthostatic hypotension
SE: Arthralgia, cramp, pain, Nausea, orthostasis, dizziness
Only when high risk of fracture since LT use CI (max 2 years)
Keep in the fridge, requires protection from light
Tymlos
Abaloparatide
PTH analogue for osteoporosis
Injection
SC 80 mg QD
BB: Bone cancer (bone cancer) with LT use (rats studies)
CI: Bone cancer or bone metabolic dx
Warnings: Hypercalcemia, use carefully when urolithiasis, Orthostatic hypotension
SE: Arthralgia, cramp, pain, Nausea, orthostasis, dizziness, ↑uric acid, antibody development, erythema at injection site (58%)
Only when high risk of fracture since LT use CI (max 2 years)
Keep in the fridge
Prolia
Denosumab
RANKL used in osteoporosis (last line)
SC 60 mg every 6 months for postmenopausal women or men
CI: Hypocalcemia (must be corrected before Tx), Pregnancy
Warnings: Osteonecrosis of the jaw, Hypocalcemia, Atypical fracture, Serious infection
SE: Hypertension, fatigue, edema, dyspnea, HA, N/V/D, ↓ PO4
Norvasc
Amlodipine CCB (DHP) used in HTN Talets 2.5-10 mg QD Warnings: Hypotension (especially in patients with severe aortic stenosis); worsening angina and/or MI has occurred with initiation or dosage titration (reflex tachycardia); severe hepatic impairment (start low and titrate slowly); use caution in HF SE: Peripheral edema, flushing, HA, palpitation/tachycardia, gingival hyperplasia, dizziness, fatigue Monitoring: BP, HR, peripheral edema Amlodipine = safest for ↓ BP in HFrEF
Adalat CC
Nifedipine ER
CCB (DHP) used in HTN
ER Talets
30-90 mg QD
Warnings: Hypotension (especially in patients with severe aortic stenosis); worsening angina and/or MI has occurred with initiation or dosage titration (reflex tachycardia); severe hepatic impairment (start low and titrate slowly); use caution in HF
SE: Peripheral edema, flushing, HA, palpitation/tachycardia, gingival hyperplasia, dizziness, fatigue
Monitoring: BP, HR, peripheral edema
Nifedipine ER drug of choice in pregnancy
Adalat CC, Procardia XL OROS => ghost tablet
Procardia XL
Nifedipine ER
CCB (DHP) used in HTN
ER Talets
30-90 mg QD
Warnings: Hypotension (especially in patients with severe aortic stenosis); worsening angina and/or MI has occurred with initiation or dosage titration (reflex tachycardia); severe hepatic impairment (start low and titrate slowly); use caution in HF
SE: Peripheral edema, flushing, HA, palpitation/tachycardia, gingival hyperplasia, dizziness, fatigue
Monitoring: BP, HR, peripheral edema
Nifedipine ER drug of choice in pregnancy
Adalat CC, Procardia XL OROS => ghost tablet
Afeditab CR
Nifedipine ER
CCB (DHP) used in HTN
ER Talets
30-90 mg QD
Warnings: Hypotension (especially in patients with severe aortic stenosis); worsening angina and/or MI has occurred with initiation or dosage titration (reflex tachycardia); severe hepatic impairment (start low and titrate slowly); use caution in HF
SE: Peripheral edema, flushing, HA, palpitation/tachycardia, gingival hyperplasia, dizziness, fatigue
Monitoring: BP, HR, peripheral edema
Nifedipine ER drug of choice in pregnancy
Adalat CC, Procardia XL OROS => ghost tablet
Sular
Nisoldipine ER
CCB (DHP) used in HTN
ER Talets
8.5-34 mg QD
Warnings: Hypotension (especially in patients with severe aortic stenosis); worsening angina and/or MI has occurred with initiation or dosage titration (reflex tachycardia); severe hepatic impairment (start low and titrate slowly); use caution in HF
SE: Peripheral edema, flushing, HA, palpitation/tachycardia, gingival hyperplasia, dizziness, fatigue
Monitoring: BP, HR, peripheral edema
Cardene IV
Nicardipin IV
CCB (DHP) used in HTN
Injection
5 mg/h, ↑ by 2.5 mg/h every 5-15 min up to max 15 mg/h
Warnings: Hypotension (especially in patients with severe aortic stenosis); worsening angina and/or MI has occurred with initiation or dosage titration (reflex tachycardia); severe hepatic impairment (start low and titrate slowly); use caution in HF
SE: Peripheral edema, flushing, HA, palpitation/tachycardia, gingival hyperplasia, dizziness, fatigue
Monitoring: BP, HR, peripheral edema
Cleviprex
Clevidipine
CCB (DHP) used in HTN
Injection
1-21 mg/h
CI: Allergy to soybeans, soy products, or eggs; effective lipid metabolism (lipoid nephrosis, HDL with acute pancreatitis), severe aortic stenosis
Warnings: Hypotension; reflex tachycardia, hypertriglyceridemia, infections
SE: HA, atrial fibrillation, nausea, fever
Monitoring: BP, HR
Lipid emulsion (2 kcal/ml), milky-white
Use strict aseptic technique, maximum time of use after vial puncture = 12h
AndroGel
Testosterone gel 1%,1.62% used in hypogonadism Tx
1% applied QAM on upper arms, shoulders and abdomen
1.62% applied daily on upper arms, shoulders
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Volgelxo
Testosterone gel 1% used in hypogonadism Tx
QAM upper arms, shoulders
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: ↑ Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Testim
Testosterone gel 1% used in hypogonadism Tx
QAM upper arms, shoulders
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Fortesta
Testosterone gel 2% used in hypogonadism Tx
QAM tighs
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Natesto
Testosterone nasal gel used in hypogonadism Tx
1 spray per nostril TID
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea, nasal irritation
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Androderm
Testosterone transdermal patches used in hypogonadism Tx
