Counseling Closeout Drug Review Flashcards

1
Q

Tenormin

A

Generic Name: Atenolol
Class: Beta Blocker
Indication: Hypertension, MI, Angina
Side Effects: Bradycardia, Initial Fatigue, dizziness, decreased exercise tolerance, sexual dysfunction in men

CAUTION IN ASTHMA due to Beta 2 receptors in lungs

Monitor blood pressure

Follow up in around 4 weeks

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2
Q

Lisinopril

A

Brand Names: Zestril, Prinivil
Class: Ace Inhibitor
Indication: Hypertension, renal protection
Dosing: qd or bid
Side effects: Initial dizziness when you first start or if you increase the dose, cough (which may occur months later), angiodema, hyperkalemia (make sure your doctor is aware if you are on potassium supplements as well as ace inhibitor)

Monitor Blood pressure

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3
Q

Norvasc

A
Generic name: Amlodipine 
Class: CCB 
Indication: Hypertension 
Dosing: qd
Adverse Effects: peripheral edema, dizziness (associated with hypotension; body usually adjusts)
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4
Q

HCTZ

A

Generic Name: Hydrochlorothiazide
Brand Names: Hydrodiuril, microzide
Class: Diuretic
Indication: Hypertension, also used to treat edema
Side effects: Increased urination (does level off after a while), initial dizziness possible, hypokalemia, photosensitivity

Monitor Blood Pressure

DOSING SHOULD OCCUR IN MORNING

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5
Q

Spironolactone

A

Brand name: Aldactone
Indication: CHF, hypertension
Side effects: Increased urination, dizziness, take with food if there is any GI upset

Monitor blood pressure levels, especially if used with ACE inhibitors, ARBs or salt substitutes (see if they are all from the same physician - ask if their doctor talked about their potassium levels followed with “when are they going to monitor your potassium levels”)

Dosing should occur in the morning due to increased urination

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6
Q

Losartan

A

Brand Name: Cozaar
Class: ARB
Indication: Hypertension, diabetic nephropathy
Dosing: 25-100mg once a day
Side effects: Dizziness, postural hypotension, cough (much less than ACE inhibitors)

Patient information: Should take around the same time each day, avoid salt substitutes and caution with potassium sparing diuretics, watch for dizziness (especially when first starting)

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7
Q

Lasix

A

Generic: Furosemide
Class: Loop diuretic (much more potent type of diuretic)
Indication: CHF, Hypertension
Dosing: Once daily in the morning, sometimes BID (later afternoon, avoid second dose late at night)
Side effects: Dizziness, orthostatic hypotension, photosensitivity

This medication is much more potassium wasting than other diuretics (ASK ABOUT SUPPLEMENTS or at least ask about when they are going to have their potassium levels checked) Patients should usually be on a potassium supplement

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8
Q

Simvastatin

A

Brand name: Zocor
Class: HMG CoA Reductase Inhibitors
Indication: Cholesterol lowering (lower LDL, raise HDL)
Dosing: HS due to higher cholesterol production while sleeping
Side effects: Myopathy (patient should check with physician at first sign of muscle pain, could be a sign that more severe damage is occurring)

Patient should monitor LFTs and cholesterol

Advise patient to watch diet and get exercise

There should be some follow-up within at least a few months (liver function tests since there is the rare possibility of toxicity, cholesterol levels, etc)

NO GRAPEFRUIT JUICE

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9
Q

Lantus

A

Generic name: Glargine
Class: Insulin - Long Acting
Dosing: Once daily at night, sometimes twice; adjust dose to needs of patient
Side effects: Hypoglycemia (make sure patient knows the signs of hypoglycemia), injection site irritation

Make sure patient knows the proper injection technique.

Storage: Up to 28 days at room temperature after opening

Counsel on managing diabetes

FIND OUT WHAT THEY ALREADY KNOW IN ORDER TO SAVE TIME

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10
Q

Aspart

A

Brand Name: Novolog
Class: Insulin, rapid acting
Dosing: Subcutaneous injection before meals
Side effects: Hypoglycemia

Storage and expiration

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11
Q

Metformin

A

Brand Name: Glucophage
Indication: Type 2 diabetes, Polycystic ovary syndrome
Mechanism: Reduction of hepatic glucose production, increase of insulin sensitivity
Dosing: With meals (qd, bid, tid - depends on individual and dosage forms)
Side effects: GI adverse effects including nausea, vomiting and diarrhea as well as flatulence (these effects should resolve with time)

Counsel patient to maintain a health diet, exercise and monitor blood glucose

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12
Q

Hydrocodone/Acetaminophen

A

Brand Names: Vicodin, Norco, Lortab
Indication: Pain, sometimes cough
Side effects: Drowsiness, constipation

POTENTIALLY HABIT FORMING, RISK OF ABUSE

NO ACOHOL WHILE ON THIS MEDICATION

Caution patient when it comes to using APAP containing medications alongside this medication; watch the max dose of APAP

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13
Q

What is the max daily dose of acetaminophen?

