Cholesterol/Asthma/COPD/Smoking/Hypertensives Flashcards
Statins
Lovastatin
Slimvastatin
Atorvastatin
Statin ADRs
Myopathy
Increased liver enzymes
Increased blood glucose
Also: Statins are P450 drugs!
Absorption Inhibitors (Cholesterol Meds)
Ezetimibe
Ezetimibe ADRs
Increased LFTs
Myopathy
URI
Fibric Acids (Cholesterol Meds)
Gemfibrozil
Fenofibrate
Fenofibric acid
Fibric Acid ADRs
Increased LFTs
Myopathy
GI upset
Miscellaneous Cholesterol Med and ADRs
Niacin (Nicotinic Acid) Flushing Increased blood glucose Hepatotoxicity Hyperuricemia
Bile Acid Sequestrants (Cholesterol Meds)
Cholestyramine
Colestipol
Colesevelam
Bile Acid Sequestrants ADRs
GI distress
Constipation
Decreased absorption of other drugs
Omega 3s (Cholesterol Meds)
Fish Oil
Lovaza
Vascepa
Omega 3s ADRs
Eructation (fishy burps - store in fridge)
Dysgeusia
Dyspepsia
Increased bleeding
New Cholesterol Drugs & ADRs
Lomitapide PCSK9 Inhibitors (Evolocumab, Alirocumab) Hepatic steatosis Increased LFTs N/V/D
The 5 A’s of Smoking Cessation
Ask about smoking at each visit
Advise patients to stop smoking
Assess readiness to quit
Assist patients with medications and educational materials
Arrange follow-up visits to support patient progress
Nicotine Gum and ADRs
Nicorette and generics
Mouth and jaw soreness
Hiccups
Dyspepsia
Nicotine Gum Instructions for Use:
1 piece q 1-2 hours for 1-3 months
Chew slowly until peppery taste/tingle, park between gum and cheek, once taste gone, chew slowly again
Nicotine Medications Pharmaceutic Company
Glaxosmithkline
Nicotine Lozenges and ADRs
Commit, Nicorette Mini, and generics
Nausea
HA
Cough
Transdermal Nicotine Patch and ADRs
Nicoderm CQ and generics HA Burning Itching Tingling
Transdermal Nicotine Patch Instructions
Apply patch to different area every day
Do not use same area for at least 1 week
Do not cut patches –> nicotine may evaporate and cause patch to be less effective
Nicotine Inhaler and ADRs
Nicotrol Inhaler
Irritation of mouth and throat
Cough
HA
Non Nicotinic Cessation Aid, Warnings, and ADRs
Varenicline (oral formulation)
Warnings: suicidal ideation/attempts, hallucinations, depression
ADRs: N/V, flatulence, constipation
2nd Line Smoking Cessation Options and ADRs
Clonidine Nortriptyline ADRs: Dry mouth Sedation Dizziness
SABA
Albuterol
Levalbuterol
Pirbuterol
SABA ADRs
Tachycardia
Tremor
HA
Inhaled Anticholinergics
Off-label for asthma
Ipratropium
Ipratropium and albuterol
Inhaled Anticholinergics ADRs
Dry mouth
Increased wheezing
Systemic Corticosteroids
Prednisone
Methylprednisolone
Prednisolone
Systemic Corticosteroids ADRs
Weight Gain
Fluid retention
Increased appetite
Inhaled Corticosteroids
Beclomethsone
Fluticasone
Mometasone
Inhaled Corticosteroids ADRs
Oral candidiasis
Dysphonia cough
Reflex cough and bronchospasms
LABA
Salmeterol
Formoterol
Indacaterol
LABA ADRs
Tachycardia
Tremor
Hypokalemia
Leukotriene Modifiers
Montelukast
Zafirlukast
Zileuton
Leukotriene Modifiers ADRs
URI
Fever
HA
COPD Anticholinergics
Short Acting: Ipratropium
Long Acting: Tiotropium
New COPD Inhalers and ADRs
Glycopyrrolate
Aclidinium
URI, cough, nasopharyngitis
Methylxanthines (COPD)
Amirophylline
Theophylline
Extreme COPD Medication (Not first line)
Roflumilast
ADRs: N/D, sucidality, depression, anxiety
Thiazide Diuretics
Chlorthalidone
Hydrochlorothiazide
Metolazone
Thiazide Diuretics ADRs
Hyponatremia
Hypercalcemia
Hyperuricemia
Loop Diuretics
Furosemide
Bumetanide
Torsemide
Loop Diuretic ADRs
Hypokalemia
Hyponatremia
Hyperuricemia
Potassium Sparing Diuretics
Trimterene
Amiloride
Eplerenone
Potassium Sparing Diuretic ADRs
N/V/D
ACEI
Captopril
Quinapril
Lisinopril
ACEI ADRs
Dry cough
Hyperkalemia
Angioedema
ARBS
Losartan
Valsartan
Candesartan
Can add HCTZ to all
ARBS ADRs
Cough, angioedema (rare)
Hyperkalemia
Rhabdomyolysis
DRI (Direct Renin Inhibitors) and ADRs
Antihypertensive
Aliskiren ADRs: Angioedema Hyperkalemia Renal impairment
Calcium Channel Blockers
Two Groups:
- Diltiazem and Verapamil (heart)
- Dihydropyridines (arterioles)
Dihydropyridines (CCBs)
Amlodipine
Nifedipine
Clevidipine
Diltiazem and Verapamil ADRs
Nausea
Dizziness
Rash
Dihydropyridine ADRs
Edema
HA
Flushing
Beta Blockers
Propranolol
Metopranolol
Atenolol
Beta Blockers ADRs
Bradycardia
Fatigue
ED
Alpha Agonists
Clonidine Methyldopa (gestational HTN)
Clonidine (AA) ADRs
Dry mouth
Sedation
ED
Methyldopa (AA) ADRs
Fatigue
HA
Hemolytic anemia