2 mg, 4 mg: on upper arm, abdomen, thighs, back each night
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea, skin irritation
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
do not apply 2x2mg to reach the 4 mg dose
remove before MRI
Striant
Testosterone buccal tabs used in hypogonadism Tx
30 mg BID (gum region)
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea, buccal irritation
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Testopel
Testosterone implantable pellets (SC) used in hypogonadism Tx
SC every 3-6 months
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Depo-testosterone
Testosterone cypionate IM injection
Used in hypogonadism Tx
IM every 4 weeks (2 doses) then every 10 weeks
BB: Secondary child exposure
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer, cardiac, hepatic, renal dx
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Aveed
Testosterone undecanoate IM injection
Used in hypogonadism Tx
IM every 2- weeks
BB: Secondary child exposure, POME (pulmonary oil microembolism, life-threatening, require observation for 30 minutes after injection
CI: Breast cancer, breastfeeding, pregnancy, prostate cancer, allergy to castor oil or benzyl benzoate
Warnings: Risk breast cancer, prostate cancer, priapism, gynecomastia, VTE, cardiac event, dyslipidemia, liver dx, worsen BPH
SE: Appetite, Scr, sensitive nipples, acne, edema, hepatotoxicity, reduced sperm count, sleep apnea
Monitoring: Testosterone, PSA, liver fct, cholesterol, hematocrit for some products
Cardizem
Diltiazem
CCB non-DHP used in HTN
Tablet (IR, ER), Capsule (ER 12h/ER 24hr), Injection
120-360 mg QD, IR: divided in 4, ER: divided BID (12h) or QD
CI: Hypotension (SBP<90 mmHg) or cardiogenic shock; 2nd or 3rd degree AV block or sick sinus syndrome (unless patient has a functioning artificial pacemaker); acute MI and pulmonary congestion
Warnings: Hypotension, HF (may worsen Sx), bradycardia, AV block, ↑ LFT
SE: Edema, constipation, (>verapamil), gingival hyperplasia, HA, dizziness
Monitoring: BP, HR. ECG, LFT
IV:PO conversion 1:1
Cartia XT
Diltiazem
CCB non-DHP used in HTN
CI: Hypotension (SBP<90 mmHg) or cardiogenic shock; 2nd or 3rd degree AV block or sick sinus syndrome (unless patient has a functioning artificial pacemaker); acute MI and pulmonary congestion
Warnings: Hypotension, HF (may worsen Sx), bradycardia, AV block, ↑ LFT
SE: Edema, constipation, (>verapamil), gingival hyperplasia, HA, dizziness
Monitoring: BP, HR. ECG, LFT
Calan
Verapamil
CCB non-DHP used in HTN
Tablet, Capsule, Injection
240-480 mg QD, IR: TID, SR: BID
CI: Hypotension (SBP<90 mmHg) or cardiogenic shock; 2nd or 3rd degree AV block or sick sinus syndrome (unless patient has a functioning artificial pacemaker); acute MI and pulmonary congestion
Warnings: Hypotension, HF (may worsen Sx), bradycardia, AV block, ↑ LFT
SE: Edema, constipation (>verapamil), gingival hyperplasia, HA, dizziness
Monitoring: BP, HR. ECG, LFT
IV:PO conversion 1:1
Verelan
Verapamil
CCB non-DHP used in HTN
240-480 mg QD
CI: Hypotension (SBP<90 mmHg) or cardiogenic shock; 2nd or 3rd degree AV block or sick sinus syndrome (unless patient has a functioning artificial pacemaker); acute MI and pulmonary congestion
Warnings: Hypotension, HF (may worsen Sx), bradycardia, AV block, ↑ LFT
SE: Edema, constipation, (>verapamil), gingival hyperplasia, HA, dizziness
Monitoring: BP, HR. ECG, LFT
Tiazac
Diltiazem
CCB non-DHP used in HTN
ER capsules
120 - 360 mg QD
CI: Hypotension (SBP<90 mmHg) or cardiogenic shock; 2nd or 3rd degree AV block or sick sinus syndrome (unless patient has a functioning artificial pacemaker); acute MI and pulmonary congestion
Warnings: Hypotension, HF (may worsen Sx), bradycardia, AV block, ↑ LFT
SE: Edema, constipation, (>verapamil), gingival hyperplasia, HA, dizziness
Monitoring: BP, HR. ECG, LFT
Lotensin
Benazepril
ACEI used in HTN
5-40 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Vasotec
Enalapril
ACEI used in HTN
PO: 5-20 mg QD or BID, IV: 0.625-5 mg Q6H
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Epaned
Enalapril
ACEI used in HTN
Powder for oral solution
PO: 5-20 mg QD or BID
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Prinivil
Lisinopril
ACEI used in HTN
5-40 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Zestril
Lisinopril
ACEI used in HTN
5-40 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Qbrelis
Lisinopril oral solution
ACEI used in HTN
5-40 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Accupril
Quinapril
ACEI used in HTN
5-40 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Altace
Ramipril
ACEI used in HTN
2.5-20 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes, Within 36 hrs with entresto
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitoring: BP, K, renal function, Sx of angioedema
Lipitor
Atorvastatin
HMG-CoA reductase for hypercholesterolemia
10-80 mg
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Pravachol
Pravastatin
HMG-CoA reductase for hypercholesterolemia
10-80 mg
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Crestor
Rosuvastatin
HMG-CoA reductase for hypercholesterolemia
5-40 mg
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Zocor
Simvastatin
HMG-CoA reductase for hypercholesterolemia
10-40 mg QPM
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Altoprev
Lovastatin
HMG-CoA reductase for hypercholesterolemia
20-80 mg QPM