A

4000 mg

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14
Q

Oxycodone Immediate Release and Extended Release

A

Brand Names: OxyIR and Oxycontin (respectively)
Indication: Moderate to severe pain; acute and chronic pain
Side effects: Sedation, constipation (especially with chronic use - can be managed with laxatives)

HABIT FORMING AND RISK FOR ABUSE

Also available with APAP (percocet) and aspirin (Percodan)

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15
Q

Tramadol

A

Brand Name: Ultram
Indication: Moderate to moderate severely pain
Dose: 50 to 100mg q4-6h prn (not to exceed 400 mg/day)
Side effects: dizziness, headache, drowsiness, constipation, nausea, flushing

POTENTIAL FOR ABUSE

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16
Q

Sumatriptan

A

Brand name: Imitrex
Class: Selective serotonin agonist (triptans)
Indication: Migraine headaches
Dosing: One at onset and MR in 2 hours
Side effects: dizziness, chest pain, pressure, tightness

17
Q

Diclofenac Sodium/Diclofenac Potassium

A

Brand Names: Cataflam, Voltaren
Class: NSAID - oral and topical
Indication: Osteoarthritis, rheumatoid arthritis, pain
Dosing: bid or tid

Voltaren tablets - delayed release, enteric coated
Cataflam - immediate release

Take with food to minimize GI upset

DO NOT USE IN THIRD TRIMESTER OF PREGNANCY

18
Q

Flexeril

A

Generic Name: cyclobenzaprine
Class: Skeletal muscle relaxant
Dosing: 5 to 10mg tid prn
Side effects: Sedation, dry mouth, fatigue, headache

Patient information: Do not drink alcohol, may cause drowsiness, do not operate machinery

19
Q

Tizanidine

A

Brand Names: Zanaflex
Class: Skeletal Muscle Relaxant
Dosing: 2 to 4mg q6-8h prn
Side effects: Sedation (not as much as cyclobenzaprine), dry mouth, asthenia, hypotension

Patient Information: Do not drink alcohol, may cause drowsiness, do not operate machinery

20
Q

Paroxetine

A

Brand Name: Paxil
Class: SSRI
Indication: Depression, Panic Disorder, OCD, PTSD
Dosing: 10-40mg/day
Side effects: Drowsiness, insomnia, nausea, dry mouth, sexual dysfunction

SUCIDAL IDEATION

4-6 weeks for the full effect

Patient should have follow up within 2 to 4 weeks of starting this.

21
Q

Amitriptyline

A

Brand name: Elavil
Mechanism: Inhibits reuptake of serotonin and norepinephrine
Dosing: 25mg to 150mg usually HS but can be divided doses
Indications: Neuropathic pain, depression, migraine HA prophylaxis, fibromyalgia
Side effects: Drowsiness, nausea, dry mouth (anticholinergic), weight gain, sexual dysfunction in men
(not a very specific medication so tons of side effects at higher doses used for depression)

SUICIDAL IDEATION

4-6 weeks for full effect if used for depression

22
Q

Trazadone

A

Brand name: Desyrel
Indications: Depression, insomnia
Side effects: Sedation, dizziness, headache, priapism

May see anticholinergic side effects at high doses (dry mouth, blurred vision, constipation, sedation, hallucinations)

23
Q

Bupropion SR, XL, IR

A

Brand Names: Wellbutrin, Zyban (smoking cessation)
Mechanism: Blocks reuptake of dopamine and norepinephrine
Dose: bid for SR, qd for XL, tid for IR
Side Effects: Insomnia, dry mouth, nervousness

4 to 6 weeks to see full effect

24
Q

Venlafaxine

A

Brand Names: Effexor, Effexor XR
Class: SNRI
Mechanism: Blocks reuptake of serotonin and norepinephrine
Dose: XR 37.5 to 75 mg start; BID to TID for immediate release formulation
Side Effects: Insomnia, dry mouth, nervousness, dizziness

4 to 6 weeks for the full effect

25
Q

Xanax

A
Generic name: Alprazolam
Class: Benzodiazepine 
Indication: Anxiety 
Dosing: up to TID but usually prn 
Side effects: Drowsiness, dizziness, memory

Avoid driving, etoh

Possibility for dependency

CAUTION IN ELDERLY

26
Q

Ambien

A

Generic Name: Zolpidem
Indication: insomnia
Side effects: Drowsiness,
Dosing: Take immediately before bed; recommended 5mg for women

INCREASED RISK OF FALLS IN ELDERLY

MEMORY IMPAIRMENT, PERFORMING ACTIVITIES WHILE SLEEPING

27
Q

What diet advice would you give to someone to control their cholesterol?

A

Emphasize veggies, fruits, whole grains, low fat dairy, etc.

Limit sweets, sugars, red meats, sodium under 2400 mg.

Exercise for 3 to 4 times a week for 40 minutes

28
Q

What are the signs of hypoglycemia?

A

Sweatiness, nervousness, shaking, hunger/nausea, fast heartbeat, weakness, fatigue, headache, irritability, confusion, etc.

29
Q

Blood pressure values

A

Normal (Under 120 and Under 80)
Prehypertension (120-139; 80-89)
Stage 1 (140-159;90-99)
Stage 2(Over 160, Over 100)

30
Q

Diabetes Lab Values (A1C)

A

Normal (under 5.7); Prediabetes (5.7-6.4); Diabetes (Over 6.5)

31
Q

Diabetes Values (FBG)

A

Normal - Under 100
Pre - 100-125
Diabetes - Over 126

32
Q

Diabetes OGTT and RBG Values

A

Normal - less than 140
Pre - 140-199
Diabetic - Over 200

33
Q

Cholesterol Levels

A

Desired - Under 200
Elevated - 200-239
High - 240 or above