CI: Liver dx, Pregnancy, breastfeeding, CYP3A4 inhibitors (Simvastatin, lovastatin), Cyclosporine (pitavastatin)
Warnings: Rhabdomyolisis (higher with dose, age, inhibitors, renal impairment, hypothyroidism), Hepatotoxicity, Hyperglycemia (↑A1C, FBG)
SE: Muscle pain, Diarrhea, Cognitive impairment
Monitoring: LFT, Lipid panel every 3 months then every year
Zetia
Ezetimibe
Hypercholesterolemia (inhibit cholesterol absorption in the gut)
10 mg QD
CI: active liver dx (including unexplained ↑ LFT), pregnancy, breastfeeding
Warnings: Avoid use in moderate or severe hepatic impairment, Skeletal muscle effects (eg myopathy, rhabdomolysis), ↑ risk when used with statin
SE: Myalgia, diarrhea, URTI, arthralgia, pain in extremities, sinusitis
Monitoring: When used with a stain or fibrate, LFT at baseline and as clinically indicated thereafter
Niacor
Niacin IR
Hypercholesterolemia
250 mg with evening meal, Max 3 g QD in 3 divided doses, Titrate every week
CI: Active liver dx, active PUD, arterial bleeding
Warnings: Caution in patient with unstable angina or in acute phase of MI, Rhabdomyolysis with niacin ≥ 1g/day combined with statin, Hepatotoxicity
SE: Flushing, pruritus, N/V/D, ↑ BG, hyperuricemia, cough, orthostatic hypotension, hypophosphatemia, ↓ platelets
Monitoring: LFT baseline, every 3 months the 1st year, every 6 months thereafter, If diabetes, BG, If gout, uric acid, If warfarin, INR, Lipid profile
IR poor tolerability due to flushing/itching (Niacor), CR/SR a bit less flushing but more hepatotoxic (Slo-Niacin), ER Niaspan (Niaspan) = best clinical choice but more expensive
↓ flushing by taking 325 mg of aspirin (or ibuprofen 200 mg) 30 to 60 min before niacin, take niacin with food (avoid spicy and hot beverages)
Flush free niacin, niacinamide, or nicotinamide are not effective
Niaspan
Niacin ER
Hypercholesterolemia
500 mg before bed for 4 weeks, Max 2 g QD
CI: Active liver dx, active PUD, arterial bleeding
Warnings: Caution in patient with unstable angina or in acute phase of MI, Rhabdomyolysis with niacin ≥ 1g/day combined with statin, Hepatotoxicity
SE: Flushing, pruritus, N/V/D, ↑ BG, hyperuricemia, cough, orthostatic hypotension, hypophosphatemia, ↓ platelets
Monitoring: LFT baseline, every 3 months the 1st year, every 6 months thereafter, If diabetes, BG, If gout, uric acid, If warfarin, INR, Lipid profile
IR poor tolerability due to flushing/itching (Niacor), CR/SR a bit less flushing but more hepatotoxic (Slo-Niacin), ER Niaspan (Niaspan) = best clinical choice but more expensive
↓ flushing by taking 325 mg of aspirin (or ibuprofen 200 mg) 30 to 60 min before niacin, take niacin with food (avoid spicy and hot beverages)
Flush free niacin, niacinamide, or nicotinamide are not effective
Slo-Niacin
Niacin CR or SR
250-750 mg QD
CI: Active liver dx, active PUD, arterial bleeding
Warnings: Caution in patient with unstable angina or in acute phase of MI, Rhabdomyolysis with niacin ≥ 1g/day combined with statin, Hepatotoxicity
SE: Flushing, pruritus, N/V/D, ↑ BG, hyperuricemia, cough, orthostatic hypotension, hypophosphatemia, ↓ platelets
Monitoring: LFT baseline, every 3 months the 1st year, every 6 months thereafter, If diabetes, BG, If gout, uric acid, If warfarin, INR, Lipid profile
IR poor tolerability due to flushing/itching (Niacor), CR/SR a bit less flushing but more hepatotoxic (Slo-Niacin), ER Niaspan (Niaspan) = best clinical choice but more expensive
↓ flushing by taking 325 mg of aspirin (or ibuprofen 200 mg) 30 to 60 min before niacin, take niacin with food (avoid spicy and hot beverages)
Flush free niacin, niacinamide, or nicotinamide are not effective
Lovaza
Omega-3 acid ethyl ester
Fish oil for hypertriglyceridemia
1 g capsule = 465 g eicosapentaenoic (EPA) acid and 375 m docosahexaenoic acid (DHA)
4 capsules QD, 2 capsules BID
Warnings: Caution if known hypersensitivity to fish or shellfish, Lovaza, Epanova: ↑ LDL (monitor), Monitor LFT and LDL periodically during therapy, Possible association between Lovaza and Atrial fibrillation or flutter during the 1st month of therapy in patient with paroxysmal or persistent atrial fibrillation
SE: Eructation, dyspepsia, taste perversion (Lovaza, Epanova), Arthralgia (Vascepa), Vomiting, flatulence (Epanova)
Many OTC with omega-3 fatty acid but only Lovaza, Epanova, Vascepa approved by FDA in addition to diet for TG ≥ 500 mg/dl
Stop before surgery, ↑ risk of bleeding
Vascepa
Icosapent ethyl
Fish oil for hypertriglyceridemia
0.5 or 1 g of icosapent ethyl = ethyl ester of Omega-3 fatty acid EPA
0.5 g capsules: 4 BID with food, 1g capsules: 2 BID with food
Warnings: Caution if known hypersensitivity to fish or shellfish
Lovaza, Epanova: ↑ LDL (monitor)
Monitor LFT and LDL periodically during therapy
Possible association between Lovaza and Atrial fibrillation or flutter during the 1st month of therapy in patient with paroxysmal or persistent atrial fibrillation
SE: Eructation, dyspepsia, taste perversion (Lovaza, Epanova), Arthralgia (Vascepa), Vomiting, flatulence (Epanova)
Many OTC with omega-3 fatty acid but only Lovaza, Epanova, Vascepa approved by FDA in addition to diet for TG ≥ 500 mg/dl
Stop before surgery, ↑ risk of bleeding
Epanova
Omega-3-carboxylic acids
Fish oil for hypertriglyceridemia
1g capsule = 3-carboxylic acids with 850 mg of polyunsaturated fatty acid (mostly EPA +DHA)
2-4 capsules QD
Warnings: Caution if known hypersensitivity to fish or shellfish
Lovaza, Epanova: ↑ LDL (monitor)
Monitor LFT and LDL periodically during therapy
Possible association between Lovaza and Atrial fibrillation or flutter during the 1st month of therapy in patient with paroxysmal or persistent atrial fibrillation
SE: Eructation, dyspepsia, taste perversion (Lovaza, Epanova), Arthralgia (Vascepa), Vomiting, flatulence (Epanova)
Many OTC with omega-3 fatty acid but only Lovaza, Epanova, Vascepa approved by FDA in addition to diet for TG ≥ 500 mg/dl
Stop before surgery, ↑ risk of bleeding
Juxtapid
Lomitapide
For HoFH (homozygous familial hypercholesterolemia)
Capsule
5-60 mg QD, hepatic, renal Dx: dosage adjustment, Take whole, HS without food, at least 2hrs after your evening meal
BB: Hepatotoxicity (↑ LFT, steatosis)
CI: Active liver dx (unexplained ↑ LFT), moderate or sever hepatic impairment, Lomitapide: pregnancy and 3A4 inhibitors
SE: N/V/D, dyspepsia, abdominal pain, constipation, flatulence, ↑ LFT, chest pain, back pain, fatigue, weight loss, influenza, nasopharyngitis, Mipomersen: injection site reaction, flu-like Sx, antibody formation
Monitoring: LFT (including total bilirubin), alkaline phosphatase, lipids
Lomitapide: pregnancy test before tx
Hepatotoxic => available only through REMS program
Interactions with 3A4, Expensive: 433,000-$440,000/year
Kynamro
Mipomersen
For HoFH (homozygous familial hypercholesterolemia)
Prefilled syringe
200 mg SC once weekly
BB: Hepatotoxicity (↑ LFT, steatosis)
CI: Active liver dx (unexplained ↑ LFT), moderate or sever hepatic impairment, Lomitapide: pregnancy and 3A4 inhibitors
SE: N/V/D, dyspepsia, abdominal pain, constipation, flatulence, ↑ LFT, chest pain, back pain, fatigue, weight loss, influenza, nasopharyngitis, Mipomersen: injection site reaction, flu-like Sx, antibody formation
Monitoring: LFT (including total bilirubin), alkaline phosphatase, lipids
Lomitapide: pregnancy test before tx
Hepatotoxic => available only through REMS program
Interactions with 3A4, Expensive: 433,000-$440,000/year
Cancidas
Caspofungin
Antifungal (Echinocandins)
Injection
70 mg day one then 50 mg QD
Hepatic adjustment: 70 mg IV once then 35 mg QD, No renal adj
Warnings: Histamine-mediated symptoms / Allergic reactions (skin, anaphylaxis)
SE: ↑ LFTs, ↑ Scr, Hypotension, ↑ K, Mg, Fever, N/V/D, Hypoglycemia, Rash, severe skin reactions
Monitoring: LFTs
Mycamine
Micafungin
Antifungal (Echinocandins)
Injection
Candidemia: 100 mg IV QD, Esophageal Candidiasis: 150 mg IV QD, No renal adj
Warnings: Histamine-mediated symptoms / Allergic reactions (skin, anaphylaxis)
SE: ↑ LFTs, ↑ Scr, Hypotension, ↑ K, Mg, Fever, N/V/D, Hypoglycemia, Rash, severe skin reactions
Monitoring: LFTs
Ancef
Cefazoline
Cephalosporine 1st generation
1-1.5 grams IV/IM Q8H
CI: Ceftriaxone: hyperbilirubinemic neonates (biliary sludging), concurrent use with Ca-containing IV products in neonates ≤ 28 days old
Warnings: Anaphylaxis/hypersensitivity reaction, Some can ↑ INR with warfarin, Cross sensitivity with PNC allergy (<10%): do not use in patients with type 1 PCN allergy (angioedema, anaphylaxis, swelling), Cefotetan: side chain (N-Methylthiotetrazole, NMTT or 1-MTT) ↑ risk of bleeding and disulfiram-like reaction with alcohol
SE: Seizures (accumulation), GI upset, diarrhea, rash/allergic/anaphylactic reaction, acute interstitial nephritis, myelosuppression with LT use, ↑ LFT, drug fever
Monitoring: Renal fct, Sx anaphylaxy with 1st dose, LFT, CBC
Diflucan
Fluconazole
Azole antifungal
Tablet, Suspension, Injection
50 - 800 mg QD, Vaginal candidiasis: 150 mg PO once
Warnings: Hepatotoxicity, Skin disorder (peeling)
SE: ↑LFTs, QT prolongation, N/V, HA, Rash, ↑TG, ↓ Mg, HTN, Edema, Dizziness, Hair problems (loss, growth, texture change)
Nizoral
Ketoconazole
Azole antifungal
Tablet, Cream, Foam, Gel, Shampoo
200-400 mg PO QD
BB: Hepatotoxicity (Liver transplant / death), Do not use with cisapride, dofetilide, pimozide, quinidine (QT prolongation drugs and torsade de pointe), Oral tablet = last line therapy
Warnings: Hepatotoxicity, Skin disorder (peeling)
SE: ↑LFTs, QT prolongation, N/V, HA, Rash, ↑TG, ↓ Mg, HTN, Edema, Dizziness, Hair problems (loss, growth, texture change)
Ketodan
Ketoconazole
Azole antifungal
BB: Hepatotoxicity (Liver transplant / death), Do not use with cisapride, dofetilide, pimozide, quinidine (QT prolongation drugs and torsade de pointe), Oral tablet = last line therapy
Warnings: Hepatotoxicity, Skin disorder (peeling)
SE: ↑LFTs, QT prolongation, N/V, HA, Rash, ↑TG, ↓ Mg, HTN, Edema, Dizziness, Hair problems (loss, growth, texture change)
Extina
Ketoconazole
Azole antifungal
BB: Hepatotoxicity (Liver transplant / death), Do not use with cisapride, dofetilide, pimozide, quinidine (QT prolongation drugs and torsade de pointe), Oral tablet = last line therapy
Warnings: Hepatotoxicity, Skin disorder (peeling)
SE: ↑LFTs, QT prolongation, N/V, HA, Rash, ↑TG, ↓ Mg, HTN, Edema, Dizziness, Hair problems (loss, growth, texture change)
Xolegel
Ketoconazole
Azole antifungal
BB: Hepatotoxicity (Liver transplant / death), Do not use with cisapride, dofetilide, pimozide, quinidine (QT prolongation drugs and torsade de pointe), Oral tablet = last line therapy
Warnings: Hepatotoxicity, Skin disorder (peeling)
SE: ↑LFTs, QT prolongation, N/V, HA, Rash, ↑TG, ↓ Mg, HTN, Edema, Dizziness, Hair problems (loss, growth, texture change)
Sporanox
Itraconazole
Azole antifungal
Tablet, Capsules
200-400 mg PO QD
BB: Not in cadio pt, Big inhibitor and QT prolongation => not with a lot of drugs
Warnings: Hepatotoxicity, Skin disorder (peeling)
SE: ↑LFTs, QT prolongation, N/V, HA, Rash, ↑TG, ↓ Mg, HTN, Edema, Dizziness, Hair problems (loss, growth, texture change)
Onmel
Itraconazole
Azole antifungal
Solution
BB: Not in cadio pt, Big inhibitor and QT prolongation => not with a lot of drugs
Warnings: Hepatotoxicity, Skin disorder (peeling)
SE: ↑LFTs, QT prolongation, N/V, HA, Rash, ↑TG, ↓ Mg, HTN, Edema, Dizziness, Hair problems (loss, growth, texture change)
Vfend
Voriconazole
Azole antifungal
Tablet, Suspension, Injection
Loading dose: 6 mg/kg Q12H (2 doses), Maintenance dose: 4 mg/kg Q12H or 400 mg PO Q12H
Trough level:1-5 mcg/mL
CrCl<50: PO preferred bcz less nephrotoxic (excipient of injection form)(loading dose IV maintenance dose PO)
CI: Not with barbiturates, carbamazepine, efavirenz, ergot alkaloids, pimozide, quinidine, rifabutin, rifampin, ritonavir, sirolimus, St John’s wort
Warnings: Hepatotoxicity, visual disturbance (optic neuritis)(caution when driving), QT prolongation, phototoxicity (avoid sunlight), skin reactions, infusion-related reaction, embryotoxcity
SE: Visual change,↑ LFTs,↑ SCr, CNS toxicity (hallucination, dizziness, HA)
Monitoring: LFTs, SCr, Electrolytes, Visual function, Through concentration (therapeutic range = through levels1-5 mcg/ml)
Noxafil
Posaconazole
Azole antifungal
Tablet, Suspension, injection
Suspension: 200 mg TID or 400 mg BID, Tablet: 300 mg PO BID day 1 after QD, Injection: 300 mg BID day 1 after QD
CrCl<50: PO preferred bcz less nephrotoxic (excipient of injection form)(loading dose IV maintenance dose PO)
CI: Sirolimus (↑sirolimus level 9x),Ergot alkaloid(higher risk of vasoconstriction), CYP3A4 substrate (Higher risk of QT prolongation): pimozide, quinidine, atorvastatin, lovastatin, simvastatin
Warnings: QT prolongation
SE: N/V/D, Fever,HA
Monitoring: LFT, renal function, electrolytes, CBC
Cresemba
Isavuconazonium Sulfate
Azole antifungal for aspergillus and zygomycetes
Capsules, Injection
CI: Use with strong 3A4 inhibitors, inducers, familial short QT syndrome
Warnings: Hepatic adverse drug reaction, infusion reaction (discontinue infusion if occurs), hypersensitivity reactions (anaphylaxis, SJS/TEN), embryofetal toxicity, drug interactions, particulates (undissolved drug)
SE: N/V/D, HA, infusion reactions (hypotension, dyspnea, chills, dizziness, tingling, and numbness), peripheral edema, ↓ K, LFT
Monitoring: LFT, electrolytes
Require a filter (0.2-1.2 micron) during administration due to possible particulates
Causes QT shortening (not prolongation)
Capsules must be protected from moisture, original container has desiccant
Vabomere
Meropenem/vaborbactam
Carbapenem
Injection IV
4 g Q8H
CI: Anaphylactic reactions to beta-lactams
Warnings: CNS AE including confusion and seizures
Doripenem: do not use for the tx of pneumonia (including HAP, VAP)
Do not use in patients with PNC allergy (cross-reactivity reported to be as high as 50% but more recent studies show 10%
SE: Diarrhea, rash/ severe skin reactions (DRESS), seizures with higher doses and in patient with impaired renal fct (mainly imipenem), bone marrow suppression with prolonged use, ↑ LFT
Garamycin
Gentamicin
Aminoglycoside
IV, IM, Ophthalmic, Topical
Traditional dosing: 1-2.5 mg/kg/dose, Extended dosing: 4-7 mg/kg/dose (common 7 mg/kg/dose)
Renal adj: CrCl≥60: Q8H, CrCl 40-60: Q12H, CrCl 20-40: Q24H, CrCl<20: 1X then per level
BB: Nephrotoxicity, ototoxicity (hearing loss, vertigo, ataxia), Avoid use with other nephrotoxic, neurotoxic drugs, Neuromuscular blockade and respiratory paralysis, Fetal harm if given in pregnancy
Warnings: Caution in renal dx, elderly and other nephrotoxic drugs (amphotericin B, cisplatin, polymyxin, cyclosporine, loop diuretics, NSAIDS, contrast dye, tacrolimus, vancomycin)
SE: Nephrotoxicity (acute tubular necrosis), Hearing loss (early toxicity associated with high-pitched sounds), Vestibular toxicity (balance deficits)
Monitoring: Drug level, renal function, urine output, hearing test
Amikacin has the broadest spectrum of activity
Amikin
Amikacin
Aminoglycoside
IV, IM
5-7.5 mg/kg/dose Q8H
BB: Nephrotoxicity, ototoxicity (hearing loss, vertigo, ataxia), Avoid use with other nephrotoxic, neurotoxic drugs, Neuromuscular blockade and respiratory paralysis, Fetal harm if given in pregnancy
Warnings: Caution in renal dx, elderly and other nephrotoxic drugs (amphotericin B, cisplatin, polymyxin, cyclosporine, loop diuretics, NSAIDS, contrast dye, tacrolimus, vancomycin)
SE: Nephrotoxicity (acute tubular necrosis), Hearing loss (early toxicity associated with high-pitched sounds), Vestibular toxicity (balance deficits)
Monitoring: Drug level, renal function, urine output, hearing test
Amikacin has the broadest spectrum of activity
Nebcin
Tobramycin
Aminoglycoside
IV, IM, Ophthalmic, Inhaled
Traditional dosing: 1-2.5 mg/kg/dose Extended dosing: 4-7 mg/kg/dose (common 7 mg/kg/dose)
Renal adj: CrCl≥60: Q8H, CrCl 40-60: Q12H, CrCl 20-40: Q24H, CrCl<20: 1X then per level
BB: Nephrotoxicity, ototoxicity (hearing loss, vertigo, ataxia), Avoid use with other nephrotoxic, neurotoxic drugs, Neuromuscular blockade and respiratory paralysis, Fetal harm if given in pregnancy
Warnings: Caution in renal dx, elderly and other nephrotoxic drugs (amphotericin B, cisplatin, polymyxin, cyclosporine, loop diuretics, NSAIDS, contrast dye, tacrolimus, vancomycin)
SE: Nephrotoxicity (acute tubular necrosis), Hearing loss (early toxicity associated with high-pitched sounds), Vestibular toxicity (balance deficits)
Monitoring: Drug level, renal function, urine output, hearing test
Amikacin has the broadest spectrum of activity
Zemdri
Plazomicin
Aminoglycoside
15 mg/kg IV QD
Renal adj: CrCl<60
BB: Nephrotoxicity, ototoxicity (hearing loss, vertigo, ataxia), Avoid use with other nephrotoxic, neurotoxic drugs, Neuromuscular blockade and respiratory paralysis, Fetal harm if given in pregnancy
Warnings: Caution in renal dx, elderly and other nephrotoxic drugs (amphotericin B, cisplatin, polymyxin, cyclosporine, loop diuretics, NSAIDS, contrast dye, tacrolimus, vancomycin)
SE: Nephrotoxicity (acute tubular necrosis), Hearing loss (early toxicity associated with high-pitched sounds), Vestibular toxicity (balance deficits)
Monitoring: Drug level, renal function, urine output, hearing test
Amikacin has the broadest spectrum of activity
Rituxan
Rituximab
Biologic DMARDs / NON-ANTI-TNF used in RA
IV
BB: Serious and fatal infusion-related reactions (usually with the 1st infusion), progressive multifocal leukoencephalopathy (PML) due to JC virus (can be fatal), serious skin reaction (SJS/TEN), hepatitis B virus reactivation, some cases resulting in fulminant hepatitis, hepatic failure and death, screen high risk groups for HBV and HCV prior initiation of therapy, monitor patients for clinical and laboratory signs (HBsAg and anti-HBc) several months
Warnings: Infections, do not give with other biologic DMARDs or live vaccine
SE: In patient treated for RA: infusion-related reactions, URTI, UTI, N/V/D, peripheral edema, weight gain, HTN, HA, angioedema, fever, insomnia, pain
Monitoring: ECG, vitals, infusion reactions, CBC, SCr, electrolytes, screen for HBV before tx
Kineret
Anakinra
Biologic DMARDs / NON-ANTI-TNF used in RA
SC
Warnings: Malignancies and serious infections, D/C if a serious infection develops, screen for TB prior initiating therapy, do not give with other biological DMARDs or live vaccines
SE: URTI, HA, N/V/D, abdominal pain, injection site reactions, antibody development, arthralgia
Monitoring: CBC, SCr, signs of infections
Do not shake or freeze, refrigerate and protect from light
Orencia
Abatacept
Biologic DMARDs / NON-ANTI-TNF used in RA
IV/SC
Warnings: Malignancies and serious infections, D/C if a serious infection develops, screen for TB prior initiating therapy, do not give with other biological DMARDs or live vaccines, caution in patients with COPD, may worsen sx
SE: HA, nausea, injection site reactions, infections, nasopharyngitis, antibody development
Monitoring: Signs of infection, hypersensitivity
Stable in NS only, require a filter and light protection during administration, do not shake
Actemra
Tocilizumab
Biologic DMARDs / NON-ANTI-TNF used in RA
IV/SC
BB: Serious infection, D/C if a serious infection develops, screen for TB prior initiating therapy
Warnings: ↑ LFT, neutropenia and thrombocytopenia, GI perforation, can cause demyelinating dx, hypersensitivity reactions, lipid abnormalities, do not give with other DMARDs or live vaccines
SE: URTI, HA, HTN, injection-site reactions, ↑ LDL and total cholesterol
Monitoring: LFT, CBC (baseline, 4-8 weeks after start of therapy, and every 3 months thereafter), lipid panel, signs of infection
Kevzara
Sarilumab
Biologic DMARDs / NON-ANTI-TNF used in RA
SC
BB: Serious infection, D/C if a serious infection develops, screen for TB prior initiating therapy
Warnings: ↑ LFT, neutropenia and thrombocytopenia, GI perforation, can cause demyelinating dx, hypersensitivity reactions, lipid abnormalities, do not give with other DMARDs or live vaccines
SE: URTI, HA, HTN, injection-site reactions, ↑ LDL and total cholesterol
Monitoring: LFT, CBC (baseline, 4-8 weeks after start of therapy, and every 3 months thereafter), lipid panel, signs of infection
Effexor
Venlafaxine
SNRI used in Depression, GAD, Panic disorder, Social anxiety disorder
37.5 to 375 mg QD (max 375 mg/day for IR and
225 mg / day for ER)
BB: Suicidal behavior
CI: MAOI and hypertensive crisis, Do not initiate in patients receiving linezolid, methylene blue IV
SE: See SSRIs
SE dur to ↑ NE: ↑ HR, dilated pupils (can lead to narrow angle glaucoma), dry mouth, excessive sweating and constipation, Can affect urethral resistance => caution in patients prone to obstructive urinary disorders
↑ BP (> venlafaxine when > 150 mg/day) all have risk, especially at higher doses => ↓ dose, use antihypertensive or change therapy
↓ dose in renal impairment, do not use levomilnacipran CrCl < 15, or duloxetine CrCl < 30
Pristiq
Desvenlafaxine
SNRI used in Depression
50 mg QD (can ↑ to 400 mg/day but no benefit to > 50 mg)
BB: Suicidal behavior
CI: MAOI and hypertensive crisis, Do not initiate in patients receiving linezolid, methylene blue IV
SE: See SSRIs
SE due to ↑ NE: ↑ HR, dilated pupils (can lead to narrow angle glaucoma), dry mouth, excessive sweating and constipation, Can affect urethral resistance => caution in patients prone to obstructive urinary disorders
↑ BP (> venlafaxine when > 150 mg/day) all have risk, especially at higher doses => ↓ dose, use antihypertensive or change therapy
↓ dose in renal impairment, do not use levomilnacipran CrCl < 15, or duloxetine CrCl < 30
Cymbalta
Duloxetine
SNRI used in Depression, Peripheral neuropathy (pain), Fibromyalgia, GAD, Chronic musculoskeletal pain
40-60 mg QD (or 20-30 mg BID), max 120 mg/day but dose > 60 mg/day not more effective
Do not use when CrCL < 30 ml/min
BB: Suicidal behavior
CI: MAOI and hypertensive crisis, Do not initiate in patients receiving linezolid, methylene blue IV
SE: See SSRIs
SE dur to ↑ NE: ↑ HR, dilated pupils (can lead to narrow angle glaucoma), dry mouth, excessive sweating and constipation, Can affect urethral resistance => caution in patients prone to obstructive urinary disorders
↑ BP (> venlafaxine when > 150 mg/day) all have risk, especially at higher doses => ↓ dose, use antihypertensive or change therapy
↓ dose in renal impairment, do not use levomilnacipran CrCl < 15, or duloxetine CrCl < 30
Edarbi
Azilsartan
ARB used in hypertension
40-80 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Atacand
Candesartan
ARB used in hypertension
8-32 mg daily in 1-2 doses
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Avapro
Irbesartan
ARB used in hypertension
75-300 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Cozaar
Losartan
ARB used in hypertension
25-100 mg daily in 1-2 divided doses
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Benicar
Olmesartan
ARB used in hypertension
10-40 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Olmesartan: sprue-like enteropathy can appear long after starting Tx characterized by sever chronic diarrhea
Micardis
Telmisartan
ARB used in hypertension
40-80 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Diovan
Valsartan
ARB used in hypertension
80-320 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Prexxartan
Valsartan
ARB used in hypertension
oral solution
80-320 mg QD
BB: Pregnancy (fetal injury, death when taken 2nd, 3rd trimester)
CI: Hx of angioedema, With aliskiren in pt with diabetes
Warnings: Angioedema, Hyperkalemia, Hypotension, Renal impairment, Renal artery stenosis
SE: Cough, Dizziness, HA, Rash
Monitor: BP, K, renal function, Sx of angioedema
Lupron depot
Leuprolide GnRH agonists (LHRH agonist) used in prostate cancer
Eligard
Leuprolide GnRH agonists (LHRH agonist) used in prostate cancer
Zoladex
Goserelin GnRH agonists (LHRH agonist) used in prostate cancer
Supprelin LA
Histrelin GnRH agonists (LHRH agonist) used in prostate cancer
Vantas
Histrelin GnRH agonists (LHRH agonist) used in prostate cancer
Trelstar
Triptorelin GnRH agonists (LHRH agonist) used in prostate cancer
Firmagon
Degarelix
GnRH antagonists used in prostate cancer
Casodex
Bicalutamide
Antiandrogens 1st generation used in prostate cancer
Nilandron
Nilutamide
Antiandrogens 1st generation used in prostate cancer
Xtandi
Enzalutamide
Antiandrogen 2nd generation used in prostate cancer
Zytiga
Abiraterone
Androgen biosynthesis inhibitors used in prostate cancer
Ultiva
Remifentanil
opioid analgesisc used in ICU
IV injection
Precedex
Dexmedetomidine
Agents for agitation/sedation in ICU
Warnings: Caution in patient with hepatic dx, diabetes, heart block, bradycardia, severe ventricular dysfunction, hypovolemia, chronic HTN
SE: Hypo/hypertension, bradycardia, dry mouth, nausea, constipation
Monitoring: BP, HR, sedation scale
Does not require refrigeration
Duration of infusion should not > 24h (FDA)
For sedation in intubated and non intubated patients (pt are arousable, alert when stimulated, less respiratory depression than other sedatives)
Diprivan
Propofol
Agents for agitation/sedation in ICU
CI: Hypersensitivity to eggs, egg product, soy, soy product
SE: Hypotension, apnea, hypertriglyceridemia, green urine/hair/nail beds, PRIS (propofol related infusion syndrome / can be fatal), myoclonus, pancreatitis, pain (injection), QT prolongation
Monitoring: BP, HR, RR, sedation scale, TG (if > 2days) Sx pancreatitis
Shake well, do not use if not homogenous, use strict aseptic technique (risk of infection) and discard vial and tubing within 12hrs, if transferred to syringe prior administration, syringe must be D/C within 6h, do not use filter < 5 microns for administration
Does not require refrigeration
Lipid (oil in water) emulsion (1.1 kcal/d)
Ketalar
Ketamine
Agents for agitation/sedation in ICU
Warnings: Emergence reactions (vivid dreams, hallucinations, delirium) CSF pressure ↑, respiratory depression, apnea, may cause dependence/tolerance
Monitoring: BP, HR, respiratory status, emergence reaction, sedation scale
Pretreatment with BZD ↓ emergence reaction by 50%
NMDA receptor antagonist
Used as induction for intubation
Amidate
Etomidate
Agents for agitation/sedation in ICU
Wanings: Inhibit 11-B- hydroxylase => ↓ cortisol production for up to 24h
Monitoring: Adrenal insufficiency (hypotension, hypokalemia), respiratory status, BP, HR, infusion site, sedation scale
Ultra short acting agent used for induction when intubating
Versed
Midazolam
Agents for agitation/sedation in ICU
BB: Respiratory depression, respiratory arrest, apnea, start lowest dose in debilitated patients and geriatric, do mot administer by rapid injection in neonates
CI: Intrathecal and epidural administration (Benzyl alcohol in formulation), acute narrow angle glaucoma, potent 3A4 inhibitors
SE: Hypotension
Monitoring: BP, HR, RR, sedation scale
Short action vs lorazepam if normal fct
Can accumulate in obese patients (highly lipophilic) and renal impairment
Xylocaine
Lidocaine
Anesthetic used in ICU
Local and injectable
Never dual route (eg IV and topical)
Lidocaine / epinephrine combination for local anesthesia only (eg IV line insertion) never inject!
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Exparel
Liposomal bipuvacaine
Anesthetic used in ICU
Local
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Suprane
Desflurane
Anesthetic used in ICU
Inhaled
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Ultane
Sevoflurane
Anesthetic used in ICU
Inhaled
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Forane
Isoflurane
Anesthetic used in ICU
Inhaled
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Marcaine
Bupivacaine
Anesthetic used in ICU
Injectable
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Sensorcaine
Bupivacaine
Anesthetic used in ICU
Injectable
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Naropin
Ropivacaine
Anesthetic used in ICU
Injectable
SE of anesthetic: Hypotension, bradycardia, N/V, ↓ body temp (shivering), Overdose => respiratory depression, Inhaled anesthetic => malignant hyperthermia (rare), Bupivacaine for epidural never IV (fatal)
Quelicin
Succinylcholine
Depolarizing Neuromuscular blocking agents
Auxiliary label: WARNING, PARALYZING AGENT (should be kept separate from other injectables to prevent mistake)
Patients receiving NMBA are unable to breath, cough, move, blink => special cares like protect the skin, lubricate eyes, airway suction frequently to clear secretion / glycopyrrolate (Robinul) anticholinergic that ↓secretion
paralyze skeletal muscle including respiratory muscles => must be mechanically ventilated
Anectine
Succinylcholine
Depolarizing Neuromuscular blocking agents
Auxiliary label: WARNING, PARALYZING AGENT (should be kept separate from other injectables to prevent mistake)
Patients receiving NMBA are unable to breath, cough, move, blink => special cares like protect the skin, lubricate eyes, airway suction frequently to clear secretion / glycopyrrolate (Robinul) anticholinergic that ↓secretion
paralyze skeletal muscle including respiratory muscles => must be mechanically ventilated
Nimbex
Cisatracurium
Non-depolarizing Neuromuscular blocking agents
Auxiliary label: WARNING, PARALYZING AGENT (should be kept separate from other injectables to prevent mistake)
Patients receiving NMBA are unable to breath, cough, move, blink => special cares like protect the skin, lubricate eyes, airway suction frequently to clear secretion / glycopyrrolate (Robinul) anticholinergic that ↓secretion
paralyze skeletal muscle including respiratory muscles => must be mechanically ventilated
Short t1/2, intermediate acting, metabolize by Hofmann elimination (indepdt of renal and hepatic fcts)
Zemuron
Rocuronium
Non-depolarizing Neuromuscular blocking agents
Auxiliary label: WARNING, PARALYZING AGENT (should be kept separate from other injectables to prevent mistake)
Patients receiving NMBA are unable to breath, cough, move, blink => special cares like protect the skin, lubricate eyes, airway suction frequently to clear secretion / glycopyrrolate (Robinul) anticholinergic that ↓secretion
paralyze skeletal muscle including respiratory muscles => must be mechanically ventilated
Amicar
Aminocaproic acid
Hemostatic agents used in ICU
Tablet, Solution, Injection
Cyklokapron
Tranexamic acid
Hemostatic agents used in ICU
Injection
CI: IV: acquired defective color vision, active clotting, subarachnoid hemorrhage
Oral: thromboembolic dx, combination hormonal contraception
SE: IV: vascular occlusion, thrombosis
Oral: retinal clotting
Lysteda approved for Menorrhagia (heavy menstruation)
Injection is approved for bleeding with hemophilia but often use off-label for surgical bleeding
Lysteda
Tranexamic acid
Hemostatic agents used in ICU
Tablet
CI: IV: acquired defective color vision, active clotting, subarachnoid hemorrhage
Oral: thromboembolic dx, combination hormonal contraception
SE: IV: vascular occlusion, thrombosis
Oral: retinal clotting
Lysteda approved for Menorrhagia (heavy menstruation)
Injection is approved for bleeding with hemophilia but often use off-label for surgical bleeding
NovoSeven RT
Recombinant Factor VIIa
Hemostatic agents used in ICU
Injection
Nuvaring
Combined Hormonal Contraceptives (CHC)
Vaginal ring Inserted once a month in the vagina (small flexible ring)
Inserted for 3 weeks and 1 week off (sometimes for 4 weeks to avoid menses)
If ring expelled or removed
During week 1-2: if > 3 hrs, rinse and reinsert + back up for 7 days
During week 3: discard and use a new ring + back up for 7 days
Store at room temperature for 4 months (in the fridge at the pharmacy)
Annovera
Combined Hormonal Contraceptives (CHC)
Vaginal ring Inserted once a month in the vagina (small flexible ring)
Inserted 3 weeks and remove for 1 week (reusable for 1 year)
Wash and store in case
Xulane
Combined Hormonal Contraceptives (CHC)
Patch
Buttock, stomach, upper arm, upper torso (not breast) once a week for 21 days ( 3 patches by cycle) / 7 days off
If patch loose or fall off for more than 24 hrs, use back up contraception method for 7 days (idem if you forget to apply new patch after 7 days)
Start on Day 1 (no back up) or Sunday (back up for 7 days)
Less effective when > 198 pounds
Same CI, SE than pill with higher systemic estrogen exposure => do not use if clot risk factor or smoking or > 35 yo
Amethyst
Continuous contraception (COC) Taken continuously, no period, no placebo
Amethia
Combination Oral Contraception (COC)
Extended Cycle = period very 3 months
84 days active pill + 7 low dose estrogen
Camrese Lo
Combination Oral Contraception (COC)
Extended Cycle = period very 3 months
84 days active pill + 7 low dose estrogen
Camrese
Combination Oral Contraception (COC)
Extended Cycle = period very 3 months
84 days active pill + 7 low dose estrogen
Seasonique
Combination Oral Contraception (COC)
Extended Cycle = period very 3 months
84 days active pill + 7 low dose estrogen
Jolessa
Combination Oral Contraception (COC)
Extended Cycle = period very 3 months
84 days active pill + 7 placebo
Nora-Be
Norethindrone
Pill
Also called mini-pill, 28 days of progestin (no estrogens), Should be taken in a window of 3 hrs schedule to be efficient, Usually for women breastfeeding (estrogen inhibits lactation)
Can be started 3-6 weeks after delivery (estrogen cannot be started so soon due to the increased risk of clot), Can also be used in women intolerant to estrogen or when estrogen CI
Camilla
Norethindrone
Pill
Also called mini-pill, 28 days of progestin (no estrogens), Should be taken in a window of 3 hrs schedule to be efficient, Usually for women breastfeeding (estrogen inhibits lactation)
Can be started 3-6 weeks after delivery (estrogen cannot be started so soon due to the increased risk of clot), Can also be used in women intolerant to estrogen or when estrogen CI
Erin
Norethindrone
Pill
Also called mini-pill, 28 days of progestin (no estrogens), Should be taken in a window of 3 hrs schedule to be efficient, Usually for women breastfeeding (estrogen inhibits lactation)
Can be started 3-6 weeks after delivery (estrogen cannot be started so soon due to the increased risk of clot), Can also be used in women intolerant to estrogen or when estrogen CI
Mirena
IUD with hormone (lighter bleeding/no cramping)
Up to 5 years
For heavy menses
Kyleena
IUD with hormone (lighter bleeding/no cramping)
Up to 5 years
Skyla
IUD with hormone (lighter bleeding/no cramping)
Up to 3 years
Liletta
IUD with hormone (lighter bleeding/no cramping)
Up to 3 years
Paragard
Copper-T UID (non hormonal method)
For EC or normal contraception
Up to 10 years but heavy menses and cramping
Nexplanon
Implant, Plastic rod placed subdermally Release progestin (etonogestrel) for 3 years
Zestoretic
Lisinopril + HCTZ
blood pressure drug
Hyzaar
Losartan + HCTZ
Blood pressure drugs
Lotrel
Benazepril + amlodipine
Blood pressure drug
Exforge
Valsartan + amlodipine
Blood pressure drug
Tenoretic
Atenolol + chlorthalidone
Blood pressure drug
Ziac
Bisoprolol + HCTZ
Blood pressure drug
Maxzide
Triamterene + HCTZ
Blood pressure drug
Diazide
Triamterene + HCTZ
Blood pressure drug
